First cases of rubella infection during pregnancy detected by new reporting system in Italy.
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Adult↗
Biomedical subjects
L Masini
Publications and source records attributed to L Masini.
Occurrence and characterization of Aeromonas spp. in mussels from the Adriatic Sea.
Samples of mussels (Mytilus galloprovincialis) were collected from natural beds on the Adriatic Sea in front of Ancona Province (Marches, Central Italy) officially recognized for human consumption. The mussels were analyzed to evaluate the prevalence of Aeromonas spp. pathogenic strains. Out of 144 samples, 32 Aeromonas strains were isolated and 12 showed virulence and enterophatogenicity on mice. Isolates were also examined to check their sensitivity to different antimicrobial agents. All isolates were sensitive to imepenem, neomycin, ciprofloxacin, tetracycline, oxytetracycline, doxycicline, chloramphenicol, polymyxin B, and colistin sulfate, but resistant to penicillin, carbenicillin, cephalotin, sulfamethoxazole, lincomycin, novobiocin, and rifampicin. Multiple resistance to antimicrobial agents with different mechanism of action was observed. Owing to the high occurrence of pathogenic Aeromonas strains, the risk of developing human infections by eating raw or undercooked mussels is envisaged.
Aeromonas↗
A biochemical protocol for the isolation and identification of current species of Vibrio in seafood.
AIMS: We report a biochemical method for the isolation and identification of the current species of vibrios using just one operative protocol. METHODS AND RESULTS: The method involves an enrichment phase with incubation at 30 degrees C for 8-24 h in alkaline peptone water and an isolation phase on thiosulphate-citrate-salt sucrose agar plates incubating at 30 degrees C for 24 h. Four biochemical tests and Alsina's scheme were performed for genus and species identification, respectively. All biochemical tests were optimized as regards conditions of temperature, time of incubation and media composition. The whole standardized protocol was always able to give a correct identification when applied to 25 reference strains of Vibrio and 134 field isolates. CONCLUSIONS: The data demonstrated that the assay method allows an efficient recovery, isolation and identification of current species of Vibrio in seafood obtaining results within 2-7 days. SIGNIFICANCE AND IMPACT OF THE STUDY: This method based on biochemical tests could be applicable even in basic microbiology laboratories, and can be used simultaneously to isolate and discriminate all clinically relevant species of Vibrio.
Bacterial Typing Techniques↗
Antimicrobial susceptibility of potentially pathogenic halophilic vibrios isolated from seafood.
Susceptibility patterns to 27 antimicrobial agents and beta-lactamase production were investigated in potentially pathogenic halophilic vibrios from seafood. The effect of salinity on the response to the drugs in vitro was also studied. All isolates were uniformly sensitive to choramphenicol, imipenem, meropenem but resistant to lincomycin. All were highly sensitive to oxolinic acid, trimethoprim-sulphamethoxazole, doxycycline, flumequine, cefotaxime, nalidixic acid and ciprofloxacin. Some strains of V. harveyi, V. alginolyticus and V. parahaemolyticus apparently had mechanisms of resistance to several beta-lactam antibiotics other than by the production of beta-lactamases. Sixty-nine strains produced penicillinase but a low correlation between beta-lactamase activity and resistance to beta-lactam antibiotics was noted. The salt concentration affected the in vitro susceptibility of halophilic vibrios and the effect of salinity depended on both the individual strains and the antimicrobial tested.
Animals↗
Correlation between medium acidification and pathogenicity in environmental halophilic non-cholera vibrios.
AIMS: The metabolic characterization and pathogenicity of vibrios isolated from seafood were studied. METHODS AND RESULTS: Strains of halophilic vibrios, grown in the presence of 0.5% glucose, induced high medium acidification and were non-culturable after 24 h, while moderately acidifying strains were culturable, produced cytotoxins, and remained lethal when inoculated intraperitoneally in mice. Highly acidifying strains failed to elicit pathogenicity in vivo and in vitro. CONCLUSION: The high acidification of the medium and the self-killing activity of NCVs might be considered a significant phenotypic marker of virulence and/or cytotoxicity. SIGNIFICANCE AND IMPACT OF THE STUDY: We suggest the medium acidification test as possible screening method for pathogenic NCVs in food microbiology.
