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P Crimi

Publications and source records attributed to P Crimi.

At least 19 recordsLinked to original sources
PubMed2006

Microbiological surveillance of hospital ventilation systems in departments at high risk of nosocomial infections.

The air in hospital wards with patients at high risk (Surgeries, Intensive Care Units and Bone Marrow Transplant Centers) has been surveyed less than the one in Operating Rooms. Therefore in this study we considered useful to verify the microbic contamination of the air of those wards evaluating the consistency of ventilation systems in relation also to the presence and location of HEPA absolute filters. Seven departments of Genoese San Martino Hospital at high risk of infection were taken into account. In there, environmental investigations have been performed by air samplings and by analyzing bacterial and fungal growth on plates after an incubation period. Almost 60% of all samples taken in wards yielded a positive result and the average values of bacterial and aspergillar charges measured at air flow emission openings decisively exceed the ones considered standard in operating rooms. Still, the average values of airborne bacterial charges were significantly higher in those wards equipped with central filters (p < 0.001), while as far as the aspergillar charge is concerned, no statistically relevant differences were noticed. In wards with ventilation system, the bacterial charge value raises from the emission grids to the middle of the room and to the aspiration grids, while the ward not equipped with a ventilation system presents in the middle of the room an average bacterial charge 2 to 10 times higher than the one in other wards. The average values regarding bacterial and aspergillar charges resulted quite high in all the departments surveyed. Nevertheless, if we take into account ventilation systems equipped with absolute filters HEPA located centrally or peripherally, it can be outlined that the air quality from the point of view of both microbic and aspergillar contamination turns out to be decisively better in systems with peripheral filters. Moreover, a compared analysis of the three Hematology wards allows us to infer that the presence of artificial ventilation systems can lower the bacterial and fungal compared with a ward with natural ventilation.

Air Microbiology↗
PubMed2004

Correlation between meteorological conditions and Parietaria pollen concentration in Alassio, north-west Italy.

The pollen grains in the atmosphere in different geographical areas differ according to the species present, the pollination seasons and pollen grain concentrations, but possibly the greatest contributors to this variability are the meteorological conditions. The aim of our research is to establish a possible correlation between Parietaria pollen concentration and meteorological conditions during the period from 1991 to 1995 in the town of Alassio (north-west Italy). As far as vegetation is concerned, the Mediterranean climatic conditions support the blooming of extensive grasslands in the environment surrounding the town; these grasslands mainly comprise Urticaceae and shrubs. The study demonstrates that the most influential parameters affecting the Urticaceae grain concentration upsurge are the absence of rainfall, a maximum daily temperature of about 21 degrees C, and a diurnal temperature range of about 5 degrees C. Moreover, our aeropalinological study indicates that this last parameter has the greatest influence on Urticaceae pollination. In fact, an increase in diurnal temperature range could be responsible for a dehydration of pollens resulting in a loss in mass. This grain lightness and volatility would ultimately permit atmospheric dispersion if there is a significant wind speed. On the other hand, days with rain or high relative humidity make pollens heavier, preventing them from flying long distances and therefore partially explaining the decline in airbone pollen concentration.

Italy↗
PubMed2001

Asthma and rhinitis in schoolchildren: the impact of allergic sensitization to aeroallergens.

This study aimed to evaluate the prevalence of asthma and rhinitis in schoolchildren living in the Genoa area by using a validated questionnaire and to investigate the prevalence of sensitizations using skin prick tests. An ATS modified questionnaire was given to 781 schoolchildren (all of them aged between 11 and 14 years) resident in the Genoa area. The main outcome of the present survey demonstrates a high prevalence of sensitized children (40.7%). Asthma and rhinitis prevalences are very high, mainly concerning the lifetime diagnosis. Actual asthma prevalence is about 6%, confirming ISAAC results, but rhinitis prevalence is notably higher and there is no difference between seasonal and perennial forms. Mites are the most important cause of sensitization and pollens are more frequently the cause of polysensitization. A distinct percentage of the asthmatic children and a higher percentage of rhinitic children are nonallergic. On the other hand, about one third of the sensitized children are without symptoms: They may be considered as subjects at risk of developing clinical respiratory diseases later. In conclusion, this study shows the importance of evaluating the existence of atopy, since there are many subjects with asthma and rhinitis who are nonallergic, and subjects at risk of developing respiratory allergies may be detected.

Adolescent↗
PubMed1999

Differences in prevalence of allergic sensitization in urban and rural school children.

