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Biomedical subjects

M Olivieri

Publications and source records attributed to M Olivieri.

At least 19 recordsLinked to original sources
PubMed2002

An expandable nailing system for the management of pathological humerus fractures.

BACKGROUND: People with metastatic fracture of the humerus are of poor general health. Often they are not able to compensate the handicap of an impaired extremity. Standard osteosynthetic techniques are not always applicable. To reduce the trauma of the operation, we used the Fixion expandable nail system. METHODS: At two centers, 23 metastatic fractures of the humerus (in 22 patients) were stabilized with a new nailing system. The nail expands under hydraulic pressure up to 150% of its uninflated diameter, gaining long frictional contact to the bone. All patients were followed up until osseous healing occurred or until they died. RESULTS AND CONCLUSIONS: The operative time was approximately 32 min, including 1.4 min fluoroscopy time. Nail insertion is brief and therefore not very stressful to the group of debilitated patients who require this intervention. Immediately postoperatively, the upper extremity is stable to permit physiotherapy. In these few patients, we saw no complications. The advantages of the surgical approach appear to outweigh those of conservative management options if a simple and safe surgical technique makes the humerus stable enough to resist normal daily loads.

Aged↗
PubMed2002

Respiratory symptoms, asthma, atopy and Chlamydia pneumoniae IgG antibodies in a general population sample of young adults.

BACKGROUND: This study was designed to test the association of Chlamydia pneumoniae infection with respiratory symptoms and atopy. METHODS: A general population sample of 369 young adults (aged 20-44 years) completed a questionnaire on respiratory symptoms and underwent skin prick testing. C. pneumoniae IgG and IgM serum titers were measured by microimmunofluorescence. Prior infection was defined by titers of IgG > or = 1:32, acute infection by titers of IgG > or = 1:512 and/or IgM > or = 1:16. RESULTS: The prevalence of cough and phlegm was higher in subjects with (19.0%) than in those without (11.4%) prior C. pneumoniae infection (p = 0.01). A similar difference was found for wheezing (14.3% vs 8.0%; p = 0.05), whereas the percentage of asthmatics was equally distributed between seropositive and seronegative subjects. IgG titers > or = 1:128 were found more frequently in atopic subjects (p = 0.04). After adjusting for any confounding factors, cough and phlegm (but not wheezing) were found significantly associated with C. pneumoniae positivity, both for 1:32 (OR 1.80; 95% CI: 1.01-3.36; p = 0.05) and for 1:128 titers (OR 2.31; 95% CI: 1.20-4.42; p = 0.01). A significant association was also found for atopy, for titers > or = 1:128 (OR 1.73; 95% CI: 1.01-3.20, p = 0.05). Acute infection was not associated with respiratory symptoms or asthma. CONCLUSION: We conclude that C. pneumoniae infection is associated with cough and phlegm and may have a role in the pathogenesis of chronic respiratory diseases. Moreover, our results indicate a relationship between atopy and C. pneumoniae infection.

Adult↗
PubMed2002

Prevalence and features of allergic rhinitis in Italy.

BACKGROUND: Italian data on the prevalence of allergic rhinitis are sparse and with wide variations, maybe because of different diagnostic criteria and methods of investigation. This study analyzes the information on rhinitis collected in northern Italy through standardized methods within the European Community Respiratory Health Survey. METHODS: A screening questionnaire was sent by mail to a random sample of the general population aged 20-44 years, and nonresponders were contacted again by phone, achieving a final response rate of 86% (6031/7000). Among the responders, 914 randomly selected underwent a standardized clinical interview, skin prick test (SPT) and total and specific immunoglobulin (Ig)E determination. RESULTS: The overall prevalence of self-reported allergic rhinitis was 15.9% (95% CI 15.0-16.8%). Allergic rhinitis was more common in men below 35 years and in women older than that (P = 0.006), in urban areas (P < 0.001) and in early responders (P < 0.001). A larger percentage of subjects (37.7%) reported nasal symptoms when exposed to indoor or outdoor allergens. Atopy was present in 79% of the subjects reporting allergic rhinitis. CONCLUSIONS: This study demonstrates that the prevalence of allergic rhinitis in northern Italy is similar to the prevalence observed in other European countries and that this disease is more common in urban areas.

