Biomedical subjects
Publications and source records attributed to F Romano.
Blastoschizomyces capitatus strains resistant to fluconazole were isolated in three cancer patients. All of the strains had identical genomic DNA restriction profiles. Our findings give evidence for the emergence of fluconazole-resistant B. capitatus and suggest a nosocomial acquisition emanating from a common source within the hospital environment.
Twenty-nine women believed to be affected with benign uterine pathologies underwent transvaginal hysterosonography insertion of a physiological solution into the cervical cavity by means of a catheter positioned in the cervical canal. This new technique, due to the acoustic window created by the fluid, made it possible to find: one cervical polyp, six endometrial polyps, one endometrial synechia, five submucosa myomas and one uterine malformation, the presence of which, with traditional ultrasonography can only be suspected. The subsequent hysteroscopic check-up confirmed the high diagnostic reliability of hysterosonography which is also easy to carry out, safe and costs little.
OBJECTIVE: To assess the usefulness of transabdominal sonohysterography in the diagnosis and evaluation of submucous myomas. METHODS: Fifty-two premenopausal women hospitalized for hysterectomy for benign gynecologic indications underwent preoperative conventional transvaginal sonography, transabdominal sonohysterography, and hysteroscopy. The results of the three techniques in terms of diagnosis, size, intracavitary growth, and location of the submucous myomas were compared with those revealed by direct inspection of the surgical specimens. RESULTS: Conventional transvaginal sonography for the diagnosis of submucous myomas had a sensitivity of 90% and a specificity of 98%; the predictive values of abnormal and normal scans were 90 and 98%, respectively. Transabdominal sonohysterography had sensitivity, specificity, and predictive values of 100%, as did hysteroscopy. In all cases, the sonographic techniques measured tumor size more accurately than did hysteroscopy. The transabdominal sonohysterography measurements differed from direct evaluation by no more than 2 mm, and the hysteroscopic measurements were significantly different from those of the surgical specimens. The sonohysterographic evaluation of intrauterine growth was significantly more precise than that of the other techniques, differing from direct measurements by no more than 5-10%. Conventional transvaginal sonography failed to localize three of 11 myomas; hysteroscopy and transabdominal sonohysterography provided the exact location in all cases. CONCLUSION: Transabdominal sonohysterography is the most accurate technique for detecting submucous myomas and evaluating their size, intracavitary growth, and location.
OBJECTIVE: Microalbuminuria is considered an important predictor of cardiovascular events in diabetic patients. In this study, a possible association of microalbuminuria with significant changes in left ventricular (LV) morphology and function and generalized vascular dysfunction was analyzed in insulin-dependent diabetes mellitus (IDDM) patients without hypertension, coronary artery disease, or autonomic dysfunction. RESEARCH DESIGN AND METHODS: Thirty-four young long-term IDDM patients, 16 with and 18 without microalbuminuria, and 20 control subjects were studied. LV systolic function and wall thickness were evaluated by M-mode echocardiography. LV diastolic function was studied using a combined echo-Doppler and phonocardiographic technique. The hyperemic response to forearm ischemia was measured by strain-gauge plethysmography. All patients underwent 24-h ambulatory blood pressure monitoring. RESULTS: LV mass index and wall thickness:radius ratio were significantly higher in microalbuminuric patients. LV relaxation was significantly impaired in both diabetic groups compared with control subjects; moreover, this impairment was significantly greater in microalbuminuric than in normoalbuminuric patients. In microalbuminuric patients, forearm postischemic vasodilation was also significantly lower and mean awake diastolic blood pressure (dBP) was significantly higher than in the other two groups. CONCLUSIONS: Our data suggest that microalbuminuria is associated with significant changes in LV morphology, a more severe impairment of cardiac diastolic function, altered vascular dilatory capacity, and higher daytime dBP. Therefore, microalbuminuric patients should be considered to have a higher risk of cardiovascular complications and be kept under closer surveillance.
