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Biomedical subjects

C Molinari

Publications and source records attributed to C Molinari.

At least 55 records · Page 3Linked to original sources
PubMed1995

Changing pattern of pathogens causing broviac catheter-related bacteraemias in children with cancer.

The incidence of pathogens causing catheter-related bacteraemias in children undergoing antineoplastic chemotherapy with or without bone marrow transplantation at G. Gaslini Children's Hospital, Genoa, Italy, was analysed by comparing data from a retrospective study (1985-1988) with that obtained from a prospective one (1989-1992). In both periods catheter-related bacteraemias one (1989-1992). In both periods catheter-related bacteraemias were more frequent in non-neutropenic than in neutropenic patients. Among catheter-unrelated bacteraemias the pattern of infecting pathogens remained unchanged between the study periods, with Gram-positive bacteria remaining the predominant pathogens. Conversely, among catheter-related bacteraemias, the incidence of Gram-negative bacilli increased significantly from 3 to 38%, and that of Gram-positive bacteria fell from 63 to 32% (P = 0.001, chi 2 test for heterogeneity.

Antineoplastic Agents↗
PubMed1995

Role of ventrolateral medulla in reflex cardiovascular responses to activation of skin and muscle nerves.

Central neuronal circuits mediating reflex cardiovascular responses to skin and muscle nerve stimulation were studied in rats under urethan anesthesia. Responses of right rostral ventrolateral medulla (RVLM) and caudal ventrolateral medulla (CVLM) cardiovascular neurons to stimulation of contralateral skin and muscle afferent fibers were investigated. Stimulation of the tibial (muscle) nerve excited 19 (86%) of 22 CVLM neurons and inhibited 18 (82%) of 22 RVLM neurons. Stimulation of the sural (skin) nerve excited 20 (91%) of the 22 RVLM neurons but did not affect the firing rate of any of the 22 CVLM neurons. Electrolytic lesions of the CVLM abolished the depressor responses induced by stimulation of the tibial nerve without affecting the pressor response caused by sural nerve stimulation. Similarly, reversible blockade of the CVLM by microinjection of gamma-amino-butyric acid or CoCl2 abolished the depressor response to stimulation of the tibial nerve without affecting the pressor response induced by sural nerve stimulation. These results suggest that vasodepressor responses to muscle nerve activation are mediated by a neuronal inhibitory pathway to the RVLM relayed through the CVLM.

Afferent Pathways↗
PubMed1995

Does the hospital board need a doctor? The influence of physician board participation on hospital financial performance.

In this study, the authors attempted to determine if physician board participation enhances or impairs the operational performance of a hospital. Two theories--managerialism and agency theory--are compared to determine if participation on the hospital board by inside (i.e., medical staff) and outside physicians provides informational advantages (managerialism) or poses the threat for opportunism (agency theory). Using hospital operating margin to measure hospital performance for a 4-year period (1985-1988), the findings indicate that boards with inside physician (medical staff) participation had significantly better performance than those without such physician participation. Supportive of the managerialist perspective, the findings strongly suggest that medical staff board participation can enhance operational performance. Implications of physician-hospital relations for future hospital strategies as well as health care reform issues are discussed.

Data Collection↗
PubMed1993

Somatic and visceral inputs to neurons of the rostral ventrolateral medulla.

Sympathoexcitatory neurons in the rostral ventrolateral medulla (RVLM) play an essential role in the generation of basal sympathetic tone and in the reflex regulation of blood pressure. In this study responses of RVLM "cardiovascular" neurons to somatic and visceral afferent stimulation were investigated. The activity of 34 RVLM neurons was recorded in urethan-anesthetized paralyzed and artificially ventilated rats. These neurons were identified as cardiovascular based on their baroreceptor sensitivity and their pulse-synchronous discharge. Electrical stimulation of the sciatic nerve excited 31 of the 34 RVLM units (91%). Renal nerve stimulation inhibited firing of 14 of 22 RVLM neurons tested (64%), not affecting the remaining 8 units. Stimulation of splenic nerves inhibited the discharge of 7 of 12 RVLM neurons tested (58%), whereas the remaining 5 units were not affected. All RVLM units responsive to visceral afferent stimulation were also responsive to sciatic nerve stimulation. These results indicate that RVLM cardiovascular neurons receive somatic and visceral inputs, suggesting an involvement of these units in the integration of homeostatic responses to changes in the internal and external environment.

Animals↗
PubMed1993

Hospital board effectiveness: relationships between governing board composition and hospital financial viability.