Adult↗
PubMed2001

Relation between body composition, fat distribution, and lung function in elderly men.

BACKGROUND: Body composition changes with age, with increases in fat mass and visceral fat and declines in skeletal muscle mass; lung function also declines with age. Age-related changes in body composition and fat distribution may be associated with the pulmonary impairment observed in the elderly. OBJECTIVE: Our goal was to evaluate the relations between body composition, fat distribution, and lung function in elderly men. DESIGN: We studied 97 men aged 67-78 y with body mass indexes (BMIs; in kg/m2) ranging from 19.8 to 37.1. Body composition was evaluated by using dual-energy X-ray absorptiometry and fat distribution was evaluated by using waist and hip circumferences, waist-to-hip ratio, and sagittal abdominal diameter (SAD). Spirometry was done in all subjects and the distance walked by each subject during a 6-min walking test was evaluated as was leg strength. RESULTS: A significant negative correlation was found between adiposity, fat distribution indexes, forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV1). A positive correlation was found between fat-free mass and FVC. After adjustment for age, height, and weight, SAD still correlated negatively with FVC and FEV1 (r = -0.367 and -0.348, respectively; P < 0.01), whereas percentage body fat and fat mass correlated negatively and fat-free mass correlated positively with FVC (r = -0.313, -0.323, and 0.299, respectively; all P < 0.01). After the sample was subdivided by tertile of fat-free mass adjusted for age and BMI, FVC and FEV1 were significantly lower in the lowest fat-free mass tertile (P < 0.01). Stepwise multiple regression analysis performed with use of lung function variables as the dependent variables and age, height, fat mass, fat-free mass, waist circumference, and SAD as the independent variables showed that 3 variables entered the regression for predicting FVC: height, which entered the regression first; SAD, which entered second; and fat-free mass, which entered third. Only 2 variables entered the regression for predicting FEV1: height, which entered the regression first, and SAD, which entered second. CONCLUSION: Our cross-sectional data show a significant association between body composition, fat distribution, and lung function in elderly men.

Absorptiometry, Photon↗
PubMed2000

Cough threshold in reflux oesophagitis: influence of acid and of laryngeal and oesophageal damage.

BACKGROUND: Gastro-oesophageal reflux is often associated with cough. Patients with reflux show an enhanced tussive response to bronchial irritants, even in the absence of respiratory symptoms. AIM: To investigate the effect of mucosal damage (either oesophageal or laryngeal) and of oesophageal acid flooding on cough threshold in reflux patients. PATIENTS: We studied 21 patients with reflux oesophagitis and digestive symptoms. Respiratory diseases, smoking, and use of drugs influencing cough were considered exclusion criteria. METHODS: Patients underwent pH monitoring, manometry, digestive endoscopy, laryngoscopy, and methacholine challenge. We evaluated the cough response to inhaled capsaicin (expressed as PD5, the dose producing five coughs) before therapy, after five days of omeprazole therapy, and when oesophageal and laryngeal damage had healed. RESULTS: In all patients spirometry and methacholine challenge were normal. Thirteen patients had posterior laryngitis and eight complained of coughing. Twenty patients showed an enhanced cough response (basal PD5 0.92 (0.47) nM; mean (SEM)) which improved after five and 60 days (2.87 (0.82) and 5.88 (0.85) nM; p<0.0001). The severity of oesophagitis did not influence PD5 variation. On the contrary, the response to treatment was significantly different in patients with and without laryngitis (p = 0.038). In patients with no laryngitis, the cough threshold improved after five days with no further change thereafter. In patients with laryngitis, the cough threshold improved after five days and improved further after 60 days. Proximal and distal oesophageal acid exposure did not influence PD5. Heartburn disappeared during the first five days but the decrease in cough and throat clearing were slower. CONCLUSIONS: Patients with reflux oesophagitis have a decreased cough threshold. This is related to both laryngeal inflammation and acid flooding of the oesophagus but not to the severity of oesophagitis. Omeprazole improves not only respiratory and gastro-oesophageal symptoms but also the cough threshold.

Adult↗
PubMed1999

Serious childhood respiratory infections and asthma in adult life. A population based study. ECRHS Italy. European Community Respiratory Health Survey.

