PubMed Health⌕ Search

Biomedical subjects

P Fioretti

Publications and source records attributed to P Fioretti.

At least 109 records · Page 6Linked to original sources
PubMed1989

The topical administration of steroids in the treatment of typical vulvar dystrophies.

Sixty-eight patients with histologically diagnosed typical vulvar dystrophies were treated with local administration of steroids. Twenty-three patients with hyperplastic dystrophies received topical fluorinated corticosteroids twice a day for 4 weeks and once a day for another 2 weeks. Thirty-five patients with lichen sclerosus were given local 2% testosterone propionate in vaseline twice a day for 8 weeks, once a day for another 8 weeks and then 3 times a week for another 8 weeks. Ten patients with mixed dystrophy first received topical fluorinated corticosteroids twice a day for 4 weeks and once a day for another 2 weeks, and then local 2% testosterone propionate in vaseline twice a day for 4 weeks and once a day for another 4 weeks. A relief of symptomatology and a regression of gross appearance were obtained in 82.6% and 69.6% of patients respectively with hyperplastic dystrophy, in 82.9% and 65.7% of those with lichen sclerosus and in 80% and 40% of those with mixed dystrophy. A recurrence of symptomatology often occurred at various times after the end of therapy.

Administration, Topical↗
PubMed1989

[Effects of low-dose oral contraceptives on sugar metabolism].

The effects on carbohydrate metabolism by four low-dose oral contraceptives were evaluated in four low-dose oral contraceptives were evaluated-66 young women randomly divided in four groups. In the various preparations there were a different dosage of estrogen (ethinylestradiol) together different doses and types of progestogen (desogestrel, gestodene, cyproterone acetate). After six months of treatment, in all groups a slight increase of glycemic and insulinemic responses during OGTT was observed; the significance was achieved with the preparation containing cyproterone acetate alone. Glycated hemoglobin did not change. Our results suggest that these new low-dose oral contraceptives induced negligible metabolic side effects.

Adolescent↗
PubMed1989

Surgery and radiotherapy in the treatment of early stage uterine sarcomas.

Twenty-three patients with early stage uterine sarcomas underwent surgery (5 patients) or surgery and pelvic irradiation (18 patients). Twelve (52%) of the patients developed a recurrence: relapsing disease was pelvic in 3 (25%) of them, extrapelvic in 8 (66.7%) and both pelvic and extrapelvic in one (8.3%). Out of the whole series the 2- and 5-year actuarial survival rates were 61% and 33% respectively. Among the patients with leiomyosarcoma the 2- and 5-year actuarial survival rates were 54% and 39% respectively. Among the patients with carcinosarcoma the 2- and 5-year actuarial survival rates were 66% and 23% respectively. The high incidence of extrapelvic recurrences after locoregional treatment seems to suggest the use of an adjuvant chemotherapy in the management of patients with early stage uterine sarcomas.

Adult↗
PubMed1989

The therapy of verrucous carcinoma of the vulva. Observations on three cases.

Vulvar verrucous carcinoma is a distinct variant of squamous cell carcinoma, with a very low biological aggressiveness. Surgery is considered to be the elective treatment, even if there is no agreement in literature about the extent of surgical resection. Radiotherapy cannot be used in the management of this neoplasia. Sometimes this therapeutic modality induces an anaplastic transformation of the tumor, which can turn into a more aggressive malignancy. In this paper the clinical histories of 3 patients with vulvar verrucous carcinoma are discussed, in particular as regards therapy.

Aged↗
PubMed1988

Correlations between quantitative cineangiography, coronary flow reserve measured with digital subtraction cineangiography and exercise thallium perfusion scintigraphy.

The goal of this investigation was to establish which anatomical parameters of stenotic lesions correlate best with its functional severity. Therefore, thirty-eight patients with single vessel disease underwent coronary cineangiography and exercise/redistribution thallium-201 scintigraphy. Cross-sectional area at the site of obstruction (OA), percentage diameter stenosis (DS), the calculated pressuredrop over the stenosis (PD), as well as coronary flow reserve (CFR) derived from myocardial contrast appearance time and density were determined. The relations between CFR and the 3 anatomical parameters were described by the following equations: CFR = 4.6 - 0.053 DS, r = 0.82, SEE: 0.79, p less than 0.001 CFR = 0.5 + 0.75 OA, r = 0.87, SEE: 0.68, p less than 0.001 CFR = 3.6 - 1.5 log PD, r = 0.90, SEE: 0.62, p less than 0.001 The calculated pressuredrop was highly predictive of the thallium scintigraphic results with a sensitivity of 94% and a specificity of 90%. Therefore, the calculated pressuredrop is a better anatomical parameter for assessing the functional importance of a stenosis than percentage diameter stenosis or obstruction area. However, the 95% confidence limits of the relation between pressuredrop and coronary flow reserve are wide, making measurement of CFR a valuable addition to quantitative angiography, especially when determining the functional importance of moderately severe coronary artery lesions.

