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Biomedical subjects

M Vichi

Publications and source records attributed to M Vichi.

At least 19 recordsLinked to original sources

[Breastfeeding and health promotion of child: survey results in Molise region].

AIM: The aim of this study is to compare initiation and duration rates of breastfeeding in Molise region (Italy) to those targeted from World Health Organization (WHO), and to examine factors associated with infant health. METHODS: Trained caregivers administered interviews to 430 mothers whose infants were receiving the 2nd dose of compulsory immunisation in 4 primary health care centers (ASL) of Molise region, during October-December 2001. Type of breastfeeding was classified as predominant or partial, according to the WHO definitions. RESULTS: The rate of breastfeeding initiation was 92%, dropping to 30% when infants were 6 months of age. We found strong differences among the 4 health care centers involved in the study. Lacking of support after discharge, non-breastfed previous child, receiving infant formulas, breastfeeding on schedule, rooming-in not effected at hospital, both maternal and familiar smoking, were significantly associated with early breastfeeding cessation. The rate of iodine supplemented salt consuming was 40%; the rate of mothers who knew the importance of using folic acid in preconceptional age was 19%; only 1/3 of infants (34%) was placed back to sleep. CONCLUSIONS: Although we meet WHO goals regarding breastfeeding initiation, we don't about breastfeeding duration, yet. Moreover, the leading factors negatively linked to infant health, are not widely recognized. It is therefore necessary to promote the whole infant health, either supporting predominantly breastfeeding, especially in some ASL, or providing better knowledge about risk factors.

Breast Feeding↗

Gender differentials in life expectancy in Italy.

OBJECTIVE: To analyze the gender differential in life expectancy in Italy from 1970 to 1997, to determine which ages and causes of death mostly influenced its trend. METHODS: Pollard method was used to explain which ages and which pathologies give the highest contribution to the gender differential. RESULTS: A slight reduction of the gender differential has been observed since 1980. The olds and very olds became the most relevant contributors to the differential. Cardiovascular diseases were the principal contributing causes of death until 1980 and Cancer replaced them afterwards. CONCLUSION: Relatively recent adoption of unhealthy life styles by women together with an opposite process run by young men towards healthier behaviour, seem to be at the basis of the slight reduction of the gender differential in life expectancy observed since 1980.

Cause of Death↗

Differential impact of combined antiretroviral therapy on the survival of italian patients with specific AIDS-defining illnesses.

BACKGROUND: A decrease in HIV-related mortality and morbidity has been observed since 1996 in most developed countries as a consequence of the extensive use of combined antiretroviral therapies. The purpose of this study was to investigate whether combined antiretroviral therapies had a differential impact on the survival of patients with different AIDS-defining illnesses (ADIs). METHODS: In total, 35,318 persons representing all the adults with AIDS (PWAs) diagnosed in Italy from January 1, 1990 to August 31, 1998 were studied. Actuarial life tables and the Kaplan-Meier method were used to estimate the cumulative probability of survival; the multivariate Cox proportional hazards model was used to estimate adjusted relative hazard of death (RH). RESULTS: Among PWAs diagnosed after 1995, the proportion of survivors 24 months after diagnosis was more than doubled (66%) compared with that of PWAs diagnosed before the end of 1995 (31%). Significantly decreased RHs for some ADIs were observed as early as 1996 (i.e., esophageal candidiasis, Pneumocystis carinii pneumonia, brain toxoplasmosis, HIV-wasting syndrome, and pulmonary tuberculosis). In the last period (1997-1998), the decrease was marked and significant for almost all the ADIs, ranging from 55% to 80% compared with the RHs of the reference year (1995). Conversely, primary lymphoma of the brain and Burkitt's lymphoma showed a low and not statistically significant decrease; these were the ADIs with the worst outcome. CONCLUSIONS: After 1995, there was a rather uniform increase in the survival of PWAs diagnosed with most specific ADIs but not for patients affected by primary brain lymphoma and Burkitt's lymphoma. The determinants of this differential effect need to be investigated.

