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Biomedical subjects

S Navarra

Publications and source records attributed to S Navarra.

At least 19 recordsLinked to original sources
PubMed2004

Estrogens sensitize anterior pituitary gland to apoptosis.

Tissue homeostasis results from a balance between cell proliferation and cell death by apoptosis. Estradiol affects proliferation as well as apoptosis in hormone-dependent tissues. In the present study, we investigated the apoptotic response of the anterior pituitary gland to lipopolysaccharide (LPS) in cycling female rats, and the influence of estradiol in this response in ovariectomized (OVX) rats. The OVX rats were chronically estrogenized with implanted Silastic capsules containing 1 mg of 17beta-estradiol (E2). Cycling or OVX and E2-treated rats were injected with LPS (250 microg/rat ip). Apoptosis was determined by the terminal deoxynucleotidyl-mediated dUTP nick-end labeling (TUNEL) method in sections of the anterior pituitary gland and spleen. Chronic estrogenization induced apoptosis in the anterior pituitary gland. Acute endotoxemia triggered apoptosis of cells in the anterior pituitary gland of E2-treated rats but not of OVX rats. No differences were observed in the apoptotic response to LPS in spleen between OVX and E2-treated rats. The apoptotic response of the anterior pituitary to LPS was variable along the estrous cycle, being higher at proestrus than at estrus or diestrus I. Approximately 75% of the apoptotic cells were identified as lactotropes by immunofluorescence. In conclusion, our results indicate that estradiol induces apoptosis and enables the proapoptotic action of LPS in the anterior pituitary gland. Also, our study suggests that estrogens may be involved in anterior pituitary cell renewal during the estrous cycle, sensitizing lactotropes to proapoptotic stimuli.

Animals↗
PubMed2001

[Treatment of idiopathic retroperitoneal fibrosis].

Idiopathic retroperitoneal fibrosis is a rare disease and a delay in diagnosis may cause renal failure. Medical treatment i.e. corticotherapy or more recently, tamoxifene has been used successfully. This approach is recommended in patients either with moderate obstruction of the upper urinary, risk of major surgery or in cases of recurrence after surgical treatment. Ureterolysis using conventional surgery or laparoscopy remains the treatment of choice. This procedure should be considered in patients with neoplasic fibrosis, corticoresistant fibrosis or in cases of peri-aneurysm fibrosis.

Humans↗
PubMed2001

Laparoscopic ureterolithotomy for ureteral calculi.

BACKGROUND AND PURPOSE: Most patients with ureteral calculi that do not pass spontaneously can be treated by either extracorporeal shockwave lithotripsy (SWL) or ureteroscopy. In rare cases of large, hard and chronically impacted stones, or after failure of first-line treatments, surgical ureterolithotomy is still indicated. Laparoscopy allows performing this procedure in a minimally invasive manner. PATIENTS AND METHODS: Twenty-four patients (22 men and 2 women) underwent laparoscopic ureterolithotomy between 1994 and 1999. The procedure was indicated in 10 cases as a salvage treatment after failure of SWL (5 patients), ureteroscopy (2 patients), both (1 patient), laparoscopic ureterolithotomy (1 patient), or even open ureterolithotomy (1 patient), and in 14 patients as a primary treatment for large stones (median size 11.5, range 8-33 mm). The first 3 procedures were carried out via the retroperitoneal route and the following 21 via the transperitoneal approach. RESULTS: All but 1 stone were successfully removed in a mean operating time of 111 (range 45- 180) min. Postoperative pain was managed with first-line analgesics. Hospital stay ranged from 2 to 10 (mean 3.8) days. The 2 postoperative complications encountered were prolonged ileus (1 patient) and venous thrombosis (1 patient). CONCLUSIONS: Laparoscopic ureterolithotomy is a safe and effective procedure that enables the urologist to maintain a minimally invasive strategy when first-line treatment have failed or are unlikely to be effective.

Adult↗
PubMed2001

Robotic assisted, laparoscopic pelvic lymph node dissection in humans.

PURPOSE: We evaluate the feasibility and efficacy of robotic assisted, laparoscopic pelvic lymph node dissection for locally advanced prostate cancer staging. MATERIALS AND METHODS: Robotic assisted, laparoscopic pelvic lymph node dissection was performed in 10 consecutive patients with mainly T3 M0 prostatic carcinoma (robotic group). Operative, postoperative and pathological parameters were compared with the results of the last 10 patients undergoing conventional, laparoscopic pelvic lymph node dissection performed with similar indications by the same operator (laparoscopy group). RESULTS: All operations were performed according to the established protocol with no specific intraoperative or postoperative complications. No conversion was required, and no technical incidents were observed in the robotic group. Mean operating time plus or minus standard deviation for the robotic group was 125 +/- 57 minutes (range 75 to 215), significantly longer than that for the laparoscopy group, which was 60 +/- 15 minutes (p = 0.0013). In the robotic group 2 patients presented with postoperative lymphoceles revealed in 1 by deep venous thrombosis and in the second by obturator pain. In the laparoscopy group 1 patient presented with acute urinary retention. The histological results concerning the number of lymph nodes removed were similar in both groups (p = 0.5). CONCLUSIONS: We show the technical feasibility of robotic assisted, laparoscopic pelvic lymph node dissection in humans. Although the benefit of this technique has not yet been established, predictable technological improvements would suggest the development of telesurgery and an improved precision of surgical procedure.

Aged↗
PubMed2001

[Consultation skills in urology: a model for teaching and evaluation].

