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Biomedical subjects

D Castello

Publications and source records attributed to D Castello.

At least 19 recordsLinked to original sources
PubMed1999

[Anti-pseudomonas-specific precipitins as a marker of chronic infection in patients with cystic fibrosis].

AIMS: The authors underline the characteristics of Pseudomonas aeruginosa and its methods of action on bronchial mucosa in cystic fibrosis. They then discuss the two concepts of "colonisation" and "chronic infection". METHODS: The level of "infection" was evaluated using an immunoelectrophoretic method involving the precipitation of bands of specific precipitins. A technical description of the method is included. The authors illustrate the use of the method in 78 cases of cystic fibrosis, comparing the positive results obtained using precipitin electrophoresis with the results of direct bacteriological findings. RESULTS: Using the bacteriological criteria, a total of 26.9% of patients were diagnosed as infected, whereas this percentage rose to 32.1% using precipitins. 87.2% of cases were concordant using both methods. CONCLUSIONS: As a practical solution, the authors recommend that the two methods are combined, thus obtaining a marked reduction in the number of false positives with obvious consequences in terms of therapeutic decisions.

Adolescent↗
PubMed1999

[A survey regarding the problem of cigarette smoke pollution in a hospital environment].

AIMS: The study aimed to survey smoking habits in a specific environment, namely hospitals, paying special attention to the pediatric sector. METHODS: The survey was carried out using data from questionnaires distributed to all hospital personnel. RESULTS: Of a total of 2425 forms distributed, only 20% were compiled and returned. The most interesting findings to emerge were that in 86% of cases smokers admit to smoking in the presence of others and 10% admit to smoking in the presence of patients. 83% affirm that non-smokers should be protected. The most popular proposal was to create "smoking" rooms inside hospitals. CONCLUSIONS: Almost all smokers say that they are aware of the damage caused by tobacco, but they justify the habit by the fact that "they cannot do without it". Non-smokers feel that health education courses or personal conviction are of little use, and that punitive measures should be introduced for those smoking in hospitals.

Female↗
PubMed1998

[The psychological aspects of asthma in childhood].

BACKGROUND AND AIMS: The hypothesis of an emotional component in asthma has been put forward since antiquity. It is currently explored using a psychodynamic, cognitive-behavioural and systemic-relational approach. This study, carried out using a psychodynamic approach, aimed to identify the psychological aspects of recurrent asthmatic attacks in childhood. METHODS: The study examined 20 subjects, aged between 9 months and 7 years and 11 months, attending the Pneumological Division of the Ospedale Infantile in Turin. The study consisted of the collection of social and personal data regarding the family and clinical and medical history; a semi-structured interview with the mothers, discussed as part of individual supervision regarding the mother-child relationship and the emotive reactions to an asthma attack. RESULTS: Although all subjects had an early onset of manifest asthma, ascertained allergic pathogenesis was only revealed in 30% of children. All cases revealed a lacking and/or conflictual quality in the mother-child relationship, as well as the young patient's difficulty in growing up, implying the acquisition of gradual autonomy. CONCLUSIONS: The authors emphasise the need to focus greater attention on the emotive situation of the child and its parents, in particular those aspects regarding the quality of life under the influence of disease.

Asthma↗
PubMed1997

Bi-level positive airway pressure (BiPAP) ventilation in an infant with central hypoventilation syndrome.