OBJECTIVES: To evaluate the usefulness of abdominal and vaginal sonohysterography (SHG) (considered both singly and in combination) for the diagnosis of intrauterine abnormalities. METHODS: At the Department of Obstetrics and Gynecology, University of Bari, Italy, the results of the abdominal and vaginal SHG were retrospectively compared with those of conventional transvaginal sonography and hysteroscopy in 35 fertile women in whom a hysteroscopy was indicated. The sensitivity and specificity for the diagnosis of intrauterine abnormalities of both kinds of SHG (considered both singly and in combination), transvaginal sonography and hysteroscopy were compared; the predictive values of abnormal and normal SHG were determined by a 2 x 2 table relating the test results to the patients' abnormalities shown at hysteroscopy. RESULTS: The combination of both abdominal and vaginal SHG had a sensitivity of 95% and a specificity of 100%; the predictive value of an abnormal test was 100% and that of a normal test 94%. CONCLUSIONS: SHG provides a reliable diagnosis of intrauterine abnormalities. However, hysteroscopy and guided biopsies remain the decisive diagnostic test for investigating intrauterine abnormalities.
A cluster of disseminated Candida albicans infections, which occurred at the Intensive Care Unit of the Department of Heart Surgery, was investigated. Ten patients became infected and seven died. A wide microbiological surveillance was carried out. A total of 14 isolates of Candida albicans, four environmental and ten human, were examined using the Restriction Endonuclease Analysis (REA) of DNA. The isolates were classified into five different main groups. Five of the clinical isolates had the predominant pattern Ab and two more clinical strains were very closely related. Two more isolates from the emergency kit desk and the hands of a nurse gave the same REA profile. Such a relationship proved the epidemic nature of the cluster, with most of the patients cross-infected, and strongly suggested transmission on the hands of the staff as a determinant of the epidemic. Thus, REA has the potential to address many important questions in the study of nosocomial epidemiology of Candida albicans.
The objective of this retrospective study was to evaluate the usefulness of abdominal and vaginal sonohysterography (SHG; considered both singly and in combination) for the diagnosis of uterine polyps. Fifty fertile women hospitalized for hysterectomy for benign gynecologic indications were enrolled. Main outcome measures were preoperative conventional vaginosonography, transabdominal and vaginal SHG, hysteroscopy and histologic evaluation of the surgical specimen. Conventional vaginosonography had a sensitivity of 33.3% and a specificity of 100%; the predictive values of abnormal and normal scans were 100 and 79.5%, respectively. Transabdominal SHG had a sensitivity of 75% and a specificity of 100%. The predictive value of an abnormal scan was 100%; that of a normal scan 91.2%. Vaginal SHG had a sensitivity of 58.3% and a specificity of 100%; the predictive value of an abnormal scan was 100%, that of a normal scan 86.1%. The combination of the two kinds of SHG had a sensitivity of 91.7% and specificity of 100%; the predictive value of an abnormal test was 100% and that of a normal test 96.9%. The sensitivity, specificity and predictive values of abnormal and normal hysteroscopic examination were all 100%. In conclusion, the presence of endouterine polyps can be effectively investigated by SHG; nevertheless, hysteroscopy is more sensitive, being capable of detecting even very small endouterine neoformations.
