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Biomedical subjects

A Conti

Publications and source records attributed to A Conti.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

Propafenone versus amiodarone in field treatment of primary atrial tachydysrhythmias.

Thirty-nine patients with paroxysmal atrial fibrillation or supraventricular tachycardia randomly received amiodarone or propafenone intravenously at home. Fifteen patients received amiodarone and 24 received propafenone; 87.5% of the patients who received propafenone and 40% of the patients who received amiodarone were converted at home to sinus rhythm (P less than .005). The median time of conversion was 10 minutes (range 5 to 35) for propafenone and 60 minutes (range 20 to 130) for amiodarone (P less than 0.005). When either drug failed to terminate atrial tachydysrhythmias at home, the same drug always restored sinus rhythm with subsequent oral treatment during hospitalization. No major side effects were observed after the infusion of either drug. The incidence of minor side effects was not significantly different between the two drugs. Both the drugs are efficacious and safe in the acute management of primary supraventricular tachydysrhythmias. Propafenone showed a greater rapidity of action.

Aged↗
PubMedDate not supplied

Early out-of-hospital lidocaine administration decreases the incidence of primary ventricular fibrillation in acute myocardial infarction.

This study was designed to assess the effectiveness of early prehospital intravenous administration of lidocaine in preventing primary ventricular fibrillation (PVF) in patients with suspected acute myocardial infarction (AMI). Sixty patients with suspected AMI, seen by the Mobile Coronary Care Unit (MCCU) of Florence, were randomly allocated at home to treatment with lidocaine (bolus i.v. of 1 mg/kg, followed by an infusion of 4 mg/min) or placebo (infusion of saline at a rate of 1 mL/min), respectively. The lidocaine group (27 patients) and the control group (33 patients) were not significantly different in age, clinical condition, or time of randomization. The diagnosis of AMI was confirmed in all 60 patients during the hospital stay. Ventricular fibrillation (VF) occurred in 5 patients in the control group in comparison to none in the lidocaine group (P < 0.05). Three patients experienced VF at home and were successfully resuscitated by an MCCU cardiologist. In another two patients, VF occurred during the first 4 hours after onset of symptoms. No major side effects were observed after the infusion of lidocaine. Our findings support the effectiveness of the prophylactic administration of lidocaine in preventing PVF in the prehospital phase of AMI and suggest that the drug can be safely administered in this setting by prehospital personnel.

Aged↗
PubMedDate not supplied

5 alpha-reductase inhibitors, chemical and clinical models.

An active site model of 5 alpha-reductase type 2 isoenzyme on an "active-analog approach" and based on 4-azasteroidal inhibitors has been constructed to evaluate the effects on the inhibitory potency of substituents on the steroid A ring. This model has proven able to predict the potential inhibitory activity of 19-nor-10-azasteroid and 6-azasteroid compounds. A model for the evaluation of clinical efficacy of an inhibitor, based on in vitro data, has also been developed and applied to finasteride. This inhibitory potency evaluation of finasteride in human scalp homogenates, plus pharmacokinetic data, allows the calculation of a theoretical in situ inhibition value for human scalp. From the IC50 curve of finasteride in scalp homogenates, it is possible to calculate that for an inhibition level similar to that obtained in prostate with 5 mg of finasteride, the necessary plasma concentration of the drug is 1 microM, a level obtained after the acute administration of 50 mg of finasteride.

Cholestenone 5 alpha-Reductase↗
PubMedDate not supplied

Internet agents for telemedicine services.

Telemedicine can be defined as telematic support of collaboration between distant medical professionals, co-operating on shared resources of various kinds. Attention should be paid to telematics and informatics concepts, especially those oriented towards collaboration. In particular, the recent agent paradigm seems suitable for the analysis, design and development of telemedicine services because of its commitment to intercommunication and sharing of resources. The present paper is an introduction to the agent paradigm from its theoretical basis to the technological issues, and describes an agent-based approach to telemedicine, specifically applied to telepathology applications. The system is based on an agent-based model and template (JAMES) using Java, which has been used to implement a prototype multipurpose telepathology application based on a federated agency architecture.

Internet↗
PubMedDate not supplied

Total hip disarticulation prosthesis with suction socket: report of two cases.

