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Biomedical subjects

P Ghiringhelli

Publications and source records attributed to P Ghiringhelli.

At least 19 recordsLinked to original sources
PubMed2006

Patient re-training in peritoneal dialysis: why and when it is needed.

The aim of this multicenter, quantitative, observational study was to analyze compliance and re-training needs of patients on peritoneal dialysis (PD) through the assessment of patient knowledge (with a Patient Questionnaire; phase 1) and patient behavior (home visit with a Score Card; phase 2). A total of 353 patients from 11 Italian centers participated in the first phase and 191 patients from nine centers in the second phase. Overall, 66% of questions on the Patient Questionnaire were answered correctly. Correct answers were more frequent in females than males, in patients under 55 years of age, and in those with higher education. The lowest rate of correct answers involved questions related to diet and physical activity (67% and 51%, respectively). Data collected during the home visit showed that 25% of patients were partially compliant with their drug therapy. Twenty-three percent of patients were non-compliant with the exchange protocol procedures, with a significant association between compliance and the incidence of peritonitis, and 11% were non-compliant with the exit-site protocol procedures without a statistically significant correlation to peritonitis. By combining the two evaluations, we found that approximately one-third (29%) of patients needed reinforcement of knowledge and ability to correctly perform PD as related to infection control and 27% for the correct use of drugs. Looking at the combined evaluation of infection control and drug use, results showed that 47% of patients needed re-training. This need for re-training was greater for younger patients (less than 55 years old), patients with lower education degree and patients in the early or late phase of PD therapy (less than 18 months or more than 36 months). Gender and degree of autonomy had no effect on the need for re-training.

Aged↗
PubMed1999

[Adult-onset Still's disease. Report of 5 cases].

The authors report 5 cases of Still's disease in adults whose symptoms were mainly characterised by high fever, transient exanthema, polyarthralgia and/or polyarthritis, lymphoadenomegaly, splenomegaly and neutrophil leukocytosis. Assays for leukocytosis were positive, as were those for inflammatory markers and serum ferritin was also high in all 3 patients in which it assayed. On the contrary, serum ferritin latex test, Waaler-Rose reaction and all other tests commonly used to diagnose long-term fevers were all negative. All the subjects examined recovered after prolonged steroid therapy. Only one patient reported severe sequelae in the hip joints and subsequently underwent bilateral hip replacement surgery.

Female↗
PubMed1989

[Angioimmunoblastic lymphadenopathy. 2 case reports].

Of the two cases of angioimmunoblastic lymphadenopathy described, one had arisen after infection by a non-A non-B hepatitis virus and HIV. The possible cause of the immunological changes that triggered the disease are discussed as are its clinical picture, course and treatment. In the first case a 6 month remission period was obtained after a short cycle of cortisone treatment, a second remission followed treatment with CVP. Unfortunately the bronchial pneumonia that followed the second cycle proved fatal. The second case featured recurring infections of the middle ear and respiratory tract causing the patient's death about a year after the onset of the disease.

Aged↗
PubMed1988

[Lymphadenopathies and diseases with manifestations of autoimmunity].

The diseases responsible for lymphadenopathies with autoimmune features were examined. Such features play a major role in a vast number of clinical conditions whose aetiology is for the most part unknown but which present several clinical, histological and laboratory aspects in common. The most significant of these conditions are serum sickness and similar pictures induced by drugs, iodised contrast media and hymenoptera venom, angioimmunoblastic lymphadenopathies, giant multicentric lymph node hyperplasia, diffuse connectivitis, Wegener's granulomatosis lymphoid granulomatosis, necrotic lymphadenitis without granulocyte infiltration, mucocutaneous lymph node syndrome, angiofollicular hyperplasia with eosinophilia and histiocytosis of the sinuses. In some of these conditions, the lymphadenopathy is a constant and characteristic feature of the disease; in others it is common, in others rare and at time purely local. The autoimmune changes encountered in these conditions may, at times, be responsible for the morbidity, as in serum sickness. In others they merely constitute major or minor symptoms. In some they are no more than marginal aspects. The onset is usually acute with widespread symptoms and a clinical control featuring manifestations of hypersensitivity and immune deficiency. The most common and characteristic laboratory findings are polyclonal hypergammaglobulinaemia, circulating immune complexes, cryoglobulinemia and hypocomplementaemia and finally medullary plasmocytosis. Lymph node biopsy also tends to reveal a standard picture characterised by polymorphic infiltration of immunologically normal cells and the proliferation of newly formed small calibre blood vessels, mostly venules: In other words an aspecific reactive picture. For this reason diagnosis will sometimes be provided by blood tests, sometimes by repeated biopsy at a later date, sometimes by the evolution of the clinical picture. One other feature of these conditions and common, incidentally, to almost all diseases involving immunological alterations, is that they may be complicated by the appearance of lymphomas. Among the diseases quoted particular attention was paid to angioimmunoblastic lymphadenopathy and Castleman's disease given their greater frequency and the importance of their aetiopathogenic and clinical aspects.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Clinical medicine of disorders of porphyrin metabolism in man].

