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Biomedical subjects

C Sanguinetti

Publications and source records attributed to C Sanguinetti.

At least 19 recordsLinked to original sources
PubMed2001

An observational study on the epidemiology of respiratory tract bacterial pathogens and their susceptibility to four injectable beta-lactam antibiotics: piperacillin, piperacillin/tazobactam, ceftazidime and ceftriaxone.

Bacterial infections of the respiratory tract account for a large proportion of total medical consultations in general practice. In recent years, antibiotic resistance has increased alarmingly in a number of bacterial species that are common causes of these infections. The aim of this observational study was to determine the antibiotic resistance of microbial agents isolated from patients with acute or acutely exacerbated respiratory infections. Subjects recruited as potential sources of bacteria were either outpatients seen in a number of specialized clinics and hospital practices, or hospitalized patients. Overall, 648 consecutive patients (67% male, mean age 48.1+/-27.0 years) with infection of the upper or lower respiratory tract were observed during a 13-month period. A total of 551 pathogenic microbial strains were isolated and tested for their in vitro susceptibility to piperacillin, piperacillin/tazobactam, ceftazidime, and ceftriaxone. Among all isolates, the four most frequent pathogens were Pseudomonas aeruginosa (132 isolates, 24%), Streptococcus pyogenes (99 isolates, 18%), Staphylococcus aureus (93 isolates, 17%), and Klebsiella pneumoniae (46 isolates, 8%). The susceptibility of gram-positive isolates ranged from 97.5% to 95.1%, and no remarkable difference was found in the antibacterial activity of tested b-lactam antibiotics. The susceptibility of gram-negative isolates to piperacillin and piperacillin/tazobactam was also similar: 96.5% and 97.1%, respectively. In contrast, differences were found between piperacillin (or piperacillin/tazobactam) and either ceftazidime (p=0.003) or ceftriaxone (p<0.0003) in gram-negative isolates. We conclude that, despite the extensive use of beta-lactam antibiotics (piperacillin, ceftazidime, and ceftriaxone) in medical practice during the past three decades, the susceptibility of the most common pathogens involved in the etiology of upper and lower respiratory tract infections to these antibiotics is still high. In particular, bacterial resistance developed by gram-positive organisms against piperacillin is negligible and not alarming.

Adolescent↗
PubMed2000

Neurofilament mRNAs are present and translated in the normal and severed sciatic nerve.

Local protein synthesis within axons has been studied on a limited scale. In the present study, several techniques were used to investigate this synthesis in sciatic nerve, and to show that it increases after damage to the axon. Neurofilament (NF) mRNAs were probed by RT-PCR, Northern blot and in situ hybridization in axons of intact rat sciatic nerve, and in proximal or distal stumps after sciatic nerve transection. RT-PCR demonstrated the presence of NF-L, NF-M and NF-H mRNAs in intact sciatic nerve, as well as in proximal and distal stumps of severed nerves. Northern blot analysis of severed nerve detected NF-L and NF-M, but not NF-H. This technique did not detect the three NFs mRNAs in intact nerve. Detection of NF-L and NF-M mRNA in injured nerve, however, indicated that there was an up-regulation in response to nerve injury. In situ hybridization showed that NF-L mRNA was localized in the Schwann cell perinuclear area, in the myelin sheath, and at the boundary between myelin sheath and cortical axoplasm. RNA and protein synthesizing activities were always greater in proximal as compared to distal stumps. NF triplet proteins were also shown to be synthesized de novo in the proximal stump. The detection of neurofilament mRNAs in nerves, their possible upregulation during injury and the synthesis of neurofilament protein triplet in the proximal stumps, suggest that these mRNAs may be involved in nerve regeneration, providing a novel point of view of this phenomenon.

Animals↗
PubMed1994

Predicting in-hospital mortality after hip fracture in elderly patients.

Ninety-seven patients aged 88 +/- 4 years (range, 80-97 years) (study group), and 74 aged 75 +/- 3 years (range, 70-79 years) (control group), were prospectively studied to investigate whether basic medical variables can predict in-hospital mortality in very old patients undergoing hip surgery because of femoral fracture. Mortality was 16.5% and 6.7% in the study and control groups, respectively (p = 0.054). In the study group, mortality was significantly correlated with age (p < 0.01), venous disorders (p < 0.05), malnutrition (p < 0.0001), duration of surgery (p < 0.006), and postoperative noninfectious complications (p < 0.005). In the control group, age was the only significant correlate of mortality (p < 0.005). After exclusion of surgery-related variables, the logistic regression analysis confirmed the predictive role of venous disorders (odds ratio = 2.04, confidence limits = 1.09-3.79) and malnutrition (odds ratio = 6.01, confidence limits = 1.85-19.47) but not of age in the study group. However, the goodness-of-fit test showed that the statistical model did not fit the data adequately. We conclude that in-hospital mortality after hip surgery in the very old cannot be predicted on the basis of underlying medical conditions alone.

Age Factors↗
PubMed1993

Continuous geriatric care in orthopedic wards: a valuable alternative to orthogeriatric units.

