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Biomedical subjects

E Grandi

Publications and source records attributed to E Grandi.

At least 19 recordsLinked to original sources
PubMed2005

Relative role of major risk factors for Type 2 diabetes development in the historical cohort of the Brisighella Heart Study: an 8-year follow-up.

AIM: The aim of this study was to evaluate and quantify the role of different risk factors in the long-term development of Type 2 diabetes mellitus in a rural Italian population. METHODS: The Brisighella Heart Study (BHS; 1972-2003) is a prospective, population-based longitudinal epidemiological cohort involving 2939 randomly selected subjects, aged 14-84 years, resident in the rural Italian town of Brisighella. For this study, we randomly selected 1441 adult subjects representative of the Brisighella population; consecutively visited during three BHS surveys. A step-wise Cox regression analysis determined the prognostic significance of each independent risk factor for the development of Type 2 diabetes in the 8-year long follow-up. RESULTS: Blood pressure, high-density lipoprotein cholesterol, triglycerides, physical activity, total energy intake, and drug treatment had no effect on the incidence of diabetes. Age was a significant predictor of Type 2 diabetes when inserted alone in the model (P = 0.007), but irrelevant when adjusted for baseline body mass index (BMI) and or fasting plasma glucose. Among these with impaired fasting glucose (IFG), the diabetes incidence/year was estimated to be 6.6% for men and 11.2% for women (P < 0.001). Basal glycaemia under 6.1 mmol/l were not significant long-term predictors of diabetes development, while higher basal glycaemia and each level BMI were. CONCLUSION: Our findings confirm that IFG and BMI predict Type 2 diabetes development in our population. This should help to identify effective approaches to prevention.

Adolescent↗
PubMed2004

Assessment of the health status in the Massa Lombarda cohort: a preliminary description of the program evaluating cardio-cerebro-vascular disease risk factors and quality of life in an elderly population.

The Massa Lombarda program (MLP) is the first step of a European multi-center program, promoted and coordinated from Bologna University's Academic Spin off Health Research and Development, which attempts to manage advanced sanitary research in general population. The instant individual definition (IID) study is the first phase of the program concerning the study of risk factors (RF) and early diagnosis of coronary heart disease (CHD), through a new diagnostic technology called myocardial perfusion scoring system (MPS). The study consists of a longitudinal observational epidemiological investigation of adult population (above 25 years of age) resident in Massa Lombarda (Ravenna), with the survey of social and biological parameters. The elderly part of the population (1000 subjects above 75 years) was submitted to a more complex analysis, as part of the study on health status in European aging populations, aimed at revealing the determinants influencing the healthy aging, and at identifying their impact on mortality,cardiovascular and respiratory morbidity, disability and decline of quality of life. Laboratory analyses were aimed at identifying the following factors: (i) Genetic markers related to pro and anti-inflammatory cytokine- codifying genes. (ii) Oxidative stress-involved molecules,and inflammation-involved genes, and more in general genes involved in the brittleness(iii) (ApoE). Appraising the degree of interaction with non-genetic factors, like measurable immunological markers in the peripheral blood, markers of reactions to oxidative stress,evaluation of metabolic parameters. Moreover, old population is expected to answer the questionnaires for evaluation of the dietary habits, physical activity, self-sufficiency,cognitive ability, motor coordination, perceived stress and social relationships.

Aged↗
PubMed2003

Eccrine spiradenoma of the ear: case report.

A case of eccrine spiradenoma of the left pinna is described. To the best of our knowledge, this is the first report regarding this site. The treatment was a surgical excision in safe margins. This rare benign tumour should be considered for the differential diagnosis of solitary or multiple soft tissue lesions of the head and neck.

Adenoma, Sweat Gland↗
PubMed2003

[Neuro-link, an Italian traumatic coma data bank: what did we learn from the first 1000 patients and how can we do better? ].

