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Biomedical subjects

G Bonaccorsi

Publications and source records attributed to G Bonaccorsi.

At least 19 recordsLinked to original sources
PubMed2003

Factors influencing hospital infection control policies in Italian hospitals.

A study was undertaken to determine the resources available in Italian hospitals for the control of nosocomial infections and the factors favouring a successful approach. During January-May 2000 a questionnaire about infection control was sent to the hospital health director of all Italian National Health System hospitals treating acute patients and with more than 3500 admissions in 1999. An active programme was defined as a hospital infection control committee (HICC) meeting at least four times in 1999, the presence of a doctor with infection control responsibilities, a nurse employed in infection control and at least one surveillance activity and one infection control guideline issued or updated in the past two years. There was a response rate of 87.5% (463/529). Almost fifteen percent (69/463) of hospitals had an active programme for Infection Control and 76.2% (353/463) had a HICC. Seventy-one percent (330/463) of the hospitals had a hospital infection control physician and 53% (250/463) had infection control nurses. Fifty-two percent (242/463) reported at least one surveillance activity and 70.8% (328/463) had issued or updated at least one guidance document in the last two years. The presence of regional policies [odds ratio (OR) 8.7], operative groups (OR 4.2), at least one full-time nurse (OR 4.6) and a hospital annual plan which specified infection control (OR 2.1) were statistically associated with an active programme in the multivariate analysis.

Cross Infection↗
PubMed2001

Vaccination against hepatitis B in health care workers.

Hepatitis B is the most important infectious occupational disease for health care workers. The high risk of being infected is the consequence of the prevalence of virus carriers in the assisted population, the high frequency of exposure to blood and other body fluids and the high contagiousness of hepatitis B virus (HBV). Vaccination is able to prevent the most threatening consequences of the infection (acute disease and chronic carriage) in responders, even after loss of detectable antibodies. Non-responders to the primary series may benefit from administration of up to three more doses of vaccine (40-70% of initial non-responders show seroconversion to the new series). However, newly developed vaccines that seem more immunogenic are presently under evaluation and should further decrease the number of non-immune workers in the near future. In the mean time, coverage with standard vaccines should be improved also by supplying complete information on the risks of hepatitis B and on the safety and efficacy of active immunisation.

Adult↗
PubMed2001

Primary systemic anaplastic large-cell lymphoma (CD30+): advances in biology and current therapeutic approaches.

In 1985, Stein et al demonstrated the expression of the lymphoid activation antigen CD30/Ki by neoplastic cells. Fifteen years after the first description, anaplastic large-cell lymphomas (ALCL) are now thought to be a heterogeneous group in terms of their clinical, morphologic, phenotypic, cytogenetic, and molecular biology features. However, on the basis of a specific genetic anomaly and expression of a chimeric nucleophosmin anaplastic lymphoma kinase (NPM-ALK) protein and its variants, a distinct clinicopathologic entity defined as "ALK-positive lymphoma" or "ALKoma" can be recognized. Based on molecular and clinical criteria, 3 entities of primary ALCL can be identified: primary systemic ALK positive, primary systemic ALK negative, and primary cutaneous ALCL. This review focuses on advances in the knowledge of primary systemic ALCL biology and discusses therapeutic approaches based on ALK expression. The presence of this protein appears to be an important prognostic factor and, combined with an age-adjusted International Prognostic Index, could allow researchers to design more specific clinical trials aimed at finding new, more efficacious and less toxic treatments.

Age Factors↗
PubMed2000

Reversal of bone marrow hypoplasia in anorexia nervosa: case report.

BACKGROUND: Bone marrow hypoplasia seems to be uncommon in anorexia nervosa. This marrow abnormality is rapidly reversible with intensive nutritional rehabilitation. The patient described in this case report had anorexia nervosa. METHOD: She presented with complete serous atrophy of the bone marrow associated with pancytopenia. RESULTS: She was cured with recombinant human erythropoietin administered subcutaneously. After 25, days, the hematological situation was normalized. DISCUSSION: The possible advantage and practical implications of the administration of erythropoietin are discussed.

