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Biomedical subjects

F Ferri

Publications and source records attributed to F Ferri.

At least 19 recordsLinked to original sources
PubMed1999

Positive and sustained effects of highly active antiretroviral therapy on HIV-1-associated neurocognitive impairment.

OBJECTIVES: To determine whether highly active antiretroviral therapy (HAART) is effective in HIV-associated neurocognitive impairment. DESIGN: An open label, prospective, observational study. METHODS: Since April 1996, 116 patients with advanced HIV infection, reverse transcriptase inhibitor (nRTI) experienced but protease inhibitor (PI) naive, were screened for the presence of neurocognitive impairment. Ninety patients with confounding neurological illness, opportunistic infections or drug abuse were excluded. The remaining 26 patients underwent comprehensive neuropsychological testing, and laboratory measures before, after 6 and after 15 months of treatment with one PI plus two nRTI. RESULTS: The prevalence of neurocognitive impairment decreased from 80.8% (baseline) to 50.0% (P<0.05) (sixth month) and to 21.7% (P<0.001) (15th month). Among the functions explored, the impairment of concentration and speed of mental processing decreased from 65.4 to 21.7% (P<0.01) and of memory impairment from 50 to 8.7% (P<0.01). Comparing baseline with the sixth and 15th month raw scores, a statistically significant improvement was seen in measures exploring concentration and speed of mental processing (P<0.05), mental flexibility (P<0.05), memory (P<0.05), fine motor functions (P<0.05) and visuospatial and constructional abilities (P<0.01). After 6 months of HAART patients with a normal neuropsychological examination had lower mean plasma viraemia (2.95 versus 3.97 log copies/ml, P<0.05) and greater mean log plasma HIV RNA changes from baseline (-1.84 versus -0.83 log copies/ml, P<0.05) than neuropsychologically impaired subjects. CONCLUSION: HAART produces a positive and sustained effect on neurocognitive impairment in HIV-infected patients. A reduction of plasma viral load was associated with the regression of neuropsychological test abnormalities.

Adult↗
PubMed1998

Sporadic hepatitis C virus infection: a case-control study of transmission routes in a selected hospital sample of the general population in Italy.

A case-control study was performed on 9,175 Italian adult outpatients in 5 hospitals in Rome. The study was carried out to clarify the role of some less investigated risk factors (RF) in the spread of hepatitis C virus (HCV) infection. All subjects were contacted by interviewers, who completed a questionnaire. Their sera were stored and subsequently tested for both HCV and hepatitis B virus core (HBc) antibodies. 365 subjects, positive for anti-HCV and anti-HBc-negative, and who had denied intravenous drug use (IDU) (cases) were compared with an equal number of suitable random controls negative for anti-HCV and anti-HBc. Gender, age and region of birth and residence were matched. The prevalence of 13 RFs were statistically compared by univariate and multivariate analysis. A positive anti-HCV test was significantly associated, by multivariate analysis with intravenous treatments and minor surgical procedures (both before 1975) (p < 0.001), blood transfusions (before 1991) (p < 0.01), diabetes (p < 0.01), and deliveries in hospital (p < 0.05) (both before 1975). After 1975 (1991 for transfusions), all associations lost their significance. Intra-familial (sexual and non sexual), occupational RFs and dental care were not significantly associated with the presence of anti-HCV. We suggest that non-disposable syringes, commonly used until 1975 in Italy for i.v. treatments, have been the major route for HCV transmission in Italy among non-IDU subjects.

Adult↗
PubMed1998

SeCD electronic folder: CADMIO's application for the medical folder of a service for the care of drug addicts.

In this paper we will describe the SeCD (Service for the Care of Drug addicts) electronic folder, a specific application of CADMIO [1] (Computer Aided Design for Medical Information Objects) system. CADMIO is a system for the definition, construction and management of multimedia clinical folders. The Ser.T. (Servizio per la Tossicodipendenza/Service for Drug Addicts) has earned a very special place within the Italian clinical structures as well as any service for drug addicts has done in the rest of the world. Such a structure has special needs and the characteristics of its medical folders are very different from any other folder. Actually, a Ser.T. has to keep updated the patient situation either from the clinical point of view as well as the psychiatric one. Moreover, it must keep track of the clinician subjective considerations about the patient psychic state and his situation in regard of the law. So, we had to redesign some of the features of the existing CADMIO application, to accommodate such highly not structured data into objects easily manipulated by an informative system. The objectives we hope to achieve were mainly two: To show that a well designed adaptive system can be easily exploited to support even very complex and poorly structured data types and actions To design data structures able to accommodate medical, psychiatric and administrative data in an homogeneous manner.

