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Biomedical subjects

A Antonelli

Publications and source records attributed to A Antonelli.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Verapamil versus amlodipine in proteinuric non-diabetic nephropathies treated with trandolapril (VVANNTT study): design of a prospective randomized multicenter trial.

Angiotensin converting enzyme inhibitors (ACEI) are the most effective antiproteinuric agents and should be used as first-line drugs in both diabetic and non-diabetic proteinuric nephropathies. The role of calcium channel blockers (CCB) is much more controversial. In diabetic patients verapamil and diltiazem seem more effective than dihydropyridines in reducing urinary protein excretion, and have additive effects with ACEI, but little is available on chronic treatment of non-diabetic nephropathies for non-dihydropyridine CCBs. To test whether the combination of verapamil 180 mg or amlodipine 5 mg with trandolapril 2 mg reduces urinary protein excretion more than trandolapril 2 mg alone, we planned a prospective, randomized, double-blind, multicenter trial. The secondary aims are to evaluate the effects of both treatments on the selectivity of proteinuria and check their safety. Consecutive patients aged between 18 and 70 years with non-diabetic proteinuria > or =2 g/24 h and plasma creatinine < 3 mg/dl or creatinine clearance > or = 20 ml/min are asked to participate. After a four-week run-in during which previous antihypertensive therapy is withdrawn, a single dose of trandolapril 2 mg is given once a day in open conditions for four weeks. At the end of this period patients are randomly assigned to receive once a day, in a double blind fashion, either trandolapril 2 mg and verapamil 180 mg [plus a placebo], or trandolapril 2 mg plus amlodipine 5 mg. They are monitored after one, two, five and eight months.

Adult↗
PubMedDate not supplied

Thyroid cancer in HCV-related mixed cryoglobulinemia patients.

OBJECTIVE: The prevalence of thyroid cancer in a series of unselected HCV-related mixed cryoglobulinemic patients was investigated in comparison with a control group. METHODS: Among 107 consecutive patients with mixed cryoglobulinemia (MC), 94 were eligible for the study. A control group was obtained from a sample of the general population (2,401 subjects), age > 50 years, who had undergone thyroid ultrasonography (582 subjects); 5 sex-matched controls were randomly assigned to each MC patients (470 individuals). The mean age was similar in the MC patients and controls (64.2 +/- 10.0 vs. 63.4 +/- 7.0). RESULTS: The prevalence of thyroid nodules was higher, although not significantly so, in control subjects than in MC patients (65.3 vs. 54.8%). Two patients with papillary thyroid cancer were found in the MC series, while no case was observed among controls (p = 0.001, chi-square P value; p = 0.02, Fisher's exact test). In both MC patients with papillary thyroid cancer lymphocytic infiltration was observed in the thyroid tissue. CONCLUSION: The possible association between HCV-related MC and thyroid cancer indicates that a careful monitoring of the thyroid would be opportune during the clinical follow-up of HCV-associated MC patients, especially in those with signs of thyroid autoimmune disorders.

Aged↗
PubMedDate not supplied

Nerve growth factor serum level is reduced in patients with sensorineural hearing impairment: possible clinical implications.

Nerve growth factor (NGF) is the first and best characterised member of a family of neurotrophic factor. NGF is produced by numerous cells and it is present in physiologically relevant amounts in the bloodstream. It is known to promote the survival of peripheral sensory neurons and can be potentially useful as a therapeutic agent in neuronal system. On the both these observations we based our hypothesis that low circulating NGF might lead to sensorineural hearing loss (SNHL). To address this question we measured the levels of NGF in the bloodstream of patients affected by SNHL. The results showed that the amount of circulating NGF in these patients is significantly lower compared to levels found in patients not affected by this deficit. The results of the present study demonstrated that NGF might be a useful candidate for preventing the damage and promoting recovery or degeneration of the auditory pathways in humans.

Adolescent↗
PubMedDate not supplied

Treatment of the carcinoid syndrome with somatostatin, salmon calcitonin, or octreotide.