A 4-month-old baby girl, after a period of apparent good health, began to have aphonia, dyspnea, difficulties with swallowing, cyanosis, apnea, and hypopnea during sleep that resulted in admission to an intensive care unit for intubation and mechanical ventilation. At the age of 9 months she was admitted to our hospital with a possible diagnosis of central hypoventilation syndrome. A polysomnographic study showed apnea and hypopnea (apnea + hypopnea index = 47.1), hypercapnia (mean end-tidal PCO2 89 +/- 15.0 mmHg), and arterial desaturation (mean SaO2 91 +/- 1.7%; lowest SaO2 < 50%; 68% of total sleep time at SaO2 below 93%); the study also showed an absent ventilatory response to CO2, absent cardiac responses to apnea during sleep, and right ventricular hypertrophy. Nocturnal nasal bi-level positive airway pressure (BIPAP), applied initially at 6 cmH2O and gradually increased to 16 cmH2O, caused the sleep-related abnormal respiratory events to disappear. End-tidal PCO2 decreased to 39 mmHg, and SaO2 increased to 94%. After 6 months of nocturnal BiPAP ventricular right hypertrophy reversed and arrested growth and hypotonia normalized. The child has tolerated and has remained on BiPAP support up to her current age of 3 years and continues to use this form of ventilatory assistance without difficulties.

Female↗
PubMed1997

[Adolescence in patients with cystic fibrosis studied by Rorschach test].

BACKGROUND: The majority of patients with cystic fibrosis today reach adulthood. During adolescence, however, many ask themselves questions regarding their possible future realisation. AIMS: The aim of this study, which was performed using the Rorschach test, was to identify areas of particular problems in a group of CF adolescents monitored by the Pneumology Division of Regina Margherita Children's Hospital in Turin: 26 subjects aged between 14 and 18, including 11 females and 15 males. METHODS: The analysis of the test was based on the use of thought, interior resources, instincts and interpersonal relations. The type of intimate resonance was also taken into account and, lastly, a study of the contents was performed using a self-representation grid. RESULTS: The results obtained show a dishomogeneous profile of the development and quality of intellectual processes faced with the intensity of anxiety, mainly loss anxiety, linked to the disease, even if unrelated to its severity. The integration of emotive and instinctual aspects is difficult: mental development towards adult life appears to be impeded by the predominance of regressive modalities. CONCLUSIONS: On the basis of the study performed, it is possible to hypothesise the need for psychological help aimed at achieving a more evolved psychic organisation, possible as part of an overall management programme by the medical and nursing team.

Adolescent↗
PubMed1997

[Personality structure in children with cystic fibrosis studied using Rorschach test].

BACKGROUND AND AIMS: The recent positive evolution in the development of cystic fibrosis, resulting in the current prospect of survival, has led to the formation of a new population of chronic patients. The characteristics of the disease and treatment (hereditary, early onset, affecting the alimentary tract and airways) may interfere with personality structuring processes. The aim of the study was to identify the psychopathological risk. METHODS: The study was performed using the Rorschach test in a population of children with cystic fibrosis monitored by the Pneumology Division of the Ospedale Infantile Regina Margherita in Turin: 20 children aged between 7 and 13 years old were included in the study, most of whom had been diagnosed before the age of 2. The analysis of tests was focused on the use of thought, interior resources, instincts and interpersonal relations. A study of the contents was also made using a self-representational grid. RESULTS: The results obtained highlight an inhibitory attitude which cannot be attributed to intellectual insufficiency, but rather to the failed attempt to invest in the intellectual sphere, typical of this age range, owing to the intensity of anguish. Children with cystic fibrosis appear to be at an earlier stage of development, marked by emotive coarctation and the use of adult-type defensive methods, tending towards rationalisation. CONCLUSIONS: Oh the basis of this study, it is possible to detect a danger of disharmonious organisation in the personality structuring process of these children. The hospital must therefore offer adequate psychological support for their psychic evolution.

Adolescent↗
PubMed1996

[The sweat test. The proposal to revise the concept of the "grey zone"].

The results of the sweat tests performed in Turin CF Centre in the last four years were reviewed. The opportunity of changing the range of doubt, commonly situated between 40 and 70 mEq/l Cl-, has been considered. The sweat test appears worth to be repeated only for values > 60, unless clinical signs and symptoms persist.

Cystic Fibrosis↗
PubMed1994

[Study of IGG subgroups as prognosis markers in cystic fibrosis].

