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Biomedical subjects

C Gianni

Publications and source records attributed to C Gianni.

At least 19 recordsLinked to original sources
PubMed2006

Tinea incognito in Italy: a 15-year survey.

Tinea incognito or steroid modified tinea is a dermatophytic infection in which topical or systemic steroids, administered as a result of dermatological misdiagnosis or preexisting pathologies, have modified the clinical appearance of the fungal infection, transforming the typical ringworm and mimicking other skin diseases. This is a retrospective study of the agents, clinical aspects, sources of infection of 200 cases (98 males, 102 females, mean age 42 years) of tinea incognito, observed in Siena and Milan, Italy, in the period 1987-2002. In order of decreasing frequency, Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis, Microsporum gypseum, Trichophyton violaceum and Trichophyton erinacei were isolated. The clinical appearance of the infection was lupus erythematosus discoid-like, eczema-like, rosacea-like, especially on the face, impetigo-like and eczema-like on trunk and limbs. Less often the dermatophytosis resembled psoriasis, purpura, seborrhoic dermatitis and lichen planus. There was folliculitis in 9% of cases and dermatophytid in 3% of cases. Antimycotic therapy brought about clinical and mycological recovery in all patients except one, who had iatrogenic immunodepression.

Administration, Topical↗
PubMed2005

Onychomycosis in children: a survey of 46 cases.

This is a retrospective study of the agents, clinical aspects, sources of infection and therapy of onychomycosis in children. In the period 1989-2000, we observed 46 consecutive children, until 16 years of age with onychomycosis (29 boys, 17 girls, mean age 10.8 years). Dermatophytes were isolated in 30 cases (Trichophyton rubrum in 22 cases, Trichophyton mentagrophytes in five, Epidermophyton floccosum in two and Trichophyton violaceum in one) and Candida spp. in 16, associated with Trichophyton rubrum in two. Moulds were isolated in three children (Fusarium oxysporum in one, Scopulariopsis brevicaulis in another and Aspergillus fumigatus associated with Trichophyton rubrum in a third). The commonest features were distal and distolateral subungual hyperkeratosis in dermatophyte infections (93%) and onychodystrophy and paronychia in Candida infections (56% and 50% respectively). Forty patients achieved clinical and mycological recovery. It is appropriate to suspect onychomycosis in children, perform microbiological diagnosis and undertake early treatment. An approach of this kind may help to prevent nail dystrophy and the spread of infection.

Adolescent↗
PubMed2004

The mitochondrial superoxide dismutase A16V polymorphism in the cardiomyopathy associated with hereditary haemochromatosis.

The A16V mitochondrial targeting sequence polymorphism influences the antioxidant activity of MnSOD, an enzyme involved in neutralising iron induced oxidative stress. Patients with hereditary haemochromatosis develop parenchymal iron overload, which may lead to cirrhosis, diabetes, hypogonadism, and heart disease. The objective of this study was to determine in patients with haemochromatosis whether the presence of the Val MnSOD allele, associated with reduced enzymatic activity, affects tissue damage, and in particular heart disease, as MnSOD knockout mice develop lethal cardiomyopathy. We studied 217 consecutive unrelated probands with haemochromatosis, and 212 healthy controls. MnSOD polymorphism was evaluated by restriction analysis. The frequency distribution of the polymorphism did not differ between patients and controls. Patients carrying the Val allele had higher prevalence of cardiomyopathy (A/A 4%, A/V 11%, V/V 30%, p = 0.0006) but not of cirrhosis, diabetes, or hypogonadism, independently of age, sex, alcohol misuse, diabetes, and iron overload (odds ratio 10.1 for V/V, p = 0.006). The frequency of the Val allele was higher in patients with cardiomyopathy (0.67 v 0.45, p = 0.003). The association was significant in both C282Y+/+ (p = 0.02), and in non-C282Y+/+ patients (p = 0.003), and for both dilated (p = 0.01) and non-dilated stage (p = 0.04) cardiomyopathy, but not for ischaemic heart disease. In patients with hereditary haemochromatosis, the MnSOD genotype affects the risk of cardiomyopathy related to iron overload and possibly to other known and unknown risk factors and could represent an iron toxicity modifier gene.

