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Biomedical subjects

A Zappa

Publications and source records attributed to A Zappa.

At least 19 recordsLinked to original sources

Safety and immunogenicity of 23-valent pneumococcal polysaccharide vaccine in HIV-1 infected former drug users.

The immunogenicity of 23-valent pneumococcal polysaccharide vaccine was assessed in 57 HIV-1 infected former intravenous drug users and in 20 HIV-1 negative controls. The effect of vaccination on HIV-1 infection was studied in a subgroup of 38 patients, 60% of whom under highly active antiretroviral therapy (HAART). Antibody to capsular polysaccharides from Streptococcus pneumoniae serotypes 3, 4, 6B, 19F, 23 F, and changes in CD4+ count, HIV-1 RNA, proviral DNA and HIV-1 phenotype were measured in pre- and post-vaccination samples. Vaccinations were well-tolerated. The rate of responders was higher (P<0.05) in HIV-1 negative than in HIV-1 infected individuals. No difference in antibody response was found within HIV-1 infected patients stratified according to CD4+ counts. Post-vaccination antibody geometric mean concentrations (GMCs) to the five antigens were higher (P<0.05) than baseline in HIV-1 negative subjects, but not in HIV-1 positive individuals. Those with CD4+ >500 cells/mm(3) showed a significant increase of antibody against type 3 only. Immunisation caused no significant changes in CD4+ counts and in either plasma HIV-1 RNA nor proviral DNA levels. Pneumococcal vaccination does not induce virological or immunological deterioration in HIV infected patients, but the antibody response to a single dose of vaccine is poor.

Adult↗

Comparison of three nucleic acid amplification assays of cerebrospinal fluid for diagnosis of cytomegalovirus encephalitis.

The diagnostic reliabilities of three cytomegalovirus (CMV) nucleic acid amplification assays of cerebrospinal fluid (CSF) were compared by using CSF samples from human immunodeficiency virus-infected patients with a postmortem histopathological diagnosis of CMV encephalitis (n = 15) or other central nervous system conditions (n = 16). By using a nested PCR assay, the quantitative COBAS AMPLICOR CMV MONITOR PCR, and the NucliSens CMV pp67 nucleic acid sequence-based amplification assay, sensitivities were 93.3, 86.6, and 93.3%, respectively, and specificities were 93.7, 93.7, and 87.5%, respectively. The COBAS AMPLICOR assay revealed significantly higher CMV DNA levels in patients with diffuse ventriculoencephalitis than in patients with focal periventricular lesions.

AIDS-Related Opportunistic Infections↗

Surgical treatment of carotid kinking.

The authors take in exam 34 anatomical variation in the extracranial internal carotid artery (compared with more than 450 operated carotid artery), 15 of which involved kinking in patients with overt neurological symptoms, underwent corrective surgical treatment, and test the most useful and appropriate techniques in any case.

Adolescent↗

[Surgery of the descending thoracic and thoraco-abdominal arteries. Report of 105 cases].

The Authors show their casistic of about 105 cases of thoracic descending and thoraco-abdominal aorta pathologies between 1.1.1993 and 30.12.1995. After a short introduction about the improvements in anesthesia and reanimation of these pathologies as well as the good reliability of diagnostic and currently available instruments, mortality and mobility parameters are taken into account, the last one referring to paraplegia and ARF. The casistic is evaluated splitting the cases into 2 groups, urgent surgery and election surgery, and differentiating the aneurysm type from the dissection type. Besides, the mortality and mobility are reported for any pathology, with a discussion of the parameters which drove the choice of the most suitable methodology to be adopted (ECC femoro-subclavian shunt, simple clamping). The results achieved show a mortality of 40% in urgency, between 5 and 15% in election, with a rate of paraplegia around 8-10% and a ARF between 5 and 15%. These data match the literature statistics and support the quality of the adopted methodologies.

Adult↗

[Spinal cord protection in surgery of the thoracic, descending, and thoraco-abdominal aorta. Comparison of methods].

The authors compare the strategus needed for the elimination of paraplegia and for protection of abdominal organs after replacement of descending thoracic or thoraco-abdominal aorta. They analyse single technique considering the advantages and the controindications; furthermore they compare these properties and those of possible variants in the light of the presentation; type of disease and general conditions of the patient. These considerations are in agreement with later literature as well as the attitude of the surgeon.

Aortic Aneurysm↗

[Pseudoaneurysms after carotid endarterectomy].

