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A Parisi

Publications and source records attributed to A Parisi.

107 records · Page 6Linked to original sources
PubMedDate not supplied

Identification of blood erythroid markers useful in revealing erythropoietin abuse in athletes.

Recombinant human erythropoietin (rEpo) is being used with increasing frequency by endurance athletes to improve aerobic potential. Although rEpo administration has been banned by the International Olympic Committee, no methods are available to unequivocally detect its abuse in sports. Prompted by these considerations, we evaluated the main hematological and biochemical modifications measured in the blood of 18 volunteers upon rEpo administration. Different rEpo regimens, iron, folic acid, and vitamin B12 administration did not significantly modify the percentage increase in hematocrit. However, a significant decrease in circulating ferritin (fr) and an increase in the soluble transferrin receptor (sTfr) were not found in athletes receiving low (30 IU/kg) doses of rEpo. Thus, an increase in the sTfr/fr ratio cannot be used as an indicator of rEpo abuse, at least when the hormone is administered at low concentrations. In contrast, the amounts of beta-globin mRNA detected by quantitative competitive (RT)-PCR in whole blood samples significantly increased above the threshold levels in all of the treatments investigated. Taken together, these data suggest that hematocrit value, reticulocyte count, soluble transferrin receptor content, and concentration of beta-globin mRNA, when included in a new multiparametric formula, can detect rEpo abuse in 57.5% of the samples examined with a confidence interval of 99.99%. Thus, the method reported in this paper could significantly improve the tests currently available, which in similar experiments allowed the detection of rEpo abuse in only 7.6% of the samples examined.

Adolescent↗
PubMedDate not supplied

Isoenzyme analysis of Entamoeba histolytica for evaluation of pathogenicity: detection of zymodeme XIX in South America.

Authors report the results of the isoenzyme analysis of strains of Entamoeba histolytica isolated from international travellers. This recently developed method allows the detection of pathogenic strains by evaluating the electrophoretic mobility of cytoplasmic enzymes and was proved to be more reliable and quickly feasible than previous ones. The experience reported refers to three strains isolated from travellers coming from Ecuador, Brazil and Indonesia, respectively; the zymodeme XIX (in accordance with the Sargeaunt's classification) was identified in all the three cases. This zymodeme has been first detected in 1981 and should currently be considered rare; moreover, it has never been previously reported from the Americas.

Amebiasis↗
PubMedDate not supplied

Degranulation patterns of eosinophils in advanced gastric carcinoma: an electron microscopic study.

Recruitment and activation of eosinophils have been studied intensely in asthma and other allergic diseases. Less is known about the infiltration and degranulation patterns of eosinophils in the tumor stroma. Seven cases of advanced gastric carcinomas were found to be massively infiltrated by eosinophils and studied by light and electron microscopy. Gastric carcinomas, despite having similar numbers of tissue eosinophils, exhibited markedly different degranulation patterns. In 2 cases, resting nondegranulating eosinophils were found. Piecemeal degranulation was the predominant mode of secretion from eosinophils localized within the tumor stroma in 4 cases. Eosinophil exocytosis and cytolysis were rarely observed. In 1 case, crystals morphologically similar to Charcot-Leyden crystals were observed at the extracellular level as well as in phagosomes of tissue macrophages, confirming active sequestrations of eosinophil Charcot-Leyden protein by macrophages in vivo. In the same case, eosinophils showed characteristic features of early and late apoptotic changes, such as condensed chromatin, focal dilatation of nuclear envelope, and preserved plasma membrane. Morphological association between apoptotic eosinophils and deposition of granules in the tumor stroma was found. Extracellular deposition of intact granules from apoptotic eosinophils was distinct from eosinophilic (necrotic) cytolysis, and has reported previously in experimental studies in vitro. To the knowledge of the authors, this case represents the first report of late apoptotic eosinophils that release their granules within the tumor stroma in a human gastric carcinoma.

Aged↗
PubMedDate not supplied

Can loss and grief activate latent neoplasia? A clinical case of possible interaction between genetic risk and stress in breast cancer.

