A case of death after insertion of an intragastric balloon for treatment of morbid obesity.
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Fatal Outcome↗
Biomedical subjects
M Del Piano
Publications and source records attributed to M Del Piano.
Utilization of the intestinal tract as a delivery system for urogenital probiotics.
Orally consumed viable bacteria with proposed beneficial health effects, the so-called probiotics, are increasingly used to treat disorders of the gastrointestinal tract. It has been recently suggested that specifically selected lactobacilli could have a therapeutic role in female urogenital tract infections. It has been also suggested that some of these bacteria could be not intravaginally instilled, but also orally delivered. The authors investigate the ability of lactobacilli isolated from the vagina to survive gastrointestinal tract transit, and establish a link between the rate of intestinal survival and vaginal colonization.
Administration, Oral↗
Hymecromone in the treatment of motor disorders of the bile ducts: a multicenter, double-blind, placebo-controlled clinical study.
Biliary dyskinesia is frequently encountered in clinical practice and is characterized by pain during or after meals. The present study was designed to assess the action of hymecromone in patients with motor disorders of the bile ducts. One hundred twenty-three patients (36 men and 87 women) were enrolled in the multicenter double-blind placebo-controlled study. The mean age was 60.3 years +/- 14.2 SD. Diagnosis was dyspepsia in 58 patients, dyskinesia in 59, cholelithiasis in five and hepatopathy in one. The patients were divided into two groups. One group (61 patients) was treated with hymecromone (300 mg tablets at a dosage of 1,200 mg/day, 2 tablets midday and evening) and another group (62 patients) was treated with placebo. Treatment lasted for 14 days. Control of dyspepsia and pain symptoms of biliary origin was more marked and constant with hymecromone than with placebo. By the end of the treatment, patients in the hymecromone group showed a 70.3% reduction in intensity of spontaneous abdominal pain, while the placebo group showed a 43.8% reduction. Hymecromone was well accepted by the patients and judged to be effective by the investigator in 88.5% of patients treated. The possibility of using hymecromone in 300-mg tablets in the treatment of motor disorders of the bile ducts is thus confirmed.
Adolescent↗
Lyme borreliosis in central Italy (1995-1998).
From January 1995 to July 1998, 340 serum samples collected in Central Italy from patients clinically suspected of having Lyme borreliosis were investigated. All samples were tested for the presence of antibodies to B. burgdorferi by Elisa. The Elisa positive samples were subjected to further tests by Western Blot for confirmation. Out of 340 patients, 13 (3.8%) proved to be B. burgdorferi positive, while 9 (2.6%) were found to have Lyme disease with seroprevalence being higher in these latter than that of blood donors from Central Italy. Our results indicate that Lyme borreliosis is present in Central Italy. A comparison between Italian and European studies reveals that Lyme disease is still underestimated in Italy, the main reason being that a monitoring system for the study of Lyme borreliosis was only established in 1990.
Animals↗
Biofilm formation on the surface of ceramic tiles.
The aim of the study was to investigate the formation of biofilm on the surface of ceramic tiles, widely present in public and private buildings, using six parallel flow chambers. Our flow system was conceived and made to compare biofilm results by parallel distributed rectangular tiles. The tiles, divided into two identical A and B sections, were placed within the flow chambers. Biofilm formation was performed after 72 h and was quantified by viable counts of bacteria. Average viable counts ranged from 1.1x10(7) to 7.3x10(7) cfu cm(-2) and from 1.1x10(7) to 5.8x10(7) cfu cm(-2) respectively for biofilm A and B sections. As statistical analysis does not show significant differences, we can conclude that biofilms obtained were so similar to each other that they confirmed the system reproducibility. Our next step will be to use our system to study Legionella pneumophila and to evaluate the efficacy of antibacterial agents.
Biofilms↗
The major epidemic infections: a gift from the Old World to the New?
With the discovery of the New World, the Europeans flocked to America and with them spread infectious diseases. During long sea voyages the agents of these diseases increased their diffusion capacity in a suitable environment. Lack of hygiene, fatigue and privations, a diet without vitamins and many persons kept in confined spaces were the essential features of this environment. Sick persons, whose health conditions worsened during the journey to the New World, carried the germs of infectious diseases. The first disease to appear in the New World was smallpox described in 1518 in Hispaniola. From there the disease moved rapidly to Mexico in 1520, exterminating most of the Aztecs, Guatemala and to the territories of Incas from 1525-26, killing most of them and the King himself. The second disease, influenza, appeared in La Isabela, a few years later, causing a heavy epidemic between 1558 and 1559. Other diseases followed such as yellow fever and malaria. So Europeans and these invisible and mortal agents caused enormous destruction of American populations. In fact historians have estimated that beginning from early 1500, in only 50 years the population of Peru and Mexico fell from 60 to 10 million; in the latter country, in one century, the populations fell from an initial 10 million to only 2 million.
