Biomedical subjects

Giuliano Sansebastiano

Publications and source records attributed to Giuliano Sansebastiano.

7 recordsLinked to original sources

PubMed2006

Prospective comparison of laparoscopic left hemicolectomy for colon cancer with laparoscopic left hemicolectomy for benign colorectal disease.

BACKGROUND: Short-term outcome and anorectal function results after laparoscopic hemicolectomy for colon cancer were compared with results after laparoscopic hemicolectomy for benign diseases. METHODS: A total of 108 patients who underwent laparoscopic left colectomy (60 for colon cancer, 48 for diverticulitis or polyposis) were enrolled in the study. Left hemicolectomy in patients affected by cancer was performed by high ligation of the inferior mesenteric artery. A questionnaire concerning anorectal function was mailed to patients 6 months after surgery. RESULTS: Complications were more frequent in the cancer group than in the benign disease group: overall morbidity rate (29.6% versus 8.7%; P = 0.009), diarrhea during the first 6 postoperative months (58.7% versus 34.1%; P = 0.022), and anorectal function problems (fecal incontinence and/or the inability to discriminate between gas and stool, and/or urgency, and/or tenesmus) (65.2% versus 31.7%; P = 0.002). DISCUSSION: The level of ligation of the lower mesenteric artery and damage at the lower mesenteric ganglion could explain the poorer anorectal function outcome in the colon cancer group.

Aged↗

PubMed2006

Predicting conversion to open surgery in laparoscopic left hemicolectomy.

PURPOSE: The objective of this study was to quantify the risk of conversion to open surgery of laparoscopic left hemicolectomy at an early stage of the learning curve. METHODS: A multiple logistic regression analysis of 100 laparoscopic left hemicolectomies completed between April 2001 and May 2004 was performed. RESULTS: The overall conversion rate was 12%. At univariate analysis, 2 factors were found to be predictive of conversion to open surgery: malignancy (17.2% vs. 5%; P=0.046), and weight level (<60 kg=6.1%; 60 to 90 kg=11.3%; >90 kg=28.6%; P=0.049). At multiple logistic regression, the risk of conversion rose only for patients weighing more than 90 kg. CONCLUSIONS: On the basis of the results of this study, the surgeon will be able to quantify the risk of conversion to laparotomy with some precision in order to obtain the informed consent of the first 100 patients to whom laparoscopic left hemicolectomy is proposed.

Colectomy↗

PubMed2004

Chlorination by-products (CBPs) in drinking water and adverse pregnancy outcomes in Italy.

Chlorination by-products (CBPs) in drinking water have been associated with an increased risk of adverse pregnancy outcomes, including small for gestational age at term (term-SGA) and preterm delivery. Epidemiological evidence is weakened by a generally inaccurate exposure assessment, often at an ecological level. A case control study with incident cases was performed in nine Italian towns between October 1999 and September 2000. A total of 1,194 subjects were enrolled: 343 preterm births (26th-37th not completed week of pregnancy), 239 term-SGA (from 37th completed week, and weight less than the lowest 10th percentile) and 612 controls. Exposure was assessed both by applying a questionnaire on mothers' personal habits during pregnancy and by water sampling directly at mothers' homes. Levels of trihalomethanes (THMs) were low (median: 1.10 microg l(-1)), while chlorite and chlorate concentrations were relatively high (median: 216.5 microg l(-1) for chlorites and 76.5 microg l(-1) for chlorates). Preterm birth showed no association with CBPs, while term-SGA, when chlorite levels > or =200 microg l(-1) combined with low and high levels of inhalation exposure are considered, suggested a dose-response relationship (adjusted-Odds Ratios (ORs): 1.52, 95%CI: 0.91-2.54 and 1.70, 95%CI: 0.97-3.0, respectively). A weak association with high exposure levels of either THMs (> or =30 microg l(-1)), or chlorite or chlorate (> or =200 microg l(-1)) was also found (adjusted-OR: 1.38, 95%CI: 0.92-2.07). Chlorine dioxide treatment is widespread in Italy; therefore, chlorite levels should be regularly and carefully monitored and their potential effects on pregnancy further evaluated and better understood.

Adult↗

PubMed2003

Relationships between serum IGF-1, IGFBP-2, interleukin-1beta and interleukin-6 in inflammatory bowel disease.

