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G Nardi

Publications and source records attributed to G Nardi.

At least 55 records · Page 3Linked to original sources

A case-control study on GB virus C/hepatitis G virus infection and hepatocellular carcinoma. Brescia HCC Study.

A new hepatitis-associated RNA virus of the Flaviviridae family has been identified and named GB virus C/ hepatitis G virus (HGV). We carried out a case-control study to evaluate the association of HGV infection with hepatocellular carcinoma (HCC). We recruited 170 patients hospitalized for HCC (143 male and 27 female, mean age 64 years) and 306 patients hospitalized for nonliver diseases (controls) in Brescia, Italy. HGV RNA was detected by reverse transcription-polymerase chain reaction (RT-PCR) and antibodies against HGV E2 protein (anti-E2) by an immunoassay test. HGV RNA was found in 8 cases (4.7%) and 4 controls (1.3%). The relative risk (RR) for HGV RNA positivity adjusted for demographic variables and hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) RNA, and alcohol was 7.3 (95% confidence interval, 1.7-30.6; P = .009). No HGV RNA-positive subject was also positive for anti-E2. Anti-E2 prevalence did not differ significantly between cases (20%) and controls (15.3%), and no RR increase was found by this marker. Among subjects with HGV exposure (HGV RNA plus anti-E2 positive), a greater proportion of cases (40%) than controls (14%) had transfusion history. The possible role of HGV in HCC etiology seems modest because the population-attributable risk is lower (4%) than those for HBsAg (22%), HCV RNA (36%), and heavy alcohol intake (52%). This study supports the hypothesis of an association between HGV infection and HCC, although at present there are insufficient data on the causality of the association.

Aged↗

[Circulatory instability in potential donor organ patients in a state of brain death. Investigation of predictive factors].

OBJECTIVE: To assess the factors influencing and predicting the degree of circulatory impairment of the brain-dead cardiac donors (BDCD). DESIGN: Retrospective study. SETTING: General ICU of a 1400 bed High Specialty Regional Hospital. PATIENTS: 53 patients undergoing brain death (BD) assessment as suitable cardiac-donors. INTERVENTIONS: Fluids were given up to a central venous pressure (CVP) > 5 mmHg and adrenergic drugs in a sequential manner trying to keep the systolic blood pressure > 90 mmHg. METHODS: Every hour during the time of BD assessment were recorded: invasive blood pressure (BP), CVP, fluid balance, the demographic data, the dosage of adrenergic drugs, the cause of admission, the time from admission to ICU to BD, the report of an echocardiogram. The patients were divided into 4 classes according to the dosage of the adrenergic drugs required to achieve the pressure-goal. The 4 classes were compared for the above mentioned parameters. RESULTS: No differences were found among the 4 groups. CONCLUSIONS: In BDCD the degree of circulatory instability and vasopressor needs cannot be anticipated by the parameters examined. This could be due partly to the relative homogeneity of these patients, since they underwent a clinical selection and similar interventions, partly to a possibly inadequate standard of monitoring. Anyway the unique hemodynamic situation after BD is probably not very affected by the previous events. Further studies are necessary to explain the variability of the circulatory instability and to assess its effects on the quality of the transplanted organs.

Adolescent↗

Free radicals and not acetaldehyde influence the circulating levels of glutathione after acute or chronic alcohol abuse: in vivo and in vitro studies.

BACKGROUND: The oxidation of ethanol and acetaldehyde enhances the production of various free radicals involved in membrane lipoperoxidation, and decreases glutathione levels. AIMS: We evaluated the effects of acute and chronic ethanol use in vivo, with or without the administration of S-adenosyl-methionine (SAME, 2 g I.v.), and the effects of ethanol and acetaldehyde in vitro, on the erythrocyte levels of malonyldialdehyde and glutathione, and of its principal synthesizing enzymes, gamma-glutamyl-cysteine-synthetase and glutathione-synthetase. METHODS: Twelve healthy volunteers (age range 26-44 years, median 32 years) and 20 chronic alcohol abusers without liver disease (age range 26-57 years, median 44 years) were studied. Malonyldialdehyde was evaluated by thiobarbituric acid; glutathione and its enzymes by high performance liquid chromatography using a fluorescent detector. RESULTS: In the healthy subjects, an acute load of ethanol induced a significant decrease in plasma levels of glutathione, which was inhibited by the infusion of S-adenosyl-methionine. In the erythrocytes of alcoholic patients, glutathione and glutathione-synthetase were decreased while malonyldialdehyde was increased. In vitro, acetaldehyde did not affect either the glutathione or the glutathione-related enzyme levels. CONCLUSIONS: Our data suggest that the alterations in glutathione metabolism in the erythrocytes of alcoholics may be due principally to the production of free radicals, as supported by the high levels of malonyldialdehyde observed.

