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Biomedical subjects

P Greco

Publications and source records attributed to P Greco.

At least 19 recordsLinked to original sources
PubMed2004

Helicobacter pylori infection in Burkina Faso: an enigma within an enigma.

BACKGROUND: In Burkina Faso, in contrast with high rates of Helicobacter pylori infection from an early age, the prevalence of H. pylori-associated diseases (ulcer and gastric cancer) is low. AIMS: To look for the prevalence of H. pylori in healthy natives of Burkina Faso, both children and adults. METHODS: We studied the prevalence of H. pylori infection in 258 healthy natives of Burkina Faso (70 children aged 6 months-15 years and 188 adults aged 16-65 years), using a serological screening (IgA and IgG H. pylori antibodies). All the studied subjects underwent a questionnaire regarding their life-style, socio-economic status, dietary habits and hygienic sanitary conditions. Data concerning the questionnaire were compared between H. pylori positive and negative subjects. RESULTS: The rates of H. pylori positivity in children were significantly higher than in adults, and in adults the positivity for H. pylori infection decreased with increasing age. The comparison of the questionnaire's data between H. pylori seropositive and seronegative subjects showed that poor socio-economic status and hygienic sanitary conditions were similar in the two groups. Instead, a higher prevalence of H. pylori positivity was observed in subjects belonging to families living in close contact with sheep, because of their labour and agro-pastoral tradition (shepherds and sedentary farmers). CONCLUSION: H. pylori infection in Burkina Faso is acquired early in life and is related not only to some yet well-known risk factors (poor socio-economic and hygienic status), but also to a close contact with sheep. The gradually decreasing H. pylori seropositivity in adult population of Burkina Faso represents an unexplained enigma, which needs further studies.

Adolescent↗
PubMed2003

The ultrasound assessment of adipose tissue deposition in fetuses of "well controlled" insulin-dependent diabetic pregnancies.

OBJECTIVE: To assess differences in adipose deposition in fetuses from normal pregnancies and women with diabetes. RESEARCH DESIGN AND METHODS: The study group consisted of 15 well controlled insulin-dependent women with diabetes and 16 controls with a normal glucose. Ultrasound measurements were taken of subcuticular tissue thickness at the abdominal and suprascapular level at 31 and 37 weeks gestation. Triceps and subscapular skinfold thickness were also measured at birth. RESULTS: Gestational age at delivery and birthweights were not significantly different. At 31 weeks, fasting glucose levels were 5.0 +/- 1 mmol/l for diabetic vs. 3.3 +/- 0.3 mmol/l for controls (P < 0.01), post-prandial 5.6 +/- 0.4 vs. 5.1 +/- 0.3 mmol/l (P < 0.01). At 37 weeks, they were 4.6 +/- 0.2 mmol/l vs. 3.8 +/- 1.1 mmol/l (P < 0.01) and 6.0 +/- 0.6 mmol/l vs. 5.3 +/- 0.3 mmol/l (P < 0.01). Abdominal and suprascapular subcuticular thickness were 4.4 +/- 0.1 mm vs. 3.7 +/- 0.1 mm (P < 0.05) and 4.3 +/- 0.2 mm vs. 3.5 +/- 0.2 mm (P < 0.05) at 31; 5.6 +/- 0.2 mm vs. 4.8 +/- 0.1 mm (P < 0.05) and 5.4 +/- 0.2 mm vs. 4.4 +/- 0.1 mm (P < 0.05) at 37 weeks. At birth, triceps and suprascapular skinfolds were 4.7 +/- 0.1 mm vs. 4.1 +/- 0.1 mm (P < 0.05) and 4.7 +/- 0.2 mm vs. 3.8 +/- 0.1 mm (P < 0.01). CONCLUSION: Adipose tissue disposition is increased in fetuses of women with well-controlled diabetes. This may be a reflection of higher maternal glucose levels in these women and may explain why even well-controlled diabetic pregnancies are at risk of macrosomia.

