48 research outputs found
A case of pheochromocytoma with renal artery stenosis and post-surgical watery diarrhea
No full textA 35-year-old woman was admitted to our hospital with the following complaints, headache, sweating, anxiety, dizziness, nausea, vomiting and severe hypertension. The technical images (abdominal CT, scintigraphic octreotide scan and renal arteriography) revealed the presence of a left adrenal pheochromocytoma and stenosis of the renal artery. Ten days following adrenalectomy, watery diarrhea appeared. The long-acting somatostatin analogue octreotide (LAR, 30 mg/month, i.m.), was started, and after 2 weeks diarrhea decreased and gradually disappeared. In conclusion, we were confronted with an unusual case of pheochromocytoma associated with renal artery stenosis and the appearance of watery diarrhea some days after surgical treatment. Treatment with octreotide brought about the remission of diarrhea in this patient. Copyright (C) 2002 S. Karger AG, Basel
Bone mass, bone metabolism, and prevalence of spinal fractures in recipients of allogenic bone marrow transplantation for leukemia
No full textThe aim of this study was to evaluate in 65 patients, who had previously undergone allogenic bone marrow transplantation (ABMT), the bone mineral density (BMD), the skeletal turnover and the prevalence of vertebral fractures. At the moment of recruiting, 10 of 65 transplanted subjects (15.3%) presented with signs of rejection of the transplanted tissue, thus they were excluded. The remaining 55 patients (21 males, 34 females, mean age 30.8 +/- 6.4 years), with a follow-up of 60 +/- 9 months after the transplant and without any treatment inducing osteopenia, underwent ABMT respectively for: chronic myeloid leukemia (n = 24); acute myeloid leukemia (n = 18); acute lymphatic leukemia (n = 13). One hundred and ten healthy control subjects (42 males and 68 females, mean age 31.0 +/- 3.7 years) matching with the patients for age, weight and height, were successively enrolled. All the participants were submitted to a densitometric evaluation (DEXA) of lumbar spine (L1-L4), of femoral neck and total femur; besides some skeletal metabolism parameters were dosed, such as: total alkaline phosphatase, bone alkaline phosphatase and urinary excretion of C-terminal telopeptide fragments normalized to creatinine. On the contrary, the morphometric evaluation, performed through a lateral dorsolumbar radiography, was actually carried out only in patients who had already undergone ABMT. The L1-L4 BMD study showed: 10/55 osteoporotic (18.1%), 19/55 osteopenic (34.5%) and 26/55 normal patients (47.4%). In transplanted patients BMD values, obtained at the three considered sites, resulted significantly reduced (p < 0.01) in comparison to controls. Moreover, in patients who underwent ABMT, a statistically significant increase was observed, in comparison to healthy subjects, in total alkaline phosphatase (p < 0.01), in bone alkaline phosphatase (p < 0.01) and in urinary excretion of C-terminal telopeptide fragments normalized to creatinine levels (p < 0.001). Seven of the 55 transplanted patients (12.7%) presented at the moment of Rx morphometric evaluation at least one vertebral fracture: 6 of whom were affected by osteoporosis and 1 by osteopenia. In conclusion, the subjects who had previously undergone ABMT maintain, even at a certain time after the transplant and without any rejection, an increased skeletal turnover and BMD values meanly lower than normal, leading to an increased risk for vertebral fracture
BONE MASS, BONE METABOLISM, AND PREVALENCE OF SPINAL FRACTURES IN RECIPIENTS OF ALLOGENIC BONE MARROW TRANSPLANTATION FOR LEUKEMIA
No full textThe aim of this study was to evaluate in 65 patients, who had previously undergone allogenic bone marrow transplantation (ABMT), the bone mineral density (BMD), the skeletal turnover and the prevalence of vertebral fractures. At the moment of recruiting, 10 of 65 transplanted subjects (15.3%) presented with signs of rejection of the transplanted tissue, thus they were excluded. The remaining 55 patients (21 males, 34 females, mean age 30.8 ± 6.4 years), with a follow-up of 60 ± 9 months after the transplant and without any treatment inducing osteopenia, underwent ABMT respectively for: chronic myeloid leukemia (n = 24); acute myeloid leukemia (n = 18); acute lymphatic leukemia (n = 13). One hundred and ten healthy control subjects (42 males and 68 females, mean age 31.0 ± 3.7 years) matching with the patients for age, weight and height, were successively enrolled. All the participants were submitted to a densitometric evaluation (DEXA) of lumbar spine (L1-L4), of femoral neck and total femur; besides some skeletal metabolism parameters were dosed, such as: total alkaline phosphatase, bone alkaline phosphatase and urinary excretion of C-terminal telopeptide fragments normalized to creatinine. On the contrary, the morphometric evaluation, performed through a lateral dorsolumbar radiography, was actually carried out only in patients who had already undergone ABMT. The L1-L4 BMD study showed: 10/55 osteoporotic (18.1%), 19/55 osteopenic (34.5%) and 26/55 normal patients (47.4%). In transplanted patients BMD values, obtained at the three considered sites, resulted significantly reduced (p < 0.01) in comparison to controls. Moreover, in patients who underwent ABMT, a statistically significant increase was observed, in comparison to healthy subjects, in total alkaline phosphatase (p < 0.01), in bone alkaline phosphatase (p < 0.01) and in urinary excretion of C-terminal telopeptide fragments normalized to creatinine levels (p < 0.001). Seven of the 55 transplanted patients (12.7%) presented at the moment of Rx morphometric evaluation at least one vertebral fracture: 6 of whom were affected by osteoporosis and 1 by osteopenia. In conclusion, the subjects who had previously undergone ABMT maintain, even at a certain time after the transplant and without any rejection, an increased skeletal turnover and BMD values meanly lower than normal, leading to an increased risk for vertebral fracture
False-positive diagnosis of adrenal pheochromocytoma on iodine-123-MIBG scan
No full text1-123 metaiodobenzylguanidine (1-123 MIBG) scintigraphy is known for its high specificity in detecting pheochromocytoma and other tumors of neural crest origin. In this rare case report, we describe a definite adrenocortical adenoma that demonstrated false-positive uptake at 1-123 MIBG scintigraphy and a remarkable accumulation of 75-SE-6-beta-selenomethyl-norcholesterol. (C)1998, Editrice Kurtis
Aerostasi in chirurgia toracica nell’Azienda Ospedaliero-Universitaria di Parma: introduzione nella pratica clinica del Tachosil, un sigillante registrato come farmaco
No full text
Allestimento di formulazioni di bleomicina intralesionale per carcinoma spinocellulare in dermatologia chirurgica in un’Unità di Manipolazione Chemioterapici Antiblastici (UMaCA).
