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Biomedical subjects

S Bianchi

Publications and source records attributed to S Bianchi.

At least 289 records · Page 16Linked to original sources
PubMed1991

Fracture and posterior dislocation of the os peroneum associated with rupture of the peroneus longus tendon.

Subcutaneous rupture of the peroneus longus tendon occurring through a fracture of the os peroneum (OP) or secondary to posterior dislocation of this uncommon sesamoid bone is rare. The authors report three incidents of this injury, which presented either as fracture of the OP with diastasis of the fragments or as posterior dislocation of the whole OP without fracture. In all cases conservative treatment yielded satisfactory results. It is emphasized that, in all cases of ankle injury, radiologists should carefully examine the plain radiographs because most OP injuries are not seen in images obtained at the time of injury and are discovered retrospectively when the fragments separate. Not treating the problem at an early stage may lead to instability of the ankle or to peroneal compartment syndrome.

Ankle Injuries↗
PubMed1991

Repetitive conservative surgery for recurrence of endometriosis.

We evaluated the recovery of fertility and the relief of pain symptoms in a long-term follow-up of 42 women undergoing repetitive conservative surgery for recurrent endometriosis. The mean age of the patients was 31.1 +/- 4.3 years. At the time of their second operation the disease was stage IV in 14 women, stage III in 25, and stage I in three. After reoperation, the patients were followed for a mean period of 41.8 +/- 30.3 months. Pain symptoms returned in eight women, dysmenorrhea and deep dyspareunia in eight, and pelvic pain in seven. Eight of the 28 women (28.6%) who attempted to conceive achieved a total of 13 pregnancies. The corrected pregnancy rate was 35%, and the cumulative rate at 27 months was 30.7%. A third operation was necessary in six women after a mean period of 35 months. Conservative surgery is an effective therapeutic option for infertile patients with recurrent endometriosis.

Adult↗
PubMed1991

Transvaginal ultrasonography versus hysteroscopy in the diagnosis of uterine submucous myomas.

Seventy-one women with symptomatic uterine myomas, hospitalized for hysterectomy, underwent preoperative transvaginal ultrasonography and hysteroscopy to compare their reliability in the diagnosis of submucous myomas. After the operation, the surgical specimen was studied carefully and the results were compared with the preoperative diagnostic findings. Transvaginal ultrasonography had a sensitivity of 100% and specificity of 94%; the predictive value of an abnormal ultrasound scan was 81% and that of a normal one was 100%. The sensitivity of hysteroscopy was 100% and the specificity 96%; the predictive value of an abnormal hysteroscopic finding was 87% and that of a normal result was 100%. Mapping of uterine myomas is more precise with transvaginal ultrasonography than with hysteroscopy, but the former method cannot distinguish between a myoma and an endometrial polyp.

Adult↗
PubMed1991

Microalbuminuria in patients with essential hypertension. Effects of an angiotensin converting enzyme inhibitor and of a calcium channel blocker.

Several patients with essential hypertension manifest an abnormal (greater than 30 mg/24 h) urinary albumin excretion (UAE). Since microalbuminuria is considered an independent predictor of cardiovascular morbidity and mortality, studies are currently being undertaken to determine the effect of various antihypertensive agents on UAE, on the assumption that a reduction of UAE might result in improved prognosis in patients with essential hypertension. Twenty-four patients with essential hypertension were randomly divided into two groups of 12. The first group received 20 mg/day enalapril for 8 weeks, followed by 20 to 40 mg/day nitrendipine for 8 more weeks. The second group received nitrendipine for 8 weeks, followed by enalapril. Mean arterial pressure decreased similarly during both therapeutic regimens in the two groups of patients. In patients of group 1, UAE decreased significantly (P less than .01) from 74 +/- 7.0 to 33 +/- 5.8 mg/24 h after 8 weeks of treatment with enalapril; during the following 8 weeks of treatment with nitrendipine, UAE increased to 58 +/- 5.3 mg/24 h (P less than .02). In patients of group 2, UAE did not change during the first 8 weeks of therapy with nitrendipine despite a significant reduction in blood pressure; subsequently, after 8 weeks of therapy with enalapril, UAE decreased from 62 +/- 9.2 to 31 +/- 4.8 mg/24 h (P less than .01). This study demonstrates that enalapril but not nitrendipine may reduce UAE in patients with essential hypertension despite similar antihypertensive efficacy. The significance of microalbuminuria and the impact of the normalization of UAE on cardiovascular morbidity and mortality in patients with essential hypertension remains to be determined.

Adult↗
PubMed1990

A case-control study of gastric cancer and diet in Italy: II. Association with nutrients.

