PubMed Health⌕ Search

Biomedical subjects

N Rizzo

Publications and source records attributed to N Rizzo.

At least 37 records · Page 2Linked to original sources

Neurological involvement in primary Sjögren's syndrome: clinical and instrumental evaluation in a cohort of Italian patients.

To evaluate nervous system involvement in a cohort of Italian patients with primary Sjögren's syndrome (pSS), 87 unselected patients (83 female, and four male) observed consecutively at our institution over a period of 5 years were screened by clinical and instrumental (MRI, SPECT, electrophysiological testing, CSF analysis) investigations for peripheral and central neurological abnormalities. Seroimmunological parameters and extraglandular features other than neurological manifestations were also evaluated. Seven patients had central nervous system (CNS) disease (8%), mostly non-focal dysfunction, and 12 had peripheral nervous system (PNS) disease (13.8%), mostly mild or severe sensory or sensory-motor polyneuropathies. One patient had concomitant CNS and PNS involvement. Compared with CNS disease, PNS involvement occurred in older patients (> 50 years), independent of the disease duration. Patients with and without neurological abnormalities did not differ for seroimmunological parameters (including antiphospholipid antibodies) or extraglandular manifestations. From a statistical point of view, the only relevant finding was the detection of a slight increase in serum IgA and IgM levels (p < 0.05) in patients with an intact nervous system. Neurological involvement in pSS, be it central or peripheral, is not a rare finding. A careful clinical neurological evaluation, combined with a multiplicity of instrumental investigations, is recommended in the global assessment of pSS patients.

Adult↗

Pattern analysis for ultrasound anomalies in fetuses with normal karyotype.

Two hundred cases of double or multiple anomalies (up to five in the same fetus) out of 828 karyotypically normal fetuses with at least one ultrasound finding were enrolled in the present study. One hundred and sixty patterns belonging to 200 fetuses were found. Then, we included in the final analysis only those double or triple patterns of anomalies with frequency more then 1. Thus, 123 cases and 83 patterns were analyzed. A double pattern was intended as any combination of ultrasound findings present in the same fetus. Exact Chi-square test was used to evaluate the specificity of the association of the most frequent patterns. The association of patterns was expressed as ratio between observed and expected frequency (O/E) ratio. Pattern analysis was used as statistical tool to calculate the number of possible associations of ultrasound finding. Anomalies of fluid distribution, as well as Central Nervous System malformations, and facial malformations were among the most significant associations. Among the triple patterns, Cleft Lip + Cleft Palate + Holoprosencephaly showed the highest degree of association. Antenatal diagnosis of ultrasound finding can benefits by considering the present results.

Abnormalities, Multiple↗

Amniotic fluid volume and onset of labor in physiological pregnancy.

We measure, by means of ultrasound, the amniotic fluid volume (expressed as maximal vertical pocket or MVP) in 646 normal pregnancies at the 39th gestational week. Our aim is to evaluate the possible correlation between MVP and onset of the labor. In a 2-week follow-up, the onset of the labor is considered the "event" variable in a time-dependent statistical analysis. Univariate analysis (Kaplan-Meier algorithm) describes a different trend in predicting the onset of labor when a stratification of MVP < 50 and > or = 50 mm was performed (chi2 = 7.91 p < 0.0049 with 1 df, Breslow-Gehan test). The first category was comprised of 496 fetuses with a median (min-max) MVP of 39 mm (25-49), the second category of 150 fetuses with a MVP of 57 mm (50-100). The results suggest that lower levels of MVP are associated to a higher percentage of the onset of labor. Furthermore, in our measurement, performed at the 39th gestational week, the correlation with the events is higher within the 40th gestational week. In fact, at 7 days from the amniotic fluid measurement, the onset of labor and the subsequent delivery is observed in 80.65 and 73.00% of the cases when they are stratified according to MVP < 50 and > or = 50 mm. At the end of the follow-up, instead, the percentage of "events" is similar, 88.10 and 86.67%, respectively. Adjustment for covariates (Cox analysis), as well as maternal age, neonatal weight, and obstetrics history, show an odds ratio (95% C.I.) of 2.08 (1.61-2.69) for MVP, using the above cutoff level. In physiological pregnancy, lower levels of amniotic fluid at term correlated to a higher probability of the onset of labor.

Adolescent↗

Alpha-1-antichymotrypsin immunoreactivity in papillary carcinoma of the thyroid gland.

