[Systemic sclerosis after a long-term follow-up].

The authors suggest some remarks on the aetiopathogenesis of systemic sclerosis through a critical review of a group of 51 patients affected by this disease for many years. In this paper the authors report their previous studies regarding the correlation of immunological response, both cell-mediated and humoral, hemocoagulative aspects and haemorheological changes. From the results of immunological studies, the authors report a long-term treatment with an immunomodulating drug: thymopentin.

Further considerations on the changing face of pneumonia in Marche Region (central Adriatic coast of Italy).

The present paper provides a more detailed review of some themes already discussed in previous papers concerning the changing face of pneumonia in an area of the central Adriatic coast of Italy, including an ex novo examination of the correlations between radiological findings and serological groups not previously reported. The discussion concentrates particularly on some questions raised by the research, such as the apparent rarity of pneumococcus, the elevated number of seronegatives appearing as atypical pneumonia, the high percentage of "bacterial-type" cases occurring among the viral-like, and the therapeutic problem.

Which induction drug for cesarean section? A comparison of thiopental sodium, propofol, and midazolam.

Study Objective: To determine maternal and neonatal effects of three different induction drugs (thiopental sodium, propofol, and midazolam) for cesarean section.

Design: Randomized, double-blind study.

Setting: Inpatient obstetric department at a general hospital.

Alkalinization improves the quality of lidocaine-fentanyl epidural anaesthesia for caesarean section.

This double-blind randomized study of 116 healthy women was undertaken to evaluate whether alkalinization potentiated the analgesic effects of epidural fentanyl-lidocaine for elective Caesarean section. After a test-dose of 3 ml, lidocaine 2% with adrenaline 1:200,000, all patients received 100 micrograms, fentanyl in 5 ml saline and they were then divided into two groups, to receive incremental doses of 5 ml lidocaine 2% with adrenaline 1:200,000 with or without 0.1 mEq.

Ventilatory effects of subarachnoid fentanyl in the elderly.

Twenty-eight elderly patients scheduled for urological surgery were randomly assigned to receive, in a double-blind study, subarachnoid hyperbaric bupivacaine 15 mg with 50 micrograms (group A, n = 7), 25 micrograms (group B, n = 7), or 12.5 micrograms (group C, n = 7) of fentanyl or 1 ml of saline (group D, n = 7) in a total volume of 4 ml. The pattern of breathing and the ventilatory response to CO2 were studied before and 90, 150 and 480 min after the subarachnoid injection.

Propofol and thiopentone for caesarean section revisited: maternal effects and neonatal outcome.

In 56 women undergoing elective caesarean section, general anaesthesia was induced with either propofol 1% or thiopentone 2.5% followed by 50% nitrous oxide in oxygen and isoflurane 0.75% until delivery.

Epidural mepivacaine for cesarean section: effects of a pH-adjusted solution.

Study Objective: To determine the clinical effects of the alkalinization of 2% mepivacaine with epinephrine used for epidural block during cesarean section.

Design: Randomized, double-blind, placebo-controlled (standard commercial preparation of 2% mepivacaine with epinephrine) study.

Setting: Inpatient obstetric department at a general hospital.

[Post-operative analgesia with sub-arachnoid fentanyl: ventilatory effects in elderly patients].

Twenty eight elderly patients scheduled for urologic surgery were randomly assigned to receive in a double blind fashion subarachnoid hyperbaric bupivacaine 15 mg with the addition of 50 micrograms (group A, n = 7), 25 micrograms (group B, n = 7), 12.5 micrograms (group C, n = 7), of fentanyl or 1 ml of saline (group D, n = 7) for a total volume of 4 ml. The pattern of breathing and the ventilatory response to CO2 were studied before 90, 150, 480 minutes after the subarachnoid injection.

Epidural analgesia during and after cesarean delivery. Comparison of five opioids.

A randomized, double-blind study was designed to determine the effects on maternal intraoperative analgesia of adding one of the following opioids to the local anesthetic at the onset of epidural block, before surgery and neonatal delivery: morphine (3 mg), fentanyl (75 micrograms), sufentanil (50 micrograms), buprenorphine (0.3 mg) and oxymorphone (1 mg). The duration of postoperative analgesia, the presence of side effects and the neonatal outcome were also studied.

[Continuous intravenous infusion with patient-controlled anesthesia for postoperative analgesia in cesarean section: morphine versus buprenorphine].

A double blind comparison between morphine and buprenorphine was performed in 20 patients using a new demand and continuous infusion analgesic system to provide analgesia after cesarean section. The patients were randomized in two equal groups to receive either morphine 1 mg/h or buprenorphine 0.03 mg/h.

[Abnormal coronary vasomotility in subjects with normal coronary arteries and reduced reserve of coronary flow].

A reduced coronary flow reserve has been reported in patients with ischemia-like symptoms and normal coronary arteries. In 13 such subjects both coronary vasomotion and flow reserve were studied. The luminal area of the proximal and distal third of the left anterior descending and left circumflex artery were determined by biplane quantitative coronary arteriography using a computer-assisted system.

[Natural history of synchronous hepatic metastases from a non-treated colorectal cancer].

The authors present a retrospective study concerning 135 cases of untreated synchronous metastases from colorectal cancer. The median survival is 5.5 months and the natural history is depending on the percentage of liver replacement, on the "performance status" of each patient and on the stage of primary tumors classified according to Dukes.

[Inguinal hernia in children].

The authors report 611 cases of inguinal hernias of childhood operated between 1967 and 1985, which represent 28% of operations performed in all children in the same period. The mean age of patients was 33 +/- 4.1 months and the ratio M:F = 5.

Adenine and pyridine nucleotides in the red blood cells of subjects with solid tumors.

The concentration of adenine (ATP, ADP, AMP) and pyridine (NADP+, NADPH, NAD+, NADH) nucleotides in the erythrocytes of subjects affected by solid tumors was evaluated using a method which allows their simultaneous extraction and reverse-phase high-performance liquid chromatographic analysis. The results showed a lower level of ATP in the erythrocytes of subjects affected by solid tumors, whereas no significant modifications were observed in the other compounds. In fact, the mean value of ATP in these subjects was 27% lower than that of normal adults.

Conservative treatment in the clinical stage T1N0 of breast cancer.

A 18-year experience with 643 cases operated for breast cancer is reported. 161 cases belonged to the clinical stage T1N0: 78 underwent modified radical mastectomy (group 1) and 83 underwent conservative surgery (group 2). Conservative treatment consisted in quadrantectomy and axillary dissection of 1st, 2nd and 3rd level with postoperative radiotherapy (5000 rad).

Solid tumors and enzyme activity in human lymphocytes.

A study on the enzyme activity of glucose metabolism in the lymphocytes of patients with solid malignant tumors is reported. The results have shown a 30% mean increase of the hexokinase (HK) activity in patients with solid malignant tumors as compared to the mean value observed in a group of healthy subjects. A relationship between level of HK increase and stage of tumor was also observed.