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M Comelli

Publications and source records attributed to M Comelli.

47 records · Page 3Linked to original sources
PubMed1988

[Imported malaria in Lombardia. A second review of hospitalized cases in 1981-1985].

We carried out a research on hospitalized cases of imported malaria in Lombardy in the period 1981-1985 to characterize the risk factors and the clinical features of this phenomenon and to identify its trend in comparison with the previous quinquennium (Carosi et al., 1983). 1) Prevalent factors of risk are: the P. falciparum etiology (68%), the african origin of the strains, the work motivated travelling (56%) and a long period of stay (56%) in the summer-autumnal season (62%). On the contrary, in the previous quinquennium, short periods of stay during winter season prevailed. 2) As far as the chemoprophylaxis is concerned, it has been adopted in 55% of the cases, but only in 14 cases it was correct. In 52% of the cases, symptoms were noted within 20 days of re-entry, and in 17% of the cases they started abroad. In 62% of the cases a correct diagnosis was made within 10 days from the onset of symptoms and in 72% fever disappeared within 48 hours after therapy. Data show an inversion of the trend of the previous quinquennium and evidentiate a wider use of chemoprophylaxis and a more effective therapeutic action by the Sanitary Structure in Lombardy. The Authors stress the need for improvement in malaria control programs by Italian industries working in Developing Countries (roads and dams construction) and the increasing prophylactic problems related to che widespread extent of chloroquine resistant P. falciparum strains in Africa. Our causistry shows the outcome of 14 falciparum malaria cases in spite of correct chloroquine chemoprophylaxis.

Adult↗
PubMed1987

Sepsis score and acute-phase protein response as predictors of outcome in septic surgical patients.

In a series of 135 patients with severe surgical infections, we determined the sepsis score and the plasma level of the acute-phase proteins alpha-1-acid glycoprotein, alpha 1-antitrypsin, complement factor B, and C3. The initial sepsis score was a strong determinant of survival: in survivors it was significantly lower than in nonsurvivors. Only 8% of patients with a sepsis score above 20 survived. At the onset of severe sepsis, the plasma levels of all four acute-phase proteins were significantly lower in nonsurvivors. A significant elevation of C3a levels in the plasma of both surviving and nonsurviving patients indicated marked consumption of complement components in all patients with severe sepsis. A linear equation was developed to predict survival: sepsis index of survival (SIS) % = 121 + 0.26 (complement factor B) + 0.36 (alpha-1-acid glycoprotein)-6 (sepsis score). Based on our analysis, at the onset of severe sepsis, an SIS of 50% or more can correctly predict 88% of survivors and an SIS less than 50% can correctly predict 86% of nonsurvivors several days in advance of clinical outcome.

Adult↗
PubMed1987

[Epidemiological aspects of imported malaria 1976-1985].

The comparative analysis of the cases of imported malaria in Lombardy and in Italy during the ten-years period 1976-1985 shows that the prevalent factors of risk are, in both case-lists, the young age, the work motivated travelling and the stay in endemic areas of tropical Africa, where P. falciparum is greatly prevalent. Interesting outcomes of comparison of the two consecutive five-years periods 1976-1980 and 1981-1985 are discussed. As far as the african provenience (decreased) and the work motivated travelling (increased) are concerned, the two case lists are consistent and agree, yet P. falciparum malaria cases are decreased in Lombardy only. The increasing habit of chloroquine chemoprophylaxis in Lombardy, the persistant sensitivity of P. vivax to this drug and the widespread extent of chloroquine-resistant P. falciparum strains in Africa are to be taken into account.

Adult↗
PubMed1983

[Importation of malaria to Lombardy. I - Analysis of reported cases].

The comparative analysis of the cases of imported malaria in Lombardy and in Italy during 1976-1980, shows that the prevalent factors of risk are, in both, the male sex, the young age, the stay in endemic areas of tropical Africa where P. falciparum is greatly prevalent. The only very significant difference is represented by the prevalence of touristic motivation of the stay among the cases of Lombardy. The efficacy of prophylaxis against these factors of risk allowed to note, in the two last years considered (1979-1980), a sharp reduction of the annual number of cases in opposition to the trend of European cases of malaria.

