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Biomedical subjects

M Sorrentino

Publications and source records attributed to M Sorrentino.

At least 19 recordsLinked to original sources
PubMed2004

Risedronate and pamidronate treatment in the clinical management of patients with severe Paget's disease of bone and acquired resistance to bisphosphonates.

The aim of this study was to evaluate the efficacy and safety of risedronate and pamidronate in 30 patients (mean age = 57.86 +/- 8.90 years) with severe Paget's disease of bone (PDB), showing acquired resistance to intravenous (IV) clodronate treatment. Fifteen patients were treated with oral risedronate (30 mg/day for 8 weeks). Treatment was repeated in patients without evidence of PDB remission [total alkaline phosphatase (tALP) serum levels in the normal range] at day 120. Fifteen patients were treated with IV pamidronate (30 mg/day for 3 days). Pamidronate treatment (60 mg/day for 3 days) was repeated in patients without evidence of PDB remission at day 120. At day 60, a significant decrease in tALP serum levels was obtained in all pagetic patients. At day 360, 13 (86.6%) patients treated with risedronate achieved PDB remission, 9 patients during the initial treatment and 4 after retreatment. Two patients showed a significant decrease in tALP serum levels without clinical remission after two risedronate treatments. At the same time, 12 (80%) patients treated with pamidronate achieved PDB remission, 6 patients during the first treatment and 6 after retreatment. Three patients showed a significant decrease in tALP serum levels but no clinical remission after two pamidronate courses. Two of these patients showed a relapse during the study. The incidence of minor side effects and transient hyperparathyroidism related to bisphosphonate treatment was significantly lower after risedronate therapy. In patients with resistant PDB, oral risedronate therapy has comparable efficacy to IV pamidronate with a lower incidence of treatment-related side effects.

Administration, Oral↗
PubMed2001

Physician-performed point-of-care echocardiography using a laptop platform compared with physical examination in the cardiovascular patient.

OBJECTIVES: The purpose of this study was to compare the results of physical examinations (PEs) performed by board-certified cardiologists with the results of point-of-care (POC) echocardiography in a group of patients with cardiovascular disease. BACKGROUND: Although cardiovascular PE is crucial in the evaluation of patients with suspected heart disease, the skills required to diagnose abnormal cardiovascular findings have been declining. Echocardiography is a powerful noninvasive cardiovascular diagnostic tool; however, echocardiographic evaluation of patients is not performed at the time of patient encounter (POC echocardiography), beacuse current platforms are cumbersome and expensive for individual physician use. The development of miniaturized echocardiographic equipment has the potential to overcome some of these limitations. METHODS: Thirty-six subjects had a complete cardiovascular examination by four board-certified cardiologists. The physicians subsequently imaged each patient using a miniaturized echocardiographic platform. The yield of PE and POC echocardiography were compared using a complete echocardiographic study as the gold standard, performed on an upper-end platform. RESULTS: Cardiac examination failed to detect 59% of the overall cardiovascular findings. Physician-performed echocardiography with the prototype device missed 29% of the overall cardiovascular pathology. When considering only the major cardiovascular findings, the cardiologists' PEs still failed to correctly detect 43%. Point-of-care echocardiography reduced this to 21% without significant interphysician variation. CONCLUSIONS: Point-of-care echocardiography using a miniaturized echocardiographic platform substantially improved the detection of important cardiovascular pathology compared with PE. Use of this device by a cardiovascular specialist with training in echocardiography as a routine adjunct to PE appears to be useful.

Echocardiography↗
PubMed2000

Criteria predicting the absence of spermatozoa in the Sertoli cell-only syndrome can be used to improve success rates of sperm retrieval.

