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Biomedical subjects

M Massari

Publications and source records attributed to M Massari.

At least 19 recordsLinked to original sources
PubMed1998

[Plasma and urinary fibrin fibrinogen degradation products in a case of renal thromboembolism].

The authors examined the trend of plasma (FDPp) and urine (FDPu) fibrin-fibrinogen degradation products in a case of renal thromboembolism during atrial fibrillation. No alterations of FDP are reported in the literature for this renal pathology. This raises the question of whether this laboratory parameter is of diagnostic value during the course of renal embolism. The case concerned a patient who was admitted to the emergency ward with painful symptoms in his right flank. He was initially hospitalised with a diagnosis of right renal colic. A few days later multiple thromboembolism of the right kidney was diagnosed using CAT with i.v. infusion of contrast medium and renal scintigraphy with 99Tc DTPA. From day 6 to day 17 after the start of painful symptoms, a number of assays were made of FDPp and FDPu using the rapid latex test for FDP which uses specific anti-fragment D and E antiserum (Thrombo-Wellcotester). Alterations of plasma and urine FDP were found which also showed an opposite trend: an inversion of the changes was noted on day 8 with normalisation of FDPp and a persistent increase in FDPu by day 17. Earlier tests may confirm the trend of FDP and their value in diagnostic screening for cases of renal thromboembolism.

Adult↗
PubMed1997

Endoscopic ultrasonography for preoperative staging of esophageal carcinoma.

Endoscopic ultrasonography (EUS) is a relatively new diagnostic method to assess the extent and the depth of infiltration of esophageal carcinoma. Since October 1990, EUS was performed in 55 patients presenting with squamous-cell carcinoma of the esophagus, 40 of whom were operated on. The first 23 patients underwent EUS with an Olympus GF-2/EU-M2 echoendoscope with a 7.5-MHz transducer; the last 32 patients underwent EUS with an Olympus GF-3/EU-M3 instrument with a 7.5-12-MHz echoprobe. In 22 patients, the procedure was not completed because of the impossibility of passing through the neoplastic stenosis. The depth of infiltration (T parameter) was correctly defined by EUS in 36 of 40 patients (90%) compared with 50% of computed tomography (CT). The 12-MHz echoprobe yielded a global accuracy in staging T parameter of 94% compared to 82% of 7.5-MHz transducer. The lymph-node involvement (N parameter) was correctly classified by EUS in 20 of 23 patients (87%) compared with 39% by CT. EUS provides a high degree of accuracy in assessing the T and the N parameter in the staging of squamous-cell esophageal carcinoma. The major problem of the instrument is still the frequent impossibility of passing through the neoplastic stenosis.

Carcinoma, Squamous Cell↗
PubMed1997

[Treatment with human tetanus immunoglobulins in the Emergency Department. Effects of informed consent].

BACKGROUND: The impact of informed consent to tetanus prophylaxis with human immunoglobulins on patients treated in the Emergency Department has been evaluated. METHODS: Tetanus vaccination history was investigated in 1435 patients in 1995 and in 1300 patients in 1996 with post-traumatic skin lesions. RESULTS: The study has shown that in 1995, 55% and in 1996 49.5% of the total patients studied had not received vaccine for tetanus or boosters for over 10 years. These patients had been proposed the treatment with human tetanus immunoglobulins (TIG). The research was performed comparing the consent obtained before (from 17/5 to 15/7/1995) and after (from 17/5 to 15/7/1996) the introduction of the informed consent. The survey was divided into 15-day periods. In 1995 prophylaxis with human immunoglobulins was refused by 42 patients out of 831 (5%) while, in the following year, by 284 out of 641 (44.3%). Every period examined has shown highly significant differences (p < 0.000). CONCLUSIONS: Informing the patients that tetanus prophylaxis with human immunoglobulins can expose them to the risk, at present remote, of transmission of viral infections, has caused a heavy rise of denials to the suggestion of treatment with human immunoglobulins. The amount of the treated patients and the time that was devoted to informed consent would make Emergency Department one of the main places for effective and widespread tetanus prophylaxis. However a greater activity of outer structures would also be hoped for.

Adolescent↗
PubMed1996

Different clinical behaviors of acute hepatitis C virus infection are associated with different vigor of the anti-viral cell-mediated immune response.

The anti-viral T cell response is believed to play a central role in the pathogenesis of hepatitis C virus infection. Since chronic evolution occurs in > 50% of HCV infections, the sequential analysis of the T cell response from the early clinical stages of disease may contribute to define the features of the T cell response associated with recovery or chronic viral persistence. For this purpose, 21 subjects with acute hepatitis C virus infection were sequentially followed for an average time of 44 wk. Twelve patients normalized transaminase values that remained normal throughout the follow-up period; all but two cleared hepatitis C virus-RNA from serum. The remaining nine patients showed persistent viremia and elevated transaminases. Analysis of the peripheral blood T cell proliferative response to core, E1, E2, NS3, NS4, and NS5 recombinant antigens and synthetic peptides showed that responses to all hepatitis C virus antigens, except E1, were significantly more vigorous and more frequently detectable in patients who normalized transaminase levels than in those who did not. By sequential evaluation of the T cell response, a difference between the two groups of patients was already detectable at the very early stages of acute infection and then maintained throughout the follow-up period. The results suggest that the vigor of the T cell response during the early stages of infection may be a critical determinant of disease resolution and control of infection.