Computer Systems↗
PubMed1998

[Blood lead levels in children from a ceramic center with respect to residence and parental occupation].

In a survey carried out in 1981, Pb exposure of children living in two geographical areas of the district of Scandiano and attending the first year of primary school was studied. The two areas were different concerning both traffic and the presence of ceramic tile industries, thus suggesting a different exposure of children. The survey demonstrated blood lead levels (PbB) markedly higher than 10 micrograms/100 ml, a value recently identified by the Centers for Disease Control (CDC, Atlanta, USA) as the limit beyond which children's learning capacity may be damaged. It was evident that both the occupational exposure of parents and, to a lower extent, the residence in zones with higher levels of pollution influenced PbB levels. During the last ten years significant improvements have led to the reduction of atmospheric emissions and of occupational exposure of ceramic workers. A new survey has been carried out in 1995. We examined 147 children attending the first year of primary school, and living in two zones for which a different level of Pb exposure could be assumed. In both zones, a clear reduction of PbB was observed in comparison with data obtained in 1981. Mean and standard deviation for PbB in the two groups were 4.1 +/- 1.71 and 4.5 +/- 2.04 micrograms/100 ml, with median values of 3.7 and 4.0 micrograms/100 ml, respectively. Only two cases (1.4%) exceeded the limit values proposed by CDC. Although the mean PbB were much lower than those observed in 1981, higher PbB were found in children whose parents were occupationally exposed to Pb. Maternal exposure seems to be particularly important in determining PbB in children. In comparison with data from the international literature, our results are very close to those obtained for children living in Scandinavian countries, in Germany or in France and rather different from those obtained by other authors in Italy.

Air Pollutants↗
PubMed1998

[Lead exposure in the ceramic tile industry: time trends and current exposure levels].

There is a high density of industries for the production of ceramic tiles in the District of Scandiano (province of Reggio Emilia, Emilia Romagna region). In this area, since the beginning of 1970s, the time trend of Pb exposure in ceramic tile plants has been evaluated by means of biological monitoring (BM) data collected at the Service of Prevention and Safety in the Work Environment and its associated Toxicology Laboratory. From these data, a clear decreasing time trend of exposure levels is documented, the reduction being more evident during the seventies and in 1985-88. During the seventies BM was introduced systematically in all ceramic tile plants with the determination of delta-aminolevulinic acid in urine (ALA-U). As a consequence of the BM programme, hygienic measures for the abatement of pollution inside the plants were implemented, and a reduction, from 20.6% to 2%, of ALA-U values exceeding 10 mg/l, was observed. In 1985, the determination of lead in blood (PbB) replaced that of ALA-U in the BM programmes and highlighted the persistence of high level of exposure to Pb, which could not be outlined by means of ALA-U because of its lower sensitivity. PbB levels were 36.1 micrograms/100 ml and 25.7 micrograms/100 ml in male and female workers, respectively. These results required the implementation, within the plants, of additional hygienic measures and a significant reduction of PbB was obtained in the following three years. In 1988 PbB levels were 26.0 +/- 10.7 and 21.6 +/- 10.3 micrograms/100 ml in male and female workers, respectively. In 1993-95 Pb levels were obtained from 1328 male and 771 female workers of 56 plants, accounting for about 40% of the total number of workers in the ceramic industry, in the zones of Sassuolo and Scandiano. Exposure levels are not different from those observed in the preceding years, with PbB levels of 25.3 +/- 11.1 and 19.1 +/- 9.2 micrograms/100 ml in male and female workers, respectively.

Adult↗
PubMed1998

Toward a general model for the description of multimedia clinical data.

The patient folder integrates information originating from heterogeneous sources. For this reason computerized tools for patient data management should exploit the advantages of multimediality and offer an integrated environment for data presentation, and image and biosignal visualization. Object-oriented modeling is the best approach for designing systems for multimedia patient folder management. We propose an object-oriented model, able to define the entities constituting the patient folder and their logical organization. This model has sufficient flexibility to adapt to the most varied clinical environments. It allows the physician to structure the information needed for his/her patient folder without employing a programming language.

Computer Simulation↗
PubMed1997

A system to define and allocate health care resources on a territory to improve the life quality of the populations in developing countries.

