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Biomedical subjects

E Franco

Publications and source records attributed to E Franco.

At least 163 records · Page 9Linked to original sources
PubMed1975

Detection of anti-HBs in two groups of institutionalized people by solid-phase radioimmunoassay using human labelled antibody.

A modification of Ausria II-125 solid-phase radio-immunoassay has been performed for the detection of anti-HGs in sera from 217 subjects living in two institutions. 129 subjects were mentally retarded and belonged to an institution; the other 88 were healthy people living in another institution, 74 of whom were residents and 14 members of the assistance staff. These 88 subjects were tested again three months later. Contemporaneously HBsAg was tested by Ausria II-125. Out of 129 mentally retarded subjects, 18 (13.9%) were positive for anti-HBs and 6 (4.6%1 for HBsAg. Out of 88 apparently healthy residents and members of the assistance staff, anti-HBs was detected in 24 (27.3%) and in 25 (28.4%), in the first and second bleeding, respectively; the distribution of anti-HBs carriers between residents and staff was quite similar. The screening of anti-HBs by rHA, performed in the same 88 subjects, showed a greater sensitivity than RIA modified in detecting anti-HBs carriers. Our findings outline the importance of the detection of anti-HBs as a marker of the virus B infection.

Adolescent↗
PubMedDate not supplied

Prognostic factors in myelodysplastic syndromes: analysis of five scoring systems.

PURPOSE: To evaluate the prognostic significance of five scoring systems applied with predictive trends to myelodysplastic syndromes (MDS). PATIENTS AND METHODS: This study was comprised of 226 patients with MDS diagnosed in accordance with the FAB criteria and followed up in our department between January 1975 and April 1992. The following MDS subtypes were found: refractory anaemia (RA), 59 cases; refractory sideroblastic anaemia (RSA), 49 cases; refractory anaemia with excess of blasts (RAEB), 56 cases; RAEB in transformation (RAEB-T) 48 cases; and chronic myelomonocytic leukemia (CMML), 14 cases. The following scoring systems were applied: Mufti's 1985, Varela's 1985, Sanz's 1989, Rubio's 1991 and Aul's 1992. The statistical analysis was performed according to Kaplan-Meier actuarial systems and the log-rank test of survival. RESULTS: (1) Three groups (A, B and C) can be defined by Mufti's system, with median survival of 54.0, 16.0 and 8.5 months, respectively. The majority of cases (138) were included in group B. Group A did not reach 25 per cent of actuarial survival probability, whereas groups B and C did at 31.1 and 12.2 months, respectively. With regard to the morphologic subtypes, RA and RSA were included in groups A and B, and RAEB, RAEB-T and CMML pertained mostly to group C. Sixty-six cases (33.6 per cent) developed into acute leukemia (AL) corresponding to those last groups. (2) The three groups defined by Varela's system (0-1, 2-5 and 6 or more) had median survival of 91.8, 24 and 13 months, respectively. As in the former system, group 0-1 did not reach 25 per cent actuarial probability, this appearing at 60 and 20 months, respectively, in groups 2-5 and > 6. The distribution of the cytological varieties, RA and RSA among the groups is heterogenous although they were more common within the cases included in groups 0-1. All cases developing AL were included in the groups 2-5 and > 6. (3) The three groups of the system proposed by Sanz (0-1, 2-3 and 4-5) had median survival of, 55.3, 15 and 12.6 months respectively. As in the preceding cases, group 0-1 did not reach the 25 per cent actuarial probability, while this figure appeared at 28.2 months for group 2-3 and at 19.3 months for group 4-5. RA and RSA varieties were included chiefly in group 0-1, while RAEB and RAEB-T appear mostly in groups 2-3 and 4-5. The distribution of the cases and the evolution of AL was heterogeneous according to this system, although they predominate in groups 2-3 and 4-5. (4) Using the Aul's system, three groups A, B and C were defined. The median survival time was 14 months for group C and 24 months for group B. For group A, the median survival was not reached. RA and RSA were exclusive for group A, while RAEB and RAEB-T varieties were outstanding in group C. Regarding the evolution to leukemia the differences observed had no statistical relevance. (5) Three prognostic groups were defined by Rubio's system (namely 0-2.5, 3-5.5, > or = 6) with median survival of 53.3, 16.8 and 10.5 months, respectively. A striking difference was seen when studying the cumulated survival observed, in each of the three percentages considered, between the groups. The different cytological varieties were reasonably distributed with higher incidence of RA and RSA in group I and RAEB, RAEB-T and CMML in group III. This system offers statistical significance when comparing RA with RSA, RAEB with RAEB-T and, obviously RA+RSA with RAEB+RAEB-T+CMML. The evolution into AL also showed statistical significance with respect to the three groups.

