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Biomedical subjects

R Franceschini

Publications and source records attributed to R Franceschini.

122 records · Page 7Linked to original sources
PubMedDate not supplied

Evaluation of beta-endorphin secretion in patients suffering from episodic cluster headache.

In order to obtain data regarding peripheral levels of beta-endorphin in head pain syndromes, we evaluated the plasma beta-endorphin secretory pattern in 12 adult male patients suffering from cluster headache. Blood samples were drawn every 2 hours for a 24-hour period, and in addition at 30-minute intervals for 120 minutes during cluster attacks. The same sampling was repeated during an asymptomatic period. Cluster headache patients showed no significant beta-endorphin circadian rhythm and a delayed acrophase during cluster periods compared with that recorded in the remission period and in normal subjects. Eighteen cluster headache attacks were recorded during the study day, 13 (72%) of which were followed by a significant increase in beta-endorphin levels. No correlation was found between beta-endorphin maximum net increase and intensity and/or duration of pain. These data suggest the hypothesis of a temporary alteration of beta-endorphin circadian secretion, probably related to involvement of neural structures controlling biorhythm pacemakers.

Adult↗
PubMedDate not supplied

Free DNA in urine: a new marker for bladder cancer? Preliminary data.

The aim of the present preliminary study was to investigate the presence of free DNA (FDNA) in urine as a possible marker for the diagnosis of bladder cancer. Naturally voided morning urine specimens were collected from 57 patients with suspected bladder cancer before cystoscopy. A standard urine test was performed; the specimens were then processed in order to obtain a quantitative evaluation of the presence of free DNA in the urine. Twenty-two patients were excluded from the study because they had leukocyturia and/or bacteriuria. Free DNA concentrations higher than 250 ng/mL were found in all 16 patients showing bladder cancer at cystoscopy and in seven (36.8%) of the 19 patients with negative cystoscopy. Urinary FDNA seems to have an excellent sensitivity: we observed no false negative cases and 36.8% false positive cases. By contrast, only 6.25% of the bladder cancer patients had positive urine cytology. Our results seem promising, although further studies and larger numbers are needed to define urinary free DNA as a reliable marker of bladder cancer.

Aged↗
PubMedDate not supplied

On the clinical usefulness of the free-to-total prostate-specific antigen ratio.

The free-to-total prostate-specific antigen ratio (F/T PSA) is associated with the presence of prostate cancer and is thus used as an indicator for suspicion of prostate cancer and as a determinant for biopsy. We reviewed a recent retrospective series of 966 consecutive prostate biopsies where F/T PSA was blindly determined and did not influence biopsy indication. We simulated the association of F/T PSA with biopsy outcome and its impact as a biopsy determinant. When adopting an F/T PSA cutoff of 10%, 13%, 16% or 20% among random sextant biopsies in the 4-10 ng/mL total PSA range, the sensitivity was 15%, 37%, 55% and 72% and the specificity 89%, 80%, 64% and 44%, respectively. Using F/T PSA as a biopsy determinant, from 1.7 to 2.6 cancer biopsies would have been delayed to avoid 10 benign biopsies. As this balance is not acceptable, F/T PSA has no role as a biopsy indicator and its clinical use is questionable.

Biomarkers, Tumor↗
PubMedDate not supplied

[The stress index: proposed method for risk assessment of stress and burnout in health care settings].

To assess the risk from exposure to stress and burnout in health care workers, a pilot study was planned to compare and integrate the information based on the risk evaluation obtained through different parameters that can be quantified and elaborated to produce a numerical index, called the "Stress Index", and the subjective symptoms from the individual workers. For these purposes, three internationally validated questionnaires were administered: the Job Content Questionnaire, the State-Trait Anxiety Inventory and the Maslach Burnout Inventory. The study considered six different Units from three divisions of Internal Medicine of a large public hospital in Northern Italy, and a total group of 228 health care workers employed in the six units. The results showed an association between the Stress Index scores and the scores from the questionnaires. In particular, in the two units with the highest levels of the index, a significantly higher unbalance between job demand and decision latitude was observed, together with the highest levels of state and trait anxiety and of depersonalization, indicating higher burnout levels.

Burnout, Professional↗
PubMedDate not supplied

[The preoperative staging of rectal cancer with endorectal echography].

