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Biomedical subjects

G Angelini

Publications and source records attributed to G Angelini.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Frequency of pancreatographic changes in subjects with upper abdominal symptoms and its relationship with alcohol intake.

The aim of this study was to evaluate the endoscopic retrograde pancreatographic (ERP) findings in respect of alcohol intake. Two hundred eleven patients consecutively submitted to ERP for upper abdominal symptomatology, with suspected pancreatic disease (SPD; 79 patients) or without (NSPD; 132 subjects), were classified in 3 groups of different ethanol intake: 1 (0-40 g/day), 2 (41-80 g/day), 3 (more than 80 g/day). The following conclusions could be drawn: (1) the frequency of ERP changes increases with the increase of alcohol intake both in SPD (34.6-63.8%) and NSPD (8.2-29.8%); (2) the frequency of pancreatic cancer was not related to alcohol intake, but in NSPD it was about 2-fold that in SPD: 12/132 (9.1%) vs 4/79 (5.06%); (3) a pancreatic morphological assessment, by means of ERP or other imaging techniques, should be performed in every subject with upper abdominal pain of unknown origin both in alcoholics (for the high incidence of chronic pancreatitis) and in non-alcoholics (for the risk of pancreatic cancer, which approximates 10%).

Abdomen↗
PubMedDate not supplied

Percutaneous transhepatic sphincterotomy of the major papilla and stone extraction without endoscopic control.

Obstructive jaundice due to an impacted stone in the common bile duct (CBD) was seen in a patient who had previously undergone Billroth II gastric resection and cholecystectomy. Surgical and endoscopic approaches to the common bile duct failed owing to pericholedochal adhesions and the excessive length of the duodenal loop. The patient was therefore treated percutaneously (sphincterotomy and stone extraction) without endoscopic control.

Ampulla of Vater↗
PubMedDate not supplied

Nd:YAG laser versus polidocanol injection for palliation of esophageal malignancy: a prospective, randomized study.

Palliation is often the only treatment that can be offered to patients affected by esophageal malignancy. This prospective study was carried out in order to compare two endoscopic palliative treatments: Nd:YAG laser and local injection of 3% polidocanol. We randomized 34 patients with inoperable malignancies to one of the two treatments. After the first course, 88.8% of the patients in the laser group and 81.5% in the polidocanol group were able to swallow a normal oral caloric intake. Only one major complication (esophageal perforation) was observed (polidocanol group) and was successfully treated with endoscopic placement of a prosthesis. We believe that both techniques are safe and effective for the palliation of esophageal malignant strictures but that polidocanol injection is cheap, simple, and more widely available.

Adenocarcinoma↗
PubMedDate not supplied

Loss of polymorphic restriction fragments of class I and class II MHC genes in a malignant melanoma.

DNAs from human malignant melanoma cells and autologous peripheral blood lymphocytes were evaluated by Southern blot analysis with probes for class I and II HLA genes. DNA of melanoma cells digested with PvuII, EcoRI and BglI and hybridized with a DR beta probe showed a loss of several fragments when compared with DNA from lymphocytes. The same DNAs were not distinguishable when hybridized with a DQ beta probe. Analysis of melanoma and autologous lymphocyte DNAs from the same patient with a class I cDNA, after digestion with several endonucleases, revealed a further loss of fragments in melanoma cells. Comparison of restriction fragment patterns of melanoma and lymphocytes with those of homozygous, serologically-typed cell lines indicated that melanoma cells have lost fragments diagnostic of DR2 and A1 antigens. A densitometric analysis of signals of several oncogenes in comparison with that of DR indicated that a duplication of the remaining DR allele had occurred in melanoma cells.

DNA, Neoplasm↗
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Rubidium deficiency in dialysis patients.

