Endometrial carcinoma bone metastases in unusual sites.
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Adenocarcinoma↗
Biomedical subjects
R Lazzari
Publications and source records attributed to R Lazzari.
Self-organized growth of nanoparticles on a surface patterned by a buried dislocation network.
The self-organized growth of Co nanoparticles is achieved at room temperature on an inhomogenously strained Ag(001) surface arising from an underlying square misfit dislocation network of 10 nm periodicity buried at the interface between a 5 nm-thick Ag film and a MgO(001) substrate. This is revealed by in situ grazing-incidence small-angle x-ray scattering. Simulations of the data performed in the distorted wave Born approximation framework demonstrate that the Co clusters grow above the dislocation crossing lines. This is confirmed by molecular dynamic simulations indicating preferential Co adsorption on tensile sites.
Journal Article↗
When mastectomy becomes inevitable: the nipple-sparing approach.
The preservation of the nipple areola complex (NAC) could improve the quality of life in cases of mastectomy. A novel radiosurgical treatment combining subcutaneous mastectomy with intraoperative radiotherapy is proposed. Three hundred nipple-sparing mastectomies (NSM) were performed. Invasive (58%) and in situ (42%) carcinomas were included. Clinical complications, aesthetic results, oncological and psychological results were recorded. The NAC necrosed totally in 10 cases and partially in 29 and it was removed in 12. Nine infections (3%) were observed and 10 prostheses removed. Good results were rated by 82.3% of the patients and by 84.8% of the surgeons. In 7.5% a radiodystrophy was observed. The sensitivity of the NAC recovered partially in 48%. Two local recurrences occurred outside the radiated field. Overall, we observed three metastases and no deaths. Sixty-eight of the patients were satisfied with their reconstructed breast and 85.5% were satisfied having preserved the NAC.
Adult↗
Emotional activation of obese and normal women due to imagery and food content of verbal stimuli in a memory task.
The aim of this study is to look for correlation between a physiological variable (skin conductance, SCL) and cognitive variables (reaction time, RT and productivity score) obtained in a memory task. Subjects were 17 females, including 7 patients and 10 controls. Patients were recruited among women who went to a clinic for alimentary disorders because of obesity and volunteered for this study; controls were normal women of comparable age without any alimentary problem. Tonic variations of SCL were recorded by a computerized polygraph during the execution of the cognitive task, which consisted of a computerized presentation of frequent, everyday used words evenly divided according to an alimentary/nonalimentary content and to a high/low imagery quality. The acquisition session was followed by an immediate recognition session where subjects were asked to identify the previously presented words among an equal number of similar words not included in the acquisition list. The two session series (acquisition and recognition) were repeated three times to evaluate the learning curve and habituation. This same procedure was separately performed with high imagery alimentary/nonalimentary words and with another list of low imagery alimentary/nonalimentary words. During the recognition tasks, both RT and productivity scores were recorded. A correlation analysis between cognitive and physiological variables was carried out to explore how subjects with different attitudes to food react in cognitive and somatic terms when exposed to verbal stimuli concerning this topic and to neutral verbal stimuli. Results show that obese patients have a different emotional activation in front of these verbal stimuli where both the cognitive activity and the somatic responses are affected by their involvement with the verbal stimuli. On the contrary, the imagery effect does not seem to be influenced by the content and by the idiosyncratic reactions to it of the specific groups of subjects.
Adult↗
Intraoperative radiation therapy with electrons (ELIOT) in early-stage breast cancer.
Local recurrences after breast-conserving surgery occur mostly in the quadrant harbouring primary carcinoma. The main objective of postoperative radiotherapy should be the sterilisation of residual cancer cells in the operative area while irradiation of the whole breast may be avoided. We have developed a new technique of intraoperative radiotherapy of a breast quadrant after the removal of the primary carcinoma (ELIOT). A mobile linear accelerator with a robotic arm is utilised delivering electron beams able to produce energies from 3 to 9 MeV. Different dose levels were tested from 10 to 21 Gy without important side effects. A randomized trial is currently ongoing in order to compare conventional irradiation and ELIOT. More than 400 patients have been enrolled. In addition a new approach for nipple and areola complex conservation, including ELIOT, is under investigation.
