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Biomedical subjects

M Monti

Publications and source records attributed to M Monti.

At least 361 records · Page 20Linked to original sources
PubMedDate not supplied

Prevalence of duodenal and jejunal lesions in dermatitis herpetiformis.

Sixty-eight patients with dermatitis herpetiformis underwent jejunal suction biopsies and/or multiple endoscopic duodenal biopsies to evaluate the incidence of small bowel mucosal atrophy and to compare the diagnostic yield of the two methods. Small bowel function tests were also performed to evaluate the extent of functional impairment. Small bowel lesions were observed in 89.4% of jejunal suction biopsies and in 100% of endoscopic duodenal biopsies. Of the 10 patients who underwent both procedures, one had lesions only in the duodenum, one had more severe lesions in the duodenum than in the jejunum, while the remaining 8 patients showed identical lesions at both sites. The 1-h blood d-xylose test after a dose of 5 g proved more sensitive than xylosuria or serum folic acid assay in detecting subclinical malabsorption. Finally, histological features of gluten-sensitive enteropathy can be found in nearly 100% of patients with dermatitis herpetiformis. Upper gastrointestinal endoscopy with duodenal biopsies is at least as sensitive as jejunal suction biopsy in assessing small bowel involvement in dermatitis herpetiformis.

Adolescent↗
PubMedDate not supplied

Treatment of gonorrhea with thiamphenicol.

For many years thiamphenicol has been the drug of choice for the treatment of uncomplicated gonorrhea at the Center for Venereal Disease of the University of Milan. During the last four years, 1,110 of 1,112 cases of uncomplicated gonorrhea treated with 500 mg of oral thiamphenicol three times a day for six days have been cured. Recently, the effectiveness of single-dose treatment of uncomplicated gonorrhea with this drug was evaluated. A dose of 2.5 g of thiamphenicol was given orally to 159 patients. The diagnosis of gonococcal infection was based on culture results in all cases. In 77 cases red and white blood cell counts and hemoglobin and serum iron determinations were made before and one week after therapy. Clinical and bacteriologic cure was achieved in 144 (90.6%) of the 159 patients. The only adverse reactions to the drug were transient diarrhea in ten patients, epigastric pain in two, and vomiting in one. No statistically significant variations were detected in blood tests.

Anal Canal↗
PubMedDate not supplied

Tissue polypeptide antigen (TPA) modifications in hepatic cirrhosis, aggressive chronic hepatitis, persistent chronic hepatitis, and in minimal pathology.

A total of 104 patients with various liver diseases were studied. Hepatic biopsy was performed and the AST, ALT and TPA in serum were measured. Higher levels of TPA, AST and ALT were found in CAH and LC, lower in CPH and MHP. High serum TPA values, usually suggesting the possibility of neoplasm, should be considered with attention. A follow-up with periodic TPA assays (in addition to AST and ALT) is suggested in patients with acute hepatitis, in order to predict further possible complications such as CAH and LC.

Adult↗
PubMedDate not supplied

Sialic acid, ferritin and CEA levels in peripheral blood and blood draining from the tumor in breast cancer.

Concentrations of total serum N-acetyl-neuraminic acid, carcinoembryonic antigen, ferritin, lactate dehydrogenase, creatine phosphokinase and total proteins were measured in both tumor drainage blood (axillary vein) and in peripheral blood taken during surgery from 44 breast cancer patients. There were no significant differences in any of the markers between mean values in peripheral and tumor drainage blood, between cancer patients and healthy controls, between patients with or without axillary lymph node metastases, or according to the site of breast mass.

Adult↗
PubMedDate not supplied

Tartrate-resistant acid phosphatase (TRAP) activity in serum: potential use in assessing bone resorption in patients with multiple myeloma.

We measured serum tartrate-resistant acid phosphatase (TRAP) activity in 120 healthy subjects and 35 patients with multiple myeloma as well as urinary hydroxyproline excretion in the myeloma patients. Young subjects (0-18 years) showed higher TRAP levels (ANOVA p less than 0.01) compared with the other age classes due to the more active bone remodelling processes associated with growth. Myeloma patients with bone lytic lesions (MM+) showed higher serum TRAP values than controls (p less than 0.01). Hydroxyproline excretion was higher in MM+ patients but the difference between patients with and without bone lesions was not statistically significant. Our data suggest that serum TRAP activity may be a suitable, simple biochemical test to assess bone turnover in patients with multiple myeloma but that its clinical usefulness as a marker of bone resorption needs further evaluation.

Acid Phosphatase↗
PubMedDate not supplied

Plasma monomeric calcitonin as a marker of disease activity in multiple myeloma patients with osteolysis.