A majority of hip disarticulations are performed in young people, with malignancy being the most common cause. The exoskeletal Canadian Hip Disarticulation prosthesis had been widely used as a standard total hip disarticulation prosthesis until recently when an endoskeletal modular version became the prosthesis of choice. However, the "basket-shaped" socket provided by the standard total hip disarticulation prostheses has been a source of discomfort and a reason for prosthetic rejection by many patients. This report concerns two patients with true lower limb disarticulation at the hip joint. Both of the patients failed to adapt to the standard total hip disarticulation prosthesis but successfully used a new total contact suction socket design. This new prosthesis provided improved suspension, better patient compliance, and enhanced prosthetic acceptance and mobility.

Activities of Daily Living↗
PubMedDate not supplied

Human milk components cross-reacting with antibodies against bovine beta-lactoglobulin.

The human whey components cross-reacting with antibodies raised against bovine and/or equine beta-lactoglobulin were screened systematically. The milk of six women on a normal diet was collected within 72 h of confinement and whey components were fractionated by high-speed size exclusion chromatography and reversed-phase techniques. The fractions which were immunoreactive in double diffusion experiments with antisera anti-bovine and/or equine beta-lactoglobulin were subsequently purified by native PAGE and then electroblotted on Pro-blott membrane (Western blotting). Pro-blot membranes were stained in parallel with Coomassie and by immunostaining using antibodies against bovine and/or equine beta-lactoglobulin as first antibody solution. The immunoreactive bands were cut out from the membrane and N-terminally sequenced; all the immunoreactive components were clearly identified as human beta-casein or its (mainly tryptic) fragments. The strong antigenic similarity between human beta-casein and beta-lactoglobulin (bovine and equine) might be of immunological importance; it could mean that breast-fed neonates risk being sensitized to beta-lactoglobulin irrespective of the presence of cow's milk in the mother's diet.

Amino Acid Sequence↗
PubMedDate not supplied

Melatonin and the immune-hematopoietic system therapeutic and adverse pharmacological correlates.

The pineal neurohormone melatonin functionally synchronizes the photoperiod in the organism. In the last decade, it has become increasingly clear that the pineal gland and melatonin also play an important immunoregulatory role. T helper (Th) cells bear G-protein-coupled melatonin receptors. Activation of melatonin receptors enhances the release of Th cell cytokines, such as gamma-interferon and interleukin-2, as well as novel opioid cytokines which cross-react immunologically with both interleukin-4 and dynorphin B. These mediators may counteract secondary immunodeficiencies, protect mice against lethal viral and bacterial diseases, synergize with interleukin-2 in cancer patients and affect hematopoiesis. Hematopoiesis is apparently influenced by the action of melatonin-induced opioids on kappa-opioid receptors present on stromal bone marrow cells. Most interestingly, gamma-interferon and colony-stimulating factors may modulate the production of melatonin in the pineal gland. A hypothetical pineal-immune-hematopoietic network is, therefore, taking shape. From the immunopharmacological point of view, there is a need for clinical studies on the effect of melatonin in human immunodeficiency-virus-infected patients and cancer patients. In conclusion, melatonin seems to be an important immunomodulatory hormone which deserves to be further studied to identify its relevance in immune-based diseases, its therapeutic indications and its adverse effects.

Adjuvants, Immunologic↗
PubMedDate not supplied

A study of the mechanisms involved in the immunostimulatory action of the pineal hormone in cancer patients.

The mechanisms responsible for the immunostimulatory role of the pineal hormone melatonin (MLT) are still obscure. To investigate the influence of MLT on interleukin-2 (IL-2)-induced immune effects in cancer, we compared the results obtained in 14 cancer patients treated with IL-2 (6 x 10(6) IU/day s.c. for 5 days/week for 4 weeks) plus MLT (10 mg/day orally) with those seen in 14 patients treated with IL-2 alone and with those obtained from 14 other patients treated with MLT only. All patients were affected by metastatic solid neoplasms. The increase in the mean number of lymphocytes, T lymphocytes, natural killer cells, CD25-positive cells and eosinophils was significantly higher in patients treated with IL-2 plus MLT than in those receiving IL-2 alone. On the contrary, the increase in mean serum levels of the macrophage marker neopterin was significantly higher in patients treated with IL-2 alone than in those treated with IL-2 plus MLT. Finally, MLT alone has no significant effect on immune cell mean number and on neopterin secretion. These results would suggest that the immunostimulatory action of MLT requires the concomitant presence of IL-2 and that two of the main target cells for MLT activity in humans are represented by T helper lymphocytes of type 2, which are involved in IL-2-induced eosinophilia by the release of IL-5, and macrophages, which may inhibit IL-2-dependent immune functions.

