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1.
Eur Rev Med Pharmacol Sci ; 24(19): 10045-10050, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33090412

RESUMO

OBJECTIVE: Crohn's Disease (CD) has been associated with non-Hodgkin lymphoma. Follicular Lymphoma (FL) limited to the liver is extremely rare, accounting for 1% to 4.4% of all Primary Hepatic Lymphoma (PHL). CASE PRESENTATION: In 2018, an 85-years old male patient with post-operative recurrence of ileal CD referred rare episodes of fever and mild diffuse abdominal pain. Since cholecystectomy in 2001, clinical history was characterized by recurrent episodes of cholangitis and common bile duct stones. In 2018, ultrasonography and MRI showed a solid focal hepatic lesion (FHL)(4.5 cm x 2.5 cm) in the IV hepatic segment. The radiographic aspect of the lesion was unusual. Initially, focal nodular hyperplasia was suspected. Clinical history of cholangitis and radiological findings subsequently suggested a diagnosis of Hepatic Abscess (HA). A progressive enlargement of the FHL (7.3 cm x 5.8 cm) despite antibiotic treatments, led to perform a liver biopsy. Histological and immunophenotypical analysis of the FHL (7.5 cm x 5.4 cm) enabled a final diagnosis of FL. The "in situ" hybridization for Epstein-Barr virus (EBER) was negative. No additional lesions related to FL were initially detected, thus suggesting a very rare case of PHL in an old patient with CD never treated with thiopurines. CONCLUSIONS: This case report highlights the need to consider a rare diagnosis of FL of the liver in patients showing a challenging focal hepatic lesion of unknown origin.

2.
Clin Ter ; 171(5): e401-e406, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32901782

RESUMO

INTRODUCTION: The study in question starts from a general analysis of Law n. 219/2017 and then to deepen the patient's right to self-determination, which is exercised through the expression of an informed consent to medical therapy. The analysis refers in particular to the patient's decision-making autonomy, the professional autonomy of the doctor and his consequent responsibility. MATERIALS AND METHODS: This study examines the art. 5 of the Law n. 219/2017, where the Legislator has defined the theme of shared planning of care. The authors compare the Advance Treatment Provisions (Article 4 - Law No. 219/2017) and the Shared Care Planning, to then examine the emerging relationship of care between doctor and patient. RESULT: The relationship of care must be related to the patient's willingness to decide on his future and to the technical and scientific information that the doctor is required to give. CONCLUSION: In conclusion, the Authors highlight the innovative content of the shared care plan, emphasizing the importance for a patient suffering from a chronic and progressive disease to be actively involved in formulating their own therapeutic plan.


Assuntos
Consentimento Livre e Esclarecido/legislação & jurisprudência , Direitos do Paciente/legislação & jurisprudência , Humanos , Itália , Administração dos Cuidados ao Paciente , Participação do Paciente , Autonomia Pessoal
3.
G Ital Med Lav Ergon ; 34(3 Suppl): 156-8, 2012.
Artigo em Italiano | MEDLINE | ID: mdl-23405607

RESUMO

The marketing of fish products determines for the fishmongers contact with water, ice and use of sharp tools. This study evaluates the skin reactions after fish handling manipulation in a group of fishmongers. 60 questionnaires were administered for information on seniority, use of IPDs, training received, work injuries and general health. We have performed a physical examination of the fishmongers' hands. 98.3% of workers reported the use of IPDs. During the examination were found dyschromic lesions, freezing and foreign bodies, mainly in those who did not use gloves. The study shows the hands' skin condition in those fishmongers that did not use IPDs. This phenomenom requires formative and informative targeted interventions and stronger oversights.


