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Biomedical subjects

A Mazzola

Publications and source records attributed to A Mazzola.

At least 19 recordsLinked to original sources
PubMed2004

Pulmonary tuberculosis in Italian children by age at presentation.

AIM: To evaluate the clinical characteristics, diagnostic methods and outcome of paediatric pulmonary tuberculosis (PTB) in relation to children's ages when observed. METHODS: Children under 15, who had been admitted to the Children's Hospital with PTB were prospectively evaluated. Our sample included patients with a positive tuberculin skin test and signs or symptoms of tuberculosis (TB), including abnormal chest X-rays which suggested PTB. We collected demographic, clinical, radiographic and microbiological data from the patients, in addition to carrying out contact investigations in order to find a source case. All the patients involved in this study were subjected to anti-tuberculosis treatment. RESULTS: Sixty-two patients (44% under 5) were eligible for inclusion in our study. Children with presenting symptoms were younger than asymptomatic patients (p<0.05). A source case was found in 38 patients out of 62 children (62%) and children under 5 were more likely to have a source case than that found with older children (p<0.05). Ghon complex (infiltrate + adenopathy) tended to occur in young children (median age of 3.25, p<0.05). Fourteen children (23%) had clinical specimens which tested positive for Mycobacterium tuberculosis (MT), and 20 (32%) for MT DNA according to a polymerase chain reaction (PCR). Resistant strains to 1 or more anti-tuberculosis drugs were found in 5 children and in 4 adult sources. The patients with minimal or no radiographic change during therapy displayed symptoms for a longer period of time and were infected by a resistant strain (p<0.05). CONCLUSION: Improvements in case detection, case management and contact investigations are necessary for controlling paediatric TB, especially in young children. Given that any diagnosis of TB in children is supported by epidemiological and clinical evidence rather than isolating MT, detection of the source case is important in selecting appropriate treatment.

Adolescent↗
PubMed2004

Tuberculosis of the central nervous system in children: 32 years survey.

AIM: In order to study the impact of clinical and diagnostic parameters on the clinical outcome of children with central nervous system tuberculosis (CNS-TB), we retrospectively reviewed all cases of CNS-TB diagnosed over a 32-year period at the Children's Hospital of Palermo, Italy. METHODS: Data were collected with regard to the clinical, laboratory and demographic characteristics of patients, as well as the results of radiological investigations and data on clinical outcome. In relation to the date of introduction of new diagnostic methods (indirect as well direct) and to the change of treatment periods, the authors compared the clinical outcome of patients admitted prior and after 1984. They also classified the patients into 3 different stages of illness according to the severity of the disease on admission. RESULTS: We identified 80 patients with CNS-TB. The mean age of the children was 3 years with 54% of patients younger than 5 years. The contact source was documented in 40 patients (50%). The mean duration of symptoms prior to admission was 22 days (range 5 days - 3 months). Mantoux skin test was positive on admission in 50 patients (62%). CSF smear microscopy and culture were positive in 29% and 45% of patients respectively. PCR for Mycobacterium tuberculosis introduced in 1994 was positive in 11 out of 13 tested patients. Determination of CSF gdT lymphocytes composition applied in 7 patients shows a predominance of Vg9/Vd2 T lymphocytes. Fifteen subjects (19%) died; 11 (13%) suffered from permanent sequelae. The died children and those with permanent sequelae were younger than the others (p<0.05). Prior to 1984, none of the patients were identified during early stage of illness and 4 out of 37 patients with stage II illness died. After 1985, 44% of children were in stage I and 2 out of 4 patients with stage III died (p<0.05). CONCLUSIONS: Stage of disease and young age are still the decisive factors in the clinical outcome of children with CNS-TB. The availability of new advanced methods has improved the identification of patients with CNS-TB in stage I and therefore the possibility of an early treatment of such patients.

Age Factors↗
PubMed2002

Nematode community response to fish-farm impact in the western Mediterranean.

