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Biomedical subjects

M Giuliani

Publications and source records attributed to M Giuliani.

At least 55 records · Page 3Linked to original sources
PubMed1998

Risk factors for cervical presence of human papillomavirus DNA among women at risk for HIV infection. DIANAIDS Collaborative Study Group.

Risk factors for cervical infection with human papillomavirus (HPV) were assessed among 236 Italian women at risk for human immunodeficiency virus (HIV) infection (intravenous drug users (IVDU) or sexual partners of males at risk for HIV infection). All study participants underwent a structured interview, determination of HIV serostatus and detection of HPV cervical infection by means of polymerase chain reaction (PCR). Overall, the cervical presence of HPV DNA was ascertained in 86 of these 236 women (36.4%), while squamous intraepithelial lesions (SIL) were diagnosed in 57 (24.1%). HPV-infected and non-infected women did not differ in age, education and cigarette smoking. A statistically significant trend in the risk of HPV infection with increasing number of lifetime sexual partners was noted (P = 0.01), but such trend was attenuated in multivariate analysis (multiple logistic regression (MLR) odds ratio (OR) for > or = 20 partners vs 1 = 1.6, 95% confidence intervals (CI): 0.4-5.9). A nearly threefold higher risk of HPV cervical infection emerged among IVDU women (MLR-OR: 2.7, 95% CI: 1.4-5.0), and this difference was not influenced by HIV serostatus. The prevalence of HIV infection was higher among HPV-positive than HPV-negative women (62.8% and 54.0%, respectively) (MLR-OR = 1.9, 95% CI: 0.9-3.8), and the proportion of women with less than 200 CD4+ cells/mm3 was slightly and not significantly higher among HPV-positive (47.1%) than negative women (37.2%).

DNA, Viral↗
PubMed1998

Sentinel surveillance of sexually transmitted diseases in Italy.

Statutory notifications suggest that the incidence of gonorrhoea and syphilis have fallen in the past 30 years in Italy, as in other developed countries. Nevertheless, during the 1980s, the annual notification rates in Italy were from 15 to 50 times lower

Journal Article↗
PubMed1997

HIV infection increases the risk of squamous intra-epithelial lesions in women with HPV infection: an analysis of HPV genotypes. DIANAIDS Collaborative Study Group.

We assessed the association between different HPV genotypes, HIV infection, and cervical squamous intra-epithelial lesions (SIL) in 236 women with known HIV serostatus enrolled in a longitudinal multicentric study in Italy. Of these women, 135 were HIV-infected, and were not markedly different from HIV-negative women with regard to demographic characteristics, sexual practices, smoking, or intravenous drug use. We obtained 232 cervical smears suitable for cytological examination and HPV-genotype analysis (134 from HIV-positive women and 98 from HIV-negative women). For 86 HIV-positive and 89 HIV-negative women, the smears appeared normal at cytomorphological analysis. Cytological dysplasia of varying degrees was detected in 48 smears from HIV-positive women and in 9 from HIV-negative women. HPV prevalence, assessed using polymerase-chain-reaction analysis, did not significantly differ between HIV-positive and HIV-negative women. The prevalence of HPV-associated SIL was much greater among HIV-infected women. The most frequently detected genotypes in both groups were HPV 16 and HPV 18. The prevalence of HPV 16 among HIV-positive women was similar to that for HIV-negative women; this was also true for HPV 18. However, in the HIV-positive group, most of these genotypes were associated with SIL. HIV-positive women showed a wider spectrum of genotypes, including non-oncogenic and rare types. An association between SIL and HIV infection was confirmed for all HPV genotype classes.

Adult↗
PubMed1997

Efficacy of compression of different capacitance beds in the amelioration of orthostatic hypotension.

