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Biomedical subjects

P Pepe

Publications and source records attributed to P Pepe.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Mediterranean anemia in 124 Sicilian pregnant women].

INTRODUCTION AND AIMS: The aim of this study was to verify knowledge of beta-thalassemia in a group of Sicilian puerpere. METHODS: The study was performed in a group of 124 pregnant women chosen at random from 2769 who gave birth in 1995 in the third trimester of pregnancy at the Specialised Maternity Hospital of Santo Bambino in Catania. RESULTS: A total of 124 puerpere replied to the questionnaire out of 124 interviewed. Their age ranged from 15 to 46 years old; the most frequent age group was 20-35 years old (81 cases-65.4%). 69.3% (86 cases) were married, 5.6% (7 cases) were separated or divorced, 24.9% (31 cases) were single or living with partners. The level of education was mainly lower (39.6%-49 cases) and upper (26.6%-33 cases) secondary school; there were few cases of illiteracy (3.2%-4 cases). The women were predominantly workers (25%-31 cases), employees (37.1%-41 cases) and in 14.4% (18 cases) neither of the couple worked. 4% (5 cases) of women lived alone. 73.3% (91 cases) reported that they knew what Mediterranean anemia was, 85% (35 cases) had recently spoken about this pathology with their doctor, 57.2% (71 cases) with their gynecologist. 36.2% (45 cases) knew the meaning of hemoglobinophoresis. 25% (31 cases) replied in the affirmative to the question regarding the hemoglobinophoresis test, 28.5% (35 cases) were unable to answer and 46.7% (58 cases) replied negatively. 11.2% (14 cases) of the puerperae had been informed about this disease when they were under 20, 39.5% (49 cases) between 20 and 35 years old, and 0.80% (1 case) after 36 years old. 36.2% of those interviewed (45 cases) responded correctly to the question "when does a carrier of Mediterranean anemia risk producing children suffering from a severe blood pathology?".

Adult↗
PubMed1997

[Volocimetric evaluation of spermatic vessels with echo color doppler in patients with idiopathic varicocele].

BACKGROUND AND AIMS: There is a high incidence of varicocele or dilatation of the spermatic vessels associated with reflux in the male population varying, according to statistics, from 4.5 to 30.7%. Among the numerous hypotheses put forward to explain infertility in approximately 50% of patients with varicocele, it has recently been shown that there is an increased concentration of noradrenalin in the spermatic vessel which might be responsible for chronic arterial vasoconstriction affecting the gonads, leading to endothelial hyperplasia and consequent infertility. MATERIALS AND METHODS: In this study the authors have evaluated the bilateral flow of spermatic arteries at the level of the scrotum in patients with varicocele and in the healthy (varicocele-free) population with normal and hypospermatogenesis. RESULTS: In all groups and in the absence of other major pathologies (including arterial hypertension), no significant differences were found in systolic peak velocity (SPV) in relation to the presence or otherwise of varicocele and the degree of reflux. Mean SPV ranged between 3.5 and 4 cm/sec in patients with hypo- and/or normal zoospermia both in the varicocele and healthy population. CONCLUSIONS: In line with other authors, we feel that despite the lack of substantial differences in arterial flow in the patients examined, it is not possible at present to explore the testicular microcirculation and possible hypoperfusion using eco color-Doppler, in spite of the fact that the method shows a high level of diagnostic accuracy in the diagnosis of phlogistic pathologies and/or twisting of the spermatic cord. New approaches might be provided through the improved study of the microcirculation using power Doppler which appears to be more sensitive than eco color-Doppler in visualizing small intraparenchymal vessels.

Adolescent↗
PubMed1996

Future directions for resuscitation research. III. External cardiopulmonary resuscitation advanced life support.

This discussion about advanced cardiac life support (ACLS) reflects disappointment with the over 50% of out-of-hospital cardiopulmonary resuscitation (CPR) attempts that fail to achieve restoration of spontaneous circulation (ROSC). Hospital discharge rates are equally poor for in-hospital CPR attempts outside special care units. Early bystander CPR and early defibrillation (manual, semi-automatic or automatic) are the most effective methods for achieving ROSC from ventricular fibrillation (VF). Automated external defibrillation (AED), which is effective in the hands of first responders in the out-of-hospital setting, should also be used and evaluated in hospitals, inside and outside of special care units. The first countershock is most important. Biphasic waveforms seem to have advantages over monophasic ones. Tracheal intubation has obvious efficacy when the airway is threatened. Scientific documentation of specific types, doses, and timing of drug treatments (epinephrine, bicarbonate, lidocaine, bretylium) are weak. Clinical trials have failed so far to document anything statistically but a breakthrough effect. Interactions between catecholamines and buffers need further exploration. A major cause of unsuccessful attempts at ROSC is the underlying disease, which present ACLS guidelines do not consider adequately. Early thrombolysis and early coronary revascularization procedures should also be considered for selected victims of sudden cardiac death. Emergency cardiopulmonary bypass (CPB) could be a breakthrough measure, but cannot be initiated rapidly enough in the field due to technical limitations. Open-chest CPR by ambulance physicians deserves further trials. In searches for causes of VF, neurocardiology gives clues for new directions. Fibrillation and defibrillation thresholds are influenced by the peripheral sympathetic and parasympathetic nervous systems and impulses from the frontal cerebral cortex. CPR for cardiac arrest of the mother in advanced pregnancy requires modifications and outcome data. Until more recognizable critical factors for ROSC are identified, titrated sequencing of ACLS measures, based on physiologic rationale and sound judgement, rather than rigid standards, gives the best chance for achieving survival with good cerebral function.

