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Biomedical subjects

A Ferrara

Publications and source records attributed to A Ferrara.

At least 127 records · Page 7Linked to original sources

[Influence of posture in respiratory function examination in obese subjects. II. In the patient with ventilation disorders].

On earlier occasions healthy subjects, and normal weight cold patients and obese subjects not suffering from hypoventilation were subjected to respiratory function tests in different postures using the plethysmographic and helium dilution methods. This protocol was then applied to a series of obese patients with the functional characteristics of alveolar hypoventilation identified in preliminary functional tests. The study revealed: a) significant differences between plethysmographic and helium dilution findings; b) not significant volumetric differences produces by different postures (standing or squatting) especially as far as Total Lung Capacity and the main lung volume parameters are concerned. These results confirm the findings of others (Sharp et al., 1986) that diaphragmatic adjustment to changes in posture is inadequate in the obese with bronchial obstruction in whom absence of the fibre-length compensation phrenophrenic reflex and by the muscle flattening cause by the alveolar hyperinsufflation. On the basis of these data and others already published an index of "diaphragmatic passivity" based on the ratio between TLC in squatting and TLC in standing x 100 is proposed as an indicator of the lung volume available for use. This simple system would indicate the functional condition of the diaphragm and provide information for the functional assessment of patients proposed for rehabilitation treatment during follow-up.

Adult↗

[Involvement of the polypeptide system and ACE in Crohn disease].

The polypeptidyc system was studied and serum concentrations of ACE (Angiotension Converting Enzyme) were assayed in patients with Crohn's disease in the active and stabilising phases. The study was undertaken on the assumption that as a granulomatous condition Crohn's disease involves the polypeptidyc system in much the same way as in sarcoidosis. The results confirm the hypothesis revealing a significant increase in ACE levels in patients with the active disease, whereas levels in the stabilized disease were lower than in the controls. It is suggested that, as in sarcoidosis, ACE levels are useful in the diagnosis, prognosis and follow-up of Crohn's disease, especially in relation to the use of steroid drugs.

Adult↗

Postnatal overestimation of gestational age in preterm infants.

In a study involving 25 preterm infants, obstetric clinical age (standard gestational age) was determined by history, physical examination, and ultrasonographic evaluation. Postnatally, these infants were then evaluated using the Dubowitz Scoring System (DSS) for gestational age assessment. The DSS, as administered by us, significantly overestimated gestational age compared with the standard gestational age (mean +/- 1 SD: 34.2 +/- 2.9 vs 32.5 +/- 3.9 weeks, respectively) in preterm infants. To illustrate, the gestational ages of 13 newborns (52%) in the total study group were each overestimated by more than two weeks. This percentage increased to 75% among the 16 infants whose gestational ages were less than 34 weeks (by standard gestational age). When the standard gestational age was underestimated by the DSS, this difference never exceeded two weeks. These findings suggest that the present system of postnatal assessment of gestational age in preterm infants needs further investigation.

Body Height↗

Outcome of colorectal cancer.

The outcome of 454 patients who presented with colorectal carcinoma during a 16 year period is reviewed: 54 per cent were males, 58 per cent were aged more than 60 and 10 per cent had an emergency admission, 42 per cent of tumours occurred in the rectum. A curative resection was possible in 68 per cent. Postoperative mortality was 7 per cent. The overall crude 5-year survival was 41 per cent. The mortality from local recurrence was significantly higher in rectal (11.7 per cent) than in colonic cancer (8.8 per cent; P less than 0.01). The rate of recurrence and metastases was higher in patients with low rectal cancer than in patients with cancer of the middle and the upper rectum (P less than 0.01). Distant metastases were the cause of death in 94 per cent of the patients who had a Miles' operation for cancer of the middle rectum, whereas local recurrence was responsible for late mortality in 80 per cent of patients who underwent an anterior resection. No difference in 5-year survival was found in the restorative and in the excisional group.

Adult↗

Intraluminal release of serotonin, substance P, and gastrin in the canine small intestine.

