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Biomedical subjects

G Longo

Publications and source records attributed to G Longo.

At least 145 records · Page 8Linked to original sources
PubMed1989

[Lipoma of the colon: apropos of 2 cases].

The lipoma of the colon is a rare benign tumour. The Authors describe two cases of colonic lipoma and stress diagnostic and therapeutic problems related to this condition. They also emphasize the importance of double contrast enema and colonoscopy associated to bioptic examination. The indication to lipomas removal is based on clinical remarks and differential diagnosis with adenomatous polyps. The modality of removal, where feasible for local conditions, should be preferably endoscopic.

Adult↗
PubMed1989

The effect of bacterial infection in the worsening of atopic dermatitis: correlations with humoral immunologic patterns.

The contribution of secondary infection to severity and tendency to relapse in atopic dermatitis during childhood has been assessed. A total of 57 children aged between 4 months and 14 years were followed for an average of 4.73 months. A secondary infection was diagnosed in 22 (31.4%) of 70 relapses, since the lesions only subsided with antibiotics active on the bacteria isolated from the skin, usually a coagulase-positive Staphylococcus aureus. The eczema was more severe at presentation and hypogammaglobulinemia G more often found in those children who were more susceptible to secondary infections. The hypogammaglobulinemia G was present in 13 out of the 57 patients, but it normalized with age and was not correlated with IgE levels. In the children in whom the relapse or the worsening of the eczema could be attributed to secondary infection because of the positive response to the antibiotic treatment, the lesions had the appearance of pustules or showed more exudation, although in some cases only the worsening of the erythema and itching was observed. A secondary bacterial infection should be considered a likely cause of relapse or worsening of atopic dermatitis. Furthermore it may be that, at least in first year of life, hypogammaglobulinemia G is part of an immunologic impairment of atopic dermatitis which favors the susceptibility to secondary infections.

Adolescent↗
PubMed1988

Multi-variate analysis of factors governing the pharmacokinetics of exogenous factor VIII in haemophiliacs.

The pharmacokinetics of Factor VIII was evaluated by mathematical modeling in a large-scale study in 62 haemophilia-A subjects, in whom 137 plasma Factor VIII-time curves were measured during single dose (n = 87) and repeated-dose (n = 47) treatments for prophylaxis or minor bleeding episodes. The pharmacokinetic parameters [mean (SD)] estimated from single-dose curves were: clearance 3.85 ml.h-1.kg-1, volume of distribution 58.2 ml.kg-1, mean residence time 15.9 h. Parameters calculated from repeated-dose curves were: clearance 3.93 ml.h-1.kg-1, volume of distribution 61.8 ml.kg-1, and half-life 12.2 h. In patients with mild haemophilia, pharmaco-statistical analysis revealed that the endogenous synthesis of Factor VIII was constant and was not influenced by the administration of exogenous Factor VIII. The coefficient of variation for intra-individual variability of Factor VIII kinetics (estimated according to the Standard Two-Stage method) was 20.7% in single-dose curves and 23.2% in repeated-dose curves.

Adolescent↗
PubMed1988

13-cis-Retinoic acid treatment in patients with myelodysplastic syndrome.

Twenty patients with primary myelodysplastic syndromes (16 refractory anemia without or with ringed sideroblasts, 2 refractory anemia with excess blasts, 2 refractory anemia with excess blasts in transformation) received 13-cis-retinoic acid at a dosage of 50-100 mg/m2/day for a minimum of 4 weeks. Twelve patients obtained an increase of hemoglobin levels greater than 1 g/dl and 7 showed an associated increase of granulocyte count greater than 50% of baseline values. No significant biochemical signs of dyslipidemia or liver damage were noted. A sustained response was noted only in refractory anemia without or with ringed sideroblasts and normal or hypercellular bone marrow. Five patients are still on therapy from 23 to 82 weeks without transfusion requirement and all have shown an improvement in performance status. We conclude that 13-retinoic acid may only be clinically useful in selected patients since in myelodysplastic syndromes with blast excess the drug does not seem to improve the course of the disease.

Aged↗
PubMed1988

A simple system for auditing the quality of primary care screening in school-age children.

