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Biomedical subjects

F Monaco

Publications and source records attributed to F Monaco.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Lack of association between vigabatrin and impaired cognition.

Of 14 patients with a history of partial epilepsy who received vigabatrin 2 g daily for 6 months, eight were newly diagnosed and received vigabatrin as monotherapy, while the remaining six received vigabatrin in addition to pre-existing treatment with phenobarbitone. Neurophysiological and neuropsychological evaluations, done before and after the therapeutic period, included the Luria-Nebraska neuropsychological battery (LNNB), electroencephalograms (EEGs) and evoked potentials. The results for each item of the test battery at baseline were compared with those after 6 months' treatment. There were no statistically significant differences on the functional scales of the LNNB, the EEG or the evoked potentials. There was a significant improvement (P = 0.01) in the LNNB topographic scales for the right frontal lobe and the motor-sensory area following treatment. These results indicate that vigabatrin has no detrimental effects on cognitive function and may improve function.

Adolescent↗
PubMedDate not supplied

[The clinical use of human recombinant TSH].

The recent cloning of human TSH-beta gene has allowed the production of recombinant human TSH (rhTSH) by recombinant DNA technology in mammalian cells (Chinese hamster ovary cells). Studies aimed at biochemical and biological characterization have shown that rhTSH, unlike pituitary TSH, is highly sialylated and is biological active in stimulating c-AMP accumulation in FRTL-5 cells. Phase I/II and phase III clinical studies have been performed to evaluate the safety and efficacy of rhTSH in stimulating radioactive iodine uptake in patients after total thyroidectomy for differentiated thyroid cancer. In these patients therapy with thyroid hormones is performed to replace hormone production and to suppress TSH-stimulated tumor growth. To detect residual or recurrent cancer, the therapy has to be withdrawn in order to obtain rise in endogenous TSH to perform a total body scan. rhTSH, as a source of exogenous human TSH, has been shown as an additional diagnostic tool in the follow-up of patients with thyroid cancer. Used in patients maintained on thyroid hormone suppressive therapy, rhTSH enhances the sensitivity of serum Tg testing. Although the sensitivity of scans obtained after rhTSH administration is slightly lower than that after thyroid hormone withdrawal, the use of rhTSH avoids the clinical signs and symptom of hypothyroidism and can be used in selected patients.

Carcinoma↗
PubMedDate not supplied

[Thyroid surgery in assisted local anesthesia].

To evaluate the advantages of thyroidectomy under assisted local anesthesia, 35 cases operated on from January 1998 to February 1999 were reviewed. The patients were studied in ambulatory setting and adequately informed on the program of thyroid operation under local anesthesia. Multinodular goitre was present in all the cases. In 12 cases, it was intrathoracic. The morning of operation, all the patients underwent to pre-operative sedation and, in operative room, to local anesthesia with Mepivacaine 1% and adrenaline 1,200,000 U. The operations were performed with a mean of 30 cc of local anesthetic. During operation, in none case the conversion to general anesthesia was necessary. No mortality and morbility were registered. In the majority of cases, an analgesic was necessary meanly 4 hours after operation. The evening of operation in all the patient oral nutrition was restored. Twenty-nine patients were discharged from the hospital 48 hours after surgery. Eight days after operation, surgical recovery was evident in all the patients reviewed in the out patients setting. The advantages of thyroid surgery under assisted local anesthesia are outlined.

Adult↗
PubMedDate not supplied

[Diaphragm rupture caused by closed trauma. A more and more frequent condition].

The Authors report a case of rupture of the diaphragm in blunt trauma of the abdomen, to examine the more significant features of this condition whose incidence proves to be increasing, after a review of the literature data, parallel to the increase of accidents on the road and at work. They examine the most important pathogenic problems and these related to the mechanism leading to diaphragmatic lesion and they highlight the deeper pathophysiological changes suffered from the patient with such a condition. They draw attention to what they consider to be the most important aspect, and therefore the diagnosis. In fact, in accordance with the various series of cases reported in the literature, it is crucial in the diagnostic problem is when the possible cause of the rupture is suspected and necessary diagnostic cascade (Rx, echotomography, TC) is activated so to highlight the lesion. Therefore a quick diagnostic fitting is necessary for the survival of the acute patient with hernia of the thorax cavity, as well as quick surgical correction of the lesion that, as in the case described, serves to achieve the best possible anatomic-functional results.

Diaphragm↗
PubMedDate not supplied

[Nf-kB transcription factor: role in the pathogenesis of inflammatory, autoimmune, and neoplastic diseases and therapy implications].