Studies on cultured human renin(R)-producing tumors cells are few. In this work the R secretion by a human juxtaglomerular tumor (JGT) in various tissue culture models was evaluated by a new immunoradiometric assay. Freshly isolated JGT cells actively secreted total R (tR; about 70% of which is proR) into the perfusion media of very short-term cultures (tR concentration, 100-400 ng/ml/10(6) cells), independently of factors stimulating or inhibiting R output by normal JG cells. Primary monolayer cultures of the same JGT rapidly lost their tR-secreting capability and died by apoptosis within two months. Conversely, a JGT explant survived for up to 22 months in vitro. During the first year of culture, this explant increased in volume and generated, at 3- to 4-monthly intervals, several self-limited cellular outgrowths, from which it became detached. Meanwhile, tR secretion by the explant decreased very slowly, though its decline was transiently and partly reversed by various combinations of growth factors, hormones, a prostaglandin, and selenous acid added to either a serum-enriched or a synthetic medium. By the 12th month in vitro, tR secretion had faded away. Like the primary monolayers, the various explant outgrowths, once detached, stopped secreting tR and died in a few weeks. Hence, the preservation of a histiotypic relationship and the actions of several mitogenic and/or differentiating agents are essential for the long-term survival and the continuance of R secretion by human JGT cells in vitro.
The clinical significance of the fetal choroid plexus cysts, observed by prenatal sonographic examination, is now a days still discussed. A consequence of this situation is the discordance of opinions about the question of whether karyotype analysis is always necessary to evaluate chromosomal anomalies sometimes correlated, especially in the presence of (as some authors have reported) large (> 1 cm), bilateral, persistent cysts and of other structural abnormalities. We have effected a prospective study to estimate the incidence of fetal choroid plexus cysts and to establish the obstetrical behaviour to be adapted in these cases. During 834 routine ultrasonographic examinations at 18-21 weeks' gestational age, we have evaluated the presence of fetal choroid plexus cysts in 9 fetuses, with an incidence of 1.07%. Three of these cysts were larger than 1 cm, three were bilateral. Karyotype analysis, effected in all cases, diagnosed a case of Trisomy 18 in a fetus who ultrasonographically showed, in addition to a unilateral cyst of 1.2 cm, also a diaphragmatic hernia. Careful ultrasound follow-up revealed that all the cysts disappeared spontaneously, but two of them (whose dimensions were larger than 1 cm) were still visible at 24 weeks' gestation and probably this age will be too advanced to begin a chromosome analysis. In conclusion, we think that the presence of fetal choroid plexus cysts always imposes a careful ultrasonographic evaluation of fetal morphology and, since there is always the risk that other small fetal anomalies (evocative of abnormal fetal karyotypes) wight not be noted, we believe that it is better, in any case, to recommend to the patient a prenatal cytogenetical analysis.
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To evaluate determinants of the prevalence of human T-cell leukemia virus type I (HTLV-I) antibody positivity in an endemic region, Miyazaki Prefecture, Japan, demographic and serologic data were collected on 7,055 individuals consecutively seen at Miyazaki City Health Promotion Center between September 1983 and December 1984. The overall HTLV-I seroprevalence was 8.5%; age and gender distributions of HTLV-1 antibody positivity were consistent with previous findings for endemic populations. The prefecture could be divided into two geographic areas based on seroprevalence: high prevalence (12.1%) in the southwest and medium prevalence (6.6%) for the rest of the prefecture. Current occupation in fishing, forestry, or livestock raising significantly correlated with HTLV-1 seropositivity [relative risk (RR) = 3.0, 2.5, 2.0, respectively]; farming also was associated but only in the medium prevalence region (RR = 1.3; p = 0.06). For a subset of 157 HTLV-I-positives and 175 negative controls screened for antibodies to the toxoplasmosis organisms, toxoplasma exposure was not significantly associated with HTLV-I infection. In this endemic Japanese population, both geographic and sociologic factors characterized the distribution of HTLV-I seroprevalence, reflecting transmission patterns and historical duration of the infection.
An open multicentre trial to study the efficacy and safety of ceftazidime in elderly patients has been conducted in four geriatric units on 135 subjects suffering from urinary-tract or respiratory-tract infections. Sixty-two patients were cured (45.9%), and 60 improved (44.4%). Of the evaluable cases bacteriological eradication was achieved in 91.3%. No adverse events were recorded.
