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Biomedical subjects

M Pirovino

Publications and source records attributed to M Pirovino.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Metoclopramide, methylprednisolone and flunitrazepam in cytostatic-induced vomiting].

The antiemetic efficacy of a combination of high-dose metoclopramide, methylprednisolone and flunitrazepam was tested in an open pilot study in 30 tumor patients undergoing strongly emetic chemotherapy. 26 of 30 patients (87%) were partially or completely protected from nausea and vomiting. In 11 of 12 patients receiving the strongly emetogenic cytostatic agent cisplatin in a dose of greater than or equal to 50 mg/m2, the gastrointestinal side effects were partially or completely abolished. The antiemetic efficacy of the combination was maintained during subsequent courses of chemotherapy. All patients experienced somnolence after administration of flunitrazepam. Only 2 of 30 patients had a shortlived extrapyramidal reaction. The combination of high-dose metoclopramide, methylprednisolone and flunitrazepam is an effective antiemetic treatment and should be considered as first-line antiemetic treatment in patients receiving strongly emetic cancer chemotherapy.

Adolescent↗
PubMed1987

[High incidence of unexplained hypoalbuminemia in an internal medicine practice].

The frequent observation of hypoalbuminemia in patients without hepatic disease or renal protein loss led us to compare different methods of direct and indirect serum albumin measurement. One hundred patients were randomly selected and analysed retrospectively and the serum albumin was related to clinical, hematological and biochemical parameters. 51Cr labeled albumin was injected intravenously in 6 healthy volunteers and 8 patients with hypoalbuminemia to obtain further information on the pathogenesis of hypoalbuminemia. The results obtained by the method using bromcresol purple were almost identical with those obtained by immunological methods. On the other hand, serum electrophoresis gave results that were a mean 14% higher than those with the method using bromcresol purple. Nearly half of the patients selected randomly, generally without signs of liver disease or renal protein loss, were hypoalbuminemic. There was no correlation with the age, sex, blood sedimentation rate, serum orosomucoid, hemoglobin, aminotransferase or the prothrombin time. 51Cr labeled albumin showed normal disappearance in four patients and an accelerated disappearance in another four patients. Hypoalbuminemia is a common finding in internal medicine which is underestimated in incidence and extent when serum electrophoresis is used. There is no correlation with the age and the hematological or chemical parameters measured. Both reduced synthesis and/or increased loss or catabolism are important factors in the pathogenesis of hypoalbuminemia.

Age Factors↗
PubMed1987

[Focal nodular hyperplasia of the liver].

The differential diagnosis of focal nodular hyperplasia of the liver (FNH) encompasses a variety of hepatic mass lesions with differing prognosis and therapy. Ten patients with FNH confirmed by histology form the basis of this review of the pathogenesis, the clinical features and of diagnostic and therapeutic aspects. - FNH is usually diagnosed fortuitously in women of childbearing age. It is considered to be a reactive process rather than a true neoplasia, and its biological behaviour seems to be modified by female sex steroids. In contrast to liver cell adenoma, rupture and bleeding are exceptional. For the diagnosis of FNH a combination of dynamic computed tomography and 99mTc sulphur colloid liver scintigraphy is most reliable, whereas ultrasonography lacks specificity. Once the diagnosis of FNH is established, surgery usually is unnecessary.

Adult↗
PubMed1986

[Estrogen and progesterone receptors in human liver: does their study contribute to a better understanding of benign contraceptive-associated liver tumors?].

The estrogen and progesterone receptor content of liver cytosol was measured in female patients with focal nodular hyperplasia associated with oral contraceptive use and compared with the receptor content of non-tumorous liver and of primary hepatocellular carcinomas. Receptors were found in very low concentrations or were not measurable at all. In one case of focal nodular hyperplasia the estrogen receptor content of the tumor was higher than that in the adjacent normal liver. Malignant liver tumors and the male liver were characterized by a low or non-measurable receptor content. The study of nuclear receptors combined with the use of monoclonal antibodies may be more helpful in elucidating the complex relationship between oral contraceptive use, benign liver tumors and hepatic steroid receptors.

Adult↗
PubMed1986

[Atypical neurologic symptoms in the course of acquired immunodeficiency syndrome (AIDS)].

Unusual neurological symptoms were observed in three homosexual men in whom antibodies against HTLV-III were demonstrated. In case 1, with a known Kaposi sarcoma, multiple intracerebral space-occupying lesions with severe perifocal oedema resulted in marked focal neurological deficits. In case 2, there occurred a transitory myelopathic syndrome lasting a few days, followed by severe retinal changes, associated with a generalized cytomegalic infection, and a cerebrovascular accident in the brainstem. In case 3, a severe myositis especially of the shoulder girdle was diagnosed and treated one year before the demonstration of the HTLV-III infection. The pathogenetic relationship between these illnesses and the HTLV-III infection remains unexplained.

