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Biomedical subjects

E Ricci

Publications and source records attributed to E Ricci.

At least 19 recordsLinked to original sources

Use of sedation for routine diagnostic upper gastrointestinal endoscopy: a European Society of Gastrointestinal Endoscopy Survey of National Endoscopy Society Members.

BACKGROUND/AIMS: Sedation rates may vary among countries, depending on patients' and endoscopists' preferences. The aim of this survey was to investigate the rate of using premedication for routine diagnostic upper gastrointestinal (UGI) endoscopy in endoscopy societies, members of the European Society of Gastrointestinal Endoscopy (ESGE). METHODS: We evaluated a multiple-choice questionnaire which was e-mailed to representatives of national endoscopy societies, which are members of the ESGE. The questionnaire had 14 items referring to endoscopy practices in each country and the representatives' endoscopy units. RESULTS: The response rate was 76% (34/45). In 47% of the countries, less than 25% of patients undergo routine diagnostic UGI endoscopy with conscious sedation. In 62% of the responders' endoscopy units, patients are not asked their preference for sedation and do not sign a consent form (59%). Common sedatives in use are midazolam (82%), diazepam (38%) or propofol (47%). Monitoring equipment is not available 'in most of the endoscopy units' in 46% (13/28) of the countries. Though they were available in 91% of the national representatives' endoscopy units, they are rarely (21%) used to monitor unsedated routine diagnostic UGI endoscopy. CONCLUSIONS: In about 50% of ESGE-related countries, less than 25% of patients are sedated for routine diagnostic UGI endoscopy. Major issues to improve include availability of monitoring equipment and the use of a consent form.

Procedural Sedation↗

Expanding the clinical spectrum of POMT1 phenotype.

Mutations in POMT1 have been identified in Walker-Warburg syndrome and in patients with limb-girdle muscular dystrophy and mental retardation (LGMD2K). The authors report new POMT1 mutations in three unrelated children with severe motor impairment, leg hypertrophy, and mental retardation but without brain and ocular malformations. These patients are similar to LGMD2K but have earlier onset and more severe motor disability. The current findings expand the spectrum of POMT1-associated phenotypes.

Adolescent↗

NCAM is hyposialylated in hereditary inclusion body myopathy due to GNE mutations.

The authors found that the neural cell adhesion molecule (NCAM) is hyposialylated in hereditary inclusion body myopathy (HIBM) muscle, as suggested by its decreased molecular weight by Western blot. This abnormality represented the only pathologic feature differentiating HIBM due to GNE mutations from other myopathies with similar clinical and pathologic characteristics. If further confirmed in larger series of patients, this may be a useful diagnostic marker of GNE-related HIBM.

Adult↗

Alcohol drinking and risk of small for gestational age birth.

OBJECTIVE: To assess if alcohol drinking is a risk factor for small for gestational age (SGA) birth. METHODS: Case-control study. Cases were 555 women (mean age 31 years, range 16-43) who delivered SGA babies at the Clinica Luigi Mangiagalli and the Obstetric and Gynecology Clinic of the University of Verona. The controls were 1966 women (mean age 31 years, range 14-43) who gave birth at term (> or =37 weeks of gestation) to healthy infants of normal weight at the hospitals where cases had been identified. RESULTS: No increase in the risk of SGA birth was observed in women drinking one or two drinks/day in pregnancy, but three or more per day increased the risk: odds ratios (OR) were 3.2 (1.7-6.2) for > or =3 drinks during the first trimester, 2.7 (1.4-5.3) during the second and 2.9 (1.5-5.7) during the third. CONCLUSIONS: The study shows an increased risk of SGA births in mothers who drink > or =3 units/day of alcohol in pregnancy.

Adolescent↗

Coffee drinking and risk of preterm birth.

OBJECTIVES: We analysed the association between coffee drinking before and during the three trimesters of pregnancy and the risk of preterm birth of babies normal for gestational age (NGA) or small for gestational age (SGA). METHODS: Case-control study conducted in University clinics of North Italy. Cases were 502 women who delivered at <37 weeks of gestation. The controls included 1966 women who gave birth at term (>or=37 weeks of gestation) to healthy infants on randomly selected days at the hospitals where cases had been identified. RESULTS: There was inverse association for coffee consumption in the third trimester of pregnancy in SGA cases compared to NGA (heterogeneity test between OR: chi1(2)=5.6811 P<0.05). In comparison with not drinkers, all the ORs of overall intake of caffeine were closed near the unity for both SGA and NGA preterm birth. CONCLUSION: Compared with no consumption, a low consumption of coffee during pregnancy may not have significant effects on preterm birth.

