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Biomedical subjects

S Baldi

Publications and source records attributed to S Baldi.

At least 55 records · Page 3Linked to original sources
PubMed1994

Pulmonary lymphangioleiomyomatosis in postmenopausal women: report of two cases and review of the literature.

Pulmonary lymphangioleiomyomatosis, a disease largely confined to women in their reproductive years, is reported in two postmenopausal patients. Nine similar cases in the literature are reviewed. In older women, the disease appears to be similar to that described in younger women, with the possible exception that the clinical course may be longer and more benign after the menopause. It would appear that hormonal factors play a role in the development of the disease both before and after the menopause, and that hormonal treatment may be beneficial in the older women.

Female↗
PubMed1993

Relation of birthweight to maternal plasma glucose and insulin concentrations during normal pregnancy.

Maternal diabetes mellitus is complicated by fetal macrosomia and predisposes the offspring to diabetes, but recent evidence indicates that a low, not high, birthweight is associated with a higher incidence of Type 2 (non-insulin dependent) diabetes in adult life. To clarify the relationships between maternal glucose and insulin levels and birthweight, we measured oral glucose tolerance and neonatal weight in a large group (n = 529) of women during the 26th week of pregnancy. Women with gestational diabetes (n = 17) had more familial diabetes, higher pre-pregnancy body weight, and tended to have large-for-gestational-age babies. In contrast, women with essential hypertension (n = 10) gave birth to significantly (p < 0.01) smaller babies. In the normal group (without gestational diabetes or hypertension, n = 503), maternal body weight before pregnancy and at term, maternal height, week of delivery, gender of the newborn, and parity were all significant, independent predictors of birthweight, together explaining 23% of the variability of neonatal weight. In addition, both fasting (p < 0.006) and 2-h post-glucose (p = 0.03) maternal plasma glucose concentrations were positively associated with birthweight independent of the other physiological determinants, accounting, however, for only 10% of the explained variability. In a subgroup of 134 normal mothers with pre-pregnancy body mass index of less than 25 kg.m-2, in whom plasma insulin measurements were available, the insulin area-under-curve was inversely related to birthweight (p < 0.02) after simultaneously adjusting for physiological factors and glucose area.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Insulin resistance of stress: sites and mechanisms.

1. Stress is associated with a severe, yet reversible, form of insulin resistance. The aim of this study was to quantify the kinetics of insulin action (sensitivity and responsiveness) on intermediary metabolism during post-surgical stress. 2. We studied nine patients 6-8 h after major uncomplicated surgery, and eight healthy subjects matched for age, weight, glucose tolerance and duration of fast. A three-step isoglycaemic insulin clamp was combined with indirect calorimetry, [6-3H]glucose infusion and the forearm technique. 3. The following significant (P < 0.05 or less) abnormalities were found in the patients. Hepatic glucose production was higher at baseline, and less suppressed by insulin. Whole-body glucose disposal was impaired at all insulin doses (by 33-60%). Glucose oxidation was depressed throughout the dose range but its increments in response to insulin were normal. In contrast, non-oxidative glucose disposal was essentially unresponsive. At all insulin levels, forearm glucose extraction was markedly depressed and forearm lactate release was in excess of concurrent glucose uptake, suggesting ongoing glycogenolysis despite insulin. Total lipolysis (plasma free fatty acid and glycerol levels) promptly responded to insulin but remained higher than in the control subjects throughout. In the forearm, even the highest insulin dose could not suppress net free fatty acid and glycerol release. Total lipid oxidation was increased throughout the insulin range, and calculated direct free fatty acid (as opposed to plasma free fatty acid) oxidation was virtually unaffected by insulin. Protein oxidation was slightly (35%) increased, but was suppressed normally in response to insulin. Energy expenditure was 20% higher at baseline, and failed to rise with insulin. Arterial blood pH values were consistently (if slightly) lower, and net forearm proton release was higher, both at baseline and during insulin infusion. 4. Post-surgical insulin resistance is characterized by normal sensitivity but decreased responsiveness of glucose oxidation, lipolysis and plasma free fatty acid oxidation, whereas glycogen synthesis and direct free fatty acid oxidation are virtually unresponsive. For both glucose and lipid metabolism, the insulin resistance is particularly severe in forearm tissues, in which mild metabolic acidosis may play an additional role.