Americas↗
Mesalazine foam (Salofalk foam) in the treatment of active distal ulcerative colitis. A comparative trial vs Salofalk enema. The SAF-3 study group.
BACKGROUND: Mesalazine enemas are of well proven efficacy for the topical treatment of distal ulcerative colitis. Although new rectal formulations of mesalazine are not expected to be superior in efficacy and tolerability to standard formulations, they may offer secondary advantages in terms of overall acceptability. AIM: To compare the efficacy, tolerability and overall acceptability of a new mesalazine rectal foam (Salofalk foam) with mesalazine enema in the treatment of active distal ulcerative colitis. PATIENTS AND METHODS: A multicentre study was carried out in patients with active proctitis, proctosigmoiditis and left-sided ulcerative colitis as evaluated by the Clinical Activity Index (CAI > or =4) and Endoscopic Index (EI > or =6). Patients were randomly assigned to receive, in open-label fashion, either mesalazine foam 2 g twice a day or mesalazine enema (2 g/60 ml twice a day) for 3 weeks. Patients who did not achieve remission (defined as CAI <4 and EI <6) after 3 weeks continued the study receiving the alternative galenic formulation for a further 3 weeks. RESULTS: A total of 195 patients were enrolled. Characteristics at baseline were similar except for concomitant therapy with oral 5-ASA products: during the 1st treatment phase, 41% of patients on enema received such treatment vs only 29% of those on foam. Patients with at least one post-treatment efficacy evaluation were included in the intent-to-treat analysis (n=89 foam, n=96 enema). After 3 weeks of treatment, 112 patients were in remission and only 59 patients entered the 2nd treatment phase thus providing data on acceptability. Remission was achieved after 3 weeks in 54% of patients treated with foam and in 67% of those treated with enema. The 90% confidence interval for the difference in remission rates was 0 to 24 and thus within the clinically acceptable range of therapeutic equivalence. At the end of the 2nd phase, 70% of patients switched to foam were in remission vs 65% to the enema. Two patients discontinued treatment with foam prematurely due to anal burning. No clinically important changes were seen in the laboratory tests. CONCLUSIONS: Salofalk foam and enema are equally effective for the treatment of proctitis, proctosigmoiditis and left-sided ulcerative colitis. The new foam preparation is as well tolerated and accepted as enemas and can be used as a therapeutic alternative to conventional mesalazine enema formulations.
Administration, Topical↗
[Infective agents in the pathogenesis of ischemic cardiopathy].
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Humans↗
Borrelia burgdorferi s.l. and Ehrlichia chaffeensis in the National Park of Abruzzo.
The aims of the present study were (a) to determine the presence of Ixodes ricinus in three different areas of the National Park of Abruzzo; (b) to search for the presence of Borrelia burgdorferi in the collected sample of Ixodes; (c) to determine the seroprevalence of B. burgdorferi antibodies and E. chaffeensis antibodies in inhabitants of the park and in park workers. The presence of B. burgdorferi in Ixodes was checked by PCR. For the detection of antibodies to B. burgdorferi all sera were assayed by ELISA as screening test and by Western blot as confirmatory test. For the detection of antibodies to E. chaffeensis all sera were assayed by IFA. Antibodies to B. burgdorferi were present in 9.1% of the park workers, 4.5% were confirmed positive by the IgG Western blot test. None of the inhabitants of the park was positive. Antibodies against E. chaffeensis were found in 4.5% of the park workers and 8% of the inhabitants of the park. The results obtained in the collecting of the ticks seem to show that the presence of I. ricinus in the park territory is rather discontinuous and small in number, therefore it is not epidemiologically significant for the transmission of B. burgdorferi sensu lato. Serological study for Ehrlichia revealed a high frequency of E. chaffeensis antibodies in the park inhabitants and a lower prevalence in the park workers.
Animals↗
Evaluation of the efficacy of nicergoline on blood flow and ocular function in patients affected by chronic simple glaucoma.
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Administration, Oral↗
[Chlamydia pneumoniae infection and cardiac ischemic syndromes].
