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Biomedical subjects

G Gentili

Publications and source records attributed to G Gentili.

At least 55 records · Page 3Linked to original sources

[Assessment of the effects of alfuzosin on miction with dynamic echography].

Alfuzosina has a specific antagonist effect on the alfa-1-adrenergic post-junctional receptor posed at urethral laeve musculature, prostatic capsule and vesical trgonum. It's and ideal drug the symptoms of the difficult urinary flow typical of the benign prostatic hypertrophia (IPB) and of some patologies of vesical collum to attenuate. With this work we want to demonstrate the anatomic alterations of vesical collum and prostatic urethra by means of dynamic recording mictional phase with transrectal scan carried out before and after treatment. In this study, 30 patients were divided into three groups of 10 in relation to the pathology: overtone of vesical collum, little benign prostatic ipertrophia and great benign prostatic ipertrophia have included. The patients of each group have also been divided in undergroups of five (selected with the method of double-blind) of which the first treated with alfuzosina 7.5 mg/die for 30 days and the second with placebo. Considering the limits of this study, the analysis of the results have permitted to conclude that the drug has determined a subjective improvement in all patients except those with great IPB, while the objective valuation, reached comparing scan dynamic pictures before and after treatment, has made it possible to visualize an improvement on the opening of the vesical collum and the prostatic urethra after therapy with great variations of the size of che mictional funnel and same prostatic urethra. The alfuzosina is efficacious, in the cases under examination, except the third group were the compression on the urethra was of an elevated degree.

Adrenergic alpha-Antagonists↗

The outbreak of hepatitis A in Italian patients with hemophilia: facts and fancies.

To determine whether an outbreak of hepatitis A that occurred in 52 Italian hemophiliacs was acquired through the infusion of contaminated factor VIII or through environmental enteric transmission, a case-control study of the first 29 infected patients was carried out. Case patients were neither more nor less likely than controls (hemophiliacs without HAV infection) to have traveled to high-risk countries, consumed raw shellfish or had contact with persons with jaundice. The case patients, however, were more likely than controls to have received a factor VIII concentrate treated with solvent-detergent and to have had larger infusions of the concentrate during the presumed HAV incubation period. In the PCR analysis of HAV sequences from implicated lots of factor VIII, HAV sequences were found in 5 of 12 lots of factor VIII implicated in the outbreak. Three different strains of HAV were recovered, suggesting that lots were not contaminated from the same plasmapheresis donor. To obtain molecular evidence that the HAV detected in the factor VIII preparations was responsible for transmission of HAV, serial serum samples from two patients were tested for HAV gene sequences and compared with those of the implicated lots. The genomic sequences of HAV obtained for two matched sets of factor VIII and recipient serum samples were identical within each set, but different for the two sets.

Adolescent↗

Brush-border-enzyme-mediated intestine-specific drug delivery. Amino acid prodrugs of 5-aminosalicylic acid.

5-Aminosalicylic acid (5-ASA) is the active principle of a number of preparations aimed at the treatment of inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis, but its efficacy is limited by early absorption and metabolism. The possibility to exploit the selective hydrolytic activity of brush border enzymes such as aminopeptidase A and carboxypeptidases was studied by preparing the following four amino acid prodrugs of 5-ASA: 5-(N-L-aspartylamino)-2-salicylic acid, disodium salt (18), 5-(N-L-glutamylamino)-2-salicylic acid, disodium salt (19), [(5-aminosalicyl)-L-prolyl]-L-leucine, sodium salt (25), and [[5-(N-L-glutamylamino)salicyl]-L-prolyl]-L-leucine, disodium salt (28). In these compounds, the peptide bond is selectively split by the intestinal brush border aminopeptidase A (compounds 18, 19, and 28) and carboxypeptidases (compounds 25 and 28).

Amino Acids↗

Tetanus immunity among Italians born after the introduction of mandatory vaccination of children.

In Italy systematic mandatory tetanus immunization of children started in 1968. In a national sample of 241 young males born after 1968 the prevalence of non-immune subjects was 11.2% (5.5% in the North-Centre, 15.9% in the South-Islands; p < 0.02). Comparing these data with the corresponding figure obtained in a previous study of subjects born before 1968 a significant decrease (11.2% versus 32.6%; p < 0.01) is observed. The prevalence of non-immune subjects born after 1968 is significantly (p < 0.01) lower than that observed in subjects born before 1968 by geographical area as well as by area (urban/rural) of residence. These findings indicate that the introduction of compulsory tetanus vaccination for all newborns has favourably affected the immune status of younger Italian men. However, more efforts should still be addressed to decrease regional inequalities in the delivery of health care.

Adolescent↗

Non invasive evaluation in cerebrovascular study: possibility and prospects.

The authors outline the importance of the global investigation of the cerebrovascular system in order to obtain more exact information about the ethiopathology of vascular ischaemic brain disease. Each patient is always submitted to the following investigations: Duplex scanner of epiaortic vessels, Transcranial doppler and echocardiographic screening in our vascular laboratory; moreover, when haemodynamic carotid artery stenosis is present, duplex scanner of femoro-popliteal vessels and microcirculatory study of the brain with Zenon133, via inhalation, were undertaken. In the second part of the study the authors refer a relationship between the instrumental doppler signal and the real risk evidenced by techniques which can provide information on the composition, structure and stability of the plaques and correlate this information with the data from the doppler analysis. Instrumental techniques such as thermal analysis, atomic absorption spectroscopy, ICP analysis and IR spectroscopy were used to carry out this study.

