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Biomedical subjects

M Castello

Publications and source records attributed to M Castello.

At least 19 recordsLinked to original sources
PubMed1998

[The psychological aspects of asthma in childhood].

BACKGROUND AND AIMS: The hypothesis of an emotional component in asthma has been put forward since antiquity. It is currently explored using a psychodynamic, cognitive-behavioural and systemic-relational approach. This study, carried out using a psychodynamic approach, aimed to identify the psychological aspects of recurrent asthmatic attacks in childhood. METHODS: The study examined 20 subjects, aged between 9 months and 7 years and 11 months, attending the Pneumological Division of the Ospedale Infantile in Turin. The study consisted of the collection of social and personal data regarding the family and clinical and medical history; a semi-structured interview with the mothers, discussed as part of individual supervision regarding the mother-child relationship and the emotive reactions to an asthma attack. RESULTS: Although all subjects had an early onset of manifest asthma, ascertained allergic pathogenesis was only revealed in 30% of children. All cases revealed a lacking and/or conflictual quality in the mother-child relationship, as well as the young patient's difficulty in growing up, implying the acquisition of gradual autonomy. CONCLUSIONS: The authors emphasise the need to focus greater attention on the emotive situation of the child and its parents, in particular those aspects regarding the quality of life under the influence of disease.

Asthma↗
PubMed1997

Ganciclovir therapy for cytomegalovirus-associated liver disease in immunocompetent or immunocompromised children.

Ganciclovir therapy was given intravenously to 20 children with cytomegalovirus (CMV)-associated liver disease, of whom 6 were immunocompetent and 14 were immunocompromised (9 had AIDS and 5 had solid tumors). Immunocompetent children had isolated liver disease diagnosed at birth (4 children), or systemic congenital CMV infection including liver disease (2 children). Ganciclovir was used following two regimens: A) 5 mg/kg twice daily for 8 to 86 days (mean 21); B) 7.5 mg/kg twice daily for 14 days followed by 10 mg/kg three times weekly for three months. CMV infection was diagnosed by viral isolation, detection of viral antigens, and/or CMV DNA from blood and urine. All immunocompetent children had negative CMV culture and CMV DNA detection from blood and/or urine after 14 weeks of treatment. However, the three children who were treated with regimen B showed normal ALT levels at the end of the maintenance course, whereas the children who received ganciclovir with regimen A had normal ALT levels only after about 1 year. All children with tumors initiated regimen B, but only three, who had negative CMV detection and markedly decreased ALT levels, received full treatment; of the remaining two children, one recovered after only an initial course, and the other had therapy interrupted because of hepatic failure and died 9 days later. In contrast, the children with AIDS received several ganciclovir courses for different periods at the lower dosage: they generally improved during treatment but did not recover completely, and five children died with active CMV infections. Based on our study, CMV-associated liver disease can be efficiently treated with ganciclovir both in immunocompetent and immunodeficient children. However, a single ganciclovir course including a higher dosage and prolonged therapy appeared to be more effective than several courses with lower dosages.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Adolescence in patients with cystic fibrosis studied by Rorschach test].

BACKGROUND: The majority of patients with cystic fibrosis today reach adulthood. During adolescence, however, many ask themselves questions regarding their possible future realisation. AIMS: The aim of this study, which was performed using the Rorschach test, was to identify areas of particular problems in a group of CF adolescents monitored by the Pneumology Division of Regina Margherita Children's Hospital in Turin: 26 subjects aged between 14 and 18, including 11 females and 15 males. METHODS: The analysis of the test was based on the use of thought, interior resources, instincts and interpersonal relations. The type of intimate resonance was also taken into account and, lastly, a study of the contents was performed using a self-representation grid. RESULTS: The results obtained show a dishomogeneous profile of the development and quality of intellectual processes faced with the intensity of anxiety, mainly loss anxiety, linked to the disease, even if unrelated to its severity. The integration of emotive and instinctual aspects is difficult: mental development towards adult life appears to be impeded by the predominance of regressive modalities. CONCLUSIONS: On the basis of the study performed, it is possible to hypothesise the need for psychological help aimed at achieving a more evolved psychic organisation, possible as part of an overall management programme by the medical and nursing team.

Adolescent↗
PubMed1997

[Personality structure in children with cystic fibrosis studied using Rorschach test].

