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Biomedical subjects

L Spazzafumo

Publications and source records attributed to L Spazzafumo.

At least 19 recordsLinked to original sources
PubMed2005

Evacuation sonography.

BACKGROUND: Because of the drawbacks of defecography (radiation hazard and lack of standardization), a new method by introital sonography is described to assess the evacuation phenomenon in women as an alternative to contrast radiographic studies. METHODS: Ten consecutive women (mean age, 41 years; range, 33-50; mean parity, 2; range, 1-4) without evacuation disturbances (history and physical examination) nor prior pelvic surgery underwent hypoechoic contrast-enhanced evacuation sonography in the squatting position and fluoroscopic defecography, when appropriate, within a 10-minute interval. RESULTS: Both techniques gave clear images of anal neck opening and funneling. While ultrasonography underestimated anorectal junction mobility, it showed soft tissue details (flap valve) not seen at defecography. Other advantages with sonography included lack of radiation hazard and prolonged observation time. CONCLUSIONS: Evacuation sonography may be useful as an alternative to defecography for research purposes and for screening of evacuation dysfunctions in women.

Adult↗
PubMed2005

Predictors of high level of burden and distress in caregivers of demented patients: results of an Italian multicenter study.

BACKGROUND: Considerable suffering is experienced by carers of patients with dementia. Most existing studies do not consider the coexistence of subjective and objective aspects that cause, interacting to each other, this suffering. OBJECTIVES: In this study we: (1) define the high-risk group of caregivers on the bases of the scores obtained on the four scales evaluating burden, distress, depression and anxiety (BDDA) taken into account simultaneously and (2) evaluate risk factors related to the high level of BDDA. SUBJECTS AND METHODS: 419 elderly outpatients with dementia and their caregivers were enrolled. Patients were evaluated for their cognitive, neuropsychological and functional impairment and for comorbidity. Caregivers were evaluated with four scales for the assessment of burden, distress related to neuropsychological disturbances, depression and anxiety. Cluster analysis was used to identify the group with the High level of BDDA (HBDDA). RESULTS: By multiple logistic analysis, disability, specific behavioural disturbances of the patients as well as caregiver's age, type of relationship and living in the south of Italy were observed to be a major risk factor for HBDDA. CONCLUSION: The targeted use of scales specifically assessing BDDA of the caregiver and the identification of particular patient and caregiver characteristics are able to allow a precise and early definition of caregivers at high risk of burden and distress. This might be helpful in planning the correct social/clinical/rehabilitative approach.

Adolescent↗
PubMed2003

The COPE index--a first stage assessment of negative impact, positive value and quality of support of caregiving in informal carers of older people.

Data was collected in five countries from informal carers of older people (n = 577) via a common protocol. Carers completed: (1) a 17-item version of the Carers of Older People in Europe (COPE) Index, an assessment of carers' perceptions of their role : (2) a questionnaire on demographic and caregiving circumstances : and (3) three instruments included for the criterion validation of the COPE Index (the General Health Questionnaire, the Hospital Anxiety and Depression Scale, and the World Health Organization Quality of Life-BREF). Principal Component Analysis of the COPE Index was followed by internal consistency analysis of emergent components. Scales derived by summing items loading on the components were analyzed for their association with the criterion measures. Two components, negative impact and positive value, emerged consistently across countries. A third component, quality of support was less consistent across countries. Scales derived from the negative impact and positive value components were internally consistent and significantly associated with the criterion validity measures. These two scales and four items drawn from the quality of support component were retained in the final COPE Index. While further testing is required, the COPE Index has current utility in increasing understanding of the role perceptions of carers of older people.

Affect↗
PubMed2000

Different age-related effects of thymectomy in myasthenia gravis: role of thymoma, zinc, thymulin, IL-2 and IL-6.

