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Biomedical subjects

F Conti

Publications and source records attributed to F Conti.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

[Disinfection is prevention].

Prevention of outbreaks is very important in haemodialysis units because of the high risk of infectious complications caused by contaminated water or equipment. Our aim was to evaluate the efficiency of a chloride based disinfectant for haemodialysis machines. Five different machines were tested for infection by culturing water drawn from both inlet (point A) and outlet (point B) of the dialyser and from the waste site (point C). Six series of tests were analysed during a 3-week period. In the first week water was drawn from point A before and after disinfection on two different days; during the second and third weeks the same procedure was performed at points B and C, respectively. Three non-contaminated samples of 2 mL each were sent to the microbiology department for cultures. Samples from point B grew a number of bacteria even after the disinfectant for the water system was changed. We conclude that machine contamination is due to patients and, therefore, a very accurate cleaning and disinfection of system components is essential. This procedure can avoid isolation of infected patients. Prevention of infection is a complex procedure and should engage water systems, machines, as well as environment and nurses.

Cross Infection↗
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[Chemotherapy in the treatment of breast carcinoma].

Breast cancer (BC) is the most common malignancy and the second most common cause of cancer-related death in Western European and North American women. Neoadjuvant chemotherapy may be used in the management of both BC patients with locally advanced disease, and those with earlier stage and operable tumors. Data from recently phase III trials and worldwide consensus conference document the benefit of adjuvant chemotherapy in improving disease free survival and overall survival for patients diagnosed with invasive BC > 1 cm. When BC cells metastasize to distant organs, the disease is incurable, but chemotherapy may offer these patients a significant palliation.

Antineoplastic Agents, Hormonal↗
PubMedDate not supplied

A new method for measuring venous blood flow with the aid of an electromagnetic flowmeter.

Using a silicone elastometer sheath, wrapped around the portal vein, with an external probe for electromagnetic flowmetry, and with the aid of an outside depression, the authors succeeded in measuring portal vein blood flow with great precision, both under normal conditions and during vasoconstriction induced by drug administration. The above system allows variations synchronous with respiration and cardiac contractions to be seen. The reproducibility of a "no flow" point further enables registrations to be continued for hours for physiological and pharmacological studies. The sheath probe system described for the registration of portal vein blood flow is applicable to all other veins.

Blood Circulation↗
PubMedDate not supplied

[Hepatic allograft rejection. Diagnostic and therapeutic aspects].

Rejection is still a major problem in liver transplantation: 50-70% of patients present at least one acute episode, while 5-15% develop chronic rejection. Acute rejection is suggested by clinical signs and abnormal laboratory test results, but only histological signs on biopsy specimens are adequately specific. The three most frequent elementary lesions are a portal infiltrate, bile duct alterations and endothelial inflammation. Several systems have been forwarded to classify the degree of rejection. Chronic rejection is characterized by a progressive reduction in the number of interlobular bile ducts. It does not respond to available immunosuppressive drugs and thus requires retransplantation. Prophylactic immunosuppression is usually based on the triple-drug combination cyclosporine/azathioprine/corticosteroids. The orthoclone OKT3 and FK506 have recently been proposed for prophylactic use in this setting. Treatment of liver graft recipients with cyclosporine carries a number of specific disadvantages, particularly with regard to gastrointestinal interactions (delayed intestinal absorption in patients with cholestasis, bile derivation, diarrhea or receiving cholestyramine; possibility of a sharp increase in blood cyclosporine levels when the Kehr drain is clamped), and drug interactions (cyclosporine metabolization of CP450-IIIA accounts for most such interactions). The results of radioimmunoassay and TDx must be interpreted with care, and HPLC remains the reference technique in borderline cases. Cyclosporine is hepatotoxic in about 20% of cases, generally giving rise to cholestasis. This toxicity is dose-dependent and therefore diminishes when the dosage is reduced. Most groups initially treat rejection with corticosteroids. The response to treatment is generally evaluated in terms of liver function tests.(ABSTRACT TRUNCATED AT 250 WORDS)

Graft Rejection↗
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Wrist joint involvement in systemic lupus erythematosus. An ultrasonographic study.

