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Biomedical subjects

M Orsini

Publications and source records attributed to M Orsini.

At least 19 recordsLinked to original sources

Electrochemically promoted C-N bond formation from amines and CO2 in ionic liquid BMIm-BF4: Synthesis of carbamates.

A new electrochemical procedure for the synthesis of organic carbamates from amines and carbon dioxide has been developed using selective cathodic reduction of carbon dioxide in CO2-saturated room-temperature ionic liquid BMIm-BF4 solutions containing amines 1a-j, followed by addition of EtI as an alkylating agent. The synthesis was carried out under mild (PCO2 = 1.0 atm, t = 55 degrees C) and safe conditions, and the use of volatile and toxic solvents and catalysts (according to the growing demand for ecofriendly synthetic methodologies), as well as of any supporting electrolyte (for a very easy workup of the reaction mixture), was avoided. Carbamates 2a-j were isolated in good to high yields.

Journal Article↗

Prospective 3-year surveillance for nosocomial and environmental Legionella pneumophila: implications for infection control.

OBJECTIVES: To perform a 3-year, prospective surveillance program for legionnaires disease (LD) in a large university hospital in Rome, and to assess the usefulness of the hospital water monitoring program in predicting the risk of nosocomial LD. METHODS: Samples from patients with new cases of nosocomial pneumonia were sent for legionella laboratory investigations. Meanwhile, water samples for bacteriological analysis were collected every 6 months from high- and medium-risk hospital wards (10 in total). Legionella pneumophila isolates collected were serotyped and analyzed by pulsed-field gel electrophoresis. RESULTS: From June 2001 through May 2004, the pneumonia surveillance identified one case of nosocomial LD among 43 cases of nosocomial pneumonia (2.3%). Environmental investigations detected L. pneumophila in 12 (18.7%) of the 64 water samples, of which 50% belonged to serogroup 1. The L. pneumophila count and the percentage of positive locations never exceeded 10(2) colony-forming units/L and 20%, respectively, except when the LD nosocomial case occurred (positive water samples, 40%; L. pneumophila count, <10(2) colony-forming units/L). Genotyping showed 3 prevalent clones of L. pneumophila in the water distribution network, of which one persisted over the 3 years. One clone contained 3 different L. pneumophila serogroups (2, 4, and 6). CONCLUSIONS: The low incidence of nosocomial cases of LD appears to be associated with a low percentage (<20%) of positive water samples per semester and with a low contamination level (<10(2) colony-forming units/L). An infection control system for nosocomial LD should, therefore, be based on both environmental and clinical surveillance, together with the appropriate maintenance of the hospital water distribution system.

Cross Infection↗

Detection of metazoan species as a public health issue: simple methods for the validation of food safety and quality.

Species identification represents a critical issue in food chain safety and quality control. Several procedures are available to detect animal proteins in cattle feed or to trace transgenic foods. The most effective approach is based on the use of DNA as a marker. Amplification of DNA provides rapid, sensitive and specific protocols. Several target genes can be used, but new insights come from the mitochondrial genome, which is naturally amplified in each cell and shows a remarkable resistance to degradation. These are key points when analysing complex matrices such as foods, animal feedstuff or environmental samples. Traceability is important to prevent BSE or to monitor novel foods, such as genetically modified organisms. Amplification is commonly performed, but it requires expertise and a molecular biology laboratory to perform restriction analysis, electrophoresis or gel staining for the visualisation of results. Hereby, we consider a strategy based on multiple nested amplification and reverse hybridisation assay that virtually requires only a thermocycler and a water bath. The protocol is rapid and simple and can simultaneously detect different species in a DNA sample. This promising approach allows microarray developments, opening up to further perspectives. An international application has been published under the patent cooperation treaty. Presently, a ban on feeding ruminants on cattle-derived proteins is in force in Europe and USA. The identification of metazoan traces in a sample is not only a mere preventive measure for BSE, but represents a possible screening system for monitoring biotechnology products and procedures, as well as a quality control strategy to assure consumer's rights.

Animals↗

Molecular epidemiology of Legionella pneumophila environmental isolates representing nine different serogroups determined by automated ribotyping and pulsed-field gel electrophoresis.

