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Biomedical subjects

M Neri

Publications and source records attributed to M Neri.

At least 73 records · Page 4Linked to original sources
PubMed1998

Comparison of two methods of processing induced sputum: selected versus entire sputum.

Sputum analysis is increasingly used to assess airway inflammation in asthma. The analysis of sputum is currently performed with two techniques, i.e., analysis of selected sputum (plugs) and analysis of entire sputum. To investigate the diagnostic value of these two methods, we compared total and differential cell counts and supernatant eosinophil cationic protein (ECP) in selected and entire sputum collected on two occasions in a group of healthy and asthmatic subjects. We induced sputum with hypertonic saline in 18 asthmatics and in eight healthy subjects. On one occasion we analyzed selected sputum, and on another occasion we analyzed entire sputum. In each sample we measured total and differential cell counts and ECP concentration in supernatant. We found a higher percentage of eosinophils (15.3 versus 8.3%; p < 0.01), more viable nonsquamous cells (80.6 versus 71.8%; p < 0.01), and higher levels of ECP (548 versus 105 microg/L; p < 0.001) in selected sputum as compared with entire sputum, whereas the percentage of neutrophils was higher in the entire sputum (42.7 versus 33.3%; p < 0.05). The percentage of eosinophils and ECP concentration were significantly and similarly increased in both selected and entire sputum of asthmatic subjects, i.e., independent of the method of sputum analysis. In conclusion, the selected sputum method may indeed provide more viable cells, more eosinophils, and a higher concentration of ECP. However, both the selected sputum and the entire sputum method have the same diagnostic value in distinguishing asthmatics from healthy subjects.

Adult↗
PubMed1998

Assessing behavioural and cognitive impairment in dementia using an informant's report: evidence from the CAMDEX interview.

The consistency of measures from informants' report and from objective testing, both incorporated into the CAMDEX interview, was tested for elderly persons with mild dementia (n = 46), with moderate dementia (n = 41), and without cognitive impairment (controls, n = 56). Informants' reports permitted grading severity of dementia and provided measures of memory and mental functioning in everyday activities highly related to indices derived from objective testing.

Activities of Daily Living↗
PubMed1998

[The new norms decreed by the legislative dirrective 91-93 CCE].

The Community law now rules any sector of the economy including the Pharmaceutical Industry, which is controlled with a special attention starting from drugs manufacturing up to marketing. After detailing the Community regulations acknowledged by the Italian legislation since the adoption of the first Pharmaceutical Directive in 1965, the Authors examine the Decree Law of february 1997 by which the EEC Directive 93/39 is acknowledged (as amended Directives EEC 65/65,75/318 and 75/319 relating to medicinal products for human use). A special attention is devoted to the several regulations concerning Pharmacovigilance, whose importance is emphasized.

Drug Industry↗
PubMed1998

Surveillance of tuberculosis treatment prescription in Italy. The Varese TB Study Group.

In industrialized countries, data on antituberculosis treatment are scanty. The aim of this study was to describe the tuberculosis (TB) treatment programme from diagnosis to drug intake in a model area of northern Italy, evaluating: 1) antiTB regimens prescribed and their adequacy; 2) dosage of drugs; 3) side-effects; and 4) drug resistance. Individual data on new TB cases from all the existing health facilities of the area were collected by means or a prospective surveillance system based on the systematic review of original clinical forms. Regimens were classified as adequate, potentially adequate and inadequate, based on published recommendations. Data on drug dosage, side effects and drug resistance were analysed. Out of 109 TB cases with regimen recorded on clinical records, 20.2% included more than four major drugs, 63.3% three drugs and 16.5% two drugs. The regimens were classified as 1.8% adequate, 85% potentially inadequate and 12.8% inadequate. The dosages prescribed (mean +/- SD in mg.kg body weight-1.day-1) were: isoniazid: 6.8 +/- 2.7: rifampicin: 10.2 +/- 2.5; ethambutol: 21.3 +/- 4.5; streptomycin: 17.4 +/- 4.0: and pyrazinamide: 15.2. Twelve per cent of cases required treatment modification due to side-effects. Resistance to one single drug was found in 9% of cases, but no case with multidrug-resistant TB. The description of the treatment programme revealed that: 1) the majority of regimens are potentially adequate; 2) they are at a proper dosage; 3) the side-effects are in agreement with the literature; and 4) drug-resistance rates are low.

Antitubercular Agents↗
PubMed1998

[Dyspepsia: a reappraisal problem].

