[Physiopathology and diagnostic evaluation of platelet aggregation in pediatrics].
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Biomedical subjects
Publications and source records attributed to A Palumbo.
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OBJECTIVE: We summarized general principles related to apoptosis and reviewed the current evidence regarding apoptosis in the normal ovary during follicular atresia, ovulation, and corpus luteum formation and regression, and in the polycystic ovary. DATA SOURCES: Published articles and abstracts from national scientific meetings were reviewed. DATA SYNTHESIS: Apoptosis is a physiologic type of cell death that may regulate tissue remodeling. In the ovary, apoptosis occurs in atretic follicles, in the ovarian epithelium at the time of ovulation, and in the corpus luteum. Certain apoptosis-related genes are expressed during follicular atresia, which suggests a role for genes in the regulation of apoptosis in the ovary. In a rat model of polycystic ovaries, apoptosis occurs in both atretric follicles and cysts. CONCLUSIONS: Apoptosis is an important physiologic process in the ovary, and abnormalities in this process may lead to pathologic conditions. The study of ovarian apoptosis is still at an early stage, and further research will uncover the steps in this process.
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OBJECTIVE: We reviewed the evidence for an intrinsic ovarian renin-angiotensin system (OVRAS), highlighting potential diverse signaling in this system through different bioactive angiotensin peptides, their specific receptors, and second messengers. In addition, sites of action for OVRAS in the regulation of ovarian function in health and disease were reviewed. DATA SOURCES: We used published journals and abstracts from national scientific meetings. Current developments in the renin-angiotensin field are historically set. STUDY SELECTION: One hundred referenced articles provided studies on renin-angiotensin systems in mammalian species, including humans. DATA ABSTRACTION: Interpretation of the reviewed publication was in line with the original authors' conclusions and statistical analysis. DATA SYNTHESIS: Techniques in molecular biology, biochemistry, and immunohistochemistry have identified an OVRAS in mammalian species. Ovarian tissues contain all the elements for the production of angiotensin, including prorenin/renin, angiotensinogen, and angiotensin-converting enzyme. In addition, angiotensin II is present in ovarian compartments, and receptors for angiotensin II are demonstrated on specific ovarian cells. Angiotensin II is implicated to play a role in ovulation, steroidogenesis, follicular atresia, and hyperandrogenic syndromes. CONCLUSIONS: The newly identified OVRAS may have important actions in the ovary that range from regulation of ovulation to ovarian dysfunction, such as hyperandrogenic syndromes in women. In this respect, the OVRAS is a putative paracrine/autocrine regulator in the ovary, and pharmacologic regulation of the OVRAS may provide new methods for the management of fertility and reproduction.
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INTRODUCTION: Solitary thyroid nodule is an important pathology with an incidence of 2-5% in Italian population. The diagnosis was based on clinical exam, laboratory tests and ultrasonographic evaluation. MATERIALS AND METHODS: The study undertook has the purpose to assess the usefulness between lobe-isthmusectomy (with corresponding risk of possible relapse and complications for reintervention) and total thyroidectomy, (with corresponding post-surgical treatment complications), for benign thyroid disease with solitary nodule, on selected cases for disease and corresponding risk factors, in the retrospective clinical study, using laboratory tests and ultrasonographic evaluation. The study was conducted on 80 patients admitted from 1994 to 2000 with diagnosis of benign thyroid nodule and operated with lobeisthmusectomy. In seven patients the operation had to be converted in total thyroidectomy. RESULTS: Operative mortality was nil and long-term results at a mean follow-up of three years are encouraging. DISCUSSION: The main advantages of lobe-isthmusectomy for benign solitary thyroid nodule consist in less postoperative complications and less hospital stay. CONCLUSION: Therefore our experience has carried us to consider the lobectomy which treatment choice for all those benign thyroid diseases, with, solitary nodule.
