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Biomedical subjects

G Mazzarella

Publications and source records attributed to G Mazzarella.

At least 55 records · Page 3Linked to original sources
PubMed1991

Perinatal mortality in southern Italy.

Perinatal deaths occurring in the Campania region of southern Italy in 1982 were analysed. The perinatal mortality rate was 17.6 per thousand (stillbirth rate 8.3, early neonatal mortality rate 9.3). Compared with Swedish data, our deaths excess does not seem attributable to an unfavourable birthweight distribution, but to high birthweight mortality rates in every birthweight category and particularly in the normal birthweight group (greater than 2500 g). This group of newborns, representing about 94% of the births, contributes 45.4% of perinatal deaths; this situation is not common in developed countries, where the normal birthweight newborns form a much smaller proportion of perinatal deaths. The analysis of the causes of perinatal mortality, even though autopsies are rarely executed in Campania, shows a high prevalence of events which should be prevented by good antenatal and perinatal care.

Cause of Death↗
PubMed1991

Antenatal and perinatal care in southern Italy. I. The mothers' reports.

A population-based cross-sectional study of antenatal and perinatal care was performed in Campania, a region of southern Italy. One thousand three hundred women who had given birth in 1982 were interviewed. The number of antenatal visits was very low, less than 1% of the mothers having attended more than three times during pregnancy. The women at high obstetric risk did not attend more than those at low risk and certain aspects of their antenatal care were unsatisfactory. The place of birth was similar for high risk and low risk mothers, with 40% delivering in small private facilities (with few neonatal resuscitation facilities and often with inadequate infant transport services). The labour was induced or accelerated in 60% of the mothers. The organisation of perinatal care did not take into account many of the needs of the mothers such as presence of a relative at delivery, ambulation during labour, early relationship with the newborn, rooming-in, or encouragement to breastfeed.

Cross-Sectional Studies↗
PubMed1991

Antenatal and perinatal care in southern Italy. II. The clinicians' reactions.

One hundred obstetricians and 50 paediatricians engaged in public antenatal and perinatal care in southern Italy were interviewed about the provision of care in their facilities: 93% of the obstetricians judged the coverage of the target population to be insufficient and 53% of them considered the use of the risk approach to be unsatisfactory in public clinics. For example, no initiative was taken by 60% of public clinics when a woman at high risk failed to attend a booked antenatal visit. Bed rest during labour was prescribed by 72% of the obstetricians, a supporting relative was admitted to only 18% of the births and routine episiotomy was performed in 77% of primigravidae. Only 56% of the paediatricians interviewed allowed early contact between mother and baby. In public hospitals, 80% of paediatricians were present in the delivery room for the births. Screening for congenital hypothyroidism and phenylketonuria was executed in only 37% of the public hospitals. Newborn transport system adequate to national standards was available in only 33% of the hospitals. Antenatal and perinatal care need to be rapidly improved to meet population needs in southern Italy.

Attitude of Health Personnel↗
PubMedDate not supplied

Risk factors for tuberculosis infection and disease.

We conducted a prospective study among patients with newly diagnosed pulmonary tuberculosis and their close contacts to identify clinical and socio-economic risk factors for tuberculosis infection and disease. Ninety patients and 277 contacts were enrolled. The prevalence of infection was 45% [95% confidence interval (CI): 39-51%] among contacts. Factors like age, gender, race, delay of diagnosis and treatment, presence of cavitation in chest radiograph, cough, unwillingness to cover the mouth, volume of air shared by close contacts and patients were investigated. Inclusion of all these factors in a multivariate logistic regression model showed that only delay in diagnosis is significantly associated to the increase of prevalence (p < 0.0002), documenting that delay in diagnosis of the case is a crucial factor for tuberculosis infection and/or disease.

Adult↗
PubMedDate not supplied

Virus-induced asthma.

