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Biomedical subjects

R Pinto

Publications and source records attributed to R Pinto.

At least 37 records · Page 2Linked to original sources
PubMed1990

Severe anemia is an important negative predictor for survival with disseminated Mycobacterium avium-intracellulare in acquired immunodeficiency syndrome.

Disseminated Mycobacterium avium-intracellulare (MAI) in patients with the acquired immunodeficiency syndrome (AIDS) is usually unresponsive to antimycobacterial therapy. We examined clinical and laboratory characteristics of MAI organisms and their relationship to the length of survival. We studied factors influencing survival and compared these in 76 patients with AIDS with and without MAI. Serum levels of p24 antigen and erythropoietin, and CD4-positive helper T-lymphocytes in blood were assessed in 36 additional patients with various clinical stages of HIV infection. In patients with MAI infection, survival was significantly related only to total lymphocyte count, hematocrit, platelet count, and sex. Of these, hematocrit and total lymphocyte count were the only linear predictors of survival. Anemia was significantly more profound in patients with AIDS and MAI than in the other patients. This anemia in patients with MAI could not be ascribed to increased peripheral destruction of red cells, deficient nutritional factors, or erythropoietin production, HIV viral or bacterial load, or a general effect on other blood elements such as neutrophils or platelets. The influence of MAI on survival in patients with AIDS did depend upon whether the MAI occurred as an index infection or was preceded by other opportunistic infections. Patients with other preceding opportunistic infection lived for a much shorter duration from the time of diagnosis of MAI.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Responses to smoking-related stimuli and early relapse to smoking.

Prior to engaging in treatment for smoking cessation, subjects were tested for their responsiveness to cigarette smoking cues. Subjects performed a role-play with a confederate who lit their preferred brand of cigarette. Heart rate (HR) and galvanic skin conductance were assessed continuously, while urge to smoke and anxiety were rated subjectively after the role-play. Three months after treatment ended, subjects were divided into groups of continuous quitters, verified by expired carbon monoxide measurement, and relapsers. The results showed a significant difference between the groups in the pattern of pretreatment HR response to the lighting of the cigarette; relapsers displayed a sharp HR deceleration in response to the stimulus, while quitters' HR did not decelerate. The theoretical and clinical significance of these results is discussed.

Adult↗
PubMed1989

Autologous bone marrow or peripheral blood stem cell transplantation for patients with chronic myelogenous leukaemia in chronic phase.

The progressive and fatal course of chronic myelogenous leukemia has not been affected significantly by chemotherapeutic agents that control the benign phase of the disease. Combination chemotherapy and aggressive treatments may offer some advantages: however, these approaches do not appear to produce stable suppression of Ph1 chromosome or to prolong chronic phase and survival of these patients. Only allogeneic bone marrow transplantation has been demonstrated to be capable of inducing a stable, complete suppression of Ph1+ cells. Recently alpha Interferons (IFN) have been shown to control myeloid proliferation in patients with CML and to determine a progressive and persistent decline of Ph1+ bone marrow cells in some cases. The hypothesis that in most newly diagnosed patients with CML various amount of Ph1 negative cells must still be present, albeit in suppressed state in the bone marrow (BM) or in the peripheral blood (PB), have led some Authors to treat patients with high-dose chemotherapy followed by reinfusion of stem cells collected at diagnosis or after a response to cytoreductive treatments. We report 34 patients with CML treated in chronic phase with Busulohan and Melphalan conditioning regimen followed by reinfusion of BM or PB stem cells.

Adult↗
PubMed1988

[Role of magnetic resonance in acute capsular-ligamentous pathology of the knee].

Magnetic Resonance (MR) imaging was employed to evaluate musculoskeletal pathoanatomy, and proved to be extremely useful in characterizing knee pathology. Between October 1986 and November 1987, 24 patients with suspected traumatic ligament injuries were examined with high resolution MR imaging in the RMRC diagnostic center, Naples, with a 0.5 T superconducting magnet (5000 Magniscan CGR) using a surface coil and a 500/28 (repetition time: TR: ms/echo time: TE-ms), 1200-1600/35-105 spin-echo pulse sequence. Nineteen patients with positive MR imaging exams underwent diagnostic and/or therapeutic arthroscopy. Arthroscopy confirmed MR diagnosis in the whole of cases. In 6 patients with negative MR findings no arthroscopy followed and the patients' successful outcome confirmed the accuracy of MR negative predictive value. Such results prove MR imaging to have a high diagnostic accuracy in the evaluation of acute joint injuries of the knee. Moreover, MR imaging--an uninvasive screening technique--appears to have high potentials for the evaluation of those cases where diagnostic arthroscopy is not required.

Acute Disease↗
PubMed1987

[Magnetic resonance imaging of the knee. Preliminary study of non-neoplastic osteoarticular pathology].

Magnetic Resonance Imaging (MRI) has been applied to musculoskeletal pathoanatomy and has proved to be useful in the detection and characterization of knee pathology. Thirty-two acutely injured knees and 8 normal knees were examined. The images were obtained in the Diagnostic Centre RMRC of Naples on a 0.5 T superconductive magnet system, using a surface coil and a spin-echo pulse sequence (SE 600/28 ms). The examined limb was immobilized and bent at 8-10 degrees, extrarotated for the examination of the anterior cruciate ligament (ACL) only. Images were obtained on a 256 x 256 matrix and had a 2 or 4-mm thickness. MRI clearly showed all the anatomical structures. The anterior and posterior cruciate ligaments (ACL and PCL) and the patellar ligament were shown by sagittal SE images through the intercondylar notch; the tibial and fibular collateral ligaments (TCL and FCL) were evaluated on coronal SE images; the articular capsula and menisci on axial transverse SE images. Objective criteria for ACL and PCL tears were: lack of continuity of the signal and change in signal intensity; in meniscal pathology, menisci with small linear regions of increased signal or with grossly truncated shape were interpreted as tears. Preliminary results of this study indicate that MRI together with clinical evaluation may be an useful non-invasive procedure in the assessment of acute injuries of the knee.