Acute Disease↗
PubMed1995

[Long-term cyclic and periodic omeprazole in the prevention of recurrences of duodenal ulcer].

The aim of this study was to establish if the discontinuous assumption of omeprazole was effective to reduce the recurrence of duodenal ulcer disease as the cyclic periodical assumptions of the same drug. Consequently two different posologies, after duodenal ulcer recovery, were compared, both based on omeprazole. In the first trial 20 mg/die were administrated for the first 15 days of every month, for 1 year. In the second, the same dose were administrated for 15 days only when symptoms occurred. It was not utilised a comparison with placebo or other drugs. Symptomatic score and recurrence rate were evaluated by means of EGDS after 6 months and 1 year. In some patients were also controlled the gastrinemia. Both trials were effective in the prevention of duodenal ulcer relapse, without increasing gastrinemia. Nevertheless patients assuming omeprazole only when symptomatic, showed a greater symptomatic score. Concluding, the assumption of omeprazole only when symptoms occur is effective in the prevention of relapse but require a close relation between patients and the medical team.

Adult↗
PubMed1993

Cell-type-specific transactivation of the parathyroid hormone-related protein gene promoter by the human T-cell leukemia virus type I (HTLV-I) tax and HTLV-II tax proteins.

The human T-cell leukemia virus type I (HTLV-I) and HTLV-II Tax proteins are potent transactivators of viral and cellular gene expression. Using deletion mutants, the downstream parathyroid hormone-related protein (PTHrP) promoter is shown to be responsive to both HTLV-I and HTLV-II Tax as well as the AP1/c-jun proto-oncogene. Transactivation of PTHrP by Tax was seen in T cells but not in B-cell lines or fibroblasts. A carboxy terminal Tax deletion mutant was deficient in transactivation of both the PTHrP and IL2R alpha promoters but not the HTLV-I long terminal repeat (LTR). Exogenous provision of NFkB rescued IL2R alpha expression but not the PTHrP promoter. Thus, HTLV-I Tax, HTLV-II Tax, and c-jun transactivate PTHrP and may contribute to the pathogenesis of hypercalcemia in adult T-cell leukemia.

Animals↗
PubMed1991

Loss of nocturnal decline of blood pressure in hypertension due to chronic renal failure.

The aim of this study was to assess the blood pressure profile of chronic renal failure in comparison with essential hypertension. Thirty hypertensive patients with chronic renal failure due to non-vascular nephropathies were matched by age, sex, and mean 24 h blood pressure, with 30 patients affected by uncomplicated mild-to-moderate essential hypertension. They were studied in an open hospital ward. Diet, meal times, sleep times, and activity schedules were standardized. Noninvasive, automatic, blood pressure recordings were performed for 48 h at sampling intervals of 15 min. The mean 24 h blood pressure almost coincided in the two groups. However, in essential hypertension a mean (+/- SD) nocturnal fall of systolic and diastolic blood pressure was found (12.7 +/- 3.8 and 12.9 +/- 4.8 mm Hg, respectively), while renal patients displayed an average nocturnal increase of 2.7 +/- 8.9 mm Hg and 3.7 +/- 7.8 (P less than .001). The renal patients had also higher heart rates, with a significantly blunted nocturnal fall (4.4 +/- 4.5 beats/min as compared to 9.3 +/- 3.1 beats/min of essential hypertension; P less than .001). Among the renal patients, the day-night blood pressure changes showed no significant correlation with age, creatinine clearance, hematocrit, nocturnal change in heart rate, or day or night mean blood pressure levels. These data suggest that an abnormal day-night pattern of blood pressure is present in chronic renal failure patients independently from external interfering factors. Hence, casual measurements of blood pressure confined to daytime may underestimate a hypertensive condition associated with chronic renal failure.

Adult↗
PubMed1989

[Diagnosis and treatment of hepatic echinococcosis with fistulas of the major bile ducts].

The authors report their experience of secondary major biliary fistula (MBF) for hepatic echinococcosis. The analysis of the results of the surgical treatments showed that "conservative" operations have major mortality than "radical" operations. The importance of an exact preoperative diagnosis of presence, side and size of MBF, in order to a correct choice of the most suitable operations, is underlined. Endoscopic retrograde cholangio-pancreatography seems to be a reliable diagnostical technique, also if compared with traditional methods (U.S., C.T.).

Bile Duct Diseases↗
PubMed1989

[Epidemiology of beta-hemolytic streptococcus group B colonization in perinatology. Methodology considerations and personal data].