Adjuvants, Immunologic↗
PubMedDate not supplied

Effects of 12 months rhGH treatment on bone and collagen turnover in children with constitutional growth delay.

Serum bone Gla protein (BGP), marker of osteoblast function, serum carboxyterminal cross-linked telopeptide of type I collagen (ICTP) and urinary free deoxypyridinoline (DPD), markers of bone resorption, and the aminoterminal propeptide of type III procollagen (PIIINP), marker of type III collagen turnover, were determined in eight prepubertal children (8 males, age range 7-9.6 yr, Tanner stage I) with constitutional growth delay (CGD), before and after 6-12 months of treatment with rhGH (Saizen, Serono, 0.6 IU/kg/week, s.c.). Serum BGP (mean+/-SD: 15.4+/-1.7 ng/ml), ICTP (9.4+/-1.6 ng/ml) and urinary DPD/creatinine (11.3+/-1.7 nmol/mmol) levels were significantly lower (p<0.02, p<0.0001 and p<0.02, respectively) in children with CGD than in healthy age-matched controls (BGP: 18.9+/-3.6 ng/ml, ICTP: 14.3+/-2.6 ng/ml, DPD: 20.7+/-10.0 nmol/mmol), while PIIINP levels of patients were similar to those recorded in controls (6.3+/-0.7 vs 6.7+/-2.3 ng/ml, respectively). Serum BGP, urinary free DPD/creatinine and PIIINP levels significantly increased after 6 (BGP: 20.9+/-2.1 ng/ml, p<0.0001; DPD/creatinine: 16.3+/-3.6 nmol/mmol, p<0.001; PIIINP: 8.1+/-1.6 ng/ml, p<0.005) and 12 months (BGP: 19.2+/-2.0 ng/ml, p<0.0001; DPD/creatinine: 19.7+/-5.1 nmol/mmol, p<0.001; PIIINP: 8.8+/-1.9 ng/ml, p<0.002) of GH treatment. Serum ICTP levels did not significantly change after 6 months (10.6+/-2.1 ng/ml), while a significant increase (p<0.002) was evident after 12 months of therapy (13.6+/-1.3 ng/ml). Our study shows that BGP, ICTP and DPD/creatinine levels are significantly reduced in children with CGD, thus indicating the presence of low bone turnover in this form of short stature. Since GH treatment is able to reactivate bone remodeling and increase collagen synthesis, it is tempting to speculate that a partial GH-IGF-I defect (i.e. locally at bone level) might be one of the factors involved in determining the biochemical alterations of bone metabolism found in this clinical condition.

Biomarkers↗
PubMedDate not supplied

Late evoked responses to acoustic stimuli in relation to age.

Late hearing potentials (contigent negative variations; CNV) were studied in 66 subjects of different ages: 15 children, 26 adults and 25 elderly people (extreme ages of 4 and 100 years). Particular care was taken in selection of phonetic material suitable for each age. No CNVs were recorded in children under the age of 5 years; only 2 of the children examined presented late responses for all the phonetic lists. In adults, such cases rose to 5(19.2%), while another 16(61.5%) presented responses for some or a good part of the lists in question. Only in 9 elderly people were typical CNVs observed (36%). The discussion outlines the reasons for the low percentages of late responses obtained in children and point out that in some elderly subject accustomed to psychic and motor activities typical CNV are present.

Acoustic Stimulation↗
PubMedDate not supplied

Giant retroperitoneal angiomyolipoma. A case report.