AIM: Papillary thyroid carcinoma (PTC) is the most common malignant tumour of the thyroid gland. The immunohistochemical profile of PTC is characterized by immunoreactivity of tumour cells for cytokeratins, thyroglobulin, vimentin, EMA and S100 protein. Recently, the presence of a serum protease inhibitor, alpha-1-antitrypsin (A1AT), has been demonstrated in tumour cells of PTC. The aim of our study was to test immunoreactivity of PTC for another inhibitor of proteases, alpha-1-antichymotrypsin (A1ACT). METHODS AND RESULTS: Serial paraffin sections of nine consecutive cases of PTC were tested with anti-A1AT and anti-A1ACT antibodies. No immunoreactivity for A1AT and A1ACT was found in the normal thyroid tissue surrounding each tumour. In seven out of nine cases, tumour cells of PTC showed cytoplasmic immunoreactivity for A1ACT. In two cases, A1ACT was detected even in the nuclei. Immunoreactivity for A1AT was found only in three cases. Two cases of PTC showed no staining for both A1ACT and A1AT. No significant correlation of A1ACT staining was found with various prognostic indices (age of patients, histological pattern, tumour size, presence of regional lymph node metastases). The two cases showing a lack of staining for both A1ACT and A1AT showed a more aggressive clinical behaviour. CONCLUSIONS: Our preliminary study shows that A1ACT is expressed by tumour cells in a large proportion of papillary carcinomas of the thyroid gland. Its significance remains, to the best of our knowledge, still unknown. The observation of a more aggressive behaviour in the two cases characterized by the absence of immunoreactivity for both A1ACT and A1AT suggests that the presence or absence of protease inhibitors could play a role in controlling tumour progression in PTC.

Adolescent↗

Telemedicine and medical care to ships without a doctor on board.

Providing medical assistance to ships at sea was probably one of the first practical applications of telemedicine. At present, about 200 different organizations worldwide give medical assistance to ships without a doctor on board. The activity of the Foundation Centro Internazionale Radio Medico (CIRM), which probably has the largest experience in the world of telemedicine applied to seafarers, is reviewed. Medical assistance to seafarers has not improved in parallel with advances in medicine and telecommunications. Possible initiatives for improving teledelivery of medical assistance to seafarers are discussed.

Humans↗

Impact of long-term ethanol consumption on CYP1A2 activity.

Ethanol is a well-known inducer of CYP2E1; whether or not it is an inducer of other cytochromes has not been investigated systematically. The aim of our study was to evaluate the impact of ethanol consumption on the activity of CYP1A2, which has been shown to be influenced by drugs (inhibited or induced). We evaluated CYP1A2 activity by the ratio of the molar urinary concentrations of the three end products of paraxanthine demethylation of caffeine to the molar concentration of a paraxanthine 8-hydroxylation product. This urinary metabolite ratio has previously been shown to correlate with caffeine clearance. The caffeine metabolites were measured in urine collected during the 3 hours after oral administration of 200 mg caffeine. The caffeine test was performed in 12 smokers (> 25 cigarettes/day) and 12 nonsmokers, all of whom were alcoholic inpatients (daily intake > 100 mg absolute ethanol), within the first 3 days of their hospital stay and after 14 days of abstinence from ethanol. In alcoholic patients who were smokers the molar urinary concentration ratio was 3.14 +/- 0.97 before withdrawal and 4.01 +/- 0.92 after 14 days of abstinence from ethanol. In contrast, in alcoholic patients who were nonsmokers it was 2.62 +/- 0.95 and 2.18 +/- 0.96 before and after withdrawal, respectively. In volunteers who were smokers the molar urinary concentration ratio was 5.02 +/- 1.51, whereas in volunteers who were nonsmokers it was 3.22 +/- 1.46. Our results confirm the well-known induction of CYP1A2 activity by tobacco smoking and show that this induction is masked by long-term ethanol consumption.

Adult↗

Telemedicine for airline passengers, seafarers and islanders.

Airline passengers, seafarers and islanders are three different examples of people who can benefit from telemedicine. However, the peculiar characteristics of each group require different applications. In 60 years of activity, the CIRM has assisted more than 37,000 patients. In the 10 years from 1986 to 1996 the Centre provided radio medical assistance to 7647 patients, of whom 6981 (91.3%) were sailors, 642 (8.4%) were people living in isolated areas (small italian islands) with few medical facilities, while only 24 patients (0.3%) were airline passengers. In the same period, the telecommunication service received or transmitted almost 80,000 medical messages.

Aircraft↗

Distribution of abnormal karyotypes among malformed fetuses detected by ultrasound throughout gestation.