OBJECTIVE: Two theories--agency and managerialism--are compared with respect to their usefulness in explaining the role of insiders on the hospital board: whether their participation enhances or impairs board financial decision making. DATA SOURCES/STUDY SETTING: The study used 1985 hospital financial and governing board data for a representative sample of acute care California hospitals. STUDY DESIGN: Relationships were examined cross-sectionally between the presence or absence of insiders on the board and measures of hospital financial viability while controlling for the organizational factors of system affiliation, ownership, size, region, and corporate restructuring. PRINCIPAL FINDINGS: Multiple regression analysis found significant relationships between insider (CEO, medical staff) participation and hospital viability. CONCLUSIONS: These results support the managerial theory of governance by suggesting that the CEO and medical staff provide informational advantages to the hospital governing board. However, the cross-sectional design points to the need for future longitudinal studies in order to sequence these relationships between insider participation and improved hospital viability.

Analysis of Variance↗
PubMed1992

Hospital board effectiveness: relationships between board training and hospital financial viability.

This study examined whether hospital governing boards that invest in board education and training are more informed and effective decision-making bodies. Measures of hospital financial viability (i.e., selected financial ratios and outcomes) are used as indicators of hospital board effectiveness. Board participation in educational programs was significantly associated with improved profitability, liquidity, and occupancy levels, suggesting that investment in the education of directors is likely to enhance hospital viability and thus increase board effectiveness.

Bed Occupancy↗
PubMed1991

Neuronal and cardiovascular responses to ANF microinjected into nucleus ambiguous.

Effects of microinjection of atrial natriuretic factor (ANF) into cardioinhibitory sites in the nucleus ambiguous (NA) or on single vagal cardioinhibitory neurons (VCN) were investigated in urethan-anesthetized rats. Sites containing cardioinhibitory neurons were identified by observing a marked and reproducible bradycardia in response to microiontophoretically applied (20-40 nA) or microinjected (20 nl) 0.1 M L-glutamate. In 35 of the 40 (87.5%) cardioinhibitory sites identified by microinjection of glutamate, ANF (20 nl of 10(-7) M) decreased heart rate (HR; -47.1 +/- 2.5 beats/min). No responses were elicited in the other five sites. In animals paralyzed and artificially ventilated, the HR effects of ANF were not significantly different before and after muscle paralysis. Microinjections of 10 nl of 10(-7) M ANF caused excitation of 19 of 21 VCN (90%), which was followed by a decrease in HR (-20.8 +/- 2.3 beats/min); no neuronal or cardiovascular responses were elicited by ANF in the remaining two VCN. Bilateral vagotomy or atropine sulfate (1 mg/kg iv) abolished cardiac slowing without affecting neuronal activation, whereas propranolol (2 mg/kg iv) did not affect either response to ANF. These results suggest that ANF is a neuromediator involved in the excitation of cardioinhibitory neurons in the NA.

Animals↗
PubMed1989

Actions of 3 alpha,5 alpha-tetrahydrodeoxycorticosterone on single neurones of the mesencephalic reticular formation in the rat.

The effects of microinjections of 3 alpha,5 alpha-tetrahydrodeoxycorticosterone (3 alpha-THDOC) on single neurones of the mesencephalic reticular formation (MRF) were investigated in rats anaesthetized with urethan. Microinjections of approximately 100 nl of 0.5-2 microM 3 alpha-THDOC inhibited firing of 105 of 112 neurones (94%). Microinjections of approximately 100 nl of 100-250 nM of 3 alpha-THDOC did not alter neuronal activity, but in 52 of 68 cases (76%) it potentiated the inhibitory action of microiontophoretically applied gamma-aminobutyric acid (GABA). The 3 beta-isomer of tetrahydrodeoxycorticosterone did not elicit any changes in neuronal firing. The effects of 3 alpha-THDOC were reversibly antagonized by microiontophoretically applied bicuculline. This 'in vivo' study supports the hypothesis that 3 alpha-THDOC may function as endogenous modulator of GABAA-mediated inhibition in various physiopathological conditions.

Action Potentials↗
PubMed1989

Neuronal and cardiovascular responses to ANF microinjected into the solitary nucleus.

The effect on single-unit activity, arterial pressure, and heart rate of a microinjection of atrial natriuretic factor (ANF) into 78 histologically verified sites in the nucleus tractus solitarii (NTS) was investigated in rats. Injections of 50 nl of 10(-7) M ANF excited 34 neurons (44%), mainly localized at the level of the obex, inhibited 15 (19%), and had no effect on the remaining 29 (37%). The increase in firing frequency of the 34 excited neurons was always followed by a decline in mean arterial pressure [MAP, -10.6 +/- 1.8 (SE) mmHg; P less than 0.01] and heart rate [HR, -9.6 +/- 3.1 (SE) beats/min; P less than 0.05]. When injections of ANF caused either no effect or inhibition of single-unit activity, no changes in either MAP or HR were observed. Single units excited by injections of ANF were also excited by activation of arterial baroreceptors and inhibited by baroreceptor unloading. Control injections of an inactive peptide analogue of ANF or of vehicle never produced any effects on neuronal firing frequency or on MAP and HR. Similar results were obtained from animals paralyzed and artificially ventilated. These results support the hypothesis that ANF plays a role in the chemical transmission of baroreceptor information within the NTS.