In this paper the health resource allocation problem is discussed. An object-oriented system is proposed and its implemented prototype is illustrated. It consists of two parts: a Geographical Information System, which is able to acquire and store both geographical and social-epidemiological information (including the resource distribution on that territory), and a Decision Support System, able to decide, using optimization algorithms, the new resource allocation in order to obtain a quasi-optimal solution for the cost/benefit ratio minimization problem, after having fixed the goal (e.g., the decrease of the incidence of a given disease) and constraints (e.g., a fixed budget, a given set of available resources, etc.). The object-oriented database which is part of the system can simulate and store different scenarios, depending on the different goals and constraints defined in input, by means of a user friendly interface.

Algorithms↗
PubMed1997

[Prosthetic repair of inguino-crural hernia using Rives technique].

The authors report their experience with Rives procedure, a prosthetic repair of groin hernias using preperitoneal sutured mesh by parainguinal access. This operation is not technically easy to perform and is usually done out of necessity in cases with higher risk of recurrence because of systemic factors of chronic abdominal high pressure and/or of local factors of risk, when there are contraindications to operations like Stoppa procedure. Our series report 38 patients operated upon on 5 years, with incidence of 5.8% overall hernias repaired in the same period. 33 are males, 5 females, with average age of 60.5 years. Mean time required for the operation is 94 minutes (range 55'-130'). About postoperative complications we complain of one testicular atrophy, but none infections. Follow-up range is 9-50 months (average 23.2 months) for 30 patients operated more than one year ago. All but one were revisited after almost 12 months. No recurrences were detected.

Adult↗
PubMed1997

[Stoppa's intervention. The complications nd results].

The authors report their experience with the giant prosthetic reinforcement of the visceral sac (Stoppa procedure), developed in the last 6 years operating 126 cases. Postoperative period was regular for two third of the patients, but only in 4 cases we can consider complication severe: 2 cases of preperitoneal haemorrhage with haematoma formation and subsequent recurrence; one sepsis of the preperitoneal space around the prosthesis, cured with drainage and conservative measures without recurrence, and then one peritonitis in a morbid obese individual. There was no mortality. 93.3% of the patients has been clinically controlled after over 6 months (average 27 months; range 6-67 months): 8 recurrences have been observed (3.6% of the hernias operated). 7 required reintervention. Therefore it is possible to affirm that 91% of the operated patients had good results.

Adult↗
PubMed1997

[Enoximone in the treatment of postoperative low cardiac output syndrome in pediatric heart surgery. Open study in tetralogy of Fallot].

OBJECTIVE: To evaluate the role of the phosphodiesterase inhibitor enoximone in low output states (LOS) following cardiac operations in congenital heart diseases. DESIGN: This was an unblinded, retrospective, open study. Hemodynamic effects of intravenous enoximone were investigated in 130 patients--70 adults and 60 pediatrics--offered to our Department from 1992 to 1995. To avoid multifactorial events due to different cardiopathies, our analysis was limited to 24 newborns and children operated on for correction of tetralogy of Fallot (TOF). SETTING: Cardiac surgery ICU of a Regional Hospital in Italy. METHODS: Retrospective analysis of 24 cases of postoperative LOS in surgical corrected TOF, treated with enoximone, were compared with a control group treated with conventional inotropic drugs. DATA ANALYSIS: Data were compared by "t"-Student's test for impaired data. RESULTS: Significative cardiac function improvement in treated group, demonstrated by an increased systemic pressure values, by decreased right chambers pressures and by significative improvement in oxygen mixed venous saturation. Better hemodynamic recovery after ICU discharge. No significant side effects were detected. CONCLUSIONS: Enoximone is, suggested also in pediatric patients in the management of refractory LOS following open heart surgery, especially when a long-standing treatment is predictable (more than 72-96 hrs).

Adult↗
PubMed1997

[Severe diffuse facial cellulitis].

Twenty cases of severe cervicofacial infections among 184 cases of cellulites treated in 1991 and 1992 at the Lille University Hospital were investigated. Outcome was compared with results reported in the literature. Outcomes were similar and emphasized the critical nature of this type of infection which caused 7 deaths in our series and severe anatomic and functional sequelae. All patients (n = 20) were given anti-inflammatory drugs prior to surgery. The correlation between disease severity and use of anti-inflammatory drugs would appear to be an established fact. Criteria predicting severity were identified in order to obtain a score for high or low risk and to better adapt the medical and surgical management strategy.

Adolescent↗
PubMed1997

[Iatrogenic false aneurysm of the ulnar artery. A clinical case and review of the literature].

