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Intervention study to improve smoking cessation during hospitalization. Public Health 2011; 125:457-63. [DOI: 10.1016/j.puhe.2011.03.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 12/06/2010] [Accepted: 03/15/2011] [Indexed: 11/29/2022]
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2
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Hemarthrosis as acute presentation of acquired hemophilia in a patient with systemic lupus erythematosus: successful treatment and long-lasting remission. Clin Rheumatol 2008; 27:1581-4. [PMID: 18827958 DOI: 10.1007/s10067-008-0993-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Revised: 07/25/2008] [Accepted: 07/30/2008] [Indexed: 11/25/2022]
Abstract
Hemorrhagic events due to production of antibodies directed against coagulation factors are rarely observed in systemic lupus erythematosus (SLE). We report the case of a patient with clinically quiescent SLE who developed factor VIII inhibitor in acquired hemophilia presenting as hemarthrosis. Initial treatment with FVII, FVIII and FIX plasma concentrate, metilprednisolone and immunoglobulins i.v. were started but new hemorrhagic manifestation occurred. Plasma exchange was also administered, but it was discontinued early due to partial efficacy. In addition, pulse cyclophosphamide 0.5 g/m(2) was started. Eight weeks later, FVIII and FIX activity returned within normal ranges, FVIII and FIX inhibitors decreased significantly and hemorrhagic manifestations disappeared. The rare occurrence of acquired hemophilia due to the presence of anti-factor VIII antibodies associated to SLE, which was reviewed, might explain the lack of therapeutic guide-lines; indeed therapeutic options are available but the outcome in each single patient is not predictable.
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Clinical efficacy of highly purified, doubly virus-inactivated factor VIII/von Willebrand factor concentrate (Fanhdi) in the treatment of von Willebrand disease: a retrospective clinical study. Haemophilia 2002; 8:761-7. [PMID: 12410644 DOI: 10.1046/j.1365-2516.2002.00688.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The goal of therapy in patients with von Willebrand disease (vWD) is to correct the dual defect of primary haemostasis and intrinsic coagulation reflected by low levels of von Willebrand factor (vWF) and factor VIII coagulant activity (FVIII:C). Factor VIII/von Willebrand factor (FVIII/vWF) concentrates are currently the treatment of choice in vWD patients unresponsive to desmopressin (DDAVP). However, only few studies on their clinical use are available so far. The main objective of this study was to retrospectively evaluate the clinical efficacy of a highly purified, doubly virus-inactivated FVIII/vWF concentrate with a high content of FVIII/vWF (Fanhdi). Twenty-two patients with congenital vWD have been treated from 1999 to 2001 at eight specialized centres belonging to the Italian Association of Hemophilia Centers (AICE). Ten males and 12 females, median age 28.5 years, range 5-70 years) had type 3 vWD (six cases), DDAVP-unresponsive type 1 (nine cases) and type 2B (seven cases). The study drug was given to stop or prevent 12 bleeding episodes or to prevent excessive bleeding during 14 surgical or invasive procedures. Overall, replacement therapy with the concentrate showed an excellent to good clinical efficacy in 92% of bleeding episodes and in 93% of surgical procedures. No adverse events occurred during 1,601 infusions, accounting for a total of 304,500 IU of FVIII:C administered. These results confirm the efficacy and safety of this concentrate in the management of bleeding episodes and in the prevention of excessive bleeding during major and minor surgery.