The purposes of the study were (i) to describe the abundance and epidemiology of Legionellaceae in the man-made environment in a northern Italian area, (ii) to assess the concordance between pulsed-field gel electrophoresis (PFGE) and automated ribotyping (AR) techniques for genotyping L. pneumophila and (iii) to investigate the correlation between serogrouping and genotyping data. Water was sampled from reservoirs in 12 buildings across an area of 80-km radius. Despite the water temperature always being maintained above 55 degrees C, all of the buildings sampled were contaminated with Legionellaceae on at least one occasion and 63 L. pneumophila isolates representing nine different serogroups were collected. The two DNA methods revealed a high degree of genetic heterogeneity, even though identical L. pneumophila clones were recovered at different sites. The AR technique provided a fairly reliable approximation of PFGE results (73% concordance), however there was poor correlation between serogrouping and genotyping data as identical DNA fingerprints were shared by isolates of different serogroups.

Electrophoresis, Gel, Pulsed-Field↗

Leishmania/HIV co-infection in Brazil: an appraisal.

Given the epidemiology of human leishmaniasis and AIDS in Brazil, numerous cases of Leishmania/HIV co-infection might be expected. Relatively few Brazilian cases have been reported, however, even from regions where the overall incidences of HIV and Leishmania infection are both relatively high. Many cases of co-infection probably go undetected because of a lack of awareness among clinicians or limited access to appropriate diagnostic methods. In contrast to the situation in Europe, intravenous-drug users do not predominate among those exposed to HIV infection in Brazil. The success of the Brazilian programme for the free and universal distribution of antiretroviral drugs has decreased the prevalences of the commoner opportunistic infections among HIV-positives and increased the longevity of AIDS cases. Recent changes in the epidemiological patterns of HIV and Leishmania infections are likely to lead to a greater degree of overlap and a greater risk of co-infection and they justify increased alertness. This review of the co-infection in Brazil addresses three main topics: the current situation, in terms of the epidemiology of AIDS and Leishmania infection; the related epidemiological trends and their likely impact on the co-infection; and the co-infection cases reported in Brazil by June 2003.

AIDS-Related Opportunistic Infections↗

A molecular typing approach for evaluating bioaerosol exposure in wastewater treatment plant workers.

Bioaerosols associated with wastewater treatment process may represent a health risk for occupationally exposed personnel. To evaluate microbial contamination in plant workers, we compared oral cavity isolates against isolates collected from aerosol surrounding the aeration basin. Typing was performed by metabolic profile and arbitrarily primed-polymerase chain reaction. The latter is more sensitive and rapid than conventional tests. After comparison, isolates from the air samples were not related to those obtained from the exposed workers. This molecular approach can support bioaerosol risk evaluation .

Aerosols↗

A microwave-based method for nucleic acid isolation from environmental samples.

AIMS: A simple and rapid method was described for DNA isolation directly from activated sludge or other environmental sources, including soil and sediments. METHODS AND RESULTS: The present method is based on microwave thermal shock and provides DNA suitable for further analysis. It is also effective for RNA extraction. CONCLUSION: The protocol is effective, easy, fast and does not require the use of expensive equipment or reagents. SIGNIFICANCE AND IMPACT OF THE STUDY: The described method can be applied to difficult substrates in environmental microbiology studies.

DNA, Bacterial↗

Comparison of calcium sulfate and autogenous bone graft to bioabsorbable membranes plus autogenous bone graft in the treatment of intrabony periodontal defects: a split-mouth study.

BACKGROUND: Current literature shows that calcium sulfate can be used in guided tissue regeneration. Its biocompatibility and resorbability give it significant advantages in the treatment of periodontal and endodontic defects. Clinically guided tissue regeneration procedures have demonstrated significant positive clinical change, beyond that achieved with debridement alone, in treating intraosseous defects. The aim of the present investigation was to evaluate the clinical results obtained with autologous bone plus calcium sulfate, and to compare them with the results obtained using autologous bone plus membrane. METHODS: A total of 12 patients were treated in the present investigation. A split-mouth design was utilized. Twelve 3-wall periodontal defects were treated with calcium sulfate plus autologous bone graft (test) and compared with 12 contra-lateral defects treated with a bioabsorbable membrane plus autologous bone graft (control). Before the surgical procedure, patients were instructed about oral hygiene and scaling and root planing (SRP) was completed. Probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded at baseline and 6 months. RESULTS: There were no statistical differences between test and control defects at baseline. BOP was 58% and 50% for control and test defects, respectively. Mean PD was 7.75+/-0.96 mm (control) and 8.0+/-1.28 mm (test). Mean CAL was 8.58+/-1.31 mm (control) and 8.83+/-0.91 mm (test). At 6 months, mean PD was 3.41+/-0.51 (P = 0.0022) for control defects and 3.58+/-0.51 (P = 0.0022) for test defects. CAL showed a mean gain of 5+/-0.85 for controls (P = 0.0022) and 5.25+/-0.75 for test defects (P = 0.0022). Thus, there was a mean reduction of PD of 4.33 mm (56%) for control sites and 4.42 mm (55%) for test sites. The mean clinical attachment gain was 3.57 mm for control sites and 3.58 mm for test sites. As there were no sham-operated controls, it is not clear that the healing of these test or control-treated sites was any better than similar 3-walled defects sham operated. CONCLUSIONS: Both therapies led to short-term improvement of the measured parameters; neither was superior to the other.

