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Biomedical subjects

C Maffei

Publications and source records attributed to C Maffei.

At least 19 recordsLinked to original sources

Epilepsy in an Italian community as assessed by a survey for prescriptions of antiepileptic drugs: epidemiology and patterns of care.

The prescriptions of antiepileptic drugs in the years 1985 and 1986 were used to identify all possible cases of epilepsy in a population of about 50,000 people. The general practitioners of the study area filled out a questionnaire for each user of antiepileptic drugs registered as a patient of theirs. This information was integrated using data obtained by local specialist services or directly collected by visits and/or phone interviews. Two-hundred and fifty-six of the 417 antiepileptic drug users proved to be active epileptics with a prevalence rate of 5.2/1000, the annual incidence rate for 1986 being 51.8/100,000. The main patterns of the disease appeared to be consistent with those of the literature while the prior history of seizures in the previous five years was generally lower. The health care of epileptic patients involved a wide range of specialists. The general practitioners were responsible for the final diagnosis of epilepsy in 10% of patients and for the management of the disease in 22%, most of the patients being over 50 years old. The calculated mean prescribed daily doses of the antiepileptic drugs suggested that many epileptics were taking therapeutic schedules lower than those of the literature.

Adolescent

How we teach the doctor-patient relationship.

Since the reform of the Italian medical degree in 1988, fourth-year students now study the dynamics of the doctor-patient relationship as part of the compulsory 'methodology of the clinical, therapeutic, prevention and rehabilitation approach' course. This work illustrates a pilot scheme carried out at the Milan University Medical School and begun shortly before the reform of the Italian medical degree. In dealing with the teaching of the doctor-patient relationship, the authors look into a relational-psychological perspective which is supported by notions and instruments intrinsic to medical pedagogy. The work is handled along three main lines: (a) presentation of a relational teaching model and definition of teaching objectives; (b) presentation of the methods and techniques used (role-playing, videotape recordings, video simulation and group work); and (c) discussion on the evaluation criteria.

Curriculum

Nosocomial outbreak of systemic candidosis associated with parenteral nutrition.

Eight patients in two surgical units developed systemic candidosis during a 40-day period from June 5 to July 13, 1987 (in five cases Candida albicans was identified). Three of them died. All cases belonged to a group of 27 patients receiving parenteral nutrition (PN), while among the 108 patients who did not receive PN, no cases were observed (p = .000001). Candida was cultured from two PN bags administered to the cases. A specialized nutrition nurse was responsible for the PN compounding and for maintaining administration sets in the two wards involved. An epidemiological investigation, in which 19 uninfected patients who had had PN were used as controls, showed no significant difference between cases and controls except that lipids were more frequently added to bags administered to cases (p = .0005). Furthermore, the bags administered to cases contained a higher average number of multidose constituents (p = .0008) when the comparison was focused on the two days before the onset of symptoms. Given the favorable medium provided by lipids, even a low level contamination of PN solutions during compounding and/or administration could have been responsible for the exposure of cases to multidose vials suggests, although not conclusively, that an extrinsic contamination occurred during compounding. Six isolates of C albicans were available from four cases. C albicans was cultured from the pharyngeal swabs of two physicians and three nurses, including the specialized nutrition nurse.

Aged

Psittacosis in a highly endemic area in Italy.

In one locality in Italy where the incidence of psittacosis has increased rapidly since 1980, a hospital-based study and a seroepidemiological survey were carried out in order to define the clinical and epidemiological features of psittacosis in that area. Registers of the Virology Unit of the University of Ancona, Italy, were reviewed and all hospitalized patients with a serological diagnosis of psittacosis were identified. A total of 76 cases were found and studied. A presumptive bird source was identified in 80% of 62 patients, on whom a detailed investigation had been possible. Poultry represented the most frequent probable source of infection. Clinically, the predominant pattern of illness was a moderately severe lower respiratory tract infection, with chest X-rays showing pulmonary shadowings in 68 patients (89%). In the seroepidemiological study, 51 out of 143 subjects were exposed to birds (35.7%), but only 7 out of 96 urban adult blood donors (7.3%) were positive for chlamydial antibodies using the microimmunofluorescence test.

Adult

A waterborne outbreak of leptospirosis.

During the period from July 10-26, 1984, 33 cases of serologically confirmed leptospirosis occurred in a small town in central Italy. The fatality rate, including the deaths of two unconfirmed cases, was 8.6% (3 of 35). Based on serologic evidence, the infection was caused by leptospires of the serogroup Australis. Epidemiologic study showed that the patients contracted the infection by drinking water from a fountain. The source of leptospiral contamination was probably a hedgehog trapped in a reservoir of water not in use but still connected to the water system of the fountain.

Adult

An international perspective on assessment of negative and positive symptoms in schizophrenia.

The authors used the Scale for Assessment of Negative Symptoms and the Scale for Assessment of Positive Symptoms in interviews of 96 psychiatric inpatients in Italy. They evaluated the interrater reliability and the internal consistency of these scales for the assessment of negative and positive symptoms in schizophrenia. Their findings indicate that the results of these scales are similar in Italy and the United States, countries with different languages and cultures.