Cardiomyopathies↗
PubMed2004

Effects of feeding rations with genetically modified whole cottonseed to lactating Holstein cows.

Two experiments were conducted to evaluate dry matter intake (DMI), milk yield, and milk composition from feeding rations that contained different sources of genetically modified whole cottonseed to Argentinean Holstein dairy cows. Twenty-four lactating multiparous Argentinean Holstein dairy cows were used in 2 experiments with a replicated 4 x 4 Latin square design, with cows averaging 565 kg body weight and 53 d in milk at the beginning of the experiments. Treatments in Experiment 1 were: Bollgard cotton containing the cry1Ac gene, Bollgard II cotton containing cry1Ac and cry2Ab genes, Roundup Ready cotton containing the cp4 epsps gene, and a control nongenetically modified but genetically similar cottonseed. In Experiment 2, two commercial sources, a parental control line, and the transgenic cotton containing both cry1Ac and cp4 epsps genes were used as treatments. All cows received the same total mixed ration but with different whole cottonseed sources. Cottonseed was included to provide 2.50 kg per cow daily (dry matter [DM] basis) or about 10% of the total diet DM. The ingredient composition of the total mixed ration was 32% alfalfa hay, 28% corn silage, 22% corn grain, 17% soybean meal, and 2% minerals and vitamins. In addition, genomic DNA was extracted from a subset of milk samples and analyzed by polymerase chain reaction followed by Southern blot hybridization for small fragments of the cry1Ac transgene and an endogenous cotton gene, acp1. No sample was positive for transgenic or plant DNA fragments at the limits of detection for the assays following detailed data evaluation criteria. The DMI, milk yield, milk composition, body weight, and body condition score did not differ among treatments. Cottonseed from genetically modified varieties used in these studies yielded similar performance in lactating dairy cows when compared to non-transgenic control and reference cottonseed.

Animal Feed↗
PubMed2002

Case Reports. Tinea capitis due to Trichophyton soudanense and Trichophyton schoenleinii.

Four cases of tinea capitis, two due to Trichophyton soudanense in Italian children who had had contact with Africans, and two due to Trichophyton schoenleinii in an African and an Italian child, respectively, are reported. Infections caused by anthropophilic dermatophytes are rare in Italy and are related to immigration. The most frequent agents of tinea capitis in Italy are zoophilic dermatophytes.

Child↗
PubMed2001

Usefulness of histological examination for the diagnosis of onychomycosis.

BACKGROUND: [corrected] Direct microscopy and culture tests currently used in the diagnosis of nail mycosis can yield false-negative results, and confirmation of the pathogenic agent, especially in non-dermatophyte infections, is often a lengthy process. OBJECTIVE: The aim of this study was to investigate the usefulness of the histological examination of nail clipping samples in supplementing the standard microscopic and culture techniques for the diagnosis of onychomycosis. PATIENTS AND METHODS: One hundred and seventy-two subjects affected by nail alterations suggestive of onychomycosis were evaluated. Nail specimens were studied with 3 different techniques: direct microscopic examination of a 40% KOH clarified preparation, fungal culture and histological examination. Patients positive for fungal infection were re-evaluated with the same techniques after treatment with oral terbinafine, fluconazole or itraconazole and topical application of bifonazole or ciclopirox for 2 months. RESULTS: Direct microscopy was positive in 102 (59.3%) nail specimens. The culture test was positive in 90 cases (52.9%), showing a dermatophyte in 45, a yeast in 23 and a mould in 22 samples. The histological examination was positive in 94 (54.6%) samples. In 4 cases, it was the only investigation confirming the clinical diagnosis of nail mycosis. In most of the cases, the morphological aspect of the hyphae and/or spores suggested also to which group of pathogens (dermatophytes, yeasts or moulds) the mycetes observed in the histological sections could be ascribed. The concurrent presence of a dermatophyte and a mould was evidenced in a few specimens. The control histological examination at the end of the treatment showed negative results or residual non-vital hyphae and/or spores. CONCLUSIONS: Results of the present study indicate that the histological examination of nail clipping specimens is a relatively inexpensive, rapid and easily performed procedure. It is useful to confirm or refute the results of routine microscopy and culture tests. Moreover, nail histopathological observation may help in ascribing a pathogenic role of non-dermatophyte isolates and evaluating the effectiveness of antifungal treatment.

