Biomedical subjects

G C Passali

Publications and source records attributed to G C Passali.

8 recordsLinked to original sources

PubMed2006

[Rhinosinusitis: etiopathogenesis and antimicrobial therapy, an update].

The aim of the current study is to underline once again the etiopathogenetic aspects of rhinosinusitis, by a revision of most significative and updated study in otorhinolaryngologic literature to guide the right management of this disease. The focal role of ostio-meatal complex is reported; epidemiological data on old and emergent pathogens are described together with their role on acute or chronic or recurrent rhinosinusitis pathogenesis. According to recent evidence based medicine documents, diagnostic criteria and methodologies are reported to control surgical and medical long-term results. On the bases of the current etiopathogenetic concepts, medical treatment is suggested. The central role of medical management is based on the choice of antimicrobial treatment. The fundamental concepts on pharmacocinetic and pharmacodinamic are reported, togther with updated data on antimicrobial resistance.

Administration, Oral↗

PubMed2003

Allergic rhinitis in Italy: epidemiology and definition of most commonly used diagnostic and therapeutic modalities.

Allergic rhinitis is classically defined as an IgE-mediated inflammation of nasal mucosa, characterised by nasal obstruction, rhinorrhea, sneezing and nasal itching. It is certainly a high-prevalence disease and an important social and medical problem in many industrialised Countries, affecting about 20% of the general population; moreover, it is diagnosed with increasing frequency, both in adults and children in many developing countries. In view of the high medical and social costs, a correct diagnostic approach to allergic rhinitis is a fundamental need for the otorhinolaryngologist, also considering the severe complications (asthma, rhinosinusitis, rhino-otitis, rhinosinusal polyposis) which could develop if this disease is not recognised and adequately treated in its early phases. In order to evaluate not only the present epidemiological characteristics of allergic rhinitis in Italy but also the most commonly used diagnostic and therapeutic approaches in the management of this disease, 145 Italian otorhinolaringologists were selected to take part in the investigation. Each was invited to complete a questionnaire, divided into 8 different sections, to be answered according to their daily clinical practice. The significance of the results has been compared with those of the international samples comprised in the ARIA Document and in the epidemiologic survey of the Standing Committee on Rhinology and Allergy of the International Federation of Otorhinolaryngological Societies. A critical analysis of these data leads to some interesting epidemiological and therapeutic considerations.

Adolescent↗

PubMed2002

A preventive measure for otitis media in children with upper respiratory tract infections.

Recurrent upper respiratory tract infections (URTI) are very common in patients of all ages. Rhinitis, bronchitis, chronic sinusitis and otitis appear to be the prevalent forms of recurrent respiratory infections in the paediatric population. The aim of treatment is so the solution of the respiratory pathology and the also the prevention of their complications. Antibacterial therapy is still the classical treatment approach in patients both with respiratory tract infections and with otitis media, despite the fact that antibacterials have several well known drawbacks, especially when used to treat recurrent infections. Eighty-four paediatric patients of both sexes (range: 4-14 years) with otitis were enrolled in the study. Patients were included if they had a >2 years' history of recurrent or chronic respiratory infections, and/or had experienced at least three episodes requiring medical consultations and/or treatment during the winter prior to the study. The young patients were randomised to receive Immucytal (group A) or placebo (group B) treatment according to the following protocol: (1) starting therapy (1 month): one tablet daily in the morning 4 days per week for 3 consecutive weeks; (2) maintenance period (5 months): one tablet daily in the morning 4 days per week for 1 week every month. Placebo and Immucytal tablets were identical in shape and size, in order to maintain double-blind conditions. Patients of group A with recurrent URTI had a significantly decreased incidence of ENT infections, fever and shorter duration of illness, decreased requirement for ancillary medications and fewer work-days lost. The reduction in the incidence of infectious episodes became significant vs. placebo. A significantly improved outcome vs. placebo was also observed on the incidence of fever, frequency and duration of infectious episodes, ancillary therapies. Immucytal treatment was associated with significant changes in both immunological and auditory function parameters. Serum concentrations of immunoglobulins were significantly increased in Immucytal. For both evaluations, a significant difference between treatment groups was found (P>0.001). Preventive strategies, such as ribosomal immunotherapy, may represent a valid alternative approach.

Administration, Oral↗

PubMed2002

[Computerized modification of Fukuda test].

OBJECTIVES: To study a new method to apply to Fukuda test in order to overcome the interpretational difficulty associated with a subjective evaluation of the exam. MATERIALS AND METHODS: During the exam, the patient wears a specially-designed headpiece, with a band at the back fitted with a sensor accommodating both a gyroscope and a bi-axial accelerometer. When asked to step in place, he does so in the Romberg position, eyes closed, successively rotating his head to the right and to the left. RESULTS: On analyzing the data obtained through the laterality variable (right/left oscillation) and time variable, it resulted that the difference between the averages referring to the laterality variable of right-handed and left-handed subjects was statistically significant (P = 0.001), while the difference between the averages of the time variable was not. CONCLUSIONS: To be able to propose an evaluation of the clinical validity of the test, further research must be carried out on pathological subjects, thus verifying the applicability of the method to the full.

Adolescent↗

PubMed2000

[Acoustic rhinometry: proposal for the standardization of the examination method].