Pseudoaneurysms after TEA of the internal carotid artery are one of the rarest and most severe complications of this form of surgery. Their etiology appears to depend on 3 causes: a suturing defect due to technical errors made by the surgeon or to the incorrect choice of threads; an infections, and lastly the arterial wall weakened by TEA. The patch increases the risk of false aneurysm approximately four fold. We therefore agree with other authors that, in spite of the undoubted value of the patch in the prevention of restenosis, it must only be used in the presence of an internal carotid of small diameter (less than 4 mm). Contrary to what is reported in the literature we performed both these operations under loco-regional anesthesia and a detailed knowledge of this method allows is to be performed on the carotid axis. Only through a careful follow-up of all the carotids operated can the small dilations which often do not require surgical treatmente identified. The two cases reported here were treated by the removal of the pseudoaneurysms and its replacement with a prosthesis in one case and with the vena saphena in the other. Both were monitored with clinical examination and echo-Doppler and no recidivation has been reported to date.

Aneurysm↗

[Invasion of the chest wall in primary lung neoplasms].

The authors analyse a series of 5 patients who underwent pulmonary and parietal resection between 1990 and 1993 due to non.microcytoma bronchogenic carcinoma with invasion of the thoracic wall. The patients comprised four men and one woman aged between 45 and 69 years old. Thoracic pain was present in two patients. Pulmonary resection with extrapleural stripping was performed in two patients whereas a block resection from one to five ribs and the corresponding intercostal spaces was performed in the other three patients. The authors' approach is not to perform these operations according to rigid protocols but to adapt them according to the local status of tumour invasion. Therefore to resort to extrapleural resection when there is a free cleavage plane between parietal pleura and rib wall; resection in block of the wall where the carcinoma has infiltrated the endothoracic fascia or deeper. The authors do not report any major complications and record a postoperative mortality rate of 0%. In two cases the thoracic wall was reconstructed using a sheet of Gore-Tex which did not provoke rejection phenomena. Radiotherapy was carried out in cases with positive lymph nodes. The series presented here is too recent to provide significant data regarding survival. However, the only factor seen to influence prognosis in the five patients was the presence or otherwise of lymph node metastasis, irrespective of the histological type and operation performed. The five year survival rate of T3N0M0 patients is in fact similar to that of T2N0M0 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Hepatic resection. A contribution and its analysis].

The authors outline their experience in the field of resective hepatic surgery, both with regard to benign and malignant pathologies, and analyse the results in relation to indications and techniques, but also focusing attention on the assessment of postoperative functional alterations, in order to evaluate the hepatic reserve and the organ's response to demolitive surgery. All operations were carried put in the First Division of Surgery at the Ospedale Civile, Asti, from January 1989 to September 1992. In all cases, even in major hepatectomies, a "trans-parenchymal" technique was adopted. Before surgery tests were carried out in relation to the topography of disease, its nature, associated pathologies and the functional hepatic reserve. Operative mortality was zero and morbidity was negligible, probably because rigorous selection criteria and indications for surgery were adopted. Morbidity was even restricted in the two patients suffering from HCC on cirrhosis (?) and this may probably be attributed to the limitation of resection to solely oncological purposes and their classification as Child-Pugh's stage A. The results regarding the liver response to demolitive surgery appear to be indicative and revealed a highly significant and discriminating difference between elective and emergency surgery.

Adolescent↗

[Major and minor complications in carotid surgery].

The Authors report their experience of major and minor complications in carotid surgery. They analyse the causes and emphasize that a thorough preoperative study and a quick surgical technique are very important in reducing the rate of complications in this essentially preventive form of surgery.

Aged↗

[Palliative gastric resection].

The surgical treatment of stomach carcinoma is reassessed. Stress is laid on the more aggressive attitude with regard to advanced gastric cancer where total or partial palliative resection is the only operation offering good results. This tendency emerges both from the series presented and those reported in the literature. It is concluded that if more aggressive surgery is justified in IVth stage stomach tumours it must still depend on the patient's general condition.

Aged↗

[Tumors of the anus].

On the basis of an analysis of a personal series of anal tumours, it is concluded that the polychemotherapeutic protocol with mitomycin and 5-fluorouracil and extensive local tumour removal proposed by Nigro et al. could present a valid alternative to Miles anorectal amputation. The treatment proposed offers better quality of life for the patient without changing oncological radicality and survival.

Aged↗

[Lesions of the colon caused by pancreatitis].

A case of stenosis of the splenic flexure of the colon consequent on acute pancreatitis is reported. Literature reports on the colic complications of pancreatitis are examined, analysing the pathogenetic mechanisms, clinical pictures and therapeutic problems involved in this pathology.

Acute Disease↗

Relationships between adipose tissue characteristics of newborn pigs and subsequent performance: I. Characteristics at 8 days of age and growth rate until slaughter.