Dyspepsia is a major public problem. It occurs in 25-40% of the general population negatively affecting the quality of life. 2-3% of the patients visited by the GP and up to 30% of those visited by the gastroenterologist have dyspepsia. Both diagnostic procedure and therapy are expensive. Definition, aetiology and pathogenesis of the disorder are not clear cut. The aim of this review is to outline the main trends in the relevant area of the clinical practice. The authors choose the most comprehensive definition among the thirty of the medical literature. To rule out, the most commonly and frequently wrong opinions risk factors have been examined. The authors distinguished between symptoms of function and organic dyspepsia and those of Irritable Bowel Syndrome and Gastro-Esophageal Reflux Disease, which often overlap and make difficult the management of the patient. The aetiology and pathogenesis have also been discussed, with particular emphasis on Hp. Advantages and drawbacks of different diagnostic approaches have been investigated. An age and symptoms related approach of the cases with dyspepsia is proposed, which allows to manage the patient without the necessity of invasive procedures. It is finally suggested that are cases which can be managed by the GP and others for whom the gastroenterologist intervention is mandatory.

Adult↗
PubMed1997

The Fab region of IgG2 human myeloma proteins does not bear the streptococcal protein G-specific determinant.

Seven out of ten Fab (F(ab')2/Fab') preparations derived from purified human myeloma IgG showed a substantial binding to protein G-Sepharose. Subclass analysis revealed that the 7 protein G-reactive Fabs included 3 IgG1, 2 IgG3 and 2 IgG4 Fabs, whereas the remaining 3 which were not adsorbed were IgG2 Fab. Incubation of protein G-Sepharose with non-saturating amounts of 4 Fab preparations, representative of all IgG subclasses, showed that gamma 1, gamma 3 and gamma 4 Fabs adsorbed from 26 to 28.3%, whereas 80% of gamma 2 Fab was left in the supernatant after adsorption. These results indicate that human IgG2 lack PG-specific Fab-associated reactive site(s).

Antibodies, Monoclonal↗
PubMed1997

Immunogenicity of influenza vaccine (1993-94 winter season) in HIV-seropositive and -seronegative ex-intravenous drug users.

The humoral response (haemagglutination inhibiting antibodies) to trivalent split influenza vaccine for the 1993-94 winter season (A/Beijing/32/92 (H3N2), A/Singapore/6/86 (H1N1) and B/Panama/45/90) was evaluated in a group of young HIV-seropositive ex-intravenous heroin users and compared with responses measured in HIV-seronegative individuals with a similar history. HIV-negative volunteers showed an overall positive response suggesting that previous heroin use did not influence their humoral response to influenza vaccine. Comparable results were obtained in HIV-positive subjects with CD4+ lymphocyte counts > 500 microliters-1, whereas impaired reactivity was found in HIV-positive volunteers with CD4+ counts < 500 microliters-1. Booster vaccination did not increase antibody levels in any of the groups studied, although the data did not exclude a positive influence of a second vaccine dose on persistence of antibody at 120 days after the first dose. No significant changes were observed in p24 antigenemia levels in HIV-positive individuals after vaccination.

Adult↗
PubMed1997

Optimal combination of media for primary isolation of Helicobacter pylori from gastric biopsy specimens.

The aim of the present study was to compare eight media, four nonselective and four selective media, to determine the best combination of media for the primary isolation of Helicobacter pylori. Over a period of 5 months, mucosal antral biopsy specimens were obtained from 222 consecutive dyspeptic patients undergoing endoscopy. Biopsy samples were plated in parallel on all eight media. Egg yolk emulsion agar (EYE), Skirrow's medium, Dent's medium, and modified Thayer-Martin medium were used as selective media; modified chocolate agar (MCHOC), Triptycase soy agar (TSA), brucella agar, and brain heart infusion agar were used as nonselective media. Overall, by using these eight media, H. pylori was recovered from biopsy specimens from 114 of 222 patients, yielding an isolation rate of 51%. Comparison of all possible combinations of the eight media showed that the highest rate of isolation of H. pylori was 100% (114 of 114) with EYE-MCHOC, followed by 96.5% (110 of 114) when EYE-TSA was used. Conversely, it was found that none of the media used alone yielded a 100% rate of recovery (the maximum recovery rate was 95%, which was achieved with EYE). These results indicate that the association of EYE and MCHOC yielded the maximum recovery of H. pylori from gastric biopsy specimens. Therefore, the use of selective and nonselective media in parallel offers optimal recovery rates with only a slight increase in costs.

