Biomedical subjects

A Milani

Publications and source records attributed to A Milani.

93 records · Page 6Linked to original sources

PubMedDate not supplied

[A probabilistic approach to the natural course of liver cirrhosis: a model of interactive simulation].

We propose a computerized mathematical model of the natural history of patients with liver cirrhosis in order to investigate the relationships between the various events that characterize the clinical course of the disease. By means of a rigorously probabilistic approach, the stimulation exposes each hypothetical patient to a series of risks of significant clinical events; whether or not these events occur is determined by preestablished probabilities. Analysis of the effects of arbitrary modifications of these theoretical risks provides useful information on the prospective relevance of the clinical events examined. For example, we compared the simulated follow-up of a population of control cirrhotic subjects with follow-ups of patient groups in whom different degrees of reduction of the risk for gastroesophageal bleeding were postulated on the basis of hypothetical primary or secondary prophylaxis. Our data confirm that the size of the investigated population strongly influences the threshold level of the bleeding-risk reduction able to determine a significant improvement in overall survival. In fact, in large populations (a 6 year follow-up of 3000 cirrhotic subjects), the threshold level was 25% (primary risk) and 45% (secondary risk) with respect to control subjects, while in more limited populations (300 subjects) even a 100% risk-reduction does not seem sufficient to bring about significant improvement in overall survival. Our data may help to explain the different results of controlled trials found in the literature; in fact, only the conclusions arrived at through meta-analysis procedures in large populations have been confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Simulation↗

PubMedDate not supplied

Positive allergological tests may turn negative with no further exposure to the specific allergen: a long-term, prospective, follow-up study in patients allergic to penicillin.

Preliminary literature reports suggest the possibility that, in an allergic patient, a previously positive allergological test may turn negative after a long period of time with no further exposure to the specific allergen. The aim of this study was to evaluate the rate by which a previously positive skin test or RAST may turn negative in a group of patients allergic to penicillin if no further exposure to the specific allergen occurs. Sixty-three patients allergic to penicillin (48 with type I allergy and 15 with type IV allergy) were enrolled in a long-term, prospective, follow-up study, undergoing a successive complete allergological testing within 6 years of the first positive examination. During the follow-up period, skin tests progressively became negative in 28 (58.3%) type I allergic patients and in only one (6.7%) subject with type IV allergy. Similarly, the positive RAST turned negative in as many as 13 subjects (43.3% of cases). The cumulative skin test positivity (type I allergy) was significantly lower than that of patch tests (type IV allergy) (chi 2 = 10.4; d.f. = 1; p < 0.005, Logrank test). No significant difference in the progressive rate of decrease in skin test and RAST cumulative positivity was observed in the 30 patients showing both RAST and skin test positivity on entering the follow-up study. Our results provide strong evidence that a positive allergological test performed in a drug-allergic patient may become negative with time, in the absence of further exposure to the specific antigen. A negative allergological test cannot, therefore, rule out the immunological basis of a drug sensitivity. This is why we always suggest advising patients with a personal history of drug hypersensitivity against any further administration of the responsible drug, even in the presence of a completely negative allergological examination.

Adolescent↗

PubMedDate not supplied

Food allergy in children: results of a standardized protocol for oral desensitization.

BACKGROUND/AIMS: Food allergy in children is still an unresolved problem that merits investigation, particularly when the food is fundamental for the child's growth. Reports in the literature that deal with the possibility of a desensitizing treatment are sporadic and often inconsistent, and no standardized protocols are yet available. In this paper we propose a standardized oral desensitization program for food allergy in children. METHODOLOGY: The treatment was carried out in 14 cases with allergy to food (milk in 6 cases, egg in 5, fish in 2 and apple in 1 case). The control group consisted of 10 age and sex matched allergic subjects (5 to milk, 4 to egg and 1 to fish), who underwent a strict elimination diet regimen. RESULTS: Compliance to treatment was satisfactory, since 12 out of the 14 treated cases (85.7%) completed the program. Treatment was successful in 100% of the cases that completed the program: all the treated patients are now able to tolerate any food with no untoward effects or need for preventive drugs. CONCLUSIONS: The proposed standardized oral desensitization treatment may represent a safe and convenient alternative in the management of food-allergic subjects.

Adolescent↗