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Biomedical subjects

A Barlattani

Publications and source records attributed to A Barlattani.

At least 19 recordsLinked to original sources

Pharmacologic treatment of the dysfunctional patient.

It is common knowledge that therapeutical approach of temporomandibular disorders (TMD) is multidisciplinary and directed to remove the cause of disorder, to eliminate symptomatology and to make an improvement to patient's life. Most of the subjects observed have pain, often caused by muscular component (90-95%) and rarely by the intercapsule. Generally, it deals with chronic-ache, bound by a layer of stress and by considerable emotionalism. A correct diagnosis is the indispensable requirement for the drugs prescription, not only, but remarkable is: to attach importance to the knowledge of workings action, the side effects and active principals contraindications took into account. This article will be a question of medicines which are the basis of medical therapy for temporal-jaw excess with: analgesic, antinflammatory, short-relaxing and tranquillizer, tricyclical antidepressant and local anesthetic. As regards to TMD, notice that pharmacological therapy must not be over protracted for too much time, especially for use of benzodiazepine and tricyclic antidepressants, dosage demanded are decisively less if we compare, usually main therapeutical indications. The pharmacological therapy can be an agent for competent method for symptomatology treatment of temporal-jaw disorder but, patient must be acquainted about a fact, trouble often could not disappear only with a drug. To conclude, we can assert that the right use of medicines, in addition with physiotherapeutical therapy and an occlusal splint, represent the most efficient means to deal with the majority of temporal-jaw diseases.

Analgesics↗

A randomized controlled trial of amantadine plus interferon-alpha2a vs. interferon-alpha2a alone in naive patients with chronic hepatitis C randomized according to the early virological response to interferon-alpha2a monotherapy.

BACKGROUND: An early virological response to interferon-alpha treatment is a strong predictor of sustained response, but it has never been exploited to stratify patients in clinical trials. AIM: To evaluate the efficacy of amantadine plus interferon-alpha compared with interferon-alpha alone in naive patients with chronic hepatitis C who were randomized on the basis of the early virological response to interferon-alpha. METHODS: One hundred and eighty-one patients received recombinant interferon-alpha2a (3 MU three times weekly) for 2 months and 164 were evaluated for early (i.e. month 2) virological response. Hepatitis C virus (HCV) RNA-negative patients (n = 66) were randomized to receive 3 MU of interferon-alpha three times weekly, with or without amantadine (200 mg/day); HCV RNA-positive patients (n = 98) were randomized to receive 6 MU of interferon-alpha three times weekly, with or without amantadine (200 mg/day). HCV RNA-positive patients at 6 months discontinued treatment, and all others completed 12 months. RESULTS: At month 6, HCV RNA-negative patients made up 54.2% of the interferon + amantadine group and 42.0% of the monotherapy group (P = 0.07). At month 12, HCV RNA-negative patients made up 38.5% of the interferon + amantadine group and 28.4% of the monotherapy group (N.S.). The sustained virological response rates were 21.6% and 20.9%, respectively (N.S.). CONCLUSION: The addition of amantadine does not enhance the sustained virological response to interferon-alpha in naive patients with chronic hepatitis C; however, an additive effect of amantadine occurs in the first 6 months, mainly in patients without an early response to monotherapy. Early response to interferon-alpha is a strong predictor of sustained virological response.

Adolescent↗

Successful treatment with lamivudine for reactivated hepatitis B infection following chemotherapy for non-Hodgkin's lymphoma.

Reactivation of hepatitis B virus (HBV) infection in subjects receiving cytotoxic treatment for non-Hodgkin's lymphoma (NHL) is well documented. This report describes the case of a 69-year-old male chronic HBV carrier who developed severe flare-up of hepatitis B following chemotherapy for large B-cell NHL. Prior to chemotherapy, the patient had normal liver function tests and was negative for HBV DNA by polymerase chain reaction (PCR) assay. HBV reactivation consisted of a rise in hepatic transaminases (peak alanine aminotransferase=1178 IU/ml), hyperbilirubinemia (7.1 mg/dl), and high levels of serum HBV DNA (63.6 x 10(6) copies/ml). A liver biopsy revealed highly active hepatitis and confluent necroses. Lamivudine treatment (100 mg daily) resulted in rapid loss of hepatitis B virus DNA, resolution of hepatitis, and clinical recovery. The patient is still in remission for NHL. Lamivudine is effective in the control of HBV reactivation following chemotherapy.

Aged↗

Unfavourable effects of colchicine in combination with interferon-alpha in the treatment of chronic hepatitis C.

