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S Modoni

Publications and source records attributed to S Modoni.

32 records · Page 2Linked to original sources
PubMed1994

[Plasma levels of basal beta-endorphin and after effort in patients with severe left ventricular dysfunction and heart failure].

BACKGROUNDS: Purpose of the study was to evaluate beta-endorphin plasma levels at rest and after exercise, and the beta-endorphin release, in relation to exercise capacity, in patients with severe left ventricular dysfunction and heart failure. METHODS: Beta-endorphin plasma levels were assayed by radio-immunoassay before and after cardiopulmonary exercise testing in 28 heart failure patients with radionuclide ejection fraction < 35%, left ventricular end-dyastolic dimension > 60 mm and heart failure, and in 9 age-matched normal subjects. According to Weber's classification, 10 patients were in class A, 9 in class B, and 9 in class C. RESULTS: Beta-endorphin plasma levels at rest were respectively 3.52 +/- 2.31 pmol/L in patients, and 1.77 +/- 0.84 pmol/L (p < 0.05) in normals. In patients, baseline beta-endorphin correlated to VO2max (r = -0.76), peak rate-pressure product (r = -0.60) and exercise time (r = -0.56), then progressively increasing from class A to C. After exercise, beta-endorphin plasma levels increased respectively to 6.42 +/- 3.44 pmol/L (p < 0.001 vs baseline) in patients, and to 5.46 +/- 2.14 pmol/L (p < 0.001 vs baseline and NS vs patients) in normals. In patients, the release during exercise of beta-endorphin (exercise - baseline/baseline x 100) correlated to VO2max (r = 0.82), peak rate-pressure product (r = 0.64) and exercise time (r = 0.55), then progressively decreasing from class A to C. At multivariate analysis beta-endorphin release showed the greater correlation to exercise capacity parameters. CONCLUSIONS: In heart failure patients, beta-endorphin plasma levels are elevated at rest and its release during exercise is reduced in relation to functional impairment.

Adult↗
PubMed1993

Increased risk of neurological relapse in acute lymphoblastic leukemias with high levels of cerebrospinal fluid thymidine kinase at diagnosis.

Cerebrospinal fluid thymidine kinase (CSF-TK) was measured at diagnosis in 62 patients with acute lymphoblastic leukemia (ALL) without initial neurological manifestations, who achieved a complete remission after chemotherapy. During the follow-up period, 10 patients developed central nervous system (CNS) involvement. At the onset of the disease mean CSF-TK levels in these subjects were found to be significantly higher than those observed in patients without subsequent CNS complications. In particular, 7/10 (70%) of these patients who presented CSF-TK levels above the upper limit of normal (1.4 U/microliters) had evidence of a neurological relapse, while 49/52 (94.2%) of subjects with presenting CSF-TK levels of up to 1.4 U/microliters did not develop a neurological leukemic disease (p < 0.00001). The white blood cell count at diagnosis was significantly increased, but not directly correlated to CSF-TK levels, in the group with CNS involvement, while age, serum thymidine kinase levels and lactic dehydrogenase, FAB classification or immunophenotype were not different in patients with or without neurological relapse. In conclusion, increased levels of CSF-TK at presentation correlate with a high risk of subsequent CNS involvement in patients with responsive ALL.

Adolescent↗
PubMed1992

[Chronic inflammatory bowel diseases in childhood. Case contribution and critical considerations].

The term "inflammatory bowel disease" describes 2 major categories of chronic disease: Crohn's disease and ulcerative colitis. Non specific chronic colitis and allergic colitis in childhood can usually be distinguished by clinical and histopathologic criteria. This study regards a retrospective analysis of 23 patients suffering from chronic inflammatory bowel disease. Clinical manifestations began between 4 and 18 years of age. The Authors report remarkable frequency in pediatric age and common diagnostic delay, especially in Crohn's disease. The possibility of extraintestinal symptoms (erythema nodosum, arthritis, iridocyclitis) is also showed. Moreover they analyse present diagnostic proceedings: in childhood the employ of 99 mTc-HmPAO-labelled granulocytes is a new and non invasive test useful in the follow-up of the patients. In the treatment corticosteroids and sulfasalazine are used in various combinations associated with general supportive measures. Finally the Authors confirm that chronic inflammatory bowel disease may cause, especially in childhood, remarkable involvement on the growth and several psychological disorders.

