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Biomedical subjects

R Macchi

Publications and source records attributed to R Macchi.

At least 19 recordsLinked to original sources
PubMed1996

Prolonged treatment of chronic C hepatitis by means of medium-high doses of recombinant alpha-2b interferon: an open study to evaluate response and long-term relapse.

Thirty-six patients with hepatitis C virus-RNA positive chronic hepatitis were studied to evaluate whether recombinant alpha-2b interferon, in medium-high doses, (6-9 MU 3 times/week) over a long period (12-18 months), was more effective in reducing or normalizing alanine aminotransferase values, and in reducing the relapsing percentage than the historical trials. At the end of the 12th and 18th month of treatment, mean alanine aminotransferase values were significantly reduced; the level of complete responses was 36.1%, at the end of the 12th month, and 19.4% at the end of the 18th month (intention to treat). These results were no better than comparable findings in the literature. At the end of the first follow-up (12th month), percent complete responses fell to 15.5%, with a relapse rate of 14.3%. At the end of the second follow-up (24th month), percent complete responses fell further to 11.1% (all 4 patients with a 24 months sustained response showed absence of viraemia), with a relapse rate of 42.9%; even these percentages were judged unsatisfactory. In conclusion, no significant advantage was obtained by prolonging interferon treatment and/or using higher dosages. However, the possible virus clearance in all the long-term responders seems to justify further investigation in terms of cost-benefit analysis.

Alanine Transaminase↗
PubMed1995

[Psychological and psychopathological correlates in Dupuytren's disease].

The etiology of Dupuytren's disease, a chronic and depressive lesion of the palmar aponeurosis, is still unclear. Numerous factors have been implicated, including psychopathological elements and a stressor psychosomatic response, possibly in the presence of a personality structure which may represent a diathesis. On the other hand, from a psychosomatic point of view, any psychic correlates could be secondary to somatic damage. In order to look for common psychological and psychopathological elements in the syndrome 39 patients were examined by a team of orthopedics specialised in hand surgery during the period 1990-91. All cases were studied by clinical interview, the evaluation of anamnestic data of possible psychiatric importance and the use of Rorschach and MMPI tests. The data obtained do not confirm that specific personality elements or psychopathological factors can be correlated to the clinical symptoms of Dupuytren's disease given that the results are comparable to what may be considered the characteristics of a non-selected but age- and culturally-matched population. There are only sporadic findings indicating neurotic and depressive factors, or senile involution. Likewise, no reliable and uniform stressing events were observed, or particular signs of maladaptation related to environmental reactivity or the disease itself.

Adult↗
PubMed1994

The evaluation of fine-needle procedures for the diagnosis of focal liver lesions in cirrhosis.

To evaluate the diagnostic accuracy of fine-needle aspiration, fine-needle biopsy and extranodular fine needle biopsy in identifying focal lesions in cirrhosis, 100 consecutive ultrasound detected nodules were studied. Seventy-three were hepatocellular carcinomas (31 were well-differentiated hepatocellular carcinomas), 23 were benign lesions (one angioma and 22 large regenerative nodules) and two were metastases. The lesions were divided according to maximum diameter as follows: < 20 mm in 36, > 20 < 30 mm in 27, and > 30 mm in 33. In four cases there were multiple nodules of different sizes. Fine needle aspiration, intranodular fine needle biopsy and extranodular fine needle biopsy were obtained in each lesion. The sensitivity, specificity and diagnostic accuracy of each procedure were evaluated separately by three independent pathologists. Seven fine needle aspirations and three intranodular fine needle biopsies were considered inadequate. The highest diagnostic accuracy (96%) was obtained by the combined analysis of fine needle aspiration plus intranodular and extranodular fine needle biopsy, and this superiority was confirmed in each group of lesions. Fine needle aspiration showed a lower accuracy (48%) than intranodular fine needle biopsy (67%). When fine needle aspiration and intranodular fine needle biopsy were evaluated together, an accuracy of 91% was found. Intralesional fine needle biopsy plus extranodular fine needle biopsy analysis gave an accuracy of 78% and, particularly relevant, a specificity of 95%. These results indicate that, in patients with cirrhosis with nodular lesions < 30 mm, fine needle biopsy is superior to fine needle aspiration and that the combined evaluation of fine needle aspiration plus intranodular and extranodular fine needle biopsy is the most accurate approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy, Needle↗
PubMed1991

[A case of teratoma of the urachus].

The paper reports a case of teratoma of the urachus in a 53-year-old patient. The difficulties of diagnosing this pathology are underlined, in particular in relation to the rarity of the site of which no other examples have been reported in the literature.

Diagnosis, Differential↗
PubMed1990

[Amoxicillin associated with clavulanic acid. Clinical efficacy and tolerance].

The Authors, after having analysed the problems involving the choice of an antibiotical therapy in the odontostomatological field, present a study concerning the evaluation of the clinical efficacy and tolerability of Amoxycillin associated with clavulanic acid. This drug has been orally administered to 154 ambulatorial patients. The results thus obtained in this clinical sperimentation show that Stacillin is a good and efficacious antibiotic in odontostomatologic affections, and that it is also well tolerated. These characteristics make it a first choice antibiotic in the odontostomatologic sphere.