Assuntos
Dermatite Ocupacional/epidemiologia , Indústria Alimentícia , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Feminino , Peixes , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Saúde da População Urbana , Adulto Jovem
4.
G Ital Med Lav Ergon ; 30(3): 263-6, 2008.
Artigo em Italiano | MEDLINE | ID: mdl-19069227

RESUMO

The author effects a critical analysis of the new table of work-related diseases both on industry and agriculture, issued by D.M. 09.04.2008, following the processing of Scientific Committee; the target of the author is to point out the positive aspects, according to European Community Recommendations as well as Government guidelines, aiming at levelling the dealing with work-related diseases in different European country to adequate them following the evolution of scientific knowledge. Furthermore, the author aiming at stressing the critical problems deriving from the difficult interpretation of the law on the legal medicine.


Assuntos
Doenças Profissionais/classificação , Medicina do Trabalho/legislação & jurisprudência , Humanos , Itália
5.
Eur J Histochem ; 47(1): 81-6, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12685561

RESUMO

Age-related changes of the monoaminoxidases, evaluated by enzymatic staining, quantitative analysis of images, biochemical assay and statistical analysis of data were studied in cerebellar cortex of young (3-month-old) and aged (26-month-old) male Sprague-Dawley rats. The enzymatic staining shows the presence of monoamino-oxidases within the molecular and granular layers as well as within the Purkinje neurons of the cerebellum of young and aged animals. In molecular layer, and in Purkinje neurons the levels of monoaminooxidases were strongly increased in old rats. The granular layer showed, on the contrary, an age-dependent loss of enzymatic staining. These morphological findings were confirmed by biochemical results. The possibility that age-related changes in monoaminooxidase levels may be due to impaired energy production mechanisms and/or represent the consequence of reduced energetic needs is discussed.


Assuntos
Envelhecimento/fisiologia , Cerebelo/enzimologia , Monoaminoxidase/metabolismo , Animais , Cerebelo/citologia , Cerebelo/efeitos dos fármacos , Clorgilina/farmacologia , Inibidores Enzimáticos/farmacologia , Inibidores da Monoaminoxidase/farmacologia , Proteínas/metabolismo , Ratos
6.
Genomics ; 62(3): 525-8, 1999 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-10644452

RESUMO

The HPC-1/syntaxin 1A (STX1A) gene maps to the Williams syndrome (WS) commonly deleted region on chromosome 7q11.23 and encodes a protein implicated in the docking of synaptic vesicles with the presynaptic plasma membrane. To assess the potential role of STX1A in the WS phenotype, we carried out expression studies at the RNA and protein levels, in fetal and adult human tissues. RNA in situ hybridization on human embryo sections showed strong STX1A expression in spinal cord and ganglia. However, in adulthood, this gene was preferentially expressed in brain, as shown by Northern blot and RT-PCR experiments. Marked expression levels were observed in cerebellum and cerebral cortex. The STX1A protein was prevalently distributed in the molecular layer of the cerebellar cortex. A qualitative and quantitative analysis using a specific anti-STX1A antibody did not disclose any significant difference among frontal, temporal, and occipital poles of the human adult cortex in the two hemispheres. This is the first study focused on STX1A expression in humans. Our results indicate that this gene is strongly expressed in cerebral areas involved in cognitive process, supporting a likely role in the neurological symptoms of WS.


Assuntos
Antígenos de Superfície/biossíntese , Antígenos de Superfície/genética , Deleção de Genes , Regulação da Expressão Gênica no Desenvolvimento , Proteínas do Tecido Nervoso/biossíntese , Proteínas do Tecido Nervoso/genética , Síndrome de Williams/genética , Northern Blotting , Cerebelo/metabolismo , Córtex Cerebral/metabolismo , Cromossomos Humanos Par 7/genética , Densitometria , Feto , Gânglios/metabolismo , Humanos , Immunoblotting , Hibridização In Situ , Especificidade de Órgãos/genética , RNA Mensageiro/biossíntese , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Medula Espinal/metabolismo , Sintaxina 1
7.
J Am Coll Cardiol ; 28(3): 720-4, 1996 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8772762