Adult↗
PubMedDate not supplied

Baseline seroepidemiology of hepatitis A virus infection among children and teenagers in Italy.

During the period from May 1987 through November 1989, the prevalence of antibodies to hepatitis A virus infection (anti-HAV) was assayed by the ELISA method in the serum samples of 5,507 (54% males, 46% females) apparently healthy subjects three to 19 years old in Italy. Subjects were selected by a systematic cluster sampling in five different geographical areas of Italy. The overall prevalence of anti-HAV was 9.5%; it increased from 2.3% among children three to five-years-old to 16.3% in teenagers 17 to 19 years old (p less than 0.001). A slight preponderance of females was observed (10% versus 9.1%), but the difference was not statistically significant. The prevalence was significantly higher in Southern Italy than in Northern Italy (27.4% versus 4.8%; p less than 0.01). The prevalence of anti-HAV was inversely related to the fathers' years of schooling (O.R. 3.3; 95% C.I. = 2.5-4.2) and positively related to the family size (O.R. 2.4; 95% C.I. = 1.9-3.1). These findings indicate that, today, exposure to HAV infection at a young age in Italy is very low. However, sociodemographic factors are still important determinants in the spread of this infection.

Adolescent↗
PubMedDate not supplied

Specific and reversible inhibition of Entamoeba histolytica cysteine-proteinase activities by Zn2+: implications for adhesion and cell damage.

BACKGROUND: Cysteine-proteinases are thought to play an important role in E. histolytica pathogenicity. Although effective blockage of proteolytic activities can be obtained with several known inhibitors, the high cellular toxicity of most of the inhibitors precludes experimentation with live cells or animal models. Specific cysteine-proteinase inhibitors that could be utilized in studies of virulence are of great need in the field of amebiasis. METHODS: Cysteine-proteinase activities were determined in trophozoite lysates by azocasein degradation and after PAGE and gelatin zymograms. Inhibition of the activities was assessed in the presence of 0.01-2.5 mM concentrations of divalent cations of the IIB and VIII series such as Zn, Cd, Hg, Ni, and Co. Reversibility was induced with 25 mM L-cysteine or 50 mM L-histidine and by metal chelation with 5 mM phenantroline. The inhibitory effect of ZnCl2 was tested with live cells in fibronectin-binding and cytotoxicity assays. RESULTS: ZnCl2 specifically inhibited cysteine-proteinase activities in trophozoite lysates in a concentration-dependent manner. Additionally, 1.0-2.5 mM ZnCl2 blocked proteolysis in more than 70%. This inhibition was completely reverted by L-cysteine, L-histidine, or phenantroline. Similar results were obtained by analyzing individual cysteine-proteinase activities separated in gelatin zymograms. At these concentrations, ZnCl2 significantly interfered with trophozoite adhesion, thus making amebas deficient in substrate degradation and cell damage. CONCLUSIONS: ZnCl2 is an effective inhibitor of amebic cysteine-proteinases. Its low toxicity at relatively high concentrations, high solubility, and low cost make it adequate for live cell experimentation and animal models of amebic virulence.

Animals↗
PubMedDate not supplied

Viral hepatitis in the Bhutanese population: preliminary results of a seroepidemiological investigation.

