Biomedical subjects

F De Luca

Publications and source records attributed to F De Luca.

At least 91 records · Page 5Linked to original sources

PubMed1996

Cyclical variation in paroxysmal supraventricular tachycardia in women.

BACKGROUND: Paroxysmal supraventricular tachycardia (SVT) in premenopausal women is often judged to be related to anxiety, and may be associated with the menstrual cycle. The aim of this study was to determine whether a cyclical variation of episodes of SVT exists and to correlate such variation with cyclical variation in plasma ovarian hormones. METHODS: 26 women (mean age 36 [SD 8] years; with paroxysmal SVT were screened; those with regular menses who experienced at least three episodes of paroxysmal SVT in two consecutive 48-hour ambulatory ECG recordings were included. 13 patients (aged 32 [6] years) met these criteria. Patients underwent 48-hour ambulatory ECG monitoring and determination of plasma concentrations of oestradiol-17 beta and progesterone on day 7, 14, 21, and 28 of their menstrual cycle. FINDINGS: An increase in the number and duration of episodes of paroxysmal SVT was observed on day 28 as compared to day 7 of the menstrual cycle. A significant positive correlation was found between plasma progesterone and number of episodes and duration of SVT (5.6 [2.2] ng/mL; r=0.83, p=0.0004; and r=0.82, p=0.0005), while a significant inverse correlation was found between plasma oestradiol-17 beta and number of episodes and duration of SVT (155 [22] pg/mL; r=0.89, p<0.0001; and r=0.81, p=0.0007). INTERPRETATION: Women with paroxysmal SVT and normal menses exhibit a cyclical variation in the occurrence of the arrhythmia with their menstrual cycle. There is a close correlation between the episodes of paroxysmal SVT and the plasma concentrations of ovarian hormones. These data suggest that changes in plasma levels of ovarian hormones (and their interaction) may be of importance in determining episodes of arrhythmia in such patients. The mechanisms of these effects are unknown.

Adult↗

PubMed1996

Neoplastic cells of Hodgkin's disease show differences in EBV expression between Kenya and Italy.

The Epstein-Barr Virus (EBV) has been implicated in the pathogenesis of Hodgkin's disease (HD). However, the association of EBV with this disease varies greatly from series to series and from country to country. Epidemiological studies have shown differences in HD occurring in different parts of the world. In particular, it has been reported that HD in developing countries differs from HD in Western countries in terms of epidemiological, pathological and clinical characteristics. These discrepancies among populations suggest an interaction with environmental factors and a direct role of different etiological agents. At present, there are no data on the frequency of association of EBV with HD in equatorial Africa. In this study, a large series of HD cases have been collected at the University of Nairobi, Kenya, and at the Universities of Bologna and Siena, Italy. The cases have been reviewed and classified according to the REAL Classification and the presence of EBV has been assessed by in situ hybridization (ISH). A statistical difference in EBV expression was found between HD from Kenya and HD from Italy. EBV-positive neoplastic cells were detected in 92% of Kenyan cases, whereas only 48% of Italian cases showed EBER1/2 positivity in the neoplastic cells. Our results suggest that, in Kenya, EBV plays a more direct role in the pathogenesis of HD, as it does for endemic Burkitt lymphoma.

Adolescent↗

PubMed1996

Use of low-frequency electrical impedance measurements to determine phospholipid content in amniotic fluid.

In this report we propose a new method for an in vitro test of the foetal lung maturity based on the measurement of the electrical conductivity of the overall amniotic fluid obtained from transabdominal amniocentesis, since this quantity can be linked to a first approximation in a very simple way to the phospholipid content. We have carried out measurements of 85 different samples of amniotic fluid as a function of gestation weeks and we have observed a pronounced change of the electrical conductivity that reflects the increase in the phospholipid concentration occurring at the end of normal pregnancies. The method could be further developed to obtain similar information on in vivo experiments by means of bioelectric impedance tomography, taking advantage of the frequency dependence of the tissue electrical impedance.

Amniocentesis↗

PubMed1996

Portal vein thrombosis complicating hepatocellular carcinoma. Value of ultrasound-guided fine-needle biopsy of the thrombus in the therapeutic management.