Blood Glucose↗
PubMed1991

Histamine hyperresponsiveness of the extrathoracic airway in patients with asthmatic symptoms.

Functional abnormalities of the extrathoracic airway (EA) may produce symptoms mimicking bronchial asthma. We assessed the bronchial (B) and EA responsiveness to inhaled histamine in 40 patients with asthmatic symptoms and in nine asymptomatic controls. FEV1 and maximal mid-inspiratory flow (MIF50) were used as index of bronchial and EA narrowing. Hyperresponsiveness of the intra-(BHR) or extra-(EA-HR) thoracic airway was diagnosed when the provocative concentrations of histamine (PC20FEV1 or PC25MIF50) were less than 8 mg/ml. Fiberoptic laryngoscopy was performed in nine patients and three controls. The glottal region was measured at mid-volume of maximal inspiration (AgMI) and expiration (AgME) before and after histamine. Predominant EA-HR was found in 13 patients, predominant BHR in 12, equivalent BHR and EA-HR in another 12; no significant airway narrowing was observed in three patients and in the nine controls. EA-HR was significantly associated with female sex, sinusitis, post-nasal drip, dysphonia; BHR with atopy, wheezing and lower MEF50. The percent change in AgMI after histamine was closely related to the PC25MIF50 (r = 0.87, P less than 0.001), that of AgME to the PC20FEV1 (r = 0.78, P less than 0.01). These findings suggest that the assessment of EA responsiveness may be useful in the evaluation of asthmatic symptoms, especially in patients with no BHR.

Asthma↗
PubMed1991

Tumor-associated trypsin inhibitor (TATI) in pleural effusions.

The purpose of this study was to evaluate the usefulness of tumor-associated trypsin inhibitor (TATI) determination in serum and pleural fluid for differential diagnosis of relapsing pleural effusions. The concentrations of TATI were determined in samples of serum and pleural fluid from 51 patients with pleural effusions comprising 20 benign exudates, 5 transudates and 26 malignant effusions. TATI levels overlapped in benign and malignant fluids. This precludes the use of this marker for diagnosis of pleural effusions. For this purpose CEA seems to be the best tumor marker with a sensitivity frequently higher than that of cytology.

Biomarkers, Tumor↗
PubMed1991

Tumor-associated trypsin inhibitor (TATI) in the diagnosis of lung cancer.

To evaluate the usefulness of tumor-associated trypsin inhibitor (TATI) as a marker for the diagnosis of lung cancer we determined serum levels of this peptide in 255 patients with lung cancer and in 74 patients with chronic obstructive lung disease. A reference population consisting of 151 healthy volunteers was also studied. TATI concentrations were measured by radioimmunoassay. As a cut-off point we used the 99th percentile of the TATI concentrations in a reference population, which was 32 micrograms/l. TATI does not appear to be a good tumor marker in lung cancer. Its sensitivity is poor in comparison with CEA and TPA. The correlation between TATI levels and stage of the disease and histological type was weak.

Biomarkers, Tumor↗
PubMed1990

Bronchial responsiveness in patients with mitral valve disease.

Bronchial responsiveness has been evaluated in patients with chronic lung congestion secondary to mitral valve disease. Methacholine bronchial challenge was performed by intermittent aerosol generation in 31 patients with mitral valve disease, 18 in New York Heart Association (NYHA) Class II and 13 in NYHA Class III, non-atopic and with baseline forced expiratory volume in one second/vital capacity (FEV1/VC) greater than 85% of predicted and in 30 normal controls. Haemodynamic data were available in 17 patients. The methacholine bronchial provocation dose causing a 35% fall of airway conductance (PD35sGaw) was significantly lower in patients (507 +/- C.I. 205 micrograms) than in normals (2779 +/- C.I. 358 micrograms), (p less than 0.001). In patients log PD35sGaw was significantly correlated with mean pulmonary artery pressure (r = 0.53, p less than 0.05), mean pulmonary capillary wedge pressure (r = 0.67, p less than 0.01), but not with any spirometric parameters. Bronchial hyperresponsiveness seems to be common in patients with mitral valve disease and evidence of lung congestion.

Bronchial Provocation Tests↗
PubMed1989

Effect of ascorbic acid on increased bronchial responsiveness during upper airway infection.

