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Biomedical subjects

R De Marco

Publications and source records attributed to R De Marco.

At least 37 records · Page 2Linked to original sources

Chronic respiratory symptoms, bronchial responsiveness and dietary sodium and potassium: a population-based study.

A possible relationship between Na+ intake and increased prevalence and mortality from asthma and chronic obstructive pulmonary disease (COPD) has been suggested but not clearly proven for several reasons (difficulty in assessing Na+ and K+ both by 24 h excretion and dietary recall, too small an effect of these ions on the pathology, and the role of potential confounders). We wanted to determine the relationship of Na+ and K+ intake, assessed by means of a 7 day recall, with chronic respiratory symptoms and bronchial responsiveness in a sample of the general population. Two hundred and five subjects were studied, with complete dietary and respiratory questionnaires, and baseline respiratory function tests, together with a subsample of 146 subjects who underwent histamine challenge. The 7 day recall consisted of two parts: the first assessed discretionary Na+; and the second assessed Na+ and K+ contained in food. The whole sample was split into two groups based on the levels of consumption, and the statistical analysis was performed contrasting the three lower quartiles vs the highest. Smoking habit, social economic status, age and body mass index (BMI) were not confounders for Na+ and K+ intake. The prevalence of symptomatic subjects and baseline respiratory function values were not significantly different in the two groups of quartiles for Na+ and K+. Baseline respiratory values and dose-response slope of the subsample were also not significantly different. We did not prove a relationship between these dietary factors and either bronchial responsiveness or chronic respiratory symptoms. Although we consider that our questionnaire is more reliable than other methods for Na+ and K+ assessment, several potential biases still remain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

A case of Parinaud's syndrome in a boy with delayed puberty.

The authors describe a case of Parinaud's syndrome in a 14-year-old boy with delayed puberty. The neurological examination and the neuroradiological work-up excluded the presence of cerebral pathological processes except for a pituitary microadenoma. As the sole presence of the microadenoma cannot justify gonadotropin deficiency, the authors in this case favor a form of isolated gonadotropin deficiency, and they suggest that the elevation paralysis can be put in the range of median line defects, such as labiopalatoschisis and hypoplasia of the olfactory bulbs, frequently associated with isolated hypogonadotropic hypogonadism.

Adenoma↗

Relationships between physical and psychological symptomatology in the 22-item Langner's scale.

A systematic evaluation has been made of the validity and dimensionality of the 22-item Langner's scale, Italian version, in order to determine its suitability in epidemiological psychiatric surveys. Data from 1543 teachers working in Milan have been used for this purpose. The results show that the scale, when used as a continuous measuring instrument, successfully discriminates subjects suffering from psychological disturbance from the controls and that the scale's items seem to pertain only to the dimension of psychological disease. For this reason the distinction proposed by some authors between physiological and psychological dimensions of the scale would seem of little interest from a methodological point of view. On the other hand, the low specificity of the scale, if confirmed by further more specific studies, would require that caution was to be exercised when using it as a screening method.

Adult↗

Insulinogenic indexes in psoriasis.

We have earlier demonstrated that in psoriasis there exists a reduced tolerance to carbohydrates in association with hyperinsulinism. To pursue this problem further, we felt it worthwhile to deal with the results of the oral glucose tolerance test performed on 78 subjects (divided into homogenous groups of normal, obese and psoriatic groups, both with and without diabetic genetic history and obesity) with determinations of both blood glucose and blood insulin levels. We have calculated the insulinogenic indexes by using the techniques elaborated by various authors (I/G, delta I/delta G, AI/AG) and we have then carried out a statistical evaluation both of these indexes and of the ratio between the various indexes employing not only the usual techniques but also that of correlation and simple and multiple regression. We have done this in order to evaluate which of these indexes is better suited to demonstrate the physiopathological mechanism concerning the relationship between insulin hypersecretion and reduced carbohydrate tolerance in the various pathological conditions which we have dealt with.

Blood Glucose↗

Measuring contrast sensitivity in aretinopathic patients with Insulin Dependent Diabetes Mellitus.

Contrast sensitivity measurements were obtained from 66 patients with Insulin Dependent Diabetes Mellitus (IDDM) and no visible diabetic retinopathy (Group A, n = 30 prepubescent and pubescent subjects; Group B, n = 36 postpubescent subjects). Contrast thresholds were determined for stationary and 6.87 Hz phase-alternating gratings at eight spatial frequencies from 0.18 to 15.7 c/deg. Data from each group of diabetic patients was compared with data from puberty-matched normal subjects. Mean value of the last four determinations of glycohemoglobin Alc (HbAlc) was used as a index of glycemic control. We found that patients with IDDM and no retinopathy had normal contrast sensitivity and that contrast thresholds were not significantly related to sexual maturity, duration of diabetes and glycemic control.

