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Biomedical subjects

G Villa

Publications and source records attributed to G Villa.

At least 73 records · Page 4Linked to original sources
PubMed1996

Conservative management of cocaine-packet ingestion: experience in Milan, the main Italian smuggling center of South American cocaine.

OBJECTIVE: To assess retrospectively the effectiveness and the safety of the conservative medical management of asymptomatic cocaine body-packers. DESIGN: Case series collected during twelve years (1980-1992). SETTING: Milan Airports Health Center. Department of Surgery and Intensive Care Unit of San Raffaele Hospital-University of Milan. PARTICIPANTS: 189 suspected cocaine body packers (143 male, 53 female), aged between 18-53 years, were brought to our observation by customs after disembarking at the Milan International Airports of Malpensa and Linate. 61 subjects (32%) turned to be carriers of packets containing cocaine (ovules). INTERVENTIONS: Medical conservative treatment, based on close clinical observation and light solid diet, free assumption of liquids and oily laxatives. Plain abdominal X-ray and ultrasound were performed for the diagnosis of cocaine packet ingestion and then repeated up to the complete evacuation of all ovules. Two laparotomies with surgical removal of ovules in symptomatic patients (bowel obstruction and acute cocaine intoxication due to the intraluminal rupture). MEASURES: Physical examination with neurological assessment every 8 hours and vital signs (including blood pressure, heart frequency and temperature) every 4 hours to detect complications (acute cocaine intoxication, bowel obstruction or perforation) secondary to cocaine packet ingestion. Structural features of the containers, cocaine amount per ovule, and rate and indications for surgical treatment have been reviewed. RESULTS: Evacuation period lasted from 3 to 6 days. Ingested containers varied from 52 to 117 with a mean of 88 +/- 13 ovules for each body packer. Total amount of recovered 95% pure cocaine hydrochloride was 41 kilograms. Signs of cocaine toxicity and bowel obstruction requiring emergency laparotomy occurred in two cases (3.3%). Both patients recovered uneventfully. CONCLUSIONS: Conservative management during spontaneous evacuation of the containers is the first choice approach to the body-packet ingestion. Close clinical observation allows an early detection of the patients with complications requiring emergency surgical treatment.

Adolescent↗
PubMed1995

Subvertical grooves of interproximal facets in Neandertal posterior teeth.

Subvertical grooves, located on the interproximal facets of most Neandertal posterior teeth, are less frequently noted on the teeth of other hominids, including modern humans. These grooves, 0.1-0.5 mm in width, are strictly localized within the facet area. Scanning electron microscopic (SEM) examination of grooves present on Neandertal teeth from Caverna delle Fate (Liguria, Italy) and Genay (Côte d'Or, France) demonstrated that they were produced during the life of these individuals. Characteristics of the groove surface suggest an erosion-abrasion mechanism of formation. These grooves, which developed in parts of the dentition exposed to marked stress, originated in areas characterized by changes in the orientation of enamel prism bundles (i.e., Hunter-Schreger bands). Observations carried out on modern human molars showed a subvertical disposition of these bands near interproximal ridges facilitating subvertical microfractures. Possible correlations between enamel structure, masticatory stress, and interproximal groove formation in Neandertals are discussed.

Animals↗
PubMed1995

Neuropsychological tests and [99mTc]-HM PAO SPECT in the diagnosis of Alzheimer's dementia.

Twenty-three patients with Alzheimer's dementia (AD) in relatively early stages and 40 patients with other cognitive disorders of vascular or degenerative aetiology underwent neuropsychological examination and [99mTc]-HM PAO single photon emission computed tomography (SPECT). In contrast to the commonly accepted notion of a posterior temporoparietal reduction of tracer uptake as the typical SPECT pattern of AD, the most consistent feature found in the SPECT images of our AD patients was a hippocampal uptake deficit, associated with a variable degree of temporal, parietal and frontal deficit (extending from the posterior to the anterior regions), according to the severity of the disease. These results support the theory of AD as a "hippocampal dementia", at least in the early stages. Neuropsychological tests were found to be somewhat more specific and more accurate than SPECT in distinguishing AD from non-AD cases.