BACKGROUND: Nineteenth-century physicians working with cancer patients frequently reported that severe emotional losses and grief occurred in some cases before cancer. Research on psychoneuroimmunology seems to reactivate this interest and could give a possible convincing background. METHOD: We recently observed the case of a 45-year-old woman who developed symptoms of breast cancer (ductal infiltrating carcinoma, T1, N1, M0) 3 years after the loss of her only child. The affection for the child compensated inadequacies of her marriage, which became increasingly unstable. The child died in a dramatic accident at home, while his mother was near him but unable to help. RESULTS: The patient had a moderate genetic-familial risk of mammary cancer. Animal studies strongly suggest that stress, through neuroimmunomodulatory mediatory mechanisms, can significantly affect appearance and progression of mammary cancer. The patient developed long-lasting intense grief, despair and hopelessness. DISCUSSION: We discuss the case from three main standpoints: genetic and risk factors for breast cancer; findings which demonstrated a relationship between stress, neuroimmunomodulation and cancer in animals; data from autopsy studies which found foci of latent breast cancer in 20% of healthy women in the same age range. Stress does not create cancer. However we hypothesize that in this case it could have contributed by the activation of a latent neoplasia and/or by impairing immunosurveillance during a critical life phase.

Adult↗
PubMedDate not supplied

[Minimally invasive percutaneous ultrasonography-guided treatment of postoperative splenic abscess. Personal experience with 5 clinical cases].

INTRODUCTION: Splenic abscesses are very rare pathologies encountered in daily clinical practice. The treatment, after failure of other medical treatments, has basically been surgical, in spite of large diffusion of percutaneous echo and CT techniques. The initial hesitation in applying this sort of method was caused by an unfounded fear of difficult management of haemorrhagic complications. METHODS: In our Clinic we treated 6 postoperative abscesses, observed in 5 patients. One of these (16%) was double and 3 concomitant with other intraperitoneal abscessual septic collections, which received priority in percutaneous treatment. In four cases (67%), Van-Sonnemberg drainage catheters were placed which caliber varied from 12 to 14 F. In the remaining two cases, we evacuated the abscess using an echo-guided needle puncture. In two cases we applied fibrinic glue; in one case as a haemostatic agent and in the other, to protect the wide abscessual cavity. RESULTS: We recorded the resolution of the symptomatology and instrumental findings in all patients. One patient died two weeks later due to unrelated causes. We recorded one minor complication which involved an intra-abscessual haemorrhage, which was then treated by fibrinic glue (Tissucol). CONCLUSION: Echo-guided percutaneous treatment, at present, is the treatment of choice for both multiple or single splenic abscesses. This treatment is not used for the miliaric form because we believe that in this case, the most appropriate choice is intensive medical treatment, which if fails, may require splenectomy.

Abdominal Abscess↗
PubMedDate not supplied

[Sensitivity and specificity of transrectal ultrasonography in the preoperative staging and postoperative follow-up in rectal neoplasms. Experience with 100 clinical cases].

UNLABELLED: Preoperative staging plays an important role in the surgical treatment of rectal cancer. The most sensitive imaging techniques currently available are CT, MRI and transanal ultrasound (TAUS). The aim of the study was to evaluate the sensitivity and specificity of TAUS in the preoperative staging and postoperative follow-up of rectal cancer. METHODS: From January 1992 to May 1999, TAUS was used to study 100 patients with rectal cancer. RESULTS: Patients were staged according to the Astler-Coller classification: 1) A: 8 patients; 2) B1: 16 patients; 3) B2: 22 patients; C1: 30 patients; C2: 24 patients. The sensitivity and specificity of TAUS in the preoperative staging of these tumors were 96% for the T parameter, and 100% for the N parameter. The N but not the T parameter results are in line with the values reported in the international literature. CONCLUSION: Transanal ultrasound, in our personal experience, has proved to be a very accurate imaging technique in the preoperative staging and postoperative follow-up of rectal cancer.