Adolescent↗

Oxygen tensioactivity on liquid-metal drops.

The influence of oxygen on the surface tension of liquid metals is a topic of undoubted interest as the formation of oxide films, or even oxygen contamination of the metal interface, represents the main source of error in determining the surface tension. The evaluation of gas-atmosphere mass exchanges under stationary conditions allows the evaluation of an effective oxygen pressure at which the oxidation of metal becomes evident. This effective oxygen pressure can be considered as a property of the system and, according to experimental evidence, can be many orders of magnitude greater than the equilibrium pressure. The measurement of the surface tension is a good way of studying interface properties, their temporal change and their connections to transport and reaction rates. This paper represents a review of a work undertaken with the aim of understanding oxygen mass transport at the liquid metal surface in relation to the study of capillary phenomena at high temperature.

Atmospheric Pressure↗

A population survival model for breast cancer.

Breast cancer is a major health problem, and disease control depends on an effective healthcare system. A registry-based tool to monitor the quality of breast cancer care could be useful. The aim of this study was to develop a population survival model for breast cancer based on the Nottingham Prognostic Model (NPM). To this end, 1452 cases of breast cancer diagnosed in the Umbria Region, Italy, during the period 1994-1996 were studied. An extensive search for routinely available variants in prognosis and treatment was performed. In about 80% of cases complete information on factors included in the NPM was available. The Cox model was used to assess the prognostic value of study factors. Nodal stage was the most important prognostic factor. In women who did not undergo axillary dissection (17%) the risk of death was twice that in women with no affected nodes, but they received chemotherapy with the same frequency. Radiotherapy was also less frequently used in this group. Grading was a significant prognostic factor only when women over 80 were excluded. Population survival models based on data from cancer registries may provide a tool that can be used to evaluate healthcare systems and the effectiveness of interventions. The inclusion of older women in our models decreased the significance of many established prognostic factors because of the frequency of incomplete evaluation and less aggressive treatment in these patients. Not undergoing surgical axillary dissection was associated with a worse prognosis and with less aggressive treatment.

Aged↗

Endoscopic treatment of gastroesophageal reflux disease.

Gastroesophageal reflux disease is a common chronic disorder which has a severe effect on the patient's quality of life. In view of the high cost of medical therapy and the limitations of surgery, a variety of endoscopic techniques have been developed for the treatment of this condition, and these have shown apparently encouraging results, at least in the short term. However, promising results have been obtained in only around two-thirds of patients over a short-term follow-up period of about 6 months. Moreover, several inconsistencies have emerged between the efficacy of this form of treatment in improving symptoms and quality of life and a lack of improvement of objective parameters, such as lower esophageal sphincter pressure and esophageal acid exposure. The authors strongly endorse the need for comprehensive evaluation of clinical evidence on this topic. After an extensive evaluation of existing literature, we suggest that controlled studies are urgently needed in order to clarify the potential of endoscopic therapy, either in terms of cost-effectiveness or in comparison with standard therapy. Meanwhile, with regard to current practice, the use of endoscopic treatment should be limited to clinical trials, which should incorporate the provision of comprehensive and unbiased information to study patients.

Catheter Ablation↗

Premature ejaculation: prevalence and associated conditions in a sample of 12,558 men attending the andrology prevention week 2001--a study of the Italian Society of Andrology (SIA).

INTRODUCTION: Premature ejaculation (PE) is the most frequent sexual complaint. AIM: To investigate prevalence of PE and its associated conditions. METHODS: We analyzed information gathered from men attending a free andrologic consultation in 186 Italian medical centers, in the setting of a project focused on andrologic prevention. MAIN OUTCOME MEASURES: Risk factors for PE. RESULTS: Five hundred sixty-nine men suffered from lifelong PE; 1,855 had previously normal ejaculation; and 234 had PE not specified. Men with PE were younger than those without, but after adjusting for concomitant erectile dysfunction the risk of PE significantly decreased with aging. Men more educated, or who had experienced a divorce had a slightly increased risk. Also, lifestyle and occupational status affected the risk of PE. Concerning medical history, a decreased risk of PE emerged in men with treated diabetes, and no association was found with hypertension, cardiopathy, hypercholesterolemia, and peripheral or central neuropathy. CONCLUSIONS: The results of the analysis of a large dataset show that subjects with PE who are seeking treatment either have experienced stress-related problems or have a physical condition predisposing to this dysfunction (genital anomalies, prostate inflammation).