Biopsy↗
PubMed1997

Comparative evaluation of the E test, agar dilution, and broth microdilution for testing susceptibilities of Helicobacter pylori strains to 20 antimicrobial agents.

The Epsilometer test (E test; AB Biodisk, Solna, Sweden), a new quantitative technique for the determination of antimicrobial susceptibility, was compared to reference methods (agar dilution and broth microdilution) for the antimicrobial susceptibility testing of Helicobacter pylori. Seventy-one H. pylori strains isolated from patients with duodenal ulcers were tested against 20 antimicrobial agents. The E test and the agar dilution method were carried out on Mueller-Hinton agar; the broth microdilution method was performed with Mueller-Hinton broth. The E-test results showed excellent correlation with the agar dilution results, with 91.3 and 98.8% agreement within 1 and 2 log2 dilution steps, respectively, in a total of 1,350 tests. The correlation between the E-test results and the broth microdilution results was slightly higher, with 91.6 and 99.1% agreement within 1 and 2 log2 dilution steps, respectively, in a total of 1,317 tests. There were six major errors and two very major errors by the metronidazole E test compared to the results obtained by reference methods. Excellent agreement between E-test, agar dilution, and broth microdilution results was found for resistance to erythromycin (8%), clarithromycin (6%), and tetracycline (6%). Our results confirm that the E test is comparable to standardized methods for susceptibility testing. Therefore, the E test is a reliable and alternative method for testing H. pylori susceptibility to a wide range of antimicrobial agents in clinical practice.

Anti-Bacterial Agents↗
PubMed1997

Fibre types in skeletal muscles of chronic obstructive pulmonary disease patients related to respiratory function and exercise tolerance.

This study aimed to investigate the relationship between skeletal muscle, fibre type composition, functional respiratory impairment and exercise tolerance in patients with moderate to severe chronic obstructive pulmonary disease (COPD). A group of 22 COPD patients and 10 healthy control subjects were studied. In COPD patients, vital capacity (VC) and forced expiratory volume in one second (FEV1) were reduced to 79% and 51%, respectively. Diffusion indices (transfer factor of the lung for carbon monoxide (TL,CO) and carbon monoxide transfer coefficient (KCO)) were also reduced. Arterial oxygen tension (Pa,O2) was normal or slightly altered. A maximal exercise test was performed and anaerobic threshold was calculated. Muscle samples from vastus lateralis were obtained by needle biopsy. Myosin heavy chain (MHC) and light chain (MLC) isoforms were separated by gel electrophoresis and quantified by densitometry. MHC isoforms were considered as molecular markers of fibre types. The proportion of the fast MHC-2B isoform was increased in COPD patients. TL,CO, KCO, VC and FEV1 were positively correlated with slow MHC isoform content. TL,CO and KCO were also negatively correlated with the content of the fast MHC-2B isoform. No correlation was found between exercise parameters and MHC isoform composition. The co-ordinated expression between MHC and MLC isoforms was altered in COPD patients. We conclude that reduced oxygen availability, probably in combination with muscle disuse, may determine muscle alterations in chronic obstructive pulmonary disease patients. The altered correlations between myosin heavy chain and light chain isoforms suggest that co-ordinated protein expression is lost in chronic obstructive pulmonary disease muscles.

Adult↗
PubMed1997

Induced sputum to assess airway inflammation: a study of reproducibility.

BACKGROUND: Infiltration of the airways mucosa with activated inflammatory cells appears to be a major factor in the pathogenesis of asthma and other airway diseases. Examination of sputum provides a direct method to investigate airway inflammation non-invasively. OBJECTIVES: The aim of the present study was to evaluate the reproducibility of cell counts on cytospins and fluid phase (eosinophil cationic protein, ECP) measurements in a selected portion of induced sputum. We aimed to confirm the validity of the tecnique by comparing measurements between stable asthmatics, allergic rhinithis and healthy subjects. METHODS: Sputum was induced with hypertonic saline (4.5%) twice within one week in 53 stable asthmatics, 16 subjects with seasonal rhinitis (out of the pollen season), and 19 healthy subjects. Reproducibility was examined within sample (two different plugs of the same sample) between sample (two specimens of induced sputum obtained within one week) and between examiners on stable subjects taking into account sample size, number of examinations per patients and Confidence Interval (CI) of the estimates. RESULTS: We have found that the method is highly reproducible within sample and between examiners for all types of cells and fluid phase measurements of ECP. It is reproducible between sample for eosinophils, macrophages, neutrophils and ECP, but not for lymphocytes and weakly for epithelial cells. Sputum from asthmatics, in comparison with the sputum of healthy subjects and subjects with rhinitis had higher eosinophils (asthmatics: 12.2% +/- 12.9, rhinitis: 0.4 +/- 0.8, normals: 0.4 +/- 0.7 (%) and ECP (asthmatics: 827 +/- 491 microg/L, rhinitis: 127 +/- 82 normals: 157 +/- 203). No significant differences were found between healthy subjects and subjects with rhinitis. Eosinophil counts were inversely correlated with FEV1 (r = -0.37) expressed as percentage of predicted, but not significantly correlated with PC20 methacholine (r = -0.28) or blood eosinophils (r = 0.26). CONCLUSIONS: The importance of this study is the confirmation, within important statistical guidelines for a study of reproducibility, that the methods examined are reproducible and valid.

