Biomedical subjects

M Conti

Publications and source records attributed to M Conti.

At least 343 records · Page 19Linked to original sources

PubMedDate not supplied

Receptor regulation and target cell responses: studies in the ovarian luteal cell.

Studies of hormone-induced 'desensitization' in the luteinized rat ovary show that changes in receptor number and adenylate cyclase at the cell surface result in an altered biological effect of luteinizing hormone on progesterone production. The sensitivity of these effects to changes in gonadotropin levels suggests that receptor turnover or processing is involved in the normal mechanism of hormone action.

Animals↗

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Hospital-acquired myiasis.

In three years we encountered two patients with hospital-acquired myiasis, a rarely reported nosocomial problem. Both patients were elderly and had lengthy thoracic surgery in August in the same operating room. Larvae removed from the nares of one patient and from the chest incision of the other were of the same species, Phaenicia serricata. There was no evidence of tissue destruction or invasion in either case. Investigation revealed several factors that contributed to the presence of flies in the operating room. After a presumed environmental access site was closed and insecticide spraying was augmented, no additional cases occurred. This experience illustrates an unusual problem that may confront those responsible for infection control programs.

Aged↗

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Controlled vitamin K content diet for improving the management of poorly controlled anticoagulated patients: a clinical practice proposal.

The aim of our study was to investigate the effect of a diet with a known vitamin K content on the monitor test for oral anticoagulant therapy. We studied 10 poorly controlled patients (7 women and 3 men, mean age 48 +/- 15 years) in therapy with acenocoumarol for at least 1 year. Another group of 10 poorly controlled patients was considered as a control group. After a baseline period, during which a free diet was allowed, patients were administered a diet with a controlled vitamin K content; in the same period, control subjects were not subjected to any dietary restriction. Thrombotest (Nyegaard, Oslo) was employed for monitoring oral anticoagulant therapy, with a therapeutic range between 2.3 and 4.8 INR. We found a significant difference by thrombotest between the percentages within the therapeutic range obtained before and during dietary treatment (p = 0.0001). The difference in percentages was -0.31 and the 95% CI, of the difference ranged from -0.45 to -0.17. No significant difference was shown in the control group in the same periods. Our data suggest that a diet with a controlled vitamin K content is effective in increasing the percentage of tests within the therapeutic range in patients with poorly controlled anticoagulation.

Acenocoumarol↗

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Intrahepatic chemotherapy with floxuridine, leucovorin and dexamethasone in continuous infusion and mitomycin-C bolus in unresectable hepatic metastases from colorectal cancer: a phase II study.

BACKGROUND: Intrahepatic continuous infusion FUDR induces a 50% response rate in patients with hepatic metastases from colorectal cancer. Lower rates have been observed in pretreated patients. The combination of floxuridine plus leucovorin has obtained over 70% responses, with high hepatic toxicity. The use of dexamethasone can decrease hepatic toxicity. A randomized study reported an increase in response rate and a decrease in hepatic toxicity in a group of patients treated with floxuridine plus dexamethasone compared to a group receiving only floxuridine. Moreover, the combination of mitomycin C, carmustine and floxuridine is also effective in pretreated patients. METHODS: On such premises, since July 1993 we have treated 39 patients affected by unresectable hepatic metastases from colon carcinoma (26 patients) and rectal carcinoma (13 patients) with the combination continuous infusion of floxuridine (0.20 mg/kg per day) + leucovorin (7.5 mg/m2/day) + dexamethasone (20 mg on days 1 to 14) and bolus mitomycin C (10 mg/m2 on day 1) via the hepatic artery. Cycles were administered every four weeks. There were as 28 males and 11 females, with a median age of 64 years (range, 39-75) and a median PS = 0. Twenty-two patients were pretreated with systemic chemotherapy including 5-fluorouracil plus leucovorin. Total number of cycles was 189, with a median of 6 cycles per patient (range, 1-12). RESULTS: Of 39 patients 37 were assessable for response (2 patients were not assessable because they stopped chemotherapy for occlusion of the catheter after the first cycle). There were 3 complete responses (1 in a naive patient and 2 in pretreated patients), 16 partial responses (11 in pretreated patients and 5 in chemonaive patients), 4 minor responses, 4 stable disease and 10 progressive disease. The overall response rate was 51.3% (95 Cl, 51.3-86.7%). Median time to progression was 6 months (range, 1-34+). Overall survival was 18 months (range, 1-34+). Of 39 patients, 36 were assessable for toxicity (WHO) (3 patients died after the first cycle for progression of disease): diarrhea and nausea-vomiting grade 3-4 occurred respectively in 15 (41%) and 3 patients (8%); hepatic toxicity was mild. CONCLUSIONS: The treatment we used showed an elevated activity in liver metastases from colorectal cancer even in patients pretreated and resistant to systemic chemotherapy, although toxicity grade 3-4 diarrhea occurred in approximately 40% of the patients.

Adult↗

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Reverse HAGL: a possible complication of a tight anterior gleno-humeral stabilization.