Adolescent↗

Extensive scanning of the calpain-3 gene broadens the spectrum of LGMD2A phenotypes.

BACKGROUND: The limb girdle muscular dystrophies (LGMD) are a heterogeneous group of Mendelian disorders highlighted by weakness of the pelvic and shoulder girdle muscles. Seventeen autosomal loci have been so far identified and genetic tests are mandatory to distinguish among the forms. Mutations at the calpain 3 locus (CAPN3) cause LGMD type 2A. OBJECTIVE: To obtain unbiased information on the consequences of CAPN3 mutations. PATIENTS: 530 subjects with different grades of symptoms and 300 controls. METHODS: High throughput denaturing HPLC analysis of DNA pools. RESULTS: 141 LGMD2A cases were identified, carrying 82 different CAPN3 mutations (45 novel), along with 18 novel polymorphisms/variants. Females had a more favourable course than males. In 94% of the more severely affected patient group, the defect was also discovered in the second allele. This proves the sensitivity of the approach. CAPN3 mutations were found in 35.1% of classical LGMD phenotypes. Mutations were also found in 18.4% of atypical patients and in 12.6% of subjects with high serum creatine kinase levels. CONCLUSIONS: A non-invasive and cost-effective strategy, based on the high throughput denaturing HPLC analysis of DNA pools, was used to obtain unbiased information on the consequences of CAPN3 mutations in the largest genetic study ever undertaken. This broadens the spectrum of LGMD2A phenotypes and sets the carrier frequency at 1:103.

Adult↗

Comparison of Allevyn Adhesive and Biatain Adhesive in the management of pressure ulcers.

OBJECTIVE: The primary objective was to assess dressing delamination and the ensuing potential consequences during wear and/or removal, as well as the effect of residue remaining in the ulcer following foam breakdown. METHOD: In this prospective multicentre study, 32 patients with a grade II or III pressure ulcer were randomised to receive either Allevyn Adhesive or Biatain Adhesive dressing. The performance of the dressings was assessed over seven dressing changes or a maximum of six weeks. The primary efficacy variable was the proportion of patients with at least one delaminated dressing (delamination being defined as the falling apart of a dressing during wear or removal, or the presence of residue from the dressing in the ulcer). RESULTS: Allevyn Adhesive was significantly less likely to delaminate than Biatain Adhesive: 83% of patients given Biatain Adhesive had a dressing that delaminated compared with 14% for Allevyn Adhesive (p = 0.014). Furthermore, a greater proportion of the Biatain Adhesive dressings delaminated compared with the Allevyn Adhesive dressings: 50% versus 4% (p < 0.001). Allevyn Adhesive performed significantly better in the following parameters: handling exudate (p = 0.044), comfort (p = 0.007), ease of application (p = 0.004), conformability during application (p = 0.003) and removal (p < 0.0001), and adherence to the skin during application (p = 0.003) and prior to removal (p = 0.011). Three patients given Allevyn Adhesive (21%) reported three adverse events; six patients given Biatain Adhesive (33%) reported eight adverse events. CONCLUSION: Allevyn Adhesive is effective and well tolerated in the management of pressure ulcers and less likely to delaminate than Biatain Adhesive.

Adult↗

Effects of aging on the cardiac remodeling induced by chronic high-altitude hypoxia in rat.

Effects of chronic high-altitude hypoxia on the remodeling of right ventricle were examined in three age groups of rats: 2, 6, and 18 mo. The extent of right ventricular (RV) hypertrophy (RVH) showed an age-associated diminution. RV cell size and pericellular fibrosis showed a significant increase in the 2- and 6-mo-old exposed rats but not in the 18-mo-old exposed rats compared with control. A hyperplasic response was underscored in the three exposed age groups but appeared less pronounced in the 18-mo-old rats. A significant decrease in the transient outward potassium current (Ito) density was observed in RV cell only in the 2-mo-old exposed group compared with the control group. In the control group, there was a clear tendency for Ito density to decrease as a function of age. The sustained outward current density was modified neither by the hypoxia condition nor by the age. Neither the cytochrome c oxidase activity nor the heat shock protein 72 content in the RV was altered after hypoxic exposure regardless of age. The norepinephrine content in the RV was significantly decreased in each age group exposed to hypoxia when compared with their age-matched control group. Our findings indicate that the remodeling (at morphological and electrophysiological levels) induced by chronic hypoxia in the RV can be decreased by the natural aging process.