RESUMO

OBJECTIVES: We sought to demonstrate the determinants of spontaneous onset of ventricular tachycardia in right ventricular dysplasia. BACKGROUND: Sudden death during athletic activities has been described in patients with right ventricular dysplasia, but few data are available on the clinical circumstances of well tolerated ventricular tachycardias. METHODS: The spontaneous occurrence of 43 episodes of sustained monomorphic ventricular tachycardia was recorded during ambulatory electrocardiographic (Holter) monitoring in 12 patients. RESULTS: The ventricular tachycardia usually occurred without a significant immediate precipitating arrhythmic event: Atrial arrhythmia was never present, and long-short cycle sequences by postextrasystolic pauses or runs of polymorphic extrasystoles were also unusual (four episodes of ventricular tachycardia each). Finally, no arrhythmia was present immediately before the tachycardia in 36 (84%) of the 43 episodes and in 8 of 12 patients. Examination of the sinus rate before the initial episode of tachycardia in each patient showed a continuous increase from 30 min to the few cycles before the tachycardia (mean RR decrease from 876 +/- 778 to 830.5 +/- 189 ms, with a mean slope of approximately 8.4 ms/min; both p = 0.01 by Wilcoxon test). A within-patient comparison showed that the first cycle of the ventricular tachycardia was shorter than that of runs or couplets (389 +/- 88 vs. 453 +/- 121 and 520 +/- 133 ms, p = 0.03 and p < 0.01, respectively, by paired t test) and that the second cycle was shorter than that of runs (383 +/- 96 vs. 435 +/- 120 ms, p = 0.03). Sinus rate measured 15 beats before the event was higher for ventricular tachycardia than for isolated beats (mean RR interval 835 +/- 184 vs. 908 +/- 153 ms, p < 0.01). CONCLUSIONS: Increased heart rate and shortening of the coupling intervals of the first cycles before the tachycardia are due to a change in the vagosympathetic balance with an increased sympathetic tone. This increase appears to be the main determinant of the ventricular tachycardia in this disease in contrast to the multifactorial origin of ventricular tachycardia due to coronary heart disease. It should be considered in patients participating in strenuous athletic activities.


Assuntos
Taquicardia Ventricular/fisiopatologia , Disfunção Ventricular Direita/complicações , Adulto , Eletrocardiografia Ambulatorial , Feminino , Humanos , Masculino , Taquicardia Ventricular/etiologia
8.
Minerva Cardioangiol ; 43(11-12): 493-9, 1995.
Artigo em Italiano | MEDLINE | ID: mdl-8710139