In patients with non-obstructive azoospermia, testicular sperm extraction (TESE) is a method of choice to recover spermatozoa as a male therapeutic approach in intracytoplasmic sperm injection (ICSI) programmes. However, the efficacy of TESE in this indication is burdened by a frequent failure of sperm recovery, which renders useless both the invasive testicular intervention and ovarian stimulation of the patient's spouse. One of the most frequent pathological pictures characterizing complete absence of spermatozoa is germinal aplasia (Sertoli cell- only syndrome or SCOS). Two different histological patterns of SCOS have been already described during the past five decades. These two patterns can be characterized as the congenital (pure) and the secondary (mixed) forms. Both patterns, with different prognosis to retrieve spermatozoa by therapeutic testicular biopsy, are frequently confused when TESE is performed during ICSI programmes. Useful criteria to predict the absence of spermatozoa can be obtained by a definite recognition of the two typical histological patterns during the diagnostic testicular biopsy. The diagnosis of congenital or acquired SCOS can be refined by endocrine, chemical, immunohistochemical and molecular biology aids. Reduction of both sperm retrieval failure and unnecessary ovarian stimulation can be achieved by combination of these methods.

Forecasting↗
PubMed2000

Effectiveness of palivizumab: evaluation of outcomes from the 1998 to 1999 respiratory syncytial virus season. The Palivizumab Outcomes Study Group.

BACKGROUND: Respiratory syncytial virus (RSV) remains a significant cause of morbidity, especially in premature infants and immunocompromised children, resulting in approximately 100 000 hospitalizations annually. A study was performed to evaluate the outcomes of those given palivizumab (Synagis; MedImmune, Inc., Gaithersburg, MD) during the 1998 to 1999 RSV season, its first season in general use. METHODS: A retrospective chart review of 1839 patients from 9 United States sites was conducted, representing all patients given palivizumab at each site. Those evaluated were to have a gestational age of < or =35 weeks, were to be <2 years old at their first injection and were to have received at least one dose of palivizumab (humanized monoclonal antibody against RSV) between September, 1998, and May, 1999. Gestational age, comorbidities, frequency of injections, hospitalizations and length of hospital stays were assessed. RESULTS: The antigen- or culture-positive RSV hospitalization rates for those given prophylaxis were 2.3% (42 of 1839) overall, 16/399 (4.0%) with chronic lung disease of infancy and 26 of 1227 (2.1%) born prematurely without chronic lung disease of infancy. Twenty-six patients had a gestational age of >35 weeks and were included in the analysis. CONCLUSIONS: Only 2.3% of children receiving palivizumab prophylaxis were hospitalized with RSV lower respiratory infection. This compares favorably with the rates observed in the pivotal trial (IMpact-RSV trial in 1996 to 1997), in which prophylaxis reduced hospitalization from 10.6% in the placebo group to 4.8% in those children receiving prophylaxis.

Antibodies, Monoclonal↗
PubMed1999

Mechanism of neurogenesis during the embryonic development of a tunicate.

Ascidian and vertebrate nervous systems share basic characteristics, such as their origin from a neural plate, a tripartite regionalization of the brain, and the expression of similar genes during development. In ascidians, the larval chordate-like nervous system regresses during metamorphosis, and the adult's neural complex, composed of the cerebral ganglion and the associated neural gland is formed. Classically, the homology of the neural gland with the vertebrate hypophysis has long been debated. We show that in the colonial ascidian Botryllus schlosseri, the primordium of the neural complex consists of the ectodermal neurohypophysial duct, which forms from the left side of the anterior end of the embryonal neural tube. The duct contacts and fuses with the ciliated duct rudiment, a pharyngeal dorsal evagination whose cells exhibit ectodermic markers being covered by a tunic. The neurohypophysial duct then differentiates into the neural gland rudiment whereas its ventral wall begins to proliferate pioneer nerve cells which migrate and converge to make up the cerebral ganglion. The most posterior part of the neural gland differentiates into the dorsal organ, homologous to the dorsal strand. Neurogenetic mechanisms in embryogenesis and vegetative reproduction of B. schlosseri are compared, and the possible homology of the neurohypophysial duct with the olfactory/adenohypophysial/hypothalamic placodes of vertebrates is discussed. In particular, the evidence that neurohypophysial duct cells are able to delaminate and migrate as neuronal cells suggests that the common ancestor of all chordates possessed the precursor of vertebrate neural crest/placode cells.