BACKGROUND: Environmental factors are important causes of sensitization, even though the effect of specific pollutants and the interaction between pollution and aeroallergens are not completely known. PURPOSE: To evaluate whether the exposure to pollutants or to allergens is a more important contributing factor in causing sensitization. METHODS: A group of 312 children living in the city and a group of 225 children living in a rural area, ages 11 to 14, were studied. All subjects underwent a skin prick test. The pollen counts were performed in the two different areas during the peak of the pollen season. At the same time the levels of ozone and suspended particulates were measured. RESULTS: The students living in the rural area showed a significantly higher percentage of sensitization than those in the city (P = .046). Sensitization to pollen was more frequent in the rural area (P < .001) but pet sensitization was more frequent in the city. More rural area students were sensitive to multiple allergens (P = .034). Pollen levels were higher in the rural area (P = .001). Both ozone and suspended particulate levels were higher in the city (P = .001 and P < .001, respectively). CONCLUSIONS: The degree of pollen exposure is a larger contributing pathogenic factor in inducing sensitization than air pollution.

Adolescent↗
PubMed1999

[Surgical wound infection. Review of the guidelines and results of a prevalence study by the Presidio Ospedaliero de Voghera].

BACKGROUND: A prevalence study regarding hospital acquired infections and particularly surgical wound infections was performed from 17-4-1995 to 17-7-1995 in the Voghera hospital, a large one in Northern Italy. METHODS: The records of all subjects who have operated since at least 24 hours have been checked and the surgical wounds have been classified according to the guidelines of CDC (Atlanta). RESULTS: The prevalence rate of surgical wound infections was 13.73% of operated patients, confirming the seriousness of the problem of nosocomial infections surveillance. Pseudonomas aeruginosa (31.27%) and Staphylococcus aureus (21.92%) were the most frequently isolated organisms. CONCLUSIONS: Finally, behaviour guideline have been reproposed to try to reduce surgical wound infections for a best Quality of care in the light of a Regional credit.

Adult↗
PubMed1997

Frequency and specific sensitization to inhalant allergens within nuclear families of children with asthma and/or rhinitis.

OBJECTIVE: The purpose of this study was to investigate the frequency of allergy in 85 families of pediatric patients with asthma and/or rhinitis. METHODS: Families enrolled were drawn according to a table of randomization, from those whose children were referred the outpatient clinic of the Pulmonology Department of Gaslini Institute (Genoa, Italy). In patients and in both their mothers and fathers, allergic sensitization to the three most common classes of inhalant allergens (house dust mites, pollens, and animal danders) was evaluated by skin prick test. RESULTS: As compared with their parents, children showed a similar prevalence of positive skin prick test (50.0% and 58.8%, respectively; chi 2 = 1.4; P > .1), but a significantly higher frequency of specific sensitization to house dust mites, pollens, or pets (P < .05, each chi 2). These differences were at least partially related to the higher frequency of polysensitization (i.e., sensitization to more than one class of allergens) in children than in their parents [chi 2 = 4.2, odds ratio (OR) = 2.3, 95% confidence interval (CI95%) = 1.0 to 5.1; P < .05). In addition, both in children (chi 2 = 5.8, OR = 11.3, CI95% = 1.4 to 81.5; P < .05] and in their parents (chi 2 = 7.4, OR = 4.8, CI95% = 1.5 to 16.7; P < .01), allergy to pollens was less frequent in monosensitized than in polysensitized families, while the prevalence of sensitization to house dust mites was similar in monosensitized and in polysensitized families. The analysis of the role of parental sensitization in the development of allergy in the offspring demonstrated that the prevalence of allergic children: (1) seemed to be higher, without reaching statistical significance, in families with sensitized parents than in those with non-sensitized parents (chi 2 = 0.41, P > .1) and (2) was higher in families with one or both polysensitized parents than in those with one or both monosensitized parents (chi 2 = 4.5, OR = 4.0, CI95% = 1.1 to 15.6; P < .05). In addition, within each family, the coincidence of sensitization to house dust mites was more frequent than that to pollens (60.0% and 36.0%, respectively; chi 2 = 7.6, OR = 4.5, CI95% = 1.5 to 14.3; P < .01), and it was not influenced by the number of parents sensitized to same allergen. CONCLUSION: These data support the concept that, in addition to genetic predisposition, other factors (i.e., environmental exposure) may influence the development of specific sensitization in children with respiratory symptoms. The different sensitization found in this study between children and their parents occurred in a generation span, so as it is more likely to be related to environmental changes than to genetic factors.

Administration, Inhalation↗
PubMed1996

Sensitization to airborne allergens in children with respiratory symptoms.