RESUMO

The authors describe a rare case of pulmonary thromboembolism with unusual clinical findings and emphasized the large difficulty encountered in formuling a correct diagnosis in a reasonable time. A man, 60 years old, was admitted to a Medical Division of our hospital for the appearance of chest pain and epigastric pain during effort in the last year. He smoked 20 cigarettes a day and drank wine (1 or 2 litres a day). He was affected by hypercholesterolemia and in the past reported relapsed thrombophlebitis in the left leg. Four years before admission to our hospital he underwent large and small left saphenectomy. He had no cardiac events in the past. After a non significant exercise stress test the patient was treated with nitrates and asa and was discharged from the hospital. At home the symptoms increased and after 8 months the patient was admitted again to the Cardiologic Division of the hospital. At admission he reported dyspnea and chest pain at rest, not only during effort and the ECG showed negative T waves in anterior and inferior leads. Intravenous heparine, nitrates and calcium antagonists stabilized the clinical picture. The following examinations revealed: reduction of the T wave negativity at the ECG registered during chest pain; mild enlargement of the heart at the chest roentgenogram; normal value of the left ventricle and apical and midseptal by ipokinesia at the transthoracic echocardiogram; normal coronary artery at the coronary arteriography. "Vasospastic angina" was diagnosed and the patient was discharged after 20 days, asymptomatic. After 15 days he returned to the hospital again for chest pain, dyspnea, hypotension and syncope despite therapy. At physical examination he showed a painful left tibio-tarsal tumefaction, an increased and splitting second heart sound in the pulmonary area and a systolic murmur in the third and fourth left interspace. The ECG showed a severe anterior ischemia, while a new transthoracic echocardiogram revealed a considerable dilatation of the right atrium, right ventricle and the main pulmonary artery with severe tricuspid regurgitation and pulmonary hypertension (mean PAP about 50 mmHg). The following pulmonary perfusion scintigraphy confirmed the diagnosis of pulmonary embolism and the selective right and left pulmonary arteriography exhibited multiple thrombi and large intravascular filling defects. The right heart catheterization confirmed a chronic precapillary pulmonary hypertension (mean PAP = 55 mmHg). About 24 hours after these examinations the patient died because of a cardiac arrest with electromechanical dissociation. Pulmonary thromboembolism is a potentially fatal disease characterized by a largely variable clinical presentation. Frequently pulmonary embolism diagnosis is difficult especially when clinical findings are unusual. In the case observed the "typical" chest and epigastric pains associated with the electrocardiographic findings directed diagnosis towards myocardial ischemia. Also after the coronary arteriography that showed normal coronary artery, the erroneous diagnosis persisted. Pulmonary embolism was correctly diagnosed too late to begin an effective therapy. These unusual clinical findings and diagnostic mistakes are stressed and critically reviewed in the article.


Assuntos
Embolia Pulmonar/diagnóstico , Angina Instável/complicações , Diagnóstico Diferencial , Eletrocardiografia , Humanos , Hipertensão Pulmonar/complicações , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/etiologia , Embolia Pulmonar/fisiopatologia
9.
Minerva Cardioangiol ; 41(10): 439-44, 1993 Oct.
Artigo em Italiano | MEDLINE | ID: mdl-8302440

RESUMO

We have verified the utility of echo-dipyridamole test in the diagnosis of chest pain of unsure origin, especially in patients who cannot be quickly submitted to exercise stress test because of permanent abnormalities at basal ECG or because of clinical reasons. 17 patients with chest pain, abnormalities at basal ECG not evolutive and insignificant for myocardial ischemia, absence of enzymatic curve, were admitted to our hospital from September 1988 to January 1990. All these patients were submitted before the ninth and fifteenth day of hospitalization to the echo-dipyridamole test. Drugs were discontinued 3 days before the test. Dipyridamole was administered intravenously in 4 minutes at dosage of 0.56 mg/kg during ECG and echocardiographic monitoring. If no ECG or echocardiographic changes were observed, a second intravenous bolus of dipyridamole at a dosage of 0.28 mg/kg in 2 minutes was made. After the end of infusion continuous ECG and echocardiographic monitoring was performed for 20 minutes at least. Blood pressure was controlled every 3 minutes. Only the major changes in segmental wall motion were considered for analysis to minimize possible errors. Moreover a second physician not present during the test, revised in following the wall motion changes of all the tests. The test was positive in 5 patients (29%) (positive group) and negative in 12 (71%) (negative group). The changes in the heart rate and blood pressure observed during the test were not significantly different in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Angina Pectoris/diagnóstico , Dor no Peito/etiologia , Doença das Coronárias/diagnóstico , Dipiridamol , Ecocardiografia/métodos , Isquemia Miocárdica/diagnóstico , Adulto , Idoso , Angina Pectoris/etiologia , Diagnóstico Diferencial , Eletrocardiografia , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
G Ital Cardiol ; 20(12): 1161-7, 1990 Dec.
Artigo em Italiano | MEDLINE | ID: mdl-2128068