Adult↗
PubMed1988

Interaction between veralipride and the endogenous opioid system in the regulation of body temperature in postmenopausal women.

The influence of endogenous opioid peptides on body thermoregulation has been studied in untreated postmenopausal women and in the same subjects after chronic administration of the antidopaminergic drug veralipride (200 mg/day for 20 days). Subjects randomly received an infusion of the opioid antagonist naloxone (1.6 mg/h for 4 h) or saline on two consecutive days, both before and after veralipride treatment. In untreated subjects body core temperature, as evaluated by rectal temperature, did not vary during saline infusion, whereas a significant decrease was observed during naloxone infusion. Chronic administration of veralipride significantly increased the hypothermic response to naloxone. Therefore, veralipride seems to increase the activity of endogenous opioid peptides on mechanisms which regulate body temperature in postmenopausal women.

Body Temperature↗
PubMed1988

Which cineangiographically assessed anatomic variable correlates best with functional measurements of stenosis severity? A comparison of quantitative analysis of the coronary cineangiogram with measured coronary flow reserve and exercise/redistribution thallium-201 scintigraphy.

The goal of this investigation was to establish which measured anatomic variable of stenotic coronary lesions correlates best with functional severity. Therefore, 38 patients with single vessel disease underwent coronary cineangiography and exercise/redistribution thallium-201 scintigraphy. The computer-based Cardiovascular Angiography Analysis System was used to determine the cross-sectional area at the site of obstruction (OA) and percent diameter stenosis (DS), and to calculate the pressure drop over the stenosis (PD) with use of fluid dynamic equations. Coronary flow reserve was measured radiographically. Myocardial perfusion defects on thallium scintigrams were analyzed quantitatively and by visual interpretation. The relations between coronary flow reserve (CFR) and the three anatomic variables were described by the following equations: 1) CFR = 4.6 - 0.053 DS, r = 0.82; SEE: 0.79, p less than 0.001. 2) CFR = 0.5 + 0.75 OA, r = 0.87; SEE: 0.68, p less than 0.001). 3 CFR = 3.6 - 1.5 log PD, r = 0.90; SEE: 0.62, p less than 0.001. The calculated pressure drop was highly predictive of the thallium scintigraphic results with a sensitivity of 94% and a specificity of 90%. The calculated pressure drop is a better anatomic variable for assessing the functional importance of a stenosis than is percent diameter stenosis or obstruction area. However, the 95% confidence limits of the relation between pressure drop and coronary flow reserve are wide, making the measurement of coronary flow reserve an indispensable addition to quantitative angiography, especially when determining the functional importance of moderately severe coronary artery lesions.

Adult↗
PubMed1988

Social fate and long-term survival of patients with a recent myocardial infarction, after cardiac rehabilitation.

The aim of this study was to assess the social fate (work resumption) and long-term (four years) survival in 141 patients who completed a cardiac rehabilitation programme after a recent myocardial infarction. Out of the 100 patients who had been working up to recently before the myocardial infarction, 58 resumed their work. Of the predischarge evaluation (clinical data, resting radionuclide ventriculography, bicycle ergometry and 24-h ambulatory ECG monitoring) and bicycle ergometry after the rehabilitation, the only significant predictor of work resumption was a better exercise tolerance at discharge (P less than 0.02). Work was resumed by 68% of white-collar workers and by 52% of blue-collar workers. The four-year cardiac mortality in patients who completed the rehabilitation was 8.5% (N = 12). Four patients died during the first year. Clinical, ventriculographic and ergometric variables collected at hospital discharge, which were related to left ventricular dysfunction, were predictive of survival, while ventricular arrhythmias and markers of myocardial ischaemia were less predictive. The exercise testing performed after the rehabilitation programme was not useful for risk assessment. It is concluded that markers of left-ventricular dysfunction are predictive of a poor outcome; however, due to the low risk of patients who were referred to our rehabilitation unit and completed the rehabilitation programme, it seems reasonable for return to work to be based primarily on clinical information, exercise tolerance, and on psychological and social grounds. An additional extensive cardiological evaluation should be individually tailored for patients with specific symptoms.

Adult↗
PubMed1988

Four-year prognostic value of exercise-induced angina and painless ST segment depression early after myocardial infarction.