Animals↗
Acute recurrent polyhydramnios and amniotic prolactin.
A 25 year-old patient in her third pregnancy presented with acute polyhydramnios at 24 weeks' gestation, which was the same time as in the two previous pregnancies. In both she had preterm premature rupture of membranes, preterm delivery and neonatal deaths. In the third pregnancy, amnioreductions combined with medical treatment resulted in the birth by Caesarean section of a normally formed live male at 31 weeks of pregnancy. Acute recurrent polyhydramnios is an extremely rare condition of unknown aetiology. We hypothesized that amniotic prolactin plays a role in this pathology. It was measured serially in amniotic fluid and high levels were found.
Acute Disease↗
Acute leukemia following a previous malignancy: do acute lymphoid leukemia and acute myeloid leukemia have common risk factors?
INTRODUCTION: Within the framework of the GIMEMA Study Group, the characteristics of acute lymphoid leukemia and acute myeloid leukemia occurring in patients who have suffered a previous malignancy were studied. Assessment was also made of the clinical course, laboratory features and overall outcome of these conditions. MATERIALS AND METHODS: A four-year, multi-center retrospective study was conducted to evaluate the effect of treatment for previous hematological malignancy on the development of secondary leukemia. The study collected in the GIMEMA Archive of Adult Acute Leukemia 3934 new cases of acute leukemia (2964 AML, 901 ALL, 60 acute biphenotypic leukemia). Among these cases, data were evaluated from patients with a personal history of a previous malignancy, and included inquiring into demographic data, history of neoplastic diseases in the 1st degree relatives, type and treatment of the previous malignancy, latency until the development of a secondary acute leukemia diagnosis, laboratory features, treatment and outcome at the onset of secondary acute leukemia. RESULTS: Approximately 200 (5.1%) patients presented a previous malignancy. Twenty-one were affected by ALL and 179 by AML. The proportion of patients with secondary AML was higher than that of patients with secondary ALL (179/2964 vs 21/901, O.R. 2.69-95% C.I. 1.66-4.39, P<0.001). The median latency, from the onset of the previous malignancy to the development of secondary ALL was 27 months and to the development of secondary AML was 52 months (P<0.05). Furthermore, of patients who previously received chemotherapy more developed a second AML (66/127 sAML vs 5/21 sALL; O.R. 3.46-95% C.I. 1.10-11.56, P<0.01). CONCLUSION: In most cases, chemotherapy treatment for a previous malignancy can play a role in the development of secondary AML. In almost all cases of secondary ALL, the role of previous drugs does not appear to be relevant. On the basis of our analysis, performed systematically for the first time on a large adult series of acute leukemia, we conclude that in these patients a biological predisposition to cancer may be suspected.
Acute Disease↗
[Frequency of musculoskeletal symptoms in diagnostic medical sonographers. Results of a pilot survey].