During a 4-year period portal vein thrombosis was diagnosed in 20 Child class A patients with cirrhosis by means of ultrasound and ultrasound-Doppler study. Seventeen of them showed single or multiple focal liver lesions diagnosed as hepatocellular carcinoma by ultrasound-guided fine-needle biopsy and the remaining three a coarse liver echo-pattern without focal lesions. One patient was found to have developed portal vein thrombosis after the fifth ethanol injection of a single hepatocellular carcinoma lesion 17 mm in diameter. Ultrasound-guided fine-needle biopsy of the thrombus was performed on all the patients: portal vein thrombosis was neoplastic in 13 cases and non-neoplastic in seven cases (five patients with a single lesion; one with two lesions; one with coarse liver echo-pattern). Among the five patients with a single lesion, one had already been treated by percutaneous ethanol injection therapy. There were no complications related to the biopsy procedures. The diagnosis of non-neoplastic thrombosis allowed five new patients to be recruited for percutaneous ethanol injection treatment and allowed it to continue in the patient with portal vein thrombosis occurring after the fifth ethanol injection. The routine use of ultrasound-guided fine-needle biopsy of portal vein thrombosis yields an accurate diagnosis of the nature of the thrombus and can improve the selection for percutaneous ethanol injection treatment of patients with cirrhosis with hepatocellular carcinoma lesions.

Aged↗

PubMed1996

Metabolic and clinical events preceding diabetes mellitus onset in cystic fibrosis.

Serial assessments of glucose tolerance, of glucose and insulin areas during an oral glucose tolerance test (OGTT) and of clinical parameters as well were evaluated retrospectively in seven diabetic cystic fibrosis patients (study group) during the 4-6.3 years that preceded diabetes mellitus diagnosis. The same metabolic and clinical parameters were also evaluated in seven age-matched patients who did not develop diabetes during a similar observation period (control group). In the study group, glucose tolerance was impaired in all patients but one since the first OGTT and glucose areas progressively increased over time, whereas in the control group glucose tolerance remained stable during the whole observation period. A significant and progressive blunting of insulin secretion occurred over time in both groups. Insulin secretion, however, was reduced but not exhausted at diabetes diagnosis. Neither modification of glycosylated haemoglobin levels over time nor serum islet cell antibodies at diabetes onset were observed in the study group. The overall clinical course of the disease was not different in either group and remained stable during the observation period. These results indicate that in cystic fibrosis diabetes mellitus onset is preceded by a long-standing deterioration of glucose tolerance, whilst insulin secretion progressively declines over time, irrespectively of glucose tolerance status. The prediabetic worsening of glucose tolerance is not necessarily linked to a worsening of overall clinical status.

Adolescent↗

PubMed1996

Final height outcome of growth hormone-deficient patients treated since less than five years of age.

Thirteen growth hormone deficient infants underwent substitutive treatment for a least 9 years, since less than 5 years of age until adulthood. They presented with average growth failure reaching 4.1 SDS and attained an adult mean height close to target height. In eight subjects final height exceeded the respective target height and only three patients failed to achieve an end height within the target range. The analysis of the factors conditioning ultimate stature pointed out that height outcome correlated negatively with chronological age at therapy initiation and positively with height at puberty onset. It is concluded that full catch-up growth to target percentile is possible in growth hormone-deficient children, provided that substitutive treatment is begun within the 5 years of life. This conclusion is substantiated for the first time by data on end stature.

Adolescent↗

PubMed1996

[Synovial cyst of the cruciate ligament. Findings with magnetic resonance in 8 symptomatic cases].