Acoustic Rhinometry is a rhinological test essential to evaluate nasal fossae geometry. The test requires that the patient be positioned so that a 120 degrees angle is formed between the nasal adapter and the floor of the nasal fossa. The use of a craniostat ensures that the patient is actually in this condition and that the position remains unvaried throughout subsequent tests. The purpose of the present study has been to evaluate the reproducibility and reliability of craniostat-aided acoustic rhinometry in routine clinical practice. A total of 33 patients with hypertrophy of the lower turbinates were enrolled in the study. Rhinometry was performed in the basal conditions and after decongestion with a vasoconstrictor spray. Statistical analysis was performed on the sampling and showed that acoustic rhinometry performed with the craniostat was more reproducible and more reliable than those readings taken without the aid of the craniostat.

Acoustics↗

PubMedDate not supplied

Do tryptase, ECP and specific IgE measurement by nasal incubation increase the specific nasal provocation test sensitivity?

The specific Nasal Provocation Test (sNPT) is a third level diagnostic tool. Fitted to reproduce natural exposure condition to pick the responsible allergen for nasal symptoms out, it is applied when prick test and RAST responses are doubtful. SNPT results have been evaluated measuring nasal resistance (anterior rhinomanometry) and nasal symptoms (clinical score), reaching 50% of sensitivity. This study focused on the determination of allergic response markers, triggered by nasal challenge: tryptase levels in the nose, specific IgE and ECP (Eosinophil Cationic Protein). The aim was to increase sNPT sensitivity. Twenty patients suffering from allergic rhinitis and 16 age-matched-nonallergic subjects were enrolled in the study. Tryptase, specific IgE and ECP were determined in nasal mucosa applying a new method, based on in situ incubation, before and after sNPT. The latter was performed following a standardized method. Tryptase levels increased in 13 patients (65%), were unchanged in four patients (20%), and slightly decreased in three patients (15%). The increase recorded was significant in mite allergic patients (p=0.005), but not significant (p> 0.05) in pollen allergic patients. ECP values increased in 13 patients (65%), were unchanged in two patients (10%), and highly decreased in five patients (25%). ECP increase was not significant (p> 0.05). Specific IgE levels increased in seven patients (35%), were unchanged in 11 patients (55%) and decreased in two patients (10%). The IgE increase was significant in pollen-allergic patients (p<0.05), while it was not significant in mite-allergic patients (p>0.05). Tryptase, ECP, and specific IgE were not detected in the control group. The data obtained showed a positive sNPT response in 12 patients (60%). Comparing our results with those derived from classical-parameter employment, we gathered an improvement of 10%. On the basis of the usual parameters, in fact, we recorded 50% positivity, while the use of mediators provided an additional 10% improvement in sNPT sensitivity: taking together the usual parameters and nasal allergic mediators values, we reached an sNPT over-all sensitivity of 85%.

Adolescent↗

PubMedDate not supplied

[Use of PTFE membranes in the orbital floor fractures].

BACKGROUND: Because the orbital-malar complex has a peculiar anatomic constitution and position, it is at the third place for frequency of the fractures especially if we compare it with another skeleton's parts. Till now have been tested numerous materials with advantages but also some disadvantages used to rebuild the orbital floor. We thought it right to test a material with biocompatibility, easy handiness, chemical stability and elasticit, as PTFE membrane. METHODS: We studied 40 cases of both sexes (age between 19 and 70 years) of orbital-malar complex fractures: 14 with isolated fractures, 20 with complexes fractures and 6 politraumatized. They show various degree prolapse of the orbital contents in the maxillary sinus. We make clinic examination and orthoptic analysis by Hess's screen, test of forced traction, axial and coronal TC. In all patients, surgery approach and methodology of plate application were the same. RESULTS: All the floors had a optimal and immediate functional renewal; there wasn't any inflammatory reaction neither immediately nor after a two years follow-up. CONCLUSIONS: In conclusion, the results show a lot of clinical and practical advantages of the PTFE membrane: the extreme biocompatibility and the easy handiness, the ductility and the low cost.

Adult↗

PubMedDate not supplied

[Skin and respiratory allergic disease caused by polyfunctional aziridine].

BACKGROUND: Polyfunctional aziridine (PFA) hardener is increasingly used in water-based paints and inks as a replacement for organic solvents. Allergic contact dermatitis, contact urticaria, respiratory allergy in occupationally exposed patients with hypersensitivity to PFA are reported. OBJECTIVES: The aim was to study a population of adhesive tape printers for occupational respiratory and skin sensitisation to PFA hardener. Also 2 cases of occupational asthma in workers exposed to PFA in tanneries are reported. METHODS: A standard series prick and patch tests was carried out on 15 workers with skin symptoms out of 36 adhesive tape printers exposed to PFA. Prick tests with a 1% PFA water solution and patch tests with a dilution series (0.1-0.32-0.5-1%) of PFA in petrolatum were performed. Lung and nasal provocation tests with PFA hardener were also carried out on 4 subjects with skin and respiratory symptoms. RESULTS: Skin sensitivity to PFA prick tests was demonstrated in 8.3% of the exposed population; 22.2% of the exposed workers suffered from allergic contact dermatitis due to PFA with positive patch tests for this compound. One case of occupational rhinitis due to PFA was diagnosed. CONCLUSIONS: PFA is a strong sensitizer and the use of gloves and protective clothing appears to be insufficient to prevent occupational allergic diseases. Elimination of PFA from production processes is desirable.

Adult↗