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Biomedical subjects

M Quaranta

Publications and source records attributed to M Quaranta.

At least 19 recordsLinked to original sources

[Low-vision rehabilitation of age-related macular degeneration patients with retrofoveal choroidal new-vessels treated with photodynamic therapy with verteporfin].

PURPOSE: To demonstrate the rehabilitation benefit and immediate optical magnification and electronic equipment advantage in an age-related macular degeneration population with retrofoveal choroidal new-vessels treated by photodynamic therapy using Visudyne. PATIENTS AND METHODS: Sixty seven consecutive patients with retrofoveal choroidal new-vessels treated by Photodynamic Therapy using Visudyne were referred to an orthoptist for low-vision rehabilitation. The criteria investigated for this study were: long distance visual acuity, reading ability, contrast sensitivity, (before treatment and during post-treatment examinations), and fixation localization and optical equipment model. RESULTS: This study showed and studied visual acuity variations, mostly for patients with good visual acuity at inclusion. Contrast sensitivity stayed more or less the same. Retinal fixation was foveolar most of the time (68.7%). Optical or electronic devices for low-vision patients are numerous and video systems were the most currently used among our population. 62.7% des patients had low-vision rehabilitation with optic aids. DISCUSSION AND CONCLUSION: This study threw light on patient optic aids which must be prescribed according to his needs and difficulties, without delay. This equipment will then be readapted at each stage of the patient evolution. PDT treatment gives an important role to low-vision rehabilitation associated with optic magnification aids.

Aged↗

Study on the frequency of protozoa and mycetes in the oral cavity.

The importance of a good knowledge in microbiology of the oral cavity is every day more and more indispensable in order to propose proper therapeutic treatments. In this study, the most frequent protozoa and mycetes present in the oral cavity are described, distinguishing the different species and their pathologies.

Animals↗

[Prismatic treatment in low-vision rehabilitation of patients with age-related macular degeneration].

PURPOSE: To evaluate visual improvement in an age-related macular degeneration (ARMD) population with bilateral central scotomas, after a 3- to 6-month prismatic treatment. PATIENTS AND METHODS: Prisms prescribed for both eyes were oriented according to eccentric fixation. Criteria were visual acuity (VA), reading ability, contrast sensitivity subjective visual comfort, prism wearing frequency and autonomy level. RESULTS: Thirty-one patients (23 women, 8 men) 65-95 years old (mean, 78 years) were selected. Mean long distance VA remained stable (0.249 at inclusion and 0.261 after prismatic treatment); long distance VA was unchanged for 51.6% of patients, improved by at least one line for 35.5% and decreased for 12.9%. Reading ability was slightly improved (average of 1 line), as was short distance VA (P14 at inclusion, P12 after prismatic treatment); reading ability was unchanged for 45.2% of patients, improved by at least one line for 38.7%, and decreased for 16.1%. Contrast sensitivity was improved for all levels: to 98% of contrasts (mean at inclusion 0.248 and 0.280 after prismatic treatment), to 50% of contrasts (0.214 at inclusion and 0.238 after prismatic treatment) and to 25% of contrasts (0.157 at inclusion and 0.185 after prismatic treatment). Visual comfort improved immediately after prismatic treatment for 90.3% of patients; 80.6% of patients wore their prismatic correction regularly. DISCUSSION AND CONCLUSION: Prismatic treatment in this population mainly improves contrast sensitivity and visual comfort. It provides patients with better initiation and stabilization of their eccentric viewing. Most of the time, prismatic treatment must be associated with low-vision rehabilitation.

Aged↗

[Prevalence of Helicobacter pylori in central serous chorioretinopathy and diffuse retinal epitheliopathy: a complementary study].

INTRODUCTION: In 2001, Mauget-Faysse et al. found a prevalence of Helicobacter pylori infection of 56.3% in 16 patients with central serous chorioretinopathy (CSC) and diffuse retinal epitheliopathy (DRE). This prevalence was twice that of the French population. This complementary study aimed to verify these results. PATIENTS: and method: Between 1996 and 2002, 78 patients living in the southeast of France with CSC/DRE were included in this study. H. pylori infection was assessed by the 13C-urea breath test. Diagnosis was confirmed by fundus biomicroscopy, fluorescein and ICG angiographies and retinal OCT scans (from 2002). Results were analyzed with the Chi2test. RESULTS: Out of 78 patients, there were 60 males (76.9%) and 18 females (23.1%), with a mean age of 53 years (range, 29-80 years); 27 had CSC (34.6%) and 51 had DRE (65.4%). H. pylori infection was detected as positive in 31 patients (39.7%) and negative in 47 (60.3%). Men were detected positive in 43.3% of cases, compared to women detected positive in only 27.8%. The difference in prevalence of H. pylori between the study population (39.7%) and the overall population of 58,419,710 inhabitants of France in 1999 (25.4%) was found statistically highly significant (p = 0.0036). DISCUSSION: and conclusion: These results may indicate a possible association between H. pylori infection and CSC/DRE manifestations. These data confirm the first results of the 2001 prospective pilot study and also show a higher prevalence of H. pylori infection in men than in women.

