Biomedical subjects
Publications and source records attributed to L Leo.
In literature there have been only 8 cases of unavoidable laparotomy due to uterine leiomyomas performed in patients with breast cancer on Tamoxifen (TAM). Our article describes two cases of rapidly growing leiomyomas in patients treated with TAM: one of these underwent abdominal hysterectomy while the second stopped taking TAM and began therapy with Triptorelin. This therapeutical alternative could be a useful choice.
Twelve healthy adults divided into a well-nourished (WN; n = 6) and a chronically energy deficient (CED; n = 6) groups underwent a single 30 min infusion of norepinephrine (NE) administered at the rate of 0.15 micrograms/kg fat-free mass/min. Measured parameters in the basal state and during the infusion included heart rate (by electrocardiograph), stroke volume, cardiac output and other cardiac indices (by impedance cardiography) and blood pressure recordings. The data are suggestive of fairly similar cardiovascular responses in the CED and WN subjects, with the exception of cardiac inotropy (i.e. strength of cardiac muscle contractility) and changes in total peripheral resistance, both of which were enhanced in the CED. Peak NE levels of both groups during the infusion were similar and so was the clearance rate for NE corrected for fat-free mass differences. Although plasma half-life of NE tended to be higher in the CED group, plasma appearance rates of NE were comparable between the groups, suggesting that plasma NE kinetics were not altered in CED adults.
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The associations between depressive symptoms and functional disability and chronic conditions are examined in an elderly cohort of 2,806 noninstitutionalized men and women living in New Haven, Connecticut who were interviewed in 1982 as a part of the Yale Health and Aging Project. The aim is to explore several potential sources of invalidity in using the Center for Epidemiologic Studies-Depression scale (CES-D) to measure depressive symptoms in elderly populations. In particular, the authors are concerned with the possibility that prevalent physical illnesses and disabilities may cause the older person to report many somatic complaints, a major component of most measures of depressive symptomatology, and thereby inflate his or her CES-D score. Mean CES-D scores are 4.86 for those without any disabilities and range to 13.51 for those with major functional disabilities. However, physical disability is significantly associated with virtually every item on the CES-D scale not just those somatically-oriented items. The addition of functional disability to a multivariate model including age subfactor analysis of responses from this elderly sample produces results almost identical to those reported by earlier investigators who studied younger and middle-aged adults. The authors conclude that physical disabilities among the elderly do not appear to be a major threat to the validity of the CES-D scale and that the strong associations between physical and mental health should be rigorously investigated.
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In rats bled to invariably fatal haemorrhagic shock (mean arterial pressure = 18-24 mmHg), the prompt and sustained improvement of cardiovascular function, obtained with the i.v. injection of cholecystokinin octapeptide (CCK-8, 20 g/kg) is associated with a massive increase in the volume of residual circulating blood (0.69 +/- 0.12 ml/100 g b.w. in saline-treated rats; 1.61 +/- 0.09 ml/100 g b.w. in CCK-8-treated rats). The number of red cells/mm3 and the % Hb content is the same in CCK-8-treated and in control rats. So, in a condition of severe haemorrhage, otherwise incompatible with survival, the i.v. injection of CCK-8 not only induces an impressive increase in arterial pressure and in circulating blood volume, but also greatly improves tissue oxygenation.
We conducted a hospital-based case-control study of 153 patients who had been recently diagnosed with myocardial infarction; there were 157 hospital controls. All subjects were 35-70-y-old males who lived in the province of Torino (northern Italy). These individuals were nonsmokers or had quit smoking for at least 6 mo. A protective role of migration from southern Italy was found (age-adjusted odds ratio for northern versus southern origin = 1.82, 95% confidence interval = 1.0, 3.3). Although fat consumption differed greatly between those born in northern Italy and those in southern Italy (i.e., the former used mainly butter and the latter used mainly olive oil during their early lives), it did not explain the migration effect. A family history of myocardial infarction increased the risk of a myocardial infarction (odds ratio = 2.4, 95% confidence interval = 1.1, 4.9). Moderate coffee consumption also increased the risk and was not explained by the known coronary risk factors. Relative risks were up to 4 among both nonsmokers and exsmokers who drank more than 4 cups of coffee each day. We controlled for coffee drinking and found that the association with southern origin appeared strengthened.
AIMS AND BACKGROUND: Intraoperative lymphatic mapping and sentinel node (SLN) biopsy have generated a tremendous amount of interest and are already established as part of the standard practice in the surgical management of breast cancer and melanoma. To reduce extensive radical procedures and decrease the morbidity in the treatment of gynecologic malignancies, much effort is being made to use less aggressive interventions. The purpose of our study was to determine the feasibility of SLN mapping in a group of patients with endometrial cancer at early stages. METHOD AND STUDY DESIGN: Between September 2000 and May 2001 11 patients with endometrial cancer FIGO stage Ib (n = 10) and IIa (n = 1) underwent laparoscopic SNL detection during laparoscopy-assisted vaginal hysterectomy with bilateral salpingo-oophorectomy and bilateral systematic pelvic lymphadenectomy. Radioactive isotope injection was performed 24 hours before surgery and blue dye injection was performed just before surgery in the cervix at 3,6, 9 and 12 hours. A 350 mm laparoscopic gamma scintyprobe MR 100 type 11, 99mTc settled (Pol Hi Tech), was used intraoperatively for SLN detection. RESULTS: Seventeen (17) SLNs were detected with lymphoscintigraphy (six bilateral and five unilateral). At laparoscopic surgery we found the same locations belonging at internal iliac lymph nodes (the so-called Lebeuf-Godard area, lateral to the inferior vesical artery, ventral to the origin of the uterine artery and medial or caudal to the external iliac vein). Fourteen (14) SLNs were negative on histological analysis and three were positive for micrometastases (mean SLN sections = 60). All other pelvic lymph nodes were negative at histological analysis. The same SLN locations detected with the gamma scintyprobe were observed at laparoscopy after patent blue dye injection. CONCLUSIONS: Our preliminary data suggest that combined 99mTc-labeled colloid and vital blue-dye techniques are feasible for SLA detection in endometrial cancer; they represent a very promising tool to transform the management of early-stage endometrial cancer. The clinical validity of this combined technique should be evaluated prospectively.