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Biomedical subjects

M Bonacini

Publications and source records attributed to M Bonacini.

52 records · Page 3Linked to original sources
PubMed1991

The effect of cataract severity and morphology on the reliability of the Lens Opacities Classification System II (LOCS II).

Data collected from 3646 eyes in the Italian-American Natural History Study of Age-Related Cataract were used to investigate whether the reliability of the Lens Opacities Classification System II (LOCS II) by the severity of the opacity that is being graded or is influenced by the presence and severity of coexisting opacities. Reliability was assessed by comparing the slit-lamp gradings of two clinical examiners (346 eyes) and the gradings performed at the slit lamp with gradings of photographs (3646 eyes). The severity of cortical and nuclear opacities did not affect the reproducibility of slit-lamp gradings, but clinical grading of posterior subcapsular opacities became more reliable as the severity of the posterior subcapsular opacities increased. More advanced coexisting opacities decreased the agreement in the slit-lamp diagnosis of nuclear, but not cortical or posterior subcapsular, opacities. Comparisons of clinical and photographic gradings showed very good to excellent agreement for nuclear and cortical opacities, regardless of the severity of the specific opacity or the severity of the coexisting opacities. Agreement in diagnosing posterior subcapsular opacities was decreased in eyes with milder posterior subcapsular opacities and in eyes with more severe coexisting nuclear and/or cortical opacities. The effect of the severity of the opacity being graded and the severity of coexisting opacities on the reliability of the LOCS II must be considered in studies that use the system to classify and grade cataracts.

Aged↗
PubMed1990

Distribution of lens opacities in the Italian-American Case-Control Study of Age-Related Cataract. The Italian-American Study Group.

The Lens Opacities Classification System I (LOCS I) was used to classify lens opacities in the clinic-based Italian-American Case-Control Study of Age-Related Cataract. Data on the distribution of cataract types among the 1008 patients (age range, 45-79 years) are presented. A single type of cataract was found in 65% of all cases in whom both lenses could be graded. Among all patients and among patients with only one type of cataract, cortical opacities occurred most frequently and posterior subcapsular opacities least frequently. In patients with bilateral cataracts there was a high degree of concordance of cataract type and severity. The high degree of concordance of cataract type between eyes and the decreasing prevalence of unilateral cataract with increasing age suggest that patients with unilateral cataract are at high risk of developing the same opacity in the fellow eye. Cortical cataracts were found more frequently in women, and in patients with unilateral cataract, the left eye was more frequently affected. Clinic-based data on the distribution of cataract may be of assistance in planning future clinical studies of cataract.

Aged↗
PubMed1990

Gastrointestinal, hepatic, and pancreatic involvement with Cryptococcus neoformans in AIDS.

We describe three cases of acquired immunodeficiency syndrome (AIDS) complicated by disseminated cryptococcosis with gastrointestinal involvement. The stomach, duodenum, colon, pancreas, and liver showed invasion by the fungus. Although none of the patients had any symptoms attributable to Cryptococcus neoformans, we speculate that cryptococcal invasion of the liver and gastrointestinal tract may be a contributor to the morbidity in these immunocompromised patients.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Prospective evaluation of blind brushing of the esophagus for Candida esophagitis in patients with human immunodeficiency virus infection.

We prospectively evaluated the diagnostic value of blind brushing of the esophagus via nasogastric tube in 66 patients with human immunodeficiency virus (HIV) infection [acquired immune deficiency syndrome (AIDS) (N = 59), or AIDS-related complex (ARC), (N = 7)] complaining of odynophagia and/or dysphagia. Brushings were obtained between 20 and 35 cm from the incisors. Patients then underwent upper endoscopy with directed brushings and biopsies; esophageal lavage was also done in the first 40 patients. Candida esophagitis was defined as an abnormal appearance of the esophageal mucosa, together with microscopic evidence of pseudohyphae in the endoscopic brushings or invasive candidiasis on biopsy. The presence of oral thrush was also recorded. Candida esophagitis was present in 28 (42%) of the 66 patients. Blind brushings diagnosed candidiasis in 27/28 cases and produced five false positives (sensitivity 96%, specificity 87%). Blind brushing of the esophagus was significantly more sensitive than the presence of oral thrush for the diagnosis of esophageal candidiasis (p = 0.02). Oral thrush was found in only 20/28 cases of Candida esophagitis and in eight patients without Candida (sensitivity 71%, specificity 79%). Esophageal lavage yielded Candida in all cases (sensitivity 100%) but had a poor specificity (64%). We conclude that blind brushing of the esophagus is a rapid, safe, and economical way to diagnose Candida esophagitis in patients with AIDS. This procedure can be performed by primary care physicians with minimal loss of sensitivity and specificity as compared to endoscopy.

Acquired Immunodeficiency Syndrome↗
PubMed1989

An independent evaluation of the Lens Opacities Classification System II (LOCS II). The Italian-American Cataract Study Group.