Several gastrointestinal hormones have been found in the intestinal lumen, but as yet their physiologic role is not yet clear. We have previously shown in anesthesized animals that electrical vagal stimulation provokes simultaneous intraluminal release of serotonin (5-HT) and substance P (SP). The aim of this study was to investigate if a physiologic stimulus, a meal, releases 5-HT, SP, and gastrin (G) into the canine jejunum. In 10 dogs, chronic jejunal Thiry-Vella loops were perfused with saline (37 degrees C) before and after: a test meal; atropine, 0.2 mg/kg intravenously before the meal; atropine alone at the same dose; propanolol, 0.5 mg/kg intravenously before the meal; and propanolol alone at the same dose. Effluent perfusates and peripheral blood samples were assayed by radioimmunoassay for concentrations of 5-HT, SP, and G. Large amounts of all three humoral agents were found intraluminally during the interdigestive period. The meal resulted in increased circulating levels of 5-HT, SP, and G, while intraluminal concentrations of 5-HT and SP but not G increased following the meal. Both atropine and propanolol pretreatment significantly reduced this response, while alone, these drugs did not affect basal values. We postulate that 5-HT and SP released into the intestinal lumen in response to a meal act as local neurocrine/paracrine modulators. Their release mechanisms appear to be under both cholinergic and adrenergic control.

Animals↗

Invasive candidiasis does not complicate short-term cimetidine treatment of duodenal ulcer.

The purpose of this study was to record the frequency of invasive candidiasis of duodenal ulcer and to determine whether or not it is enhanced by cimetidine treatment. Our multicenter prospective trial involved 99 patients with endoscopically proven duodenal ulcer who were undergoing a 4- or 8-week cimetidine (800 mg/day) treatment program. At the endoscopic examination, performed before and after the 4- or 8-week treatment, three biopsy samples were taken from the ulcer edge or from the healed tissue. Ulcer infiltration by Candida was presumed by the presence of mycetes in stained tissue samples. Healing rate was 76% at 4 weeks and 89.9% at 8 weeks. Candida infiltration was not seen in any biopsy specimen. Short-term treatment with cimetidine does not promote invasion of mycetes into the duodenal ulcer lesion.

Adult↗

The presence of methanobacteria in human subgingival plaque.

Through a procedure of setting up a strictly anaerobic chain from sampling subgingival plaque to incubation in an anaerobic cabinet (O2 less than 10 ppm), it was possible to, for the first time, isolate methanobacteria from human subgingival plaque.

Adult↗

Rapid estimation of insertional length of umbilical catheters in newborns.

To determine the neonatal body measurement that best predicts insertional umbilical catheter lengths, we studied two commonly used parameters--shoulder-to-umbilicus length and total body length--and two new parameters--suprasternal notch-pubic symphysis length and birth weight (BW)--on 43 umbilical artery (UA) and ten umbilical vein (UV) catheterizations. The new parameters showed better correlations than the currently used ones. The BW variable, with the highest coefficient of correlation among all four parameters, was applied prospectively in 25 UA and 16 UV catheter insertions. All catheter tips thus placed were found to be in acceptable positions. Although any one of the four parameters can be used clinically, we prefer the BW parameter for its reliability, reproducibility, and ability to be estimated in emergency settings. The modified regression (estimating) equations utilizing BW are as follows: UA catheter length = 3 X BW + 9; UV catheter length = 1/2 X UA line calculation + 1, in which lengths are measured in centimeters and BW is measured in kilograms.

Birth Weight↗

Intraluminal release of serotonin during the interdigestive migrating complex in the canine small intestine.

Intraluminal release of serotonin (5-HT) was evaluated in relation to the interdigestive migrating complex (IMC) in the canine small intestine. Thirty-Vella loops (TVL) were constructed in the proximal jejunum of eight dogs. After recovery, the loops were continuously perfused with normal saline at 37 degrees C and changes in intraluminal pressure recorded. For each 10-min period, a motility index (MI) was calculated using computer-assisted planimetry and expressed in mm2/10 min. Serotonin contents in the effluent perfusates were measured by radioimmunoassay. A characteristic phasic motor activity was recognized in the TVL with periods of rest or minimal activity (MI = 406 +/- 45 mm2/10 min, Phase I) alternating with periods of vigorous activity (MI = 2082 +/- 134 mm2/10 min, Phases II and III). Serotonin was constantly found in the effluent perfusates in relatively high concentrations, but 5-HT levels did not vary significantly with intestinal activity; levels averaged 120 +/- 19 ng/ml during Phase I and 110 +/- 13 ng/ml during phases II and III. We conclude that intraluminal 5-HT plays no major role in the physiologic local regulation of the canine IMC in the small intestine.

Animals↗

Comparative effects of ketanserin, atropine and methysergide on the gastrointestinal effects of hyperserotoninemia in the awake dog.