Acquired Immunodeficiency Syndrome↗
PubMed1986

The antiemetic activity of high-dose alizapride and high-dose metoclopramide in patients receiving cancer chemotherapy: a prospective, randomized, double-blind trial.

Alizapride is a new substituted benzamide with suggested superior antiemetic efficacy to and fewer side effects than metoclopramide. High-dose alizapride (4 mg/kg X five doses) was compared with high-dose metoclopramide (2 mg/kg X five doses) in a prospective, randomized, double-blind trial in 62 evaluable patients undergoing strongly emetic cancer chemotherapy. Patients receiving metoclopramide experienced significantly fewer vomiting episodes than patients receiving alizapride (median of three episodes vs. eight episodes; P less than 0.001). Metoclopramide was more effective in decreasing the volume of emesis than was alizapride (median of 100 ml vs. 360 ml; P less than 0.02). Seventy-two percent of the patients receiving alizapride and 57% of those receiving metoclopramide experienced side effects. High-dose metoclopramide is an effective antiemetic in patients receiving cancer chemotherapy. Alizapride is less effective and has more side effects than metoclopramide. We do not recommend the further use of alizapride.

Adult↗
PubMed1984

[Malignant neuroleptics syndrome].

The neuroleptic malignant syndrome is clinically characterised by the presence of severe muscular rigidity, altered consciousness, hyperthermia and by signs of autonomic dysfunction. A severe form of the syndrome lasting several weeks was observed in a 20-year-old, mentally retarded female patient while under fluphenazine treatment. Cerebrospinal fluid was examined for monoamine metabolites by high-performance liquid chromatography both during the acute and the convalescent phases of the disease. Since the disease carries a considerable mortality, early diagnosis and rapid withdrawal of all neuroleptic medication is of primary importance.

Adult↗
PubMed1984

[Interferon production in acute virus hepatitis].

Serum interferon activity was measured in 40 patients with acute viral hepatitis A, B and non-A-non-B during the acute stage of the disease and correlated with the severity, the long-term outcome and the viral etiology of the disease. Patients with alcoholic hepatitis, patients with an influenza-like illness and healthy volunteers served as controls. 80% of all patients with virus hepatitis revealed no measureable or only borderline interferon activity in their serum. No correlation was found with severity and long-term outcome of the disease, but patients with virus hepatitis A showed a stronger interferon induction than patients with hepatitis B and non-A-non-B. Further investigations of the interferon system in patients with virus hepatitis might help to improve our understanding of the different forms of the disease. The data presently available, however, do not permit as yet to define the value of interferon in the treatment of severe forms of acute virus hepatitis.

Hepatitis A↗
PubMed1983

[Bouveret syndrome].

Bouveret syndrome, a rare form of gallstone ileus predominantly encountered in elderly female patients, is clinically characterized by the sequelae of duodenal obstruction. Two patients observed within one year are presented and the clinical, diagnostic and therapeutic aspects of the disease are discussed. The surgical treatment of choice is one-stage removal of stone, closure of fistula and cholecystectomy completed by a careful search for residual stones in the small and large intestine.

Aged↗
PubMed1983

[Hepatitis B virus infection and hepatocellular carcinoma: indication for a possible causal connection even in non-endemic Switzerland].

62 patients with histologically proven hepatocellular carcinoma have been investigated for the presence of serological markers of hepatitis B virus infection, and the findings have been related to alpha 1-fetoprotein measurements and to the nature of the basic disease process affecting the liver. The results document a statistically significant increase in the prevalence of hepatitis B virus markers as compared to patients with cirrhosis of the liver only, pointing to a probable etiological relationship between hepatitis B virus infection and hepatocellular carcinoma even in areas of the world where the infection is not endemic. Early detection of hepatocellular carcinoma is limited by the remarkably high percentage of patients who have no, or only marginal, elevation of serum alpha 1-fetoprotein.

Adult↗
PubMed1983

[Long-term course of sporadic non-A, non-B hepatitis: a biochemical, immunologic and histologic follow-up study].

36 patients with acute sporadic non-A, non-B viral hepatitis were prospectively followed up. Study parameters included biochemical and immunological (hepatitis A/B) data, histology of the acute and chronic stage of the disease and immunohistology for hepatitis B markers. The mean follow-up period for the patients with complete remission was 8.5 months, and 30.5 months for the patients with progression to chronic liver disease. 13 (36%) patients developed histologically confirmed chronic hepatitis (6 CPH, 7 CAH). In the chronic stage of the disease, the transaminases showed a markedly fluctuating course in 8 of the 13 patients. Two of the 6 patients with CPH showed complete remission after 25 and 58 months respectively; in the 4 others the disease remained unchanged. In the 7 patients with CAH no remission occurred, but in 2 patients complete cirrhotic transformation of the liver was demonstrated after 36 and 38 months respectively. Hence the prognosis of chronic sporadic non-A, non-B hepatitis seems to be worse than the prognosis of chronic posttransfusion non-A, non-B hepatitis.