Three patients with the carcinoid syndrome received intravenous somatostatin (3.5 micrograms/min) for one day; intravenous salmon calcitonin (8 IU/hr) for one day; subcutaneous salmon calcitonin (100 IU three times daily) for ten days; and subcutaneous octreotide (150 micrograms three times daily) for ten days. Octreotide (SMS-201.995) is a stable analogue of somatostatin. There was a five-day washout period between each treatment. During each of these treatments, reductions in the numbers of daily flushes and bowel movements, stool weight, and urinary 5-hydroxyindoleacetic acid (5-HIAA) levels were observed. Relief of cramping abdominal pains was also reported. Patients 1 and 3 chose to continue receiving the subcutaneous calcitonin and patient 2 chose the octreotide. Patient 1 (aged 67 years) reported relief of symptoms for five months until she developed an intestinal obstruction as a result of tumor infiltration. Patient 3 (aged 67 years) has received the calcitonin for about 16 months with relief of symptoms and reduced urinary 5-HIAA levels. Patient 2 (aged 57 years) has continued octreotide treatment for one year and reports relief of symptoms.

Aged↗
PubMedDate not supplied

Efficacy of intravenous immunoglobulin therapy in a case of autoimmune-mediated chronic active hepatitis.

In a patient suffering from histologically-documented immuno-mediated chronic active hepatitis, intravenous immunoglobulin (IVIG) treatment was initiated as an obligatory alternative therapy because of femur head aseptic necrosis which had followed long-term therapy with steroids. The first cycle of IVIG was followed by remission of most symptoms, normalization of liver enzymes, disappearance of circulating immunecomplexes (CIC), and a negative lupus band test. Improvement in the patient's condition was demonstrated, in liver histology, by the disappearance of peri-portal mononuclear cells infiltrates, while immunohistochemistry showed the disappearance of the intracellular IgG deposits.

Autoimmune Diseases↗
PubMedDate not supplied

[Epidemiologic approaches, in school health education programs with particular attention to dentistry].

At the request of the Cultural Union of the Upper Aniene Valley, the social-health workers dealing with school medicine of the Teaching District of Affile (Rome) have tried to define the programming lines for a health education intervention in the elementary schools of the district. The basic requisites of the intervention were pinpointed as: effectiveness, in terms of improvement of health conditions; short-term results; cognitive-transformative methodology having a spiral progression (cognitive, decision-making, implementative and of verification). The departure point of the intervention was the cognitive study on the social-health situation of the school population based on an analysis of the individual data contained in the medical files compiled by the school doctor, standardised and filled out with the pupils' social and family data. Out of 257 children, 212 were examined, namely 82.4% of the school population. The first social-anamnestic data on pupils' families was in respect of parents' level of education, giving the following results: 65% with elementary schooling only, 11% semi-illiterate and 10.5% diploma- or degree-holders. In respect of parents' working activities, on the other hand, a clear difference emerged: compared with 50.4% of worker or artisan fathers and about 33.3% engaged in the tertiary sector, almost all the mothers were still home-based (90.9% housewives). Another interesting fact emerged from the cards, namely that only 69% of the boys and girls have undergone the full cycle of antidiphtheria-antitetanus vaccinations, and only 80% of antipolio vaccinations. As regards pupils pathological anamnesis, cases of hospitalisation were for the following causes: 5.7% fractures and/or burns, followed by intestinal infections (4.5%). Whereas, as regards current pathology the high incidence of a cariogenic pathology emerged, with such high values as to indicate, in the field of prevention and health education, oral hygiene as the priority intervention to be undertaken in respect of the pupils included in the teaching district. The stages of the planned intervention were fixed as follows: -campaign to make teachers and families, considered as the primary educators, aware of this health problem; -meetings with pupils for the purpose of informing them in a simple way of the problem of caries and of discussing together behaviours liable to ensure greater dental hygiene; -involvement of the school and local administrative authorities for the implementation of any measures aimed at favouring the improvement of the behavioural and eating habits of the boys and girls (access for all to school canteens, free dental examinations, etc.).(ABSTRACT TRUNCATED AT 400 WORDS)

Child↗
PubMedDate not supplied

[Retrospective demographic study in a small mountainous region of the province of Rome].