Breast Neoplasms↗
Eating behavior of ballet dancers.
Ballet dancers are frequently regarded as having a higher risk of developing eating disorders (ED). This paper describes the eating habits and prevalence of ED in a group of female students from a dance academy in Rome, Italy. Participants were assessed with an array of measures conventionally employed (usually singly) in epidemiological studies of ED, namely: an anthropometrical-nutritional evaluation, the EAT, EDI, and BUT questionnaires, and the EDE interview. The 160 students who agreed to participate were evaluated anthropometrically, nutritionally and psychometrically and 83 underwent the EDE structured interview. Their calorie intake was insufficient in all age groups in terms of the nutritional standards required by their daily physical activity. EAT, EDI and BUT enhanced concerns about dieting, food intake control and body image. The significance of the correlations between calorie intake and the EAT Dieting and the EDI Perfectionism and Interceptive Awareness scores increased in function of age. Food, weight and body image concerns increased with age and length of time in the ballet environment The reduced calorie intake was not necessarily linked to the presence of psychopathological signs.
Adolescent↗
Prevalence and clinical picture of celiac disease in italian down syndrome patients: a multicenter study.
BACKGROUND: A multicenter research study of Down syndrome patients was carried out to estimate the prevalence of celiac disease in patients with Down syndrome and to show clinical characteristics and laboratory data of Down syndrome patients. METHODS: The authors studied 1,202 Down syndrome patients. Fifty-five celiac disease patients (group 1) were compared with 55 immunoglobulin A antigliadin-positive antiendomysium antibodies-negative patients (group 2) and with 57 immunoglobulin A antigliadin-negative antiendomysium antibodies-negative patients (group 3). RESULTS: Celiac disease was diagnosed in 55 of 1,202 Down syndrome patients (4.6%). In group 1, weight and height percentiles were shifted to the left, whereas these parameters were normally distributed in groups 2 and 3. In celiac patients, diarrhea, vomiting, failure to thrive, anorexia, constipation, and abdominal distension were higher than in the other two groups. Low levels of hemoglobinemia, serum iron, and calcium were observed more frequently in group 1. The diagnosis of celiac disease was made after a mean period of 3.8 years from the initiation of symptoms. Sixty-nine percent of patients showed a classic presentation, 11% had atypical symptoms, and 20% had silent celiac disease. Autoimmune disorders were more frequent (30.9%) in group 1 than in the other two groups examined (15%; P < 0.05). CONCLUSIONS: This study reconfirms a high prevalence of celiac disease in Down syndrome. However, the diagnostic delay, the detection of atypical symptoms or silent form in one third of the cases, and the increased incidence of autoimmune disorders suggest the need for the screening of celiac disease in all Down syndrome patients.
Adolescent↗
Validation of the 13C-urea breath test for the diagnosis of Helicobacter pylori infection in children: a multicenter study.
OBJECTIVE: The 13C-urea breath test (13C-UBT) is a safe, noninvasive, and accurate test for the detection of Helicobacter pylori (H. pylori) infection in adults. The aim of this study was to evaluate sensitivity and specificity of 13C-UBT in children using different types of test meal, doses of 13C-urea and breath sampling intervals. As yet, a validated, standardized 13C-UBT protocol for children has not been formulated. METHODS: 13C-UBT was performed in 115 children and repeated within 3 days, modifying the test meal or the dose of 13C-urea. H. pylori status was assessed by histology and rapid urease test. 13C-UBT was performed using 100 mg or 50 mg of 13C-urea and a fatty test meal (100 FA; 50 FA), 50 mg of 13C-urea, and a carbohydrate test meal (50 CA). Breath samples were collected every 10 min for 60 min. RESULTS: The 13C-UBT in children was highly sensitive and specific with all three protocols used. The best combination of sensitivity (97.92%) and specificity (97.96%) was obtained with Protocol 50 FA at 30 min with a cut-off of 3.5 per mil. CONCLUSIONS: The 13C-UBT is an accurate test for the detection of H. pylori infection also in children. Administration of 50 mg of 13C-urea, a fatty test meal, and breath sampling at 30 min appears to be the most convenient protocol.
