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Biomedical subjects

S Neri

Publications and source records attributed to S Neri.

At least 55 records · Page 3Linked to original sources
PubMed1999

Quality of life in patients with ductal carcinoma in situ of the breast treated with conservative surgery and postoperative irradiation.

AIM OF THE STUDY: To evaluate the quality of life (QL) in patients with ductal carcinoma in situ of the breast treated with conservative surgery and postoperative irradiation. MATERIAL AND METHODS: A self-completed questionnaire covering many disease-, symptom-, and treatment-specific issues was administered to 106 conservatively treated patients affected by non-infiltrating breast cancer. The questionnaire was based on a series of 34 items assessing five main fields of post-treatment adjustment: physical well being, sexual adaptation, aesthetic outcome, emotional/psychological well being, relational behaviour. Furthermore, the patients were requested to evaluate the degree of information provided by the medical staff concerning surgical procedures and radiation therapy, and to evaluate the effects of the treatment on their social and overall life. RESULTS: The questionnaire was completed by 83 patients (78%), who had a median follow-up of 54.5 months. This final sample had a median age of 50 years (range 29-88) at the time of treatment and 54 years (range 32-94) at the time of study. The patients claimed to be in good physical condition. Data relating to sexual life were provided by 93% of the sample. Some limitations in sexuality, some interference with sexual desire, and some modifications during intercourse were reported by 5, 6, and 5 patients, respectively. The subjective evaluations of the cosmetic results of the therapies were generally good. Only 13 patients (16%) reported the perception of a worsened body image. Forty-six percent of the sample (38 patients) declared that they felt tense, 48% (39 patients) nervous, 29% (38 patients) lonely, 59% (41 patients) anxious, and 41% (34 patients) depressed. Only seven patients (8%) declared that the treatment had had a bad effect on their social life, and 15 (18%) thought that their current life had been affected by the treatment. The amount of information received concerning the disease and treatment (surgery and radiotherapy) was considered sufficient by 79%, 75%, and 79% of the sample, respectively. CONCLUSIONS: This study revealed a good QL in patients treated with breast conservation and postoperative irradiation, with a preserved favourable body image and a lack of negative impact on sexuality. Radiation therapy did not lead to any significant additional problems capable of affecting the QL.

Adult↗
PubMed1999

Magnetic resonance appearance of asbestos-related benign and malignant pleural diseases.

OBJECTIVES: This study describes the magnetic resonance findings of benign and malignant pleural diseases in asbestos-exposed subjects. METHODS: Thirty patients with a history of asbestos exposure and pleural lesions in chest X-rays and computed tomography scans were examined with a 0.5- and a 1.5-T magnetic resonance unit. The examination protocol included cardiac-gated proton density and T2-weighted images, unenhanced and enhanced (Gd-DTPA; 0.1 mmol/ kg) T1-weighted images in the axial plane and sometimes in another orthogonal plane (sagittal or coronal or both). All the magnetic resonance images were reviewed by 3 experienced observers, who visually evaluated morphologic features, signal intensity, and contrast enhancement of pleural lesions. The diagnosis was established by means of percutaneous biopsy, thoracotomy, and combined clinical and radiological follow-up for at least 3 years. RESULTS: Eighteen patients affected with multiple pleural plaques showed low signal intensity on both unenhanced and enhanced T1-weighted and proton density and T2-weighted images. In 2 of these patients an acute pleural effusion was observed. All the malignant lesions (11 mesotheliomas) and a solitary benign pleural plaque revealed high signal intensity on the proton density and T2-weighted images and inhomogeneous contrast enhancement in the postcontrast T1-weighted images. The sensitivity, specificity, and diagnostic accuracy of the magnetic resonance imaging in classifying a lesion as suggestive of malignancy were 100%, 95% and 97%, respectively. CONCLUSIONS: The results point out 2 magnetic resonance signal intensity patterns for asbestos-related pleural lesions: (i) low-signal intensity on unenhanced and enhanced T1-weighted and proton density and T2-weighted images for benign plaques and (ii) nonhomogeneous hyperintensity in T2-weighted and enhanced T1-weighted images for malignant mesotheliomas.