Adult↗
PubMed1996

Cloning and chromosomal localization of a cDNA encoding a mitochondrial porin from Drosophila melanogaster.

We have raised polyclonal antibodies against purified the Drosphila melanogaster mitochondrial porin. They showed high titre and specificity and were thus used as a tool for screening an expression library. The isolated clone 1T1 showed 74% sequence identity in the last 19 residues at the C-terminus of human porin. A subclone of 1T1, containing the porin-like sequence, was thus used as a probe for re-screening a cDNA library and several positive clones were plaque-purified. We present here the sequence of a 1363 bp cDNA encoding a protein of 279 amino acids. Its identity with porin was also confirmed by N-terminal Edman degradation of the purified protein. The D. melanogaster porin shows an overall 51.8% identity with human porin isoform 1 (porin 31HL or HVDAC1) and an overall 55.7% identity with human porin isoform 2 (HVDAC2). Hydrophobicity plots and secondary structure predictions showed a very high similarity with data obtained from known porin sequences. The D. melanogaster porin cDNA was used as a probe for in situ hybridization to polytenic salivar gland chromosomes. It hybridizes with different intensities in two sites, in chromosome 2L, at region 31E and in chromosome 3L at region 79D. Thus, also in Drosophila melanogaster porin polypeptide(s) belong(s) to a multigene family.

Amino Acid Sequence↗
PubMed1996

Possible correlation between low antigenic drift of A(H1N1) influenza viruses and induction of HI antibodies.

This study examined whether, during a seven-year period of low A(H1N1) influenza virus antigenic drift (1988-1989 and 1994-1995, winters), humoral antibody response of elderly volunteers to influenza vaccines could suggest a lack of antibody pressure for drift. In all the years studied A/Taiwan/1/86, the A(H1N1) vaccine component, had a low ability to induce protective hemagglutination-inhibiting (HI) antibody titres (> or = 1:40). However a similar low immunogenicity was found for some of the different A(H3N2) strain variants of influenza virus, co-circulating in the same period and showing a regular extent of antigenic variations. Although our data could be at least in part explained by the type of study population (elderly and repeatedly vaccinated), postepidemic serological studies did not evidence a consistently lower ability in mounting protective immune response in elderly people as compared with younger against the influenza strains studied. Therefore, our present results did not exclude a true low immunogenicity of A/Taiwan and of some A(H3N2) influenza strains, circulating in the winters examined. This suggests that, besides the necessity to evade prior immunity, additional factors could influence the frequency of influenza viruses antigenic drifts.

Aged↗
PubMed1996

1995 IPA/Bayer Research Awards in Psychogeriatrics. Bihemispheric language disorders in early-stage dementia of the Alzheimer type: evidence from a novel metalinguistic task.

Because dementia of the Alzheimer type (DAT) is commonly characterized by bilateral cerebral atrophy, we examined the issue of higher linguistic abilities lateralized to the right cerebral hemisphere (RH) in earlystage DAT. A modified version of an insertion task was administered to 14 patients with probable DAT, 8 right-hemisphere brain-damaged (RHD) patients, 8 left-hemisphere brain-damaged (LHD) patients, and 28 normal elderly (control, CTR) right-handed subjects. The task consisted of presenting the subjects with 53 well-formed sentences; in each a word or syntagm had to be inserted grammatically. Twenty-eight word/syntagm insertions required grammatical role reassignment of a lexical item in the stimulus sentence (shift, sensitive to RHD); 25 insertions implied only semantic reinterpretation of the target sentence (nonshift, sensitive to LHD). The three pathological groups were relatively and similarly impaired on standard aphasia assessment. The performances of the DAT patients, controlled for global cognitive verbal proficiency, verbal cognitive skills, and mood, were found to be significantly worse than the performances of the CTR group on both insertion subtests, whereas there were no significant differences between the DAT and RHD subjects on the shift items or between the DAT and LHD subjects on the nonshift items. Similarly, no differences were noted between the RHD and CTR nonshift scores, or between the LHD and CTR shift scores. On the other hand, the LHD group outscored the RHD group on the shift insertions. A comparison between the two insertion subtests revealed that only the RHD and DAT groups performed significantly worse on the shift than on the nonshift items. Results are consistent with other anecdotally reported RH-specific language-related disorders in early DAT and replicate previous findings of bihemispheric extralinguistic disturbances in these patients.