Acetaldehyde↗

Glutathione suppresses spontaneous activity in the frog spinal cord.

Spontaneous electrical activity in the isolated hemisected frog spinal cord increased in the presence of the SH reductant dithiothreitol (DTT) was reversibly suppressed by the oxidant 5-5'-dithio-bis-(2 nitrobenzoic acid) (DTNB) and was irreversibly suppressed by the sulphydryl modifying agents N-ethyl-maleimide (NEM) and monobromotrimethylammonio bimane. Glutathione (GSH), an important natural low molecular weight thiol, reversibly suppressed spontaneous activity. Cords pretreated with glutathione and successively exposed to NEM or bimane maintained their normal electrical activity. This indicates that GSH had interacted with the exposed sulphydryls and prevented their reaction with NEM or bimane. Incubation with bimane resulted in fluorescence-labelled neurones in the dorsal and ventral horns, whereas samples pretreated with NEM or with GSH were not labelled. Neurones appeared again fluorescent in cords preincubated with GSH and sequentially exposed to NEM or bimane. Both electrophysiological and histochemical methods indicate that exposed membrane sulphydryls are involved in the genesis and/or modulation of spontaneous electrical potentials.

Animals↗

Primary liver cancer in a high-incidence area in north Italy: etiological hypotheses arising from routinely collected data.

The incidence rate for primary liver cancer (PLC) was investigated in the Health Unit of Brescia (about 325,000 inhabitants), North Italy, in the 5-year period 1986-90, in order to ascertain whether there was a high risk for developing the disease in the area as suggested by mortality data. A total of 349 incident cases were observed (male: female ratio = 3.4: 1), of which 182 (52.1%) were diagnosed through histology. The cumulative risk was about 5% and 1% in males and females, respectively. The crude incidence rates were 34.5/100,000 in males and 9.4/100,000 in females, and the age-standardized rates were the highest among all those observed in the 9 Italian areas covered by Cancer Registries. Although about half of the cases in males can be attributed to either chronic alcoholic disease or HBV infection or both, further research is needed to investigate the role of known risk factors for PLC in the Health Unit.

Adult↗

Patterns and covariates of alcohol drinking among high school students in 10 towns in Italy: a cross-sectional study.

A self-report questionnaire on alcohol and tobacco use was administered anonymously to 5221 high-school students in grade 9 (aged 14-15) and to 4154 students in grade 13 (aged 18-19) in 10 Italian towns. Alcohol consumption was greater among males than females and among 13th graders with respect to 9th graders. Students who drank alcoholic beverages every day were, in males and females, respectively, 22.5% and 9.0% among 9th grade and 31.3% and 10.0% among 13th grade students; those who drank 7 or more alcohol units a week were 26.8% and 11.1% among 9th grade and 42.7% and 13.9% among 13th grade students; finally, those who felt drunk at least once in the last 12 months were 19.8% and 13.9% among 9th grade and 41.4% and 19.0% among 13th grade students. Both alcohol consumption and frequency of drunkenness were found to be associated with both experimental and regular cigarette smoking and with psychoactive drug consumption, but not with socio-economic, cultural and demographic factors. Two main distinct drinking patterns were found among Italian adolescents: on the one hand, the daily drinking of moderate amount of wine with meals, together with parents, which was more common among males than females, as in other 'Latin' countries; and on the other hand, the occasional intake of alcoholic beverages in excess, especially beer and spirits, out of the family but together with peers.

Adolescent↗

Incident cases of primary liver cancer (PLC): proposal for the use of a standardised method in case-definition.