To understand the complex physiopathology of post-traumatic brain damage is important to have data on epidemiology, clinical course, monitoring, effect of therapy and outcomes. In 1997 3 neuro-intensive care units in the Milan metropolitan area developed a computer assisted database named Neuro-Link (NL) for collection of information on head injury. All head injured patients requiring intensive care during the first 24 hours post-trauma were eligible. The data collection form was designed for use with a computer interface to cover: 1) general, previous and admission data; 2) secondary insults and complication; 3) CT scan and monitoring data; 4) outcome data. Two different data collections were performed: 1) NL domestic (data from 3 centres from 1997); 2) NL 18 centres (3 month survey of Italian centres with interest in neurotrauma care). An audit of the data was performed. NL domestic included 1 085 patients from 1997 to 2002. NL 18 centres included 282 patients in the 3 month period. Audit is performed on 35 000 data per year.A large number of good quality information on head injury patients is now available. The database is useful for: 1) production of information; 2) base for prospective studies.

Coma↗
PubMed2001

Hibernoma of the neck.

A hibernoma is a rare, benign, soft-tissue tumor composed of cells similar to those of brown adipose tissue. Only nine cases in the cervical area have been reported. Typically, hibernomas are asymptomatic and slow growing. Adequate treatment consists of complete excision. We describe an additional case of neck hibernoma and review the literature to clarify a pathologic condition rarely included in the differential diagnosis of cervical masses.

Adult↗
PubMed2001

[Rhinoscleroma with extramaxillary extension: report of a clinical case].

Rhinoscleroma is a chronic, granulomatous infection most frequently affecting the respiratory tract mucosa. The disease is endemic in some geographic areas and is sporadic in Italy, where medio-facial granulomatoses must be differentiated from malignant naso-sinus neoplasms. The present work describes a case of rhino-sinus scleroma with extramaxillary extension, defining the most important clinical characteristics and the treatment performed.

Aged↗
PubMed2001

[Hemoptysis in a patient with post-obstructive pneumonia due to a broncholith].

A case of a 51-year-old man admitted to the hospital for hemoptysis after a three-week history of fever and cough is presented. The chest x-ray film revealed consolidation in the left upper lobe. Because microbiologic studies of the bronchial lavage showed the grew of Pseudomonas aeruginosa, the patient was treated with piperacilline and pefloxacin. Haemoptysis and abnormal temperature was persistent for several days. Revaluation of the chest x-ray permitted to discover a little calcified nodule of 1 mm diameter. CT scan of the thorax confirmed the consolidation of the left upper lobe and the little calcification. A second fiberoptic bronchoscopy was performed in 10th day, using a bronchoscope with a smaller diameter; it was possible to observe the occlusion of the subsegment bronchus LB 1&2 due to a mobile protruding mass. The mass was gentle removed by the use of alligator bioptic forceps; it presented as a grey, hard, 2 mm diameter body with irregular surface like a "floating mine". On microscopical examination of the mass, aspergillus hyphae appeared as broad septate filaments. Culture of the samples were negative. Haemoptysis and fever stopped after FOB. Chest x-ray in 19th day was negative: consolidation and calcification were absent.

Aspergillosis↗
PubMed2001

[Malignant fibrous histiocytoma of the larynx. Presentation of a clinical case and review of the literature].

Malignant Fibrous Histiocytoma (MFH) is a tumor of mesenchymal origin which rarely occurs in head and neck. At the laryngeal level this neoplasm manifests itself as a sessile or peduncolate mass with ulcerations. Histological diagnosis of small biopsy samples is difficult and is, therefore, performed on the full surgical piece. The treatment of choice is complete exeresis of the mass within a safety margins. The Authors present a case report, the 37th laryngeal MFH reported in the literature and, in particular, the 5th case presented in a supraglottic site. Surgical treatment performed in this patient was exeresis of the neoplasm through pharyngothyrotomy conduced with safety margins and reconstruction by thyrohyoidpexy.

Adult↗
PubMed1999

Cervical necrotizing fasciitis.

Necrotizing fasciitis is a severe soft tissue infection that results in necrosis of the fasciae and subcutaneous tissues; the infection can quickly prove fatal. Although involvement of the head and neck is rare, causes are usually odontogenic or pharyngeal but can also be insect bites, local trauma, burns or surgery. We present a clinical case of a 31-year-old Italian woman with cervical necrotizing fasciitis having an uncommon presentation. While under treatment, the patient's husband was admitted for necrotizing fasciitis of the medial fasciae of his left leg subsequent to an insect sting. The causes, diagnosis and treatment of necrotizing fasciitis are reviewed.