A case-control study involving interviews with 1,016 gastric cancer (GC) patients and 1,159 population-based controls in high- and low-risk areas was conducted to evaluate dietary factors and their contribution to the marked geographic variation in mortality from this cancer within Italy. Risks of GC were found to vary significantly with estimated nutrient intake. Risk rose with increasing consumption of nitrites and protein, and decreased in proportion to intake of ascorbic acid, beta-carotene, alpha-tocopherol, and vegetable fat. The associations with nitrite and beta-carotene tended to fade, however, in multivariate analyses adjusting for intake of other nutrients. Ascorbic acid showed the strongest geographic gradient, with highest consumption in low-risk areas. The findings suggest that the protective effects we previously reported for consumption of fresh fruit, fresh vegetables and olive oil may be linked to the vitamins C and E contained in these foods. The findings are consistent with the hypothesis that N-nitroso compounds are involved in GC risks, since elevated risks were apparent for agents (nitrites, protein) that promote nitrosation, while decreased risks were found for nutrients (ascorbic acid and alpha-tocopherol) which inhibit the process.

Case-Control Studies↗
PubMed1990

Ischemia reperfusion injury and histamine release in isolated and perfused guinea-pig heart: pharmacological interventions.

Experiments were carried out to provide further information on the biochemical and morphological changes occurring in the guinea-pig heart after multiple ligature and reopening of the left anterior descending (LAD) coronary artery. In isolated perfused guinea-pig heart the reopening of LAD coronary artery leads to a release of histamine related to a loss of metachromasia by cardiac mast cells. The process is associated with malonyldialdehyde (MDA) production, cellular overload of calcium and ventricular arrhythmias which can be modulated by pharmacological interventions.

Animals↗
PubMed1990

Laparoscopy in the diagnosis of gynecologic chronic pelvic pain.

Laparoscopy was performed on 126 women with undiagnosed chronic pelvic pain. Abnormalities were demonstrated in 62.7% of the cases. Endometriosis was present in 32.5% of the women. Laparoscopy is useful in the differential diagnosis of chronic pelvic pain and is indicated when symptoms persist for over 6 months.

Adolescent↗
PubMed1990

Stage and localization of pelvic endometriosis and pain.

We analyzed the prevalence of dysmenorrhea, pelvic pain, and dyspareunia in relation to the disease stage in 160 women with endometriosis but no other associated pelvic disease who underwent their first gynecologic surgery (laparoscopy or laparotomy) at the First Obstetric and Gynecology Clinic of the University of Milan between 1985 and 1987. Dysmenorrhea was reported by 78% of the patients, pelvic pain by 39%; and deep dyspareunia by 32%. No relation was found between severity of the pain symptoms and stage of the disease or site of the endometriotic lesions.

Adolescent↗
PubMed1990

Structural and ultrastructural defects in preovulatory endometrium of normo-ovulating infertile women with minimal or mild endometriosis.

To investigate whether a primary endometrial factor is involved in the pathogenesis of infertility in patients with minimal or mild endometriosis, we compared light, scanning, and transmission electron microscopic studies of preovulatory endometria of 15 endometriotic patients with 12 normal controls. All the women were infertile and normo-ovulating by standard criteria. Six morphometric indexes were considered. The scanning electron microscopic analysis revealed heterogeneity of the endometrial surface epithelium in 77% of the patients with endometriosis and in 16% of the controls. Glandular and stromal mitoses, basal vacuolated cells, and the ciliated:nonciliated cell ratio was significantly reduced in the endometriosis group compared with the controls. Further studies are needed to clarify the role of the observed endometrial anomalies in the pathogenesis of infertility associated with endometriosis.

Adult↗
PubMed1990

Haemodynamic effect of supraaortic ridge enhancement on the closure mechanism of the aortic valve and its implications in aortic valve repair.

The presence of the sinus of valsalva plays an essential part in the closing mechanism of the aortic valve. High-energy vortices are initiated at the upper limit of each sinus or supraaortic crest, and last during the whole valve closing time. An attempt was made to prove this hypothesis in vivo by intermittent augmentation of each supraaortic ridge. In a series of five dogs without cardiopulmonary bypass, pledgeted sutures were placed at the level of each crest and passed through tourniquets. In a series of three sheep, similar sutures were placed under direct vision with cardiopulmonary bypass. The supraaortic crests were augmented or maintained normal by tightening or loosening the tourniquets repeatedly. Simultaneous aortic and ventricular pressures and 2D- and M-mode echocardiography were recorded. In the dog series the results were unpredictable due to variability in the supraaortic crest enhancement because the sutures did not correspond to the anatomical crest. In the sheep series the sutures were correctly placed and M-mode echocardiography demonstrated a significant (p less than 0.01) shortening in systolic time. These results suggest the use of enhancement of the supraaortic crest as an adjunct technique in aortic valve repair.

Animals↗
PubMed1990

Treatment with GnRH agonists before myomectomy and the risk of short-term myoma recurrence.