Adolescent↗
PubMed2001

Diagnostic accuracy and prognostic implications of stress testing for coronary artery disease in the elderly.

BACKGROUND: The aim of this study was to define the diagnostic accuracy and the prognostic significance of stress electrocardiography (ECG) and of thallium-201 single-photon emission computed tomography (SPECT) in determining the incidence of coronary artery disease (CAD) in an elderly population. METHODS: A selected series of 132 patients (90 males, mean age 72.4 years; 42 females, mean age 68.2 years) hospitalized because of cardiac events associated with suspected CAD, underwent stress ECG and thallium-201 testing; as endpoints we considered the heart rate and the appearance of clinical symptoms or ST segment depression. Patients unable to develop an adequate exercise workload, were tested with dipyridamole. All patients also underwent coronary angiography following the stress test. One hundred and twenty-four patients had a mean follow-up of 2 years. Endpoints included subsequent coronary events or new serious disease. The sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values of both ECG and of thallium-201 SPECT were calculated. RESULTS: ECG findings were positive in 102 patients and coronary angiography confirmed the presence of CAD in 92 of them; ECG findings were negative in 30 patients, but only 14 were free from obstructive coronary lesions. Thallium-201 SPECT findings were positive in 112 patients (coronary angiograms confirmed CAD in 101) and negative in 20 patients (in 13 of whom angiography confirmed the absence of disease). The sensitivity of the stress tests was quite good: 85.1% for ECG and 93.5% for thallium-201 SPECT; conversely, the specificity of ECG was superior to that of SPECT (58.3 vs 54.1%). The sensitivity of both techniques was superior in males than in females and seemed to correlate with the extent of CAD. CONCLUSIONS: The diagnostic accuracy of thallium-201 SPECT was 86.3% whereas that of ECG was 80.3%. Considering the overall cardiac events, the predictive value of SPECT was superior to that of ECG both in terms of the positive value (54 vs 51%, p = NS) and, more importantly, in terms of the negative value (84 vs 62%, p < 0.03). In fact, patients with normal thallium images were at low risk for future cardiac events.

Aged↗
PubMed2001

Case reports. Six cases of infection due to Trichophyton verrucosum.

Dermatophyte infections due to Trichopkyton verrucosum are not frequent in Europe. Six cases observed in Italy in the period 1995-99 are reported. Two were cases of tinea barbae, two of tinea corporis and two of tinea capitis, one of which had been preceded by tinea faciei. In three cases the source of contagion was horses, in two it was cattle and in one case it was another person. The two cases of tinea barbae were initially interpreted and treated as bacterial infections, a diagnostic error reported with increasing frequency in the literature regarding dermatophytosis due to T. verrucosum.

Adolescent↗
PubMed2001

[CT virtual angioscopy in the study of thoracic aortic dissection].

