Biomedical subjects
Publications and source records attributed to M Ferri.
After a short survey of pathogenetic hypotheses for pancreatitis during papillary lithiasis, stress is laid on the importance of the use of the microscope in peroperative diagnosis of infundibulo-papillar pathology and in the surgery of distal Wirsung.
A case history is reported of a spontaneous, nontraumatic, hemoperitoneum in an eleven year old girl. The onset, the accompanying symptoms and the clinical course, mimicked those of acute appendicitis. However the etiology was found to be the spontaneous rupture of a cavernous hemangioma of the omentum. Only one other similar case has been reported in the literature.
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The use of totally implantable right atrial catheters was evaluated in pediatric oncology patients. From September 15, 1987 to March 31, 1989, 26 catheters were inserted in patients (1 year to 20 years of age) with the following diagnosis: acute leukemia (6), osteosarcoma (5), lymphoma (4), central nervous system tumors (6), osteosarcoma (5), lymphoma (4), central nervous system tumors (6) and other solid tumors (5). Total number of catheter days was 5,475. The catheters were maintained for a mean of 210 days (range 10-534). Complications included: documented local infection in 1 patient, successfully treated with antibiotics without removing the catheter and transient obstructions resolved with injection of heparin or urokinase in other children. The use of these right atrial catheters has been widely accepted by patients and families as well as by the health team. Complications have been minimal. Our experience confirms that these catheters contribute to improving quality of life in pediatric patients with neoplasms.
Twenty four men with insulin dependent diabetes and different degrees of autonomic neuropathy were studied to establish the response of the QT interval to various heart rates. Nine men with autonomic neuropathy had a longer QT interval than 13 healthy individuals and 15 patients who had diabetes without, or with only mild, autonomic neuropathy. Those with autonomic neuropathy also had a proportionally greater lengthening of the QT interval for a given increase in RR interval. The results of this study suggest a basis for the finding that sudden death is more common in patients with diabetic autonomic neuropathy.
A clear difference in survival among the patients affected by gastric cancer has been observed worldwide between Early Gastric Cancer (EGC) and Advanced Gastric Cancer (AGC). Optical fiber endoscopy has allowed a sharp increase in the number of diagnoses of EGC since the sixties. Among 182 our patients operated on, 19 [10.4%] had an EGC. A difference in incidence was found between males and females, while no difference was found in the age distribution. The main symptom was epigastric pain; EGCS common findings were ulceration or a flat tumor. Surgical procedures were carried out with the same criteria used for AGC. No difference was found in the tumor location. Local spread was studied according to the Japanese Research Society for Gastric Cancer, while histological type was classified according to Lauren classification. Crude 5-year survival was 80% (8 out of 10), with a mean of 76.8 +/- 13 (SEM) months.
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To differentiate between the possible reflex and mechanical components in the heart rate response to cough, eight healthy subjects performed a standardized cough test before and after pharmacological autonomic blockade; to test the clinical usefulness of the cough manoeuvre two groups of diabetic patients (without and with autonomic neuropathy) were compared with a group of age-matched normal subjects. Because of the use of abdominal and expiratory muscles during cough, the cardioacceleratory response was compared with that induced by an intense contraction of the arm muscles (handgrip). The cardioacceleratory response was completely abolished by atropine while propranolol failed to affect it. The diabetic patients with autonomic neuropathy showed a response similar to that after cholinergic blockade. The response was similar to that induced by muscular contraction for 4 s, after which it differed showing a continued cardioacceleration. The patterns of recovery were not different. The cough-induced cardioacceleration is essentially reflex in nature and under cholinergic control; initially the mechanism may be partially related to the intense contraction of abdominal and expiratory muscles; later, the arterial hypotension related to the cough may contribute to the more sustained shortening of the R-R interval. The cough test may be useful for the evaluation of cardiac parasympathetic integrity.
