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Biomedical subjects

F Garofalo

Publications and source records attributed to F Garofalo.

15 recordsLinked to original sources

Cardiac morphodynamic remodelling in the growing eel (Anguilla anguilla L.).

The morphodynamic changes occurring during growth were evaluated in the eel (Anguilla anguilla L.) heart. Using an in vitro working heart preparation, cardiac performance of small (body mass 96.76 +/- 27.49 g; mean +/- s.d.) and large (body mass 656 +/- 12 g; mean +/- s.d.) eels was compared under basal conditions and under loading (i.e. preload and afterload) challenges. A parallel morphometric evaluation of the ventricle was made using light and transmission electron microscope images. The small eel hearts show a basal cardiac output lower than their large counterparts (heart rate fh, 38.93 +/- 2.82 and 52.7 +/- 1.8 beats min(-1), respectively; stroke volume Vs, 0.27 +/- 0.017 and 0.37 +/- 0.016 ml kg(-1), respectively; means +/- s.e.m.). The two groups show similar responses at increasing preload, but differ remarkably at increasing afterload. Small eel hearts decreased Vs at afterload greater than 3 kPa, in contrast to larger hearts, which maintained constant Vs up to 6 kPa. These changes in mechanical performance are related to structural differences. Compared with the small eels, the large eels show an increase in the compacta thickness and in the diameter of the trabeculae in the spongiosa, together with reduction of the lacunary spaces. The increased compacta thickness is attained by enlargements of both the muscular and vascular compartments and reduction of the interstitium; consequently, this layer appears more compacted. Both compacta and spongiosa show higher number of myocytes together with reduced cross-sectional area and myofibrillar compartment. The compacta also shows an increased mitochondrial compartment. Our results document a cardiac morphodynamic remodelling in the growing eel.

Analysis of Variance↗

Pressure-flow studies in men with benign prostatic hypertrophy before and after treatment with transurethral needle ablation.

BACKGROUND/AIMS: In this study we wanted to examine the effects that transurethral needle ablation (TUNA) might have on the urodynamic characteristics of bladder outlet obstruction and to evaluate the clinical changes and the safety profile in patients undergoing the TUNA procedure, including the effects on erectile and ejaculatory function. MATERIALS AND METHODS: We evaluated 24 patients, aged between 66 and 81 (mean 73.4) years with a mean prostatic volume of 57 +/- 15 ml. Before treatment, the clinical history was collected, then prostate-specific antigen (PSA) analysis, digital rectal examinations, I-PSS and quality-of-life (QOL) tests, uroflowmetry with residual volume, and pressure-flow studies were performed in all patients. After treatment, all the patients were evaluated at 6, 12 and 24 months by the same parameters. RESULTS: After treatment, the I-PSS and QOL scores were considerably improved, and the mean flow rate and the residual volume were also improved. The serum PSA level remained unchanged. The prostatic volume was almost unchanged, and pressure-flow studies showed a reduction in the mean opening pressure and detrusor pressure at maximum flow after treatment. None of the patients complained of alterations in sexual activity nor retrograde ejaculation. CONCLUSIONS: Our study confirms that in patients with benign prostatic hyperplasia, the TUNA procedure results in no major complications and in significant clinical improvements. There was an improvement in the subjective and objective variables, such as symptom scores and frequency-volume charts and, in the majority of patients, subjective and objective improvements were sustained for the duration of this study, which included a 2-year follow-up with pressure-flow studies. From our experience we can say that the ideal candidate for TUNA treatment should be younger than 70 years, with a prostatic volume of <60 cm H(2)O, with a baseline detrusor pressure at maximum flow of <60 cm H(2)O, with a pretreatment residual volume of <100 ml and with a QOL score of <5.

Aged↗

Direct DNA analysis in a new Italian carrier of Hb-Belfast: beta 15 (A12) Trp-->Arg.

