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A Nunziata

Publications and source records attributed to A Nunziata.

48 records · Page 3Linked to original sources

Pharmacological properties of new neuroleptic compounds.

RMI 61 140, RMI 61 144 and RMI 61 280 are newly synthetized N-[8-R-dibenzo(b,f)oxepin-10-yl]-N'-methyl-piperazine-maleates which show interesting psychopharmacologic effects. This work contains the results of a study performed with these three compounds, in order to demonstrate their neuropsycholeptic activity in comparison with chloropromazine (CPZ) and chlordiazepoxide (CPD). The inhibition of motility observed in mice shows that the compounds reduce the normal spontaneous motility as well as the muscle tone. The central-depressant activity is evidenced by increased barbiturate-induced sleep and a remarkable eyelid ptosis can also be observed. Our compounds do not show any activity on electroshock just as do CPZ and CPD. As to the antipsychotic outline, our compounds show strong reduction of lethality due to amphetamine in grouped mice and a strong antiapomorphine activity. They show also an antiaggressive effect and an inhibitory activity on avoidance behaviour much stronger than CPZ. We have also found extrapyramidal effects, as catalepsy, common to many tranquillizers of the kind of the standards used by us. As for vegetative phenomena, the compounds show hypotensive dose related action ranging from moderate to strong, probably due to an a-receptor inhibition. Adrenolytic activity against lethal doses of adrenaline, antiserotonin and antihistaminic effects, as well as other actions (hypothermia, analgesia, etc.) confirm that RMI 61 140, RMI 61 144 and RMI 61 280 are endowed with pharmacologic properties similar and more potent than those of CPZ. Studies on the metabolism of brain catecholamines show that they are similar to CPZ, although with less effect on dopamine level.

Aggression↗

Active abdominal bleeding: contrast-enhanced sonography.

Active contrast medium extravasation is a recognized and important angiographic and computed tomographic (CT) sign of bleeding. It is an indicator of active, ongoing, and potentially life-threatening hemorrhage and, hence, of the need for an immediate surgical or interventional treatment. Sonography (US) is frequently used as the first imaging option for screening patients with traumatic and nontraumatic abdominal emergencies. Owing to the current possibilities of low-mechanical index, real-time, contrast-specific systems, it is now possible to detect a contrast leakage by using US. This finding opens new possibilities in the assessment and management of several abdominal emergencies, including trauma (initial workup and monitoring), spontaneous hematomas, and rupture of aneurysms or masses. This article describes the technique, findings, possibilities, and limitations of contrast-enhanced US in the evaluation of active abdominal bleeding.

Angiomyolipoma↗

Multiphase helical CT findings after percutaneous ablation procedures for hepatocellular carcinoma.

BACKGROUND: Multiple-phase helical computed tomography (CT) has been regarded as the method of choice in the evaluation of patients with hepatocellular carcinoma (HCC) treated by nonsurgical procedures. The aim of this article was to report our experience in the assessment of nodular and parenchymal changes recognizable after various percutaneous ablation therapies. METHODS: We reviewed the studies of 116 consecutive patients with HCC treated with multisession percutaneous ethanol injection (56 patients, 98 nodules), single-session percutaneous ethanol injection (14 patients, 31 nodules), radiofrequency thermal ablation (32 patients, 48 nodules), and interstitial laser photocoagulation (14 patients, 25 nodules). CT had been performed 3-28 days after the last session (mean = 18 days) with unenhanced helical acquisition and with contrast-enhanced double- or triple-phase helical acquisition. RESULTS: Persisting neoplastic tissue was identified within 54.5% of the nodules. It was located centrally in 4.5% of these nodules, peripherally in 11%, and eccentrically in 84.5%, and its shape was crescent in 58%, globular in 24.5%, and other in 16%. On arterial phase scans, viable tumor was hyperdense in 97% of the lesions and isodense in 3%; on portal phase scans, the tumor was hyperdense in 20%, isodense in 28%, and hypodense in 52%; on delayed phase scans, the tumor was consistently hypodense. Tumor necrosis was always hypodense on contrast-enhanced scans. On unenhanced images, 7.4% of the nodules were undetectable. Nodule diameter appeared as unchanged in 53% of the nodules and as larger in 47%; its shape was unchanged in 54% and modified in 46%; its margins were unchanged in 36% and modified in 64%. A rim of granulation tissue was detected around 15% of the nodules, and a perilesional transient attenuation difference was detected in 21%. Perihepatic effusion was seen in 13% of the patients, segmental biliary duct dilation and local atrophy each in 9%, arterioportal fistula in 6%, portal vein thrombosis, subcapsular collection and pleural effusion each in 7%, hepatic infarction in 5%, and inferior vena cava thrombosis in 2%. CONCLUSION: Percutaneous ablation of HCC may cause several changes. Knowledge of their CT appearance is mandatory to correctly assess and manage this tumor.

Adult↗

Helical CT findings in patients with hepatocellular carcinoma treated with percutaneous ablation procedures.

Nonsurgical treatment of hepatocellular carcinoma is used worldwide as a result of the early detection and slow growth of this tumor in patients with chronic liver disease. Multiple-phase helical computed tomography is a commonly used method for evaluating the main features related to percutaneous ablation procedures: nodular changes, tumor necrosis, parenchymal changes, complications, and tumor recurrence. Knowledge of all features recognizable after local ablation therapy is mandatory to avoid diagnostic pitfalls and to optimally assess treatment response.

