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Biomedical subjects

M Spina

Publications and source records attributed to M Spina.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Changes in coeliac disease behaviour over the years.

We performed a retrospective study of 325 coeliac children (179 females and 146 males, F/M ratio 1:2), diagnosed from 1984 to 1989. The children were divided into two groups; group A were diagnosed between 1984 and 1986 and group B were diagnosed between 1987 and 1989, when the antigliadin antibody test had been introduced in our routine. The data showed a difference between the number of diagnoses in the two groups, 117 in group A versus 208 in group B, with a yearly increment of new cases. In both groups, the onset of the disease occurred within the 2nd year of life, in most cases (group A, 88.9%; group B 89.4%) showing a mode at approximately the 9th month. Diagnosis was made within the 2nd year of life in the majority of cases (group A, 80.3%; group B, 87.4%), showing a mode of approximately the 12th month. In both groups, chronic diarrhoea was the most frequent symptom (75.2% in group A and 70.2% in group B), while minor symptoms, such as isolated short stature, pallor, delayed puberty and others, did not show any important change. We conclude that in Sicily, in recent years, the incidence of coeliac disease has been increasing. The most representative clinical form is the classic one, with onset within the 2nd year of life, and chronic diarrhoea, growth failure and abdominal distention as key symptoms.

Adolescent↗
PubMedDate not supplied

Age-related changes in composition and mechanical properties of the tunica media of the upper thoracic human aorta.

A cylindrical segment, free of complex atherosclerotic lesions, was resected at autopsy from each of 59 descending human thoracic aortas by cutting just below the level of the first pair of intercostal arteries and 35 mm distal to this incision. Each isolated tunica media was defatted and subjected to successive treatment with EDTA-Tris, 5 M guanidine hydrochloride-Tris, 5 M guanidine hydrochloride-Tris-DTE, collagenase and either trypsin or hot alkali. After each extraction or digestion, the dimensions and weight of the segments were measured and the extracted materials were analyzed and quantitated. This allowed the total content of the various components of the tunica media to be assessed by both gravimetric and analytical means. An age-related rise was observed in the total content of the following components: proteins and glycoproteins soluble in chaotropic solvents (ranging from 24 mg/cm in the youngest samples to 46 mg/cm in the oldest) and collagen (38 mg/cm to 69 mg/cm). In contrast, the total content of elastin remained constant at 70 mg/cm at all ages, but its concentration decreased due to the rise in the concentration of the other tissue components as the tunica media thickened with age. It was also noted that with increasing age there was an accumulation of protein(s) which could not be solubilized by extraction with chaotropic agents or with collagenase, but which could be removed by treatment with either trypsin or hot alkali. Mechanical measurements conducted before and after trypsin digestion on samples previously subjected to purification with the first four agents used suggest that this accumulated protein(s) influenced the elastic response of the tissue to the applied stress by increasing the incremental modulus, the breaking stress, and the hysteresis. After the removal of this additional protein(s), the mechanical behavior of the elastin component was found to be identical in all samples, irrespective of age. It is therefore proposed that the morphological changes and the stiffening observed in the aging aortic wall are not due to degradation of its elastin network but to variations in the supramolecular organization of connective tissue components.

Adult↗
PubMedDate not supplied

[Headache as atypical presentation of celiac disease: report of a clinical case].

Coeliac disease (CD) is a gluten dependent enteropathy with genetic predisposition. The introduction of the gluten with the diet leads to a damage of the intestinal mucosa losing the ability of absorption. Together with the "classic forms", in wich the intestinal symptomatology is prevalent, there are atypical forms, with unusual clinical presentation and silent forms with no clinical symptoms. The neurologic symptoms are not frequent and regard seizures, headache, ataxia and psychiatric problems. We report on a patient with headache since 3 years of age in which the headache the only manifestation of CD. The diagnosis of CD was made at 11 years, when he came at our observation for episodes of headache. Also the older sister is found affected by CD. After three months of gluten free diet, it was obtained the complete resolution of the headache. Also if the pathogenesis of the headache in patient with CD is unknown we think that a autoimmune, vascular or blood flow mechanism could be ipotizeable.

Celiac Disease↗
PubMedDate not supplied

[Temporary vascular access for haemodialysis: is infection still the most important complication?].

BACKGROUND: Aging in the dialitic population currently shows the problem of vascular access for haemodialysis. The use of temporary catheters for haemodialysis has increased the risk of infections. DOQI guidelines underline this problem. We think that the thrombosis of central veins is a problem as important as infection. METHODS: In the last two years we studied prospectively 310 patients. 686 catheters for haemodialysis were placed. Infection, malfunctioning of catheters and thrombosis of central veins were studied. We compared femoral catheters with jugular catheters. Finally we studied by ultrasound the jugular vessels diameter and thrombi of jugular vein. RESULTS. Fever was present in 5.55% of patients with femoral catheters and in 5.84% of the patients with jugular catheters. The malfunctioning incidence in patients with femoral catheters was 22.75% and 8.76% in patients with jugular catheters with statistic difference. Ultrasound study of jugular veins showed thrombotic incidence of internal jugular vein in 20,8% of patients. CONCLUSIONS: We think that with correct management of catheters there is no difference in the incidence of fever in patients with jugular catheters versus femoral catheters. Probably jugular catheters have better performance than femoral catheters. We need controlled studies to better understand the problem of central vein thrombosis.

Bacteremia↗
PubMedDate not supplied

Immunoenzymatic assay of erbB2 protein in cancer and non-malignant breast tissue. Relationships with clinical and biochemical parameters.

