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Biomedical subjects

G Maina

Publications and source records attributed to G Maina.

At least 37 records · Page 2Linked to original sources

Exposure to cobalt and nickel in the hard-metal production industry.

OBJECTIVE: The shortage of cobalt (Co) on the metal market forced the industry to add nickel (Ni) to Co as a binding agent for the sintering of hard metal. This change enabled us to study (1) the exposure to Ni powder and (2) the effect of Ni on Co uptake (and vice versa). METHODS: Equal amounts of Co and Ni were used in the mixture in a plant employing 50 workers. Both personal ambient-air samples and single-void urine samples were taken twice in the same week, i.e., on Monday and Thursday. Atomic absorption spectroscopy (AAS) was used for analyses. RESULTS: The airborne availability of Ni (mean value 41.65 +/- 6.29 micrograms/m3) was 2-fold that of Co (mean value 21.85 +/- 24.25 micrograms/m3), although the two series of data (n = 20) were significantly correlated. Even if the Co and Ni urinary concentration values (n = 45) recorded on Monday morning and Thursday evening were significantly correlated, at the end of the week there was a 3-fold increase, specifically, from 7.3 to 22.28 micrograms/l, in Co elimination (a significant difference) and a 30% increase in Ni elimination from 11.98 to 15.83 micrograms/l. Moreover, on Monday morning, 90% of Ni urinary concentration values were higher than those of Co as opposed to only 33% on Thursday evening. In the six cases in which both airborne and urine determinations were performed on the 2 days, no significant relationship was found between external exposure and biological monitoring data. CONCLUSIONS: Although Ni uptake was variable, it was generally low, whereas Co uptake was substantial, as had previously been observed in the same plant when Co was the only binder under use. It was therefore possible to rule out any influence of Ni exposure on Co uptake and to suggest the contrary, as has been demonstrated in bacterial species and in rats using everted intestinal sacs.

Adult↗

Episodic and chronic obsessive-compulsive disorder.

Several lines of evidence support the concept of obsessive-compulsive disorder (OCD) as a heterogeneous illness. Using a range of factors such as demographic, psychosocial, and clinical variables, we compared OCD patients with chronic (n = 55) versus episodic (n = 46) courses of illness. Patients were evaluated monthly for 1 year while receiving no treatment. Significant differences in sex ratio, age at onset of the disorder, illness duration, type of symptoms, and familial history were found between the two groups. These findings are consistent with the concept of OCD as a heterogeneous disorder. Patients with an episodic course of the disorder may be a distinct subgroup within the whole group of obsessive-compulsive patients.

Acute Disease↗

Drug treatment of obsessive-compulsive disorder (OCD): long-term trial with clomipramine and selective serotonin reuptake inhibitors (SSRIs).

A 2-year, open-label followup was performed on 130 obsessive-compulsive patients who were responders to a previous 6-month treatment with clomipramine (150 mg/day), fluoxetine (40 mg/day), or fluvoxamine (300 mg/day). Continuation treatment with the same daily dose was compared to continuation with half doses or to discontinuation of pharmacotherapy. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the Clinical Global Impressions (CGI) scale were used every 3 months, or whenever a worsening of symptoms was experienced. Maintenance treatments were found significantly superior to discontinuation in preventing relapses, and no differences in efficacy were found between full and half doses. A comparison of the three subgroups of patients who were withdrawn from drug therapy failed to demonstrate any statistical difference.

Adult↗

Therapeutic effect and safety of adjunctive risperidone in refractory obsessive-compulsive disorder (OCD).

It has been well established that more than 40 percent of patients with obsessive-compulsive disorder (OCD) do not improve after an adequate trial with serotonin uptake inhibitors (SUIs). The first purpose of this trial was to compare the short-term efficacy and safety of two different strategies in a sample of treatment-refractory OCD patients: dose increase of the ongoing treatment versus the addition of another SUI. The second purpose was to investigate the short-term efficacy and safety of adjunctive risperidone in SUI-refractory OCD patients. Thirty-three OCD patients who were unimproved after a short-term treatment with clomipramine (150 mg/day) were admitted to the study. In the first part of the study, the dose increase of clomipramine was compared with sertraline addition, in an open-label manner. The addition of sertraline to the ongoing treatment appeared to be more effective and tolerable than the clomipramine dose increase. Seven (50%) of the 14 patients who were considered nonresponders after the first part of the study, showed good clinical improvement and good tolerability after risperidone augmentation. These results suggest that risperidone addition to ongoing SUIs may be useful in augmenting pharmacologic response in OCD.

Adult↗

Type I and type II schizophrenia: relations between tonic electrodermal activity and clinical ratings before and after haloperidol treatment.

