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Biomedical subjects

G Zamboni

Publications and source records attributed to G Zamboni.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

[Bioethics, deontology, and law in neonatal intensive care].

Neonatal intensive care has greatly improved the survival chances but, at the same time, it has also given rise to serious ethical problems. Different contexts influence both physicians attitude and end-of-life practices in neonatology. The clinicians can not ever follow the principles of bioethics, as they are sometimes in conflict. Also, the strategies or guidelines proposed as approaches to neonatal decision-making are difficult to practise. Probably a neonatologist makes his decision even on the basis of his interior conviction and it is well known that in Italy the debate on bioethics is the subject of confrontation between Roman Catholic and secular viewpoint, expressing two positions: the so-called sanctity and the quality of life. However, a clinician has also an obligation to follow the Code of Professional Medical Ethics which cautions against therapeutic aggressiveness; but this document has not legal status. In addition, Italian law is strongly protective of infant life and any discrimination on the basis of malformation or poor prognosis violates constitutional law; moreover, the resuscitation of a preterm infant is mandatory even when the birth is the result of induced late abortion. The author concludes emphasizing the importance, in decision making, of accepting difference as opposed to the logic of the absoluteness of normality, because many handicaps may be accepted and a society expresses its moral richness also by the solidarity reserved to its weakest sons.

Bioethics↗
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[Metahemorrhagic adrenal pseudocysts: our experience].

Hemorrhagic adrenal cysts are a pathologic entity rarely described in literature. In this paper we present two cases of hemorrhagic adrenal cyst and we discuss about diagnosis and therapy.

Adrenal Gland Diseases↗
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[Recent findings on the etiopathogenesis of multinodular goiter. I. Immunoglobulin stimulation of thyroid growth].

This present review of the literature deals with the possible autoimmune genesis of the multinodular goiter. Some investigators have identified an immunoglobulin stimulating specifically the growth of the thyroid gland (TGI) in the sera of patients affected with sporadic goiter, quite different from TSI, involved in Graves' disease. Other authors report divergent results; however there are many methological differences in these studies that give rise to controversies about the evaluation of the data. At present, these studies have failed to demonstrate consistently an autoimmune genesis of multinodular goiter.

Autoantibodies↗
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[Recent findings on the etiopathogenesis of multinodular goiter. II. Thyroid growth factors].

In the last ten years several experimental data have suggested that growth factors may play an important role in modulating thyroid growth and function. Epidermal Growth Factor (EGF) is present in large quantities in thyroid tissue, where it appears to stimulate DNA synthesis and inhibit cellular function. Insulin-like Growth Factors (IGFs), Interleukin I (IL-I) and Fibroblast Growth Factor (FGF) show the same stimulation on cell proliferation. On the contrary Transforming Growth Factor beta (TGF-beta) and somatostatin display inhibitory effects on follicular growth. Therefore it is likely that growth factors' altered production and/or their receptors abnormal expression on the thyroid cells surface might be involved in the development of multinodular goiter and some thyroid neoplasms.

Epidermal Growth Factor↗
PubMedDate not supplied

[The lipid model in hemodialyzed patients].

In the context of metabolic alteration in dialysis patients the Authors have studied the characteristics, incidence, pathogenesis, effect of dialysis, atherogenic risk and therapeutic approach to hyperlipemia in hemodialysis patients. Hypertriglyceridemia secondary to reduced lipolytic activity is the most frequent alteration observed in hemodialytic patients (36.7% of cases). In addition, hemodialysis reduces the levels of lipoprotein in the blood whereas the atherogenic role of hyperlipemia does not appear to be as important as that of arterial hypertension and smoking. Simvastatin breaks down the lipidic fractions which are involved in atherogenesis and coronary cardiopathy, thus acting as a valuable prevention against cardiovascular involvement in dialysis.

Adult↗
PubMedDate not supplied

A neurochemical approach to the study of sleep.

Sleep deprivation and recovery induce, in the hypothalamic preoptic region of the rat, opposite changes in cyclic AMP concentration which, when plotted in the standard form of the normal distribution, define two significantly divergent distributions. Thus, these opposite functional conditions may be related to corresponding changes in a biochemical parameter within an area involved in the control of the sleeping-waking cycle.

Animals↗
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[Endocrine-gynecological problems in female adolescents].

