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Biomedical subjects

P Morelli

Publications and source records attributed to P Morelli.

17 recordsLinked to original sources

Dehydroepiandrosterone sulphate plasma levels in normal women and patients with benign breast disease.

Dehydroepiandrosterone sulphate plasma levels were measured in patients with benign breast disease and in healthy women. In addition the adrenal secretion of dehydroepiandrosterone sulphate was assessed by means of an ACTH stimulation test in some patients and control subjects. The results obtained demonstrate that dehydroepiandrosterone sulphate plasma levels of patients with benign breast disease overlap those found in controls and that the adrenal response to ACTH of patients with breast pathology does not differ from that of healthy women.

Adrenocorticotropic Hormone

Endocrine aspects of benign breast disease.

The purpose of this study was to determine the levels of dehydroepiandrosterone sulfate (DHAS) in the plasma of women with benign breast disease (BBD) and in normal subjects. Possible changes in DHAS plasma levels and in its adrenal secretion under adrenocorticotrophin hormone (ACTH) were also investigated in women with BBD before and after bromocriptine therapy. Our results demonstrate that plasma levels of DHAS in women with BBD overlap with those found in controls. Prolactin (PRL) suppression in women with BBD receiving bromocriptine treatment was associated with a significant (p less than 0.02) decrease of baseline DHAS plasma levels and of stimulated ACTH response curve (p less than 0.02). These data suggest a possible relationship between PRL and DHAS secretion in women with BBD.

Adrenal Glands

[Defibrotide vs. calcium heparin in the prevention of deep vein thrombosis in gynecologic oncologic surgery].

Eighty-one patients were submitted to gynaecological malignancy surgery in a randomized study aimed at the evaluation of the efficacy of defibrotide (40 patients) and calcium heparin (41 patients) in perioperative prophylaxis. They were randomly allocated to defibrotide group (400 mg bid im starting one day before surgery and continuing until the 7th postoperative day) or calcium heparin group (5000 IU bid sc starting two hours before surgery and continuing likewise for 7 days). No cases of DVT diagnosed by means of a Doppler CW were observed in either treatment group. Laboratory parameters have shown similar modifications in the two treatment groups. Three cases of bleeding were observed in the calcium heparin group while no cases of bleeding were detected in the defibrotide group. The results obtained suggest that defibrotide is at least as effective as calcium heparin in perioperative DVT prevention and that the former drug has a possibly better tolerability profile, due to a decisively lower tendency to bleeding.

Aged

Minimum eliciting patch test concentration of thimerosal.

Positive patch test reactions to thimerosal 0.1% pet. (40/690 subjects: 5.8%) were more common in younger age groups, in the allergic contact dermatitis group and in subjects who had used contact lens solutions. In the 40 thimerosal-positive patients, the minimum eliciting quantity of preservative was evaluated using different test concentrations: 0.05% and 0.01% pet. (patch testing) and 1:10,000 in saline (intradermal testing). Cross-reactions between thimerosal and other mercury compounds and sensitivity to thiosalicylic acid were also examined. The results of the investigation demonstrate that many of the reactions to 0.1% thimerosal are probably irritant, because only half the subjects studied had positive patch tests when allergen concentrations 5 to 10x lower than that conventionally used for patch testing, were utilized. In these subjects, the average strength of patch test reactions was higher, intradermal testing was more often positive and cross-reactions between mercurials more frequent. These data indicate that the optimal eliciting patch test concentration for studying thimerosal sensitivity is 0.05% pet.

Adolescent

Prolactin secretion and dehydroepiandrosterone sulphate plasma levels in women with benign breast disease.

The purpose of the present investigation was to verify possible positive correlations between prolactin secretion and dehydroepiandrosterone sulphate levels in plasma of women with benign breast disease. Prolactin secretion was evaluated in terms of basal levels, maximum peak, percent increase above baseline levels, total integrated area, response area after TRH stimulation. No correlation was found between the parameters of prolactin secretion and dehydroepiandrosterone sulphate levels.

Adult

[Defibrotide versus heparin in antithrombotic prophylaxis in gynecological surgery].

Deep venous thrombosis (DVT) can be a significant complication of the postoperative course in gynaecological surgery, because of traumatism and compression to which the vascular pelvic structures are subjected. A protocol was therefore designed to evaluate the effectiveness and tolerability of defibrotide, a new antithrombotic and profibrinolytic drug, compared with low-dose heparin. The study was conducted on 102 women, undergoing major gynaecological surgery for benign and malignant affections, randomly assigned to the following two treatment groups. A) defibrotide (400 mg i.v./i.m. b.i.d., starting the day before the surgery for 8 days); B) calcium heparin (5000 IU s.c. b.i.d., starting on the day of surgery, for/days). Clinical, haematological and instrumental (Doppler ultrasound) parameters were assessed and no major events were noted in either of the two treatment groups though in the calcium heparin group, 2 patients showed clinical signs of DVT (not confirmed by Doppler ultrasound) and no side effects were noticed, except for a cutaneous rash in one defibrotide patient and an episode of bleeding on the third postoperative day in a patient treated with calcium heparin. Defibrotide proved as effective as calcium heparin in the prevention of DVT in gynaecological surgery.