Adult↗

Serum vascular endothelial growth factor concentrations in hepatocellular cancer patients undergoing percutaneously radiofrequency thermal ablation.

Vascular endothelial growth factor (VEGF) is known to play a central role in tumour angiogenesis. However, no data have been published with regard to the clinical-biological significance of serum (S)-VEGF in hepatocellular cancer (HCC) patients undergoing to percutaneously radiofrequency thermal ablation (PRFA). The aim of this study was to assess the modifications of S-VEGF levels in a series of 28 HCC patients in hepatitis C virus-positive cirrhosis before and after PRFA, respectively. Samples of S were taken before, 2 and 5 days after PRFA respectively and VEGF levels were assessed by ELISA. No significant difference was found between pre- and post-VEGF levels (p= n.s.; by Wilcoxon test). We suggest that S-VEGF level is not useful as early predictive marker of response to PRFA.

Adult↗

Awareness of breast cancer genetics and interest in predictive genetic testing: a survey of a southern Italian population.

BACKGROUND: Before starting a molecular screening program for breast cancer risk and in order to develop ad hoc educational strategies, a population survey in Apulia, Italy, was performed to gather information on women's awareness of breast cancer genetics and their attitude toward genetic testing for breast cancer risk. PATIENTS AND METHODS: A consecutive series of 677 healthy women with or without a family history of breast cancer, who attended the outpatient clinics of Lega Italiana per la Lotta contro i Tumori in Bari, Italy, for preventive visits, were asked to complete a 20-item questionnaire on socio-demographics, risk perception, psychological characteristics and interest in genetic testing for breast cancer predisposing genes. RESULTS: Most women (77%) reported knowing something about the genetics of breast cancer; only 7% of the women were not interested at all in genetic testing. These figures were not significantly different for women with or without a family history of breast cancer. The two most frequently cited reasons for being interested in genetic testing, accounting for more than 50% of collected responses, were 'to learn about your children's risk' and 'to help advance research'. On multiple logistic regression analysis, only older age [odds ratio (OR) 1.9; 95% confidence interval (CI) 1.3-2.9] was associated with women's knowledge of genetic testing. Moreover, marital status (OR 4.0; 95% CI 1.1-14.6) and thinking of cancer (OR 2.2; 95% CI 1.0-4.7) independently predicted the interest in having genetic testing. CONCLUSIONS: Southern Italian women seem highly interested in genetic testing for breast cancer risk. However, their expectations mainly regard their concerns about their children or their altruistic need to help research rather than the idea of a direct clinical benefit. The great interest of the women in genetic testing probably reflects their inappropriate knowledge of the information that genetic testing can provide for breast cancer risk analysis.

Adult↗

The impact of body mass index and type 2 diabetes on breast cancer: current therapeutic measures of prevention.

Epidemiological data have suggested a possible relationship between obesity, diabetes mellitus and cancer risk, particularly breast cancer. We set out to investigate the effect of body mass index and diabetes mellitus on the presence of breast cancer in the Apulian population. We selected 1,663 women affected with primary breast cancer and 4,702 control patients. All patients with breast cancer underwent surgical excision of the tumor and their tumors were histologically confirmed. The prevalence of type 2 diabetes (8%) in the women affected by breast cancer was significantly higher than in the control group (5%) (p<0.05). The majority of the diabetic women affected by breast cancer had a BMI value >25, both in premenopause and in postmenopause. With respect to BMI, the non-diabetic patients with breast cancer in postmenopause showed the same pattern as the diabetic ones. Instead, among the women in premenopause a higher percentage (55%) of patients with a BMI <24.9 was found (p<0.01). In the Apulian population, the presence of both type 2 diabetes and elevated values of BMI (that is in a condition of hyperinsulinemia) were found to enhance the frequency of breast cancer.