BACKGROUND: A number of epidemiologic studies have tried to establish whether respiratory tract infections in early childhood cause obstructive pulmonary disease in adult life. OBJECTIVE: To determine whether reported serious respiratory infection before the age of 5 years (SRI) is a significant risk factor for subsequent development of bronchial asthma and/or bronchial hyperresponsiveness in adults. METHODS: We investigated a random population sample of 1,104 subjects (aged 20 to 40 years), participating in the European Respiratory Health Survey in Italy. Bronchial response to methacholine and answers to a standardized questionnaire were analyzed. RESULTS: The prevalence of SRI (ie, a positive response to the question "Have you ever had a serious respiratory infection before the age of 5 years?") was significantly higher in the subjects with a positive family history of allergic diseases than in those with a negative one (O.R. 1.89; 95% C.I. 1.24 to 2.87, P < .01). No relationship was found between SRI and current adult asthma; however, asthma in the past was found in 20.5% of the SRI positive subjects and in 9.1% of SRI negative subjects (O.R. 2.47; 95% C.I. 1.47 to 4.15, P < .05). No difference in the response to methacholine and in FEV1, FEV1/FVC values was found between SRI positive and SRI negative subjects. CONCLUSIONS: We suggest that a positive family history of atopy is associated with a significantly higher prevalence of SRI. Furthermore our results indicate that exposure to SRI is a risk factor for asthma in the past (ie, asthma in childhood and adolescence) but not for adult asthma or for the development of bronchial impairment in adult life.

Adult↗
PubMed1998

Prevalence of asthma and asthma-like symptoms in an adult population sample from Verona. ECRHS Verona. European Community Respiratory Health Survey.

The aim of the study was to assess the prevalence of asthma and asthma-like symptoms in the general population of Verona. A screening questionnaire, with seven questions on respiratory symptoms, was sent by mail to 3000 randomly selected subjects, aged 20-44 yrs. After three subsequent mailings, nonresponders were interviewed by telephone. The overall response rate was 92%. At least one respiratory symptom was reported by 44% subjects. The prevalence of the most frequent symptoms differed according to the type of contact: early respondents (i.e. those who responded by mail) were more likely to report symptoms than late respondents (i.e. those who were interviewed by telephone). Wheezing was reported by 11.3% of males and 8.0% of females (p < 0.01). The allergic rhinitis and hay-fever prevalence was 16.9% with no differences owing to sex or age. The prevalence of an "episode of asthma" (defined as a self-reported attack of asthma or treatment for asthma) and of "current asthma" (defined as a self-reported attack of asthma, treatment for asthma or wheezing other than due to a cold with dyspnoea in the last 12 months) was 4.1 and 4.7%, respectively. No differences were found on the basis of age and sex. The prevalence of asthma was greater in urban (5.0%) than in suburban (2.7%) areas (p < 0.05), where lower pollution levels were registered. The greater prevalence in urban areas suggests that some factors related to the urban environment could play a role in the development of asthma and asthma-like disorders.

Adult↗
PubMed1997

Effect of once daily and twice daily sustained release theophylline formulations on daytime variation of bronchial hyperresponsiveness in asthmatic patients.