Different age-related immune pathogenetic mechanisms in myasthenia gravis (MG) have been suggested because of restoration after thymectomy (Tx) of altered zinc, thymulin (TH) and T-cell subsets exclusively in early-onset patients (younger <50 years), not in late-onset patients (older >50 years). In this context interleukin-2 (IL-2), interleukin-6 (IL-6) and thymoma are crucial because both involved in MG pathogenesis and correlated with acetylcholine receptors (AchRs) Ab production. Moreover, IL-2 and IL-6 are zinc-dependent, are altered in aging and related with zinc and TH age-dependent declines. Moreover, zinc is relevant for immune efficiency. In order to confirm these different age-related pathogenetic mechanisms further, the role of thymoma, zinc, TH, IL-2 and IL-6 is studied in MG patients with generalized MG with and without thymoma before and 1 month and 1 year after Tx. The high IL-2, IL-6, zinc, and AChR Ab levels observed before Tx are significantly correlated each other in younger MG patients (<50 years) independently by thymoma and in older MG patients (>50 years) with thymoma. No correlations exist in older MG patients without thymoma. Thymulin is not correlated with other parameters considered to be both in younger and older MG patients independently by the thymoma. Thymectomy restores zinc; immune parameters and AChR Ab are exclusively in the younger group, not in the older one. These findings suggest that IL-2 and IL-6, via zinc, rather than TH, may be involved in different age-related pathogenetic mechanisms mainly in early-onset MG. By contrast, thymoma may be involved in MG etiology in late-onset representing, as such, a useful discriminant tool for MG etiology between early and late-onset MG patients. Because autoimmune phenomena may rise in aging, a parallelism with altered immune functions during aging is discussed.

Adolescent↗
PubMed2000

Do men and women follow different trajectories to reach extreme longevity? Italian Multicenter Study on Centenarians (IMUSCE).

Gender accounts for important differences in the incidence and prevalence of a variety of age-related diseases. Considering people of far advanced age, demographic data document a clear-cut prevalence of females compared to males, suggesting that sex-specific mortality rates follow different trajectories during aging. In the present investigation, we report data from a nationwide study on Italian centenarians (a total of 1162 subjects), and from two studies on centenarians living in two distinct zones of Italy, i.e., the island of Sardinia (a total of 222 subjects) and the Mantova province (Northern Italy) (a total of 43 subjects). The female/male ratio was about 2:1 in Sardinia, 4:1 in the whole of Italy, and about 7:1 in the Mantova province. Thus, a complex interaction of environmental, historical and genetic factors, differently characterizing the various parts of Italy, likely plays an important role in determining the gender-specific probability of achieving longevity. Gender differences in the health status of centenarians are also reported, and an innovative score method to classify long-lived people in different health categories, according to clinical and functional parameters, is proposed. Our data indicate that not only is this selected group of people, as a whole, highly heterogeneous, but also that a marked gender difference exists, since male centenarians are less heterogeneous and more healthy than female centenarians. Immunological factors regarding the age-related increase in pro-inflammatory status, and the frequency of HLA ancestral haplotypes also show gender differences that likely contribute to the different strategies that men and women seem to follow to achieve longevity. Concerning the different impact of genetic factors on the probability of reaching the extreme limits of the human life-span, emerging evidence (regarding mtDNA haplogroups, Thyrosine Hydroxilase, and IL-6 genes) suggests that female longevity is less dependent on genetics than male longevity, and that female centenarians likely exploited a healthier life-style and more favorable environmental conditions, owing to gender-specific cultural and anthropological characteristics of the Italian society in the last 100 years.

Aged↗
PubMed2000

Acceptance and use of technological solutions by the elderly in the outdoor environment: findings from a European survey.

This article examines the use and acceptance of ticket machines, automatic teller machines (ATMs) and telephone cards by the elderly in four European regions. The analyses are based on data from an international project entitled "Keeping the Elderly Mobile", collected in Mannheim (former West Germany; N = 404 home-dwelling respondents), Chemnitz (former East Germany; N = 400), Ancona (Italy; N = 600), and Jyväskylä (Finland; N = 618). The random sample was stratified by age and gender in each country. Two generations of men and women (aged 55-74 and 75+ years, respectively) participated in the study. Results show that respondents generally made little use of the three technologies under investigation: in fact, the majority of respondents does not use them at all. The most frequently used devices were ATMs in Chemnitz and ticket machines and telephone cards in Mannheim. On the basis of logistic regression analysis, age was the most important explanatory factor for the three technologies and for all four regions, i.e., the users were mostly the "young-old." Education was a more important variable than gender. In all four regions, the majority of the respondents who used the technologies assessed felt that each of them made life easier; nevertheless, ticket machines make life more difficult to almost every third user in Mannheim. Interesting differences and similarities among the towns were also found. The present study exhibits preliminary results regarding elderly and technology which future research should investigate in greater depth.

Activities of Daily Living↗
PubMed1999

Measurement of the anorectal angle by defecography for the diagnosis of fecal incontinence.

