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Biomedical subjects

M Gipponi

Publications and source records attributed to M Gipponi.

At least 55 records · Page 3Linked to original sources

Role of diagnostic lymphnode biopsies in 56 anti-HIV positive patients.

The authors have examined two separate series of samples from 33 and 23 anti-HIV positive patients with persistent generalized lymphadenopathy (PGL) undergoing lymphnode biopsy. For the first group of patients, the aim was to evaluate the diagnostic and prognostic correlation between clinical and laboratory features and histologic findings. For the second group, an assessment was made of the indications for lymphnode biopsy as determined by the rate of positive histopathologic findings. Histologic alterations were classified into four types according to Ràcz, without knowledge of clinical and laboratory data. At the time of biopsy, the first sample (n = 33) included 21 lymphadenopathy associated syndrome (LAS) (64%), 6 ARC (18%), and 6 AIDS (18%) patients; a significant prevalence of type 1 histologic features was evident in LAS/ARC patients, while type 4 was exclusively present in the AIDS group. These preliminary results suggested that only symptomatic anti-HIV positive patients (ARC/AIDS) should have been selected for lymphnode biopsy, because of the expected high rate of opportunistic infections, malignant lymphoma, or Kaposi's sarcoma (KS) in this specific subset of patients. Actually, in the second sample of 23 patients (ARC = 8: AIDS = 15) the detection rate of AIDS-related neoplasms included ten Kaposi's sarcoma and three Hodgkin's disease. These findings suggest that diagnostic lymphnode biopsies should be limited to selected anti-HIV positive patients with evidence of AIDS-related neoplasms or treatable opportunistic infections, or for the purpose of detecting histopathologic features of prognostic significance.

AIDS-Related Complex↗

[Antibiotic prophylaxis in major surgery of the neck and head].

Twenty-two patients undergoing major head and neck surgery were included in a randomized trial to value the efficacy and side effects of parenteral short-term antibiotic prophylaxis of post-operative infections. Two different antibiotic regimens were compared: group A, ceftazidime i.v. (2 g) in three doses (half an hour before surgery, 8 and 16 hours, from the first dose); group B, netilmicin (100 mg) plus clindamycin (600 mg i.v.), following the same chronological schedule. Overall infection rate was 18% (4/22): all post-operative infections occurred in group A patients, including one case of wound infection and 3 mixed infections (wound infection associated with lung infection), with a significant reduction of post-operative infection rate in group B patients (p = 0.045; Fisher's exact test).

Adult↗

[Pre-operative identification of patients at risk for septic complications after surgery for neoplasms of the digestive system. A multiphasic multicenter study].

One hundred ninety-six patients undergoing surgical treatment for digestive tract cancer were recruited in a polycentric, multistep study to value significant differences of pre-operative nutritional and immunologic parameters between patients with or without post-operative infections. Such parameters might be useful for the identification of "septic risk" patients. Primarily, 63 patients were given a complete anthropometric evaluation, laboratory screening and immunologic assessment (surface marker analysis of peripheral blood mononuclear cells, polymorphonuclears in vitro chemotaxis and phagocytosis). Only a few serologic parameters were significantly reduced in patients with post-operative infections, namely: total serum proteins (p less than 0.02), albumin (p less than 0.02), beta-globulins (p less than 0.01), and C3c (p less than 0.05). These parameters were elaborated with Fisher's linear discriminant function to detect the optimal discriminant threshold able to identify "septic risk" patients. The predictivity of this discriminant function was validated in a second group of patients (n = 49) in which total serum protein with electrophoresis were pre-operatively assayed as well as skin test reactivity to intradermal injection of recall antigens (Multitest skin-testing); discriminant sensitivity was 80%, the specificity 50%, and positive predictivity 62%. This low discriminant power of the equation based only on serum proteins assessment coupled with the significant negative relationship between skin testing and post-operative infections (male, p less than 0.005; female, less than 0.025) suggested a re-elaboration of the discriminant function, including the skin-testing score. The definite assessment of this new discriminant equation was evaluated in the third sample of patients (n = 84) which showed 67% sensitivity, 88% specificity, and 76% positive predictivity, thus suggesting the high reliability of this test for the pre-operative selection of "septic risk" patients.

Aged↗

Selection of pre-operative haematobiochemical parameters for the identification of patients 'at risk of infection' undergoing surgery for gastro-intestinal cancer.

Sixty-three patients were given a complete laboratory screening before undergoing surgical treatment for cancer of the digestive tract. The values of all these parameters were correlated with the incidence of postoperative infections, with the aim of identifying those markers which could be useful for the pre-operative selection of the patients at risk of infection. Patients who developed postoperative infections showed a significant pre-operative reduction of total serum proteins (P less than 0.02), albumins (P less than 0.02), beta-globulins (P less than 0.01) and C3c (P less than 0.05), while alpha 1-globulins were slightly, but not significantly, increased. The possible clinical applications of these parameters, to develop a predictive model which may help identify the patients at risk of infection, are discussed.

Aged↗

Lymph node biopsy in the diagnostic and prognostic assessment of patients with HIV infection.