We defined some standardised criteria for classifying incident cases of liver cancer into either Primary Liver Cancer (PLC) or Unspecified Liver Cancer (ULC), on the basis of the diagnostic procedures performed. A pilot hospital-based study (98 cases) was carried out in Verona, northern Italy, in order to assess the feasibility of the method. The same protocol was subsequently applied in a population-based study (349 cases) in Bresica, northern Italy. The percentage of cases with histological verification was 38.7 and 41.8%, respectively, with a wide variation among different hospitals. The percentage of cases we attributed to the PLC category was 78.6% in the hospital-based study and 78.8% in the population-based study. No differences in the proportion of cases attributed to PLC were found according to patients' age, sex or hospital of admission. Repeatability of the method was assessed through a cross-panel review of 198 cases, with a 91.9% interobserver agreement. Implications of this method are discussed and some suggestions for cancer registration and future research are proposed.

Aged↗

Smoking among high school students in 10 Italian towns: patterns and covariates.

The associations between tobacco smoking and demographic, socioeconomic, environmental, and behavioral factors among adolescents were investigated by administering an anonymous questionnaire to 5,221 ninth (aged 14-15 years) and 4,154 thirteenth grade (aged 18-19 years) students in 10 Italian towns. Using logistic regression analysis, both current smoking and experimental smoking were statistically associated with sibling, best friend, and partner smoking, alcohol drinking, and frequency of drunkenness in both grades and sexes. Attitude of parents toward children's smoking was also found to be associated with the probability of being a current smoker, especially among ninth graders. Parental smoking was associated with current smoking among females only. Socioeconomic factors and level of knowledge of the health consequences of smoking were not associated with either experimental or regular smoking. In conclusion, this survey suggests that social environment plays a fundamental role in both first experimentation with smoking and the process of becoming a regular smoker among adolescents. Students with one or more siblings who smoke, and especially those with best friends and a partner who smoke, were much more likely to have tried smoking and to be current smokers than students without smokers in their environment.

Adolescent↗

Effect of S-adenosyl-L-methionine administration on red blood cell cysteine and glutathione levels in alcoholic patients with and without liver disease.

We measured glutathione and cysteine concentrations in erythrocytes of chronic alcohol misusers with (20 subjects) and without liver cirrhosis (20 subjects). Glutathione levels were decreased, whereas those of cysteine were increased in all patients. Parenteral treatment with S-adenosylmethionine (SAME); (2 g daily in 250 ml 0.15 M NaCl for 15 days) corrected the erythrocyte thiol alterations. We conclude that parenteral treatment with SAME affects the metabolism of SH compounds in erythrocytes of alcoholic patients.

Adult↗

Impact of emergency medical helicopter service on mortality for trauma in north-east Italy. A regional prospective audit.

The hypothesis that high level on-the-field ATLS could influence mortality in severe trauma patients was tested by means of a prospective study. During a 7 month period, data of all the victims of severe involuntary trauma (road traffic accidents, work and sport accidents) in 3 Provinces of north-east Italy were entered in a database and analysed. The whole area is covered by a single emergency service which has direct control over all the ambulances and the Emergency Helicopter Service (EMHS). The area concerned by the study has a surface of 7,300 kmq with a population of 1 million inhabitants and is served by 12 first level hospitals and 4 second level institutions (trauma centres). All the patients who were still alive at the time of arrival of the first rescuers were considered, but only severe trauma patients with ISS > 15 were enclosed into the study. All the patients were followed up to their discharge from the ICUs (end point). There were three different rescue approaches: 82 Patients (GROUP A) were rescued by EMTs with BLS training, transported to the nearest level 1 hospital for stabilisation and subsequently transferred to a trauma center; 98 Patients (GROUP B) were rescued by EMTs and directly transported to a trauma centre which was the nearest institution; 42 Patients were rescued on the scene by the EMHS team including an anaesthesiologist with 10 years experience in trauma care and directly transported to a trauma centre after full on-the-field stabilisation (GROUP C) RESULTS: 222 severe trauma patients (ISS > 15) were considered. Mean ISS was 35.1 +/- 18.2 in group A, 33.4 +/- 19.6 in group B and 36.0 +/- 17.8 in group C. 67 patients died previous to ICU discharge (31%). 31 over the 82 pts in Group A (38%) died. 23 of them died even before reaching the trauma centre. The mean time elapsed between the first emergency call and the arrival at the trauma centre was 162 min (90'-300'). Mean ICU stay for patients who survived was 15 days. In Group B 31 over 98 patients (32%) died before ICU discharge. The mean time between the emergency call and hospital admission was 27'. Mean ICU stay for patients who were discharged, was 13 days. 5 over 42 patients rescued by the EMHS (Group C) died, none of them in the pre-hospital setting. Stabilisation included tracheal intubation in 34 cases (81%) and thoracic drainage in 6 (14%). All the patients arrived at the hospital with 2 i.v. line. The average amount of infused fluids were 600 mls of colloids and 810 mls of crystalloid. 13 patients with hypotension received and average of 1000 mls of colloids and 1200 mls of crystalloid. The average time elapsed between the emergency call and the final admission to the definitive care institution was 55'. Mean ICU stay was 11 days. Mortality rate in this group was 12%, significantly lower than in group A (p < 0.005) and group B (p < 0.05).