Recently the posterior humeral avulsion of the glenohumeral capsule (Reverse HAGL or RHAGL) has been reported in the orthopaedic literature as another possible cause of posterior traumatic shoulder instability. In the present paper we describe three patients in whom a RHAGL was probably a consequence of a tight open anterior shoulder stabilisation. The main complaint of these patients was a stiff shoulder after an open anterior stabilisation. A progressive and worsening discomfort was reported by patients in spite of an accurate rehabilitation program. At persistence of symptoms arthroscopy was performed with evidence of RHAGL that was repaired in association with an anterior release. Clinical and functional improvement was observed but the final outcome seems to be related to range of motion recovery and not only to the posterior repair.

Adult↗

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[Sex behavior and sexually transmitted diseases in drug-dependent women: study of 465 cases].

465 intravenous drug abuser (IVDA) women were studied to evaluate the prevalence of sexually transmitted diseases, 2207 university students have been considered as control group. A complete gynecological evaluation with Pap smear and cervico-vaginal cultures were performed. Informations on sexual and behavioural patterns were collected using a standard questionnaire. IVDAs show early onset of sexual activity (15 vs. 18 yrs) and many sexual partners; just a small percentage of them use condom, efficacious in the protection against venereal diseases. These peculiar behavioural patterns and the immunodeficiency ascribable to the drug abuse may condition the high frequency of viral and bacterial infections of lower genital tract (53% vs 0.8% and 67% vs 10% respectively). Cervical intraepithelial neoplasia has been found significantly more frequently in IVDA women (16%) than in control group (1%) p less than .01.

Adult↗

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Prevention of hemoperitoneum during ovulation by oral contraceptives in women with type III von Willebrand disease and afibrinogenemia. Case reports.

The follicle ruptures at the time of ovulation and fills with blood, forming a corpus hemorrhagicum. Minor bleeding from the follicle into the abdominal cavity may cause peritoneal irritation and, when it occurs in a patient with a defect of primary hemostasis, hemoperitoneum can occur. Von Willebrand disease and afibrinogenemia are two important bleeding disorders in which both primary hemostasis and coagulation are involved. Bleeding during ovulation is one major clinical complication in women with these disease. We have studied three patients with this hemorrhagic complication. Our data show that oral contraceptives are an effective way to avoid hemoperitoneum.

Adult↗

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[Incidence of atherosclerosis of the internal mammary artery compared with the coronary artery. A study of 22 non-selected autopsy cases].

In the present work the examination and comparison of the degree of atherosclerotic involvement of the left coronary artery (CDA) and internal mammary artery (AMI) was performed on 22 unselected subjects at necroscopy examination. The maximum age was 77 and the minimal was 25 (average 62.59 +/- 2.47); 13 were male and 9 female. We macroscopically and microscopically examined three sections obtained from three different segments for each vessel. First we macroscopically evaluated the degree of narrowing of the lumen giving a score (+ to +). (Tab. II). Then the sections, 6 micron thick, stained with Haematoxylin-eosine, Alcian blue, PAS and Van Gieson methods were accurately examined at microscope with a graduated eyepiece. The lumen, the intima and the media were measured at the level of maximum thickness of the intima. Then the thickness of intima and the intima to media ratio, accordingly to the literature, were assumed as major indicators of atherosclerosis involvement. The intima to media ratio average was 5.05 (+/- 5.81) in the CDA vs. 0.44 (+/- 0.29) in the AMI (p less than 0.001). The intima in the CDA was 0.86 mm (+/- 0.76) thick (average) vs. 0.09 mm (+/- 0.07) in the AMI (p less than 0.001). These results show a great difference in atherosclerosis involvement which results to be ten times greater in CDA than in AMI in non selected people. Almost the same result is obtained by the measurement of the intima. On the contrary no detectable difference was found between the media of the two vessels.

Adult↗

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Subclinical activation of fibrinolysis in atherosclerotic disease detected by B beta 15-42 assay.

Plasma B beta 15-42 and fibrinopeptide A (FPA) concentrations, which are respectively indicators of plasmin and thrombin in vivo activity, were measured in 46 patients with ischemic arterial disease without signs of acute thrombosis. In the group as a whole, an increase in both B beta 15-42 and FPA was found. When the patients were divided in two groups on the basis of their reversible (transitory ischemic attacks and unstable angina) or irreversible (stroke and myocardial infarction) ischemic episodes, the levels of B beta 15-42 were significantly elevated only in the former group when compared to controls (p less than 0.01). In the latter group we found significantly increased levels of FPA with respect to both controls (p less than 0.01) and patients with reversible and transient ischemic episodes (p less than 0.05). Moreover, the B beta 15-42/FPA ratio was significantly lower in patients with irreversible ischemic episodes than in controls (p less than 0.01) and patients with transient ischemic episodes (p less than 0.01), while no difference was found between the latter group and controls, although FPA and B beta 15-42 were significantly higher. These results suggest that in patients with transient and reversible ischemic episodes fibrinolytic activity is able to counterbalance an increased thrombin activity, while this does not appear to occur in patients with irreversible ischemic episodes.

Adult↗

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[Prodromic syndrome and recovery time in acute myocardial infarction].

The presence of prodromic syndrome and the time between the first symptoms and the actual admission to hospital have been considered in a personal series of 644 patients with acute myocardial infarction. The applicability of a systemic thrombolysis protocol has been examined in a subgroup of 108 patients. The high percentage of patients who had prodromic syndrome (46.8%) and of patients who have been admitted in C.C.U. too late (39.2% over the sixth hour) emphasized the need of a sanitary education program in order to get faster admission times of the ischemic patients.

Aged↗

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