Adult↗

Direct rapid diagnosis of rifampicin-resistant M. tuberculosis infection in clinical samples by line probe assay (INNO LiPA Rif-TB).

M. tuberculosis is one of the leading causes of death worldwide and Multi Drug Resistant Tuberculosis (MDR-TB) is associated with a high case-fatality rate. Rapid identification of resistant strains is crucial to institute prompt appropriate therapy, and prevent the development of further resistance and spreading of MDR strains. The INNO-LiPA Rif. TB is a commercial reverse hybridisation line probe assay designed for rapid detection of rpoB gene mutations in clinical isolates. We applied this test directly to 44 smear-positive and 45 smear-negative clinical specimens collected from patients suspected of active TB. The capability of this technique to correctly identify local MDR-TB strains was tested on 50 MDR strains isolated in Italy. Results of the test were compared to conventional antibiogram performed on isolated strains. The concordance rate of the LiPA test results on clinical specimens with those obtained with "in vitro" sensitivity was 100%. These results show that the LiPA test can be useful in rapid detection and prompt management of tuberculosis when MDR disease is suspected.

Antibiotics, Antitubercular↗

[Phototoxic drugs and age-related maculopathy].

OBJECTIVES: To disclose a correlation between age-related macular degeneration (AMD) and long-lasting treatments with potentially phototoxic drugs. DESIGN: Case-control study. METHODS: The case group was made up of 90 randomized patients, 65 years old or older, with documented AMD, examined in 1998 and 1999. The M/F sex ratio was 0.54, and mean age 79.9 years. The control group was randomized with age- and sex-matched subjects. In both groups, we noted long-lasting oral treatment for hypertension, diabetes mellitus, epilepsy, hyperuricemia, and psychiatric pathologies. All the study group patients underwent a complete ophthalmological examination for visual acuity, contrast sensitivity, biomicroscopy, fundus color and red-free photographs, fluorescein and ICG angiographies. RESULTS: When the study group was compared with the control group, neovascular AMD was positively associated with thiazide diuretics (p<0.001). When the study group was analyzed alone, intake of one or several antihypertensive drugs was positively associated with occult neovascularization and mild to moderate visual loss (p=0.009). Only thiazide diuretic intake was positively associated with severe bilateral loss of vision (p=0.041) and extensive choroidal neovascularization with major subretinal hemorrhages (p=0.022). CONCLUSIONS: These findings suggest that severe neovascular AMD is associated with long-term thiazide diuretic treatment.

Aged↗

Dental anomalies associated with genetic factors.

The article reviews the association between dental anomalies and genetic diseases. Knowledge of these hereditary diseases will enable the dentist to make a more extensive analysis of the families in which such diseases occur, and above all to evaluate more precisely the dental aspects that such conditions favour. This will lead to better management of diseases linked to malocclusion, congenital absence of teeth and anomalous development of dental tissues. Hereditary diseases are caused either by a single mutant gene, inherited from 1 parent and acting as dominant gene, or from a pair of mutant genes, inherited from both parents and acting recessively. Autosomal-dominant and autosomal-recessive inherited diseases are described, together with hereditary sex-linked conditions and those of multi-factorial origin. The purpose is to review such diseases so that the dentist can make an early diagnosis in clinical practice, check the predisposition toward such diseases and put in place preventive measures.

Chromosome Disorders↗

[Helicobacter pylori in central serous chorioretinopathy and diffuse retinal epitheliopathy. Results of the first prospective pilot study].

PURPOSE: Helicobacter pylori has been implicated in focal occlusive arterial diseases in young people. Central serous chorioretinopathy (CSC) and diffuse retinal epitheliopathy (DRE) being suspected vascular occlusive diseases of choriocapillaris, the purpose of this study was to determine the prevalence of H. pylori infection in patients with long-lasting (>6 months) CSC and/or DRE. METHODS: Sixteen consecutive patients living in southeastern France were included in this prospective pilot study. H. pylori infection was assessed by the (13)C-urea breath test, serology, as well as histology of gastric biopsy specimens in some cases. RESULTS: Evidence for H. pylori infection was detected in nine out of the 16 patients with active long-lasting CSC/DRE (56.3%). H. pylori-infected patients more frequently presented gastric pain (four of nine H. pylori-positive patients: 44%) than H. pylori-negative patients (one out of seven: 14%). Men were more frequently H. pylori-positive (seven men out of ten: 70%) than women (two women out of a total of six: 33%). DISCUSSION: When the prevalence of H. pylori infection (56.3%) was compared to the prevalence in a historical control population from southeastern France (27.5%), it was found to be significantly higher (P<0.05). CONCLUSION: These results may indicate a possible association between H. pylori infection and CSC/DRE manifestations. This new etiopathogenic hypothesis deserves to be confirmed in a national or international multicenter study because it could lead to a new therapeutic approach in CSC/DRE, i.e., Helicobacter pylori eradication.

