[Self-injured inflicted and anxiety-depressive syndrome in patients that came to Protected Medicine of Sandro Pertini Hospital in Rome]. / Autolesionismo e sindrome ansioso-depressiva in pazienti afferenti alla Medicina Protetta dell'Ospedale Sandro Pertini di Roma.

UNLABELLED: The aim of our study is to observe the self-injured inflicted dimension in prisoners and to estimate the presence of one correlation with the anxiety-depressive syndrome. MATERIALS AND METHODS: From 15th of Oct 2006 till 31st Aug 2009 we have admitted to our department 150 patients that showed previous or recent evidences of self inflicted injuries and the use and abuse of tranquillizers and antidepressive drugs. The patients were classified in data base and we made an observation study. RESULTS: Out of 150 (100%) patients admitted to hospital, 55 (37%) patients had had a recent or previous episode of self-injured inflicted, 23 (15%) patients had taken antidepressive drugs and 72 (48%) patients had been in treatment with benzodiazepines. Among 55 patients that reported on medical history evidences of self-injured inflicted only 4 (7%) had taken antidepressive drugs and 18 (33%) had been in treatment with benzodiazepines. Among 18 patients in treatment with benzodiazepines, 12 (67%) patients had begun to use it during the detention regime. CONCLUSION: The phenomenon of self-injured inflicted among the patients that came to our department is very widespread and it resulted to be more frequent than in common people. We observed a correlation among the episodes of self-injured inflicted and the anxiety-depressive syndrome. Often the hardships is pre-existent to admittance in prison and the detention stresses that phenomenon. In fact, most of episodes of self-injured inflicted occurred during detention regime.

[Changes in tumor markers CEA, Ca 19-9 and Ca 125 in monitoring of response to chemotherapy in elderly patients with advanced gastric cancer]. / Le modificazioni dei valori dei markers tumorali CEA, Ca 19-9 e Ca 125 nel monitoraggio della risposta alla chemioterapia in pazienti anziani con carcinoma gastrico avanzato.

PURPOSE: We have evaluated whether tumor markers can be used to assess response to systemic chemotherapy. We analyzed the relationship between the response to chemotherapy based on serial imaging and on change in serum tumor marker level of CEA Ca 19-9 and Ca 125. PATIENTS AND METHODS: The levels of serum CEA, Ca 19.9 and Ca 125 were measured before and after 6 and 12 week systemic chemotherapy in twenty-five elderly patients age 68-80 (median age 71) with advanced gastric cancer. We evaluated the relationship between the change in serum tumor markers level and response assessment by imaging studies throughout the treatment course. RESULTS: There was a significant correlation between the assessment of response by tumor markers and by imaging studies. The survival time of responders assessed by tumor markers was significantly longer than that of non-responders. CONCLUSIONS: The serum levels tumor markers may be used as a mean of monitoring treatment in elderly patients, when in a imaging study it is difficult, to assess response to chemotherapy and in predicting the prognosis of patients with advanced gastric cancer.

[Renal carcinoma: effective modulation of low-dose interferon-alpha and interleukin-2 with medroxyprogesterone acetate and 13-cis retinoic acid]. / Carcinoma renale: efficace modulazione dell'interferone-alpha e dell'interleuchina 2 a basse dosi con medrossiprogesterone acetato e acido 13-cis retinoico.

We report a case history of a patient with clear renal carcinoma. After surgical treatment of primary tumor patient had been treated with medium-high doses IL-2 and alpha IFN for lung metastasis and paraaortic nodes, without significant response. Subsequently, low doses alpha IFN/IL-2 produced a response, and further response have been obtained by the combination of low-doses alpha IFN/IL-2 plus medroxyprogesterone acetate and cis-retinoic acid. We can therefore conclude that in immunogenic tumors, such as renal cancer, various immunologic strategies are justified, also employing in combination drugs not active as single agents, or modifying doses and schedules.

[Value of immunohistocytochemistry in the diagnosis of laterocervical masses in patients with a previous history of thyroid carcinoma]. / Valore della immunocitochimica nella diagnosi di masse laterocervicali in pazienti con pregresso carcinoma della tiroide.