BACKGROUND: Allergy is one of the most common causes of respiratory symptoms in children and youth. OBJECTIVE: Evaluate the presence and the type of allergic sensitization in a paediatric population with respiratory symptoms. METHODS: We studied 564 consecutive children, 5 months to 17 years of age, with a male to female ratio (M/F) = 1.4, referred to our outpatient clinic in a 12-month period retrospectively. Patients were arbitrarily divided into four groups (grs) according to their age: gr1 = 5 months to 4 years old (181 patients), gr2 = 4 to 7 years (201 patients), gr3 = 7 to 10 years (96 patients), and gr4 = 10 to 17 years (86 patients). Sensitization to house dust mites, pollens, animal dander, and molds was determined by skin prick testing. RESULTS: Sensitization to at least one class of allergen occurred in 304 of the 564 patients (53.9%, M/F ratio = 2.0); the percentage of allergic patients increased with age as follows: 29.8% (54 patients) of the patients in gr1, 55.2% (111 patients) in gr2, 68.8% (66 patients) in gr3 and 84.9% (73 patients) in gr4 (chi(2) = 84.1, P < .01). In the entire allergic population and in gr1 to gr3, the most common positive allergic reaction was to house dust mites (P < .01, chi(2) test each comparison). In contrast, gr4 patients showed a nearly equal percentage of sensitization to pollens and to house dust mites (79.5% and 78.1% respectively) (chi(2) = 0.0, P = >.1). Sensitization to only one class of allergen occurred in 51.3% of the allergic patients and the percentage of these monosensitized patients tended to decrease from gr1 to gr4 (chi(2) = 15.2, P < .1). In the monosensitized group, sensitization to house dust mites was the most frequent in gr1 to gr3 (age <10 years) as in the whole sample. In gr4, the frequency of sensitization to house dust mites was similar to that of sensitization to pollens. On the contrary, within the patient group sensitized to two or more allergens (polysensitized patients), sensitization to house dust mites was as frequent as sensitization to pollens already in gr2 as compared with monosensitized patients. CONCLUSIONS: In children with respiratory symptoms, the percentage of allergic individuals was high and increased with the age of the patients. This phenomenon was associated with an age-related enhancement in the ratio of polysensitized to monosensitized patients and with an age-related increase in the frequency of sensitization to seasonal allergens (ie, pollens).

Adolescent↗
PubMed1996

Increase of asthma and allergic rhinitis prevalence in young Italian men.

Our previous studies have reported that the prevalence of asthma was 2.89% and of allergic rhinitis 1.54% in Ligurian conscripts for the army during 1983. Since several authors reported an increasing prevalence of these diseases in different geographic areas, the aim of the present study was to evaluate the trend of prevalence rates in a same homogeneous group of Ligurian conscripts. The prevalence of asthma and allergic rhinitis was assessed in a group of 4310 young Ligurian men (18 years old) who had undergone medical examination for call-up to the navy during 1993, 1994 and 1995. Subjects were investigated by history, clinic visit, spirometry, metacholine bronchial challenge and skin prick test. The prevalence of asthma is 4.39% and of allergic rhinitis 2.2%. Comparing these results with previous data, a significant increase appears in this area 12 years later (respectively, p < 0.001 and p < 0.006). In addition, the association with asthma in allergic rhinitics increases from 41 to 77%, as well as an increasing trend appears for perennial allergens (i.e. mites and cat) and the polysensitizations increase from 48 to 67%. Possible explanations for these phenomena might be due to environmental factors (i.e. pollutants, viral infections, changes in domestic microenvironment).

Adolescent↗
PubMed1992

Bronchial and bronchoalveolar lavage after allergen challenge in atopic patients.

Twenty patients with allergic rhinitis and/or asthma sensitised to Dermatophagoides pteronyssinus were studied. On two consecutive days they underwent methacholine challenge and allergen bronchial challenge. 72 h after allergen challenge, fibreoptic bronchoscopy with bronchial (BL) and bronchoalveolar (BAL) lavage was performed. Specific IgE antibodies were measured both in serum and in BL from 14 patients. Both BAL and BL cell differentials were similar in patients with isolated early response to allergen and in patients with dual response. Patients with dual response to allergen showed higher levels of antigen specific IgE antibodies in BL than patients with isolated early response, while IgE levels in serum were similar in the two groups.

Adolescent↗
PubMed1991

Local immunotherapy with Dermatophagoides extract in asthma.

