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Biomedical subjects

R Orvieto

Publications and source records attributed to R Orvieto.

At least 145 records · Page 8Linked to original sources
PubMed1994

Low back pain and body mass index.

We have examined the association between body mass index and the prevalence of low back pain in about a quarter of a million male recruits aged 17-18 years at the time of their medical draft examination. Low back pain prevalence is shown to rise with increasing body mass index. This statistically significant association may suggest a role of body weight and height in the pathogenesis of low back pain and supports the previously reported need for education regarding weight reduction as a useful implement in low back pain prevention.

Adolescent↗
PubMed1993

[Pregnancy in Marfan's syndrome].

Marfan's syndrome is a hereditary disorder of connective tissue affecting mainly the bones, cardiovascular system and eyes. Women affected by this syndrome who are considering pregnancy are confronted with several problems: a 50% risk of inheritance of the syndrome by their offspring, shortened life expectancy as a parent, and the potential for cardiovascular complications, such as aortic aneurysm and dissection during pregnancy.

Adult↗
PubMed1993

The possible role of intravenous immunoglobulin in preventing pre-eclampsia.

Our understanding of the pathophysiologic abnormalities contributing to pre-eclampsia has increased substantially over the past decade. This has been accompanied by the introduction of various methods which reduce the incidence of pre-eclampsia to approximately the same range (4-11.8% in high risk group), by attempting to correct the pathophysiologic abnormalities involved, rather than averting its occurrence. Numerous reports suggest that pre-eclampsia is caused by an abnormal maternal immune response to antigenic challenge by the fetoplacental allograft. If this assumption is true, it may be possible to manipulate the maternal immune response to fetal allograft and to assist the immunologic homeostasis of the maternal host with her conceptus by passive immunization with intravenous immunoglobulins (IVIg) and thus, to prevent pre-eclampsia. Recently IV preparations of Ig have become available for clinical use including treatment of various immunologic disorders during pregnancy. The effectiveness of this new mode of therapy can be related to several immunological mechanisms such as blockade of antibody binding to receptors on macrophages, increase in T suppressor cells, or decrease in antibody synthesis. The latter effect may be mediated by anti-idiotypic antibodies in the Ig preparation, which may bind to idiotypes on pathogenic autoantibodies and neutralise their activity.

Animals↗
PubMed1993

Testicular carcinoma: a study of knowledge, awareness, and practice of testicular self-examination in male soldiers and military physicians.

Multiple-choice questionnaires devised to evaluate knowledge and awareness of testicular carcinoma and the practice of testicular self-examination (TSE) were distributed to 717 male soldiers and 200 military physicians in the Israeli army. Twenty-one percent of the soldiers had received explanations about the importance of TSE; 16% actually received instruction on TSE; yet only 2% practiced TSE regularly. Seventy percent of physicians had been taught how to examine testicles, but only 10% of physicians examined testicles in their routine physical exams. TSE was practiced most frequently among soldiers who had received instruction in the technique. Physicians should encourage their young male patients to practice TSE.

Adolescent↗
PubMed1992

Bone density, mineral content, and cortical index in patients with thalassemia major and the correlation to their bone fractures, blood transfusions, and treatment with desferrioxamine.

In an attempt to explain the increased frequency of pathological fractures found in thalassemia major patients, we examined noninvasively several properties of bones in 17 patients. We found a significant decrease in the bone mineral content (BMC) and the bone density (BD) of both trabecular (34% and 4% diminution, respectively) and cortical bone (24% and 3% diminution, respectively), as compared with normal controls. We also found that metacarpal cortical indices (CI) were significantly lower in thalassemic patients as compared with normal controls (36% diminution). As expected, upper limb fractures were more frequent in those patients with greater bone diminution. Furthermore, the degree of bone diminution was greater in patients receiving fewer blood transfusions and shorter courses of desferrioxamine. Bone densitometry should probably be included in the comprehensive evaluation of thalassemia patients in order to help guide overall treatment.

Adolescent↗
PubMed1992

Cytokines--involvement in reproduction.