The aim of this study was to assess the presence of Chlamydia pneumoniae antibodies in patients with angiographically verified atherosclerotic coronary artery disease. A total of 114 consecutive patients were investigated between April 1995 and June 1996. Patients were divided into two groups: 72 patients with acute myocardial infarction (AMI; 53 men, 19 women, mean age 62.27 +/- 10.1 years), and 42 patients with chronic ischemic heart disease (CAD; 37 men, 5 women, mean age 62.75 +/- 9.2 years). A control group of 50 normal subjects matched for age (mean 62 +/- 9 years), sex, social status and geographical area was used. Identification of Chlamydia pneumoniae was carried out with the microimmunofluorescence method, on two serum samples taken from patients on admission and after 15 days. The IgM, IgG and IgA anti-Chlamydia pneumoniae titers were assessed, values > or = 1:16, > or = 1:32 and > or = 1:8 being respectively considered positive. Acute (IgM > or = 16 or four fold rise of IgG titer) and chronic (IgG > or = 128 e IgA > or = 32 or only elevated IgA titer) infections were analyzed. IgM antibodies were not found in AMI, CAD and control groups. IgG positivity (IgG > or = 32) was found in 38% of the control group, in 58.3% of the AMI group (p < 0.05) and 42.8% of the CAD group (p < 0.01). IgA positivity > or = 8) was found in 22% of the control group, in 31.9% of the AMI group (NS) and in 33.3% of the CAD group (p < or = 0.05). Acute infection was observed in 5.5% of AMI patients and in 12% of CAD patients (NS), whereas no subject of the control group showed these values. Chronic infection was observed in 9.7% of AMI patients and in 16.6% of CAD patients (NS) whereas nobody of the control group showed these values. In conclusion, our results suggest that Chlamydia pneumoniae infection is present only in the AMI and CAD groups. It is possible to suppose that this infection may be linked to atherosclerosis through an endothelial damage or a systemic endogenous procoagulant and inflammatory activity.
Aged↗
Controlled trial of oral 5-aminosalicylic acid for the prevention of early relapse in Crohn's disease.
BACKGROUND: Recent data indicate that 5-aminosalicylic acid (5-ASA) is most effective in preventing relapse of Crohn's disease in patients with a short duration of remission before enrollment. AIM: To evaluate the efficacy of oral 5-ASA treatment, started immediately after achieving steroid-induced remission, in preventing clinical relapses of Crohn's disease. METHODS: Patients with active Crohn's disease, achieving remission on steroids, were randomized to oral 5-ASA 3 g/day or placebo, while steroids were tapered over 6 weeks. The trial was terminated after interim analysis showed a slightly higher relapse rate in the 5-ASA group, and the calculated probability of seeing a statistically significant difference by completing the study was minimal. RESULTS: Final analysis included 117 patients (58 taking 5-ASA and 59 taking placebo; follow-up 9.2 +/- 6.5 months). Cumulative relapse rates at 6 and 12 months were 34% and 58% in 5-ASA patients and 31% and 52% in placebo patients, respectively (rate difference +0.095; 95% CI = -0.085 to +0.274). Subgroups analysis showed that 5-ASA was equally ineffective in patients with ileal, colonic or ileocolonic disease. CONCLUSIONS: Contrary to previous results, in our study early introduction of treatment with oral 5-ASA did not prevent relapse in Crohn's disease patients treated with steroids to induce remission.
Adolescent↗
Geographical incidence of infection with Borrelia burgdorferi in Europe.
During recent years many seroepidemiological studies have been published about Lyme borreliosis in various European countries. This paper presents a review of these studies to clarify the geographical incidence of the infection by B. burgdorferi in Europe and particularly in Italy. Data of Lyme disease seroprevalence has been established in European patients or at-risk populations and in blood donors or control subjects. In Northern Europe the sero-prevalence of antibodies to B. burgdorferi in patients or in at-risk subjects is higher in Sweden, 19% and lower in Estonia, 2.7%. In Central Europe the incidence of antibodies to B. burgdorferi in patients or in at-risk subjects is higher in The Netherlands, 28% and Switzerland, about 26%, and lower in Poland, 15%. The range of antibodies to B. burgdorferi in blood donors or control subjects shows the highest spikes in Ireland 15% and the lowest in Austria 7.7% and in Germany 5.5%. In Southern Europe we have the highest incidence in Croatia, 43%, while we have the lowest incidence in Greece, 1.1%. In Italy the seroprevalence of antibodies to B. burgdorferi in patients or in at-risk subjects seems to vary, in Northern Italy, from the lowest incidence in Lombardia 3.2% to the highest in Friuli 22.3%; in Central Italy, from the lowest incidence in Emilia (Parma) 0.2% to the highest in Toscana 18.3%. The range of antibodies to B. burgdorferi in blood donors or control subjects shows the lowest spikes in Lazio 1.5%, while the highest are in Sicilia 10.9%. Although the amount of works on infection diffusion by B. burgdorferi is increasing, the statistical evaluations, comparisons and the drawing of acceptable conclusions continue to be difficult. In fact data, obtained from various European laboratories, are often not directly comparable, because of different serological tests used to detect antibodies to B. burgdorferi. Consequently it seems very important the work that could be performed by a multicenter study on the standardization of the criteria to be used in WB interpretation, presently in progress among several different European laboratories, and the necessary consequent efforts to elaborate a common panel of criteria about the comparison of the data.