Absorbable Implants↗

Influence of bioactive glass on changes in alveolar process dimensions after exodontia.

BACKGROUND: Preservation of the alveolar process after tooth extraction is desirable because it facilitates placement of endosseous implants and minimizes adverse esthetic results associated with fixed partial dentures. The purpose of this study was to evaluate the clinical effectiveness of bioactive glass used as a graft material combined with calcium sulfate used in the form of a mechanical barrier in preserving alveolar ridges after tooth extraction. METHODS: Sixteen patients who required extraction of 2 anterior teeth or bicuspids participated in the study (split mouth design). After tooth extraction and elevation of a buccal full-thickness flap, experimental sockets were filled with bioactive glass, which in turn was covered with a layer of calcium sulfate. Control sites did not receive any graft or calcium sulfate. Titanium pins served as fixed reference points for measurements. No attempt was made to advance the flap to cover the socket areas on control or experimental sites (open socket approach). Reentry surgeries were performed at 6 months. RESULTS: Reentry surgeries showed that experimental sites presented with (1) significantly more internal socket bone fill (6.43 +/- 2.78 mm vs 4.00 +/- 2.33 mm on control sites), (2) less (although not statistically significantly less) resorption of alveolar bone height (0.38 +/- 3.18 mm vs 1.00 +/- 2. 25 mm on control sites), and (3) similar degree of horizontal resorption of the alveolar bony ridge as compared with controls (3. 48 +/- 2.68 mm vs 3.06 +/- 2.41 mm on control sites). CONCLUSIONS: This study suggests that treatment of extraction sockets with a combination of bioactive glass and calcium sulfate is of some benefit in preserving alveolar ridge dimensions after tooth extraction.

Adult↗

Dissolution of gallbladder stones with methyl tert-butyl ether and stone recurrence: a European survey.

Since there are now several ways to treat symptomatic gallstone disease, one is able to select treatment on the basis of the patient's comfort, the practicability, effectiveness, and side effects of the technique, and the relative costs. In order to assess the present status of contact dissolution with methyl tert-butyl ether with regard to these aspects, the present enquiry reports the data of 21 European hospitals. Eight hundred three patients were selected for contact litholysis of cholesterol gallbladder stones using methyl tert-butyl ether. Percutaneous transhepatic puncture of the gallbladder was performed under x-ray or ultrasound guidance. Dissolution rate, side effects, and treatment times of 268 patients from one single center were compared to those of 535 patients from the other 20 centers. Two hundred sixty-four patients were followed for five years to assess stone recurrence. Physicians were asked how they assessed the expenditure of the method, the discomfort to the patients, and the staffing situation. Patients were asked to indicate their acceptance on an analog scale. Puncture was successful in 761 (94.8%) patients. Prophylactic administration of antibiotics was not necessary. Stones were dissolved in 724 (95.1%) patients. In 315 (43.5%) sludge remained in the gallbladder. The most severe complication was bile leakage, which led 12 (1.6%) patients to have elective cholecystectomy. Toxic injuries due to the ether were not reported. Method-related lethality amounted to 0%, 30-day-lethality to 0.4%. Stone recurrence rate was about 40% in solitary stones and about 70% in multiple stones over five years. Patients with multiple stones developed recurrent stones almost twice as often as those with solitary stones. The probability of stone recurrence in patients with sludge in the gallbladder after catheter removal was not statistically significantly different from those without sludge. Seventy to 90% of the centers found the puncture to be simple and not distressing for patients and the relation between expenditure and therapeutic success to be acceptable. The acceptance of contact litholysis by the patients was excellent. Contact litholysis when applied by an experienced team provides real advantages in the treatment of gallstone disease. The method is technically simple, well accepted by the patients, and can be easily applied in community hospitals. Contact litholysis may be of particular value in patients who are not suitable for anesthesia or surgery.

Adolescent↗

Gallbladder motility and gallstone formation in obese patients following very low calorie diets. Use it (fat) to lose it (well).

