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Biomedical subjects

L Donati

Publications and source records attributed to L Donati.

At least 37 records · Page 2Linked to original sources
PubMed1992

Updated evaluation of the activity of antibiotics in a burn centre.

The results of microbiological tests performed in a burns unit between January 1989 and December 1990 have been analysed. Burn wound swabs and biopsies, blood cultures, central venous and urinary catheters, bronchial aspirates, pharyngeal swabs and faecal cultures for a total of 7950 examinations were considered. Staph. aureus was the most frequently isolated bacterium, followed by Staph. epidermidis, Pseud. aeruginosa and E. coli. The antibiograms have shown a low efficacy rate of cephalosporins, even of the latest generation, while with Gram-positive isolates the highest rates of activity were recorded by vancomycin and teicoplanin (100 per cent sensitivity). The situation seems better with Gram-negative organisms since they appear to be sensitive to a larger number of antimicrobial agents.

Adolescent↗
PubMed1992

Antihypertensive mechanism of amlodipine in essential hypertension: role of pressor reactivity to norepinephrine and angiotensin II.

Calcium entry blockade may affect the pressor reactivity to vasoconstrictors. The pressor response to norepinephrine and angiotensin II, as well as several other blood pressure modulating factors, were studied in normal subjects (n = 9) and patients with essential hypertension (n = 10) before and after 8 weeks of treatment with the long-acting dihydropyridine amlodipine. In control subjects, calcium entry blockade did not modify blood pressure, the pressor and aldosterone response to angiotensin II, the activity of the renin-angiotensin and sympathetic nervous systems, or urinary dinoprostone (prostaglandin E2) excretion; however, the pressor response to norepinephrine was significantly decreased (p less than 0.01). In patients with hypertension, amlodipine decreased blood pressure (p less than 0.01) and the pressor response to both norepinephrine and angiotensin II (p less than 0.01), without changes in body weight, plasma renin, angiotensin II and catecholamine levels, dinoprostone excretion, or aldosterone responsiveness to angiotensin II. These findings suggest that calcium entry blockade modifies sympathetic-dependent vasoconstriction in both normal subjects and in patients with hypertension. Angiotensin II pressor response may be selectively decreased in essential hypertension.

Adult↗
PubMed1992

Clinical picture of endemic cretinism in central Apennines (Montefeltro).

Endemic cretinism is still present in an endemic goiter area of the central Apennines (Montefeltro) (goiter prevalence 55%; mean urinary iodine level 39 micrograms/g creatinine). Clinical and biochemical features of patients with myxedematous, neurologic, and mixed cretinism were studied. Also, in this area, as in most other, neurologic cretinism is more prevalent than myxedematous and mixed forms. The hormonal profiles of the three types of cretinism were clearly different. Nevertheless, all myxedematous cretins had some neurologic disorders (hyperreflexia, increased muscle tone, disorder of gait, Babinski sign, hypoacusia) that were similar to those present in neurologic cretins. These findings suggest that neurologic damage is very similar in all forms of endemic cretinism, reflecting a diffuse insult to the developing fetal nervous system. Furthermore, these data support the hypothesis that the primary pathophysiologic event in the different types of endemic cretinism is represented by maternal and fetal hypothyroidism, while differences may be explained by the extent and duration of postnatal hypothyroidism. All the cretins were over 35 of age, suggesting a severe iodine deficiency in the past decades, and a progressive improvement of nutritional status resulted in "silent iodine prophylaxis." However, recent studies have revealed the persistence of a moderate iodine deficiency, a high prevalence of neurologic hypoacusia, and reduction of mental performance in normal schoolchildren of this area. These findings constitute strong evidence in favor of adequate iodine prophylaxis.

Adult↗
PubMed1992

Teicoplanin--its role as systemic therapy of burn infections and as prophylaxis for orthopaedic surgery. Italian Study Groups for Antimicrobial Prophylaxis in Orthopaedic Surgery and Burns.