INTRODUCTION: We report the results of a pilot survey in diagnostic medical sonographers. Aim of the study was to evaluate the frequency of musculoskeletal disorders in sonologists and the relationship of these symptoms to ergonomic factors. MATERIALS AND METHODS: 340 sonographers (258 male, 82 female doctors; mean age 41.5 +/- 7.2 years) were given a questionnaire to fill out. The questionnaire asked questions about the sonologist's age, gender, technique of ultrasound procedure, physical activity, and work-related musculoskeletal complaints. Two symptom lists regarded carpal tunnel syndrome (CTS) symptoms (8 items) and other work-related musculoskeletal symptoms (13 items). The categorized response variables "have now" or "in the past" were provided. The symptoms experienced were categorized into three levels as no symptoms, few symptoms (1-4 symptoms), and many symptoms (> 5 symptoms). RESULTS: One third of the respondents reported having at least one or more work-related symptoms in the upper extremities. The most frequent symptoms were tingling (17.6%), numbness or finger pain (13.5%). Carpal tunnel syndrome had been diagnosed in 5 cases (1.5%). More than 60% of all respondents have experienced one or more musculoskeletal symptoms in the cervical or lumbar spine. The commonest symptom was neck and low back pain (67%). The pain was generally intermittent and occurred at the end of the workday. Motion impairment in the neck and/or back was present in 23.5% of cases. Twenty-five percent of respondents had received treatments for their symptoms and 10% reported having stopped work because of their symptoms. Data analysis showed that muscular efforts such as gripping the transducer, applying sustained pressure, and scanning with a correlated flexed or hyperextended wrist were significantly correlated with increasing severity of symptoms in the hand, wrist, and forearm area. On the other hand, low back pain appeared to be negatively correlated with correct position of the body. CONCLUSIONS: Several physical risk factors (e.g., repetitive work and force exertion, twisting of the body and poorly-adjustable chairs) have been identified for work-related upper extremity and spine disorders. Ergonomic redesign of the workstation configuration as well as allowing sufficient recovery time to body and arm muscles appear to be the main goals to achieve prevention of musculoskeletal disorders in sonographers.
Adult↗
Lymphotropic herpes virus (EBV, HHV-6, HHV-8) DNA sequences in HIV negative Castleman's disease.
Aim-To evaluate the possible involvement of lymphotropic herpes viruses in Castleman's disease.Methods-Archival formalin fixed, paraffin wax embedded biopsy specimens from 16 HIV negative patients (11 with localised and five of multicentric disease) were studied. Epstein-Barr virus (EBV), human herpes virus-6 (HHV-6) and human herpes virus-8 (HHV-8) DNA was detected using PCR. PCR was also used to characterise the EBV genomes and the clonal status of the lesions.Results-EBV sequences were identified in nine (56%) cases. The main EBV genotype detected was type 1. Two (12%) cases were positive for both HHV-6 and EBV sequences. HHV-8 sequences were detected in one case of localised Castleman's disease, the sequence of which differed from that of the HHV-8 prototype. No clonal immunoglobulin gene rearrangements were found.Conclusions-EBV DNA was detected in a substantial proportion of cases, suggesting that it may have a role in the pathogenesis of Castleman's disease, unlike HHV-6 which was detected rarely. This is the first report of HHV-8 specific sequences in the localised from of the disease.
Journal Article↗
[Magnetic resonance imaging in assessing the complications of cardiac surgery involving the ascending aorta].
Complications involving the ascending aorta after cardiac surgery are rare (< 1%). Clinical findings are aspecific and may present a long time after surgery. Diagnostic imaging is used to show the type of complication and to provide adequate information for a suitable therapy. The authors investigated both efficacy and usefulness of MRI in the study of cardiac surgery complications involving the ascending aorta. Ten patients treated for heart disease were examined with MRI. Eight of them had had aortic valve replacement, 1 ascending aorta replacement and 1 both. Chest radiography and MRI were performed in every patient; 4 patients underwent transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE), 2 patients TTE and 1 TEE; 2 patients were submitted to CT and 4 to angiography. MRI showed 3 ascending aorta aneurysms, 3 dissecting aneurysms and 4 pseudoaneurysms. In the patients with aneurysms and dissecting aneurysms, MRI correctly demonstrated both the aneurysm and the intimal flap. MRI showed only large pseudoaneurysms, depicting mediastinal hemorrhage suggestive of pseudoaneurysm if the latter was small. In such cases, only angiography showed the breach site. In conclusion, MRI can be considered the method of choice to depict cardiac surgery complications involving the ascending aorta if aneurysms and dissecting aneurysms are present, because it yields enough information for both diagnosis and surgery. In contrast, in pseudoaneurysms or mediastinal hematomas angiography is necessary to show the exact rupture site of the aortic wall.