Adipose Tissue↗
PubMed2003

Idarubicin containing regimen in multiple myeloma: preliminary results of a pilot study using a modified "TANDEM" transplant program.

Tandem autologous transplant actually represents a challenge in multiple myeloma treatment, but the best conditioning regimen is still under investigation. With the aim of evaluating the feasibility of a modified tandem transplant strategy, we treated 10 multiple myeloma patients after conventional first line chemotherapy with a two step conditioning regimen consisting of high-dose melphalan (200 mg/m2) followed by high-dose melphalan (180 mg/m2) together with indarubicin (15 mg/sqm2 c.i. x 3 days) both with peripheral stem cell support. At first transplant, the median age wasyears, performance status was good and disease status was CR in 2 patients and PR in the rest. At the end of the first transplant, 70% of patients achieved CR and only mild toxicity was observed. After the second transplant further improvement of the response rate was obtained with 90% CR. However, we observed three toxic early infection-related deaths from CMV and legionella pneumonia at day + 17, +26, +54 after transplantation. Although this schedule seems to be effective in terms of response rate, the 30% TRM imposes an anthracycline dose-reduction with careful patient selection. This approach could reduce the toxic effects and maintain the efficacy of therapy at the same time.

Aged↗
PubMed2003

[Second trimester termination of pregnancy with gemeprost: a review of 306 cases].

AIM: Prostaglandin analogues provide an effective method for induction of abortion in the second trimester of pregnancy. The clinical outcome and the risk of complications were evaluated in a group of women having a medical termination of pregnancy with gemeprost. METHODS: Three-hundred and six women undergoing second trimester termination of pregnancy, between January 1998 and July 2002 in our center, were studied. All women were given 1 mg vaginal gemeprost every 3 h up to a maximum of 3 doses in the first 24 hours. If the abortion did not occur within the first 24 hours after initiation of treatment, they were given a 2(nd) course of gemeprost. Outcome measures included failure of the 1st course of gemeprost, length of hospital stay after expulsion of conceptus, heavy blood loss with or without necessity of uterine packing or blood transfusion, and failure of induction. RESULTS: There was a significant difference, with better results in women with previous deliveries (vaginal or abdominal), as to the failure to abort after the 1(st) course of PG (P<0.01). Length of hospital stay, complications and failure of induction were independent from parity. Twelve (3.9%) women failed to abort with gemeprost and required other methods for abortion. CONCLUSIONS: The study confirms the efficacy of gemeprost for mid-trimester termination of pregnancy, although it is a risky and costly procedure, requiring hospitalisation and is associated with higher complication rate than the first trimester surgical abortion.

Abortifacient Agents, Nonsteroidal↗
PubMed2003

The use of olive mill wastes for the control of root-knot nematodes.

The suppressive effect of olive mill wastes was tested in a field experiment in sandy soil, infested by Meloidogyne incognita, in the Province of Lecce, southern Italy. The field was subdivided in 12 m2 plots distributed at random in four blocks. Treatment consisted of different dosages (10, 20 and 40 t/ha) of two composts prepared with either exhausted or fresh olive pomace or raw extraction sewage at rate of 40 or 80 m3/ha. There were four untreated control plots and four plots on which the granular 5% formulation of fenamiphos had been broadcast incorporated into the soil at the rate of 300 Kg/ha, one week before planting the tomato cv. Tondino di Zagaria. All treatments statistically increased tomato yields with respect to the control. Conversely, the root gall index, assessed according to a scale from 0 (no gall at all) to 5 (root system of reduced size and deformed by large galls), was significantly reduced in all treated plots. Also soil populations of the root-knot nematode declined, significantly compared to the control, except in the soil treated with the lowest doses of raw sewage or exhausted pomace compost.

Animals↗
PubMed2002

The effects of a soy rich diet on serum lipids: the Menfis randomized trial.