We assessed the reliability of anorectal angle (ARA) measurement as an index of fecal incontinence. The "posterior" ARA was measured at rest, squeezing, and straining in 69 continent and 82 incontinent subjects all complaining of various evacuation dysfunctions. The two groups were homogeneous with regard to sex distribution (48.6% vs. 51.4% men and 44.7% vs. 55.3% women, n.s.) and age (56.5 +/- 10.2 vs. 59.3 +/- 9.7 years, n.s.). The incidence of rectal prolapse was the same in the two groups (40 each). The intraobserver agreement index from two independent measurements (Pearson's correlation coefficient), age, and gender interaction [T2 Hotelling test in multivariate analysis of variance (ANOVA)] and the most discriminating category of ARA measurement (Fisher's F test in ANOVA) were calculated. In addition, the relationship between ARA and severity of incontinence was assessed by the eta coefficient. Pearson's correlation coefficient was between 0.78 and 0.98 (P < 0.01). The mean ARA differed significantly between the continent and incontinent subjects (104.5 +/- 10.3 degrees vs. 116.2 +/- 23.6 degrees at rest, 84.5 +/- 14.2 degrees vs. 95.1 +/- 20.1 degrees on squeezing, and 133.7 +/- 21.7 degrees vs. 141.7 +/- 25.9 degrees on straining; T2 0.066, P < 0.05 in multivariate ANOVA). No interaction was noted between groups and gender (T2 = 0.023; F = 1.11, n.s.). Resting ARA was shown by ANOVA to be the most discriminating index (F = 9.4 P < 0.01) between the two groups. Overall, ARA measurement was correlated with the severity of fecal incontinence (eta coefficient: 0.894 at rest; 0.811 on squeezing; 0.695 on straining); its accuracy was 79%, the false-positive rate was 15.3% and the false-negative rate 26.5%. Irrespective of the underlying abnormality, namely rectal prolapse, ARA measurement by defecography can: (a) be reinterpreted reliably by the same observer and (b) differentiate continent from incontinent subjects.

Adolescent↗
PubMed1998

[Evaluation of the accuracy of calcaneus bone tissue findings by a contact ultrasound system. Comparison with the most used absorptiometry methods].

BACKGROUND: Ultrasound measurements of bone include Broadband Ultrasound Attenuation (BUA) and Speed Of Sound (SOS) through a skeletal segment. These techniques do not expose patients to ionizing radiations. Aim of the present study was to evaluate reproducibility, specificity, sensibility and accuracy of these measurements as compared with those obtained by absorptiometric devices at the distal radius and lumbar spine (L2-L4). METHODS: Mean c.v. for repeated measurements on the same subjects was 2.7% for BUA and 0.9 for SOS. Both BUA and SOS were able to separate young normal from healthy post-menopausal subjects and patients with recent vertebral osteoporotic fractures as well as absorptiometric techniques. RESULTS: All compared methods of bone measurements showed non statistically significant differences for what concerns sensibility, specificity and accuracy. CONCLUSIONS: We conclude by affirming that both BUA and SOS measurements at the os calcis with the contact ultrasound analyzer CUBA may represent safe and available methods for routinary assessment of skeletal health. The contact device allows more rapid measurements than other US devices the use of whom is conditioned by the immersion of the foot in a water bath; furthermore the CUBA system detects BUA and SOS in the mid os calcis: at this level bone density resulted more homogeneous than in other regions of the same bone.

Absorptiometry, Photon↗
PubMed1995

Modifications of Intestinal Permeability Test Induced by Biliopancreatic Diversion: Preliminary Results.

BACKGROUND: Biliopancreatic Diversion (BPD), excluding the jejunum and part of the ileum from the transit of the food, reduces the absorptive intestinal area available to 250 cm of the distal ileum. The Intestinal Permeability Test (IPT) with Lactulose/Mannitol is performed to assess the intestinal mucosa function. The aim of this study was to investigate the effect of intestinal anatomical modifications induced by BPD on IPT in a group of severely obese patients. METHODS: Group A: 18 severely obese subjects who underwent BPD; the IPT was performed before (T0) and 8.2 +/- 0.9 days after BPD (T1). Group B: nine subjects of Group A; IPT was repeated 96.1 +/- 12.7 days (T2) and 180.4 +/- 19.7 days (T3) after BPD, respectively. IPT was expressed as the %Lactulose/%Mannitol ratio in the urine collected during 5 h after oral administration (normal %L/%M < 0.04). RESULTS: Data from Group A (paired Student's t-test) exhibited significantly higher values in T, with respect to T0 for %L/%M (p < 0.05) and for %L (p < 0.05), and significantly lower values in T, with respect to T0 (p < 0.001) for %M. In the Group B analysis of Variance from T0-T1-T2-T3 resulted statistically significant (p < 0.05) for % L/ % M and % M. CONCLUSIONS: The reduction of intestinal absorption surface induced by BPD causes a significant increase of the Lactulose/Mannitol IPT values, showing an intestinal mucosa function impairment. The IPT values improve progressively at 3 and 6 months after this surgical procedure.