Adolescent↗
PubMed1990

Asymptomatic parathyroid adenoma manifested by intratumoral hemorrhage.

A 48-year-old woman whose past history was unrevealing presented with sudden swelling of the neck with pain and dysphonia. Neck ultrasonography suggested the possibility of hemorrhage in a parathyroid adenoma. Surgical exploration revealed a hemorrhagic parathyroid adenoma of the chief cell type. This event is exceedingly rare, but should be considered in the differential diagnosis of suddenly appearing masses of the neck region.

Adenoma↗
PubMed1989

[Therapy with L-thyroxine in thyroid struma. Study with ultrasonic evaluation].

L-thyroxine therapy in thyroid goiter. Study with ultrasound imaging evaluation. The literature contains conflicting reports regarding the treatment of thyroid goiter. We evaluated the efficacy of thyrotropin-suppressive therapy with L-thyroxine to reduce the goiter. We studied two groups of 15 and 19 patients with euthyroid goiter for a period of six months: the former were untreated, the latter received L-thyroxine. Six patients represented the controls. All patients treated had suppressed thyrotropin secretion (as evaluated by immunoradiometric assay); sonography was used to measure the goiter. We found no statistically significant difference in size nodule between the two groups. Therapy was also unable to prevent the formation of new nodules.

Adult↗
PubMed1986

Liver cell dysplasia in cirrhosis. A serologic and immunohistochemical study.

Liver cell dysplasia (LCD) was investigated for hepatitis B virus (HBV) markers, alpha-fetoprotein (AFP) and ferritin by serologic and immunohistochemical methods in 101 patients with cirrhosis. LCD was found in 30 cases (29.7%), with the highest incidence in cases of posthepatitic cirrhosis (67%). In the group of dysplastic cirrhosis (DC) 46.6% of the patients had active HBV infection (hepatitis B surface antigen [HBsAg] serum positivity) compared with 7% of the patients with nondysplastic cirrhosis (NDC) (P less than 0.01). The mean serum AFP concentration was significantly raised in the DC group compared with that in the NDC group (P less than 0.05). In seven patients with LCD at the initial biopsy, the histologic followup showed the persistence of LCD in all cases, and the development of hepatocellular carcinoma (HCC) in three cases. In serologic HBsAg-positive cases, dysplastic cells, at variance with the surrounding liver parenchyma, were almost always negative for tissue HBsAg, and always negative for tissue hepatitis B core antigens (HBcAg). AFP was never detected in either normal or dysplastic cells. Ferritin was found in all cases, but dysplastic foci displayed a lesser amount of this protein. These serologic and immunohistochemical data strongly suggest a preneoplastic significance of LCD. The importance of monitoring cirrhotic patients with LCD and particularly those with HBV infection and/or increased AFP levels with more aggressive follow-up is also stressed.

Antibodies, Viral↗
PubMedDate not supplied

Chronic autoimmune thyroid disease.

A total of 67 patients with chronic autoimmune thyroid disease were followed, mainly as outpatients, for a period of a few months to over 15 years. The diagnosis was euthyroidism (n = 16, 23.8%), subclinical hypothyroidism (n = 20, 29.8%), primary hypothyroidism (n = 28, 41.7%) or hashitoxicosis (n = 3, 4.47%). Patients with goiters fit Hashimoto's original description of "struma lymphomatosa". The diagnosis was made on clinical grounds and the usual laboratory hormonal tests. Histological examination was carried out at surgery or by fine needle aspiration in 35 patients (52.2%), and a clinical diagnosis was made in 32 (47.7%). Three patients had juvenile Hashimoto's thyroiditis. Most patients were in the fourth, fifth or sixth decade (64.8%), and of these 12 (18%) had subclinical hypothyroidism, which should be suspected when thyrotropin (TSH) is twice the upper normal limit. In these cases thyrotropin releasing hormone (TRH) testing and evaluation of anti-thyroglobulin antibodies (TgAb) and anti-microsomal antigen antibodies (MsAb) are mandatory. Hypothyroidism with few symptoms develops insidiously in young or elderly patients; the most sensitive test is TSH assay in conjunction with tests for TgAb and MsAb. L-thyroxine administration may be harmful in older patients with late diagnosed primary hypothyroidism. Thyroid supplementation is suggested for patients with subclinical hypothyroidism if TSH values are above 10 mU/L; otherwise they should be followed up annually, as should patients with positive thyroid autoantibodies who are still euthyroid.

Age Factors↗
PubMedDate not supplied

Studies on anti-myelin antibodies in patients with multiple sclerosis.

We studied the CSF and sera from 16 patients with MS to detect IgG antibody activity against normal CNS myelin and some of its proteic and lipidic components. IgG binding to a protein band of the same MW of myelin basic protein was detected by "immunoblot" in the sera and/or CSF of 25% of patients with MS and in none of the controls with OND. No IgG antibody reactivity against other components of CNS myelin was detectable in patients with MS, and immunoabsorption of the CSF of MS patients with CNS myelin did not modify the oligoclonal prophile of CSF IgG. Anti-myelin antibodies do not seem to represent the bulk of oligoclonal IgG in MS patients.

Antibodies, Neoplasm↗