Adolescent↗
Incidence of stroke in young adults in the Reggio Emilia area, northern Italy.
A retrospective epidemiological study on the first episode of stroke in young adults aged 15-44 years was carried out in the territory of the Local Health Unit No. 9 in Reggio Emilia (46,491 km2), Italy, from 1987 to 1989. 29 patients were identified: 17 were affected with cerebral infarction and 12 with hemorrhage. All young patients were discharged with diagnostic codes 430-438 according to the International Classification of Disease, i.e. the criteria of the World Health Organisation for stroke definition. All patients had computed tomography or necropsy. The average annual incidence rate per 100,000 population aged 15-44 for all strokes was 13.6 and the 95% confidence interval (CI 95%) was 9.1-19.6. The general population of the same age on January 1, 1987, was 69,845 and 71,920 on December 31, 1989; the incidence rate of stroke was 14.0 for males (CI 95% 7.9-2.3) and 13.2 (CI 95% 7.1-22.2) for females. The average annual incidence rates were 8.0 (CI 95% 4.7-12.2) for cerebral infarction (8.4, CI 95% 3.9-16 for males, 7.6, CI 95% 3.3-14.9 for females), 5.6 (CI 95% 2.9-9.9) for cerebral hemorrhage and 2.8 (CI 95% 1.0-6.1) for both subarachnoid (SAH) and intracerebral hemorrhage (ICH). Based on angiography or necropsy findings, aneurysms or arteriovenous malformations were present in 83% of the patients with SAH and in 66% of the patients with ICH. The 1-month fatality ratio was 0 for cerebral infarction, 50% for SAH and 33% for ICH.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Early prenatal diagnosis and therapy of fetal hypothyroid goiter.
We report a case of early diagnosis of iodide-induced fetal hypothyroidism at 22 weeks of gestation, confirmed at 29 weeks by cordocentesis and successfully treated intra-amniotically. The ultrasonographic feature was the presence of two echogenic masses in the fetal neck; polyhydramnios was absent. Mild hypothyroidism was diagnosed based on fetal serum obtained by percutaneous umbilical blood sampling at 29 weeks of gestation. The persistence of fetal hypothyroidism in spite of maternal thyroid improvement was confirmed by a second cordocentesis at 35 weeks of gestation, and a single injection of intra-amniotic levothyroxine (250 micrograms) was performed. The serial ultrasonographic examinations showed disappearance of the fetal goiter. A healthy female baby (3,630 g) was delivered at term. At birth, the thyroid gland was not enlarged, and neonatal thyroid hormones were within the normal range. This case suggests that cordocentesis is a reliable method to assess the fetal thyroid status; moreover a single injection of intra-amniotic thyroxine was effective in treating fetal hypothyroid goiter.
Adult↗
Prenatal diagnosis of congenital uropathies.
We discuss data on urinary tract dilatations diagnosed in utero from February 1980 to May 1988. Over 8,900 pregnancies prenatally investigated with ultrasound during second and third trimester in our center. We diagnosed 401 fetal defects (4.5%) with 121 urinary system anomalies (1.35%). In 90 cases (1.01%) urinary tract dilatation was present, representing the most frequent urinary pathology in utero (74.3% of all urinary anomalies). We describe some diagnostic findings as particularly useful in differential diagnosis of functional and obstructive conditions, stressing the possibility and the difficulty of diagnostic accuracy for urinary tract anomalies. The perinatal outcome of each condition is reported.
Diagnosis, Differential↗
[Usefulness and limits of the ultrasonic examination in the diagnosis and prognosis of early pregnancies with vaginal bleeding].