Aged↗
PubMed1995

Community control of hypertension at work-site: epidemiological data of the Agusta project.

In order to set up a program of community control of hypertension at the work site, 8811 employees belonging to 12 factories of the same company (Agusta SpA, Italy) were screened. Seven hundred and seventy-two subjects (8%) were found to be hypertensive; 48% of them were hypercholesterolemic, 44% were smokers, 5% presented with hyperglycemia and 4% had left ventricular hypertrophy. Multiple regression analysis showed a significant correlation between hypertension and age, hypercholesterolemia, body mass index, occupational exposure to noise exceeding 80 dB and, below the age of 40 years, the type of job. Seven hundred and twenty-nine hypertensives were assigned to pharmacological treatment. This group of patients will be followed up for 3 years.

Adolescent↗
PubMed1995

Effects of different antihypertensive drugs on plasma fibrinogen in hypertensive patients.

1. In order to evaluate whether treatment with different antihypertensive drugs would affect plasma fibrinogen levels, 118 mild to moderate essential hypertensive subjects, all males, aged 18 to 65 years, were randomly treated with amlodipine 10 mg, atenolol 100 mg, hydrochlorothiazide 25 mg or lisinopril 20 mg, all given once daily for 8 weeks. 2. Before and after 8 weeks' treatment, blood pressure (BP), heart rate (HR), fibrinogen, total cholesterol (TC), HDL-C, LDL-C, triglycerides (TG), plasma glucose, plasma uric acid, serum creatinine and serum potassium were evaluated. 3. All four medications significantly reduced BP values, although the BP lowering effect of lisinopril, amlodipine and atenolol was significantly greater compared with that of hydrochlorothiazide. 4. Plasma fibrinogen levels were unaffected by atenolol, hydrochlorothiazide and amlodipine, whereas they were significantly decreased by lisinopril (-11.2%, P = 0.002). This fibrinogen lowering effect was more evident in smokers (-17.7%) than in non smokers (-7.4%). 5. Atenolol and amlodipine did not significantly affect plasma lipids, hydrochlorothiazide increased TC, LDL-C and TG and reduced HDL-C; lisinopril increased HDL-C and decreased TC and LDL-C. 6. Hydrochlorothiazide increased plasma glucose and uric acid concentrations, which were unaffected by the other drugs. The diuretic also reduced serum potassium. 7. The results of this study indicate that lisinopril reduces levels of plasma fibrinogen and confirm that different antihypertensive drugs may elicit different metabolic effects, which may variously influence the overall risk profile of the hypertensive patients.

Adolescent↗
PubMed1995

[Nuclear Magnetic Resonance Imaging in the staging of adenocarcinoma of the uterine cervix].

Clinical staging is often inaccurate in the evaluation of local extension of cervical carcinoma. In the present study the sensivity of MR imaging in predicting extracervical tumor invasion on the basis of the detection of a thinning of the univolved cervical stromal ring (3 mm or less) was compared to the sensivity achieved by direct visualization of a complete stomal interruption. Fifteen consecutive patients with adenocarcinoma of the uterine cervix (FIGO stage Ib-IIa), were examined with axial and sagittal weighed MR sequences. Pathologic proof after hysterectomy was obtained in all subjects. The sensitivity in predicting extracervical involvement on the basis of the MR Imaging visualization of a thinned stroma was 83%, whereas the sensitivity obtained by detection of a complete stromal interruption was 50%. Among women with a spared cervical stroma of more than 3 mm at MR Imaging, only one had at pathologic examination microscopic metastasis in a parametrial lymphnode, accounting for a negative predictivity value of 87%. The results of our study points out a high concordance between MR Imaging findings and pathologic results, and indicate that the detection of a intact cervical stromal ring exceeding 3 mm at MR imaging is related to a very low risk of extracervical seeding of tumor. On the other side, the detection of a thinned stromal ring is related to a high incidence of parametrial invasion. The information obtained by this imaging technique may therefore be extremely useful in the accurate tailoring of treatment for these patients.