Adult↗
PubMed1999

[Hypersplenism: current status and perspectives].

The hypersplenism is a syndrome characterized by cytopenia (involving one or several cellular lines of peripheral blood), increased or normal medullar cellularity, elevated turnover of the involved cellular line. Several studies have emphasized the important role of the spleen as an immunocompetent organ, with a microcirculation and typical functional characteristics. The authors attempt to assess relations between the hypersplenism and splenomegaly, as well as indications, risks and complications of splenectomy in pathological conditions. Finally, the alternative procedures to splenectomy are described.

Administration, Cutaneous↗
PubMed1998

Early endothelial alterations in non-insulin-dependent diabetes mellitus.

The high incidence of cardiovascular morbidity and mortality in non-insulin-dependent diabetes mellitus with albuminuria cannot be fully explained by the presence of standard cardiovascular risk factors. We assessed some pathogenic factors of diabetic vascular atherosclerotic damage in 72 non-insulin-dependent diabetes mellitus patients controlled by diet alone and 60 healthy controls. Our study aim was to assess the early onset of these alterations and to correlate them with the presence of microalbuminuria. We determined their incidence in two carefully selected groups of diabetic patients without clinical signs of cardiovascular risk and complications, where diet alone achieved glycometabolic balance. Microalbuminuric patients had an alterated oxide-reductive balance and elevated values of plasminogen activator inhibitor, tissue plasminogen activator, von Willebrand factor, endothelin-1 and betathromboglobulin compared with the normoalbuminuric diabetics and controls. Our findings support the hypothesis that a state of endothelial dysfunction characterized by altered oxide-reductive balance, modified hemostasis and changes in the endothelial barrier properties occurs much earlier in non-insulin-dependent diabetic patient especially in diabetics with microalbuminuria. In addition, alterations in the oxide-reductive balance, and hemostasis occur early and may be an underlying cause of microangiopathic complications in microalbuminuric diabetics.

Albuminuria↗
PubMed1998

Hyde's prurigo nodularis and chronic HCV hepatitis.

The authors describe a woman with chronic active hepatitis, Hyde's prurigo nodularis and hepatitis C virus infection. The association of these three pathologies and their parallel evolution during treatment suggest a possible pathogenic link between the chronic hepatitis C virus infection and the skin disease.

Female↗
PubMed1998

Diagnosis of renovascular disease by extra- and intrarenal Doppler parameters.

It is still a matter of debate as to which parameters should be used for noninvasive diagnosis of renovascular disease by renal Doppler sonography (RDS). The accuracy of RDS in the detection of renal artery stenosis (RAS) was tested in 95 consecutive, moderate to severe hypertensive patients (I-II World Health Organization [WHO] stages). Reno-aortic ratio (RAR) for peak systolic velocity (PSV) was also calculated to assist in the diagnosis of significant (>50%) RAS. Paired receiver-operating characteristic (ROC) analysis was plotted for evaluating the relationship between sensitivity and specificity for each parameter. In a subset of 57 kidneys, the influence of blood pressure and age on intraparenchymal parameters was evaluated. Measurements of maximal peak systolic velocity (PSV) at the site of stenosis, RAR for PSV, and minimum acceleration index in the main renal artery showed high accuracy (areas under the ROC curve 0.97, 0.88, and 0.80, respectively). Among intraparenchymal parameters, early systolic acceleration showed the best area under the ROC curve (0.90), but provided a low positive predictive value (29%) and was significantly influenced by blood pressure (multiple r=0.56; p=0.001). Pulsatility and resistive indices were found to be less powerful as absolute values, and both significantly influenced by blood pressure and age (multiple r=0.60 and 0.50; p=0.001, p=0.02, respectively). However, interindividual variance of intrarenal indices should be minimized by calculation of side difference, although this procedure would become misleading or impossible in patients with bilateral RAS or a single kidney, respectively. These results support the use of extraparenchymal parameters for noninvasive detection of RAS, and emphasize that intrarenal parameters cannot be considered as absolute values.

