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Biomedical subjects

M Meregalli

Publications and source records attributed to M Meregalli.

At least 19 recordsLinked to original sources

Skin-derived stem cells transplanted into resorbable guides provide functional nerve regeneration after sciatic nerve resection.

The regeneration in the peripheral nervous system is often incomplete and the treatment of severe lesions with nerve tissue loss is primarily aimed at recreating nerve continuity. Guide tubes of various types, filled with Schwann cells, stem cells, or nerve growth factors are attractive as an alternative therapy to nerve grafts. In this study, we evaluated whether skin-derived stem cells (SDSCs) can improve peripheral nerve regeneration after transplantation into nerve guides. We compared peripheral nerve regeneration in adult rats with sciatic nerve gaps of 16 mm after autologous transplantation of GFP-labeled SDSCs into two different types of guides: a synthetic guide, obtained by dip coating with a L-lactide and trimethylene carbonate (PLA-TMC) copolymer and a collagen-based guide. The sciatic function index and the recovery rates of the compound muscle action potential were significantly higher in the animals that received SDSCs transplantation, in particular, into the collagen guide, compared to the control guides filled only with PBS. For these guides the morphological and immunohistochemical analysis demonstrated an increased number of myelinated axons expressing S100 and Neurofilament 70, suggesting the presence of regenerating nerve fibers along the gap. GFP positive cells were found around regenerating nerve fibers and few of them were positive for the expression of glial markers as S-100 and glial fibrillary acidic protein. RT-PCR analysis confirmed the expression of S100 and myelin basic protein in the animals treated with the collagen guide filled with SDSCs. These data support the hypothesis that SDSCs could represent a tool for future cell therapy applications in peripheral nerve regeneration.

Action Potentials↗

Effect of acupressure on nausea and vomiting induced by chemotherapy in cancer patients.

AIM: Corticosteroids, antidopaminergig agents and 5-HT3 antagonists are the most commonly used drugs in the treatment of chemotherapy-induced vomiting. Acupuncture and acupressure have also appeared to exert antiemetic effects. The aim of this study was to evaluate the efficacy of acupressure in the treatment of chemotherapy-induced vomiting resistant to the standard antiemetic therapies. METHODS: The study included 40 consecutive advanced cancer patients with untreatable chemotherapy-induced vomiting. Colorectal cancer, lung cancer and breast cancer were the neoplasm most frequent in our patients. According to tumour histotype, patients received chemotherapeutic regimens containing the main emetic cytotoxic agents, including cisplatin and athracyclines. Acupressure was made by PC6 point stimulation for at least 6 h/day at the onset of chemotherapy. RESULTS: The therapeutic approach was well accepted by the overall patients. An evident improvement in the emetic symptomatology was achieved in 28/40 (70%) patients, without significant differences in relation to neither tumor histotype, nor type of chemotherapeutic agent. CONCLUSIONS: This preliminary study seems to suggest that a bioenergetic approach by acupressure on PC6 point may be effective in the treatment of chemotherapy-induced vomiting resistant to the conventional pharmacological strategies, as previously demonstrated for vomiting occurring during pregnancy.

Acupressure↗

Subcutaneous administration of interleukin-2 and interferon-alpha 2b in advanced renal cell carcinoma: long-term results.

Clinical data have supported the combination of subcutaneous r-interleukin-2 (rIL-2) and r-interferon-alpha (rIFN-alpha) as a promising combination for advanced renal cell carcinoma (RCC), with a reduced toxicity. We evaluated the activity and safety of this outpatient immunotherapy and report on the clinical results and the long-term survival analysis. Objective responses was observed in 9 of 50 (18%) patients, 6 of whom (12%) achieved a complete response. Overall median survival is 12 months, six patients were surviving at a median follow-up of 24 months, and three (6%) are still progression-free.

Adult↗

High dose dexamethasone as first line therapy of multiple myeloma? A case report.

