Biomedical subjects

A Mancini

Publications and source records attributed to A Mancini.

At least 271 records · Page 15Linked to original sources

PubMedDate not supplied

Primary hyperparathyroidism. Our experience.

We report our experience in the clinical presentation and management of 12 patients with primary hyperparathyroidism, who underwent successful surgery. Comparing our results with those previously reported in the literature, we have attempted to correlate the kind of parathyroid lesion, the magnitude of hypercalcemia and PTH increase, and clinical symptoms. Often these relationships are intriguing; we have tried to classify our patients describing four groups, according to clinical and humoral findings: 1) patients with very mild hypercalcemia and aspecific symptoms; 2) patients with a finding of recurrent hypercalcemia and prevalent renal involvement; 3) patients with severe hypercalcemia, plurisystemic involvement and general decay; 4) patients with medical emergencies. Finally, some considerations on rare histological pictures (hyperfunctioning carcinoma, oxyphil cell adenoma) are reported.

Adenoma↗

PubMedDate not supplied

Neoadjuvant chemotherapy for the treatment of osteosarcoma of the limbs. Preliminary results in 100 patients treated preoperatively with high doses of methotrexate i.v. followed by cisplatin (i.a.) and adriamycin.

One-hundred patients affected with non-metastatic osteosarcoma of the limbs were treated according to a new adjuvant chemotherapy protocol. Preoperative treatment consisted in high doses of methotrexate (i.v.), followed after one week by cisplatin continuous intra-arterial infusion for 72 hours and adriamycin in intravenous infusion for 8 hours. There was good clinical and radiographic response in all of the cases, and conservative treatment was used in 86 cases (86%). A postsurgery histological examination of the segment showed "good" necrosis (greater than 90%) in 75 patients (75%). The incidence of "good" necroses obtained with this protocol was significantly higher as compared to that observed previously at our Center when a preoperative chemotherapy scheme was used, which involved methotrexate and cisplatin alone. Up until now, patients with a good histological response to preoperative chemotherapy have always had an excellent prognosis. Thus, it is our belief that the 23% increase in good histological responses observed must correspond to an increase in the percentage of healing. The preliminary results (83% of patients with no signs of disease) seem to encourage our hypothesis.

Adolescent↗

PubMedDate not supplied

The role of surgery in the treatment of localized Ewing's sarcoma.

This study includes 193 patients affected with localized Ewing's sarcoma and treated at the Rizzoli Orthopaedic Institute between April 1972 and May 1988. It is the purpose of this study to evaluate the efficacy of surgical treatment with regard to the prognosis of patients affected with E.S. and to define its indications as well as its limits as compared with radiotherapy. Ninety patients were treated surgically: 13 underwent amputation (localization of the disease in the leg and foot), 4 underwent debulking, 48 had resection of the tumor without any reconstruction (expendable bones), while for 25 other patients resection of the tumor required alloplastic or allograft replacement. In cases of E.S. localized in the pelvis and spine, surgery did not obtain improvement in prognosis. In the other sites, the percentage of disease-free patients increased from 57% to 72% in cases where surgery +/- radiotherapy was used instead of radiotherapy alone, while the percentage of local recurrences decreased from 18% to 5.5%, respectively. As for functional results, the highest incidence of excellent to good scores was obtained with surgery associated with radiotherapy (69%). The incidence of complications was only slightly different for the two groups.

Amputation, Surgical↗

PubMedDate not supplied

[Role of endogenous opioids in the modulation of hypophyseal hormone secretion].

