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Biomedical subjects

M Vassallo

Publications and source records attributed to M Vassallo.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Effect of estriol treatment per vaginam before Burch culposuspension].

BACKGROUND: To assess the effect of estriol treatment per vaginam before Burch culposuspension in postmenopausal women with stress urinary incontinence (IUS). METHODS DESIGN: prospective randomised study. SETTING: Department of Gynaecology, Obstetrics and Physiopathology of Human Reproduction-Medical School-University of Naples Federico II . PATIENTS: twenty women in postmenopause at least from five years with a urogenital symptomatology due to IUS. INTERVENTIONS: women were randomised into one of two groups (treated or control) and they were submitted to an evaluation of vulva and vagina trophism. All the women were submitted to a urodynamic examination and to a transvaginal ultrasonography with evaluation of pubis-bladder neck distance, bladder and proximal urethra position, before treatment, one week before the operation and after six months from the same operation. EVALUATIONS: subjective symptomatology and urodynamic parameters between treated and control groups before and after operation. RESULTS: After 12 weeks of treatment, a significant improvement of subjective symptomatology and a not significant improvement of all the urodynamic parameters in the treated group in comparison with the control group have been demonstrated, while any anatomic alteration compared with the basal hasn t been observed. After six months from the operation in all the women a significant reduction of subjective quantity of urine lost after a strain has been demonstrated and significant variations of urodynamic parameters without significant differences between treated group and control group were also observed. CONCLUSIONS: The estriol treatment per vaginam is not so effective on the result of Burch culposuspension in postmenopausal women with IUS.

Administration, Intravaginal↗
PubMed2000

Cardiovascular disease and outcome of acute stroke: influence of pre-existing cardiac failure.

BACKGROUND AND AIMS: Whilst a number of variables, mostly a consequence of a stroke, are known to predict mortality of acute stroke there is limited information on the significance of pre-existing cardiovascular variables on stroke mortality. We have investigated the influence of pre-existing cardiovascular factors in one cohort of stroke patients. METHODS: We studied 295 patients, mean age 74+/-10 (range 34-96) years; 133 males, presenting with acute stroke for pre-existing cardiovascular disease (CVD) defined as hypertension, atrial fibrillation (AF), ischaemic heart disease (IHD) and cardiac failure (CF). In addition, data were collected on epidemiological and neurological variables known to influence stroke mortality. The most significant of the cardiovascular factors was further investigated against all the other cardiovascular groups together and against those without any CVD. Outcome was measured as their influence on acute phase and 3-month mortality. RESULTS: There was no significant difference in 3-month mortality with hypertension (P=0.62) and IHD (P=0.33) but there was a significant higher mortality in patients with AF (P=0.05) and CF (P <0.001). CF was more significant than all other CVD (hypertension+AF+IHD) together without the failure (P<0.001); odds ratio of 4.5 (95% CI 2.28-9.07). Partial correlation coefficient revealed CF to be an independent significant variable to influence stroke mortality when controlled with AF, stroke syndromes, age, incontinence, pyrexia, dysphagia and Glasgow coma score. CONCLUSIONS: Pre-existing CF has an adverse influence on stroke mortality independent of other known factors. Cardiovascular factors without failure do not have such an effect except the marginal effect of AF.

Adult↗
PubMed2000

The role of attitudes, intentions and habit in predicting actual consumption of fat containing foods in Italy.

OBJECTIVE: To explore which were the most important predictors of the actual consumption of foods containing fat and to test if there were different profiles of beliefs and attitudes. DESIGN: A total of 1200 households participated in a food consumption survey for 7 days. A questionnaire, containing questions on belief, attitude and intention items based on Ajzen and Fishbein's model, was completed on the first day of the survey. SETTING: The study was conducted at the beginning of 1994 in Italy. SUBJECTS: In all, 860 subjects, randomly selected for each household participating in the food consumption survey, were included in this study. RESULTS: A cluster analysis based on average daily intake per capita of nine types of food containing fats was carried out on 860 subjects. The three clusters represented people with different criteria of preference for milk. The relationship between the variables was tested using the forward selection method in multiple regression. The attitude entered sequentially into the model assessing the intention of consuming, after the habit component. Habit was found to be the most the most important predictor of the actual consumption of each type of food. The intention entered into the equation as predictor of the consumption only for butter and olive oil. Habit has been found more important than intention in influencing the consumption of all types of food, whereas the intention did not enter into the model as determinant of the consumption with exception of butter and olive oil in which it remains as a significant predictor. CONCLUSIONS: The results of the cluster analysis suggested that subjects of cluster 1 might be more concerned about fat intake. The findings of the regressions showed that the subjective measure of habit entered in the model as the most important predictor of the actual consumption of each type of food. The low prediction of the actual consumption indicated that there could be other important variables influencing the consumption not included in this study.