Endosonography↗
PubMedDate not supplied

[Palliative treatment of neoplasms of the bilio-pancreatic area. Surgical diversion treatment versus endoscopic-percutaneous approach].

Bilio-pancreatic (BPD) tumours are pathologies with an overall resectability rate of 20-25%, with a high percentage of patients directed towards palliative treatment (70-90%). One hundred and twenty-eight patients underwent palliative treatment for BPD tumours. The M:F ratio was 1:1.5 and the mean age 61 years. The tumours were topographically divided into: 84 (63%) localised in the pancreatic head region; 34 (25%) biliary duct tumours and 6 arising in the ampulla of Vater. 42 patients (30%) underwent palliative surgical treatment (group 1) and 86 (70%) received non-surgical treatment (endoscopic percutaneous) (group 2). We also performed 6 gastrointestinal by-passes (GEA). The early morbidity rate was 36% in the first group and 12.8% in the second. The incidence of late morbidity in the first group was nil, with a mean survival of 10 months. Mortality was nil in both groups. Surgical by-pass is advisable in the presence of patients with a longer life expectancy and in good clinical condition but presents a high rate of early morbidity and a low percentage of late complications. The authors conclude that validity of the methods is similar. They believe that, in selected cases, surgical treatment remains the therapy of choice for BPD tumours.

Biliary Tract Neoplasms↗
PubMedDate not supplied

[Short- and long-term monitoring with high-resolution ultrasonography of postoperative thyroid residue. Personal experience with 200 thyroidectomies].

BACKGROUND: After having abandoned conservative operations of the thyroid (partial resection, enucleal resection) today total thyroidectomy and sub-total thyroidectomy and near total thyroidectomy are the operations of choice. Cause the frequent post-operative scintigraphic signs, on the 3rd month, of thyroidal residue of significative size, founded in our patients operated for sub-total thyroidectomy, we begun to study the echografical monitoring of the thyroidal recess. METHODS: From January 1995 to December 1997 we operated 200 patients for Thyroidectomy. The kinds of operations were: total thyroidectomy for 96 patients (48%), sub-total thyroidectomy for 64 patients (32%), and near total thyroidectomy for 40 patients (20%). We controlled all the patients by ecografical monitoring of the thyroidal recess to detect and to determinate the possible thyroidal residue, that it will be monitorized on the 7th day, on the 1st month, on the 6th month and on the 12th month. We measured the thyroidal residual dimensions and volume. We recorded all the examinations by VCR or film and after we elaborated the results by exponential graphics. The patients that showed the thyroidal residues underwent to a scintigraphy. RESULTS: The thyroidal residuals were measured within the 7Th post-operative day. In the following controls we have noted a thyroidal residue hypertrophy. Multinodular goither was the disease with the highest degree of growth (until the 200% of the first measure of the residue). After an initial phase of growth almost all the patients showed a trend to the stabilization, with the exception only of the patient that suffered from multinodular goither. The scintigraphic examination was not realiable, in our experience, about the mathematic measurement of the thyroidal tissue, showing always an overvaluation of the residue. The best specificity was showed by US-HR. CONCLUSIONS: The patient that undergoes to total thyroidectomy needs an adequate suppressive and substitutive therapy. We identify the presence of several stimulating factors the growth of the residual thyroidal tissue that could arise to promote the hyperplasia and the hypertrophy of the parenchyma (EGF, TSG, TSI, PG). There are factors that are unidentified and are not subject to the suppression caused by substitutive therapy.

Adolescent↗
PubMedDate not supplied

[Periampullar tumors: role of intraoperative color-Doppler ultrasonography in the evaluation of vascular invasion. Methods available to the surgeon and personal experience].