BACKGROUND: Since dialysis has brought long-term survival to uremic patients, we can now speculate on more subtle problems derived from imbalance or sub-optimal regulation of some elements such as trace metals. We focused on the rubidium (Rb) status in dialysis patients (HD), as concerns about its possible deficiency have been raised. METHODS: Rb in uremic patients was evaluated by: A) serum concentration (graphite furnace atomic absorption spectroscopy) from blood samples of 70 patients on chronic hemodialysis (HD) in comparison with 75 controls; B) tissue concentration (neutron activation analysis) from autopsy or biopsy samples (20) of HD patients in comparison with 21 controls; C) in vivo intradialytic mass balance during standard bicarbonate dialysis in 8 HD patients. RESULTS: A) Serum Rb concentrations in HD patients significantly were lower than in normal controls (304 +/- 81 micrograms/L versus 350 +/- 74 micrograms/L p < 0.001, log-transformed 5.68 +/- 0.28 versus 5.84 +/- 0.20, p < 0.001). Univariate logistic regression analysis found a significantly higher risk of serum Rb < 250-300 and 350 micrograms/L in uremic patients than in controls (Odd ratios or 12.6, 95% CI 2.77-57.04; 4.0, 95% CI 1.92-8.4; 2.08, 95% CI 1.02-4.25, respectively). B) Rb was significantly lower in tissues of HD patients, including brain (2250 +/- 1520 ng/g versus 5490 +/- 1250 ng/g, p = 0.0002) than normal controls. C) Rb was transferred from the patients' blood to the dialysis bath during a standard bicarbonate dialysis session, giving mean intradialytic Rb removal of 4.0 +/- 1.1 mg/session. CONCLUSIONS: These results confirm that Rb deficiency may arise in uremic patients, and indicate that diffusive dialysis treatments allow Rb removal which, however, with a standard bicarbonate schedule does not seem to be any greater than that expected with normal urine output (20 mg/week). Further studies are needed to clarify the roles of many factors in this Rb deficiency, including the effects of uremia by itself, pre-dialysis factors (diet, impaired renal function and drugs), dialysis procedures (frequency, hours, diffusive/convective components) or other biochemical/clinical parameters (hemoglobin, body mass index, age). The finding of a Rb deficiency in uremia is important as it has a role in neurobehavioural functions, mainly as an antidepressant. As Rb deficiency may be implicated in central nervous system alterations which strongly influence the quality of life, we believe that monitoring serum Rb in uremic patients and clarifying the causal mechanisms of deficiency will facilitate future therapeutic approaches.

Adult↗
PubMedDate not supplied

[Incidence of psychopathologic symptoms in patients treated for mouth cancer].

BACKGROUND: The first aim of the study is to evaluate the possible onset of anxiety, major or minor forms of depression and delirium in patients treated for head and neck malignancies. The second aim is to study the possible association between the psychological conditions and the different parameters connected with the treatment (site of tumor, time of hospitalisation and surgery, kind of reconstruction). METHODS: The study included 35 patients (21 males; 14 females) with diagnosis of head and neck squamous cell carcinoma (HNSCC). All the patients were examined before surgery, during the preoperative phase, and after surgery. Three evaluation questionnaires were used during the interview: Spielberg's StaiY1 and Y2 test, to evaluate anxiety, and Zung Self-Rating Depression scale, to evaluate depression. RESULTS: Patients revealed anxiety before surgery, while after intervention the level was normal. There was a prevalence of anxiety over depression. There was no correlation between diagnosis, site of tumor, time of hospitalisation and psychological symptoms. An association between time of surgery, kind of reconstruction, anxiety and depression was found. The patients with a higher degree of anxiety were more tending to delirium. CONCLUSIONS: Malignancy of the head and neck causes considerable physical and psychological problems which may adversely affect the quality of life during and after treatment. The better reconstruction is correlated with the lower psychopathological problems. The study underlines the need to offer psychological support during diagnostic and therapeutic procedures.

Carcinoma, Squamous Cell↗
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[Percutaneous endoscopic gastrostomy in children with ventriculoperitoneal shunt].

The complications of percutaneous endoscopic gastrostomy (PEG) placement or replacement or of home management of gastrostomy, must be taken in account in patients with hydrocephalus and ventriculoperitoneal shunt. In this report we describe four children with spastic quadriplegia and ventriculoperitoneal shunt who had a median follow-up of 15 months (range 4-32 months) after PEG placement. Intravenous antibiotic prophylaxis was always used during routine procedures and no shunt infection was observed. In a patient, during accidental PEG dislodgement, peritoneal infection developed that required temporary diversion of the catheter. A second dislodgement, in the same individual, determined a large amount of serous peritoneal fluid that needed to be evacuated but no shunt infection or malfunction. In nobody of our patients, the shunt, located in the upper left abdomen, interfered with gastrostomy placement. Our experience confirms that PEG is not contraindicated in patients with ventriculoperitoneal shunt, provided that the risks of catheter infection are known and prevented.

