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Biomedical subjects

C Penna

Publications and source records attributed to C Penna.

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

[Cerebral aneurysm related to pediatric AIDS. Case report].

INTRODUCTION: Aneurysms, described in pediatric AIDS, are related with bad prognosis with high mortality in 5 months. The twenty reports found in literature were considered late (mean age 9.97 years old) and associated with severe immunological involvement. The mean CD-4 count was 79.17 cells and mean viral load 222,662 copies/mL. Some authors consider this complication associated to the human immunodeficiency virus (HIV), to an opportunistic agent (citomegalovirus and Mycobacterium avium) or due to inflammatory mechanisms related with the immunological improvement. CASE REPORT: This paper present a 9 years old girl with severe AIDS (C-3) and with transient amaurosis related to transient ischemic attacks on ophthalmic artery during her immunological improvement on viral load and CD-4 counts. Necropsy showed aneurysm due to atypical micobateriosis. CONCLUSION: This report highlights the occurrence of this rare but severe HIV complication witch was associated with an opportunistic etiology during an immunological recovery, when inflammatory mediators could play a role.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Ileo-anal pouch anastomosis: results in ulcero-hemorrhagic rectocolitis and in familial adenomatous polyposis].

Two hundred twenty-four ileal pouch-anal anastomoses have been made, 122 for ulcerative colitis and 102 for familial adenomatous polyposis. All the patients had a J pouch and a diverting temporary ileostomy. Mortality was 0.5%. Twenty-eight % of the patients with ulcerative colitis and 24% of the patients with familial adenomatous polyposis had various postoperative complications. Seventy-two patients with ulcerative colitis had a follow-up of more than one year. They had a mean of 4.6 stools per 24 hours; 84% had a normal day-time continence and 70% a normal nocturnal continence. Sixty-nine patients with familial adenomatous polyposis had a follow-up of more than one year. They had a mean of 4.1 stools per 24 hours; 93% had a normal daytime continence and 91% a normal nocturnal continence. In conclusion, ileal pouch-anal anastomosis can be made safely, with good functional results.

Adenomatous Polyposis Coli↗
PubMedDate not supplied

[Vulval vestibular papillomatosis: anatomo-clinical study].

Vestibular papillomatosis of the vulva is only by some authors considered as a viral lesion, and its origin is controversial. A study of 44 women with vestibular papillomatosis was undertaken, and in all the cases biopsies of vulvar skin were taken. We did not reveal any presence of koilocytotic change suggestive of viral infection, and no human papillomavirus sequences were detected by DNA probe technique. These results suggest that this vestibular papillomatosis of the vulva can be considered as an anatomical variant of the vestibular mucosa. Only in case of viral over-infection, ablative treatment is justified.

Adult↗
PubMedDate not supplied

[Cervical intraepithelial neoplasia and genital condylomatosis in HIV-positive patients. Clinical aspects and management].

In this study prevalence of cervical intraepithelial neoplasia (CIN) and genital condylomatosis in HIV-positive women and the possible relation between HIV and HPV infection and CIN have been analyzed. 66 seropositive women underwent cytological, colposcopic and, when necessary, histologic examination and the results have been compared with those obtained from 150 HIV-seronegative controls. HIV-positive patients were divided in two groups, depending on number of CD4+/mm3, < 400 or > = 400, to evaluate the relation between immunity and HPV infection and/or CIN. 35 seropositive and 136 seronegative patients affected by genital condylomatosis and/or CIN I were submitted to laser CO2 vaporization and the results of the treatment have been compared. All cases of CIN II and III underwent laser CO2 conization. Among HIV-seropositive patients the prevalence of genital condylomatosis appeared to be 87.9% and among the seronegative controls 18% (p < 0.001). Multilocated condylomatosis represented 58.7% of genital condylomatosis among seropositive women and 11.1% among the seronegative patients. In HIV-seropositive group the prevalence of genital condylomatosis was of 95.2% among women with CD4+ < 400 and of 75% among those with CD4+ > = 400 (p > 0.01). 13 patients (19.7%) of the 66 seropositive women and 12 of the 150 (8%) seronegative had a cervical intraepithelial neoplasia. A CIN III was diagnosed in 9 seropositive patients (13.6%) and in 5 seronegative (3.3%). Among the HIV-seropositive women who underwent laser vaporization for genital condylomatosis a cure-rate of 34.5% was found; among seronegative women who underwent the same treatment the cure-rate was of 79.4%. Those patients who underwent laser conization resulted all cured at first check. In the group of HIV-seropositive women a higher prevalence (p < 0.001) of genital condylomatosis, particularly multilocated localization, has been found than in HIV-seronegative patients. An increased prevalence of CIN has also been found among HIV-seropositive women. Genital condylomatosis in seropositive patients resulted extremely difficult to treat with laser vaporization in contrast with the 100% success in laser conization for high-grade CIN.