Porphyrin metabolism disorders are grouped into three classes. 1) Hereditary porphyrias including those caused by an inherited deficiency in one of the enzymes responsible for porphyrin synthesis. 2) Secondary porphyrias: well defined clinical situations due to disturbed porphyrin metabolism caused by a variety of toxic substances or drugs or secondary to other pathological conditions. 3) porphyrin metabolism disorders as concomitant featured of certain types of poisoning or particular pathologies. This is followed by a brief description of porphyrin synthesis and the enzymes involved in it, and the distribution of porphyrins and their precursors in certain tissues and biological materials. Hereditary porphyrins are treated individually and not classified since all the classification systems proposed are open to criticism. However the value of grouping acute intermittent porphyria, hereditary coproporphyria, variegated porphyria and the porphyria caused by PBG-synthetase deficiency under "acute porphyrias" is recognised since all involve acute attacks with similar symptoms and prognoses, all are triggered by the same factors and all are treated in the same way. The various forms of hereditary porphyrias are grouped into 3 main categories: a) acute attacks featuring abdominal colics and signs of distress on the cerebral and peripheral nervous systems; b) skin alteration due to photosensitisation; c) haemolytic anaemia. Treatment is divided into preventive, symptomatic and aetiopathogenic. The individual hereditary porphyrias are then examined. The secondary porphyrias examined include lead poisoning, porphyria of the skin caused by hexachlorobenzene, subacute or chronic tyrosinaemia and acute intermittent porphyria caused by carbamazepine. Finally the porphyrin metabolism disorders concomitant with other diseases are examined including those encountered in anaemia, liver disease, dermatological conditions and infections and conditions caused by drugs and toxic substances.

Chemical Phenomena↗
PubMed1986

[Remarks on a case of Fitz-Hugh-Curtis syndrome].

A case of Fitz-Hugh Curtis syndrome caused by chlamydia is described in which the perihepatic and abdominal swelling also extended to the right perirenal tissue. The case was diagnosed on the basis of the clinical picture, the behaviour of anti-chlamydia serum antibodies, abdominal echography and laparoscopy. The infection was quickly cured by the administration of tetracycline.

Adult↗
PubMed1986

[Indications for surgical intervention in patients with pulmonary cancer. Observations on 714 cases].

Selection modes for surgery were studied in a group of lung cancer patients. Selection is based: on the certain diagnosis of the disease, its histological classification and stage respiratory function tests and the assessment of any surgical indications. A total of 714 lung cancer cases were examined. Of these, 28.4% were at stage 1, 19.8% at stage 2 and 51.8% at stage 3. Only 141 patients or 19.8% of all cases examined were judged fit for radical exeresis. In the absence of metastasis all three stages of epidermoid carcinomas and adenocarcinomas were judged operable. In the case of microcytomas indication to surgery was limited to very few cases and only those in the first two stages. In the presence of metastasis to the hilar lymph nodes, surgery was only indicated where the metastasis was small. Exeresis was also indicated in the presence of single metastases to mediastinal lymph nodes on the same side as the neoplasia especially if these were considered intranodal. The difficulty of precise assessment of metastases to the hilar and mediastinal lymph nodes even with the aid of modern techniques like CAT scanning and mediastinoscopy was also noted. In 87 of 141 patients operated it was possible to check the result which was radical in 84 cases. In all, 19 pneumonectomies, 49 lobectomies and 16 bilobectomies were performed. The operative mortality rate was 3.4%. The various surgical indications were also examined in relation to the diverse clinical situations presented by lung cancers. In conclusion the modalities to be followed in order to enhance the value of radical resections in lung cancer are outlined. Above all diagnostic means must be refined to a point where the disease can be staged with maximum precision, patients for surgery must be selected with the utmost care and diagnosis must be as early as possible.

Humans↗
PubMed1985

[Primary intestinal lymphangiectasis. Apropos of a clinical case].

A case of primary intestinal lymphangiectasia in a 40-year old patient is described. The diagnosis was rendered more difficult by the association of this disease, breast cancer and the mistaken diagnosis of neoplastic cells in the pleural fluid. The clinical situation, laboratory and radiological findings, and biopsy results are compared with findings reported in the literature. A rapid, long-term improvement was obtained by the administration of a hypolipidic diet containing medium chain length fats.

Adult↗
PubMed1985

Bronchospasm: prevention and treatment.

We compared the results obtained in the treatment of bronchospastic conditions in two groups of 20 patients, one treated with an extempore combination of salbutamol (2 mg tablets) and oxatomide (30 mg tablets) and the other with salbutamol (2 mg tablets) alone. Positive results were obtained with the combination in 95% of cases, as against 55% in those treated with salbutamol alone. Generally speaking, treatment with the combination produced resolution of the bronchospasm, prevention of dyspnea attacks and an improvement in the respiratory status of the patients. The combination was well tolerated in all cases with no incidence of side effects, whereas in the patients on treatment with salbutamol alone, 3 cases of mild muscular tremors were observed, accompanied by tachycardia, but did not require discontinuation of the treatment.