The authors describe a case of multiple myeloma in which a complete remission was obtained by treatment with high dose dexamethasone. This was the only therapy suitable for the patient because of heavy myelosuppression due to disease and to one course of conventional treatment with melphalan and prednisone. Further trials are needed to evaluate the usefulness and safety of this treatment as first line therapy, especially in the elderly, with pancytopenia and bad performance status.

Aged↗

[Temporal arteritis associated with hyperthyroidism and complicated by angina pectoris. A case report].

A case of temporal arteritis is described in a woman of 67, affected by non insulin dependent diabetes mellitus, associated with polymyalgia rheumatica and complicated by angina pectoris. Angina, which appeared a few days after diagnosis, was coupled with electrocardiographic alterations, which did not seem sensitive to nitrates but went back when steroid at full dose was added. The patient was also affected by Basedow disease, which was present during the whole course of the vasculitis. Furthermore islet-cell antibodies (ICA) were present. HLA typing showed the presence of the B8, DR3 haplotype. The patient died after 22 months from the diagnosis of digestive hemorrhage, probably favoured by extended cortisone therapy, while signs of arteritis were still evident.

Aged↗

Subcutaneous administration of interleukin 2 and interferon-alpha-2b in advanced renal cell carcinoma: a confirmatory study.

Recent clinical studies have suggested that the combination of subcutaneous recombinant human interleukin 2 (rIL-2) and interferon alpha (rIFN-alpha) is especially promising in advanced renal cell carcinoma. We assessed the safety, activity and toxicity of home therapy with these two agents in 50 patients. Each treatment cycle consisted of a 2 day pulse phase, with 9 x 10(6) IU m-2 of rIL-2 being given subcutaneously every 12 h, followed by a 6 week maintenance phase during which rIL-2 1.8 x 10(6) IU m-2 was administered subcutaneously every 12 h on days 1-5 and rIFN-alpha 2b 5 x 10(6) IU m-2 once a day on days 1, 3 and 5. Objective responses (CR+PR) occurred in 9/50 (18%) patients, six of whom (12%) achieved a complete response. Disease stabilisation was observed in 17 cases (34%) and 18 patients progressed during therapy. In the other six cases, treatment was interrupted early for toxicity or patient refusal. One patient died of myocardial infarction during the second cycle. The overall median survival was 12 months. Home therapy with subcutaneous rIL-2 + rIFN-alpha 2b proved to be active, feasible and moderately toxic, but serious adverse events can sometimes occur.

Adult↗

Carbohydrate-deficient transferrin in alcohol and nonalcohol abusers with liver disease.

Carbohydrate-deficient transferrin (CDT) has been demonstrated to be a marker of prolonged heavy alcohol consumption. We compared this marker with gamma-glutamyltranspeptidase (GGT) and mean corpuscular volume (MCV) in alcohol and nonalcohol abusers with liver disease. Our results confirm that the sensitivity of CDT in alcoholics is high, although lower than that of GGT and MCV; however, the specificity of CDT was higher than that of the other two markers. This finding supports the notion that CDT is only partially influenced by the presence of liver damage, whereas increases of GGT and MCV are greatly affected by several factors, including liver damage and drugs. Moreover, we observed that the sensitivity and the specificity of CDT were greater than those of GGT and MCV in younger drinkers.

Adult↗

POEMS syndrome in a female Italian patient. A case report.

POEMS syndrome is an uncommon association of polyneuropathy, organomegaly (liver, spleen, lymph nodes), endocrinopathy (hypogonadism primary hypothyroidism, diabetes mellitus, adrenal insufficiency), monoclonal gammopathy and skin changes; bone lesions (generally osteosclerotic, less frequently osteolytic or mixed) are nearly always present in this multisystem disease. We describe the first case of a female Italian patient with POEMS syndrome. Therapy with prednisone was of scant benefit and the patient died of cardiogenic shock some days after temporary pacemaker implantation, performed for recurrent episodes of bradycardia. From the beginning of steroid therapy she survived about fifteen months.