At the Department of Obstetrics and Gynecology of Catholic University in Rome 1257 pregnancies with vaginal bleeding in the first or second trimesters were ultrasonically observed. Pregnancy was found to be in normal development in 538 cases (42.80%); spontaneous abortion was reported in 688 cases (54.73%) and ectopic pregnancy, confirmed at surgery, in 31 cases (2.47%). The duration of bleeding appeared to have a significant effect on the prognosis of the pregnancy. Bleeding for 4 days or more predicted abortion almost significantly more often than a shorter bleeding episode. The spontaneous abortion rate increased with advancing maternal age and decreased with advancing gestational age. After detection of fetal life signs, the pregnancies ended in later abortion only in 9.29% of the cases. In this case there are no significant differences between normal or abnormal ultrasonic examinations. In our experience the ultrasound scanning, in patients with early pregnancy bleeding, is able to differentiate between live gestation or abortion but cannot predict the future.
Abortion, Spontaneous↗
Doppler blood flow waveforms in the descending thoracic aorta of the human fetus.
A linear-array pulsed Doppler duplex has been used to study third-trimester Doppler flow velocity waveforms (FVW) in the descending thoracic aorta of 98 normal and 20 severely growth-retarded fetuses. Waveforms have been normalized (frequency index profile; FIP) to remove the effect of the angle of insonation and so allow comparison at different gestational ages and with complicated pregnancies. There is an increase in end-diastolic velocities with advancing gestational age indicating a reduction in placental resistance. The growth-retarded fetuses showed a significant reduction in end-diastolic velocities and an increase in the pulsatility index (normal PI: mean 1.83, SD 0.22; growth-retarded PI: mean 2.78, SD 0.60). This reduction of diastolic blood flow may indicate reduced placental vascularity and predict impending fetal hypoxia.
Aorta, Thoracic↗
A follow-up electrophysiological study of rats with poor intrauterine fetal growth: the development of visual evoked responses (VERs).
The development of some electrophysiological activities of the visual system (VERs) was compared in control rats and in young rats with poor intrauterine fetal growth caused by an electrolytic lesion of the placenta. Treated rats showed a delayed development of the electrophysiological functions considered, thus confirming the postnatal effect of poor intrauterine fetal growth.
Animals↗
Fetal infection from rubeovirus or cytomegalovirus: correlation among maternal serological profiles, invasive diagnostic procedures, and long-term follow-up.
Different variables influence the possibility that maternal viral infection may be transmitted to the fetus, although not all fetal infections result in fetal "illness" with consequent fetopathy. As concerns the fetus, prenatal diagnosis includes invasive techniques necessary for fetal tissue sampling. These techniques carry some risks. The fetal infectious risk, as determined by maternal clinico-serological profile and according to sonographic investigation, always should be weighed against the risks and benefits of invasive diagnostic procedures. The present study re-elaborates the criteria necessary for defining fetal risk as related to the maternal serological profile. In the 26 mothers with rubeola infection, the incidence of fetal mortality was 7.7%. Fetal prognosis worsens with the precocity of eruption. In these cases the esantema is the most reliable prognostic element as an indication to perform the invasive procedure. In the 15 patients with cytomegalovirus infection, no fetal or postnatal losses occurred. Morbidity occurred in 13.3% of cases, and the two ill fetuses were classified in the same risk group. In this group of patients, the maternal serological profile is a significant predictor of fetal morbidity.
Amniotic Fluid↗
Congenital cystic adenomatoid malformation of the lung: antenatal ultrasound findings and fetal-neonatal outcome. Fifteen years of experience.
Seventeen cases of congenital cystic adenomatoid malformation of the lung (CCAM) are reported. They were followed up over a period of 1 month to 15 years. Diagnosis was made by prenatal ultrasound. Our purpose was to evaluate the fetal-neonatal outcome and the prognostic elements observable through ultrasound techniques, and to compare all types of CCAM. The outcome observed ranged from total prenatal resolution to postnatal spontaneous regression of the lesion, to complications due to the presence of nonimmune fetal hydrops (NIFH), intrauterine death and the necessity of surgical intervention. In our experience only hydrops represented a negative predictor of outcome since death occurred in all cases with this pathology. In the absence of NIFH, counselling should stress the prevalence of a positive outcome, even in cases of surgical intervention.
Cesarean Section↗