Biomedical subjects
Publications and source records attributed to A Mele.
The authors, after reviewing the literature, particularly the classification of optic nerve-head abnormalities, describe several clinical cases dealing especially with the notable diagnostic possibilities of ultrasound examination.
The relationships between left ventricular mass (LVM), assessed by echocardiography, and several biohumoral and hemodynamic parameters were studied in 63 mild or moderate hypertensive patients and in an age-matched group of 23 normotensive subjects. In hypertensive patients, but not in normotensives, LVM index was significantly correlated with beta-adrenoceptor responsiveness, as evaluated by the chronotropic response to isoproterenol ( CD25 ) (r = 0.525, p less than 0.001) and with the 24-hour catecholamine urinary output (r = 0.485, p less than 0.001). Both CD25 and the catecholamine urinary output were significantly higher in the hypertensives as compared with the normotensive subjects. Moreover, left ventricular wall thickness (septum + posterior wall) was significantly correlated with CD25 and urinary catecholamines only in hypertensive patients. No significant correlation was found between LVM or wall thickness and body surface area, age, blood pressure, heart rate, cardiac output, total peripheral resistance and left ventricular systolic wall stress, whereas CD25 was correlated with urinary catecholamines only in hypertensive patients (r = 0.606, p less than 0.001). These results seem to support the hypothesis that an elevated adrenergic tone may exert a permissive role in the development of left ventricular hypertrophy in human hypertension.
A patient with a juxtapapillary hamartoma is described, in consideration not only for the scarcity of such cases described in the literature, but also for the clinical and echographic characteristics that were observed for the involvement of the right eye, and because the patient was female. Echography and especially standardized A-scan echography, showing a lesion at high reflectivity without acoustic shadowing, allowed us to exclude the presence of a malignant melanoma and retinoblastoma, and directing us to the diagnosis of a malformation of angiomatous type.
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A study of 164 consecutive patients (97 males, 67 females; aged 3-11 years) with acute hepatitis was done. Hepatitis A was the most frequent etiologic type. It occurred in 82.7% of the 3-5-year age group, and in 72.2% and 57.2% of the 6-8- and 9-11-year age groups, respectively. Non-A, non-B hepatitis was rather infrequent (4.3%). Hepatitis B occurred in 13.7% of the 3-5-year age group and reached 39.6% in the 9-11-year age group. While all hepatitis A and non-A, non-B cases recovered within a relatively short time, hepatitis B patients recovered more slowly; two cases recovered 1 year after the onset of symptoms. Chronicity was demonstrated in 23.8% of hepatitis B patients 2 years after the onset of the disease. HBsAg clearance was slower in children than in adults. At 4 months, only 59% of patients had serum converted, and a chronic carrier state occurred in 13 of 42 subjects followed for up to 2 years (three healthy carriers and 10 with chronic hepatitis of various types). Our data show that persistence of HBeAg positivity does not always lead to chronicity in children. Of the eight patients HBeAg-positive 1 year after the onset of symptoms, two recovered.
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Corticotropin releasing factor (CRF) and sauvagine (SVG) when injected ICV both reduced aggressive behavior and sociability while increasing defensive behavior in isolated DBA/2 mice interacting with a group-housed intruder. SVG was more effective than CRF in producing such behavioral effects. These results add further evidence to the similarity between CRF and SVG, and are discussed in terms of the involvement of these peptides in emotional reactivity in the laboratory mouse.
Viral hepatitis type C is of public health importance in all parts of the world. In Italy, hepatitis C accounts for approximately 18% of the annually reported cases of acute viral hepatitis. The national rate of acute non-A, non-B hepatitis (the majority of which are hepatitis C) has significantly decreased during the last decades. At present, the onset of the disease occurs more frequently in individuals 15-24 years old, in men more frequently than in women and in persons living in the south of the country. During the last 5 years the rate of transfusion-associated hepatitis C has dropped (4.8 cases per 1,000,000 in 1989 versus 0.4 per 1,000,000 in 1993), while the percentage of patients who are intravenous drug abusers (IVDA) has increased from 18% to 33%. The high prevalence of anti-HCV (hepatitis C virus) antibody in blood and blood products recipients, IVDA and health-care workers with occupational exposure to blood indicates that HCV is efficiently transmitted parenterally. Data concerning transmission of HCV from mother to infant or by person-to-person contact, either by sexual or by non-sexual household contact, are controversial. However, there is almost universal agreement that the presence of concurrent infection with HCV and human immunodeficiency virus enhances the rate of vertical/perinatal HCV transmission as well as transmission through sexual and other types of person-to-person contact.(ABSTRACT TRUNCATED AT 250 WORDS)
UNLABELLED: The presence of ventricular complex cardiac arrhythmias in coronary patients, both at rest or during physical exercise, is considered a risk factor for future coronary events or sudden death during long time follow up. The meaning of ventricular complex arrhythmias (VCA) in patients with normal ventricular function and without myocardium ischemia has still not been explained. This study aimed to evaluate if patients with normal ventricular function and no evidence of cardiac ischemia (determined by means of Gated SPECT) who developed VCA during stress test show an increase in cardiac events on later monitoring. PATIENTS AND METHODS: All patients were studied by means of an ergometric exercise test using a standard Bruce protocol and Gated SPECT with Methoxyisobutyl Isonitrile-99mTechnetium (99mTC-MIBI). Sixty-seven (67) patients with normal ventricular function and no evidence of cardiac ischemia were included. RESULTS: 13 patients had VCA and 54 had no ventricular arrhythmias during stress test. During the follow up of 681.3 +/- 469 days, none of the 13 patients had sudden death, angina pectoris or myocardium infarction. CONCLUSIONS: In our sample, the appearance of VCA during stress test in patients without myocardium ischemia and normal ventricular function was not associated with an increase of cardiac events during the monitoring which was carried out.
BACKGROUND: Since 1994, the hypothesis of a potential causal relationship between vaccination against hepatitis B and multiple sclerosis (and other demyelinating diseases) was brought to the attention of the French health authority, and to public debate. In Italy, since 1991, vaccination against hepatitis B has been mandatory for newborns and 12-year-old children, and also recommended for high-risk groups. AIM: To re-evaluate the risk/benefit profile of the Italian strategy of hepatitis B vaccination. SUBJECTS: The study population is a hypothetical cohort of 100,000 newborns. METHODS: We present a simulation of the hepatitis B cases that could be prevented with the vaccination and of the potential excess of multiple sclerosis cases which would occur, assuming different odds ratios of multiple sclerosis among vaccinees, and by effecting the vaccination at different ages. RESULTS: In the cohort, we would expect 1,099 hepatitis B cases, that would be prevented with vaccination. Assuming that the highest odds ratio of 1.7 reported is true, the excess of "life-time" multiple sclerosis incidence would be 0.3% for 12-year-old subjects, and 2.9% for adults. CONCLUSIONS: On the basis of these data, our opinion is that the hepatitis B vaccination strategy presently adopted in Italy for newborns, teen-agers and high risk groups should not be modified.
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