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Biomedical subjects

R Pippi

Publications and source records attributed to R Pippi.

18 recordsLinked to original sources
PubMed2006

Early detection of insulin deprivation in continuous subcutaneous insulin infusion-treated patients with type 1 diabetes.

BACKGROUND: This study was performed to define the clinical relevance of early changes of capillary 3beta-hydroxybutyrate (3betaOHB), for detection of metabolic deterioration before occurrence of overt diabetic ketoacidosis following interruption of continuous subcutaneous insulin infusion (CSII). METHODS: An open clinical trial was performed with eight patients with type 1 diabetes on CSII therapy. After an overnight fast, at 8 a.m. (T0) CSII was interrupted for 4 h. At noon (T240) CSII was re-established, and at 4 p.m. (T480) the study was ended. Blood glucose (BG) and capillary and plasma 3betaOHB were measured at 30-min intervals, plasma insulin at 60-min intervals, and urinary ketones at 120-min intervals. RESULTS: After CSII interruption mean BG increased from 149.8+/-54.4 mg/dL at T0 to 224.8+/-56.2 mg/dL at T240 (P<0.05), and mean capillary 3betaOHB increased from 0.1+/-0.1 mmol/L at T0 to 0.9+/-0.6 mmol/L at T240 (P<0.001). The rate of increase of capillary 3betaOHB was faster and significantly more relevant than that of BG (P<0.05). The restoration of CSII produced a significant reduction of mean BG and capillary 3betaOHB (T480, 119.5+/-24 mg/dL and 0.2+/-0.2 mmol/L, respectively; P<0.05 for both vs. T240). The recovery of capillary 3betaOHB was significantly faster than that of BG (P=0.03). CONCLUSIONS: The dynamic evaluation of changes of capillary 3betaOHB levels can represent a useful support to home BG monitoring in the event of CSII interruption, providing faster information on early metabolic deterioration due to insulin deprivation and allowing preventative action for avoiding the evolution towards overt diabetic ketoacidosis. After reintroduction of insulin infusion the monitoring of the faster recovery of 3betaOHB relative to BG can provide useful information for the prevention of late hypoglycemia due to insulin overinfusion.

3-Hydroxybutyric Acid↗
PubMed2006

Benign odontogenic tumours: Clinical, epidemiological and therapeutic aspects of a sixteen years sample.

AIM: An original sample of benign odontogenic tumours collected over a period of 16 years has been evaluated as to its clinical, epidemiological and therapeutic aspects. METHODS: Data collection included a retrospective study from January 1, 1987 to December 31, 1999 and a prospective study from January 1, 2000 to December 1, 2002. RESULTS: A total number of 53 benign odontogenic tumours were collected; 9 different types of tumours were found with a slight prevalence in males rather than in females (1.2:1). The medium age of the patients at the time of diagnosis was 28.6 years. Odontomas represented the most frequent tumour, about 53% of the sample. The mandible was more interested (71%) than the maxillary bones and in only 63.5% of the sample symptoms or signs were present at the discovery time. The surgical treatment was almost always conservative with enucleation of the pathological tissue and the curettage of the residual bone cavity. CONCLUSIONS: Odontogenic tumours are more frequently diagnosed in the first three decades of life and therefore they can interfere with the physiological growth of the dento-skeletal apparatus. An early radiographic screening is therefore important to reveal these tumours at an initial stage of their development, when clinical signs or symptoms are not yet present. Due to the usual small size and the benign behaviour of these tumours, a conservative surgical approach is almost always effective in their treatment.

Adolescent↗
PubMed2005

Extraoral extraction: a very rare surgical approach to tooth impaction. A case report.

Extraoral route of access is usually not considered in surgical extraction of teeth because of technical difficulties and above all because of scar resulting from surgical skin wound healing. Some specific conditions, however, should suggest the use of this kind of access. A case of an impacted transmigrated right mandibular canine in an 18-year-old girl is reported. A CT examination has been carried out to evaluate the anatomy of the impacted toot as well as its relationship with the neighbouring structures. Extraoral surgical technique is then detaily described: skin incision, muscular dissection, ostectomy, tooth extraction and suture. Esthetical result was also reevaluated after 10 years. Advantages and drawbacks of intraoral and extraoral routes of access to mandibular tooth impaction are discussed and all anatomic and topographic factors related to the present impacted canine are examined. In conclusion, it is possible to confirm that extraoral access is indicated when a tooth is superficially impacted, in the molar-premolar region, toward the lingual aspect and near the lower border of the mandible.