Adult↗
PubMed1998

Does endothelin-1 play a role in the renal function of cirrhotic patients?

METHODS: We investigated plasma and urinary endothelin-1 levels in eleven cirrhotic patients and ten healthy control subjects, to evaluate whether endothelin is involved in renal functional alterations of liver cirrhosis. RESULTS: No significant difference in plasma ET-1 levels was observed between the two groups (p > 0.05) but urinary ET-1 excretion was significantly higher in cirrhotics than in controls (p < 0.001). Creatinine clearance (mean 56 +/- 7.6 ml/min) showed an inverse correlation with plasma ET-1 levels (p < 0.05) in cirrhotics. CONCLUSIONS: We believe this may be caused by enhanced local ET-1 activity linked to an up-regulation of its specific receptors and/or increased renal synthesis, resulting in augmented urinary excretion.

Aged↗
PubMed1997

[Type 4 renal tubular acidosis caused by spironolactone. A case report].

The authors describe a case of type 4 renal tubular acidosis, observed in a subject with liver cirrhosis, the pathogenetic cause of which was probably the assumption of spironolactone. It is thought that, even if such an eventuality is not very frequent, it must be considered in clinical practice, in view of the negative consequences that the reduction in urinary ammonium excretion and hyponatriemia, together with this particular form of acidosis, may have on the neurological state of the patients.

Acidosis, Renal Tubular↗
PubMed1997

[Deficit of anticoagulant factors, endothelial stress and thrombophilia].

Thrombophilia is characterised by elevated thrombotic and embolic risk and may be caused by congenital or acquired coagulating inhibitor deficit. A young man was repeatedly admitted to Emergency Medicine Units because of pain, oedema and slight functional impairment of the left leg, and recurrent thrombophlebitis was diagnosed. During the most recent hospitalization, vena cava thrombosis was diagnosed and therapeutic management consisted of application of a caval filter and administration of dicoumarin anticoagulants. This case can be classified as a hereditary protein S deficiency with APC-resistance. However, non-strenuous, protracted and repeated physical trauma may have acted synergically with the congenital coagulation inhibitor deficiency, determining the thrombotic episodes, which are probably provoked by transient and functional alterations of the non-thrombogenic properties of the endothelium.

Adult↗
PubMed1997

Endothelin-1 in arterial hypertension after cold pressor test.

BACKGROUND: We assessed plasma endothelin-1 (ET-1) concentrations in a group of hypertensive subjects in order to determine the possible presence of a disorder of ET-1 production and release. METHODS: A selected cohort of hypertensive subjects was compared with a control group. Plasma levels of ET-1 in baseline conditions and after cold the pressor test (CPT) were measured. All subjects were studied as outpatients. Twenty-one male hypertensive patients were compared with 15 male controls. The hypertensive patients had undergone clinical examinations to rule out the presence of vascular damage. Clinical examination of the controls was performed to rule out hypertension. Patients with essential hypertension were 21 males, age: 57+/-7 years, body mass index 22.3+/-11.2 kg/m2. We assessed plasma ET-1 in baseline conditions and after a cold pressor test. RESULTS: Means +/-SD baseline concentrations of ET-1 were 12.47+/-2.41 pg/ml in hypertensives and 8.2+/-3.8 pg/ml in controls (p<0.01). Mean +/-SD post CPT plasma ET-1 was 12.55+/-2.83 pg/ml in hypertensive subjects and 8.6+/-1.9 pg/ml in controls (p<0.01). CPT did not modify plasma ET-1 concentrations in either group. CPT significantly raised arterial pressure only in hypertensive subjects. CONCLUSIONS: These results lead us to postulate the presence of a disorder of ET-1 production and release in hypertensive subjects.

Adult↗
PubMed1997

[A case of deep vein thrombosis].

The case of a woman admitted to hospital various times because of the onset of a mantle-like oedematous syndrome is reported. Observations revealed a narrowing at the level of the internal jugular and right subclavian veins with total obliteration of the right anonymous vein caused by previous thrombosis induced by intravenous implantation of a pace-maker.