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Diaphragm kinetics during pneumatic belt respiratory assistance: a sonographic study in Duchenne muscular dystrophy. Neuromuscul Disord 2002; 12:569-75. [PMID: 12117482 DOI: 10.1016/s0960-8966(02)00003-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The principal aim of this study was to demonstrate the usefulness of M-mode sonography as a noninvasive technique to evaluate diaphragm excursion. The secondary aim was to assess the efficacy of pneumatic abdomino-diaphragmatic belt ventilation in patients with Duchenne muscular dystrophy. Using M-mode sonography, we measured the amplitude of diaphragm excursion in seven patients with Duchenne muscular dystrophy in various positions (0 degrees, 45 degrees, 75 degrees ) with and without pneumatic abdomino-diaphragmatic belt respiratory assistance. The belt significantly increased mean amplitude of diaphragm excursion by 62% at 45 degrees and by 55% at 75 degrees, and increased mean tidal volume by 43.5% at 45 degrees and by 49% at 75 degrees. Two patients were unable to tolerate the horizontal position (0 degrees ) During quiet breathing without the belt, amplitude of diaphragm excursion and tidal volume were positively correlated at 45 degrees (r=0.81; P=0.027) and 75 degrees (r=0.75; P=0.05). There was a significant intra-individual correlation between these two parameters during belt use but no inter-individual correlation. Without the belt, thoracic posture had no significant effect on amplitude of diaphragm excursion, either in quiet or deep breathing. After overnight respiratory assistance, arterial oxygen pressure and arterial oxygen saturation increased significantly, and arterial carbon dioxide pressure decreased from 52+/-6.4 to 46.4+/-4 mmHg. The pneumatic abdomino-diaphragmatic belt significantly improved gas exchanges and ventilation by increasing diaphragm excursion, as was clearly shown by noninvasive M-mode sonography. Indeed, M-mode sonography may be helpful in pneumatic abdomino-diaphragmatic belt pressure adjustment.
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Congenital afibrinogenemia: mutations leading to premature termination codons in fibrinogen A alpha-chain gene are not associated with the decay of the mutant mRNAs. Blood 2001; 98:3685-92. [PMID: 11739173 DOI: 10.1182/blood.v98.13.3685] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Congenital afibrinogenemia is a rare coagulation disorder with autosomal recessive inheritance, characterized by the complete absence or extremely reduced levels of fibrinogen in patients' plasma and platelets. Eight afibrinogenemic probands, with very low plasma levels of immunoreactive fibrinogen were studied. Sequencing of the fibrinogen gene cluster of each proband disclosed 4 novel point mutations (1914C>G, 1193G>T, 1215delT, and 3075C>T) and 1 already reported (3192C>T). All mutations, localized within the first 4 exons of the A alpha-chain gene, were null mutations predicted to produce severely truncated A alpha-chains because of the presence of premature termination codons. Since premature termination codons are frequently known to affect the metabolism of the corresponding messenger RNAs (mRNAs), the degree of stability of each mutant mRNA was investigated. Cotransfection experiments with plasmids expressing the wild type and each of the mutant A alpha-chains, followed by RNA extraction and semiquantitative reverse-transcriptase-polymerase chain reaction analysis, demonstrated that all the identified null mutations escaped nonsense-mediated mRNA decay. Moreover, ex vivo analysis at the protein level demonstrated that the presence of each mutation was sufficient to abolish fibrinogen secretion.
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Cryptococcal meningitis following a thrombotic microangiopathy in an unrelated donor bone marrow transplant recipient. Pediatr Hematol Oncol 1997; 14:469-74. [PMID: 9267880 DOI: 10.3109/08880019709028778] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In patients undergoing bone marrow transplantation cryptococcosis is rarely encountered. We report a fatal case of Cryptococcus meningitis in a 12-year-old girl with acute lymphoblastic leukemia (ALL) in second remission who had a transplant from a human leukocyte antigen (HLA)-identical unrelated bone marrow donor. The conditioning regimen was thiotepa, cyclophosphamide, and total body irradiation (TBI); graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporin A, methotrexate, and antilymphocyte globulin (ALG). The patient experienced stage III GVHD responsive to high-dose corticosteroids. On day +54 a thrombotic microangiopathy occurred. On day +64 neurological status worsened; a brain computed tomographic (CT) scan showed hyperdense lesions suggesting fungal infection. Detection of cryptococcal antigen by latex agglutination was positive but India ink stain and culture were negative. Despite treatment with amphotericin B, 5-flucytosine, and granulocyte-macrophage colony-stimulating factor, the patient died 13 days after the diagnosis.
