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Biomedical subjects

M Bianchi

Publications and source records attributed to M Bianchi.

At least 433 records · Page 24Linked to original sources
PubMedDate not supplied

Cytokines and cognitive function in mice.

A bidirectional flow of informations exists between the central nervous system and the immune system. Cytokines play a crucial role in this communication and exert several neuromodulatory actions. This short review considers some data concerning the effects of several cytokines, interleukin (IL)-1, IL-2, IL-6 and granulocyte-macrophage colony-stimulating factor on scopolamine-induced amnesia for a passive avoidance response, and on hippocampal neurotransmitter amino acid levels in mice. We interpret these behavioral and biochemical observations to indicate that the cytokine-to-brain communication can result in alterations in brain functions.

Amnesia↗
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Physical impairment and social life goals among adult long-term survivors of childhood cancer: a population-based study from the childhood cancer registry of Piedmont, Italy.

AIMS AND BACKGROUND: The study describes the health status and the attainment of life goals in the adult survivors of childhood cancer recorded at the Childhood Cancer Registry of Piedmont. METHODS AND STUDY DESIGN: A postal questionnaire was sent to the general practitioner of the 690 cases born before 1976 and alive in 1991 after at least 5 years from diagnosis. The answer was received for 485 (72.9%) included in the analyses. Items in the questionnaire were: sequelae related to cancer and its treatment, health-related quality of life (according to Bloom's criteria), educational level attained, and employment status. RESULTS: Vital and marital status were obtained for all 690 cases at the offices of the town of residence. No medical condition was reported for 309 cases (63.7%). The overall proportion with a high school or university education was compared to corresponding figures for Piedmont in 1991, adjusted by age, and was as high as in the general population. Similar results are observed for occupation. Patients of both genders were married less than expected. Patients with leukemia (112 cases), non-Hodgkin's lymphoma (34) or Hodgkin's lymphoma (52) were reported to have the highest quality of life. In contrast, patients with tumors of the central nervous system (151) had the highest frequency of sequelae and the lowest score for health-related quality of life. They-also presented the lowest educational achievement, the lowest proportion of employment and, among males, the lowest frequency of marriage. CONCLUSIONS: Our study shows a good social adjustment of adult survivors from childhood cancer, with the exception of central nervous system tumors. From the methodologic point of view, the present study shows the feasibility of surveillance surveys on health-related quality of life with the contribution of general practitioners.

Adolescent↗
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Acute tears of the posterior cruciate ligament: clinical study and results of operative treatment in 27 cases.

Twenty-seven knees (in 27 patients) operated on for acute posterior cruciate ligament tears at the Istituto Ortopedico "G. Pini" of Milan from 1974 to 1979 are documented according to injury, type and degree of instability, surgical technique, and treatment. Materials for this study came from clinical evaluations, roentgenograms, and operative observations. Inability to obtain follow-up data eliminated two cases from the results. Followup on the other patients ranged from 2 to 5 years and consisted in part of individual interviews conducted after reintroduction into working and sporting activity. Three separate gradings of the results were assessed: objective, subjective, and functional. The overall results in the objective category were 48% good, 44% fair, and 8% poor. Functional gradings were 55% good and 45% fair, while subjectively patients reported 70% good and 30% fair results.

Adolescent↗
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Plasma and synovial fluid concentrations of nimesulide and its main metabolite after a single or repeated oral administration in patients with knee osteoarthritis.

The aim of this study was to evaluate plasma and synovial fluid concentrations of the non-steroidal anti-inflammatory drug nimesulide and its major metabolite (hydroxynimesulide, M1), after a single 100 mg dose of nimesulide and a repeated (14 day) administration, 100 mg twice a day, in patients with osteoarthritis of the knee and joint effusion. Nimesulide was rapidly absorbed in plasma and distributed in synovial fluid. On day 1, effective concentrations were present 30 min after the first dose and on day 14, the synovial fluid concentration of nimesulide was significantly higher than that measured on day 1; no accumulation was observed in plasma. After 14 days of treatment, both the plasma and synovial fluid concentrations of M1 were significantly higher than those measured on day 1. These data may help to explain the rapid onset of the analgesic effect of nimesulide demonstrated in several clinical conditions, including painful osteoarthritis.

Administration, Oral↗
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Detection of Cryptococcus neoformans capsular polysaccharide antigen in asymptomatic HIV-infected patients.