Brachiocephalic Veins↗
PubMed1996

Activation of phospholipase D in human fibroblasts by ceramide and sphingosine: evaluation of their modulatory role in bradykinin stimulation of phospholipase D.

In the present study the modulatory action of exogenous short-chain ceramide and sphingosine on phospholipase D (PLD) activity in young and old human fibroblasts was examined. Sphingosine and also ceramide, thus far described as a negative modulator of PLD, were able to activate PLD. The stimulatory action of the exogenous lipid molecules was mimicked by cell treatment with S.aureus sphingomyelinase (SMase). Similar response was elicited by the sphingoid molecules in young and old cells. Altered levels of sphingosine and ceramide were detected in old fibroblasts confirming that a defect in sphingolipid metabolism occurs in cellular senescence. The modulatory role of sphingoid molecules on the action of bradykinin (BK) in PLD activation was then evaluated in young and old fibroblasts. C6-ceramide or SMase treatment did not affect the action of BK on PLD either in young or in old cells, whereas sphingosine further increased PLD activity stimulated by BK in young but not in old cells. In addition, preincubation with N-oleoylethanolamine, a specific inhibitor of ceramidase, did not affect BK action on PLD in young fibroblasts but significantly decreased the effect of the peptide in old fibroblasts. These results suggest that a specific alteration of BK segnalatory pathway occurs in old fibroblasts, likely involving sphingosine formation which may account for the potentiated PLD activity induced by the peptide in these cells.

Bradykinin↗
PubMed1996

Pulmonary function, smoking habits, and high resolution computed tomography (HRCT) early abnormalities of lung and pleural fibrosis in shipyard workers exposed to asbestos.

To evaluate the presence of asbestos-related pleural and parenchymal abnormalities and their correlation with pulmonary function and smoking habits, 119 asbestos-exposed asymptomatic workers (mean age, 46.2 years; mean duration of asbestos exposure, 8.6 years; mean latency time, 21.6 years) with normal standard P.A chest radiographs were submitted to HRCT, CO-diffusing capacity and pulmonary function tests. HRCT scans were normal only in 31 (26%) examined workers; 31 (26%) subjects showed both pleural and parenchymal involvement, and 50 (42%) and seven (6%) had exclusively pleural and parenchymal abnormalities, respectively. Based on CO-diffusing capacity and pulmonary function tests, no significant difference was demonstrated between workers with pleural lesions and subjects with normal pleura; however, lower values of FVC were observed in the nonsmoking workers with parenchymal abnormalities in comparison with nonsmoking subjects with normal parenchyma (78.2 vs. 89.7% of predicted values; p = 0.03 by student's two-tailed t test), and lower values of FEV1/FVC in the smokers with parenchymal lesions with respect to smokers with normal parenchyma (93.7 vs. 100.2% of predicted values; p = 0.005 by students' two-tailed t test). In conclusion, our results demonstrate that HRCT may detect early parenchymal abnormalities which correlate with exposure to asbestos and respiratory function impairment, including a reduction in obstructive indices in smokers occupationally exposed to asbestos, without any clinically evident disease.

Adult↗
PubMed1996

Multiple sclerosis and psychiatric disturbances: clinical aspects and a review of the literature.

Psychiatric disturbances during the course of multiple sclerosis (MS) may derive from the particular emotional situation induced by a more or less manifest awareness of the disease, or be directly attributable to the pathological process itself. In this latter case, the range of clinical manifestations is somewhat characteristic, as there is often a concomitant impairment of the superior nervous functions, particularly those relating to memory and attention. Interpretation of the role played by affective disorders is particularly controversial, as it is not possible to establish with precision (and the result would in any case be a simplistic interpretation of the problem) a direct relationship between the sites of cerebral lesions and the psychiatric manifestations observed in MS.

Anxiety↗
PubMed1996

Peripancreatic lymphoadenopathy and extrahepatic immunological manifestations in chronic hepatitis C.