Cerebrovascular Circulation↗

Oral bile acid treatment and the patient with Zellweger syndrome.

The cerebrohepatorenal syndrome of Zellweger is a congenital syndrome of multiple manifestations, including hepatomegaly and liver dysfunction. Treatment is generally of a supportive nature, aimed at improving nutrition and growth, controlling the central nervous system symptoms and limiting progression of liver disease. Because the liver disease in Zellweger syndrome may be attributed to an overproduction and accumulation of cholestanoic acids, exacerbated by diminished primary bile acid synthesis, we hypothesized that primary bile acid administration would be beneficial in improving liver function by a mechanism involving down-regulation in the synthesis of these atypical bile acids. We report here the clinical and biochemical responses to primary bile acid administration in a 2-mo-old boy who was seen with the typical signs of Zellweger syndrome. Liver disease was evident from hepatomegaly and elevated serum liver enzymes and bilirubin. The diagnosis was supported by markedly elevated serum very long chain fatty acids and the bile acids dihydroxycholestanoic acid and trihydroxycholestanoic acid. Confirmation of the lack of peroxisomes was established by electron microscopy. When the patient was 6 mo old, the primary bile acids cholic acid and chenodeoxycholic acid, (100 mg each/day) were administered orally. A significant improvement in biochemical indices of liver function occurred with a normalization of the serum bilirubin and liver enzymes and a histological improvement in the extent of inflammation and bile duct proliferation and disappearance of cannalicular plugs. Serum and urinary cholestanoic acids showed a significant decrease within a few days. A striking and sustained increase in growth was observed after therapy, and an improvement in neurological symptoms was noted. In conclusion, this study indicates that primary bile acid therapy improves liver function and growth in the patient with peroxisomal dysfunction and should be considered in the supportive therapies for this condition.

Administration, Oral↗

Effect of intraduodenal administration of 23-methyl-UDCA diastereoisomers on bile flow in hamsters.

3 alpha,7 beta-Dihydroxy-23-methyl-5 beta-cholan-24-oic acid (MUDCA) and its two diastereoisomers, alpha- and beta-MUDCA, were infused intraduodenally in biliary fistula hamsters in order to evaluate the effect on bile flow and their hepatic biotransformation processes compared with the natural analog ursodeoxycholic acid (UDCA). In addition, the corresponding glycine conjugates were compared. The bile acids were administered at different doses (0.7-6 mumol/min/kg) over periods of 90 min. The results indicate that the racemic mixture exhibits a potent choleretic effect at both low and high doses, while the two individual diastereoisomers show this effect only at high doses. The presence of a C-23 methyl group in the side chain prevents hepatic amidation and alternative conjugations occur, such as glucuronidation, in order to facilitate their biliary secretion. Biotransformation of the methyl derivatives of UDCA occurred mainly by conversion to more polar glucuronide conjugates. There was little alteration to the molecule and, unlike UDCA, very little amidation occurred. These data indicate that the presence of a C-23 methyl group prevents the usual side-chain amidation common to the most naturally occurring bile acids and that glucuronidation is a requisite for efficient biliary excretion.

Acute Disease↗

Prevalence of antibodies to human immunodeficiency virus type 1 and condom use among outpatients at a sexually transmitted disease clinic in Rome.

To assess the prevalence of HIV-1 infection and study selected risk factors among patients attending a clinic for sexually transmitted diseases in Rome, 1442 outpatients seen consecutively between 20 February and 12 December 1989 were anonymously tested for anti-HIV-1. An evaluation of the trend of the HIV-1 infection was attempted by comparing the results of the present study with those obtained from a similar sample studied in 1986 in the same clinic. The overall estimated prevalence of anti-HIV-1 was 1.2% among heterosexual non-drug user subjects and 16.1% among homosexual or bisexual men. The anti-HIV-1 seropositivity was significantly higher in heterosexual subjects who reported sexual contact with intravenous drug users, as compared with those who did not report such exposure (12.5% vs 0.8%, p less than 0.005). Comparing the present data with those of a study conducted in 1986 in the same clinic, a lower prevalence of anti-HIV-1 was found among heterosexual subjects (1.2% in 1989 vs 6.0% in 1986, p less than 0.001). The availability after 1986 of several outpatient facilities attracting seropositive subjects and a change in the sexual behaviour of anti-HIV-1 positive subjects could explain this finding. Twenty percent of the heterosexual subjects and 62% of the homosexual or bisexual men reported consistent use of condoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Tetanus immunity in a partially vaccinated population of children in a district of Naples (Secondigliano).