OBJECTIVE: To assess beneficial effects of a soy rich diet on the main biomarkers of cardiovascular health in menopause, compared with the effects of the hormone replacement therapy (HRT). METHODS: 187 healthy asymptomatic postmenopausal women, aged 39-60, were recruited and randomized into three groups: a soy rich diet group, a HRT group, and a control group. Lipid profile, body mass index, blood pressure, endometrial thickness, uterine artery resistance index (RI), were evaluated in all the participants at the baseline, after 6 months, and at the end of the study. RESULTS: After a 6-month intervention period, the lipid profile in the soy rich diet group showed a favourable outcome, similar to that observed in the HRT group, but compliance to the diet was low. CONCLUSION: Soy products may be used in the prevention of cardiovascular risk in postmenopausal women because of their efficacy in contrasting the negative effects of menopause on the cardiovascular system, but our findings should be confirmed; moreover, suitable strategies to improve the compliance have to be considered.

Adult↗
PubMed2002

Intratumoral blood flow characteristics and prognostic factors in patients with endometrial carcinoma.

Purposes of the study were to evaluate the correlation between intratumoral blood flow and stage, histologic grade, depth of myometrial invasion and lymph node metastasis in endometrial carcinoma and to assess if vascular/lymphatic spaces invasion is predictable by Doppler ultrasound. Fifty-three patients with endometrial carcinoma were enrolled before surgical treatment. Transvaginal Color Doppler Ultrasound was performed to detect the areas of increased vascularity (>/=3) and to record the lowest resistance index (RI) from the blood flow signals within the tumour. Formalin fixed, paraffin embedded pathology slides were reviewed by a senior pathologist to evaluate histologic grading, depth of myometrial invasion, presence of lymph node metastasis and vascular/lymphatic spaces invasion. The number of patients with positive lymph node metastasis was too small to perform any statistical evaluation. Significantly lower RI was noted in tumours of advanced stage (>FIGO Stage I), tumours with higher histologic grade (Grade 3) and with presence of vascular invasion. No correlation was found for myometrial invasion (>50%). A high number of vascular areas was positively correlated with all the prognostic signs. Assessment of tumour changes in vascularity using colour Doppler ultrasound provides useful information for the preoperative prediction regarding stage and histologic grade. The good correlation between Doppler ultrasound results and histological finding of vascular/lymphatic spaces invasion is another point in favour of routine colour Doppler studies in patients with endometrial carcinoma. We believe this technique is useful both for preoperative staging and that recording of tumour recurrence pattern may lead to early selection of those patients that need additional therapy.

Adult↗
PubMed2002

Efficacy of the liquid formulation of some nematicides.

Bunches of 25 g of tomato galled roots containing ca. 270 eggs and juveniles/g of Meloidogyne incognita were buried on 29 September 2001 in gauze bags at the depth of 15, 30 and 45 cm in a sandy loam. The liquid formulation of the nematicides 1,3 dichloropropene (at the rate of 100, 200 and 300 l/ha), metam sodium (at the rate of 500, 1000, and 1500 l/ha), oxamyl (at the rate of 50, 100 and 150 l/ha) and fenamiphos (at the rate of 30, 60, and 90 l/ha) were then applied in 10, 20 or 40 l/m2 of water. Control plots received only plain water. One month later all bags were recovered and the roots mixed with steamed soil and filled in plastic pots in which two tomato seeds were planted. Fifty days later plants were uprooted and aliquots of roots were macerated in blender to determine the number of eggs and juveniles. 1,3 dichloropropene, metam sodium and oxamyl were equally effective in controlling root-knot nematodes; fenamiphos was less effective. For all chemicals degree of control increased with the increase of rate of application and the volume of water of application, but decreased in the increase of depth of nematode burial.

Allyl Compounds↗
PubMed2001

Indications and outcome for intensive care unit admission during puerperium.

