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Biomedical subjects

R Lazzari

Publications and source records attributed to R Lazzari.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Diagnosis of gastro-esophageal reflux in children. Ultrasonography versus pH monitoring].

The reliability of ultrasonography (US) was investigated in the diagnosis of gastroesophageal reflux in the pediatric patient. Therefore, specificity and sensitivity of US were compared with those of a 24-hour pH monitoring. A hundred and twenty-nine patients were examined; their age ranged 38 days to 14 years (56 were under and 73 over 2 years old). Since these patients presented with gastroesophageal symptoms, they underwent both pH monitoring and US. The results of the two methods were in agreement in 79.8% of the cases. Notably, in the age group ranging 0 to 2 years, US exhibited greater sensitivity (87% vs. 78.8%) and slightly lower specificity (76.5% vs. 81.1%) than in the age group ranging 2 to 14 years. The greater sensitivity in the 0-2 age group can be explained by physiological factors (which are typical of the first months of life) as well as by technical factors. Therefore, in infants, US should be combined with pH monitoring to identify the cases which are unquestionably pathological. The high specificity in the children over 2 years of age could justify the use of US alone in this group of patients for both diagnosis and follow-up, while pH monitoring might be used only in the most severe and/or complicated cases. The results suggest that, in the two age groups considered, abdominal US can be used not only as the diagnostic method of choice in the study of gastroesophageal reflux, but also as an extremely useful tool during follow-up when therapeutic monitoring is also needed.

Adolescent↗
PubMed1991

What will be the adult height of coeliac patients?

We studied three groups of patients with coeliac disease: group 1 = 95 adult patients with gastro-intestinal symptoms diagnosed after reaching adult height, 41 of whom had had symptoms during childhood; group 2 = 23 adult patients with classic coeliac disease treated before or during puberty; group 3 = 11 coeliac children with short stature and no gastro-intestinal symptoms diagnosed and treated before or during puberty. We evaluated the adult height in groups 1 and 2 and the growth during the first years of diet in group 3. Our study leads us to the following conclusions. Dieting leads to a modest increase (on average not more than 3 cm) of the final height of coeliac patients. Subjects with gastro-intestinal symptoms who have been treated before adulthood reach a mean height similar to the normal population and have a slightly better adult height than non-treated subjects. This difference seems to exist only in men and this might be related to puberty evolving more rapidly in women receiving treatment. Subjects without symptoms during childhood reach a normal final height even without treatment. In our patients, early treatment seemed to have no great effect on adult height.

Adolescent↗
PubMed1991

Intellectual functions and personality in subjects with noncongenital myotonic muscular dystrophy.

Mental retardation and personality disorders are commonly described among the symptoms of myotonic dystrophy. Nevertheless, this tendency is not supported by systematic studies performed on large samples, whose results are controversial. We studied the cognitive functions and personalities of a group of 28 patients, in whom myotonic dystrophy had commenced in juvenile or adult life. The severity of the disease was variable, but all subjects were self-sufficient. Only 7.1% of subjects showed low intelligence with deterioration of perceptual-motor functions. This was not correlated with the severity of their disease. Women had a substantially lower mean Wechsler-Bellevue score than men. The personality function study of the entire group showed no change of psychiatric relevance but did present a depressive attitude with marked somatic concern and difficulties in establishing relationships in social life.

Activities of Daily Living↗
PubMed1991

Psychological aspects of therapeutic abortion after early prenatal diagnosis.

The early discovery of a fetal pathology creates a "crisis" situation fraught with psychic problems for the couple who must live through it. The Authors observed a group of patients in the second trimester of pregnancy. They had all requested therapeutic abortion since serious malformation of the fetus had been confirmed. By means of a questionnaire constructed for the purpose, certain characteristics of fetal malformation and of pregnancy were evidenced, as well as the way these were experienced by the patients. The immediate and delayed reactions to the diagnosis of malformation were also studied, as was the experience lived when faced with the choice of abortion.

Abortion, Therapeutic↗
PubMed1991

[Hypercalcemia and changes in cardiac rythm].

Holter's test was performed in eight patients with advanced breast cancer and paraneoplastic hypercalcemia. In spite of several reports of cardiac arrhythmias, none were found in these patients.

Adult↗
PubMed1990

Neurotransmitter, opiodergic system, steroid-hormone interaction and involvement in the replacement therapy of sexual disorders.

Dopamine (DA) and serotonin (5-HT) are the neurotransmitters most directly involved in sexual activity. DA plays a stimulatory role while 5-HT has an inhibitory effect. The two monoaminergic systems modulate the secretion of many hormones (GnRH, LH, testosterone, prolactin and endorphins) involved in sexual functional capacity. Furthermore, hormones influence synthesis and storage of brain neurotransmitters. Impotence can often be associated to clinical depression and altered neurotransmitter function. Moreover, stress represents an unbalance between various neurotransmitter systems and can induce impotence especially when disorders of the endorphinic system are present. Replacement therapy is based upon the understanding of these basic concepts. Impotence due to an underlying depressive illness must be treated with dopaminergic antidepressant drugs; while in stressful conditions a good response to the naloxone test is the preliminary criterion to subsequent naltrexone treatment. When a hormonal deficiency has been proved, the hormone replacement therapy is of course highly effective (gonadotropins in hypogonadotropic syndromes, testosterone in aging, etc.). Finally, idiopathic impotence could be treated by DA agonist and/or 5-HT antagonist drugs either alone or better yet in association with psychotherapy.

