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Biomedical subjects

A Bianco

Publications and source records attributed to A Bianco.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

Multistep synthesis of 2,5-diketopiperazines on different solid supports monitored by high resolution magic angle spinning NMR spectroscopy.

The solid-phase synthesis of 2,5-diketopiperazines containing the trans-4-hydroxy-L-proline amino acid residue (Hyp) was performed on Ellman polystyrene, polyoxyethylene-polyoxypropylene (POEPOP), polystyrene-polyoxyethylene NovaSyn, and Wang resins, respectively. The reaction pathway allowed the introduction of different functional groups around the bicyclic scaffold in a combinatorial approach, and it generated mixtures of isomers. A detailed characterization of the single reaction steps by high resolution magic angle spinning (HRMAS) NMR spectroscopy was performed. The NMR spectral resolution of the resin-bound intermediates and final products was greatly influenced by the polymer matrix. The POEPOP resin permitted to obtain HRMAS NMR spectra with a resolution comparable with that of the spectra of the molecules in solution. Moreover, configurational and conformational isomers formed during the solid-phase reaction steps could be detected and easily assigned. Therefore, the combination of the HRMAS NMR technique with the use of nonaromatic resins may become an extremely powerful tool in solid-phase organic synthesis. This approach will allow the monitoring of multistep reactions and the conception of on-bead structural studies either on small molecules or on natural and/or synthetic oligomers.

Journal Article↗
PubMedDate not supplied

Spondylo-costal dysostosis in two siblings.

Two new cases of Spondylo-Costal Dysostosis (SCD) are reported in two siblings with strikingly similar skeletal abnormalities. Parental consanguinity documents in this family an autosomal recessive inheritance of trait. Clinical variability of SCD is discussed on the basis of clinical and radiological features. Its genetic heterogeneity is pointed out even considering the occurrence of cases with autosomal dominant as well as recessive inheritance.

Abnormalities, Multiple↗
PubMedDate not supplied

Gastric non-Hodgkin's lymphoma: analysis of 252 patients from a multicenter study.

AIMS AND BACKGROUND: The stomach is the most common site of primary extranodal non-Hodgkin's lymphoma (NHL) and no agreement has been reached so far on the best therapeutic approach. The main objects of this study were to report the long-term results and to evaluate the importance of some possible prognostic factors in a large series of patients. NHL was considered primary gastric if the main symptoms at presentation were those of gastric disease. METHODS AND STUDY DESIGN: We analyzed 252 consecutive patients treated between 1980 and 1993 in five hospitals in north-east Italy. According to the Working Formulation, 98 patients had low grade lymphoma, 59 intermediate grade (D to F), 81 G or high grade and 14 were not classified. The patients were divided into two groups: one including patients with limited disease (localized to the stomach or perigastric lymph nodes: 165 patients) and one including those with advanced disease (87 patients). The treatment consisted of surgery, chemotherapy, radiotherapy or combinations of these. Sixteen patients received only supportive therapy. RESULTS: The five-year overall survival was 65.4%: 80.3% for patients with limited disease and 36.7% for those with advanced disease (P < 0.0001). Among the limited disease patients the five-year survival was 84.4% for those treated with gastrectomy alone and 88.7% for those who received also adjuvant chemotherapy (P = 0.11). However, while chemotherapy did not improve survival in low grade NHL, it seemed to produce a better survival in the intermediate and high grade groups (P = 0.06). Twelve patients were treated with primary chemotherapy and the five-year survival was 71.2%. In multivariate regression analysis the most important variable for overall survival was surgery for the whole group of 252 patients (P < 0.0001), while it was age for the group with limited disease (P = 0.0008). CONCLUSIONS: Surgery alone can be curative for most patients with gastric lymphoma limited to the stomach or to the perigastric lymph nodes; surgery followed by chemotherapy seems to produce better results than surgery alone in intermediate and high grade lymphomas. Also a non-surgical approach with first-line chemotherapy is associated with a high rate of complete remissions and five-year survival. In advanced disease the five-year survival is similar to that of nodal NHL.

Adolescent↗
PubMedDate not supplied

Liver metastases of endocrine tumour associated with multiple endocrine neoplasia type 1: a sustained response to interferon therapy or a peculiar benign course?

The authors describe the case of a 51-year-old male with Zollinger-Ellison syndrome manifested by epigastralgia, nausea, vomiting, hypergastrinemia and multiple endocrine neoplasia type 1. History included a Billroth II procedure for a perforated duodenal ulcer. Multiple metastatic liver lesions were found that were gastrin-negative and chromogranin-positive. Endoscopy revealed a large ulcerated gastro-jejuno-colonic fistula which was surgically repaired. Pre- and postoperative imaging studies, including the highly sensitive somatostatin-receptor scintigraphic scan using In-pentetreotide, have consistently failed to disclose other tumors. Recent reports indicate that most Zollinger-Ellison syndrome-associated gastrinomas are small, easily overlooked lesions located in the proximal duodenum rather than in the pancreas as formerly believed. In the present patient therapy with omeprazole and alpha-interferon has produced complete remission of the Zollinger-Ellison syndrome and a stabilization of tumor growth has occurred during the last 7 years, allowing the patient to live a normal life. This peculiar response to therapy is discussed.