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Abstract
PURPOSE The standard conditions of spirometry (i.e., wearing a noseclip and breathing through a mouthpiece and a pneumotachograph) are likely to alter the ventilatory pattern. We used "time motion" mode (M-mode) sonography to assess the changes in diaphragm kinetics induced by spirometry during quiet breathing. METHODS An M-mode sonographic study of the right diaphragm was performed before and during standard spirometry in eight patients without respiratory disease (age 34 to 68 yr). RESULTS During spirometry, the diaphragm inspiratory amplitude (DIA) increased from 1.34 +/- 0.18 cm to 1.80 +/- 0.18 cm (P = 0.007), whereas the diaphragmatic inspiratory (T1 diaph) increased from 1.27 +/- 0.15 to 1.53 +/- 0.23 sec, (P = 0.015, without change in diaphragmatic total time interval (Ttot diaph). Therefore, the diaphragm duty cycle (T1 diaph/Ttot diaph) increased from 38% +/- 1% to 44% +/- 4% (P = 0.023). The diaphragm inspiratory (DIV) and expiratory (DEV) motion velocity (P = 0.007). CONCLUSION M-mode sonography enabled us to demonstrate that the wearing of a nose clip and breathing through a mouthpiece and a pneumotachograph induce measurable changes in diaphragm kinetics.
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Age distribution of childhood acute lymphoblastic leukemia cases suggests etiological clues. Leukemia 1996; 10:1558-9. [PMID: 8751481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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9
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Pulmonary gas exchange capacity is reduced during normovolaemic haemodilution in healthy human subjects. Can J Anaesth 1996; 43:672-7. [PMID: 8807171 DOI: 10.1007/bf03017949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To test the hypothesis that a physiological compensatory mechanism maintains respiratory gas exchange during normovolaemic haemodilution. METHODS Pulmonary gas exchange capacity was evaluated in seven healthy subjects by measuring the lung diffusion of carbon monoxide (DLCO). During the measurement, various breath-holding times, inspiratory volumes, and sitting or supine positions, were randomly selected in an attempt to alter pulmonary capillary perfusion. KCO was calculated as the percentage of theoretical values of the ratio of DLCO by alveolar volume and normalized by sex, age, and height. Normovolaemic haemodilution (NH) was performed by bleeding an average blood volume of 1 L with simultaneous Dextran 60 replacement to obtain an haematocrit below 35%. RESULTS After NH, haemoblogin concentration [Hb] decreased from 14.94 +/- 0.96 to 12.5 +/- 0.98 g.dl-1 (P < 0.001). KCO decreased (P < 0.02) but remained closely correlated to [Hb] at every lung volume (P < 0.02). Breathholding time and body position had no effect. CONCLUSION Moderate NH impairs pulmonary gas exchange capacity in awake, resting healthy subjects. There is no evidence of any compensatory mechanism since the KCO vs [Hb] relationship is unchanged.
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Analysis of risk factors in a cluster of childhood acute lymphoblastic leukemia. ARCHIVES OF ENVIRONMENTAL HEALTH 1996; 51:242-4. [PMID: 8687246 DOI: 10.1080/00039896.1996.9936022] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
A case-control investigation of childhood acute lymphoblastic leukemia was conducted in the town of Carbonia (Sardinia, Italy). Parents of 9 cases diagnosed between 1980 and 1989 and 36 controls were interviewed at their respective residences. None of the risk factors analyzed was associated significantly with childhood acute lymphoblastic leukemia. The following were associated with an increased risk for childhood acute lymphoblastic leukemia: parents born outside of Carbonia, family history of cancer, alcohol consumption by fathers that exceeded 60 g/d, exposure of fathers to solvents at their workplaces, maternal smoking, use of antinausea medications during pregnancy, and presence of a well in the backyard. Chance and recall bias likely played a role in generating positive associations. The increases in childhood leukemia risk associated with the presence of a well and with use of antinausea medications during pregnancy are consistent with previous reports and require further investigation.
