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Biomedical subjects

A Beltrame

Publications and source records attributed to A Beltrame.

At least 19 recordsLinked to original sources
PubMed2006

Neurological manifestation of tick-borne encephalitis in North-Eastern Italy.

Tick-borne encephalitis (TBE) is an infectious zoonotic disease, moving from Central Europe to other countries and still rare in Italy. The disease, produced by the European subtype virus, typically takes a biphasic course with neurological disorders of different severity during its second phase. We report the first three TBE cases in Friuli Venezia Giulia (FVG), characterised by extremely variable clinical features. Knowledge of these different presentations will assist physicians in increasing their level of attention to TBE also in this region, where no cases of TBE had been reported in the past, despite the fact that it borders countries with high prevalence of the infection.

Adolescent↗
PubMed2003

HIV/HTLV co-infection: frequency and epidemiological characteristics among patients admitted to an Italian hospital.

BACKGROUND: Human T-cell leukemia/lymphoma viruses (HTLV) and HIV share identical modes of transmission and co-infections may be detected in populations that are highly exposed to common risk factors. MATERIALS AND METHODS: A total of 599 serum samples from HIV-positive patients attending our outpatient clinic during the last semester of 2000 were tested to assess the prevalence of HTLV co-infection in both Italian (n = 472) and non-European HIV-infected patients (n = 127). RESULTS: 72 samples were positive for HTLV-II. Most of the HTLV-II-positive patients were Italian (71/72, 98.6%) and 98.5% of them had acquired the HIV infection through use of intravenous recreational drugs. CONCLUSION: These data demonstrate a high HTLV-II exposure among HIV-positive intravenous drug users in our area which was not previously considered to be an area of endemicity for HTLV-II.

Adult↗
PubMed2002

Treatment of patients with arthrosis of the temporomandibular joint by infiltration of sodium hyaluronate: a preliminary study.

Patients with degenerative disease of the temporomandibular joint (TMJ) who did not respond to conservative medical therapy (splint therapy, selected grinding or physiotherapy) can be treated by arthrocentesis, which is associated with intra-articular injections of sodium hyaluronate (Hyalgan). In this study, we treated ten dysfunctional patients with degenerative joint disease (DJD) who had been diagnosed clinically and had had the diagnosis confirmed by MRI. All subjects presented impaired mouth opening, joint pain at rest and on movement and impaired masticatory efficiency. We performed one cycle of five infiltrations with joint arthrocentesis and the injection of sodium hyaluronate at weekly intervals. The following parameters were assessed before and after infiltration and at follow-up after 6 months: mouth opening (with a mean of between 36.5 mm and 41.9 mm); sideways movements (to the right 4.9 mm to 8.9 mm and to the left 4.7 mm to 9.2 mm); pain at rest (VAS=1.8 to 0.5) and on movement (VAS=7.8 to 1.1); masticatory efficiency (VAS=5.7 to 8.6); subjective judgement of the functional TMJ limitation level (from 2.8 to 0.8); judgement of efficacy (from 2.4 to 3.2); judgement of tolerability to the therapy (from 2.0 to 3.1). The therapeutic benefits observed can be attributed both to joint arthrocentesis and to the characteristics of sodium hyaluronate itself. All the parameters considered revealed a statistically significant positive variation that persisted over time ( P<0.05). The results obtained by this minimally invasive, fast and easy technique proved to be valid and lasting. This infiltration technique using sodium hyaluronate looks very promising for patients affected by symptomatic DJD who do not respond to conservative medical therapy, reflecting similarly encouraging findings in the orthopaedic treatment of degenerative knee pathology.

Adjuvants, Immunologic↗
PubMed2002

gammadelta T lymphocytes in the peripheral blood of patients with tuberculosis with and without HIV co-infection.

BACKGROUND: Several recent studies suggest that gammadelta T lymphocytes play an important role in immunity against Mycobacterium tuberculosis. However, the dynamics of these cells in the peripheral blood of patients with tuberculosis (TB) with and without HIV infection is not fully understood. A study was undertaken to evaluate the profile of the gammadelta T cell population in patients at the time the diagnosis of TB was established. METHODS: A cross sectional study was performed in consecutive TB patients from the Department of Infectious Diseases, Spedali Civili, Brescia. CD4+, CD8+ and Vdelta1 and Vdelta2 T cell counts were analysed. Lymphocyte surface membrane expression was evaluated with the FITC-TCRgammadelta, -Vdelta1, -Vdelta2 and PE-Vdelta1 monoclonal antibodies. Blood donors and HIV seropositive asymptomatic individuals acted as controls. RESULTS: Seventy four TB patients were evaluated, 20 of whom (27%) were co-infected with HIV. HIV seronegative TB patients (n=54) had total gammadelta T cells and Vdelta1 subsets comparable to those in blood donors (n=39). However, the percentage with the Vdelta2 subset was significantly lower in patients with TB than in controls (median 1.5 v 2.1; p=0.05). Responsiveness to PPD was not associated with predominance of a specific gammadelta T cell subset. HIV seropositive individuals had a decreased percentage of circulating Vdelta2 cells at a level similar to that in HIV seronegative TB patients, regardless of the presence of active TB. CONCLUSIONS: HIV seronegative TB patients and HIV infected individuals (with or without active TB) have a reduced number of circulating Vdelta2 T cells compared with healthy individuals. Whether TB and HIV infection share a common mechanism causing Vdelta2 T cell depletion still needs to be established.

