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Biomedical subjects

G Pastore

Publications and source records attributed to G Pastore.

At least 217 records · Page 12Linked to original sources

[Statistical study of the risk of cardiovascular disease in hysterectomized patients].

The risk of atherosclerotic or hypertensive cardiovascular disease increases after physiological or surgical menopause, irrespective of whether or not the ovaries are removed. In order to evaluate the direct contribution of the uterus in cutting down the incidence of cardiovascular diseases, the clinical records of 1551 cardiovascular patients and 296 healthy women were examined. All subjects were divided into 8 different groups according to their age. The following data were considered: 1) the incidence of cardiovascular diseases; 2) the number of subjects in physiological or surgical menopause; 3) the number of women hysterectomised in premenopause; 4) the number of women who underwent hysterectomy and bilateral salpingo-oophorectomy in premenopause; 5) the number of women who underwent either operation before or after the menopause. It was found that both in hysterectomised and not hysterectomised women the hypertensive and ischaemic cardiovascular pathologies prevailed in the younger and older groups respectively. Among the patients with cardiovascular diseases the percentage of subjects who had undergone hysterectomy or hysterectomy with bilateral oophorectomy was significantly higher (p less than 0.05) than in the controls. The difference was particularly marked in the younger groups. These data indicate that when the uterus is properly stimulated by the oestrogens, is able to produce a protective factor against cardiovascular diseases. It has been suggested that this factor may be prostacyclin, a potent vasodilator and the most potent inhibitor of platelet aggregation yet discovered. The epidemiological evidence alone that premenopausal hysterectomy increases the risk of cardiovascular disease should be an important consideration in weighing the risks and benefits of the procedure. If the epidemiological data can be supported by a definite mechanism of action via prostacyclin, then current indications for hysterectomy must be carefully reconsidered.

Adult↗

Serum IgA anti-hepatitis A virus as detected by enzyme-linked immunosorbent assay. Diagnostic significance in patients with acute and protracted hepatitis A.

A capture enzyme-linked immunosorbent assay for the detection of serum IgA against hepatitis A virus has been developed. The test was highly specific, and the time course of detectability of IgA anti-HAV was longer than six months in 42/42 patients with acute or protracted hepatitis A followed prospectively, but shorter than two years in 14/14 patients tested 21-24 months after diagnosis of acute hepatitis A. IgM anti-HAV were at detectable levels in only 1/42 cases tested six months after the clinical onset. The detection of serum IgA anti-HAV is a simple and specific method to differentiate protracted cases of hepatitis A from non-A, non-B hepatitis.

Enzyme-Linked Immunosorbent Assay↗

Monophasic and polyphasic pattern of alanine aminotransferase in acute non-A, non-B hepatitis. Clinical and prognostic implications.

One-hundred-and-two out of 788 consecutive patients (12.9%) hospitalized for an attack of acute hepatitis fulfilled criteria for non-A, non-B (NANB) hepatitis, and were followed prospectively for 8 to 70 months. Forty-one out of 97 patients showed a monophasic pattern of alanine aminotransferase (ALT), and all recovered completely. In contrast, 22 of 56 (39.2%) subjects with a polyphasic pattern of ALT exhibited persistent hypertransaminasemia for more than 14-18 months, and all of them developed chronic hepatitis. Thus, a polyphasic pattern of ALT seems to characterize one of two forms of NANB hepatitis, more frequently associated with parenteral exposure, absence of jaundice and a high tendency for the development of chronic hepatitis. This suggests distinct immunopathogenetic mechanisms from two unrelated NANB agents. Benign, non-progressive chronic persistent hepatitis is the prevalent form of chronic sequela of NANB hepatitis observed in our patients. Although many of these patients show a tendency to spontaneous remission of the disease, there is the possibility in some of a deterioration of inflammatory activity of the liver that has need of immunosuppressive therapy.

Acute Disease↗

Serum binding activity for human albumin polymers in acute and chronic virus hepatitis.

We considered the serum binding activity for human albumin polymerized with glutaraldehyde in 346 serum samples of 205 subjects with acute and chronic type A, B and non-A, non-B virus hepatitis. We showed that the binding activity for pHSA in the control groups did not have a titer higher than 2(-6). All sera from patients with HAV and HBV acute infection showed a high binding titer that returned to below the threshold in the former after the peak of hepatocytolysis, and in the latter after the seroconversion of HBsAg to anti-HBs. In the subjects who became HBsAg chronic carriers after the acute episode of HBV infection, the pHSA binding activity showed a decrement of the titer in relation to the seroconversion of HBeAg to anti-HBe. Furthermore, 92% of HBsAg chronic carriers who were HBeAg positive had a high titer of pHSA binding, while only 14.3% of the anti-HBe positives showed a high titer. Acute and chronic hepatitis non-A, non-B virus showed a pHSA binding titer similar to that of the control group. The results indicate that the non-A, non-B virus does not seem to be correlated to pHSA or related factors.