Adolescent↗
Depression in adult untreated celiac subjects: diagnosis by the pediatrician.
Untreated celiac disease can lead to serious behavioral disorders. We describe three adult patients with undiagnosed or untreated celiac disease without particular intestinal signs, causing persistent depressive symptoms in three of the parents of our pediatric patients. In two of the three cases, the pediatrician suspected the diagnosis when taking the family history of the children. In fact, a diagnosis of celiac disease was made during childhood, when they had intestinal symptoms, but the gluten-free diet was spontaneously interrupted during the teenage period because of the disappearance of the typical intestinal signs. In the third case the mother was tested for antiendomysium antibodies (EmA), as she had a diagnosed celiac child. In all three patients, the depressive symptoms improved quickly with a gluten-free diet. In conclusion, celiac disease should be taken into consideration in the presence of behavioral and depressive disorders, particularly if they are not responsive to the usual antidepressive therapy.
Adult↗
Rorschach findings for patients with pseudoseizures.
This study used the Rorschach test to investigate the possible differences between a carefully selected group of 16 patients with pseudoseizures, defined as spontaneous behavior resembling partial complex epilepsy and with or without tonic clonic generalization, and a group of 12 epileptic patients with partial complex seizures. Analysis of the structural data of protocols does not support a significant difference in the Rorschach findings between the two groups.
Adult↗
Validation and reliability of the Italian EAT-26.
The Italian from of the short, 26-item Eating Attitudes Test (EAT-26) has been administered to 1277 Roman high-school students, mostly females, as a screening device. Ninety-five students with a total score > 20 and 40 students with a low score, were randomly selected, interviewed and diagnosed. The EAT-26 proved to be more sensitive to the presence of an eating disorder than to a specific clinical entity. Item analysis performed on the EAT-26 variables showed satisfactory reliability coefficients. Factor analysis using an oblique rotation was similar to that obtained by Garner et al. (1). Factor analysis with an orthogonal rotation (Cattell's screen test) identified five factors. Results suggested that the EAT-26 isolates cases at risk of clinical spectrum eating disorders.
Adolescent↗
Genome search in celiac disease.
Celiac disease (CD), a malabsorption disorder of the small intestine, results from ingestion of gluten. The HLA risk factors involved in CD are well known but do not explain the entire genetic susceptibility. To determine the localization of other genetic risk factors, a systematic screening of the genome has been undertaken. The typing information of 281 markers on 110 affected sib pairs and their parents was used to test linkage. Systematic linkage analysis was first performed on 39 pairs in which both sibs had a symptomatic form of CD. Replication of the regions of interest was then carried out on 71 pairs in which one sib had a symptomatic form and the other a silent form of CD. In addition to the HLA loci, our study suggests that a risk factor in 5qter is involved in both forms of CD (symptomatic and silent). Furthermore, a factor on 11qter possibly differentiates the two forms. In contrast, none of the regions recently published was confirmed by the present screening.
Celiac Disease↗
Faecal elastase 1 in children with cystic fibrosis.