Adolescent↗
PubMed2004

Periapical cemental (fibrous) dysplasia. Clinical, radiographic and pathologic aspects in 7 reported cases.

AIM: Periapical cemental dysplasia (PCD) is a relatively common, well-defined pathology. Because of the structural similarities existing in the group of the so-called "fibro-(cemento)-osseus lesions" of the jaws, to which PCD belongs, clinical and radiographic findings are probably more diagnostic than histology. The aim of the present paper is to analyse some new cases of PCD and to compare their clinical, radiographic and histologic features to those reported by the international literature. METHODS: Seven new cases of PCD are presented here; they were observed in a 12-year period of time. All the patients are white women and 6 lesions exceeded 1 cm in diameter. Only 2 patients were surgically treated, but all of them are still today clinically and radiographically followed. RESULTS: Clinical, radiographic and histologic data of our cases are generally in agreement with those provided by the international literature. CONCLUSION: Finally, stress is laid on the existing difficulty, at present as well as in the past, of establishing definitive classification criteria for all fibro-cemento-osseous lesions of the jaws.

Adult↗
PubMed2004

A clinical radiographic and histologic revaluation of a 10 years sample of surgically treated cysts of the jaws, with special emphasis on keratocysts.

AIM: The aim of this study was to compare the histologic features of the cysts as regards their radiographic and clinical aspects, in order to assess the accuracy of the diagnosis, the appropriateness of the treatment and the reliability of the follow-up. METHODS: A sample of 173 cysts of the jaws was reviewed in accordance with the 1992 WHO histological classification. RESULTS: Of these cysts, 77.44% were inflammatory, 12.71% follicular and 8.67% keratocysts. The cysts were slightly more frequently located in the mandible (52.60%) than in the maxilla (47.39%) and they affected men more frequently (60.11%) than women (39.88%). However keratocysts and nasopalatine cysts were twice as frequent in women than in men. No recurrence of keratocysts was found, either in those correctly diagnosed at the moment of the first histologic examination, or in those firstly erroneously diagnosed as an other type of cysts. CONCLUSION: On the basis of the fairly high percentage of non-inflammatory cysts in adult patients, it can be suggested to perform an orthopantomography as a preventive measure, every 5 years, particularly when impaired teeth are present.

Adolescent↗
PubMed2003

Circulating ghrelin levels of visceral obese men are not modified by a short-term treatment with very low doses of GH replacement.

Ghrelin, the endogenous ligand for the GH secretagogue-receptor (GHS-R), in addition to its GH-releasing action, has orexigenic and adipogenic properties. These characteristics make ghrelin a potential hormone involved in the pathogenesis of obesity. Ghrelin levels are decreased in obese humans and it is unknown whether this decrease is responsible for the blunted GH secretion reported in visceral obesity. Since only few data are available on the potential feedback regulation by GH on systemic ghrelin concentrations, it remains to be established whether the correction of circulating GH concentrations in obese individuals affects ghrelin concentrations. To answer this question, we measured plasma ghrelin levels after a week of administration of low doses of recombinant human GH (rhGH) in a randomized, double-blind, placebo (PL)-controlled trial. This study was originally designed to evaluate the effects of GH replacement on lipid kinetics in visceral obese men. Six adult men with abdominal/visceral obesity (age 42+/-3 yr, body weight 107 +/- 10 kg, BMI 33 +/- 1 kg/m2, waist circumference 111 +/- 3 cm, mean +/- SE) were evaluated in the basal state (BS) and after one week of treatment with subcutaneous bedtime injections of either PL, 2.5 (GH2.5) or 3.3 (GH3.3) pg/kg/die of rhGH. In comparison to BS either PL, GH2.5 or GH3.3 did not significantly modify circulating ghrelin concentrations (p = 0.77). In contrast, a significant increase of serum GH (p = 0.0028), IGF-I (p = 0.0033) and whole body rate of lipolysis (p = 0.038, GH2.5; p = 0.009, GH3.3) occurred, in comparison to BS or PL, after GH2.5 and GH3.3, without differences between the two treatments. These data demonstrate that in abdominal/visceral obese men a short-term treatment with very low doses of rhGH replacement, sufficient to augment the rate of lipolysis, do not modify circulating ghrelin levels.

Adult↗
PubMed2003

Prevalence of carotid stenosis in type 2 diabetic patients asymptomatic for cerebrovascular disease.