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[Right diaphragmatic kinetics measured by TM-mode ultrasonography with concomitant spirometry in normal subjects and asthmatic patients. Preliminary results]. Rev Med Interne 1995; 16:819-26. [PMID: 8570938 DOI: 10.1016/0248-8663(96)80796-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The purpose of this study was to assess the diaphragmatic excursion using the TM-mode ultrasonography with concomitant pneumotachography in eight normal and five asthmatic subjects before and after salbutamol. We report the results in normal and asthmatic patients of this procedure. Particular findings were demonstrated in asthma. Different significant correlations were found between sonographic and respiratory measurements. In view of the safety of this direct and real-time diaphragmatic investigation, we conclude that this new method could offer an effective and reliable procedure in the evaluation of patients with diaphragmatic dysfunction. However, our study was limited by the small number of patients included and definite conclusions should await further investigations.
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Childhood Acute Lymphoblastic Leukemia: A Cluster in Southwestern Sardinia (Italy). INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 1995; 1:232-238. [PMID: 9990161 DOI: 10.1179/oeh.1995.1.3.232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
In response to public concern about an increase in the incidence of leukemia among children in southwestern Sardinia (Italy), incident cases of childhood cancer (ages 0-14) were ascertained among residents in the province of Cagliari, which comprises all of southern Sardinia, in 1974-89. Completeness of the ascertainment of leukemia cases was validated by comparison with estimates derived from official statistics of mortality and survival curves. A significant excess risk of childhood acute lymphoblastic leukemia (cALL) was found for children residing in the town of Carbonia. The risk was highest in 1983-85, when seven cases occurred versus 0.8 expected. No birth-cohort effect was observed. The cALL incidence rate was significantly higher among children born and residing in Carbonia than among children born in Carbonia but residing elsewhere. However, the cALL cases did not cluster within the town of Carbonia. The proximity of the largest industrial settlement in the region of Sardinia raised the suspicion that environmental pollution was responsible for the observed excess. Information about industrial emissions from this settlement prior to the appearance of the cALL cluster was not sufficient to reject or confirm the hypothesis.
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13
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[Hemothorax in exostoses. Contribution of thoracic echography]. Presse Med 1994; 23:1270. [PMID: 7971865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Sonographic lung surface evaluation in pulmonary sarcoidosis: preliminary results. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 1994; 13:381-388. [PMID: 8015046 DOI: 10.7863/jum.1994.13.5.381] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The value of sonography in lung diseases such as sarcoidosis is not established. Twelve patients with pulmonary sarcoidosis and eight control subjects underwent a sonographic examination using a high frequency probe (7.5 MHz). The normal lung surface showed smooth and regular hyperechoic patterns, respiratory motions, and occasionally minute interruptions with comet tails. All patients with sarcoidosis showed various surface abnormalities, which appeared irregular and rough with coarse interruptions, producing an increase of artifacts. Nodular patterns were found in nine of 12 patients (75%). Sonography also revealed abnormalities not diagnosed by chest radiographs (n = 2). These findings could offer an complementary approach for evaluating sarcoidosis.
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Childhood. Leukemia in Southwest Sardinia (Italy). TUMORI JOURNAL 1993; 79:244-5. [PMID: 8249175 DOI: 10.1177/030089169307900402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim and background Public concern on an increased incidence of childhood leukemia in SW Sardinia prompted the authors to an epidemiological investigation. Methods Incident childhood neoplasms observed in the Cagliari province (Sardinia - Italy) in 1974-1989 were registered. Expected cases of the most frequent childhood cancers were calculated for each town, based on the sex-and age-specific incidence rates in the province. Results An excess risk of childhood acute lymphoblastic leukemia (ALL) was observed in Carbonia, a town located in the SW part of the province. The risk was highest in 1983-85, when 7 cases occurred versus 0.8 expected (RR = 8.7; 95 % C.I. = 4.6, 16.3). No spatial clustering of ALL cases was observed within the town. Conclusions A significantly higher than expected incidence of childhood ALL was observed in the town of Carbonia in 1983-85. In alternative to chance, possible exposure to environmental pollutants from a near industrial settlement is discussed as the cause of the observed excess, but it is far to be proven. Other hypotheses, including a viral infection in a population with increased susceptibility, as suggested for new urban settlements, cannot be discarded.
