Biomedical subjects
D Passali
Publications and source records attributed to D Passali.
Urea to calculate the dilution of nasal secretum collected by lavage.
Urea, creatinine (24 cases) and albumin (22 cases) were determined in nasal secretum and in serum in 50 subjects. The correlation between the values in the secretum and in the serum significative only for urea and creatinine. The regression coefficient of urea was particularly high and we suggest that the values of urea in nasal secretum may be calculated as 1, 3 times its serum levels. This relationship may be useful to calculate the dilution of the samples of respiratory secretum collected by lavage, utilizing the ratio between the actual urea in the sample and its theorical value.
[Study of muco-ciliary transport].
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Mucociliary flow in the nose during general and epidural anesthesia.
By means of the coloured indicator transport test (phenol red 3% in calcium-hydrogen-phosphate), mucociliary function in nose and pharynx was studied in 50 patients who underwent general or ocular surgery and in 10 healthy adult subjects. Patients were anesthetized with halothane, enflurane, NLA, and epidural analgesia. At the end of surgery, mucociliary function was significantly depressed (p less than 0.001) after halothane or enflurane anesthesia, but not after NLA or epidural analgesia. Six hours following enflurane anesthesia we still found a significant depression (p less than 0.001) of mucociliary function. No difference between halothane or enflurane was noted.
[Hearing disorders and audiometry findings in children with phenylketonuria].
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[A test of binaural masking. Level difference in direct hearing].
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Sobrerol in the treatment of secretory otitis media in childhood.
The therapeutic activity and tolerability of sobrerol, a muco-active agent, were evaluated in 30 children (aged 5-10 years) with secretory otitis media. The drug was administered once daily by inhalation for 10 days consecutively at a dose of 40 mg/3 ml. Clinical assessments showed a significant improvement in the objective measures together with good tolerability. Moreover, sobrerol was shown to improve impedance values; this is an important aspect of the modifications induced by this drug in diseases involving the ear.
A comparison of azelastine nasal spray and cetirizine tablets in the treatment of allergic rhinitis.
A total of 40 patients with perennial allergic rhinitis were treated with either azelastine nasal spray 0.14 mg/nostril twice daily (0.56 mg/day) or cetirizine tablets 10 mg once daily. Treatment was for a period of eight weeks. The rhinitis symptoms were evaluated according to a four-point scale (0 = absent, 3 = severe). The Total Rhinitis Symptom Score (TRSS) was derived from the sum of the individual symptom scores. Symptoms were assessed at baseline prior to treatment and at weeks 2, 4 and 8. Compared baseline, TRSS for both the azelastine and cetirizine groups were less at each assessment during treatment, a slight non-significant advantage was seen in the azelastine group. At the end of the study, physicians rated global efficacy as being "good" or "excellent" in 73.7% of azelastine patients and 55.5% of cetirizine patients. Both treatments were well tolerated and no serious adverse events were reported, however, two cetirizine patients withdrew from the study because of somnolence. In conclusion, azelastine has been shown to be at least as effective as cetirizine in the relief of the symptoms of perennial allergic rhinitis.
Do tryptase, ECP and specific IgE measurement by nasal incubation increase the specific nasal provocation test sensitivity?
The specific Nasal Provocation Test (sNPT) is a third level diagnostic tool. Fitted to reproduce natural exposure condition to pick the responsible allergen for nasal symptoms out, it is applied when prick test and RAST responses are doubtful. SNPT results have been evaluated measuring nasal resistance (anterior rhinomanometry) and nasal symptoms (clinical score), reaching 50% of sensitivity. This study focused on the determination of allergic response markers, triggered by nasal challenge: tryptase levels in the nose, specific IgE and ECP (Eosinophil Cationic Protein). The aim was to increase sNPT sensitivity. Twenty patients suffering from allergic rhinitis and 16 age-matched-nonallergic subjects were enrolled in the study. Tryptase, specific IgE and ECP were determined in nasal mucosa applying a new method, based on in situ incubation, before and after sNPT. The latter was performed following a standardized method. Tryptase levels increased in 13 patients (65%), were unchanged in four patients (20%), and slightly decreased in three patients (15%). The increase recorded was significant in mite allergic patients (p=0.005), but not significant (p> 0.05) in pollen allergic patients. ECP values increased in 13 patients (65%), were unchanged in two patients (10%), and highly decreased in five patients (25%). ECP increase was not significant (p> 0.05). Specific IgE levels increased in seven patients (35%), were unchanged in 11 patients (55%) and decreased in two patients (10%). The IgE increase was significant in pollen-allergic patients (p<0.05), while it was not significant in mite-allergic patients (p>0.05). Tryptase, ECP, and specific IgE were not detected in the control group. The data obtained showed a positive sNPT response in 12 patients (60%). Comparing our results with those derived from classical-parameter employment, we gathered an improvement of 10%. On the basis of the usual parameters, in fact, we recorded 50% positivity, while the use of mediators provided an additional 10% improvement in sNPT sensitivity: taking together the usual parameters and nasal allergic mediators values, we reached an sNPT over-all sensitivity of 85%.
