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Biomedical subjects

G Bertini

Publications and source records attributed to G Bertini.

At least 37 records · Page 2Linked to original sources
PubMed1998

Acute neonatal respiratory distress in Italy: a one-year prospective study. Italian Group of Neonatal Pneumology.

A prospective multicentre 12-month survey of neonatal respiratory disorders in 63 537 Italian infants was performed to evaluate the incidence of acute neonatal respiratory disorders and of the main related complications. A total of 1427 developed respiratory disorders (2.2%), 208 of whom died (14.6%). The incidence of respiratory distress syndrome was 1.16%, with a case fatality rate (CFR) of 24%; that of transient tachypnoea was 0.93%, with a CFR of 1.3%. The rates of meconium aspiration syndrome, persistent pulmonary hypertension and pneumonia were 0.06%, 0.02% and 0.07%, with CFRs of 10.3%, 38.5% and 21.7%, respectively. The occurrences of the main complications in affected newborns were: bronchopulmonary dysplasia 5.6%, necrotizing enterocolitis 1.7%, patent ductus arteriosus 9.8%, 3 degrees and 4 degrees grade intraventricular haemorrhage 6.8% and air leak 4.9%. It was concluded that the incidence of acute neonatal respiratory disorders and the main related complications was lower than that reported two decades ago and that the CFR of acute neonatal respiratory disorders had increased. These results may be the consequences of (i) progress in the management of high-risk pregnancies, (ii) an increased number of viable infants with extremely low birth weight and (iii) diffusion of antenatal treatment with corticosteroids which, in this series, seemed to reduce the morbidity but not the mortality in the high-risk infants.

Acute Disease↗
PubMed1998

Doppler echocardiography in suspected lone atrial fibrillation.

Echocardiography is frequently required in patients with atrial fibrillation (AF) to exclude underlying heart disease. In the present investigation the authors evaluated 56 patients with paroxysmal AF (PAF) (27 men, 29 women, mean age 54+/-11.3 years) in whom lone AF was suspected on clinical grounds. M-mode, B-mode, and Doppler examination were performed and measurements taken according to American Society of Echocardiography criteria. Left atrial diameter, left and right atrial volumes, left ventricular (LV) diameters, LV fractional shortening, and Doppler indexes of LV diastolic function were not different in patients with PAF in comparison with those of a control group of 56 age-matched subjects free from cardiovascular diseases. Echocardiographic examination results were entirely normal in 32/56 patients (57%) vs 39/56 of the control group (69%). Mitral valve prolapse was found in five patients (9%), but only one showed mild mitral regurgitation. Doppler examination disclosed a mild (+/++) mitral regurgitation in eight patients and a small aortic or pulmonary diastolic flow in four and two patients, respectively, in the absence of significant morphologic valvular abnormalities. In these patients the sizes of heart chambers were entirely normal. Aneurysm of the interatrial septum was found in one patient and an increased thickness of the epipericardial junction in another two patients. Finally two patients had a small increase of right atrial volume without demonstrable causes. The results suggest that lone AF can be correctly suspected on the basis of clinical findings (history, physical examination, and ECG) and that in these patients echocardiography rarely discloses organic heart disease.

Atrial Fibrillation↗
PubMed1997

Nitric oxide synthase in the adult and developing thalamus: histochemical and immunohistochemical study in the rat.