The aim of the present study is to review current knowledge of the endogenous opiates in order to identify both their basic features and their receptors' properties, including the biological effects of their stimulation, and finally their endocrine actions. Since the identification of methionine-enkephalin and leucin-enkephalin, many opioid peptides with higher molecular weight have been characterized, and their origin from specific precursor has been recognized: proopiomelanocortin, preproenkephalin A, preproenkephalin B. In particular we have analyzed the pharmacological properties and the biological effects of beta-endorphin and met -and leu-enkephalins, the most diffuse of opioids. The use of naloxone has permitted the study of endogenous opioid tone and its effects on the release of the pituitary hormones. The present study reports a summary of data in the literature and personal observation indicating that the peripheral sexual steroids are the most important modulators of naloxone effects on endogenous opioid tone. Finally, the paper reports preliminary observations indicating that during naloxone infusion, females with hypothalamic amenorrhoea show a hormonal profile which differs from normal subjects.

Adult↗

PubMedDate not supplied

Cushing's syndrome: new variants and association with empty sella syndrome.

In this article we propose a review of the literature on clinical variants of Cushing's syndrome (CS) and personal observations on one of these variants. Clinical variants of CS are: (1) tumors of the intermediate pituitary lobe; (2) hypothalamic Cushing's with pituitary hyperplasia; (3) cyclic CS; (4) primitive nodular adrenal dysplasia; (5) pre-Cushing's syndrome; (6) association of CS and empty sella. The personal observations relate to the association of CS and empty sella. This syndrome consists of: (a) inappropriate cortisol secretion of pituitary origin; this alteration is less pronounced in comparison with other patients affected by Cushing's disease; (b) marked hirsutism; (c) slight hyperprolactinemia or augmented PRL response after metoclopramide; (d) elevated DHEAS levels.

Adolescent↗

PubMedDate not supplied

[Prevention of accidents caused by construction work].

Descriptive data on occupational accidents and diseases in the field of construction and particularly among builders are reported. They derive from publications of the National Insurance Institute for Occupational Accidents (INAIL) and refer to the Italian and Umbrian situation. Data show that the number and the severity of the accidents in this field are of great concern. The characteristics of the building work in our areas are too peculiar as the work is carried out in small building sites and lasts for a short period of time; subcontracting and piecework are widely diffused; health surveillance is nearly absent. One must take into account all of these characteristics when prevention programs are to be planned. Intervention priority must be given to a) information on occupational risks of contractors and workers; b) first level prevention; c) control and inspection activity. In this respect the A.A. report the results of the watch activity in 703 erecting yards by one to health unit's Department for the health security, safety and welfare of persons at work (period May 1985 - May 1988). The A.A. define a type of organization to achieve a continual intervention in the erecting yards.

Accidents, Occupational↗

PubMedDate not supplied

[Coexistence of hyperthyroidism and thyroid carcinoma. Description of a clinical case].

The association of hyperthyroidism and thyroid carcinoma, especially multicentric forms, is an unusual event. We present the case of a 49-year-old woman with clinical and radiological findings of hyperfunctioning thyroid nodule that showed, after a subtotal thyroidectomy, histologic evidence of multicentric carcinoma in one lobe and adenoma in the other lobe. The interest of this clinical case is in the coexistence of an independent adenoma with a multicentric carcinoma, revealed by radical surgery that was necessary for the occurrence of a multinodular goiter. The incidence of this situation could be underestimated in consequence of the current surgical approach to the single "hot" nodule and suggests we pay attention to these patients for the possible presence of malignancy in functionally-inhibited thyroid tissue.

Adenocarcinoma↗

PubMedDate not supplied

High dose peptichemio in pretreated neuroblastoma.

The aim of this study was to evaluate the antitumor effect and toxicity of a single course of Peptichemio at high dose (450 mg/sq m) given to children with neuroblastoma resistant to first line treatment or at relapse. A total of 28 children were treated. Seven children showed partial response, 4 minor response, 8 had stable disease, and in 8 the tumor progressed. The principal toxic effect was myelosuppression. Hemorrhagic enteritis with liver failure and toxic death occurred in 1 patient. High dose Peptichemio can be administered with tolerable toxicity, inducing tumor regression in one third of previously treated patients.

Adolescent↗

PubMedDate not supplied