Two randomized studies have been initiated to establish the role of teicoplanin as systemic therapy for infections in burns patients and as short-term prophylaxis for orthopaedic implant surgery. Opportunistic micro-organisms causing infections in burn patients are often acquired in hospital. These infections commonly involve Gram-positive organisms which may be resistant to several antibiotics. Teicoplanin, alone and in combination with additional antibacterial drugs, is effective in the treatment of Gram-positive infections of various types. In addition, teicoplanin has proved useful as prophylaxis against infection in orthopaedic surgery. Deep prosthetic infections are very difficult to cure without removing the infected device; the outcome can be devastating, such as total loss of joint function, amputation, and, occasionally, death. Preliminary results from the two studies are encouraging and show that teicoplanin has a role to play both in treatment of infection and as prophylaxis against hospital-acquired infection.

Adult↗
PubMed1991

Quality problems in waters used for drinking purposes in Italy.

With a grant from the Italian Ministry of the Environment, the National Institute of Health (Istituto Superiore di Sanità) promoted and coordinated some activities aimed at determining the extent and the intensity of contamination of waters used for human consumption by some chemical agents, and describing causes and modalities of contamination and human health implications. The chemical agents examined were herbicides, nitrates, trihalomethanes, asbestos, manganese and fluoride. In this paper a first nationwide picture of these problems is reported.

Asbestos↗
PubMed1989

Legionnaire's pneumonia complicating a thermal burn.

The report describes a patient with 45 per cent BSA burns who developed Legionnaire's disease 3 days after the acute injury. The diagnosis of this life-threatening complication was late because most of its signs and symptoms can be encountered in the burned patient. This delay could have been fatal to the patient and required the evacuation of the burn centre for disinfection.

Anti-Bacterial Agents↗
PubMed1989

[Echocardiographic changes in primary autoimmune hypothyroidism].

Echocardiographic features in patients with autoimmune hypothyroidism have been described. Plasma levels of T3, T4 and TSH have been compared with the severity of the echocardiographic alterations. Echocardiography demonstrated abnormalities more frequently in patients with severe hypothyroidism. No pericardial effusion has been detected. We discuss the possible etiopathogenic mechanisms.

Adult↗
PubMed1988

Influence of environmental iodine deficiency on neonatal thyroid screening results.

During a multicentric pilot screening program for congenital hypothyroidism a comparison between the results obtained from Urbino, an area characterized by low iodine supply and endemic goiter, and Rome, a non-endemic area, has been made. The evaluation of neonatal urinary iodine excretion in the two areas showed significantly lower iodine urinary excretion levels in Urbino than in Rome. A shift of TSH at screening toward higher values as well as a higher percentage of recall in Urbino area than in Rome was observed. This finding, which well correlates with a low environmental iodine supply, emphasizes the importance of screening for congenital hypothyroidism as a suitable index of the presence and action of goitrogenic factors in the environment.

Child, Preschool↗
PubMed1988

Use of the hydrocolloidal dressing duoderm for skin donor sites for burns.

We have made a study of the use of Duoderm hydroactive sterile occlusive dressing on 10 patients for skin donor sites. Its therapeutic efficacy is evident and the dressing enhances the wound debridement and accelerates the re-epithelialization, with complete healing in 8.5 days on the average. In comparison with a conventional dressing with paraffin gauze, Duoderm allows a more rapid re-epithelialization. In addition, the new skin is softer, smoother and more homogeneous. Duoderm is also easy to use and is well tolerated by the patients.

Adult↗
PubMed1987

Prophylactic plasma exchange in burn treatment.

The first cause of death in burned patients is still sepsis. A great number of studies point out a serious immunodeficiency due to several circulating mediators. Nowadays early excision and plasma exchange appear to be the most efficient procedures in order to remove from the patient these circulating agents. Therefore in this study the authors have treated 8 patients (average age 25 years), who presented an average of total burned surface of 49%, with plasma exchange performed early after injury. The results of PMN and lymphocyte function tests showed a significant therapeutic correction of these parameters in patients treated with plasma exchange. The clinical observations agreed with the results: in 7 patients with positive outcome, no invasive infections were recorded. The positive results obtained warrant further investigation with this procedure.

Adolescent↗