Adolescent↗
PubMed1991

Gallbladder function and gastric liquid emptying in achalasia.

Because of evidence that the abnormalities in achalasia are not restricted to the distal esophagus, we investigated gallbladder function by cholescintigraphy in the steady state and in response to CCK and the scintigraphic gastric emptying of a liquid caloric meal in 10 individuals with achalasia and 10 normal controls. No abnormalities were found during the filling phase of the gallbladder but seven of the 10 patients showed a 50% reduction in the ejection fraction (39.4% +/- 30.4 vs 80.3 +/- 8.3 of controls, mean +/- SD, P = 0.007) and a slower than normal ejection phase (9.1%/min +/- 6.6 vs 18.1 +/- 4.5, P = 0.02. In eight of the 10 patients, gastric liquid emptying was accelerated with a T1/2 of 41.5 min +/- 15.4 vs 74.7 min +/- 11.5 in the controls (P = 0.007). It is concluded that in some achalasia patients extraesophageal functional abnormalities of the gastrointestinal tract may be found. Whether these findings are promoted by degenerative charges of extraesophageal nerve fibers as well as their clinical significance require further investigations.

Cholecystokinin↗
PubMed1990

Are the lower oesophageal sphincter relaxations in achalasia always incomplete? A manometric and scintigraphic study.

In two patients with achalasia we found intermittent, complete lower oesophageal sphincter (LES) relaxations at manometric evaluation. These patients had no weight loss, minimal oesophageal dilation, lower LES pressure and faster radionuclide oesophageal emptying when compared with other achalasia patients. Concurrent performing of radionuclide oesophageal emptying and manometry showed that the complete relaxations (CRs) were too short and functionally unsuccessful. Our findings suggest that these patients may be at an earlier disease stage and that intermittent CRs of LES may occasionally occur in achalasia.

Barium Sulfate↗
PubMed1989

Evaluation of the use of ultrasonography in the study of liquid gastric emptying.

Gastric emptying of two different test liquid meals (500 ml isotonic saline and 500 ml skimmed milk, 1.8% fat) has been measured in 10 (saline) and in 19 (milk) normal volunteers by means of real-time ultrasonography (RUS) and scintigraphy, employed simultaneously. In each subject, saline and milk contained 37 MBq of diethylenetriaminopentacetic acid (DPTA) marked with 99mTc. Determinations were made thereafter every 5 min up to 45 min with saline and every 30 min up to a maximum of 220 min with milk. The determination of gastric emptying by RUS was obtained indirectly through the measurement of gastric dimensions, with a single scan performed at the epigastrium, while the subject was kept in a standing position. At each observation, the percent decrease of gastric measurements and the decay in radioactivity over the gastric region were calculated, blind, by two independent examiners. Linear regression and correlation coefficient were subsequently computed for gastric measurements and decay in radioactivity. The results show that the values obtained with RUS do not differ grossly from the ones obtained with scintigraphy. This suggests that the ultrasonographic determination of gastric dimensions with a single section of the stomach may be a valuable method for use in the evaluation of gastric emptying of liquids.

Adult↗
PubMed1988

Scintigraphic oesophageal clearance in diabetics: clinical usefulness.

The whole digestive tract is one of the sites most involved in diabetic autonomic neuropathy. The aim of this work was to validate the clinical usefulness of oesophageal scintigraphy in the early detection of this complication of diabetes. Eighty-one diabetic patients without oesophageal symptoms were studied by solid meal scintigraphic test (SMST) and 35 out of them also by liquid meal scintigraphic test (LMST). As controls, 20 normal volunteers were studied by LMST and 14 by SMST. Forty-seven diabetics studied by SMST were also evaluated by cardiovascular tests (CT) and for the presence of retinopathy and peripheral neuropathy. The most statistically significant difference between diabetics and controls was found at 75s with SMST. SMST results showed a statistically significant correlation with CT. No correlation was found with the presence of retinopathy or peripheral neuropathy. We conclude that SMST is a useful, safe, low-cost diagnostic tool in the detection of diabetic autonomic neuropathy.

Adult↗
PubMedDate not supplied

Preliminary clinical evaluation of free/total PSA ratio by the IMMULITE system.