A previous investigation on fish-farm biodeposition effects on benthos, carried out in the Gaeta Gulf (northwestern Mediterranean Sea), revealed a strong impact on meiofaunal assemblages. This study implements these findings by examining in detail the nematode assemblage and its response to organic enrichment from the start of a fish farm activity to the conclusion of the fish rearing cycle. Density, community structure and individual size were utilised for univariate (genus, trophic diversity and abundance patterns) and multivariate analyses (MDS) in order to identify the best descriptors of impact and the response of the nematode assemblages. Nematodes displayed significantly reduced densities, diversity and richness in sediments beneath fish farms. The impact of biodeposition was evident not only from structural community parameters but also in terms of functional indices. Forty-five days after starting fish farming, an increase of the nematode individual biomass was observed. MDS ordination pointed out the presence of two different nematode communities in disturbed sediments and in the control site. These results were substantiated by the analysis of the temporal changes of k-dominance curves, the maturity index and, to a lesser extent, by the index of trophic diversity. Some nematode genera were highly sensitive to biodeposition (Setosabatieria, Latronema and Elzalia) and disappeared almost completely in farm sediments, whereas other genera largely increased their dominance (Sabatieria, Dorylaimopsis and Oxystomina). This study indicates that nematodes are very sensitive to this kind of environmental disturbance. The use of simple tools, such as the k-dominance analysis and maturity index, are recommended for monitoring of aquaculture impact.

Animals↗
PubMed2001

Heterotrophic bacteria community and pollution indicators of mussel--farm impact in the Gulf of Gaeta (Tyrrhenian Sea).

Field studies were carried out to determine and compare the impact of organic loads due to the biodeposition of a mussel farm on the water quality and sediment in a coastal area of the Tyrrhenian Sea (Western Mediterranean). A total of five environmental and five microbial parameters were examined from March, 1997 to February, 1998 on a monthly basis at three stations: the first was located under the mussel farm, the second located at about 40 m away from the mussel farm, while the third designed as a control was at about 1-km. No clear changes in the physical characteristics of the water masses were observed, comparing the three sampling sites and the water column generally showed homogeneous conditions (in terms of temperature and salinity). Changes in density of aerobic heterotrophic bacteria, Escherichia coli and Enterococci in the water column are apparently independent from changes in environmental parameters. At all stations a constant significant correlation between temperature and presumptive Vibrio parahaemolyticus was reported suggesting that this abiotic factor exerted a major control on this bacterial group and its distribution in the water column is not related to the biodeposition of the mussel farm. The major impact identified was on the sediment where variations in bacterial abundance was observed. In the Mussel station sediment enrichment of organic compounds, and the consequent modification of the characteristics of the benthic environment, determined an increase in aerobic heterotrophic bacteria, and particularly of vibrios density (on average about 60%), suggesting that these bacteria are good indicators of organic enrichment.

Animals↗
PubMed2001

Differential responses of benthic microbes and meiofauna to fish-farm disturbance in coastal sediments.

Bacterial and meiofaunal abundance and biomass and their response to the disturbance induced by fish-farm biodeposition were investigated from March to October 1997 on a monthly basis at two stations of the Gaeta Gulf (Tyrrhenian Sea, Mediterranean Sea). The biopolymeric fraction of the organic matter was characterized by high concentrations which was similar at both fish-farming-impacted and control stations. Similarly, bacteria accounted for a small fraction of the biopolymeric organic carbon (< 1%), while the contribution due to auto-fluorescent cell biomass (i.e. prokaryotic and eukaryotic cells displaying auto-fluorescence) to the total biopolymeric carbon was quantitatively negligible (< 0.1%). Benthic bacteria appear to be sensitive to organic enrichment as their abundance increased significantly beneath the cage, whilst numbers of meiofauna was lower than in the control. Changes occurred also in terms of individual nematode biomass that increased as result of the biodeposition. A particularly useful tool appeared to be represented by the ratio of benthic auto-fluorescent cells to bacterial abundance, bacteria to meiofaunal biomass and auto-fluorescent cells to meiofauna biomass. All these parameters described well the impact due to biodeposition on the benthic environment as their ratios displayed significantly higher values in farm sediments, but recovered rapidly (15 days) to values observed in the control (i.e. undisturbed conditions) immediately after cage removal. Changes observed in the present study highlight that the increased organic loading determined a shift of the relative contribution of the different benthic components to the total biopolymeric carbon, so that in highly impacted systems total benthic biomass becomes increasingly dominated by microbial components.