PURPOSE: Description of the involvement of the transcription factor NF-kB in inflammatory, autoimmune and neoplastic processes. Clinical implications from basic research. DESIGN: Review of the most significant data reported in the literature and personal publications. RESULTS: NF-kB is an ubiquitous transcription factor member of the proto-oncogene family rel. NF-kB regulates the expression of several genes involved in inflammatory and immune responses. The classical activated form of NF-kB consists of the p50/p65 heterodimer, different dimers may be formed with members of rel, AP1, steroid hormones receptors family. Many studies suggest that NF-kB should be considered as an important mechanisms of inflammatory processes and autoimmune diseases. Many important anti-inflammatory drugs and immunosuppressants inhibit NF-kB. Several observations have suggested a role of the inappropriate activation of NF-kB in cell proliferation, transformation, and tumor development, mainly lymphomas. Conversely, it has been proposed that the activation of NF-kB in immune cells may contribute to anti-tumor immunity. CONCLUSIONS: NF-kB is an optimal target of anti-inflammatory and immunosuppresant therapies. Molecular studies on NF-kB are very important to understand the pathogenesis of inflammatory, autoimmune and neoplastic diseases, and to identify new drugs that inhibit NF-kB activation.

Autoimmune Diseases↗
PubMedDate not supplied

[Role of thymectomy in the treatment of myasthenia gravis: considerations and personal cases].

The therapeutic impact of thymectomy on the clinical course of myasthenia gravis is still very controversial. In fact, while nowadays the surgical approach is widely adopted for thymomas, its role is still debatable in patients suffering from myasthenia gravis. The surgical approach of choice for total thymectomy is represented by median sternotomy. Other surgical methodologies include cervical access and partial sternotomy. All these approaches have shown excellent results in the exeresis of the thymus. More recently video-assisted thoracoscopic thymectomy has been proposed as a less invasive and similarly effective technique for the removal of this organ and the treatment of myasthenia gravis. Aim of the present study is to report Author's experience with thymectomy, emphasizing the data available in the international literature on the surgical mortality, complications and aesthetical results of the different surgical accesses.

Adult↗
PubMedDate not supplied

[Surgical treatment of hydatid cysts].

Hydatidosis represents a form of helminthic zoonosis with a stronger medical, social and economic impact. It is endemic in some areas of the world including Mediterranean countries, and therefore Italy. The disease is often diagnosed in an advanced phase, due to the poor symptomatology in the early stages. The best treatment is surgery. Emergency surgery is similar to elective surgery, though in some cases is preferable only a drainage procedure until the stabilization of the genreal and local conditions of the patient allow a radical intervention. The Authors report on their five year experience of surgical treatment of compliated pulmonar hydatidosis pointing out that exeresis must be aimed at preserving pulmonar function as much as possible.

Adolescent↗
PubMedDate not supplied

[Haemothorax and chylothorax: surgical approach].

Diseases causing blood accumulation in the pleural space (or haemothorax) are usually very demanding for diagnosis and require a multidisciplinar therapeutical approach in emergency. So, their treatment should always be immediate and should aim to restore the optimal patient's haemodynamic conditions and to find the site of bleeding. Chylothorax, a lymphatic effusion in the pleural space, is also a very important pathology, as it effects the nutritional and immunological state of the patient causing pleural involvement and respiratory insufficiency. Stabilisation of vital parameters with adequate systemic therapies (blood perfusions, fluids and pro-coagulation factors, TPN) preceeds surgery, which can be the placement of a thoracic drain or emergency thorascopy and/or thoracotomy. The Authors report the casistic of the latest three years for diagnosis and treatment of haemothorax and chylothorax stressing the advantages of a minimal invasive approach for evacuation and identification of the origin of bleeding and haemorrhage and/or lymphatic effusion control.

Adult↗
PubMedDate not supplied

[Indications, surgical strategies and evaluation of prognostic factors in the treatment of pulmonary metastases].

Pulmonary metastases resection is a method universally accepted in selected patients. Long-term survival reaches good levels after complete resection of lung metastases independently of primary tumour histology. The Authors emphasizes literature data; they report data of their experience no statistically significant but useful for valuation of results. They discuss of advantages vs disadvantages of the surgical procedures. In conclusion they believe metastasectomy is a safe treatment of pulmonary metastases.

Adolescent↗
PubMedDate not supplied

[Autonomous thyroid nodule: relations between clinical symptomatology and goiter endemia].

Sixty-three patients with autonomous thyroid nodule were studied, thirty-five from an endemic goiter area (EA) and twenty-eight from a non-endemic goiter area (NEA). Clinical history, physical examination, ultrasonography, thyroid hormone levels, and fine needle aspiration (FNA), were utilized to investigate whether or not iodine deficiency determined differences in the latency of progression to toxicity, the seriousness of illness and thyroid hormone levels. No significant difference was observed in the age of onset of nodularity, while the latency of progression to toxicity was significantly decreased in the EA (p less than 0.001). The ultrasonographic pattern did not show significant volume variations between the EA and NEA, but there was a slight prevalence of multinodular lesions in EA. No significant difference in serum thyroid hormone levels was found between the two areas in non toxic patients, while at the onset of hyperthyroidism higher levels of FT were observed in the EA than in the NEA. FNA showed a prevalence of colloid lesions in EA, while hyperplastic lesions prevail in the NEA. Forty-two patients underwent surgery: the extent of surgery was greater in patients from the EA. In conclusion, in iodine deficient areas earlier clinical thyrotoxicosis and a higher prevalence of hypoactive thyroid nodules were observed. Furthermore, in EA, the autonomous nodule in non toxic phase is more frequently associated with colloid lesions than hyperplastic lesions.

Adult↗