RESUMO

A high degree AV block during paroxysmal supraventricular tachycardia is an uncommon and short-lasting finding in patients with intranodal re-entry circuits. The AV block is the result of temporary inadequacy of the infranodal conduction system--which is not part of the circuit--to cope with the sudden increase in heart rate in terms of refractory periods and conduction velocity. In a patient with paroxysmal reciprocating tachycardia at a very high rate (230-250 bpm), 2:1 intra-hisian AV block was constantly observed after arrhythmia initiation by atrial extrastimuli. This persisted for 1-4 minutes and then progressively subsided passing through a period of 3:2 intra- infra-hisian AV block until it reached 1:1 conduction with transient left bundle branch block. The latter occasionally disappeared as result of retrograde activation of the area of functional anterograde block and of subsequent noncompensatory pause, following a premature ventricular depolarization. Tachycardia-dependent AV block was abolished by verapamil and flecainide, because of lengthening of the tachycardia cycle length. Functional and electropharmacological features of retrograde conduction were consistent with an extranodal concealed atrio-hisian accessory pathway acting as the retrograde limb of the re-entry circuit. Moreover, His bundle electrogram was prolonged and polyphasic even in sinus rhythm. Therefore, tachycardia-dependent advanced AV block can occur not only in truly intranodal re-entry but also in very fast atrio-hisian re-entry tachycardias with evidence of transient impairment of intra-hisian conduction, distal to the insertion of the accessory pathway. Localized morphofunctional pathological changes in the His bundle are probably involved in the mechanism of this uncommon pattern.


Assuntos
Fascículo Atrioventricular , Bloqueio Cardíaco/etiologia , Sistema de Condução Cardíaco/fisiopatologia , Taquicardia Paroxística/fisiopatologia , Taquicardia Supraventricular/fisiopatologia , Eletrocardiografia , Feminino , Flecainida/uso terapêutico , Bloqueio Cardíaco/fisiopatologia , Humanos , Pessoa de Meia-Idade , Taquicardia Paroxística/complicações , Taquicardia Paroxística/tratamento farmacológico , Taquicardia Supraventricular/complicações , Taquicardia Supraventricular/tratamento farmacológico , Fatores de Tempo , Verapamil/uso terapêutico
11.
Cardiologia ; 34(4): 357-63, 1989 Apr.
Artigo em Italiano | MEDLINE | ID: mdl-2758441

RESUMO

Sustained ventricular tachycardia (VT) in coronary heart disease (CHD) represents a major risk factor for sudden death. The Authors evaluated the prophylactic efficacy of the chronic administration of amiodarone (A) on this arrhythmia and simultaneously the trend of ventricular extrasystole during the antiarrhythmic treatment. Twenty-three patients were examined, 17 with post-infarction cardiopathy and 6 with mixed angina. They showed either 1 or more episodes (2 patients) of sustained VT involving hemodynamic difficulties. The ejection fraction (EF) ranged between 20 and 45% average (35.2 +/- 9). All patients underwent a basal 24 hour ECG 3 days after the VT cardioversion, and every 6 months. All subjects took A orally for a period ranging from 7 to 67 months (average 23.04 +/- 14) at the dose of 800 mg/day 7 for days, and then 200 or 400 mg/day according to the presence or absence of ventricular extrasystoles (VE) greater than or equal to 30/hr and/or Lown's class (L) greater than or equal to 3. No patients died suddenly during the follow-up; 6 of them died for causes other than arrhythmia. Four of them showed only 1 sustained VT relapse after a period of 6 to 11 months. Two of these 4 patients showed a persistent increase of the number of VE and L-class while, in the remaining 2 patients, the number of VE remained substantially unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Amiodarona/uso terapêutico , Doença das Coronárias/complicações , Taquicardia/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , Amiodarona/efeitos adversos , Morte Súbita/prevenção & controle , Eletrocardiografia , Feminino , Ventrículos do Coração , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Fisiológica , Taquicardia/diagnóstico
13.
Schweiz Med Wochenschr ; 115(51): 1857-60, 1985 Dec 21.
Artigo em Francês | MEDLINE | ID: mdl-4089585