The erbB2-encoded protein p185 was determined in 130 breast cancer specimens and in 29 non-malignant breast tissues using a recently available ELISA method. The assay showed good characteristics of precision and accuracy. In the non-malignant tissue p185 concentrations were normally distributed and directly correlated with estrogen receptors (ER) and progesterone receptors (PR). In cancer tissue p185 showed higher concentrations than in non-malignant tissue. No relationships were found between p185 and the main clinical and pathological parameters, except that a direct association with nuclear grade was found. We have categorized the breast cancer samples according to p185 concentrations as p185-negative (concentrations lower than the higher non-malignant tissue) and p185-positive. Our data suggested a different behaviour of p185 in samples with low or high p185 concentrations. Indeed, in p185-negative samples the concentrations were directly correlated with both ER and PR. Conversely, p185-positive samples were directly associated with node status and pT, and inversely associated with ER and PR.

Adult↗
PubMedDate not supplied

[Blood beta-carotene after oral administration of carotenoids. A dynamic test of lipid absorption].

Authors report a method on the functional investigation of intestinal epithelium, based upon the dosage of serum carotene levels after administration of carotenoids. This test takes advantage of the modality of beta-carotene absorption that it behaves like a lipid. The "beta-carotene test" has demonstrated, as regards to T.A.R.T., great sensibility and specificity over 90%. It doesn't show value overlapping between normal and coeliac children and also it shows good compliance of children and simplicity in laboratory determination. For all these characteristics the Authors suggest the utilization of "beta-carotene test" as screening tool of malabsorption.

Administration, Oral↗
PubMedDate not supplied

MRI in diagnosis of osteoid osteoma of the proximal femur: a potentially deviating aspect. Description of a clinical case.

Osteoid osteoma constitutes 10-12% of all benign neoplasms of the bone. The tumor more frequently involves the male sex (male to female ratio 2.1:1) and it may be observed in all age groups, with evident predilection for the second decade of life. All of the skeletal segments may be affected, but the most frequent site is the long bones, in the diaphyseal, metaphyseal and more rarely epiphyseal regions. The lesion is characterized by an osteolytic area, the nidus, which is at times partially calcified, surrounded by an osteosclerotic zone that is more or less accentuated. Clinical suspicion and traditional radiography are essential in diagnostic orientation; usually, further imaging methods are also recommended, such as bone scan with Tc99, CT scan and MRI. This last method allows for easy localization of the lesion, although with a sensitivity that is less than that of the CT scan. Nonetheless, the finding, if not supported by clinical suspicion, may be dangerously deviating and it may orient diagnosis towards a more aggressive disease.

Adult↗
PubMedDate not supplied

[The physiology and pathology of bile acid metabolism].

The biochemistry and metabolism of bile acids are briefly described together with their importance in the maintenance of biliary homeostasis. An account is given os some situations in which such metabolism is impaired: in cirrhosis of the liver, an isotope technique was used to show a fall in cholic acid (expression of liver cell damage); in cholostasis, stress is laid on reduced bile acid synthesis and a simultaneous increase in sensitivity of the bile canicular epithelium to secretin stimulation. Lastly, evidence is produced to suggest that the diarrhoea which often recurs after extensive intestinal resection is secondary to an increase in intestinal AMPc cells induced by bile acids.

Bile Acids and Salts↗
PubMedDate not supplied

[Diffuse symptomatic polypoid lipomatosis of the colon with hyperplasia of epiploic appendices: a case report].

Diffuse and symptomatic lipomatosis of the colon, particularly when associated with hyperplasia of the appendices epiploicae, is a rare disease. We report here the case of a lean, 26-year-old woman who had polypoid lipomatosis of the colon with submucosal and subserous expression (involving the mesentery and peritoneum) associated with extreme hyperplasia of the appendices epiploicae. Her disease led to a recurrent subocclusive syndrome which required total colectomy. We discuss the case and review the literature on this subject. The particular characteristics of this case and early onset of disease would suggest that our patient was affected by a congenital lipomatous syndrome linked to mesenchymal dysplasia. Long-term monitoring will enable prompt intervention in the case of reformation of lipomatous tissue.

Adult↗
PubMedDate not supplied

[Cisapride efficacy in gastroesophageal reflux in children].

In the last years gastroesophageal reflux disease received more attentions, due to an improving in diagnostic techniques. Motility disorders, such as reduced competence of lower esophageal sphincter, motor esophageal disorders, delayed gastric emptying are important factors in the pathogenesis of the disease. Therefore therapy using prokinetic agents has been considered useful. A variety of drugs such as bethanecol, metoclopramide and domperidone have been used. There are conflicting report on the effects of these drugs and it should also be emphasized that they are not devoid of side effects related to dopamine antagonism. Recently cisapride, prokinetic agent which acts through facilitation of acetylcholine release, has been considered effective and well tolerate drug for the treatment of gastroesophageal reflux disease. In this view we investigated the effects of oral administration of cisapride in 12 children (age range 3-40 months), 7 females and 5 males, suffering from gastroesophageal reflux disease diagnosed on the bases of: clinic criteria, barium swallow radiological examination, 24-hour intraesophageal pH monitoring. After diagnosis a treatment with cisapride (1 mg/kg/die) before feedings for 8 weeks was started in all children. At the end of the trial clinical assessment and 24-hour intraesophageal pH test were performed. Clinical assessment was determined through weight, length and a clinical score calculated using the following parameters: regurgitation, vomiting, irritability, nocturnal weeping, meteorism, respiratory complaints. The total score was evaluated at diagnosis and during the follow-up (1st, 2nd, 4th and 8th week).(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