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Biomedical subjects

M G Marin

Publications and source records attributed to M G Marin.

At least 19 recordsLinked to original sources

Field validation of autometallographical black silver deposit (BSD) extent in three bivalve species from the Lagoon of Venice, Italy (Mytilus galloprovincialis, Tapes philippinarum, Scapharca inaequivalvis) for metal bioavailability assessment.

The autometallographic approach was applied to three filter-feeder bivalves from differently polluted sites of the Lagoon of Venice. The area density (AD) values of black silver deposits (BSDs) were therefore seasonally quantified by image analysis in digestive cell lysosomes. Sediments were characterised in terms of grain size, organic content and metal concentrations (Cd, Cu, Ni, Pb, Zn). The physiological status of the bivalves was also evaluated by applying the "survival in air" test as a generic stress index. Chemical results showed that Zn contributed to the total metal load for more than 60% in sediments and for 85%-94% in mussel and clam digestive glands, respectively (data processed from published results obtained on the same samples). Regression analyses between extent of BSDs and both total metal and Zn concentrations in digestive gland followed a linear pattern in mussels and clams, but not in arks. Similarly, in mussels and clams only, BSD amount was significantly correlated with total metal concentrations in sediments according to a logarithmic model. Consequently, results obtained from autometallography can discriminate sites on the basis of their metal pollution levels, like chemical analyses on both sediments and digestive glands, evaluations being supported by the results of the physiological stress index. As a conclusion, it is suggested that autometallography in bivalves may provide overall estimates of metal fractions moving from sediments towards organisms through the ingestion of metal-enriched particles. Future work is needed to define the bioaccumulation model in arks and to clarify their possible use as metal biomonitors.

Animals↗

Effects of copper and cadmium exposure on functional responses of hemocytes in the clam, Tapes philippinarum.

The effects of Cu and Cd on functional responses of hemocytes in Tapes philippinarum, a Veneridae clam widespread in the lagoon of Venice, were evaluated. Bivalves were exposed for 7 days to various concentrations of CuCl(2) x 2H(2)O (0, 10, 60, and 110 microg/L) and CdCl(2) x H(2)O (0, 150, 300, and 450 microg/L). Hemocytes were collected from exposed clams, and the effects of Cu and Cd on phagocytosis, Neutral Red retention capacity, superoxide dismutase, and cytochrome oxidase activities were investigated. Hemocytes from animals exposed to Cu showed a significant decrease in phagocytic activity, whereas no inhibition was observed in cells from Cd-exposed animals. Diffusion of Neutral Red into the cytosol, an index of lysosomal membrane alteration, was enhanced by high concentrations of both metals. Different results in biochemical parameters were observed. Exposure to 60 and 110 microg Cu/L caused a significant reduction in hemocyte superoxide dismutase activity, whereas no changes resulted after Cd exposure. Increased cytochrome oxidase activity was observed in hemocytes from mollusks exposed to 60 microg Cu/L and 300 microg Cd/L; no significant differences were found in cells from bivalves exposed to 110 microg Cu/L and 450 microg Cd/L. These results suggest a relationship between heavy metal exposure and alterations in functional responses of hemocytes in T. philippinarum and indicate that the type of observed effects vary with the nature and concentration of heavy metals. Moreover, the data obtained in the analyzed clam support the possibility of using it as sentinel organism in biomonitoring studies, even if used biomarkers will be further evaluated in field conditions.

Animals↗

Haemocytes of the clam Tapes philippinarum (Adams & Reeve, 1850): morphofunctional characterisation.