Adult↗
PubMed1999

Heavy metals in atmospheric surrogate dry deposition

This paper describes a methodological approach for the assessment of the amount of surrogate dry deposition of several toxic heavy metals (Cd, Cr, Cu, Ni, Pb, V, Zn) associated with atmospheric particulate matter at ground level. The objectives of the study were twofold: i) the evaluation of several techniques for the digestion of dry deposition samples for trace metal analysis; ii) the comparison of the results from two samplers with different collecting surfaces. A dry solid surface sampler (DRY sampler, Andersen--USA) and a water layer surface sampler (DAS sampler--MTX Italy) were employed. The samples were collected over a one-year period in an urban site of Bologna (northern Italy). A description is given of the complete procedure, from sampling to data elaboration, including sample storage, digestion and analytical methods. According to the results obtained with three different digestion techniques (Teflon bomb, microwave digester and Teflon flask with vapour cooling system), the highest recovery rate was achieved by the Teflon bomb procedure employing an NBS 1648 Standard Reference Material; 90-95% of the elements considered were recovered by dissolution in a pressurized Teflon bomb with an HNO3-HF mixture. Given these results, the technique was adopted for dry deposition sample digestion. On the basis of the amount of heavy metals measured as monthly deposition fluxes (microg/m2), the collecting efficiency of the DAS sampler for a number of elements was found to be as much as two to three times greater than that of the DRY sampler.

Journal Article↗
PubMed1998

Usefulness of brushing urease test for diagnosis of Helicobacter pylori infection.

BACKGROUND AND AIMS: Gastric brushing cytology is an accurate technique for rapidly detecting Helicobacter pylori infection, but it is not routinely employed since the presence of personnel experienced in this field, is necessary in the endoscopy suite. To evaluate the diagnostic usefulness of rapid urease test carried out on cytological brushing. PATIENTS: A total of 143 consecutive patients with suspected Helicobacter pylori infection, referred for elective gastroscopy. METHODS: For each patient, 2 brushings were carried out and 4 biopsies were taken from antral mucosa during gastroscopy. The former brushing was smeared on a slide, and stained by a rapid staining set for blood smears. The latter was used for rapid urease test, by shaking the brush into the urea broth. Two biopsies were used for rapid urease test and two for histologic examination. Histology was considered as the gold standard. RESULTS: Of 143 patients, 73 were diagnosed as Helicobacter pylori infected using histology. Six brushing slides were inadequate due to insufficient cytology material. Biopsy-rapid urease test and brushing-rapid urease test had similar sensitivity (87.3% vs 83.5%), specificity (98.4% vs 96.8%) and overall accuracy (92.3% vs 89.5%). In 62 Helicobacter pylori infected patients, both rapid urease test techniques were positive. Brushing-rapid urease test became positive in a significantly shorter time than biopsy-rapid urease test (22 +/- 54 minutes vs 39 +/- 63 minutes; p < 0.01). CONCLUSIONS: Brushing-rapid urease test is as accurate as biopsy-rapid urease test in detecting Helicobacter pylori infection, but it is significantly faster. Special care should be taken to carry out brushing adequately, to minimize the occurrence of false negatives.

Adult↗
PubMed1997

Touch cytology. A reliable and cost-effective method for diagnosis of Helicobacter pylori infection.

A variety of reliable methods are available for detecting Helicobacter pylori (Hp) during upper gastrointestinal endoscopy. We evaluated the clinical utility and cost-effectiveness of rapid urease test (RUT), touch cytology (TC), and histology (H). Two hundred thirty-eight consecutive patients (178 without previous medical treatment and 60 formerly treated with anti-Hp therapy) were tested for Hp infection by RUT, TC, and H (H&E stain). The infection status for each patient was established by a concordance of two test results. The time to carry out the three tests and their cost were also calculated. Sensitivity of TC (100%) was significantly higher than that of RUT (86.8%; P < 0.001), but not than that of H (94.9%). RUT was significantly more specific than H (100% vs 95.6%; P < 0.05), but not than TC (96.4%). Hp infection was more frequent in the patients with chronic active gastritis than in those with chronic nonactive gastritis (P < 0.001). No Hp infection was detected in absence of chronic antral inflammation. RUT resulted the cheapest method and H the most expensive; TC is faster and cheaper than H. When additional information about the severity of mucosal damage or the presence of cell atypias is not necessary, histologic examination can be omitted, and a cost-effective strategy for assessing Hp status might consist in taking two antral biopsies, the former for performing RUT and the latter for preparing a slide by TC, which should be stained and examined only when the RUT result is negative.