Orthostatic hypotension (OH) is the most disabling and serious manifestation of adrenergic failure, occurring in the autonomic neuropathies, pure autonomic failure (PAF) and multiple system atrophy (MSA). No specific treatment is currently available for most etiologies of OH. A reduction in venous capacity, secondary to some physical counter maneuvers (e.g., squatting or leg crossing), or the use of compressive garments, can ameliorate OH. However, there is little information on the differential efficacy, or the mechanisms of improvement, engendered by compression of specific capacitance beds. We therefore evaluated the efficacy of compression of specific compartments (calves, thighs, low abdomen, calves and thighs, and all compartments combined), using a modified antigravity suit, on the end-points of orthostatic blood pressure, and symptoms of orthostatic intolerance. Fourteen patients (PAF, n = 9; MSA, n = 3; diabetic autonomic neuropathy, n = 2; five males and nine females) with clinical OH were studied. The mean age was 62 years (range 31-78). The mean +/- SEM orthostatic systolic blood pressure when all compartments were compressed was 115.9 +/- 7.4 mmHg, significantly improved (p < 0.001) over the head-up tilt value without compression of 89.6 +/- 7.0 mmHg. The abdomen was the only single compartment whose compression significantly reduced OH (p < 0.005). There was a significant increase of peripheral resistance index (PRI) with compression of abdomen (p < 0.001) or all compartments (p < 0.001); end-diastolic index and cardiac index did not change. We conclude that denervation increases vascular capacity, and that venous compression improves OH by reducing this capacity and increasing PRI. Compression of all compartments is the most efficacious, followed by abdominal compression, whereas leg compression alone was less effective, presumably reflecting the large capacity of the abdomen relative to the legs.

Adult↗
PubMed1997

Heritability of 39 orthodontic cephalometric parameters on MZ, DZ twins and MN-paired singletons.

The twin method is one of the most effective methods available for investigating genetically determined variables in orthodontics, as well as in other medical fields, depending on the variance in the shape and the size of skull and teeth, both on genetic and environmental influences. The former have been extensively evaluated and, in particular, most of the facial and dental cephalometric parameters have shown high heritability, the vertical parameters have a higher genetic control compared with the horizontal ones. Nevertheless, most of the results provided by twin research have been considered arbitrary if directly transferred to a singleton population and in further studies, including extensive analysis of the parents, familial and nutritional habits have been recommended. In this study, heritability of 39 lateral orthodontic cephalometric parameters has been estimated by both statistical method of path analysis and Dahlberg' quotient in three orthodontic samples of young monozygotic and dizygotic twins and same-sex pairs of singletons living together, matched for sex and age, to evaluate genetic versus environmental factors affecting heritability of craniofacial features in the aim to obtain results not only statistically significant but also transferrable to a singleton population. Different inheritance trends, showing the highest concordance of values between monozygotic twin pairs when compared with dizygotic twin pairs or the same-sex singletons paired group, come from the 39 selected lateral cephalometric parameters, confirming the hypothesis that strong genetic control is exerted especially on the vertical ones. Heritability seems to have more influence on anterior vertical parameters than posterior. Mandibular structure seems to be more genetically determined than mandibular size. All five Ricketts' cephalometric typological parameters confirm high heritability coefficients, the same applies to the linear horizontal McNamara's measurement and lower incisor to A-Pg line. The two tested statistical methods showed relevant concordance of results.

Adolescent↗
PubMed1997

Sexually transmitted diseases among foreigners in Italy. Migration Medicine Study Group.

A sentinel surveillance system for the control of sexually transmitted diseases (STD) among foreigners was developed in Italy in 1991. From January 1991 to June 1995, 4030 foreigners with a new STD episode were reported. More than one-third of them were North-Africans. The most frequent STDs were non-specific urethritis and genital warts among men, and non-specific vaginitis and latent syphilis among women. The overall HIV prevalence was 5%, with large differences in rates in people from different continents. Very high HIV-positivity rates were observed among homosexuals and homosexual IDUs from Central-South America, with 39.1% and 77.8% seropositive individuals respectively. These data stress the need for increased knowledge of both the spread of risk factors for STDs among immigrants. Particular attention should be paid to counselling procedures focused on the prevention of risk behaviours for acquiring STDs and HIV infection.

Adult↗
PubMed1997

Determinants of squamous intraepithelial lesions (SIL) on Pap smear: the role of HPV infection and of HIV-1-induced immunosuppression. DIANAIDS Collaborative Study Group.