Animals↗
PubMed2000

Early activation of gammadelta T lymphocytes in the elderly.

T cell function is altered in vivo and in vitro in elderly compared with young subjects, and this alteration is believed to contribute to morbidity and mortality in man due to the greater incidence of infection, as well as autoimmunity and cancer in elderly. The majority of T cells express TCRalphabeta whereas TCRgammadelta is expressed on a minority of T cells. Moreover, it is known that gammadelta T lymphocytes display major histocompatibility complex (MHC)- unrestricted cytotoxicity that is reminiscent of natural killer (NK) activity. In view of earlier findings on both T cells and NK cells in the elderly, we hypothesised a different behaviour of gammadelta T lymphocytes from old subjects when compared with gammadelta T lymphocytes obtained from young people. Therefore, to gain further insight into mechanisms of immunosenescence in this little-studied population, we studied immunofluorescence analysis gammadelta T cells from the elderly. Our preliminary results show that the percentage of blood gammadelta T cells in lymphocytes from old subjects is decreased when compared with the young. Interestingly, these cells are more activated in the elderly than in young subjects; expression of CD69, an early activation marker, is increased in gammadelta T lymphocytes from old subjects after three hours of in vitro culture both with and without lipopolysaccharide stimulation. Thus, our findings, which need confirmation, strongly suggest that, in humans, gammadelta T cells are early responders when compared with alphabeta T cells. They may act as 'first aid' cells to replace the described deficit of the specific and aspecific immunity in elderly. In this view, the proinflammatory status, observable in the elderly, renders them ready to be stimulated by exogenous agents.

Adult↗
PubMed2000

Usefulness of transesophageal echocardiography in the assessment of aortic dissection.

The acute dissection of the ascending aorta requires prompt and reliable diagnosis to reduce the high risk of mortality; in addition, prognosis is influenced by long-term complications. The aim of this article is to discuss transesophageal echocardiography (TEE) and (1) its diagnostic accuracy in the presurgical evaluation of patients, (2) its role in reducing time of diagnosis and surgery, and (3) its ability to reduce hospital mortality. TEE has also been tested as a screening method in the postsurgical follow-up of these patients. The retrospective investigation concerns a sample of 80 cases of acute dissection of the aorta, submitted for surgical intervention from April 1986 to February 1999. TEE has allowed a precise estimation of aortic diameters and optimal visualization of intimal flap and tear entry with a fine distinction between true and false lumen. A direct comparison of the results of TEE and of transthoracic echocardiography has demonstrated that some elements (visualization of flap and diameters in descending aorta, sites of entry and reentry, direction of jet trough intimal tears, phasic intimal flap movement, diastolic collapse of flap on the valvular plane, false lumen thrombosis, coronary involvement, intramural hematoma, and aortic fissuration) were identified only by TEE, whereas other additional diagnostic elements (cardiac tamponade, aortic valve insufficiency, left ventricular function) show a similar pattern of significance. Routine employment of this method has confirmed a reduction of hospitalization time (about 1.5 hours of waiting time), and hospital mortality has changed from 42.8% to 17.3%. In the follow-up of patients operated on for aortic dissection, fundamental information may be obtained from TEE (assessment of the progression of thrombosis in the false lumen with its complete obliteration and modifications in aortic diameter with a consequent, possible worsening of aortic valve insufficiency). In conclusion, our study demonstrated that TEE may provide fast and efficient detection of acute aortic dissection. In the postsurgical follow-up, TEE has confirmed detection of major complications that can influence long-term prognosis and may be proposed as a method with easy access-one that is repeatable and inexpensive for the screening of aortic dissection surgical patients.

Aortic Dissection↗
PubMed2000

A probabilistic methodology for the assessment of safety from dropped loads in offshore engineering

Pipeline damage by dropped objects from crane activities is a significant hazard for offshore platform installations. In this paper a probabilistic methodology is utilized for the estimation of the pipeline impact and rupture frequencies; this information is obtained both for the overall pipeline section exposed to the hazard and for a number of critical locations along the pipeline route. The presented algorithm has been implemented in a computer program that allows the analysis of a large number of possible drop points and pipeline target point locations. This methodology may be used in common risk analysis studies for evaluating the risk for platform personnel from dropped objects; however, the proposed technique may also be useful for other applications where engineering judgment has so far been the main driving criterion. In particular, two sample cases have been analyzed. The first one is the problem of selecting the best approaching route to a platform. By analyzing different route alternatives, a reduction of the impact frequency and therefore of the risk for the platform personnel may be achieved. The second application deals with the selection of the location for a safety valve at the riser base. The analysis may give useful information, such as the highest impact frequency location and the rupture frequencies upstream and downstream of the valve as a function of the valve position; this information, together with the transported medium inventory upstream of the valve, may give the designer a documented and justifiable rationale for selecting the best location for the valve from a safety point of view.

