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Biomedical subjects

E Mazzei

Publications and source records attributed to E Mazzei.

7 recordsLinked to original sources

Depressive disorder in preschool children: patterns of affective organization.

In the present study the authors attempt to identify the pattern of depressive problems in children aged 3 to 6 years by employing a new rating scale (The Preschool Children Depression Checklist). Depressive symptoms were expressed in the form of 32 questions that cover an array of depressive behaviors as manifested in this age range. A factor analysis was carried out on 156 checklists submitted to the teachers of the control group in order to identify early affective behavioral patterns of the depressive disorder. Results confirmed the hypothesis that a coherent emotional structure underpins children's manifest behaviors. Three factors were empirically derived. These factors seem to be particularly important since statistical comparison showed significant differences among factor scores of a sample of children who met diagnosis of depression, a sample of children who met diagnosis of anxiety disorder, a sample of control children.

Age of Onset↗

A common mutation of the insulin receptor substrate-1 gene is a risk factor for coronary artery disease.

Insulin resistance is associated with increased risk of atherosclerosis. Insulin receptor substrate-1 (IRS-1) plays a key role in tissue insulin sensitivity. A common mutation (G972R) of the IRS-1 gene has been shown to impair IRS-1 function, and it has been associated with reduced insulin sensitivity and lipid abnormalities. This led us to investigate the role of the G972R mutation in predisposing individuals to coronary artery disease (CAD). The DNA of 318 subjects with angiographically documented coronary atherosclerosis (>50% stenosis) and 208 population control subjects was analyzed for the presence of the G972R mutation. This mutation was detected by nested polymerase chain reaction and BstNI restriction enzyme digestion. The frequency of the G972R mutation was significantly higher among patients with CAD than controls (18. 9% versus 6.8%, respectively; P<0.001). After controlling for other coronary risk factors, the relative risk of CAD associated with the G972R mutation was 2.93 (95% CI 1.30 to 6.60; P<0.02) in the entire cohort. This risk was found to be even higher in the subgroups of obese subjects (odds ratio [OR] 6.97, 95% CI 2.24 to 21.4; P<0.001) and subjects with clinical features of insulin resistance syndrome (OR 27.3, 95% CI 7.19 to 104.0; P<0.001). The IRS-1 gene variant was associated with a higher frequency of diabetes mellitus (14.9% among carriers versus 6.5% among noncarriers; P<0.01) and with a 60% increase of plasma total triglycerides (P<0.001). Also, plasma concentrations of total cholesterol and the ratio of total cholesterol to HDL cholesterol were significantly (P<0.001) higher among carriers than noncarriers, although to lesser a extent. These effects were independent of CAD status. The G972R mutation in the IRS-1 gene was found to be a significant independent predictor of CAD. Moreover, this mutation greatly increased the risk of CAD in obese subjects and in patients with the cluster of abnormalities of insulin resistance syndrome. Besides the increased frequency of diabetes, carriers showed a more atherogenic lipid profile, suggesting a potential role of the IRS-1 gene in the pathogenesis of lipid abnormalities associated with CAD.

Adult↗

Monitoring for cytomegalovirus infection in organ transplant recipients: analysis of pp65 antigen, DNA and late mRNA in peripheral blood leukocytes.

The use of sensitive and specific methods for rapid and reliable diagnosis is required due to the considerable impact of human cytomegalovirus (HCMV) in organ transplant recipients. For this purpose the demonstration of the presence of viral antigens in peripheral blood leukocytes (PMNLs) and of viral nucleic acids in the same cells or in sera would seem to be of valid support. The present study was designed to test pp65 antigen, HCMV DNA and HCMV late mRNA in order to provide clinical information for the management of the infection. Fifty solid organ recipients were monitored for six months after transplant. The data obtained from the various tests were analysed from the first evidence of HCMV infection revealed by positive antigenaemia and/or DNA-polymerase chain reaction (PCR). In 3 asymptomatic and in 7 symptomatic patients, PCR became positive 1-2 weeks before antigenaemia but PCR did not discriminate the clinical evolution of HCMV infection. The antigenaemia test well correlated to the development of viral infection being positive in all symptomatics and in 31, 2% of asymptomatics. The antigenic load > 100/2 x 10(5) positive cells was always associated with clinical signs of illness. The detection of late mRNA was more indicative of the virus replicative status in the follow-up of patients treated with ganciclovir. In some cases there was evidence, prior to the other two tests, the block of viral replication due to the antiviral therapy and in others the onset of HCMV infection relapse.

