PubMed Health⌕ Search

Biomedical subjects

L Donati

Publications and source records attributed to L Donati.

At least 19 recordsLinked to original sources
PubMed1995

Prenatal evaluation of congenital heart disease in high-risk pregnancies.

The authors report their experience of echocardiography performed on a group of 736 pregnancies with specific risk-factors for congenital heart disease (CHD). The aim of the study was to evaluate the influence of specific risk-factors (established through the genetic counselling) in detecting fetal cardiac anomalies and diagnostic accuracy of extended fetal echocardiographic examination in high-risk pregnancies. Twenty-seven heart defects were observed (3.6%), of these 24 were detected at ultrasound. Specificity and sensitivity were 99% and 90% respectively. These results suggest the importance of an early detection of pregnancies at increased risk for CHD and confirm the good diagnostic accuracy of a multiple cardiac examination.

Animals↗
PubMed1994

Protective effect of some exogenous glycolipids on human cultured keratinocytes against lipid peroxidation.

Cultured human keratinocytes were incubated in the presence of glycolipids (GM1, asialoGM1, glucosylceramide and galactosylceramide) added to the medium at a concentration of 10(-5) M. All of them became associated with the cells, but in different amounts depending on the type of glycolipid and on the time in culture. GM1- and asialoGM1-treated keratinocytes developed a resistance to peroxidative stress induced by FeSO4/H2O2 treatment. These results suggest that these exogenously added glycolipids could play a role as eutrophic, repairing and protective agents for the epidermis.

Cells, Cultured↗
PubMed1994

Antibiotic treatment of burned patients: an Italian multicentre study.

Antibiotic therapy in burn centres with highly specialized ICUs has reduced the mortality and morbidity in burn and trauma but, in spite of constantly improving supportive surgical and resuscitation methods, infection remains a major problem. Indeed, the clinical experience, as recorded in Europe and the USA, using different antimicrobial drugs and regimens, emphasizes a constantly evolving pattern of pathogenic microorganisms in the wound and in the rest of the patient's body, and their increasing chemoresistance. We report the preliminary results of 559 patients in a large controlled multicentre clinical study (mean age 41.4 +/- 17.8 years and burns covering a mean body surface area of 35.7%), with the collaboration of 13 of the 15 major Italian burn centres. The antibiotic treatment consisted of prophylactic administration of pefloxacin (800 mg i.v. OD for 4 days) for all patients as a first treatment while waiting for an antibiogram, and chemotherapy with teicoplanin (800 mg i.v. OD) together with netilmicin (300 mg i.m. OD) in one or more cycles. At random, half of the patients received thymostimulin (70 mg i.m. OD pro die for the first month and every other day thereafter until discharge from hospital). Of the bacterial pathogens involved in septic complications, 63.3% were Gram-positive (Staphylococcus spp. and Streptococcus spp.). The mortality rate was 15.5%. Pefloxacin chemoprophylaxis was successful in 19.4% of patients and cure or improvement was seen with combination chemotherapy in 66.7% of patients, mainly with only one treatment cycle. The incidence of mortality and sepsis was not significantly influenced by treatment with thymostimulin.

Adolescent↗
PubMed1994

The surgical anatomy of the subcutaneous fascial system of the scalp.

The surgical anatomy of the fascial layers and vascularization of the scalp was studied by means of 11 bilateral cadaver dissections. This article is organized as follows: first, a description of the layers and fasciae of the scalp and their relationships with the main vascular structures, and then a description of the histological structure of the subgaleal fascia (composed of multiple connective vascularized sheets that glide over one another) and of its blood supply. In our dissections, we found the constant topographic distribution of the major perforant vessels to the subgaleal tissues as follows: in the temporal region, perforant vessels from the superficial temporal artery near and 10 to 14 cm above the zygomatic arch, where the superficial temporal artery leaves the surface of the galea to enter the superficial subcutaneous tissue, and in the fronto-parieto-occipital region, many small perforant vessels evenly entering the subgaleal plane every 5 to 10 mm. These findings could lead to greater use of fascial or composite flaps from the scalp region.

Arteries↗
PubMed1993

[Burn patients in major emergencies. The preparation of air-drop kits for emergency surgical-resuscitation use].

