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Biomedical subjects

G Marinelli

Publications and source records attributed to G Marinelli.

At least 19 recordsLinked to original sources

Amyloid deposition as a cause of atrial remodelling in persistent valvular atrial fibrillation.

AIM: The spectrum of histological alterations, namely atrial amyloidosis, in the right and left atria of patients with chronic persistent atrial fibrillation (AF) and rheumatic heart disease is not completely known. METHODS AND RESULTS: One hundred and twenty-eight atrial appendages (66 left and 62 right), obtained from 72 patients with rheumatic valve disease and chronic AF undergoing cardiac surgery for valve replacement or repair and AF treatment were histologically evaluated for the presence of amyloid deposits. One hundred and four specimens of left and right auricles from 52 patients in sinus rhythm with severe chronic heart failure undergoing heart transplant were also analyzed (controls). Amyloid was found in 33 (46%) valvular patients with chronic persistent AF and in 6 (12%) controls. Amyloid was related to the presence and duration of AF, was more frequently found in left atrial samples and was independent of age. On stepwise logistic regression analysis, AF duration and female gender were independently related to amyloid deposition. CONCLUSIONS: Patients with long-standing AF and rheumatic heart disease have a very high prevalence of atrial amyloidosis. Amyloid deposition is more frequent in left than in right atrial appendage and correlates with AF duration and female gender. Amyloid deposition could constitute an additional histological feature in the structural remodeling of atria during long-standing AF, at least in rheumatic valve disease. Persistence of AF might play a pivotal role in promoting amyloid deposition.

Aged↗

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↗

Dilated cardiomyopathy in dialysis patients--beneficial effects of carvedilol: a double-blind, placebo-controlled trial.

OBJECTIVES: The aim of this study was to investigate in dialysis patients with symptomatic heart failure New York Heart Association (NYHA) functional class II or III whether the addition of carvedilol to conventional therapy is associated with beneficial effects on cardiac architecture, function and clinical status. BACKGROUND: Congestive heart failure (CHF) in chronic hemodialyzed patients, particularly when associated with dilated cardiomyopathy, represents an ominous complication and is an independent risk factor for cardiac mortality. METHODS: We enrolled 114 dialysis patients with dilated cardiomyopathy. All patients were treated with carvedilol for 12 months in a double-blind, placebo-controlled, randomized trial. The patients underwent M-mode and two-dimensional echocardiography at baseline, 1, 6 and 12 months after the randomization. Each patient's clinical status was assessed using an NYHA functional classification that was determined after 6 and 12 months of treatment. RESULTS: Carvedilol treatment improved left ventricular (LV) function. In the active-treatment group, the increase in LV ejection fraction (from 26.3% to 34.8%, p < 0.05 vs. basal and placebo group) and the reduction of both LV end-diastolic volume (from 100 ml/m2 to 94 ml/m2, p < 0.05 vs. basal and placebo group) and end-systolic volume (from 74 ml/m2 to 62 ml/m2, p < 0.05 vs. basal and placebo group) reached statistical significance after six months of therapy, compared with baseline and corresponding placebo values, and they remained constant at one year of treatment (p < 0.05 vs. basal and placebo group). The clinical status of patients, assessed by NYHA functional classification, improved during the treatment period. Moreover, at the end of the trial, there were no patients in NYHA functional class IV in the carvedilol group, compared with 5.9% of the patients in the placebo arm. CONCLUSIONS: One year of therapy with carvedilol in dialysis patients with CHF and dilated cardiomyopathy reduces LV volumes and improves LV function and clinical status.

Adult↗

Extracorporeal right to left atrial bypass to treat right ventricular failure.

Graft right ventricular failure after heart transplantation, secondary to preoperative functional pulmonary hypertension, was successfully managed in a 49-year-old patient using an extracorporeal right to left atrial bypass. We comment on the case and discuss the type of mechanical assistance used.

Cardiomyopathy, Dilated↗

Activity-rest stimulation of latissimus dorsi for cardiomyoplasty: 1-year results in sheep.

BACKGROUND: In dynamic cardiomyoplasty electro-stimulation achieves full transformation of the latissimus dorsi (LD); therefore, its slowness limits the systolic support. Daily activity-rest could maintain partial transformation of the LD. METHODS: Sheep LD were burst-stimulated either 10 or 24 hours/day. Before and 2, 4, 6, and 12 months after stimulation, LD power output, fatigue resistance, and tetanic fusion frequency were assessed. Latissimus dorsi were biopsied at 6 months, and sheep sacrificed at 12 months. RESULTS: After 1 year of 10 hours/day stimulation LD was substantially conserved and contained large amounts of fast type myosin. From 2 months to 1 year of stimulation the power per muscle of the daily rested LD was greater than that of the left ventricle, being three to four times higher than in the 24-hour/day stimulation. CONCLUSIONS: If extended to humans, these results could be the rationale for the need of a cardiomyostimulator, whose discontinuous activity could offer to patients the long-standing advantage of a faster and powerful muscle contraction.

Animals↗

[A sampling epidemiological study of infant health in relation to the type of feeding].