The distribution of neuronal elements that express nitric oxide synthase (NOS), the synthetic enzyme of the free radical nitric oxide, was investigated in the adult and developing rat thalamus by means of NADPH-diaphorase (NADPH-d) histochemistry, which is a marker of NOS. Immunocytochemistry was also used to confirm the equivalence between the histochemical pattern of staining and the distribution of the expression of the neuronal NOS isoform. In the adult thalamus, NADPH-d-positive and NOS-immunoreactive perikarya were selectively concentrated along the midline (in the paraventricular, rhomboid, and central medial nuclei) and in the dorsal and ventral lateral geniculate nuclei. Isolated clusters of stained neurons were also observed in the lateral posterior nucleus, in the dorsal part of the medial geniculate nucleus, and in the ventromedial nucleus. Positive perikarya were either absent or very sparse in the other thalamic nuclei. Many thalamic domains were, however, characterized by distinct patterns of NADPH-d-positive fibers, preterminal and terminal-like elements. The highest density of stained neuropil was observed in the anteroventral and anteromedial nuclei, in several of the midline nuclei, in the anterior intralaminar nuclei, and in the lateral and medial geniculate nuclei. Although histochemical reactivity was observed in the thalamus at birth, the intensity and the pattern of distribution of staining observed in adulthood was not achieved until the end of the third postnatal week. The NADPH-d histochemical positivity followed discrete developmental schedules in various thalamic domains, and different areas reached a mature pattern at different ages. In addition, populations of transiently stained neuronal cell bodies were observed in the medial thalamus during the first two postnatal weeks. These results show discrete patterns of expression of NOS in the adult and developing thalamus and suggest that nitric oxide may be involved in selected physiological and developmental roles in different thalamic domains.

Aging↗
PubMed1997

Intravenous nitrates in the prehospital management of acute pulmonary edema.

STUDY OBJECTIVE: We sought to assess the effect of nitrates on prehospital mortality among patients with acute pulmonary edema (APE). METHODS: The study involved a retrospective evaluation of the records of prehospital outcome in 640 patients with APE rescued by the mobile CCU (MCCU) of Florence, Italy, between January 1980 and December 1991. The MCCU serves an urban environment with a population of 400,000 in a 102-sq km area. In the years 1980 through 1983, patients were treated with oxygen, morphine, furosemide, digoxin, nitrates, aminophylline, or dopamine, according to the attending physician's judgment. From 1984 through 1991, new guidelines for the use of intravenous nitrates, based on differential treatment according to blood pressure, were in use. RESULTS: Overall prehospital mortality rate for APE in all patients was 7.8% (50 of of 640 patients). Mortality after 1984 was significantly lower than before (5.3% versus 13%, P < .01). Nitrates were effective in reducing mortality, even in hypotensive patients. Multivariate analysis showed that outcome was significantly affected by two clinical features (dyspnea and low blood pressure), treatment with nitrates, and calendar period effects (before/after 1984). CONCLUSION: Our findings suggest that the use of intravenous nitrates improves short-term prognosis in APE.

Acute Disease↗
PubMed1997

Learning perceptual skills: behavioral probes into adult cortical plasticity.

Recent studies of the improvement of perceptual performance as a function of training - perceptual learning - have provided new insights into the neuronal substrates of this type of skill learning in the adult brain. Issues such as where in the brain, when and under what conditions practice-related changes occur are under investigation. The results of these studies suggest that a behaviorally relevant degree of plasticity is retained in the adult cortex, even within early, low-level representations in sensory and motor processing streams. The acquisition and retention of skills may share many characteristics with the functional plasticity subserving early-life learning and development. While the specificity of learning provides localization constraints, an important clue to the nature of the underlying neuronal changes is the time course of learning.

Adult↗
PubMed1997

The prevalence of latex allergy in children seen in a university hospital allergy clinic.

Natural rubber latex allergy is responsible for a wide spectrum of clinical symptoms, ranging from rhinoconjunctivitis to severe anaphylaxis, in both adults and children. An association between allergy to latex and allergy to various fruits has been reported. This study investigated the prevalence and clinical significance of latex sensitization in children seen in a university hospital allergy clinic. A total of 453 consecutive children were screened in a 7-month period. A detailed clinical history with particular attention to the past surgical history and the eventual presence of latex- or food-induced allergic symptoms was obtained. Skin prick tests (SPT) for the more important inhalant allergens and foods were performed on all children. In patients with positive latex SPT, latex challenge and additional SPT for some fresh foods (avocado, pineapple, apricot, grape, banana, pear, apple, orange, almond, and chestnut) were also performed. RAST for the same food antigens, as well as patch test with latex and a standard battery of contact allergens, was also done. Of 326 atopic children, 10 (3%) presented positive skin test to latex, but only five (1.5%) also had a positive clinical history to latex exposure. Latex challenge was positive in 3/9 positive-latex-SPT children. None of the nonatopic children had positive skin test to latex or symptoms to latex exposure. A history of previous surgery was found in 5/10 positive-latex-SPT children, in 63/316 negative-latex-SPT atopic children (P < 0.05), and in 23/127 nonatopic children. RAST to latex was positive in 5/10 positive-latex-SPT children. Associated fruit-specific IgE (SPT and/or RAST) were found in all latex-symptomatic children and in 2/5 latex-asymptomatic children. Apple, kiwi, and chestnut were the most common SPT-positive foods. Only one patient with clinical allergy to latex and positive skin tests to fruits had a history of clinical symptoms after ingestion of kiwi and orange. The natural history of the positive-latex-SPT children without clinical reactions to latex exposure and the clinical significance of the association of latex and fruit sensitivity require further studies.