Journal Article↗
PubMed1991

Left ventricular aneurysm secondary to Behçet's disease.

A 16-year-old boy with Behçet's disease who was seen with thrombophlebitis of the leg was found to have coronary artery occlusion with postinfarction left ventricular aneurysm. Recurrent femoral artery aneurysms and orogenital ulceration developed in him. The diagnostic features together with successful treatment of this patient and a discussion of Behçet's syndrome are presented.

Adolescent↗
PubMed1988

Giant left atrium and mitral valve replacement: risk factor analysis.

Giant left atrium (GLA) associated with mitral valve disease (MVD) has been reported as a significant risk factor in mitral valve surgery with mortality ranging from 8%-32%. Plication of the left atrium has been suggested to reduce postoperative left ventricular failure, respiratory failure and mortality. The 203 consecutive patients with MVD operated upon between 1980 and 1986 were reviewed and divided in two groups: group A without GLA (165 patients) and group B with GLA (38 patients = 19%). The pertinent preoperative and intraoperative notes and the early and late postoperative course were reviewed and correlated. The hospital mortality was 2.4% in group A and 2.6% in group B. Late mortality, at a mean follow-up of 54 months was 4.3% in group A and 5.4% in group B. In this series, GLA was not a significant risk factor in MVR and did not affect early and late results as compared with cases without GLA. Plication may not be required in absence of extracardiac signs of compression.

Cardiomegaly↗
PubMed1986

Intracaval and intracardiac leiomyomatosis of uterine origin.

Intracaval leiomyomatosis of uterine origin is a rare disease. Extension to the right heart is exceptional. Based on the review of 11 cases reported in the literature and the case presented herein, which was treated successfully, the diagnostic and therapeutic problems are discussed. Diagnosis should be suggested when a female patient operated on previously for myofibroma of the uterus by hysterectomy, presents with a picture of cardiac myxoma. Diagnosis can be confirmed by iliocavogram and computerized tomography of the abdomen. Excision calls for a cardiac procedure under extracorporeal circulation and caval exploration which may be performed either simultaneously or as a two stage procedure.

Adult↗
PubMed1983

Plasmatic TXB2 and 6-keto-PGF1 alpha levels during charcoal hemoperfusion in chronic renal failure patients.

6 patients with end-stage renal disease underwent hemoperfusion with charcoal columns, for 60 min. Blood samples anticoagulated with 2% EDTA/aspirin solution were obtained from arteriovenous fistulas in the basal condition, 5 min after a bolus injection of heparin (7,500 U), at the end of hemoperfusion, and 30 min after. The study was repeated few days later, in the same patients, two hours after 100 mg aspirin by mouth. TXB2 and 6-keto-PGF1 alpha were assayed with RIA in unextracted (U) and extracted (E) and chromatographed platelet poor plasma (PPP). Platelet counts before and after hemoperfusion were also performed. Low levels of the two prostaglandins were found in plasma; this could be related to the procedures for collection and processing of plasma samples; no significant differences were observed between extracted and unextracted samples: there were slightly higher levels of 6-keto-PGF1 alpha in unextracted samples. After charcoal hemoperfusion there was only a slight and not significant increase of TXB2 and 6-keto-PGF1 alpha; low dose aspirin did not modify significantly plasma levels of the two prostaglandins before hemoperfusion but it reduced TXB2 and 6-keto-PGF1 alpha levels after charcoal hemoperfusion. The platelet count fell (-22%) after charcoal hemoperfusion with heparin alone and in similar manner after low-dose aspirin pretreatment (-24%, 7%).

6-Ketoprostaglandin F1 alpha↗