Adolescent↗

Hypoglycemic therapy and hemostasis in maturity- onset diabetes mellitus: existence of an early prethrombotic state.

We studied 115 patients with uncomplicated maturity-onset diabetes mellitus, 55 males and 60 females; patients were divided into 7 groups according to the hypoglycemic therapy (diet alone, tolbutamide, glibenclamide, phenformin, combination of the last two drugs, insulin, combination of insulin and phenformin). All patients were tested for a prethrombotic state by the simultaneous determination of the following parameters: ADP-induced platelet aggregation, Factor VIII as antigen and procoagulant activity and the plasma levels of fibrinogen and antithrobin III. Our results show that these parameters were markedly altered in diabetic patients when compared to apparently normal subjects of the same age; on the contrary, differences between groups of diabetic patients were very slight and hardly ever statistically significant. These results suggest that the prethrombotic alterations of hemostatic system are very similar in all groups of diabetic patients; this is true also for patients submitted to diet alone, i.e. with slight and usually recent-onset diabetes mellitus. In conclusion, our study suggests the opportunity, at least from the theoretical point of view, of systematic antiaggregant and/or anticoagulant treatment(s) in maturity-onset diabetes mellitus, whose severe and precocious prethrombotic alterations seem to be independent of the hypoglycemic treatment applied.

Adenosine Diphosphate↗

Hypoglycemic treatments and the fibrinolytic system in maturity-onset diabetes mellitus without thromboembolic manifestations.

The fibrinolytic system was investigated in 115 patients with maturity-onset diabetes mellitus in good metabolic control and without thromboembolic manifestations. The patients were divided into 7 groups according to the hypoglycemic therapy: diet alone, tolbutamide, glibenclamide, phenformin, combination of the last two drugs, insulin, combination of insulin and phenformin. Our results indicate that in maturity-onset diabetes both fibrinolytic activity and inhibitors of fibrinolysis are increased. The enhanced fibrinolytic activity was not affected by different hypoglycemic drugs, whereas the main antiplasmins showed wide variations in the different treatment groups. In particular, a significant reduction of alpha 2M was observed in patients on glibenclamide therapy. In conclusion, our study showed that the high fibrinolytic state seems to be a constant element in diabetes, and that the different behaviors of the fibrinolytic system, reported by various authors in patients taking different hypoglycemic drugs, could be explained by the wide range of plasmin inhibitor levels observed in these conditions.

Aged↗

Characterization of cystic tumors of the pancreas: CT accuracy.

PURPOSE: The purpose of this work was to evaluate the capabilities of CT to accurately characterize cystic tumors of the pancreas. METHOD: Two observers retrospectively evaluated the CT exams of 100 cystic masses of the pancreas, with pathological confirmation. The two observers, blinded about clinical information and the final diagnosis, tried to categorize the lesions according to well established morphologic features. Statistical analysis was performed to measure the agreement between each radiologist and the consensus diagnosis and to evaluate the usefulness of certain CT findings in differentiating one type of cystic pancreatic neoplasm from another. RESULTS: Serous cystadenoma was better diagnosed by CT [Youden misclassification index (Ymi) = 0.72] than mucinous cystic tumor (Ymi = 0.44) and solid pseudopapillary tumor (cystic variant) (Ymi = 0.47). CONCLUSION: As patients with previous history of pancreatitis were excluded from the study, CT findings allowed correct characterization of only 60% of cystic pancreatic masses. Among the remaining 40%, 15-20% of the wrong diagnoses could not be corrected by means of CT, given the patterns shown by the tumors. In 20-25% of the cases, a nonspecific diagnosis of cystic mass was made.

Contrast Media↗

Comparison of emedastine 0.05% or nedocromil sodium 2% eye drops and placebo in controlling local reactions in subjects with allergic conjunctivitis.