To test the hypothesis that schizophrenic patients with positive vs. negative symptoms show different tonic electrodermal patterns, 26 patients with Type I schizophrenia and 19 patients with Type II schizophrenia were evaluated before and after 2 weeks of haloperidol treatment (standard daily dose = 4.5 mg). Clinical assessments were made with the Brief Psychiatric Rating Scale, the Scale for the Assessment of Positive Symptoms, and the Scale for the Assessment of Negative Symptoms. Skin conductance level (SCL) and spontaneous fluctuations (SF) frequency were recorded for each patient. Before treatment, Type I patients showed higher SCL and SF compared with Type II patients; after treatment, a significative decrease of clinical and psychophysiological variables was found only in Type I patients.

Adolescent↗

Predictors of drug treatment response in obsessive-compulsive disorder.

BACKGROUND: Although a large body of evidence indicates the efficacy of pharmacotherapy in the treatment of obsessive-compulsive disorder (OCD), a considerable percentage of these patients do not respond. Very few studies focus on factors related to treatment response of OCD. The purpose of this study was to investigate which clinical factors are related to drug treatment response in OCD. METHOD: We examined 53 OCD patients treated with either clomipramine or fluoxetine for a period of 6 months, dividing the sample into "responders" and "nonresponders" to treatment. At admission, patients were evaluated using a semistructured clinical interview, the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), the Hamilton Rating Scale for Depression, and the Hamilton Rating Scale for Anxiety. We then compared acute-phase patient characteristics and response to drug treatment. Response was defined as a decrease of at least 40% in the Y-BOCS total score and a rating of "improved" or "very improved" on the Clinical Global Impressions scale within 16 weeks of treatment and maintained over three consecutive evaluations. RESULTS: By the sixth month of treatment, 31 patients (58.5%) responded to either clomipramine or fluoxetine. Nonresponders had lower age at onset and longer duration of the disorder; in addition, they showed higher frequency of compulsions, washing rituals, chronic course, concomitant schizotypal personality disorder, and previous hospitalizations. A worse response to drug treatment was predicted in a stepwise multiple regression by (1) concomitant schizotypal personality disorder, (2) presence of compulsions, and (3) longer illness length. CONCLUSION: Our findings suggest that there are distinct types of OCD with respect to drug treatment response. They provide indirect evidence of treatment specificity by identifying characteristics responsive to different modalities, which may be of value in the selection of patients for alternative treatments.

Adolescent↗

[The general practitioner and psychiatric assistance. A study carried out in the Piedmont region].

The study examines the relation between the general practitioner, in the Piedmont Region, and the possibility of providing psychiatric assistance (direct prescription of psychopharmacological treatment, psychological interview for generally psychotherapeutic purposes, referral of patient to psychiatric specialist) within the context of out-patient activities. For this purpose a 24-question questionnaire was drawn up and sent to 303 G.P.'s Piedmont whose names were supplied by the Italian Society of General Medicine. One hundred and forty-four GPs returned the answered questionnaire; from an analysis of the replies it emerged that the problems (GP's personal anxiety, lack of specific training, problems of time, payment and diagnosis of psychiatric disorders) concerning the relation between the said GPs and the aforesaid psychiatric assistance have not changed over the past 15 years even in view of the high attendance rate of patients with psychic pathologies and a widespread readiness of the GPs to take personal responsibility for these patients.

Drug Prescriptions↗

[Generalized anxiety disorder. Clinical and nosological remarks].

The authors review current understanding of generalized anxiety disorder, with particular regard to the clinical description made by the DSM-III-R. Discussion is focused on the validity of the diagnostic criteria of the disorder and on the debate on the nosological position of the illness. The review cites evidence regarding prevalence of the disorder and data on its comorbidity with the other anxiety disorders and with mood disorders. Evidence on intra-episodic, longitudinal and familial co-morbidities are assessed. Aspects of psychopathology of generalized anxiety disorders are also discussed.

Anxiety Disorders↗

Peripheral-type benzodiazepine receptors in anxiety disorders.

Peripheral benzodiazepine receptors (pBDZr) were analyzed in lymphocyte membranes from patients with anxiety disorders (generalized anxiety disorder (GAD), n = 15; panic disorder (PD), n = 10; obsessive-compulsive disorder (OCD), n = 18), other mental disorders (n = 40) and 50 healthy controls, by the specific binding of 3H-PK11195. The number of binding sites (Bmax) was significantly decreased in groups with both GAD and OCD as compared with age-matched controls, by 45% and 25% respectively, whereas the binding affinity (Kd) was the same in all disorder and control groups. Conversely, no changes in binding capacity was observed in the other disorder groups and particularly in the one with PD. The abnormality in pBDZr observed in patients with GAD was restored to a normal value after long-term treatment with 2'-chloro-N-desmethyldiazepam, which also coincided with their recovery from anxiety. Our data suggest that the clinical heterogeneity in anxiety disorders might be related to different biological mechanisms and that lymphocyte pBDZr might be useful in demonstrating these differences.

Anti-Anxiety Agents↗

[Clinical aspects of pelvic histangiopathies. New therapeutic possibilities with danazol].