Stroke, with an incidence of 2.5 x 10(3) yr(-1) (95% CI, 2.3-2.8 x 10(3) yr(-1)), is the third most frequent cause of death and the first cause of disability in western society. Diabetes is an important risk factor for ischaemic stroke, second only to hypertension, whereas it does not seem to be associated with an increased risk of haemorrhagic stroke. The incidence of stroke in men and women between 45 and 74 yr has been found to be 2.5 and 3.5 times higher in diabetics than in non-diabetic subjects, with a relative risk higher in females than in males with diabetes and greater in both sexes in the 50-to-60-yr age group but decreased in subjects who were 70 and above. It is known that there is an association between ischaemic stroke and carotid stenosis. However, the prevalence of carotid stenosis in Type 2 diabetes mellitus (T2DM) patients has not been well investigated, mainly in the Italian diabetic population. Therefore, the aim of this study was to evaluate the prevalence of carotid artery stenosis in a population of T2DM patients asymptomatic for cerebrovascular disease selected from the files of the Diabetes Clinics, and from the computerised files of General Practitioners (GPs). Three hundred and sixty-five subjects were examined: 187 were non-diabetic (89 males, 98 females) and 178 were T2DM patients (82 males, 96 females). The mean age of all the subjects was 67 +/- 7.8 yr; 66 +/- 7.9 for the non-diabetic subjects and 67 +/- 7.5 yr in the diabetic subjects. In the echo-Doppler examination of the carotid, a degree of stenosis ranging 10-99% was recorded in 143/365 subjects (39.1%), 49/187 non-diabetics (26.2%) and 94/178 diabetics (52.8%). The differences were highly significant (p < 0.001). Severe stenosis was recorded in 17/143 subjects (12%); 12 of these were diabetic (70%) and 5 non-diabetic (30%). The diabetics were three times more likely to develop carotid stenosis than the non-diabetics with an odds ratio of 3.152, (95% CI, 2.032-4.889).

Aged↗
PubMed2003

Florid cemento-osseous dysplasia. Report of a case in a white woman with both mandibular and maxillary involvement.

Florid cemento-osseous dysplasia (FLCOD) is a rare pathological entity whose classification is not yet completely defined although its non-neoplastic clinical and histologic behaviour is very clear. FLCOD is a self-limiting lesion scarcely delimited from the surrounding healthy tissue and whose surgical treatment therefore is not elective, unless inflammatory signs are present. A case of a white woman with both mandibular and maxillary involvement is presented; she was referred to us for partial impaction of her lower 3(rd) molars. Standard radiographic and CT images are examined and the patient management is discussed.

Adult↗
PubMed2002

Unusual surgical approach in a bilateral case of mandibular buccal infected cyst.

In the new edition of WHO's "Histological typing of odontogenic tumors", the mandibular infected buccal cyst, that is associated with the lower first or second permanent molars, is considered a paradental cyst as well as the inflammatory collateral cyst, which is usually related to the lower third molar. The lesion occurs on the buccal and lateral aspects of the roots of mandibular molars with vital pulp, at the eruption time, in children aged between 6 and 10 years. The inflammation is always present in these cysts and may have an important role in their pathogenesis because it stimulates hyperplasia and cystic change of the reduced enamel epithelium or the epithelial cell rests of Malassez. The authors report the case of a 7-year-old girl, in whom both first mandibular molars were affected by an infected buccal cyst. A different surgical approach was performed with marsupialization on the left side and cystectomy on the right side. The case reported here seems to be interesting because it is the second well documented case of bilateral mandibular infected cyst associated with unerupted molars and because the adopted treatment differs from the therapeutical approach suggested in the literature. A 6-year follow-up demonstrates a correct dental and bone evolution on both mandibular molar sides.

Child↗
PubMed2002

Lingual displacement of an entire lower third molar. Report of a case with suggestions for prevention and management.

Perfect knowledge of regional anatomy is the main factor in the prevention of tooth displacement during lower third molar extraction. Some technical expedients should be used to avoid the occurrence of this accident and to manage it if it anyway happens. The patient was seen just 2 days after his left lower third molar was lingually displaced during surgical extraction. Two mucoperiosteal flaps were made under general anaesthesia, one on each side of the mandible, to obtain good exposure of the previous bone access and to retrieve the tooth. No further complications occurred. Lower third molar extraction becomes complicated if tooth displacement happens. Predisposing factors of this accident are analyzed and the rules to minimize the risk of its occurrence and to simplify the retrieval of the displaced tooth are discussed.