Adult↗
PubMed2000

Plasma lipoproteins in soy-treated postmenopausal women: a double-blind, placebo-controlled trial.

BACKGROUND AND AIM: Postmenopausal modification of the lipid profile plays a major role in the risk of ischemic heart disease. Lifestyle counseling and estrogen replacement therapy have all been proposed as first-line measures, but there is no agreement on the best way to treat climacteric dyslipidemia. Soybean-based diet seems particularly attractive in this context, given its cholesterol lowering potential, its hypothetical anticancerous effects and possible modification of climacteric symptoms. METHODS AND RESULTS: We evaluated the effect of 60 g isolated soy protein (ISP) daily on the lipid profile of 104 postmenopausal women (53.3 +/- 3.3 years) in a double-blind, parallel, placebo-controlled (caseinate) trial, as part of a broader assessment of the effect of ISP on climacteric symptomatology. Serum total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, apo A-I, apo B and lipoprotein (a) were determined before and after a 12-week diet modification. Seventy-seven women completed the trial. Both soy and placebo determined a significant reduction in total cholesterol (-0.42 +/- 0.79 and -0.40 +/- 0.57 mmol/L) and LDL-cholesterol (-0.35 +/- 0.72 and -0.31 +/- 0.54 mmol/L), but only soy had a significant lowering effect on apo B and the LDL-cholesterol/HDL-cholesterol ratio (-6% and -8% from baseline respectively); lipoprotein (a) plasma levels were not significantly changed by either treatment. Forty-four women were dyslipidemic at baseline; those with increased LDL concentrations showed a somewhat greater improvement in their lipoprotein profile (LDL-cholesterol and apo B reduction) with soy rather than placebo. No further information emerged when the subjects were divided into three apo E phenotypes. CONCLUSIONS: We conclude that diet supplementation with 60 g ISP is slightly better than caseinate in favorably modifying the lipoprotein metabolism of postmenopausal women; this effect is more evident in hypercholesterolemic subjects.

Caseins↗
PubMed1999

Dietary soy supplementation and phytoestrogen levels.

OBJECTIVE: To investigate the relationship between levels of phytoestrogens in blood and urine and symptom control in postmenopausal women whose diets were supplemented with soy containing high levels of phytoestrogen. METHODS: Phytoestrogen levels in blood and urine were correlated with the number of hot flushes and vaginal maturation indices in 104 postmenopausal women whose diets were supplemented with 60 g of soy powder daily for 3 months in a double-masked, parallel, placebo-controlled trial. The effect of soy supplementation on menopausal symptoms in this study population was reported previously. RESULTS: Serum levels of genistin, daidzin, and equol were significantly higher in women after soy diet supplementation (+756%, +593%, +1008%, and 57% respectively). The concentration of enterolactone in the soy group was increased by 57% compared with baseline, but the difference with placebo was not statistically significant. The increase in phytoestrogen levels in the soy group in blood or urine did not correlate with fewer hot flushes. Vaginal maturation indices did not change in the soy group. CONCLUSION: Phytoestrogen levels increased in women who consumed soy supplement, but that does not fully explain climacteric symptom reduction. It is possible that other types of yet unknown phytoestrogens or components in soy other than phytoestrogen influence hot flushes.

Climacteric↗
PubMed1998

The effect of dietary soy supplementation on hot flushes.

OBJECTIVE: To assess the effect of daily dietary supplementation of soy protein isolate powder on hot flushes in postmenopausal women. METHODS: We carried out a double-blind, parallel, multicenter, randomized placebo-controlled trial of 104 postmenopausal women. Fifty-one patients (age range 48-61 years) took 60 g of products containing 40 g of isolated soy protein [corrected] daily and 53 patients (age range 45-62 years) took 60 g of placebo (casein) daily. The study lasted 12 weeks. Using analysis of covariance, we analyzed changes from baseline in mean number of moderate to severe hot flushes (including night sweats) during treatment. RESULTS: Soy was significantly superior to placebo (P < .01 in reducing the mean number of hot flushes per 24 hours after 4, 8, and 12 weeks of treatment. In particular, women taking soy had a 26% reduction in the mean number of hot flushes by week 3 and a 33% reduction by week 4 (P < .001 by the Wilcoxon exact test). By the end of the 12th week, patients taking soy had a 45% reduction in their daily hot flushes versus a 30% reduction obtained with the placebo (P < .01). The overall rates of adverse effects were similar for soy and casein-placebo. Twenty-five patients dropped out of the study: 11 in the soy group and 14 in the placebo group. Gastrointestinal side effects were the most common cause of premature withdrawal from the study (seven patients in each group). CONCLUSION: Soy protein isolate added daily to the diet substantially reduced the frequency of hot flushes in climacteric women.