A young woman aged 21 was found to be a new carrier of Hb-Belfast: beta 15 (A 12) Trp-->Arg, and the characteristics of her hemoglobinopathy were not different from those of the four cases so far described: mild hemolysis with molecular instability of the abnormal Hb, red cells inclusion bodies, and slight alterations of some functional parameters of whole blood. On this occasion, direct DNA analysis indicated the genomic nucleotide replacement of the disease: TGG-AGG. This was inherited by the mother, originating from Bari (Apulia).

Adult↗

Bone density and metabolism in thalassaemia.

Twenty-seven thalassaemic patients (13 F, 14 M, aged 8.1-14.9 yr), regularly transfused and chelated with desferrioxamine (30-40 mg/kg/day) were studied. Every patient was submitted to auxological evaluations, dual X-ray absorptiometry to measure bone mineral density (BMD), and to the determination of bone metabolic markers of osteoclastic activity (total urinary hydroxylysylpyridinoline crosslinks, carboxyterminal pyridinoline crosslinked telopeptide of type I collagen [ICTP]) and of osteoblastic activity (bone Gla protein [BGP] and carboxyterminal propeptide of type I procollagen [PIPC]). The evaluations were repeated after 1 year, during which 13 patients continued desferrioxamine chelation while 14 underwent deferiprone chelation (75 mg/kg/day in 3 doses). The data demonstrate widespread bone alterations consisting of osteoporosis, growth failure and bone age delay. Lumber spine (L2-L4) BMD areal values (Z score) inversely correlated with age, as did height SDS of both male and female patients, indicating osteoporosis progressing with age in parallel with growth insufficiency. No clear-cut alterations in bone mineral metabolism were found in basal state and after 1 year. Extensive MR imaging studies are needed to define the contribution of residual bone marrow hyperplasia to thalassaemic osteopathy suggested by subtle radiological signs as enlargement of bone marrow cavities with thinning of the cortical bone and abnormalities of the trabecules of spongy bone.

Absorptiometry, Photon↗

[Transurethral needle ablation (TUNA) in benign prostatic hypertrophy: 2-year follow-up].

In this study we have evaluated the effectiveness, safety and tolerability of TUNA in the long term follow-up. We have evaluated 24 patients, aged between 66 and 81 years (mean age 73, 4 yrs) with a mean prostatic volume of 57 ml (range 33-140 mls). Before treatment, urodynamic investigation (max flow rate), residual volume, PSA, IPSS and quality of life tests have been performed in all patients. After treatment, all the patient have been evaluated at 6, 12 and 24 months by the same parameters. Based on our experience, we can say that the results obtained after 24 months are similar to those observed 12 months after treatment, except a slight increase in IPSS and quality of life tests in patients older than 70 years, with a baseline maximal detrusorial pressure > 60 cm H2O, with a baseline residual urine > 100 cc and with a baseline quality of life = 5.

Aged↗

Controlled clinical studies of nimesulide in the treatment of urogenital inflammation.

Two double-blind, randomised studies were conducted to compare the efficacy and tolerability of nimesulide (200 mg/day) with those of placebo or bromeline (240 mg/day). Treatments were administered orally to patients of either sex (aged 19 to 70 years) with acute infection and inflammation of the urogenital tract, and were given concomitantly with antimicrobial therapy for approximately 9 days. In both studies, a clinically significant improvement in symptoms, leading to complete remission, was achieved in most patients treated with nimesulide. Furthermore, treatment with nimesulide resulted in a more rapid improvement in symptoms and complete remission in a greater number of patients than did treatment with bromeline. Both nimesulide and bromeline were well tolerated.

Adult↗

Low dose intermittent 5-fluorouracil, epirubicin and cyclophosphamide (FEC) in poor risk patients with advanced transitional cell bladder cancer: a pilot study.