OBJECTIVE: Dieting obese subjects are at risk of developing gallstones. A gallbladder motor dysfunction could have a pathogenetic role. The principal aim of this study was to evaluate the long term effects of two very low calorie diets differing in fat content on gallbladder emptying and gallstone formation in obese subjects. DESIGN AND SUBJECTS: Gallbladder emptying in response to meals (breakfast, lunch and dinner) in two different diet regimens (3.0 vs 12.2 g of fat/d) was evaluated by ultrasonography in 32 gallstone-free obese patients on different days, before and during (at 45 d intervals) one or two 6-month weight reduction diets (for the first three months: 2.24 MJ (535.2 kcal), 3.0 g fat/d vs 2.415 MJ (577.0 kcal), 12.2 g fat/d; for the second three months, the same low calorie diet of 4.194 MJ (1002 kcal)/d for both groups). In 10 subjects, bile analysis was also performed. RESULTS: Twenty-two (69%) subjects concluded the study, eleven in each group, and a significant weight loss was achieved by all subjects. Gallstones (asymptomatic) developed in 6/11 (54.5%) (P < 0.01) of subjects following the lower fat diet, but in none with the higher fat regimen. In the dieters during the first three months (very low calorie phase) the higher fat meals always induced a significantly greater gallbladder emptying than the lower fat meals. The cholesterol saturation index initially increased significantly and then decreased, without difference between the two groups. CONCLUSION: In the obese during rapid weight loss from a very low calorie diet, a relatively high fat intake could prevent gallstone formation, probably by maintaining an adequate gallbladder emptying, which could counterbalance lithogenic mechanisms acting during weight loss.

Adolescent↗

A bone regenerative approach to alveolar ridge maintenance following tooth extraction. Report of 10 cases.

TEN PATIENTS WHO REQUIRED two or more anterior teeth extractions were utilized in this study. Extraction procedures were carried out with a full thickness surgical flap approach. After flap reflection, teeth were removed with a minimum of trauma to the surrounding bone. Following extraction silicone-based impression techniques were used to produce a model of the alveolar process and small metal pins were placed in the alveolus to be used as fixed points to make measurements of ridge dimensions. One socket was covered with an expanded polytetrafluoroethylene (ePTFE) barrier membrane (experimental site); the other socket was a conventional control. The soft tissue flaps were then mobilized using periosteal releasing incision and the wound closed with ePTFE mattress sutures. Six months following extraction, patients were treated with flap surgery to expose both extractions sites to remove the ePTFE membranes and to measure ridge dimensions using the pins as fixed points. Clinical and model measurements have shown statistically significant better ridge dimensions at experimental sites than at control (P < or = 0.05). Three patients with exposed membranes had similar dimensional changes as controls. Results from this study suggested that this improved technique offers a predictable alveolar ridge maintenance enhancing the bone quality for dental implant procedures and esthetic restorative dentistry.

Alveolar Bone Loss↗

Alpha interferon treatment may prevent hepatocellular carcinoma in HCV-related liver cirrhosis.

BACKGROUND/AIMS: The aims of alpha-interferon treatment for chronic viral liver infections are clearance of the virus and healing of the disease. Hepatocellular carcinoma is a complication of viral cirrhosis; but it is not yet known whether treatment of viral cirrhosis with alpha-interferon prevents this complication. METHODS: The incidence and the risk (Cox regression analysis) of developing hepatocellular carcinoma were calculated in 347 patients with hepatic cirrhosis; 227 (34 hepatitis B virus and 193 hepatitis C virus related) were treated with alpha-interferon and 120 (28 hepatitis B virus and 92 hepatitis C virus) did not receive this treatment, in order to evaluate the efficacy of alpha-interferon in the prevention of hepatocellular carcinoma. In all patients, the cirrhosis was well compensated (Child A). RESULTS: Over mean follow-up periods of 49 months for hepatitis B virus and 32 months for hepatitis C virus, 20/347 patients (6/62 hepatitis B virus and 14/285 hepatitis C virus) developed hepatocellular carcinoma. The risk of developing this tumor was significantly greater in males (p < 0.007) and in patients not treated with alpha-interferon (p < 0.01). The Relative Risk of developing hepatocellular carcinoma increased significantly (p < 0.0002) with each passing year. In patients with hepatic cirrhosis secondary to hepatitis B virus infections, the risk did not seem to be modified by alpha-interferon treatment, even though a greater, but not significant risk (Relative Risk = 4.9; p = 0.3) was calculated for untreated patients; in contrast, in hepatitis C virus-related cirrhosis, this risk was reduced by a factor of 4.0 (p = 0.04). The tumor developed only in non-responder patients regardless of virus type. After adjustment for confounding factors (sex, age, alcohol consumption, cigarette smoking), a statistically significant (p < 0.025) effect of interferon treatment in preventing hepatocellular carcinoma was still demonstrated when responders were matched with controls, but not when responders were compared with non-responders. CONCLUSIONS: These results show that, in addition to its ability to halt the progression of viral-induced liver disease, alpha-interferon is also of benefit in patients with hepatitis C virus cirrhosis who respond to this treatment by lowering their risk of developing hepatocellular carcinoma.