Adult↗
PubMed1990

Hyperendorphinemia in obesity is not related to the affective state.

In seventy-two patients affected by hyperphagic obesity and forty age-matched, normal weight volunteers we performed a psychological assessment, through various mental tests, and evaluated the beta-endorphin (B-Ep), ACTH and cortisol circulating levels, in basal condition and following an overnight short dexamethasone suppression test (DST). The hormones were measured by radioimmunoassay either directly in the serum (cortisol) and the plasma (ACTH), or after affinity gel column chromatography (B-Ep). In obese subjects B-Ep levels in basal conditions were four times greater than in normal weight controls and showed significantly less reduction after DST. ACTH and cortisol levels, in contrast, were in the normal range and were suppressed following dexamethasone as was also true in the control group. Psychological evaluation on M.M.P.I. (Minnesota Multiphasic Personality Inventory) revealed a trend toward hypochondria, depression, hysterias, psychoasthenia and schizophrenia. However, no significant correlation has been found between M.M.P.I. clinical scale scores and circulating levels of B-Ep and cortisol either in basal conditions or after DST. In conclusion, these data do not support the hypothesis that abnormalities of the hypothalamus-pituitary-adrenal axis in hyperphagic obesity are related to affective disorders.

Adrenocorticotropic Hormone↗
PubMed1989

Endorphins in male impotence: evidence for naltrexone stimulation of erectile activity in patient therapy.

In the present study we evaluated whether naltrexone administration could stimulate sexual function in 30 male patients, ages 25 to 50 years, with idiopathic impotence of at least one year's duration and not of organic etiology. The patients received naltrexone (50 mg/day) or placebo, on a random basis for two weeks. Sexual performance, expressed as the number of full coitus/week, was assessed before (time 0) and during (on days 7 and 15) each treatment. The naltrexone therapy significantly increased the number of successful coitus compared to placebo after 7 and 15 days of treatment: improvement of sexual performance was evident in 11 out of the 15 treated patients. All the patients experienced a significant increase in morning and spontaneous full penile erections/week. No significant side effects were reported. Endocrine studies revealed no significant modification of plasma LH, FSH or testosterone by naltrexone, suggesting that the positive effect of the drug on sexual behavior was exerted at a central level. A two-month follow-up, at which time patients were off treatment, erectile capacity had returned to baseline in 10 patients, while five reported complete recovery of their sexual ability. We hypothesize that an alteration in central opioid tone is present in idiopathic impotence and is involved in the impairment of sexual behavior.

Adult↗
PubMed1988

Immunoglobulin A antigliadin antibodies in jejunal juice: markers of severe intestinal damage in coeliac children.

Antibodies to gliadin (AGA), detected in jejunal juice by immunofluorescence and enzyme-linked immunosorbent assay, have been found in 13 of 15 (87%) children with untreated coeliac disease. Jejunal AGA were also positive in 6 of the 9 (67%) coeliac children on gluten challenge, while they were consistently negative in coeliac children on a gluten-free diet and in controls. Jejunal AGA were always of immunoglobulin A (IgA) class, associated with IgM in some cases. Moreover, the presence of IgA AGA in jejunal juice was strictly related to the severity of intestinal damage. These data suggest that IgA AGA, detected in jejunal juice are synthesized from gut mucosa and are markers of its abnormal function. Like AGA, antibodies to milk and egg proteins were only found in jejunal juice of coeliac patients with flat intestinal mucosa, but their prevalence was significantly lower than that of AGA.

Celiac Disease↗
PubMed1988

Psychologic evolution of patients with Menière's disease in relation to therapy.

The state of anxiety experienced by menieric patients indicates the importance of the psychologic component in this disease. Uncertainties as to the type of treatment that is actually curative for this disease have put doubts on the favorable outcome for patients referred for endolymphatic shunt procedures; some clinicians claim that in such cases surgery simply had a psychologic support function. To evaluate the effectiveness of such a statement, the authors have studied three groups of patients: patients who underwent surgery; patients who underwent medical treatment; and nonmenieric, otosclerotic subjects prior to surgery as a control group. The first group was further divided into subjects with and without improvement after surgery. The following personality tests were used: Minnesota Multiphase Personality Inventory, reduced version; Adjective Check List; State-Trait Anxiety Inventory; and Symptom Check List. The results relative to the whole menieric group show a tendency toward a state of dysphoria and more striking somatizations than in the otosclerotic group. In regard to the distinction between operated and nonoperated patients, the former group showed a personality with a strong neurotic trait associated with dysphoria and a state of free anxiety tending toward hypochondria. The outcome of the operation (improvement of the vertigo) does not seem to influence the personality of the subjects, even though there are signs of higher anxiety levels than in subjects without improvement.