A system for auditing quality of care and increasing effectiveness was applied to a health screening program for school-age children and the results were analyzed during 2 subsequent years. A problem-oriented record to be filled in whenever the screening was positive represented the basic tool for the evaluation. The record was sent to the specialist who was requested to make a diagnostic assessment and a treatment plan. The same record returned back to the first-level staff thus providing feedback information about diagnostic accuracy and effectiveness of the screening. Periodic self-evaluation meetings and a tutorial system for diagnostic procedures were instituted leading to a general improvement in quality indexes.

Adolescent↗
PubMed1987

Intravenous and subcutaneous administration of desmopressin (DDAVP) to hemophiliacs: pharmacokinetics and factor VIII responses.

When desmopressin (DDAVP) is given to mild and moderate hemophiliacs intravenously (i.v.) or subcutaneously (s.c.), there is a very large between-patient variability for peak levels of factor VIII coagulant activity (VIII:C). To evaluate whether or not between-patient variability is related to DDAVP levels achieved in plasma, we measured drug levels in 14 hemophilic volunteers (VIII:C 2 to 31 U/dL) who were randomly given 0.3 micrograms/Kg of i.v. or s.c. DDAVP and crossed-over to the other treatment after an interval of 15-30 days. Peak DDAVP levels (Cmax) were higher for i.v. DDAVP (p less than 0.02), times to peak levels (tmax) were shorter for i.v. DDAVP (p less than 0.001). There was no difference between the i.v. and s.c. routes for plasma DDAVP time curve (AUC) and half-life (t 1/2), but there was much larger variability for pharmacokinetic parameters with i.v. than with s.c. DDAVP. Post-DDAVP VIII:C increased 3.4 +/- 1.6 fold (i.v.) and 3.3 +/- 1.3 fold (s.c.) over baseline levels, with no significant correlation between peak VIII:C and DDAVP levels for either route of administration. These findings establish the s.c. route of DDAVP administration to be bioequivalent in effect to the i.v. route, albeit with less variability. At the DDAVP dosage used in this study and currently recommended for therapy, the VIII:C response is neither a function of the rate of absorption of the compound nor of the magnitude of its plasma concentration.

Deamino Arginine Vasopressin↗
PubMed1987

Genetic factors in nonspecific bronchial hyperreactivity. An epidemiologic study.

We tested bronchial reactivity to carbachol in 50 asthmatics, healthy parents of 40 asthmatic children, and 70 healthy subjects with no personal or family history of asthma. Stepped doses of carbachol (0.1%) aerosol were given until a 50% drop in forced expiratory flow rate from 25% to 75% was observed, or until the subject had inhaled 80 of his or her own vital-capacity equivalent volumes of the aerosol. The area under the dose-response curve was computed. Histograms of the carbachol reactivity showed a bimodal distribution: 10% of normal subjects and 50% of nonasthmatic parents had values in the asthmatic range. In 85% of parent couples at least one of the two parents had bronchial reactivity without being asthmatic. Our findings suggest that bronchial reactivity to a cholinergic bronchoconstrictor indicates an autosomal-dominant pattern of inheritance.

Adolescent↗
PubMed1987

Adjuvant medroxyprogesterone acetate to radical nephrectomy in renal cancer: 5-year results of a prospective randomized study.

From July 1, 1979 to June 30, 1983, 136 consecutive patients from 5 centers in Lombardy entered a prospective randomized study to compare 500 mg. adjuvant medroxyprogesterone acetate 3 times a week for 1 year to no treatment following radical nephrectomy for category M0 renal cancer. After a median followup of 5 years (range 42 to 90 months) 40 of 120 evaluable patients (33.3 per cent) experienced relapse after a median interval free of disease of 17 months (range 2 to 74 months). Relapses occurred in 19 of 58 evaluable patients in the adjuvant treatment group (32.7 per cent) and in 21 of the 62 evaluable controls (33.9 per cent). Sex steroid hormone receptors were studied in 102 of the 120 evaluable patients with the dextran-coated charcoal technique. No significant correlation could be found among receptors, relapses and treatment. On the other hand, 33 (56.9 per cent) of the 58 treated patients experienced 39 complications related to the long-term hormonal therapy. Three patients had to discontinue medroxyprogesterone acetate for severe toxicity after 2 to 3 months. Medroxyprogesterone acetate cannot be recommended as adjuvant therapy to radical nephrectomy in patients with renal cell carcinoma.