This study aimed to identify risk factors for squamous intraepithelial lesions (SIL) in women with known HIV status and to explore the association between SIL, HPV subtype, and HIV-induced immunosuppression. The study population consisted of women with known HIV serological status who were attending a network of 16 clinical centres in Italy. Detailed behavioural data, clinical and laboratory parameters, and samples for diagnosis of SIL by Papanicolau smear and HPV infection using a polymerase chain reaction (PCR) were obtained from each study participant. The strength of the association between SIL and possible risk factors was assessed calculating crude and adjusted odds ratios derived from univariate analysis and multivariate models. We enrolled 236 women, of whom 135 (57.2%) were HIV-infected. SIL was diagnosed in 57 women (24.1%); of these, 48 (35.6%) were HIV-infected and 9 (8.9%) were HIV-negative. HPV-DNA was detected in 41 (72%) women with SIL and in 45 (25%) women without SIL. HPV-DNA was more often detected among HIV-infected women than among HIV-negative women (40% vs. 32%), but the difference was not statistically significant. Women infected with high-risk types or with low-risk-uncharacterised types of HPV both had a higher risk of SIL compared with HPV-negative women (respectively, AOR: 17.53 and AOR: 2.89). HIV-infected women with severe or moderate immunosuppression were more likely to have SIL than HIV-negative women (respectively, AOR: 7.29 and AOR: 3.09) also independently from HPV infection. Women reporting use of a contraceptive pill had a 2.5 times higher risk of SIL compared with those who never used hormonal contraceptives. The results confirm that high-risk HPV types are strongly associated with SIL, and that HIV infection may strengthen the effect of HPV at cervical level. The use of oral contraceptives may slightly increase the risk of SIL in women with at-risk behaviour for HIV infection.

Adult↗
PubMed1997

Incidence and determinants of hepatitis C virus infection among individuals at risk of sexually transmitted diseases attending a human immunodeficiency virus type 1 testing program.

BACKGROUND: The role of sexual transmission of hepatitis C virus (HCV) infection is still not completely understood, partly because of the lack of longitudinal studies among cohorts of HCV-negative individuals who engage in at-risk sexual behavior. GOALS: To evaluate the incidence of HCV infection in a population at risk for human immunodeficiency virus type 1 (HIV-1) infection and other sexually transmitted diseases (STD) and to identify factors associated with HCV seroconversion. STUDY DESIGN: A retrospective longitudinal study was carried out on a cohort of consecutive attendees of a voluntary HIV-1 testing and counseling program in a large STD center in Rome. All individuals undergoing at least two consecutive tests for HCV antibodies were enrolled. Clinical data and information on individual behavior were collected for all study participants. RESULTS: Between June, 1992 and December, 1994, a total of 709 individuals (12 intravenous drug users [IDU], 244 homosexuals, and 453 heterosexual non-IDUs), initially negative for HCV antibody, were tested more than once. Among these individuals, 15 HCV seroconversions occurred. The average follow-up time was 1.25 person/years (p/y) for an incidence rate of 1.69 per 100 p/y. The incidence rates by exposure category were 39.30 per 100 p/y among IDUs, 1.37 per 100 p/y among homosexual men, and 0.97 per 100 p/y among heterosexual non-IDUs. Excluding IDUs, of the 697 STD clinic attendees engaging in at-risk sexual behavior, HIV-1-positive status tended to be associated with HCV seroconversion (relative hazard = 5.48; 95% confidence interval = 0.85-35.40). The HCV crude incidence rates among HIV-1-infected patients at enrollment was 11.5%, 4.2%, and 2.4% in those with severe, moderate, and mild levels of immunosuppression, respectively (chi-square for trend = 2.38, P = 0.1). CONCLUSIONS: In this cohort, HCV infection was confirmed to be strongly associated with intravenous drug use. Nonetheless, the occurrence of two thirds of the total HCV seroconversions in non-IDU individuals engaging in at-risk behavior suggests a role of sexual practices in the transmission of the infection. Among non-IDU individuals, the risk for development of HCV infection tended to increase in those who were HIV-1 infected.

Adolescent↗
PubMed1997

[Saliva: clinical and diagnostic usefulness. Review of the literature].