Aging↗

Osteopenia and osteoporosis in HIV+ patients, untreated or receiving HAART.

In the last few years there are increasing evidences suggesting that osteopenia and osteoporosis are frequent among HIV positive patients. It is still not clear if the bone demineralization is a direct consequence of viral infection or of the antiretroviral drugs. Studies to date therefore give conflicting results. We performed a study to evaluate the prevalence of osteopenia and osteoporosis in HIV positive patients, either untreated or receiving antiretroviral therapy, to asses the frequency of these conditions and the role of antiretroviral drugs.

Adult↗

Skip lesion of the cecum associated with proctitis: an atypical case of ulcerative colitis.

The authors report the clinical case of a patient who underwent total colectomy for acute ulcerative colitis. The unusual element in this case was the presence of a lesion ('skip lesion'), typical of ulcerative colitis, in the periappendiceal area of the cecum, which was discontinuous to the main site of disease located in the rectum and left colon. The presence of skip lesions, whose clinicopathological relevance is still unknown, would seem to disprove the widely held view that ulcerative colitis involves only the mucous membrane of the large intestine, with inflammatory processes of varying intensity, but without intervening normal areas. The alteration in mucosal immune response by sharing of some factors as bacterial flora, stasis and secretory products is a suggestive pathogenetic supposition.

Acute Disease↗

Determinants of erectile dysfunction risk in a large series of Italian men attending andrology clinics.

OBJECTIVE: To assess determinants of ED in men who asked for a free of charge andrologic consultation during a week focused on andrologic prevention in Italy. METHODS: Men were invited to attend 178 participating andrology centers for a free of charge visit for counselling about urologic or andrologic conditions. Data were recorded with a simple questionnaire used by all centers. RESULTS: 2499 (19.9%) were diagnosed having ED. The frequency of ED increased with age, ranging from 4.6% in men under 25 years, to 37.6% in men over 74. In comparison with men with primary education the OR of ED was 0.8 (95% CI 0.7-0.9) in men with secondary education and 0.7 (95% CI 0.6-0.9) in those with university degree. After adjusting for age, the risk of ED was significantly higher in men consuming more than 3 glasses/day of alcoholic drinking (OR 1.4, 95% CI 1.1-2.0), in subjects smoking more than 10 cigarettes/day (OR 1.2, CI 95% 1.1-1.4) and in former smokers (OR 1.2, CI 95% 1.1-1.4). Men performing at least two hours per week of physical activity had a decreased risk of ED (OR 0.8, CI 95% 0.7-0.9). We found an increased risk of ED in men with diabetes (OR 1.2, 95% CI 1.1-1.4), hypertension (OR 1.3, 95% CI 1.1-1.4), cardiopathy (OR 1.5, 95% CI 1.3-1.8) and hypercholesterolemia (OR 1.4, 95% CI 1.2-1.6). CONCLUSIONS: This study provides further data on determinants of ED risk in a large data set and underlines the relationship between ED and cardiovascular diseases.

Adolescent↗

Changes in motor cortex excitability in facioscapulohumeral muscular dystrophy.

Previous studies found that some patients with severe, early onset facioscapulohumeral muscular dystrophy (FSHD) present epilepsy and mental retardation. This suggests a functional involvement of central nervous system in severe FSHD. It is unknown whether minor functional changes of central nervous system are also present in less severe forms of FSHD. To investigate this, we examined the excitability of neuronal networks of the motor cortex with a range of transcranial magnetic stimulation paradigms in 20 FSHD patients with heterogeneous clinical severity and compared the data with that from 20 age-matched healthy individuals and from 6 age-matched patients with other muscle diseases. There was significantly less intracortical inhibition in FSHD patients (mean responses +/- SD reduced to 58.1+/-43.5% of the test size) than in controls (mean responses +/- SD reduced to 29.3+/-13.5% of the test size; P=0.025) and in patients with other muscle diseases (mean responses +/-SD, reduced to 30.6+/-11.7% of the test size; P=0.046). No significant difference was found between the control group and patients with other muscle diseases (P=0.970).

Adolescent↗