BACKGROUND: Previous studies evaluating spirometric values and symptoms have shown that once daily theophylline administered in the evening produces greater stabilisation of the airway function in asthmatic patients than the prototype theophylline given twice a day. The aim of this study was to compare the effects on bronchial responsiveness to methacholine of an ultrasustained release theophylline formulation (Diffumal-24, Malesci, Florence, Italy) administered once a day, a sustained release theophylline formulation (Theo-Dur, Recordati, Milan, Italy) administered twice a day, and placebo. METHODS: The study was performed in 12 adult patients with asthma using a randomised, double blind, three phase, cross-over design. Each phase lasted seven days and was followed or preceded by at least three days of theophylline washout. Diffumal-24 was administered once a day at 20.00 hours whereas Theo-Dur was given twice a day at 08.00 hours and 20.00 hours. In each patient the total daily dose of theophylline was the same during both phases. The dose of the two active preparations was titrated to individual needs before the beginning of the study and then given in divided or once daily doses. At 08.00, 14.00, and 20.00 hours on day 7 of each phase serum theophylline concentrations were measured and spirometric tests (FEV1) and bronchial challenge with methacholine were also performed. RESULTS: When the administration of Diffumal-24 was compared with that of Theo-Dur, a higher serum theophylline concentration of the former was seen in the morning whereas at 20.00 hours the reverse was true. Compared with placebo, at 08.00 hours Diffumal-24 improved FEV1 whereas Theo-Dur did not (difference between treatments 0.29 1, 95% CI 0.12 to 0.45). At 08.00 hours Diffumal-24 decreased bronchial sensitivity to methacholine, expressed as a natural logarithm of PD20, to a greater extent than Theo-Dur (difference between treatments 0.54 log units, 95% CI 0.016 to 1.08). The morning advantage observed with Diffumal-24 administration was not associated with a deterioration in the state of the airway during the daytime, the protective activity against methacholine during the 12 hours of the monitoring period being constant. Furthermore there was no difference in the mean FEV1 between the two treatments at 14.00 and 20.00 hours. CONCLUSIONS: In adults with stable bronchial asthma treatment with a single dose of Diffumal-24 administered in the evening improved airflow obstruction and reduced bronchial hyperresponsiveness.

Adult↗
PubMed1997

Effect of changing position on arterial oxygenation in a patient with agenesia of the left pulmonary artery.

The effects of body position (supine, right and left lateral decubitus) on gas exchange were evaluated in a patient with agenesis of the left pulmonary artery, subjected to mechanical ventilation because of adult respiratory distress syndrome. Arterial blood gases were measured 60 min after each of the three positions was attained and showed that lying on the left side (i.e. the side of the impaired lung) produced higher arterial oxygen pressure (68.5 +/- 1.5 mm Hg) than lying on the opposite side (50.0 +/- 1.2 mm Hg); (p < 0.05). No significant differences in mean arterial carbon dioxide pressure were found. In contrast to unilateral lung diseases affecting the parenchyma, the position improving arterial oxygenation was the one in which the healthy lung was uppermost, in our patient with a unilateral perfusion defect.

Adult↗
PubMed1996

The provision of psychiatric care in southern Italy. Results from the 'Psychiatry in Southern Italy's Services' (De PISIS) survey.

OBJECTIVE: To describe structural features, attenders' characteristics and intervention habits in a large sample of Community Mental Health Departments (CMHDs) in Southern Italy. DESIGN AND SETTING: 1) Survey of resources and organization features of collaborating CMHDs; 2) Unreplicated registration of all attenders and of therapeutic interventions during an index week. RESULTS: A self-selected sample of 47 CMHDs in Southern Italy recruited 3845 patients during the last week of October 1992. Participating CMHDs were serving a socially deprived and severely ill population: 45.8% of attenders had 8 years or less of formal education; only 18.9% were employed, 30.9% of diagnoses were of the schizophrenia spectrum group and 23% of the affective disorders group. Sixty-eight per cent of patients were being treated with psychotropic drugs, while only 19% received rehabilitative interventions. The activity of CMHDs were oriented more towards the control of active symptomatology than towards rehabilitation. A significantly higher proportion of patients receiving a schizophrenia-spectrum disorder diagnosis were found in contact during the index week with those CMHDs providing both residential and semiresidential (day-hospital, community center) facilities.

Adolescent↗
PubMed1995

Sonographic evaluation of intramuscular ganglia.

The study presents the ultrasound appearance of the intramuscular ganglia arising from the superior tibio-fibular joint. An oval, anechoic septated mass with distal sound enhancement in the antero-lateral aspect of the leg was seen in five examined patients. In all the cases, ultrasound-guided needle aspiration was performed and viscous fluid characteristic of ganglia was obtained. All the patients were treated by surgical excision of mass. Local recurrence, which occurred in three cases, was confirmed by ultrasound. The study indicates that ultrasound is useful in diagnosing intramuscular ganglia, in planning the treatment, and in the follow-up examination. Ultrasound-guided needle aspiration is a helpful technique in confirming the diagnosis.

Adult↗
PubMed1995

Effect of three different doses of a slow-release theophylline formulation on bronchial response to inhaled methacholine in asthmatic patients.