Circulating monomeric human calcitonin (hCT-M), parathyroid hormone, osteocalcin, alkaline phosphatase, urinary hydroxyproline, corrected serum calcium and inorganic phosphate were measured in 49 multiple myeloma patients and 49 matched controls. In patients with Durie-Salmon stage III disease hCT-M levels (16.9 +/- 5.8 ng/l, mean +/- SD) were significantly higher than controls and stage I patients (P less than 0.01), and correlated directly with corrected serum calcium (r = 0.74; P less than 0.001). In the same subgroup 14 of 15 patients had plasma hCT-M concentrations higher than the mean + 2SD of the controls. The calcium infusion test induced an increase of hCT-M in normocalcemic patients which was significantly greater in patients with advanced disease than in either controls or stage I patients. These findings suggest that hCT-M may be a biochemical index of bone resorption and disease activity in myeloma patients with osteolysis. In fact, its plasma concentrations were elevated in a large proportion (93%) of patients with severe bone involvement, and correlated directly with serum calcium. Moreover, our findings suggest the presence of a calcitonin-dependent calcium homeostatic mechanism, that protects against hypercalcemia due to tumor osteolysis.

Adult↗
PubMedDate not supplied

Serum levels of procollagen type I carboxyterminal extension peptide in cancer patients with bone metastases.

Serum levels of procollagen type I carboxy-terminal extension peptide (PICP) reflect the synthesis of type I collagen. As PICP is produced by osteoblasts and is not incorporated into bone matrix, serum PICP levels have been suggested as a marker of bone formation. In 37 cancer patients (21 men and 16 women; age: 72.4 +/- 8.6 (mean +/- SD) years) with bone metastases and 23 women (age: 77.3 +/- 6.64 years) as controls, the following biochemical variables were measured: serum PICP, calcium (Ca), phosphorus, alkaline phosphatase (AP) and tartrate-resistant acid phosphatase (TRAP), and urinary hydroxyproline and calcium corrected for creatinine excretion. Higher serum levels of PICP were observed in cancer patients than in control (245 +/- 177 micrograms/l vs 121.7 +/- 36 micrograms/l, p < 0.01). Cancer patients also had higher AP levels than controls (704 +/- 755 U/l vs 216.5 +/- 56 U/l, p < 0.01). Abnormal PICP and AP serum concentrations (above the mean + 2SD of controls) were found in 46% and 51% of patients, respectively. Moreover, patients showed significantly lower serum calcium concentrations (p < 0.001), and higher TRAP and hydroxyproline levels although statistical significance was not reached. In the patients, PICP was correlated directly with AP (r = 0.50, p < 0.01) and TRAP (r = 0.34, p < 0.05). In conclusion, patients with bone metastases have increased bone turnover as shown by serum markers. Serum PICP may be used as an adjunctive, non-invasive index to assess bone metabolism. However, the clinical usefulness of PICP in cancer patients needs further evaluations.

Acid Phosphatase↗
PubMedDate not supplied

[The assessment of exposure to the risk of the manual lifting of patients. The results of a clinical study in a geriatric institute of Milan].

In a geriatric hospital in Milan, with over 1000 beds and 750 healthcare workers (with different skills and training), by means of an accident register, during 1997 an 11% incidence of acute low back pain was recorded, with a mean of 19 days absence from work. For this reason, special attention was given to the assessment of manual patient handling risk and to the consequent effects on the lumbar spine using, for the purpose, the method proposed by the EPM Research Unit. Of the 10 wards analysed none showed a negligible exposure index (MAPO Index < 1.5), only one was in the medium exposure class (MAPO Index = 3.05) and the other 9 wards had high exposure (MAPO Index 5.63-24). A group of 59 men (mean age 35.6 years and mean job seniority 9 years) and 179 women (mean age 36.7 years and mean job seniority 10 years) were examined. The most significant result of the physical examination was the high prevalence of subjects who reported at least one episode of acute low back pain in the previous 12 months (16). This was double the prevalence for the country as a whole (8.3%) and 7 times greater compared to the group not exposed to manual load handling risk (2.3%). The prevalence of degenerative disorders of the lumbar spine in the group under study (4.2%) was also analysed, and is of particular interest if associated with the difficulties in completing the diagnostic process. Lastly, 6.3% of the subjects examined were judged unfit (temporarily of permanently) for work involving manual handling of patients.

Adolescent↗
PubMedDate not supplied

[Facial rejuvenation with chemical peeling using phenol (Exoderm)].

The authors report their personal experience in the treatment of the resurfacing by means of phenol chemical peeling using a new solution described by Dr. Yoram Fintsi and called Exoderm. They report dressing technique and possible contraindications as well.

