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Biomedical subjects

M Mauri

Publications and source records attributed to M Mauri.

At least 55 records · Page 3Linked to original sources
PubMed1998

Conservative surgery and radiotherapy in early stage breast cancer: a comparison between tumourectomy and quadrantectomy.

BACKGROUND AND PURPOSE: This study analyses and compares the results of local regional control, distant metastases and survival in two series of patients irradiated from 1986 to 1992 in our radiation oncology centre following quadrantectomy or tumourectomy for early stage breast cancer. MATERIALS AND METHODS: The quadrantectomy group consisted of 152 women, 109 (72%) with T1 and 43 (28%) with T2 tumours. Axillary nodes in this group were positive in 51 (33%) patients. The tumourectomy group included 123 women, 71 (58%) with T1 and 52 (42%) with T2 tumours. Positive axillary nodes were found in 56 (46%) of these patients. All quadrantectomy and tumourectomy patients received a dose of 50 Gy in 5 weeks to the whole breast, followed by a 10-16 Gy electron boost. Node positive patients in the tumourectomy group also received 50 Gy to the axillary apex and supraclavicular region. In both surgical groups, node positive premenopausal and postmenopausal patients received adjuvant CMF or tamoxifen therapy, respectively. RESULTS: After a median follow-up of 58 months, 89% of women in the tumourectomy group and 87% in the quadrantectomy group were alive and 80 and 73%, respectively, were free of disease. Breast and nodal failures were detected in 4.9 and 0.8% of cases, respectively, in the tumourectomy group, as compared to 5.9 and 3.3% of cases, respectively, in the quadrantectomy group. Distant relapses were observed in 16 and 18% of patients in the former and latter groups, respectively. Actuarial overall and disease-free survival was similar in the two series, with 5-year rates of 90 and 72%, respectively, in the tumourectomy group, and of 91 and 78%, respectively, in the quadrantectomy group. The differences in survival are not statistically different. CONCLUSIONS: Our findings show that tumourectomy and quadrantectomy, followed by adequate radiotherapy, provide comparable results in terms of local-regional control and survival.

Adult↗
PubMed1998

Memory performances in young, elderly, and very old healthy individuals versus patients with Alzheimer's disease: evidence for discontinuity between normal and pathological aging.

In this study we compared memory performances of 29 probable patients with AD (17 mildly and 12 moderately demented) with those of 39 healthy young subjects, 36 elderly subjects (matched with the AD group for age and years of schooling), and 19 healthy very old subjects. In most of the memory tasks used in the present study, a progressive decline in performance was observed passing from the Young to the Elderly to the Very Old to the AD group. However, patients with AD were selectively impaired in the backward reproduction of verbal and spatial span sequences and in the semantic encoding of verbal material. These data are consistent with the hypothesis of not only quantitative but also a qualitative discontinuity between the process of normal aging and the dementia syndrome.

Adult↗
PubMed1998

Influence of anti-insulin antibodies on insulin immunoassays in the autoimmune insulin syndrome.

The autoimmune insulin syndrome (AIS) is a rare, benign syndrome characterized by hyperinsulinaemia and hypoglycaemia associated with the presence of autoantibodies to insulin in patients who have not been treated with insulin. We report here the case of a 52-year-old patient with recurrent attacks of severe postprandial hypoglycaemia and we also present the effect of anti-insulin antibodies on insulin immunoassays. The patient was submitted to the following diagnostic tests: 5-h oral glucose tolerance test (OGTT), a prolonged 72-h fast and an insulin tolerance test (ITT). Serum glucose, total and free insulin, C-peptide, proinsulin, insulin antibodies and other autoantibodies were measured. Insulin concentrations were measured by two methods: a double antibody radioimmunoassay (RIA) and an immunoradiometric assay (IRMA). Insulin concentration measured by RIA was extremely high in the OGTT and 72-h fast. In contrast, insulin concentrations measured by IRMA were between 120 and 888 pmol/L in the OGTT and between 37 and 133 pmol/L during the 72-h fast. Fasting free-insulin concentrations measured by RIA were between 2224 and 2669 pmol/L, whereas free-insulin concentrations measured by IRMA ranged between 93 and 237 pmol/L. Total insulin concentrations measured by RIA and IRMA were 57,615 and 94,021 pmol/L, respectively. The C-peptide concentrations were moderately high in the three tests. Serum insulin antibody concentrations were extremely high (62-71%), compared with less than 3% in normal serum samples. In conclusion, the high insulin concentrations measured by RIA were caused by insulin autoantibodies. However, insulin concentrations measured by IRMA were not influenced by them. We conclude that IRMA is the more accurate method for measuring insulin concentrations in such cases.

Autoantibodies↗
PubMed1997

Clinical and hormonal effects of the combination gonadotrophin-releasing hormone agonist plus oral contraceptive pills containing ethinyl-oestradiol (EE) and cyproterone acetate (CPA) versus the EE-CPA pill alone on polycystic ovarian disease-related hyperandrogenisms.