Adolescent↗
PubMedDate not supplied

[Cervical intraepithelial neoplasia (CIN) and human papillomavirus (HPV) infection].

Many studies have shown a strong correlation between CIN and HPV infection. Molecular biology has allowed identification of types of HPV which seem to be connected, more frequently than others, to dysplastic lesions. Physical state of HPV-genome seems to play an important role in the development of cervical cancer. In this study the HPV-genome has been searched in tissue specimens obtained from 34 women affected by CIN II and III. All patients underwent laser conization. Immediately before treatment, colposcopically directed biopsies of the cervical lesion and of the areas with no colposcopically apparent disease were taken and on these samples, HPV-DNA has been searched, isolated and analysed for HPV types and physical state. Histologic examination on cones showed 6 cases of CIN II (3 with HPV), 24 cases of CIN III (14 with HPV), 1 microinvasive carcinoma and 3 with no residual lesion. Southern blot analysis detected HPV-DNA in 4 cases of CIN II (16.7%) and in 20 cases of CIN III (70.6%). In 50% of CIN II and 85% of CIN III HPV 16 DNA has been found and in the remaining 50% of CIN II and 15% of CIN III HPV 31 DNA has been detected. All CIN II and 14 cases of CIN III showed episomal HPV-DNA. Integrated HPV-DNA has been found in 3 cases of CIN III and the other 3 cases of CIN III showed both integrated and episomal HPV-genome. Integrated form has been noticed only for HPV 16 type. In no case of colposcopically normal tissue has HPV-DNA been found. These data seem to confirm the strong correlation between HPV 16 type, which often has integrated form, and CIN III strengthening the hypothesis of its potential oncogenic action.

Adult↗
PubMedDate not supplied

Coronary reactive hyperaemia after nitric oxide inhibition in the anaesthetized goat.

In the dog it has been shown that, while the inhibition of the endothelial release of nitric oxide reduces the duration, the total hyperaemic flow and the peak flow of the acetylcholine and myogenic coronary vasodilator responses, in the reactive hyperaemia the peak is not affected. The difference has been attributed to the different time required by the coronary blood flow to reach its maximum: long enough when acetylcholine is given or myogenic vasodilatation is elicited, this time is very short in the reactive hyperaemia. Thus it has been argued that only when the time to the peak of a hyperaemic response is sufficiently long, the increased shear stress acting on the coronary endothelium at the beginning of the hyperaemia can enhance the maximum value of the vasodilatation. Such an effect is impaired by NO-inhibition. Since in the goat the time to the peak of the coronary reactive hyperaemia is much longer than in the dog (10-14 s vs 3-4 s), the present study aimed at investigating whether the same effect caused by the NO-inhibition on the maximum flow of the acetylcholine and myogenic hyperaemic responses in the dog, can also be obtained in the goat for the peak flow of the coronary reactive hyperaemia. Experiments performed in anaesthetised goats showed that NO-inhibition reduces the duration of the reactive hyperaemia without affecting the maximum hyperaemic flow. It is suggested that in the reactive hyperaemia the large predominance of metabolic factors prevents the shear stress from playing a role in enhancing the peak flow.

Anesthesia↗
PubMedDate not supplied

Mycobacterium paratuberculosis and Mycobacterium avium subsp. silvaticum DNA cannot be detected by PCR in Crohn's disease tissue.

BACKGROUND: The etiology of Crohn's disease remains unknown. A putative mycobacterial cause of the disease is still controversial. AIMS: To assess the mycobacterial hypothesis in Crohn's disease using a polymerase chain reaction technique. PATIENTS AND METHODS: Nested polymerase chain reaction with primers on the 16S-rRNA coding region (16S-rDNA) and with primers specific both to the insertion sequences (IS) 900, and IS 901/902 were used to amplify Mycobacterium paratuberculosis or Mycobacterium avium subsp. silvaticum DNA in frozen endoscopic intestinal biopsies or surgical resection specimens from patients with Crohn's disease (n = 47: 25 endoscopic biopsies and 22 surgical resection samples, +/- lymph nodes), ulcerative colitis (n = 27), and non inflammatory bowel diseases (n = 20: colonic tumors and diverticulitis). Positive as well as negative controls were used throughout the study. RESULTS: All strains of Mycobacterium paratuberculosis and Mycobacterium avium subsp. silvaticum tested were positive for both primer systems. Of the 94 biopsies tested, 5 (2 Crohn's disease, 1 ulcerative colitis and 2 controls) were positive with the 16S-rDNA primers but did not correspond to Mycobacterium paratuberculosis or Mycobacterium avium subsp. silvaticum. None of the specimens was positive with the IS primers. CONCLUSION: These results do not support the hypothesis that Mycobacterium paratuberculosis, or Mycobacterium avium subsp. silvaticum play a role in Crohn's disease.

Adult↗