We evaluated the efficacy of different doses of methimazole (MMI) as the initial therapy for Graves' disease. Fourteen patients were treated with 15 mg/die of the drug (group A) and 14 with 30 mg/die (group B). Blood samples for T3, T4, FT3 and FT4 were obtained before beginning therapy, every 48 h during the first 12 days and on the 45th day of treatment. All these hormonal parameters fell significantly from the 2nd day of therapy in both groups. All the patients, except for one in group B, had normal or subnormal levels of thyroidal hormones on the 45th day of treatment. The comparison between the two groups of regression coefficients over the first 12 days showed no significant differences. The absolute decrease of each examined parameter on day 12 was positively correlated with the relevant pretreatment value. These results demonstrate that doses of MMI (15 mg/die) much lower than those commonly recommended are able to rapidly control thyroidal overproduction as effectively as 30 mg/die.

Adult↗

PubMed1987

Limited diagnostic value of lymphocytic karyotype in primary amenorrhea with streak gonads.

Cytogenetic data represent a first line diagnostic aid in gonadal dysgenesis. Generally, the results of a peripheral blood examination reflect the genotypic alteration of the patient. Nevertheless, on occasion one may encounter cases in which clinical and hormonal evidence suggestive of dysgenesis is not accompanied by an anomalous chromosomal finding, upon cytogenetic analysis of the peripheral blood. In these cases, a cytogenetic alteration may be present in cellular components of the ovary and the cutis. In the light of the above, two patients presenting with primary hypergonadotropic amenorrhea, streak gonads and normal peripheral karyotype are described. In one patient presenting with phenotype alterations, ovarian wedge biopsy via laparotomy followed by cytogenetic analysis of ovarian tissue and tissue from the cutis revealed a 45,X/46,XX-type mosaicism. In the other patient, the ovarian cytogenetic findings were unremarkable. Extending chromosomal analysis to several tissues, beyond the peripheral level, in selected cases, is discussed.

Adolescent↗

PubMed1986

Hormonal correlations in the polycystic ovary syndrome.

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17-alpha-Hydroxyprogesterone↗

PubMed1983

[A case of primary undifferentiated carcinoma of the perineo-bulbar urethra].

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Aged↗

PubMedDate not supplied

Peribulbar and retrobulbar combined anesthesia for vitreoretinal surgery using ropivacaine.

PURPOSE: To evaluate the efficacy and clinical effects of local retrobulbar anesthesia using ropivacaine in vitreoretinal surgery. METHODS: Prospective study. A total of 919 vitreoretinal operations were followed. The operations were divided into three groups, depending on the degree of anesthesia needed. Group A: Vitrectomies with episcleral procedures (208 vitrectomies for detached retina or perforating trauma). Group B: Episcleral procedures only (410 operations for detached retina without vitrectomy). Group C: Vitrectomies without episcleral surgery (301 operations for macular pucker or hole, proliferative diabetic retinopathy, or silicone oil removal). Anesthesia was administered using a 23-gauge Atkinson-type retrobulbar needle, after topical anesthesia. Six mL of the solution containing 7.5 mg ropivacaine/mL were injected into the peribulbar space, and the other 4 mL deeper, into the retrobulbar space. The degree of infiltration of the palpebral region, the motor block in the extrinsic ocular muscles, and pain felt were checked and rated. RESULTS: Swelling of lids was seen in 885 patients (96%); in 21 (2%) swelling was partial. In 13 patients (1%) there were no signs of infiltration. The motor block was total in 801 (87%) eyes, while 118 (12%) had reduced ocular movements. The degree of anesthesia was as follows, considering the three groups together: no pain = 855 (93%) patients; moderate pain = 44 (4%) patients; very strong pain = 20 (2%) patients. No adverse events or side effects were observed. CONCLUSIONS: Ropivacaine used for retrobulbar-peribulbar combined anesthesia in vitreoretinal surgery showed excellent clinical efficacy as regards analgesia and muscle akinesia.

Adult↗

PubMedDate not supplied

[Bacteriology of abdominal pus in 43 cases of acute appendicitis and appendiceal abscess at the Ivrea-Castellamonte Hospital, isolation of aerobic and anaerobic bacteria and drug sensitivity].

A retrospective study on the microbiology of abdominal pus from acute appendicitis or peritonitis was carried out by the authors. A total of 45 specimens were examined, 38 of them (84.4%) where found to be positive, of which 29 (76.3%) were polymicrobial and 9 (23.7%) were monomicrobial. The most represented species were Escherichia coli (28.4%), Bacteroides fragilis (7.8%), Streptococcus milleri (7.8%), Bacteroides oralis (3.9%) and Pseudomonas aeruginosa (3.9%). The polymicrobial associations more represented include Bacteroidaceae, Enterobacteriaceae and streptococcus genus. The most active drugs in vitro were found to be Piperacillin and Chloramphenicol, Cephalosporin (cefotaxime, ceftriaxone and cefoxitin) showed a good capability of being active against isolated microorganisms although they were less effective when used against anaerobic microorganisms then aerobic ones. On the contrary, Rifampicin, Metronidazole and Clindamycin were found to be quite effective against the anaerobes.

Abscess↗

PubMedDate not supplied

[Community- and hospital-acquired bacteremia: a retrospective study in a regional hospital. III. Microbiological aspects].

A retrospective study was made of all blood cultures performed over a 40-month period at the Ivrea-Castellamonte Hospital (Turin, Italy). A total of 4386 vials from 619 patients were examined. There were 619 positive vials (14.1%) from 131 patients (21.2%) corresponding to 145 bacteremia episodes, including 129 monomicrobial (89%) and 16 polymicrobial (11%). Ten patients (1.6%) had more than one episode. There were 73 polluted vials (1.7%). A total of 165 microorganism were isolated: Gram-positive (52.7%) and Gram-negative (46%) bacteria, and mycetes (1.2%), anaerobic flora (9.7%). The predominant families were: Enterobacteriaceae (29.5%), Micrococcaceae (27.3%), Pseudomonadaceae (4.8%), Bacteroidaceae (4.8%) and Streptococcus "Genus" (18.8%). The species frequencies were: Escherichia coli (20%), Staphylococcus aureus (15.8%), Enterococcus (8.5%), Staphylococcus epidermidis (7.3%), Pseudomonas aeruginosa (4.8%), Proteus mirabilis (4.2%), Brucella spp. (2.4%), Bacteroides fragilis, Streptococcus bovis e Propionibacterium acnes (1.8%). These findings are compared with those published in the Italian and international literature. Stress is laid on periodical review of the isolations from samples of this kind as a useful aid towards the diagnosis and treatment of hospital infections, and in their monitoring and epidemiological evaluation.

Bacteremia↗

PubMedDate not supplied