BACKGROUND: The aim of this study is to evaluate the additional diagnostic significance of immunocytochemical staining of thyreoglobulin (TG) in Fine Needle Aspiration Biopsy (FNAB) of neck lymph-nodes, in patients with a previous history of thyroid carcinoma. METHODS: Twenty-five smears performed by ultrasound-guided FNAB on laterocervical nodes with a 21-23 gauge needle were evaluates. All smears were stained according to Papanicolaou and microscopically examined. RESULTS: Of these 25 smears, 15 were diagnostic and 10 were non diagnostic. Of the 15 diagnostic cases, 10 were positive for metastatic lesions from thyroid neoplasm and the other 4 were classified as reactive lymphoadenitis. One smear for each case was selected for the immunohistochemical stain. All the 10 non-diagnostic cases showed no reaction to thyreoglobulin. Neoplastic cells, from 9 out of 11 cytologically positive smears, expressed thyreoglobulin in the cytoplasm. In one case no reaction was evident and the other one was discarded for technical reasons. In 3 of the 4 cases cytologically classified as lymphoadenitis, immunoreactive thyreoglobulin was not found. In the fourth case, blastic-like cells showed a scanty cytoplasmic rime which was immunoreactive for TG and thus was classified as a metastatic tumour. On this basis, it is suggested that FNAB should be performed routinelly in the diagnostic evaluation of neck masses of unknown origin in patients with a previous history of thyroid neoplasm. CONCLUSIONS: If the FNAB is inconclusive, a second aspiration should be performed while immunoperoxidase stain to evidentiate TG may be an adjuntive diagnostic tool in cytologically negative cases.

[Incidence and prevalence of anti-HVC antibodies and HBV markers in patients undergoing extracorporeal hemodialysis]. / Incidenza e prevalenza degli anticorpi anti-HCV e dei marcatori di HBV nei pazienti sottoposti ad emodialisi extracorporea.

OBJECT: To assess the prevalence and the incidence of the anti-HCV and HBV markers in extracorporeal dialysis patients. METHOD: From 1990 to 1993, every six months, anti-HCV and anti-HBV markers were determined in 88 dialyzed patients, in 24 health workers from the Nephrology and Dialysis Departments and checked with 4143 blood donors. ALT values were also checked monthly. RESULTS: A 13.6 prevalence of anti-HCV was found while no new anti-HCV case was seen in the three-year observation period. Data referring to HBV infection were affected by vaccination. Statistical survey has shown a significant relation between anti-HCV and blood transfusions and between anti-HBV infection and duration of dialysis. The incidence of HCV infection was 4.1% among health workers who were all HBV vaccinated in the year before the research. COMMENT: We strongly recommend the observance of such rules as hygiene and prophylaxis, disinfection, sterilization and the use of disposable material. Also, a reduction of the number of transfusions seems to cut down the incidence of hematic infections.

[Psychodynamic aspects of patients undergoing dialysis treatment regarding the prospect of renal transplantation]. / Aspetti psicodinamici dei pazienti sottoposti a trattamento dialitico in rapporto alla prospettiva di trapianto renale.

The aim of the study was to identify what defence mechanisms are operative in hemodialysed subjects in regard to the prospect of renal transplantation. The study included twenty hemodialysed patients, ranging in age from 25 to 60, half of whom could not undergo renal transplantation. Ten healthy subjects were also included as a control group. From an analysis of the findings it is clear that different types of defence mechanisms operate in patients according to their hemodialysis status and that there is a more stereotyped use of these mechanisms in patients with no possibility of escape-except of death-seems to provoke rigid and stereotyped defence mechanisms in these patients.

Response of rat hepatic fatty acid synthesis and activities of related enzymes to changes in level of dietary fat.

The rate of in vivo fatty acid synthesis as well as the levels of glucose-6-phosphate dehydrogenase (G6PD), 6-phosphogluconate dehydrogenase (6PGD), malic enzyme (ME), citrate cleavage enzyme (CCE), acetyl-CoA carboxylase (ACX) and fatty acid synthetase (FAS) activities, have been studied in the liver of rats fed a fat-free diet for 7 days, followed by diets containing different amounts of soybean oil (0 to 24.79 kcal%) for 7 days. The dietary fat depressed activities of G6PD, 6PGD, ME, CCE, and FAS significantly at 1.24 or 2.48 kcal%. On the other hand, AC activity and the rate of fatty acid synthesis were decreased when the level of dietary fat was 12.39 kcal% or greater. These findings, as well as the pattern of decrement of enzyme activities and of lipogenesis, suggest a close correlation of fat feeding to ACX activity and fatty acid synthesis. The results also suggest that changes of G6PD, 6PGD, ME, CCE, and FAS activities may be largely independent of those modifications which occur in the substrate flux, concomitantly with the decrease of lipogenesis caused by the inclusion of fat in the diet.