Medicina (Florence, Italy)最新文献

{"title":"[Prevalence and clinical meaning of insulin-specific IgE antibodies].","authors":"C Tosoni,&nbsp;R Cattaneo,&nbsp;U Valentini,&nbsp;L Rocca,&nbsp;C Marchetti,&nbsp;M Braga","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Systemic and local reactions to insulins in patients affected by insulin-dependent diabetes are uncommon but may be life threatening. Both systemic and local adverse reactions to therapy may be managed by different therapeutic schemes. The availability of human (DNA recombinant) insulin raised hopes that this be the choice treatment for allergic complications. However, controlled studies showed that reaginic (IgE) antibodies are directed to common insulin determinants and not to heterologus protein contaminants. Therefore we investigated in 62 patients undergoing insulin therapy, prevalence and clinical significance of the detection of specific IgE to insulin. Furthermore, we searched for a relationship between atopic status and the presence of antiinsulin IgE. In our study prevalence of specific IgE to insulin was 16.1%. We showed a correlation between clinical symptoms and the presence of specific IgE to insulin, when these antibodies are of an elevated class (R.A.S.T. class 2 or more). When specific IgE were present we detected antibodies to all insulines (bovine, porcine and human) thus confirming that specific IgE are directed to a common antigenic determinant. Finally, we couldn't find a relationship between atopic status and the presence of reaginic antibodies to insulin.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"396-8"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Adverse effects of corticosteroids].","authors":"L Patoia,&nbsp;E Baratta,&nbsp;G Bucaneve,&nbsp;A Rossi,&nbsp;A Perelli,&nbsp;M S Dionisi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Due to their anti-inflammatory and immunosuppressive properties, as well as their action on the hematopoietic system and the calcium phosphate turnover, corticosteroids are widely employed in the treatment of many diseases. However, the therapeutic use of these compounds is frequently associated with unwanted, mainly type A, effects that are directly dependent on the wide spectrum of their pharmacological activities. In this study these side effects are critically reviewed and classified on the basis of the organs and systems involved. Where possible, the incidence, pathogenesis, type of steroid, dose and schedule are reported, and the precautions that should prove useful in reducing the incidence and gravity of the side effects are given.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"363-72"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Lisinopril].","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"439-41"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13124658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prognostic factors in Raynaud's phenomenon: usefulness of antinuclear antibodies and of periungual capillaroscopy].","authors":"G Passiu,&nbsp;G D Sebastiani,&nbsp;M Galeazzi,&nbsp;M A Tuveri,&nbsp;P M Nicosia,&nbsp;R Boirivant","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Antinuclear antibodies (ANA) and nailfold capillary microscopy have been evaluated as prognostic markers in patients with apparently idiopathic Raynaud's phenomenon. Results have shown that either ANA and peculiar alterations in nailfold capillaries are important risk factors as regard to the evolution into a connective tissue disease; furthermore, when both these markers are present in a patient with Raynaud's phenomenon, the risk of evolution is even greater. When sensibility and specificity have been compared, ANA appeared to be a more sensible test but nailfold capillary microscopy seemed to be more specific. Our data suggest that ANA and capillary microscopy are important tests in patients with Raynaud's phenomenon; they should be performed in order to identify those patients who are at greater risk of evolving to overt connective tissue disease.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"405-7"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Mantoux intradermal reaction and lymphocyte populations in asymptomatic HIV-seropositive subjects].","authors":"P A Canessa,&nbsp;A Torraca,&nbsp;G Mattei","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Individuals who are infected with human immunodeficiency virus (HIV) are at high risk of developing tuberculosis, probably due to the reactivation of latent infection associated with HIV-induced immunosuppression. Tuberculin skin test is the best diagnostic means to assess a previous tuberculous infection, but this test may be falsely negative in HIV seropositive subjects. To assess the validity of a non-reactive tuberculin skin test in asymptomatic HIV seropositive subject, we performed Mantoux test 5 TU, chest x-ray, HIV serologic tests on 141 asymptomatic prisoners. Determination of lymphocyte subsets in HIV seropositive carriers had already been performed. Chest x-ray film showed no pleuro-pulmonary lesion in any subject. We found 101 HIV seronegative subjects (89 men and 12 women; 30 +/- 6 yrs with 18-39 range; 34 Mantoux reactive and 67 non-reactive) and 40 HIV seropositive individuals (30 men and 10 women; 29 +/- 6 yrs with 21-39 range; 7 Mantoux reactive and 33 non-reactive). By subdividing HIV seropositive subjects in two groups (reactive and non-reactive to tuberculin test) a significant decrease of CD 4 lymphocytes and CD 4/CD 8 ratio was found in HIV seropositive/Mantoux non-reactive group, without changes in total lymphocytes and CD 8 subset. We conclude that: 1) a non-reactive tuberculin skin test cannot be confidently explained in asymptomatic HIV seropositive subjects with a T helper lymphocyte count decrease; 2) T helper cells are important to keep alive delayed hypersensitivity reaction.