Anti-Inflammatory Agents↗

[Heart sarcoidosis. A case of mitral and ascending aorta involvement].

We describe a case of cardiac sarcoidosis manifested by arrhythmias, shock, chest pain, mitral valve prolapse and incompetence, aortic vascular involvement. Steroid therapy corrected shock and arrhythmias, but was unable to prevent the progression of the mitral valve insufficiency. Subsequently pulmonary and tricuspid valve incompetence were also observed.

Adult↗

[The role of HBV and HCV viruses in the pathogenesis of hepatic lesions in alcoholics].

Due to the high prevalence in the population of both viral hepatitis and alcoholism it is not uncommon to find patients with chronic hepatitis in whom both these stigmata are simultaneously present. In such cases, the risk of evolution to cirrhosis is thought to be greater. In this study was evaluated 104 alcoholic patients (50 of whom had hepatic biopsy), with or without antibodies (ab) to hepatitis C virus (HCV). In addition, we retrospectively examined 183 hepatic biopsies of alcoholic patients with or without hepatitis B virus (HBV markers). At the end of the study the following conclusions were drawn: (i) Contact with HBV is unlikely to effect either the histologic picture or the course of alcoholic liver disease. (ii) The incidence of ab to HCV is higher in more advanced stages of the disease. (iii) As regards biopsies of alcoholic patients, sometimes it was impossible to establish a relationship between piece-meal necrosis or portitis and viral markers of hepatitis; therefore, other factors may be synergic with alcohol (ie nutritional, immunologic, genetic factors, concomitant diseases, etc.). For each of these factors, the relative risk of cirrhotic evolution could be assessed by a multicenter survey with case-control design.

Adult↗

[Study of thyroid function in patients chronically treated with amiodarone].

The authors studied thyroid function by dosage of total T3 and T4, corresponding free portions, thyroid binding globulin (TBG), thyroid stimulating hormone (TSH) and reverse T3 (rT3) in 68 clinically euthyroid patients, treated with amiodarone, divided in two groups including 25 subjects treated for less than one month and 43 subjects in therapy for more than one month. The data obtained in the first group have been compared with the second one and with data obtained in a group of 40 healthy subjects. The statistical analysis of results showed a reduction of total T3 and free T3 and an increase of TSH, total T4, free T4 and rT3 in each of two groups of treated patients compared with control group, while there was no difference in comparison between the two treated group.

Amiodarone↗

[2 clinical cases of hypopotassemia during treatment with indapamide].

Indapamide, an antihypertensive drug with diuretic and vasodilative effect, causes a reduction in plasmatic potassium concentration that is generally moderate and not such as to cause damages. In the present article two cases are described that showed severe changes due to hypokalaemia resulting from treatment with indapamide.

Aged↗

[A case of thrombotic thrombocytopenic purpura].

Thrombocytopenic thrombotic purpura is a comparatively rare disease and little is known about its aetiopathogenesis. Once almost invariably negative, the prognosis has been changed by the introduction of plasmapheresis. A particularly complex clinical case is described and a number of conclusions are drawn from it: 1) there is no criterion for opting for any particular therapeutic approach; 2) evaluation of the clinical response is the only criterion for monitoring the effectiveness of ongoing treatment; 3) plasmapheresis is proposed as the treatment of choice; 4) vincristine is a useful alternative in the treatment of recalcitrant cases.

Adult↗

[A comparative evaluation of tumor markers (TPA and CEA) in various malignant neoplasms at an advanced stage].

Radioimmunology was used to measure serum levels of CEA (carcinoembryonic antigen) in 108 patients with a variety of different advanced malignant neoplasms and in a control group of 60 healthy subjects. TPA proved more sensitive as a tumour marker than CEA, since increased TPA was found in 76% of the cancer cases compared to 42% for CEA. No significant increase in diagnostic sensitivity was obtained by using both markers rather than PTA alone.

Antigens, Neoplasm↗