Adult

Childhood enteritis: a community study.

The population aged 0-12 years living in the area of an Italian Local Health Unit (about 8,800 children) was studied for one year in order to estimate the overall incidence rate of enteritis and the incidence rates of diarrheas from bacterial agents. All children complaining of acute diarrhea and seen by the pediatric practices of the study area were recorded by date, age, and sex; the microbiological study of stools was performed for a sample of patients. All hospitalized cases of childhood enteritis occurring in the same period in the study population were studied too. Campylobacter jejuni and Salmonella were cultured from 5 out of 71 examined out-patients (7.0%), with a projected annual consultation rate of 2.1 per 1000 population aged 0-12 years. Yersinia enterocolitica was cultured from 2 out-patients (2.8%), while no cases from Shigella and enterotoxigenic Escherichia coli were observed in this group. Data concerning hospitalized cases confirmed this pattern of results. Bacterial enteritis is an important public health problem in the study area and its occurrence is possibly related to animal reservoirs of infection, with particular regard to poultry and pets.

Campylobacter Infections

Human leptospirosis in an area of central Italy: results from a serological survey.

The results of a serosurvey for leptospiral antibodies in a random sample of healthy subjects are reported. The study was carried out in an area where a waterborne outbreak of leptospirosis, due to leptospires of serogroup Australis, had occurred a month before. Sera were tested with the microagglutination technique. Leptospiral agglutinins were found in 13.8% of tested subjects, mostly in adult females. The highest prevalence rate was observed for serovar lora belonging to serogroup Australis. The leptospires of this group have a relevant spread in the study area in keeping with other surveys carried out in Italy.

Adult

[A small epidemic focus of pulmonitis caused by Legionella].

A mini-epidemic consisting of 5 cases of Legionnaire's disease treated during september 1983 is reported. These patients shared many of the symptoms distinguishing the most common form of this disease in its severe or very severe form and some characteristic features of this case series are emphasised. It was impossible to trace the source of the outbreak, in spite of the fact that the mini-epidemic took place in an open situation. It is underlined that diagnosis is mainly clinical. The Legionella pneumophila bacteria should always be considered as one of the causal agents of bronchopneumonia, particularly when the following conditions are fulfilled: a) the disease takes the form of a confined, out-of-season, mini-epidemic; b) it is accompanied by multisystemic symptomatology and/or much greater involvement of general conditions that is usually to be expected in normal cases of bronchopneumonia. Since the disease is often fatal, erythromycin or rifampicin treatment should be started upon the slightest suspicion of contagion.

Adolescent

[Seroepidemiology of infection by hepatitis B virus in student nurses: some implications for vaccination policy].

To estimate the risk of hepatitis B virus (HBV) infection among student nurses, we measured the prevalence of HBV infection in 218 student nurses (192 female and 26 male nurses) and the annual attack rate in a subgroup of 117 subjects. In both studies sera were tested with an enzyme immunoassay for the presence of HBsAg, anti-HBc and anti-HBs. In the prevalence study 24 student nurses (11.1%) had a marker of prior HBV infection; the presence of both anti-HBc and anti-HBs was the most prevalent serologic pattern. 2 student nurses were HBsAg positive (0.9%). Prevalence of infection was strongly related to increasing age, while the occupation of the head of the family showed no effect. In the incidence study 7 subjects seroconverted in a year (6.2%): 6 acquired only anti-HBc and 1 only anti-HBs. These data suggested the hypothesis that the presence of anti-HBc alone (a pattern usually associated with past infections in which anti-HBs is no more detectable) may represent false positive results. The implications of such hypothesis are discussed with particular reference to prevaccination screening policy.

Adult

beta-N-acetyl-D-glucosaminidase isoenzymes by chromatofocusing from serum and skin in diabetes.

beta-N-Acetyl-D-glucosaminidase and its kinetic characteristics were determined in serum and skin from both diabetes mellitus and impaired glucose tolerance patients and controls. Mean total activity was reduced (p less than 0.05) in the skin of both patient groups. beta-N-Acetyl-D-glucosaminidase isoenzyme expression was investigated using chromatofocusing on PBE-94 coupled with automated enzyme assay. The isoenzyme profiles from serum showed two major forms (A and B) whose ratio varied from 2:1 in controls to 3:1 in diabetics. Moreover, diabetes mellitus and impaired glucose tolerance subjects displayed an intermediate (I) form. The A/B isoenzyme ratio was completely reversed in skin.

Acetylglucosaminidase

A distinct beta-hexosaminidase isoenzyme separated from human leukemic lymphocytes and myelocytes.

The beta-hexosaminidase (EC 3.2.1.30) isoenzymes were separated on the basis of their carbohydrate moieties by an affinity chromatography using immobilized phenylboronate. Normal lymphocytes and granulocytes contain two major forms of beta-hexosaminidase, acute lymphoblastic, acute myeloblastic, chronic lymphocytic and chronic myelocytic leukemic cells contain an extra, distinct isoenzyme of beta-hexosaminidase. This extra isoenzyme may be a marker for the leukemic conversion of hematopoietic tissue.

Bone Marrow