Clinical and experimental investigations indicate that respiratory viral infections are important triggers for asthma attacks. Viral upper respiratory infections have been associated with 80% of asthma exacerbations in children and 50% of all asthma episodes in adults. Human Rhinovirus (HRV) has been implicated as the most common virus associated with asthma episodes. The observation that the great majority of wheezing lower respiratory tract illnesses in early life are associated with acute viral infections suggests that viruses may also alter the development of the lungs or of the immune system, acting as co-factors for the inception of asthma. Whilst there is no doubt that viruses are important asthma exacerbation factors, the role of viral infections in the development of asthma still remains controversial.

Asthma↗
PubMedDate not supplied

Genetically modified animals as models of pulmonary disease.

Improvements in biological research and the development of new techniques for human health protection require animal experimentation of various species. In particular, animal models are always necessary to test new therapies for the treatment of various human diseases. The latest advances in molecular biology involving genetic modification are aimed at developing new animal models of human diseases that are not present in spontaneous murine broods or obtainable with other experimental manipulations. Transgenic techniques and, in particular, the possibility to directly modify specific genetic information in the experimental animal have led to the acquisition of important knowledge on the physiologic functions of many proteins and their function in the course of various diseases. The advent of new transgenic animals is opening up new and interesting frontiers, full of hope and opportunity, for the research into pulmonary diseases. New advances in cystic fibrosis, emphysema, and pulmonary fibrosis have been made through the study of a large number of proteins implicated in the complex of acute and chronic inflammatory processes of lung parenchyma, which are responsible for permanent changes in organ structure and function. Recent studies carried out on murine inbred strains have yielded significant new data on the multifactor origin of pulmonary disease, because of their correlation with the major histocompatibility complex (H2 in mice) or through the different genetic map of the strains. Today it is possible to outweigh or potentiate the function and expression of some genes, obtaining a deficit or abundance, respectively, of specific proteins. These techniques have permitted and will continue to permit the development of new models of human disease, leading to further therapeutic advances as a consequence.

Animals↗
PubMedDate not supplied

Detection and qualitative identification of mineral fibers and particles in alveolar macrophages of BAL fluid by SEM and EDXA.

Inorganic dust inhalation diseases represent one of the most important chapters in respiratory medicine because of their diagnostic, therapeutic, legal, ecological and social implications. While, in fact, toxic substances inhalation may be easily related to particular occupations, it is more difficult to recognize the potential damage represented by occasional and fortuitous exposition due to pollution of one's living environment. The aim of this study was to suggest a useful investigative method for detecting the presence of mineral substances (dusts and fibers) in the lung in pulmonary fibrosis of uncertain origin. We used scanning electron microscopy (SEM) and semi-quantitative energy-dispersive x-ray microanalysis (EDXA) on broncholaveolar lavage (BAL) and sputum samples of 10 patients, all males, aged 41-66 years, smokers, affected by interstitial lung disease. Two subjects had a negative professional anamnesis while the other 8 declared a potential exposition to inorganic toxic dusts: 2 subjects were involved in the production of asbestos-containing building materials, 2 were miners, 1 a ceramic worker, and 3 insulating materials handlers. Data are reported on the detection of asbestos bodies, vitreous fibers and silica content of alveolar macrophages in BAL fluid.

Adult↗
PubMedDate not supplied

Respiratory function and atmospheric pollution.