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Peripheral pulmonary lesions: ultrasonic features and ultrasonically guided fine needle aspiration biopsy. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 1993; 12:369-374. [PMID: 8355329 DOI: 10.7863/jum.1993.12.7.369] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
When transthoracic biopsy is required for diagnosing lung diseases, radiographic procedures are the methods of choice, sonographic application being still limited. Sixty-four consecutive patients with pulmonary lesions adjacent to the chest wall underwent sonography. Findings showed hypoechoic homogeneous lesions (56 cases) with posterior regular margin (57 cases). Increasing echoes deep to the mass and sonographic interruption of hyperechoic surface were seen in all patients. In two cases, chest wall invasion had been diagnosed. Histologic diagnosis was made in 55 of the 64 patients (85.9%). Two pneumothoraces occurred. Sonography is a useful, accurate, and safe technique for diagnosing selected pulmonary lesions.
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Intérêt du G-CSF dans le traitement des agranulocytoses médicamenteuses chez les patients non cancéreux. Rev Med Interne 1993. [DOI: 10.1016/s0248-8663(05)80544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Sixteen consecutive patients with one or more osteolytic bone lesions of the chest wall radiologically confirmed underwent ultrasonically guided aspiration biopsy. Nine patients (56.2 percent) had bronchogenic carcinoma with a direct extension. Other diagnostic techniques had failed to diagnose disease in these patients. The lesion showed heterogeneous echogenicity (n = 16) caused by the hyperechoic signals of bone fragments. The interruption of the cortex bone was detected in all cases and extraosseous tumor portion in 14 of 16 patients (87.5 percent). No respiratory motions of the lesion could be demonstrated (n = 16). Definitive histologic diagnosis was made in 14 of the 16 patients (87.5 percent). In malignancy, diagnosis was established in 13 of 14 patients (92.8 percent). Of two confirmed benign lesions, one diagnosis of tuberculosis was obtained. No complication occurred. Sonography and consequently ultrasonically guided aspiration biopsy are a useful, accurate, safe, and low-cost technique for osteolytic lesions in thoracic diseases.
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Abstract
Ultrasonography is considered to have limited application in respiratory diseases because air reflects sound waves. Twenty-four patients with radiologically confirmed pneumothorax and 100 healthy subjects underwent sonography. In all normal subjects, the hyperechoic pulmonary interface showed respiratory motions termed the "gliding sign" with some comet-tail artifacts. Sonographic signs were shown in all pneumothoraces: disappearance of the gliding sign and no comet tails. The extent of collapse cannot be evaluated, but it is possible to determine its area in partial pneumothorax (N = 5). The follow-up (N = 8) showed the reappearance of the gliding sign. Ultrasonography may be helpful in diagnosing pneumothorax in certain cases.
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Sonographic guidance in diagnosing anterior mediastinal mass: importance of visualizing internal mammary vessels. JOURNAL OF CLINICAL ULTRASOUND : JCU 1993; 21:203-206. [PMID: 8382224 DOI: 10.1002/jcu.1870210310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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21
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[Von Willebrand's disease]. LA PEDIATRIA MEDICA E CHIRURGICA 1992; 14:381-6. [PMID: 1461776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Abstract
Ultrasound results for 11 patients with HPN confirmed by CXR were compared with those for 100 healthy subjects. The observation of the hyperechogenic line of the pleuropulmonary surface (normal subjects) showed back-and-forth respiratory movements in every case which we call the "gliding sign." Ultrasonographic signs were shown in all patients with HPN. Visualizing the gassy effusion above the pleural fluid, the disappearance of the "gliding sign" (n = 11) indicates PN. The image of the HPN allows in addition a "curtain sign" which depicts the movement of air/fluid level (n = 11), the pulmonary collapse being calculated across the liquid window whose echostructure is analyzed. A "polymicrobullous" image (n = 2) caused by air microbubbles within the fluid effusion, is reported. We conclude that echography appears to be a new approach to diagnosing HPN, which is particularly useful during or after ultrasonically guided procedures including pleural drainage, and should be recognized by sonographers.