Diurnal activity of the nasal mucosa. Relationship between mucociliary transport and local production of secretory immunoglobulins.
Within the ambit of the cyclic activity of the nasal mucosa the purpose of this study was to verify the existence of possible correlation between the rate of mucociliary transport (MCT) during the day and the circadian changes of the SIgA concentrations already found in a previous study. In the present work, a daily fluctuation of the SIgA concentrations was confirmed and it was shown that the values decrease from the greatest limit at 4.00 a.m. to the lowest at 10.00 a.m. Circadian changes of the MCT times are also shown. Moreover, the comparison of the data pertaining to these two parameters showed opposite patterns: when the mucociliary transport velocity decreases, the secretory immunoglubulins reach the highest levels. The phase-displacement of the two examined functions thus makes it possible to compensate cyclic impairments of one activity with contemporary improvement of the other.
[Histomorphological changes induced by recurrent tonsillitis].
Palatine tonsils are lymphoepithelial mucosal structures whose particular role as a defense mechanism in the human immune system makes them fundamental in protecting organs of much greater importance. If follows, therefore, that dealing with recurrent tonsillar phlogosis--diagnosis as well as therapy choice, surgical or medical--is today problematic and shrouded in doubt. The authors examined tonsillar tissue specimens of 65 patients (age range 4-30 years) who had previously undergone tonsillectomy. Light microscopy and immunocytochemistry were used to study subepithelial tissue while scanning electronic microscope was employed to observe epithelial ultrastructure in order to determine which alterations were most meaningfully correlated to the history and clinical picture of the subjects. In 100% of the cases the cryptic reticular epithelium was hyperplastic while in 44% a squamous metaplasia was observed. Epithelial alteration in various forms was also revealed with scanning electronic microscope: cellular disjunction ridging of the cryptic floor, conrifying squamous epithelial cells, plasma cells and infiltrated lymphocytes. The authors suggest that it is precisely epithelial alteration which, due to inadequate antigen uptake, triggers the series of events which leads from tonsillar disorders to systemic metafocal manifestation.
[Cyclic activity of the nasal mucosa: relationship between muco-ciliary transport and local production of secretory immunoglobulin].
The aim of the present work has been to study the existence, presumed on the basis of recollection, of a correlation between circadian changes in SIgA concentrations in nasal secretum and the M.C.T. rate throughout the day. In order to reconfirm previously obtained data, again in this case a fluctuation in SIgA concentration was studied, finding peak values at 4 a.m. and the lowest at 10 a.m. Circadian changes were also witnessed between M.C.T. times, thus making it possible to reveal further information regarding cyclic activity of the nasal mucosa. Comparison of these two parameters showed an inverse rate; in fact, when the SIgA concentration increases the muco-ciliary transport rate decreases and vice versa. In other words, the muco-ciliary transport time is more efficient when the production of secretory immunoglobulins by the nasal mucosa is lower, as though a temporary lack in nasal defense is made up for by simultaneous improvement of the other activity.
[Furosemide long-term inhalation therapy in patients with nasal polyposis].
Study aimed principally at applying the data recently gathered with regard to Bronchial Reactivity to rhinology, with special regard to non-atopic or allergic hyperresponsiveness. In the past decade, Ultrasonic Nebulized Distilled Water (U.N.D.W.) was recognized as one of the best test in Bronchial Reactivity. In allergic and non-allergic rhinitis, the Authors tried to use U.N.D.W. to reproduce symptoms of rhinitis. Results show that U.N.D.W. could be included in the Nasal Hyperreactivity test. Secondly, but not less interesting, is the prevention of experimental rhinitis with U.N.D.W. by using Furosemide, a diuretic administered by inhalation. The prevention of Ca++ penetration into nasal cell can block any mediator-activation. Such procedure may be applied in polyposis after surgery in order to prevention recurrence, data show the complete applicability of this pharmacological treatment in children as well.