Carcinoma, Hepatocellular↗

[Multiple-phase spiral computerized tomography of small hepatocellular carcinoma: technique optimization and diagnostic yield].

PURPOSE: Spiral imaging has dramatically increased the diagnostic capabilities of Computed Tomography (CT) in the evaluation of small hepatocellular carcinomas (HCCs, O < 3 cm). We report our experience with multiple-phase CT of small HCC relative to both examination technique and lesion patterns. We compared the yield of biphasic (arterial-dominant + portal-dominant phases) and triphasic (arterial-dominant + portal-dominant + delayed phases) and also reviewed the literature for a meta-analysis of the techniques used. MATERIAL AND METHODS: December 1996 to July 1998, forty-eight patients with small nodular HCCs were examined--98 nodules in all (range 1-9, mean 2 per patient). After baseline CT, a nonionic contrast agent (350 mgI/mL, 130-140 mL, 4 mL/s) was administered through a power injector and a 16-gauge needle. Biphasic volume images were acquired in 19 subjects (early-phase delay 24 s, venous-phase delay 75 s) and triphasic images in 29 (early-phase delay 24 s, venous-phase delay 60 s, delayed-phase delay 100 s). Retrospectively we assessed the number of nodules detected with each protocol in every phase, nodule conspicuity (graded I-IV) relative to surrounding parenchyma, and nodule patterns in the various phases. Nodule patterns were distinguished into homogeneous, peripheral, central and mixed hyperdensity, and homogeneous hypodensity. RESULTS: Thirty-seven lesions were found in the patients examined with the biphasic technique: baseline images showed 35% of the nodules, arterial images 92%, portal images 76% and combined arterial and portal acquisitions 95%. Sixty-one lesions were found in the patients examined with the triphasic technique: baseline images showed 43% of the nodules, arterial images 93%, portal images 70%, and delayed images 77%; combined arterial and portal acquisitions detected 93% of the nodules, combined arterial and delayed images 95%, combined arterial and delayed images 80%. Finally, 95% of lesions were demonstrated when the three phases were combined. Overall conspicuity grades were I in 44% of cases, II in 28%, III in 18% and IV in 10% of cases at baseline scanning; I in 9%, II in 24%, III in 34% and IV in 33% in the arterial phase; I in 28%, II in 41%, III in 18% and IV in 13% in the portal phase; I in 23%, II in 30%, III in 26% and IV in 21% of cases in the delayed phase. At baseline, 10% of lesions were hyperdense (homogeneously and peripherally in 5% each); mixed density was seen in 8%, and hypodensity in 82%. In the arterial phase, 93% of lesions were hyperdense (homogeneously in 80%, peripherally in 10% and centrally in 3%); mixed density was seen in 5%, and hypodensity in 1%. In the portal phase, 4% of lesions were hyperdense (homogeneously in 1% and centrally in 3%); mixed density was seen in 11%, and hypodensity in 85%. In the delayed phase, the lesions appeared mixed in 11% of cases and hypodense in 89%. CONCLUSIONS: Spiral CT scanning of small HCCs requires dedicated and meticulous technique. Multipassage assessment is mandatory, with 2 or 3 dynamic acquisitions of the whole liver. No major difference in nodule detection was demonstrated between these two options and thus the choice rests with the radiologist's preference. Early CT images proved best for lesion detection, followed by delayed, venous, and baseline studies; lesion recognition depends largely on nodular diameter. The same applies to conspicuity, which however depends on tumor volume less. Lesion patterns are quite typical and constant in all phases and are independent of lesion diameter.

Adult↗

[Nicotine addiction and current therapy of smoking cessation].

Nicotine is defined as substance which provokes addiction because it creates both physiological and biochemical modifications in the nervous system stimulating the activity of dopaminergic neurons releasing dopamine in the areas of the brain that control pleasure. In this paper, after a short overview of neurobiological and cellular mechanisms involved in the pathway of nicotine addiction, the main therapies, used in order to provide support to smokers who decide to reduce their cigarette consumption or to quit smoking, are examined. These therapies can be enclosed in the following categories: nicotine replacement therapy (NRT), non-nicotine pharmacological therapy (NNPT), psychological-behavioural therapies (PBT), alternative therapies (AT). In this work the advantages and disadvantages of various therapies are analysed, assessing the criteria found in literature. Results from randomised and controlled clinical studies which examine some of these therapies, alone or in association, also related to relapse time are reported. In conclusion, results of this analysis confirm that, as well as therapies and their treatment time, psychological support and personal motivation are indispensable for successful smoking cessation.

Adolescent↗

[Diffuse pulmonary microlithiasis (a clinical case)].

The authors present a clinical case pertinent to a patient suffering from persistent dry cough and dyspnea by effort. It is described the diagnostic course that enables to identify a diffuse pulmonary microlithiasis, of rare cheeking, whose pathogenetic hypotheses and differential problems are tackled.

Adult↗

[Experimental analysis of interference between alpha-adrenergic stimulants with anti-hypertensive activity and the narcotic activity of pentobarbital].

The interactions of 3 classical alpha-adrenergic antihypertensives of prevalently central type (St 155 or clonidine St 600; BR 750 or guanabenz) with the narcotic effects of pentobarbital have been investigated in the Mus musculus. Interferences between convulsant drugs and spontaneous and coordinatory motor activity were also analysed in comparative studies.

Adrenergic alpha-Agonists↗