Intestinal handling of water and electrolytes and motility were monitored in conscious dogs with chronic 25-cm Thiry-Vella loops of proximal jejunum. Absorption/secretion was quantitated using a neutral isosmotic perfusate containing [14C]polyethylene glycol as a recovery marker. Under basal conditions the animals absorbed water, Na+ and Cl-, while there was no net action on K+. Intravenous serotonin infusion (30 micrograms/kg/min) increased circulating levels of serotonin to a mean of 1556 +/- 191 ng/ml within 15 min of the commencement of the infusion. The infusion induced a significant secretion of water (mean -73 +/- 7 microliters/min) and electrolytes (sodium -10.4 +/- 0.7 muEq/min; potassium -0.8 +/- 0.05 muEq/min; chloride -12.4 +/- 1.0 muEq/min) in the dogs and all showed signs of hyperserotoninemia (salivation, loose bowel movements, tachypnea). After administration of ketanserin (33 micrograms/kg/min), a significant reduction in secretion was demonstrated (water +20.8 +/- 16.1 microliters/min; sodium 7.2 +/- 3.0 muEq/min; potassium -0.02 +/- 0.1 muEq/min; and chloride -1.9 +/- 2.8 muEq/min) as well as reduced motor activity. A similar antisecretory effect was demonstrated with atropine infusion (20 micrograms/kg/min), although this drug had a far more significant effect on the gastrointestinal motility recorded in the loop. Infusion of methysergide (33 micrograms/kg/min) did not significantly affect secretion (water -111.4 +/- 59.0 microliter/min; sodium -17.4 +/- 9 muEq/min; potassium -0.9 +/- 0.4 muEq/min; chloride -20.3 +/- 7.0 muEq/min). These results suggest possible actions which may make ketanserin useful in the treatment of symptoms of the carcinoid syndrome.

Animals↗

In vitro activity of flurithromycin, a novel macrolide antibiotic.

Flurithromycin is an (8,S)-8-fluoroerythromycin isolated from the fermentation broth of Streptomyces erythraeus ATCC 31772, a blocked mutant of a strain producer of erythromycin. Its in vitro antibacterial activity has been determined on recent clinical isolates of respiratory pathogens. The range of MIC for Streptococcus pneumoniae and Streptococcus beta-haemolyticus group A is from 0.0015 to 0.006 microgram/ml, for Haemophilus influenzae from 0.012 to 0.4 microgram/ml, for Staphylococcus aureus from 0.1 to 3.1 micrograms/ml. Its action is bacteriostatic and increases at alkaline pH. Among anaerobes Clostridium perfringens, Bacteroides fragilis, other species of Bacteroides and Peptostreptococcus are particularly susceptible. Flurithromycin also showed some activity on Mycobacterium bovis, M. scrofulaceum and M. phley. The determination of killing curves indicated that in most cases a killing effect was obtained at 4 X MIC. A combination of flurithromycin with ampicillin or doxycycline sometimes was synergic, but more often additive and never antagonistic. The possible interference of flurithromycin on some parameters of the natural system of defense was determined. At concentrations equal to therapeutic levels in blood and tissues, flurithromycin did not influence chemotaxis, phagocytosis, metabolic activation and the killing activity of neutrophils.

Ampicillin↗

Neonatal stabilization score. A quantitative method of auditing medical care in transported newborns weighing less than 1,000 g at birth.

A reduction in newborn (NB) mortality is contingent on efforts of NB stabilization. The authors attempted to quantify stabilization into a score, the neonatal stabilization score (NSS) that correlates with outcome. The population for the study comprised 192 transported NBs who weighed less than 1,000 g at birth moved from level 1 hospitals in New York City during 5 years, 1977-1981. The NSS score was based on five components: vital signs, laboratory investigations, respiratory support, I.V. fluid administration, and specific managements. Each was rated 0, 1, or 2. A maximum score of 10 indicated excellent stabilization. Analyses for the validity and reliability of the NSS included the Mantel-Haenszel test (which controlled for birth weight and Apgar) and measurement of interrater agreement "k" (kappa statistic). Mortality rates were lower in those with higher NSS and odds of death were 2.39 times greater in NB with low NSS (chi 2 = 5.16; P less than 0.025). The calculated index of agreement k on 16 charts represented an excellent agreement beyond chance (k = 0.76, P less than 0.01).

Female↗

Bronchial hyperreactivity and arterial carboxyhemoglobin as detectors of air pollution in Milan: a study on normal subjects.