BACKGROUND: The prognosis of chronic hepatitis depends on the progression of hepatic fibrosis. AIM: To investigate whether the antifibrotic drug colchicine, in combination with interferon-alpha has a role in the treatment of chronic hepatitis C. METHODS: Sixty-five HCV-RNA positive patients with chronic hepatitis were randomized to receive interferon-alpha, 6 MU t.i.w. for 6 months followed by 3 MU t.i.w. for further 6 months, with or without the adjunct of colchicine, 1 mg o.d., 6 days a week, for 3 years. We report an interim analysis after the first 18 months. RESULTS: Thirty-four patients received interferon-alpha and 31 received interferon-alpha and colchicine. The two groups were comparable for baseline data, including HCV-RNA levels, genotypes and histological grading/staging. Drop-outs and side-effects were similar. The proportion of patients who achieved alanine transaminase normalization or undetectable HCV-RNA at month 6 was higher in the interferon-alpha (68% and 47%, respectively) than in the interferon-alpha plus colchicine group (32% and 23%, P=0.004 and P=0. 04, respectively). End-of-treatment biochemical and virological response occurred in 41% and 29% of the interferon-alpha and 19% and 10% of the combination group, respectively (P=0.05 and P=0.05). Sustained biochemical response occurred in 26% of the interferon-alpha and 6% of the interferon-alpha plus colchicine group (P=0.03), corresponding percentages of sustained HCV-RNA loss being 21% and 3% (P=0.04). CONCLUSIONS: The combination of colchicine and interferon-alpha worsens the effectiveness of interferon-alpha alone in HCV chronic hepatitis. These alarming findings prompted us to interrupt the trial at this stage.

Adult↗

Bacterial adhesion to dental alloys. The role of the surface and composition.

BACKGROUND: In the oral cavity, many bacteria can only survive by adhering to hard surfaces. The roughness and free energy of these surfaces play an important part in this process. Precision dental alloys may undergo corrosion, but findings show that this does not seem to cause problems of biocompatibility. The release of metallic ions into the oral cavity may both inhibit bacterial growth and influence bacterial adhesion. The object of the present study was to bring to light any possible correlation between corrosion and/or ionic release and bacterial adhesion with regard to 18 different types of dental alloy, both before and after polishing. METHODS: Electrochemical analyses were carried out (cyclic potentiodynamic and potentiostatic polarisation tests). Corrodible elements were analysed through Atomic Absorption Spectroscopy of specimens of each alloy. The inhibition of bacterial adhesion and growth was determined using bacteria specific to the oral cavity. RESULTS: All the alloys examined show a tendency towards spontaneous passivation with low values of anodic current. The evaluation of ionic release confirmed the biocompatibility of the tested materials and the solutions conditioned with the alloys did not inhibit bacterial growth. There was no significant bacterial adhesion after polishing. Bacteria adhere to unpolished alloys in a specific manner and are inhibited from doing so in the presence of alloys for gold-resin restorations containing silver and copper. CONCLUSIONS: When polished, all the alloys are resistant to in vitro electrochemical corrosion and bacterial adhesion. The possibility cannot be excluded that bacterial adhesion occurs after the materials have been in place in the oral cavity for some time. The alloys which were found to inhibit bacterial attack may be more suitable, while not representing a biological risk for the surrounding tissues.

Bacterial Adhesion↗

Iron and porphyria cutanea tarda.

In order to evaluate the pathogenetic role of iron in Porphyria cutanea tarda (PCT), the metabolism of iron was studied in 440 patient with PCT and associated chronic liver disease (CLD) and in 91 nonporphyric CLD patients (used as a control group). The parameters considered were the following: serum iron, ferritin, Total Iron Binding Capacity (TIBC) and percent saturation of transferrin. The statistical analysis showed that the differences between the means, in the two groups, were not significant in any of the parameters examined. To investigate the possible relationships between iron metabolism and other chemico-clinical parameters concerning the porphyric disease, the associated hepatic disease and hemometry, we studied the correlations between iron parameters and total urinary and serum porphyrins, serum copper, serum albumin, hemoglobin, red blood cells, ALT, AST, CHE and GLDH. This investigation was only possible in the last 99 cases. In addition to the obvious correlations between the parameters concerning iron metabolism, the highly significant (p < 0.001) correlation between ferritin and enzyme activities which indicate cytolysis (ALT, AST, GLDH) is extremely interesting. The results seem to point to the tentative conclusion that the alterations of iron metabolism are more related to the hepatocellular necrosis than to the metabolism of porphyrins.

Adolescent↗

[A fatal case of postpartum Budd-Chiari syndrome in a woman with SLA].

We report a case of Budd Chiari syndrome with clinical onset during post partum in a patient with SLE. Etiopathogenetic correlations between pregnancy and BDS and between SLE and BDS are discussed, with particular regard to lupus anticoagulant factor. Furthermore, the diagnostic role of abdominal CT is emphasized.

Adult↗

[Segmentary veno-occlusive disease of the liver secondary to insecticide inhalation].

We report a case of venocclusive (VOD) disease secondary to inhalation of an insecticide. Pathological features of liver injury are illustrated with regard to patchy lesions shown by a new computer assisted colorimetric method. A possible role of immuno-complexes in the development of endothelium damage to centro-lobular veins is discussed.

Adult↗

[Dowel cores, traditional and alternative. Bond test].

