Hypovitaminosis D in internal medicine inpatients.

Some studies have suggested that hypovitaminosis D may be a consequence of protein-calorie malnutrition. This study assessed both the relationship between vitamin D status, malnutrition, calcium and phosphorus metabolism indices and the importance attached by internists to these alterations. There were 239 patients admitted to an internal medicine division who underwent examinations to assess nutritional state, liver and renal function, and bone metabolism. At the end of the study, the clinical data included in the discharge letter, the treatment prescribed, and the diagnosis assigned to patients on their hospital discharge form were collected. Hypovitaminosis D was found in 72% and hypoalbuminemia in 34.3% of patients. Subjects with hypovitaminosis were generally older and had lower albumin levels than those with mild or no hypovitaminosis. 25-Hydroxyvitamin D was inversely related with parathyroid hormone and directly related with albumin. Alterations of calcium and phosphorus metabolism were present in 55.6% and recorded by the division's physicians for only 13.53% of patients, of whom 72.37% were not specifically treated. There is a direct correlation between 25-hydroxyvitamin D and albumin levels. The high incidence and the metabolic consequence of hypovitaminosis D and of protein-calorie malnutrition is significantly underestimated and undertreated by physicians.

[Methyl-ter-butyl ether (MTBE) therapy of cholesterol biliary calculosis. First long-term controls (up to 22 months)]. / Trattamento con metil-ter-butil etere (MTBE) della calcolosi biliare colesterinica. Primi controlli a distanza (fino a 22 mesi).

The results and clinical and instrumental examinations of 12 patients at least 6 months after MTBE treatment for cholesterine biliary calculosis are presented. No recurrence of stones or alterations to the biliary ways or duodenal mucosa attributable to MTBE were encountered.

Methyl-TER-butyl ether (MTBE) and endoscopic sphincterotomy. A possible solution for dissolving gallstones.

MTBE was instilled in 6 cases of lithiasis (1 intrahepatic, 5 giant common bile duct stones following EPT). The nasobiliary route (3 cases) and a percutaneous biliary drain (3 cases) were used for this purpose. Complete stone dissolution was achieved in four cases. In the other two, volume reduction was sufficient to allow spontaneous elimination after EPT. A full clinical recovery was obtained in all cases. Further investigation is required in cases of intrahepatic and common bile duct stones when their removal by EPT is not enough to lead to clinical resolution. Follow-up is indispensable.

[Clinical evaluation of chemical cholelitholysis using methyl tertiary butyl ether in lithiasis of the bile ducts]. / Valutazione clinica della colelitolisi chimica con MTBE nella litiasi delle vie biliari.

Personal experience is reported in the treatment of calculosis of the biliary ways using MTBE and injected through percutaneous biliary drainage catheters placed surgically or endoscopically in 11 patients in whom surgery appeared to be contraindicated or particularly dangerous. In 10 out of the 11 cases chemical cholelitholysis was successful and the technique is therefore proposed as a valid alternative to surgery in ductal cholelitholysis when sphincterotomy and endoscopic removal of the stones cannot cure the conditions.

[Transcutaneous chemical cholelitholysis with methyl tert-butyl ether (MTBE). lst results in man]. / Colelitolisi chimica transcutanea con metil-ter-butil etere (MTBE). Primi risultati nell'uomo.

Three patients have been treated, with instillation of MTBE through a transcutaneous biliary drainage after transduodenal sphincterotomy. The first had gallbladder stones, the second common bile duct stones and the last intrahepatic stones (V segment). While in the first case there has been only a partial success in the other two we have obtained a total dissolution of the stones, with complete clinical recovery. This treatment has not caused immediate side effects but the absence of long term damage has not yet been proven. We think that the use of MTBE is not indicated in gallbladder stone disease. Its major indication is the dissolution of ductal gallstones when transduodenal sphincterotomy and endoscopic removal of the stones have failed.

[Evaluation of some blood clotting parameters in relation to the administration of estroprogestins]. / Valutazione di alcuni parametri emo-coagulativi in rapporto alla somministrazione di estroprogestinici.

A number of blood clotting parameters have been determined in the plasma of 25 women who had not previously taken steroid contraceptives. After the administration of an oestroprogestinic association (ethynyloestradiol 0.05 mg + norgestrol 0.25 mg) for five cycles, the same subjects were controlled again for the determination of the same haematochemical parameters. The changes observed highlighted a marked increase in fibrinogenaemia and fibrinolysis, a slight rise in associated clotting factors II-VII-X, no change in the activity of antithrombin III and platelet aggregation.

[Clinical and secretory evaluation of the use of cimetidine in peptic ulcer]. / Valutazione clinica e secretoria sull'uso della cimetidina nella patologia peptica.

Cimetidine (an H2 receptor blocking agent) was used to treat 35 patients with gastroduodenal peptic ulcer. Endoscopic and secretory controls before and after the treatment showed that pain was reduced in all cases, that complete or partial re-epithelialisation occurred in 33/35, and that there was a significant reduction in basal and post-histamine acid secretion. Alkaline secretion was not significantly altered. Follow-up of the series is regarded as indispensable.