Adenocarcinoma↗
PubMed1994

Small hepatocellular carcinoma treated with percutaneous ethanol injection: unenhanced and gadolinium-enhanced MR imaging follow-up.

PURPOSE: To determine the value of magnetic resonance (MR) imaging in follow-up of small (< 3 cm) hepatocellular carcinoma treated with percutaneous ethanol injection (PEI). MATERIALS AND METHODS: Fifty-seven patients underwent MR imaging before and after PEI. At follow-up every 6 months, MR images were correlated with results of fine-needle aspiration biopsy (FNAB). In 12 patients, correlation with histologic findings in surgical specimens was possible. RESULTS: In 39 patients followed up for 24 months, the treated lesions showed hypointensity on unenhanced (T2-weighted) images and loss of enhancement on enhanced (T1-weighted) images. At 6-month follow-up in six patients, the lesions showed areas of hyperintensity on unenhanced images and enhancement on enhanced images. These lesions contained residual viable tumor at FNAB. Twelve patients underwent surgical resection after 6-month follow-up. Correct diagnosis of complete or partial tumor necrosis was made in nine of these 12 patients with enhanced images and in three with unenhanced images. CONCLUSION: Gadolinium-enhanced T1-weighted MR imaging is more accurate than unenhanced T2-weighted MR imaging in evaluation of PEI therapy.

Aged↗
PubMed1994

Fibrinogen levels in normotensive and hypertensive men: a cross-sectional study.

BACKGROUND: The aim of this study was to compare plasma fibrinogen levels in hypertensive and normotensive men. Possible confounding factors, such as age, cholesterol levels, body-mass index and smoking habits were also to be considered. METHODS: We studied 708 men with essential hypertension (according to the World Health Organization's criteria) and 944 with normal blood pressures, all of whom had similar lifestyles; the overall age range was 18-60 years. The clinical evaluation included measurements of blood pressure, heart rate, body weight and height as well as a medical examination and personal habits history. After an overnight fast, blood samples were taken in order to measure fibrinogen and total-cholesterol levels. RESULTS: The mean fibrinogen level did not differ between the groups, although the distribution of the levels was different and was J-shaped in the hypertensive group. Plasma fibrinogen levels increased significantly with age in both groups. A significant positive correlation was found between fibrinogen and total-cholesterol levels, but not between fibrinogen and body-mass index or systolic or diastolic blood pressures. Cigarette smokers had significantly higher fibrinogen levels than non-smokers, irrespective of their blood pressure status; ex-smokers had intermediate values, suggesting a direct but reversible effect of tobacco. In cigarette smokers, fibrinogen levels increased with the number of cigarettes smoked, which is indicative of a dose-response relationship. CONCLUSION: This study confirms the strong association between fibrinogen levels and smoking and the weaker association with age and total-cholesterol levels. Mean fibrinogen level was not significantly related to blood pressure, although the distribution of fibrinogen levels appeared to be J-shaped in hypertensive men.

Adolescent↗
PubMed1994

Associations between plasma fibrinogen levels and cardiovascular risk factors in hypertensive men.