The aim of this study was to establish if angina pectoris and silent ST segment depression during pre-discharge exercise tests are predictive of 4 years survival after myocardial infarction. Accordingly, 377 consecutive hospital survivors of myocardial infarction underwent symptom-limited bicycle ergometry at hospital discharge. Sixty-eight patients had angina during exercise, 124 patients had silent ST segment depression and 184 had neither angina nor ST depression. The baseline demographic profile, exercise capacity during ergometry and radionuclide left ventricular ejection fraction were comparable in the three groups. The total mortality within 4 years in the three groups was 15%, 21% and 22%, and mortality due to reinfarction or sudden death was 10%, 17% and 14%. When patients on digitalis were excluded, the incidence of mortality due to reinfarction or sudden death in the group with painless ST segment depression was 11%. Coronary artery bypass grafting or percutaneous transluminal coronary angioplasty due to recurrent symptoms was performed in 41%, 20% and 18% respectively of the three groups. It is concluded that conditional upon modern treatment, including secondary prevention with beta-blockers and revascularization procedures in selected patients with symptoms refractory to medical therapy, exercise-induced angina and painless ST segment depression do not identify a group of patients at higher risk of sudden death or fatal reinfarction during the 4 years after myocardial infarction.

Angina Pectoris↗
PubMed1988

Improvement in transient and 'persistent' perfusion defects on early and late post-exercise thallium-201 tomograms after coronary artery bypass grafting.

In order to assess the changes in the number and severity of transient and persistent myocardial perfusion defects before and after coronary artery bypass grafting (CABG), early and late post-exercise thallium-201 (tl-201) tomography was performed in 25 patients, on average 10 days before and 2.5 months after CABG. Six patients had a previous Q wave myocardial infarction. Comparing the pre- and post-CABG exercise test data (symptom limited bicycle ergometry) showed an improvement in working capacity (from 129 +/- 34 to 145 +/- 35 W, P less than 0.05) and a reduction in exercise induced angina from 77 to 9% of the patients (P less than 0.001). From the tomographic data, six short axis and three sagittal cross-sections of the left ventricular myocardium were reconstructed. In each patient study, a total of 51 myocardial segments were defined and analysed in a semi-quantitative manner by means of a five point scoring method indicative of the severity of a defect (from 0 = normal tl-201 uptake to 4 = absence of tl-201 activity). In this patient population the total number of segments with transient tl-201 perfusion defects decreased from 11.0 +/- 7 segments per patient (mean +/- SD) before surgery to 4.9 +/- 4 after surgery (P less than 0.01); the number of segments with 'persistent' tl-201 defects decreased as well, from 7.5 +/- 6 to 3.9 +/- 4 segments per patient (P less than 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Artery Bypass↗
PubMed1988

Immediate PTCA after successful thrombolysis with intracoronary streptokinase, three years follow-up. A matched pair analysis of the effect of PTCA in the randomized multicentre trial of intracoronary streptokinase, conducted by the Interuniversity Cardiology Institute of The Netherlands.

Immediate PTCA following thrombolysis with streptokinase was performed in 46 out of 533 patients enrolled in a multicentre randomized trial of early reperfusion in patients with acute myocardial infarction. Additional effects of PTCA in patients with a residual diameter stenosis in the infarct-related coronary artery of 70% or more after thrombolysis were compared with successful thrombolysis alone in a matched pair analysis. Thirty six pairs of patients were formed identical with respect to the infarct related coronary artery, presence or absence of previous myocardial infarction, total ST segment elevation on the ECG at admission to the trial, and delay between onset of symptoms and hospital admission. PTCA after thrombolysis did not lead to additional limitation of infarct size, nor to further preservation of left ventricular function. Infarction rate during the three-year follow-up was 14% after PTCA versus 30% after thrombolysis alone (P = 0.05). Similarly, patients had less angina or heart failure after PTCA, since on average 128 out of 156 weeks follow-up were symptom free, while this was only 102 weeks after thrombolysis alone (P = 0.03). Immediate PTCA after thrombolysis with intracoronary streptokinase seems to prevent recurrent ischemia and reinfarction. Further studies should address the proper indication and timing of PTCA after thrombolysis.

Angioplasty, Balloon↗
PubMed1988

Improvement of myocardial perfusion after thrombolysis assessed by thallium-201 exercise scintigraphy. Report of the Working Group on Thrombolytic Therapy in Acute Myocardial Infarction of the Netherlands Interuniversity Institute of Cardiology.