Aged↗
PubMed1981

Amino acid transport in pig lymphocytes. Enhanced activity of transport system asc following mitogenic stimulation.

Changes in neutral amino acid transport activity caused by addition of phytohaemagglutinin-P to quiescent peripheral pig lymphocytes have been evaluated by measurements of 14C-labelled neutral and analogue amino acids under conditions approaching initial entry rates. Utilizing methylaminoisobutyric acid, the best model substrate of System A, we confirmed our previous report (Borghetti, A.F., Kay, J.E. and Wheeler, K.P. (1979) Biochem. J. 182, 27-32) on the absence of this transport system in quiescent cells and its emergence following stimulation. Furthermore, we demonstrated the presence in quiescent cells of an Na+-dependent transport system for neutral amino acids that has been characterized as System ASC by several criteria including intolerance to methylaminoisobutyric acid, strict Na+-dependence, the property of transtimulation and specificity for pertinent substrates such as alanine, serine, cysteine and threonine. Analysis of the relationship between influx and substrate concentration revealed that two independent saturable components contribute to entry of alanine in quiescent cells: a low affinity (Km = approximately 4 mM) and a high affinity (Km = approximately 0.2 mM) component. The high affinity component could be inhibited in a competitive way by serine, cysteine and threonine, but methylaminoisobutyric acid did not change appreciably its constants. The enhanced activity of alanine transport through the ASC system observed in activated cells resulted from a large increase in the capacity (V) of the high affinity component without any substantial change in the apparent affinity constant (Km).

Alanine↗
PubMed1980

Cell density and amino acid transport in 3T3, SV3T3, and SV3T3 revertant cells.

The transport of selected neutral and cationic amino acids has been studied in Balb/c 3T3, SV3T3, and SV3T3 revertant cell lines. After properly timed preincubations to control the size of internal amino acid pools, the activity of systems A, ASC, L, and Ly+ has been discriminated by measurements of amino acid uptake (initial entry rate) in the presence and absence of sodium and of transport-specific model substrates. L-Proline, 2-aminoisobutyric acid, and glycine were primarily taken up by system A; L-alanine and L-serine by system ASC; L-phenylalanine by system L; and L-lysine by system Ly+ in SV3T3 cells. L-Proline and L-serine were also preferential substrates of systems A and ASC, respectively, in 3T3 and SV3T3 revertant cells. Transport activity of the Na+-dependent systems A and ASC decreased markedly with the increase of cell density, whereas the activity of the Na+-independent systems L and Ly+ remained substantially unchanged. The density-dependent change in activity of system A occurred through a mechanism affecting transport maximum (Vmax) rather than substrate concentration for half-maximal velocity (Km). Transport activity of systems A and ASC was several-fold higher in transformed SV3T3 cells than in 3T3 parental cells at all the culture densities that could be compared. In SV3T3 revertant cells, transport activity by these systems remained substantially similar to that observed in transformed SV3T3 cells. The results presented here add cell density as a regulatory factor of the activity of systems A and ASC, and show that this control mechanism of amino acid transport is maintained in SV40 virus-transformed 3T3 cells that have lost density-dependent inhibition of growth, as well as in SV3T3 revertant cells that have resumed it.

Amino Acids↗
PubMedDate not supplied

[Temporomandibular joint involvement in juvenile idiopathic arthritis: treatment with an orthodontic appliance].

OBJECTIVE: About 65% of children suffering from juvenile idiopathic arthritis (JIA) shows a more or less marked involvement of temporo-mandibular joint (TMJ) with altered mandibular growth, resorption of the condyles, occlusary instability, reduced chewing ability and facial dysmorphia. The purpose of our study is to prevent and to treat the progressive evolution of JIA on craniofacial growth and morphology with a functional appliance; surgery should be considered only in so far as the adequacy of TMJ movement is concerned. METHODS: From 1992 until now 72 children with proved JIA and TMJ involvement have been treated (50 females, 22 males, aged 6 to 16 years old). TMJ involvement was bilateral in 61% and unilateral in 39% of patients. A diagnostic workup was carried out involving tomograms of TMJ and cephalometric radiograph and analysis. The authors used a bimaxillary activator in the attempt to modify the unfavourable growth pattern and provide a gradual ante-rotation of the jaw. RESULTS: Almost all JIA patients showed satisfactory long term results, easing of pain, reduced skeletal discrepancy, increased function and good facial profile. CONCLUSIONS: The long term results of this study indicate that orthopaedic therapy might control the vicious circle of the malocclusion in children with JIA, preventing exacerbation of mandibular clockwise rotation. Surgical intervention for the improvement of TMJ function should be considered only if a severe restricted state is imminent.

Adolescent↗