We investigated the acute effect of ascorbic acid on histamine bronchial responsiveness (PC 20: concentration causing a 20% fall in FEV1) in 9 hospital staff members with upper respiratory tract infection (URI) and cough. Subjects were examined within 5 days from the start of illness and 6 weeks after. On day 1, the reproducibility of PC20 was assessed by 2 consecutive inhalation challenges 1 h apart; the two values were closely related (r = 0.96, p less than 0.001). Five subjects had bronchial hyperresponsiveness (PC20 less than 8 mg/ml histamine). On the following day, PC20 was measured before and 1 h after oral intake of 2 g ascorbic acid. Vitamin C produced a significant increase in average PC20 (p less than 0.01) from 7.8 +/- (SE) 1.2 to 25.1 +/- (SE) 1.2 mg/ml. None had airway hyperresponsiveness after treatment. Six weeks after the onset of URI, bronchial responsiveness was normal in all the subjects but one. The mean PC20 was 15.5 +/- (SE) 1.25 mg/ml, significantly higher than during URI (p less than 0.05); after ascorbic acid it increased nonsignificantly to 25.7 +/- (SE) 1.35 mg/ml. Our results indicate that vitamin C inhibits the transient increase in bronchial responsiveness occurring in otherwise normal subjects during URI.

Adult↗
PubMed1989

[Bronchial carcinoma in subjects under 40].

We investigated a series of 30 patients younger than 40 years with histologically proven bronchogenic carcinoma. Most patients were symptomatic for a mean duration of 3 months before examination. The most common cell types were squamous carcinoma in 10 patients, oat cell carcinoma in 9 patients, and adenocarcinoma in 5 patients. The disease was categorized as Stage I in 3 patients, Stage II in 3, Stage III in 17, and Stage IV in 7. Ten patients underwent resection, whereas 3 patients were inoperable at surgery. The average length of survival for the nonoperated patients was 4.2 months (range 1 to 16 months). The mean survival for the surgically treated patients was 23.3 months (range 0 to 84 months). Extent of resection did not have any statistical significance in the survival rates which were mainly affected by staging of disease.

Adenocarcinoma↗
PubMed1988

[Determination of serum neuron-specific enolase in bronchial tumors of neuroendocrine origin].

Neurone-specific enolase, a serum marker of neuroendocrine tumours has been determined in small-cell anaplastic bronchial carcinomas, in typical and atypical carcinoid. The marker presents good sensitivity in small-cell tumours and in atypical carcinoids, while blood levels are within normal limits in cases of typical carcinoid. The low serum levels of neurone-specific enolase found in typical carcinoid suggest a failure of the enzyme to express itself in the circulation owing to the poor or lack of cellular necrosis.

Biomarkers, Tumor↗
PubMed1988

[Respiratory function evaluation in esophageal surgery. Predictive value of tests].

In the context of major surgery the predictive significance of respiratory function tests in relation to postoperative pleuro-pulmonary complications is assessed. A statistical analysis is performed on a series of 85 oesophagectomy after thoracotomy and laparotomy. The most significant respiratory function indices are found to be those relating to volume restriction and the Mottley index.

Adult↗
PubMed1987

[Collageno-vascular diseases and interstitial pulmonary fibrosis. An analysis of diagnostic tests].

Collagenovascular diseases, particularly rheumatoid arthritis, LES and scleroderma frequently involve the lung. A group of 15 patients with collagen vasculopathies was analysed with a view to identifying the most suitable invasive and noninvasive tests for the diagnosis of the interstitial fibrosis of the lung that often accompanies such disorders. Among the noninvasive tests only the respiratory function tests (especially DLCO) are adequately sensitive, while chest X-rays, gallium scintigraphy of the lung and ACE are relatively unreliable. Bronchoalveolar lavage is often altered (though the intensity varies considerably) and transbronchial biopsy appears to be the ideal diagnostic examination.

Aged↗
PubMed1987

[Usefulness of the determination of CEA and Ca 19-9 in the diagnosis and staging of bronchial carcinoma].

The value of CEA and Ca 19-9 assays in the diagnosis and staging of lung cancer is examined. The particular sensitivity of CEA especially in extensive or metastasised tumours is demonstrated. The minimal sensitivity of Ca 19-9 is pointed out but also its absolute specificity in high risk control groups (smokers and BPCO). It is therefore concluded that Ca 19-9 might be used together with CEA in the diagnosis and staging of lung cancer.

Antigens, Neoplasm↗