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Biomedical subjects

F Cecere

Publications and source records attributed to F Cecere.

11 recordsLinked to original sources
PubMed2000

Initial development of a system-wide maternal-fetal outcomes assessment program.

OBJECTIVE: This study was undertaken to develop a comprehensive risk-assessment approach capable of evaluating maternal and fetal outcomes. STUDY DESIGN: Data from 10,984 women and 11,066 infants delivered at 79 military treatment facilities in the United States from 1995 to 1997 were used to develop two individual but complementary risk-adjustment models for maternal and, separately, fetal outcomes. A range of maternal and delivery-related risk variables and clinically important outcomes were identified by expert opinion and selected and weighted with ordinal logistic regression analysis. Receiver operating characteristic curves for the maternal and fetal models were determined. Variation across the facilities in risk-adjusted performance was also evaluated. RESULTS: Risk factors and poor outcomes were rare for both mothers and infants, with 96.9% of infants and 97.7% of mothers having good or excellent outcomes (0.7% mortality and 0.01% mortality, respectively). Despite the low frequency of poor outcomes both models performed well, with receiver operating characteristic curves of 0.75 for maternal outcomes and 0.78 for infant outcomes. When the models were applied to the military treatment facilities, there were significant differences among facilities in risk-adjusted outcomes. Twenty-four of the facilities in the study (30%) had outcomes odds ratios that were significantly >1 or significantly <1 (P <.05). There did not appear to be any relationship between the performance of a military treatment facility for maternal outcome and that for infant outcome. CONCLUSION: Complementary risk models for maternal and infant outcomes were developed that had satisfactory discriminatory power across a variety of facilities within a large health system. With further development and refinement this approach holds promise of being able to detect variations in risk-adjusted performance that could be used to identify best practices. The results might also be used to help coordinate and improve the quality of care for the entire conception-to-delivery process.

Female↗
PubMed1997

Stress-induced changes in the functional electromyographic activity of the masticatory muscles.

The present study was undertaken to assess the effect of a non-experimental emotional stress situation on the functional electromyographic (EMG) activity of the masticatory muscles. The material comprised 15 dental students without signs and symptoms of disorders from the temporomandibular system. The activity of the masseter and anterior temporalis muscles was recorded bilaterally by means of surface EMG. The subjective degree of helplessness of the subjects was assessed and related to the EMG activity response, to assess a possible interrelation. The EMG activity during the stress situation was significantly greater than for the non-stress situation. This shift in EMG activity was seen for all the muscles and all the functions analyzed. No significant gender differences were found. When the subjective degree of helplessness is taken into consideration, women showed significantly higher ratings than male subjects. The Helplessness Scale ratings correlated with the changes in EMG activity.

Adult↗
PubMed1996

Is quantitative electromyography reliable?

The reliability of quantitative electromyography (EMG) of the masticatory muscles was investigated in 14 subjects without any signs or symptoms of temporomandibular disorders. Integrated EMG activity from the anterior temporalis and masseter muscles was recorded bilaterally by means of bipolar surface electrodes during chewing and biting activities. In the first experiment, the influence of electrode relocation was investigated. No influence of electrode relocation on the recorded EMG signal could be detected. In a second experiment, three sessions of EMG recordings during five different chewing and biting activities were performed in the morning (I); 1 hour later without intermediate removal of the electrodes (II); and in the afternoon, using new electrodes (III). The method errors for different time intervals (I-II and I-III errors) for each muscle and each function were calculated. Depending on the time interval between the EMG recordings, the muscles considered, and the function performed, the individual errors ranged from 5% to 63%. The method error increased significantly (P < .05 to P < .01) with the time interval between recordings. The error for the masseter (mean 27.2%) was higher than for the temporalis (mean 20.0%). The largest function error was found during maximal biting in intercuspal position (mean 23.1%). Based on the findings, quantitative electromyography of the masticatory muscles seems to have a limited value in diagnostics and in the evaluation of individual treatment results.

Adolescent↗
PubMed1992

Mortality rates among psychiatric patients, during and after the "psychiatric reform", in the area of Rome (Italy).

The issue of supposedly high mortality rates among psychiatric patients discharged from mental hospitals after the implementation in Italy of Law 180 is controversial. We have studied a cohort of 1858 long-term psychiatric inpatients of Public Mental Hospitals in the area of Rome (Italy), followed up for 9 years during and after the implementation of Law 180. As expected, age adjusted mortality rates were higher than those observed in the general population living in the study area, and death rates among patients with "organic mental disorders" were higher than those among patients with "functional disorders". No difference in death rates was observed between the group of discharged patients and that of patients not yet discharged.

Cohort Studies↗
PubMed1985

Psychiatric hospitalization in Italy before and after 1978.

The available information system in Italy does not allow to adequately evaluate the change in patterns of hospitalization that have taken place after the 1978 Mental Health Act came into force. There are huge differences among Northern and Southern Italy and inside these areas. On average, the reduction of public psychiatric hospitals activity had begun around 70's. People living in these hospitals at the census day January 1st were about 75,000 in the first years of the 70's, were 58,000 in 1977 and further decreased to 38,000 in 1981 (67.6 per 100,000 total population). This decrease was not counterbalanced either by private psychiatric hospitals, or by the newly opened Psychiatric Departments in general hospitals. Scant or no information is available on intermediate facilities, and on follow-up of discharged inpatients.

Affective Disorders, Psychotic↗
PubMed1983

Relationship between the articular manifestations of rheumatoid arthritis and circulating immune complexes detected by three methods and specific classes of rheumatoid factors.

Although detected in most patients with rheumatoid arthritis (RA), the relationship of the concentration of circulating immune complexes and specific classes of rheumatoid factors (RF) to the activity of the articular manifestations is uncertain. Therefore, 57 patients were evaluated in a prospective fashion. Combining all data, the concentration of IgG RF and the erythrocyte sedimentation rate (ESR) correlated most strongly with the articular index (Pc less than 10(-4], while the concentrations of IgM RF and IgA RF did not correlate. The quantity of immune complexes detected by the C1q-SP and the mRF-SP assays correlated significantly with articular manifestations (Pc less than 0.02 and less than 0.002) while those detected by the C1q-BA did not. Strong associations between the change of the articular index and both the change of ESR (r = 0.76, Pc less than 0.007) and the change of IgG RF (r = 0.72, Pc less than 0.014) were noted in those begun on remittive agents during the course of this investigation. Of the assays for immune complexes, changes of those detected by the C1q-SP correlated most closely with the articular index (r = 0.63) in this group. These observations support a potential role for the selective use of certain laboratory parameters, in addition to the ESR, in monitoring the articular activity of certain patients with RA.

Adult↗
PubMed1982

Evidence for the local production and utilization of immune reactants in rheumatoid arthritis.

Immunoglobulins, including rheumatoid factors, are produced by the rheumatoid synovial membrane. A significant contribution of the synovial membrane to the total IgG and IgM detected in the synovial fluid has been documented. The present study was designed to examine the contribution of the synovial membrane to the rheumatoid factors detected in the synovial fluid. Analysis of the data demonstrated that the synovial membrane was the source of a significant component of the total synovial fluid IgA rheumatoid factor and IgM rheumatoid factor. While some fluids possessed extremely elevated concentrations of the IgG rheumatoid factor, the data suggested that IgG rheumatoid factor was preferentially reduced, relative to total IgG, by the rheumatoid inflammatory process. These observations suggest a potentially important role for IgG rheumatoid factor in rheumatoid synovitis.

Arthritis, Rheumatoid↗