1,721,071 research outputs found
Bone mineral disease, metabolism in patients with neurofibromatosis Type 1 (Von Recklinghausen Disease)
No full textThe neurofibromatosis type 1 is characterized by specific cutaneous features (neurofibromas, “café-au-lait” spots of the skin) and alterations of several tissue (nervous, vascular) and bone deformities, such as scoliosis, congenital pseudoarthrosis of the tibia and dysplasia. Moreover, several studies have shown systemic involvement of bone tissue in NF1 patients, leading to reduced bone mass.
Aim of our study was to evaluate some bone mineral metabolism parameters before and after calcium and vitamin D supplementation in NF1 patients.
We evaluated in 70 NF1 consecutive patients the mineral metabolism and bone mineral density compared to 40 normal subjects (NS). We showed bone alterations in 35% of patients and the increase of bone formation markers, such as bone isoenzyme of alkaline phosphatase (41.2±15.5 UI vs. 25.6±8.7UI, p60%). Moreover, we revealed a significant reduction of bone mass density at spine (L1-L4) (0.935±0.13 gr/cm2 vs 1.110±0.17 gr/cm2; p <0.001) and femoral neck side (FN) (0.765±0.09 gr/cm2 vs 0.839±0.12 gr/cm2; p<0.02), with high prevalence of osteoporosis (18%) and osteopenia (44%). After 12-months of calcium (1200mg/die) and cholecalciferol supplementation (800UI/die) we found a significant increase of (25)OH-vitamin D level (21.8±12.3 ng/mL vs 35±13 ng/mL; p <0.01) without changes in bone mass density.
In conclusion, NF1 patients may present mineral bone involvement, with vitamin D deficiency; Calcium and vitamin D supplementation is necessary to restore these bone mineral metabolic alterations
Aldosterone-induced oxidative stress: a potential mechanism of aldosterone autonomy in primary aldosteronism
No full textPigmented 'black' cardiac paraganglioma in a patient with a novel germ-line SDHD mutation
No full text[No abstract available
Transverse study of personality characteristics in patients with arterial hypertension
Full text linkOBJECTIVE: To verify whether hypertensive patients, with recent or old poor-controlled hypertension, asymptomatic for anxiety and/or depression, seem more disturbed in personality than normotensive patients. MATERIALS AND METHODS: 122 patients with arterial hypertension (62 women, 60 men, mean age 47 +/- 12.7 years, divided in new-hypertensive patients who don't take any drugs and old-hypertensive patients with a chronic therapy) and 65 normotensive subjects (37 women, 28 men, middle age 41 +/- 11.7 years) answered two self-extiming questionnaires: A.S.Q. by Krug and Cattel and C.D.Q. by Krug and Laughlin. For every group of variables it has been calculated the mean and standard deviation and statistical analysis was performed by Mann-Whitney's t test. A value of p < 0.05 was considered statistically significatant. RESULTS: 37 hypertensive patients (30.3%) were positive in the C.D.Q. and 34 (27.8%) in the A.S.Q. test. In the group of normotensive subjects, 13 (20%) were positive in C.D.Q. and 12 (8.4%) in A.S.Q. There was a statistic difference in C.D.Q and A.S.Q. between hypertensive and normotensive subjects. No statistic difference was found in C.D.Q. and A.S.Q. between new and old-hypertensives. CONCLUSIONS: The study has shown a significant higher level of anxiety and depression in hypertensive subjects as compared to normotensives. However, no significant difference in anxiety and depression levels was found between new- and old-hypertensive patients or in relation with the use of antihypertensive drugs
Surgery for Adrenocortical Carcinoma: Do We Have Enough Evidence to Perform Robotic Approach? A Systematic Review
No full textSurgery is the treatment of choice for adrenocortical carcinoma (stage I-III). In recent years, many authors demonstrated the safety and feasibility of minimally invasive approaches when applied to highly selected cases. The aim of the present study is to provide an overview about technical details and surgical and oncological outcomes of robotic approach compared to traditional open or laparoscopic surgery in patients with adrenocortical carcinoma. A literature search, according to the PRISMA guidelines, was performed via PubMed, Scopus, and Cochrane Library. The search thread was robotic adrenalectomy, minimally invasive surgery, and adrenocortical carcinoma. Only studies involving patients with adrenocortical carcinoma comparing robotic approach with laparoscopic and open adrenalectomy and reporting relevant clinical outcomes were included. Among all reports identified, only three studies matching the inclusion criteria were finally selected for the analysis. All of them were retrospective and demonstrated the superiority of robotic approach over laparoscopy for adrenocortical carcinoma as regards open conversion rate with no significant differences in terms of length of stay, readmissions, and 90-day mortality. A study reported significantly higher odds of positive margins for laparoscopic adrenalectomy that seems to be associated with significantly shorter overall survival. The most relevant reports strictly concerning the robotic approach to adrenocortical carcinoma revealed the safety and feasibility of robotic surgery with better outcomes in terms of open conversion rate and negative resection margins that are powerful predictors for overall survival. Multicenter case series analysis is still needed to confirm the real advantages of robotic approach in the treatment of adrenocortical carcinoma
Parathyroidectomy erase increased myocardial electrical vulnerability in patients with primary hyperparathyroidism
No full textBackground: Patients with primary hyperparathyroidism (pHPT) show an increased bioelectrical risk not related to cardiovascular complications, this risk seems to persist after surgery and this last finding is still controversial and probably related to follow-up length. Methods: The aim of the study is to evaluate QT parameters in 11 patients with primary hyperparathyroidism (pHPT) 18 months after parathyroid surgery using computed standard 12-leads ECG compared to those of 29 healthy subjects (HS). Results: In pHPT patients, 4 months after parathyroidectomy QT and QTc dispersion persist significantly higher than HS. 18 months after surgery, QT and QTc dispersion resulted comparable with HS. QT dispersion was found significantly higher in pHPT at 4 months respect 18 months after parathyroidectomy. Conclusions: ECG alteration after parathyroidectomy gradually return within normal limits and we can affirm that surgery erase bioelectrical risk in pHPT. © 2008 Elsevier Ireland Ltd. All rights reserved
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