Modern clinical pathology is mainly based on the analysis of blood samples, carried out through more and more sophisticated techniques. Being the blood test an invasive technique, it certainly reduces the possibility of carrying out blood analysis, especially in patients such as children, old people, handicapped people and every person who needs continuous biochemical or pharmacological monitoring. In these cases it is very important to find other body fluids that can be easily obtained and that can offer the same reliable data as blood. Due to some of its characteristics, sometime saliva may be a good alternative to venous blood, as it presents the same features of plasma or urine. The chemical analysis of saliva provides some information that are useful for metabolic, inflammatory, neoplastic and genetic diseases; furthermore radioimmunological dosages allow to assess small concentrations of active substances. On the basis of an accurate review of literature, the aim of this study is to analyse the importance of saliva in diagnosing and monitoring certain systemic diseases, the utilization of saliva in hormonal and pharmacological dosages and the use of saliva in some epidemiological studies. Finally, it is emphasized that saliva in monitoring may help to manage several clinical conditions.

Diagnostic Techniques and Procedures↗
PubMed1996

Episodic ataxia and myokymia syndrome: a new mutation of potassium channel gene Kv1.1.

Episodic ataxia and myokymia syndrome is an autosomal dominant disorder characterized by persistent myokymia and attacks of unsteadiness, slurred speech, and tremulousness. This disease has been associated with point mutations in the potassium channel gene Kv1.1 (KCNA1), located at chromosome 12p13. Here, we describe a novel mutation within this gene in a newly diagnosed family.

Ataxia↗
PubMed1996

Intrapatient comparison of atrial and ventricular sensing, pacing threshold, and impedance: benefits with steroid-eluting leads.

We compared the atrial and ventricular bio-electrical effects relating to pacing threshold, pacing impedance, and pacing energy in each of 58 patients to determine the importance of pacing impedance in safe low energy stimulations. The study was conducted during 4 years of follow-up. Of the 58 patients in our study, 31 were stimulated in both chambers with steroid-eluting leads (Capsure 4503 and 4003) and 27 with platinum electrode catheters (Target Tip 4511 and 4011). The two groups were homogeneous in sex, age, cardiopathy, and reason for implant. At 6 months, the mean impedance values for the Target Tip were: 358 +/- 72 omega for the atrium and 443 +/- 72 omega for the ventricle (P < 0.00002); after 1 year, atrium = 386 +/- 77 omega, ventricle = 439 +/- 42 omega (P < 0.04); at 2 years, atrium = 409 +/- 86 omega, ventricle = 510 +/- 94 omega (P < 0.0001); at 3 years, atrium = 428 +/- 81 omega, ventricle = 494 +/- 67 omega (P < 0.02); and at 4 years, atrium = 424 +/- 71 omega and ventricle = 501 +/- 69 omega (P < 0.003). The mean impedance value (for the Capsure) was: atrium = 351 +/- 43 omega, ventricle = 431 +/- 81 omega at 6 months (P < 0.03); at 1 year, atrium = 359 +/- 38 omega, ventricle = 446 +/- 83 omega (P < 0.01); at 2 years, atrium = 304 +/- 124 omega, ventricle = 459 +/- 108 omega (P < 0.0003); at 3 years, atrium = 359 +/- 108 omega, ventricle = 461 +/- 89 omega (P < 0.02); and at 4 years, atrium = 419 +/- 133 omega and ventricle = 515 +/- 75 omega (P < 0.01). In view of the chronic threshold, low energy stimulation was used at follow-up. The mean low energy stimulation values programmed for Target Tip were: atrium = 2.5 V/0.35 ms, ventricle = 2.5 V/0.30 ms; for Capsure, atrium = 2.5 V/0.25 ms, ventricle = 2.5 V/0.25 ms. The mean stimulation energy value was 31% higher in the atrium than in the ventricle with Capsure leads, and 39% higher with Target Tip. Pacing impedance was lower in the atrium than in the ventricle with both leads. Energy consumption in the atrium is significantly greater than in the ventricle with both leads, particularly with Target Tip.

Aged↗
PubMed1995

[Physiopathology of vasovagal syncope: review of the most endorsed theories and recent findings].

