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Biomedical subjects

M Barberis

Publications and source records attributed to M Barberis.

At least 37 records · Page 2Linked to original sources

[HIV infection. The risks for health providers and prevention and control measures].

The odontostomathologist and the dentist expose themselves to pathogenic agents present in the oral cavity. Taking in consideration at the present time the increasing number of seropositive patients, HIV infection and its pathogenic manifestations are of great interest. Considering that the main transmission of the virus is the ematic, the professional men who practise dentistry and the oral hygiene represent a particular risky class. For this reason they must adopt a series of preventive measures to protect themselves, their collaborators and the patient himself too.

Acquired Immunodeficiency Syndrome↗

Inflammatory meningioma of the fourth ventricle. Case report.

A case of meningioma with inflammatory reaction within the fourth ventricle in a 37 year-old man is described. The differential diagnosis between inflammatory meningioma, plasma cell granuloma and a possible collision of a meningioma with a plasmacytoma is discussed. The immunohistochemical examination of plasma cell population is emphasized. This is the first case reported of inflammatory meningioma located in the fourth ventricle.

Adult↗

Gastrointestinal presentation of Churg Strauss syndrome.

Gastrointestinal involvement is frequent in patients with Churg Strauss Syndrome: clinical symptoms (abdominal pain, diarrhea or bleeding) range from 44 to 89%, pathologic involvement of the bowel from 33 to 92%, and gastrointestinal death (bleeding or perforation), described in 8% of cases, is the fourth leading cause of death after heart, CNS and renal failure. In spite of this wide-spread digestive involvement, gastrointestinal presentation has never been described. We present a 56 year old man with Churg Strauss Syndrome, where eosinophilia, diarrhea and gastrointestinal bleeding appeared three years before asthma. This is probably the first description of gastrointestinal presentation of Churg Strauss Syndrome.

Abdominal Pain↗

Pulmonary hypertension secondary to thrombosis of the pulmonary vessels in a patient with the primary antiphospholipid syndrome.

Recurrent pulmonary emboli or microthromboses are hypothesized as possible causes of pulmonary hypertension in the antiphospholipid syndrome (APS), but thrombosis of the pulmonary vessels has been rarely documented. We describe the case of a 45-year-old Caucasian man affected by thrombocytopenia, recurrent deep venous thrombosis, recurrent pulmonary embolism and fatal chronic pulmonary hypertension (systolic pressure: 85 mm Hg). Anticardiolipin antibodies were highly positive, and the lupus anticoagulant was present. At autopsy, recent thromboses of small vessels were observed in the lung, with organized clots and recanalized channels. Furthermore, friable and firm vegetations and nodules were observed on the cusps of the mitral and tricuspid valves, intermingled with recent surface fibrinous thrombi. In the adrenals we found vascular thrombotic lesions similar to those in the lungs. The pathological lesions suggest pulmonary hypertension secondary to pulmonary arterial microthromboses. Moreover, this is the first documentation of tricuspid valve pathology in a patient with APS.

Adult↗

[The use of metal vascular prosthesis in the palliative treatment of neoplastic esophago-gastric stenosis].

The paper reports the authors' experience regarding the use of expandable metal prostheses designed for vascular stenoses but adapted for unoperable esophago-gastric stenoses. Their first impressions are very positive so much so that they affirm that these prostheses are close to being ideal since they are flexible and have an insertion diameter of 3 mm which does not therefore require dilatation. As a result: 1) they involve limited trauma to the patient; 2) reduce the risk of perforation to virtually zero. Moreover: 3) they can be inserted in twisted and angled stenoses and in esophaguses with difficult access due to axial deviations and restriction of the upper cervical aperture; 4) they function well even in notoriously "difficult" sections such as the cardia and esophago-jejunal anastomoses; 5) the unfastening system is easy and rapid. On the strength of these characteristics the authors suggest that these prostheses should be used in an outpatient setting, as occurred in the case of the last of the 10 patients treated, and even at a preoperative stage in preparation for resective surgery so as to preserve normal oral feeding. The structure of these prostheses renders them contraindicated for use in stenoses associated with fistulas in air paths and requires an evaluation of long-term results to verify the incidence with which the following occur: 1) tumoral growth between the mesh; 2) food obstruction; 3) hemorrhage due to compressive necrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Esophageal Neoplasms↗

Multi-element follow up in biological specimens of hard metal pneumoconiosis.