Intraarticular ganglion cysts are uncommon findings: only 30 cases have been reported since the first paper by Caan in 1924 and they were all associated with cruciate ligaments. Many different cystic or pseudocystic lesions are found in articular knee conditions: the most common cystic lesions are popliteal cysts (Baker's cysts), followed by synovial pseudocysts of the posterior cruciate ligament, meniscal cysts and, finally, ganglion cysts of the cruciate ligaments. In our series of 1600 knee MR exams carried out in our MR department since June, 1994, we have found 8 ganglion cysts of the cruciate ligaments. MR studies are always performed on a dedicated 0.2-T permanent magnet (Artoscan, Esaote Biomedica, Genoa, Italy). Five patients were operated on with arthroscopy. The ganglion cysts affected the anterior cruciate ligaments in 4 cases and the posterior cruciate ligaments in 4 cases. The symptoms were mainly pain radiating to the medial side and worsening in forced flexion or extension. The diagnostic suspicion was meniscal tears in 4 patients, chondral lesions in 3 and a loose intraarticular body in one patient. The shape and structure of ganglion cysts in the cruciate ligaments are clearly depicted with MRI. The ganglion cysts in the anterior cruciate ligaments are usually spindle-shaped and within the ligament, while those in the posterior cruciate ligaments have a well-defined outline, with multilocular appearance, and they are usually localized along the ligament, most often on the dorsal aspect. MR signal studies show intermediate signal intensity on SE T1-weighted images and markedly increased signal intensity on SE T2-weighted images. These typical patterns may change depending on lesion content, for instance in the presence of hemoglobin due to an associated angioma. The origin of ganglion cysts in the cruciate ligaments is still unknown, even though many theories have been suggested, including a synovial herniation in ligament fibers, the ectopic inclusion of synovial tissue, a posttraumatic connectival degeneration and, finally, the proliferation of totipotent mesenchymal cells. From a histologic point of view, "synovial ganglion" is a much better definition than "synovial ganglion cyst", because the typical wall of real synovial cysts is missing. The MR patterns are typical of the morphological features described and of the presence of high protein fluid content.

Adult↗

PubMed1995

In vivo 31P spectroscopy study of treated and untreated recovery of rat partial brain ischemia.

Quantitative 31P NMR was used to follow the time variation of the hypometabolic response to hypoxic partial ischemia in an animal model. The purpose of the study was to establish the value of this repeated spectroscopy operating by means of a surface coil. It aimed at determining whether a therapeutic intervention could influence the transient changes occurring during the insult or early recovery. A pharmacological substance was thus used during a reversible forebrain ischemia, induced by a combination of vascular occlusion and mild hypoxia in two groups of rats. As an available and convenient example, L-carnitine was chosen. Statistical analysis of the experimental results revealed a significant difference of the Pi and PCr levels between treated and untreated animals.

Adenosine Triphosphate↗

PubMed1995

Concurrent nitroglycerin administration reduces the efficacy of recombinant tissue-type plasminogen activator in patients with acute anterior wall myocardial infarction.

The aim of this study was to evaluate the impact of concurrent nitroglycerin administration on the thrombolytic efficacy of recombinant tissue-type plasminogen activator (rTPA) in patients with acute anterior myocardial infarction (AMI). Sixty patients (53 men, 7 women; mean age 54 +/- 7 years) with AMI entered the study. Thirty-three patients were randomized to receive rTPA alone (100 mg in 3 hours) (group A) and 27 to receive rTPA plus nitroglycerin (100 micrograms/min) (group B). Time from the onset of chest pain and delivery of rTPA was similar in the two groups of patients. Patients in group A had signs of reperfusion more often than the patients in group B (25 of 33 or 75.7% vs 15 of 27 or 55.5%, p < 0.05). Time to reperfusion was also shorter in group A than in group B (19.6 +/- 9.4 minutes vs 37.8 +/- 5.9 minutes, p < 0.05). Group B had a greater incidence of in-hospital adverse events (9 of 27 vs 5 of 33, p < 0.05) and a higher incidence of coronary artery reocclusion (8 of 15 or 53.3% vs 6 of 25 or 24%, p < 0.05). Peak plasma levels of rTPA antigen were higher in group A compared with group B (1427 +/- 679 vs 512 +/- 312 ng/ml, p < 0.01). In conclusion, concurrent nitroglycerin administration reduces the thrombolytic efficacy of rTPA in patients with AMI probably by lowering the plasma levels of rTPA antigen. The diminished efficacy of rTPA is associated with an adverse outcome.

Antigens↗

PubMed1995

Auxological, clinical and neuroradiological findings in infants with early onset growth hormone deficiency.

Sixteen infants less than 2 years of age with apparently idiopathic hypopituitarism were studied. At birth, 11 of 16 patients (69%) had subnormal length associated with relative adiposity and 10 of 16 (62%) showed significant deterioration in length deficiency from birth onwards. These findings suggest that: (a) growth hormone deficiency, in a number of patients, had started well before delivery; (b) growth hormones may play a role in intrauterine growth; and (c) growth hormone may also be involved in early postnatal growth. Magnetic resonance imaging in these patients was very similar to that described in hypopituitarism of later onset. This suggests that even in the latter case, hypopituitarism may have a prenatal onset. Finally, the severity of growth failure and the coexistence of other hypopituitary symptoms at the time of diagnosis in 31% of our patients indicate that early clinical screening of hypopituitarism is possible.