Adolescent↗
PubMed1996

NADPH-diaphorase activity in brain macrophages during postnatal development in the rat.

NADPH-diaphorase histochemistry, that allows the visualization of cells producing the gaseous intercellular messenger nitric oxide, was used in the study of the forebrain during the first three postnatal weeks in the rat. Subpopulations of NADPH-diaphorase positive neurons were observed at all ages studied. In addition, non-neuronal NADPH-diaphorase-stained cells were detected in the subcortical white matter, and were very numerous in the supraventricular portion of the corpus callosum, and in the internal and external capsules. These cells were present during the first two postnatal weeks, and were especially prominent at the end of the first postnatal week. They were round-shaped and morphologically similar to the brain macrophages, whose phagocytic activity has been shown in previous studies to play a role in naturally occurring cell death and elimination of exhuberant axons. Series of sections adjacent to those stained with NADPH-diaphorase were processed with immunohistochemistry, using two different antibodies (OX-42 and ED-1) that detect macrophagic and microglial markers, and antibodies that recognize the neuronal form of nitric oxide synthase. Furthermore, brain sections from rats at postnatal day 7 were sequentially processed for either OX-42 or nitric oxide synthase immunohistochemistry followed by NADPH-diaphorase histochemistry. The morphological features and distribution of the non-neuronal NADPH-diaphorase-positive cells were superimposable to those obtained with OX-42 and ED-1 immunohistochemistry. In addition, these cells did not display nitric oxide synthase immunoreactivity. Double-labelled NADPH-diaphorase-positive and OX-42-immunoreactive cells were detected at postnatal day 7. The present results show that brain macrophages express NADPH-diaphorase activity during the early stages of the normal postnatal maturation and suggest that nitric oxide produced by brain macrophages could be involved in the development reshaping of the central nervous system.

Animals↗
PubMed1996

The chemical heterogeneity of cortical interneurons: nitric oxide synthase vs. calbindin and parvalbumin immunoreactivity in the rat.

Neurons that contain nitric oxide synthase (NOS) type I and the calcium binding proteins calbindin D28k or parvalbumin were simultaneously visualized by means of double immunohistofluorescence in the cerebral cortex of Wistar and Sprague-Dawley rats. All the three immunoreactive cell populations were primarily represented by nonpyramidal neurons. NOS-immunoreactive cells were less numerous than the calbindin- or parvalbumin-immunoreactive ones, and were intermingled with the neurons containing these calcium binding proteins. NOS-immunoreactive cells were separate from the parvalbumin-immunoreactive ones, whereas a minor proportion of them was found to be colocalized with calbindin. The cortical neurons in which NOS and calbindin coexisted were more numerous in the Sprague-Dawley than in the Wistar rats, and displayed an anteroposterior gradient of density, with the highest concentration in the medial prefrontal, frontal, and cingulate cortices. Double NOS-calbindin-immunoreactive neurons prevailed in the deep cortical layers and they were relatively numerous in the cingulate cortex. The present data indicate a selectivity in the expression of NOS vs. calbindin and parvalbumin in cortical cells, and further support the chemical heterogeneity of GABAergic interneurons in the cerebral cortex.

