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Biomedical subjects

A Russo

Publications and source records attributed to A Russo.

At least 73 records · Page 4Linked to original sources
PubMed2004

[Surgical treatment in day surgery of uncertain breast lesions].

AIM: New models of care are proposed to reduce the costs of traditional hospitalization and to improve the utilization of resources in surgery. Day surgery is widely employed in breast surgery. In this study we report the conversion rate and causes in ordinary hospitalization and we identify some contraindications related to breast surgery in day surgery. METHODS: A cohort study was performed on 306 patients operated on between July 1999 and December 2001 for breast lesions with uncertain interpretation at the clinical and/or instrumental examination. Those patients who lived at a distance of less than 50 km from the hospital, had a telephone, a suitable house, direct family support and, if necessary, could benefit from home health care in addition to hospitalization, were considered as eligible to day surgery. The kind of anesthesia and hospital admission were established after clinical, psycho-emotional, and socio-familiar evaluation of the patients by the surgeon and the anesthetist. RESULTS: A total of 250 excisional biopsies and 56 biopsies with a Mammotome were performed. Surgery was performed under local anesthesia in 278 patients and general anesthesia in 28 subjects. Observation exceeding 24 hours was only necessary in 10 patients reporting hypotension syndrome and anxiety. The conversion rate in ordinary hospitalization was 0.3%. Postoperative morbidity was 1%. CONCLUSION: Day surgery is an effective model of care in breast surgery for diagnostic and therapeutic purposes without axillary dissection. A good selection of patients, perfect interdisciplinary collaboration, and an efficient structural organization are necessary to control the complication and conversion rates of traditional hospitalization.

Ambulatory Surgical Procedures↗
PubMed2004

Baseline and CRH-stimulated ACTH and cortisol levels after administration of the peroxisome proliferator-activated receptor-gamma ligand, rosiglitazone, in Cushing's disease.

UNLABELLED: The ability of acute rosiglitazone administration in influencing ACTH/cortisol secretion in basal conditions and after CRH stimulation was studied in patients with Cushing's disease. Ten patients (8 women and 2 men, aged 18-65 yr) with Cushing's disease were enrolled in the study: 6 of them had previously undergone unsuccessful surgery and 4 were untreated. Plasma ACTH and serum cortisol levels were evaluated at serial time points for 3 h during saline infusion and after the administration of rosiglitazone (8 mg, po) and for 1 h after the injection of CRH (1 microg/kg iv) given alone or 30 min following rosiglitazone administration. The 4 tests were performed in all subjects in randomized order on different days. No significant difference was observed between the pattern of hormone secretion during saline alone and after rosiglitazone, as evaluated by two-way analysis of variance (ANOVA). The integrated areas under the curves (AUCs) were also not significantly different (ACTH: 5683 +/- 1038 vs 6111 +/- 1007 pg/ml/180 min; cortisol: 2333 +/- 267 vs 2902 +/- 486 microg/dl/180 min). In addition, there was no difference for ACTH and cortisol responses to CRH given either alone or after rosiglitazone, when evaluated as peak, increment or AUC; the pattern of the responses analyzed by two-way ANOVA was also similar. IN CONCLUSION: 1) the administration of a single dose of rosiglitazone did not decrease ACTH/cortisol levels or blunt their response after CRH injection; 2) the activation of PPAR-gamma receptors by rosiglitazone seems unable to affect ACTH and cortisol secretion, at least in acute conditions, in patients with ACTH-secreting pituitary adenomas.

Adolescent↗
PubMed2004

Internal auditory canal metastasis.

This report deals with 3 cases of internal auditory canal metastasis, an extremely rare lesion, few cases having been reported in the international literature. Since pre-operative diagnosis is fundamental in the planning of a correct therapeutic strategy, it is important that the neurotologist be aware of the possibility of their occurrence in this particular area. Metastasis can occur unilaterally as well as bilaterally; the latter being the case in 1 of the patients described herein. Correct pre-operative diagnosis is particularly difficult in patients in whom the primary tumour has not been detected at the time of identification of the lesion in the internal auditory canal. The only characteristic, specific of metastasis, is the presence of multifocal cerebral lesions. However, these were detected in only 1 of the present cases. On the contrary, in cases of a single metastasis, both magnetic resonance imaging and computed tomography usually fail to show any distinctive feature when compared to the most common tumours of the internal auditory canal (vestibular schwannomas and meningiomas). Bilateral metastases can also be misdiagnosed as neurofibromatosis type 2. Clinical data that should alert the clinician are: rapidly progressive sensorineural hearing loss, followed by onset of progressive facial nerve weakness. Radiotherapy and/or chemotherapy are the two main treatment modalities, while surgical removal is reserved for selected cases of a single metastasis. Albeit, due to the paucity of specific radiological and clinical characteristics, surgical removal is often necessary to reach the correct diagnosis, as occurred in 2 of the present patients.