UNLABELLED: Recently, a new ELISA kit for determination of elastase 1 in faeces has become commercially available. Studies in patients with chronic pancreatitis have indicated that it is a simple and sensitive test of exocrine pancreatic function. The aim of this study was to assess the clinical value of this new test in cystic fibrosis. A total of 72 children were studied: 27 who were healthy, 22 with cystic fibrosis and 23 with non-pancreatic disorders. Oral pancreatic extracts were not discontinued in the children with cystic fibrosis. A small sample of faeces was collected from each subject for elastase 1 concentration and chymotrypsin activity determination. In all of the healthy children and most of those with non-pancreatic disorders (20/23), elastase 1 concentrations were greater than 500 microg/g; in contrast, the vast majority (20/22) of children with cystic fibrosis had very low values (less than 20 microg/g). The differences between children with cystic fibrosis and the other two groups were highly significant (P < 0.001). With a cut-off level of 132 microg/g, the sensitivity and specificity of faecal elastase 1 for the determination of exocrine pancreatic insufficiency were 96% and 100%, respectively. The specificity of faecal chymotrypsin was 96%, but its sensitivity was not calculated since the children with cystic fibrosis continued to take pancreatic extracts during the study. CONCLUSION: The determination of faecal elastase 1 concentration is a simple and reliable means of assessing exocrine pancreatic function in children with cystic fibrosis. Results are not influenced by non-pancreatic disorders or by enzyme supplementation.
Adolescent↗
The coeliac iceberg in Italy. A multicentre antigliadin antibodies screening for coeliac disease in school-age subjects.
BACKGROUND: Recent studies suggest that coeliac disease (CD) is one of the commonest, life-long disorders in Italy. The aims of this multicentre work were: (a) to establish the prevalence of CD on a nationwide basis; and (b) to characterize the CD clinical spectrum in Italy. PATIENTS AND METHODS: Fifteen centres screened 17,201 students aged 6-15 years (68.6% of the eligible population) by the combined determination of serum IgG- and IgA-antigliadin antibody (AGA) test; 1289 (7.5%) were IgG and/or IgA-AGA positive and were recalled for the second-level investigation; 111 of them met the criteria for the intestinal biopsy: IgA-AGA positivity and/or AEA positivity or IgG-AGA positivity plus serum IgA deficiency. RESULTS: Intestinal biopsy was performed on 98 of the 111 subjects. CD was diagnosed in 82 subjects (75 biopsy proven, 7 not biopsied but with associated AGA and AEA positivity). Most of the screening-detected coeliac patients showed low-grade intensity illness often associated with decreased psychophysical well-being. There were two AEA negative cases with associated CD and IgA deficiency. The prevalence of undiagnosed CD was 4.77 x 1000 (95% CI 3.79-5.91), 1 in 210 subjects. The overall prevalence of CD, including known CD cases, was 5.44 x 1000 (95% CI 4.57-6.44), 1 in 184 subjects. The ratio of known to undiagnosed CD cases was 1 in 7. CONCLUSIONS: These findings confirm that, in Italy, CD is one of the most common chronic disorders showing a wide and heterogeneous clinical spectrum. Most CD cases remain undiagnosed unless actively searched.
Adolescent↗
Dissociative trance disorder: clinical and Rorschach findings in ten persons reporting demon possession and treated by exorcism.
Although dissociative trance disorders, especially possession disorder, are probably more common than is usually though, precise clinical data are lacking. Ten persons undergoing exorcisms for devil trance possession state were studied with the Dissociative Disorders Diagnostic Schedule and the Rorschach test. These persons had many traits in common with dissociative identity disorder patients. They were overwhelmed by paranormal experiences. Despite claiming possession by a demon, most of them managed to maintain normal social functioning. Rorschach findings showed that these persons had a complex personality organization: Some of them displayed a tendency to oversimplify stimulus perception whereas others seemed more committed to psychological complexity. Most had severe impairment of reality testing, and 6 of the participants had an extratensive coping stile. In this group of persons reporting demon possession, dissociative trance disorder seems to be a distinct clinical manifestation of a dissociative continuum, sharing some features with dissociative identity disorder.
Adult↗
[The use of granisetron per os in radiotherapy-induced emesis].