Diagnosis, Differential↗
PubMed1986

Long-term treatment with 'Duovent' in elderly patients affected by chronic obstructive lung disease.

Twelve patients, aged over 60 years and suffering from chronic obstructive lung disease, were treated for 12 weeks with Duovent (fenoterol + ipratropium bromide). The clinical check-ups and indices of bronchial obstruction (FEV1, VC, RV, sGaw) were performed every 14 days. Improvement in symptoms corresponded to a significant improvement in the functional parameters. No negative cardiovascular effects, significant side-effects, or tolerance were seen after drug administration.

Aged↗
PubMed1985

[Subphrenic adipose tissue, an infrequent cause of increased distance between the diaphragm and liver. Radiological study and echographic comparison].

Nine obese patients (4M/5F) showing on a standard chest-X-ray a right subdiaphragmatic radiolucent area were submitted to ecography. This method excluded pathologic causes and showed adipose tissue as the cause of the increased distance between diaphragm and liver. Besides, ecography showed some limits in the evaluation of adipose area, because of the difficulty in studying obese patients.

Adipose Tissue↗
PubMed1984

Sodium taurocholate effect on beta-glucosidase activity: a new approach for identification of Gaucher disease using the synthetic substrate and leucocytes.

In this work we have studied the leucocytes and sera of 3 Gaucher patients, 4 obligate heterozygotes, 11 brothers and sisters of patients and 11 controls. Beta-glucosidase activity with 4-M-U-beta-glucopyranoside has been assayed at different pH's, in the presence of pure sodium taurocholate. At pH 4.5 and 5.0 sodium taurocholate activates the beta-glucosidase of control leucocytes, but inhibits the residual enzyme present in Gaucher leucocytes. The ratio of beta-glucosidase activity in the presence and absence of this effector seems to be a good approach to the diagnosis of Gaucher disease and it has proved indispensible in one patient's diagnosis. The apparent Km of beta-glucosidase determined for the same substrate, at pH 4.5 and 5.5 in the presence of sodium taurocholate showed markedly lower values in the patients than in the controls. An increased serum acid phosphatase activity, previously described as a secondary alteration in Gaucher disease, has also been studied and seems to be a useful complementary test, particularly when its age dependence is taken into account.

Acid Phosphatase↗
PubMed1983

Transient neurologic disturbances, brain tumors, and normal computed tomography scans.

During a 4-year period, four patients presented with transient disturbances in neurologic function that were diagnosed as seizures in two and transient ischemic attacks in the other two. Computed tomography (CT scan), both with and without contrast, was normal in all four patients. Isotopic brain scans (3 patients), cerebral angiograms (4 patients), and lumbar punctures (4 patients) were normal. Electroencephalograms (EEG) were normal in two patients and abnormal in two patients (consisting of focal slowing). Within 4.5 months, all patients developed symptoms and signs of a brain tumor, and in all four, CT scan now revealed a large mass lesion which at surgery was shown to be a malignant astrocytoma. These four patients constituted 4% of the total number of patients with malignant astrocytomas that were seen at the NYU Medical Center during this same time period. It is stressed that the CT scan may be normal early in the course of patients with brain tumors, particularly if they present with a transient disturbance in neurologic function. The first evidence of the tumor in such patients may be a slow-wave abnormality on the EEG. Patients who are suspected of having a brain tumor should, if the initial CT scan is normal, have the scan repeated later.

Adult↗
PubMed1982

The totally occluded internal carotid artery. Preliminary observations using rapid sequential computerized tomographic scanning.

Cerebral angiography often cannot distinguish between complete thrombosis or fibrosis of the internal carotid artery (ICA) and nonvisualization due to a total occlusion of the common carotid or origin of the ICA. Whereas surgery may be beneficial if the distal carotid is patent (type 1), thromboendarterectomy may be contraindicated if thrombus or fibrosis extend to the intracranial branches (type 2). Rapid sequential computerized tomography (RSCT) was used to examine 15 patients whose ICAs appeared occluded by angiography. Of four ICAs classed as type 1 by RSCT, three were found to be patent during surgical exploration, and carotid reconstruction was successfully performed. Three other ICAs classed as type 2 by RSCT were also surgically explored, and complete thrombosis was confirmed. The RSCT technique provides an effective and nonoperative means of determining whether a nonvisualized ICA is reconstructible.

Arterial Occlusive Diseases↗
PubMed1982

[Diffuse gastric pseudolymphoma or reactive lymphoid hyperplasia (RLH). Apropos of a case].

The authors report a case of superficial diffuse gastric pseudolymphoma studied by double contrast examination induced by pharmacologic agents and full filling of the stomach after compressive manoeuvres. The authors emphasize the importance of this nosologic entity and the problems of differentials diagnosis with all the stages of gastric cancer, with the peptic ulcer, with the healed ulcer, with lymphomas, with erosive gastritis, with nodular benign lesions. The stress that the certitude of diagnosis is given only by the histologic examination.

Diagnosis, Differential↗
PubMed1980

Benign osteoblastoma of a thoracic vertebra. Case report.

A patient with osteoblastoma of the T-11 vertebral body presented with symptoms of spinal cord compression. Six weeks after an emergency laminectomy and subtotal removal, spinal computerized tomography disclosed residual tumor, which was totally removed via a combined anterior transthoracic approach and posterior laminectomy.

Adult↗