Nowadays false aneurysms have become an important part of the workload of a vascular surgeon as a result of the increasing number of iatrogenic arterial trauma occurring during diagnostic and therapeutic procedures requiring puncture or exposure of blood vessels. A case of a false aneurysm in the ulnar artery caused by a simple syringe needle during an intravenous cannulation is reported. The clinical symptoms and details of the diagnostic procedure based upon color-Doppler and angiography are examined. The vascular operation consisted in proximal and distal arterial control, resection of the aneurysm and end-to-end anastomosis. After surgical treatment the patient experienced an excellent anatomic and functional recovery.

Aged↗
PubMed1996

Long-term exposure to zidovudine affects in vitro and in vivo the efficiency of phosphorylation of thymidine kinase.

The purpose of this study was to investigate the mechanism of acquired cellular resistance to AZT, a mechanism that has been described as a potential source of drug resistance in addition to viral mutations. To study this phenomenon the kinetics parameters of thymidine kinase (TK) activity have been defined in CEMazt, a cell line previously selected for resistance to AZT, in comparison with the parental AZT-sensitive CEM cells. The results revealed that the value of the maximum velocity (Vmax) of TK activity for deoxythymidine (dThd) phosphorylation is decreased in CEMazt as compared to the wild-type cell line (Vmax: CEM = 105.3 +/- 17.6 nmol/hr/mg of protein; CEMazt = 0.3 +/- 0.02 nmol/hr/mg of protein; p < 0.001). Furthermore, the enzyme affinity versus dThd is lower in CEMazt as compared to CEM (Km: CEM = 0.9 +/- 0.2 microM; CEMazt = 1.6 +/- 0.2 microM; p < 0.01). Consequently phosphorylation efficiency, expressed as the ratio between Vmax and Km, is also reduced in CEMazt (p < 0.001). To evaluate whether such a phenomenon may also occur in patients, ex vivo experiments were carried out by using PBMCs from HIV-infected patients, treated or not treated with AZT. The results (mean values from 10 patients for each group) indicate that a prolonged treatment (> 6 months) with AZT may modify the enzymatic kinetics of TK, leading to a significant reduction in the phosphorylation efficiency of the enzyme (4.07 +/- 1.7 in treated patients versus 13.5 +/- 1.7 in untreated patients; p < 0.001). These results indicate that AZT treatment can also induce a defect in TK activity in patients.

Cell Line↗
PubMed1995

[Extra-pelvic mesonephric cyst].

The authors report a case of parovarian mesonephryc cyst that came out through femoral canal outside the pelvis and appeared in crural region. Briefly its features are discussed and compared to Literature.

Cysts↗
PubMed1995

CADMIO: computer aided design for medical information objects.

The growth of the computational capability and the tools of graphic software is nowadays available in an integrated manner into the development environments, thus permitting the realization of tool kits capable of handling information that is complex and of different kinds such as the typical medical information. This has given a great impulse to the creation of electronic medical folders joining together with new and stimulating functionality with respect to the usual paper document [1]. In the present work, we propose a tool capable of defining a multimedia electronic medical folder and representing its architecture through a layout that is formed on the basis of the particular data types to be handled. This tool is capable of providing an integrated view of data that, even though they are close in cognitive sense, are often stored and represented apart in the practice. Different approaches to the browsing feature are giving within the system, thus the user can personalize the way of viewing the information stored into the folder or can let the system guide the browsing.

Computer Graphics↗
PubMed1995

Toward an improvement of life optimizing resource use.

In this paper an object-oriented system for the storing and the managing of epidemiological data in order to decrease the incidence of a given groups of diseases by means of health care strategy application and of the relative health care resource allocation is described. The system starts from the present epidemiological situation of the territory examined and from the real distribution on this territory of human and material health care resources. The health care manager inputs the available budget, some information regarding the population living on this area, other geographical and climatic informations, the values of certain epidemiological parameters of the diseases considered--the system has stored the mathematical and departmental models of these diseases--and the system allocates (using own allocation algorithms) human and material health care resources, optimizing the cost-benefit rate.

Algorithms↗
PubMed1995

User modeling techniques as support in the clinical decision-making process.

This paper describes research work on the design and creation of a medical folder management system capable of establishing co-operative dialogue with users who have access to the information contained therein. The research work has addressed the problem of integrating into the system knowledge about the medical domain and that about users, both necessary to activate co-operative dialogue. The CADMIO [2] prototype has been developed since the study was made. The last version of the CADMIO system stores information about users for the use in recognizing and interpreting their behavior, providing help, and in acquiring and returning further information. Depending on this information the system retrieves and shows the data of the medical folder in an intelligent way by highlighting links between data. It simplifies and increases the speed of the interaction by focusing on the data useful to the decisional activity of the physician.

Bayes Theorem↗