Adolescent↗
PubMed1987

Single-dose pharmacokinetics of factor IX evaluated by model-independent methods.

We studied the pharmacokinetic data of 13 subjects with hemophilia B treated with a single-dose of a Factor IX concentrate (Bebulin TIM2, N = 9; Preconativ, N = 4). The decay curves of Factor IX were evaluated by model-independent methods and the following pharmacokinetic parameters (mean +/- SD) were estimated: clearance (ml/h/kg) = 4.99 +/- 2.01; mean residence time (h) = 22.9 +/- 10.6; volume of distribution (ml/kg) = 99.9 +/- 35.5. The in vivo recovery (59.8% +/- 16.9%) was found to be inversely correlated with the volume of distribution. No significant difference in the pharmacokinetic parameters was found between patients treated with Preconativ and those treated with Bebulin. A model-dependent compartmental evaluation of the 13 decay curves showed that the two-compartment model was better than the one-compartment model in 7 cases (53.8%), but the improvement of fit resulting from the two-compartment model was statistically significant in only 2 cases (15.4%).

Factor IX↗
PubMed1987

Clinical pharmacokinetics of factor VIII in patients with classic haemophilia.

Studies of Factor VIII pharmacokinetics in haemophiliacs can be classified into 2 groups depending on whether single-dose or multiple-dose Factor VIII curves are used. This review analyses information published so far in both these areas, with particular emphasis on the choice of appropriate models for pharmacokinetic analysis. Single-dose studies of Factor VIII kinetics have previously used a wide variety of methods for pharmacokinetic analysis (empirical methods of Factor VIII level prediction, graphical techniques for semilog analysis, 1-compartment and 2-compartment models). However, Factor VIII poses unique problems to the pharmacokineticist because decay curves can be either monophasic (monoexponential) or biphasic (biexponential) for unknown reasons, and because Factor VIII concentrations are generally subject to significant assay error. Problems of compartmental analysis that occurred in previous studies are highlighted, and a model-independent non-compartmental approach for analysing Factor VIII curves is proposed. To date, fewer data have been published on multiple-dose kinetics of Factor VIII. From a clinical point of view, repeated-dose regimens are most commonly required in patients undergoing surgery and in patients with severe bleeding. A fairly well defined 'therapeutic window' of optimal Factor VIII plasma concentrations has been identified, particularly in surgical patients. This fact has spurred research aimed at applying to haemophilia patients the pharmacokinetic dosing methods commonly used for therapeutic monitoring of drugs (e.g. Bayesian method for dosage individualization). A few papers have already been published in this field, and this review summarises problems encountered by previous investigators, and evaluates comparatively the pharmacokinetic methods used.

Factor VIII↗
PubMed1987

[Follow-up of patients with chloracne in the Seveso area].

Three follow-up surveys from 1976 to 1985 were carried out on 193 subjects who developed chloracne following the Seveso accident (1976). A comparison group, age and sex matched, was selected randomly from the municipal list of Varedo (in the same health district but out of dioxin polluted zone). At each follow-up a questionnaire was administered and biochemical tests, skin examination and electrophysiologic measurements were performed. Biochemical indicators of hepatic function and nerve conduction studies did not show either significant differences between groups or temporal trends. Chloracne was shown to be clinically reversible: all the chloracne cases (except for one subject) clinically recovered by 1983. The discrepancy between our results and the previous experiences can be related to: different type of exposure, target population and interval since exposure.

Accidents, Occupational↗
PubMed1987

The measurement of relative interfragmentary deformation in diaphyseal fractures of the lower extremity stabilised by flexible endomedullary nailing. A radiographic analysis.