PURPOSE: Virtual endoscopy is a technique in which helical-CT and MR data sets are processed by a special software creating a three-dimensional viewing of the inner surface of hollow viscera that simulates the endoscopic view. We report our 2.5-year experience with virtual intraluminal endoscopy (VIE) in the study of the thoracic aorta in patients with aortic dissection and in patients with normal aorta. MATERIAL AND METHODS: From December 1997 to June 2000, CT angiography (CTA) data sets of the thoracic aorta obtained in a series of 43 patients were retrospectively evaluated. Our series included 23 patients with clinical or radiological suspicion of aortic dissection and 20 patients in whom the study of the thoracic aorta was carried out as a necessary completion of an abdominal aortic disease. CTA data sets were processed with a dedicated software (Navigator); the view point and view direction could be set arbitrarily in the vessel, obtaining an intraluminal endoscopic view of the inner surface of the vessel. Multiple views were obtained and visualised consecutively through a cine-loop technique. The entire thoracic aorta was studied. RESULTS: VIE enabled correct visualisation of the intimal flap in all cases of aortic dissection (=23) and of its origin at the level of the ascending aorta in 16 cases (Stanford A) and in the descending aorta in the remaining 7 patients (Stanford B). In the control group (=20) no signs of intimal flap were identified with the VIE. In all patients with aortic dissection false and true lumen were entirely visualised. VIE allowed the understanding of the relation between false lumen and supraaortic vessels that originated from the true lumen in all cases and were found to be dissected in 6 patients. In 16 cases the dissection included thoracic and abdominal aorta. In some cases the endoscopic view was altered by artifacts related to the selected threshold levels and represented by pierced surface and floating shape artifacts. A correlation with axial and multiplanar (MPR) images allowed the correct interpretation of such artifacts. CONCLUSIONS: According to our experience, virtual endoscopy represents a useful tool in the evaluation of the dissection of the thoracic aorta, allowing a better definition of anatomical details. A correlation with axial images and multiplanar views remains compulsory for a better understanding of VIE findings, which is nevertheless significantly influenced by the operator's experience.

Aortic Dissection↗
PubMed2000

Non-dermatophytic onychomycosis. An understimated entity? A study of 51 cases.

The aim of our study was to evaluate the incidence, the clinic characteristics, the therapeutic antifungal response and the evaluation of side-effects in 51 non-dermatophytic onychomycosis cases which were observed in a case-study of 1012 patients, affected by different types of onychopathy, attending the Mycology Ambulatory of San Paolo Hospital, Milan, Italy during the period 1994-97.

Antifungal Agents↗
PubMed1997

Unusual clinical features of fingernail infection by Fusarium oxysporum.

Four cases of invasion of fingernails caused by Fusarium oxysporum are described. The typical picture of onychomycosis by this non-dermatophytic mould is a 'white superficial onychomycosis' which usually affects the great toenail. Only few cases of fingernail infections by this organism have been described in the literature and, to our knowledge, there are no reported cases on the pustulous and eczema-like aspect of paronychia by Fusarium oxysporum. We report different and unusual clinical features of this infection successfully treated with systemic antifungals. Two patients were treated with terbinafine, 250 mg daily for 3 months, and two patients with itraconazole, 200 mg daily for 3 months.

Adult↗
PubMed1997

Ungual phaeohyphomycosis caused by Alternaria alternata.

Phaeohyphomycoses are a heterogeneous group of rare mycotic infections caused by dematiaceous fungi. They are classified into four forms: superficial, cutaneous and corneal, subcutaneous, systemic. Alternaria species are ubiquitous fungi that are occasionally aetiological agents of pheohyphomycosis. A case of onychomycosis caused by Alternaria alternata treated with itraconazole is reported.

Aged↗
PubMed1989

Advanced neuroblastoma: results of two treatment programs including sequential hemibody irradiation.