Animals↗
PubMed1995

Quantitative description of echographic images of morphea plaques as assessed by computerized image analysis on 20 MHz B-scan recordings.

In order to find image descriptors enabling the characterization of sclerotic skin of morphea plaques and their objective differentiation from normal skin, we studied 52 lesions in 35 patients affected by plaque type morphea. Echographic evaluations were carried out using a 20 MHz B-scanner, providing cross-sectional images of the skin. Images were processed by a program providing a numerical representation of the picture data, based on the following parameters, which were considered for 7 different amplitude intervals: 1) the extension of image areas marked by amplitude bands of interest, 2) the percentage of the image surface reflecting within a homogeneous amplitude band, 3) the number of objects composing the image, 4) the average object size, and 5) the "density" of the objects. For all parameters considered, marked differences between sclerotic skin and normal tissue were observable. When assessment is performed with amplitude bands covering the lower part of the scale, the image referring to sclerotic tissue appears relatively homogeneous with few, large objects within a thickened skin block, which occupy a more extended image surface in comparison to images of normal skin, characterized by spots, which are small and closely packed. On the contrary, binary images of morphea plaques transformed by intermediate to high amplitude intervals appear with fewer objects of approximately the same size or smaller, which are less compressed in respect to healthy skin images.

Adult↗
PubMed1995

Sodium hydroxide-induced irritant dermatitis as assessed by computerized elaboration of 20 MHz B-scan images and by TEWL measurement: a method for investigating skin barrier function.

Sodium hydroxide-induced irritation was studied in 34 volunteers, by means of 24-h patch testing at different concentrations, and by a 10-min testing procedure employing 0.1 mol/l NaOH. As a supplement to subjective evaluation of skin changes, assessments of test areas by TEWL measurement and sonography were performed at 24, 48 and 72 h. After 24-h patch testing, instrumental evaluations showed an increase in the extension of the hypo-echogenic dermal area and in TEWL, whereas a 10-min NaOH application induced a decrease of the dermal and epidermal reflectivity and an increase in TEWL. Twenty-four hour patch testing with 4% NaOH allowed a classification of subjects into two categories: subjects who reacted normally and hyper-reactors. Hyper-reactors showed an enhanced inflammatory response and a more pronounced barrier function damage, as assessed clinically and instrumentally by decreased dermal reflectivity, and by higher postexposure TEWL. Subjects with a more marked inflammatory response to 4% NaOH also showed greater TEWL increases during the short-term testing procedure employing 0.1 mol/l NaOH. Moreover, these subjects were characterized by higher baseline TEWL values, indicating that cutaneous reactivity to NaOH is at least partly correlated to impaired stratum corneum function, which is inadequate to effectively prevent compounds from penetrating the skin.

Adolescent↗
PubMed1995

[Ultrasonography and prostatic adenocarcinoma].

In the report we refer to our experience as regards the role of transrectal ultrasonography in the early diagnosis of prostatic heteroplasia based on the results obtained by a research led from January 1991 to January 1995 on 1185 dysuria patients who have been subjected also to a rectal exploration and a serous dosage of PSA. Among the 306/1185 (25.8%) of the patients subjected to prostatic echoguided biopsy sec. Hodge in 238 (77.7%) a hypoechogenic zone on behalf of the periphery of the prostatic parenchyma has been reported. The histological result has pointed out the presence of adenocarcinoma in 81 (26.4%) patients; of benign prostatic hypertrophy in 196 (64%); of acute and/or chronic non specific phlogosis in 26 patients (8.4%) and granulomatosis prostatitis in 3 (1%). The sensibility, the specificity and the diagnostic efficiency of the transrectal ultrasonography in the diagnosis of prostatic heteroplasia have resulted equal, respectively to 100%, to 30.2% and to 48.6%. In 122 patients (66%) the hypoechogenic zone was not pathognomonic of prostatic heteroplasia. Definitely, considering the high sensibility in opposition to the insufficient specificity of the echography, it is our future intention not submit to prostatic biopsy those patients who show only a hypoechogenic zone in absence of pathology EDR and PSA but to monitor them through quarterly clinic checks.

