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Biomedical subjects

N Stefenelli

Publications and source records attributed to N Stefenelli.

At least 19 recordsLinked to original sources

[Goncharov's novel Oblomow as an example of the story of impeded convalescence].

After the termination of an illness involving a long period of being bedridden and in need of care, not every patients is willing to immediately terminate the state of being ill. Some patients show a more or less concealed resistance to return into their customary social lives, which can hinder the progress of convalescence and rehabilitation. Two of the possible bases for such behaviour were described in depth in medical, but above all in non-medical literature: for one in Goncarov's novel Oblomov, published in 1859, and for another in numerous reports concerning the possible consequences of boredom. To recognize a patient's proneness to such behaviour at an early stage and to be able to implement appropriate countermeasures, extensive knowledge of the person of Oblomov, so called oblomovism, and boredom with its various sequelae is required.

Adult↗

[Carotid lesions and vascular risk factors].

BACKGROUND AND AIMS: Recent studies have underlined a significant incidence of peripheral arterial occlusive disease (PAOD) of the lower limbs in the general population which is often wrongly diagnosed. The "classic" risk factors--like dyslipidemia--are not always present in significant percentages in patients suffering from PAOD of the lower limbs. The aim of this study was to evaluate the incidence of the most common vascular risk factors (smoking, hypertension, hyperglycemia, dyslipidemia) in patients suffering from stenosing lesions of the extracranial carotid axes, comparing the data with similar findings in lower limbs. Moreover, the authors evaluated the association between these risk factors, carotid atheromatous lesions and ischemic cardiomyopathy (CI). METHODS: A retrospective study was performed to evaluate the data from 1643 patients examined consecutively. A total of 636 (age > 40, carotid stenosis > 40%, presence of risk factors) were considered eligible. RESULTS: The results showed that, contrary to the findings in patients suffering from PAOD, diabetes was not among the most frequently associated risk factors, whereas a relatively large number of patients had a history of smoking, including both smokers and ex-smokers. CONCLUSIONS: The difference in the most frequent risk factors identified for PAOD and carotid lesions suggests different etiopathogenetic mechanisms for the two districts.

Aged↗

[Unidentified arteriopathy: an epidemiological study. The preliminary results].

The importance of the social and medical impact of arteriosclerotic disease fully justifies a series of studies focused on improving knowledge of this pathology before symptoms become manifest, so as to orientate treatment increasingly towards prevention. The aim of this study-of which the authors now report the preliminary results-was to establish the incidence of unidentified lower limb arteriopathy in the general population and to evaluate the relations between this and the possible presence of risk factors. The authors therefore decided to evaluate patients attending outpatient General Surgery clinic for symptoms manifestly not related to lower limb vascular pathology (arterial or venous). Patients suffering from any arterial disease were likewise excluded from the study. The importance of performing a large-scale epidemiological study (sample size, stratification of population studied, vast geographic area, etc.) persuaded the authors to adopt a multi-centre structure. Twelve General Surgery departments at hospitals in the Veneto area were involved: each was required to evaluate an average of 150 patients, giving a total of 1950 subjects. The method of study chosen was the residual pressure index (RPI) measured using Doppler velocimetry. Patients were divided into two study groups: patients in Group A (with pathological RPI) were re-evaluated after correction for risk factors, integrated or not by medical treatment. Preliminary results relating to 46% of the total sample show that 26.7% of the subjects present pathological RPI. The evaluation of risk factors and the comparison of their presence in the two groups (A--pathological patients, B--non-pathological subjects) reveals significant differences regarding diabetes and hypertension.

Adult↗

[Effects of confrontation of medical students and hospital physicians with human cadavers].

Eighty male and female doctors of various ages working in a general hospital were questioned on their feelings on being confronted with human corpses and the possible effects of the experience. Their responses were analysed and compared with those of 100 male and female medical students. The potential short-term effects and lasting consequences are many and varied. Forty-four per cent of the doctors reported that repeated dealings with the bodies of patients known to them did not lead to habituation. A high proportion of the students and doctors stated that exposure to corpses had a positive effect on their dealings with living patients. The reluctance of some doctors to attend autopsies of their patients is connected with their difficulties in coping with the experience. Further, more detailed studies are called for.

Adaptation, Psychological↗

Serum sialic acid in malignant tumors, bacterial infections, and chronic liver diseases.

The total serum sialic acid concentration was determined in 2,264 persons with various malignant tumors, bacterial infections, rheumatic diseases, and chronic liver diseases, and in a control group. The thiobarbiturate method according to Warren was used. The upper limit (95% percentile) in the control group was 2.23 mumol/ml. Higher values were found in the groups with neoplasms (mean: 3.04 mumol/ml), inflammatory diseases (e.g., pneumonia: 3.02 mumol/ml), and active rheumatoid arthritis (3.05 mumol/ml). In the group with malignant diseases, the sialic acid concentration at the time of diagnosis was highest for bronchial carcinoma (3.29 mumol/ml) and lowest for breast cancer (2.58 mumol/ml). In chronic liver diseases the mean sialic acid level was lower than in a heterogeneous group of noninflammatory and nonneoplastic diseases. The estimation of the serum sialic acid concentration could be useful in the detection of tumor burden and metastases, and in the evaluation of the later course and prognosis of malignant neoplasms if bacterial/inflammatory and active rheumatoid processes can be excluded.

Adolescent↗

[Changes in gastric mucosa, liver and mesenteric vessels following bipolar electrocoagulation].