AIMS: To study the relationships between serum IGF-1, IGFBP-3 and IGFBP-2 and interleukin (IL)-1beta and IL-6 in inflammatory bowel disease (IBD). METHODS: Thirty-seven patients (18 males, 19 females, aged 8.8-26.1 years) with IBD (Crohn's disease, CD, n = 17, and ulcerative colitis, UC, n = 20) were studied. Patients were in relapse or remission according to established criteria. Serum IGF-1, IGFBP-3, IGFBP-2, IL-1beta and IL-6 levels were determined in patients and 15 healthy controls (aged 8.2-19.0 years). RESULTS: IGF-1 levels were lower in patients with CD in relapse compared with controls (p < 0.05). IGFBP-2 levels were higher in CD in relapse compared with other groups (all p < 0.05). In CD and UC patients (n = 37), IGF-1 levels were inversely correlated with the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). IGFBP-2 levels correlated positively with ESR and IL-1beta. IL-6 levels correlated positively with ESR and CRP. IL-1beta levels were elevated in CD in relapse compared to controls (p < 0.05) and were higher in UC in relapse than in other groups (all p < 0.05). In combined CD/UC patients in relapse (n = 20), IL-1beta levels were higher (p < 0.05) in patients with recto-sigmoiditis (n = 5) than in other patients. CONCLUSIONS: IGF-1, IGFBP-2 levels were related to IL levels, disease activity and anatomical distribution, consistent with active inflammation modifying the IGF-IGFBP system, possibly relevant to disturbance of growth.

Adolescent↗

PubMedDate not supplied

[Particulate matter (PM10) air pollution, daily mortality, and hospital admissions: recent findings].

The first studies conducted to evaluate a possible association between air pollution and mortality date back to the serious events that occurred in the Mosa Valley, Belgium (1930), in the small city of Donora ("killer fog" incident of 1948) and in London (1952). The latter episode led to the introduction of air pollution control policies. Following the introduction of air pollution control measures in economically advanced cities in the 60s and 70s, the concentration levels of pollutants reached were believed, for many years, to be risk free. However, despite improvements in air quality achieved by many industrialized countries the negative effects of air pollution remain today an important public health problem. Among all air pollutants, particulate matter is the type of air pollution that causes the most numerous and serious effects on human health, because of the broad range of diverse toxic substances it contains,. For this reason, when assessing human health risk, PM10 may be considered to be a reliable indicator of the impact of global air pollution. Various epidemiologic studies conducted in the last 10 years, such as the Air Pollution and Health-European Approach (APHEA) project, the National Morbidity, Mortality and Air Pollution (NMMAPS) Study and Italian Meta-analysis of Studies on the short-term effects of Air pollution (MISA), have shown that current ambient concentrations of PM10 may lead to increased mortality and morbidity. Various studies have reported mean increases in mortality below 1% for 10 ?g/mc increases of ambient PM10. Studies have also underscored the role of particulate matter in aggravating cardiorespiratory diseases and consequently increasing hospital admissions. Air quality standards have been recently revised by legislation. The EU has issued a directive that sets limiting values and, where appropriate, threshold values, for the different air pollutants.

Air Pollution↗

PubMedDate not supplied

[Further research on the kinetics of inactivation of HAV and enteroviruses with peracetic acid. Note II].

Further research was performed on the disinfectant efficacy of peracetic acid on viruses. Hepatitis A virus (HM-175 strain), Poliovirus 2 (attenuated strain) and Coxsackie virus B5 (isolated strain) were tested using peracetic acid concentrations between 160 mg/l and 1280 mg/l. Inactivation tests were carried out at +20 degrees C and at 3 different pH conditions, acid, neutral and basic. The results confirmed that HAV virus, which showed a decline with concentrations above 320 mg/l, has the highest resistance with respect to the other viruses. The other two Enteroviruses were found to be less resistant, especially in neutral and acid conditions.

Animals↗

PubMedDate not supplied

[Treatment of thermal pool waters].

No laws currently exist regarding the treatment of spa pool water, since it is not completely logical that these should have the same requirements as normal swimming pools. The problem arises especially with regards to the use of chlorine as a disinfectant, which may actually annulate the therapeutic effects of spring waters by altering their physical-chemical characteristics. Possible choices may be represented by frequent replacement of pool water, which may be easily achievable for small pools but more difficult to implement for larger pools, or by alternative disinfection methods such as ozone or ultraviolet rays. The efficacy of these methods must be shown through frequent chemical and microbiological analyses and future, to be hoped-for laws or guidelines, will need to be aimed at defining safety performance standards rather than prescribing analytical intervention and control methods. Beyond the choice of disinfection method, it is extremely important to highlight some relevant hygienic measures that bathers should take and that play a fundamental role in preventing infectious diseases which may be acquired in pools. The most important of these include: showering before entering the pool, wearing slippers around the pool, not urinating in the pool, not bathing if affected by diarrhea, wearing a bathing cap, avoiding the use of contact lenses while bathing and avoiding exchanging towels. Pool managers have the important role of avoiding overcrowding of the facilities and ensuring that all technological systems function properly.

Bacterial Infections↗