AIDS-Related Opportunistic Infections↗
PubMed2002

Soil transmitted helminth (STH) infections in an indigenous community in Ortigueira, Paraná, Brazil and relationship with its nutritional status.

Within the frame of World Health Organisation (WHO) guidelines for the control of soil transmitted helminth (STH) infections, a baseline survey has been conducted in Queimadas Indian schoolchildren (group A) as compared with urban schoolchildren (group B), both located in Ortigueira, Paraná, Brazil, with the aim of orientating investigations. In an opportunistic study, the possible relationship between STH infection and nutritional status has been investigated. A total of 236 schoolchildren aged 5-15 years were enrolled, 100 in group A and 136 in group B. Prevalence of STH infections and heavy intensity infections were significantly higher in the group A (P < .001). A statistical significant correlation between stunting (Z-score < -2) and intensity of STH infections was noted. These results strongly suggested that mass treatment would be indicated in the indigenous community, possibly leading to improved nutritional status.

Adolescent↗
PubMed2001

Urinary excretion of IgG and alpha(1)-microglobulin predicts clinical course better than extent of proteinuria in membranous nephropathy.

In idiopathic membranous nephropathy (MN), the main predictors for progression to chronic renal failure (CRF) are the amount of proteinuria and extent of tubulointerstitial damage. The aim of this study is to evaluate whether urinary excretion of proteins reflecting the alteration of permselectivity in the glomerular capillary wall, such as immunoglobulin G (IgG), and the reabsorption impairment of low-molecular-weight proteins, such as alpha(1)-microglobulin (alpha(1)m), correlates with the extent of tubulointerstitial damage and have a predictive value for functional outcome and response to therapy better than 24-hour proteinuria. In 78 patients with MN, urinary excretion of albumin, transferrin, IgG, and alpha(1)m was measured by immunonephelometry in second-morning urine samples and expressed in milligrams per gram of urinary creatinine (uCr). In 48 patients with characterization of proteinuria and renal biopsy performed at the same time, excretion of IgG (P = 0.0087) and alpha(1)m (P = 0.0024), but not albumin (P = 0.37), transferrin (P = 0.38), or 24-hour proteinuria (P = 0.32), was associated significantly with the extent of tubulointerstitial damage (score, 0 to 1 versus >/=2). Only alpha(1)m excretion was associated significantly with global glomerular sclerosis (P = 0.0032) and arteriolar hyalinosis (P = 0.0004). Moreover, urinary excretion of alpha(1)m was significantly dependent on IgG excretion (r = 0.67; P = 0.0001), but not on albumin (P = 0.66) or 24-hour proteinuria (P = 0.07). Functional outcome could be evaluated in 38 patients with nephrotic syndrome and baseline normal renal function (serum creatinine, 0.99 +/- 0.20 mg/dL; follow-up, 44 +/- 22 months). Remission was 100% versus 20% in patients with IgG excretion less than 110 mg/g uCr versus 110 mg/g uCr or greater (P = 0.0001) and 77% versus 17% in patients with alpha(1)m excretion less than 33.5 mg/g uCr versus 33.5 mg/g uCr or greater (P = 0.0009), respectively. In patients with IgG and alpha(1)m excretion less than or greater than the cutoff value, progression to CRF was 0% versus 35% (P = 0.0026) and 0% versus 58% (P = 0.0001), respectively. Nineteen patients treated with immunosuppressive therapy were compared with 19 untreated patients. There was no difference in remission or progression between treated and untreated patients when IgG and alpha(1)m excretion were less than the cutoff value. There was a significant difference for progression to CRF between treated and untreated patients when alpha(1)m excretion was greater than the cutoff value (17% versus 100%; P = 0.0076). In conclusion, IgG excretion is associated significantly with the extent of tubulointerstitial damage and alpha(1)m excretion. This observation supports the hypothesis that IgG may be the toxic moiety of proteinuria. Excretion of IgG and alpha(1)m has a significant predictive value for both remission and progression and is useful to identify patients who are at risk for progression and for whom treatment with immunosuppressive therapy is indicated soon after diagnosis.