Humans↗
PubMedDate not supplied

[Abdominal actinomycosis and retroperitoneal fibrosis. Considerations on a clinical case].

Abdominal actinomycosis is a rare disease which often resembles an acute suppurative infection or/and abdominal tumour causing abscesses, fistulas and massive fibrosis. The preoperative diagnosis is difficult and surgical exploration is always needed because of major involvement of visceral and retroperitoneal structures. The disease can be diagnosed with certainty only on the basis of findings of bacterial colonies in histopathologic sections and typical sulphur grains in secretions from fistulas. The authors describe a case of abdominal actinomycosis involving the caecum and right colon, causing extensive retroperitoneal fibrosis and a fistula tract with an external cutaneous orifice at the level of the right iliac crest. These features resembled an acute appendicitis at first, and several surgical explorations were required before a correct diagnosis could be achieved. Abdominal actinomycosis can be treated by simple administration of antibiotics. With a correct diagnosis, medical therapy alone has proved effective in a substantial percentage of patients, thus avoiding the need for surgery, if important visceral or retroperitoneal structures are not involved. Abdominal actinomycosis always requires a careful differential diagnosis and must be considered in patients presenting abdominal tumours associated with abscesses and/or fistulas since early and efficient medical therapy, along with surgical intervention, where necessary, can lead to definitive recovery. Useful diagnostic tools are abdominal CT and selective FNAB.

Actinomycosis↗
PubMedDate not supplied

Virus-induced asthma.

Clinical and experimental investigations indicate that respiratory viral infections are important triggers for asthma attacks. Viral upper respiratory infections have been associated with 80% of asthma exacerbations in children and 50% of all asthma episodes in adults. Human Rhinovirus (HRV) has been implicated as the most common virus associated with asthma episodes. The observation that the great majority of wheezing lower respiratory tract illnesses in early life are associated with acute viral infections suggests that viruses may also alter the development of the lungs or of the immune system, acting as co-factors for the inception of asthma. Whilst there is no doubt that viruses are important asthma exacerbation factors, the role of viral infections in the development of asthma still remains controversial.

Asthma↗
PubMedDate not supplied

Twenty-four-hour intragastric pH-metry: evidence of nightly gastric alkalinization in subjects with and without active duodenal ulcer.

Continuous 24-hour gastric pH monitoring was performed in 68 subjects to evaluate the spontaneous nightly alkalinization phenomenon (SNA). Two groups of patients were compared: the first (group A) was composed of 27 subjects with active duodenal ulcer disease; group B included 12 healthy volunteers and 29 patients with gastroesophageal reflux. Patients with duodenal disease had an alkalinization of 196.2 +/- 97.9 seconds in duration, while healthy subjects and even gastroesophageal refluxers exhibit a SNA lasting 5269 +/- 748.3 seconds (t = 6.72; p < 0.001). The absence of SNA was used as a predictive test of duodenal ulcer disease and its discriminating ability was evaluated. The evidence of this phenomenon was able to exclude the disease in 90% of group B subjects (negative predictive value) while its absence suggested correctly the presence of duodenal disease in 82% of patients (positive predictive value). The lack of SNA in duodenal ulcer patients is so frequent that its absence might be a diagnostic sign of the peptic disease.

Adult↗
PubMedDate not supplied

Twenty-four-hour intragastric pH-metry: H2-receptor antagonist restoration of nightly gastric spontaneous alkalinization in duodenal ulcer healing.

Continuous 24-hour intragastric pH monitoring allows the evaluation of spontaneous late night gastric alkalinization phenomenon (SNA). This nocturnal increase of intragastric pH is strongly evident in healthy volunteers but is insignificant in patients with active duodenal ulcer. Gastric acidity was monitored by 24-hour continuous pH-metry in nine patients with active duodenal ulcer disease before and after two weeks of therapy with ranitidine. A twice daily dose of the drug (150 mg at 08.00 h and 150 mg at 20.00 h) was orally administered to each subject. Before treatment the ulcer patients did not show the SNA phenomenon, but the therapy led it to reappear. Ranitidine significantly reduced the time during which the gastric acidity was lower than 4 pH units; moreover the drug was effective on the ulcer healing during a period as brief as two weeks of therapy. At least a complete healing of the duodenal ulcer could be seen in patients whose overall gastric acidity time was reduced almost to the 40% of the pre-treatment value, meal times excluded from the pH-metric calculation.

Adult↗
PubMedDate not supplied

[Prevalence of glycopeptide resistant enterococci in hospitalized patients and in the community in Calabria (Italy)].