Cohort Studies↗
PubMed1996

Sequential addition of low dose of medrogestone or medroxyprogesterone acetate to transdermal estradiol: a pilot study on their influence on the endometrium.

We evaluated bleeding pattern and endometrium following the administration of two of the most common types of progestogens used in hormone replacement therapy, medroxyprogesterone acetate (MPA) and medrogestone acetate. Twenty eight patients in spontaneous menopause were randomly allocated to two groups. Group 1 (n = 14) received 5 mg/day of of MPA and group 2 (n = 14) received 5 mg/day of medrogestone: both the progestogens were sequentially added for the last 12 days of a 21-day period of transdermal estradiol administration (50 micrograms per day). A 7-day treatment-free period completed the cycle. The study treatments were administered for 6 cycles. The endomtria were checked for their thickness by transvaginal ultrasound before starting treatment and at 6th treatment cycle (days 6-10 of the estrogen-only phase and during the period between days 8 and 12 of the progestogen addition). Endometrial biopsies were performed before starting treatment only in the patients with a positive progesterone challenge test and in all the patients at the end of the study during the addition of the progestogen. The bleeding pattern was closely monitored. MPA is accompanied by a thick endometrium with full secretory transformation in all cases. On the contrary, the same dose of medrogestone induced a consistent decrease of estrogen primed endometrium with only 4 cases of full secretory transformation. Four medrogestone-treated patients dropped out due to unscheduled bleeding. A low dose of medrogestone added to transdermal estradiol induced incomplete transformation of endometrium and oligo-amenorrhea more frequently than MPA, but it increased the chances of irregular bleeding. MPA fully transformed the endometrium: periods were thus heavier but regular. None of the patients in either group had endometrial hyperplasia.

Administration, Cutaneous↗
PubMed1996

Hepatitis C virus infection in subsets of neoplastic lymphoproliferations not associated with cryoglobulinemia.

Hepatitis C virus (HCV) is both hepatotropic and lymphotropic and a clear-cut association has been proposed between HCV infection and mixed cryoglobulinemia (MC), a benign lymphoproliferative disorder, which sometimes evolves into a frank malignant B cell non-Hodgkin's lymphoma (B-NHL). Moreover, in the presence of antibodies to HCV, as well as of HCV-specific genomes has been reported in the sera of over 37% patients with B-NHL, not associated with MC. Thus, we decided to perform both a serologic and a molecular study to give insights into a possible relationship between HCV infection and neoplastic lymphoproliferations. We used ELISA and RIBA tests to show that anti-HCV antibodies were present in the serum of 29 out of 69 unselected B-NHL patients (42%), while seropositivity in a healthy population was about 1%. The prevalence of anti-HCV antibodies was low in definite subsets of B lymphoid disorders, including multiple myeloma, Waldenström's macroglobulinemia and monoclonal gammopathies of undetermined significance. Then, using reverse transcriptase polymerase chain reaction, we detected HCV sequences directly in the pathologic lymph node biopsies in 13 out of 34 B-NHL cases, and in particular in six out of eight low-grade lymphomas of MALT type and in five out of eight centroblastic-centrocytic follicular lymphomas. In contrast, the peripheral blood samples from 10 B cell chronic lymphocytic leukemia patients resulted negative for the presence of HCV genomes. Similarly, viral sequences were absent in 10 T cell NHL, while only one out of the 14 Hodgkin's disease cases tested resulted positive. Finally, we used a PCR-based assay to characterize the genotypes (I-IV) present in the positive lymphomatous tissues. The presence of both serologic and molecular markers of HCV infection in a high percentage of certain types of B-NHL, not associated with cryoglobulinemia, and its absence from other lymphoproliferative diseases extends the spectrum of HCV-associated lymphoproliferations arguing in favor of some role of this viral infection in the pathogenesis of the malignant proliferation of definite B lymphoid populations.