Aged↗
PubMed2004

Isolated, benign, intraorbital schwannoma arising from the supraorbital nerve. Case report and review of the literature.

The authors describe the rare case of a 65-year-old man, with absent clinical evidence of von Recklinghausen's disease, harbouring an isolated, benign schwannoma of the right supraorbital nerve. The patient presented a progressive, painless proptosis of the eye for the past 2 years, did not complain of any intra- or periorbital pain, and did not experience any form of visual disturbance or field defect. The lesion was completely resected using a fronto-orbitozygomatic approach. The clinicopathological, radiological and surgical features are discussed, and the literature on supraorbital nerve schwannomas reviewed. To the authors' knowledge the fronto-orbitozygomatic approach has not been previously reported for the removal of supraorbital nerve tumors.

Aged↗
PubMed2003

Treatment of chronic patellar dislocation with a modified Elmslie-Trillat procedure.

BACKGROUND: This paper describes a modification of the Elmslie-Trillat procedure that is usually performed in severe cases of habitual or recurrent patellar instability. METHODS: Eighteen knees (7 men and 8 women) treated for recurrent or habitual patellar dislocation were evaluated clinically and radiographically at a mean follow-up of 5 years (range 24 months to 9 years). The mean age at follow-up was 26.3 years (range 17-44 years). The IKDC and Kujala and Tegner scores were used for the clinical evaluation. Anteroposterior, lateral and Merchant views were done for radiographic monitoring. When the patella was still unstable during dynamic evaluation after execution of the Elmslie-Trillat procedure, the medial third of the patellar tendon was isolated and harvested with a corresponding 1 cm long and 0.5 cm wide bone plug, maintaining its insertion to the inferior medial side of the patella. This ligament was medialized and put under tension, trying to find a medial insertion that guaranteed patellar stability throughout the full range of motion. RESULTS: IKDC classified 11 knees as A (normal), 4 knees as B (almost normal), 2 knees as C (abnormal) and 1 knee as D (severely abnormal). The Kujala score showed excellent results in 16 knees, 1 fair and 1 poor knee. The mean Tegner score rose from 2 preoperatively to 5 at follow-up. The poor knee presented an over-correction of the congruence angle on radiography. On follow-up radiographs, the parameters were almost completely corrected. Statistical analysis showed a significant correction of radiograph parameters, and significantly worse results in patients who underwent trochleoplasty. CONCLUSION: The technique described tries to achieve a dynamic stability of the patella throughout the full range of motion in severe patellar instability where the Elmslie-Trillat procedure is insufficient. No recurrence of patellar instability has been observed. The stability must be obtained with dynamic control in the initial degrees of flexion, trying to avoid an excessive patellar medialization.

Adolescent↗
PubMed2003

Multiple approach to the exploration of genotype-phenotype correlations in familial adenomatous polyposis.

PURPOSE: Familial adenomatous polyposis (FAP), caused by a mutation in the APC gene, is a colorectal cancer predisposition syndrome associated with several other clinical conditions. The severity of the FAP is related to the position of the inherited mutation in the APC gene. We analyzed a large series of FAP patients to identify associations among major clinical manifestations and to correlate the mutation site with specific disease manifestations. MATERIALS AND METHODS: APC mutations were identified in 953 FAP patients from 187 families. We used unconditional logistic regression models and a method involving generalized estimating equations to investigate the association between genotype and phenotype. We used multiple correspondence analysis to represent the interrelationships of a multiway contingency table of the considered variables. RESULTS: APC germline mutations were located between codons 156 and 2011 of the APC gene. Mutations spanning the region between codons 543 and 1309 were variable, but strongly associated with congenital hypertrophy of retinal pigment epithelium. Mutations between codons 1310 and 2011 were associated with a six-fold risk of desmoid tumors relative to the low-risk reference region (159 to 495). Mutations at codon 1309 were associated with early development of colorectal cancer. Mutations between codons 976 and 1067 were associated with a three- to four-fold increased risk of duodenal adenomas. The cumulative frequency of extracolonic manifestations was highest for mutations between codons 976 and 1067, followed by mutations between 1310 and 2011. CONCLUSION: Analysis of the relation between APC mutation site and phenotype identifies subgroups of FAP patients at high risk for major extracolonic disease, which is useful for surveillance and prevention.