The implications of bipolar electrocoagulation with a modified probe (BICAP) were tested in rat gastric mucosa, liver tissue and mesenteric vessels. This was done during the coagulation and at different intervals, up to 14 days later, by intravital microscopy of the exposed organs. A histological treatment of the respective tissues ensued at the closing of each experiment. Applying a current of 25 watt and contact times lasting for 5 secs and longer, perfect tissue necrosis develops which has clean and straight edges. The extensions on the surface and into the depth of gastric mucosa match precisely the contact area with the instrument. In the deeper mucosal layers there is a fungiform spread of necrosis while in the liver it remains uniform and shows the same diameter as on the surface. As a late result and notwithstanding the confinement of the coagulation to the mucous membrane, a local peritonitis may develop. Within contractile vessels the action of bipolar coagulation stops the blood flow which is only irreversible, when the current and contact times are extended to bring about necrosis in neighbouring tissue. Within the microcirculation of the liver the blood flow is preserved up to the very boundary of the necrosis.

Animals↗

[Changes in physical capacity and lung function after a single parenteral alcohol dose].

The purpose of this study was to test whether a parenteral infusion of ethanol had any influence on pulmonary function or cardio-pulmonary capacity. 11 healthy male test persons supplied with an infusion of 0.4 g ethanol per kg body weight in isotonic saline (25--38 g ethanol) and of 400 mls of isotonic solution alternatively. The following measurements were taken: Body-plethysmography, Ergospirometry using a bicycle ergometer, ECG, measuring cardiac frequency, blood gases and lactate concentration. At average maximal alcohol blood levels of 0.61% we found a significant decrease of the residual volume without changes of the bronchial resistance. At increasing physical loads on the bicycle ergometer we found a significant decrease of the maximal oxygen uptake at the same watt ratings and the same maximal respiratory minute volume. The results indicate a shift of respiratory balance and a decrease of the cardiac output after supply of alcohol.

Acetaldehyde↗

[Agammaglobulinemia and eosinophilic gastroenteritis].

The case is reported of a 34-year-old patient with diffuse eosinophilic gastroenteritis in connection with agammaglobulinaemia and B-cell defect. The syndrome was manifested by malabsorption, and gastrointestinal protein loss, complicated by temporary pyloric obstruction and duodenal ulceration. As in the case of sprue-like changes in the small intestinal mucosa, and nodular lymphoid hyperplasia, this diffuse eosinophilic gastroenteritis may be a reaction of the stomach and small intestine to immunological abnormalities.

Adult↗

[Changes of alcohol resorption through apomorphine in subemetic dosage].

Apomorphine in sub-emetic doses inhibits gastric emptying without producing nausea or vomiting. This discovery was applied to 21 persons to find out correlation between gastric emptying rate and alcohol absorption. In the 60 minutes after a single oral ingestion the shape of the alcohol-tolerance curve is considerably flatter after administration of apromorphine as compared to controls. The peak blood alcohol concentration occurs later and is significantly lower. These findings suggest that absorption of ethyl alcohol after a single oral alcohol ingestion can be controlled to a considerable extent by the gastric emptying rate.

Adult↗

[Alcohol and gastrointestinal tract (author's transl)].

Alcohol drinking induces acute and chronic lesions of the GI tract; some other GI disorders do occur more frequently in drinkers than in other persons. Alcoholics suffer from gastroesophageal reflux, Barrett's syndrome, exophageal cancer and Mallory-Weiss syndrome as well as from hemorrhagic erosive gastritis more often than normal. It is still unsettled if chronic gastritis can be due to alcohol drinking. Alcohol inhibits to some degree the absorption of water, electrolytes, disaccharides and vitamin B12 in the small intestine; it may as well impair intestinal motility and cause diarrhea. Many aspects of the effects of alcohol on the GI tract still remain to be elucidated. The main stay of therapy is abstenence.

Alcoholism↗

[The extent to which ethanol absorption is influenced by an alteration of gastric emptying (author's transl)].

Gastric emptying of a 500ml liquid test meal containing 6.2% ethanol and phenol red was studied on two consecutive days in a group of persons without gastroduodenal disease. On the first day an aqueous ethanol solution was administered, whilst on the second day a solution of ethanol in 10% glucose was given in order to delay gastric emptying. Twenty minutes after introduction of the test meal by tube, the gastric contents were recovered by aspiration and a gastroscopic examination was performed. Simultaneously, the amount of ethanol absorbed by the stomach, as well as the ethanol level in the peripheral venous blood was determined over a period of 10 to 90 minutes. Considerable individual variations were observed both in respect to the gastric emptying rate and the level of blood ethanol during the absorptive phase. The absorption rate and blood ethanol curvetion rate and blood ethanol during the absorptive phase. The absorption rate and blood ethanol curve were markedly reduced as a result of a delay in gastric emptying. The tolerance to alcohol may be greatly influenced by the rate of gastric emptying and, consequently, by the composition of alcholic beverages, drinking habits, and food intake.

Adult↗

[Self-inflicted injuries by injecting contaminated solutions through the chest wall (author's transl)].

In the case of three prisoners, we observed the results of their attempt to induce an infection of the pleura and lungs by injecting themselves through the chest wall with a contaminated substance in order that they might be transferred to a sanatorium. Traces of the solution they had administered, which among other substances contained faeces, were found in the chest wall, in the pleural and subphrenic area, in the lungs and in the liver. The self-inflicted injuries described, led in the case of one of the prisoners to his death following a subphrenic abscess, a necrosis and abscess of the liver, septic shock and respiratory insufficiency. The clinically recognizable results of the injection only set in after a period of latency of several days. In one case there were still traces of stool in the liver 24 days after its initial introduction.

Adult↗