The kit described is for air-dropping for immediate use in the surgical treatment and resuscitation of burn victims in major emergencies when there is no direct access to the disaster area by rescue teams or vehicles. The kit can also be used to make up for deficiencies in medicines or medical materials in remote hospitals that have admitted people with severe burns who are not immediately transferable to other hospitals.

Aviation↗
PubMed1993

Infection and antibiotic therapy in 4000 burned patients treated in Milan, Italy, between 1976 and 1988.

The pathogenic flora, isolated from burn wounds of patients admitted to a burn care unit during the years between 1976 and 1988 were typed and the in vitro susceptibility to antibacterial agents was recorded. Between 1976 and 1988 the general therapeutic approach was changed three times, in congruence with the prevalent nosocomial bacterial resistance. The most frequent isolates were: Pseud. aeruginosa, Staphylococcus aureus, Enterococcus spp., Proteus mirabilis, Escherichia coli, Enterobacter cloacae, Klebsiella spp. and other Enterobacteriaceae, such as Acinetobacter, Citrobacter. The most striking finding was the increase in antibiotic-resistant Enterococcus isolates. Staph. aureus, Klebsiella and E. cloacae showed susceptibility to cephalosporins, imipenem, pefloxacin, vancomycin; Enterococcus susceptibility to pefloxacin and vancomycin, and Pseud. aeruginosa sensitivity to piperacillin, amikacin, tobramycin was generally good. E. coli showed a satisfactory susceptibility on average, and P. mirabilis showed a good sensitivity to piperacillin, cephalosporins, amikacin, tobramycin, aztreonam and imipenem. Thus, the general bacterial flora and susceptibility have remained mostly unchanged over the years, with the conspicuous exception of Enterococcus spp. and E. cloacae, which demonstrated a marked increase in incidence, with a concomitant dramatic decrease in the sensitivity of Enterococcus spp. to antibiotics.

Bacteria↗
PubMed1993

[Surgical treatment of gynecomastia. Indications and methods].

In this paper the authors present their experience in the surgical treatment of gynecomastia; the different surgical techniques used (liposuction, adenomammectomy, liposuction associated with adenomammectomy) are compared bilaterally 42 patients (37 patients) were affected of bilateral gynecomastia, 5 patients monolateral only (age 18-38 years) were treated in the Department of Plastic and Reconstructive Surgery-Ca' Granda Hospital of Milan, from 1985 to 1991. 12 patients were treated by the adenomammectomy technique; plain liposuction alone was used in 4 patients only. The associated method (liposuction and adenomammectomy) was performed on 26 patients. The results obtained suggest that the associated method is usually the most effective, because esthetic results are excellent and post-operative complications are very low. In selected cases however the other techniques should be preferred, and the criteria of selection are discussed.

Adolescent↗
PubMed1993

Review of leaching characteristics of triazines and their degradation products.

Only few data have been published on the environmental impact of pesticide degradation products on soil and groundwater. It is known that some of the degradation products of triazines, particularly those formed from N-dealkylation reactions, can be phytotoxic and more mobile than their parent compounds. In some cases it has been shown that they are present at even higher concentrations than the latter. Yet, their impact on groundwater quality is unknown since information on both environmental levels and chemiodynamic parameters are generally lacking. The conclusions of this work are that many triazine degradation products may pose a significant hazard to the quality of groundwater and that there is a need to promote and extend the production of experimental data on this topic.

Biodegradation, Environmental↗
PubMed1992

Updated evaluation of the activity of antibiotics in a burn centre.

The results of microbiological tests performed in a burns unit between January 1989 and December 1990 have been analysed. Burn wound swabs and biopsies, blood cultures, central venous and urinary catheters, bronchial aspirates, pharyngeal swabs and faecal cultures for a total of 7950 examinations were considered. Staph. aureus was the most frequently isolated bacterium, followed by Staph. epidermidis, Pseud. aeruginosa and E. coli. The antibiograms have shown a low efficacy rate of cephalosporins, even of the latest generation, while with Gram-positive isolates the highest rates of activity were recorded by vancomycin and teicoplanin (100 per cent sensitivity). The situation seems better with Gram-negative organisms since they appear to be sensitive to a larger number of antimicrobial agents.

Adolescent↗
PubMed1992

Antihypertensive mechanism of amlodipine in essential hypertension: role of pressor reactivity to norepinephrine and angiotensin II.