BACKGROUND: Fibrinogen levels are reported to be elevated in hypertensive patients and tend to cluster with nearly all other established cardiovascular risk factors. The aim of this study was to evaluate the relationship between plasma fibrinogen and a number of other cardiovascular risk factors in patients with essential hypertension. METHODS: We studied 118 men with essential hypertension, aged 18-65 years. The clinical evaluation included measurements of blood pressure (mercury sphygmomanometer, Korotkoff I and V), levels of plasma fibrinogen, total cholesterol, high-density-lipoprotein (HDL) cholesterol, triglycerides and blood glucose and the ratio of total-cholesterol to HDL-cholesterol levels; a detailed history of medical and personal habits was also recorded. RESULTS: As expected, plasma fibrinogen levels were significantly higher in smokers than in non-smokers, with the number of cigarettes smoked correlating positively with the fibrinogen level. Patients with a total-cholesterol level in excess of 220 mg/dl had significantly higher fibrinogen levels, and both univariate and multivariate analyses showed total-cholesterol and fibrinogen levels to be positively correlated. A weaker but significant relationship was noted between the fibrinogen level and triglyceride levels (P = 0.0017) and between the fibrinogen level and the ratio of total-cholesterol to HDL-cholesterol levels (P = 0.0006). Fibrinogen levels were not significantly associated with either systolic or diastolic blood pressures. CONCLUSION: A family history of hypertension appears to potentiate the tendency of fibrinogen to cluster with other cardiovascular risk factors in hypertensive patients.

Adolescent↗
PubMed1994

Occupational noise exposure and blood pressure.

OBJECTIVE: To investigate the relationship between occupational noise exposure and blood pressure. METHODS: We studied 8811 workers at a metallurgical factory, who were exposed to different levels of noise at the worksite: < or = 80 dB for 8078 workers and > 80 dB for 733 workers. A clinical examination, including measurements of blood pressure (by mercury sphygmomanometer, Korotkoff phases I and V), heart rate (by pulse palpation), body weight and height, was performed. The subjects were stratified into four age groups (18-30, 31-40, 41-50 and > 50 years) and into two body mass index groups: normal weight (< or = 25 kg/m2) and overweight (> 25 kg/m2). In order to eliminate possible confounding factors and statistical bias, a retrospective case versus control analysis was also carried out. RESULTS: The epidemiologic approach showed that the systolic blood pressure (SBP) but neither the diastolic blood pressure (DBP) nor the heart rate values were statistically higher in the group who were exposed to noise levels of > 80 dB, although the difference could be considered clinically relevant only in the older age group. The prevalence of hypertension (according to World Health Organization criteria) was higher among the workers who were exposed to the higher levels of noise. Stratification for body mass index confirmed the existence of a higher prevalence of hypertension in the exposed group. The results from the case versus control analysis indicated that both the SBP and the DBP levels in the exposed group were significantly higher than those in the reference group, and confirmed the existence of a higher prevalence of hypertension in the exposed group. CONCLUSIONS: The present data suggest that occupational exposure to noise levels exceeding 80 dB may lead to a higher prevalence of hypertension and to increased blood pressure values, although the results appear quantitatively different according to the approach that is taken to the problem (i.e. the epidemiologic or the case versus control approach).

Adolescent↗
PubMed1993

Neuropsychological abnormalities in AIDS and asymptomatic HIV seropositive patients.

Neuropsychological and immunological parameters were studied in 36 AIDS patients with early disease and without clinical, laboratory, and neuroradiological signs of CNS impairment, and also in 33 asymptomatic HIV seropositive subjects. Many AIDS patients performed abnormally on timed psychomotor tasks, tasks involving sequencing and "set-shifting", and memory tasks stressing attention, learning, active retrieval, and monitoring of information. Asymptomatic HIV seropositive subjects as a group did not perform significantly worse than controls. However, on the basis of a cut off number of pathological performances on neuropsychological tasks, 52.8% of AIDS and 30.3% of asymptomatic HIV seropositive subjects had cognitive impairment, compared with 3.9% of HIV seronegative controls. Low values of CD4+ cells and of CD4+/CD8+ ratio and high titres of P-24 antigen in the blood prevailed among subjects with cognitive impairment, especially in the asymptomatic HIV seropositive group.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Small hepatocellular carcinoma: MR follow-up of treatment with percutaneous ethanol injection.