Serum samples from 242 HIV-positive persons were studied for the detection of capsular polysaccharide antigen of Cryptococcus neoformans; 193 of these patients presented less than 300 CD4+ cells/microliters of blood and 49 patients had more than 300 CD4+ cells/microliters. None of them had symptoms or signs characteristic of cryptococcosis. The capsular antigen of C. neofarmans was detected by latex agglutination technique with pronase pretreatment (IMMY, Crypto-Latex Antigen Detection System, Immunomycologics Inc., OK, USA); in 61% of the samples, ELISA technique was also used (Premier, Cryptococcal Antigen, Meridian Diagnostic Inc., Cincinnati, Oh, USA). The comparative study of both methods showed that the results obtained were similar in 96.9% of the cases. The capsular antigen was detected in 13 out of 193 (6.7%) patients with less than 300 CD4+ cells/microliters. Cryptococcosis was confirmed mycologically in 3 of these 13 cases (23%) by the isolation of C. neoformans in CSF or blood cultures. Three patients, who had presented negative results of both tests for capsular antigen, suffered disseminated cryptococcosis 4 to 8 months later. The predictive diagnostic value of capsular antigen detection of C. neoformans seems to be low and we believe that it should not be done routinely in asymptomatic HIV-positive persons.

Acquired Immunodeficiency Syndrome↗
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[Video thoracoscopy in the diagnosis of pleural effusions].

BACKGROUND: At present video thoracoscopy is a primary diagnostic procedure in the diagnosis of pleural diseases, particularly when pleural effusions have unknown origin. METHODS: In this article the personal experience is reported about 20 patients in which video thoracoscopy was very important in the diagnosis of pleural effusions. RESULTS: Thoracoscopy permits to explore the thoracic cavity and to do a lot of biopsies. Video thoracoscopy, made it possible to diagnose 10 cases of malignant mesothelioma, 2 cases of pleural metastases (renal mts and mammary mts) and 8 cases of inflammatory diseases. CONCLUSIONS: At last, is laid on the contribution of video thoracoscopy to determine the stage of malignant mesothelioma.

Adult↗
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[Acute pancreatitis: case reports from 1992-1997. Analysis of the costs of DRG, role of ERCP in the reduction of hospitalization time].

In the period 1992-1997, 211 cases of acute pancreatitis were observed: 81 grave cases; 130 slight cases. The ERCP and endoscopic sphincterotomy were performed in 84 cases. From the critical revision 2 groups of patients emerged, homogeneous for etiology and clinical classification, the first submitted to ERCP within 72 hours from the entry in hospital; the other after 72 from the hospitalisation. The "t" Students test for small numbers was significant (p < 001) showing a decrease of hospitalisation in the submitted group to ERCP within 3 days. In 42 cases of acute pancreatitis observed in 1997 a study was made about the hospitalised patients' costs. Two homogeneous groups of acute and slight pancreatitis have been considered. The parameters analysed were about the costs of: a) days hospitalisations; b) pharmaceutical expenses; c) hematological examination; d) surgical operation, laparothomic and laparoscopic surgery; e) instrumental examination. The results of the expense have been compared with the obtained DRG, both for each single case and also for homogeneous group of grave and slight pancreatitis. This comparison showed that the obtained gain through DRG is: a) insufficient to cover the expenses of the grave pancreatitis cases; b) clearly positive in the slight cases. This last result has been very important in the final balance; in fact is only for this positive result that final balance was economically favourable.

Acute Disease↗
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[Pneumothorax secondary to pulmonary histiocytosis X].