Adolescent↗
PubMed2000

Methodology for sampling questing nymphs of Ixodes ricinus (Acari: Ixodidae), the principal vector of Lyme disease in Europe.

To assess the Lyme borreliosis vector population density we set up a methodology for sampling the Ixodes ricinus L. population host questing on the vegetation. We focused on the collection of the nymphal stage, which is the principal stage of disease transmission to humans. This study was carried out in Rambouillet forest (Yvelines, France) where seven study areas were demarcated. These areas are maximally homogeneous for plant species using a finer scale than the phytosociological classification as defined by the method of landscape diagnostics. Out of 23 collections performed from March 1997 to May 1998, 2,906 I. ricinus nymphs were collected. The sampling technique chosen was the cloth lure technique. The technical parameters were studied and fixed (cloth type, cloth size, sample size, researcher position). It appeared that toweling was the best cloth type to optimize the number of ticks collected; the position of the researcher had no effect on tick samples. To satisfy the criteria for correct sampling, we studied representativity, randomness, and nonselectivity of our methodology. The spatial distribution of nymphs in a homogeneous area was close to random and thus very few subsamples were needed to obtain a relative density which was representative. No significant differences were found between random samples and following transect samples; and nonselectivity was totally satisfied because we only worked on questing nymphs. We grouped the samples that presented no significant differences to attribute a density index, which varied from 0 to 5. This methodology, applied with the same parameters, offers potential for producing comparable results from studies in different geographical areas and at different times of the years.

Animals↗
PubMed2000

Prognostic value of CT scan features in acute ischaemic stroke and relationship with clinical stroke syndromes.

The aim of this prospective study was to investigate the value of CT scan in prognosis of acute ischaemic stroke patients as a variable additional to clinical stroke syndromes to develop a simple classification of CT scan features to provide a practical approach to prognosticate and manage such patients. One hundred and eight nine patients admitted with ischaemic stroke were investigated with a CT scan. CT scan features were classified into two groups: large infarct, LI (across more than one lobe) and non-large infarcts (N-LI) for all other features. Patients were also studied for clinical syndromes, analysing results for total anterior circulation syndrome (TACS). Outcome was measured as early post stroke Barthel index, acute phase and 3-month mortality. Patients with LI had features of severe strokes and had a lower Barthel index (p < 0.001), lower Glasgow coma score (p < 0.001), more association with incontinence (p < 0.001), pyrexia (p = 0.007) and dysphagia (p < 0.001). LI patients required higher level of care in acute wards and had a higher length of stay (p = 0.01). Both the LI and TACS individually had a significantly higher mortality (p < 0.001) and similar positive predictive value, sensitivity and specificity for 3-month mortality. While the combined factor of 'large infarct and TACS' provided the highest likelihood ratio (3.1) for mortality, the factor of 'large infarct or TACS' was the most sensitive (85%) to identify majority of patients at a risk of mortality. N-LI patients had a better prognosis. Classification of cerebral infarcts into large and non-large categories identifies patients who require higher level of care in acute wards and have a higher mortality. Combined factor of 'large infarct and/or TACS' identifies the majority of patients at risk of 3-month mortality as compared to either variable taken individually. CT scan features are complimentary to clinical syndromes for managing acute stroke patients.

Adult↗
PubMed2000

An epidemiological study of falls on integrated general medical wards.

Reducing falls in hospital requires an environmental as well as a patient-orientated approach. We studied patient and ward characteristics relating to falls in an acute setting. In a prospective open observational study, we examined fall characteristics in two nuclear designed wards (A and B) and a longitudinal ward (C). We recorded 63 falls among 1609 patients. Ward C had the most falls (31 vs 18/14; p = 0.01), fall positive days (29 vs 15/10; p = 0.002) and fallers (27 vs 13/12; p = 0.001; OR 2.54, CI--1.41-4.57). Ward C had a higher cumulative risk of falls (p = 0.006) and fall positive days (p = 0.003). Choice of ward was a significant independent risk factor for falls (p = 0.01) when controlled for age, sex, and diagnostic variation between the wards. Most falls were intrinsic (A 66.7%, B 64.2%, C 61.3%, p = 0.45). A significantly higher proportion of falls on ward C occurred by the bed (p = 0.04). Significant differences exist between the wards, and fall reduction programmes should identify and compensate for adverse ward-related factors to increase the effectiveness of patient-targeted fall risk assessments.

Accidental Falls↗
PubMed1998

[Lyme borreliosis, emergent disease linked with the environment].