Adrenal Cortex Function Tests↗

PubMed1995

Four-year follow-up of glucose tolerance and beta-cell function in nondiabetic cystic fibrosis patients.

Plasma glucose and insulin responses to oral glucose load were investigated and reinvestigated approximately 4 years later in 29 cystic fibrosis children and adolescents with initially normal fasting blood glucose levels. Patients' clinical status was evaluated at the time of both oral glucose tolerance tests. With respect to the basal test, the second one elicited blunted insulin responses and enhanced glycemic levels. Moreover, the prevalence of patients with diabetic glucose tolerance was significantly increased at the second evaluation and insulin secretion was markedly reduced in these patients. Deterioration of glucose tolerance and/or of insulin secretion over time was never accompanied by a significant worsening of clinical and/or nutritional status. In conclusion, in cystic fibrosis subjects with fasting euglycemia (a) both insulin secretion and glucose tolerance deteriorate during a 4-year follow-up, (b) an insulin secretion decrease is more evident in patients who develop diabetic glucose tolerance and (c) these metabolic changes are not significantly linked to a worsening of either nutritional or clinical parameters, even in the patients who develop diabetic glucose tolerance.

Adolescent↗

PubMed1995

Catch-up growth and height prognosis in early treated children with congenital hypopituitarism.

The aim of this retrospective study was to ascertain, whether an early growth hormone (GH) treatment can normalize height prognosis of children with congenital GH deficiency (GHD). The study covers 23 children with early onset GHD who received GH 0.1 U/kg/day from the beginning of therapy (0.4-4.9 years). This dose was corrected for weight every 3 months during the whole duration of treatment (mean 7.9 +/- 2.4 years). As a consequence of the significant growth acceleration induced by GH treatment, the patients' height deficiency at the last check had changed from a range of between -8.0 and -1.8 SDS to between +0.5 and -4.3 SDS; on the average, it was significantly less severe than before treatment. Satisfactory growth acceleration was achieved in most patients concomitantly with accelerated bone maturation, as was shown by the stable height age/bone age ratio observed during the follow-up period. The predicted ultimate height was significantly greater than the pretreatment height and it did not differ from the target height. It is concluded that catch-up growth to the target percentile in GHD patients is possible, provided that substitutive treatment is begun during the first years of life and that GH doses are adjusted periodically for weight changes.

Adolescent↗

PubMed1995

Ultrasonographic signs of sliding gastric hiatal hernia and their prospective evaluation.

This study was conducted to identify the sonographic findings that might be used to diagnose sliding gastric hiatal hernia. We first performed a retrospective evaluation of 12 patients known to have sliding hiatal hernia and 18 normal controls. In the controls the esophagogastric junction could be visualized clearly in all cases and the alimentary tract section at the diaphragmatic hiatus ranged from 7.1 to 10.0 mm. The esophagogastric junction was not visualized in any of the hernia patients, whose alimentary tract diameters ranged from 16.0 to 21.0 mm. These two markers (nonvisualization of the junction and diameter greater than 16 mm) were then evaluated for their ability to predict the occurrence of sliding hiatus hernia in a prospective study of 38 patients subsequently diagnosed by means of barium contrast examinations and endoscopy. In this group, each sign had a positive predictive value of 100%. The negative predictive value of the alimentary tract diameter was 90%; that of nonvisualization of the esophagogastric junction was 94.7%. Inclusion of ultrasonography in the initial work-up of patients with symptoms of gastroesophageal reflux may reduce the need for more invasive diagnostic procedures.

Adult↗

PubMed1995

[The malignant transformation of leukoplakia of the oral cavity. A review of the literature and clinical case reports].