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[Towards another diagnostic approach of peripheral pulmonary masses. Ultrasound-guided puncture]. JOURNAL DE RADIOLOGIE 1992; 73:159-64. [PMID: 1602447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In a series of 50 patients with lung lesions touching the thoracic wall, percutaneous ultrasonically guided needle aspiration yielded a pathological diagnosis in 44 cases (sensitivity: 88%). The histological diagnosis of malignant lesion could be confirmed in 41 of these 44 patients. In this group of patients with neoplasia the diagnosis obtained by extemporaneous cytology was compared with that obtained by lung biopsy: the diagnostic sensitivity of cytology proved to be higher than that of biopsy (86.36% and 65.90% respectively). Using the two methods concomitantly increased sensitivity up to 93.18%. A pathological diagnosis could be obtained in 3 out of the 6 patients in this series who had benign lesions.
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Diagnosis of pneumothorax by ultrasound immediately after ultrasonically guided aspiration biopsy. Chest 1992; 101:855-6. [PMID: 1541160 DOI: 10.1378/chest.101.3.855] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
We report two cases of pneumothorax detected by echographic examination immediately after ultrasonically guided aspiration biopsy and confirmed by chest x-ray film. The pneumothorax was characterized by the disappearance of the lung tumor. In the real-time image, the respiratory excursions of the visceral pleura also disappeared.
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Phase II study of pirarubicin in untreated metastatic small cell lung carcinoma. Groupe Français de Pneumo-Cancérologie (GFPC). Eur J Cancer 1991; 27:943. [PMID: 1657080 DOI: 10.1016/0277-5379(91)90156-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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[Prethrombotic states in pediatrics]. LA PEDIATRIA MEDICA E CHIRURGICA 1991; 13:139-45. [PMID: 1896379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Pirarubicin phase II study in untreated metastatic small-cell lung carcinoma. A cooperative study of the Groupe Français de Pneumo-Cancérologie (GFPC). Am J Clin Oncol 1990; 13 Suppl 1:S20-3. [PMID: 1963272 DOI: 10.1097/00000421-199012001-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Pirarubicin (THP) (Roger Bellon Laboratory, France) is a new anthracycline under clinical development. In order to assess the efficacy and toxicity of the drug in small-cell lung carcinoma (SCLC), we have undertaken this trial in front-line therapy in patients with metastatic disease, PS less than 3 and at least one evaluable lesion. Responses were assessed after two cycles of THP (60 mg/m2 i.v. bolus every 3-4 weeks) and a further cross over to VP16 + CDDP (three cycles) was systematic whatever the response to THP. This crossover was performed after only one cycle in case of obvious progression. From June 1988 to April 1990, 32 patients were enrolled: 6 were ineligible (4 non-SCLC, 2 M0), 26 patients were fully evaluable for THP and 18 patients for VP16-CDDP. The characteristics of the patients were as follows: mean age 57.4 years (38-71); T4: 54%; T3: 27%; T2: 19%; N3: 62%; N2: 35%; No: 4%. The efficacy was as follows 1 complete response and 2 partial responses (confirmed by endoscopy); 12 patients received only one cycle because of obvious progression; the overall response rate is 12% (95% confidence interval 0-24%). The patient who had complete response after pirarubicin remained in CR after VP16-CDDP, whereas the 2 patients who had partial response achieved CR for one and PR for the other; among the 15 who did not respond 1 CR and 7 PR were observed. The only significant toxicity of THP was granulopenia without infection. THP seems to be an effective anthracycline in SCLC, and the study is continuing. A response could be reached in 50% of the nonresponders with standard therapy and 10 of 24 patients (42%) finally responded. Therefore, this schedule for testing new drugs in metastatic SCLC appears ethically acceptable.