Results of two consecutive treatment programs for advanced neuroblastoma, including sequential hemibody irradiation, are analyzed and compared. The first treatment program (I-TP) included one single-fraction (7 Gy) irradiation to the upper and lower halves of the body as consolidation of remission achieved by previous chemotherapy with CDDP and VP16. A fractionated technique (2 Gy daily for 4 consecutive days to each hemibody) was used in the second treatment program (II-TP) for children in remission following a combination of CDDP + VP16 and ADM + VCR + CTX. In both treatment programs, chemotherapy was continued according to the same pre-radiation regimen following the two sessions of hemibody irradiation. Overall response rate to pre-radiation chemotherapy was 84% and 60% for I-TP and II-TP, respectively. Thirty-month overall progression-free survival was 0 for I-TP and 20% for II-TP. No treatment-related fatalities occurred. In the subsets of patients who reached complete or good partial remission during the pre-radiation chemotherapeutic phase, 30-month progression-free survival in I-TP and II-TP was 0 and 33%, respectively. The role of fractionated hemibody irradiation in prolonging the progression-free survival can be inferred.

Adolescent↗
PubMed1983

Childhood non-Hodgkin's lymphoma: prognostic relevance of clinical stages and histologic subgroups.

Seventy-nine consecutive children with non-Hodgkin's lymphoma were treated with a uniform intensive radiotherapy-chemotherapy program including high-dose MTX and CNS prophylaxis. Burkitt-type NHL was diagnosed in 44% and convoluted cell-type NHL in 33%. Complete remission rate was 97.5%. Forty-eight of 79 children (61%) remain progression-free after 18-78 months of follow-up. Patients belonging to the Burkitt type subgroup showed a peculiar clinical behavior as well as a significantly shorter survival than the other NHL patients (3-year overall survival rates of 50% vs. 72%, respectively). Clinical stages were related to the progression-free survival. It is concluded that treatment should be tailored according to the histology (Burkitt-type NHL vs. other histologic types) and the clinical stage.

Adolescent↗
PubMed1983

Childhood rhabdomyosarcoma with meningeal extension: results of combined therapy including central nervous system prophylaxis.

Results achieved in two consecutive series of children with rhabdomyosarcoma (RMSA) of the head and neck area, presenting with meningeal involvement, are compared. The first series consisted of 12 children treated with local radiotherapy and with (mostly) polidrug systemic chemotherapy from 1969 to 1977. The second series consisted of 11 children who, besides local radiotherapy and polichemotherapy, received brain radiotherapy (30 Gy) and intrathecal (I.T.) methotrexate (MTX) as central nervous system (CNS) prophylaxis from 1978 to 1980. In the first group, 50% of patients achieved a complete remission and only one child (8%) is surviving relapse-free. In the second group, 91% of patients achieved a complete remission and seven (64%) are surviving relapse-free after a median follow-up of 32 months. The most important reason for failure in the first series was represented by the inability to achieve a persistent local control of the primary tumor. This observation and the higher doses of radiotherapy delivered to the primary tumor in the second series prevent the conclusion that the improved results are attributable entirely to the addition of CNS prophylaxis.

Adolescent↗
PubMed1982

Nasopharyngeal carcinoma in childhood.

We have retrospectively evaluated a series of 27 consecutive children observed from 1965 to 1980 with nasopharyngeal carcinoma (NPC). Histological diagnosis in each patient was undifferentiated carcinoma of nasopharyngeal type (UCNT) with prominent lymphocytic infiltration. Regional node involvement was present in 26 of 27 patients and two children presented with distant metastases. Twenty evaluable children with primary nasopharyngeal tumor with or without positive cervical nodes underwent radiotherapy (RT) with uniform criteria in technique. Adjuvant cyclophosphamide (CPM) was administered to a total of 11 children. The actuarial relapse-free survival and overall survival are 40% and 55% at four years, respectively. In this series, the most important prognostic factor was represented by the extent of the tumor in the nasopharynx. Permanent control of the primary tumor was obtained in 85% of patients. CPM given after RT did not reduce the incidence of relapse. However, the fact that 45% of patients developed distant metastases as first treatment failure suggests that combined chemotherapy should be tested in the management of NPC in children, especially when primary tumor is locally advanced.

Adolescent↗