The effects of environmental pollutants on human health and, in particular, on the respiratory apparatus, can be studied fundamentally by means of epidemiological and controlled exposure studies. One epidemiological study has reported the results of research which compared pulmonary function in adults with the average annual concentration of major pollutants in 8 geographical areas of Switzerland; the results demonstrated a direct relationship between atmospheric pollution and a worsening of pulmonary function. Controlled exposure studies, on the other hand, document the effects of specific air pollutants. Ozone (O3) is a secondary pollutant produced in the atmosphere by photochemical reactions which exerts a potent antioxidant and peroxidant action on biomolecules, whether intra or extracellular, with the production of free radicals. Nitrogen dioxide (NO2) is found mainly indoors due to its being a product of combustion of kitchen gas--it possesses low reactivity and low solubility that allows its penetration to the periphery of the lungs; the harmful mechanisms induced by NO2 are not well understood and could differ from those of O3. Sulphur dioxide (SO2) is found above all outdoors and is documented to affect the respiratory function of asthmatic subjects at concentrations above 1 part per million (ppm) while it has a doubtful effect on healthy subjects. Suspended particulate matter (SPM) is one of the major pollutants present in the air that comes mainly from vehicle exhausts, especially diesel models. Although the epidemiological data indicates a close relationship with both cardiac and respiratory pathology, the biological mechanisms by which it exerts its toxicity are still not well established. The great variability in individual response to pollutants suggests the need for further sensitivity tests to be carried out: it is of importance to identify specific genes with a stabilising role in cellular protection against oxidative stress, that influence the production of chemical mediators of inflammation.

Air Pollutants↗
PubMedDate not supplied

Future treatment of chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Theoretically, an appropriate management of the disease should be aimed to prevent and reduce symptoms, to reduce the number and the severity of exacerbations, to improve exercise tolerance and lung function and to decrease the rate of mortality. However, the rapid progress in understanding the pathophysiologic aspects of COPD has been followed by very few advances in its management and currently there is no pharmacological treatment which is able to reduce the decline in lung function that occurs in these patients or to affect mortality. Effective symptomatic relief and improvement in exercise capacity can be obtained with inhaled bronchodilators and a new long-acting (> 24 h) inhaled anticholinergic, tiotropium bromide, is now available. New pharmacological approaches for COPD include the development of drugs which should be able to control the neutrophilic, steroid-insensitive inflammation, to reassess the protease/antiprotease balance and to reduce oxidative stress in the airways. While most of these drugs are still in preclinical evaluation, some recent phase II-III clinical trials have shown the beneficial effects of a new class of anti-inflammatory compounds, the phosphodiesterase-4 (PDE-4) inhibitors, in patients with COPD. Given the relevance of mucus hypersecretion in the pathophysiology of this disease, efforts have been made also to draw definitive conclusions on the effectiveness of the available mucoactive drugs and in the development of new mucoactive molecules. Further studies are required to understand the impact of each potential therapeutic strategy in the effective control of COPD.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMedDate not supplied

[Correlations between the prick test and aspecific bronchial reactivity in atopic patients].

Aspecific bronchial provocation test with Methacholine plays an outstanding role in the diagnostic routine of asthmatic disease, in order to accomplish a correct interpretation of the relation between A.B.I. and bronchial asthma. All researches give a special prominence to the bronchial reactivity distribution among the population, and point out that the distribution curve of response to aspecific challenge shows itself as an unimodal curve, since there is no clinic group (neither that one including subjects defined asthmatic from a clinic or anamnestic point of view) which clearly separates from the rest. A further important consideration indicates that a positive response to the test is not specific of bronchial asthmatic subjects, but it can also occur in patients affected with other pathologies such as chronic bronchitis, allergic rhinitis, and so on. Our study aimed, therefore, to evaluate the correlations occurring between skin sensitivity and aspecific bronchial reactivity in 5 groups of atopic patients (affected with: (1) asthma; (2) asthma + rhinitis; (3) asthma + rhinitis + conjunctivitis; (4) rhinitis + conjunctivitis; (5) rhinitis). In doing such correlations we also considered some other factors like sex, smoking habit, town or country provenance. Sensitiveness, specificity, and predicting value of Prick-test in comparison with Methacholine test have been analysed as well. The results so obtained show that no correlation occurs between Prick-test and Aspecific Bronchial Test in the groups of tested subjects. Test sensitiveness increases in the groups of patients affected with associated pathologies, and depends on factors like sex, smoking habit, town or country provenance.

Asthma↗