Adolescent↗
PubMedDate not supplied

[Feeding neurologically disabled children with dysphagia: the role for gastrostomy].

INTRODUCTION: Undernutrition and growth retardation are often observed in children with severe neurological disabilities. Our experience of feeding gastrostomy in children and adolescents with central nervous system (CNS) disease and dysphagia is reported. PATIENTS AND METHODS: A gastrostomy feeding tube was placed in 11 children who had severe impairment of swallowing and clinically evident food aspiration. Percutaneous endoscopic technique was preferred, unless operative placement was suggested by unfavourable anatomical conditions or concomitant abdominal surgery. Commercial formulas or natural food were used at home and the children were regularly followed-up at the outpatient clinic. RESULTS: Median age at the gastrostomy placement and median follow-up lenght were 5.9 years (range 1.8-16.7 years) and 15 months (3-66 months) respectively. Four of 11 patients had moderate (weight/height (W/H) ratio = 80%) and 3 severe (W/H ratio < 70%) malnutrition. Ten of 11 subject were exclusively gastrostomy fed. After 3 months of enteral nutrition a weight gain was observed in all patients as well as a significant increase of mean W/H ratio (81.2% vs. 87.2%, p = .002). Nutritional improvement was confirmed at follow-up, despite caloric intakes lower (< 50%) than recommended for age and weight. Micronutrients and vitamins were supplemented on the basis of calculated intakes. CONCLUSIONS: In children with severe CNS disease and dysphagia, long-term gastrostomy feeding is a safe and useful method that allows adequate nutritional and micronutrient intakes and prevents the risk of dystrophy.

Adolescent↗
PubMedDate not supplied

Acute and chronic pancreatitis: an up-date.

According to the 1988 Marseilles-Rome classification inflammatory pancreatic diseases are represented by acute (AP) and chronic pancreatitis (CP), pancreatic fibrosis and abscesses (due to infection of cystic cavities). Each form is defined by specific etiological, pathomorphological, functional and evolutive aspects. In our experience with 348 AP cases, gallstones and chronic alcohol abuse, alone or together, represent the major causative factors (over 70% of cases). Mortality observed in necrotizing AP only, varies from 26% of idiopathic to 8% of biliary cases. Ductal scars, exocrine and endocrine impairment were observed in about 45% and 20% respectively as sequelae of necrotizing AP, whatever the etiology. As far as CP is concerned, the main etiological factor is chronic alcohol consumption (82% of cases). The clinical evolution of CP may be roughly divided in two phases, the earlier (within 5 years from onset) characterized by frequently recurrent pain, calcifications and cystic cavities and the later when pain spontaneously regresses and steatorrhea and diabetes tend to appear. Heavy alcohol intake, smoking and frequent relapses are related to a less favourable course. About 60% of the patients underwent surgery within 5 years from onset. Pain relief was achieved in the large majority. Reduction in alcohol intake and the natural tendency of the disease to burn out, probably aid pain relief. Mortality in CP is due to diseases secondary to alcohol and smoking abuse (cardiovascular and neoplastic) more than to CP alone. We believe that multiple parameters are required for a complete definition of each pancreatic patient.

Adult↗
PubMedDate not supplied

[Clinical usefulness of dexamethasone test in depression].

The paper stresses the importance of the dexamethasone suppression test in the diagnosis of severe depression (major psychiatric disorders). For some decades researchers have been aware of the importance of the hypothalamus-pituitary-adrenal gland axis in the physiological response to stress, and likewise the importance of possible correlations between emotional and biological factors in psychiatric disorders. Several studies have sustained that in major psychiatric disorders, and in particular in depression, not only is there a hypersecretion of cortisol, but also a resistance to the suppression of cortisol secretion which normally follows the injection of an exogenous steroid, for example dexamethasone. This laboratory test is therefore of value both for diagnostic purposes and for identifying severe depression from other morbid conditions; it may also be usefully employed for prognostic and therapeutic purposes.

Depressive Disorder↗