BACKGROUND AND AIMS: The recent positive evolution in the development of cystic fibrosis, resulting in the current prospect of survival, has led to the formation of a new population of chronic patients. The characteristics of the disease and treatment (hereditary, early onset, affecting the alimentary tract and airways) may interfere with personality structuring processes. The aim of the study was to identify the psychopathological risk. METHODS: The study was performed using the Rorschach test in a population of children with cystic fibrosis monitored by the Pneumology Division of the Ospedale Infantile Regina Margherita in Turin: 20 children aged between 7 and 13 years old were included in the study, most of whom had been diagnosed before the age of 2. The analysis of tests was focused on the use of thought, interior resources, instincts and interpersonal relations. A study of the contents was also made using a self-representational grid. RESULTS: The results obtained highlight an inhibitory attitude which cannot be attributed to intellectual insufficiency, but rather to the failed attempt to invest in the intellectual sphere, typical of this age range, owing to the intensity of anguish. Children with cystic fibrosis appear to be at an earlier stage of development, marked by emotive coarctation and the use of adult-type defensive methods, tending towards rationalisation. CONCLUSIONS: Oh the basis of this study, it is possible to detect a danger of disharmonious organisation in the personality structuring process of these children. The hospital must therefore offer adequate psychological support for their psychic evolution.

Adolescent↗
PubMed1996

[The sweat test. The proposal to revise the concept of the "grey zone"].

The results of the sweat tests performed in Turin CF Centre in the last four years were reviewed. The opportunity of changing the range of doubt, commonly situated between 40 and 70 mEq/l Cl-, has been considered. The sweat test appears worth to be repeated only for values > 60, unless clinical signs and symptoms persist.

Cystic Fibrosis↗
PubMed1995

Cytomegalovirus-associated stage 4S neuroblastoma relapsed stage 4.

Neuroblastoma is one of the most frequent solid tumors in childhood, rarely recurrent after five years from diagnosis. Cytomegalovirus (CMV), a major pathogen causing congenital birth defects and severe opportunistic diseases, has been shown to have teratogenic, immunodepressive and oncogenic properties. The case of a girl with stage 4S neuroblastoma diagnosed at three months and relapsed as stage 4 five years later is reported. In both circumstances, active CMV infection was revealed by positive CMV-specific IgM and IgA antibodies, CMV-DNAemia and CMV culture. At three months, the patient presented with subcutaneous nodules, hepatosplenomegaly and increased aminotransferase levels, and the opsolonus-myoclonus syndrome. Mental retardation developed later on. At 5 years, relapsed neuroblastoma was preceded by a mononucleosis-like syndrome concomitant with active CMV infection and decreased levels of immune cells and natural killer activity. Clinical, virologic, and immunologic findings suggest an immune-mediated pathogenic role for CMV in this tumor.

Abdominal Neoplasms↗
PubMed1995

[Diagnostic considerations on sinusitis in childhood].

The presence of a radiographic sinusal opacification without any other clinical sign or symptom cannot lead to the diagnosis of "Sinusitis", if considered alone. In a previous paper we observed a high prevalence of patients with both clinical and radiographic signs of sinusitis and a high prevalence of neutrophils in the nasal secretions, now we tried to discover which clinical signs and symptoms are more likely to indicate an acute sinusitis. We compared cough, headache, bacteriological culture of nasal secretions with a sinusal CT scan, without finding any relationship. On the contrary, neutrophils in the nasal secretions and Rx are strictly inter-related with CT scan, with a sensitivity of 77% and a specificity of 100%.

Adolescent↗
PubMed1995

[Pseudomonas aeruginosa colonization in Turin CF center. Microbiological and therapeutic observations].

We reviewed 4,277 sputum cultures performed in our FC patients during antipseudomonas courses of antibiotic therapy. The median age of colonization is 8.6 years, and the chronically infected subjects are 33.65% of all our patients. The most efficient antibiotics were imipenem, aztreonam, ceftazidime and amikacin. Ceftazidime gave the best results in terms of antibiotic resistance.

Anti-Bacterial Agents↗
PubMed1994

[Study of IGG subgroups as prognosis markers in cystic fibrosis].

Pressler et al. (1988) showed a correlation between elevated serum levels of IgG2 and IgG3 with decreased lung function. We tried to verify that hypothesis and to evaluate the usefulness of IgG subclasses as prognostic markers in 54 cystic fibrosis patients. The serum levels of the IgG subclasses were determined by radial immunodiffusion and correlated to Vital capacity (VC), obtained with a bell spirometer (Biomedin), and to oxyhemoglobin saturation (SaO2), obtained with a pulse oximeter (Minolta Pulsox 7). For statistical analysis, Student's "t" test, Pearson's chi-square and multiple regression were used. Significance was accepted at p < 0.05. We found significant correlation between elevated serum levels of IgG1 and decreased VC (r = -0.53; p < 0.01), and between high levels of IgG1 and decreased SaO2 (r = -0.45; p < 0.01). Elevated serum levels of IgG1 are significantly correlated with high levels of IgG2 (r = 0.41; p < 0.05) and with high levels of IgG4 (r = 0.43; p < 0.05). There is significant correlation between the increase in IgG4 and SaO2 impairment (r = 0.51; p < 0.01), but no significant correlation between IgG4 and VC was found. Patients with elevated serum levels of IgG1 had significantly lower VC than patients with IgG1 below the normal range (p < 0.002). No difference in VC was found, when comparing patients with low and high levels of the other subclasses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Langerhans cell histiocytosis in childhood: results from the Italian Cooperative AIEOP-CNR-H.X '83 study.