The movement of Co and the other components of the hard metal in the body fluids, their solubility, their links to the cells and proteins of the body, and their clearance are largely unknown. The first aim of this work is to evaluate whether Neutron Activation Analysis (NAA), a new analytical technique based on the radiochemical separation of samples irradiated in a Nuclear Reactor, may be suitable for studying the movement of elements in tissues or body fluids of workers over time. We have investigated seven hard metal workers, all employed in the grinding process, with NAA studies (single study in two, follow-up in five) of 29 elements on lung tissue, BAL fluid, blood, urine, pubic hair, toenails and sperm. In three, the diagnosis of hard metal pneumoconiosis was easy; in the other four, due to evident bilateral hilar lymphadenopathy, it was difficult to distinguish between pneumoconiosis and sarcoidosis stage II, and the final diagnosis, after pulmonary biopsy, was hard metal pneumoconiosis in three, and sarcoidosis in one. In spite of high potential, NAA gives a number of unexpected results, with apparent controversies and no clear relationship in the evolution of levels of Co, W and Ta: there is no simple explanation for such apparent inconsistencies at present, so that the study of the movement of elements in body fluid sometimes appears disappointing with this technique. Other observations were noted from the data available: 1) the concentration of elements (Co, Ta, W) in lung tissue is far higher than in BAL fluid, but the factor is so variable that BAL fluid cannot be taken as representative of the concentration of elements in lung tissue. 2) High concentrations in tissues or body fluids are indicative for exposure, but not for disease. In the light of available data, there are no levels above which development of disease is inevitable. 3) When the problem is to distinguish between sarcoidosis and pneumoconiosis in exposed subjects, the concentration of elements is of no value, and the pulmonary biopsy is still necessary. However a NAA study may be helpful to confirm the presence of the offending agent, and to avoid pulmonary biopsy in cases where the occupational history is unclear.

Adult↗

[Pulmonary hypertensive vascular disease in patients with interventricular defect or complete atrioventricular canal].

In 34 patients operated on the morphological and morphometric patterns of the pulmonary vascular bed on lung biopsies, performed during the operation for ventricular septal defect or complete atrio-ventricular septal defect were studied. These patterns were related to the preoperative hemodynamic data. Ages ranged from 2 to 20 months. There were 16 ventricular septal defect (mean age 10 +/- 4 months) and 18 complete atrio-ventricular septal defect (mean age 9.8 +/- 1.2 months). Furthermore, of the latter 15/18 (83%) patients had Down's syndrome. The following hemodynamic data were considered: a) ratio between the pulmonary systolic artery pressure and the systemic systolic artery pressure; b) diastolic pulmonary artery pressure; c) pulmonary vascular resistance; d) ratio between pulmonary and systemic flow. The lung specimens obtained at surgery were routinely processed and embedded in paraffin. Sections measuring 4 microns were stained with hematoxylin-eosin, Masson's thricrome and Miller's elastin. The status of the small pulmonary arteries was assessed according to the Heath-Edwards classification and to the morphometric parameters proposed by Rabinovitch and coll. Ratio between the pulmonary systolic artery pressure and the systemic systolic artery pressure ranged from 0.48 to 1 (mean 0.8 +/- 0.23) in patients with ventricular septal defect, whereas in complete atrio-ventricular septal defects it ranged from 0.42 to 1 (mean 0.86 +/- 0.21). The mean diastolic pulmonary artery pressure was 20 +/- 10 mmHg (range 8-40 mmHg) in ventricular septal defects and 19.5 +/- 2.3 mmHg (range 10-35 mmHg) in complete atrio-ventricular septal defects.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗

Spontaneous regression of amiodarone pulmonary toxicity.