Female↗
PubMed1983

Lomest psychiatric case register: the statistical context required for planning.

Descriptive statistics derived from a psychiatric case register are presented. They may be useful for a more rational planning of new services, and provide a preliminary evaluation of the effects of the recent Act (1978) which has abolished large mental hospitals in Italy. Each component of the 1-year prevalence rates has been examined closely, and the results have indicated three main considerations: abolishing the large mental hospital does not abolish the long-stay patients still living in it, and these people will remain a heavy load on the mental health care system for a long time; the new Act has halved admission rates, but the decline may be a positive result if in-care and out-care are sufficiently integrated; treated out-patients tend to increase year by year, and they seem more and more to be "young men and middle-aged women" suffering from minor psychiatric disorders. Finally, a closer collaboration between planners and evaluators is suggested.

Adolescent↗
PubMedDate not supplied

Melatonin and oxidative damage in mice liver induced by the prooxidant antitumor drug, adriamycin.

Antioxidant properties have been attributed to melatonin; it seemed therefore worthwhile to determine its effects in relation to the prooxidant action of adriamycin, which contributes to its toxic and therapeutic effects. Melatonin effectively acts as a direct free radical scavenger in the concentration range of 20-100 microM as determined in vitro, using Fenton reaction as a source of free radicals that were determined by EPR using spin trapping method. Following the administration of a single i.v. dose of 28 mg/Kg or of 3 repeated i. p. doses of 5 mg/Kg adriamycin to CBA mice, glutathione levels in the liver cells were significantly reduced. When the treatment with adriamycin was preceded by the s.c. administration of 2 mg/Kg melatonin, the decrease in total and reduced glutathione concentrations was significantly prevented. A significant increase in lipid peroxidation was observed in liver cells after a single administration of adriamycin which was not attenuated by pretreatment with melatonin. These results indicate that further examination of the possible protective action of melatonin on the toxic effects of prooxidant antitumor drugs on normal and neoplastic tissues would be of interest also in relation to their chronotoxicological properties.

Animals↗
PubMedDate not supplied

Estimate of expected survival at diagnosis in Hodgkin's disease: a means of weighting prognostic factors and a tool for treatment choice and clinical research. A report from the International Database on Hodgkin's Disease (IDHD).

PURPOSE: The aim was to identify a mathematical model that, when fitted with the survival time distribution of a Hodgkin's disease population, would provide a reliable estimate of expected survival at diagnosis for any new Hodgkin patient. This model would be based upon a multivariable selection of the best prognostic factors evaluable at diagnosis and its forecast could be of assistance in the choice of treatment. METHODS: The study sample consisted of the 5,023 patients whose basic clinical information was collected into the IDHD. These were people treated with standard protocols over the last two decades in 18 institutions. Several survival time distributions (exponential, Weibull, Gompertz, log-logistic and log-normal) were investigated to find the one that best fit the data and to relate its parameters to patient prognostic characteristics. RESULTS: The log-normal model provided the best fit for the data. The most statistically significant prognostic covariates were stage, age, histotype, B symptoms, serum albumin, sex and involved area distribution. Mediastinal, extranodal or bone marrow involvement, erythrocyte sedimentation rate, hemoglobin, serum alkaline phosphatase and lactate dehydrogenase did not add significant information. An equation containing these seven variables was derived to estimate median survival. Five distinct prognostic classes were identified by four cut-off values for this estimate. CONCLUSIONS: Direct use of estimated median survival or allocating each patient into one of the five prognostic classes allows better tailoring of clinical strategies according to prognostic characteristics, more accurate patient stratification and evaluation of results in clinical trials and metaanalyses. Instructions are given for using this tool for both clinical and investigational purposes.

Adolescent↗