Cryoglobulinemia↗
PubMed1995

Trazodone: a non-hormonal alternative for neurovegetative climacteric symptoms.

Hormone replacement therapy (HRT) is the treatment of choice for neurovegetative climacteric symptoms. In some women, however, HRT may either be contraindicated, or the patients themselves may prefer a non-hormonal form of treatment. Trazodone is a drug that acts a weak, but specific, inhibitor of the uptake of 3H-serotonin and is generally used for its antidepressant effects. In this study we have observed the efficacy of oral Trazodone (75 mg/day) in the treatment of the climacteric symptoms in 25 menopausal patients recruited at the Menopause Clinic of Ferrara University Hospital. The symptoms were scored from 0 to 3 according to presence and intensity. The patients were all complaining of climacteric neurovegetative symptoms (average symptom score 2.43). Symptoms scores were recorded before starting treatment and then again after 3 months. The appeared to be particularly effective on the intensity of anxiety (OR: 0.08, CI: 0-0.080), insomnia (OR: 0.15, CI: 0.02-0.71), and irritability (OR: 0.29, CI: 0.04-1.48). The intensity of hot flushes appeared reduced but was not statistically significant (OR: 0.52, CI: 0.08-1.87). However, the average total score of symptoms appearing in the Kupperman scale was reduced (-14%) after treatment. Trazodone should be kept in mind as a possible alternative to HRT. This drug can be particularly useful for those patients whose climacteric symptoms have a marked connotation of anxiety rather than for hot flushes or when HRT are contraindicated.

Anti-Anxiety Agents↗
PubMed1994

The menopausal transition: a dynamic approach to the pathogenesis of neurovegetative complaints.

In our cross-sectional study we investigated the separate influence of three main factors, namely menopausal and estrogen status, and chronological age, on ten neurovegetative climacteric complaints reported in the scale of Kupperman et al. A multivariate statistical analysis was performed by a multivariate statistical approach on 1161 untreated women seen at the Menopause Center of the Ferrara University Hospital. Ninety women (age range, 41-54 years) were premenopausal; 492 women (age range, 38-55 years) were perimenopausal with irregular periods or amenorrhea for less than 12 months; 468 women (age range, 41-69 years) had a spontaneous menopause (age range, 37-66 years); 111 had had hysterectomy with bilateral ovariectomy while still regularly menstruating. Serum estrone was used as the indicator of the patients' estrogen status. A clear positive trend was demonstrated between menopausal status and the prevalence of depression, hot flushes, insomnia and joint pain. However, only the prevalence of hot flushes amongst these four symptoms was significantly related with the climacteric estrogen decline (beta = -0.006, P = 0.001). Moreover, menopausal status appeared to influence the intensity of fatigue, hot flushes, insomnia and paresthesia. Age was found to significantly (P = 0.053) co-vary only with the intensity of the hot flushes, with a positive relation (beta = 0.092, r = 0.104, P = 0.003), whereas estrone values did not significantly co-vary with any symptom. Furthermore, while neurovegetative symptoms are largely present also in the absence of hot flushes, when these latter are present, they exacerbate both the intensity and the prevalence of all the other symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Haematocervix during hormonal replacement therapy.

A postmenopausal woman, receiving cyclic hormonal therapy, presented to our clinic with acute pelvic pain, absence of withdrawal bleeding and clinical signs of vagal stimulation (nausea and vomiting). Vaginal exploration and ultrasonographic imaging accounted for haematocervix, which was confirmed by surgical blood evacuation.