The study evaluated prevalence of glycopeptide (vancomycin and teicoplanin) resistant enterococci (VRE) in hospitalized patients and in the community in Calabria (Italy). Rectal swabs were collected from hospitalized and community subjects. Information was gathered on demographics, ward and duration of hospital stay and antibiotics administered; in community subjects information on previous hospitalizations and antibiotics use in the previous year were also collected. Rectal swabs were plated on Enterococcosel agar alone and with addition of vancomycin (6 mg/l) and incubated aerobically at 37 degrees for 24-48 hours. Typical colonies were tested for Gram stain and catalase production. Enterococci were identified to the species level by biochemical tests. Antimicrobial susceptibility test and E-test were performed by the disk diffusion method to evaluate vancomycin and teicoplanin susceptibility. t-test and chi square test were performed to evaluate difference in means and proportions, respectively. Samples were collected from 211 subjects; 132 (62.6%) from community and 79 (37.4%) from hospitals. Enterococci were isolated from 145 subjects (68.7%), 72.7% and 62% in community and in hospital, respectively. The most frequent isolates were E. faecium (30.4%), followed by E. faecalis and E. durans (25.5%), and, finally, by Leuconostoc (18.6%). Only one E. faecium strain was resistant to both vancomycin and teicoplanin, isolated from a non-hospitalized 45 years old woman (1.3%). The results did not show emergence of VRE in our area, although surveillance to confirm these findings is needed, considering the substantial spread of antibiotics in hospitals and in the community.

Adult↗
PubMedDate not supplied

[Study of the arrhythmia in patients with chronic uremia in periodic hemodialysis with Holter dynamic electrocardiography].

For the purpose of evaluating cause, frequency, type and seriousness of arrhythmias in dialysis patients, 14 chronic uremics, 8 on bicarbonate-dialysis, 6 on acetate-dialysis underwent a basal ECG, echocardiography and a Holter dynamic electrocardiography (ECGD) for a duration of 96 hours. Before and after dialysis PAO, body weight, serum electrolytes and arterial pH were controlled. In 11 patients (78%) supraventricular and ventricular arrhythmias were discovered of equal frequency and seriousness both in the inter and intra dialytic phase, even if more frequent in ventricular hypertrophic patients (IVSn) the complex ventricular arrhythmias (Lown greater than 2). The seriousness and frequency of ventricular and supraventricular arrhythmias in the dialytic phase did not seem to depend either on the type of tampon or on the presence or absence of cardiopathies while in the inter-dialytic phase the seriousness of ventricular arrhythmias seems to depend upon the presence of cardiopathies. The Authors conclude that the pathogenesis of arrhythmias in uremic patients on dialysis is multifactorial and that their elevated incidence makes the use of a Holter in these patients recommendable.

Aged↗
PubMedDate not supplied

[Pefloxacin in the treatment of lower respiratory tract infections].

Pefloxacin is an antibacterial agent belonging to the group of quinolones having a methyl-carboxylic acid which possesses a high activity as compared to other quinolonic drugs. In this study we tested the efficacy and tolerability of the drug in the treatment of 25 patients with environmental L.R.T.I. (Low Respiratory Tract Infections). The microbiological and clinical characteristics of the drug were tested in this study. Excellent results were obtained in 96% of the patients treated and the tolerability was also very good.

Acute Disease↗
PubMedDate not supplied

[Pentoxifylline in the blood rheological and coagulative changes in chronic respiratory failure].

In this study, some hemorheological and coagulative parameters (blood viscosity, erythrocyte filtrability, CPA, platelet aggregation) have been evaluated in 40 patients with Chronic Respiratory Failure. The results obtained document in these patients, important hemorheologic changes. 11 patients with most serious rheologic changes have been treated with Pentossifillina. A significative improvement of the explored parameters and of the clinical condition has been checked after treatment.

Blood Coagulation↗
PubMedDate not supplied

Clarithromycin in the treatment of bacterial relapses of chronic bronchitis.

Clarithromycin is a new semisynthetic macrolide, Erythromycin A derivative, which is bactericidal for the most of growing aerobic and anaerobic Gram-positive and Gram-negative organisms. The drug has also a potent activity against the pathogens surviving into intracellular medium and, just like all other macrolides, achieves its effect by inhibiting protein synthesis. Our study investigated the efficacy and tolerability of Clarithromycin in 11 ambulatory patients (8 m, 3f) suffering from bacterial relapses of chronic bronchitis. The macrolide was administered at the oral dosage of 250 mg twice daily for a period ranging from 7 to 11 days, only after microbiological evaluation of sputum. There was a withdrawal because one of the three bacteria isolated from sputum sample was resistant to Clarithromycin, 7 patients were clinically cured, 3 showed only clinical improvement. In all the ten patients there was eradication of causative agents. No adverse events or changes in biochemical and haematological tests were observed.

Adolescent↗