Borrelia Infections↗
Determination of antibodies to Borrelia burgdorferi in the serum of patients living in Calabria, southern Italy.
The aim of our work was to determine the sero-prevalence of antibodies to B. burgdorferi in 300 patients living in Calabria, a region of southern Italy. The research of antibodies to B. burgdorferi was conducted by ELISA as a screening method and Western Blot as a confirmatory test. Out of the 300 patients we found a rate of positivity of 7.3% with ELISA and 4.5% with Western Blot. This data allows us to classify Calabria, among the regions where Lyme borreliosis is non-endemic and where sero-epidemiological research has been carried out on patients, as having a degree of positivity second to that of Campania (9.1%) and higher than Lombardy (3.2%) and Umbria (2.8%). Considering all the demographic and clinical data, only that of the higher IgG positivity of males over females is statistically significant.
Adult↗
Percutaneous endoscopic gastrostomy and enteral nutrition in amyotrophic lateral sclerosis.
Bulbar involvement in amyotrophic lateral sclerosis (ALS) is often related to a worse prognosis on account of the higher risk of pulmonary aspiration and undernutrition due to dysphagia. The aim of our study was to assess the effects of enteral feeding by percutaneous endoscopic gastrostomy (PEG) in a long-term follow-up of ALS patients. We report the results of PEG in 31 ALS patients with bulbar involvement. The patients were observed at 3-monthly intervals over a period of 2 years after PEG. All the data were compared with those obtained from a control group of 35 ALS patients who refused PEG. Mortality did not differ significantly between the two groups of patients during the first 6 months of observation, whereas after this period it was lower in the PEG group. In the patients who had had PEG, the body mass index showed a mild but statistically significant improvement after tube insertion while in the control group it decreased significantly. The findings of this study demonstrate that PEG can improve survival in elderly and young ALS patients with bulbar involvement; it enhances their quality of life and helps their integration in their social and family surroundings. We think that PEG should be included symptomatic treatment of all ALS patients with bulbar involvement from the onset of symptoms.
Adult↗
Lyme disease seroprevalence in a region of central Italy.
The present study reports the seroprevalence of IgG antibodies to B. burgdorferi by testing sera from volunteer blood donors in Latium, a region of Central Italy. All samples were tested by ELISA and the positive samples were assayed by Western blotting as a confirmatory test. A positivity rate of 4.3% was recorded by ELISA, while after the confirmatory test by Western blotting the positivity rate decreased to 1.5%. The presence of significant antibody titers to B. burgdorferi in the sera of healthy subjects shows that further investigations are necessary to clarify the real prevalence of Lyme disease in our region.
Adult↗
Epidemiology of urogenital infections caused by Chlamydia trachomatis and outline of characteristic features of patients at risk.
A study of Chlamydia trachomatis infection was conducted in two stages on 15,656 subjects at urogenital clinics of the Faculty of Medicine and Surgery at La Sapienza University in Rome, the S. Anna Hospital in Turin, and the Niguarda Hospital in Milan. The overall incidence of the disease was 6.4% in patients examined throughout the whole study period. The rate of positive cases was 5.8% for the 5270 patients examined up to 1990, and 6.7% for the 10,386 patients examined from 1990 to 1992, showing an increasing trend. There was a much higher positivity rate in men (9.8%) than in women (6.0%); the difference was statistically significant. Of all patients, 60%, were asymptomatic. In symptomatic patients, C. trachomatis was present in 18.5% of cases of non-gonococcal urethritis and in 12.8% of cases of salpingitis. The highest incidence of C. trachomatis infection was in women who had begun sexual activity at an early age, (under 25 years in age), had several sexual partners and used intra-uterine contraceptive devices or spermicides or both.
Adult↗
Rate of occurrence of Helicobacter pylori in patients with gastroduodenal pathology: pilot research.
In an attempt to establish the etiologic role of Helicobacter pylori (H. pylori) in gastric and/or duodenal pathology, 169 patients were tested and compared with a control group of 25 healthy subjects, for a total of 194 subjects. Data on sex, age, familiarity, smoking, coffee and alcohol habits were collected and each patient underwent histological, microbiological and immunological tests. 80 (41.2%) subjects were found positive to H. pylori. This bacterium was detected in 53.3% of patients with gastric ulcer while IgG were found in 86.7%; in 50% of patients with chronic atrophic gastritis while IgG were detected in 80%; in 48.5% of patients with duodenal ulcer while IgG were found in 87.9%; in 41.8% of patients with superficial chronic gastritis while IgG were detected in 80.2%. In the control group of healthy patients H. pylori was found in 28% of patients while IgG were detected in 62.5%. The results do not confirm a direct clear-cut correlation between this microorganism and the pathologies studied.
Adult↗