Tapes philippinarum is a bivalve mollusc of the Pacific Ocean, successfully imported for human consumption into the northern Adriatic Sea (Europe). For better knowledge of its considerable adaptive ability in comparison with similar autochthonous species, a morpho-functional characterisation of its haemocytes was carried out with the establishment of short-term cell cultures (60 min at 25 degrees C). Various methods of cytochemical staining identified four cell types in the haemolymph: granulocytes (48.05% +/- 1.43), hyalinocytes (32.18% +/- 0.99), haemoblasts (18.97% +/- 0.63) and serous cells (0.8% +/- 0.19). The granulocytes, possessing cytoplasmic granules with differing dye affinity, included basophils, neutrophils and acidophils. Such granules stained vitally with Neutral Red, and correspond to lysosomes. Hydrolytic and oxidative enzymes were mainly detectable after stimulation in the presence of yeast cells. Both granulocytes and hyalinocytes were positive for alkaline phosphatase, non-specific esterase, peroxidase, and cytochrome C oxidase, whereas only granulocytes were positive for beta-glucuronidase, acid esterase, and arylsulphatase. Both cell types were competent phagocytes towards yeast and plasma had an opsonising effect. Moreover, the respiratory burst accompanied phagocytosis with superoxide anion production, recognisable through cytoplasmic deposits of formazan after treatment with nitro blue tetrazolium. Haemoblasts were small undifferentiated cells which, due to their morphology and positivity to the anti-CD34 antibody, show the typical features of stem cells. Serous cells, probably arising from Keber's gland and belonging to another differentiation pathway, contained non-sulphate acid mucopolysaccharides and play an important role in early defence mechanisms, taking part in the formation of clots.

5'-Nucleotidase↗

Adverse behavioral and sexual factors in chronic vulvar disease.

OBJECTIVE: We investigated the prevalence of adverse sexual, personal hygiene, and self-treatment behavior among women with chronic benign vulvar and vaginal disorders. STUDY DESIGN: This study was carried out by means of a scientific clinical audit producing actuarial data by way of a semistructured questionnaire. Subjects consisted of a sample of 530 cases treated at a specialist clinic for vulvar diseases. In addition to clinical and laboratory investigations, the patients were interviewed by the clinic's psychologist, who used a structured interview schedule developed specifically for the study. Descriptive analysis and analysis of variance were used to investigate data. RESULTS: Most patients remained sexually active in spite of arousal failure and discomfort and engaged in unlubricated and often painful sexual intercourse. Most women engaged in potentially harmful genital hygiene and self-treatment behavior. Adverse self-treatment practices but not adverse genital hygiene practices were associated with greater symptom duration. CONCLUSIONS: Adverse practices should be addressed during the management of cases of chronic vulvar disease.

Adult↗

Prevention of nosocomial bloodstream infections: effectiveness of antimicrobial-impregnated and heparin-bonded central venous catheters.

OBJECTIVES: To examine the effectiveness of antimicrobial-impregnated and heparin-bonded catheters relative to standard central venous catheters in lessening catheter-related bloodstream infections. DATA SOURCES: Articles were identified by computer-assisted searching. STUDY SELECTION: Studies were eliminated from further consideration if they did not contain original data relevant to lessening catheter-related bloodstream infections, were nonrandomized or uncontrolled, described subjects <17 yrs of age, or used animal subjects. DATA ABSTRACTION: From each eligible article, we abstracted the following: a) citation; b) type of control; c) study setting; d) type of experimental catheter; e) catheter-specific complications; f) total numbers of patients and catheters; g) number of experimental catheters used that resulted in a catheter-related bloodstream infection; h) number of control catheters used that resulted in a catheter-related bloodstream infection; i) number of experimental catheters used without catheter-related bloodstream infections; and j) number of control catheters used without infections. We also recorded the duration of catheter use and the types of microbes cultured in association with the catheters and with catheter-related bloodstream infections. DATA SYNTHESIS: Eleven eligible studies were identified. Using meta-analysis, we showed that antimicrobial-impregnated and heparin-bonded central venous catheters significantly decreased catheter-related bloodstream infections by 2.32% (95% confidence interval, 1.04% to 3.61%). CONCLUSIONS: The modest additional cost for the use of these catheters relative to the considerable cost of treating even a single bloodstream infection makes their use cost-effective.