Adult↗
PubMed1997

Lymphoepithelial cyst of the pancreas.

A rare case of lymphoepithelial cyst of the pancreas is reported. Microscopically the cyst content consisted of keratinous material and the walls were lined by mature squamous epithelium surrounded by dense lymphoid tissue. Immunohistochemistry showed diffuse reactivity for CD20 and CD3 in the lymphoid tissue and uniform positivity for cytokeratins in the squamous epithelium. Although the histogenesis of lymphoepithelial cysts of the pancreas is not understood, awareness of this lesion is helpful in differentiating it from other pancreatic cystic lesions.

Epithelium↗
PubMed1996

[Fatal pulmonary embolism. Risk factors and anatomo-pathological findings related to gender and age].

OBJECTIVES: The aim of this study was to evaluate possible variations in clinical risk factors and anatomopathological findings in fatal pulmonary embolism in relation to sex and age. METHODS: The total sample consisted of 230 subjects (mean age 72 +/- 11 years), 103 males and 127 females, of which 74 died out-of-hospital and 156 in the course of hospitalization. 124 cases were then considered also separately as "sudden death group". The sample was stratified by sex and into 4 groups by age: subjects aged less than 60 years, between 60 and 69, between 70 and 79, and more than 80 years. RESULTS: Age at occurrence of pulmonary embolism was significantly higher in females, compared with males (75 +/- 11 vs 69 +/- 11 years, p < 0.001), and the men/women ratio was higher in younger age groups, tending to inversion with aging. An increased frequency of males was found between subgroups of subjects affected by valvular heart disease (10.6% vs 2.3%, p = 0.019), and chronic pulmonary disease (7.7% vs 1.8%, p = 0.049), whereas an increased frequency of women was found in a group of subjects suffering from trauma or fracture (12.6% vs 2.9%, p = 0.016). As concerns age subgroups, a significant increased frequency of subjects aged < 60 years was found in risk groups "surgery" (36%, p < 0.001) and "malignancy" (40%, p = 0.002). Moreover, in subjects aged less than 80 years, main predisposing factors were recent trauma and/or a fracture (16.2%, p = 0.013). CONCLUSION: The difference in frequency of risk factors between sexes could depend on the higher life expectancy in women, with consequent increase in likelihood of risk factors specifically related to the elderly.

Age Factors↗
PubMed1996

Out-of-hospital sudden death referring to an emergency department.

Over an 11-year period, autopsies were performed on 957 of 1038 nontraumatic deaths in the Emergency Department of the Central Hospital in Ferrara, Italy. Of these 957 cases, 732 (76.5%) met criteria for sudden death. In 100 (14%) of these cases, the death could be attributed to pulmonary embolism (55 cases), stroke (17), or rupture of aortic aneurysm (28). Acute myocardial infarction accounted for 403 (55%) of all sudden deaths. Severe coronary artery disease was found in 340 (84%) of these 403 deaths, with plaque fissuring or thrombi in 189 or 151 cases, respectively. Among the 229 sudden deaths for whom no immediate cause could be determined (31% of the total population), all had evidence of heart disease: 147 individuals had severe coronary artery disease, with plaque fissuring or thrombi found in 72 or 43, respectively. The remaining cases with no immediate cause of death had evidence of a cardiomyopathy (61) or valvular disease (21). We conclude that acute myocardial infarction accounts for the majority of cases of nontraumatic sudden death in our Emergency Department. Altogether, 84% of these patients had severe coronary artery disease. In approximately one-third of cases for whom no immediate cause of sudden death could be determined, all had evidence of heart disease, and about two-thirds had severe coronary artery disease.

Cause of Death↗