Estrogen Replacement Therapy↗
PubMed1993

Influence of spontaneous and surgical menopause on atherogenic metabolic risk.

We evaluated serum total-, LDL-, HDL-, cholesterol and triglycerides in 858 women. Sixty-seven were in premenopause, 307 in perimenopause, 326 in spontaneous menopause, and 158 women underwent hysterectomy. Of these, 101 had bilateral ovariectomy, 24 with unilateral ovariectomy and 33 with retention of both ovaries. After correcting for chronological age and body mass index by variance analysis, it was found that total-, LDL- and HDL-cholesterol significantly increased during menopause without changes in the total cholesterol/HDL-cholesterol, LDL-cholesterol/HDL-cholesterol and triglycerides/HDL-cholesterol ratio. The changes gradually occurred during the months preceding spontaneous cessation of menses. Atherogenic metabolic risk (as relative risk of high total and LDL-cholesterol, estimated by logistic regression analysis) significantly increased in all groups of women in reference to premenopause. The risk observed in surgical menopause with bilateral ovariectomy was higher than in spontaneous menopause, and conservation of ovaries in hysterectomized women seems to protect only partially against such an increase.

Adult↗
PubMed1992

Evaluation of bone metabolic markers as indicators of osteopenia in climacteric women.

Lumbar bone mass (LBM) determination by quantitative computerized tomography in pre-, peri- and postmenopausal women was utilized to identify subjects at risk to develop osteoporosis. The results were related to determinations of bone metabolic markers (serum osteocalcin and urinary calcium excretion). Osteocalcin was the only metabolic marker which underwent significative changes. However, we found very poor correlations between LBM and metabolic markers and it is concluded that bone mass determination remains the method of choice to select women for preventive therapy.

Adult↗
PubMed1991

[Normal ranges of bone mineral content of the distal radius determined with single photon absorptiometry. Study of 1521 cases].

The normal ranges and mathematical equations of bone mineral content (BMC), normalized to radial width (BMC/W) vs. age at the distal radius, were obtained by single photon absorptiometry (SPA), and compared in two different normal populations, one of postmenopausal females and the other of control males. The female population included 1359 postmenopausal women, aged 35 to 75 years; normal control males were 162, of the same age. The results obtained in the two groups of patients show a statistically significant (p less than 0.001) correlation between age and BMC/W, expressed in a polinomial third-degree regression. The slope of the regression curves is quite different between males and females: the mean decrement, evaluated from regression polinomial fits, results 0.5% per year for normal females, and 0.3% per year for normal males. The maximum decrement (1% per year) is observed at the mean age of 51 years, which is the average age of peri-menopausal women in our province (Ferrara). The authors believe SPA to be a simple and reliable technique in measuring peripheral bone loss rate. SPA may be useful in the diagnosis and treatment of postmenopausal women, but is not recommended in the short-term follow-up of osteoporosis.

Absorptiometry, Photon↗
PubMed1990

Influence of estrogens on serum free fatty acid levels in women.

A relationship between plasma levels of FFA and incidence of hormone-dependent breast cancer has been suggested. This observation has drawn our attention to possible complementary actions of ovarian steroids on circulating FFA levels. Measurements taken in normal women during the menstrual cycle and in ovariectomized women with and without estrogen replacement therapy demonstrate that 1) levels of FFA present in serum are lower during the luteal phase than during the follicular phase; 2) levels of FFA are significantly higher after ovariectomy; and 3) these are again reduced by substitutive estrogen therapy.

Estradiol↗
PubMed1990

Endometrial cancer: our experience.

The Authors have referred to their experience based on 293 endometrial cancer patients operated at the II University Gynecological Clinic in Catania, between 1975 and 1989. Many prognostic indicators such as stage, histologic grade, myometrial invasion depth, lymph-node metastasis, non-neoplastic endometrium histology, tumor size and histology were studied; the Authors affirm the validity of two risk factors such as tumor size and the histology of the non-neoplastic endometrium, readily observable by hysteroscopy during the preoperative assessment and which are well correlated with the depth of myometrial invasion and lymph node methastasis.

Endometrium↗