Animals↗
PubMed1997

[Laparoscopic versus laparotomic adrenalectomy: preliminary experiences].

The authors report their experience about laparoscopic surgery in the treatment of adrenal tumours. Three laparoscopic right adrenalectomies were performed. From a comparison with five open adrenalectomies, microinvasive surgery is more advantageous than traditional management: recovery is earlier, incisions are smaller, post-operative discomfort is less, physiologic functions recover in a short time, return to full professional activity in one week.

Adenoma↗
PubMed1996

[Solid papillary tumor of the pancreas. A clinical case].

The solid papillary tumor of the pancreas is a relative rare neoplasm that often is unknown because of its diagnostic difficulties. It is frequent in young women. It has no typical clinical signs, sometimes produces abdominal mass, sometimes is found casually during investigations for other diseases. Instead the prognosis of this tumor is more typical: long-term survival is good. The natural history of the solid papillary is the same as neoplasm with a low malignancy potential. For this reason, it's important to make up a differential diagnosis between it and the other pancreatic tumors. Unlike the other malignancies, surgical conservative therapy is enough without making great demolitions of the pancreas. Lumpectomy gives a complete cure, decreasing surgical risk and dangerous functional complications. In the present paper, a case of solid papillary tumour of the pancreas is reported. It was diagnosed in a young woman and treated with simple lumpectomy. She is alive and disease free.

Adult↗
PubMed1996

[Hemoperitoneum caused by lesions to the appendix epiploica. An unusual complication of colonoscopy].

A rare case of hemoperitoneum in a young man who performed a diagnostic colonoscopy is reported. The rupture of an epiploic appendix among rectum and colon sigma caused massive bleeding into the peritoneum cavity followed by haemorrhagic shock. Diagnostic and therapeutic colonoscopy has a low rate of morbility; perforation and bleeding are the most common events; hemoperitoneum following colonscopy is usually due to spleen rupture. Among other complications, ileal and cecal volvolus, incarceration of hernias and subcutaneous emphysema are reported.

Adult↗
PubMed1994

The effects of intraperitoneal local anesthetic on analgesic requirements and endocrine response after laparoscopic cholecystectomy: a randomized double-blind controlled study.

This randomized double-blind placebo-controlled study was designed to evaluate the effects on postoperative pain of the local anesthetic, 0.5% bupivacaine with epinephrine, sprayed hepatodiaphragmatically under the surgeon's direct view during laparoscopic cholecystectomy. Metabolic endocrine responses to surgery (glucose and cortisol) and nonsteroidal anti-inflammatory drug requirements were investigated, as well as the presence of nausea, vomiting, and sweating. Local anesthetics or placebo solutions were given as follows. Immediately following the creation of a pneumoperitoneum, surgeons sprayed the first 20 mL of solution (S1), and an additional 20 mL of solution (S2) was sprayed at the end of the operation. Patients were classified into three groups (14 patients per group). Group A received 20 mL of saline during both S1 and S2, group B received 20 mL of saline during S1 and 20 mL of bupivacaine during S2, and group C received 20 mL of bupivacaine during both S1 and S2. The degree of postoperative pain was assessed using the visual analogue scale (VAS) and the verbal rating scale (VRS) on arrival in the recovery room and subsequently at time intervals of 4 h, 8 h, 12 h, and 24 h. The results of this study indicate a significant decrease of postoperative pain in patients treated with local anesthetic. VAS and VRS pain scores, as well as respiratory rate and analgesic requirements, were significantly lower in group C. The postoperative plasma cortisol level in group C was significantly lower than in groups A and B.