The aim of this study was to compare the clinical and hormonal effects of the combination of a long-acting gonadotrophin-releasing hormone analogue (GnRH-a) plus an oral contraceptive (OC) pill containing ethinyl-oestradiol (EE) and cyproterone acetate (CPA) versus the EE-CPA pill alone in patients with polycystic ovarian disease (PCOD) and related hyperandrogenisms, in order to evaluate whether the addition of GnRH-a has any advantage. A total of 12 PCOD patients were treated with the EE-CPA pill alone for 10 consecutive cycles according to an OC standard regimen. A further 12 patients were treated with GnRH-a, one i.m. injection every 28 days for a total of eight injections, combined with the EE-CPA pill for 10 consecutive cycles. The latter was thus prolonged for two cycles more than GnRH-a. Clinical evaluations (symptoms, weight, Ferriman-Gallwey score) and hormonal and biochemical analyses were assessed before, during (at 3 or 6 months) and after treatment, either when spontaneous cycles had resumed or after 3 months of amenorrhoea. There was a significant improvement in hirsutism, and a strong reduction in gonadotrophin, oestradiol, testosterone, androstenedione and 17-OH-progesterone concentrations in both treatment groups but with no significant differences between them, except in the gonadotrophin concentrations. Cortisol and triglyceride concentrations increased during treatment in both groups. The Ferriman-Gallwey score remained significantly decreased in both groups after treatment, as did androstenedione in the GnRH-a plus EE-CPA pill group, but there were no significant differences between the two groups. No changes were observed in prolactin, dehydroepiandrosterone sulphate (DHEA-S), insulin, glycaemia and cholesterol concentrations. However, when only the obese and more hirsute patients were considered, significant differences between the two groups were found during treatment in the Ferriman-Gallwey score and the gonadotrophin and DHEA-S concentrations (which increased during treatment in obese patients with the pill alone), and after treatment in the Ferriman-Gallwey score and the concentration of 17-OH-progesterone in the more hirsute patients, with the GnRH-a plus pill group having better results. In conclusion, a cyclic prolonged treatment with OC EE-CPA pills is not improved in most PCOD patients by the addition of GnRH-a, and is complicated and expensive. However, the addition of a long-acting GnRH-a may be recommended in obese and severely hirsute patients.

Adolescent↗
PubMed1997

Neurophysiological and neuropsychological monitoring of fatigue during extreme environmental and driving conditions.

Aim of the present study was to evaluate the modifications of neurophysiological and neuropsychological variables during extreme environmental and driving conditions. Eight subjects (four drivers and four passengers) were evaluated while driving a four wheels drive across the Big West Algerian Erg. The following procedures were carried out in basal conditions and at the end of the 1st, 3rd, and 5th day of driving: surface EMG of masseter and cervical para-spinal muscles during maximum isometric contraction lasting 12 sec; test of simple visual and acoustic reaction times, Cancellation test, Trial Making test. As from the second day, the drivers used appropriate dental plates. In the drivers, EMG spectrum analysis revealed a significant decrease in mean frequency values at the end of the 1st day. This finding was more relevant in masseter muscles. No significant fatigue phenomena were detected on the subsequent controls. On the contrary, the passengers showed a decrease in mean EMG frequency values. No significant modifications in the cognitive variables were detected at the end of the 1st day (initial response to stress), whereas a progressive worsening was observed in the subsequent evaluations. EMG fatigue of masseter muscles seems to be more related to psychic stress. The beneficial effects of the dental plates were also confirmed.

Adolescent↗
PubMed1997

[Echography of the shoulder with the patient supine in the diagnosis of rotator cuff rupture].

We report a new method for shoulder sonography (US): the patient lies supine and his/her arm is positioned so as to optimize tendon depiction. The supraspinatus tendon, which is the most frequently involved structure in rotator cuff tears, is studied with the patient's arm dropped, elbow extended and forearm prone. Our series consisted of 49 surgical patients (arthroscopy in 16 and open surgery in 33 patients): US sensitivity in tear depiction was 84.8%, specificity 100% and accuracy 89.8%. Medium-small tears appeared as transonic areas within tendon substance and/or tendon focal thinning. Large tears appeared as: (a) missed or markedly thinned rotator cuff, with deltoid muscle approximation to the humeral head surface, (b) plenty of fluid collected around bulky tear margins. The US images of 36 patients were then reviewed and the details discussed. A new sign was observed in medium-small tears, that is a sharp hyperechoic band encircling the humeral cartilage (the compass sign). In conclusion, we believe that US performed with the patient in supine recumbency is easier to perform and provides a bigger field of view of the supraspinatus tendon; it also permits to keep stretched rotator cuff, with consequent image quality improvement.

Adult↗
PubMed1996

[Improvement of expected and final height in girls with central precocious puberty treated with gonadotropin releasing hormone analogues].