We discuss a case of a giant renal angiomyolipoma. A 28 year-old woman presented with a history of a painless and swelling abdominal mass. A computerized tomography (CT) scan of the abdomen demonstrated a 27 x 13 x 11 cm tumor in the right retroperitoneum. At laparotomy, a wide excision of the mass was performed and the histopathological examination of the resected specimen revealed the presence of an angiomyolipoma. The clinical, radiological and pathological findings of this case are reported with a review of the literature.

Adult↗
PubMedDate not supplied

Solitary splenic recurrence of epithelial ovarian cancer: a case report and review.

The metastatic involvement of the spleen in epithelial ovarian cancer is rare and usually reflects late disseminated disease. Isolated parenchymal metastasis in the spleen is an extremely unusual event, in fact in most cases in medical literature, the spleen was involved as part of diffuse peritoneal carcinomatosis. We report a rare case of epithelial ovarian carcinoma, which recurred in the splenic parenchyma 15 years after initial treatment. The patient underwent a splenectomy followed by six cycles of platinum-based poly-chemotherapy. Currently, 8 years after splenectomy, the patient has no evidence of relapsed disease. In the solitary splenic recurrence of epithelial ovarian cancer our case suggests that accurate surgical resection of the spleen, followed by platinum-based chemotherapy, is correlated with a prolonged survival.

Adenocarcinoma↗
PubMedDate not supplied

[2 cases of chylothorax during total parenteral nutrition: the etiopathogenetic considerations].

The authors report the onset of bilateral chylothorax during postoperative total parenteral nutrition. They underline the peculiar origin of the complication. Therefore, attention is payed to the possible pathogenic causes. The overload of fluids, in the elderly with minimal functional reserves, may increase central blood pressure, so to adversely affect lymphatic drainage causing chylothorax.

Aged↗
PubMedDate not supplied

Immunological effects of a single evening subcutaneous injection of low-dose interleukin-2 in association with the pineal hormone melatonin in advanced cancer patients.

Recent experiments have shown that a great variety of neurohormones can interact with IL-2 in the modulation of host antitumor immune response. On the basis of these data, a study was started to evaluate the effect of the pineal hormone melatonin (MLT) on IL-2-induced immune changes in cancer. The study included 30 advanced cancer patients. They were randomized to be treated with IL-2 at a dose of 3 million IU subcutaneously twice/daily (8.00 a.m. and 8.00 p.m.) for 6 days/week for 4 weeks, with IL-2 once/daily in the evening, with IL-2 once/daily plus MLT at 10 or at 50 mg/day. MLT was given orally at 8.00 p.m. Both IL-2 given twice daily and IL-2 given once daily and IL-2 given once daily in association with MTL induced a significant increase in mean number of lymphocytes, T lymphocytes, NK cells, CD25-positive cells and eosinophils, whereas the single administration of IL-2 alone was unable to determine a significant rise in the mean number of immune cells. Soluble IL-2 receptor and neopterin increase was significantly higher during IL-2 given twice/daily than during IL-2 plus MLT, while no difference was seen in TNF rise. This study would suggest that a single daily injection of low-dose IL-2 is able to efficiently activate the lymphocyte proliferation in cancer patients when it is given in association with the pineal hormone MLT.

Adult↗
PubMedDate not supplied

The concept of "context" in health care: historical perspective and current views.

The concept of "Context" presents various aspects ranging from the emotive to the cognitive, from the structural and organisational to the methodological, from the social to the educational, and therefore merits consideration. Furthermore, the influence of the health context on clinical outcomes has recently had a rebound of attention in biomedical literature, given that the ability of clinicians to modify their professional practice is considered to be strongly influenced by the organisational and managerial milieu of their work. In the past attention was largely focussed on the ability of the environment to modify the health status of individuals and so to cause, or con-cause, diseases. There was instead a relative lack of interest in the influence of the health context on health operators, and, more importantly, in its effect on the relationship between patients and health operators and, in turn, of this latter relationship on clinical outcomes. This interest has recently been investigated and research has provided preliminary evidence that physicians adopting a friendly and reassuring approach are more effective than those who keep visits and counselling at a formal level. An awareness that many features of the concept of context in health care have been relatively little studied should address future research to clarifying scientifically the global role of context in health. The promising findings of the studies available, such as those here illustrated, point to the fact that valid research would be both feasible and effective.

Delivery of Health Care↗