Antigens, Viral↗

[Quantitative evaluation of endocervical cells in women with human papillomavirus infection].

UNLABELLED: Human papilloma virus (HPV) DNA in cells of endocervical origin has been demonstrated by in situ hybridization and Polimerase Chain Reaction (PCR). Similarly, the presence of HPV DNA has been shown in many cases of endocervical Adenocarcinoma. Morphological changes in squamous cells, specific for HPV infection, have already been described in previous reports, but similar specific alterations in the endocervical elements have not yet been reported. In this retrospective study we analyzed 30 endocervical smears from women with HPV infection, ascertained colposcopically, cytologically and/or histologically. Thirty endocervical samples have been taken from healthy women of the same age and hormonal status, as a control group. We evaluated maximum and minimum nuclear diameters, anisocariosis, chromatin pattern and cytoplasmic characteristics of at least 60 endocervical cells selected from each specimen. RESULTS: In the cases with HPV infection, the mean nuclear diameter of endocervical cells was increased and anisonucleosis was more evident. However, the most significant parameter was the chromatin distribution with a granular pattern in almost 90% of the cilindrical cells in more than 80% of the cases. The cytoplasm does not show any peculiar alteration of endocervical cells except for an unconspicous "alo" in some elements, but this pattern is not frequent. In conclusion, some of the parameters studied seem to have a diagnostic relevance in confirming HPV infection. This may suggest that this infection could be present even at endocervical site, and should be confirmed by molecular techniques or by microcolpohysteroscopy.

Adenocarcinoma↗

Topical cardiac hypothermia in patients with coronary disease. An unnecessary adjunct to cardioplegic protection and cause of pulmonary morbidity.

This retrospective analysis tests the hypothesis that topical cardiac hypothermia is an unnecessary adjunct to intraoperative myocardial protection and an avoidable cause of pulmonary morbidity in patients with coronary disease receiving blood cardioplegia. The hospital records of 150 nonrandomized consecutive patients undergoing elective and emergency isolated coronary revascularization were reviewed. All patients received multidose cold blood cardioplegia followed by warm blood cardioplegic reperfusion distributed through grafts. Fifty patients received iced slush, 50 received topical 4 degrees C saline, and no topical cooling was used in 50 others. Patients groups were comparable in number of grafts (3.7 versus 3.5 versus 3.5) and crossclamp time (61 versus 62 versus 61 minutes). More emergency operations were performed in the patients receiving no topical hypothermia (12/50 versus 8/50 versus 7/50). Postoperative x-ray films were reviewed by a radiologist who did not know of patient grouping. Postoperative results were comparable in hemodynamics, inotropic requirements (10/50 ice versus 8/50 saline versus 5/50 no cooling), myocardial infarction (1/50 versus 2/50 versus 2/50), and enzymes (aspartate aminotransferase myocardial band creatine kinase). No patient died. Ice topical hypothermia (versus no topical cooling) was associated with more left pleural effusions (25/50 versus 9/50; p less than 0.05), atelectasis (33/50 versus 18/50; p less than 0.05), elevated left hemidiaphragms (13/50 versus 0/50; p less than 0.05), and longer postoperative hospitalization (11.2 versus 8.5 days; p less than 0.05). Topical 4 degrees C saline reduced diaphragmatic elevation and pleural effusion (versus topical ice) but was associated with more atelectasis (34/50 versus 18/50; p less than 0.05) than no topical cooling. These data suggest that routine topical hypothermia is an unnecessary adjunct to blood cardioplegic protection in patients with coronary disease, since supplemental topical cooling does not improve postoperative hemodynamics or reduce inotropic requirements, enzyme release, or prevalence of postoperative myocardial infarction, and it increases pulmonary morbidity, which can be reduced by its avoidance.

Blood↗