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Biomedical subjects

G Marchesi

Publications and source records attributed to G Marchesi.

At least 19 recordsLinked to original sources

[Role of nurses in the evaluation of septic patients].

ICU nurses hold an important role in the management of septic patients underlining with their ability to recognize SIRS that is the first step in the proinflammatory and procoagulant cascade following an infection. Early and timely approach to organ dysfunction can indeed modify the damages due to hypoperfusion. The ability to recognize organ dysfunction using different monitoring devices available should be part of the nursing attitudes.

Central Nervous System↗

Validation of automated oscillometric sphygmomanometer (HDBPM) for arterial pressure measurement during haemodialysis.

An HDBPM oscillometric sphygmomanometer used for the automatic measurement of arterial blood pressure is evaluated according to the ANSI/AAMI SP10-1992 standard. The accuracy of the HDBPM is ascertained by comparing it against the standard Riva-Rocci ascultatory method. Following the ascultatory method, two independent observers use the HDBPM devise to simultaneously measure the arterial blood pressure in 92 subjects of varying ages and having different blood pressures and arm sizes. High agreement is found when comparing the observers' pressure determinations (within 10 mmHg for 100% of observations). Correlation between the average of two ascultatory determinations and the HDBPM is high both for the systolic (r = 0.98) and diastolic (r = 0.94) pressures. The mean of the differences between the pressures measured by the observers and the HDBPM device are 0.2 mmHg (systolic) and -0.4 mmHg (diastolic). The percentages of readings within 10 mmHg between those taken by the observers and those taken by the HDBPM are 88% (systolic) and 97% (diastolic). These results largely satisfy current requirements.

Adolescent↗

[Gastric tumors with fatty components. CT findings and differential diagnosis].

PURPOSE: To assess the role of CT in diagnosing and characterizing gastric fatty tumors. MATERIAL AND METHODS: We reviewed the CT scans of 16 patients (8 men, 8 women, mean age 52 years) with gastric fatty tumors (11 lipomas, 3 liposarcomas, 1 angiolipoma, 1 teratoma) examined from 1990 to 1999. The differential diagnosis considered primary and secondary lipomatosis, carcinoma engulfing the perivisceral fat and thus mimicking a liposarcoma, mesenchymal gastric and primary peritoneal tumors. RESULTS: Lipomas involved the fundus (7/11), the body (3/11), the antrum (1/11). Multifocality was found in one case. Lesions size ranged 25 to 65 mm (mean 35 mm). All the lipomas showed homogeneous structure with negative (-30 -100) HU values. A pseudocapsule was demonstrated in 7/11 cases. No infiltrative growth was demonstrated. The angiolipoma located in the fundus showed a vascular component with strong contrast enhancement. All the liposarcomas were bigger than 10 cm and there was a strong correlation between pathologic specimen and CT findings. The differentiated liposarcomas showed the classic heterogeneous fatty density; on the contrary the myxoid and the pleomorphic types showed an aspecific structure with necrotic/cystic changes, mostly demonstrated in the myxoid type. The teratoma was a solid mass with fatty, solid, necrotic and calcified components. CONCLUSION: CT allows the diagnosis and characterization of gastric fatty tumors. The preoperative diagnosis of lipomas plays a major clinical role because it often makes surgery unnecessary.

Adult↗

[Hormone evaluation in brain death].

BACKGROUND: In this study, the level and the variation of a number of hormone and metabolic parameters during brain death treatment in potential organ donors have been monitored. METHODS: Thirty-nine consecutive brain-dead patients were enrolled in 3 Intensive Care Units of Regional Hospitals of the North of Italy. All patients were potential organ donors and free from diseases before the accident leading to death. The levels of ADH, ACTH, TSH, prolactin, cortisol, aldosterone, FT3, FT4, renin, serum lactate and plasma osmolality were measured immediately after the diagnosis of brain death (T0), certified following the Italian law of December 29, 1993, n. 578, and after 6 hours (T6). RESULTS: Hormone levels were normal in the majority of subjects, and there was no significant variation during the 6 hours of the observation period. No correlation was found between the hormone levels considered and the metabolic parameters; ADH levels were not correlated with plasma osmolality. FT3 levels were below the normal range in the majority of subjects, but were not associated with a higher lactate level, which is used as a marker of a shift toward tissue anaerobic metabolism. CONCLUSIONS: In conclusion, triiodothyronine administration to improve metabolic order and thus the function of organs for transplantation is not justified in brain-dead patients.

Adolescent↗

Low-grade non-Hodgkin B-cell lymphoma presenting as sensory neuropathy.

Low-grade non-Hodgkin B-cell lymphoma was found during the evaluation of 3 aged patients with predominantly sensory neuropathy of mild to moderate severity. Presenting manifestations were sensory ataxia and right ulnar mononeuropathy in a 75-year-old man, and painful dysesthesias of the legs in two 78-year-old women. A neurophysiological study showed mainly axonopathic alterations. M-protein was present in all cases (Ig-kappa in two, triclonal gammopathy IgG(kappa)/IgM(kappa)/IgM-gamma in one). The male patient had IgM antisulfatide antibody in high titer, whereas the other 2 patients had cryoglobulinemia (type II and type III, respectively). Our report emphasizes the occurrence of mild polyneuropathy as presenting manifestation of low-grade non-Hodgkin lymphoma, different from the clinicopathological entity of neurolymphomatosis, in which severe nerve damage occurs in association with manifest lymphoma, related to nerve infiltration by lymphomatous cells. Alternative pathogenetic mechanisms, such as antibody-mediated nerve damage, or vasa nervorum changes caused by cryoglobulin, may be implicated in our cases. Non-Hodgkin lymphoma should be considered in the diagnostic evaluation of polyneuropathy of unknown cause, especially in patients with paraproteinemia and/or cryoglobulinemia.