Clinical Trials as Topic

[Celiac disease and its diagnostic evolution. Comparisons and experiences in a hospital pediatric department (1975-1992). I].

The coeliac disease (CD) or gluten-sensitive enteropathy (GSE) is a permanent intolerance to wheat gliadin and to correlated proteins inducing malabsorption and typical damages of the jejunal mucosa (total or subtotal villous atrophy = SVA) in genetically-predisposed individuals ("DQW2"). A large amount of research has been devoted to CD pathogenesis: the most recent studies, thanks to sophisticated and experimental methods, support the pathogenetic immunological theory and the one of direct cytotoxicity. The correct diagnostic procedure for CD, established in 1970 by the European Society for Pediatric Gastroenterology and Nutrition (ESPGAN), suggested three small bowel mucosal biopsies. In the last years, because of the difficulties of such a practice, the necessity of non-invasive diagnostic approaches has developed; such approaches have been verified in absorption tests (one-hour blood xylose, intestinal permeability methods) and in immunogenetic tests (antibodies antigliadin, anti-reticulin, anti-endomysium, anti 90 KD glycoprotein, anti-human jejunum, HLA I/II antigens). The specific MHC antigens establish CD's incidence in several population and in particular situations, as in first-degree relatives and in diseases associated with CD (dermatitis herpetiformis (DH), insulin dependent diabetes mellitus (IDDM) and other auto-immune syndromes). The specific serum antibodies singly used as first level screening if estimated in combination with absorption tests, reach the highest levels of specificity and sensibility in CD diagnosis. It's anyway fundamental the comparison with at least a typical CD histological feature, caused by a challenge with a sufficient gluten to be carried in dubious cases and in non high auxological risk age (ESPGAN 1989). Adolescence is a period of frequent non compliance with a gluten-free diet and of particular psychological and physical problems: the apparent "gluten insensitivity", typical of teen-agers and adults, recalls the definitions of silent CD and latent CD (iceberg like). In the first case the jejunal mucosa is abnormal and the symptomatology isn't evident. In latent CD, genetically restricted, the mucosa is normal but there are minimal markers of inappropriate immunity to gliadin (at intestinal humoral immunity level) and a possible worsening of histological lesions to the third stage under environmental stimuli. This represents a two-stage model CD. That's why CD is still under-evaluated despite recent statistics reporting an increasing incidence (late and atypical forms). Prevalence rates between 1:300 and 1:4,000 and more are quoted in literature. The necessity of a strict gluten-free diet is confirmed by the evident frequency of lymphoma and by the increased risk of malignancy in untreated CD.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent

[Hemoglobin H disease. Presentation of a case].

Haemoglobin H (Hb H) disease, the most important clinical form of alpha-thalassaemia, shows remarkable clinical variability. Hb H si an unstable tetramer of beta-globin chains which accumulates because of the lack of adequate numbers of alpha-globin chains and precipitates in the red cells, causing their premature destruction. A case of Hb H disease in a 9-yr-old child, admitted into hospital for acute haemolysis after use of pyrazolone derived, is presented. Haematologic data with synthesis in vitro of globin chains were obtained from the parents and sister. The clinical and haematologic features of this form of haemoglobinopathy are briefly discussed in the light of recent knowledges of his genetic mechanism of transmission.

Anti-Inflammatory Agents

[Value of rectal sensitivity test in chronic childhood constipation].

The rectal sensitivity test evaluates the distension volume for which the initial transient sensation occurs on defecation (conscious rectal sensitivity threshold). The conscious rectal sensitivity threshold (S.S.R.C.) was performed on 10 normal controlled subjects and 103 children with chronic constipation, functional megarectum and normal rectoanal inhibitory reflex. Children were between 5 and 14 years old. S.S.R.C. was increased in children with chronic constipation. Encopresis was proportionally increased with relation to S.S.R.C. increase. A therapeutical protocol was applied in all patients. Fifteen patients are still being treated: 87 obtained a normal function within 8 to 23 months of treatment; in one case the treatment was unsuccessful. The period of treatment was proportional to S.S.R.C. increase. Physiopathological background of a correct management is discussed.

Adolescent

[Primary vesico-uretero-renal reflux. Results of surgical treatment in over 1,100 refluxing ureters].

Primary vesicorenal reflux (P.V.R.R.) is the most important cause in the pathogenesis of chronic pyelonephritis, better known in medical literature as "reflux nephropathy". The Authors stress out the criteria adopted in their Center for surgical treatment of P.V.R.R. and report the results in 1158 refluxing ureters (858 children) operated on. In 5 ureters an ureteronephrectomy and in 1153 remaining ureters and ureteral reimplantation was carried out. About 57% of ureters operated on was affected by severe reflux (IV - V grade). The Authors obtained 98.6% of surgical successes. In 16 ureters operated on, stricture (9 ureters) and reflux (7 ureters) were postoperatively present. The percentage of successes in infants less than 2 years old at operation was 98%.

Adolescent

[Seidlmayer's "cockade" purpura. Report of a case].

Among hemorrhagic disorders affecting infants and depending on a vessel increased permeability, Seidlmayer "cockade purpura" is characteristic for its typical cutaneous manifestations. Owing to the rarity of this disease, we report a recently observed case.

Diagnosis, Differential