The aim of this study was to assess whether assigning a geriatrician to provide daily medical care to geriatric patients in the orthopedic ward can improve the prognosis and reduce the length of stay. Time series analysis was performed in two parts: 1) prospective analysis of two years' workload, and 2) retrospective analysis of data collected over the 4 years prior to the intervention. Intervention and control populations were pooled, and the effects of geriatric care and patient-related factors on outcome measures were assessed by logistic regression analysis. All subjects were patients aged > or = 70 years who attended the orthopedic ward in a university hospital in years 1989-90 (studied group: 287 cases) and in years 1985-88 (control group: 474 cases). In the study period, mortality was 8.4% compared to 18% in 1985-86 (p < 0.0006) and 14% in 1987-88 (p < 0.01). The operation rate in the study period was 89.9% vs 83.8% in 1985-86 (p < 0.02) and 81.8% in 1987-88 (p < 0.005). Length of stay was 26.2 +/- 14.4 days vs 32.9 +/- 30.9 days in 1985-86 (p < 0.05) and 26.9 +/- 16.5 days in 1987-88 (NS). Length of stay was more strikingly shortened in the subset of patients with femoral fracture undergoing surgical management (28.5 +/- 12.7 vs 37.6 +/- 32.6 days in 1985-86, p < 0.003, and 30.8 +/- 15 days in 1987-88, p < 0.02). Given the positive relationship between geriatric care and operation rate (o.r. = 1.5, CI = 1.1-1.9), the protective effect of surgical treatment on mortality (o.r. = 0.6, CI = 0.4-0.8) to some extent may mask the collinear effect of geriatric care. We conclude that assigning a geriatrician to assist with the medical care of elderly orthopedic patients in orthopedic wards is associated with increased operation rate, decreased mortality and shortened length of stay.

Aged↗
PubMed1993

Post-operative electrolyte imbalance: its incidence and prognostic implications for elderly orthopaedic patients.

In order to assess incidence and prognostic implications of post-operative electrolyte disorders for elderly patients, 180 patients aged 79.5 +/- 6.8 years, range 70-96 years, admitted to a geriatric-orthopaedic liaison service were prospectively followed from admission to discharge or death. The association of age, basic medical conditions, type of anaesthesia and perioperative complications with post-operative sodium/potassium imbalance and fatality was assessed by logistic regression analysis. The incidence of post-operative electrolyte imbalance and fatality was 15% and 8.8%, respectively. Electrolyte imbalance was independently predicted by spinal anaesthesia [odds ratio (OR) = 2, confidence limits (CL) = 1.24-3.19], multiple pathology (OR = 2, CL = 1.1-3.58), use of cathartics (OR = 1.76, CL = 1.05-2.91) and intra-operative complications (OR = 1.7, CL = 1.03-2.88). Death was predicted by electrolyte imbalance (OR = 2.32, CL = 1.21-4.43), post-operative noninfective complications (OR = 2.3, CL = 1.09-4.84) and age greater than 79 years (OR = 1.17, CL = 1.06-1.3). Post-operative electrolyte imbalance is a marker of very frail medical status and a risk factor for death among elderly orthopaedic patients.

Aged↗
PubMed1993

Surgical treatment of displaced acetabular fractures: results of 50 consecutive cases.

Results of the surgical treatment of 50 consecutive displaced acetabular fractures were reviewed after a minimum of 2 years and a maximum of 6 years. Twenty-five fractures were complex, and 15 were treated at > or = 3 weeks postinjury. The quality of the reduction was anatomic in 74% of the patients. The rate of osteonecrosis of the femoral head was 10%. Heterotopic bone appeared in 24% of the patients, but function was impaired in only three. Excellent and good results were noted in 76% of the patients. Fractures operated on at > or = 3 weeks (delayed) had a failure rate of 40% compared with 17% for fresh fractures. The failure rate of delayed fractures was negatively influenced by nonoperative treatment initiated before surgery in other centers. Surgical treatment is considered the method of choice for displaced acetabular fractures, provided it is performed by knowledgeable and proficient surgeons.

Acetabulum↗
PubMed1993

Clinical and pathological aspects of solitary spinal neurofibroma.

Four cases are described of solitary spinal neurofibroma, a rare tumour of the spinal cord or nerve roots. Computerised tomography provided an accurate topographical definition of the tumour. Magnetic resonance imaging showed an increased T2-weighted signal and multiple areas of decreased T1- and T2-weighted signals centrally. The MR signals matched the histological examination which showed hyperplastic interfascicular connective tissue, pleomorphic cells, and tightly packed nerve fibres compressed by the surrounding loose connective tissue. Electron microscopy showed three types of cell: Schwann cells, fibroblast-like cells, and mast cells. The histological findings suggests that solitary spinal neurofibroma is a distinct pathological entity which could be diagnosed preoperatively from the MR images.

Adult↗
PubMed1992

The ultrastructure of peripheral neurofibroma: the role of mast cells and their interaction with perineurial cells.