AIDS-Related Opportunistic Infections↗

The impact of the major causes of death on life expectancy in Italy.

BACKGROUND: This study aims to evaluate the contribution of the reduction in major cardiovascular diseases (CVD), malignant neoplasms (MN), accidents and AIDS mortality to the gains in life expectancy observed during the decade 1985-1994, as well as to calculate and compare the potential gains due to the partial or total elimination of these causes. METHODS: Mortality data from the Italian Mortality Data Base were analysed by the method of decomposition of changes in life expectancy and the partial multiple decrement life table technique. RESULTS: In Italy, considering the decade 1985-1994, the gain in life expectancy at birth was 2.27 years for men and 2.16 for women. The major contribution to this increase was the reduction in CVD mortality followed by fewer deaths from accidents and MN. Conversely, AIDS caused a loss in the length of life of adults. Major potential gains in life expectancy at birth could be obtained by the elimination or even partial reduction of CVD and MN mortality. When working life (15-64 years) is considered, the relative importance of the causes changes. The elimination of accidents and AIDS would result in increased life expectancy longer than that associated with a 50% reduction in CVD. CONCLUSIONS: The findings of this study provide useful information which could contribute to a more effective allocation of resources for research activity and public health programmes.

Accidents↗

Eruption anomalies of the maxillary permanent cuspids in children with cleft lip and/or palate.

Eruption anomalies of the maxillary permanent cuspid on the cleft side was analyzed in a sample of 77 children with mono- and bi-lateral cleft lip/palate. The main findings were: 1) The permanent cuspid showed an initial mesial position in relation to the root of its primary predecessor in a relatively high number of cases. Nearly all those cuspids that showed an anomalous position (mesial or distal) in relation to the corresponding primary teeth at the time of the first observation erupted in malposition (palatally in the cleft area, mesially or distally to the primary cuspids). 2) In most cases presenting a mesially positioned permanent cuspid at the time of first observation, the permanent later incisor was congenitally missing, microdontic or in a mesial position in relation to the cleft. 3) Distally positioned permanent cuspids were always associated with a supernumerary lateral incisor. 4) A congenitally missing lateral incisor could represent a predisposing factor to a mesial position of the permanent cuspid. An early radiographic evaluation of the position of the permanent cuspid was suggested especially in those children presenting a congenitally missing lateral incisor.

Adolescent↗

Increased expression of tissue plasminogen activator and its inhibitor and reduced fibrinolytic potential of human endothelial cells cultured in elevated glucose.

In diabetic patients, elevated plasma levels of t-PA and PAI-1 accompany impaired fibrinolysis. To identify mechanisms for these abnormalities, we examined whether vascular endothelial cells exposed to high glucose upregulate t-PA and PAI-1 production and whether ambient PA activity is decreased concomitantly. In 17 cultures of human umbilical vein endothelial cells grown to confluency in 30 mM glucose, the t-PA antigen released to the medium in 24 h was (median) 52 ng/10(6) cells (range 10-384) and the PAI-1 antigen was 872 ng/10(6) cells (range 217-2074)--both greater (P less than 0.02) than the amounts released by paired control cultures grown in 5 mM glucose--29 ng/10(6) cells (range 7.5-216) and 461 ng/10(6) cells (range 230-3215), respectively. In the presence of high glucose, the steady-state levels of t-PA and PAI-1 mRNAs were increased correspondingly (median 142 and 183% of control, respectively, P less than 0.05); high glucose per se and hypertonicity contributed to the upregulation in additive fashion. The PA activity of conditioned medium from cultures exposed to high glucose was 0.4 IU/ml (range 0.2-0.6), which was significantly lower (P less than 0.02) than the PA activity of control medium (0.5 IU/ml, range 0.2-0.9). No difference was observed when comparing the PA activities of acidified conditioned media, expected to be depleted of inhibitors. Thus, high glucose coordinately upregulates endothelial t-PA and PAI-1 expression through effects exerted at the pretranslational level and enhanced by even mild degrees of hypertonicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Cells, Cultured↗

[The transmigration of the permanent lower canine].