RESUMO

A case of recurrent syncopal attacks in a 70-year-old woman with oesophageal hiatus hernia is reported. Dynamic ECG recording showed paroxysmal II and III degree A-V block during solid food swallowing. Electrophysiologic examination was normal in the basal condition and showed a II degree A-V nodal block with 2: 1 conduction ratio during solid food swallowing. This phenomenon was not reproducible after atropine administration. A permanent cardiac pacemaker (VVIP) rendered the patient completely symptomfree. The likely pathogenetic mechanism of "swallowing A-V block" is described.


Assuntos
Deglutição , Bloqueio Cardíaco/etiologia , Idoso , Feminino , Hérnia Hiatal/fisiopatologia , Humanos
14.
G Ital Cardiol ; 14(5): 352-6, 1984 May.
Artigo em Italiano | MEDLINE | ID: mdl-6468816

RESUMO

We have compared the efficacy of Propafenon and Mexiletine in 12 subjects (7 males and 5 females, age range of 22-61 year) affected by chronic ventricular extrasystolic beats. Propafenon and Mexiletine were orally administered in doses of 900 mg/day and 600 mg/day respectively in a single blind, cross-over fashion. Our results show that: Propafenon is better tolerated; Propafenon has caused a statistically significant reduction of the total number of ventricular ectopic beats/24 hours; the efficacy of Propafenon has been greater than that of Mexiletine (66% and 25% respectively); with both drugs, in 2 cases, there was an increase of the total number of ventricular ectopic beats/24 hours; Propafenon has induced clear-cut electrocardiogram changes (statistically significant lengthening of P-Q and Q-T intervals).


Assuntos
Antiarrítmicos/uso terapêutico , Arritmias Cardíacas/tratamento farmacológico , Mexiletina/uso terapêutico , Propiofenonas/uso terapêutico , Propilaminas/uso terapêutico , Adulto , Avaliação de Medicamentos , Eletrocardiografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Propafenona
15.
Acta Cardiol ; 33(4): 231-9, 1978.
Artigo em Inglês | MEDLINE | ID: mdl-309264

RESUMO

The interference of placebo effect in the treatment of angina pectoris has been studied in a group of patients with stable angina pectoris, selected on the basis of normal electrocardiogram at rest and a pathologic ergometric electrocardiographic test. It was found that the patients could be divided, according to the results of the exercise test, into two groups: placebo responders and place-bo-non-responders. The anti-anginal effect of beta-blocking agents has been clearly demonstrated only in the placebo-non-responders group. No statistically significant effect of beta-blocking agents was observed in the placebo-responders group. This result shows that it is necessary, in double blind trials, at first to separate placebo-responders from placebo-non responders. Otherwise the correct evaluation of a drug can be modified by the placebo-responders group.


Assuntos
Angina Pectoris/tratamento farmacológico , Placebos/uso terapêutico , Practolol/uso terapêutico , Adulto , Idoso , Angina Pectoris/fisiopatologia , Método Duplo-Cego , Avaliação de Medicamentos , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
G Ital Cardiol ; 6(5): 821-8, 1976.
Artigo em Italiano | MEDLINE | ID: mdl-137824

RESUMO

Systolic time intervals at rest and after exercise were studied in 56 patients with essential hypertension. The patients were divided into groups according to the presence or absence at rest of electrocardiographic patterns of left atrial hypertrophy, and left ventricular strain. An impaired left ventricular function was shown, at rest and after exercise, in patients who had an electrocardiographic pattern of "left ventricular strain".


Assuntos
Sistema de Condução Cardíaco/fisiopatologia , Coração/fisiopatologia , Hipertensão/fisiopatologia , Adulto , Cardiomegalia/fisiopatologia , Eletrocardiografia , Feminino , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade
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