Creatinine clearance, daily urinary protein excretion, serum concentrations of thyroid hormones (TT4, TT3, fT4, fT3), TSH and parathyroid hormone (PTH), have been measured before and after 2 or 6 months of a low protein diet supplemented with aminoacids and ketoanalogues in 18 patients affected by chronic nephrotic syndrome without significant impairment of renal function. Mean creatinine clearance and mean serum protein concentration (79.5 +/- 13.8 ml/min and 5.4 +/- 0.6 g/dl, mean +/- S.D., respectively) did not significantly change (79.1 +/- 17.3 ml/min and 5.5 +/- 0.6 g/dl) after the diet. Mean daily urinary protein excretion (7.1 +/- 2.2 g/day basally) significantly decreased (5.5 +/- 1.9 g/day) after the diet (p less than 0.05). Mean serum TT4 concentration (5.6 +/- 1.8 micrograms/dl basally) significantly increased (6.7 +/- 2 micrograms/dl, p less than 0.05) after the diet. Mean serum TT3 concentration (106.7 +/- 28.5 ng/dl, basally) significantly increased (126.7 +/- 22.6 ng/dl) after the diet (p less than 0.01). Mean serum fT4 and fT3 concentrations (8.0 +/- 2.9 pg/ml and 4.5 +/- 1.6 pg/ml, respectively) did not significantly change (9.4 +/- 2.7 pg/ml, and 4.9 +/- 1.9 pg/ml, respectively) after the diet. In some patients low basal serum concentration values of TT4, TT3, fT4, fT3 became normal after the diet. Mean serum TSH concentration (3.1 +/- 2.3 microU/ml basally), significantly decreased (1.5 +/- 1.3 microU/ml) after the diet (p less than 0.05). Mean serum PTH concentration (0.7 +/- 0.3 ng/ml basally) significantly decreased (0.4 +/- 0.2 ng/ml) after the diet (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
The prevalences of dental caries and developmental enamel defects were assessed in 643 randomly selected children aged 11 to 13 years who were lifelong residents of three areas of Naples with high (4 ppm), optimal (1 ppm), and low (0.3 ppm) concentrations of fluoride in their drinking water. The children living in the high fluoride area had significantly lower dental caries scores (DMFT 0.59, DMFS 1.01) than those in the optimal fluoride area (DMFT 1.67, DMFS 2.87) and those in the low fluoride area (DMFT 1.97, DMFS 3.48). The FDI index of developmental defects of dental enamel (DDE) was used to record enamel defects. There was a significant increase in the number of children with at least one tooth affected by an enamel defect as the fluoride level in their drinking water increased; the prevalences were 9.8 per cent in the low fluoride area, 23 per cent in the optimal area and 53.1 per cent in the high fluoride area. The prevalences of teeth affected were 2.2 per cent in the low fluoride area, 5.7 per cent in the optimal, and 20.3 per cent in the high. Demarcated opacities were the most common defect seen. Diffuse opacities were found to be the discriminating factor between fluoride and non-fluoride areas. In the high fluoride area 64.3 per cent of children with enamel defects had at least six teeth affected. In the maxilla the central incisors were the most affected teeth followed by the second and first premolars; in the mandible the first premolars and first molars were the most affected teeth.
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A comparison was made of different culture media and procedures for detection of Serratia marcescens from faecal, pharyngeal and ocular swabs collected from 213 neonates. MacConkey agar and MacConkey agar with sorbitol (1%) and/or colistin (200 i.u./ml) were used both for primary isolation and after enrichment using Mossel Enterobacteriaceae broth with colistin (200 i.u./ml). The use of MacConkey agar supplemented with colistin for primary isolation improved considerably the isolation rate of S. marcescens from faecal swabs but not from pharyngeal swabs; the number of ocular isolations were insufficient to demonstrate differences between procedures. Moreover the enrichment procedures consistently increased the number of S. marcescens isolates especially from pharyngeal and ocular swabs. Use of sorbitol made detection of S. marcescens from clinical specimens easier and time- and cost-efficient.