Adult↗

Cost-effectiveness of a post-exposure HIV chemoprophylaxis program for blood exposures in health care workers.

We performed a cost-effectiveness analysis of a post-exposure chemoprophylaxis program for health care workers who sustained exposures to blood. We analyzed a program of (1) treatment with zidovudine alone versus no treatment and (2) treatment with three-drug therapy versus no treatment. Assuming that 35% of exposures were to HIV-positive sources, the zidovudine regimen prevented 53 HIV seroconversions per 100,000 exposures, at a societal cost of $2.0 million per case of HIV prevented. The cost per quality-adjusted life year saved was $175,222. A three-drug chemoprophylactic therapy program (postulating 100% effectiveness and 35% source HIV positivity), prevented 66 seroconversions per 100,000 exposures, at a cost of $2.1 million per case of HIV prevented and $190,392 per quality-adjusted life year saved. Treating sources known to be HIV-positive and treating severe exposures were the most cost-effective strategies.

Adult↗

Immunotoxic effects of organotin compounds in Tapes philippinarum.

One of the most harmful groups of coastal pollutants is the organotin compounds (OTCs) which have severe effects on both aquatic organisms and mammals including humans. The immunotoxic effects of OTCs were studied in the cultivated clam Tapes philippinarum by determining the immunosuppressant role on in vitro yeast phagocytosis at low doses (0.01, 0.05, 0.1 microM). The phagocytic index was significantly reduced in an irreversible non-lethal manner depending on concentration and lipophilic affinity. The order of inhibition was TBT > or = DBT > MBT for butyltins and TPTC > TPTA > or = TPTH for triphenyltins.

Animals↗

Dyspareunia and vulvar disease.

OBJECTIVE: To determine the presence and frequency of contributing factors in functional dyspareunia and if these factors differ between patients with an epithelial disorder and those with apparently healthy genitalia. STUDY DESIGN: A psychologist assessed patients reporting dyspareunia at a vulvar diseases clinic by using a structured interview questionnaire, the Beck Depression Inventory, and the Spielberger State/Trait Anxiety Inventory. The questionnaire topics included sexual behavior, stresses and coping. Data were divided into two groups based on patients' functional diagnosis or epithelial disorder. RESULTS: Both groups recorded high levels of trauma-producing sexual behavior. Such behavior included unlubricated, unaroused and undesired sex. High levels of psychological and coping difficulties were also seen. Differences between the groups were seen in undesired sex, capacity to cope, stress factors coincidental with symptom onset and distress at the time of interview. CONCLUSION: Due to the high frequency of factors contributing to dyspareunia, such factors should be address regardless of the diagnosis. In all such patients it is recommended that a sexual and stress history be taken and counseling be considered.

Adaptation, Psychological↗

Low-dose methotrexate spares steroid usage in steroid-dependent asthmatic patients: a meta-analysis.

STUDY OBJECTIVES: To determine if treatment with low-dose methotrexate spares oral steroids in adult, steroid-dependent, asthmatic patients. DESIGN: Articles identified by computer search were excluded if they (1) did not contain original data relating to the primary question, (2) had no controls, or (3) described subjects younger than 18 years of age. MEASUREMENTS: From each article, the following was abstracted: reference citation; type of control; whether study incorporated a run-in period in which the baseline level of prednisone was reduced to the lowest possible dose; dosage and length of methotrexate therapy; baseline dosage; and type of steroid. Also, the following was determined during both placebo and methotrexate arms of each study: steroid dosage, FEV1, serious side effects, and alteration in level of serum aspartate aminotransferase. RESULTS: Eleven eligible studies were identified. Methotrexate treatment resulted in a decrease in prednisone or prednisolone usage by an average of 4.37 mg/d or 23.7% of the initial dosage. The summary effect size in standard deviations (SDs) was -0.53 (95% confidence interval=-0.29 to -0.77). Subgroup analysis showed that patients treated with prolonged (6-month) therapy with methotrexate, those with low long-term usage of steroids (< or = 20 mg/d), and those whose study design incorporated a run-in period, tended to have the greatest steroid-sparing effects with methotrexate. CONCLUSIONS: Low-dose methotrexate has a significant steroid-sparing effect in steroid-dependent asthmatic patients. The greatest effect was evident in patients in whom an effort was made to reduce baseline steroid dosage and in whom methotrexate was used for 24 weeks.