A karyotype was obtained from 755 fetuses with structural anomalies detected by sonography between 13 and 40 weeks' gestation. Gestational age was found to have no influence on the prevalence of chromosomal aberrations. The incidence in the second and third trimesters of pregnancy was 15.7 and 17.5 per cent, respectively. The contribution of the different malformations to such proportions did, however, change throughout gestation. Cystic hygroma was by far predominant in the early second trimester, cardiac defects in the late second trimester, and duodenal atresia in late pregnancy. Our findings confirm that karyotyping of malformed fetuses is highly advisable; the importance of chromosomal investigation is not dependent on the gestational age at detection of the structural defect as the likelihood of finding a chromosomal anomaly during the second and third trimesters is quite similar. Spontaneous intrauterine selection of chromosomally abnormal fetuses is most likely counterbalanced by the limited accuracy of prenatal ultrasound in recognizing many fetal anomalies early in pregnancy.

Chromosome Aberrations↗

Omeprazole and lansoprazole are not inducers of cytochrome P4501A2 under conventional therapeutic conditions.

OBJECTIVES: Claims that substituted benzimidazole molecules induce cytochromes P4501A2 are still controversial. This study was undertaken to evaluate their inducing potency under conventional therapeutic conditions. METHODS: Twelve healthy non-smoking young volunteers were given 20 mg omeprazole or 30 mg lansoprazole daily, in random order, for 2 weeks, separated by a 3 week wash-out period. We evaluated the CYP1A2 activity by the ratio of the molar urinary concentrations (CUM ratio) of the three end products of the paraxanthine demethylation of caffeine over the molar concentration of a paraxanthine 8-hydroxylation product. RESULTS: This urinary metabolite ratio has previously been shown to be correlated with caffeine clearance. There was slight but non-significant enhancement of the CUM ratio after 2 weeks of treatment with omeprazole (3.62 (1.58) on Day 15 vs 3.09 (1.43) on Day 1), and after lansoprazole (4.26 (2.3) vs 3.65 (2.36)). Similarly, one week of treatment did not significantly alter the CUM ratio after omeprazole or lansoprazole (3.11 (1.58) and 3.28 (1.59), respectively on Day 8). CONCLUSION: The results show that both omeprazole and lansoprazole in the daily recommended therapeutic doses of 20 mg and 30 mg, respectively, have no influence on the metabolism of caffeine, and therefore no influence on cytochrome CYP1A2 activity.

2-Pyridinylmethylsulfinylbenzimidazoles↗

Sonography of pregnancies with first-trimester bleeding and a viable embryo: a study of prognostic indicators by logistic regression analysis.

The objective of our study was to investigate the relationship between sonographic findings and the occurrence of abortion in pregnancies complicated by first-trimester bleeding in which fetal cardiac activity was documented upon admission. A prospective study of transvaginal sonography was performed in 270 pregnant patients with bleeding between 5 and 12 weeks' gestation. The study group included 149 cases in which a singleton fetus with cardiac activity was initially documented. The outcome variable was pregnancy loss prior to 20 weeks. The influence of sonographic findings on admission was studied by univariate analysis and logistic regression. The prevalence of abortion was 23/149 (15%). A significant relationship (p < 0.05) was found between the occurrence of abortion and the following: fetal bradycardia (heart rate less than -1.2 SD from the mean), a discrepancy between the diameter of the gestational sac and crown-rump length less than -0.5 SD from the mean, and a discrepancy between menstrual and sonographic age of more than 1 week. According to the logistic regression equation that was obtained, the probability of abortion in first-trimester bleeding with documented fetal cardiac activity upon admission varied between a minimum of 6% when none of the above risk factors were present and a maximum of 84% when all were present. The presence of any of the above factors identified 84% of all subsequent abortions.

Abortion, Spontaneous↗

Population pharmacokinetic study of teicoplanin in severely neutropenic patients.