INTRODUCTION: The correlation between hypocalcemia and total thyroidectomy could be correlated to the influence practice from the TSH hormone on the thyroid C cells, in fact in conditions of hyperthyroidism the low values of the thyrotropin is correlated to a reduction of the plasmatic concentration of calcitonin and consequently of calcemia. of our study is verify the incidence of the hypocalcemia post-tyroidectomy and appraise the effectiveness of the pharmacological treatment with calcium salts and possibly D vitamin. MATERIALS AND METHODS: Of the 432 operated patients, 348 has stayed subjected to total thyroidectomy and 84 to loboistmusectomy. In none case subjected to emityroidectomy has been verified a hypocalcemia in the post-operative and in 67 cases in which we have administered pre-operative calcium salts orally, calcemia has sustained within acceptable values. RESULTS: Our experience only 1'11.2% of the patients subjected to total thyroidectomy they have presented a reduction of the calcemia to the of under of the 7.10 mg/dl and they have stayed subjected medical therapy with calcium salts in ev in the symptomatic forms, and to oral therapy in patients absent symptoms, while in two cases is not been practiced any therapy because the symptomatology has disappeared spontaneously DISCUSSION: Syndrome hypocalcemica has determined from the deficit-also transitory-parathyroid glands, from the action of the calcitonin (it favors the amassing of the calcium in to bon), and from a reduced bony reserve of calcium. In fact in those patients operated for a euthyroid goitre or for thyroid tumor the saving of the parathyroid glands avoids the outbreak of hypocalcemia (7, 8). Therefore the physio-pathological mechanism responsible of symptoms (excluded the medical causes: pharmacological treatments with steroid, oral conraceptives, diuretics, salts of lithium, oral antacid and diazepam) (9) also not being still of the all known, it would have his primum movens in the parathyroid glands ischemia. CONCLUSIONS: The precocious evaluation of the calcemia in the period post-operative is useful to discern the patients that will require of a pharmacological treatment of support, so that avoid of the serious and permanent damages to the varied organs.
INTRODUCTION: Solitary thyroid nodule is an important pathology with an incidence of 2-5% in the Italian population. The diagnosis was based on clinical exam, laboratory tests and ultrasonographic evaluation. MATERIALS AND METHODS: The study undertook has the purpose to assess the usefulness between lobe-isthmusectomy (with corresponding risk of possible relapse and complications for reintervention) and total thyroidectomy (with corresponding post-surgical treatment complications), for benign thyroid disease with solitary nodule, on selected cases for disease and corresponding risk factors, in the retrospective clinical study, using laboratory tests and ultrasonographic evaluation. The study was conducted on 80 patients admitted from 1994 to 2000 with diagnosis of benign thyroid nodule and operated with lobe-isthmusectomy. In seven patients the operation had to be converted in total thyroidectomy. RESULTS: Operative mortality was nil and long-term results at a mean follow-up of three years are encouraging. DISCUSSION: The main advantages of lobe-isthmusectomy for benign solitary thyroid nodule consist in less postoperative complications and less hospital stay. CONCLUSIONS: Therefore our experience has carried us to consider the lobectomy which treatment of choice for all those benign thyroid diseases with solitary nodule.
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BACKGROUND: In myeloma patients resistance to both melphalan- and doxorubicin-containing regimens has been related to very short survival (approximately 6 months). The development of effective regimens combined with a low toxicity rate is mandatory in this patient subgroup. METHODS: Fourteen resistant myeloma patients were treated with cyclophosphamide (a total of 3.6 g/m2 was delivered in 2 doses on days 1 and 3) and prednisone (2 mg/kg, days 1-4) every month for 4 cycles. G-CSF support was administered to reduce myelosuppression. RESULTS: This combination was well tolerated. Granulocyte levels fell below 0.1 x 10(9)/L in all patients after a median of 9 days (range 8-11), followed by recovery to 0.5 x 10(9)/L after a median of 12 days from the start of treatment (range 10-13 days). Platelets never fell below 50 x 10(9)/L. All patients were treated on an outpatient basis and only 2 required hospitalization for major complications (pneumonia and heart failure). Response to cyclophosphamide was observed in 6/14 patients: 2 achieved complete remission, 4 showed a 50% or greater reduction of the M-component. Five patients are still in remission after 2, 6, 7, 9 and 10 months; 1 relapsed after 10 months. All patients except one are alive 4-16 months from the start of treatment. CONCLUSIONS: This schedule may represent a new approach for resistant myeloma, and its very low toxicity allows it to be delivered on an outpatient basis.
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