BACKGROUND: A significant decrease of maternal mortality related to improvement in diagnosis and prevention of disorders in pregnancy has been observed without a similar reduction of puerperal morbidity. Objective of this study was to identify risk factors and outcome of patients, which required intensive care during puerperium. METHODS: During the period 1987-1998 all pregnant patients, which were transferred from Department of Obstetrics and Gynecology to Intensive Care Unit (ICU) of University of Bari, were retrospectively included into the study. Several risk factors (age, preexisting diseases, gestational age, medical complication of pregnancy, mode of delivery, surgical additional procedure, fetal outcome, intrapartum transfusions, and puerperal complications) and the indications for transfer were evaluated. RESULTS: The overall incidence of admission into Intensive Care Unit was 0.17% (41/23.694) of deliveries. Indications for admission into ICU were worsening of preeclampsia in 75.6% of cases, severe bleeding in 14.7% of cases, maternal cardiac disease stage III AHA in 4.9% of cases, pulmonary embolism and acute pulmonary oedema respectively in 2.4% of cases. CONCLUSIONS: Transfer of patients to ICU due to hypovolemic postraumatic shock seems progressively declining thanks to modern criteria of obstetric management; on the contrary we assist to a prevalence of serious intrinsic maternal diseases often preexisting pregnancy or late consequence of preeclampsia, pulmonary embolism and sequelae of abnormal insertion of placenta.

Adult↗
PubMed2001

Adenocarcinoma of the lower third of the rectum surgically treated with a <10-MM distal clearance: preliminary results in 35 N0 patients.

BACKGROUND: Recent reports suggest that a distal clearance (DC) of 10 mm at the lower surgical margin may be considered adequate in the surgical treatment of rectal cancer, but there are no data on the possible adequacy of a < 10-mm DC in N0 patients in whom a good prognosis can otherwise be expected, that is, those with negative surgical margins and negative lymph nodes. METHODS: Between November 1991 and December 1998, 154 consecutive patients with adenocarcinoma of the lower third of the rectum had a total rectal resection with total mesorectal excision and coloendoanal anastomosis. Among 76 N0 patients, there were 35 with <10-mm DC and 41 with > or =10-mm DC. Each group was divided into two subgroups depending on whether the surgical margins were involved or not, and the rate of local recurrence in the various categories was compared. All B2 Astler-Coller stage patients in the series received postsurgical chemoradiotherapy. RESULTS: The local recurrence rate in the 35 patients with DC < 10 mm was 11.4% and that of the 41 patients with DC > or =10 mm was 7.3%. When only patients with negative surgical margins were considered, the local recurrence rate was 3.4% for those with < 10-mm DC and 5.1% for those with > or =10-mm DC. CONCLUSIONS: Our results suggest that a radical surgery with <10-mm DC followed by chemoradiotherapy may be adequate in N0 patients, provided that a careful pathologic examination of the surgical specimen excludes the presence of lymph node metastases and that the distal rectal and mesorectal resection margins fall in healthy tissue.

Adenocarcinoma↗
PubMed2001

Polycystic ovary syndrome: relationship between insulin sensitivity, sex hormone levels and ovarian stromal blood flow.