Acute Disease↗

[Evaluation of an immunoenzyme test (ELISA) for the determination of an Ag/Ab system correlated to non-A, non-B post-transfusion hepatitis].

An ELISA for the detection of a Ag/Ab system related to non-A, non-B post-transfusion hepatitis (NANB-PTH) has been developed. A convalescent serum from a patient suffering, 14 month before, of NANB-PTH was used both as capture and detector antibody in a "sandwich" type immunoassay to detect an Ag (Ag-NANB). A "blocking" immunoassay was used, in the same test, to detect the corresponding antibody (Ab-NANB). All patients with NANB-PTH were positive, alternately, for Ag-NANB or Ab-NANB. The Ag was found in the acute phase sera of 3 out of 22 cases of NANB-PTH (13,6%), but in none of 29 acute hepatitis type B,26 acute hepatitis type A,14 NANB sporadic hepatitis, 5 infectious mononucleosis and 8 healthy subjects. 2/3 Ag-NANB positive subjects became chronic carriers of this Ag, whereas the third seroconverted for Ab-NANB after the first two months of their disease. Furthermore, a significant increase of the Ab-NANB titer was observed in the convalescent phase of the disease in 18/20 NANB-PTH. As expected, a relatively high prevalence for Ab-NANB was found in the other groups of patients, suggesting the high diffusion of the agent, but none of these subjects showed a progressive increase of the antibody titer during the course of their disease.

Antigens, Viral↗

[Immunoenzyme determination of IgA specific anti-HAV in the serological diagnosis of hepatitis A].

A capture enzyme immuno assay for the detection in the serum of specific IgA antibodies to HAV is described. A total of 203 sera from patients and controls were tested. IgA anti-HAV were present only in sera from patients with recent hepatitis A. 23 patients were followed prospectively and IgA anti-HAV were at detectable levels for at least six months after the onset. The detection of IgA anti-HAV is proposed as an important test to differentiate hepatitis A with persistent hypertransaminasemia from non-A, non-B patients.

Antibodies, Viral↗

[Behavior of theophylline-sensitive T lymphocytes in viral A, B, non-A, non-B hepatitis. I. Methodological aspects].

To evaluate the behaviour of the Theophylline-sensitive T lymphocytes subpopulation some modifications of the standard procedure are proposed. Lymphoprep purified lymphocytes were counted in a Neubauer hemocytometer after Acridine Orange stain, viability was evaluated by Ethidium Bromide counterstain and monocytes contamination was evaluated by the peroxidase stain. Sheep red blood cells were treated with AET, Theophylline was used at 3 mM (final concentration) and the results compared with untreated lymphocytes; the enumeration of the rosetting lymphocytes was facilitated by adding Acridine Orange prior to the resuspension. The modifications described were able to increase the % of rosetting T lymphocytes, to eliminate differences depending by different lots of sheep red blood cells and to decrease differences depending by subjective evaluation of the rosetting T lymphocytes.

Acridine Orange↗

[Behavior of theophylline-sensitive T lymphocytes in viral A, B, non-A, non-B hepatitis. II. Application aspects].

The pathogenesis of the hepatic damage in hepatitis is not well understood but an imbalance in immunoregulatory T lymphocytes is probable. We tested the Theophylline-sensitive T lymphocytes in acute and protracted cases of hepatitis A, in hepatitis B and non-A, non-B. A delayed increment of such cells was demonstrated in hepatitis B suggesting a positive role in the recovery from the disease. The results were indicative for a direct action of the HAV and nAnB on the lymphocytes. Theophylline-sensitive lymphocytes were increased in the course of protracted hepatitis A whereas were progressively decreasing in nAnB hepatitis. This behaviour of suppressor cells in nAnB hepatitis may explain the high frequency of evolution in chronic liver disease.

Hepatitis, Viral, Human↗

Peptichemio in neuroblastoma at relapse.

Peptichemio (PTC), a multipeptidic complex of m-L-phenyl-alanine mustard, was administered to 39 children with neuroblastoma at relapse. The compound was given in two 5-day cycles at dosages varying from 1.0-1.5 mg/kg/day. We were able to evaluate 29 of the initial 39 children for PTC effect; 21 of them had received PTC as first therapy following diagnosis. Ten patients underwent other chemotherapy for relapse before PTC. Three patients were off therapy when relapse occurred. Subjective improvement was observed in 18 cases (62%). Eleven patients (38%) experienced an objective regression, which was scored as complete response in three cases, partial response in two, mixed response in six. In ten children no significant disease change was observed; the remaining eight had a progression of their disease while receiving PTC. The incidence of responses has been higher in patients off therapy at moment of relapse, and lower in those pretreated for their relapse. Previous administration of PTC did not reduce the chance of response at relapse. Major toxic effects were transient, mostly moderate myelodepression and phlebosclerosis. Allergic reactions, nausea, and vomiting, occurred in a few patients. These data indicate that PTC may exert objective antitumor activity in approximately one-third of neuroblastoma patients at relapse.