This retrospective study takes into consideration demographic and epidemiological data relative to the population of Arcinazzo Romano, a little village on the mountains situated at 831 m. above sea level in the province of Rome. The socio-economic structure of the village is mainly agropastoral, though, in the last decades, 50% of the ground has been left uncultivated due to emigration and commuting. ISTAT data relative to population censuses of 1951, 1961, 1971 and 1981 have been used to study the population natural movement from 1943 to 1987. The active/passive rate and the population ageing index have also been considered. Whenever possible local population data have been compared with similar data on a provincial, regional and national level. From 1943 (1697 inhabitants according to the archives of the Civil Status Office) the population of Arcinazzo R. has been increasing until 1955 (1903 inhabitants). Afterwards, there has been a slow, but constant, decrement till 1987 (1435 inhabitants). The reason for this is undoubtedly the migration movement (mainly towards Rome) due to the scarcity of job possibilities in the zone. This has resulted in a decrease in both active population and agricultural manpower. From 1943 to 1987 there has been a continuous decrease in birth-rate. Starting from 33.5 in 1943, the lowest value (4.6) is reached in 1981; in the last decade the index has settled on average values (11.22) which are slightly higher than national and regional averages (10.2 and 9.7 respectively). The general death-rate has its highest value in 1944 (19.3) and its lowest value in 1958 (4.8). From this date on, the index settles on an average of 12.0, which is slightly higher than national and regional averages (9.5 and 8.4 respectively). The infant death-rate starts from a value of 228/1000 in 1943 to decrease in following years. Keeping into account that the number of children born each year in Arcinazzo R. is very small, a comparison with national or regional averages is not felt to be appropriate. In fact, local values of this index may casually result very high: for instance, in 1981, the death of two premature twins, on a total of seven children born in the same year, brings the infant death-rate to a value of 285/1000 while in the years 1982-87 the infant death-rate is 0. The population natural growth index is obtained from the difference between general birth- and death-rates.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMedDate not supplied

[Audiological and neuropsychological development study in a sample of school children from a low-iodine area of the Central Apennines that is endemic for cretinism].

We have evaluated neuropsychic development in 70 normal schoolchildren in an area of severe endemic goitre and cretinism in the Central Apennines (Montefeltro). In each subject we have studied auxological, psychometric and audiometric parameters, together with tympanograms and stapedial reflexograms. Auxological data were in the normal range, as were the stapedial reflexograms and tympanograms. On the contrary, 54.8% of the sample performed below the 25th percentile in psychometric tests (Raven test PM-47), being also 22.8% below the 5th percentile. Audiometric data showed a neurological hearing impairment in 3.1% of the children tested, as compared with 0.28% in the area of Pisa. These data point out that an impairment of central nervous system function still persists in this area of severe endemic goitre.

Child↗
PubMedDate not supplied

Radioimmunoassay for human thyroxine-binding prealbumin.

A radioimmunoassay (RIA) for human thyroxine-binding prealbumin (PA) is described. It employs highly purified PA, anti-human PA serum at 1:30,000 final dilution, normal bovine serum as a carrier, and polyethyleneglycol to precipitate the immune complexes. This assay is extremely sensitive (limit of detection less than 0.2 micrograms per dL or less than 3.6 X 10(-15) moles per tube), accurate (recovery = 98.7 +/- 9 percent, mean +/- S.D.) and reproducible (intra- and inter-assay coefficients of variation = 3.6 to 6.3 percent and 7.2 to 9.5 percent, respectively). There was a highly significant correlation when the RIA was compared with radical immunodiffusion or with PA maximal binding capacity for thyroxine (r = 0.944 and r = 0.724, respectively, p less than 0.001). Concentration of PA in sera from normal subjects (age range = 20 to 88 years) averaged 27.7 +/- 0.5 mg per dL (mean +/- S.E.M.), with significantly higher values in males than in females in all age groups with the exception of the older subjects (20 to 50 years: males = 26.5 to 37 mg per dL; females = 23.1 to 33.8 mg per dL). Levels of PA progressively declined after the fifth decade of life. Pregnancy, hyperthyroidism, chronic liver diseases, cystic fibrosis, cancer and other non-thyroidal illnesses were associated with decreased levels of serum PA. Untreated hypothyroidism and chronic renal diseases showed widely scattered values of PA. Inherited thyroxine-binding globulin (TBG) abnormalities and bisalbuminemia had no apparent effect on concentrations of serum PA.

Adult↗