PubMed Health⌕ Search

Biomedical subjects

S Leone

Publications and source records attributed to S Leone.

At least 19 recordsLinked to original sources
PubMed1995

Influence of glucose load on cardiovascular and humoral responses to a cold pressure test.

To investigate the relationship between insulin and reactivity to the cold pressure test four groups of mildly obese patients (12 per group: normotensive, essential hypertensive, normotensive (N-NIDD) and hypertensive non-insulin-dependent diabetics (H-NIDD)) underwent a standardised oral glucose tolerance test. During the test, BP and heart rate were monitored and venous blood samples were obtained at 0, 60 and 120 minutes to determine serum levels of glucose, insulin (microU/ml), sodium, potassium (mEq/I), renin activity (ng/ml/hour), aldosterone, noradrenaline and adrenaline. The cold pressure tests were performed before glucose ingestion (I-CPT) and again at 60 minute after ingestion (II-CPT). As expected, glucose ingestion caused a significant increase in glycaemia and serum insulin; the latter rose significantly more at 60 minutes in normotensives (85 +/- 6) and essential hypertensives (83 +/- 5) than in N-NIDD (30 +/- 4) and H-NIDD (29 +/- 3). Plasma K significantly decreased in normotensives (4.4 +/- 0.1 vs. 3.6 +/- 0.1, P < 0.05) and essential hypertensives (4.3 +/- 0.1 vs. 3.5 +/- 0.1, P < 0.05) but did not change in either N-NIDD or H-NIDD. PRA significantly increased in normotensives (0.6 +/- 0.1 vs. 1.2 +/- 0.1, P < 0.01) and essential hypertensives (0.8 +/- 0.1 vs. 1.5 +/- 0.2, P < 0.05) but did not change in N-NIDD or H-NIDD. Plasma sodium and catecholamines did not change in any group. I-CPT induced similar reactivity in all the groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1994

Use of cytomegalovirus (CMV) hyperimmune globulin for prevention of CMV disease in CMV-seropositive lung transplant recipients.

Our data suggest that CMVIG in combination with ganciclovir effectively reduces the incidence, and delays the onset of CMV infections in seropositive lung transplant recipients. In addition, its use may be associated with less severe CMV infection and a lower incidence of bacterial or fungal opportunistic infection. Although the number of patients in the study is small, high-titer CMVIG may be more effective than standard titer immunoglobulin in the prevention of CMV disease in lung transplant recipients. Several questions remain in addition to these: What is the optimal dosage and duration of treatment with CMVIG for prophylaxis of CMV infection and disease in lung transplant recipients; Is this strategy cost-effective; Will it reduce the incidence of obliterative bronchiolitis following lung transplantation and enhance allograft survival? A prospective, random-assignment trial is warranted to answer these questions.

Acyclovir↗
PubMed1992

Long-term evaluation of the abdominal wall competence after total and selective harvesting of the rectus abdominis muscle.

Fifty patients who underwent unilateral breast reconstruction by transverse rectus abdominis musculocutaneous flap transposition between January 1987 and December 1989 are the object of this study. Every patient underwent selective harvesting of the medial portion of the muscle, whereas the lateral strip was left in place and studied intraoperatively by selective stimulation of the ninth intercostal motor nerve before closure of the fascial defect. Two separate ecographic scans of the abdominal wall were performed respectively 7 days and 6 months postoperatively, to evaluate the diameters of the residual portion of the rectus muscle and its long-term evolution. Our results show that in a considerable number of patients, the lateral strip of rectus was denervated at surgery. Long-term ecographic scans demonstrate, however, that in spite of this finding, the residual muscle usually maintains its diameters, thus significantly contributing to the competence of the abdominal wall, at least from the static point of view.

Abdominal Muscles↗
PubMed1992

Correction of type II breast deformities following conservative cancer surgery.

Breast deformities following conservative cancer surgery are seen with increasing frequency and often represent difficult reconstructive problems. Type II deformities are characterized by localized tissue insufficiency, which can be due to skin insufficiency (type IIa), subcutaneous tissue insufficiency (type IIb), or both (type IIab). Correction of a locally damaged breast is a surgical challenge that can result in a fully restored breast if selection of the surgical procedure is properly carried out. A series of 37 patients who underwent correction of type II deformities from 1980 to 1989 was reviewed. Results obtained with different surgical procedures, including simple submuscular placement of traditional or expandable implants, breast reshaping, transposition of a latissimus dorsi muscle or musculocutaneous flap, TRAM flap, and reverse abdominoplasty, were evaluated. Aesthetic outcome was judged to be good or excellent in 78 percent of patients. Guidelines for selection of the most appropriate surgical procedure according to the defect's etiology, morphology, and location and to the breast's size and shape are presented.