GBS have attracted increasing attention in recent years as a major cause of serious neonatal sepsis. The maternal genital tract is the principal source of organism for babies with the most serious early onset form of disease. Reported rates of GBS carriage in the genital and anorectal tract of pregnant women vary widely: much of the variations is undoubtedly associated with differences in laboratory technique, sampling site and number of samples taken. The key bacteriological factor is the use of enrichment culture technique. We have studied GBS colonization in 274 pregnant women during labor and in their newborns (275). Carriage was documented in 25.91% women by vaginal (low portion) and anorectal swabs, and in 6.14% newborns by auricolar, pharyngeal and rectal swabs taken at birth and before leaving nursery. The higher rectal colonization rate in pregnant women suggests that the gastrointestinal tract is the primary site of GBS carriage. Colonized newborns have no obstetrics risk factors, except for maternal GBS carriage. Our data confirms that limiting antimicrobial intrapartum prophylaxis to premature infants leaves term infants (who account for 60% of the fetal cases of early onset disease) unprotected, unless membrane rupture is prolonged. Prevention of early onset infections among low-risk term infants will require additional investigations.

Female↗
PubMed1989

[Male pseudohermaphroditism caused by 17-alpha-hydroxylase deficiency. Personal case reports and a review of the literature].

Adrenal hyperplasia due to 17-alpha-hydroxylase deficiency is coupled with precocious hypogonadism, which causes pseudohermaphroditism in XY subjects and primary amenorrhea in XX subjects. The physiology of gluco- and mineral-corticoid adrenal activity, as well as the biosynthesis of gonadal steroids, is totally altered. We report two cases of XY subjects, identified as females, who came to our observation for primary amenorrhea and exhibited a hypertension with hypokaliemia. We also report a critical review of the literature, with a main attention to differential diagnosis and mineralcorticoid physiopathology, in order to contribute to the knowledge of normal adrenal function and of this enzymatic defect.

Adolescent↗
PubMed1988

Effects of heroin addiction on the responses of glucose, C-peptide and insulin to a standard meal.

1. The aim of the study was to examine the responses of plasma glucose, C-peptide immunoreactivity (CPR) and total immunoreactive insulin (IRI) to a standard meal in heroin addicts, since the presence of immunoreactive beta-endorphin has been demonstrated in human endocrine pancreas. 2. Ten heroin addicts and 10 control subjects participated in the study. The addicts had been taking heroin (from 0.5 to 2 g/day) for at least 2 months and they had no detectable diseases. 3. After a 12 h fast, each subject received a standard meal; blood samples were taken at -15, 0, 15, 30, 60 and 120 min to determine glucose, CPR and IRI. Calculation of the CPR/IRI molar ratio was used as a semiquantitative estimation of the hepatic extraction of insulin. 4. No difference in plasma glucose was observed between the groups. Addicts had lower CPR than normals at 15, 30 and 120 min (P less than 0.01). On the contrary, IRI was higher in addicts than in normals (P less than 0.05 at -15 and 0 min, P less than 0.01 at 15, 30 and 60 min), except at 120 min. The CPR/IRI molar ratio was lower in addicts (P less than 0.01). 5. Heroin addiction seems to produce a beta-cell failure and contemporaneously a state of hyperinsulinaemia; blood glucose remains in the normal range. 6. We conclude that chronic heroin addiction may produce a change in the rate of hepatic extraction of insulin.

Adult↗
PubMed1988

Calcium antagonists and hormone release. VI. Effects of a calcium antagonist (verapamil) on the biphasic insulin release in vivo.

The present study was designed to investigate the influence of a calcium antagonist (verapamil) on the two phases of insulin release. The present results confirmed our previous studies and in vitro data, showing that the first phase insulin release is not inhibited by a calcium antagonist and strongly indicated that glucose stimulated insulin secretion has two phases of release: (1) the first phase of release, which is independent from extracellular calcium; (2) the second phase of release, which was inhibited by calcium antagonists, is dependent from calcium uptake from an extracellular source.

Adult↗
PubMed1987

L-arginine methylester reduces Ca2+/Cl(-)-dependent L-[3H]glutamate binding and Ca2+-activated neutral protease activity in rat hippocampal membranes.

Specific binding of L-[3H]glutamate was measured in Tris-HCl buffer in rat hippocampal membranes. In these experimental conditions 1 mM CaCl2 induced an increase in binding due to an increase in Bmax. L-Arginine methylester did not modify the Cl(-)-dependent binding of L-[3H]glutamate, but it decreased Ca2+/Cl(-)-stimulated binding in a dose-dependent manner, decreasing Bmax without changing KD. L-Arginine methylester reduced calcium-activated neutral protease activity in a dose-dependent manner. Serine protease inhibitors (aprotinin and di-isopropylfluorophosphate) did not affect L-[3H]glutamate binding, whereas leupeptin reduced it in a dose-dependent manner. L-Arginine did not mimic the effect of L-arginine methylester in either model.

Animals↗