The authors report a case of pneumothorax in a young man suffering from pulmonary histiocytosis. They take this observation as a starting point for discussing about the so-called "histiocytosis X". The term "histiocytosis" is a term for a variety of proliferative disorders of histiocytes or macrophages. There is a small cluster of conditions characterized by proliferation of a special type of histiocyte called the "Langerhans' cell". The proliferation of Langerhans' cells results from disturbances in immunoregulation. Particularly, there are three clinicopathologic entities: *Letterer-Siwe disease (acute disseminated Langerhans' cells histiocytosis), *multifocal eosinophilic granuloma or Hand-Schüller-Christian disease (multifocal Langerhans' cells histiocytosis), *unifocal eosinophilic granuloma (unifocal Langerhans' cells histiocytosis). In the past, these were collected in the not specific term of histiocytosis X. Most patients with Langerhans' cell granulomatosis have diseases limited to the lung, only a small proportion have extrapulmonary involvement or a systemic disorder. Typically, there are expanding, erosive accumulations of Langerhans' cells within the medullary cavities of bones. In this reported case, a patient, two years before, was affected by osteolytic bone lesion in the left femur. Pulmonary histiocytosis is often seen in smokers in the third and fourth decade of life. The 20% of patients are asymptomatic and found to have an abnormal chest radiograph; a lesser proportion presents with pneumothorax. Some patients develop progressive fibrotic lung disease and respiratory failure. Chest radiographs may show bilateral reticular or reticulonodular infiltrates, sometimes with cystic changes, often with sparing of the costophrenic angles, but high resolution computerized tomography scans may be virtually diagnostic based on the predilection of the cysts and nodules for the upper lung zones. Sometimes the typical Langerhans' cells may be recovered in bronchoalveolar lavage fluid of patients with active disease. The combination of the characteristic CT findings and Langerhans' cells in bronchoalveolar lavage fluid should be diagnostic, decreasing the number of cases requiring for diagnosis open lung biopsy. The differential diagnosis is with sarcoidosis, tbc, diffuse metastases, lymphoma, eosinophilic pneumonia, fibrosing interstitial pneumonia.

Adult↗
PubMedDate not supplied

The effect of 17beta-estradiol and alpha-tocopherol on the oxidation of LDL cholesterol from postmenopausal women and the minor effect of gamma-tocopherol and melatonin.

OBJECTIVE: Estrogens have a potent antioxidant effect on low-density lipoprotein (LDL) cholesterol in vitro and in vivo. A variety of compounds with antioxidant properties, such as vitamins and other hormones, also have been recommended in clinical practice to prevent several diseases related to oxidation. The aim of this study was to compare the antioxidant potency of estradiol (E2), the liposoluble vitamin E (both, alpha- and gamma-tocopherol), and melatonin. DESIGN: LDL was isolated by ultracentrifugation from the plasma of 11 healthy, untreated postmenopausal women. Aliquots containing 0.5 mg of LDL protein were incubated for 4 h with 15 microM of CuSO4 to induce oxidative stress and with one of the four compounds studied: E2, alpha-tocopherol, gamma-tocopherol, or melatonin in doses of 0, 5, 15, 50, and 500 microM and 1 and 2 mM. Malondialdehyde (MDA) was measured as a marker of LDL oxidation. RESULTS: E2 induced a dose-dependent decrease in MDA concentration (nmol/mg protein). MDA values were significantly different as compared with baseline at 5 microM of E2 (F = 47.17; p < 0.0001). Alpha-tocopherol, gamma-tocopherol, and melatonin also showed a significant decrease in MDA concentration but to a lesser degree. The reduction of MDA reached statistical significance at 50 microM with alpha-tocopherol, 500 microM with melatonin, and 1 mM with gamma-tocopherol. The antioxidant effect also reached a plateau at concentrations of 50 microM of E2 and 1 mM of alpha-tocopherol; gamma-tocopherol and melatonin did not reach a plateau at any dose tested. CONCLUSIONS: The antioxidant potency of E2 in vitro is at least 10-100 times greater than alpha- and gamma-tocopherol and melatonin. Whether this finding implies a better performance of E2 as a protective agent against oxidation-related diseases remains to be determined.

Antioxidants↗
PubMedDate not supplied

[Education of the hypertensive patient: are educational booklets useful?].

A good level of knowledge about hypertension can improve patients' compliance to treatment so achieve better therapeutic results. The aim of our study was to evaluate the degree of knowledge about their disease in hypertensives followed in a hospital out-patient unit; and whether an informative booklet could increase this awareness. The patients were presented a questionnaire on the following items: 1. their interest in health news as presented by the mass-media and their judgement on physicians' willingness to provide information about hypertension; 2. the health hazards of being hypertensive; 3. the importance of a family history of hypertension; 4. life style and blood pressure; 5. the reasons for treating hypertension and the length of treatment. Upon completion of the questionnaire, the patients were handed out a booklet in which these same topics were analyzed. At the next follow-up visit, they were invited to answer a set of questions quite similar to the first ones, but presented in a different verbal form. 200 patients completed the first questionnaire; 159, both of them. Basically, they show a high degree of correct knowledge about their disease, giving between 77% and 94% of correct answers to the different questions. After the booklet, for most of the questions the percentage of correct answers remains the same; when it does change, this is usually for the worse. Simply handing out a booklet doesn't help patients to better understand their disease. On the contrary it may have an opposite effect, inducing some degree of confusion.

