[Therapeutic strategies in differentiated cancer of the thyroid: total thyroidectomy].

Differentiated thyroid cancer is peculiar for its prognosis often excellent. The Authors report their experience about 78 patients affected with differentiated thyroid carcinoma, operated between 1976-1999 at the Institute of Surgical Pathology and Surgical Clinic of Cagliari University. 70 (89.

Flow cytometric reticulocyte counting. Parallel evaluation of five fully automated analyzers: an NCCLS-ICSH approach.

We performed a parallel evaluation of 5 automated reticulocyte analyzers. The guidelines were those proposed by the National Committee for Clinical Laboratory Standards and the International Council for Standardisation in Haematology. Duplicate analyses were performed for 225 healthy subjects and 115 patients affected by various diseases.

Prevalence of hepatitis A virus infection in sewage plant workers of Central Italy: is indication for vaccination justified?

Prevalence of antibodies to hepatitis A virus (HAV) was studied in a group of 65 sewage plant workers living in Tuscany, Central Italy. In order to evaluate the effect of several confounders (age, place of birth, income, educational degree, sea-food consumption, etc.), subjects under study were matched with 160 other workers residing in the same area.

Levels of C-telopeptide fragments of collagen type I enable the monitoring and early adjustment of clodronate therapy in patients with postmenopausal osteoporosis.

We monitored the efficacy of therapy with clodronate, a bisphosphonate drug, in women with postmenopausal osteoporosis, using urinary immunoenzymatic assay of C-telopeptide of collagen type I, an eight amino acid fragment (collagen fragment) of the C-telopeptide of the alpha1-chain of collagen type I (EKAHDGGR). The analysis of the dynamics of collagen fragment concentrations (a marker of bone resorption) during treatment suggests the possibility of early modulation and customization of therapy based on the levels of this marker. This could enable improved control over secondary effects and side effects of clodronate therapy.

Critical left ventricular outflow tract obstruction due to accessory mitral valve tissue.

Left ventricular outflow tract (LVOT) obstruction due to anomalous tissue tag arising from the mitral valve is a rare congenital cardiac anomaly. It generally becomes symptomatic during the first decade of life as exercise intolerance, chest pain, or syncope at effort. To date, only a few cases of critical systemic obstruction due to isolated mitral valve anomaly in neonates have been reported.

Synthesis, fungicidal activity, and QSAR of a series of 2-dichlorophenyl-3-triazolylpropyl ethers.

A series of new alkyl and arylalkyl ethers of 2-(2, 4-dichlorophenyl)-3-(1H-1,2,4-triazol-1-yl)propanol, related to the fungicide tetraconazole, were synthesized and tested in vitro or in vivo against seven common pathogens in comparison with tetraconazole. In vitro, most of them exhibited a broad spectrum of activity and an efficacy of the same order of magnitude of the standard, but the activity was influenced by the nature of the substituents. A QSAR study showed that lipophilicity is a major positive parameter in affecting the activity; the second relevant parameter is mu, whereas geometrical descriptors indicate that linear and narrow substituents are more suitable than wide ones.

Five-year follow-up of 165 Italian patients with undifferentiated connective tissue diseases.

Objective: To study those conditions with a proven or hypothesised immunologic pathogenesis and denominated under a working definition of undifferentiated connective tissue diseases (UCTD).

Methods: A multicentre prospective study was organised involving 10 tertiary referral centers of internal medicine in Italy, with the aim of describing the natural history of UCTD and the prevalence of its different clinical and immunological manifestations.

Results: After a five-year follow-up period, data on 165 patients were available for analysis.

Visualisation of a paraganglioma by technetium-99m-sestamibi scintigraphy.

A 68-yr-old woman presented to our observation with multinodular goiter and a contiguous right laterocervical mass. In spite of ultrasound, technetium and iodine scan, CT and fine-needle biopsy, the precise origin of the mass remained uncertain. On additional multi-phase sestamibi scan, the neck region showed an early high uptake rapidly decreasing over time in the laterocervical mass, and a persistent inhomogeneous distribution in the thyroid gland.

Complications of subcutaneous infusion port in the general oncology population.

Subcutaneous infusion ports (SIPs) represent a valid method for long-term chemotherapy. The SIPs have several advantages over other methods of venous access: they are easy to implant under local anaesthesia, have less discomfort for the patients, allow low costs, can be implanted in day hospital, and can be managed ambulatorily. However, SIPs have delayed complications, frequently related to clinical conditions of the neoplastic patients, and immediate complications, often due to the placement technique.

Long-term toxicity in adjuvant treatment with tamoxifen.

Long-term treatment with tamoxifen has produced few side effects, which are generally mild. Of the serious ones, all of them except eye toxicity seem to be related to the molecule's intrinsic mildly estrogen-like action, such as, for example, endometrial carcinoma. This property is also responsible for some favorable clinical effects including a lower risk of osteoporosis and cardiovascular disease.

The Friedreich ataxia GAA triplet repeat: premutation and normal alleles.

The most common mutation causing Friedreich ataxia (FRDA), an autosomal recessive neurodegenerative disease, is the hyperexpansion of a polymorphic GAA triplet repeat localized within an Alu sequence (GAA-Alu) in the first intron of the frataxin (X25) gene. GAA-Alu belongs to the AluSx subfamily and contains several polymorphisms in strong linkage disequilibrium either with a subgroup of normal alleles, or with hyperexpanded FRDA-associated alleles. GAA repeat sizes in 300 normal chromosomes (97 from carriers and 203 from controls) were distributed in two separate groups: 83% of them contained between six and 10 triplets (small normal alleles), while the remaining 17% had more than 12 triplets, up to 36 (large normal alleles).