BACKGROUND: To evaluate the effect of GnRH-analogue triptoreline on the predicted adult height and final height in central precocious puberty (CPP). PATIENTS AND METHODS: The study included 14 girls with CPP treated for 1-6 years with triptoreline depot (75 micrograms/kg/28 days/i.m.; group 1). The criteria for diagnosis included the following: compelling evidence of rapid progression of puberty, with a bone age (BA) greater than 2 SD above the mean value for chronological age (CA) associated with poor initial predicted final height and growth speed greater than 2 SD above the mean value for age. In addition we obtained data from 6 untreated girls with advanced puberty and good predicted adult height followed during the same period of time (group II). 7 of 14 girls of group I and 5 of 6 girls of group II attained final height. RESULTS: A decrease in growth speed and an increase and in CA/BA ratio were observed after three years of treatment (+4.9 +/- 0.7 SD to -1.45 +/- 2.63 SD and 0.62 +/- 0.14 to 0.74 +/- 0.09 respectively; P = 0.034; n = 6). The predicted adult height increased significantly after two years of treatment (153.1 +/- 4.49 to 156.94 +/- 5 cm; p = 0.041; n = 10) and was more evident after three years of treatment (153.84 +/- 5.77 to 160.7 +/- 7.5 cm; p = 0.03; n = 6). The final height of 7 girls of group I who attained it was similar to target height (161 +/- 3.1 vs. 159 +/- 1.3 cm; NS) and greater than initial predicted adult height (161 +/- 3.1 vs. 154 +/- 2.1 cm; p = 0.044) and than final height of the 5 girls of group II (161 +/- 3.1 vs. 154.28 +/- 6.1 cm). CONCLUSIONS: Triptorelin depot improves predicted adult height and final height of girls with early central puberty may be over their target height.

Body Height↗
PubMed1996

[Pleural cryptococcosis in patients with human immunodeficiency virus infection].

Four cases of pleural cryptococcosis as the form of onset of cryptococcosis in patients with human immunodeficiency virus (HIV) infection are reported. In two out of the four cases cryptococci were simultaneously isolated in other localizations (blood and meninges). In the two remaining patients the pleura was the only site of the disease, with serum determination of the cryptococci antigen being negative in one. The four patients evolved favourably, with three being exclusively treated with fluconazol. Pleuritis is an infrequent manifestation in cryptococcosis although it may be the form of onset and the only localization of the disease. Only 10 cases have been reported in patients with HIV infection. The present four cases represent 11% of the authors' series of cryptococcosis in AIDS patients. The diagnostic possibility of cryptococcosis should be considered in patients with human immunodeficiency virus infection presenting pleural effusion.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Longitudinal neuropsychological evaluation of HIV-infected intravenous drug users.

The present study aimed to describe the cognitive status of a group of HIV-positive asymptomatic intravenous drug users (IVDU) and changes which occurred over a 12-month follow-up period. Forty-two HIV positive IVDU were selected and matched for age, sex, educational level and pattern of drug abuse with 39 seronegative IVDU controls. Baseline and follow-up evaluation included neuropsychological tests exploring attention, language, memory, logic and visuomotor abilities, biological markers and clinical parameters. About one-third of both seropositive and seronegative subjects showed at baseline slight cognitive deficits, which did not change during the follow-up period.

AIDS Dementia Complex↗
PubMed1996

Acute and chronic changes in atrial natriuretic factor induced by ventricular pacing: a self controlled clinical trial.

A self controlled clinical trial was carried out to study the acute and chronic effects of ventricular pacing (VVI) on the atrial natriuretic factor (ANF). Eleven people were selected from a pool of 20 DDD paced patients. Pacemakers were programmed to the VVI mode for 1 month and their effectiveness tested by ECG at rest and after an effort test. AnF was measured by radioimmunoassay at baseline, after 15 minutes, and again 1 month after programming. The reliability of the radioimmunoassay was confirmed using the coefficients of variation between (12.5%) and within assay (9.7%). Data analysis was done using Wilcoxon's test. Our results showed that the onset of VVI pacing led to a sudden sharp rise in ANF in all patients (P < 0.0001). During VVI pacing, three patients were dropped from the study (2 were withdrawn because of symptoms and 1 voluntarily withdrew). After 1 month of VVI pacing, a significant increase of ANF above the baseline was observed (P < 0.05). The results showed that ventricular pacing led to an immediate rise in ANF and, that with long-term VVI pacing, there was an increase in ANF levels as well. The role of these findings in the pathophysiology of the pacemaker syndrome calls for further research.

Adult↗
PubMed1995

Symptomatic headaches.

This paper is aimed to discuss some aspects of so-called symptomatic or secondary headaches with particular reference to the diagnostic criteria proposed by the IHS Classification Committee on headache disorders, cranial neuralgias and other head pain. Symptomatic headaches, in fact, represent an heterogenous group of conditions, sometimes with relevant clinical importance as warning symptoms of major intracranial pathology, sometimes benign in nature and with ill-defined clinical pictures and unclear relationship with the causative factor or event. It is therefore important to establish general principles for a more systematic approach to the problem of this group of headaches, also considering that some particular forms of secondary headaches, may be viewed as reliable "in-vivo" models for pathophysiological investigation in head pain.

Brain Neoplasms↗