Research has been carried out in the town area of Milan on 275 subjects. For each patient the following data have been measured: ventilatory profile, aspecific bronchial reactivity, arterial concentration in CO and acid-base balance. The results obtained have been divided into four groups, according to the level of SO2 in the area of residence of the subjects, who have also been studied with reference to the habit of smoking. The data obtained have shown (1) an alteration of the ventilatory function, with decrease of oxygen tension in arterial blood in all subjects. (2) Increase of bronchial irritability and CO concentration in arterial blood have been found in these subjects, with rates higher than those established by the WHO (1.5-1.7). (3) The division of our results according to the level of SO2 pollution in the areas of residence of the patients showed the presence, in the most polluted areas of Milan (NE and SW), of higher levels of bronchial irritability and higher CO rates in arterial blood. (4) Cigarette smoking does not seem to play a major role in causing bronchial irritability. It certainly increases CO concentration: smokers have HbCO concentration higher than nonsmokers in all four areas. (5) Air pollution is more important than cigarette smoking in determining CO saturation of blood. Nonsmokers living in the most polluted areas of Milan (NE) show a higher concentration of CO in arterial blood than smokers living in the less polluted areas (SW).

Adult↗

Verapamil inhibition of the intestinal effects of substance P.

The undecapeptide substance P (SP) is contained in enterochromaffin cells and circulates in high concentrations in patients with carcinoid syndrome. We have previously reported that elevated SP levels, simulating those reported in patients with carcinoid syndrome, induce profound changes in intestinal water and electrolyte secretion, motility, and blood flow in a canine model. The purpose of this study was to attempt to block the effects of circulating carcinoid levels of SP on intestinal secretion and motility with the calcium channel blocker verapamil. In five dogs a chronic proximal jejunal Thiry-Vella loop was constructed, and after a 2-week recovery the loops were perfused with an isotonic test solution containing 14C-polyethylene glycol as a volume marker. Motor activity was measured by changes in intraluminal pressure and a motility index was calculated with computer-assisted planimetry and expressed as square millimeters per 5 minutes. After a 30-minute baseline period, SP was infused at 50 ng/kg/min for 90 minutes. SP circulating levels rose from a baseline of 6.2 +/- 1.3 pg/ml to a peak of 93.3 +/- 3.1 pg/ml during this infusion. Thirty minutes after the start of this SP infusion, a simultaneous infusion of verapamil (5.0 micrograms/kg/min) was begun at a separate site. During SP infusion there was a significant secretory response of water (-48 +/- 12 microliters/min), Na+ (-7.7 +/- 2.5 microEq/min), Cl- (-8.8 +/- 2.7 microEq/min) and K+ (-0.57 +/- 0.14 microEq/min), and hypermotility (motility index: 1479 +/- 138 mm2/5 min). When verapamil was added a reversal of secretion to net absorption was observed (water: + 116.9 +/- 15.6 microliter/min; Na+: + 13.8 +/- 2.1 microEq/min; Cl-: + 5.5 +/- 2 microEq/min; K+: + 0.38 +/- 0.9 microEq/min) (p less than 0.05). In addition, there was a reduction in motility (motility index: 853 +/- 92 mm2/5 min; p less than 0.05). These results confirm that SP has profound effects on both intestinal motility and secretion and that calcium channel blockade reduces these effects significantly.

Animals↗

A multicentre trial of live attenuated varicella vaccine in children with leukaemia in remission.

Two hundred forty children with acute leukaemia in remission for at least 1 year were immunized with live attenuated varicella vaccine. All were susceptible to varicella before immunization. There was a seroconversion to varicella-zoster virus in approximately 85% after 1 dose, and in 97% after 2 doses. The major side effect was mild to moderate rash, seen mainly in children with maintenance chemotherapy suspended for 1 week before and 1 week after vaccination. Vaccinees with rash were at some risk (10%) to transmit vaccine virus to varicella susceptibles with whom they had close contact. Twenty-nine vaccinees were subsequently exposed to varicella in their households. The attack rate of clinical varicella in these vaccinees was 21%, which is significantly lower than the 80%-90% attack rate occurring in varicella susceptibles after household exposure. All these breakthrough cases of varicella were mild, even in leukaemics receiving chemotherapy. Varicella vaccine was approximately 80% effective in preventing clinical varicella in children with leukaemia and completely effective in preventing severe varicella in this high-risk group.

Acute Disease↗

The effects of steroids on respiratory tolerance and somatic growth in gender-specific asphyxiated newborn rats.

Gender-specific newborn rats were randomized into two treatment groups: experimental (received steroid) and control (administered normal saline). Steroid treatment was initiated on 2nd day of life. Hydrocortisone sodium succinate at 10 mg/kg was administered intraperitoneally every 12 hours for four doses. On 3rd day of life, after the last dosage, all rats were asphyxiated once in a standardized manner. Steroids had no effect in improving respiratory tolerance. The experimental group in both genders, but more predominantly in females, gained less body weight compared to control littermates. However, no differences in somatic growth was detected between genders. This finding in newborn rats is in contrast to older rats where males are reported to be less resistant to the growth retarding effects of steroids.

Animals↗