Recurrences following videothoracoscopic treatment of primary spontaneous pneumothorax: the role of redo-videothoracoscopy.

Objective: There is very little experience regarding recurrences following videothoracoscopic (VATS) treatment of primary spontaneous pneumothorax. We report our experience with 19 patients who underwent redo-VATS to evaluate the feasibility of such surgical approach.

Methods: From July 1, 1992 to September 1, 2000, out of 2136 VATS procedures performed at our institution, 597 patients (27.

[Nitro derivatives: considerations on their antiplatelet activity].

The antischemic effect of nitrates is known and well accepted since more than 100 years, but recently many and interesting studies about antiaggregant property of such drugs have been reported. This action would be lied to increased synthesis of GMPc. The antiaggregant property pf nitrates may be leave open the problem to include the nitrates between the drugs able to influence the prognosis of myocardial infarction both in acute and chronic phase, such as betablockers, ASA and thrombolytics.

Psychiatric symptoms and medical utilization in primary care patients.

In two studies, the authors evaluated the impact of psychiatric disorders on medical care utilization in a primary care setting. In the first study, 526 consecutive patients in a teaching hospital primary care practice completed the 18-item RAND Mental Health Inventory to identify clinically significant depression and/or anxiety and a questionnaire about the use of psychiatric treatment and psychoactive medications. The medical utilization of those patients defined as depressed and/ or anxious was compared with those defined as not depressed and/or anxious.

Bone density in Ehlers-Danlos syndrome.

Ehlers-Danlos Syndrome (EDS) is the most common inherited disorder of connective tissue recognized. The objectives of the present study were to determine bone mineral density (BMD) and biochemical markers of bone metabolism in EDS. Twenty-three subjects with Type III EDS and 23 matched controls underwent BMD measurement by dual-Energy X-ray absorptiometry (DXA) of the lumbar spine and femoral neck.

Induction of immune tolerance to human type I collagen in patients with systemic sclerosis by oral administration of bovine type I collagen.

Objective: To determine whether oral tolerance to type I collagen (CI) could be induced in patients with systemic sclerosis (SSc).

Methods: Twenty adult patients with limited or diffuse SSc were enrolled in a study to receive 0.1 mg of solubilized native bovine CI daily for 1 month, followed by 0.

Osteoporosis associated with non-familial acro-osteolysis successful treatment with an anti-resorptive agent.

The syndrome non-familial acro-osteolysis features bone reabsorption of the digits in association with short stature. Osteoporosis is common in this disorder, but no successful treatment has been previously reported. We report a case of non-familial acro-osteolysis complicated by multiple fractures in which treatment with antiresorptive therapy improved both biochemical markers of bone turnover and bone mineral density but had no effect on the acro-osteolysis.

An interdisciplinary approach to the rehabilitation of open-heart surgical patients.

Quite often nurses in environments other than the immediate postoperative setting are responsible for the well-being of patients who have had open-heart surgery (OHS). These patients may be admitted to rehabilitation or home healthcare settings as early as 1 week after surgery. They may be deconditioned because of postoperative complications such as a cerebrovascular accident or cardiopulmonary compromise.

Lack of efficacy of oral bovine type II collagen added to existing therapy in rheumatoid arthritis.

Objective: To investigate the efficacy of oral type II collagen (CII) in the treatment of rheumatoid arthritis (RA), when added to existing therapy.

Methods: Patients with active RA (n = 190) were randomized into a 6-month, double-blind, placebo-controlled trial. Patients continued to take their current arthritis medications.

The role of collagen abnormalities in ultrasound and densitometry assessment: In vivo evidence.

There is little information concerning how the mutation of collagen affects bone mineralization and the assessment of bone properties. To estimate these influences, we performed ultrasonic assessments of the calcaneus and bone mineral density (BMD) measurements of the hip and lumbar spine. Females with diseases related to the mutation of collagen [Ehlers-Danlos syndrome (EDS) type III and systemic sclerosis (SSc)] participated in this study.

Ultrasound measurements of the calcaneus: effects of ethnicity.

This study investigated whether there were differences in quantitative ultrasound (QUS) of the calcaneus between African-American and Caucasian females. QUS-1X, an ultrasonometer by Metra Biosystems Inc., was used to determine broadband ultrasound attenuation (UBI-4) using Burg Spectral Estimation in decibels/megahertz.