PURPOSE: To assess the efficacy of nedocromil sodium 2% eye drops and emedastine difumarate 0.05% eye drops in controlling the ocular allergic reaction induced by conjunctival allergen challenge (CAC). METHODS: Thirty subjects with a personal history of allergic conjunctivitis were enrolled (first visit). At the second visit each subject randomly received emedastine 0.05% or nedocromil 2% in one eye and placebo in the other eye. Five minutes after the medication the offending allergen was instilled in both eyes. Ocular redness and itching were evaluated according to a standardized scoring system at 3, 10 and 20-minute intervals after instillation of the allergen. After one week (third visit) the whole procedure was repeated using the placebo in the eye used as control during second visit and one of the trial drug that was not used at second visit in the other eye (either emedastine or nedocromil). RESULTS: Emedastine 0.05% and nedocromil 2% eye drops were more effective than placebo in controlling ocular redness and itching (p<0.01). Emedastine was more effective (p<0.01) than nedocromil in alleviating redness and itching 3 and 10 minutes after application of the allergen. CONCLUSIONS: Emedastine 0.05% appeared superior to nedocromil 2% in producing immediate relief when subjects with allergic conjunctivitis were exposed to the offending allergen.

Adolescent↗

Retinochoroiditis associated with congenital toxoplasmosis in children: IgG antibody profiles demonstrating the synthesis of local antibodies.

PURPOSE: Retinochoroiditis is generally diagnosed after the first year of life and the association with congenital toxoplasmosis presents a diagnostic dilemma. The detection of local intraocular specific antibodies could be useful for diagnosis. METHODS: We studied six patients (mean age 7 +/- 5 years) with retinochoroiditis which appeared after the first year of life. Aqueous and serum were analysed by immunoblotting for anti T. gondii IgG to diagnose toxoplasmosis. RESULTS: All serum samples were positive only for anti T. gondii IgG. The retinochoroiditis was active in three patients and inactive in the others. Immunoblot analysis of serum and aqueous from the patients with active lesions showed IgG versus the specific antigen of T. gondii. In the patients with inactive lesions the pattern was the same in the two compartments. In active forms, aqueous and serum Western blot patterns differed in proteins lower than 16kDa and higher than 116kDa: in aqueous the findings were typically positive for 30kDa. CONCLUSIONS: Aqueous humour analysis by the Western blot technique may be useful in the diagnosis of congenital toxoplasmosis. In the present small series, we nevertheless detected different patterns for inactive and active retinochoroiditis, confirming the diagnosis in the latter. Aqueous humour paracentesis may be indicated in a child with active retinochoroiditis with unusual clinical features, appearing after the first year of life, and with no clinical or serological evidence of congenital infection.

Animals↗

A retrospective study of ocular side effects in children undergoing bone marrow transplantation.

Bone marrow transplantation (BMT) is recognized as a successful treatment for malignant and non-malignant hematological diseases. Thanks to transplantation, the number of long-term survivors has risen and with the improved prognosis a problem of ocular side effects has arisen. We carried out a retrospective study to determine the incidence and etiopathogenesis of ocular complications in a series of young patients undergoing BMT. One hundred children (62 males and 38 females) with a mean age of 7.12 (+/- 3.3) years at the time of BMT (autologous in 66 cases, allogenic in 34) were followed for a mean of 4.2 years (range 2-9). The conditioning regimens preceding BMT induced cytoreductive chemotherapy alone (47 cases) or associated with total body irradiation (TBI) (53 cases) in three or six fractions for a total dose of 10-12 Gy. We examined every child before BMT and subsequently every six months. We did not include patients with ocular complications due to the primary disease. Thirty-three children showed several complications after BMT: 17 had subcapsular posterior cataract in both eyes and eight had tear hyposecretion; one had dramatic fungal panuveitis, four had hemorrhagic complications and five optic disk edema. TBI was significantly associated with the development of subcapsular posterior cataract.

Antineoplastic Agents↗

[The use of a multistage model in the analysis of the occupational risks in those exposed to hexavalent chromium].

A brief presentation is made of the theory underlying the multistage model of Armitage and Doll and its implications in assessing the effect of exposure to a carcinogen. The theory foresees different relationships between cancer risk and the dependent time variables (time from beginning of exposure, age at start of employment, duration of exposure and time since end of exposure) according to whether the carcinogen acts in the early or late stages of the process of cell transformation leading to tumour formation. The trend in risk of death from lung cancer was studied in a cohort of workers exposed to hexavalent chromium followed up between 1948 and 1985. The results, referred to the multistage model, indicate that hexavalent chromium probably acts in the later stages of the cell transformation process; the implications of this hypothesis for prevention and/or occupational safety strategies are discussed.

Chemical Industry↗