Adolescent↗
PubMed1983

Constant kinetics and constant concentration-effect relationship during long-term beta-blockade with pindolol.

Long-term beta-blockade is said to increase the number of beta-receptors. The effect of beta-blockers could therefore be reduced after long use. We tested this hypothesis in nine healthy subjects given 15 mg pindolol daily for 4 wk. Plasma concentrations (measured fluorometrically), isoproterenol dose-response relationship (to calculate the dose needed to increase heart rate by 25 bpm), renin, epinephrine, and norepinephrine were measured several times before and after the first and last dose. Kinetic parameters remained stable: total clearance (Cltot) = 45.2 and 42.9 l/hr, and Vdss = 205.8 and 198.6 l after the first and last dose. The concentration-effect relationship, plotted as the "dose ratio minus one" against the log of the plasma concentration was identical after 4 wk. Basal plasma renin activity was reduced slightly and the increase of stimulated plasma renin was blunted by pindolol even after 4 wk. The initial lowering of unstimulated renin by pindolol in the first 2 hr after dosing was not detectable after 4 wk. Epinephrine and norepinephrine levels in plasma were not changed initially nor after 4 wk. It is concluded that pindolol has a stable kinetic profile over time and that its beta-blockade does not induce tachyphylaxis.

Adult↗
PubMed1983

Pneumatosis cystoides coli: a rare complication of colonoscopy.

A case of colonic pneumatosis cystoides intestinales (PCI) which occurred three days after a routine colonoscopy is presented. A review of the literature revealed only two other cases of PCI following colonoscopy. The close temporal association to the colonoscopy supports the mechanical hypothesis as the probably mechanism leading to intramural PCI.

Aged↗
PubMed1983

Hepatocellular carcinoma and hepatitis B virus infection. Analysis of 75 cases from Switzerland.

The prevalence of serological markers of hepatitis B virus (HBV) infection was investigated in 75 patients with histologically confirmed hepatocellular carcinoma (HCC). Hepatitis Bs-antigen (HBs-Ag) was found in 30.8% and evidence of present or past infection in 61.5%. In a control group of 115 patients with liver cirrhosis of various etiologies in whom evidence of a coexistent HCC was lacking, the corresponding numbers were significantly lower (16.5% and 41.7% resp., p less than 0.05). Below the age of 65 years, markers of present or past HBV-infection were significantly more frequent than in patients above 65 years of age (p less than 0.025). All patients positive for HBs-Ag had an underlying cirrhosis; in seven cases, HCC was found in a non-cirrhotic liver. Alpha-fetoprotein measurements failed to identify patients with HCC in up to 43.6% of the HBs-Ag negative cases. It is concluded that HBV-infection does represent a cofactor in the malignant transformation of the liver, even in areas of lower incidence. Alpha-fetoprotein measurements need to be complemented by other investigations if early recognition of HCC is to lead to better survival.

Adult↗
PubMed1983

Diabetic gastroparesis: treatment with domperidone--a double-blind, placebo-controlled trial.

6 patients with severe symptomatic diabetic gastroparesis were studied in a placebo-controlled randomized manner to establish if intravenous domperidone accelerates the delayed gastric emptying of a semisolid homogenized meal. Domperidone, 10 mg intravenously, shortened the gastric emptying half-time in all of the 6 patients significantly, but not in the healthy control subjects. These results suggest that intravenous domperidone may be potentially beneficial to diabetic gastroparesis patients by improving delayed gastric emptying.

Adult↗
PubMed1983

Multiple hepatitis attacks with immunothrombocytopenia in a heroin addict.

A 25-year-old heroin-addict had four episodes of acute hepatitis, each of them associated with thrombocytopenia. Serologically, hepatitis A and B as well as cytomegalo- or Epstein-Barr virus infections were excluded. High levels of circulating immune complexes and antibodies reacting with aminophospholipids, a component of both liver cell and platelet membranes, were detected during the last two attacks of hepatitis, but were absent during remission. Platelet-associated antibodies of the IgM class paralleled the 'anti-phospholipid' antibodies during the fourth attack. These findings demonstrate an immunological basis of the thrombocytopenia and point to the possibility of a direct association between liver cell injury and peripheral platelet destruction in certain patients.

Adult↗
PubMed1983

[Megacolon as a rare complication of diabetes mellitus].

The clinical and radiological features of diabetic megacolon and gastroparesis occurring in a 48-year-old woman are presented. The only two other well-documented cases of diabetic megacolon from the literature are reviewed. The predominant dilatation of the sigmoidal colon in the setting of a generalized megacolon may be, especially if associated with bladder atony, a clue to the diagnosis of the diabetic nature of a megacolon.

Constipation↗