Effects of long-term administration of methotrexate on bone mineral density in rheumatoid arthritis.

Because previous studies of high-dose methotrexate usage have demonstrated an effect on bone formation and resorption, this study was done to determine whether long-term, low-dose use of methotrexate for the treatment of rheumatoid arthritis causes bone loss. Bone mineral density (BMD) of the lumbar spine and hip was measured in 10 Caucasian postmenopausal women who had never received methotrexate and 10 Caucasian postmenopausal women who had received the drug for 3 or more years. There were no significant differences in BMD at the lumbar spine (L2-L4) between patients who had used long-term methotrexate compared with patients never treated with methotrexate (1.

Osteopenia, osteonecrosis, and mastocytosis.

Systemic mastocytosis has been defined as an abnormal increase in mast cells in tissues other than the skin. We report an unusual case of systemic mastocytosis that was manifested by osteopenia and osteonecrosis, and was associated with pancreatic adenocarcinoma. Our experience suggests that osteopenia and compression fractures may be the presenting features of mastocytosis and that a careful search for a malignancy is warranted in these patients.

Utility of ultrasound to assess risk of fracture.

Traditional assessments of bone properties have utilized densitometry techniques such as Dual Energy X-ray Absorptiometry (DXA). Recently, quantitative ultrasound (QUS) has been introduced as an alternative method of assessing bone properties. Advantages of QUS over X-ray techniques include low costs, portability, and nonionizing radiation.

Proteinuric hypertension in a pregnant baboon: was this pre-eclampsia?

We report the results of investigating a pregnant baboon that developed hypertension, proteinuria, and oedema in late gestation. Although the clinical presentation suggested a diagnosis of pre-eclampsia, the evolution of her clinical signs and results of a renal biopsy performed 3 weeks after delivery suggested that glomerulonephritis was the underlying disease.

[Prognostic factors in local-regional recurrences of colorectal neoplasms].

Purpose: The aim of this study was to evaluate, in a group of patients suffering of colo-rectal cancer, the influence on local recurrence of some clinical and anatomo-pathological variables.

Methods: The study was limited to 833 patients who underwent potentially curative resection and have been followed for at least two years. All patients were evaluated every six months for the first three years and yearly thereafter by means of clinical, laboratory, endoscopic and radiological investigations.

Goodpasture's Syndrome Complicating Henoch-Schönlein Purpura.

Pulmonary hemorrhage in a patient with Henoch-Schönlein purpura was shown at autopsy to be caused most likely by Goodpasture's syndrome. The diagnosis was missed in part because of repeated negative assays for glomerular basement membrane antibodies. Linear fluorescence for immunoglobulin G was found in lung and glomeruli at postmortem.

Osteoporosis of pregnancy: long-term follow-up of patients and their offspring.

Background: The usual course of osteoporosis of pregnancy is complete resolution without recurrence. We report the 10-year follow-up of two patients with osteoporosis of pregnancy and their offspring.

Cases: A 30-year-old woman presented with right hip pain at 30 weeks' gestation.

Psychotic disorder caused by a general medical condition, with delusions. Secondary "organic" delusional syndromes.

Many medical and neurologic disorders cause psychosis with delusions. The pathophysiology of this final common pathway may shed light on idiopathic psychotic disorders such as schizophrenia. By focusing on the "basal ganglia-thalamocortical" and "corticostriatal-thalamocortical" loops that connect limbically related cortical regions with the mesolimbic-mesostriatal dopamine system we can view the neural network that may produce delusional thinking when its restitutive function fails.

Combined modality therapy of resectable high risk rectal cancer.

Aim of this phase I-II study was to evaluate the efficacy of preoperative concomitant radiochemotherapy in resectable high risk (TNM stage: II and III) rectal tumors, 64 patients entered the study: 37 had low rectal cancer, 27 mid-rectal cancer. 50 patients were clinically staged as stage III (Dukes C) and 14 as stage II (Dukes B). Treatment protocol included bolus mitomycin C at the dose of 10 mg/m2 on day 1 and 5FU continuous infusion at the daily dose of 1000 mg/m2 on day 1, 2, 3, 4.