An epidemiological study has been carried out an the scholastic population of L'Aquila (Abruzzo). This study had the aim of verifying possible correlations between feeding procedures and the outbreak of illnesses whose causes are unknown. The information was registered with the collaboration of the Medical Scholastic Service, in the period of May-June in 1988-1989, interviewing four hundred and seventy-seven mothers of students, the information regards the temporary period of 1973-1985. The results of their elaboration are as follows: 75.9% of babies took breast milk at birth and in following months breast feeding was the most frequent (34.8%). The procedure breast feeding-bottle feeding was carried out in 30.4% of cases and exclusively bottle feeding in 22.4%. The study has permitted to discover thirteen cases of illnesses whose cause are unknown among which a case of SIDS (sudden infant death syndrome) in a newborn baby fed till eighteen weeks with breast milk and through twenty days before dying with undiluted cows milk. These illnesses happened in 13.4% of babies fed by bottle milk and diluted with running water; in 7.7% by cow's milk diluted with running water and in 4.3% by undiluted cow milk. Some Authors have suspected a relationship between bacterial endotoxin introduced by diet and baby illnesses whose causes are unknown. For this a quantitative determination of such substances is necessary in baby diets.

Bottle Feeding↗

PCB and other organochlorine compounds in blood of women with or without miscarriage: a hypothesis of correlation.

Polychlorobiphenyls (PCBs) have been shown to affect reproduction in experimental animals and in human beings following intoxication. The concentrations of PCBs and other organochlorine compounds were determined in blood samples from 120 women hospitalized for miscarriages and 120 full-term pregnancy controls. The average PCB hematic level (reported as Fenclor 54) was higher in women with miscarriages than in control women. No differences were detected as far as the hematic concentrations of hexachlorobenzene and DDT compounds were concerned. The reproductive history of each woman was assessed together with confounding variables on the phenomenon of miscarriage and the factors regarding environmental exposure and food intake. Food consumption did not indicate diet as the main source of PCB intake.

Abortion, Spontaneous↗

Effectiveness of steroid therapy in different stages of membranous nephropathy.

The published studies on histological staging and response to steroid therapy of membranous glomerulonephritis are not consistent. We analysed data from 25 adult patients with stage I (group 1, n = 7) and stage II (group 2, n = 18) disease. The interval between clinical onset and admission was similar in the two groups. At admission all patients had normal creatinine clearance; proteinuria averaged 5.4 +/- 4.0 in group 1 and 9.0 +/- 4.0 in group 2 (g/day per 100 ml GFR). All patients received 6 months steroid therapy (months 1-2, 1 mg/kg b.w. per day; month 3-5: 0.65 mg/kg b.w. e.o.d.; month 6, tapering). After this cycle of steroid therapy, proteinuria declined by 84% in group 1 (five patients being in partial remission, i.e. 0.4-2 g/day, and two patients in complete remission, i.e. less than or equal to 0.3 g/day) and by 47% in group 2 (two patients being in complete remission and six in partial remission). Only 1 patient in group 1 relapsed with nephrotic proteinuria after 36 months, and renal function was still normal in all patients at the most recent follow-up (59 +/- 32 months). In contrast, 14 patients in group 2 had nephrotic syndrome and seven renal insufficiency at the most recent follow-up. We conclude that short-term steroid therapy is effective only in patients with early membranous changes.

Adolescent↗

Spontaneous abortion in relation to the presence of hexachlorobenzene in the Italian environment.

This study determined hexachlorobenzene (HCB) levels in the blood of women who had suffered spontaneous abortions (120 cases) and women with healthy reproductive functions (120 controls). Samples were collected in 1984 during an epidemiological investigation into the relation between polychlorobiphenyl levels in the blood and spontaneous abortion in the women. Evaluation of the HCB data showed no significant differences between the groups, the blood of the group with spontaneous abortion containing 1.6 +/- 1.6 ppb HCB compared with 1.5 +/- 1.1 ppb for the control group.

Abortion, Spontaneous↗

Application of a simplified method for recovery of Yersinia enterocolitica from surface waters.

Yersinia enterocolitica was recovered from surface water by a simplified method: samples were taken by means of the Moore tampon and, after a short, warm preincubation in peptone-sorbitol-bile salts broth, were quickly passed to an alkali solution. Immediately after this, samples were directly plated on MacConkey agar. Y. enterocolitica was isolated from 60% of the water samples, and the identification confirmation of the strains chosen was 100%.

Bacteriological Techniques↗

[Skeletal changes in non-Hodgkin lymphoma].

140 patients affected by non-Hodgkin lymphoma (NHL) are performed by the A. Skeletal involvement of metastatic nature is observed in 14 of these (10%). Only the aggressive lymphomas have radiographic bone disseminations. At beginning of disease no patient has interested by bone changes. The most frequent roentgenographic finding observed by the A. include high incidence of osteolityc lesions: in particularly, pattern so called "permeative" is present in 35.6% of cases. Osteosclerotic and mixed manifestations were much less commonly observed (7,2% respectively). Periosteal reactions is not observed in any cases. The value of roentgen skeletal investigation in diagnosis, staging and therapy of NHL is discussed by the A.

Adult↗