OBJECTIVE: To define joint alterations in the wrists of patients with systemic lupus erythematosus (SLE) by ultrasonography (US). METHODS: Fifty-two wrists of 26 SLE patients and 30 wrists of 15 healthy controls were evaluated using US by two different experienced operators, blinded to the clinical data. A 14 MHz linear probe was used. Power Doppler (PD) was applied to evaluate the presence of synovial neoangiogenesis as a parameter of active local synovitis. The findings were correlated to the clinical evaluation, serological systemic disease activity parameters (ESR, C3 levels) and the SLE-disease activity score (SLEDAI). Statistical analysis was performed by the EPISTAT program. RESULTS: Signs of synovitis were found in 22 wrists (42.3%). Synovial proliferation was present in 10 joints (19.2%), PD positivity in 5 (9.6%) and joint effusion in 13 (25%). Erosions were present in both wrists (3.8%) of one patient. Signs of tenosynovitis of one or more tendons were shown in 23 cases (44.2%). Ganglia were found in 2 joints (3.8%). Changes of the median nerve, joint dislocations, tendons' ruptures, cysts and nodules were never detected. In 14 wrists (26.9%) no alterations were found. There was no correlation between sonographic findings and clinical, laboratory and indexes signs of disease activity. In the control group the only alteration found was tenosynovitis in 1 joint (p < 0.0001). CONCLUSION: US proved to be an useful technique to detect wrist joint alterations in SLE. These findings may help the physician to modulate treatment strategies and to perform a low cost monitoring of joint disease activity.

Adult↗
PubMedDate not supplied

Leishmania in SLE mimicking an exacerbation.

Systemic lupus erythematosus is a protean disease which may present manifestations that resemble other diseases posing serious problems of differential diagnosis. Visceral leishmaniasis is a parasitic infection, endemic in 88 countries, whose hallmarks may mimic a lupus flare. Fever, pancytopenia, splenomegaly, hypergammaglobulinemia, production of autoantibodies and complement consumption are some of the overlapping features between the two diseases. Thus, extra attention must be paid to patients with lupus who present with the mentioned symptoms. Diagnosis of visceral leishmaniasis relies on the detection of leishmania antibodies, on the presence of amastigotes in bone marrow aspirates, biopsies and cultures of the parasite. Treatment is based on the use of i.v. liposomal amphotericin B. The missed recognition of a leishmania infection in a lupus patient may lead to death, since both the omission of a specific anti-parasite treatment and the increase of the immunosuppressive therapy, in the conviction of a lupus flare, accelerate a fatal outcome. In this paper we present a case of visceral leishmaniasis occurring in a lupus patient. The clinical and laboratory features that overlap in the two diseases and the current literature on the topic were discussed.

Adult↗
PubMedDate not supplied

[Isolation of S. mbdakada from a child seen at the University of Messina pediatric clinic].

The authors made some diagnostic investigation into a serious case of diarrhoea observed in an infant in the pediatric ward of the University hospital of Messina (Sicily). They brought into evidence some of the causes of the world wide spread of salmonella infection, in particular the spread of new serum-types, such as S. mbandaka, which was involved in this case.

Child, Preschool↗
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Prevalence of chronic fatigue syndrome in Italian patients with persistent fatigue.

Our study was carried out to determine the prevalence of chronic fatigue syndrome (CFS) within a selected population of patients suffering from persistent fatigue. We studied subjects with recurrent or persistent fatigue lasting 6 months and fulfilling at least four minor Center for Disease Control (CDC) criteria for the diagnosis of CFS. Evaluation included both clinical examination and laboratory testing. All subjects filled out a questionnaire specifically designed to gain information about the length and severity of symptoms, and patients with a previously diagnosed illness associated with fatigue were excluded. The study was carried out at the Fatigue Clinic of an internal medicine unit (Clinica Medica I) of the University of Rome "La Sapienza". Sixty-three subjects, residents of the Lazio region (central Italy), completed the diagnostic assessment. Alternative diagnoses were established in 37 (59%) of the 63 patients. A diagnosis of CFS based on the CDC criteria was established in only 6 cases. In 2 subjects, CFS had appeared following infectious mononucleosis, and no definitive diagnosis could be formulated for 18 patients. In Italy, CFS seems to be an infrequent cause of severe and persistent fatigue in a selected population. Numerous morbid conditions may be responsible for a clinical picture closely resembling CFS. We recommend that patients suffering from fatigue be thoroughly evaluated.

Adolescent↗