Animals↗
PubMed1987

Effects of corticosterone on neurones of the locus coeruleus, in the rat.

The effects of microelectrophoretic application of corticosterone (CS) on single neurones of the locus coeruleus (LC) were investigated in rats under urethane anaesthesia. Ejecting currents generally ranged from 10 to 60 nA. CS produced an excitatory effect in 73% of the neurones and no effect in 27%. The prevailingly excitatory effects induced by CS on LC neurones may be related to the regulation of those complex events, which constitute the 'stress response'.

Animals↗
PubMedDate not supplied

Effect of progesterone on peripheral blood flow in prepubertal female anesthetized pigs.

This study was undertaken to determine the effects of progesterone on the peripheral circulation. In prepubertal female pigs anesthetized with sodium pentobarbitone, changes in the superior mesenteric, left renal and left external iliac flow caused by intravenous infusion of progesterone were assessed using electromagnetic flow meters. Changes in heart rate and arterial blood pressure were prevented by atrial pacing and by connecting the arterial system to a pressurized reservoir containing Ringer solution. In 20 pigs, infusion of 1 mg/kg of progesterone increased mesenteric, renal and iliac flow. In a further 4 pigs, the vasodilatory effects of the hormone were enhanced by graded increases in the dose between 1, 2 and 3 mg/kg. The mechanisms of these responses were studied in the 20 pigs by repeating the experiment after hemodynamic variables had returned to the control values before infusion. In 5 pigs, blockade of adrenergic receptors with propranolol and phentolamine did not affect the responses elicited by progesterone. The increases in mesenteric, renal and iliac flow to progesterone were prevented, respectively, by the injection of N(omega)-nitro-L-arginine methyl ester into the mesenteric (5 pigs), the renal (5 pigs) or the iliac artery (5 pigs). The present study shows that intravenous infusion of progesterone dilated mesenteric, renal and iliac circulations. The mechanism of this response involved the release of nitric oxide.

Adrenergic alpha-Antagonists↗
PubMedDate not supplied

Effects of insulin on coronary blood flow in anesthetized pigs.

Insulin can influence the vasculature by a sympathetically mediated vasoconstriction and a vasodilatation; the latter effect predominates in the renal circulation of anesthetized pigs. We determined the effect of intravenous infusion of insulin on coronary blood flow in pentobarbitone-anesthetized pigs at constant heart rate, arterial pressure and blood levels of glucose and potassium. In 6 pigs, infusion of 0.004 IU kg(-1) min(-1) of insulin decreased coronary flow despite increasing left ventricular dP dT(max)(-1); when the latter was abolished by propranolol, the coronary flow response was augmented. The mechanisms of this response were examined in 22 pigs given propranolol. Phentolamine changed coronary flow response to an increase (6 pigs) and this was abolished by intracoronary injection of N(omega)-nitro-L-arginine methyl ester (L-NAME; 5 pigs). L-NAME augmented coronary flow response (6 pigs) and this was abolished by phentolamine (5 pigs). In 18 pigs given propranolol, three incremental doses of insulin caused graded coronary flow decreases whether L-NAME was given (6 pigs) or not (6 pigs) beforehand, and caused graded coronary flow increases after phentolamine (6 pigs). Thus insulin caused a coronary vasoconstriction mediated by sympathetic alpha-adrenergic effects and a vasodilatation related to the release of nitric oxide. The net effect was a coronary vasoconstriction.

Adrenergic alpha-Antagonists↗
PubMedDate not supplied

Gains from public-private collaborations to improve community health.

In several disciplines there exists theoretical and empirical evidence to show that community affects health and behaviors; but to date such evidence has remained largely outside the health services field. In this article, the authors introduce and contribute to this evidence and then discuss how those in the healthcare sector can work to increase public-private collaborations. Telephone survey data collected in 1995 from 1,826 randomly selected residents of a Northwest urban county were used in multivariate analysis to assess the relationship between community quality and health status. Community quality was measured by residents' perceptions of community problems. Findings indicate that individual ratings of community problems predicted mental health functioning. This effect was found overall and for men and women separately. These results suggest that health is dependent on how people perceive the quality of their community. Leadership and vision can make an enormous difference in the quality of a community health system and in the cost-effectiveness of the care provided. Healthcare leaders can develop their understanding of their community and the impact of community characteristics on health through consultation with experts, input from community leaders, and visits to the neighborhoods that surround the delivery services. Community networks can be developed with the common focus of improving the community's health. Collaborative efforts between the private health sector, the public health sector, and community members can enhance social relationships and thus promote the health of residents.

Adult↗