Adolescent↗

[Effects of therapy with bis-hemisuccinate of ursodeoxycholic acid bisodium salt in patients with chronic hepatitis].

It has recently been shown that ursodeoxycholic acid administration improves liver function tests in patients with chronic liver diseases. Aim of the present study was to evaluate an ursodeoxycholic acid derivative (bis-hemisuccinate bisodic salt Ursodamor, Farmaceutici Damor, Napoli) in patients with chronic hepatitis. Forty patients (15 M, 25 F) with biopsy proven chronic liver disease participated to the study. Patients were randomly allocated to two treatment groups. Twenty patients (4 PBC, 11 CAH/CPH, 5 cirrhosis) received the ursodeoxycholic acid derivate at the dose of 600 mg/day, while 20 patients (1 PBC, 11 CAH/CPH, 8 cirrhosis) received a placebo. For both groups the treatment period was six months. ALT serum levels were significantly reduced in the treated group (from 84 +/- 14 to 62 +/- 14 p less than 0.0005) while no significant change was observed in the placebo group. In the treated group but not in the placebo group alkaline phosphatases and gamma-GT were also significantly reduced (from 268 +/- 56 to 160 +/- 23 p less than 0.0005 and from 79 +/- 21 to 45 +/- 10 p less than 0.0005). In conclusion, our results suggest that the administration of the ursodeoxycholic acid derivate, bis-hemisuccinate, bisodic salt, improves liver function tests in patients with chronic liver hepatitis. Similarly to ursodeoxycholic acid this new derivate probably interferes with bile acid pool composition by replacing the more detergent and probably more toxic endogenous bile acid.

Alkaline Phosphatase↗

Gallbladder motility in cholesterol gallstone disease. Effect of ursodeoxycholic acid administration and gallstone dissolution.

Gallbladder motility was evaluated by ultrasonography in 75 cholesterol gallstone patients and in 77 matched control subjects. All 75 gallstone patients were candidates for oral bile acid therapy (radiolucent gallstones, less than 2 cm in diameter, in well-opacified gallbladder), and 38 of them were also studied during ursodeoxycholic acid administration. An additional 20 gallstone patients were studied 1 year after confirmed gallstone dissolution with oral bile acids. Gallstone patients showed significantly greater fasting and residual volumes, a decreased percent of gallbladder emptying, but a similar absolute emptying and emptying rate compared with the control subjects. Greater fasting volumes and reduced percents of gallbladder emptying were also found in gallstone-free patients who achieved complete dissolution with oral bile acids. After ursodeoxycholic acid administration, fasting gallbladder volumes were greater, and percents of gallbladder emptying were further decreased than in untreated gallstone patients. In conclusion, greater fasting volumes, and not reduced gallbladder contractility, account for the defective gallbladder function in radiolucent (cholesterol-rich) gallstone patients. This condition is likely to precede, and possibly to promote, gallstone formation because it persists after gallstone dissolution. Ursodeoxycholic acid administration worsens the defect observed in gallstone patients. This finding also suggests, although indirectly, that the expected normalization of cholesterol saturation during oral bile acid administration is not paralleled by an improvement in gallbladder function.

Adolescent↗

[Photoplethysmography as a means of early diagnosis of changes in the microcirculation of children and adolescents with type I diabetes. Preliminary study].

Recent progress in non invasive diagnostic techniques for the study of the microcirculation, evoked a great interest in the screening of the patients with a diabetic microangiopathy. The authors, in this paper, wanted to evaluate the usefulness of photoplethysmography in the study of the microcirculation in children affected by type I diabetes; this technique was proposed as very reliable, non invasive and easily repeatable. 42 diabetic patients, with an age from 6 to 18 years, and a group of 12 healthy subjects of the same age, as a control group, were considered. Two particular points of interest were found: the statistical correlation between familial pathology for a vascular disease and the photoplethysmographic findings and the significant correlation between the age of the pathology and the beginning of the microcirculation disease. The authors, from their experience, evaluate the photoplethysmography as a reliable technique in the screening of all the diabetic subjects, children and adults, to evidence, as soon as possible, eventual lesions of the microcirculation for the beginning of an adequate therapy.

Adolescent↗