PMF represents today the best solution for the functional rescue of a tooth cured by endodontics. After a careful analysis of the international literature the Authors in this study examined the resistance of four different kinds of PMF under laboratory conditions, applying external pressure to them until a steady rise in lateral direction caused a fracture in the specimens under study. On the basis of the results obtained, the Authors deducted that among different models tested, traditional long modified PMF is the most adapt for tolerating load of compression to preserve the integrity of the dental residual structures.

Bicuspid↗

[Extracellular matrix in gingival fibroblasts].

Primary cultures of human gingival fibroblasts from patients of different age have been established. Histotype characterization has been confirmed by ultrastructural morphology and by the positivity of intermediate filament vimentin. Extracellular matrix expression has been analyzed by immunocitochemistry. Our data demonstrate that the extracellular matrix of human gingival fibroblasts is composed of type IV collagen, other than fibronectin and type I-III collagens.

Cells, Cultured↗

[Impression materials. Dimensional stability after pouring].

The Authors wanted to establish which could be for every impression material tested, the most favourable moment for the development of plaster models in a steady environment conditions of temperature and relative humidity. From the analysis of the results obtained, we can clearly conclude that every material examined offers an ideal time interval in which we have to cast the model in plaster. This study aspires to be an invitation to all operator in the sector, to repeat this experience in their work environment to know and better manage the procedures and the materials used, from the taking the impression to the executing of the plaster model.

Colloids↗

[The external pterygoid muscle. Functional aspects].

This study, starting from the revision of traditional anatomy proposed to value TMJ and its components through dissection of human TMJ, and especially to examine the anatomic function of the lateral pterygoid muscle. Twenty dissections of left human TMJ were made. Every block was fixed in solution of 10% of formalin and dissections were made to show every components of articulation. Further thin sections were made for histological examination. The purpose of the study was to evaluate the lateral pterygoid muscle as a single unit compared to the function.

Humans↗

[Cyanoacrylates as a cementation material in fixed prosthodontics].

The purpose of this study was to examine and compare, in the same experimental conditions, the effects and the behaviour of two different materials, using them for cementation of a prosthetic reconstruction: a cianoacrilic compound (B20 cianoacrilate 3M); a traditional cement of zinc phosphate (Harvard Cement). The comparative study with the optical microscope between butilcianoacrilate and traditional cement has shown minimum levels of marginal discrepancy for both materials examinated (about 13 microns). The high resistance of cianoacrilate to traction, compared with the other fixing cement, makes us conclude this study in the hope that further research could confirm and introduce this materials in the practice of prosthetic dentistry.

Cementation↗

[An unusual mechanism of lead poisoning. Presentation of a case].

A case is described, that came to our attention for suspected acute intermittent porphyria, with abdominal pain and ascending tetraplegia. The patient (HIV positive and with a HBsAg positive chronic aggressive hepatitis) was a heroin addict. In urine: high porphyrins with extremely increased delta amino-levulinic acid (ALA) and normal porphobilinogen. High protoporphyrin was present in blood red cells. The lead poisoning was confirmed by a very low ALA-dehydratase activity in erythrocytes and a high content of lead in urine and plasma. With Ca-versenate and penicillamine the abdominal and neurological symptoms rapidly disappeared. The possibility of contact with lead, professional or environmental, was ruled out. It was found however, that shortly before the appearance of symptoms, the patient had used a batch of unrefined brown sugar heroin, which was probably mixed with lead salts. It is noteworthy that during the same period, other young heroin addicts died with similar symptoms.

Adult↗

Effect of somatostatin in controlling bleeding from esophageal varices.

A multicenter double-blind clinical trial was undertaken to evaluate the efficacy of a short-term somatostatin treatment versus a short-term vasopressin treatment on acute hemorrhage from esophageal varices in patients with liver cirrhosis and portal hypertension. Forty-nine patients with massive hemorrhage and endoscopic diagnosis of bleeding esophageal varices completed the study. Patients were randomly assigned to somatostatin treatment (24 patients: 250 micrograms/hr i.v. for 48 hrs) or vasopressin treatment (25 patients: 0.1 U/min i.v. for 48 hrs). The Sengstaken-Blakemore tube was utilized, when needed, for a six hour period. In case of failure the patients were crossed-over to the other treatment. Patients in whom the bleeding stopped at 48 hrs, were randomly assigned to somatostatin (250 micrograms/hr i.v.) or placebo for seven days. Bleeding stopped in 68% of patients treated with somatostatin and in 28% of patients treated with vasopressin (p less than 0.0013). Mortality rate was lower, but not significantly so, in the somatostatin group compared to the vasopressin group. No differences were noted between somatostatin and placebo in preventing bleeding recurrences. These data suggest that somatostatin, when combined if necessary with a 6 hour period of balloon tamponade, is more effective than vasopressin at low doses in controlling severe hemorrhage from esophageal varices in patients with liver cirrhosis and portal hypertension. A clinical use of somatostatin seems to be indicated in these patients.

Clinical Trials as Topic↗