Biomedical subjects
Publications and source records attributed to M Porta.
A pneumoencephalographic study to localize the position of Monro's foramen in the skull cavity is reported. This has to be done by evaluating the place of Monro's foramen in both vertical and horizontal plane. A method to perform more accurate ultrasonic examinations is described.
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Diabetic retinopathy (DR) is the major cause of blindness in the working age groups of industrialized countries, and a programme has been launched by the World Health Organization (WHO) and the International Diabetes Federation (IDF) to reduce its morbidity in Europe. Retinopathy progresses slowly, and even when it becomes sight-threatening, may not present visual symptoms. When symptoms do occur, it is often too late to restore full vision or to stop further deterioration by retinal photocoagulation. For photocoagulation to be maximally effective, treatable sight-threatening retinopathy must be identified while still asymptomatic by means of regular fundus examination of all diabetic patients. Given the absence of effective medical treatment, prevention of retinopathy depends on mass screening. The WHO and IDF recommend that internists in charge of diabetic patients perform a fundus examination at least every two years if retinopathy is absent, or as frequently as necessary otherwise. Patients at risk should be referred for assessment and treatment to ophthalmic facilities. Either direct ophthalmoscopy or retinal photography are suitable methods. The setting up of nation-wide screening programmes is essential for coordinated action. Pilot studies have proven that screening is an effective means for decreasing diabetes related blindness and the human and social costs attached to it.
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A family with Sipple's syndrome was studied over three generations. The syndrome is transmitted as a dominant autosomic hereditary trait with high penetrance and varying expressiveness. Our series include 13 patients of three generations: 1) husband and wife who were 1st degree cousins; 2) 4 sisters and 1 brother; 3) 5 sisters and 1 brother. In the first generation we did not find any sign that could be related to the syndrome, in the second generation 2 thyroid carcinomas and a pheochromocytoma were present, and in the third one 2 sisters had these neoplasias, one pheochromocytoma and the other thyroid cancer, another one had marfanoid habitus and the fourth one had pheochromocytoma. This series includes 11 subjects of the second and third generation; the Sipple's syndrome was present in 7 females. The incidence of the syndrome was 63.8% and present only in female subjects. The high incidence rate could be caused by the strict relation between the grandparents. The diffusion of this pathology may be related to the high penetrance of the gene(s) involved whereas the clinical variations may be interpreted to the variable expressiveness and, even more so, as evidence that the other manifestations of the syndrome may occur later in time.
Quazepam (QZP), a new long half-life benzodiazepine, seems to have a more specific hypnotic activity and a "physiological" mechanism of action. This study assessed its clinical efficacy and any withdrawal symptoms occurring after the treatment with QZP and triazolam (TRZ). Sixty-five patients (mean age 41.4 yrs +/- 12.43 SD) with sleep disorders were included in the study. The patients were treated with placebo for 4 days (run-in period) and if no amelioration of insomnia was observed, were then randomly allocated to 15 mg QZP (33 patients) or TRZ (32 patients) for 8 weeks and finally placebo for another week. Sleep quality, efficiency, side-effects and withdrawal effects were assessed by specific rating scales. In comparing data obtained from the two treatments, the following conclusions were drawn: 1) both drugs showed a hypnoinductive efficacy but patients treated with QZP had significantly fewer night awakenings; 2) at the end of treatment only patients treated with TRZ had longer awakenings and rebound symptoms; 3) a lower withdrawal symptom incidence was observed in patients treated with QZP. Therefore, QZP seems to have a good hypnotic effect without inducing withdrawal symptoms. In contrast TRZ turned out to be a merely hypno-inducing drug presenting higher risks of rebound effects after withdrawal.
A retrospective survey was carried out in a group of 39 previously obese and hypertensive subjects to evaluate: the rate of blood pressure reductions achieved by dietary treatment, the smallest weight reduction accompanied by a significant decrease in blood pressure, and the mean weight reduction associated with normalization of pressure. Significant decrease in weight, systolic and diastolic pressures were observed after 15 days of treatment in 21 patients who had never assumed antihypertensive drugs and 9 who were on medication. Blood pressure normalization was achieved in 19 of the former with a weight reduction of 7.63 +/- 4.29% kg and in 7 of the latter after losing 8.63 +/- 2.20% kg; in 3 patients the medication was reduced and in 1 was withdrawn. In 4 patients weight but not pressure had decreased and in 5 neither did. Reduction, often normalization, of blood pressure can be obtained through relatively minor weight loss in most obese hypertensive patients.
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When planning diabetes education programmes it would be useful to know in advance the patients' demands and expectations. To this purpose, a questionnaire was circulated throughout Italy. Eight hundred and forty-five forms were returned from 487 men and 358 women of age 49 +/- 18 (SD) residing in all regions of Italy. Fifty percent were on insulin, 37% on oral agents and 13% on diet only. Forty-seven percent believed they had a satisfactory knowledge of diabetes, 49% thought it fair or poor and 4% judged it non-existent. Such knowledge derived from diabetic clinics, mass media, specialized publications and family doctors. Only 11% had previously attended education programmes. The vast majority (83%) believed that better information would help to improve their diabetes care and were willing to attend education courses. Printed material and group learning were preferred to audiovisual aids and individual education. Doctors were preferred as teachers (83%) to other patients or paramedical staff. Patients were mostly interested in learning about complications (84%), diet (74%), control (63%), intercurrent illnesses (61%) and inheritance (59%). The least requested subjects were CSII (20%), the artificial pancreas (22%), insulin preparations (22%), pancreatic transplant (26%) and oral agents (31%).
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Ventricular concentrations of homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) were evaluated in 17 patients suffering from brain tumor and 4 pseudo-tumor patients. Significant differences were observed in those patients in whom the tumor leads to a marked modified CSF dynamic. No relationship were on the contrary observed between VFP and HVA or 5-HIAA levels.
In 1981, 32 adult Senegalese males infected with Onchocerca volvulus but without ocular involvement were treated by groups of 8 with single oral dosages of 5, 10, 30 or 50 micrograms/kg of ivermectin . As soon as the second day after treatment, we observed a marked decrease of the dermal microfilaremic charge after a posology of 30 micrograms/kg. However the decrease is most important in the group subjected to 50 micrograms/kg and 75% of them had no more microfilariae in the dermis 28 days following treatment.
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