The in vitro activity of ofloxacin, a new broad-spectrum antimicrobial agent, was studied by a standardized single disc method. A total of 990 clinical isolates were tested, including 20 strains of anaerobic bacteria. Ofloxacin was highly active against 683 strains (70.41%), had intermediate activity against 109 (11.23%) and had no activity against 178 (18.35%). Ofloxacin was highly active against E. coli, Klebsiella sp., Citrobacter sp., Proteus mirabilis, Proteus morganii, Salmonella sp., Campylobacter jejuni, Haemophilus influenzae, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Eubacterium sp., Propionibacterium acnes and Streptococcus sp. Pseudomonas sp., Serratia sp. and Proteus vulgaris had percentages of resistance to ofloxacin of 37.11%, 32% and 33.33% respectively. High percentages of resistance to ofloxacin were found only for Providencia sp., Proteus rettgeri and Bacteroides fragilis. With regard to Streptococcus faecalis, the results obtained with the disc procedure were not reliable and MIC determination was necessary to assess the behaviour of the drug.
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To evaluate the influence of good metabolic equilibrium on Diabetic Autonomic Neuropathy (DAN), cardiovascular autonomic reflexes were monitored in 9 male insulin-dependent diabetic patients with DAN, treated with Continuous Subcutaneous Insulin Infusion (CSII) by pump: 9 for 10 days, 4 for 1 year and 2 for 20 months. Autonomic neuropathy was assessed evaluating 5 cardiovascular autonomic tests: Valsalva Manoeuvre (VR), Deep Breathing (DB), Lying-to-Standing (L-S), Sustained Handgrip (SHG), and Postural Hypotension (PH). Metabolic control was assessed evaluating the mean daily plasma glucose, glucosuria and glycosylated hemoglobin. Ten days of CSII treatment induced a normalization of glucose balance and a slight but significant improvement in some parasympathetic cardiovascular tests (VR: from 1.09 +/- 0.01 to 1.13 +/- 0.02; P less than 0.05). After 4-8 months of CSII treatment a significant improvement in VR (P less than 0.05); DB (P less than 0.01) and L-S (P less than 0.05) was recorded. The long-term treatment with CSII did not seem to induce a further amelioration in cardiovascular autonomic reflexes. These results show that the slight improvement induced by good metabolic balance in the cardiovascular autonomic response could be related to functional-metabolic rather than structural changes in the nerves.
Treatment of peptic ulcer in "non-responders" with the combination of pirenzepine and cimetidine was evaluated in a longterm study. Patients who did not respond to two months of treatment, first with cimetidine (1 g/day), and then pirenzepine (150 mg/day), were given one of these two compounds alone for 6 months or a combination at lower doses for 24 months. The combination of pirenzepine (75 mg/day) and cimetidine (400 mg/day) was successful in a high percentage of cases, and showed fewer side effects than in the single treatment groups. The effectiveness of the combination treatment might be due to its more significant anti-secretory effects.