Polycystic ovary syndrome (PCOS) is the most common cause of menstrual disorders, and is characterized by chronic anovulation, hyperandrogenism and infertility. In recent years, it has become apparent that PCOS is also associated with hyperinsulinemia that is probably central to the pathogenesis of PCOS. As a peculiar vascular pattern has been reported to be present in PCOS, the aim of this study was to investigate intraovarian stromal vascularization in PCOS patients and its possible correlation with sex hormones, gonadotropins and insulin levels. Twenty-eight oligomenorrheic or amenorrheic patients with PCOS and 14 eumenorrheic women with a PCOS-like ovarian pattern undergoing endocrine screening and ultrasound color Doppler intraovarian blood flow were recruited to the study. Ten healthy women with regular menses represented the control group. Hormonal assays (follicle-stimulating hormone (FSH), luteinizing hormone (LH), androstenedione, testosterone, sex hormone-binding globulin (SHBG) and estradiol), oral glucose tolerance test (OGTT), baseline and glucose-induced insulin levels, and transvaginal ultrasonographic and color Doppler analysis (pulsatility index (PI), resistance index (RI) and velocity (Vmax) of ovarian stromal flow) were performed in all participants in the early proliferative phase. Endocrine values showed significant differences in PCOS patients compared with PCOS-like women and controls, while PI and RI indices were significantly higher in controls. PCOS patients were divided into hyperinsulinemic (n = 16) and normoinsulinemic (n = 12). Androstenedione was significantly higher (p < 0.01) in the hyperinsulinemic than in the normoinsulinemic patients and controls, while SHBG was significantly (p < 0.01) lower in the hyperinsulinemic group. Analysis of color Doppler intraovarian vascularization showed a significantly lower RI and a higher Vmax in the hyperinsulinemic subjects than in the normoinsulinemic PCOS patients and controls. An increased stromal blood flow was observed in the PCOS and PCOS-like patients by transvaginal color Doppler evaluation, but this technique is not able to differentiate these two similar ovarian patterns. However, hyperinsulinemic PCOS patients had an increased vascularity of the ovarian stroma. A strong correlation between hyperinsulinemia, hyperandrogenism and low SHBG levels was evidenced, and a hyperinsulinemia-induced mechanism for ovarian stromal angiogenesis is discussed.

Adult↗
PubMed2001

A peer group intervention for adolescents with type 1 diabetes and their best friends.

OBJECTIVE: To devise and implement a structured intervention for integrating peers into diabetes care in a healthy and adaptive manner. METHODS: Adolescents with diabetes (n = 21) and their best friends (n = 21) participated in a group intervention aimed at increasing diabetes knowledge and social support of diabetes care. Measures of social support, knowledge about diabetes and support, diabetes functioning, and social functioning were obtained prior to and following intervention. RESULTS: Following the intervention, adolescents and their friends demonstrated higher levels of knowledge about diabetes and support, as well as a higher ratio of peer to family support, and friends demonstrated improved self-perception. Parents reported decreased diabetes-related conflict. CONCLUSIONS: Peer group intervention approaches may result in increased positive peer involvement in adolescents' diabetes care.

Adaptation, Psychological↗
PubMed2001

The value of ultrasonographic examination of the uterine cervix in predicting post-term pregnancy.

OBJECT: To assess whether transvaginal ultrasound is helpful in predicting the post-term onset of labor (> or = 1 weeks). SETTING: Antenatal clinic of a University hospital and referral center. SUBJECT AND MEHODS: One hundred and twenty singleton uncomplicated pregnancies in primiparous women were enrolled at 37 weeks of gestation. Ultrasound examination of the cervical length by a transvaginal probe was performed at recruitment and at weekly intervals until 40 completed weeks. Subjects were divided into Group A (those with spontaneous onset of labor < or = 1 completed weeks) and Group B (those not in labor by that date). RESULTS: Eighty women delivered < or = 41 completed weeks, forty were not in labor by that date. The cervix was significantly shorter at 39 and 40 weeks in group A, but no particular cervical length was predictive of post-term delivery. DISCUSSION: There is a significant difference in cervical length in women delivering at term compared with those due to have a post-term delivery. This difference is significant from 39 weeks of gestation onwards. We speculate that targeted transvaginal ultrasound may be useful in predicting the post-term onset of labor and possibly in assisting its active management.

Cervix Uteri↗
PubMed2001

Maternal complications associated with cesarean section.