Adenoma↗
PubMed2003

Red wine micronutrients as protective agents in Alzheimer-like induced insult.

Plant extract micronutrients are commonly added to diets for health and prevention of degenerative disease. However, there are barriers to the introduction of these products as antioxidant therapies in counteracting chronic human diseases, probably because the molecular bases of their therapeutic potential are poorly clarified. The present study was designed to evaluate the possible protective effect of combined micronutrients present in black grape skin on toxicity induced by 25-35 beta-amyloid peptid or by serum of Alzheimer's disease patients, in human umbilical vein endothelial cells (HUVECs). The hypothesis was tested by examining the results of lactic dehydrogenase (LDH) release to estimate cytoplasmic membrane breakdown; activity of mitochondrial complexes, reactive oxygen species (ROS) production and malonyl dialdehyde (MDA) levels as markers of oxidative stress induction and COMET assay to evaluate DNA fragmentation. The results demonstrate that black grape skin extract reduces the ROS production, protects the cellular membrane from oxidative damage, and consequently prevents DNA fragmentation. The experimental results suggest that this natural compound may be used to ameliorate the progression of pathology in AD disease therapy.

Alzheimer Disease↗
PubMed2003

Cognitive [correction of cognitve] estimation: comparison of two tests in nondemented parkinsonian patients.

The Time and Weight Estimation test (STEP) and the Cognitive Estimation Task (CET) are two recently devised tests for the assessment of cognitive estimation. In the present study, we compared their performance in 30 non-demented idiopathic parkinsonian (PD) patients, also evaluated with the Frontal Assessment Battery (FAB) as an index of executive impairment, with the aim of verifying the putative frontal circuitry of cognitive estimation processes. Six patients (20%) showed a pathological performance on either or both tests. After division of the PD sample into tertiles based on the FAB score, no significant difference was detected by either estimation test. Furthermore, the two questionnaires were unrelated to each other. Thus, deficits of cognitive estimation ability appear to be mild in PD without dementia and do not correlate with executive impairment. Unexpectedly, the CET and the STEP seem to have no unique underlying construct.

Aged↗
PubMed2003

Assessing clinically relevant cognitive decline: preliminary data on a new method.

Physiological age-related cognitive decline, practice effect and regression to the mean may interfere with the interpretation of psychometric changes between subsequent neuropsychological evaluations. The standardized regression-based (SRB) change score allows investigators to define clinically relevant cognitive change on an individual basis controlling for these confounding factors. We performed a preliminary study to test its applicability and usefulness in the neuropsychological diagnosis of dementia. We derived a regression equation for the tests of a widely used Italian battery for global cognitive assessment, the Mental Deterioration Battery, in a sample of 20 normal elderly and we tested the potential clinical application of the SRB methodology in two cases of questionable dementia.

Aged↗
PubMed2003

Cyanidin and cyanidin 3-O-beta-D -glucoside as DNA cleavage protectors and antioxidants.

Anthocyanins, colored flavonoids, are water-soluble pigments present in the plant kingdom; in fact they are secondary plant metabolites responsible for the blue, purple, and red color of many plant tissues. Present in beans, fruits, vegetables and red wines, considerable amounts of anthocyanins are ingested as constituents of the human diet (180-215 mg daily). There is now increasing interest in the in vivo protective function of natural antioxidants contained in dietary plants against oxidative damage caused by free radical species. Recently, the antioxidant activity of phenolic phytochemicals, has been investigated. Since the antioxidant mechanism of anthocyanin pigments is still controversial, in the present study we evaluated the effects of cyanidin and cyanidin 3-O-beta-D-glucoside on DNA cleavage, on their free radical scavenging capacity and on xanthine oxidase activity. Cyanidin and cyanidin 3-O-beta-D-glucoside showed a protective effect on DNA cleavage, a dose-dependent free radical scavenging activity and significant inhibition of XO activity. These effects suggest that anthocyanins exhibit interesting antioxidant properties, and could therefore represent a promising class of compounds useful in the treatment of pathologies where free radical production plays a key role.

