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Biomedical subjects

M Cappelli

Publications and source records attributed to M Cappelli.

At least 19 recordsLinked to original sources
PubMed1996

[Comparison between the CHIVA cure and stripping in the treatment of varicose veins of the legs: follow-up of 3 years].

OBJECTIVE: To assess three-year results following "CHIVA". DESIGN: Comparison between our results and data in the literature following stripping. SETTING: Phlebologic Surgery, 46 Datini Street, Florence, Italy. PATIENTS: 148 consecutive operated patients suffering from varicose veins (166 procedures). INTERVENTIONS: "CHIVA", as described by Franceschi and Bailly. MAIN OUTCOME MEASURES: The presence of visible varicose veins, graded in three categories, according to Hobbs and Einarsson, as shown by clinical examination. RESULTS: Very good results were obtained in 100 cases, who presented without any finding of varicose veins throughout the follow-up. Of the remaining 66, in 1 case we found a new varicose network completely developed, whereas in 65 cases only some visible residual or recurrent vessels were present. CONCLUSIONS: Significantly better results were observed in the CHIVA group compared with stripping groups (P < 0,001).

Adolescent↗
PubMed1995

Comparison of methods of estimating the mother-to-child transmission rate of human immunodeficiency virus type 1 (HIV-1). New York City Perinatal HIV Transmission Collaborative Study Group.

Four methods of estimating mother-to-child transmission rates of human immunodeficiency virus type 1 (HIV-1), based on the 1992 Ghent workshop, were compared in a multicenter New York City prospective cohort study in 1986-1992. Of 833 infants born to women at risk of HIV-1 infection, 388 were born HIV-1 seropositive and 445 were HIV-1 seronegative. The four methods, the Antibody Only, Indirect, Direct, and Virologic Methods, yielded transmission rate estimates of 19-25%, classifying 59-89% of the cohort. Estimation based on persistence of HIV-1 antibody and clinical assessment yielded transmission rates similar to those methods that incorporated virologic testing.

Adult↗
PubMed1995

Identifying depressed and suicidal adolescents in a teen health clinic.

PURPOSE: This study examined the 6-month prevalence of depression and suicidal probability among new referrals to an adolescent health clinic. METHODS: All subjects (n = 104) completed the Beck Depression Inventory (BDI) and the Suicide Probability Scale (SPS) prior to being seen by a physician and were categorized according to presenting problem (physical complaints only, psychological complaints only, and physical and psychological complaints combined). RESULTS: Fifty-nine percent of the sample was depressed with 21% falling in the moderate range and 21% falling within the severe range of depression. Almost 23% of the sample demonstrated significant suicidal probability. The BDI and SPS were highly correlated (r = .73, p < .001) and 22% of the sample met criteria for both moderate to severe depression and suicidal probability. A significantly greater proportion of patients presenting with physical and psychological complaints combined (60%) met BDI criteria for depression than was found for the other two groups. Suicidal probability was most prevalent in patients presenting with psychological complaints only (26%) and moderate to severe depression and significant suicidal probability also coexisted to a greater extent within this group (26%). CONCLUSIONS: Results suggest that depression and suicidal probability represent significant mental health problems within the adolescent clinic and the identification of high-risk individuals can be achieved through comprehensive screening practices.

Adolescent↗
PubMed1995

Delivery of molecular genetic services within a health care system: time analysis of the clinical workload. The Molecular Genetic Study Group.

The most recent discoveries in molecular genetics today are rapidly incorporated into clinical practice and have resulted in an unprecedented expansion of medical options. Despite this, the impact of molecular genetics on health care services has yet to be evaluated. In order to begin this assessment, clinical genetic workload was prospectively collected from cases where molecular genetic testing was considered. Participation involved all 16 urban and outreach genetic centers regionalized to service the entire population of 10 million within the Canadian province of Ontario. Molecular genetic testing has been clinically available for > 5 years, as part of a publicly supported genetic network in which there are no direct costs to residents. Cross-sectional data were collected on 1,101 clients from 544 families involving 1,742 clinical actions relating to diseases in which molecular (DNA) tests were considered. Median times per clinical genetic action were as follows: formal counseling (60 min), case review (15 min), phone call (10 min), letter (15 min), specimen arrangement (15 min), and interpretation of molecular test results (10 min). Times varied significantly with the inheritance pattern of the disease, topics involved, and location. For any given genetic case, multiple clinical actions resulted in substantial time spent by the genetic professional. Clerical and administrative times were not captured. Workload unit measurements similar to those currently employed in hospital laboratories may be helpful for predicting the clinical resources and personnel that will be required as the use of molecular genetics by other medical specialties increases.

Analysis of Variance↗
PubMed1994

Cystic fibrosis carrier screening in a high-risk population. Participation based on a traditional recruitment process.