OBJECTIVE: To assess the prevalence of cesarean section (CS) related maternal complications and to evaluate post-CS complications in relationship with relative risk factors. METHOD: 3010 patients who had a CS in the University Hospital of Bari during the period 1988-98 were retrospectively included into the study and 1007 women delivered vaginally at the same institution and in the same period of time, were randomly selected as the control group. For each single patient delivered by CS, the following risk factors were taken into account: age, parity, pre-pregnancy body mass index (BMI), and any disease antedating pregnancy or diagnosed during pregnancy. Additionally, therapeutic procedures such as blood transfusion, number of days in hospital, and admission into intensive care were followed. The prevalence of puerperal complications was assessed for vaginal deliveries and CS by Student's t-test and a correlation of CS complications with risk factors was performed by multivariate analysis. RESULTS: In the cohort of abdominal delivery, puerperal complications were significantly more frequent compared with those following vaginal delivery (p < 0.05). In the group of CS, obese women have higher prevalence of maternal complications, particularly hypertension and intestinal complications (p < 0.05). CONCLUSION: Compared with vaginal delivery, CS delivery carries a higher number of postpartum complications, and the higher rate is mainly related to obesity.

Adult↗
PubMed2001

Behavior therapy for families of adolescents with diabetes: maintenance of treatment effects.

OBJECTIVE: This study reports 6- and 12-month follow-up for the families of adolescents with diabetes who participated in a trial of Behavioral-Family Systems Therapy (BFST). RESEARCH DESIGN AND METHODS: A total of 119 families of adolescents with type 1 diabetes were randomized to 3 months of treatment with either BFST, an education and support (ES) group, or current therapy (CT). Family relationships, adjustment to diabetes, treatment adherence, and diabetic control were assessed at baseline, after 3 months of treatment, and 6 and 12 months later. This report focuses on the latter two evaluations. RESULTS: Compared with CT and ES, BFST yielded lasting improvements in parent-adolescent relationships and diabetes-specific conflict. Delayed effects on treatment adherence emerged at 6- and 12-month follow-ups. There were no immediate or delayed effects on adolescents' adjustment to diabetes or diabetic control. CONCLUSIONS: BFST yielded lasting improvement in parent-adolescent relationships and delayed improvement in treatment adherence, but it had no effect on adjustment to diabetes or diabetic control. A variety of adaptations to BFST could enhance its impact on diabetes outcomes.

Adolescent↗
PubMed2000

Reversal of foetal hydrops and foetal tachyarrhythmia associated with maternal diabetic coma.

Foetal hydrops is always a challenge for the clinician. We report a case of tachycardia associated with hydrops and hydramnios in a pregnancy complicated with diabetic coma at 28 weeks gestation. Normal foetal heart rate was recorded immediately after correction of maternal acidotic status and hydrops eventually disappeared. The woman was delivered at 32 weeks and the baby had an uncomplicated postnatal course. We hypothesise that maternal ketoacidosis has been the precipitating factor of tachycardia and congestive heart failure and that this case is conceptually similar to the "late death" phenomenon, reported in cases of poorly controlled maternal diabetes.

Adult↗
PubMed2000

Immunological markers in HIV-infected pregnant and non-pregnant women.

OBJECTIVE: To assess the influence of pregnancy on the course of HIV infection by comparing the behaviour of total lymphocyte counts and lymphocyte subsets (CD4(+) and CD8(+) and their ratio) in a cohort of infected pregnant women. SETTING: Tertiary referral centre for high risk obstetrics and infectious diseases in pregnancy. PATIENTS AND METHODS: A prospective study was designed, HIV infected women being enrolled at the beginning of pregnancy and sampled each trimester and in the puerperium. As controls, a group of non-pregnant HIV-infected women, cross-matched for age, risk factors and stage of disease were included and similarly evaluated in the same period. RESULTS: All the parameters, when longitudinally evaluated, were stable during gestation. Compared with non-pregnant subjects, patients had higher CD4(+) counts at the beginning and increased values of total lymphocytes count and subsets during the puerperium. Antepartum and postpartum risk factors such as drug abuse, smoking, antiretroviral therapy, length of gestation, maternal complications and HIV status of the neonate were not influential on the total lymphocytes counts and subsets. DISCUSSION: According to this data, pregnancy per se seems to have a negligible influence over the course of HIV infection, at least as far as immune parameters are concerned.

Adult↗