To assess the potential role of magnetic resonance (MR) imaging in the follow-up evaluation of small hepatocellular carcinoma (HCC) treated with percutaneous ethanol injection (PEI), 31 patients with a single HCC lesion less than 3.0 cm in diameter underwent MR imaging at 0.5 T before and after treatment. Posttreatment follow-up included contrast material-enhanced computed tomography (CT) and fine-needle biopsy in all cases. The most important characteristic of the treated HCC lesions was hypointensity on T2-weighted MR images in cases (27 of 31) in which complete tumor necrosis was achieved with PEI. This feature corresponded to a nonenhanced, low-attenuation area on follow-up contrast-enhanced CT scans. Four HCCs were positive for malignant cells at 6-month fine-needle biopsy; in these lesions, residual tumor tissue was of high signal intensity on T2-weighted MR images and of high attenuation on contrast-enhanced CT scans. In each case, incomplete tumor necrosis was confirmed at pathologic examination of the surgical specimen.

Aged↗
PubMed1992

Pharmacokinetics of nicorandil in patients with normal and impaired renal function.

The pharmacokinetics of oral nicorandil 20 mg 12 hourly for 9 doses was evaluated in 21 hospitalized patients with angina pectoris due to coronary heart disease and with normal and impaired renal function. Patients were divided into 3 groups based on creatinine clearance (CLCr): GROUP I (n = 6) greater than 80 ml/min, GROUP II (n = 8) 20-80 ml/min, and GROUP III (n = 7) less than 20 ml/min. After the first dose, the total clearance of nicorandil (CL) value did not change with increasing renal failure and so was not dependent on creatine clearance. After the last dose CL was 51 l.h-1 in Group I, 44 l.h-1 in Group II and 56 l.h-1 in Group III, and it was not related to creatinine clearance. The percentage of the dose excreted in the urine was 0.4%. No significant difference was noted in any of the other pharmacokinetic parameters examined in the three groups, not even on comparing values obtained on the first and last days of treatment. The findings suggest that there is no need to change the dose of nicorandil in subjects with different degrees of renal failure.

Administration, Oral↗
PubMed1992

Myometrial invasion by endometrial carcinoma: assessment with plain and gadolinium-enhanced MR imaging.

A prospective study was designed to determine the sensitivity and specificity of nonenhanced T2-weighted and contrast material-enhanced T1-weighted magnetic resonance (MR) imaging in assessing the depth of myometrial invasion in patients with proved endometrial cancer. In 56 consecutive patients with clinically determined early-stage disease, findings of the two MR imaging techniques were compared with results of histologic examination of surgical specimens. Myometrial invasion was classified as absent (stage IA), superficial (stage IB), or deep (stage IC). In the assessment of each tumor stage, the sensitivity and specificity of contrast-enhanced T1-weighted MR imaging were higher than those of non-enhanced T2-weighted MR imaging. In determining the degree of myometrial tumor invasion, the overall sensitivity of enhanced T1-weighted MR imaging was 87.5%, whereas that of nonenhanced T2-weighted MR imaging was 71.4% (P less than .05). The use of contrast material may improve the ability to assess, with MR imaging, the depth of myometrial invasion by endometrial cancer.

Adult↗
PubMed1992

Recombinant human erythropoietin reduces free erythrocyte protoporphyrin levels in patients on chronic dialysis.

We studied the significance of free erythrocyte protoporphyrin (FEP) in relation to iron status, aluminum levels and anemia in uremic patients on chronic dialysis. All but 1 patient showed high FEP values closely related to the degree of anemia. Increased FEP levels are due to a defective heme synthesis, not related to iron deficiency or aluminum overload. Treatment of anemia with recombinant human erythropoietin reduced FEP values. We therefore hypothesize that recombinant human erythropoietin ameliorates an enzymatic defect in heme synthesis.

Aluminum↗