Anthocyanins↗
PubMed2003

Gastric cancer in young patients with no alarm symptoms: focus on delay in diagnosis, stage of neoplasm and survival.

BACKGROUND: The test and treat strategy for Helicobacter pylori infection has raised some concern since young gastric cancer patients may have no alarm symptoms. In this study the frequency of alarm symptoms was assessed in a series of young gastric cancer patients, as well as the impact of absence of alarm symptoms on delay in diagnosis and stage of gastric cancer at diagnosis and survival. METHODS: A retrospective study was carried out on 92 gastric cancer patients < or = 45 years of age identified from databases in four hospitals between January 1985 and December 2001. Characteristics analysed included duration and features of dyspeptic symptoms, presence of alarm symptoms, time interval from the onset of symptoms to diagnosis, pTNM stage and survival. RESULTS: Of the 92 patients, 54 (58.7%) presented uncomplicated dyspepsia and 38 (41.3%) alarm symptoms. In those with uncomplicated dyspepsia, epigastric pain was the most common complaint (64.1%) followed by vomiting (30.4%), heartburn and nausea. Weight loss was the most common alarm symptom (30.4%), followed by anorexia (10.9%), dysphagia or anaemia (7.6%). The mean delay from first symptoms to final diagnosis was 16.8 +/- 13.9 weeks in patients with alarm symptoms and 29.3 +/- 39.9 weeks in patients without alarm symptoms (P:ns). Patients without alarm symptoms showed significantly less aggressive gastric cancer compared to patients with alarm symptoms in relation to TNM stage and survival (cumulative 5-year survival rate: 76% versus 49% P: 0.01). The survival rate, at 5 years, of patients without alarm symptoms, and with a history of dyspepsia of more than 24 weeks, was higher than that in patients with early diagnosis (93.4% versus 66.5%: P: 0.05). CONCLUSIONS: A large proportion of young gastric cancer patients present without alarm symptoms. Despite the delay in diagnosis, these patients have a better outcome than those with alarm symptoms. Thus the delay in diagnosis of patients without alarm symptoms does not affect survival.

Adult↗
PubMed2003

Large-scale spatial distribution of virioplankton in the Adriatic Sea: testing the trophic state control hypothesis.

Little is known concerning environmental factors that may control the distribution of virioplankton on large spatial scales. In previous studies workers reported high viral levels in eutrophic systems and suggested that the trophic state is a possible driving force controlling the spatial distribution of viruses. In order to test this hypothesis, we determined the distribution of viral abundance and bacterial abundance and the virus-to-bacterium ratio in a wide area covering the entire Adriatic basin (Mediterranean Sea). To gather additional information on factors controlling viral distribution on a large scale, functional microbial parameters (exoenzymatic activities, bacterial production and turnover) were related to trophic gradients. At large spatial scales, viral distribution was independent of autotrophic biomass and all other environmental parameters. We concluded that in contrast to what was previously hypothesized, changing trophic conditions do not directly affect virioplankton distribution. Since virus distribution was coupled with bacterial turnover times, our results suggest that viral abundance depends on bacterial activity and on host cell abundance.

Bacteria↗
PubMed2003

Antithrombotic drugs in secondary stroke prevention among a community dwelling older population.

BACKGROUND: Patients who suffer a cerebrovascular event are at high risk of a recurrence. Secondary prevention is crucial in reducing the burden of cerebrovascular disease. OBJECTIVE: To estimate the percentage of stroke survivors receiving antiplatelet or anticoagulant drugs and to identify factors associated with such treatment. DESIGN: Cross sectional retrospective cohort study. METHODS: Data were analysed from a large collaborative observational study, the Italian "silver network" home care project, which collected data (from 1997 to 2001) on patients admitted to home care programmes (n = 5372). Twenty two home health agencies participated in evaluating the implementation of the minimum dataset for home care (MDS-HC) instrument. For the present study, 648 individuals with a diagnosis of stroke were selected and the initial MDS-HC assessment reported. RESULTS: 70% of stroke survivors did not receive any antiplatelet or anticoagulant drugs (95% confidence interval (CI), 66.5 to 73.5). Among all age categories, aspirin and ticlopidine were the two most commonly prescribed drugs. Living alone (odds ratio (OR), 0.49 (95% CI, 0.24 to 0.89)), dependency in activities of daily living (0.66 (0.40 to 0.99)), cognitive impairment (0.58 (0.38 to 0.86)), and low educational level (0.58 (0.34 to 0.98)) were associated with a reduced likelihood of receiving secondary stroke prevention treatment. Cardiac arrhythmias, coronary artery disease, heart failure, and peripheral vascular disease were associated with the use of antiplatelet or anticoagulant treatment. CONCLUSIONS: Negative attitudes among physicians with respect to secondary stroke prevention are prevalent and reinforce the need for increased awareness of existing data on the risks and benefits for elderly individuals. Social problems and functional impairment may be issues concerning physicians when deciding whether or not the risks of treatment exceed the benefit.