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[Incidence, mortality and survival in childhood tumors in meridional Sardinia. The Cagliari province, 1981-1988]. EPIDEMIOLOGIA E PREVENZIONE 1990; 12:19-24. [PMID: 2151132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Childhood cancer incidence, mortality and relative survival rates have been estimated in the province of Cagliari for the years 1982-86. Cases were collected from pediatric and non pediatric units operating either in the province or elsewhere. Deaths were identified through the registry offices of municipal administrations. A total of 151 cases were identified, corresponding to an incidence rate of 115.0 per million. Survival rate at three years of diagnosis was 63.3%.
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[Disseminated intravascular coagulation in children. Therapeutic problems]. LA PEDIATRIA MEDICA E CHIRURGICA 1989; 11:491-4. [PMID: 2698466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The AA, after discussion on physiopathological and clinical aspects of DIC in childhood, focused their attention mostly on the utilization of AT III concentrates.
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Abstract
This article deals with a young school boy born in 1971 with a tumor in the palm of his right hand. We have considered this a juvenile aponeurotic fibroma. This tumor has recurred several times, leading to unavoidable amputation of the right wrist and hand. Seven years after the initial diagnosis, the axillary area became involved, then the pleura and lung. Such an unusual process leads to reconsidering the diagnosis and to regard this case as an intermediate form between Keasbey's juvenile aponeurotic fibroma and generalized fibromatosis.
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Hepatic echographic scanning in thalassemia major. THE JOURNAL OF NUCLEAR MEDICINE AND ALLIED SCIENCES 1984; 28:143-8. [PMID: 6397581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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[Captopril tolerability in the asthmatic patient]. Presse Med 1984; 13:1699. [PMID: 6234586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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33
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[Electromyographic analysis of the motility of the right and transverse colon in 9 colostomized patients]. GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE 1984; 8:541-544. [PMID: 6745574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The aim of this work was to study the electric pattern of proximal colonic motility in patients with permanent colostomy but without past history of an irritable bowel syndrome. Nine patients (55 to 70 years-old) were investigated using a colonoscope with 5 annular electrodes. An electromyogram was recorded during 4 h. In 5 patients, the results observed before and after a standard test meal were compared. The two usual types of electric activity (i. e. Long Spike Bursts (LSB) and Short Spike Bursts (SSB)) were recorded in the right and transverse colon. The duration of LSB and SSB activities were 8.3 +/- 5.5 and 3.7 +/- 3.5 p. 100 respectively (m +/- SD). In 6 patients, the right and transverse colons were recorded simultaneously; in these patients there was a significant difference in LSB activity between the ascending colon and the transverse colon (10.6 +/- 3.7 and 5.6 +/- 4.3 p. 100 respectively; p less than 0.01). After a meal, the right colonic LSB activity increased (greater than 30 p. 100 of the basal level) in 4 out of 5 patients whereas the transverse colonic LSB activity increased only in one patient. The most striking finding of this study was that colonic hypomotility was of a propulsive and tonic nature. These results could explain the nearly continuous flow of faeces commonly observed in patients with colostomy.