A seroepidemiological study of the prevalence of markers related to the most common forms of viral hepatitis was carried out in Bhutan on 1,666 healthy people of both sexes, from the general population. A group of 440 pregnant women were screened separately. Our results suggest that in Bhutan, hepatitis A and hepatitis B are widespread, while there is a low prevalence of hepatitis C and E. Anti-HAV (anti-hepatitis A virus) was found in all 171 tested subjects over 12 years of age, and anti-HBc (anti-hepatitis B core antigen) in 63.1% of 1,666 tested people. On the other hand, anti-HEV proved positive in 2.0% of 257 tested subjects, and anti-HCV in only 1.3% of 611 tested subjects. Hepatitis B surface antigen (HBsAg) was found in 5.9% of the sample from the general population (5.2% in children, 5.6% in young people and 6.3% in adults) and in 5.4% of the pregnant women. Furthermore, 29.1% of HBsAg-positive pregnant women were HBeAg- and HBV DNA-positive, too. Comparing the pregnant women's prevalence data to those found in children, we suggest that the main route of HBV transmission in the Bhutanese population is vertical, from mother to child; this finding is important for the implementation of a correct anti-HBV vaccination strategy in Bhutan.

Adolescent↗
PubMedDate not supplied

High-flow priapism as a complication of a veno-occlusive priapism: two case reports.

The presentation of two cases of veno-occlusive priapism, in patients of 36 and 58 years, in whom the different medical and surgical techniques employed, failed. The suspicion that high-flow priapism had been provoked by said surgical intervention was confirmed by bilateral arteriographs of the pudendal artery. The treatment, selective embolisation of the affected cavernosal artery with reabsorbable material, led to a rapid return of penile detumescence.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

Human papillomavirus testing improves the accuracy of colposcopy in detection of cervical intraepithelial neoplasia.

To assess the performance of human papillomavirus (HPV) testing and colposcopy in detection of cervical pathology. A series of 389 women referred for colposcopy due to an abnormal Pap smear had cervical swabs analyzed for oncogenic (high-risk [HR]) HPV types using Hybrid Capture II (HC2) assay. Loop electrical excision procedure cone biopsy (88%) or colposcopic biopsy (11%) was used as the gold standard. Of the atypical squamous cells of undetermined significance (ASCUS) smears, 48% were positive for HR HPV, as compared to 76.3% of low-grade squamous intraepithelial lesions (LSIL) smears. HR HPV was detected in 66.7% and 90% of patients with cervical intraepithelial neoplasia (CIN) 1 and CIN2 (or higher), respectively. The sensitivity of the Pap smear using an ASCUS threshold in detecting high-grade CIN was 94.5% (95% confidence intervals (CI): 91-97%) and that of colposcopy 98.5% (95% CI: 95-99%). The respective specificities were 30% (95% CI: 17-28%) and 35.6% (CI: 29-42%). HC2 test had comparable sensitivity, 90% (95% CI: 85-93%), but higher specificity, 54.3% (95% CI: 47-61%). Combining HC2 test with Pap increased specificity, 66.7% and 41.3% for ASCUS and LSIL cutoff, respectively. The minor-abnormality threshold together with HC2 increased specificity of colposcopy with no changes in sensitivity. High viral load (>100 relative light unit/positive control) was associated with significant disease. HPV DNA testing improves the accuracy of colposcopy in the detection of high-grade CIN in women with ASCUS or LSIL smears.

Adolescent↗
PubMedDate not supplied

Conventional cervical cytologic smears vs. ThinPrep smears. A paired comparison study on cervical cytology.

OBJECTIVE: To compare the time required for evaluation, the diagnostic accuracy and quality of conventional glass slide smears vs. ThinPrep smears in 365 women. STUDY DESIGN: Both smears were obtained at the same time using the Accellon Combi cervical biosampler. Histology served as the diagnostic "gold standard." RESULTS: The average screening time was 1 minute, 23 seconds, shorter per smear with the ThinPrep method as compared to the conventional glass slide (P < .001). Direct diagnostic agreement between the two smear methods was obtained in 311 of 364 evaluable smears (85.4%, kappa = .63). Despite the relatively high rate of "adequate but limited by absence of transformation zone components" observed with the ThinPrep method, the sensitivity and specificity of the ThinPrep method was slightly greater but not statistically significantly different than the conventional technique, irrespective of the disease categories (low and high grade squamous intraepithelial lesion and invasive cancer). CONCLUSION: The shorter time required to screen ThinPrep smears compared to conventional smears in this study was not sufficiently important to offset the current unit price for preparing ThinPrep smears.

