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Biomedical subjects

P Morosini

Publications and source records attributed to P Morosini.

At least 37 records · Page 2Linked to original sources
PubMed1998

Early intervention for schizophrenic disorders. Implementing optimal treatment strategies in routine clinical services. OTP Collaborative Group.

BACKGROUND: Early detection and intervention in schizophrenic disorders is an important challenge for psychiatry. METHOD: Review of literature on effective biomedical and psychosocial intervention strategies. RESULTS: Comprehensive programmes of drug and psychosocial interventions with adults who show early signs and symptoms of schizophrenic disorders may contribute to a lower incidence and prevalence of major episodes of schizophrenia. These programmes combine early detection of psychotic features by primary care services, with close liaison with mental health professionals. Long-term monitoring of signs of recurrence, with further intervention, appears essential to maintain these benefits. CONCLUSIONS: Field trials demonstrate that effective early treatment strategies can be routinely applied in clinical practice.

Adult↗
PubMed1997

Hepatocyte-directed MR contrast agents. Can we take advantage of bile acids?

A series of gadolinium complexes conjugated to bile acids was prepared and investigated as possible hepatospecific MR imaging contrast agents. In the design of such compounds, features such as the nature of the bile acid, the site of conjugation on the bile acid skeleton, and the global charge of the conjugate were taken into account. Relaxivity measurements carried out in human serum indicate interaction of the conjugates with human serum proteins; even small structural variations significantly affect relaxivity in human serum. Pharmacokinetic data (biliary elimination in the range of 18.4-45.6%) show that bile acids can be used as address moieties to transport gadolinium complexes through hepatocytes. For a homogeneous series of compounds, differing only in the bile acid residue conjugated, it was unexpectedly found that cholic acid is twice as efficient an address moiety as cholylglycine or cholyltaurine. Preliminary results show that none of the conjugates is transported through the basolateral membrane of hepatocytes by the Na+/taurocholate carrier.

Animals↗
PubMed1996

[Cytological diagnosis of thyroid nodules. Comparison of results obtained with guided echography with those from of a "blind" biopsy].

The goal of the study was to verify if echographic fine needle biopsy (US-FNB) improved the diagnostic accuracy of thyroid nodules with respect to a "blind" technique (B-FNB). The study group involved 6,693 patients who underwent aspiration biopsies (989 males and 5,704 females; mean age 46.3 +/- 13.7; range 5-88 years). Total biopsies were 7,952 as some patients underwent two or more biopsies in different nodules. 7,324 nodules with B-FNB and 628 nodules with US-FNB were studied; in this latter cases 136 nodules were not palpable. The diagnosis of malignancy was higher in US- FNB than B-FNB. However, non-diagnostic samples were more prevalent in US-FNB with respect to B-FNB. A histological diagnosis was available in 27 patients with US-FNB and 379 with B-FNB. In US-FNB, accuracy was 81.8%, sensitivity 86.6% and specificity 77.7%. In B-FNB, accuracy was 80.6%, sensitivity 85.1% and specificity 78.1%. These data show that US-FNB diagnostic accuracy was not better than B-FNB. The higher incidence of malignancy found in US-FNB was not dependent on better accuracy, sensitivity or specificity of the US-FNB technique with respect to the B-FNB examination. It is possible that the higher number of malignancies in patients studied with US-FNB was due to the fact that the US-FNB technique aspirated smaller nodules and particular areas of echographic suspicion, thus increasing the possibility of finding a malignancy. Based on our data, we feel that US-FNB results in a greater number of diagnostically inadequate samples. This may depend in part on the smaller size of the biopsied nodules (which are relatively more vascular than larger nodules) and in part on the greater difficulty in carrying-out this technique which directed towards particular echographic areas of suspicion resulting in greater biopsy blood contamination. The authors feel that US-FNB should be carried-out in all cases of non-palpable nodes found incidentally so as to rule out malignancy.

Adolescent↗
PubMed1994

Transforming growth factor-beta 1 is more expressed in thyroid follicular adenoma than in normal tissue.