This study investigated whether or not a sustained release formulation of theophylline (SRT) at different dosages had any effect on bronchial hyperresponsiveness as measured by the methacholine challenge. On four separate occasions, 16 patients with mild asthma took either placebo or 300, 400, 500 mg of SRT twice a day. SRT had a slight bronchodilating effect that was not dose-related, but produced a dose-related decrease in the bronchial response to inhaled methacholine (r = 0.39, p = 0.007). This effect was present after all three treatment periods with the active drug when mean +/- SE theophylline serum concentrations of 10.3 +/- 0.7, 12.6 +/- 0.9 and 17.1 +/- 1.1 mg/l respectively were reached. A highly significant relationship between theophylline serum concentration and the degree of protection against methacholine bronchospasm was also found (r = 0.45, p = 0.001). It is concluded that oral theophylline does reduce bronchial hyperresponsiveness in a dose dependent fashion, this effect being present at all the serum concentrations within the normal range.

Adult↗
PubMed1995

Tussive effect of capsaicin in patients with gastroesophageal reflux without cough.

The aim of this study was to clarify the influence of gastroesophageal reflux (GER) on cough threshold in patients with digestive symptoms but free from respiratory involvement. Of 57 consecutive subjects referred for 24-h esophageal pH monitoring because of digestive reflux symptoms, 29 patients free from respiratory disorders were studied. They underwent esophageal pH monitoring and manometry, upper gastrointestinal endoscopy, pulmonary function tests, and methacholine and capsaicin challenges. The methacholine test was performed by inhalation of increasing doses of methacholine up to 4,000 micrograms; the results were expressed as the dose causing a 20% decrease in FEV1 from baseline (PD20). The capsaicin threshold was evaluated by inhalation of increasing doses of capsaicin from 0.3 up to 9.84 nmol, expressing the results as the dose of capsaicin eliciting five coughs (PD5). Fifteen patients were considered refluxers on the basis of a total esophageal acid exposure time above 4.7%. Esophagitis grade 0 was found in 15 patients, grade 1 in seven patients, grade 2 in seven patients. PD5 was significantly lower in refluxers (median 0.51 micrograms, range 0.22 to 19.8) than in nonrefluxers (19.8 micrograms, range 0.31 to 19.8) (p < 0.001); there was no difference in baseline ventilatory parameters and in airway responsiveness to methacholine between the two groups. All patients with a pathologic acid exposure time but one had a low cough threshold, irrespective of the presence or absence of esophagitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Capsaicin↗
PubMed1995

Sonographic evaluation of lipohemarthrosis: clinical and in vitro study.

The purpose of this study is to evaluate the role of sonography in diagnosing lipohemarthrosis. Sonography was performed on seven patients with intra-articular fractures of the knee, shoulder, and hip. An in vitro mixture of fat and blood was examined as the gold standard. In the patients scanned a few minutes after immobilization, a two-band appearance of joint effusion was present, representing a fat-blood level. One patient scanned 3 hours after immobilization showed a three-band appearance of joint effusion, corresponding to the layers of fat, serum and red blood cells. Results of this study indicate a high reliability of ultrasonography in detecting lipohemarthrosis.

Adipose Tissue↗
PubMed1995

[Antiphospholipid antibodies: their prevalence, clinical significance and correlation with cytokine levels in acute myeloid leukemia and non-Hodgkin's lymphoma].

Forty-five patients with de novo acute myeloid leukemia (AML) and 22 patients with newly-diagnosed non-Hodgkin lymphoma (NHL) were investigated. Tests for antiphospholipid antibodies (APA) included the measurement of anticardiolipin antibodies (aCL) with a solid-phase immunoassay, and the detection of the lupus-like anticoagulant (LA) activity. Fifteen patients with AML (33.3%) and 9 patients with non-Hodgkin lymphoma (40.9%) presented elevated APA at diagnosis, as compared to 3 out of 174 persons of the control group (p < 0.0001). APA titles became normal in all patients responding to treatment, whereas non-responders retained elevated levels. In addition, 2 patients (1 with AML and 1 with NHL) who had normal APA at diagnosis and were either refractory to treatment or in relapse, subsequently developed LA and/or aCL positivity. At presentation, the mean levels of IgG- and IgM-aCL in patients were not significantly different from controls, and concordance between aCL and LA results reached just 12%. With regard to the clinical course, we were not able to detect any statistically significant difference between patients with normal and elevated APA. Pretreatment concentrations of IL-6 and TNF-alpha in AML, and soluble form of the receptor for interleukin-2 (sIL-2r) in NHL were found significantly elevated compared to controls (p < 0.001, p = 0.011 and p = 0.016 respectively). In addition, the levels of these cytokines correlated with IgG-aCL at the different times of laboratory investigations. These results demonstrate that APA may have a role as markers of disease activity and progression in some haematological malignancies.