The effects of recanalization by early intracoronary streptokinase in acute myocardial infarction on myocardial perfusion were studied in a subset of 236 out of 533 patients enrolled in a prospective multicentre trial, randomly allocated to either conventional treatment or to thrombolysis. Maximal symptom-limited thallium-201 stress testing was performed nine to 14 (median 12) weeks after the acute event in 236 patients with a first myocardial infarction, of whom 108 patients were allocated to conventional treatment and 128 patients to thrombolysis. Three-view thallium exercise and redistribution scintigrams were divided into eight segments. The number of normal thallium segments at redistribution was 5.3 +/- 1.6 (mean +/- SD) in the control group and 5.8 +/- 1.6 in the thrombolysis group (P less than 0.01), indicating increased myocardial perfusion after early thrombolytic treatment. This beneficial effect was particularly evident in patients with a first anterior infarction with 4.8 +/- 1.6 normal thallium segments in the control group and 5.9 +/- 1.6 normal segments in the thrombolysis group (P less than 0.001). There was no difference in residual ischaemia during exercise between the control and the thrombolysis group either in the patients with anterior or in those with inferior infarction. It is concluded that early thrombolysis within 4 h after onset of symptoms, in some of the patients followed by angioplasty or coronary artery bypass surgery, leads to sustained improvement of myocardial perfusion at rest without excessive ischaemia during exercise, particularly in patients with acute anterior infarction.

Aged↗
PubMed1988

Chronic bromocriptine administration restores luteinizing hormone response to naloxone in postmenopausal women.

To evaluate whether dopaminergic treatment may modify endogenous opioid activity at the hypothalamic-pituitary level, the effects of naloxone infusion (1.6 mg/h for 4 h) on luteinizing hormone (LH) secretion were studied in 5 postmenopausal women either before or after chronic administration of the dopaminergic drug bromocriptine (BCT; 5 mg/day for 30 days). BCT administration did not modify mean plasma LH levels. Before treatment naloxone infusion did not induce any significant modification of LH secretion. Conversely, after chronic BCT administration naloxone induced a significant (p less than 0.05) increase in plasma LH levels. The LH response to naloxone was significantly (p less than 0.001) higher than that observed before BCT. The present data show that chronic BCT administration restores the LH response to naloxone in postmenopausal women. Therefore, these results seem to demonstrate that BCT administration can enhance opioid activity, suggesting an involvement of the endogenous opioid system in dopaminergic modulation of gonadotropin release.

Bromocriptine↗
PubMed1988

Restoration of luteinizing hormone response to naloxone in postmenopausal women by chronic administration of the antidopaminergic drug veralipride.

To determine whether antidopaminergic drug administration may modify endogenous opioid activity at the hypothalamic-pituitary level, the effects of naloxone infusion (1.6 mg/h for 4 h) on LH secretion were studied in six postmenopausal women before and after administration of the potent antidopaminergic drug veralipride for 20 days. Before veralipride administration, the naloxone infusion did not alter LH secretion. Chronic administration of veralipride resulted in a significant (P less than 0.01) decline in plasma LH levels. In addition, the naloxone infusion induced a significant (P less than 0.05) increase in plasma LH levels, which reached values similar to those before veralipride administration. These results demonstrate that in postmenopausal women the antidopaminergic drug veralipride can restore, at least in part, the activity of the endogenous opioid system. These findings suggest that endogenous opioid peptides may mediate the inhibitory effect exerted by chronic antidopaminergic drug administration on LH secretion in humans.

Adult↗
PubMed1988

The association of ultrasonography and CA-125 test in the preoperative evaluation of ovarian carcinoma.

The aim of this study was to verify the role of the association of pelvic ultrasonography and CA-125 assay in the preoperative evaluation of ovarian carcinoma. The Authors examined 119 patients undergoing laparotomy for adnexal masses. Thirty-six had an ovarian carcinoma, the other 83 patients were affected by benign ovarian pathologies. Before surgery every patient underwent a pelvic ultrasonography. The data resulting from ultrasonography were processed on the basis of a personal scoring morphologic echostructural evaluation system. Furthermore in every patient the preoperative serum levels of CA-125 were measured. In the group of patients with ovarian carcinoma the ultrasonography score was greater than or equal to 10 in 26, while serum CA-125 was greater than or equal to 65 U/ml in 30 and greater than or equal to 35 U/ml in 31. In the group of patients with benign ovarian pathology the ultrasonography score was found to be greater than or equal to 10 in 2, while serum CA-125 was greater than or equal to 65 U/ml in 4 and greater than or equal to 35 U/ml in 20. Fixing 10 as reference value of ultrasonography score for ovarian carcinoma diagnosis, pelvic ultrasonography and a sensitivity of 72.2%, a specificity of 97.9%, a diagnostic accuracy of 89.9%. With a reference value of 65 U/ml CA-125 had a sensitivity of 83.3%, a specificity of 95.2%, a diagnostic accuracy of 91.9%. With a reference value of 35 U/ml CA-125 had a sensitivity of 86.1%, a specificity of 75.9%, a diagnostic accuracy of 79.0%.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Tumor-Associated, Carbohydrate↗