Albuminuria↗
PubMed2001

Efficacy and tolerability of topical 1% cidofovir cream for the treatment of external anogenital warts in HIV-infected persons.

BACKGROUND: Treatment options for anogenital warts in patients with HIV-1 are unsatisfactory because they fail to eradicate latent human papillomavirus. GOAL: To determine tolerability and efficacy of topical 1% cidofovir cream for the treatment of external anogenital warts in HIV-infected patients. STUDY DESIGN: A randomized, placebo-controlled, single-blind, crossover pilot study of either 1% cidofovir cream or placebo applied once daily 5 days a week for 2 weeks followed by 2 weeks of observation was performed. RESULTS: Six patients were randomized to 1% cidofovir cream and six to placebo. The latter patients eventually received 1% cidofovir cream. Thus, 12 treatment rounds of cidofovir were compared with six rounds of placebo. A reduction of more than 50% in the total wart area achieved by seven cidofovir treatments (58%), as compared with no placebo regimen (P = 0.02). Local reactions occurred in 10 of the 12 patients treated with cidofovir, as compared with 0 of the 6 subjects in the placebo group (P < 0.001). CONCLUSIONS: For the initial clearance of anogenital warts in HIV-infected patients, 1% cidofovir cream is significantly more effective than vehicle cream. Local mucosal erosion is a common side effect.

Administration, Cutaneous↗
PubMed2001

[Vertical trasmission of human immunodeficiency virus (HIV) and other sexually transmitted infections (STI)].

Infectious agents which are sexually transmitted determine considerable morbidity in women during the gestational period. Connatal and perinatal infection of the newborn, miscarriage, and low birthweight have all been described. Vertical transmission of HIV and other STD may occur via the placenta during gestation (the major mechanism for syphilis) or at birth during the passage through the cervico-vaginal channel (the major mechanism for HIV, HBV, HSV, gonorrhoea and chlamydia). High serum viral loads of HIV significantly increase the likelihood of newborn infection, while the presence of lesions in the genital tract at birth increases the odd for transmission for HSV. Breast feeding is a well described route of transmission for HIV infection, but it is irrelevant to the transmission of HBV. Cutaneous lesions of the breast and nipples carry a risk of transmission of syphilis and HSV through breast-feeding. Treatment of the etiologic agent is considered an effective means for the prevention of vertical transmission and is recommended for all STI agents except for HBV. HIV infected women on antiretroviral therapy should continue the same treatment regimen if they become pregnant (with the exception of indinavir and efavirenz, which should be replaced as soon as possible); women who did not assume antiretroviral drugs at the time they became pregnant, should start treatment as soon as they reach the second trimester of gestation. Delivery should be performed by elective cesarian section in all HIV infected women. Delivery should also be performed by cesarian section in women who develop a primary HSV infection and have cervico-vaginal lesions. Recurrent episodes of genital herpes are associated to a much lower risk of vertical transmission and do not represent a criterium for cesarian section. Women with documented cervical chlamydia infection should receive a full treatment regimen at the 36th week of gestation. Women with chronic HBV infection do not require etiologic treatment; however, their newborns should receive concomitant doses of HBV immunoglobulins and HBV vaccine soon after birth. Standard practices of prevention of vertical transmission of STI agents applies to women regardless their native country. However, the feasibility of implementation of the guidelines in poor resource countries is a matter of great concern: an unresolved debate is ongoing on optimal strategies for the prevention of vertical transmission of HIV in such countries.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Prevalence and distribution of soil-transmitted helminth (STH) infections in urban and indigenous schoolchildren in Ortigueira, State of Paranà, Brasil: implications for control.