OBJECTIVE: To relay the current knowledge on the interaction between the immune and reproductive systems that results from sharing certain lymphohematopoietic cytokines and their receptors. DATA IDENTIFICATION: Major studies related to this topic have been identified through MEDLINE searches and through the published literature. STUDY SELECTION: Those that have reported on the role of cytokines in the neuroendocrine events of reproduction, ovarian function, placenta, and the developing embryo. RESULTS: The field of growth factor and cytokines and their effects on reproduction is a rapidly growing new area of investigation. Immune cells and related cytokines have been shown to affect the neuroendocrine events of reproduction, ovarian function, placenta, and the developing embryo. Furthermore, it is now becoming apparent that these relationships are reciprocal in that the different cellular components of the neuroendocrine and reproductive systems and the developing embryo can modulate the production of cytokine by the immune system and can also produce certain cytokines. The presence of lymphocytes and macrophages in the female reproductive system, together with the fact that these cells may secrete soluble factors influencing embryo development and trophoblast growth, might suggest that cytokines may play a fundamental role in the mechanisms of immunological reproductive failure. In addition, different mixtures of these mediators, generated by immune cells, the developing embryo, or other maternal cells, may modulate the fine tuning of these activities. CONCLUSIONS: Current knowledge indicates a close interaction between the immune and reproductive functions. Further understanding of these interactions may lead to new concepts in fertility regulation.

Animals↗
PubMed1991

Intravenous immunoglobulin treatment for recurrent abortions caused by antiphospholipid antibodies.

There is an association between the presence of antibodies that bind to anionic phospholipids and the occurrence of repeated spontaneous abortion. Many uncontrolled studies have reported favorable pregnancy outcome in women treated with steroids, low-dose aspirin, heparin, or their combination. Similarly, treatment failures have been reported with most of these therapeutic regimens. Immunoglobulins play a central role in immune regulation. A wide spectrum of human diseases are associated with decreased or abnormal regulation of Ig levels. Recently, IV preparations of Ig have become available for clinical use, including treatment of patients with recurrent abortions and high levels of antiphospholipid antibodies. The effectiveness of this new mode of therapy can be related to several immunological mechanisms such as blockade of antibody binding to receptors on macrophages, increase in T suppressor cells, or decrease in antibody synthesis. The latter effect may be mediated by anti-idiotypic antibodies in the Ig preparation. Determination of dosage of IV Ig, duration of treatment, and treatment intervals are all empirical in patients with recurrent abortions and high levels of antiphospholipid antibodies because antiphospholipid antibody levels are not useful for monitoring therapy. Although the data available at present are promising, additional randomized trials are needed to determine the efficacy of IV Ig in patients with immunological recurrent abortions.

Abortion, Habitual↗
PubMed1990

Glycated proteins and gestational diabetes mellitus.

The use of assays of glycated serum proteins (glycohemoglobin and fructosamine) as markers of glucose homeostasis is becoming a common modality in the evaluation of the pregnant diabetic patient. The purpose of this review is to provide basic information on the interactions between glucose and the protein molecules that lead to the formations of this complex, and to evaluate these tests for their efficacy in the screening and diagnosis of gestational diabetes mellitus, the identification of fetal congenital anomalies and in their relation to early fetal wastage, fetal macrosomia and neonatal complications.

Female↗
PubMedDate not supplied

Pharmacokinetics of the progesterone-containing vaginal tablet and its use in assisted reproduction.