Activities of Daily Living↗
PubMed2003

Antiblastic drug combinations with ifosfamide: an update.

Ifosfamide is an alkylating agent that is widely used in the treatment of various neoplasms, such as sarcomas, lymphomas, pediatric malignancies, germ cell tumors, lung, breast and ovarian cancer. The clinical toxicity of ifosfamide depends on the dose and administration schedules. The pharmacologic features of this drug enable its combination with other antiblastic agents, such as vinorelbine, gemcitabine, paclitaxel and docetaxel. Moreover, the pharmacologic profile of ifosfamide allows the use of this antiblastic drug in patients who have previously failed many other treatments, and a large percentage of responses has already been obtained. There is some concern about the optimal scheduling of the drug with other novel chemotherapeutics. Clinical trials that include pharmacokinetic and pharmacodynamic studies may be the most efficient way to optimize the therapeutic efficacy of ifosfamide and define the dosing and scheduling.

Animals↗
PubMed2003

Glomus tympanicum tumour: an alternative surgical technique.

Glomus tympanicum tumour is one of the commonest neoplasms of the middle ear. It is more common in females. The most common presenting symptom is pulsatile tinnitus. A retrotympanic mass is found in the middle ear in all the cases. Computed tomography (CT) scan is the investigation of choice, however in difficult cases magnetic resonance imaging (MRI) can be helpful. Surgery is regarded as the gold standard of treatment in spite of the fact that radiation therapy has also been advocated in the literature. In this series 17 cases of glomus tympanicum treated at Gruppo Otologico Piacenza - Rome (Italy) were analysed retrospectively. A simple and safe technique has been described. All the cases were female and treated by surgery. The tumour was removed completely in all the cases and the ossicular chain kept intact. Recurrence was encountered in only one case after nine years. Surgical removal of the tumour is recommended as the treatment of choice with the following advantages: complete removal, a low complication rate, a low recurrence rate, acceptable hearing level and minimum morbidity.

Adult↗
PubMed2003

[Subsidiary instruments and rehabilitative strategies in oncological surgery of the gastrointestinal tract].

Oncological surgery, nowadays responsible for widespread visceral demolition, necessary for macroscopic eradication of malignancy, at the same time takes benefit from rehabilitative expedients, already applied during reconstructive operating time, recruited by mechanical devices, useful for the postexeretic phase, both reducing, as well as they can, the distress of anatomic and functional handicap. Surgical options, aiming at paraphysiological compensation of the lost function, through the strategies for restoring the continuity of the gastrointestinal tract, for example, are more and more incisively supported by various instruments, ranging from simple mechanical tools to biocompatible prostheses.

Anal Canal↗
PubMed2003

Colorectal tumor screening. From occult blood testing to genetic evaluation.

In Italy 250,000 subjects every year are affected by malignant tumors, causing 150,000 deaths/year. The global index (statistic prevalence) of oncological patients, either at first diagnosis, or restored to health or under treatment, aggregates 1 million and 500 thousand individuals. During his whole lifetime, every male can be exposed to the risk of tumor developing, up to 1/3 times against 1/5 of a female. At the same time it is true that just only in a decade, 5-year survival expectance for this kind of patients has significantly grown: in Italy, during the late '70s only 33% of them reached this survival, becoming 39% in the late '80s. This aim was achieved also through the recruitment of the sensibilization to the prevention and the early diagnosis, properly known as "screenings", which, from the original experiences regarding gynecology, (female breast and uterus), are involving more and more anatomic districts. The purpose of this brief is illustrating the procedures, either usually validated ones, or affirming ones, to identify colorectal neoplasms at early stady or precancerous intestinal lesions.

Adenocarcinoma↗