BACKGROUND: Tumors of the head of the pancreas and of the periampullary region, similar nosologic entity, represent the fourth most common cause of cancer death. These tumors are characterized bt high mortality rate associated with a low percentage of surgical resectability. Vascularly involvement is, in our experience, one of the criteria of exclusion for curative surgical resection. For this reason regional pancreasectomy don't show, in several case records, comforting datas about survival. METHODS: From 1995 to 1998 we introduced in the operative practice the color--doppler ultrasonography to diagnose vasculary involvement. We evaluated twenty patients that previously were candidated for surgical therapy consisting in a duodenal-pancreasectomy. All the patients were staged by preoperative abdominal ultrasound, E.R.C.P., CT, and angio M.R.I.. In no one of these patients were founded signs of vascularly involvement. We recognized by intraoperative color-doppler ultrasound three microscopic invasions of spleno-mesenteric-portal vasculary axis. RESULTS: U.S. I.O. C.D. in our case reports has underlined a sensibility and specificity of 100%. It has discovered, also, a false positive for neoplastic thrombosis, and a case of false negative. CONCLUSIONS: Intraoperative ultrasound shows a high sensibility about the intraoperative staging for the bibliopancreatic tumors. The study about the possible vascularly involvement is helped by the application of the colour in terms of an high sensibility and diagnostic care.

Adult↗
PubMedDate not supplied

[Second-line chemotherapy and new drugs for ovarian carcinoma].

Epithelial ovarian carcinoma represents a prototypic example of neoplastic disease sharing at the same time good chemosensitivity as well as marked propensity to relapse. If in one hand the definition of almost clear-cut guidelines has been reached in the setting of first-line therapy (i.e., cytoreductive surgery followed by first-line chemotherapy), more difficult to discern for the oncologist remains the choice of treatment in the occasion(s) of relapse(s). This article focuses on this particular setting of disease, analyzing the specific criteria of choice of drug or their combinations; the definite criteria followed for the use of platinum compounds in the second line of treatment, even if already utilized in the front line therapy, are also analyzed. Specific attention has also been paid in the definition of the role of single parameter as a "prognosticator" and/or as "predictor" of response. The Authors emphasize how clinical definitions remain the more reliable, simple, reproducible tools in therapeutical decision making.

Antineoplastic Agents↗
PubMedDate not supplied

[Surgical treatment of acute colonic diverticulitis. Personal experience].

BACKGROUND: Colonic acute diverticulitis presents in patients that suffered from colonic diverticula in 10-25% of cases higher percentage in the elder patient. Colonic acute diverticulitis mortality leads high rates in over 70 years old patients with a value a upper than 75-80%. Perforation and diffuse peritonitis are the more serious complications. Accurate clinical staging followed by correct surgical option are the base of the therapeutical success. METHODS: Between january 1995 and june 2000 we studied by a retrospective analysis 56 patients (34M/22F), mean age 67, hospitalized cause acute perforate colonic diverticulitis, all patients were recorded in order their clinical conditions APS score and Hinchey staging of the disease. At the time of the recovery all patients underwent at clinical examination, abdominal ultrasound, plane X-ray, and bloody tests. Surgical operations performed were: PRA; PRA and protective colostomy; Hartmann procedure. In the patients with APS score > 6-10 and aged > 70 Hartmann procedure was performed. RESULTS: Overall mortality was 9% (5 pazienti), overall morbility was 40%. On the basis of the I and II Hinchey stage mortality rate was 0%. In the III stage was recorded mortality of 4% and 33% in IV stage. Complication were: 6 anastomotic lekage; 7 infections of the laparotomic wound; 1 incisional hernia; 2 lekeages of the stomoa; 3 stomatitis; 5 proctitis. CONCLUSION: Therapeutical choise treatment has to consider Hinchey stage and APS score. Hartmann procedure is indicated in stage III-IV with score APS > 8-10. For the other patients primary resection anastomosis and if is necessary associated colostomy is the treatment recommended.

Acute Disease↗
PubMedDate not supplied

The possible role of radiofrequency as complementary treatment of locally advanced gastric cancer.