Twenty-four women with symptomatic multiple uterine myomas were allocated randomly to treatment with buserelin, 1200 micrograms/day intranasally, for 3 months followed by myomectomy (n = 8) or to immediate myomectomy (n = 16). Pre-operative treatment with buserelin reduced the mean uterine volume from 432 (SD 165) to 242 (SD 82) ml (P less than 0.01) but intra-operative blood loss and postoperative morbidity were not significantly less in this group. Six months after operation, pelvic examination was normal in all the patients. However, ultrasonography with transvaginal probe demonstrated the presence of myomas of less than 1.5 cm in five women (63%) treated pre-operatively with the analogue and in two women (13%) who underwent immediate surgery (P less than 0.05). Induction of a period of hypo-oestrogenism before myomectomy seems to favour short-term recurrence of uterine myomas, limiting the efficacy of surgery.

Adult↗
PubMed1990

Use of goserelin depot, a gonadotropin-releasing hormone agonist, for the treatment of menorrhagia and severe anemia in women with leiomyomata uteri.

Menorrhagia is the most frequent symptom in women with leiomyomata uteri. We induced transient hypoestrogenism with a gonadotropin-releasing hormone agonist, goserelin (Zoladex, I.C.I.), in a depot formulation, to resolve severe anemia in 16 women with uterine myomas. Subcutaneous administration of goserelin 3.6 mg was repeated every 28 days for 6 months. Thirteen patients became amenorrheic in 5 weeks and 3 reported scanty bleeding. Estradiol fell to postmenopausal levels after one month's treatment with hormonal surges on only three occasions. Uterine volume decreased by 49% after 3 months' treatment but subsequent reduction was not achieved. Mean hemoglobin rose from 7.4 g/dl pretreatment to 13.2 g/dl at 3 months (+78.3%) and mean hematocrit from 26.1% to 39.8% (+52.4%) without any further improvement. Serum ferritin increased constantly during the 6 months. Goserelin depot therapy in severely anemic patients with leiomyomas and menorrhagia is practical, safe and may avoid the need for preoperative transfusion.

Adult↗
PubMed1990

Susceptibility of mammalian, avian, fish, and mosquito cell lines to rabies virus infection.

The relationship between plasma membrane receptor organization and cell susceptibility in vitro was investigated in mammalian, avian, fish, and arthropod cell lines infected with fixed rabies virus. IMR32, HeLa, CER, and EPC cells were widely susceptible to infection with CVS virus, whereas a lower level of specific viral antigens was detectable in A. albopictus cells. In spite of these differences, the amount of infectious virus particles bound to the various cell surfaces was similar. Competition experiments carried out with plasma membranes extracted from ability of these components to bind the virus and to prevent infection. The different cellular permissiveness to rabies infection described here did not correlate with significant differences in number or in chemical structure of the receptor binding sites, but more likely with events following virus adsorption.

Adsorption↗
PubMed1990

Endometrial patterns during danazol and buserelin therapy for endometriosis: comparative structural and ultrastructural study.

We studied endometrial structure and ultrastructure in serial biopsy specimens from patients with endometriosis treated with danazol (N = 19) or intranasal buserelin (N = 13) for 6 months. Biopsies were performed before and at 3 and 6 months of treatment. The specimens were studied by light, scanning, and transmission electron microscopy. Six morphometric indices were evaluated. Danazol produced a progestational effect on endometrial glands and stroma associated with marked hypotrophy of the mucosa, and buserelin treatment resulted in weakly proliferative or inactive mucosa. Both drugs induced noncyclicity and hypotrophy of endometrium although with different mechanisms of action, and it is suggested that they may have similar effects on ectopic endometrium. Because the atrophic effect of danazol appeared earlier than that of buserelin, the former could be recommended for short-term therapy.

Adult↗
PubMed1990

In situ ductal carcinoma of the breast--analysis of clinical presentation and outcome in 156 consecutive cases.

We report on 156 consecutive cases of in situ ductal carcinoma (DCIS) of the breast observed from 1968 to 1988. The relative frequency of DCIS was much higher in screened, with respect to self-referred, women and a significant association of DCIS with younger age was observed. The combined use of mammography and physical examination identified 138 of 156 total DCIS cases as suspicious. Mammography, physical examination or cytology (of nipple discharge or needle aspirate) were the only tests to provide suspicious evidence in 35, 22 and four cases respectively. DCIS was a relatively unexpected surgical finding in 13 apparently benign cases. Different surgical options were recorded in the study period but a temporal trend in favour of conservative surgery was evident. Subsequent ipsilateral or contralateral breast cancer was recorded in seven and six cases respectively. Death from breast cancer occurred in five cases, all of whom had contralateral or subsequent ipsilateral infiltrating cancer. This figure confirms the high curability of DCIS if local control is achieved.

Adult↗