Cardiovascular (CV) autonomic functions were assessed in 50 insulin-dependent diabetic patients and in 30 controls using a battery of autonomic tests: Valsalva Manoeuvre (VR), Deep Breathing (DB), Lying-to-Standing (LS), Sustained Handgrip (SHG) and Postural Hypotension (PH). The results were compared with those obtained from a study of cardiac resting adjustment to different static postures (quiet lying and standing). 10 diabetics with abnormal responses to the majority of tests were considered affected by Diabetic Autonomic Neuropathy (DAN); 15 with some abnormal of borderline responses were defined much less than Borderlines much greater than. The remaining 25 diabetics, while displaying lower values than the controls in parasympathetic tests, had much less than normal much greater than autonomic responses. The VR mean (+/- SD) value was 1.71 +/- 31 in much less than normal much greater than diabetics and 2.01 +/- 0.29 in controls (p less than 0.001); the DB mean value was 20.6 +/- 87 and 28 +/- 8.13 (p less than 0.001), and the LS mean value 1.16 +/- 0.12 and 1.33 +/- 0.18 (p less than 0.001) respectively. No significant differences were found in the sympathetic tests (SHG, PH). However Heart Rate (HR) adjustment of diabetics with normal CV responses to immobile standing (RR mean 783 +/- 136 ms) and lying (RR mean increment of 25 +/- 11%; p less than 0.001) was similar to that of controls who had a resting HR standing (RR mean 749 +/- 104 ms) and lying (RR mean 884 +/- 116 ms) with a mean increment of 20.2 +/- 10.9% (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Near-normal plasma daily glucose profile was induced by Continuous Subcutaneous Insulin Infusion (CSII) treatment in order to evaluate its influence on diabetic somatic and autonomic neuropathy. Twelve insulin-dependent diabetic subjects with somatic neuropathy were studied before and after a short term CSII treatment of 10 days. Four out of these subjects, all affected by autonomic neuropathy, were followed for 1 yr with controls every four months. Metabolic equilibrium was monitored by mean daily plasma glucose (MPDG) profile and by Glycosylated Hemoglobin (GHb) evaluation. Somatic neuropathy was studied assessing conduction velocity at peroneal motor (PMCV) nerve, ulnar motor (UMCV), ulnar sensory (USCV) and sural sensory (SSCV) nerves. Autonomic neuropathy was assessed by means of a battery of five cardiovascular autonomic tests: Valsalva Manoeuvre (VR), Deep Breathing (DB), Lying-to-Standing (LS), Sustained HandGrip (SHG) and Postural Hypotension (PH). Short-term CSII treatment induced a near normalization of metabolic parameters, a significant improvement in VR (p less than 0.05) and DB (p less than 0.01) values, but no changes in NCV. The prolongation of CSII treatment in 4 subjects induced a significant (p less than 0.05) improvement in VR, DB and LS values and in PMCV and UMCV after 4 months. This improvement did not increase with the longer CSII treatment (1 yr).(ABSTRACT TRUNCATED AT 250 WORDS)
Cardiovascular autonomic reflexes were evaluated in 13 male subjects affected by Multiple Symmetric Lipomatosis (MSL) and the results were compared with those obtained in 13 age-matched male controls and in 16 male heavy drinkers matched with the MSL group for age and alcohol intake. Valsalva Manoeuvre (VR), Heart Rate variations on Deep Breathing (DB) and R-R intervals 30/15 ratio during Lying-to-Standing (LS) (tilting), were used as primarily parasympathetic tests. As primarily sympathetic tests, we assessed the increment of diastolic blood pressure in Sustained Handgrip (SHG) and the fall of systolic blood pressure on standing (Postural Hypotension = PH). Mean values of VR and DB were significantly (P less than 0.001) lower in MSL subjects than in controls and heavy drinkers. Mean LS values were significantly lower in MSL subjects (P less than 0.001) and in heavy drinkers (P less than 0.01) in relation to controls. No significant differences were observed in the 3 groups of subjects regarding the mean values of PH and SHG. The results suggest that MSL is characterized by an impairment of autonomic function. This impairment seems to be prevalently parasympathetic and not related to a high alcohol intake.
Partially hepatectomised rats have been exposed immediately after surgery and every 12 hours thereafter to pulsed extremely low frequency electromagnetic fields. Stereological analysis performed on electron micrographs has shown that the treatment limits the depletion of liver glycogen found in control untreated rats within the first post-operative day. The massive accumulation of lipid droplets found in control rats is also limited to about one half by exposing the animals to pulsed magnetic fields. The time taken for glycogen and lipid content to recover to values found at zero time decreases from seven to five days in animals undergoing treatment with pulsed electromagnetic fields. The liver wet weight and the total protein content show a pattern of changes which is consistent with the behaviour of glycogen and lipid content. Five days after operation the treated rats reach the values found at zero time, while control animals need seven days to reach the same values.