A rare dental anomaly--the transmigration--is analysed. This condition, which is sparsely recorded in the literature, typically affects the mandibular canine. Twelve cases in which an unerupted mandibular canine has crossed the midline, are described and discussed. Reference is made to considerations put forward in the past by other Authors on this subject, after which personal conclusions are drawn on the diagnosis, etiology and therapy of this rare but serious behaviour of the mandibular canine. The anomaly can be properly diagnosed only by an attentive radiographic evaluation which is primarily based on the orthopantomogram. A series of successive panoramic radiographs taken over years documents the progressive ectopic movement of an unerupted mandibular canine from its developmental site, through the symphysis of the mandible. Lateral, postero-anterior cephalometric films and periapical radiographs, provide additional important information. After having analysed the most frequent etiological factors of mandibular canine impaction, the authors present their considerations concerning the probable pathogenetic mechanism of transmigration. In addition to the proinclination of the lower incisors and the increasing axial inclination of the unerupted canine, already pointed out by other authors, an enlargement of the symphyseal cross-sectional area has been observed and documented. In conclusion it is important, also from a therapeutical point of view, to keep under control, by periodical panoramic radiographs, all those clinical situations considered at risk due to their possible evolution in transmigration and which are characterized by: 1) an unerupted canine which can be palpated in a mesial position in the labial sulcus; 2) an enlarged symphyseal cross-sectional area; 3) an obstacle to normal eruption (cysts, odontomas, ecc.); 4) a proinclination of the lower incisors. A progressive worsening of the position of the unerupted canine should induce to consider the possibility of an early interception of this anomalous condition, which, once established, results in the definitive impaction of the tooth.

Adolescent↗

Microscopical aspects of root resorption of human deciduous teeth.

In order to obtain detailed information on the tissue changes which occur during physiological root resorption, 52 human deciduous teeth at various stages of resorption were studied under light microscopy. The early stage of root resorption was defined as resorption of not more than one third of the root length; the late stage was defined as resorption of more than one third. A close topographical interrelationship was found among che sites of pressure of the permanent tooth, the extent of root resorption and the types of tissue changes. Linear resorption (which reflects suspension or marked slowing down of resorption) and redeposition of hard tissue were more pronounced at the early stage of resorption, while lacunar resorption was more pronounced at the late stage. There were pronounced haemorrhagic and inflammatory infiltrates within the pulp at the late stage of resorption and the subodontoblastic cells disappeared as the infiltrates took over the tooth. False denticles were found frequently, especially at the early stage of resorption. Unexpectedly, acellular cementum was found to be deposited against secondary dentine at the cuspidal tip of the pulp chamber of seven teeth, independently of any sign of resorption nearby. These data indicate that: 1) the pressure exerted by a permanent tooth is the most important factor in the differentiation of odontoclasts. 2) the extent of lacunar (i.e., active) resorption correlates directly with the resorption rate, which is higher at the late stage of root resorption. 3) inflammation is a consequence, rather than a cause, of resorption; it may lead to the loss of subodontoblastic cells and a consequent decrease in the ability of the pulp cells to replace damaged odontoblasts. 4) the pulp of the deciduous tooth might be cementogenic in some way, given that about 13% of the samples were found to be so.

Adolescent↗

[Cephalometric study of the results of orthodontic treatment of Class III malocclusion].

It's carried out a research on 60 children, 32 boys and 28 girls, taken from 5-12 of age, affected by Class III malocclusion. All of cases was subdivided in four groups on the ground of the age of orthodontic treatment beginning. Two teleradiographs of each patient were examined, one at the beginning and one at the conclusion of the treatment. About the results reported on the boards, were expressed some considerations on the effects of Class III malocclusions treatment as they result at the cephalometric analysis, in comparison with the starting situation of lack of balance. In every case is pointed out the significance of interception and a more favourable behaviour of cephalometric data in the groups with a earlier beginning of treatment.

Cephalometry↗