Adenocarcinoma↗
PubMed1995

[Treatment of urinary tract infections with macro-crystalline nitrofurantoin].

Therapy of urinary tract infections with nitrofurantoin macro-crystals. The aim of this study is to evaluate the therapeutic effectiveness of two dosages of nitrofurantoin macro-crystals. Between January 1993 and February 1994, 101 patients (54 male and 47 female), either suffering from urinary tract infections or on whom internal examination had been carried out, were treated with nitrofurantoin macro-crystals. There were divided into two groups: A, a posology of 100 mg 3 times daily for 7 days and B, a posology of 100 mg 4 times daily for 7 days. A urine culture was carried out on all patients before and after treatment. E. Coli was found in 60.5% of cases, Streptococcus Faecalis in 12.7% and Staphylococcus aureus in 5.6%. Infection was eliminated in 85.3% of patients in group A and 93.9% in group B. The dysuric symptomatology was cured in 84.6% of patients in group A, and 89% in group B. The statistic elaboration of the results with X2 and p tests did not reveal any difference between the two groups examined.

Adult↗
PubMed1995

[PSA and prostatic adenocarcinoma. Experience with 805 patients].

Over the last decade PSA has been widely acknowledged to be a very sensitive and specific marker of prostatic tumour pathologies. This paper reports the authors' experience relating to the use of PSA in the early diagnosis of prostatic heteroplasia on the basis of results obtained in a study performed in 805 dysuric patients who underwent rectal exploration and CAT. Echo-guided prostate biopsy according to Hodge was performed in 212 (26.4%) out of 805 patients and adenocarcinoma was found in 55 cases (25.9%). PSA ranged between 10-198 ng/ml in 42 out of 212 patients, between 4-10 ng/ml in 60, and was below 4 ng/ml in 110. In addition, PSAd was assayed in all patients with PSA < 10 mg/ml. Having established the cutoff of PSA at 10 ng/ml, it was found that some heteroplasia, above all at the initial sage, presented normal PSA blood values. In fact, in 8 cases, equivalent to 14.5% of the neoplasias diagnosed, values were under 4 ng/ml, and in 5 cases, equivalent to 9%, they ranged between 4-10 ng/ml. This finding showed that the threshold value of 10 ng/ml gives PSA a high specificity, but a lower sensitivity in the early diagnosis of prostatic adenocarcinoma. Moreover, the analysis of PSA-density does not significantly allow the diagnosis of a larger number of heteroplasias: in fact, out of 13 cases of adenocarcinoma with PSA < 10 ng/ml, PSAd was only > 0.15 in 2 patients. Therefore, in line with the data reported in the literature, the authors consider that PSA assay represents a sensitive and specific screening method for prostatic tumour pathologies in symptomatic patients, but in order to obtain an early diagnosis, and especially in cases with serum values between 4-10 ng/ml, it must be combined with both rectal exploration and, above all, transrectal scan.

Adenocarcinoma↗
PubMed1995

[The role of TPS in the diagnosis of prostatic carcinoma].

From June 1993 to July 1994 we treated 136 male patients affected by dysuria with hematic dosage of TPS and PSA, with DRE, transrectal echography and prostatic biopsy using an echograph. The patients treated were divided into two groups: A and B. Group A (TPS cut-off of 75 U/l) was made up of 91 patients, ages ranging from 41 to 85 years (average 72.5 years). Group B (TPS cut-off > 75 U/l) was made up of 45 patients, ages ranging from 39 to 88 years (average 75.1 years). In group A, 22 patients (24.2%) resulted as suffering from prostatic carcinoma, 4 (4.3%) resulted as suffering from prostatic phlogosis, and 65 (71.4%) resulted as suffering from BPH. In group B, 6 (13.3%) were affected by prostatic heteroplasia, 2 (4.4%) were affected by prostatic phlogosis, and 37 (82.2%) were affected by BPH. The TPS had a sensibility of 21.4% and a specificity of 66.3%. A comparison of the data obtained in the two groups did not reveal any significant differences. In this study the TPS showed a poor diagnostic reliability as a biologic marker of prostatic carcinoma.

Adult↗
PubMed1994

[Rehabilitation therapy in the treatment of female urinary incontinence. Our experience with 121 patients].