Following a review of current knowledge on the anatomical, histological and biomechanical aspects of fracture healing, the authors present an original method for the measurement of relative interfragmentary deformation in diaphyseal fractures of the lower extremity stabilised by flexible intramedullary nailing. The first data obtained is reported. In the examples reported, the authors have determined the precise amount of relative interfragmentary deformation in diaphyseal fractures of the lower extremity stabilised by flexible intramedullary nailing. The first data obtained is reported. In the examples reported, the authors have determined the precise amount of relative interfragmentary deformation in each case, using accurate digitizer measurement on the radiographs with and without loading. This method makes it possible to measure relative interfragmentary deformation and monitor it over a period of time. The authors conclude that relative interfragmentary deformation is beneficial to the healing of fractures provided it is kept within the limits of the "strain-tolerance" of the various types of callus which succeed one another during fracture healing.

Adolescent↗
PubMed1987

Pharmacological activity of some pyrrolo and pyrazolo pyrimidine derivatives.

4,7-Dihydro-4-ethyl-2-phenylpyrazolo-[1,5-a]pyrimidin-7-one (FPP028) is the prototype of a class of pyrazolo[1,5-a]pirimidine derivatives that has been shown to possess marked antiinflammatory and analgesic properties; 1,4-dihydro-1-ethyl-7-phenylpyrrolo[1,2-a]pyrimidin-4-one (FPP129) is a new compound belonging to a series of pyrrolo[1,2-a]pirimidine derivatives that has been synthetized in an attempt to reduce certain toxic effects observed with FPP028. To evaluate these two compounds more fully, in the present study we determined the LD50 of FPP129 in mice and assessed its activity in different experimental inflammation models. Ulcerogenic properties of FPP129 were evaluated by the test of stress-induced ulcer in rats. We also studied the in vitro and ex vivo effects of both FPP028 and FPP129 in a series of platelet-aggregation experiments using either arachidonate or collagen as aggregating agents. In the carraggeenan-induced paw edema, FPP129 exerted a marked anti-inflammatory activity with an ED50 of 22.2 mg/kg. FPP129 inhibited also the edema induced by concanavalin-A or Paf-acether. The in vitro anti-aggregatory activity of FPP028 was shown to be much less than that of indomethacin, thus confirming the hypothesis that the compound is a very weak inhibitor of cyclooxygenase. Ex vivo, both FPP028 and FPP129 were shown to exert no antiaggregatory effect in rabbits after administration of doses equal to the ED50. No ulcerogenic activity was found with FPP129, this result being consistent with previous observations on FPP028. Our data show tha FPP028 and FPP129 do not share a typical mechanism of action (cyclooxygenase inhibition) found with the majority of nonsteroidal antiinflammatory drugs. Nonetheless, the antiinflammatory properties of these compounds, together with their lack of ulcerogenic activity, indicate that both FPP028 and FPP129 are potentially interesting for future therapeutic use.

Animals↗
PubMed1986

Hepatitis-free interval after clotting factor therapy in first infused haemophiliacs.

Post-infusion hepatitis is known to occur very frequently in haemophiliacs after treatment with unheated commercial clotting factor concentrates, obtained from large plasma donation pool. On the contrary, single-donor cryoprecipitate is likely to carry a lower risk of transmitting hepatitis. To evaluate this hypothesis, we retrospectively reviewed the medical records of 25 first infused haemophiliacs (from 1981 to 1984) treated with unheated commercial clotting factor concentrates (n = 19) or cryoprecipitate (n = 6). The hepatitis-free interval after the beginning of therapy was expressed as exposure days. The end point of each patient, i.e. the hepatitis occurrence, was defined as an increase of amino-transferases (ALT and AST) and/or the seroconversion of HBV-markers, which were checked every three months. The life-table method and log-rank test showed that cryoprecipitates had a significantly longer hepatitis-free interval (p = 0.0131, log-rank test) and a lower risk of transmitting hepatitis (p = 0.01-0.05, life-table method) than the commercial concentrates. However, the safety of cryoprecipitate therapy was shown to cover only a few exposure days, and so the real advantage of this product depends on the bleeding frequency of the patient concerned. We believe that these methods and our findings may be useful to assess and compare the safety of the new "heat-treated" clotting factor concentrates.

Adolescent↗