Journal Article↗
PubMed1995

Blood pressure self-measurement in the elderly: differences between automatic and semi-automatic systems.

Arterial hypertension is the most common cardiovascular risk factor in the elderly. Its clinical control emphasises the problem of the systems used for monitoring: clinical measurement by the physician, home self-monitoring, ambulatory monitoring, etc. In particular, in the elderly population, the self-monitoring of blood pressure can present further problems associated with their situation. In our study we evaluated, in an elderly population, the differences in the self-recording of blood pressure with automatic and semi-automatic equipment using a mercury sphygmomanometer by a physician as a 'gold standard' control. We studied 28 elderly subjects using a rigid protocol for the self-measurement of their blood pressure. Our results show that automatic equipment is significantly more precise and easier to use than semiautomatic equipment in home self-measurement of blood pressure in elderly people.

Aged↗
PubMed1995

Modifications of functional and physico-chemical properties of rat ileal plasma membranes.

A membrane fraction enriched with plasma membranes was isolated from rat ileal brush-border cells before and after five-day starvation of the animals. Cholesterol/phospholipid ratio of the standard cell membranes decreased highly significantly (0.42 to 0.18), as did the microviscosity of the membranes determined by polarization of fluorescence (0.187 to 0.142). Concomitantly, the specific activity of Na,K-ATPase in the basolateral membranes significantly increased (59 to 83 mumol ATP hydrolyzed per mg protein per min).

Animals↗
PubMed1993

[Electrophysiologic diagnosis of carpal tunnel syndrome in patients with diabetes mellitus].

The authors evaluated 406 patients affected by carpal tunnel syndrome diagnosed by clinical and electromyographic data. Diabetes mellitus was recognized in 57 subjects. The others constituted the control group. The severity of the syndrome was similar in both groups. Also similar was the interval between onset and clinical diagnosis. Such parameters and the severity of the syndrome showed no modification with age in the diabetic group. In the control group, carpal tunnel syndrome was more pronounced in the aged patients, presumably for the longest latency of disease. Carpal tunnel syndrome onset was later in diabetic subjects compared the control. At lastly we found a prevalence of bilaterality in diabetics, and an M/F rate comparable in both groups, as described by other authors.

Adult↗
PubMedDate not supplied

Vasopressin, prolactin and growth hormone in Alzheimer's disease: their evaluation after metoclopramide stimulation.

Recent studies have shown that there is a relationship between an alteration of central neurotransmitters and the modification of some biohumoral parameters in Alzheimer's Disease (AD). In this study the authors evaluated, after metoclopramide (MTC) stimulation, the concentration curve of vasopressin (AVP), prolactin (PRL) and growth hormone (HGH) in the plasma of 34 subjects (20 males and 14 females, mean age 70.5+/-6.9 years; 17 were AD patients, the others constituted the control group). MTC increased AVP serum concentration in healthy (P <0.001), but not in AD patients. This result seemed to be due to the lack of 'procholinergic' action of the drug in the AD patients probably due to an alteration in their cholinergic pathways. The PRL response to MTC was reduced only in the AD female group (P <0.005), suggesting an alteration in dopaminergic control. Lastly, the HGH response in AD did not differ in the two groups, neither in basal conditions, nor after MTC stimulation. The absence of HGH response both in AD and in healthy subjects, demonstrated the ineffectiveness of MTC stimulation. We can conclude that AVP and PRL responses to MTC stimulation efficiently separated the two groups (AD and controls); the former test showing a higher discriminant power than the latter.

Journal Article↗
PubMedDate not supplied

The effects of a rehabilitation program with mnemotechniques on the institutionalized elderly subject.

After having screened the cognitive functions in 103 institutionalized elderly subjects in Terni, a sample affected by mnemic deficit was obtained so as to verify the use of mnemotechniques on the same. Generally the findings show an improvement in cognitive performance in those treated which leads to suppose that our patients were affected by apparent cognitive deficits rather than real ones, supporting in any case the use of neuropsychological rehabilitative treatment in institutionalized subjects.

Journal Article↗