Adult↗

Detection of HIV-1 proviral sequences in lymphocytes using a qualitative polymerase chain reaction assay.

The performance and clinical relevance of a qualitative PCR-based assay for the detection of HIV-1 DNA sequences in peripheral blood mononuclear cells (PBMCs) was evaluated by two different laboratories. Four hundred and one samples were obtained from 397 individuals from different risk populations. All blood donors tested had negative results; positive signals were obtained from all infected patients. HIV-1 DNA was detected in 3 of 17 infants born to seropositive mothers; Western blot indeterminate blood donors and exposed health-care workers had negative results. Our results demonstrate that this PCR assay provides both sensitive and specific results and is suitable for testing large numbers of samples and for rapid identification of HIV-1 infection.

Base Sequence↗

HCV-RNA detection in ultrasound-guided fine needle biopsies of liver nodules and surrounding tissue.

HCV-RNA was examined in serum and liver tissue obtained from 8 hepatitis B surface antigen (HBsAg) negative patients with liver nodules ranging in size from 2 to 11 cm. Histological examination of ultrasound-guided fine needle biopsies revealed the presence of hepatocellular carcinoma (HCC) in six patients (5 of whom were anti-HCV positive), cholangiocarcinoma in 1 patient (anti-HCV positive) and dysplastic regenerative nodule in 1 patient (anti-HCV negative). The HCCs were surrounded by cirrhosis (3 cases), chronic active hepatitis (CAH) (n = 2) and post hepatitic fibrosis (n = 1), the cholangiocarcinoma by CAH and the regenerative nodule by cirrhotic liver. Total and replicative intermediate HCV-RNA was analyzed by reverse-transcription-nested PCR of the 5'-untranslated region. The five patients with HCC had HCV-RNA in serum, in tumorous and surrounding liver tissues. The viral nucleic acid was also detected in the cirrhotic tissue surrounding the cholangiocarcinoma but not in the tumor. Two out of 5 HCC patients had replicative intermediate RNA (negative strand) in tumorous tissue, 4 in nontumorous tissue and 3 in serum. These results demonstrate that fine needle biopsy can provide sufficient material for both histological examination and HCV-RNA determination and suggest the existence of continuous viral replication during the carcinogenic process.

Aged↗

Hepatitis C virus viremia following clinical resolution of acute hepatitis C.

Clinical resolution of acute hepatitis C occurs in a limited proportion of cases. However, the rate of hepatitis C virus persistence remains unclear. For this purpose, we conducted a serial study of 60 patients with hepatitis C virus infection from the early stage of the disease for 24 to 80 months (average 50 months). Fourteen cases who recovered from acute hepatitis were selected from this group for prospective analysis of the behavior of liver enzymes, anti-HCV antibodies (RIBA II, Ortho Diagnostic System) and hepatitis C virus-RNA in serum and in peripheral blood lympho-mononuclear cells by nested polymerase chain reaction. Primers were derived from the 5'-untranslated region of the hepatitis C virus genome and the amplified products were detected by gel electrophoresis and a DNA enzyme immunoassay. All patients except two showed early recovery from acute hepatitis that occurred within 3 months from clinical onset. Transaminase normalization was always preceded by clearance of serum hepatitis C virus-RNA, which remained negative throughout follow-up. During the resolution phase of the disease a progressive decline in the antibody response was observed in most of the patients. At the end of the study anti-C100 was negative in half the cases, while anti-C33 and anti-C22 became negative or borderline in five cases. Hepatitis C virus-RNA was found in the peripheral blood lympho-mononuclear cells, but not in the serum, of only one of eight patients tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

Clinical significance of serum hepatitis C virus (HCV) RNA as marker of HCV infection.