Rehabilitative therapy of the perineum (FKT, SEF and biofeedback) represents an efficient method in the treatment of urinary stress incontinence without resorting to a complete uro-genital prolapse, as in patients with urethral instability and/or incontinence. One hundred twenty-one women, 55 with urinary stress incontinence (USI), 20 with urge incontinence (UI) and 46 suffering from both types of incontinence, underwent rehabilitative therapy. On each patients the following tests were carried out: an internal test, a urodynamic test (uroflowmeter, PPU, cystomanometry and pessure/flow study), a meter UEC, situated at the bladder neck, anterior and posterior urethra, both clinostatic and orthostatic, urine test with urinoculture and a pap-test. The aim of this study is that of establishing if it is possible a) to simplify the rehabilitative sitting using only FKT with weekly treatment; b) to treat women suffering from urge incontinence or from both types, but with bladder stability (standard cystomanometria) with FKT and Ditropan (1 tablet 3 times daily for weeks therapy). One group of patients underwent rehabilitative therapy while another group underwent traditional therapy, for a minimum of 12 sitting, using also electric functional stimulation (SEF). Of 121 women who underwent rehabilitative therapy, 90 (74.4%) were healed, 30 (24.7%) improved and one (0.9%) showed no signs of improvement. Patients treated with FKT, or FKT and made as good if not better grogress than those who attended more sittings and/or underwent SEF.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Incidence of scrotal disease diagnosed with ultrasonography in 60 asymptomatic patients over 70 years of age].

The aim of this study is to detect by ultrasounds the presence of scrotal pathology in a selected group of elderly men asymptomatic for scrotal pathology. From September 1990 to September 1992, 60 patients aged between 70 and 86 years (mean age 78 years) who were seen in the Department of Medicine for non-urogenital diseases were studied by 7.5 MHz linear probe. In 51.6% of patients (31 cases) an ultrasound pathology was detected with prevalence of cystic pathology of the epididymis (15 cases, 25%); in 12 patients (20%) more echographic pathologies were detected. The following abnormalities were observed: 3 cases of enlargement of the scrotal wall, 6 cases of left varicocele, 15 cases of hydrocele, 1 intratesticular area with altered echostructural pattern, 3 intraparenchymal cysts of the testis, 3 retractile testes, 2 dilatations of intratesticular blood-vessels, 15 cysts of the epididymis and 12 cases of increased size of the head of the epididymis. The authors discuss the results and conclude that high incidence of epididymis and testicular nonmalignant pathology are present in their patients; the authors suggest periodical clinical examination and, in selected patients, examination by ultrasound of the genital apparatus, in elderly patients might be useful because often scrotal pathology might be underestimated for socio-cultural reasons.

Aged↗
PubMed1992

Invalidation of the APACHE II scoring system for patients with acute trauma.

The APACHE II scoring system has been promulgated as a useful tool in the assessment of the severity of injury and prognosis for acutely ill patients. The physiologic basis for stratification is weighted toward older patients with chronic medical conditions. Recently, the APACHE II system has been proposed as a method for determining diagnosis related group (DRG) reimbursement for individual trauma patients. The present study applied the APACHE II scoring system to 280 patients with blunt or penetrating trauma who had documented systolic blood pressure < 90 mm Hg. Fifty-seven (20%) died of their injuries within the first 24 hours. APACHE II scores were recorded both in the emergency room (ED) and at 24 hours following admission. Injury Severity Scores (ISS), Revised Trauma Scores (RTS), and TRISSCAN were calculated. The APACHE II (n = 223) recorded at 24 hours (2.5 +/- 0.2) was significantly less than that recorded in the ED (6.6 +/- 0.3, p < 0.05, Mann-Whitney analysis). Using regression analysis, there was no correlation between APACHE II and ISS if recorded in the ED (r2 = 0.06) or 24 hours following admission (r2 = 0.08). APACHE II also demonstrated a poor correlation with the length of hospital stay (r2 = 0.03 [ED], = 0.19 [24 hours]). Whereas APACHE II may be helpful in defining severity of disease among patients with acute-on-chronic medical conditions, the classification lacks an anatomic component, which is essential to assess the magnitude of acute injury in patients who are typically otherwise healthy.

Acute Disease↗
PubMed1992

[Sexuality of the aging male].

The paper discusses data reported in the literature concerning the sexual behaviour of elderly males and examines the role played by anatomical alterations to the genital tract, erection physiology and psycho-physical performance. The Authors review the current possibilities of treatment for sexual therapy in elderly males.

Aged↗
PubMed1991

Ultrasound B scanning with image analysis for assessment of allergic patch test reactions.

Assessment of patch test results has been performed visually and using ultrasound in the B mode. A positive test site has a typical ultrasonographic appearance, presenting a uniform hypoechogenic area in the dermis. In this zone, the mean amplitude of ultrasound reflection peaks decreases, and the extension of this area increases, together with the intensity of the eczematous reaction. A close correlation has been shown between visual scoring, amplitude decrease and surface increase of the hypoechogenic area. This technique seems to provide a reproducible system for the evaluation of patch tests.

Adolescent↗