Biological monitoring of exposure to chlorpyrifos-methyl by assay of urinary alkylphosphates and 3,5,6-trichloro-2-pyridinol.

The results of biological monitoring by assay of urinary 3,5,6-trichloro-2-pyridinol and alkylphosphates (DMP, DMTP) in groups of 9 and 2 workers exposed to chlorpyrifos-methyl during vine spraying and manual leaf thinning 5-11 d after spraying, respectively, are reported. The results are compared with those of a control group of 46 subjects not occupationally exposed to organophosphate insecticides. Significantly higher urinary excretion of metabolites (Mann-Whitney U-test) was found in both groups than in controls.

Effects of estradiol and medroxyprogesterone-acetate treatment on erythrocyte antioxidant enzyme activities and malondialdehyde plasma levels in amenorrhoic women.

Plasma levels of 17 beta-estradiol (E2) and malondialdehyde and erythrocyte antioxidant enzyme [superoxide dismutase, catalase, and glutathione-peroxidase (GSH-Px)] activities were evaluated in 20 healthy eumenorrhoic women (EW) on day 7 of the menstrual cycle and in 48 secondary hypothalamic amenorrhea patients (AP) (time 0). The AP were randomly divided into four subgroups of 12 subjects and treated with transdermal E2 for 30 days (subgroup A), oral medroxyprogesterone-acetate for 30 days (subgroup B), and transdermal E2 plus medroxyprogesterone-acetate for 30 days (subgroup C). The fourth subgroup acted as control.

Prediction of response to recombinant human erythropoietin (rHuEpo) in anemia of malignancy.

Background: Since only a portion of anemic patients outside the uremia setting benefit from erythropoietin treatment, a reliable means of predicting potential responders and nonresponders would be very useful.

Materials And Methods: We retrospectively reviewed the clinical records of 58 patients with refractory anemia associated with various malignant disorders who had been treated with subcutaneous rHuEpo. The starting rHuEpo dose was 375 U/kg/week for 4 weeks, and was increased to 750 U/kg/week for another 4 weeks if no response was observed.

Successful pregnancy following gonadotropin therapy in a young female with juvenile idiopathic hemochromatosis and secondary hypogonadotropic hypogonadism.

Heart failure and hypogonadotropic hypogonadism are the most frequent clinical problems encountered in patients with juvenile idiopathic hemochromatosis (JIH). In this context, amenorrhea is one of the first symptoms in female patients, and hormone therapy must be added to phlebotomy to restore menstrual cycles. Here we report the case of a woman in childbearing age with hypogonadotropic hypogonadism due to JIH.

[Infective endocarditis today; heart surgery in its treatment: how and when].

The authors report the experience of 161 surgical cases operated between 1980 and 1992 because of valve endocarditis. Two hundred and two surgical procedures were performed. Patients were divided into two groups: Group I (EN) considered 117 patients with endocarditis on the native valve; Group II (EP) included 64 patients with prosthetic endocarditis.

[Biennial experience with aortic valve homografts prepared and preserved in our bank and implanted on the left ventricular outflow tract in adult patients].

A homograft bank was established in 1986 at the Institute of Cardiac Surgery of the Second University of Naples. Since then 163 aortic and pulmonary homografts have been collected, and mostly used for right ventricular outflow tract reconstruction (69 at our Institution and 14 at other Italian Centers). In March 1991 free aortic homografts were first implanted in the left ventricular outflow tract in adult patients with aortic valve and/or root disease, for a total of 15 implantations with a follow-up ranging between 3 and 19 months (mean 10 months).

Long term results of surgery for prosthetic valve endocarditis.

Operative mortality, recurrence and late survival were analyzed in 64 patients operated for prosthetic valve endocarditis (PVE) between 1980-1992: age, sex, drug addiction, early vs. late PVE, micro-organism, sepsis at the time of surgery, indication for surgery, prosthesis type and site were assessed as potential risk factors. PVE developed after replacement for native valve endocarditis in 23 cases (Group A) and after replacement for other valvular disease in 41 patients (Group B).

Etoposide, doxorubicin and cisplatin (EAP) treatment in advanced gastric carcinoma: a multicentre study of the Italian Trials in Medical Oncology (I.T.M.O.) Group.

Various reports have documented the efficacy of the combination of etoposide, doxorubicin and cisplatin (EAP) in the treatment of advanced gastric cancer, although other studies have not confirmed such results. This multicentre phase II study was designed to try to define the efficacy and tolerability of the original EAP regimen. From January 1990 to May 1992, 96 patients with locally advanced or metastatic gastric cancer were treated every 3 weeks with etoposide (120 mg/m2) on days 4, 5 and 6, doxorubicin (20 mg/m2) on days 1 and 7, and cisplatin (40 mg/m2) on days 2 and 8.

Evaluation of erythroid marrow response to recombinant human erythropoietin in patients with cancer anaemia.

Background: Anaemia is a frequent finding in patients with cancer and may be due to different causes, including blunted erythropoietin production.

Materials And Methods: In a pilot study, we administered recombinant human erythropoietin (rHuEPO) to twelve patients with solid tumours and secondary anaemia. rHuEPO was given subcutaneously 5 d per week at escalating doses (75 to 150 U/kg per day): the aim of treatment was a Hb level > or = 10 g/dl without blood transfusion.

[Relevance and therapeutic implications of dysplasia in the follow-up of ulcerative rectocolitis].

Long standing ulcerative colitis (UC) is a condition capable of malignant transformation. Even if the rate of occurrence of carcinoma differs considerably among the various series, there is general agreement that it can be detectable in advance through the finding of glandular dysplasia. The Authors examine such a problem in a series of 27 patients submitted to clinical and endoscopic follow-up from 1984 to 1989.