Adolescence is usually defined as the period of rapid physical and psychological growth and development occurring during the second decade of life. After the introduction about the physiology of puberty and menstrual cycle, the major problems in female adolescents are discussed: delayed puberty, hypo and hypergonadotropic hypogonadism, causes of primary and secondary amenorrhea, menstrual irregularity, dysfunctional uterine bleeding, dysmenorrhea, breast disorders, hirsutism, acne. Finally, adolescent pregnancy prevention and contraception are discussed. The Authors want to stress the importance of the endocrinological and gynaecological disorders in female adolescents and their impact on the psychological and emotional development at this very delicate age.

Acne Vulgaris↗
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Papillary cystic neoplasm of the pancreas: radiological findings.

We report a series of 10 papillary cystic neoplasms of the pancreas evaluated in our institution. The lesions are analyzed in retrospect to define the existence of eventual specific imaging patterns as well as to point out the existing problems of differential diagnosis versus other pancreatic tumors.

Adolescent↗
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[Normal pubertal development].

Puberty, the period of transition between childhood and adulthood, is the result of sequential changes in endocrine activity determined largely by genetic factors. The process is controlled by a number of complex neuroendocrine factors for its onset as well as its progression to full sexual maturity. The Authors summarize the morphological, biometric and hormonal changes and the factors of neuroendocrine control of puberty.

Adolescent↗
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[Acceleration of pubertal development].

Sexual precocity is defined as the appearance of physical signs of puberty at a time -3 SD before the mean age for the population, that is before 8 years for girls and 8.5-9.0 years for boys. The Authors discuss about etiology, therapeutic approach, indications for treatment, results and still open problems in this condition. From the pathogenetic point of view disorders that induce sexual precocity can be classified as gonadotropin-releasing hormone (Gn-RH) dependent or Gn-RH independent. Premature activation of the hypothalamic Gn-RH pulse generator may be induced by malformations, tumours and other neurogenic lesions of the CNS, while in more than 70% of patients the primary factor is not identifiable (idiopathic form). Idiopathic true precocious puberty is more frequent in females, whereas in males CNS lesions, especially neoplasms, are more prevalent. The main aims of therapy in precocious puberty are to inhibit puberty, to stop and possibly reverse the progression of secondary sex characteristics and particularly menses, to slow down skeletal maturation, to delay epiphyseas closure and consequently to improve final height, to preserve fertility, to improve psycho social well-being and naturally to treat the underlying cause, when known. Gonadotropin-releasing hormone agonists (Gn-RHa) are now the therapy of choice when the disease is Gn-RH dependent. They are effective both in arresting pubertal development and in improving final adult height. In selected cases with a great reduction of growth velocity an association with hGH therapy is possible. We must pay special attention to bone mineralization with this kind of treatment at this very delicate age.

Adolescent↗
PubMedDate not supplied

[Delayed puberty].

Delayed puberty can be defined as the absence of any signs of puberty in subjects that have attained an age at the upper limit (+2DS) for the onset of puberty, that means 13 years in girls and 14 years in boys. The causes of delayed puberty can be classified into three groups, functional temporary impairment in gonadotropin and sex steroid secretion (most frequently constitutional delay of puberty), hypothalamo-pituitary failure with deficiency in gonadotropin secretion, primary gonadal failure with increased gonadotropin levels. The Authors discuss about etiology, diagnostic testing and therapeutic approach in these conditions. The majority of children with delayed puberty are males that have only a constitutional delay of growth and puberty. It is difficult, in teenage years, to distinguish this common and benign condition from true gonadotropin deficiency, in spite of the variety of endocrine tests developed for this purpose. Individuals with constitutional delayed puberty with a bone age greater than 11.5 years, show after triptorelin stimulation an increase in LH capable of distinguishing them from patients with gonadotropin deficiency. In our opinion this could be an important screening test to exclude gonadotropin deficiency in boys with delayed puberty.

Adolescent↗
PubMedDate not supplied

[Sex differentiation and its anomalies].

Sex determination and differentiation is a sequential process that involves genetic, gonadal, phenotypic and psychological sex. Sex determination is primarily testis determination. The primary event is differentiation of the gonad; all subsequent sexual differentiation is hormonally controlled. The Authors present a classification of abnormal sexual development and consider the errors of primary sex differentiation (anomalies of sex chromosomes and of gonadogenesis) and the errors of sexual differentiation (inadequate masculinization of genetic male and virilization of genetic female). At the end the clinical approach to disorders of sexual differentiation is briefly considered.

Androgen-Insensitivity Syndrome↗