Adult↗
PubMed1992

Techniques for IABP timing, use--and discontinuance. Counterpulsation can reduce ischemia and improve hemodynamics.

By restoring the balance between myocardial oxygen supply and demand, intra-aortic balloon counterpulsation can aid the ischemic or failing left ventricle. Rapid inflation and deflation of the balloon reduces afterload and improves coronary perfusion. Timing of inflation and deflation is adjusted according to the arterial pressure waveform. The balloon should inflate just after the aortic valve closes and deflate just before the aortic valve opens; early or late balloon inflation or deflation blunts the therapeutic effects. Discontinue the IABP support gradually; monitor the patient frequently for any signs of hemodynamic compromise, redevelopment of ischemic chest pain, or electrocardiographic changes.

Coronary Circulation↗
PubMed1991

Patent foramen ovale associated with platypnea and orthodeoxia.

A case of positionally symptomatic right-to-left shunting across a patent foramen ovale with both platypnea and orthodeoxia despite normal pulmonary arterial pressures and normal right ventricular function is documented. When the patient was in a supine position, the calculated right-to-left shunt was 12.8 percent, and when seated 25 percent. Surgical closure of the patent foramen ovale relieved the symptoms and positionally induced shunting. The prevalence and associations of permanent and intermittent patency of the foramen ovale are discussed. It is recommended that those at risk of thromboembolism be screened for patency by contrast ultrasound or color flow techniques. If present, surgical closure needs to be considered to prevent paradoximal embolism and stroke.

Aged↗
PubMed1991

[Polyunsaturated fatty acids and atherosclerosis].

The major aspects of the antithrombogenic and antiatherogenic effects of polyunsaturated fatty acids (PUFA) have been outlined. After briefly relating on the biochemistry, the essentiality concept has been defined. Some of the many evidences of their effects both on men and animals have been reported. Eicosanoid metabolism is discussed and eicosanoid compounds derived from omega-6 and omega-3 fatty acids are compared with regard to their effects concerning atherosclerosis. Considerations about the correct amount of PUFA are reported as tentative strategies for a cardiovascular protective diet.

Animals↗
PubMed1984

Triglyceride and cholesterol levels during pregnancy in type I, type II and gestational diabetic women.

Longitudinal observation of fasting triglyceride and total cholesterol levels throughout gestation in 16 type I, 13 type II, 11 GDM and 14 normal pregnant women was made. There were no significant differences between the groups examined, except the higher levels of triglycerides in GDM group during the second trimester (p less than 0.05). Probably these results are due to "good" metabolic compensation, achieved in diabetic pregnant women.

Adult↗
PubMed1984

Cellular compartmentalization of carbonic anhydrase-C and glutamine synthetase in developing and mature mouse neural retina.

Using immunohistochemical methods, we have determined the cellular localization of the enzymes, glutamine synthetase (GS) and carbonic anhydrase-C (CA-C), in mouse neural retina during development and in the mature tissue. GS is always confined exclusively to the Müller glial cells; it is first detectable in these cells post-natally on about day 12, i.e. shortly before the eyes open. Also CA-C in the mature retina is localized in the Müller cells but, in addition, it is found in certain amacrine neurons as well. CA-C is first detectable in the retina already several days before birth; at that time it is found in most of the cells, with the exception of the emerging ganglion cells. However, with advancing differentiation, CA-C becomes progressively restricted to Müller cells and to a sub-category of amacrine neurons, and persists only in these cells in the mature retina. The present results extend our previous studies on these enzymes in the avian retina; they demonstrate that also in mammalian retina, different temporal and cellular patterns of GS and CA-C expression and localization earmark distinct phases of structural and functional differentiation of the retina. The striking developmental changes in the cellular localization of CA-C, and the finding of this enzyme in certain amacrine neurons as well as in Müller cells, raise questions about the role of CA-C in the retina, and about mechanisms regulating its expression in specific cell types.

Animals↗