The role of free (F) and complexed serum PSA is now under investigation. In the present study, we evaluated the clinical significance of F-PSA and F/Total (T) PSA ratio in a preliminary series of samples from 88 patients with prostate cancer (PC), 113 with benign prostatic disease (BPD), and 98 with non-prostatic disease (NP). We used the F-PSA and third generation T-PSA (DPC, Los Angeles, USA) chemiluminescent enzyme immunometric assays with the IMMULITE automated system. At the 10 ng/ml cutoff for T-PSA levels, we obtained a sensitivity of 83% with a specificity of 100% in NP and 80% in BPD. The addition of the F/T ratio--rather than F-PSA levels--was useful to better discriminate PC and BPD in the cases erroneously classified by T-PSA alone: 44/68 samples (65%) were correctly diagnosed. Moreover, the F/T ratio was particularly effective in the critical T-PSA range between 4.1-9.9 ng/ml; 26/40 cases (65%) were correctly evaluated. In conclusion, the F/T ratio seems to be an interesting auxiliary test to T-PSA, to be reserved for selected cases where additional diagnostic information is necessary.

Aged↗
PubMedDate not supplied

PSA and bone scintigraphy.

The authors evaluate the role of prostate specific antigen (PSA) and bone scintigraphy in the follow-up of radical prostatectomy-treated and radiotherapy-treated patients. 784 patients were evaluated by simultaneous PSA assay and bone scans. The correlation between PSA levels and extension of bone metastases was good. The frequency of extraskeletal metastases was low: only 13 patients had soft tissue metastases without bone involvement and 33/138 patients with bone metastases had also extraskeletal metastases. The results underline the importance of PSA and the possibility to omit bone scan when the PSA level is below 8 ng/ml in patients who did not undergo anti-androgenic treatments.

Adenocarcinoma↗
PubMedDate not supplied

[Determination of thymidine kinase in the cerebrospinal fluid as a marker of leukemic meningosis].

Levels of Thymidine Kinase (TK) in cerebrospinal fluid (CSF) were longitudinally evaluated in 68 patients with acute leukemia. Values significantly above the normal range were found in all cases with meningeal involvement (in two subjects before the cytological evidence of leukemic cells in CSF). Such high levels decreased until normal values after an effective treatment. Two patients with multiple cerebral neoplastic nodules without infiltration of meninges showed normal CSF-TK values. No false positive cases were observed. Both kinetic activity and mass of leukemic cells appeared to influence CSF-TK levels. Thus, CSF-TK appears to be a promising marker in diagnosing and monitoring meningeal disease in the course of acute leukemia.

Biomarkers↗
PubMedDate not supplied

Modifications of erythropoiesis in myelodysplastic syndromes treated with recombinant erythropoietin as evaluated by soluble transferrin receptor, high fluorescence reticulocytes and hypochromic erythrocytes.

BACKGROUND: The aim of this study was to evaluate changes in erythropoiesis induced in vivo by recombinant erythropoietin (r-EPO) treatment in myelodysplastic syndromes (MDS), by means of some new, non invasive laboratory parameters. PATIENTS AND METHODS: Serum levels of soluble transferrin receptor (STR), a marker of total marrow erythroid activity, and automated detection of high fluorescence reticulocytes (HFR) and hypochromic erythrocytes (HE) (respectively, indexes of effective erythropoiesis and functional iron deficiency) were longitudinally measured in 25 MDS patients treated with r-EPO, and then correlated with conventional clinical and laboratory features. RESULTS: Stimulation of erythropoiesis was documented in 8 patients, whose serum STR levels showed a significant, early (within 16 days) increase during treatment with r-EPO. However, only 3 of these patients demonstrated a concomitant rise in HFR, and these were the only subjects who experienced a significant clinical response. Two of these patients also developed a functional iron deficiency while on treatment, as documented by an increase in HE, despite normal serum iron, transferrin saturation and even very high levels of ferritin. They needed iron supplementation to maintain the response to r-EPO. No variation in STR, HFR or HE occurred in the remaining 17 unresponsive patients during at least two months of treatment. Serum levels of thymidine kinase, as aspecific marker of cellular proliferative activity, paralleled those of STR. No correlation was found between STR, HFR or HE and serum levels of endogenous EPO, hemoglobin or transfusion requirements in MDS patients. CONCLUSIONS: These findings suggest that there is a heterogeneous and complex pattern of erythroid response in MDS patients treated with r-EPO. In addition, our results indicate that STR, HFR and HE may provide useful information for the clinical management of these patients.

Adolescent↗