Ninety patients with biopsy-proven Langerhans cell histiocytosis (LCH) were enrolled from June, 1983, to December, 1988, in the multicenter AIEOP-CNR-H.X. '83 study. They were divided into two groups: poor prognosis (PP), comprising 11 children with organ dysfunction (OD), and good prognosis (GP), made up of 79 patients without OD. Eighty-four patients were evaluable for treatment results. Among GP patients, 16 with a single lesion received only local treatment, while 59 entered a clinical trial of immunotherapy and/or monochemotherapy with vinblastine (VBL). Nonresponders, sequentially received doxorubicin (ADM) and then etoposide (VP16). PP patients were treated with 4 week cycles of vincristine, ADM, cyclophosphamide, and prednisone for nine courses. The overall survival was 92.8% (100% for GP patients and 45.5% for PP patients) at 48 months. The complete response (CR) rates for immunotherapy, VBL, ADM, and VP16 were 10%, 62.9%, 42.8%, and 88.2%, respectively. Two of the 11 PP patients had a CR (18.2%), while six died and three are still alive with recurrent disease. The overall incidence of disease-related disabilities was 47.7%, while that of diabetes insipidus was 20%. Monochemotherapy is probably adequate in GP patients, while more effective treatments are needed for PP patients.

Adolescent↗
PubMed1989

Establishment and characterization of a human neuroblastoma cell line.

A continuous human cell line RN-GA was established from a stage-III primary neuroblastoma prior to therapy. Light and electron microscopic analysis of the biopsy showed morphological features typical of neuroectodermal origin. Relative cellular DNA content and N-myc oncogene copy number were also analyzed in the biopsy tissue: the tumor cells presented a near-diploid genome with N-myc amplification. The derived tumor cell line expressed distinctive ultrastructural, cytogenetic and immunological markers of neuroblastoma. Moreover, cells from the culture could be serially transplanted into splenectomized-irradiated nude mice, where they formed a progressively growing solid tumor. Surprisingly, the cells in culture did not show any N-myc amplification, while they retained a near-diploid DNA content. We propose that several techniques (electron microscopy, oncogene analysis, flow cytometry, cytogenetics, tissue culture, cell antigen immunodetection) should be used to establish a firm diagnosis and a correct clinical grading of this tumor. The establishment of this continuous cell line should be valuable as an experimental in vitro system for further studies of neuroblastoma biology and morphology.

Adrenal Gland Neoplasms↗
PubMed1988

Heterogeneity of immunological patterns in Langerhan's histiocytosis and response to crude calf thymic extract in 11 patients.

Response to treatment with daily intramuscularly administered crude calf thymic extract (Suppressin) in 11 patients with Langerhan's histiocytosis (L.H.) is reported. In ten patients, T-lymphocytic subsets were studied before starting immunotherapy: OKT3 positive and OKT4 positive cells were reduced in four patients; OKT8 positive cells were reduced in two patients; three patients were normal. After immunotherapy, one patient entered complete remission, four patients had stationary disease, and six had marked clinical progression. Subsequently eight patients underwent conventional chemotherapy, and only three entered complete remission. This study has demonstrated the heterogeneity of immunological patterns in L.H. and justifies the necessity for investigations on the immunoregulatory mechanism of L.H.

Child↗
PubMed1987

Neurofibromatosis and malignant childhood cancers: a survey in Italy, 1970-83.

Neural tumors, Wilms' tumor, rhabdomyosarcoma and several types of leukemia have been previously described in association with neurofibromatosis (NF). In a nation-wide collection of cases in Italy, 15 children (0-14 years of age) with NF and cancer or leukemia were identified; 13 of them had been diagnosed with cancer between 1976-83. The expected number of children with cancer and NF in 1976-83 was 4.48. The distribution of tumor types was different from that found in the general population, with a higher proportion of tumors of neural crest origin as well as soft tissue sarcomas. In 7/15 the family history was positive for NF; in 5/7 the individuals affected included the mother and/or a maternal relative.

Adolescent↗