The authors analyze the ultrastructure of mast cells and perineurial cells when both are present in neurofibroma of the nerve sheath. Samples of pathologic tissue taken from three patients with neurofibroma of a peripheral nerve sheath were analyzed by light and transmission electron microscopy. The observations document the characteristics of the tumor cells (Schwann cells and perineurial cells) as well as the presence of numerous mast cells, typically in close contact with the perineurial cells and never with the Schwann cells. Many electron-dense vesicles were found between the cells; these vesicles are created when the cell membrane of the mast cell buds, and then they come into contact with the adjacent perineurial cell. Endocytosis vesicles are often present in the cytoplasm of perineurial cells. Analysis of these observations led the authors to assume the existence of a metabolic interaction between the two cell type in contact with each other and an active role of the mast cells in the evolution of the tumor. The following two theories are plausible: either the mast cells actively stimulate tumor growth, or they alter the phenotype of the tumor cell. These findings could have interesting clinical applications. The use of treatment protocols which inhibit mast cell activity could, in theory, stop either the proliferation of the neurofibroma or its malignant transformation.

Cell Division↗
PubMed1991

The ultrastructure of schwannoma and neurofibroma of the peripheral nerves.

An electron microscopic study of 4 solitary schwannomas and 2 neurofibromas of peripheral nerves was performed with the aim of investigating the debated histogenesis of the two types of lesion. Our observations confirm that solitary schwannoma is composed almost exclusively of cells with characteristics of differentiated Schwann cells, thus providing evidence for a neuroectodermal origin of the tumor. Analysis of the ultrastructure of neurofibroma shows the presence of 3 different types of cells: Schwann-like cells, perineurial-like cells, and fibroblast-like cells. Perineurial-like cells were prevalent in our observations. These findings as well as the many controversial aspects of the origin of neurofibroma could be explained by separating this type of neoplasia into two pathological forms: perineurial and interstitial. Moreover, the numerous differences between solitary schwannoma and neurofibroma allow us to hypothesize a different cellular origin for each tumor. If confirmed by further observations, this would explain the difference in the capacity of the two types of neoplasia to undergo malignant change, an occurrence almost unknown in solitary schwannoma yet relatively common in neurofibroma.

Collagen↗
PubMed1990

Morphological changes in growth-plate cartilage in osteogenesis imperfecta.

We obtained specimens of growth-plate cartilage from four patients with osteogenesis imperfecta. Light microscopy showed structural changes in the tissue and morphological changes in chondrocytes and matrix, particularly in the hypertrophic zone. There were changes in the process of calcification in the primary mineralisation zone of the cartilage. We also found histochemical changes in the matrix glycosaminoglycans (GAGs) in the zones where physiological mineralisation was disturbed and where the trabeculae were interrupted and poorly mineralised. In addition to the known molecular defects in collagen, changes in GAGs and non-collagenous proteins are important factors in the pathogenesis of the disease.

Growth Plate↗
PubMed1989

[Treatment of soft tissue trauma with BPAA gel. Results of an Italian multicenter study vs. placebo].

A double-blind study vs placebo was carried out on 82 pts suffering from soft tissue trauma, to evaluate the efficacy and tolerance of a new anti-inflammatory, non-steroidal analgesic for topical use, 3% BPAA. Clinical results obtained by the group treated with BPAA gel were highly significant (p = 0.01) and positive, showing absence of local and systemic side-effects. Accordingly, BPAA gel can be recommended for treatment of soft tissue trauma.

Adolescent↗
PubMed1986

An experimental study of retrograde axonal plasmatic flow in the peripheral nerves of rats.

Retrograde axonal flow (R.A.F.) in the sciatic nerve of Sprague Dowley rats was studied by injecting horseradish peroxidase (H.R.P.) peripherally and identifying its appearance in the related segment of the spinal cord. This called for a precise identification of the vertebro-medullary topography, the afferant root levels of the sciatic nerve, and the transport velocity of the H.R.P. Our study revealed a clear difference of neuromuscular end plate permeability as between new-born and adult animals. The vertebral column of the rat consists of 8 cervical metameres, 13 dorsal, 6 lumbar, 4 sacral, and 3 coccygeal. The sciatic nerve is derived principally from the roots L4, L5, L6 and in part from L3 and S1. The injection of H.R.P. in the sural triceps of the new-born rat produced granules in the anterior horn cells as early as 12 hours later. In similar experiments with adult rats H.R.P. in the motorneurons was never detected. In our experimental model the transport velocity of H.R.P. from the point of injection to the anterior horn cells was approximately 68 mm per day. These findings provide a foundation on which to base future studies of retrograde flows in conditions of induced pathology.

Animals↗
PubMed1985

[Intermediate gastric cancer].

It is presented a case of gastric cancer that penetrates the stomach wall up to the muscular layer (C.G.P.M.). In a 53 years old patient, who consulted for abdominal pain and weight lost, and who has at the present a survival of 2 1/2 years, symptom free, the radiology, endoscopic and anato-pathologic features of this disease, are analyzed. The transcendence in diagnostic of gastric cancer in this stage is emphasized.

Gastrectomy↗