The Lens Opacities Classification System II (LOCS II) has been offered for use in clinical studies of cataract. The system uses slit lamp and retroillumination photographic standards to grade lens opacities into classes of increasing severity. The authors evaluated the reproducibility and validity of LOCS II before its possible use in a natural history study of age-related cataract. The authors found excellent inter- and intraobserver reproducibility when the LOCS II standard photographs were used for clinical or photographic gradings of cataract. There was a tendency to underestimate posterior subcapsular cataracts on photographic gradings compared with slit-lamp gradings. The accuracy of the photographic gradings of posterior subcapsular opacities tended to decrease as the severity of coexisting opacities increased.

Aged↗
PubMed1989

[Etiopathogenetic role of metabolic, circulatory, sex factors and type and duration of diabetes in diabetic retinopathy. Investigation with vitreofluorophotometry].

We have studied metabolic, circulatory and vascular parameters in a group of 57 diabetics (37 affected by IDDM, 20 affected by NIDDM; 35 were males, 22 were females). Goals of present study were: 1) quantitative evaluation of the blood retinal barrier; 2) influence of the metabolic state, blood pressure, sex, type and duration of the diabetes on the ocular conditions; 3) relationship between ophthalmoscopic appearance of the retina and vitreous fluorophotometric recordings. We concluded that: a) ocular alterations depend by lipidic metabolism, blood pressure, sex, type and duration of the diabetes; b) vitreous fluorophotometry has proved a good device for early detection of retinal damages in the diabetic retinopathy.

Blood Pressure↗
PubMed1987

Preliminary evaluation of a simple photographic cataract classification for epidemiological surveys.

A preliminary evaluation of the agreement between clinical and photographic cataract classification and its reproducibility by utilizing a very simple classification system is presented. Photographic classification was based on color Zeiss 75-SL transparencies. Results indicate that photo-derived cataract classification based on slitlamp photographs has good validity for nuclear opacities but tends to underestimate posterior subcapsular cataracts.

Cataract↗
PubMed1986

Vitreous fluorophotometry in juvenile diabetics after oral fluorescein.

Vitreous fluorophotometry was performed in young patients (8 to 19 years old) affected by insulin-dependent diabetes mellitus, with no signs of diabetic retinopathy. Oral fluorescein was administered, and measures were used to prevent hypoglycemia during the examination. The results showed a breakdown of the blood-retinal barrier in nine (43%) of the 21 patients. The oral fluorescein method allows a satisfactory evaluation of ocular fluorescence profiles, with minimal risk of systemic side effects.

Administration, Oral↗
PubMed1986

Pleurodesis in metastatic pneumothorax.

A 57-year-old woman with bilateral pneumothoraces secondary to pulmonary metastases from leiomyosarcoma of the uterus was treated successfully by intrapleural instillation of tetracycline.

Female↗
PubMedDate not supplied

Hepatitis C in patients with human immunodeficiency virus infection: diagnosis, natural history, meta-analysis of sexual and vertical transmission, and therapeutic issues.

Hepatitis C (HCV) infection occurs in as many as 33% of the patients with human immunodeficiency virus (HIV) infection. In view of their improved survival, liver disease will become more clinically significant in patients coinfected with HIV/HCV. Several studies in patients with hemophilia have shown that coinfected patients develop earlier and more severe liver disease, including hepatocellular carcinoma. In nonhemophilic cohorts, lower CD4 counts are associated with an increased prevalence of cirrhosis. However, HCV infection does not seem to alter the natural history of HIV infection in most cases. Human immunodeficiency virus coinfection in pregnant women increases the risk of perinatal HCV transmission 2-fold, with more than 25% of occurrences involving transmission of both viruses: cesarean delivery significantly decreases this risk. The expanded use of highly active antiretroviral therapy may lead to further improvement in morbidity and mortality from HIV infection. Thus, the management of coexistent HCV liver disease will need to be formulated. We suggest that alcohol be disallowed. Interferon and ribavirin in combination are likely to become the therapy of choice, particularly in coinfected patients with higher CD4 counts, lower HCV viremia, and non-1 genotype. During treatment, complete blood cell counts need to be closely monitored. Future controlled trials will determine the efficacy and safety of long-acting interferon preparations. Administration of highly active antiretroviral therapy, with the intent to prevent decreases in CD4 counts, seems crucial in stemming liver disease progression. However, some drugs have clear-cut hepatotoxic potential and patients with known liver disease should be closely monitored. Arch Intern Med. 2000;160:3365-3373.

Alcohol Drinking↗
PubMedDate not supplied

Binocular Polaroid Test for vision screening of pre-school age children.

We report the results obtained with the Binocular Polaroid Test in a large population screening devised to detect vision disturbances in pre-school age children. The Binocular Polaroid Test is a new test for rapid detection of small unilateral scotoma in the binocular visual field. The test was performed on 1566 children age 3 to 6 years in a field examination. The reliability of the test was controlled in a study examination. A complete study examination was performed in 60 of the 96 subjects with a positive response to the test. One hundred subjects selected at random among those with a negative response were used as controls. The study examination disclosed vision disturbances in 41 of the 60 children with a positive response to the Binocular Polaroid Test. The remaining 19 results were normal. No vision disturbances were detected in the control group. The predictive value and the "phi" coefficient were calculated. The results indicate that the Binocular Polaroid Test appears very suitable for vision screening in pre-school age children for whom an early diagnosis is of paramount importance for treatment and prognosis of a vision alteration.

Child↗