Adult↗

Co-localization of multiple ErbB receptors in stratified epithelium of oral squamous cell carcinoma.

The expression of all four ErbB receptors was compared by immunohistochemistry, using receptor-specific polyclonal antisera, in 32 invasive, 11 in situ carcinomas, six benign lesions, and 22 samples of histologically normal mucosa adjacent to specimens of carcinoma originating from oral cavity epithelium. Among invasive and in situ carcinoma, EGFR expression was the most prevalent (in 29/32 and 8/11 cases, respectively) followed by ErbB2 (17/32 and 2/11) and ErbB4 (9/32 and 1/10), while ErbB3 was only detected in invasive tumours (12/32). Specific patterns included invasive tumours with expression of EGFR (8/32) or ErbB4 (1/32) alone, as well as different receptor combinations (EGFR+ErbB2, EGFR+ErbB4, EGFR+ErbB2+ErbB3, EGFR+ErbB2+ErbB4, and all four receptors). Simultaneous expression of three or four ErbB receptors correlated with tumour invasion (p=2.2x10(-4)) and localized in the intermediate epithelial cell layer of well and moderately differentiated tumours. No other significant correlation with clinico-pathological features was noticed. Some benign lesions and histologically normal mucosa adjacent to carcinomas showed weak immunostaining of EGFR (10/28), ErbB2 (4/28) or ErbB4 (3/28). By comparison, overexpression, as indicated by increased staining intensity, was observed in invasive tumours for EGFR (18/32), ErbB2 (8/32), ErbB4 (3/32), and ErbB3 (3/32). Statistical evaluation demonstrated a significant association of EGFR or ErbB2 overexpression with invasive carcinoma when compared with benign lesions and apparently normal epithelium (p=5.2x10(-7) and p=5x10(-3), respectively). Tumour-specific overexpression of ErbB receptors and their co-expression, most frequently involving EGFR and ErbB2, in the same cell layer of neoplastic epithelium, implicate receptor heterodimers in the pathogenesis of oral squamous carcinoma.

Carcinoma, Squamous Cell↗

Incidental retinal phototoxicity associated with ingestion of photosensitizing drugs.

BACKGROUND: to report on the possible correlation between incident retinal phototoxicity and the use of photosensitizing drugs. METHODS: four patients were examined because of scotomas and visual loss after an incidental exposure to a strong light source. One patient (two eyes) was exposed to standard camera flash; one patient (one eye) had a brief exposure to welding light; one patient (two eyes) underwent uncomplicated phacoemulsifications with intraocular lens implantation. The fourth patient had a severe retinal phototoxicity following a secondary intraocular lens implantation. All four patients underwent a thorough assessment including history of systemic drug use. These patients had ophthalmologic evaluation including: best corrected visual acuity (ETDRS charts), fundus examination, fluorescein and indocyanine green angiographies and were followed for 1 year. RESULTS: on presentation, the mean visual acuity was 7.5/20 (range: 20/400-20/20). Fundus examination disclosed yellow-gray sub-retinal lesions in all affected eyes. Early phase fluorescein angiography showed one or multiple hypofluorescent spots surrounded by a halo of hyperfluorescent window defect. In the late phase, some of these spots leaked the fluorescein dye. Indocyanine green angiography demonstrated hypofluorescent spots throughout with ill-defined borders of hyperfluorescence observed during the late stages. The common finding in these four patients was the fact that they were all taking one or more photosensitizing drugs (hydrochlorothiazide, furosemide, allopurinol, and benzodiazepines). Three of the patients had a full visual recovery a few months after the phototoxicity. The fourth patient remained with a visual acuity of 20/60 12 months after the light exposure. Despite the visual recovery, non-homogeneous retinal pigment epithelial disturbances persisted in all affected eyes. CONCLUSION: phototoxicity following incidental light exposure may occur in patients taking drugs of photosensitizing potential. Therefore, the thorough history of systemic drug ingestion should be obtained if patients have exposure to strong light sources.