Local immunotherapy (LIT) with Dermatophagoides extract or placebo were administered to two groups of 11 patients with allergic asthma in a double-blind fashion. All patients received cromolyn sodium (20 mg four times a day) during treatments. Bronchial provocation tests with allergen and methacholine were performed before, 1 week, and 4 weeks after the end of treatments. Symptom score, drug consumption, and peak expiratory flow were monitored daily from 2 weeks before to 4 weeks after treatments. Compared to baseline, early bronchial sensitivity to allergen was significantly reduced both 1 week (p less than 0.0005) and 4 weeks (p less than 0.01) after LIT but not after placebo administration. Late bronchial reaction to allergen occurred similarly after placebo administration and LIT. However, in the group with LIT, the severity of late reaction was unchanged after treatment in spite of the significantly larger doses of allergen administered to provoke the early asthmatic reaction. Neither symptom score, nor drug consumption, nor peak expiratory flow were significantly different in the two groups before and during the treatment period even though both symptom score and drug consumption tended to be reduced after LIT. We conclude that LIT may be an effective and safe alternative to traditional immunotherapy.

Adolescent↗
PubMed1991

Bronchial responsiveness is not increased by bronchoalveolar and bronchial lavage performed after allergen challenge.

Nonspecific bronchial responsiveness was studied in 23 allergic patients with a history of rhinitis and/or bronchial asthma who underwent fiberoptic bronchoscopy with bronchoalveolar and bronchial lavage (BAL-BL) 4h (Group A) or 24 h (Group B) after an allergen inhalation challenge. In all patients, the dose of methacholine causing an FEV1 fall of 15% (PD15) was determined at baseline, 24 h before allergen challenge. Methacholine bronchial challenge was repeated 1 h before BAL-BL in patients of both groups and again 12 to 14 h after BAL-BL in Group A and 24 h after BAL-BL in Group B. In patients of Group A, the values of methacholine PD15 after BAL-BL were not significantly different from those determined before BAL-BL. This was also the case in patients in whom bronchial responsiveness was increased after allergen challenge. In patients of Group B, methacholine PD15 was significantly decreased after allergen challenge, and this decrease was correlated with the occurrence and the severity of the late asthmatic reaction. Even in patients who showed dual asthmatic reactions and an increased responsiveness after allergen challenge, methacholine PD15 was not further decreased after BAL-BL. These data support the safety of a procedure combining bronchial allergen challenge with BAL-BL, which can be used for studies on the pathophysiology of bronchial asthma.

Adolescent↗
PubMed1991

Late-phase asthmatic reaction to inhaled allergen is associated with early recruitment of eosinophils in the airways.

To determine whether a link exists between the recruitment of inflammatory cells in the airways and the development of the late-phase asthmatic reaction, we studied with bronchoalveolar lavage 54 asthmatic patients either at baseline (10 patients) or 4 h (11 patients), 24 h (13 patients), and 72 h (20 patients) after allergen inhalation challenge. Among the patients studied 4 h after allergen challenge, five were known to have a late-phase asthmatic response and showed a significant increase in the number and percentage of eosinophils in bronchoalveolar lavage compared with either patients without late-phase response (p less than 0.05) or unchallenged patients (p less than 0.01). Both the number and the percentage of eosinophils in bronchoalveolar lavage were also increased (p less than 0.05) in patients without a late-phase asthmatic reaction studied 24 h but not in those studied 4 h after allergen challenge. The numbers and the percentages of macrophages, neutrophils, or lymphocytes did not differ significantly among the different groups of patients. Of the patients studied 4 and 24 h after allergen challenge, only those with a late-phase asthmatic response showed an increased airway responsiveness to methacholine 1 h before bronchoalveolar lavage. We conclude that the development of the late-phase asthmatic response to allergen inhalation challenge and the allergen-induced increase in airway responsiveness are associated with an early recruitment of eosinophils in the airways.

Adolescent↗
PubMed1990

Effect of seasonal exposure to pollen on specific bronchial sensitivity in allergic patients.

Bronchial provocation tests with aerosol of birch extract were performed before and after pollen season in 11 sensitized subjects. Changes of metacholine bronchial responsiveness and serum-specific IgE level were also assessed. In five patients who did not take steroids to control their symptoms, both early and late asthmatic responses to inhaled allergen were enhanced after season, whereas IgE serum level, but not methacholine sensitivity, was significantly increased. In six patients who needed steroids, neither responses to allergen nor IgE serum level and methacholine sensitivity were significantly changed after season. For the whole group, the increase in immediate bronchial sensitivity to allergen was positively correlated with the increase in specific IgE antibodies. We conclude that seasonal exposure to pollen has, in sensitized patients, a priming effect on bronchial mucosa that may be blunted by steroid treatment. The increased production of specific IgE antibodies appears to be an important mechanism for this priming effect.