INTRODUCTION: Radiation-induced emesis is a quite frequent event when total and half body irradiation or wide fields on the pelvis, abdomen and mediastinum are employed. These symptoms cannot always be controlled by dopamine antagonists as metoclopramide. In these cases the use of 5-HT3 antagonist, widely employed during chemotherapy, can be studied. MATERIAL AND METHODS: We examined 15 patients, 8 males and 7 females, aged 23-79 (mean 49, median 54), with performance status = < 2 (ECOG): 4 seminomas of the testis, 4 cervical carcinomas, 3 recto-sigmoid adenocarcinomas, 2 Hodgkin's lymphomas, 1 prostate adenocarcinoma and 1 lung carcinoma. Radiotherapy was performed on the pelvis in 7 cases, on the lumboaortic and iliac regions in 4 cases, on the lumboaortic and splenic regions in 2 cases, on the lumboaortic region in 1 case and on the mediastinum in 1 case using X-rays of linear accelerator (18 MV). Usual doses and conventional fractionation were employed. During treatment we observed nausea and vomiting grade 2 (RTOG scale) uncontrolled by dopamine antagonists. These symptoms appeared 1-41 days (mean 13.5, median 7) after the start of the radiotherapy, at doses of 1.8-49 Gy (mean 16.7 Gy, median 9 Gy). In all cases we administered oral granisetron 1 mg/day 1-2 hours prior to radiotherapy (5 days/week). RESULTS: In all patients we observed complete remission of the symptoms in 1-3 days (mean 1.5, median 1). Thirty-three % of the patients had an immediate remission of nausea and vomiting. Granisetron was administered 7-28 days (mean 16.3, median 14). The compliance to the treatment was optimal: 100% in the first week. No adverse events were observed. DISCUSSION: The mechanism of radiation-induced emesis is not well known but some studies showed that 5-HT3 receptors are involved, as well as demonstrated for chemotherapy. Age, performance status, anxiety, concomitant pathologies, size of radiation fields and dose fractionation probably play an important role. Most studies concern the use of intravenous granisetron for emesis during total body of half body irradiation and conclude that this drug is very effective in prevention and treatment of this symptom. In our series we observed a very high efficacy of oral granisetron in the treatment of nausea and vomiting during irradiation by wide fields on the pelvis, abdomen and mediastinum, without adverse events. We conclude that the administration of oral granisetron can be effective and useful for radiation-induced emesis when dopamine antagonists have failed.
Administration, Oral↗
Antiendomysium antibodies and coeliac disease: solved and unsolved questions. An Italian multicentre study.
A total of 3783 subjects were enrolled to compare IgA and IgG gliadin antibodies (AGA) with IgA endomysium antibodies (EMA) in coeliac disease (CD). Among 688 children with untreated CD EMA were positive in 93.8%, IgA AGA in 84.9% and IgG AGA in 90.2%. AGA, but not EMA, sensitivity decreased with age. EMA were present in 3.8% of control subjects, IgA AGA in 14.9% and IgG AGA in 34.3%. Follow-up of 5 of 39 EMA-positive controls showed flat mucosa. Combined determination of EMA and AGA showed an increased predictive value: if EMA and AGA were both positive, the mucosa was flat in 99.1%, if both were negative, the mucosa was normal in 99.1%. After a gluten-free diet (GFD), IgA-AGA disappeared first. Among 21 patients not on a strict GFD and in 194 coeliac patients after challenge, EMA, but not AGA, were always positive. Among 67 first-degree relatives of coeliacs, the positive predictive value of EMA was 90.6%, IgA AGA 74.3% and IgG AGA 44.6%. In conclusion, EMA screening is an excellent test for the diagnosis and follow-up of CD, and for identification of its silent and latent forms.
Adolescent↗
Multicenter study on the reproducibility of antigliadin (AGA) and antiendomysial antibodies (EmA) in celiac sprue screening. The Tenue Club Group.
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Adult↗