Adenocarcinoma↗
PubMedDate not supplied

[Sphenoid metastasis mimicking a meningioma as the initial feature of adenocarcinoma of the prostate].

INTRODUCTION: Presentation of adenocarcinoma of the prostate as an intracranial metastasis is uncommon. This metastasis tends to be seen in the sphenoid bone, and in this case it is difficult to differentiate radiologically from a meningioma. Because this cancer is treatable, the differential diagnosis must be resolved as soon as possible. CLINICAL CASE: A 72 year old man presented with a rapidly progressive left parasellar syndrome. On neuroimaging there was a tumour at the level of the left lesser wing of the sphenoid, which was isodense and iso-intense and also showed homogeneous uptake of contrast material. On angiography the circulation was pathological with homogeneous delayed filling. The initial diagnosis was meningioma of the lesser wing of the sphenoid. Months later the patient complained of bone and respiratory problems. At this time plain chest X-ray was compatible with carcinomatous lymphangitis. Therefore, tumour markers were studied and for the first time the specific prostatic antigen was investigated and found to be raised. Although there were no symptoms of prostatism, per rectum there was a malignant prostatic mass. In spite of complete hormone block, his illness followed an unfavorable course. At necropsy there was adenocarcinoma of the papillary prostate and a metastasis in the left lesser wing of the sphenoid. CONCLUSIONS: In elderly men, detection of a sphenoid tumour, which radiologically may appear to be a meningioma and although prostatism has not been diagnosed, the possibility of prostatic metastasis should be considered. Per rectum examination and specific prostatic antigen determination should be done in these patients.

Adenocarcinoma↗
PubMedDate not supplied

[Spontaneous intracranial hypotension].

INTRODUCTION AND CLINICAL CASE: A 38 year old woman, with no previous history of trauma, presented complaining of interscapular pain followed by pulsating headache clearly related to posture, alleviated on lying down and worse on standing up. Subsequently, she also complained of diplopia. On examination there was paresia of the left sixth cranial nerve. Low opening pressure on lumbar puncture confirmed the presence of intracranial hypotension. The protein level of the cerebrospinal fluid was slightly raised. On CT the cortical sulci and small ventricles had disappeared. Cerebral MR (without gadolinium) showed marked diffuse meningeal hyper-intensity and apparent absence of the basal cisterni. Isotopic cisternography showed a pattern compatible with hypotension, without signs of fistulas. On spinal MR no spinal meningeal defects were seen. With conservative treatment the patient improved in a few days and the headache and diplopia disappeared. The absence of traumatism or spinal operations mean that the hypotension may be considered to be spontaneous. We discuss the CSF, neuroimaging and cisternography findings characteristic of the spontaneous intracranial hypotension syndrome. CONCLUSION: Unawareness of this syndrome, the particular neuroimaging changes and the usual CSF anomalies may lead to confusion over diagnosis, leading to the use of invasive techniques unsuitable for a condition which often has a good prognosis and in which the symptoms resolve in a few days or weeks with conservative treatment.

Abducens Nerve↗
PubMedDate not supplied

[Late symptomatic initiation of unilateral cerebellar hypoplasia].

A 65-year-old woman developed a progressive action tremor on her left hand for the last two years. On examination an intentional left hand tremor with dysmetria and tendency to deviate to left on tandem were identified. There was no mental deterioration. CT scan and MR imaging disclosed a marked unilateral, left, cerebellar hypoplasia. MR also showed multiple lacunae. Neurological family disease and exposition to drugs or alcohol were not present. In some cases cerebellar hypoplasia could become symptomatic at advanced age as result of concurrent cerebral disease affecting the compensating structures for congenital defect. In this patient a vascular mechanism is suggested as possible late trigger.

Aged↗