Adult↗
PubMed1992

[A clinico-microbiological assessment of patients who have undergone breast reconstruction with a myocutaneous flap of the rectus abdominis].

In plastic surgery a minor complication such as wound infection can cause a lot of damage, because it can put back flap revascularization or it can stop wound healing properly. So the final result is not as good as it should be. In head-neck and in breast reconstruction with prostheses there are set-treatments of antibiotic prophylaxis; while in breast reconstruction with myocutaneous flaps it is very indecisive where antibiotics are concerned. This fact has encouraged us to evaluate bacteria causing infective complications in patients who have had breast reconstruction with TRAMF. In this operation there are 4 conditions which could give rise to microbiological contamination: 1) duration of operation (about 4 hours); 2) wide and prolonged tissue exposure; 3) areas of ischemic tissue or liponecrosis; 4) drainage. In this study we have shown the percentage of bacterial infections and the type of bacteria responsible for these complications in a group of patients who had already undergone breast reconstruction with TRAMF.

Abdominal Muscles↗
PubMed1991

The transverse rectus abdominis musculocutaneous flap for breast reconstruction in obese patients.

Transverse rectus abdominis musculocutaneous (TRAM) flap breast reconstruction has often been considered contra-indicated in obese women. The morphological characteristics peculiar to this population, however, make obese women ideal candidates for this procedure because the reconstructed breast must often match a large ptotic contralateral breast. About one-third of our postmastectomy patients are corpulent, middle-aged women with "Mediterranean" body structures. Thirty-four obese women underwent TRAM flap breast reconstruction from 1985 to 1988. According to the Body Mass Index, 23 women had type II obesity and 11 had type III obesity. The preoperative and postoperative management and the surgical procedure were adapted to this particular group of women. The complication rate in this series of women was superior to that of a nonobese population; however, no severe complications were observed. The majority of women were extremely satisfied with aesthetic results; the surgeons also judged the final cosmetic outcome to be very favorable and, indeed, superior to that obtainable with simpler methods. Obesity uncomplicated by other risk factors does not represent an absolute contraindication to TRAM flap procedure.

Abdominal Muscles↗
PubMed1991

Translational control of discoidin lectin expression in drsA suppressor mutants of Dictyostelium discoideum.

Genetic analysis in Dictyostelium discoideum has identified regulatory genes which control the developmental expression of the discoidin lectin multigene family. Among these, the drsA mutation is a dominant second-site suppressor of another mutation, disB, which has the discoidinless phenotype. We now demonstrate a novel mechanism by which the drsA allele exerts its suppressive effect on the disB mutation. Interestingly, drsA does not merely bypass the disB mutation and restore the wild-type pattern of lectin expression. Rather, drsA mutant cells have high levels of discoidin lectin synthesis during growth but do not express lectins during aggregation. In contrast, wild-type cells only express lectin protein during the aggregation period of development. Phenocopies of the drsA mutation show a pattern of discoidin expression similar to that seen in the bona fide mutant. These data suggest that there may be a mechanism of negative feedback, resulting from the high levels of discoidin lectin made during growth, which inhibits further discoidin lectin expression during development. Northern (RNA) analysis of developing drsA mutant cells shows that these cells contain high levels of discoidin mRNA, although no discoidin lectin protein is being translated from these messages. Therefore, expression of the discoidin gene family can be controlled at the level of translation as well as transcription.

Blotting, Northern↗
PubMed1990

[Continuous infusion peridural analgesia in labor].

A technique of continuous infusion epidural anesthesia was used during labour in 933 patients divided into three groups according to age: Group A (14-18 years old), Group B (19-35 years old) and Group C (greater than 35 years old). Infusion was carried out using the following system: a PVC pressurized bag containing 0.3% marcain connected to 2 flow regulators which ensured a flow of 6 ml/h. During the dilatation phase, 85% of patients received sufficient analgesia, whereas 15% required extra boluses. During the expulsive phase 80% of patients received adequate analgesia of the perineal plane, 12% received an extra bolus of marcain 0.3% and local anesthesia was performed in 8% to allow infiltration. Instruments were required in 5.6% of patients in Group A, 11.3% in Group B and 7.4% in Group C. The incidence of Caesarian section was 5.6% in Group A, 9% in Group B and 14.8% in Group C. No maternal complication was observed. Epidural anesthesia via continuous infusion was therefore shown to be an efficacious and safe method for ensuring analgesia during labour.