Natural progesterone, which is devoid of androgenic activity, is widely used in assisted reproduction for luteal and pregnancy support. The vaginal route has become the most established way to deliver natural progesterone because it is easily administered, avoids liver first-pass metabolism, and has no systemic side-effects. The vagina has a large potential for absorption, and through the 'uterine first-pass effect' vaginal administration results in higher uterine progesterone concentrations. We have investigated the pharmacokinetics of natural progesterone in the form of a vaginal tablet. A single dose of 100 mg resulted in a mean C(max) of 31.53 +/- 9.15 nmol/l with a T(max) of 6.92 +/- 3.12 h. The terminal half-life was 16.39 +/- 5.25 h. The pharmacokinetic data are discussed in relation to dose, age, and estrogen priming. Single-dose pharmacokinetics of 100 mg of progesterone vaginal tablets and gelatin capsules were evaluated over 24 h. Results indicated a similar mean T(max) of 6.92 +/- 3.12 and 6.23 +/- 6.57 h, respectively. However, a significantly higher C(max) was achieved by the vaginal tablet (31.95 +/- 9.15 and 23.85 +/- 9.57 nmol/l, respectively, P < 0.05). Continuous use of vaginal progesterone did not influence the hormonal, liver, or lipid profiles evaluated. There was no case of endometrial hyperplasia. The vaginal tablet was found to be well-tolerated, safe, and easily administered. In conclusion, progesterone-containing vaginal tablets have good pharmacokinetic properties and should be used for progesterone supplementation in IVF.

Administration, Intravaginal↗
PubMedDate not supplied

Ovarian hyperstimulation syndrome: a new insight into an old enigma.

OBJECTIVE: To relay the current knowledge on the interaction between cytokines, growth factors, and ovarian hyperstimulation syndrome (OHSS) and to propose a new insight into the pathogenesis of OHSS. METHODS: Major studies that have reported on the association between cytokines, growth factors, and OHSS were identified through MEDLINE searches and through the published literature. RESULTS: Several cytokines, as well as vascular endothelial growth factor, were found to have a role, either in the prediction or pathogenesis of OHSS. Moreover, intravenous immunoglobulin, which has an anticytokine nature and inhibits the secretion of various cytokines, was shown to prevent the development of OHSS. CONCLUSION: Current knowledge indicates a close interaction between cytokines, growth factors, and OHSS. Further understanding of these interactions may lead to different understanding of ovarian hyperstimulation syndrome.

Cytokines↗
PubMedDate not supplied

Turner's syndrome and fertility: current status and possible putative prospects.

Women with Turner's syndrome should be carefully followed throughout life. Growth hormone therapy should be started at age 2-5 years. Hormone replacement therapy for the development of normal female sexual characteristics should be started at age 12-15 years and continued for the long term to prevent coronary artery disease and osteoporosis. Most women with Turner's syndrome have ovarian dysgenesis; therefore, they are usually infertile, and in very rare cases have spontaneous menses followed by early menopause. Only 2% of the women have natural pregnancies, with high rates of miscarriages, stillbirths and malformed babies. Their pregnancy rate in oocyte donation programmes is 24-47%, but even these pregnancies have a high rate of miscarriage, probably due to uterine factors. A possible future prospect is cryopreservation of ovarian tissue containing immature follicles before the onset of early menopause, but methods of replantation and in-vitro maturation still need to be developed. Should these autologous oocytes indeed be used in the future, affected women would need to undergo genetic counselling before conception, followed by prenatal assessment.

Adolescent↗
PubMedDate not supplied

Pregnancy outcome in patients with insulin dependent diabetes mellitus and diabetic nephropathy treated with ACE inhibitors before pregnancy.

The preconception and intrapregnancy parameters that are relevant to outcome in women with insulin dependent diabetes mellitus (IDDM) and diabetic nephropathy remain controversial. We analyzed the types and frequencies of maternal and neonatal complications in 24 IDDM patients with diabetic nephropathy (24 pregnancies), all with preserved to mildly impaired renal function. All patients received treatment with captopril for at least six months prior to planned pregnancy and were maintained under strict glycemic control from at least three months before pregnancy to delivery. A successful pregnancy outcome (live, healthy infant without severe handicaps two years after delivery) was observed in 87.5% of the patients. Preexisting hypertension was the only parameter found to be significantly predictive of an unsuccessful outcome (p = 0.0004). We conclude that in patients with IDDM complicated by diabetic nephropathy, pre-pregnancy captopril treatment combined with strict glycemic control offers a prolonged protective effect against possible renal deterioration and probably improves pregnancy outcome.

Adult↗