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51.
Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is mainly observed in patients with multiple myeloma and bone metastasis
from solid tumors receiving iv bisphosphonate therapy. The reported incidence of BRONJ is significantly higher with the iv
preparations zoledronic acid and pamidronate while the risk appears to be minimal for patients receiving oral bisphosphonates.
Currently available published incidence data for BRONJ are based on retrospective studies and estimates of cumulative incidence
range from 0.8 to 12%. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60–70% of cases are preceded
by a dental surgical procedure. The signs and symptoms that may occur before the appearance of clinical evident osteonecrosis
include changes in the health of periodontal tissues, non-healing mucosal ulcers, loose teeth and unexplained soft-tissue
infection. Although the definitive role of bisphosphonates remains to be elucidated, the inhibition of physiologic bone remodeling
and angiogenesis by these potent drugs impairs the regenerative capacity of the bone causing the development of BRONJ. Tooth
extraction as a precipitating event is a common observation. The significant benefits that bisphosphonates offer to patients
clearly surpass the risk of potential side effects; however, any patient for whom prolonged bisphosphonate therapy is indicated,
should be provided with preventive dental care in order to minimize the risk of developing this severe condition. This article
provides an update review of current knowledge about clinical, pathological and management aspects of BRONJ. 相似文献
52.
Malignant myoepitheliomas are rare tumors of salivary glands. Most occur in the parotid gland; few other sites of origin are described. Malignant myoepithelioma of the rhinopharynx has only been reported twice. Because the lesion is so rare, there are no specific indications for its treatment. We present a third case of malignant myoepithelioma in the rhinopharynx and discuss its diagnostic and therapeutic aspects. 相似文献
53.
Massimo Chello Costanza Goffredo Giuseppe Patti Dario Candura Rosetta Melfi Stefano Mastrobuoni Germano Di Sciascio Elvio Covino 《European journal of cardio-thoracic surgery》2005,28(6):805-810
Objective: Endothelial dysfunction represents a critical early component of organ injury following cardiopulmonary bypass. Recent studies demonstrate that the treatment with atorvastatin is associated with a significant improvement of endothelial function independently of its efficacy on cholesterol levels. Therefore, we investigated the effects of preoperative atorvastatin treatment on endothelium function after coronary surgery. Methods: Forty patients undergoing coronary surgery were randomized to treatment with atorvastatin (20 mg/die; N = 20) or placebo (N = 20) 3 weeks before surgery. Twenty normal patients served as control group. The flow-mediated dilations (FMD) of the brachial artery after both reactive hyperemia (endothelium dependent) and nitroglycerin administration (endothelium independent) were evaluated at baseline, at 48 h, and 5 days postoperatively. Results: At baseline, the endothelium-dependent FMD was significantly attenuated in coronary versus normal patients (normal 10.3 ± 1.8% vs coronary 4.1 ± 1.6%, p < 0.01). At 48 h postoperatively all patients exhibited a reduced FMD compared with baseline values: the endothelium-dependent dilatation showed a drop of 60.1 + 15% in the patients of the placebo group compared with 45.8 + 16.6% (p < 0.05) those in the atorvastatin group. At the univariate analysis, no significant correlation was found between serum levels of either total cholesterol or HDL cholesterol and FMD. The nitroglycerin-induced dilation was not significantly influenced by extracorporeal circulation as well as by atorvastatin treatment. Conclusions: The endothelial dysfunction following cardiopulmonary bypass is improved by the treatment with atorvastatin, by a mechanism unrelated to the drug efficacy of controlling serum cholesterol levels. 相似文献
54.
Giovanni Battista Luciani M.D. Giuseppe Faggian M.D. Alessandro Mazzucco M.D. 《Journal of cardiac surgery》1994,9(2):109-114
We describe a patient with neonatal Marfan syndrome presenting with massive ascending and descending thoracic aortic aneurysm. Because of rapidly progressive respiratory distress due to tracheobronchial compression, emergency replacement of the descending thoracic aorta with a 12-mm PTFE vascular prosthesis was undertaken at 1 month of age. The postoperative course was complicated by bilateral tension pneumothorax contributing to irreversible respiratory failure. The unique clinico-pathological features and the relevant surgical implications of the case are discussed. (J Card Surg 1994;9:109–114) 相似文献
55.