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[Paraneoplastic hypouricemia (apropos of 2 cases)]. Rev Med Interne 1981; 2:173-5. [PMID: 7256021 DOI: 10.1016/s0248-8663(81)80061-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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[Evaluation of the acute effect of a converting enzyme inhibitor, captopril, in normal and hypertensive subjects]. ARCHIVES DES MALADIES DU COEUR ET DES VAISSEAUX 1981; 74 Spec No:61-5. [PMID: 6794529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The response to acute oral administration of 50 mg of Captopril was assessed in 17 normal volunteers and 47 patients with hypertension; 17 had renovascular (RVH) abnormalities and 30 patients had essential hypertension (EH). All patients were maintained on ad libitum sodium intake. The effect of Captopril on mean arterial pressure (MAP) was rapid a maximal within 60 minutes. The converting enzyme inhibitor induced a similar decrease in MAP in normal subjects (-5.1 +/- I mm Hg) and patients with EH (-7.2 +/- I mm Hg). Control plasma renin activity (PRA) was similar in both groups; however, the increase in PRA following Captopril was more marked in normals (8.1 +/- 1.7 ng/ml/h) than in EH (1.7 +/- 0.7 ng/ml/h). In patients with RVH a marked fall in MAP occurred (-25.4 +/- 4 mm Hg). A fall in MAP higher than 20 mm Hg was observed in 65% of patients with RVH and none of the EH group. A negative correlation between log PRA and the change in MAP induced by Captopril was obtained (r = 0.65). Assessment of the response to acute administration of Captopril may be useful for screening patients with RVH.
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[Effect of captopril in essential hypertension (author's transl)]. LA NOUVELLE PRESSE MEDICALE 1981; 10:1579-82. [PMID: 7025849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The angiotensin I-converting enzyme inhibitor, captopril (SQ 14225) was proposed as first treatment in 12 cases of uncomplicated essential hypertension maintained on unrestricted sodium intake (group I). Arterial pressure was normalized in 7 patients (subgroup Ia) whilst hydrochlorothiazide was added to captopril in 5 patients (subgroup Ib). A significant dose-response curve between the dose of captopril (range 75 to 450 mg/day) and the antihypertensive effect was obtained with a maximum at 300 mg/day. In 8 patients (group II) hydrochlorothiazide was proposed first and the addition of captopril was necessary in 4 cases. No relationship between pretreatment PRA and the maximum effect of captopril was observed (r = -0.34, NS). No disturbance of upright blood pressure regulation was noted. Adverse reaction consisted of 4 cases of benign and spontaneously regressive skin rash or pruritus.
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Abstract
The acute effect of the orally-active converting enzyme inhibitor, captopril, was compared to that of saralasin in 13 patients with various forms of hypertension on ad libitum sodium intake. A significant difference between the effects of the two drugs on mean arterial pressure (MAP) was found (-11 +/- 3 mm Hg with saralasin, -24 +/- 4.5 mm Hg after captopril). This difference was not correlated with control plasma renin activity (PRA). To determine the influence of the endogenous kallikrein-kinin system in the antihypertensive action of captopril, the effect of aprotinin (Apro), an inhibitor of kinin generation, on the MAP level achieved by captopril was assessed in five normal subjects and 15 patients with hypertension on ad libitum sodium intake. In normal subjects, captopril did not alter MAP, nor did Apro have any effect. In six patients with essential hypertension and normal PRA, MAP decreased by 5.5 +/- 2 mm Hg following captopril, and Apro did not modify this level. In nine patients with renovascular hypertension (RVH), MAP fell by 22 +/ 3 mm Hg after captopril administration, and Apro infusion induced a rise in MAP of 13 +/- 1.7 mm Hg. A positive correlation between log control PRA and the effect of aprotinin was obtained ( r = 0.63, p less than 0.005). Apro had no effect in two patients with RVH who experiences a large drop in MAP during salasin. These results suggest that endogenous kinins as well as other substances, the generation of which is inhibited by aprotinin, may participate to the antihypertensive effect of captopril in patients with angiotensin-dependent hypertension. The lack of an aprotinin effect on the MAP level achieved during saralasin infusion suggests that the influence of the kallikrein-kinin system is related to the effect of captopril rather than the fall in arterial pressure resulting from angiotensin blockade.
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Captopril treatment of idiopathic edema. N Engl J Med 1979; 301:1289-90. [PMID: 388219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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