OBJECTIVE: Consultation activity is an important aspect of urological practice, but the specific teaching of this activity is underdeveloped. The objective of this study was to establish a list of consultancy skills as a basis for a planned and structured approach to teaching and evaluation of consultancy skills in urology. MATERIAL AND METHOD: Two-step qualitative protocol: 1) Establishment of an initial list of skills based on data of the literature; 2) Submission of this list to a series of "focus groups" (urologists, interns, referring physicians) in order to validate and progressively refine the model. RESULTS: The items identified were classified into 3 distinct lists: 1) theoretical knowledge; 2) technical skills specific to urology, predominantly performed in the consulting setting, 3) interpersonal skills exclusively concerning the consultant-referring physician relationship. CONCLUSIONS: The consensual specification of these skills can be used to objectively define teaching and evaluation strategies for urology consultancy skills.

Referral and Consultation↗
PubMed1999

[Malignant neuroendocrine tumor of the bladder: an entity not to be unrecognized].

The authors report a case of primary malignant neuroendocrine bladder tumour. This rare bladder tumour presents the morphological and immunohistochemical characteristic common to all neuroendocrine tumours observed in other organs. The urologist must recognise this histological entity, which requires multidisciplinary management.

Cystectomy↗
PubMed1998

[ST52 treatment of cancer of the prostate during the hormonal resistance phase].

OBJECTIVE: Stilboestrol phosphate (ST 52) was evaluated on pain, general status, life expectancy and PSA, in a retrospective study of patients with prostatic carcinoma and relapse to hormonal treatment. MATERIAL AND METHODS: 32 patients were treated by infusion of Stilboestrol phosphate at a daily escalating dose from 1.2 to 3 g over a period of 10 days, then subsequently oral administration. RESULTS: Minor complications, especially nausea were observed in 12 cases but no major complication or interruption of treatment. Improvement for pain alone or with general status was obtained in 50% (16 cases) at 3 months, but at one year only 10% were still improved. Median survival was 8 months, with 19.4 months for responders at the end of infusions and 4.2 months for non-responders-respectively. CONCLUSION: Stilboestrol phosphate can obtain a clinical response with low morbidity when relapse to hormonal treatment occurs. Infusion responders have a better life expectancy.

Administration, Oral↗
PubMed1998

[Recurrent febrile infections of the urinary tract and diverticulum of the urachus].

The urachus can present a partial or complete obliteration defect. If the defect is situated in its vesical extremity, it then forms a diverticulum. The authors report a case of diverticulum of the urachus in a young adult, responsible for recurrent febrile urinary tract infections since the beginning of adolescence. The diagnosis was suggested by ultrasonography and magnetic resonance imaging and confirmed by cystoscopy and histological examination. Treatment consisted of complete surgical resection via a suprapubic incision.

Adolescent↗
PubMed1993

[Hypocobaltemia in chronic obstructive arteriopathy. Physiopathologic and therapeutic importance].

The role of some so-called primary and secondary (or oligo-elements) elements in the physiopathology of the cardiocirculatory system has been well known from a number of years and they have been regularly included in the treatment protocols. Some, including K, Ca, Mg and Zn, are extremely well known and widely used in clinical practice. Recently, however, a growing number of studies have focused on the biological importance of other oligo-elements in the pathogenetic mechanisms of atherogenesis and its clinical manifestations. This study aimed to verify the exact role of free cobalt in the physiopathology of the chronic obstructive arterial diseases (COAD). A total of 80 patients affected by 2nd stage COAD were examined and the levels of some oligo-elements, including Co, were assayed. Constantly low levels were found (85% of cases) in relation to other oligo-elements studied (Cu, Zn, Mg, Ca). This findings is particularly interesting since it confirms the biochemical hypothesis of atherosclerosis according to which parietal damage plays a central role in the pathogenetic mechanism. Some enzymatic deficiencies, which lead to changes in membrane stability at the level of the endothelial cells, are closely related to the presence of tissutal and humoral peroxidation products. These peroxides (lipid peroxides), which are formed following the interaction of fatty acids with oxygen free radicals, have been identified by a number of studies as being responsible for endothelial damage. Several authors have shown that lipid peroxidation is involved in the atherogenic process through several mechanisms entailing monocytic activity and reduced prostacyclin (PG2) synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Arterial Occlusive Diseases↗
PubMed1981

[Hormone treatment of metastasizing breast carcinoma].

The hormone-dependence of breast cancer is recalled in a review of 448 metastasies cases observed between 1958 and 1978. It is shown that the percentage of positive response to hormone therapy is related to the type of treatment, menstrual age, metastasis site, and above all to the presence or absence of receptors for oestradiol, progesterone, and prolactin in the tumour tissue. The fact that hormone dependence can be evaluated via the search for such receptors means that projectine hormone management can be employed. This should lead to a marked improvement in the percentage of positive responses obtained in the treatment of metastasing breast carcinoma.

Bone Neoplasms↗
PubMed1981

[Hormone receptors in breast cancer].

Following a review of studies on the presence of hormonal receptors in breast carcinoma, reference is made to personal experience with hormone treatment of 96 patients with breast cancer. On the basis of data obtained in clinical practice, it is concluded that in order to apply target hormone treatment, it is essential to carry out a full study of hormone receptors, not just as regards oestradiol, progesterone and prolactin but the others too (testosterone, glycocorticoids, insulin, thyroid and growth hormone).

Breast Neoplasms↗