Thirty-three anti-HIV positive patients with persistent generalized lymphadenopathy (PGL) who underwent lymph-node biopsy were studied to assess the diagnostic and prognostic relations existing between clinical, histological and laboratory findings. Patients were also examined for known risk factors, laboratory and bacteriological tests, and mononuclear cell surface marker analysis. 4 histological types were identified according to Ràcz's classification. At biopsy, there were 21 cases of LAS (64%), 6 cases of ARC (18%) and 6 cases of AIDS (18%); a clear prevalence of type 1 was evidenced in LAS/ARC patients, while only type 4 was present in the AIDS group. An ARC type 3 patient developed manifest AIDS within 13 months from biopsy. These results suggest that anti-HIV positive asymptomatic patients with PGL apparently do not require lymph node biopsy, as none of them showed histologic findings suggestive of opportunistic infections, malignant lymphoma or Kaposi's sarcoma. On the contrary, lymph node biopsy can play a diagnostic and prognostic role in anti-HIV negative subjects with PGL, and in ARC and AIDS patients.

AIDS-Related Complex↗

[Study on the attitude and smoking habits of the students of a school for professional nurses].

A study on 285 students and teachers of a nurse professional school was undertaken in two hospital of Genoa. A questionnaire proposed by World Health Organization and by Italian League Against Cancer was employed to collect data on smoking habits and behaviour. Subjects included in the present study were selectively chosen as they are in a transitional phase between school application and working environment within the hospital practice. Although these sample of hospital personnel showed a slow trend toward quit smoking, the rates of smokers are rather high, both in the youth (55%) and in the teachers. Our results showed that 87% of subjects interview agreed with the necessity to avoid smoking within the hospital environment; young nurses generally lack a specific knowledge about the hazard of smoking and more detailed information is requested for a correct education and prevention of patients' health.

Adult↗

[Teachers and smoking. Methods and results of an awareness and up-dating program in Ligurian schools].

An investigation on smoking habits of teachers of secondary and high schools allowed the collection of very interesting and useful data for the organization of post-graduate up-date courses and health education programs. Smokers' proportion remains still high, as 35% of males and 30% of females teachers are smokers; this situation is different in other countries, where an inverse relationship exists between smoking habit and economic welfare and cultural level. The number of daily-cigarettes was rather low only in females teachers, as 50% smoked less than 5-10 daily-cigarettes. Teachers' interviews suggested the high degree of interest in the organization of health education programs and courses on smoking, with special regard to the courses on smoking, with special regard to the methodology that is required for prevention programs in the school. The high attendance to the courses, the quantity and quality of teachers' reports on these problems and the practical application in school environment of these theoretical concepts confirmed the reliability and effectiveness of this methodologic approach.

Adult↗

[Primary prevention in the young. Methodology and initial results of a smoking prevention program for adolescents].

An antismoking campaign aimed at the 9-18 year old Genoese school population in 1981-1985 is described. The high percentage of smokers in Italy and the worryingly early age at which the habit is acquired suggested the need for a carefully prepared ongoing programme of primary prevention that would not be limited to occasional speeches. Part of the programme was also directed towards school health officers, teachers and families for whom seminars and refresher courses and topics appropriate for each group were organised. The dangers of smoking framed in a broader context were described and debater before a total of 26,000 school children in 4 years. The results that can only now be examined due to initial difficulties in implementing the programme show that out of 4613 smokers involved in the programme 29.8% stopped smoking after a year. Significantly in the same group and in the same period only 2.5% of the school children began to smoke. In contrast 15.8% new smokers were found in the control group. Further checks on a wider sample are scheduled in order to verify and confirm the results presented.

Adolescent↗

[Role of surgery in the prognosis of AIDS and related syndromes. Case reports ].

The authors review the epidemiologic and etiopathogenetic aspects of AIDS, in agreement with data published in december by the Center for Disease Control and by the WHO for the States, Europe and Italy. In their experience twenty-one patients, with clinical clues of AIDS, undergoing lymph node biopsy, have been analysed (18 LAS-ARC and 3 AIDS) and the role of prophylaxis for the surgical approach to the patient with aids or related syndrome has been underlined.

Acquired Immunodeficiency Syndrome↗

Assessing modifications of the intestinal bacterial flora in patients on long-term oral treatment with bacampicillin or amoxicillin: a random study.

The authors conducted a randomized trial on 16 patients to evaluate intestinal aerobic microfloral changes after prolonged oral treatment with bacampicillin (b.) (16 g/die) or amoxicillin (a.) (2 g/die). The analysis showed a quantitative reduction of isolates in 6 patients: 2 patients were treated with b. while 4 with a. (Odd ratio, O.R. = 3). Mean values of CFU presented as well a more evident reduction in a.-treated patients. From the qualitative point of view, bacteria modifications occurred in one patient treated with b. and 3 with a, (O.R. = 4.2). Bacterial changes, although not statistically significant, were thus greater in patients treated with a. than b.

Adult↗

Use of a thymic factor in the prevention of postoperative infections.

A controlled study was carried out on 60 patients undergoing laparotomy to assess the role of a thymic factor (TP-1 Serono) in the prevention of postoperative infections. All patients entering the study were preoperatively shown to be at risk of sepsis on the basis of the response to skin multitest system for assay of delayed hypersensitivity (Multitest C.M.I. System). The patients were also postoperatively monitored with the same system. The lower incidence of infections in patients treated with the thymic factor with respect to untreated patients (p less than 0.05) and the postoperative response to skin tests have confirmed the efficacy of the thymic factor under study in the prevention of postoperative infections.

Adjuvants, Immunologic↗