A general opinion is that compliance with the compulsory immunization programme of children is excellent in Italy. We have studied antitetanus immunity in relation to vaccination history in a sample of 444 school children born between 1977 and 1981 in a district of Naples. Information on vaccination history was collected by interviewing the parents and validated using the official vaccination certificates. Titration of antibodies against tetanus was carried out by the immunoenzymatic method. 0.9% of our study subjects had not been vaccinated at all and only 21.2% had received 4 vaccine doses. In 18 children the presence of antitetanus antibodies was not detected; 14 of them had received one or more doses of vaccine. The lack of compliance with the vaccination programme was associated with a remarkable delay in administering the tetanus vaccine. In the population reported here, the percentage of subjects only partially covered is higher than that found in other regions of Italy.

Child↗

Detection of anti-HIV antibodies in immunoglobulin preparations: the significance of antibodies to the HIV-envelope.

Four hundred and sixty-eight immunoglobulin preparations, produced between 1969 and 1989, were examined for anti-HIV antibodies by means of two competitive immunoenzymatic assays and the Western blot test. This study refers the results obtained by the three different methods. Such results show that the detection of anti-HIV antibodies in immunoglobulins may be performed on a routine basis using commercial kits intended for human sera. The meaning of the test and the role of antibodies against the HIV envelope proteins are emphasized.

Blotting, Western↗

Heterosexual and homosexual transmission of hepatitis C virus: relation with hepatitis B virus and human immunodeficiency virus type 1.

A seroprevalence study was carried out on 1757 outpatients consecutively seen in a sexually transmitted disease (STD) clinic in order to evaluate the sexual transmission of hepatitis C virus (HCV). A total of 1442 consenting patients were tested for hepatitis C, hepatitis B and human immunodeficiency virus type 1 (HCV, HBV, HIV-1) antibodies. The relations between anti-HCV, anti-HBc and anti-HIV-1 were studied. Of 73 anti-HCV positive reactions, 45 (61.6%) were confirmed by the recombinant immunoblot assay (RIBA). The proportion of individuals with anti-HCV was higher in outpatients with a history of sexually transmitted disease than without. It was 2.8% in non drug user heterosexuals and 2.9% in non drug user homosexuals. Intravenous drug users (IDU) had higher anti-HCV prevalence when a history of STD was taken into account (42.3% in subjects with STD versus 36.7% in subjects without STD). Among non drug user heterosexuals an association was found between anti-HCV and anti-HBc. These data suggest that sexual transmission of HCV occurs, although it seems to be less efficient than other parenteral modes of transmission. When a more sensitive and specific marker of HCV infection become available, a more accurate estimate of the frequency and efficiency of the sexual transmission will be possible.

Adolescent↗

Seroprevalence of anti-Chlamydia trachomatis IgG in outpatients attending a sexually transmitted disease clinic in Italy.

Prevalence of anti-Chlamydia trachomatis specific IgG antibodies was evaluated in a sexually transmitted disease outpatient population composed of 741 heterosexuals, 470 males and 271 females, and of 147 homosexual-bisexual men. The prevalence rates were 60.0% in heterosexual males, 50.6% in females and 73.5% in homosexuals-bisexuals. A positive association between age and antibody prevalence was found in males. Among heterosexuals there is an increasing trend of seropositivity with number of partners during the previous year. A significant association between anti-chlamydial and anti-herpes simplex, type 2, antibodies has been demonstrated.

Adult↗

High prevalence of antibodies to human immunodeficiency virus in heterosexual persons attending a sexually transmitted disease clinic in Italy.

The prevalence of antibodies to human immunodeficiency virus (anti-HIV-1) was determined in 924 outpatients attending a sexually transmitted disease clinic. The overall prevalence of anti-HIV-1 was 9%. Six of 14 intravenous drug addicts and 4 of 34 patients of African origin were anti-HIV-1 positive. In the other 876 patients, the anti-HIV prevalence was 6.6% in 467 heterosexual men, 5% in 261 heterosexual women and 22.3% in 148 homosexual or bisexual men. The prevalence of anti-HIV-1 in the heterosexual subjects was much higher than that expected in the general population and than that observed in patients attending sexually transmitted disease clinics in other developed countries. Intravenous drug abusers, who represent the most important group at risk for AIDS in Italy, could contribute to the spread of HIV infection through heterosexual contacts with persons without other known risk factors.

Adolescent↗

Detection of HIV genome in HIV antibody negative men.

The presence of the human immunodeficiency virus (HIV) genome was investigated by applying in situ hybridisation techniques to peripheral blood mononuclear cells (PBMCs). Twenty asymptomatic anti-HIV seronegative homosexual men were the subjects of our study. The cells were hybridised with: (1) an SP 64 plasmid containing the nine-kilobase SstI-SstI viral insert from the lambda BH 10 recombinant clone; this can recognise both viral RNA and proviral DNA, and (2) with a pA01 plasmid containing HBV DNA genome. The DNA probes were modified by inserting an antigenic sulfone group in the cytosine moieties and the visualisation was performed by a double antibody immunohistochemical reaction. In two subjects both the HIV genome and HBV DNA were detected whereas another two subjects were positive for HBV DNA and for the HIV genome respectively. Thus people who are seronegative for anti-HIV specific antibodies may be infected with HIV.

Adult↗