OBJECTIVE: Recent advances in molecular genetic (DNA) technology have permitted identification of previously undetectable cystic fibrosis (CF) carriers. Although research has been initiated in the general population, to our knowledge no published studies have looked at the utilization of DNA-based carrier screening in the high-risk CF population (family history of CF). DESIGN: Cross-sectional, diagnostic open trial. SETTING: Carrier testing was offered to a high-risk CF population via adult patients with CF or parents of pediatric patients with CF attending two regional CF clinics over a 3-year period. PARTICIPANTS: Consecutive sample of virtually all patients with CF (n = 118) from a population of 1 million. MAIN RESULTS: Despite free services, written follow-up, and counseling for 99% of patients attending the CF clinic, there was less than 10% participation from high-risk family members (168 blood relatives and 26 spouses of identified carriers or patients with CF; 38 and 156 persons from the adult and pediatric clinic families, respectively). Nevertheless, we identified 91 CF carriers among the 168 high-risk relatives. This is comparable to the number of carriers detected in general population carrier screening that has tested substantially more individuals (> 3000 per study). CONCLUSIONS: Our results suggest that research concerning CF carrier screening not only focus on data about fundamental program resources and numbers of carriers detected but also investigate how information about the availability of carrier screening is disseminated, the motivation behind testing, and the perceived relevance of test results by those tested in the high-risk population. These issues are increasingly relevant as screening becomes feasible using DNA testing for far more prevalent disorders (such as breast cancer and diabetes).

Adolescent↗
PubMed1994

Marital quality of parents of children with spina bifida: a case-comparison study.

The impact of childhood chronic illness on parents' marital quality has received limited attention. Most studies have relied solely on mothers' reports and have not examined differences between mothers and fathers. Using a case-control design, this study compared the marital quality within and between dyads of 46 couples with children matched on the age and children matched on the age and sex of the child. During a home visit, parents completed both self-report measures and a communication observational task. Mothers' and fathers' reports of marital quality did not differ between the two groups. Also, no significant differences were found on other marital and psychosocial measures. The most interesting correlations were observed for fathers of children with spinal bifida whose marital quality was associated with parenting stress (r = -.51), depression (r = -.34), and role strain (r = -.34). Overall, the results of this study contribute to the growing body of literature demonstrating that parents of children with a chronic condition are at no greater risk for psychosocial dysfunction, including marital distress, than parents of healthy children. However, to generalize the results, additional research on marital quality with other chronic conditions is required.

Adaptation, Psychological↗
PubMed1991

Atrial natriuretic peptide and catecholamines in obstructive sleep apnea syndrome.

Nocturnal polyuria with repeated micturitions during the night is a clinically evident feature of obstructive sleep apnea syndrome (OSAS). These effects are reversed by continuous positive airway pressure (CPAP). There is some evidence that atrial natriuretic peptide (ANP) and catecholaminergic activity may be implicated in the pathogenesis of these symptoms. We studied these biochemical parameters in six patients with severe OSAS during two nights: the first (basal) in their normal conditions and the second during CPAP treatment. CPAP treatment reversed apnea episodes in all our patients. A significant (p less than 0.035) reduction of nocturnal urine volume (from 902 +/- 297 to 447 +/- 130 ml; mean +/- SD), sodium excretion (from 150 +/- 33 to 89 +/- 35 mEq/12 h), noradrenaline excretion (from 95 +/- 101 to 52 +/- 16 micrograms/g creatinine), noradrenaline plasma concentrations (from 325 +/- 96 to 259 +/- 75 pg/ml), ANP plasma concentrations (from 35 +/- 20 to 19 +/- 5 pg/ml) was observed during the night under CPAP application. These data suggest that in OSAS patients the high ANP plasma concentration is responsible for the observed elevated diuresis and sodium excretion. These effects are rapidly reversible, as they are reversed during the first CPAP treated night.

Adult↗
PubMed1989

Chronic disease and its impact. The adolescent's perspective.

Although evidence suggests that adolescents with chronic illness are at a greater risk for psychosocial disability, little is known about the adolescent's perception of the impact of the disease on his or her day-to-day life. Standardized measures of coping strategies, mastery, self-efficacy, social support, depression, and a semistructured interview on everyday difficulties were administered to matched groups (sex and age) of 31 adolescents with cystic fibrosis, 31 adolescents with diabetes, and 31 healthy controls. No differences were found between control and adolescents with a chronic disease responses on the standardized measures. The semistructured interview, however, revealed that the adolescent's perception of his or her physical health and the reaction of other family members to the illness were important sources of stress. These findings suggest that, in general, adolescents with a chronic illness cope effectively with their disability but that parents and clinicians must be sensitive to the adolescents' feelings and concerns regarding their health and its impact on the family.

Adolescent↗
PubMed1989

Parental care and overprotection of children with cystic fibrosis.