Animals↗
PubMed1996

Left atrial size changes in patients with paroxysmal lone atrial fibrillation. An echocardiographic follow-up.

Left atrial enlargement has been demonstrated to occur as a consequence of the arrhythmia in patients with chronic atrial fibrillation (AF) in the absence of organic heart disease, whereas contrasting results have been reported in patients with paroxysmal lone AF. In the present investigation the behavior of left atrial size was followed up for an average period of 30.3 months in 20 patients with paroxysmal lone AF since their first arrhythmic episode. No significant changes in left atrial size were found at the end of the follow-up period. In 65% of patients the arrhythmia recurred at least once yearly. Left atrial size at enrollment was not significantly different in these patients from those without recurrences and did not change in either group during follow-up. The results suggest that in patients with lone AF left atrial dilatation occurs only after the arrhythmia becomes chronic. Early restoration of sinus rhythm may interrupt the vicious circle leading to atrial enlargement.

Adult↗
PubMed1995

Skin-prick-test-induced anaphylaxis.

An anaphylactic reaction occurred in a 57-year-old man after a prick by prick test with fresh kiwi and in a 29-year-old man after prick tests with some species of fish. Both patients had a history of anaphylaxis after ingestion of kiwi and fish, respectively. These cases suggest that, especially in patients with a history of anaphylaxis, all efforts should be made to minimize the risk of systemic reactions, and skin prick testing should be performed only in places equipped to treat anaphylaxis.

Adult↗
PubMed1994

Co-localization of nitric oxide synthase and NGF receptor in neurons in the medial septal and diagonal band nuclei of the rat.

The relationship of neurons that express nitric oxide synthase type I (NOS-I), the synthetic enzyme of the free radical nitric oxide (NO), with cells that contain the low affinity p75 nerve growth factor receptor (NGFr) was examined in the basal forebrain region of the rat using double immunohistofluorescence. NOS and NGFr were found to be co-localized in a neuronal population that displayed a selective distribution. Double immunopositive neurons were evident in the medial septum and in rostral levels of the diagonal band nuclei where the vast majority (more than 80%) of NOS-immunoreactive cells were also NGFr-positive; the two cell populations were separate at more caudal levels of the basal forebrain. These findings support the chemical heterogeneity of septal and basal forebrain neurons which contain NGFr and indicate that in the rat a subset of neurons of the septum-diagonal band complex may release NO.

Amino Acid Oxidoreductases↗
PubMed1994

Neural substrate of a cerebellar movement disorder induced by intracerebroventricular injection of propidium iodide in the rat: a Fos immunocytochemical study.

Intracerebroventricular (icv) injection of propidium iodide (PI) in the rat results in a transient movement disorder characterized by nystagmus, ataxia, and shaking. In the present study we used c-Fos as a marker for neuronal activation to investigate the neural substrate underlying this movement disorder. PI was injected into the lateral cerebral ventricle of freely moving rats through a previously implanted cannula. Animals were perfused 3 h after the injection and the brains were processed for c-Fos immunocytochemistry. Paired control animals were injected with saline. After PI injection, a significant Fos expression was seen in the cerebral cortex, thalamic midline nuclei, thalamic intralaminar nuclei, hypothalamus, central gray, pontine nuclei, locus coeruleus, vestibular complex, inferior olive, ventrolateral medulla, nucleus of solitary tract, and deep cerebellar nuclei. Few or no Fos immunoreactive cells were seen in the above structures of the control animals. The present study indicates that a large number of neurons located in many different neural structures are activated following icv injection of PI. Second, consistent with the cerebellar feature of the movement disorder, a major Fos expression was found in the cerebellar circuitry (deep cerebellar nuclei, pontine nuclei, vestibular complex, and inferior olive). It reinforces further the assumption that the movement disorder is due to cerebellar dysfunction caused by PI.

Animals↗
PubMed1994

Predictors of successful at-home chemical cardioversion in new-onset atrial fibrillation.