We have evaluated the clinical significance of hepatitis C virus (HCV) RNA determination by analyzing a group of 221 hospitalized patients with abnormal liver function tests. Serum HCV RNA was detected by "nested" PCR amplification followed by nonisotopic hybridization. Of the 200 (90.5%) patients with anti-HCV-positive enzyme-linked immunosorbent assay results, 152 (76%) were RIBA reactive, 47 (23.5%) had indeterminate results, and 1 (0.5%) was nonreactive. Of the 180 (90%) patients positive for anti-HCV and HCV RNA, 138 (76.7%) were RIBA reactive and 42 (23.3%) were RIBA indeterminate. The pattern of RIBA reactivity did not correlate with the presence of HCV RNA. Elevated alanine aminotransferase levels were associated neither with the presence of viremia nor with the RIBA pattern. Histological findings consistent with non-A non-B hepatitis correlated with the presence of HCV RNA but not with the RIBA pattern. HCV RNA was detected in 11 of 21 (52.4%) anti-HCV-negative patients. These 11 patients were either immunosuppressed or in the prodromic phase of acute hepatitis C. Circulating HCV RNA can therefore be described as being predictive of virus-induced liver damage in anti-HCV-positive patients and may be useful in the diagnosis of HCV infection in anti-HCV-negative immunosuppressed patients or in those with early acute infection.

Adult↗

Distribution of viral genotypes in Italy determined by hepatitis C virus typing by DNA immunoassay.

The distribution of hepatitis C virus (HCV) genotypes in Italy was investigated by PCR amplification of the E1 region and hybridization with type I- and type II-specific nonisotopic probes. Positive PCR results were obtained for 65 of 72 patients (90.3%). Type I was detected in 13 of 72 patients (18%), type II was detected in 39 patients (54.2%), and a mixed type I-type II infection was detected in 7 patients (9.7%). Six amplification products not classified by this method shared a low level of homology with HCV types I and II. HCV type I was significantly associated with human immunodeficiency virus, whereas HCV type II was detected in older subjects who were negative for human immunodeficiency virus markers. These results indicate different epidemiological distributions of HCV types I and II in Italy.

Adult↗

T-cell response to structural and nonstructural hepatitis C virus antigens in persistent and self-limited hepatitis C virus infections.

Twenty-nine patients with chronic hepatitis C and 15 asymptomatic hepatitis C virus antibody-positive subjects who clinically recovered from hepatitis C virus infection were studied for their peripheral blood lymphomononuclear cell proliferative response to hepatitis C virus structural and nonstructural antigens (core, envelope, nonstructural 4 and nonstructural 5) expressed in yeast as superoxide dismutase fusion proteins, in an initial attempt to define some of the features of the virus-specific immune response. Hepatitis C virus core was the most immunogenic antigen for human leukocyte antigen class II-restricted T cells in both groups of patients studied, and the proliferative response to it was the most vigorous and the most frequently expressed in comparison with the other antigens tested. The specificity of the results was supported by the lack of response to hepatitis C virus antigens by healthy uninfected controls and confirmed by recognition of recombinant core proteins of different origin (yeast and baculovirus) by polyclonal T-cell lines produced by T-cell stimulation with yeast-derived core. Each of the antigens tested was able to induce significant although variable levels of proliferative response, indicating that all can be immunogenic at the T-cell level. Significant proliferative responses to core, nonstructural 4 and nonstructural 5 antigens were more frequently detected in subjects who were able to eradicate infection than in patients with chronic hepatitis C, although the difference was statistically not significant. No difference was observed between the two groups of patients with respect to the response to the putative envelope antigens.

Adult↗