Biomedical subjects
Publications and source records attributed to M Gentilini.
Short-term memory, perceptual speed, attention and psychomotor function were studied in 55 workers professionally exposed to styrene. The subjects were grouped according to their urinary styrene metabolites. Those with higher styrene exposure showed a significant impairment of short-term memory only.
The prevention of malaria is based on chemoprophylaxis and protection against the vector. Nocturnal mosquito bites can be avoided by individual and collective measures, while chemoprophylaxis involves the use of various agents according to the place and duration of stay. Three endemic zones can be defined on the basis of chemoresistance. Chloroquine, proguanil and mefloquine are the three drugs used in this setting, the latter being contraindicated for pregnant women and children. Travellers making long stays in areas of low-level chemoresistance and short stays in areas of high-level resistance and for whom mefloquine is contraindicated are advised to take antimalarial drugs at the first signs of potentially malarial fever when medical care is unavailable. Quinine, halofantrine and mefloquine are used for the curative treatment of malaria in areas of chloroquine resistance.
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The blood schizogonic cycle of human malaria parasites has thus far been the most exhaustively studied phase of parasite development. However, before entering red blood cells (RBCs), the parasite undergoes its first multiplication not in blood, but in hepatic cells. These hepatic stages were the last to be discovered and only a few studies have been performed in humans and other primates. Despite recent advances, in vivo studies have limitations and other approaches such as cultures of these liver forms may be necessary to investigate their chemosensitivity and their biochemical or immunological properties. Recently, sporozoites of species of rodent malaria have been made to infect cultured cell lines or primary hepatocyte cultures. We report here that the complete cycle of the human malaria parasite Plasmodium vivax can be obtained in primary cultures of human hepatocytes up to release of merozoites able to penetrate RBCs.
Enterocytozoon bieneusi and Enterocytozoon salmonis are reported in HIV-infected patients and in salmonid fish, respectively. Both species share the early development of the extrusion apparatus of the spores, which is completed prior to fission of the sporogonic syncytium into sporoblasts, and the early synthesis of polar tube constituents, but they differ in other developmental and sporogenetic processes. Enterocytozoon bieneusi develops in direct contact with the cytoplasm of epithelial cells whereas E. salmonis occurs only in the nucleus of leucocytes and epithelioid cells. Sporogonic nuclei, which are scattered throughout the sporont in E. bieneusi, are located in the periphery in E. salmonis. The multilamellar structures associated with the nuclear envelopes and the endoplasmic reticulum cisternae are specific for E. bieneusi. Additionally, the evolution of the polar tube precursors proceeds differently in the two parasites. In E. bieneusi, they transform into electron-dense bodies associated with a reticulum and polar tubes derive from these structures according to a process similar to that reported in other microsporidia. In E. salmonis, polar tube precursors fuse directly at their ends and the polar tubes appear to be formed by the assemblage of these fused precursors with a material previously synthesized in the vicinity of nuclei. In conclusion, both species appear to be less closely related than was supposed in earlier descriptions.
In West and Central Africa one adult in 4 or 5 carries AS trait. This haemoglobin abnormality therefore underlines the question of aptitude of navigation personnel in national or international air-lines. Among these personnel one should separate commercial navigation personnel (CNP) and technical navigation personnel (TNP), if the aptitude in flight of CNP may perhaps be acquired without systematic previous submission to files of Civil Aeronautics Medical Advice, on the other hand a definite and irrefutable decision on the aptitude of TNP can only be envisaged after proving tests for placing the personnel carrying sickle cell trait in the context of airling work.
Fifty patients were hospitalised at Vientiane during May and June 1975. Infection was caused by consumption of pork meat (som-mou, lap mou and lap leuat). After an incubation period of 8 to 11 days intermittent diarrhoea followed by constant fever and orbital oedema occurred. Several days later diffuse myalgias occurred. Three patients presented neurological symptoms: left hemiplegia flexible paraplegia and limb paresis; these symptoms regressed spontaneously. 87% of the clinically suspected cases had specific serum antibodies (IFI, ID, IE). Hyperleucocytosis and hypereosinophilia were a constant factor. Anti-AH antibodies were detected by the Widal test. The histopathology characteristic of myositis was seen in the 12 muscle biopsies. Also observed was the precystic state of the larvae which is in agreement with the early timing of the samples which were obtained during the 3rd and 4rd week of infection.
In endemic zones, the atovaquone-proguanil (AP) combination is well tolerated and effective in treating acute, uncomplicated malaria. Trials involving non-immune patients are lacking, however. We conducted a randomized, multicenter open-label trial to determine the efficacy and tolerability of the AP combination (1,000 mg + 400 mg once daily for 3 days) in comparison with halofantrine (HF) (1,500 mg in 3 doses) in non-immune adults with imported uncomplicated Plasmodium falciparum malaria. Follow-up visits were programmed on Days 7, 14, 21, 28, and 35 after hospital discharge. Out of 48 patients enrolled in the study, 41 were assessable for the cure rate (21 in the AP group and 20 in the HF group). All the patients were cured. The mean parasite clearance time was longer (63+/-23 hours) in the AP group than in the HF group (48+/-15 hours) (P = 0.02). The frequency of gastrointestinal adverse events was higher in the AP group. No noteworthy electrocardiographic changes were observed, particularly in the QTc interval. The AP combination appears to be a valuable alternative treatment in non-immune adults.