Vasovagal syncope is associated with an abnormal reflex and the physiopathological mechanisms of the phenomenon overall are only partially known. Experimental and clinical studies suggest that the main factor which triggers the syncope is the brusque interruption of the alpha-adrenergic tone with marked, sudden peripheral vasodilation. Although documented, vagal hypertony, with consequent bradycardia and asystolia, is only occasional and is almost always a secondary phenomenon. The most commonly suggested cause of vasovagal syncope is a Bezold-Jarish reflex starting from the cardiac receptors in the walls of the ventricle, mediated by the paradoxical activation of afferent vagal fibres. However, recent studies are suggesting that there may be other pathogenetic mechanisms such as the paradoxical activation of the venous-atrial baroceptors and other "extracardiac" vascular receptors. The neuro-endocrine aspect of the vasovagal reaction is very complex and in spite of the many studies carried out on the catecholamine, renal-angiotensive system, arginine-vasopressin, and b-endorphine trends, there are still many points awaiting clarification. The response of the autonomous nervous system linked to age also require further research.

Age Factors↗
PubMed1992

Hormonal and immunological pattern in a patient with acquired immunodeficiency syndrome related complex and Cushing's syndrome.

A case of Cushing's syndrome in a 24-yr-old homosexual with an AIDS-related complex is reported. In this patient certain symptoms common to both diseases, i.e. weakness, myalgia and muscle atrophy were accentuated, whereas other symptoms pathognomic of the human immunodeficiency virus (HIV) infection, i.e. lymphoadenopathies and weight loss, were less pronounced by the high levels of circulating adrenal steroids. Ketoconazole was administered po in order to block adrenal steroidogenesis, the drug caused a remarkable fall of cortisol serum concentrations, but was unable to modify significantly the immunological pattern of the patient. Our data suggest that changes of serum adrenal steroid levels have little effect on the immune network of patients with AIDS.

AIDS-Related Complex↗
PubMed1992

The National Surveillance System for Sexually Transmitted Diseases in Italy. STD Surveillance Working Group.

Sexually transmitted diseases (STDs) have increased in importance in recent decades as a result of their wider dissemination, the emergence of new etiologic agents, and changes in sexual behaviors. In Italy, gonorrhea and syphilis are among the 71 diseases for which reporting is legally mandated. Despite these legal requirements, however, considerable underreporting has been documented. The need for more reliable data has led to the establishment of a formal sentinel surveillance system for STDs. The Italian National STD Surveillance Network, which involves 47 reporting centers, was established in 1990. A total of 5,049 patients were reported during the pilot study and the first 6 months of surveillance. For men, the most frequently reported diseases were genital warts and nongonococcal urethritis; for women, the most frequent diagnoses were nonspecific vaginitis and genital warts. The objectives of this system are threefold: a) to obtain a rapid and accurate assessment of the occurrence and spread of STDs; b) to identify trends in disease occurrence; and c) to monitor changes over time by geographic area.

Adult↗
PubMed1991

AIDS cases in adolescents and young adults in Italy: inferences from descriptive epidemiology.

To assess the magnitude of the AIDS epidemic in the Italian adolescent (13-19 years) and young adult (20-24 years) age groups, data on AIDS cases notified to the AIDS Operational Centre as of 31 March 1990 were used. Of the 6068 reported AIDS cases, 0.7% occurred among adolescents and 15.7% among young adults. Among adolescents most cases were haemophiliacs (45.4%), while among young adults, drug use was the most frequently reported mode of transmission (87.5%). Females were more likely than males to contract the disease through the heterosexual contact in both the adolescent (20.0% vs 0%) and in young adult (15.1% vs 0.7%) age groups. Among young adults a geographical trend was present with a decrease in case rates from north to south, while for adolescents the rates were higher in northern and southern than in central Italy. If the incidence of AIDS is to be reduced in Italy, further efforts should be made to target the adolescent age group, since many of the young adult cases are likely to have resulted from HIV infection during adolescence.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Copper-zinc superoxide dismutase in human and animal dental pulp.

The activity of the enzyme superoxide dismutase, scavenger of the superoxide anion (O2-.), was assayed in the normal dental pulp of man, dog, rabbit and pig. Very low levels of Cu-Zn-containing superoxide dismutase found in the pulpal tissue investigated support the hypothesis of a relationship between the reactivity of the dental pulp to inflammatory processes and a low protection against oxy-radicals.

Animals↗