Air Ambulances↗

Alcohol drinking among adolescents from town and mountainous areas in north Italy.

Alcohol consumption was investigated among 9th and 13th grade high school students in the town of Brescia (an urban area) and in the Local Health Unit of Breno, a mountainous area in the province of Brescia. A total of 1364 students from Brescia and 1373 from Breno completed an anonymous questionnaire during school time. In both groups alcohol consumption was greater among 13th graders (modal age: 18 years) and males than 9th graders (modal age: 14 years) and females. Beer was the favourite alcoholic beverage, but wine was the most widely consumed daily beverage: among males, about 8% in grade 9 and 15% in grade 13 drank at least one glass of wine every day. The majority of both 9th and 13th graders had more than one type of alcoholic beverage a week, although many females drank beer only. Total alcohol consumption was higher among the mountainous area students than urban students, especially 9th graders, and greater differences were observed in the consumption of beer with respect to wine. The proportion of male students from Brescia and Breno who consumed more than 6 alcohol units a week were, respectively, 17% and 25% in grade 9 and 36% and 42% in grade 13. A higher prevalence of drunkenness was found among the students from the mountainous area with respect to the urban students, especially males. Among 13th grade males, 42% of students from Brescia and 60% from Breno claimed one or more episodes of drunkenness during the year prior to the interview.

Adolescent↗

Epidemiological impact of prolonged systematic use of topical SDD on bacterial colonization of the tracheobronchial tree and antibiotic resistance. A three year study.

OBJECTIVE: to evaluate the effect of the prolonged systematic use of topical SDD (tobramycin 80 mg, polymyxin E 100 mg, amphotericin B 500 mg) on ICU ecology as expressed by changes in tracheal colonization and bacterial resistances. DESIGN: Prospective microbiological survey. SETTING: Polyvalent ICU of a 2000 beds general hospital. PATIENTS: Data concerning bacterial strains isolated from the tracheo-bronchial aspirates of all the patients admitted to a polyvalent ICU over 3 consecutive periods of 12 months ('88, '89, '90) were prospectively entered in a database and subsequently analyzed. During a 3-year period 502 patients required artificial ventilation for more than 72 h and 332 of them ('89 and '90) were treated with SDD. All samples collected within 72 h from ICU admission were excluded as well as duplicate samples from the same patients. INTERVENTION: All the patients admitted to the ICU in '89 and '90 and submitted to artificial ventilation for at least 24 h were routinely treated with topical SDD without i.v. antibiotic prophylaxis; in '88 SDD was not employed. MEASUREMENTS AND RESULTS: Criteria for collecting sputum samples and microbiological procedures remained unchanged throughout the study-time. Positive sputum were significantly less in '89 (80.8% versus 92.3% p < 0.001) and this was due to a very sharp decrease in the isolation of Gram-negative strains from 43-28% (-64% p < 0.0001) involving both: Enterobacteriaceae (-45%) and Pseudomonaceae (-77%). In 1990; however, a new increase in Gram negative was observed, although the overall amount of Gram-negative was still 49% lower in '90 if compared to '88 (p < 0.0001). A dramatic increase in Pseudomonas isolation was the only factor responsible for the "rebound" observed. An increasing percentage of Pseudomonas developed a resistance towards tobramycin and only 45% of Pseudomonas strains turned out to be sensible to tobramycin in '90 against 79% in '88. A similar trend was registered for all aminoglycosides with the exception of amikacin. Gram-positive colonizations tended to increase (+63%) (p < 0.0001) and this was mainly due to Coagulase negative Staphylococci (+290% p < 0.0001) and S. pneumoniae, whereas S. aureus isolations decreased (-18%) but not significantly. CONCLUSIONS: Our data suggest that the prolonged use of SDD is associated with dramatic changes in ICU ecology: the incidence of Gram negative colonization is significantly diminished by SDD whereas Gram positive tend to increase. Pseudomonas developed an increasing resistance towards tobramycin one of the components of the SDD formula we used.