After considering the leukoplakia as defined by the WHO, the authors examine the quantitative, qualitative, histopathologic and clinical aspects of leukoplastic lesions. Afterwards, the data concerning the incidence of the malignant evolution of leukoplakia are shown. Data that have been collected and shown during years of study and that are often discordant. For this reason a study on the literature since 1931 is carried out and all the possible causes that could have led to different results are mentioned. Than the authors, among 98 cases of leukoplakia, examine those that turned malignant. In five cases, after the first biopsy, the histopathological report found the presence of microcarcinoma while, in three other cases, in the follow-up, a malignant evolution was observed. This This study points out a percentage of malignant transformation of the leukoplakia equal to 2,94% in agreement with the study of Pindborg and Banoczy.

Aged↗

PubMed1995

[Transurethral resection of the prostate: when?].

Over a period of 5 years (from 1989 to 1993) 410 patients with benign prostatic hypertrophy (BPH) were treated by transurethral resection of the prostate (TURP). A retrospective study was conducted by the Authors to evaluate indications, surgical approaches and results. The Authors' experience is compared with literature reports.

Humans↗

PubMed1995

Lipohyperplasia of the ileocaecal valve as a cause of intestinal haemorrhage: an ultrasound Doppler study.

We present a case of lipohyperplasia of the ileocaecal valve causing intermittent intestinal bleeding visualized by Doppler ultrasound of the lower abdominal quadrant as an intestinal mass with intralesional arteriovenous fistula. These findings, never described before, are suggestive of highly vascularized lesions of the ileocaecal region and their recognition may avoid the need to perform an angiographic study of the superior mesenteric artery.

Aged↗

PubMed1994

Final height in girls with central precocious puberty: comparison of two different luteinizing hormone-releasing hormone agonist treatments.

In order to evaluate the effects of two long-acting luteinizing hormone-releasing hormone agonists on growth, bone maturation and final height in girls with central precocious puberty, we analyzed growth data from 40 girls (15 treated with buserelin intranasal spray (group A), 15 treated with triptorelin depot im every 28 days (group B) and 10 untreated (group C)). Patients in group A started treatment when chronological age (CA) was 7.7 +/- 0.9 years, bone age (BA) was 10.2 +/- 1.1 years and height was 131.9 +/- 5.0 cm. Patients in group B started therapy when CA was 7.6 +/- 0.5 years, BA 9.8 +/- 1.0 years and height 133.2 +/- 7.6 cm. The diagnosis of untreated patients (group C) was made when CA was 7.2 +/- 0.9 years, BA 9.6 +/- 2.2 years and height 130.2 +/- 8.6 cm. Both luteinizing hormone-releasing hormone agonists appeared to control precocious puberty. Final height in group B (160.6 +/- 5.7 cm) was significantly higher than that of group A (153.2 +/- 5.0 cm: p < 0.05) and group C (149.6 +/- 6.3; p < 0.01), whereas the difference between groups A and C was not statistically significant. In group B a positive difference was observed between final height (160.6 +/- 5.7 cm) and target height (157.6 +/- 5.9 cm) (ns); on the contrary, in groups A and C, final height was lower than target height (155.5 +/- 5.3 and 156.4 +/- 1.3 cm, respectively), but only in group C the difference was statistically significant (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intranasal↗

PubMed1994

Subcutaneous growth hormone administration in growth-hormone-deficient children. Continuous plus pulsatile overnight versus single daily injection: effects on growth rate velocity.

The aim of this study, performed in 10 children, was to verify if a treatment schedule, better reproducing the growth hormone (GH) physiological pattern, could achieve a greater growth response than daily s.c. administration in previously successfully treated children with an isolated idiopathic GH deficiency. A 1-month washout period was observed between the previous regimen and this study. GH (0.6 U/kg/week, the same as given previously) was administered weekly in 6 equal doses. Three children received the daily dose by a single s.c. administration (at 20.00 h) and the other 7 through a 27-gauge infusion needle inserted s.c., using a mini infusion pump permitting a constant delivery of 50% of the daily dose (20.00-08.00 h) and the administration of the other 50% through 3 equal pulses (at 20.00, 24.00, and 04.00 h). After 6 months each child changed regimen undergoing the other one with a 1-month washout interval. During the 12 months of therapy, the mean height increased from -3.2 (SE 0.45) to -2.8 (SE 0.37) SDS. When evaluating the circulating insulin-like growth factor-I pattern as well as the growth velocity and the ratio bone age increase/height age increase, no differences were noted between the two treatment regimens.

Body Height↗