Soil-transmitted helminth (STH) infections represent a major public health problem in poor and developing countries. During the period September-October 1998 we conducted an epidemiological survey of STH infections in schoolchildren of an urban area (group A) and an indigenous reserve (group B), in the Municipality of Ortigueira, State of Paranà, Brazil, to assess potential benefits of mass treatment. Stool samples were examined for helminth eggs by quantitative (Kato-Katz) technique to determine the prevalence and intensity of intestinal parasitic infection. Moreover, we examined the relationship between prevalence and intensity of STH infections and housing/hygienic factors (by means of a 7-item questionnaire). 236 schoolchildren aged 5-15 years were enrolled, 136 in group A and 100 in group B. The prevalence of STH infections was significantly higher in group B (93%) than in group A (22%) (P < 0.001). Detected parasites were: A. lumbricoides (16.1% prevalence in group A, 88% in group B, P < 0.001), hookworms (5.8% in group A, 52% in group B, P < 0.001) and T. trichiura (5.1% in group A, 2% in group B, P = 0.2). Heavy infections were detected in 2.9% and 23% of the children in group A and B, respectively (P < 0.001). Housing/hygienic indicators were significantly poorer in group B. A statistically significant correlation was observed between total prevalence of STH infections and prevalence of high-intensity infections with most housing/hygienic variables. On the basis of these results, mass treatment and educational interventions were suggested for the indigenous community, whereas target treatment and educational interventions were suggested for the urban community. Even in a geographically homogeneous area different epidemiological realities can be found, which in turn can influence infection levels and control programmes.

Adolescent↗
PubMed2000

Adequacy in hemodialysis: new concepts derived from online urea monitoring.

BACKGROUND: The estimation of urea kinetic parameters [urea generation rate (Gu), normalized protein catabolic rate (NPCR), and dialysis dose (Kt/V)] is routinely performed during a single hemodialysis session as a representative sample of a stable series. To ascertain whether the stability assumption is tenable and to estimate the variability of urea kinetic parameters, a number of stable patients on regular dialysis treatment in their usual clinical setting were followed. METHODS: Thirteen stable patients on regular hemodialysis aged 61 +/- 11 were monitored from 5 to 24 weeks (median, 10 weeks) with the urea biosensor system in double-chamber hemodiafiltration. Body weight did not change appreciably. Residual renal function was negligible or absent. Weekly averaged urea concentration (TACw), Gu, NPCR, and Kt/Veq were calculated, and their serial patterns and interrelationships were evaluated through graphical analysis and linear regression. RESULTS: In six patients, the urea pool was substantially unchanged, but variability of Gu and Kt/V was comparable to that of the other groups. In three patients, body urea pool increased. Gu went from 4. 78 +/- 0.44 to 5.40 +/- 0.65 mg/min, and Kt/V went from 1.25 +/- 0. 25 to 1.34 +/- 0.31. In four patients, body urea pool decreased; Gu went from to 6.55 +/- 1.91 to 5.85 +/- 2.26 mg/min, and Kt/V did not change appreciably. Parameters might change in a nearly linear trend or occasionally as abrupt or oscillating phases. Gu was the main factor involved, and the only one affecting four of the seven unstable patients. Kt/V was never solely involved. CONCLUSIONS: Our data indicate that the estimation of urea kinetic parameters is often affected by a non-negligible degree of variability, which can be ascribed to the variability of the dialytic dose delivered and, above all, to the daily changes of diet protein assumption.

Aged↗
PubMed2000

Passive sentinel surveillance system for sexually transmitted diseases in primary healthcare sites in Ethiopia, 1991-3.

BACKGROUND: In 1989 the ministry of health of Ethiopia launched an STD control programme to strengthen the STD case management capabilities at public health centres and hospitals. The programme included the introduction of a syndrome based system for notification of STD cases. We here report the data originated by the syndromic case reporting system under programme conditions. METHODS: 35 (17%) of the total 225 hospitals and public health centres of Ethiopia were included in the programme. Information relevant to the years 1991 to 1993 was analysed at mid 1994. RESULTS: 32 clinical sites (91% of the total) provided at least one monthly report. The proportion of monthly reports received was 65% of those due, ranging from 51% in 1991 to 73% in 1992 and 42% in 1993. A total of 77,294 consultations for STD related symptoms were recorded, including 70,200 new cases, 6588 repeated consultations, and 506 partners of STD patients. Among first attendant patients 38,459 (52.7%) were males with a male to female ratio of 1:1. Urethral discharge and vaginal discharge were the leading cause of consultation among males (58%) and females (64%) respectively. The frequency of genital ulcer diseases was 26% among males and 15% among females. Inguinal adenopathy in the absence of genital ulcers was also frequent, accounting for 10% of consulting males and 5% of females. Based on Gram stain, gonorrhoea was identified in 64% of the cases of urethral discharge, while trichomoniasis and candidiasis were identified by wet mount in 28% and 16% of the cases of vaginal discharge respectively. CONCLUSIONS: STDs are a common cause of consultation at public health centre sites in Ethiopia. A syndromic case reporting system proved to be efficient and produced valuable information to initiate assessment of the problem and to set up bases for monitoring trends of STD morbidity.

Communicable Disease Control↗
PubMed2000

[Classic and emerging sexually transmitted diseases in industrialized countries and in developing countries].