Adolescent↗
PubMed1989

Systemic and renal effects of chronic angiotensin converting enzyme inhibition with captopril in hypertensive diabetic patients.

Nine outpatients with mild to moderate arterial hypertension, type 2 diabetes mellitus and persistent macroalbuminuria were studied. After 1 month of placebo, the patients were treated with 50 mg captopril twice a day for the following 6 months. Blood pressure and urinary albumin excretion were significantly reduced but no relationship was found between these two variables. No changes were detected in the renal plasma flow, glomerular filtration rate, filtration fraction, renal vascular resistance or metabolic pattern. Captopril significantly reduced blood pressure and albuminuria without any change in the renal function. The decrease in albuminuria may be related to the reduction in blood pressure as well as to a direct effect of captopril on glomerular haemodynamics.

Albuminuria↗
PubMed1984

Cytogenetic studies in five patients with myelofibrosis and myeloid metaplasia.

Chromosome studies of five patients with myelofibrosis and myeloid metaplasia were carried out on bone marrow cells and/or on peripheral blood without PHA. Abnormal clones were found in three patients. Such clones were a minority, compared with the number of cells with normal karyotypes in all three patients. Chromosomes abnormalities consisted of 5q- (case 5), 13q- (case 2), and a small supernumerary acrocentric marker (case 3). One of our five patients, a woman aged 75 (case 1), showed a constitutional karyotype 46,XX,inv(5)( p15q11 ). The same chromosome rearrangement was present in 100% of the stimulated peripheral lymphocytes of this patient and in one of her sons with a normal phenotype. One patient (case 4) had a normal karyotype. These results are discussed and compared with data from the literature concerning myelofibrosis and other myeloproliferative diseases.

Adult↗
PubMedDate not supplied

Hysteroscopic treatment of uterine septum.

Authors report their 4 years experience in the treatment of uterine septum by hysteroscopic metroplasty. 35 patients underwent procedure; no complications occurred. Postoperative reproductive outcome was evaluated in 29 women with follow-up longer than 6 months. Patients were divided into 2 groups according to presence or absence of associated factors compromising fertility. Group A composed of 19 women in which uterine septum was the only cause of pregnancy wastage. Preoperatively they had 40 pregnancies all ending in spontaneous abortion. Postoperatively 15 (79%) patients conceived and 13 (68%) had a live baby. Totally they had 18 pregnancies, 2 (12%) ended in abortion, 1 in molar pregnancy, 1 in premature delivery, 11 delivered at term and 3 are currently beyond 20 weeks pregnant, for a live birth rate of 78%. Life table analysis showed an estimated pregnancy rate of 82% at 12 months, monthly fecundability was 0.13. Group B composed of 10 women in which other factors compromising fertility were present. Preoperatively only 5 experienced pregnancy. Totally they had 8 pregnancies 7 (86%) of which ended in abortions and one in extrauterine pregnancy. Postoperatively only 3 (30%) had pregnancy and all had a live baby. Totally they had 4 pregnancies, 1 ended in abortion and 3 at term for a live birth rate of 75%. Life table analysis showed an estimated pregnancy rate of 11% at 12 months, monthly fecundability rate was 0.01. Hysteroscopic metroplasty proved to be safe and effective for solving pregnancy wastage caused by uterine septum. If other factors compromising fertility were present metroplasty did not increase fecundability, but improved live birth rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Habitual↗
PubMedDate not supplied

New issues for nosografic setting of "HELLP syndrome".

In 1982 Weinstein reported a syndrome marked by Hemolysis, Elevated Liver enzymes, Low Platelets (HELLP Syndrome). Following that report a critical review by MacKenna & Coll. reported that typical signs of the syndrome (observed in 223 cases of preeclampsia) were related to the preeclampsia so denying any nosografic autonomy to it. This report was confirmed by Killan that in 1974 described the classic HELLP syndrome as a complication of hypertensive syndrome in pregnancy. Our case report presents some patterns that may contribute to acquire new data in order to place the HELLP syndrome in its appropriate nosografic allocation.

Abdomen↗