The authors stress the value of the routine use of endorectal US for the preoperative staging of rectal cancer. This method accurately demonstrates the exact level of the lesion, the degree of circumferential invasion, the depth of local involvement and the extent of eventual spread beyond the rectal wall, the invasion of the surrounding structures and the presence of enlarged perirectal lymph nodes. A hundred and forty-one patients with rectal carcinoma located 3-16 cm from the ano-cutaneous line were examined with endorectal US preoperatively; a comparison was made between US findings and pathological data, so that a correlation could be made between US (uT) and histologic (pT) findings. A radial probe and a 7-MHz transducer were employed. Our results show US accuracy to be 93.6% with only 4 cases of understaging and 5 of overstaging. A hundred and twenty-nine patients who had undergone major surgery were also studied to evaluate US accuracy in lymph node detection: in 110 cases the actual lymph node status was correctly demonstrated; US diagnostic accuracy was 85.3% with 16 false positives and 3 false negatives. The correct evaluation of the actual local tumor spread, as demonstrated by endoluminal US, allows the choice of the correct treatment, together with a personalized therapeutic schedule, to reduce the incidence of local recurrences and to save, whenever possible, sphincter functionality.

Adult↗
PubMedDate not supplied

Updating the procedure for metaiodobenzylguanidine labelling with iodine radioisotopes employed in industrial production.

The classical procedure used for the preparation of [125I]- and [131I]metaiodobenzylguanidine (MIBG) is the solid-phase isotopic exchange between MIBG and radioiodide. This reaction requires 1.5 hours at 160 degrees C to obtain maximum total labelling yields of 75-80%. Recently, the importance of rapid procedures for the preparation of 123I-MIBG has been highlighted. A highly efficient procedure for the industrial production of 123I-MIBG using ascorbic acid, tin sulfate and copper sulfate pentahydrate in 0.01 M sulfuric acid is reported. Sequential radio-TLC analysis of the labelling mixture shows that the labelling yield reaches 98% within 45 min at 100 degrees C. The specific activity of the 123I-MIBG produced in this manner is on the order of 100 Ci/mmol.

3-Iodobenzylguanidine↗
PubMedDate not supplied

Grosse Kempf locked intramedullary nailing in the treatment of diaphyseal fractures of the lower limb. A case review.

After a review of the cases (57 between 1981 and 1988) the authors present the results of treatment of diaphyseal fractures of the lower limb by Grosse Kempf locked intramedullary nailing. The advantages and the effectiveness of the method are emphasized; the method has obtained brilliant results in complex and "boundary" fractures of the femur and tibia; furthermore, some suggestions are made with regard to surgery.

Adolescent↗
PubMedDate not supplied

Long term therapy with recombinant interferon alpha 2 b in patients with chronic hepatitis C: effects on thyroid function and autoantibodies.

Twelve anti HCV-positive patients (8 males and 4 females; 37-62 yrs) suffering from chronic active viral hepatitis have been evaluated in order to determine serum thyroid hormones and autoantibody pattern during recombinant interferon alpha 2b (IFN-alpha 2b) therapy. The interferon was given subcutaneously three times per week for six months in a single standard dose of 3 MU. For a further six months 5 patients (Group A) received the same interferon at 1MU dose three times per week and 7 (Group B) had no treatment. Serum T3, T4, FT4, TBG, TSH, TGAb and TMAb were determined on serum collected before the start of the treatment and every month for 12 months thereafter. Except for one case, in which a transient reduction in thyroid hormone values and an increase in TSH levels was recorded, none of the patients studied showed a significant variation of serum hormonal parameters or appearance of pathological TGAb and/or TMAb levels. The data indicate that the administration of recombinant IFN-alpha 2b to HCV positive chronic active hepatitis patients at the dose and schedule employed in the present study may result in a reduction in the incidence of thyroid dysfunction related to the IFN therapy.

Adult↗
PubMedDate not supplied

Crohn's-like colitis in glycogen storage disease Ib: a case report.

Association between glycogen storage disease type Ib and Crohn's like disease is rare. We present one such case. A young woman with glycogen storage disease type Ib underwent a right hemicolectomy for stenosis and a blind fistulous tract. The histological picture of the resected bowel was consistent with the diagnosis of Crohn's like disease. A leak in the entero-colostomy occurred during medical treatment with steroids, sulfasalazine, and methronidazole. Partial ileal and colonic resection and a new anastomosis were then performed. Recombinant human colony-stimulating factor (300 mcg/die subcutaneously) was then started. The neutrophils promptly increased to a normal range, and the neutrophil function tests improved. The postoperative course was uneventful and the patient did not have a relapse of the bowel disease.

Adult↗