Fifteen patients with locally advanced or metastatic bladder carcinoma and with cardiac and/or renal impairment were treated with a combination of 5-fluorouracil, 400 mg/m2, epirubicin, 40 mg/m2, and cyclophosphamide, 400 mg/m2. No complete or partial remissions were observed among the 14 evaluable patients. The toxicity level was very low. We are now trying to "tailor" platinum-based combinations to renal function.

Aged↗

L-asparaginase-induced coagulopathy in children with acute lymphoblastic leukaemia.

Haemostatic changes induced with vincristine (VCR), prednisone (PDN) and L-asparaginase (L-ase) in 53 children with ALL were prospectively evaluated. Relative to pretreatment values, mean FG concentration diminished significantly in the first week with a minimal level in the third week and PT was prolonged during the first weeks of induction. APTT decreased significantly in the last week and after cessation of L-ase therapy. Mean concentration of factor VIII remained elevated during the entire period of L-ase therapy. Three children (5.6%) developed a cerebral thrombo/haemorrhagic complication. These data demonstrate that the tendency for thrombosis is the predominant clinical manifestation of L-ase-induced coagulopathy, when the drug is associated with VCR and PDN.

Asparaginase↗

[Percutaneous nephropyelolithotomy].

The fact that one can perform a wide passage through the kidney percutaneously with the subsequent introduction of a 26 F nephroscope has radically changed the technique used to remove kidney stones. They may either be extracted directly with forceps or following ultrasonic lithotripsy. The authors report their experience of 39 cases, in 32 of which the method was successful, 3 complications have been reported. The advantages of this method, both for the patient and for the community, are discussed in comparison to the surgical pielolithotomy. The problems concerning the dose absorbed by the operator are also examined.

Adult↗

Midodrine for female incontinence: a preliminary report.

Twenty-six women (aged 26 to 60) with stress incontinence underwent urodynamic investigation before and after oral administration of 5 mg of midodrine, a new adrenergic agent with alpha-stimulant activity. A significant increase in maximum urethral closing pressure combined with a nonsignificant increase in flow time and maximum flow was observed after treatment.

Adult↗

[Clinical and pathological characteristics of carcinoma of the kidney: computerized analysis].

To evaluate the significance of the clinical and pathological features and survivorship data, we analyzed 203 cases of renal carcinoma who underwent surgery at our department from 1974 to 1988. Tumor stages P2 and P3 and grades G2 and G3 were the most frequent. The series is large enough to permit classification according to tumor stage and grade and most of the possible associations. The diagnostic procedure and the surgical technique were consistent. Radical nephrectomy via the transperitoneal approach was performed in 153 patients. Transpleural thoracophrenolaparotomy was performed in 22 patients with a very large tumor mass in the upper pole. Extended classical nephrectomy via the lumbar approach was performed in 27 patients. Computer-assisted analysis of the clinical and pathological data showed tumor stage to be an important prognostic factor. Given a similar situation for tumor stage, the histologic grade has been shown to influence prognosis significantly. Other clinical or pathological parameters such as pseudocapsule, histological type and paraneoplastic biological and humoral changes often correlated with tumor stage or grade. Clinical staging is a point of reference for surgery. However, detection of microfoci of tumor metastasis that might be responsible for late reactivation of the disease is as yet not possible.

Adult↗

[Efficacy and tolerability of nimesulide in inflammatory diseases of the genito-urinary system].

In a controlled clinical trial 80 patients of both sexes, aged between 19 and 70 years, with acute or chronic reacutized flogistic bacterial affections of the genito-urinary tract, were randomly assigned to anti-inflammatory treatment with nimesulide (200 mg/day p.o.) or placebo for a mean period of 9 days, in association to the specific antibiotic therapy. In the group treated with nimesulide a significant clinical improvement of the symptomatology was observed in the majority of cases. The therapeutic activity appeared quickly and complete remission of the symptomatology was achieved in a number of cases significantly higher than in the reference group. The tolerability of nimesulide was good.

Adult↗