Giuseppe D'AMICO 《Nephrology (Carlton, Vic.)》1997,3(1):13-17
Summary: IgAN is the commonest primary glomerulonephritis in all parts of the world; the different incidence reported in different geographical areas is mainly due to different biopsy policies, even though genetic factors, still unclarified, may be acting. Progression to ESRF occurs in IgAN at a variable rate (average renal survival at 10 years is 80–87%), and many studies, reviewed in this paper, have sought to identify clinical and histological features which are predictive of the outcome. A functional impairment at presentation and a severe proteinuria are the most powerful clinical indicators of unfavourable prognosis, while both glomerular and interstitial sclerosis are the most reliable histological indicators. The fact that these prognostic indicators are not always reliable in predicting the outcome for a single patient, probably due to the pathophysiology of the progressive damage in this disease, is stressed. 相似文献
56.
57.
Onelio Geatti Brahm Shapiro Pier Giuseppe Orsolon Gianni Proto Ugo Paolo Guerra Francesco Antonucci Daniele Gasparini 《European journal of nuclear medicine and molecular imaging》1994,21(1):17-22
Technetium-99m methoxyisobutylisonitrile (MIBI), like thallium-201, has recently been introduced as a myocardial perfusion agent and is now also showing very promising results in parathyroid scintigrapy. The results of 201Tl/99mTc-pertechnetate and 99mTc-MIBI/99mTc-pertechnetate subtraction scintigraphy, ultrasonography and computed tomography are presented in a series of 43 patients operated on for hyperparathyroidism. All four imaging modalities were confirmed to be reliable, scintigraphy being the most accurate. Sensitivities ranged from 81% to 95%, that of 99mTc-MIBI being the highest. Moreover this tracer, which has more favourable physical and also biochemical properties, yielded images of superior quality. This allowed localization of the lesion by visual inspection only in as many as 86% of the patients with positive 99mTc-MIBI/99mTc-pertechnetate subtraction scintigraphy. We believe that the higher sensitivity, superior image quality and lower cost of 99mTc-MIBI imaging will make 99mTc-MIBI the new radiopharmaceutical of choice for parathyroid scintigraphy (when one takes into account the stability of labelling with large activities it is possible to perform three or four cardiac studies together with one parathyroid scintigraphic examination using one lyophililzed vial). 相似文献
58.
Giuseppe Giuffre’ Vincenzo Schifano Maria Vadala’ 《Documenta ophthalmologica. Advances in ophthalmology》1995,91(3):255-263
We report on a case of idiopathic uveal effusion syndrome complicated by AION. To our knowledge such an association hasn't been previously described. We suggest that scleral thickening caused obstruction of vortex veins followed by uveal effusion and compression of posterior ciliary arteries within their intrascleral tract, leading to AION. Nevertheless it can't be excluded that AION was the result of mechanical compression on ciliary vessels of optic disc by choroidal detachment. 相似文献
59.
Francesco Franceschi Umile Giuseppe Longo Laura Ruzzini Paolo Simoni Bruno Beomonte Zobel Vincenzo Denaro 《Knee surgery, sports traumatology, arthroscopy》2007,15(3):266-268
Bilateral discoid medial menisci is an extremely rare condition of the knee and it can be associated to other pathological
findings, including anterior portion cyst formation. We report on the clinical features, radiographic findings, treatment
and results of one patient who presented a bilateral medial discoid meniscus combined with posterior portion cyst of the left
knee. To the best of the author’s knowledge, this is the first case of bilateral medial discoid meniscus associated with posterior
portion cyst formation. 相似文献
60.
Roberto Perniola Giuseppe Tamborrino Santo Marsigliante Corrado De Rinaldis 《Journal of oral pathology & medicine》1998,27(6):278-282
The features of enamel hypoplasia in a small group of patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) are described. Using a recently developed method, the authors evaluated quantitatively the amount of defect in each tooth by measuring the width of the hypoplastic lesions and dividing the value by the crown height. They then assessed the degree of damage in each tooth type (from central incisors to second premolars) and patient. Canines were the most severely affected among maxillary and mandibular teeth, but all tooth types were involved. Analysing both the differences between patients and their age at the beginning of the defect, the authors observe that hypoparathyroidism is not responsible for the onset of enamel hypoplasia in APECED, although it may contribute to the damage. 相似文献