Biomedical subjects
Publications and source records attributed to M D'Alessandro.
Plasma met-enkephalin (MET-ENK) levels are increased in type 1 diabetic women and in pregnant diabetic women in comparison with normal women. Plasma MET-ENK levels further increase in the peripartum period both in diabetic and non-diabetic females, probably due to the analgesic and behavioural properties of the opioid system.
Indobufen (200 mg b.i.d., by os, for 21 days) was gave to 16 patients with atherothrombotic risk in which platelet function was valued. In this subjects, indobufen significatively reduced platelet aggregation, beta-thromboglobulin, platelet factor the 4th and alpha-platelet granules' intake. No side effects were found.
A review of 2,092 patients who had sustained closed thoracic trauma or undergone mechanical ventilation was made in order to clarify the incidence, clinical picture, pathogenesis and prognosis of pneumomediastinum without pneumothorax or lesion of mediastinal organs. Air in the mediastinal space was observed in ten patients (0.5% of cases). Bronchial and esophageal lesions were excluded at bronchoscopy and esophagoscopy. The clinical presentation included subcutaneous emphysema of the neck, without signs of mediastinitis. No patient had pain or dyspnoea. Trauma or barotrauma were assumed to have caused sudden rise in the intrapulmonary pressure, leading to passage of air from the parahilar alveoli into the mediastinum along the peribronchial and perivascular spaces. Management was conservative and the prognosis good, with normalization of the chest radiogram usually within a week.
Results of chest radiotherapy on 48 patients with inoperable squamous-cell carcinoma are reported; 25 patients had continuous treatment whereas the remaining 23 patients had split-course. Objective remission was obtained in 71% of the cases; mean survival was 11.7 months for the whole series, and 14 months for responders. An advantage in objective remission rate for patients having a dose of 60 Gy or more was found. Split-course resulted in similar survival and objective remission rate but was less toxic than continuous treatment. In 43% of cases the disease progressed only loco-regionally. Radiotherapy was interrupted because of toxicity in 23% of cases and there was only a case of life-threatening toxicity.
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Oxygen free-radical reperfusion products play a critical role in postischemic tissues injury. In this study we used deferoxamine, an iron ligand that seems to inhibit hydroxyl radicals production, in renal normothermic acute ischemia in the rat. Our results demonstrated a significant protective effect of deferoxamine on kidneys subjected to normothermic acute ischemia.
We described a case of Central Pontine Myelinolysis, typical with regard to pathogenesis (excessive correction of hyponatremia), neuroanatomical damage revealed by imaging techniques (Magnetic Resonance Imaging) and clinical symptomatology. Serially performed BAEPs recordings during patient's hospitalization, showed interesting data on functional recovery which well correlate with the evolution of clinical symptomatology. These data strongly suggest the usefulness of such electrophysiological technique for a prognostic evaluation.
Exclusive irradiation is used to treat primary neoplasms localized to the larynx because it is known to be able to cure, or at least control, the disease in a high percentage of cases without affecting speech. We report our ten-year experience in the Radiotherapy Department of Chieti Hospital. From 1985 to 1994, exclusive radiotherapy was used to treat 87 patients bearing histologically proved epidermoid carcinomas of the larynx. The patients average age was 67 years. The primary site was the glottis in 64 cases and the supraglottic and subglottic areas in 21 and 2 cases, respectively. The lymph nodes were clinically positive in 8 patients (9%) and negative in 79 (91%). The minimum follow-up was 20 months. All the patients were treated with cobalt 60 beams; the daily dose was 2 Gy, fractionation was 5 days a week. Average tumor dose was 64 Gy (range: 55-70 Gy). Disease-free survival actuarial curves show 72% five-year survival for glottic cancer (75% for N0, 80% for T1 and 61% for T2-T3-T4 cases) and 21% for supraglottic cancer (25% for N0 cases). To conclude, irradiation is confirmed to be a useful tool to treat early laryngeal cancer, while new combinations of surgery, chemotherapy and irradiation are needed to treat locally advanced cancer.