Adult↗
PubMed1989

[Results of a questionnaire on malignant tumors of the oral cavity].

A set of 23 questions on malignant neoplasms of oral cavity has been submitted to a group of 38 graduate in dentistry and dental prosthesis, at the time of their qualifying examination. The answers reveal a sufficient degree of knowledge of the problem but also indicate that some specific aspects of this important question should be probed.

Education, Dental, Continuing↗
PubMed1988

Pancreatic A- and D-cell response to arginine during acute alloxan-induced intra-islet insulinopenia.

This study was performed to investigate the role of pancreatic B-cell function on glucagon and somatostatin response to arginine. Isolated perfused rat pancreas was used for the experiment. Acute B-cell destruction was induced in vitro by 0.56 mM alloxan infused directly into the vascular system of the perfused pancreas. This resulted in a fall in basal insulin release and in a complete absence of hormone response to 20 mM arginine. Glucagon and somatostatin release during metabolic stimulus was superimposable on that observed in the control experiments (no alloxan infusion). We conclude that a normal B-cell function is not required for glucagon and somatostatin response to arginine.

Alloxan↗
PubMed1986

Effects of beta non-selective and beta 1 selective adrenergic blocking agents on glucagon secretion from isolated perfused rat pancreas.

To characterize beta-receptors which affect pancreatic A-cell activity, the effects of propranolol (beta non-selective blockade) and metoprolol (beta 1 selective blockade) were evaluated on epinephrine modulated insulin (IRI) and glucagon (IRG) release both in basal state and during metabolic stimulus (arginine 20 mM). The isolated perfused rat pancreas model with the exclusion of stomach and duodenum was used. Epinephrine infusion (at 10(-7) M) caused a prompt and sustained increase in basal IRG secretion and significantly potentiated glucagon release in response to metabolic stimulus. Insulin secretion was markedly suppressed by epinephrine both in basal conditions and during metabolic stimulus. Propranolol (at 10(-7) M) and metoprolol (at 10(-7) M) infusion clearly and similarly counteracted epinephrine stimulatory effects on IRG secretion but failed to elicit any significant effect on the epinephrine inhibited IRI release either in basal state or during the metabolic stimulus. These results suggest that, at least in the rat, the adrenergic stimulation of IRG release is mediated through a beta 1 receptor.

Animals↗
PubMedDate not supplied

Alpha-adrenergic system in the modulation of pancreatic A and B cell function in normal rats.

The role of the alpha-adrenergic system in the control of pancreatic A and B cell function was investigated in an isolated perfused rat pancreas model. Two experimental procedures were performed. In the first one we evaluated the effects of two distinct concentrations (10(-8) M and 10(-7) M) of five adrenergic substances, with varying degrees of potency on the alpha-adrenergic presynaptic receptor, on insulin (IRI) and glucagon (IRG) release induced by arginine (20 mM) plus glucose (6.6 mM). In the second procedure we studied the effects of the two alpha-blocking agents yohimbine (alpha 2-blocker) and prazosin (alpha 1-blocker) at 10(-7) M on epinephrine-modulated IRI and IRG response to the same combined metabolic stimulus. The inhibitory activity on basal and metabolically induced IRI secretion of the agonists was superimposable on their potency on the presynaptic alpha 2-adrenergic receptors. Similarly, the alpha 1-blocking agent prazosin was less effective than the alpha 2-blocker yohimbine in counteracting the inhibitory effects of epinephrine on basal and arginine plus glucose-induced insulin release. The alpha-cell activity was clearly stimulated by epinephrine, whereas selective alpha-adrenergic drugs showed no significant action on IRG secretion. Both alpha-blockers were ineffective on basal IRG release, while they had some potentiating effect on the epinephrine-induced glucagon release in basal state and during the metabolic stimulus, without a significant difference between the two drugs. We conclude that, at least in the isolated perfused rat pancreas, alpha 2-adrenergic receptors are involved in the inhibition of IRI release induced by catecholamines. On the contrary, the alpha-adrenergic system does not seem to play an essential role in the regulation of IRG secretion; the potentiation of the epinephrine-induced stimulation of A cell function by the alpha-adrenergic blockade could be accounted for by a greater availability of the catecholamine at the beta-receptor binding sites.

Adrenergic alpha-Agonists↗