Antibodies↗
PubMed1990

Late asthmatic reaction to perennial and seasonal allergens.

Twelve patients with asthma sensitized to Dermatophagoides pteronyssinus and Parietaria judaica were studied. Patients were challenged before (winter), during (summer), and after (autumn) Parietaria-pollen season. Early asthmatic reaction was positive for both allergens, and the provocative dose causing a 15% decrease of FEV1 was similar in all seasons. The provocative dose of methacholine causing a 15% decrease of FEV1 and specific IgEs for both allergens were also not significantly different throughout the time of study. Late asthmatic reaction (LAR) to Dermatophagoides occurred in eight of 12 patients in winter, in six of nine in summer, and in five of six patients in autumn. The severity of LAR, expressed as the maximum fall of FEV1 3 to 8 hours after challenge, was not significantly different between seasons. LAR to Parietaria occurred in only one of 12 patients in winter, in six of 11 in summer, and in one of six patients in autumn. In summer, LAR to Parietaria was significantly more severe than in winter. In both winter and autumn, but not in summer, LAR to Dermatophagoides was significantly more severe than to Parietaria. We conclude that LAR is allergen specific, and natural exposure has a priming effect on LAR.

Adolescent↗
PubMed1989

[Evaluation of regional perfusion as an indicator of resectability in patients with centrally located bronchogenic carcinoma].

The value of using regional ventilation (V) and perfusion (Q) tests as signs of resectability has been analysed in 17 patients with centrally located lung cancers who underwent thoracotomy. The criteria for inclusion into the study were the following: (1) histological diagnosis of non-oat-cell carcinoma, (2) no distant metastases, (3) Q in the affected lung less than 40% and (4) evaluation by computed tomography of the extent of the tumor. Regional perfusion was investigated by intravenously injected 133 Xenon. CT scan proved to be the most sensitive test (90%) in order to identify non-resectable lesions; in 2 cases, however, the tumor was erroneously judged non-operable (specificity = 71%). For the evaluation of V and Q data, two parameters were assumed as a non-resectability index: (1) Q less than or equal to 30% and (2) V/Q greater than or equal to 1.5. Sensitivity was 80% for the former and 70% for the latter parameter, while specificity was 85% and 100% respectively. In conclusion, V and Q study may provide highly specific informations on the resectability of centrally located lung cancers, especially when assuming V/Q greater than or equal to 1.5 as discriminating value.

Carcinoma, Bronchogenic↗
PubMed1989

Effect of nedocromil sodium on the late asthmatic reaction to bronchial antigen challenge.

The effect of inhaled nedocromil sodium (4 mg by pressurized aerosol) on the dual asthmatic reaction to bronchial antigen challenge was studied in eight patients with asthma. The following prechallenge/postchallenge treatment combinations were administered: nedocromil sodium/placebo, nedocromil sodium/nedocromil sodium, placebo/nedocromil sodium, and placebo/placebo. Each patient received three treatment combinations assigned with a balanced incomplete block design. Nedocromil sodium administered before antigen challenge was significantly more effective than placebo in blocking both the early (p less than 0.001) and late (p less than 0.01) fall in FEV1. Postchallenge administration of nedocromil sodium tended to delay the onset of late asthmatic reaction but did not provide significant protection compared to placebo. These results demonstrated that nedocromil sodium prevents both phases of the dual asthmatic reaction to bronchial antigen provocation when it is inhaled before challenge. Further investigation is necessary to elicit a definite answer to whether nedocromil sodium administered after bronchial challenge has an effect on late asthmatic reaction.

Adolescent↗
PubMed1988

Lung function following upper sleeve lobectomy for bronchogenic carcinoma.

Eight patients who underwent upper sleeve lobectomy and six who underwent upper simple lobectomy for lung cancer were studied. The two groups were matched for age and preoperative lung function as assessed by standard spirometry. Post-operative lung function studies, including measurements of regional ventilation (Vr) and perfusion (Qr) by 133 Xenon technique showed that: 1) two weeks after surgery, forced expiratory volume at 1 s was more reduced after simple than after sleeve lobectomy, but in both groups Vr and its vertical gradient were similarly reduced in the operated lung compared to the contralateral; 2) one year after sleeve lobectomy, the vertical gradient of Vr tended to disappear in both lungs while Vr and Vr/Qr of the operated side increased significantly. These results indicate that early after surgery lung function may be less impaired after sleeve than simple lobectomy; however, long-term changes of regional lung function may occur after sleeve lobectomy resulting into a high Vr/Qr ratio in the operated lung.

Adult↗