Aged↗
PubMed1996

Gastric mucosal infiltration by Helicobacter pylori favours bacterial survival after treatment.

BACKGROUND: Although a number of patient and bacterial factors have been identified as predictors of treatment failure in Helicobacter pylori-associated gastritis, the causes of lack of response to treatment have not been fully elucidated. We hypothesized that bacterial infiltration of the gastric mucosa might be one of the factors responsible for treatment failure in patients harbouring the bacterium. METHODS: We studied 182 patients with gastritis who underwent anti-H. pylori treatment with different drugs. Gastric biopsies obtained at endoscopy, were examined for electron microscopic features of infiltration and damage. Patients were assigned to different treatment groups, and endoscopy, evaluation of H. pylori status and electron microscopy were repeated at least 4 weeks after the end of treatment. RESULTS: The overall H. pylori eradication rate was 65%. Eradication was achieved more frequently in patients without electron microscopic features of infiltration (85%), than in those patients with the bacteria deeply embedded into the gastric mucosa (45%; P < 0.0001). No treatment appeared to be clearly superior for patients with the highest degree of mucosal infiltration. CONCLUSIONS: Bacterial mucosal infiltration may facilitate the survival of H. pylori during antibacterial treatment; moreover, electron microscopy may be helpful to identify patients potentially unresponsive to anti-H. pylori treatment.

Adolescent↗
PubMed1996

AIDS and tuberculosis control programmes: an integrated approach at educational level.

In developing countries with a high prevalence of individuals co-infected by human immunodeficiency virus (HIV) and tuberculosis (TB), urgent public health measures should be implemented to prevent the spread of both diseases. This study was performed by a combined acquired immune deficiency syndrome (AIDS)-TB health team with the following aims: 1) to assess knowledge, attitudes and practice towards AIDS; 2) to identify target groups for health education (HE); 3) to evaluate HE impact; 4) to circulate correct information on AIDS and TB through target groups; and 5) to evaluate integration of AIDS and control TB activities. Secondary school students of Arua District, Uganda, participated in a standardized HE session (covering the key-points of AIDS and TB control) preceded by a pretest (multiple choice) questionnaire and followed 3 months later by the same questionnaire (post-test). The impact of HE on AIDS control was evaluated by comparing answers to pre- and post-test questionnaires and its influence on the TB programme by evaluating case-finding performances in the period preceding and following the survey. We analysed 1,478 questionnaires. The results of our study gave information on knowledge about AIDS, identified females and students < 16 yrs of age as good targets for HE, revealed that the impact of HE was significantly associated with improved knowledge, contributed to improved TB case-finding and offered suggestions for the integration of programmes. The survey represented an opportunity to create a stable AIDS/TB health team at district level.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Computerized patient record for a department of respiratory rehabilitation.

A computerized patient record (CPR) system plays an essential support role in the efficient functioning of the clinical and research services of a medical centre. We report the experience gained in developing a CPR for the Respiratory Rehabilitation Department (RRD) of the Tradate Medical Center of the Salvatore Maugeri Foundation, with specific reference to Out-patient (OP) and In-patient (IP) Units. The CPR was developed locally under the guidance of the Bioengineering Department. Several items implemented and strategies adopted are described and grouped in relation to broader objectives, such as the improvement of health-care quality, the enhancement of personnel productivity and reduction in costs, the support of clinical and health service research and the accommodation of future developments. In particular, we describe the design and implementation of anamnestic, physical and admission data collection, specifically orientated to respiratory diseases. Daily use of the CPR in the OP and IP units and its potential outcome for research and management support are also studied in detail. On the basis of our experience (1,251 out-patient examinations, 650 in-patient clinical admission cards), the computerized patient record seems a useful way of providing better health-care and a more comprehensive coverage of the rehabilitation process of patients in a Respiratory Rehabilitation Department.

Delivery of Health Care↗