The teicoplanin pharmacokinetics (PK) of 30 febrile and severely neutropenic patients (polymorphonuclear count, < 500/mm3) with hematologic malignancies were compared with those determined for five healthy volunteers (HV). Neutropenic patients were given piperacillin combined with amikacin, and teicoplanin was added to the regimen the day fever developed in patients suspected of having a staphylococcal infection or 48 h later. Teicoplanin was given intravenously at a dosage of 6 mg/kg of body weight at 0, 12, and 24 h and once a day thereafter. Five to eleven blood samples per patient were collected. Teicoplanin concentrations were measured by liquid chromatography. A bicompartmental model was fitted to the data by a nonlinear mixed-effect-model approach. Multiple-linear regression analysis was applied in an attempt to correlate PK parameters to nine covariates. The mean trough concentrations of teicoplanin 48 h after the onset of treatment and 24 h after the last injection (last trough) +/- standard deviations were 8.8 +/- 4.1 and 17.5 +/- 13.5 mg/liter, respectively. A significant increase was noted in the mean rate of elimination clearance of teicoplanin in neutropenic patients compared with that of HV (0.86 versus 0.73 liter/h, P = 0.002), as was the case with rates of distribution clearance (5.89 versus 4.94 liter/h, P = 0.002); the mean half-life of distribution was significantly shorter in patients than in HV (0.43 versus 0.61 h, P = 0.002). In contrast, the volumes of the central compartment (ca. 5.8 liters for both groups), the volumes of distribution at steady state (HV, 37.6 liters; patients, 55.9 liters), and the elimination half-lives (HV, 39.6 h; patients, 52.7 h) were not significantly different between HV and neutropenic patients. Interindividual variabilities of rates of clearance (coefficient of variation [CV], 43%) and elimination half-lives (CV, 56%) were mainly explained by the variabilities among rates of creatinine clearance. Interindividual variabilities of the volumes of the central compartment (CV, 33%) and the volumes of distribution at steady state (CV = 51%) were correlated to interindividual variabilities among numbers of leukocytes and the ages of patients, respectively. On the basis of the population PK model of teicoplanin, simulations were made to optimize the dosing schedule. A supplemental 6 mg/kg dose of teicoplanin at 36 h resulted in a trough concentration at 48 h of 16.0 +/- 4.5 mg/liter, with only 7% of patients having a trough concentration of less than 10 mg/liter, compared with 46% of patients on the usual schedule.

Adult↗

Organization and activities of the International Radio Medical Centre (CIRM).

The International Radio Medical Centre (CIRM) was founded in 1935, to provide free medical assistance by radio to ships with no doctor on board and others who cannot be reached by a doctor. In 1950 CIRM was established as a non-profit-making foundation and has benefited since 1957 from an annual contribution from the Italian government. The results achieved by the Centre over 61 years include medical assistance to 42,935 patients on board ships (as well as on small islands and aircraft), with 375,264 medical messages received and transmitted. CIRM is organized into a medical service, a telecommunications service and a studies section. The 24-h continuous medical service is provided by doctors at the CIRM headquarters. The doctor on duty gives instructions for managing the case. If necessary the medical service will coordinate the patient's hospitalization at the nearest port with suitable medical facilities or arrange the patient's transfer to another ship with a doctor on board, or an airlift. The telecommunications service receives requests for assistance, locates the ship or whoever made the request, passes the call to the doctor on duty, and relays the doctor's response to those requesting assistance. The studies section, established in 1957-58, researches occupational pathologies of sailors and contributes to their prevention. This provides a scientific basis for improving medical assistance to sailors at sea.

Emergencies↗

Insecticide barrier spraying for the control of sand fly vectors of cutaneous leishmaniasis in rural Guatemala.

An initial evaluation of insecticide barrier spraying directed against sand fly vectors of cutaneous leishmaniasis was done in a nonclimax forested area with heavy undergrowth in Peten, Guatemala. A 100 m-wide swath of vegetation was sprayed once with a 1:3 mixture of cyfluthrin insecticide and a palm oil carrier using back-pack sprayers to simulate a central cantonment area in one site while another site remained as an untreated control. Prior to spraying and throughout 87 days post-treatment, sand fly populations were monitored at both sites with light traps set at ground and canopy levels at 50-m intervals radiating out from the centers of the cantonments, 150-m in the four cardinal directions. A total of 2,876 female sand flies were captured, representing 16 species. Three species, Brumptomyia galindoi, Lutzomyia panamensis, and Lu, ovallesi, comprised 70% of the total collection. The single insecticide barrier significantly reduced sand flies from reaching the cantonment area for more than 80 days, while sand fly populations outside the treated cantonment and in the untreated (control) cantonment remained high (52 sand flies in the treated cantonment versus 235 sand flies in the untreated cantonment).

Animals↗

Radiology/pathology conference from Robert Wood Johnson Medical School.

Inflammatory pseudotumor of the heart is a benign tumor-like lesion consisting of reparitive granulation tissue with fibroblasts, myofibroblasts, and plasma cells predominating. This lesion is commonly seen in the lungs. The authors present this case report to stimulate discussion.

Child↗