The indirect peroxidase labelled technic for the diagnosis and research in malaria rests on the same principle than immunofluorescence test (I. F.). Homologous or heterologous antigens are incubated with patient serum in the same conditions than for I. F., and then with peroxydase, labelled, conjugate diluted 1/200. The resulting complex is colored by the diaminobenzidine method of Graham and Karnovski. The coloration is observed in light microscopy. This technic as sensitive as immunofluorescence test can be done, with a cheaper microscopic material. The possibility of studying the conjugate fixation in electron microscopy opens new direction for research.
The systematic research of abnormal haemoglobins has been done on 1,000 subjects of both sexes (mostly 18 to 35 years) from Guadeloupe (500) and Martinique (500), examined in Paris. The following were found without significent difference in both islands : 86,9% heterozygote AS, 4,5% heterozygote AC, 0,3% double heterozygote SC, one homozygote CC, 0,3% increase of the fraction A2 and one increase of haemoglobin F. Those results were comparable to the few anterior studies in French West Indies.
The prevention of traveller's diarrhea should be limited to the evaluation of drinking water, the avoidance of certain foods and careful hygiene of the hands. Although their efficacy is somewhat controversial in this context, these precautions at any event reduce the risk of acquiring other feco-orally transmitted diseases. Because of the increasing resistance of the bacteria responsible and their multiplicity, early treatment of any actual case of traveller's diarrhea is preferable to prophylactic antibiotics. Therapeutic indications vary according to the severity of traveller's diarrhea and the general condition of the patient. Travellers must be aware of these considerations before their departure.
Present paper reports on the results of a pilot customer satisfaction study carried out on 1.720 consecutive women (18.7 with spontaneous access) attended senology department (Trento and Borgo) in the context of a organized mammography screening programme, started in October 2000. Data were collected by a questionnarie filled by the women after mammography. 4.3% of the invited women reported the receiving the letter late, 0.9% considered it inaccurate, 7.2% had some problems for getting a new date for test, 1.8% of the whole sample reported some problems for external access and 2.2% for internal access to health facilities; 1.9% perceived waiting room as not friendly. The welcoming by the personnel is judged quite well, only 0.6% complained about it. Trento centre, is more efficient than Borgo. In 21.7% of the cases the mammography has been performed within next 30 minutes of the fixed time and in 7.9% besides that. 36.8% of the whole sample perceived mammography as tiresome and 4.1% as painful. The percentage of women reporting mammography disconforting increase, in Trento sample, according the education level as previously reported. The data about perceived quality are satisfactory, on the whole. Anyway it would be opportune to contain the waiting time.
Ultrastructural studies were done on developmental stages of Enterocytozoon bieneusi obtained from HIV seropositive patients suffering from diarrhea. The presence of elaborate multilamellar structures suggest that they give rise to various membrane systems needed for rapid production of disseminating stages.
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An enzymatic and immunologic study of 18 patients with trichinosis leads to the following conclusions: The stage of muscular invasion in trichinosis is accompanied by a release of cellular enzymes representative of striated muscle fibres in nearly all the cases. This release can be observed by a study of the LDH iso-enzymes at a time when immunological techniques are not always significantly positive. The specific aspect of this phenomenon can be proposed with reservations since there does not exist any interference with other enzymatic systems such as the gamma-GT and furthermore no other evident cause of muscular lysis is present. The existence of a blood hypereosinophilia completes the biological picture. These early modifications of the enzymatic activities are most probably transient.
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35,972 R. P. is a new schistosomicidal drug deriving from a thione dithiole pyrazinyl basic structure. It has been assessed with 125 patients suffering from an urinary tract schistosomiasis (69 cases) or from an intestinal schistosomiasis (56 cases). Five regimens have been followed. The last one was 1.50 g/day over 3 days and it included 75 patients. The clinical tolerance was satisfactory although vomiting was reported in 16 % cases and headaches were noted in 21 % cases. The efficiency was remarkable as 97 % patients were cured. New studies are been performed on a one day treatment basis.
Quantitative assessment of brain damage is a primary condition for studies in neurotraumatology. Scored clinical evaluation, neurophysiological and neuroimaging techniques are usefully applied in highly disabled or comatose patients. In minor head injury (MHI), where focal neurological signs are excluded by definition, quantification of brain dysfunction is still uncertain. We compared the incidence of post-traumatic amnesia (PTA), skull fractures and altered Auditory Brainstem Responses (ABR) in 165 patients examined within 48 hours from a MHI. Skull fractures were found in 25%. They are, however, an indirect evidence of potential cerebral damage. ABR alterations, which show brainstem dysfunction, were present in 10% only. PTA exceeding 30 min occurred in 60% of MHI patients. This clinical method seems a sensitive method for assessing brain dysfunction even in MHI patients.