After a short historical presentation of the discovery of the pathogen and its vector, the authors present the current data on bacterial and acarologic taxonomy. Then they describe their results to assess the mechanisms of circulation of the bacteria in the forests of Ile-de-France, particularly in the forest of Rambouillet. The combined study of abundance and infection frequency of the vectors, small mammals and cervids leads to the characterization of periods and areas of higher risk. The risk periods correlate with high density of I. ricinus nymphs. The risk areas correspond to those of high density of cervids. The role of reservoir of small mammals is confirmed, to the one of large mammals, so debated, is clearly demonstrated.

Environmental Health↗
PubMed1997

A case of relapsing psittacosis associated with a stroke.

Psittacosis, caused by Chlamydia psittaci, is mainly associated with an atypical pneumonia. We report a case of psittacosis where onset of respiratory symptoms was soon followed by the onset of focal neurological signs, a very uncommon feature. Despite adequate treatment with erythromycin, the patient relapsed when re-exposed to a sick pet bird. A prolonged course of doxycycline led to resolution of the pneumonia, but it is important to recall that successful management must also include the elimination of the precipitating cause of the infection.

Aged↗
PubMed1997

A study of autonomic cardiovascular reflexes in elderly patients with pneumonia.

People recovering from pneumonia are often weak for no apparent reason. Clinical features such as postural hypotension, arrhythmia and syndrome of inappropriate ADH have, in other circumstances, been attributed to impaired autonomic function. The aim of this study was to see whether elderly patients with pneumonia had impaired autonomic cardiovascular reflexes and, if so, how long this persisted. We compared healthy elderly controls, elderly controls with trauma (fractured femoral neck) and elderly patients with pneumonia. Thirty-eight subjects were studied in a series of cardiovascular autonomic function tests. Results suggest that elderly people have a high prevalence of impaired cardiovascular autonomic reflexes in the immediate post-pneumonic phase, and that this improves significantly after six weeks, with a further improvement by six months. Elderly patients recovering from pneumonia are predisposed to the adverse effects of drugs and other factors which can further impair autonomic cardiovascular reflexes.

Aged↗
PubMed1996

Annual influenza vaccination: immune response in patients over 10 years.

OBJECTIVE: To determine the effect of repeated annual influenza immunization on the host's serum antibody. DESIGN: Ten year observational study with cohort design. SETTING: Cystic Fibrosis Center at St. Vincent's Hospital and Medical Center, New York City, NY. PATIENTS: Thirty-eight children and young adults with cystic fibrosis (CF). MEASUREMENTS: Serum hemagglutination inhibition (HI) antibody titers were determined at the time of vaccination and 4 weeks later each year in the fall before the influenza epidemic. Shwachman scores were determined each year. RESULTS: While the pre-vaccination and post-vaccination geometric mean serum HI antibody titers varied from year to year, no upward or downward trend was evident over the 10 year period. The reciprocal of the post-vaccination geometric mean HI titers ranged annually from 32 to 74 for the influenza A (H3N2) vaccine strains, from 53 to 133 for the influenza A (H1N1) strains, and from 18 to 174 for influenza B strains. In addition, the majority of vaccinees had a presumably protective post-vaccination serum HI titer > or = 1:40 each year for all three vaccine strains. The initial mean Shwachman score of the group was 77. The final score of 76 after 10 years was not significantly different. CONCLUSIONS: Annual influenza vaccination appears to regularly induce presumably protective serum antibody levels in most CF children and young adults studied over a 10 year period.

Adolescent↗
PubMed1995

Factors associated with high risk of marginal hyperthermia in elderly patients living in an institution.

The elderly, the very young, and the sick are known to be adversely affected by high environmental temperatures. In a retrospective open case-note review of 872 patients in a large institution during a hot summer we identified characteristics in the elderly that increase the risk of marginal hyperthermia. Women were more likely to be affected than men (25.6% vs 16.9%). We found an age-related increase in marginal hyperthermia, 15.7% of those below 60 years developed a hyperthermia compared to 18.9% in those between 70-79 years (non-significant), 28.3% in those between 80-89 years (p = 0.01) and 50% in those above 90 years (p < 0.01). There was also a direct relationship between the incidence of hyperthermia and the ambient temperature (29% in the warmer wards, compared to 17.2% in cooler ones; p < 0.01) and with the level of dependence (42.3% of the bedridden group, p < 0.01, and 20.4% of the semi-dependent, p < 0.01, compared to 11.1% of the mobile group). These factors were more significant as predictors of risk than the diagnosis. Identifying high risk patients early and taking appropriate measures to avoid hyperthermia and dehydration is important to try to decrease mortality during heatwaves.

Adult↗