Parental overprotection has often been clinically associated with the psychological maladjustment of children with a chronic disease. The purpose of this study was to examine parental care and overprotection in children with cystic fibrosis compared to healthy controls. Results indicated no differences in the level of parental care or overprotection between controls and children with cystic fibrosis. However, a number of significant correlations were found between parental care and overprotection and children's psychosocial functioning. In particular, positive correlations were found between parental overprotection and poor psychosocial functioning in children with cystic fibrosis, whereas, poor psychosocial functioning in healthy children was associated with lack of parental care. Parental overprotection and care appear to play important roles in the emotional and psychological functioning of healthy and chronically ill children.

Adaptation, Psychological↗
PubMed1988

[Hemodynamic and renal effects of synthetic atrial natriuretic factor (alpha-h-ANF) in patients with congestive heart failure].

We studied the effects of alpha-human atrial natriuretic factor (alpha-h-ANF) on diuresis, glomerular filtration rate (GFR), natriuresis, atrial blood pressure (BP), heart rate (HR) and plasmatic levels of aldosterone, renin activity (PRA), antidiuretic hormone (ADH) in 21 patients with congestive heart failure (CHF), (NYHA, class IV) and 15 healthy volunteers. Three different doses (25, 50 and 100 micrograms) of alpha-h-ANF were administered; each subject received only one dose. Protocol was as follows: 2 periods of 30 minutes each before alpha-h-ANF administration; 2 periods of 15 minutes and 3 of 30 minutes each after it. Aldosterone, PRA, ADH and plasmatic level of ANF were measured by radioimmunoassay. In patients with CHF 25 and 50 micrograms of alpha-h-ANF produced a significant increase in diuresis, GFR, and natriuresis but no modification of BP. On the contrary BP decreased significantly after 100 micrograms of alpha-h-ANF, without changes in renal function. In healthy volunteers the effects of alpha-h-ANF appeared simultaneously and to same degree after each dose. Both in patients and healthy subjects alpha-h-ANF administration had little effect on aldosterone, renin and ADH secretion. The effects of alpha-h-ANF in patients with CHF may be caused by a lowered receptor sensitivity due to a high level of ANF and to their different haemodynamic status.

Aged↗
PubMed1987

Teacher awareness program on child abuse: a randomized controlled trial.

Teachers have a significant role in preventing, detecting and reporting child abuse and neglect. They are hindered in fulfilling this role by a serious lack of knowledge of the law, of school board policies, and of maltreatment. A comprehensive professional development workshop was developed and presented to elementary school teachers. The package was evaluated by means of a randomized controlled trial. The workshop proved to be effective in increasing and maintaining knowledge.

Awareness↗
PubMed1985

Use of a child behavior checklist in the psychosocial assessment of children with epilepsy.

Children with epilepsy are faced with many of the same psychosocial stressors as other chronically ill children, and a proper assessment is vital. The purpose of this study was to determine whether the Child Behavior Checklist of Achenbach and Edelbrock could be used as a practical and objective tool for evaluating the psychosocial needs of children with epilepsy. Thirty-eight children were randomly selected from the Neurology outpatient clinic at the Children's Hospital of Eastern Ontario. Questionnaires were completed by the mothers during their waiting period. Results demonstrated the highest risk of maladjustment was within social functioning. As children reach adolescence, adjustment problems are mostly related to school. Although as a group, our sample did not differ from norms for behavior problems, there was evidence to suggest behavioral maladjustment for individual children. The checklist appears to be a good screening tool for maladjustment that could be included as part of the pediatrician's comprehensive assessment of children with epilepsy.

Adolescent↗
PubMed1983

Influence of trait anxiety on perception of humor.

Previous research and theory suggest that a person's anxiety level plays a functional role in determining his responsiveness to and appreciation of humor. Based upon the theoretical view that humor serves to dissipate anxiety, it was proposed that highly anxious individuals would respond more favourably to a therapist's use of humor than low trait-anxiety individuals. To test the hypothesis 87 undergraduate students in psychology were classified according to their measured level of trait anxiety (high or low, on the Spielberger Trait-Anxiety Inventory). Subjects evaluated a therapist who used humor in a written therapist-client dialogue. Results were contrary to prediction; an inverse relation between anxiety and appreciation of humor obtained.

Anxiety↗
PubMed1983

[Non-invasive cardiologic study on a soccer team].

Fifteen professional football players have been examined with basal electrocardiography, M-mode echocardiography, bicycle ergometry, Holter dynamic electrocardiography; in six of them also, the electrocardiogram has been recorded by during a match. The aim of the research was to evaluate, by non-invasive tests, the cardiovascular status of an athletic team, with particular consideration to rhythm disturbances. The methods employed have given valuable informations. The echocardiographic investigation has frequently shown left ventricular dilation and/or hypertrophy. Dynamic electrocardiography has revealed in many subjects rhythm and conduction disturbances. No athlete has displayed severe rhythm disturbances during the bicycle ergometer test, except one, who had paroxysmal ventricular tachycardia, of complex etiopathogenetic and prognostic significance. Telemetric recording has been very useful to follow the heart action during a match, but its use was often hampered by technical difficulties.

Adolescent↗