Aged↗

[Alcohol and smoking. The risk factors for the oral cavity].

A higher risk for the development of oral cancer was associated with heavy smoking and heavy drinking, but alcohol drinking and tobacco smoking are also correlated with other oral cavity disease. Tobacco is the most important factor of leukoplakia, but other diseases like ANUG, periodontitis, median rhomboid glossitis, chronic hyperplastic candidiasis and others are also correlated to cigarette smoking. It was observed that smokers have more plaque than non-smokers, even if no difference in the bacteria composition was found between smokers and non-smokers samples, and the vascular reaction associated with plaque induced gingivitis is suppressed in smokers. Periodontitis are generally considered to be a consequence of an unfavourable host-parasite interaction, but personal factors that diminish the efficiency of the host defence, like tobacco smoking and alcohol drinking, can play an important role in the development of periodontal diseases. Cigarette smoking may be considered a major risk factor for periodontitis and it can also increase its severity; therefore, alveolar bone loss increases with tobacco smoking. Recent investigations show that smokers respond less favourably than no smokers to the different modalities of periodontal therapy, as surgical and non surgical, or guided tissue regeneration. Moving from these observations the authors critically analyze the literature concerning these important risk factors which appear to be strongly correlated with periodontal diseases.

Alcohol Drinking↗

Are multiple domicile changes a risk factor for multiple sclerosis? A case-control study.

A retrospective case-control study was conducted to estimate the possible association between risk of multiple sclerosis (MS) and the number of changes in residence before the age 20 years. Forty-one patients and 82 controls were interviewed. Using the Mantel-Haenszel estimate of the odds ratio, no association was found between the number of moves and MS.

Adult↗

Effect of flunarizine on pituitary secretion by healthy men and in woman with migraine.

Flunarizine is widely used in the prophylaxis of migraine. It is both a calcium blocker and a histamine antagonist at H1-receptors and either of these effects could alter hormonal secretion. The effect of administration of flunarizine to 8 women with common migraine on pituitary secretion has been studied. The dopamine antagonist domperidone (10 mg) and gonadotropin releasing hormone (100 micrograms) were injected iv before and after one month of flunarizine therapy (10 mg orally at bedtime). The basal prolactin level was significantly increased by the drug, and the peak induced by domperidone stimulation was reduced. Basal TSH concentrations were not affected, but the increase after domperidone was blunted. After 90 days of therapy there were no significant differences from the baseline concentration. Neither basal nor gonadotropin releasing hormone-stimulated secretion of FSH and LH were affected by flunarizine. Twelve healthy men were given placebo and flunarizine (10 mg at bedtime) for 5 days in single-blind fashion. Flunarizine caused a significant increase in prolactin and TSH with no effect on basal gonadotropin and thyroid hormone levels. These results can be accounted for by the calcium blocking effect of the drug, although weak interference with dopaminergic transmission is a further possibility explanation.

Adult↗

[Value of angiography and echotomography in injuries of the spleen].

In all the patients was performed angiography, while only 11 were studied by the means of Abdominal Ultrasonography. The Authors' aim is to evaluate the accuracy of these two methods and to define a correct diagnostic procedure. The results obtained with Angiography were 15 correct diagnosis and 1 false positive, whereas those obtained with Sonography were 7 correct diagnosis, 2 indicative diagnosis and 2 false negative. Therefore, when a patient is clinically suspected of having a traumatic spleen injury, the Authors suggest to perform an Abdominal Sonography at first. In case of evident spleen lesion, laparatomy will be directly carried out. However, if the sonographic result is negative or aspecific, it will be necessary for the patient to undergo Angiography in order to rule out possible false negative or establish the origin of endoabdominal bleeding correctly.

Angiography↗

[Long-term results of prolonged dicoumarol anticoagulant therapy in 327 peipheral arteriopathic subjects].

327 patients with peripheral arteriopathy were treated solely with protracted dicoumarol anticoagulant therapy. The indication for such therapy was applied not only in patients in whom the high risk and poor run-off contraindicated revascularisation operations, but also in those in good general conditions at the 2nd or 3rd stage with iliac and femoral thromboses. Two-thirds of the arteriopathics observed were given the anticoagulant treatment for more than two years, with a maximum of eight years. Clinical evolution of the disease is discussed in relation to the treated patients' age and stage, while emphasis is given to the very low incidence of complications and contraindications, despite the long period of treatment.

Adult↗

Quantitative data on cell loss and cellular atrophy of intralaminar nuclei following cortical and subcortical lesions.

Morphological changes in the intralaminar nuclei centralis medialis, paracentralis and centralis lateralis of the thalamus of adult cats after cortical excisions have been determined by means of a quantitative method. The number and size of the remaining neurons on the operated side have been compared with those of the normal side. The differences between the normal and the operated side have been compared to those found between the two sides in the control animals. The most important result is the demonstration that after cortical ablations the intralaminar nuclei show not only chromatolytic or atrophic changes of their cells but also a true cell loss. These reactions are qualitatively similar to those observed in the specific nuclei of the thalamus, the only difference being a quantitative one. As a consequence it can be suggested that some intralaminar nuclei project to certain areas of the cerebral cortex which also receive projections from one or other specific thalamic nucleus. A large essential connection of the intralaminar nuclei, in particular the nucleus centralis medialis, with subcortical structures is confirmed.

Animals↗