Child↗

New principle for the simultaneous detection of total and immunoglobulin M antibodies applied to the measurement of antibody to hepatitis B core antigen.

A new test principle for the simultaneous detection of total approximate titers and immunoglobulin M antibodies has been developed and applied to the detection of antibody to hepatitis B core antigen. The method is based on the combination of a competition radioimmunoassay, for the determination of total antibody titer, with an indirect enzyme-linked immunosorbent assay for the determination of single class antibodies. The interference of the rheumatoid factor was avoided by including heat-aggregated immunoglobulin G in the dilution buffer. The specificity, sensitivity, and clinical application of the test are discussed. The results presented suggest that the simultaneous detection of total and immunoglobulin M antibody to hepatitis B core antigen might be helpful in the differentiation between previous and recent or ongoing hepatitis B infection, as well as in the differential diagnosis of acute hepatitis, in monitoring viral activity in chronic infections, and in helping to differentiate acute from chronic infections. The test principle appears applicable in the accurate diagnosis of other infectious diseases by a single test on only one serum sample.

Acute Disease↗

Glucose metabolism in children with acute lymphoblastic leukemia treated according to two different L-asparaginase schedules.

Oral glucose tolerance tests were performed in 47 children with acute lymphoblastic leukemia (ALL), treated according to 2 consecutive protocols. Glucose and insulin values were assessed before and after L-asparaginase (L-asp). 30 children (group A) received L-asp as a single-agent consolidation course, after achieving remission with vincristine (VCR) and prednisone (PDN). Normal insulin and glucose levels were found in all patients before L-asp; 4 children (13%) had a transient impaired glucose tolerance (IGT) after completing L-asp therapy. 17 children (group B) were given L-asp during induction therapy with VCR and PDN, and all achieved complete remission. 5 patients (23%) had IGT, without hypoinsulinemia, before L-asp administration. IGT normalized in 4 patients after L-asp, the other children developed a diabetes mellitus. Only 1 patient, with a normal IGT test before L-asp therapy, showed a transient IGT after L-asp. In patients with ALL, the presence of IGT before treatment may be related to leukemia. The concomitant use of steroids does not influence the incidence of IGT in our series. Our data reveal normal insulinemia in patients with IGT. Thus, the leukemic process itself may play a much more significant role in inducing abnormalities in carbohydrate metabolism.

Adolescent↗

Influence of place of treatment on diagnosis, treatment, and survival in three pediatric solid tumors.

This study examines differences between cancer centers (CC) and noncancer centers (NCC) in terms of management procedures and outcomes for three pediatric solid tumors: Wilms' tumor (N = 147), rhabdomyosarcoma (N = 87), and medulloblastoma (N = 76). Data were derived for the period 1970-1979 from the population-based Greater Delaware Valley Pediatric Tumor Registry maintained at the Children's Cancer Research Center, which routinely collects data on all childhood neoplasms that occur in a 31-county region. Management measures reviewed included the degree to which important pretreatment evaluations were performed, types of therapy used, and extent of follow-up examinations conducted. Outcome variables were three-year disease-free survival and frequency of deaths related to complications of therapy. Differences in three-year disease-free survival between CC and NCC were noted for medulloblastoma (52% v 24%) and rhabdomyosarcoma (48% v 10%), but not for Wilms' tumor (79% v 68%). Among medulloblastoma patients, differences were detected in the frequency of pretreatment evaluations and in the therapy used. The principal management contrast found in rhabdomyosarcoma was that multiagent chemotherapy was used less often in NCC. Wilms' tumor patients were evaluated and treated similarly in the community versus the CC, except for some contrasts in the surgical approach and the frequency of follow-up for the detection of late complications.

Adolescent↗

Uterine cervical tumor metastases and their treatment.

Uterine cervical carcinoma is a locoregional disease. However, particularly in advanced stages, in the presence of N+ and pelvic relapse, it may produce secondary lesions located far from it. In our case series, consisting of 473 portio carcinomas treated at the Institute of Radiology of the U.C.S.C., we found distant metastases in 6.76% of the cases. This study examines the cases of metastasis in relation to stage, histology, risk-factors, treatment of the primary tumour and survival after the treatment of the secondary lesions.

Female↗