Adult↗
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Endotoxin regulates the maturation of sterol regulatory element binding protein-1 through the induction of cytokines.

Endotoxin (LPS), by raising the levels of cytokines, markedly influences lipid metabolism. To clarify the molecular mechanism of this effect, we examined the action of endotoxin in vitro and in vivo on the regulation of sterol regulatory element binding protein-1 (SREBP-1). In HepG2 cells stimulated with LPS, a dose-dependent increase in the level of the mature form of SREBP-1 was observed. For in vivo studies, endotoxin was administered intraperitoneally to CD1 mice fed with a standard or a cholesterol-enriched diet to increase the basal levels of circulating and liver cholesterol. Endotoxin raised cholesterol levels and stimulated the maturation of hepatic SREBP-1 in both normal and cholesterol-fed mice, indicating that the lipogenic effect of LPS was independent of endogenous sterol levels. To assess whether the lipogenic effect of endotoxin was linked to cytokine production, we administered LPS to C57Bl/6J endotoxin-sensitive and to C3H/HeJ endotoxin-resistant mice, which do not produce tumor necrosis factor in response to LPS. Significant induction of cholesterol levels and SREBP-1 activation was observed only in C57Bl/6J mice, indicating that cytokine production is crucial for the regulation of SREBP-1, and that the transcriptional activation of cholesterol biosynthesis may be part of the acute-phase response.

Animals↗
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[Nursing education at the university: what changes concerning nursing research?].

With regards to a modification in the nursing educational curriculum it is necessary to think about the role that the human resources duly trained in various educational levels will take within the nursing research process. Particular attention will be placed mainly on those resources who received a first level education not only to clarify the future role but also to emphasise the importance of including 'a nursing research methodology course' in their educational curriculum.

Curriculum↗
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[Nasopharyngeal carcinoma].

The authors report the case of a 62-year-old woman who underwent a course of radiotherapy for an undifferentiated nasopharyngeal carcinoma. One year later the patient developed liver metastasis and underwent liver resection. The authors review the various aspect of this tumour, which is particularly frequent in the countries of South-East Asia but is exceptional in Europe and North America, focusing on the possibility of the operative management of the liver metastasis.

Carcinoma↗
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[Surgical treatment of gastrointestinal stromal tumors: personal cases].

Surgical management of gastrointestinal stromal tumors: our experience. Gastrointestinal stromal tumors (GIST) are rare neoplasm even if they are the most common mesenchimal malignancies of the gastrointestinal tract. GIST have long been a source of confusion and controversy, in particular to define their pathological classification, preoperative diagnosis, management strategies, and prognosis. A radical resection of the tumor is often possible and always recommended. Recent studies have identified its principal pathogenic defect. An effective adjuvant therapy treatment (STI571) have been found for advanced and metastatic GIST.

Antineoplastic Agents↗
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Preliminary study on oncogene product immunohistochemistry (c-erbB-2, c-myc, ras p21, EGFR) in breast pathology.

The expression of oncogene products related to cell growth (c-erbB-2, c-myc, ras p21, EGFR) was investigated in benign (15 cases) and malignant breast lesions (20 cases) by means of immunohistochemistry using the avidin-biotin-peroxidase technique with polyclonal and monoclonal antibodies. The aim of this study was to evaluate the relationship between the staining positivity and various morphological and biological features, such as tumour type, grading, hormone receptor status and cell kinetic parameters. In benign breast lesions, as expected, the kinetic parameters were low, both for Ki-67 and LI. All the specimens showed a diploid condition (the DI being equal to 1) and we found a limited degree of immunoreactivity for all the growth factors and oncogene products. In breast cancer we studied the distribution of immunohistochemical positivity for EGFR, c-erbB-2, c-myc, ras p21 and Ki-67, which was related to age, nodal status, ER and PgR receptor status, LI, DI and histopathological grading. A significant positive correlation was found both between ras p21 expression and nodal status and ER-ICA positivity. We observed a strong correlation between LI and Ki-67 and an inverse relation between Ki-67 and ER expression. These findings suggest the importance of studying the relationship between prognostic factors which may provide preoperative prediction in the biological behaviour of breast cancer, not only on biopsy specimens, but also on fine needle aspirates.

Adult↗