Prehospital treatment of new-onset supraventricular arrhythmias can be attempted by physician-staffed mobile intensive care units to decrease the hospitalization rate and expense. Identification of patients suitable for at-home pharmacological treatment may help in the triage of patients with new-onset atrial fibrillation (AF). In the present investigation, the value of several clinical variables to predict the success of pharmacological at-home cardioversion was tested. A total of 924 patients with new onset (less than 24 h) AF, rescued by the Florence Mobile Coronary Care Unit (MCCU), were included in the study. By univariate analysis, female sex, palpitations as symptoms leading to MCCU call and a short delay between symptom onset and MCCU intervention were associated with a favourable outcome of treatment, whilst dyspnoea as the main complaint requiring MCCU intervention and the association of AF with an acute cardiovascular event (angina, acute myocardial infarction or pulmonary oedema) were negatively associated with the success rate of treatment. The cardioversion rate was not significantly different in patients with underlying heart disease or in patients with lone atrial fibrillation. By multivariate analysis, only sex and the drug employed for treatment (positive relation for propafenone and bunaftine, negative for amiodarone, digoxin and verapamil) were significant predictors of the outcome of MCCU intervention. Our results suggest that patients with new-onset (less than 24 h) AF with or without underlying heart disease whose main complaint is palpitation can be successfully cardioverted at home with a class IC drug (propafenone). Patients with acute coronary syndromes or left ventricular failure are good candidates for elective cardioversion after hospitalization.

Adult↗
PubMed1993

Out-of-hospital symptomatic supraventricular arrhythmias. Epidemiological aspects derived from 10 years experience of the Florence Mobile Coronary Care Unit.

The epidemiologic features and the relative incidence of symptomatic supraventricular tachycardias in out-of-hospital settings are unknown. Rhythm disturbances account for 20% of the interventions performed by the Florence Mobile Coronary Care Unit (MCCU). Between November 1979 and December 1989, the MCCU rescued 1239 patients with recent onset (less than 24 hours) symptomatic supraventricular arrhythmias. 809 had atrial fibrillation, 376 paroxysmal supraventricular tachycardia (PSVT), 36 atrial flutter and 18 different atrial dysrhythmias. Women showed an overall predominance, more evident in patients with PSVT, and the incidence of the arrhythmias increased with age. Preexisting heart disease was more frequent in atrial fibrillation (41.1%) and atrial flutter (33.4%) in comparison to PSVT (27.6%). Similarly, a higher incidence of associated cardiovascular events (AMI, acute coronary insufficiency, pulmonary edema) was found in patients with atrial fibrillation and atrial flutter. Palpitations were the main complaint in each group, however, in atrial fibrillation and atrial flutter they were frequently associated with chest pain or dyspnea.

Adult↗
PubMed1992

Role of a prehospital medical system in reducing heroin-related deaths.

OBJECTIVE: The mortality rate from heroin overdose in Italy between 1977 and 1987 increased significantly. However, in the same period, a significant increase was not observed in Tuscany, an administrative region in Italy. This study was performed to determine if the prehospital emergency medical system of Florence, the capital of Tuscany (the only one operating in Italy during the study period), affected this lower mortality rate. DESIGN: Retrospective study. SETTING: The Florence system consists of 17 mobile ICUs, each of which is staffed by a physician and three paramedics. These units are able to carry out advanced cardiopulmonary resuscitation with equipment transported to the scene of an emergency. PATIENTS: A total of 126 consecutive patients with heroin overdose, assisted by four mobile ICUs from January 1, 1984 through December 31, 1987. INTERVENTIONS: Common therapeutic protocol in the treatment of heroin overdose and of cardiac arrest. RESULTS: Fifty-two (41.3%) patients were in respiratory arrest, and seven (5.6%) patients were in cardiorespiratory arrest. The prehospital mortality rate was 1.6%, the inhospital mortality rate was 0.8%, and the overall mortality rate was 2.4%. During the period considered, the number of heroin overdose-related interventions increased significantly, as did the number of heroin overdoses complicated by respiratory arrest or by cardiorespiratory arrest, but the mortality rate remained low. CONCLUSION: We suggest that an emergency medical system can play an important role in reducing the mortality rate from heroin overdose.

Adolescent↗