No full textOBIETTIVO DELLA RICERCA
Confermata l’efficacia di bleomicina intralesionale da un’analisi della letteratura scientifica, il presente studio si è proposto di:
- Analizzare il caso clinico di un paziente affetto da carcinoma spinocellulare non eleggibile alle terapie standard per età, condizioni cliniche generali complesse e preferenza del soggetto.
- Elaborare uno schema terapeutico per l’applicazione clinica del trattamento intralesionale con bleomicina.
- Mettere a punto un’ idonea Procedura di Allestimento della terapia oncologica presso l’Unità di Manipolazione Chemioterapici Antiblastici dell’Azienda Ospedaliero-Universitaria di Parma.
- Valutare gli esiti clinici derivanti dalla somministrazione del farmaco.
- Analizzare nuovi casi clinici per indagare ulteriormente l’efficacia della terapia intralesionale con bleomicina in campo dermatologico
Farmaci biologici nella terapia della psoriasi. Progetto PSOCARE: esperienza condotta nell'Azienda Ospedaliero-Universitaria di Parma
No full textEvaluation of an automatic oscillometric method and of various cuffs for the measurement of arterial pressure in the neonate
No full textWe compared simultaneous measurements of aortic, direct (Dir) and of indirect (Ind) systolic (S), mean (M) and diastolic (D) arterial pressure (AP) determined by an automatic oscillometric instrument (DINAMAP) in neonates with birthweight of 1000-3680 g. DINAMAP measurements were performed with cuffs of increasing width and length, recommended by the manufacturer for increasing arm circumference, and with a Standard sized cuff (2.5 x 15 cm), previously considered as suitable for neonates of any body size. In addition, we compared simultaneous measurements of Dir SAP and of Ind SAP determined by a Doppler technique and the Standard cuff. In DINAMAP SAP measurements with the Standard cuff, a statistically significant correlation between arm circumference and ΔInd-Dir SAP values (i.e. the difference between simultaneous Ind and Dir SAP measurements) was found. In DINAMAP MAP measurements with the cuff recommended for arm circumference, a statistically significant difference of the mean ΔInd-Dir MAP values was observed in infants whose arm was or was not completely encircled by the bladder of the cuff. In SAP as well as in MAP DINAMAP determinations, the overall error of measurement with the Standard cuff was smaller than with the recommended cuff. The Doppler method was found considerably more accurate than the DINAMAP method for the determination of SAP. In spite of these limitations, the DINAMAP method with the Standard cuff was considered to be reasonably accurate for the clinical determination of SAP and MAP, provided that several consecutive measurements are performed and averaged in order to minimize the error of measurement. When considering DAP measurements the error was so unacceptably high than the DINA-MAP method cannot be recommended for clinical use. The need for a careful consideration of the cuff characteristics when evaluating new methods for the indirect measurement of AP in the neonate is emphasized
Endothelin-1 circulating levels increase in patients with orthotopic heart transplantation and in chronic therapy with cyclosporine
No full textBackground. The aim of the study was to investigate the behaviour of plasma levels of endothelin-1 (ET-1), an endothelial peptide with vasoconstrictive and proliferative actions, in patients with cardiac transplantation and in chronic treatment with cyclosporine A, some of whom became hypertensive after cardiac transplantation. Methods. We studied: 1) 18 consecutive patients (15 M, 3 F; mean age 53±7 yrs) who underwent cardiac transplantation about six months ago at least (range 6-108 months); 2) 15 patients with essential arterial hypertension (10 M, 5 F; mean age 42±15 yrs) without organ damage; 3) 21 normal subjects (15 M, 6 F; mean age 31±12 yrs). Plasma levels of ET-1 (RIA), haemodynamic and functional renal parameters were determined in all groups and plasma levels of cyclosporine were measured in patients with cardiac transplantation. Results. ET-1 was higher in patients with cardiac transplantation than in the other two groups (p0.05). A statistical difference was found between circulating ET-1 in hypertensive transplanted patients (61%) and those in normotensive transplanted patients. In heart transplanted patients a positive and significative correlation was found between plasma levels of ET-1 and systolic (r=0.792; p<0.0001) and diastolic (r=0.525; p<0.037) blood pressure. Conclusions. Our study shows that there is an increase of circulating ET-1 levels of in patients with heart transplanted patients and in particular in those who developed arterial hypertension. We can hypothesize that ET-1 plays an important role in the variation of systemic blood pressure