Two patients with Amiodarone-induced interstitial lung disease are described. The pulmonary lung biopsy in one of them, as well as Chest X ray, BAL cellularity and pulmonary function data in both, are in agreement with the reports from the literature, while Ga lung scan was negative in one of the two, and positive in the other one. In both, a total resolution was seen six and four months respectively after discontinuation of Amiodarone therapy. Corticosteroid therapy could be advisable only when no spontaneous resolution occurs after tapering the drug.

Aged↗

Large cell neuroendocrine carcinoma of the lung.

Large cell neuroendocrine (LCNE) carcinomas of the lung are a newly recognized, highly aggressive and frequently misdiagnosed entity. We report a case of stage I LCNE lung carcinoma initially misdiagnosed as large cell undifferentiated carcinoma or poorly differentiated adenocarcinoma. The tumor was very extensively necrotic and its neuroendocrine differentiation was only demonstrable with immunohistochemical staining with PHE-5 monoclonal antibody and with antisera against synaptophysin and calcitonin. ACTH, somatostatin and neurofilaments were not demonstrable. The clinical course was ominous and the patient died within 17 months. The reason for this rapid fatal outcome could be ascribed either to the neuroendocrine phenotype of the tumor, or to the extensive necrosis, or both.

Adenocarcinoma↗

Typical and atypical bronchial carcinoids.

From January 1955 to April 1987 111 patients with bronchial carcinoid were operated on in our department. There were 62 males and 49 females with a mean age of 45.5 years. Preoperative histological diagnosis was achieved in 22 cases, while in five patients, a false positive diagnosis of small cell lung cancer was reported. Fifteen patients required pneumonectomy, 70 had lobectomy, 16 bilobectomy, and four segmentectomy. One patient required tracheal resection, while in another patient the tumour was removed through bronchotomy. Four patients were completely treated with YAG laser phototherapy. There were three postoperative deaths. The following variables were analysed and discussed in order to evaluate their influence on prognosis: (1) size of the tumour, (2) typical or atypical appearance, (3) endoluminal or extraluminal growth, (4) vascular invasion, (5) node metastases. Atypical onset, node metastases and extraluminal invasion are significant factors in worsening the prognosis.

Adolescent↗

Determination of T lymphocyte subpopulations in patients with lung cancer. A comparison between lung lavage and peripheral blood by monoclonal antibodies and flow cytometry.

In order to determine whether the alterations of immunoregulatory T cells described both in smokers and in patients with lung cancer occur in the deep lung as well as in peripheral blood, we analyzed T lymphocyte subpopulations in bronchoalveolar lavage (BAL) and in the blood of 12 patients with untreated lung cancer and of 8 controls. The immunocompetent cellular population of BAL fluid analyzed by differential cell count of alveolar macrophages, lymphocytes and neutrophils did not show considerable differences in the two groups studied. By contrast, the analysis of BAL T lymphocytes and their subsets showed significant alterations in patients compared with controls: a percentage increase of OKT3+ and OKT8+ lymphocytes and a decrease of the OKT4+/OKT8+ ratio was found in both the involved and uninvolved lung of patients. The immunologic pattern of T lymphocytes in blood did not show significant differences between patients and controls. Our data indicate that alterations in immunoregulatory T cells in lung cancer are more pronounced in BAL fluid obtained from both lungs than in peripheral blood.

Adult↗

Massive haemoptysis in Behçet syndrome: case report.

Behçet syndrome in association with pulmonary manifestations is rare. We describe a patient suffering from recurrent oral and genital ulcerations, conjunctivitis, thrombophlebitis and fluctuating radiological opacities in the lungs who died after massive haemoptysis. The autopsy showed a necrotizing vasculitis involving pulmonary arteries, muscular arteries and veins. It was complicated by arterial thromboses, bronchial erosions by pulmonary artery aneurysms and formation of a large arteriobronchial fistula. We conclude that the spread of the inflammatory infiltrate from the wall of the vessels to the adjacent bronchi is responsible for these complications and that haemoptysis must be considered as the expression of dramatic progression of the disease.

Adult↗