Oxytocin nasal spray in fibromyalgic patients.

Fibromyalgia is a pain disorder associated with frequent comorbid mood, anxiety, and sleep disorders. Despite the frequent use of a complex, poly-drug pharmacotherapy, treatment for fibromyalgia is of limited efficacy. Oxytocin has been reported to reduce the severity of pain, anxiety, and depression, and improve the quality of sleep, suggesting that it may be useful to treat fibromyalgia. To evaluate this hypothesis, 14 women affected by fibromyalgia and comorbid disorders, assuming a complex pharmacotherapy, were enrolled in a double-blind, crossover, randomized trial to receive oxytocin and placebo nasal spray daily for 3 weeks for each treatment. Order of treatment (placebo-oxytocin or oxytocin-placebo) was randomly assigned. Patients were visited once a week. At each visit, the following instruments were administered: an adverse drug reaction record card, Visual Analog Scale of Pain Intensity, Spielberger State Anxiety Inventory, Zung Self-rating Depression Scale, and SF-12. Women self-registered painkiller assumption, pain severity, and quality of sleep in a diary. Unlikely, oxytocin nasal spray (80 IU a day) did not induce positive therapeutic effects but resulted to be safe, devoid of toxicity, and easy to handle.

[Percutaneous neurolysis of the celiac plexus under CT guidance in the invasive treatment of visceral pain caused by cancer]. / Neurolisi percutanea del plesso celiaco sotto guida TC nel trattamento invasivo del dolore viscerale da cancro.

To verify the effectiveness and the incidence of complication in the transcutaneal celiac plexus block with CT-guided in the patient with intractable upper abdominal cancer, using alcoholic solutions to different concentrations (50% and 96%), previous insertion of the peridural catheter. From December 1997 to June 2002, studies were carried out on 24 patients with CT-guided percutaneous coeliac plexus neurolysis including 17 men and 7 women with inoperable abdominal malignancy and two with chronic pancreatitis. The patients were affected by very intense pain controllable only with high doses of analgesic narcotics. Before the procedure a catheter was installed in the peridurale space between L1-T12. To avoid general anesthesia, 40 mL of marcaine 0.5% was injected to relieve the back pain sometimes reported after the neurolysis, caused by the diffusion of alcohol in the coeliac plexus. This technique requires a posterior percutaneous procedural transaortic approach CT scan guided, to determine the correct position of the needle tips and the spread of neurolytic solution (40 mL of 96% + 3 mL of contrast medium) around the origin of the coeliac trunk's anatomical center of the plexus. The first 10 patients have received 40 mL of 50% ethyl alcohol + 3 mL of contrast medium. To evaluate the rate of the analgesia relief, a visual analogue pain score (VAS) was used before and 48 hours after the neurolysis. The percutaneous neurolysis of the celiac plexus is useful to relieve the pain in patients affected by cancer developing in upper abdomen. The CT-scan guide of the needle allows an omogeneous distribution of the contrast medium. The insertion of the peridural catheter made a complete analgesia and reduced the incidence of complications. Our method provided an excellent control of the pain in all patients. In our experience the pain relief was almost complete in patients treated with 96% ethyl alcohol solution (VAS from 8 before the treatment to 1, 48 hours after the treatment). The alcohol administered in elevated concentrations (96%), does not increase the incidence of complications.

A high-throughput screening protocol for fast evaluation of enantioselective catalysts.

A new high-throughput screening protocol that allows fast evaluation of enantioselective catalysts has been developed. The usefulness of norephedrine-derived beta-amino alcohols as catalysts for the enantioselective alkylation of prochiral aldehydes has been determined by simultaneous screening of three representative substrates. GC analysis of the crude product mixture using a selectively modified cyclodextrin as the chiral stationary phase avoids time-consuming workup procedures. The chemical yield, enantioselectivity, substrate specificity, and catalytic activity of the chiral catalysts as well as the induced absolute configuration have been determined in a single screening experiment and two short GC runs.

Heart metastases from gastric sarcoma. A case report.

Cardiac involvement by metastatic gastric sarcoma is a rare event. We describe an unusual case of gastric sarcoma involving the heart in a 29-year-old man who presented with heart failure. The diagnosis was made at two-dimensional echocardiography. Heart metastases prolapsing into and obstructing the mitral valve orifice were located in the left atrium. In an attempt to excise the left atrial mass, the patient underwent heart surgery twice. The resections were non-curative. The patient died of refractory heart failure 9 months after the onset of symptoms. This case report is an example of a secondary intracavitary tumor that causes obstruction of the mitral valve orifice. Two-dimensional echocardiography has been confirmed as the examination of choice for the early diagnosis of cardiac tumors.

[Results of a cytological study of needle aspiration in 85 cases of nodular pathology of the thyroid gland, surgically controlled]. / Risultati dello studio citologico per agoaspirazione in 85 casi di patologia nodulare della tiroide controllati chirurgicamente.

UNLABELLED: The present retrospective study is related to 85 patients with nodular thyroid pathology submitted to surgical therapy. In these patients preoperative cytology, through fine needle biopsy aspiration (FNBA), has been compared with histological examination performed on the surgical specimen. Malignant lesions were detected in 30 cases (35.3%). True positives cases were 14, true negative 48, false positive and false negative (FN) were 2 and 3 respectively. Due to the high number of FN, sensibility of FNBA was only 51.8%, specificity was 96% and accuracy 80.5%. Positive and negative predictive value were 87.5% and 78.6% respectively. CONCLUSIONS: Evaluation of the several sources of error comes to a conclusion that FNBA is certainly the main diagnostic tool in nodular thyroid pathology. Its employment should undergo to a centralized diagnostic evaluation in such a way that cytology is analysed together with clinical and other instrumental data.