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"394-6"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13142033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Intraoperative echoencephalography in neurosurgery].","authors":"D Locatelli,&nbsp;N Bonfanti,&nbsp;A Ometto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Intraoperative ultrasonography with real time sonographic imaging equipment is widely used and, in the neurosurgical operating room, has been really successful, initially in the brain and subsequently in the spinal cord as well. Its main applications i.e. accurate needle biopsies, localization of intracerebral masses, placement of ventricular and cyst shunts, can diminish the amount of potential damage to normal brain tissue. Moreover results of tumor resection may be intraoperatively confirmed and the end results are more accurate. No intraoperative complications and no postoperative infections result from use of ultrasound in the operating room. No evidence is given that the small amount of mechanical vibration emitted by the transducer damages the brain or the spinal cord. Surgical procedures, as a result, are faster, safer and better planned by virtue of informations obtained by ultrasonographic intraoperative examination, instead of simple preoperative imaging procedures.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"386-90"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Corticosteroids].","authors":"P Compagnucci,&nbsp;M G Cartechini,&nbsp;F Santeusanio","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Adrenal steroids, particularly glucocorticoids, are used in a variety of conditions ranging from adrenal insufficiency requiring substitution therapy (glucocorticoids and mineral-corticoids), to a wide range of clinical disorders in which undesired inflammatory reactions must be reduced (glucocorticoids). The anti-inflammatory effect, typical of glucocorticoids, is mainly due to the interference with arachidonic acid metabolism, from which both prostaglandins and leukotriens, mediators of inflammation, take origin. ACTH is also employed with the same indications of glucocorticoids, but its use is limited, since its effect depends on the stimulation of cortico-adrenal gland with subsequent release of not only glucocorticoids but also mineral-corticoids and androgens. The therapeutical indications of glucocorticoids are numerous, but dose and duration of treatment vary in relation of the disease that is to be cured. The widespread use of steroids is accompanied by numerous unwanted reactions which depend on their metabolic actions. Therefore corticosteroids must be reserved to well defined clinical conditions and their use should be guided by criteria that are now codified. In this review the physiological and pharmacological effects and the clinical use of corticosteroids have been examined.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"345-62"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hirudin inhibition of human thrombin activity].","authors":"P Ascenzi,&nbsp;M Bolognesi,&nbsp;M Coletta,&nbsp;E Menegatti,&nbsp;G Amiconi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Thermodynamics and kinetics for hirudin binding to human alpha-, beta- and gamma-thrombin, under experimental conditions which mimic the in vivo conditions (i.e., pH = 7.35, T = 37.0 degrees C, I = 0.1 M), indicate that the inhibitor specificity for the three species of the enzyme is different. Such a finding agrees with the human thrombin:hirudin binding geometry as revealed by X-ray crystal studies. From the therapeutic viewpoint, thermodynamics and kinetics here reported indicate that the inhibitory activity of hirudin in vivo is more effective than that shown by antithrombin III, which is generally considered the most important plasma thrombin inhibitor.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"391-2"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13255828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Infectious diseases].","authors":"S Vella,&nbsp;L Sarmati,&nbsp;G Milanese,&nbsp;G Rocchi","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 4","pages":"442-5"},"PeriodicalIF":0.0,"publicationDate":"1990-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13254988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The dementias].","authors":"L Amaducci,&nbsp;A Lippi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Statistics indicate that in Europe people over 65 years of age will be 23.5% at the beginning of the next century and prevalence of severe dementias is estimated to be 5% in this population group. Clinically, dementia is a syndrome characterized by memory loss, other cognitive dysfunctions and loss of ability for self-care. This organic syndrome, that can have many different causes, must be differentiated from other similar psychiatric disorders of the elderly such as the pseudo-dementias. The most important of these causes are Alzheimer's disease (AD) and vascular dementias. Other causes are infections, toxic and metabolic disorders, normal pressure hydrocephalus and head trauma. Many efforts are required in order to reach an accurate differential diagnosis, as 10-15% of the dementia syndromes are reversible if an appropriate therapy is applied. Because of its high frequency, AD is one of the most actively studied areas in dementia research. The specific causes of AD are still unknown, but recent case-control studies suggest the importance of risk factors such as familiarity and previous head trauma. Other hypotheses concern prion infections, aluminium toxicity and immunologic disorders. The most important findings of the last years however, concern biochemical alterations in Alzheimer's brains. After the first observations of Davies and Maloney (1976), who observed a reduction of choline acetyltransferase in cerebral cortex, many reports successively indicated the importance of deficiencies of the cholinergic systems in AD. Other neurotransmitter systems, such as the noradrenergic and the serotoninergic systems, were also found to be involved in AD. From these findings a rational therapeutic approach to the disease was proposed. Initially, the clinical trials employed physostigmin with uncertain results. Later, therapeutic attempts with choline, lecitine, acetylcarnitine and phosphatidilserine resulted more promising, at least in the initial phase. However, consistent data are not yet completely available. Finally, the management of AD also concerns problems of familiar education to the behavioural management of AD patients and the eventual possibilities of social assistance. Vascular dementia and Creutzfeldt-Jakob disease will also be discussed.</p>","PeriodicalId":77570,"journal":{"name":"Medicina (Florence, Italy)","volume":"10 3","pages":"213-27"},"PeriodicalIF":0.0,"publicationDate":"1990-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13235070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}