Administration, Oral↗

Occurrence of free D-aspartic acid in the circumsoesophageal ganglia of Aplysia fasciata.

This study reports the presence of high concentrations of free D-aspartic acid (D-Asp) in the circumoesophageal ganglia of the opisthobranch mollusc Aplysia fasciata. D-Asp was discovered using specific methods that employ Octopus D-aspartate oxidase and hog kidney D-amino acid oxidase to measure D-Asp levels. The concentration of D-Asp was 0.281 mumol/g wet tissue weight, which was 8.3% of the total free aspartic acid (D and L forms) present. No other free D-amino acids that were oxidised by D-amino acid oxidase were detected. To our knowledge the only molluscs that have previously been shown to have D-Asp within their nervous tissue are the cephalopods Octopus vulgaris, Loligo vulgaris and Sepia officinalis. In these, as in A. fasciata, no other D-amino acids were detected within the nervous tissue. The fact that free D-Asp occurs specifically in the nervous tissue of the above molluscs suggests that it may have a neurological function that is yet to be described.

Animals↗

Glutathione prevents ethanol induced gastric mucosal damage and depletion of sulfhydryl compounds in humans.

Whether parenteral administration of reduced glutathione prevented ethanol induced damage to and depletion of sulfhydryl compounds in the human gastric mucosa was investigated. Ten healthy volunteers underwent endoscopy on three separate occasions. Gastric mucosal damage was induced by spraying 80% ethanol on to the gastric mucosa through the biopsy channel of the endoscope. The gastric mucosal score, total sulfhydryls, glutathione, and cysteine were evaluated in basal conditions and after ethanol administration with and without pretreatment with parenteral glutathione. Glutathione significantly decreased the extent of ethanol induced macroscopic injury to the mucosa of the gastric body and antrum. Glutathione's protective effect is associated with appreciable inhibition of ethanol induced depletion of gastric sulfhydryl compounds. This is the first report of protection against ethanol induced gastric mucosal damage by a sulfhydryl containing agent in humans.

Adult↗

Alteration of erythrocyte glutathione, cysteine and glutathione synthetase in alcoholic and non-alcoholic cirrhosis.

Glutathione (GSH) and cysteine were determined in the plasma and the erythrocytes of alcoholic and non-alcoholic cirrhotics as fluorescent monobromobimane derivatives by high-performance liquid chromatography (HPLC). Cirrhotic patients displayed a significant decrease of plasma GSH, as well as of plasma cysteine, that was related to the degree of liver disease but not to the nutritional conditions. On the contrary, erythrocyte cysteine was found to increase significantly in all cirrhotics, particularly in alcoholics, regardless of the severity of disease. In an attempt to find a possible explanation of these alterations, the GSH synthesizing enzymes, gamma-glutamylcysteine synthetase (GC-s) and GSH synthetase (GSH-s) activities were determined in the erythrocytes. GSH-s activity was significantly lower in cirrhotic patients, whereas GC-s activity did not differ in the three groups.

Adult↗

[Factors associated with alcohol consumption in the youth of the province of Brescia].

We investigated factors related to adolescent alcohol consumption by administering an anonymous questionnaire to 2737 9th and 13th grade high-school students in the province of Brescia. A total of 1364 students coming from an urban area (the town of Brescia with about 200,000 inhabitants) and 1373 students from a mountainous area (Breno, Local Health Unit N. 37 in the Lombardy Region with 83,000 inhabitants) were interviewed. The associations between alcohol drinking and some demographic, socio-economic, behavioural and environmental variables were assessed by computing the correspective odds ratios (OR) by fitting logistic regression models for ordinal response variables ("cumulative odds" models). The results showed that the following variables were positively associated with alcohol consumption: 1) residence in a mountainous area, especially as regards spirits consumption; 2) experimental and regular smoking; 3) peer alcohol drinking (best friend and partner). Parents' daily alcohol consumption was associated with wine drinking, but not with either spirits consumption or frequency of drunkenness among students. A slight inverse relationship was also found between students' alcohol intake and their knowledge of the health hazards of alcohol, but it was not significant for all groups of students.

Adolescent↗