Chemexfoliation↗
PubMedDate not supplied

[Mesothelial cyst of the diaphragm. Report of a case and review of the literature].

A case of mesothelial cyst of the right hemidiaphragm in a 44 year old man is reported. Origin (most likely due to a recess of the primary coelomiatic cavity), topographical, histological and therapeutic features are discussed, stressing that it is now more frequently recognised thanks to progress in diagnostic imaging techniques. Complete surgical excision is mandatory to definitely differentiate such lesion from primary diaphragmatic neoplasm, not infrequently malignant.

Adult↗
PubMedDate not supplied

[Fournier syndrome: report of a clinical case].

The case of a Fournier's syndrome in a 58 years old patient is reported from the Authors that describe the ethiopathogenetic and therapeutic aspects. They analyse the importance of an early surgical treatment associated with antibiotic therapy and later a riparation of the lesions with a myocutaneous skin flap of TLF.

Fournier Gangrene↗
PubMedDate not supplied

Short-term adverse effects from and discontinuation of antiretroviral post-exposure prophylaxis.

OBJECTIVE: To evaluate short-term toxicity from and discontinuation of antiretroviral combination prophylaxis in HIV-exposed individuals in Italy. DESIGN: Longitudinal, open study conducted by prospective collection of data in the National Registry of PEP. SETTING: All the Italian centres dedicated to HIV related care and licensed by the Ministry of Health to dispense antiretroviral drugs. STUDY POPULATION: Health care workers and other persons consenting to be treated with post exposure prophylaxis (PEP) after exposures to HIV. RESULTS: Until October, 2000, 207 individuals receiving two nucleoside reverse transcriptase inhibitors (NRTIs), and 354 receiving two NRTIs plus a protease inhibitor (PI) were enrolled. More individuals experienced side-effects in the 3-drug group (53% and 62%, respectively; OR 0.68, (95% CI 0.48-0.98), p < 0.03). However, the proportion of individuals discontinuing prophylaxis because of side-effects did not differ significantly between the 2 groups (21% and 25% respectively; OR 0.82 (95% CI 0.53-1.26); p=0.4). The 43 individuals in the 2 NRTI group discontinued PEP after a mean of 10.4 days of treatment (median 8, range 1-27), similarly to the 88 discontinuations observed in the 3-drug group (mean duration 10.5 days, median 7.5, range 1-26). Type and incidence of specific adverse effects were similar to those reported in the literature. CONCLUSION: Our study indicates that the difference in the proportion of individuals developing side effects and discontinuing PEP is not significant. The rate of discontinuation because of protease inhibitor side-effects does not justify per se the initial use of a less potent PEP regimen. We suggest initiating PEP with a three-drug regimen and discontinuing the protease inhibitor in the case of adverse effects.

Anti-HIV Agents↗
PubMedDate not supplied

Eosinophilic cystitis associated with urethral stricture disease from pelvic trauma. Case report and literature review.

We report a case of eosinophilic cystitis (EC) in a 65-year-old man with urethral stricture disease from blunt pelvic traumatic event. EC is a rare condition characterized by eosinophilic infiltration of the bladder wall, that usually presents with irritative voiding symptoms, suprapubic pain and hematuria. Etiology is still not clear although a review of the literature suggests that pathogenetic mechanisms probably engage an altered immune response in the bladder, with the inflammatory reaction caused by factors such as exogenous allergens and previous bladder injury or surgery to the bladder or the prostate. The diagnosis of EC has to be confirmed by biopsy, since in some cases it may manifest as other inflammatory and malignant bladder disorders. A conservative medical management is indicated initially, since this disease may be self-limited, with a benign course especially in children and young patients. In adults EC is more often a chronic recurrent condition that requires close follow-up since it may lead to serious progressive bladder and/or upper urinary tract disease. More invasive therapies (including transurethral resection, partial or total cystectomy) may also be required when conservative therapy fails.

Accidents, Traffic↗
PubMedDate not supplied

[Human allogeneic cultured epidermis: medico-legal considerations].

The possibility of cultivating in vitro human kerathinocytes has opened new prospectives in the surgical treatment of major burns and, generally, in patients with extensive skin loss (degloving, etc.). Epidermidal sheets, obtained in vitro, have been used initially, successfully, as autografts. Later, their peculiar immunological characteristic (absence of Langerhans cells expressing class II MHC antigens and inability of evocating omograft rejection) has allowed it's use as allograft without the need of resorting to treatment with immunosuppressive drugs. Medico-legal problems raised by the use of human epidermys cultivated as allograft are described hereafter.

Burns↗