Pressler et al. (1988) showed a correlation between elevated serum levels of IgG2 and IgG3 with decreased lung function. We tried to verify that hypothesis and to evaluate the usefulness of IgG subclasses as prognostic markers in 54 cystic fibrosis patients. The serum levels of the IgG subclasses were determined by radial immunodiffusion and correlated to Vital capacity (VC), obtained with a bell spirometer (Biomedin), and to oxyhemoglobin saturation (SaO2), obtained with a pulse oximeter (Minolta Pulsox 7). For statistical analysis, Student's "t" test, Pearson's chi-square and multiple regression were used. Significance was accepted at p < 0.05. We found significant correlation between elevated serum levels of IgG1 and decreased VC (r = -0.53; p < 0.01), and between high levels of IgG1 and decreased SaO2 (r = -0.45; p < 0.01). Elevated serum levels of IgG1 are significantly correlated with high levels of IgG2 (r = 0.41; p < 0.05) and with high levels of IgG4 (r = 0.43; p < 0.05). There is significant correlation between the increase in IgG4 and SaO2 impairment (r = 0.51; p < 0.01), but no significant correlation between IgG4 and VC was found. Patients with elevated serum levels of IgG1 had significantly lower VC than patients with IgG1 below the normal range (p < 0.002). No difference in VC was found, when comparing patients with low and high levels of the other subclasses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Therapeutical doses of salbutamol inhibit the somatotropic responsiveness to growth hormone-releasing hormone in asthmatic children.

In humans beta-adrenergic receptors mediate an inhibitory effect on somatotropic function, likely via stimulation of hypothalamic somatostatin release. Accordingly, salbutamol (SAL), a beta 2-agonist, given iv abolishes the GH response to GH-releasing hormone (GHRH) in adults. Taking into account that in bronchial asthma an alteration in the beta-adrenergic neural control of airways has been hypothesized, we aimed to verify whether, in asthmatic children, beta-adrenergic activation inhibits or not GH secretion. To this goal, we studied the effect of therapeutical doses of SAL on GH response to GHRH in 15 asthmatic children (12 M and 3 F, 5.9-11.1 yr, pubertal stage I-II). All children underwent a GHRH test (1 microgram/kg iv). Moreover, in 7 children (group A), SAL was administered orally (0.125 mg/kg) 1 h before GHRH, while in 8 (group B) by inhaled aerosol (2 mg) 30 min before GHRH. Oral SAL (group A) abolished the GHRH-induced GH rise (AUC, mean +/- SE 165.1 +/- 33.3 vs 959.9 +/- 158.1 micrograms/L/h; p < 0.03). In group B, the GH response to GHRH was only blunted by inhaled SAL (938.6 +/- 284.6 vs 1378.8 +/- 315.6 micrograms/L/h; p < 0.02). In conclusion, our data show that in asthmatic children, therapeutical doses of SAL exert a marked inhibitory effect on GH secretion. Further studies are needed to exclude detrimental effects of chronic treatment with beta 2-agonists on GH secretion and growth velocity in asthmatic children.

Administration, Oral↗
PubMed1990

delta F508 deletion in cystic fibrosis in Italian families.

In 20 Italian families with cystic fibrosis (CF), restriction fragment length polymorphisms were detected by five linked markers; a strong linkage disequilibrium is observed between the haplotype B (alleles 2/1 with respect to KM19/XV2c) and CF. The frequency of the delta F508 deletion in CF chromosomes of this sample is 50%. A significant correlation is found between the absence of the delta F508 mutation and pancreatic sufficiency.

Cystic Fibrosis↗
PubMed1989

[Bronchography in children. Methodologic, statistical and functional findings].

The value of bronchography in the various respiratory diseases of childhood is examined. After a brief critical review of the historical development of bronchography, 10 cases encountered in the Pneumology Unit of Regina Margherita Children's Hospital, Turin are examined in order to compare the indications to and results of bronchography. In the light of the results obtained guidelines for the selection of bronchography as a diagnostic procedure are presented, specifying the situations in which stratigraphy, CAT scans or NMR are not adequate substitutes and suggesting what should be the current role of bronchography in paediatrics.

Bronchial Diseases↗