The aim of the study was to determine the role of peripancreatic lymph node swelling in systemic immunological alterations during chronic hepatitis C (HC). The prospective study was carried out as a clinical study in a university hospital. Clinical, haematochemical and ultrasonographic findings in 182 patients were studied. Ultrasonography was performed by the same operator and the findings were evaluated blind without the operator knowing the clinical and haematochemical parameters. Hepatitis B virus (HBV) markers, anti-HCV antibodies, LKM1, cryoglobulinaemia, rheumatoid factor and anti-tissue antibodies were determined. Liver biopsy was carried out in 43 of the 182 patients. One or two pathological peripancreatic lymph nodes (PLNs) were present in 30 of the 182 patients and, of the 30, 28 were anti-HC positive. Only one patient in the non-PLN group was positive for anti-HCV, there being statistical significance (P < 0.0001) between the PLN and non-PLN groups. In HCV-positive patients, extrahepatic immunological manifestations were observed (cryoglobulinaemia; positivity to anti-smooth muscle, antinuclear and antimitochondrial antibodies; positivity to rheumatoid factor and LKM1). In five patients the presence of focal lymphocytic aggregates was detected by biopsy, whereas one patient presented typical ocular lesion of Mikulicz's syndrome. Our results may confirm the marked lymphotropism shown by the HC virus and indicate more complex immune system involvement, especially in view of the coexisting signs of immune system involvement related to the presence of intrahepatic cellular aggregates detected in our study. We believe that the peripancreatic adenopathy in chronic HCV hepatitis is an important diagnostic sign and may indicate an involvement of the C virus in the still unexplained extrahepatic immunological disorders.

Female↗
PubMed1995

Topoisomerase-II-mediated DNA cleavage within the human ribosomal genes.

The interaction of topoisomerase II (topo II) with human ribosomal DNA (rDNA) was investigated in vivo using the antitumoral drug VM26, a specific inhibitor of topo II, that stabilizes the transient cleavable complex. rDNA-protein complexes isolated from nucleoli of TG cells were analyzed for double strand breaks with probes that covered almost all intergenic transcribed spacer (IGS) and all transcribed sequences of tandem repeat ribosomal DNA genes. Preferential cleavage sites were present in only a part of nucleolar rDNA, i.e., the transcribed region. Proteins, purified from the same complexes, were analyzed by Western-blot and stained by an antiserum against both topo II forms, showing the presence of topo II beta.

Cell Line↗
PubMed1995

Primary gastric lymphoma: a clinical and therapeutic evaluation of 82 patients.

Eighty-two patients with primary gastric (IE, II1E, and II2E) non-Hodgkin's lymphoma according to the Musshoff's staging system were treated with combined modality including surgery with/without radiotherapy between January 1985 and December 1991. According to the Updated Kiel classification 54 had high-grade histologic subtypes and 28 low-grade. The strategy throughout the study was to resect primary tumor: all patients underwent gastrectomy, 40 subtotal and 42 total gastrectomy. The resection permitted complete surgical staging utilizing three pathologic features: disease confined within or beyond the serosa, negative/positive regional lymph nodes, and negative/positive surgical margins. If there was no evidence of these pathologic factors, the patients who underwent surgery alone received no further radiotherapy. On the other hand, all patients who presented at least one of three pathologic factors were treated with adjuvant radiotherapy after the resection. All except 14 patients presented at least one of the pathologic features and 50 (61%) patients had involvement of the whole gastric wall. Radiotherapy included the gastric bed and para-aortic lymph nodes and, for the patients, who had positive regional lymph nodes in combination with the complete involvement of the gastric wall, the irradiation included the whole abdominal approach. The complete response rate was 97% and the 9-year disease-free survival was 93%. All but one of the 5 relapses occurred within 18 months stressing the need for more specific staging. Gastric resection with/without radiotherapy may still represent the primary therapeutic procedure in early stage gastric non-Hodgkin's lymphoma.

Antineoplastic Combined Chemotherapy Protocols↗