It is well known that TSH is the main factor responsible for thyrocyte proliferation and growth. Recent studies have shown that other growth factors, including transforming growth factor-beta 1 (TGF-beta 1), have an important role in the control of thyrocyte proliferation and differentiation. The aim of the study was to evaluate the expression of the TGF-beta 1 gene in thyroid follicular adenoma (FA) by Northern analysis, and its protein localization by immunohistochemistry. Surgically removed thyroid tissue from 56 patients with thyroid FA was screened for the study. Normal thyroid tissue from 4 patients with papillary carcinoma was used as a control. Sixteen FA (8 with a "cold" and 8 with a "hot" scintiscan pattern) having homogeneous histological characteristics were subsequently selected. FA showed greater TGF-beta 1 gene expression than control tissue. There was not a statistically significant difference between "cold" and "hot" FA. Immunohistochemistry analysis showed that TGF-beta 1 was located in various histological structures of the adenomas (thyrocytes, endothelium, perinervium and connective tissue); on the other hand, perinodular and control tissue did not show appreciable TGF-beta 1 protein. Our data suggest that TGF-beta 1 may be involved in the pathogenesis of FA. The different TGF-beta 1 distribution in thyrocytes, endothelium, perinervium and connective tissue in FA suggests that TGF-beta 1 may be variably expressed during the natural history of FA. Since no significant difference in TGF-beta 1 gene expression between "hot" and "cold" adenomas was found, it appears that other factors are involved in their functional differentiation.

Adenoma↗
PubMed1994

Intra-articular injection of somatostatin in knee osteoarthritis: clinical results and IGF-1 serum levels.

Recently somatostatin (SST) intra-articular administration has been used in the treatment of some rheumatoid diseases such as rheumatoid arthritis, psoriatic arthritis and osteoarthritis with encouraging results. The aim of this study was to evaluate the efficacy and tolerability of SST intra-articularly injected, involving 20 patients with knee osteoarthritis. Treatment consisted of 4 injections, administered weekly, each of 750 mcg SST. Additionally, in six of them we evaluated the circulating levels of the insulin-like growth factor (IGF)-1 at the base-line time and then every 7 days (immediately before each dose of SST). The results revealed an improvement in pain and in joint function after intra-articular SST, confirmed by statistical analysis. The circulating levels of IGF-1 did not show significant variations following intra-articular administration of SST. The excellent tolerability and the absence of unwanted side-effects with SST allow us to foresee that intra-articular SST could be used in cases of painful knee osteoarthritis, especially in those patients in which other drugs are not appropriate. Moreover, in the absence of modifications of serum levels of IGF-1, SST could be used in athletes.

Aged↗
PubMed1994

[Anti-microsomal, anti-thyroglobulin antibodies and thyroid stimulants in hyperthyroid subjects. Analysis of 315 patients followed-up for 3 years at a single medical center].

The objective of the study was to evaluate the significance of the determination of antithyroid antibodies in hyperthyroid patients. Two-hundred-fifteen untreated Graves' hyperthyroid patients (active toxic diffuse goiter-TDG), 54 Plummer's hyperthyroid patients (focal hyperthyroidism) and 46 subjects with other forms of hyperthyroidism were studied. Serum levels of T4, T3, TSH, TSH receptor antibody (TRAb), microsomal antibody (TMAb), and thyroglobulin antibody (TGAb) were evaluated before starting treatment, at regular intervals during therapy, and during the follow-up period after therapy was withdrawn. The antibodies were positive in all patients with active and non-active TGD but positive in only two patients (3.7%) with focal hyperthyroidism. During the treatment interval, TRAb, TMAb and TGAb serum levels fell with a nadir in the 7th month of therapy. In particular, TRAb fell to normal levels in all patients who had basal levels less than 500 U/l (97.7% of the cases) while TMAb and TGAb remained positive. Relapses, following the completion of therapy, occurred in 20.4% after one year and in 33% after two years. Relapses were always linked to a new increase in TRAb. In conclusion, TRAb can be useful in the determination of early disease and in diagnosing remission. It did not appear useful as a prognostic indicator for relapse in individual patients.

Adult↗
PubMed1993

Treatment with a gonadotropin-releasing hormone agonist in acne or idiopathic hirsutism.