AIM: The prognosis of locally advanced gastric cancer (T3-T4) is bad. The presence of lymph nodes (N3-N4) or haematogenous metastases (liver, lung) gets worse the evolution; principally the hepatic malignancies are cause of scarce survival. The possible use of a palliative treatment as radiofrequency ablation (the good results are note about the treatment of hepatic malignancies by colo-rectal cancer) is reported in recent series. Therefore we decide to use radiofrequency ablation for the treatment of hepatic metastases by gastric cancer, difficulty treated surgically. MATERIALS AND METHODS: From January 2001 to December 2002, 25 patients affected by hepatic metastases underwent to radiofrequency thermal ablation, 2 of them were affected by gastric adenocarcinoma. Case 1: A.P., 58 year-old man, one year before underwent to subtotal gastric resection according to Billroth II. After repeated postoperative chemotherapy cycles, he presented metastases at IV hepatic segment. The patient underwent to percutaneous radiofrequency ablation. The control CT scan confirmed metastasis disappearance. After three months, a partial recurrence was treated by the alcoholization. Three months after, we observed marked jaundice for multiple diffused metastases, followed by the exitus. Case 2: B.G., 63 year-old man, with advanced gastric adenocarcinoma (T4) at the pylorus and hepatic metastasis at IV segment. The patient underwent to gastrojejunostomy and to intraoperative radiofrequency ablation. Ultrasonography and CT scan controls were performed before discharge. The patient didn't undergo to successive controls. After 7 months, the patient returned with marked jaundice for diffused hepatic metastases; he refused any treatment, and then he died one month after. CONCLUSIONS: Our preliminary results don't show complications related to the intra and peri-operative radiofrequency, with an important increase of the mean survival. The results, limited by poor experience, may indicate the complementary role of the radiofrequency in the palliative treatment of the hepatic metastases by advanced gastric cancer, difficulty treated surgically.

Adenocarcinoma↗
PubMedDate not supplied

[Neurophysiological diagnosis of AIDS dementia complex: importance of electroencephalography].

This study reports the results obtained by an Electroencephalographic screening of 450 HIV-seropositive patients, belonging to different stages of infection. The major bioelectrical changes of cerebral activity were evident in AIDS group (87.2%) and in ARC group (64.5%), whereas mild abnormalities were present in LAS group (38.8%) and in asymptomatic infection (19.2%), often without any evidence of neuropsychological impairment. Therefore, we emphasize the usefulness and the sensibility of Electroencephalography and, in particular, of Electroencephalography coupled with Computerized Spectral Analysis with the aim of identifying the subclinical stages of AIDS Dementia Complex.

AIDS Dementia Complex↗
PubMedDate not supplied

[Carcinomas of the digestive system in patients under 20 years old].

Gastrointestinal cancers are very scarce for the people under twenties. Such a rarity, as misguides diagnostic trend, is responsible, in the greater part of cases, of the lag in the recognizing these neoplasm and, consequently, reduces the expectations of surviving whether medium or long term. Authors report their experience as regards to observation of two cases of malignant neoplasm of the stomach and of the recto-sigmoid joint in young patients of fourteen and nineteen years old and they emphasize the importance of a complete diagnostic route which, in spite of age, does not exclude the possibility of a neoplastic pathology in the presence of suggestive persistent symptomatology. It is underlined the importance of early diagnosis in fact survival yield is always and however dependent on a disease stage and not on age. Furthermore it is underlined that the young patient is subject to a rate of postoperative complications which is marginal compared with intervention yield, this is translated in a better responsiveness of young patient to radical and, if it is necessary, extended interventions.

Adenocarcinoma↗
PubMedDate not supplied

[Reduced glutathione and anaerobic threshold].

In this study the authors evaluate the relationship existing between reduced glutathione (GSH) and increased indexes of muscle performance. GSH has a protective action on the cell either against the oxidative stress or for its ability of removing through out the body xenobiotic substances circulating. 15 male competitive pentathlon athletes were the sample of this research. The aim of the research is to evaluate the possible role of GSH to determine the anaerobic threshold through its blotting function.

Adult↗