Calcium entry blockade may affect the pressor reactivity to vasoconstrictors. The pressor response to norepinephrine and angiotensin II, as well as several other blood pressure modulating factors, were studied in normal subjects (n = 9) and patients with essential hypertension (n = 10) before and after 8 weeks of treatment with the long-acting dihydropyridine amlodipine. In control subjects, calcium entry blockade did not modify blood pressure, the pressor and aldosterone response to angiotensin II, the activity of the renin-angiotensin and sympathetic nervous systems, or urinary dinoprostone (prostaglandin E2) excretion; however, the pressor response to norepinephrine was significantly decreased (p less than 0.01). In patients with hypertension, amlodipine decreased blood pressure (p less than 0.01) and the pressor response to both norepinephrine and angiotensin II (p less than 0.01), without changes in body weight, plasma renin, angiotensin II and catecholamine levels, dinoprostone excretion, or aldosterone responsiveness to angiotensin II. These findings suggest that calcium entry blockade modifies sympathetic-dependent vasoconstriction in both normal subjects and in patients with hypertension. Angiotensin II pressor response may be selectively decreased in essential hypertension.

Adult↗
PubMed1992

Clinical picture of endemic cretinism in central Apennines (Montefeltro).

Endemic cretinism is still present in an endemic goiter area of the central Apennines (Montefeltro) (goiter prevalence 55%; mean urinary iodine level 39 micrograms/g creatinine). Clinical and biochemical features of patients with myxedematous, neurologic, and mixed cretinism were studied. Also, in this area, as in most other, neurologic cretinism is more prevalent than myxedematous and mixed forms. The hormonal profiles of the three types of cretinism were clearly different. Nevertheless, all myxedematous cretins had some neurologic disorders (hyperreflexia, increased muscle tone, disorder of gait, Babinski sign, hypoacusia) that were similar to those present in neurologic cretins. These findings suggest that neurologic damage is very similar in all forms of endemic cretinism, reflecting a diffuse insult to the developing fetal nervous system. Furthermore, these data support the hypothesis that the primary pathophysiologic event in the different types of endemic cretinism is represented by maternal and fetal hypothyroidism, while differences may be explained by the extent and duration of postnatal hypothyroidism. All the cretins were over 35 of age, suggesting a severe iodine deficiency in the past decades, and a progressive improvement of nutritional status resulted in "silent iodine prophylaxis." However, recent studies have revealed the persistence of a moderate iodine deficiency, a high prevalence of neurologic hypoacusia, and reduction of mental performance in normal schoolchildren of this area. These findings constitute strong evidence in favor of adequate iodine prophylaxis.

Adult↗
PubMed1992

Teicoplanin--its role as systemic therapy of burn infections and as prophylaxis for orthopaedic surgery. Italian Study Groups for Antimicrobial Prophylaxis in Orthopaedic Surgery and Burns.

Two randomized studies have been initiated to establish the role of teicoplanin as systemic therapy for infections in burns patients and as short-term prophylaxis for orthopaedic implant surgery. Opportunistic micro-organisms causing infections in burn patients are often acquired in hospital. These infections commonly involve Gram-positive organisms which may be resistant to several antibiotics. Teicoplanin, alone and in combination with additional antibacterial drugs, is effective in the treatment of Gram-positive infections of various types. In addition, teicoplanin has proved useful as prophylaxis against infection in orthopaedic surgery. Deep prosthetic infections are very difficult to cure without removing the infected device; the outcome can be devastating, such as total loss of joint function, amputation, and, occasionally, death. Preliminary results from the two studies are encouraging and show that teicoplanin has a role to play both in treatment of infection and as prophylaxis against hospital-acquired infection.

Adult↗
PubMed1991

Quality problems in waters used for drinking purposes in Italy.

With a grant from the Italian Ministry of the Environment, the National Institute of Health (Istituto Superiore di Sanità) promoted and coordinated some activities aimed at determining the extent and the intensity of contamination of waters used for human consumption by some chemical agents, and describing causes and modalities of contamination and human health implications. The chemical agents examined were herbicides, nitrates, trihalomethanes, asbestos, manganese and fluoride. In this paper a first nationwide picture of these problems is reported.

Asbestos↗