Aged↗

Malignant mixed mullerian tumor of the ovary: report of four cases.

INTRODUCTION: Malignant mixed mullerian tumor (MMMT) of the ovary is an extremely rare gynaecologic neoplasm that represents 1% of the malignances of this organ. Stage I disease is rare because it is asymptomatic in early stage. We describe four cases. CASE REPORTS: In the Department of Obstetrics and Gynecology of the University of Bari four cases of MMMT of the ovary were diagnosed. Three patients were in stage IIIC and one of them was a homologous MMMT; the fourth patient was affected by a heterologous stage IV MMMT. All women were treated with surgery and chemotherapy. Two patients are alive 14 and 12 months after diagnosis. The other two died after 37 months and one month, respectively. CONCLUSIONS: The malignant mixed mullerian tumor (MMMT) of the ovary is a particularly aggressive tumor, especially in advanced stages. The survival rate is very low in spite of surgery, chemotherapy and radiotherapy. The optimal treatment for this neoplasm is unknown because of its rarity. Our experience, when considering survival, seems to confirm the use of cisplatin and ifosfamide and to give new horizons to taxol.

Combined Modality Therapy↗

[New therapies for the treatment of age-related macular degeneration].

Age-related macular degeneration has a natural progression from the precursors (the drusen) towards atrophic or neovascular complications. Choroidal neovascularization is undoubtedly the aspect of the disease that benefits most from new therapeutical approaches. Destructive photocoagulation based on fluorescein angiography has demonstrated since 20 years its efficiency on choroidal neovascularization. The same approach based on indocyanine green (ICG) angiography would increase the number of patients available to therapy. Very recently photodynamic therapy has demonstrated its efficiency to stabilize visual acuity at least at two years in patients with choroidal new vessels predominantly well defined. Other treatment developments are considered, such as refinement of photocoagulation techniques or of surgery. Until now, none has demonstrated its efficiency although they raise justified hopes. The future approaches rely upon the progress of the research both in physiopathology of the disease and on the angiogenic process requiring a constant interaction with all thematics of research. Finally, palliative treatments will be required before heading up to a preventive treatment.

Aged↗

Multiple choroidal neovascularizations at the border of a myopic posterior macular staphyloma.

BACKGROUND: In pathologic myopia, choroidal neovascularization (CNV) usually occurs in macular region and at the center of the macular staphyloma. CNV has been reported to occur at the borders of an inferior posterior staphyloma in the tilted disc syndrome. We present a case of multiple simultaneous CNVs located at the borders of a myopic macular staphyloma. METHODS: The clinical and angiographic records of a myopic patient who presented several areas of choroidal neovascularization were reviewed. RESULTS: On fundus examination, four gray lesions surrounded by subretinal hemorrhages and covered by a large serous retinal detachment were observed at the borders of a posterior staphyloma. Fluorescein angiography revealed that these four lesions were CNVs extending from the borders of the staphyloma to the macular region. As measured by B-scan ultrasonography, the staphyloma was 4 mm deep. CONCLUSION: This case supports the hypothesis that the borders of staphylomas are sites at risk for the development of CNV in pathologic myopia.

Choroidal Neovascularization↗

Serum progesterone, estradiol-17beta and testosterone at the time of relapse in patients with epithelial ovarian cancer.

Raised levels of steroid hormones may be detected in women with ovarian cancer at the time of diagnosis. The goal of this study was to investigate the levels of progesterone, testosterone and estradiol-17beta in patients with relapsed epithelial ovarian cancer. We studied 52 patients with a histologic diagnosis of ovarian cancer; 46 of 52 patients were affected by epithelial tumors, two patients had sexcord-stromal tumors, one patient had a germ cell tumor and three patients had a metastatic cancer from the bowel. Of 34 patients with disease relapse, none had elevated serum testosterone levels (>1 ng/ml), one patient (2.9%) had an elevated serum progesterone level (>1.24 ng/ml) and two patients (5.9%) had elevated estradiol-17beta levels (>28 pg/ml). The relationship between the three hormone levels at the time of initial treatment and at relapse was tested using the Students's t-test. At the time of initial treatment venous concentrations of progesterone, estradiol-17beta and testosterone were higher and statistically different (p<0.05) from samples obtained at the time of relapse in the same patients. No significant differences were found between patients studied at the time of relapse and the control group. Measurement of progesterone, estradiol-17beta and testosterone is not helpful in detecting disease relapse in patients with epithelial ovarian cancer.

Adult↗