The genetic influence on body and adipose tissue characteristics of newborn pigs and their correlations to growth rate, BW, body length, backfat thickness and adipocyte size in the outer and inner layers of backfat in 8-d-old Large White piglets were determined. Samples of adipose tissue were obtained by biopsy. Pigs were born to 32 sows mated with the same boar. Heritability and genetic correlations were estimated with dam component of variance; therefore, bias due to common environmental effects cannot be excluded. The heritability estimate for adipocyte volume (.89 +/- .28) was higher than that for backfat thickness at the first and last thoracic vertebrae (.50 +/- .22; .63 +/- .24) and for body weight (.59 +/- .23) at 8 d. Backfat thickness was more closely related genetically and phenotypically to body weight and length than to adipose tissue cellularity. Heritability estimates were .75 +/- .28 for gain from 8 d to weaning and from weaning to 95 d (probably because of common environmental effects) but were .31 +/- .20 for ADG from 95 d to slaughter. Characteristics at 8 d were closely correlated phenotypically with growth rate until weaning. These correlations became lower in the two subsequent periods (to 95 d and to slaughter). Corresponding genetic correlations were nonsignificant.

Adipose Tissue↗

Relationships between adipose tissue characteristics of newborn pigs and subsequent performance: II. Carcass traits at 95 and 145 kilograms live weight.

Backfat thickness, carcass length, area of M. longissimus and carcass composition were determined for 253 Large White barrows and gilts to examine the genetic influence on the main characteristics of the carcass and the correlation of these traits with body measurements and fat characteristics at 8 d of age. Pigs were born to 32 sows mated to the same boar. At the age of 8 d, weight, body length and backfat thickness and cellularity were measured. Pigs were slaughtered at 95 and 145 kg live weight. Heritability and genetic correlations were estimated with dam component of variance. Higher adiposity of carcasses was noted for barrows than for gilts and for those animals slaughtered at the heavier vs at the lighter weight. High h2 values were observed for carcass length (.89 +/- .29), area of the M. longissimus (.67 +/- .26) and backfat thickness at the gluteus medius (.77 +/- .28). Percentage of commercial cuts also had high heritabilities. Phenotypic and genetic correlations between the characteristics at 8 d and backfat thickness, carcass length and M. longissimus area at slaughter were not statistically significant. However, significant phenotypic correlations were found between cellularity of the outer and inner layers at 8 d and percentage of major cuts (e.g., rp = .27 with total fat cuts); cellularity of the outer layer at 8 d also was correlated genetically with carcass composition (e.g., rg = .50 +/- .19 with total fat cuts). Genetic predisposition toward intensive fat deposition was more clearly predicted by cellularity than by thickness of adipose tissue in newborn pigs.

Adipose Tissue↗

Relationships between adipose tissue characteristics of newborn pigs and subsequent performance: III. Histological and chemical characteristics of backfat.

Genetic and phenotypic relationships between adipose tissue characteristics of 253 piglets aged 8 d and qualitative characteristics of their backfat at 95 and 145 kg live weight were studied. Heritability of these qualitative aspects was estimated as well. Backfat samples were tested for cellularity, moisture, lipid content and fatty acid composition of the outer and inner layers. Adipose cellularity at birth proved to be correlated with cell volume, moisture and total unsaturated fatty acid, C18:0 and C18:2 contents present in backfat at slaughter. Estimates of heritability calculated for the outer layer of backfat indicated that progress can be made by selecting for water content and fatty acid composition. Neonatal cellularity furnishes a useful indicator not only of the backfat cell size at slaughter but also of the chemical factors important in determining the physical and organoleptic characteristics of porcine fat.

Adipose Tissue↗

[Early diagnosis of intestinal infarcts].

In view of the often poor prognosis of intestinal infarctions personal experience and reports in the literature are reviewed in order to identify the clinical, laboratory and radiological dates that can contribute to early diagnosis. It is concluded that only emergency selective arteriography of the upper mesenteric artery will enable the surgeon to diagnose and accurately locate the infarction.

Animals↗

Long-term effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on the peripheral nervous system. Clinical and neurophysiological controlled study on subjects with chloracne from the Seveso area.

This work was set up to investigate the possible presence of peripheral nervous system involvement as a long-term effect of the exposure to dioxin in 152 subjects with chloracne from the Seveso area; 123 age- and sex-matched subjects living in nearby towns with similar environmental pollution formed the control group. The accident in Seveso took place in July, 1976, and this study was carried out from October, 1982, to May, 1983. Although a peripheral neuropathy was not found in any of the subjects, a significant increase of the number of individuals presenting at least two bilateral clinical signs (p less than 0.05) or one abnormal electrophysiological parameter (p less than 0.02) was found in the Seveso group. Principal component analysis did not show any subdivision between these two groups. The Fisher approach to discriminant analysis reveals a clear subdivision between the group of the most exposed subjects and randomly selected subgroups of control subjects. In conclusion, clinical and electrophysiological signs of peripheral nervous system involvement occur with a statistically increased frequency in the Seveso population 6 years after the accident, although a peripheral neuropathy was not evident in any of the chloracne patients using the World Health Organization diagnostic criteria.

Accidents, Occupational↗