Menometrorrhagia and hypermenorrhoea are often present in patients who also suffer from a state of insufficiency of the utero-adnexal venous system interpretable as a clinical entity of system pathology and accompanied by pictures of acquired venous ectasis. The lack of any easy clinical characteristic objectivisation often prevents easy recognition and complex diagnostic investigation is therefore indispensable. Treatment is often destructive surgery following the failure of the various medical or conservative surgical therapies that are tried. Personal experience in cases in which the clinical picture (big uterus, menometrorrhagia, pelvic pain) presents a pathology of the venous vascular system, can report considerable benefit first and disappearance later of the symptomatology, with treatment using danazol at a dose of 200-300-400 mg/die. This makes demolition surgery, which is not often well accepted by the patient, inopportune.

Adnexa Uteri↗

[Intra-lesional beta-interferon in combination with systemic thymopentin. Evaluation of results in 35 cases of CIN III and 2 cases of VAIN associated with HPV].

We performed an open study on 37 patients (average age 35 years), with CIN III or VAIN III and Viral Cytopatic Effects (VCE), who underwent a new standardized bifasic therapy by means of intralesional beta-interferon, topic beta-interferon and subcutaneous timopentine injection. Each therapeutic and checking step was made by colposcopic and microcolpohysteroscopic inspection, which showed spreading necrotic zones in the dysplastic places and peripheral typical epithelium replacement. Microcolpohysteroscopy allowed us to obtain correct diagnosis of the lesion and its location, to discriminate each pathologic aspects (CIN, VAIN, VCE), to perform an adeguated biopsy and intralesional therapy and to follow-up lesion course without repeated biopsies. After two months of therapy as maximum safety limit, we performed conization (in CIN case) in order to confirm the effects of therapy by hystology and especially to evaluate the deep lesional border. The istologic examination underlined the previous microcolpohysteroscopic report of dysplastic regression until its disapperance, with lasting VCE in all the cases.

Adjuvants, Immunologic↗

Aetiology of diarrhoea in pre-term neonates at Kenyatta National Hospital nursery, Nairobi, Kenya.

The aetiology of two outbreaks of diarrhoea in pre-term neonates (March-August; September, 1987), at Kenyatta National Hospital was studied. The first outbreak involved 98 neonates and enteropathogenic E. coli of different serotypes were the most commonly isolated agents (54%), with serotype 086a:K61 dominating. These were followed by Salmonella (16%) also of different groups, and then rotavirus (6%). Two campylobacter and two Shigella were isolated from four individual neonates. Mixed infections were mainly those of Salmonella and E. coli (5 cases). E. coli serotype 086 was found to be in circulation throughout the study period (March-August, 1987), whilst 044:0125 and 0128 circulated for a limited period. Salmonella and some strains of E. coli caused persistent diarrhoea despite antibiotic therapy. Nosocomial infections were found to play a role in subsequent diarrhoeas. In the second diarrhoea outbreak, again enteropathogenic E. coli and Salmonella were the most frequently isolated. However, in this outbreak, there was no single E. coli serotype revealed that some possessed plasmids of 120-160 megadalton. However, a search for human immunodeficiency viral antibodies in 120 stools produced negative results.

Cross Infection↗

Oxiracetam in the treatment of primary degenerative and multi-infarct dementia: a double-blind, placebo-controlled study.

A multicentre, double-blind, between-patient study was carried out to evaluate the efficacy and tolerability of oxiracetam (800-mg tablets), in comparison with placebo, each given twice daily for 12 weeks to patients suffering from primary degenerative, multi-infarct or mixed forms of dementia. Efficacy was assessed by the Inventory of Psychic and Somatic Complaints in the Elderly (IPSC-E), administered at entry and after 4, 8 and 12 weeks of treatment, and by the Blessed Dementia Scale and the Newcastle Memory, Information and Concentration Scale (NMICS), administered at the beginning and at the end of the study. Three hundred and seven patients were enrolled, 18 of whom were excluded from the analysis because of violation of the protocol. Two hundred and eighty-nine patients were analyzed (145 m, 144 f, mean age 73 years) and 272 completed the study; 3 patients in each treatment group were withdrawn because of poor tolerability, 10 because of poor compliance and 1 patient because of the occurrence of a cerebral stroke. A significantly (p less than 0.01) different effect, in favor of oxiracetam, was observed in the three main efficacy criteria (i.e. IPSC-E, Blessed Dementia Scale and NMIC total scores), and confirmed by descriptive analyses carried out on some subitems of the scales used. Thirty-one patients on oxiracetam and 27 on placebo complained of a total of 35 and 32 minor unwanted effects, respectively. No clinically or statistically significant changes were observed on routine laboratory examinations.

Aged↗

[Uterine hypoplasia and infertility].

On the basis of reported data, uterine hypoplasia is analysed from the morphological as well as the functional viewpoint (myo-endometrial receptivity and reactivity and ovarian vascularisation) through the routine use of two new methods of diagnosis: laparoscopy and hysteroscopy. Following the study of the relations between uterine hypoplasia and infertility, it is concluded that a precise therapeutic protocol should be laid down after correct diagnostic procedure.

Female↗