Six women with acne and six women with hirsutism were treated with the GnRH analog [D-Ser(Bu(t))6] LHRH-(1-9)ethylamide (Buserelin) for 6 months (nasal spray, 1,200 micrograms/day) to suppress ovarian steroidogenesis. All women were eumenorrheic and did not demonstrate any adrenal or ovarian dysfunction. During treatment, ovarian steroids, LH and FSH decreased, while DHEA-S showed minor modifications; the clinical score for both acne and hirsutism showed a significant reduction. Moreover, acne and hirsutism were still well controlled 6 months after therapy. Gonadal function resumed in all patients after discontinuation of therapy. Three patients suffered from hot flashes from the 4th month. These data demonstrate that suppression of ovarian steroid secretion might be an efficient treatment in women suffering from acne or idiopathic hirsutism, indicating that ovarian steroids may have a key-role in the pathogenesis of these conditions.

Acne Vulgaris↗
PubMed1993

[A retrospective study of a patient population with benign thyroid pathology undergoing a partial thyroidectomy intervention].

1,196 consecutive cases were analyzed. The results show that familiarity is a major risk factor on goitre insurgence; minor risk factor is pregnancy. The most frequent thyroid disease in pregnancy is the lymphocytic chronic thyroiditis; if the women have familiarity for thyroid disease the probability to display a thyroid disease in pregnancy is most augmented. Thyroid scintigraphy shows its elevated sensitivity: only in someone thyroid adenomas a difference occurs between scintigraphic imaging and surgical-anatomical presentation. Antimicrosomal antibodies relief presents highest utility in autoimmune thyropathies.

Antibodies↗
PubMed1992

Variability among geriatricians in the evaluation of functional disabilities and rehabilitation needs of the elderly.

A formal variability study has been carried out in a geriatric hospital in Genoa, Italy, in order to estimate the degree of agreement between geriatricians in disability and functional assessment, recommendation for rehabilitation treatments, need for mobility and daily activities aids, and decisions about optimal place of treatment (own home, sheltered housing, old peoples' home, nursing home). Sixteen long-stay geriatric patients, average age 83 years, were visited by eight geriatricians, a patient receiving from two to five visits. The participating physicians could visit the patients at their leisure, had access to clinical records and could interview a nurse well acquainted with the patient. A marked variability was observed for most items, e.g. the agreement concerning the recommendation for individual physiotherapy was only 52%. The results of this study may not be generalized to other situations and to actual practice; however, variability studies of this kind, that assess diagnosis habits, treatment and managerial decisions at the same time, may be useful to pinpoint the most important problems and to stimulate professionals' participation in proper Quality Assurance projects.

Aged↗
PubMed1990

Survey of performance of cervical cytopathology laboratories and of screening programs in Italy. National Working Group for Quality Assurance in Cytohistopathology.

Structure, performance, management, quality control and participation in screening programs of cervical cytology laboratories have been evaluated through a questionnaire sent to all public Italian hospitals, relevant university departments and senior members of relevant scientific associations. Completed questionnaires were received from 276 centers, which gives a response rate of 73%. In this report we concentrate on the need for improvement, but there are a number of centers who have all or almost all the features traditionally associated with good or excellent practice. The main results of the survey are the following. Most of the centers examine relatively few cervical smears, so their workload could be considered too low for maintaining a good level of practice. Six centers examine 3 specimens per woman, about 25% examine 2 specimens, and the rest only 1 specimen. There is a marked variability in filing and storing practices of positive and negative smears and results. Internal quality control is inadequate in most centers, and external quality control is limited to voluntary exchange of dubious or interesting smears. Only half of the centers are involved in screening programs. In 75% of the programs the suggested screening interval is 1 year or even 6 months; only 7 (4.5%) agree with the UICC/IARC recommended interval of 3 years. The target population coverage varies from 10% to 85%, and it is less than 50% in 78% of the programs. Only 6 programs have an active women's call system. The survey has confirmed the need for launching a national program of internal and external quality control. Almost all centers have expressed their interest to take part.

Adult↗
PubMed1990

[Follow-up of a population of patients who underwent partial thyroidectomy for benign thyroid pathology].

Natural history of partial thyroidectomy for thyroid disease has been studied in a population of 1196 consecutive cases surgically treated from 1977 to 1982. Follow-up analysis on this population (from six to eleven years) was carried out for appearance of recurrence. Generally, the recurrence incidence was small (only 9.9% of total population) but high frequency was observed for Graves' disease (46%) and lymphocytic chronic thyroiditis (21%). The substitutive/suppressive therapy administration did not influence recurrence of disease. Our results suggest that suppressive therapy does not modify the natural course of non cancerous thyroid pathology residual to partial thyroidectomy.

Adenoma↗