Acute Disease↗
PubMed1994

Prevalence and clinical significance of elevated antiphospholipid antibodies in patients with idiopathic thrombocytopenic purpura.

Antibodies against phospholipid antigens (APA) have been demonstrated in idiopathic thrombocytopenic purpura (ITP), but their clinical and pathogenetic significance has remained elusive. In this study we analyzed the prevalence and clinical features of ITP patients with elevated APA. In addition, we prospectively evaluated APA levels after treatment with corticosteroids and compared them with platelet-associated immunoglobulin (PAIgG) titers. We studied 149 patients with newly diagnosed ITP. Of these, 78 had a platelet count less than 50 x 10(9)/L and received an initial treatment with oral prednisone (PDN). In 71 asymptomatic cases with platelet counts between 50 x 10(9)/L and 120 x 10(9)/L, no therapy was scheduled. However, in five of them, the platelet count fell below 50 x 10(9)/L after more than 12 months; these patients were treated with PDN. Tests for APA included the measurement of anticardiolipin antibodies (ACA) with a solid-phase immunoassay and the detection of the lupus-like anticoagulant (LA) activity with coagulation tests that included kaolin-clotting time, dilute Russel's Viper venom time, activated partial thromboplastin time (aPTT), and dilute aPTT. Controls consisted of 174 apparently healthy subjects. Either LA or elevated ACA was seen in 69 patients (46.3%) at diagnosis. LA and ACA were both elevated in 24 cases (16.1% of the overall patient population and 34.8% of patients with high APA concentrations). No correlation was found between LA ratio values and ACA-IgG or -IgM titers, or between ACA-IgG and ACA-IgM levels. The presence of these antibodies was not associated with sex, age, platelet count, or the severity of hemorrhages. PAIgG was detected in 106 of 127 cases (83%). Again, no relationship was observed with clinical parameters or with APA levels. However, all cases with elevated APA also had increased PAIgG. With regard to the clinical course, we were not able to detect any significant difference between patients with normal and elevated APA. An initial complete response to prednisone treatment was observed in 43 of 83 cases (51.8%), with 13 (15.7%) achieving a prolonged complete remission. APA levels were not significantly modified after PDN therapy and on relapse. We conclude that APA positivity is a common finding in patients with ITP and does not select a category with different clinical features. APA levels are not influenced by immunosuppressive therapy with steroids and are not related to the activity of the disease. Therefore, we do not support a role for APA in the pathogenesis of ITP.

Adolescent↗
PubMed1993

Effects of therapeutic doses of salbutamol alone and combined with beclomethasone dipropionate on airway responsiveness and cyclic AMP plasma levels in asthmatic patients.

Twelve asthmatic patients received by inhalation for 2 weeks, in a double-blind, cross-over design, beclomethasone dipropionate (BDP; 600 micrograms/day) plus salbutamol (S; 900 micrograms/day), or S (900 micrograms/day) alone. Before and after each treatment course the subjects received intravenous cumulative doses of S up to 200 micrograms. In basal conditions and immediately before the next dose forced expiratory volume in 1 s (FEV1) and plasma cyclic AMP (cAMP) were measured. BDP+S treatment increased FEV1 basal values (p < 0.05) whereas inhaled S resulted in unsignificant improvement of ventilatory parameters. The slopes of the dose-response curves of FEV1 and plasma cAMP to intravenous S were unaffected by the two treatment courses. Our results suggest that DBP+S, differently from S alone, improves ventilatory function in asthmatic patients and that neither S nor S+BDP seem to affect adrenergic function.

Administration, Inhalation↗