In industrialised countries, there has been a drastic decrease in the number of reported cases of syphilis, gonorrhoea, and tropical sexually transmitted diseases (STD) since the introduction of antibiotics in the 1950s, whereas among the general population of non-industrialised countries, the number of cases of these diseases has remained extremely high. The World Health Organization has estimated that, worldwide, 333,000,000 new cases of curable STD occur every year and that 90% of these cases come from non-industrialised countries. Moreover, viral STD, such as genital herpes, condyloma, hepatitis B infection, and HIV-1 infection, represent an even greater problem in that they are not curable. STD are also a cause of serious complications in the genital and reproductive tracts of both genders, and curing these complications requires substantial economic resources.

Developed Countries↗
PubMed1999

PCR-RFLP-detected human papilloma virus infection in a group of senegalese women attending an STD clinic and identification of a new HPV-68 subtype.

Cancer of the cervix is the most common malignant tumor among women in Africa and, in particular, Senegal. Studies of the prevalence of human papilloma virus (HPV) infection in Africa have mainly focused on carcinomas. Data on the presence of the virus in women with normal cervical cytology are scarce. In this study, 158 cytologically normal women who had been referred to the 'Institut Pasteur de Dakar' (Senegal) for various genital complaints were investigated for the presence of HPV on exfoliated cells by PCR-RFLP. HPV was detected in 13.9% of cases. Oncogenic type HPV 16 was the most common type (40.9%), followed by HPV 53 and HPV 58, both detected in 13.6% of cases. Mixed HPV infections were present in 13. 6% of the subjects. Only HPVs belonging to the intermediate-high risk group were detected. These data suggest the need for careful cytological control of patients. A PCR-HPV fragment (GA115) possessing an original RFLP pattern was isolated. After sequencing, it showed a nucleotide homology of 97.1% with HPV 68 and should therefore be considered a new HPV 68 subtype. The use of PCR-RFLP strategy enables detection and typing of all known and as yet unknown genital HPVs. Variant and subtype classification of HPV types identified by oligonucleotide probe methods may need to be refined, especially for less prevalent HPVs and in areas where little information on HPV prevalence is available. More studies are needed to characterize satisfactorily the epidemiology of HPV in Africa.

Adolescent↗
PubMed1998

A comparison between horizontal splint and repositioning splint in the treatment of 'disc dislocation with reduction'. Literature meta-analysis.

We reviewed the literature from 1985 to 1996 concerning the preliminary treatment of disc dislocation with reduction (DDWR) by means of occlusal splints, pinpointing two main methods. The conflicting results of many papers induced us to make a literature meta-analysis of those articles with the necessary requirements in order to verify the effectiveness of the two therapeutic means more frequently used in DDWR; the repositioning splint and the bite plane. A statistical comparison between the two kinds of treatment has demonstrated that the repositioning splint is more effective both in the resolution of the articular click and of the pain at a level of P < or = 0.00001, which is noteworthy and highly significant.

Confidence Intervals↗
PubMed1998

[Principles and management of the ambulatory treatment of traveller's diarrhea].

Traveller's Diarrhea (TD, turista) is the most common health disturbance in travellers, affecting 20-50% of two-week travellers depending on their origin, destination and eating habits. The etiological agents most frequently isolated from the stools are enterotoxinogenic Escherichia coli (ETEC), Salmonella spp., Shigella spp., but the rate of isolation of Campylobacter spp. and non cholera vibrios is also high in Asia. Preventive measures in eating habits should in principle be able to curb the incidence of TD but compliance of travellers is usually poor. Antibiotic chemoprophylaxis has proved effective, but economic, safety and microbiological (drug resistance) considerations discourage its widespread use. Any treatment strategy should consider that TD is usually a self-limiting, benign illness in most travellers, even though infants, elderly people or persons with severe baseline diseases (heart diseases, diabetes, immunocompromised hosts, etc...) may sometimes suffer severe consequences. Adequate rehydration is the cornerstone of treatment and intestinal motility inhibitors may be used in adults (not in children) with severe diarrhea during the first 24 hours if the suspicion of invasive pathogen has been ruled out. Routine antibiotic treatment of TD is controversial, due to the benign nature of the syndrome and to the impossibility to ascertain its causative agent. It should be limited to severe and disabling cases. Among the many antibiotics tested, quinolones are now considered first-choice treatment worldwide, even though disturbing reports of the increasing prevalence of quinolone-resistant Campylobacter spp. from Asia have been recently published. Cotrimoxazole is efficient in Central America. The role of non absorbed antibiotics and probiotics is still to be fully elucidated.

4-Quinolones↗