Adult↗
PubMed1988

Pre-surgery information and psychological adjustment to enterostomy.

The post-surgery psychological adjustment to enterostomy was examined in a longitudinal study of 120 patients. Subjects were representative of the general enterostomy patients population. All had undergone surgery in various hospitals located in Rome and its surroundings. Adjustment to enterostomy was longitudinally evaluated by interviewing patients at various intervals after enterostomy: soon after surgery; 1 year after surgery; more than 1 year after surgery. When patients were initially interviewed, information was requested on how they were informed of their clinical condition which led to surgery, as well as of enterostomy and its consequences. 42% reported a low level of understanding about enterostomy on the basis of information received during hospitalization. Patients were consequently divided into two groups, one including those judged as adequately informed (AI), and the other including those judged as not adequately informed (NAI). These groups were compared, for immediate adjustment to enterostomy (within 3-6 mos. since surgery), delayed adjustment (1 yr. since surgery), and prolonged adjustment (more than 1 yr. since surgery). Patients of NAI group demonstrated a consistently poorer pattern of adjustment in all parameters under study (emotional, cognitive, behavioral, social) and their adjustment to enterostomy did not show any spontaneous improvement over the time. AI patients, on the other hand, showed a more favorable level of adjustment since after surgery and a more positive pattern in the follow-up period. Adequate information before surgery and during hospitalization has been evidenced as a necessary component of patient care and a very important element in determining the optimal functional and psychological recovery of patients with enterostomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1988

[Update on paraneoplastic hypercalcemia. Our experience in the treatment of hypercalcemic states of patients with advanced breast carcinoma].

The treatment of hypercalcemia of malignancy is troublesome. Personal experience with breast cancer associated hypercalcemia is presented. Eight patients were hydrated with intravenous administration of saline solution containing high doses of salmon calcitonin and subsequently six were treated with antiblastic polychemotherapy. Calcium level fell to normal in all patients. Hypercalcemia, with or without evidence of metastatic bone disease, may be caused by the production of humoral substance by tumoral tissue. In our experience the first therapeutic stage is the infusion of saline solution containing high doses of calcitonin, while the elective treatment is antiblastic polychemotherapy which, acting on tumour growth, may inhibit the release of humoral mediators of hypercalcemia causing a slower but stable reduction in serum calcium level.

Adult↗
PubMed1987

[Hormonal and psychophysiologic responses under conditions of experimental stress in subjects with essential arterial hypertension].

Two sex balanced groups of 6 subjects each (hypertensive patients vs normotensive subjects) were monitored for both biochemical and psychophysiological variables under stress (PRA, Adrenal Corticosteroid, Aldosterone, HR and Blood Pressure). A computed controlled RT procedure was employed as stress stimulation. The results suggest that different coping mechanisms are present in hypertensives and normotensives. Hypertensives were more emotionally involved and less efficient in stimulus habituation. Biochemical mechanisms have been hypothesized to explain these differences.

Anxiety↗
PubMed1986

Hyperendorphinemia in obesity and relationships to affective state.

Eight obese patients (exceeding ideal body weight by 50% or more) with no endocrinological or metabolic disorders and 8 healthy, age-matched, normal-weight volunteers were submitted to an overnight short dexamethasone (DXM) suppression test and to a psychological assessment through various psychometric scales. Plasma B-Endorphin (B-EP), B-Lipotropin (B-LPH), ACTH and cortisol concentrations were evaluated in basal conditions, as well as 9 and 17 hours after late night administration of 1 mg DXM in both groups. All hormones were measured by radioimmunoassay, either directly in the plasma (ACTH and cortisol) or after silicic acid extraction and Sephadex G-75 column chromatography (B-LPH and B-EP). In obese patients, plasma B-EP levels in basal conditions were three times higher than in normal weight controls and remained unaltered by DXM suppression. ACTH and B-LPH, in contrast, were within the normal range and were significantly reduced by DXM. In 3 of the 8 patients, plasma cortisol concentrations at 17 hours post-DXM were greater than 50 ng/ml indicating an early escape from the suppression. Psychometric evaluations revealed a prevalence of depressive personality in obese patients. These data indicate an hypersecretion of B-EP in obese patients, which is only partially dependent on hypothalamic control.

Adrenocorticotropic Hormone↗
PubMed1986

Antibodies to dietary antigens in coeliac disease.

Antibodies to gliadin (AGA) were found in 77 (94%) of 82 sera from patients with active coeliac disease (untreated and after gluten challenge). Although IgG AGA had a higher nosological sensitivity than IgA AGA (88% versus 67%), their nosological specificity was lower than that of IgA antibodies (87% versus 100%). The sensitivity of antibodies to casein, beta-lactoglobulin, and ovalbumin in active coeliac disease varied from 36% to 48% without significant difference between IgG and IgA antibodies. IgG and IgA antibodies to milk and egg proteins showed a specificity similar to that of AGA, although some IgA antibodies other than AGA were found in disease controls (Crohn's disease, ulcerative colitis, post-enteritis syndrome).

Adolescent↗