Biomedical subjects
Publications and source records attributed to P Toscano.
Critical care nurses encounter stressful events daily. What makes some nurses more apt to buffer such stressors and thus avoid the phenomenon known as burnout? This research study offers insight into burnout, hardiness, and intercorrelations between the two variables.
The intestinal parasites of the schoolchildren from one rural area and one urban area, both on Pemba Island, Zanzibar, Tanzania, were surveyed within the framework of the local Helminth Control Programme. Stool samples were examined for helminth eggs and protozoa by quantitative (Kato-Katz) and concentration (formalin-ether) techniques. The results indicate that intestinal helminthiases represent a significant public health problem in the study areas. All the subjects were found to be infected with helminths, most (> 97%) with more than one species. Hookworms and Trichuris appear to constitute the most serious challenges to the schoolchildren, both in terms of prevalence and intensity of infection. There were no significant differences between the results from the urban area and those from the rural area. The observations are important in the planning of control activities.
As reported for other chronic liver diseases, hepatitis B virus (HBV) chronic infection might result in malnutrition. In order to establish whether this disease could be responsible of malnutrition and hence influence growth, 75 children, chronically infected with HBV, have been followed up for 4 years. Thirty-one of them had chronic active hepatitis (CAH), 25 chronic persistent hepatitis (CPH), 14 chronic lobular hepatitis (CLH), and five cirrhosis (three active, two inactive). The nutritional status was evaluated every 12 months, with careful physical and laboratory examinations. General nutritional status was estimated according to Waterlow criteria (13, 14). At our first observation, 50 children were following a balanced diet with a caloric intake adequate for age and weight, whereas 25 were on a low-fat diet, begun in the belief of its therapeutic value. For seven patients of this second group, the caloric intake was below the daily requirement. The latter group showed a growth failure in weight when they were first seen at our center and gained weight when the dietary intake was normalized. However, no biochemical feature of malnutrition was observed in all the 75 children. At the end of the follow-up period, the nutritional status was satisfactory for all of them.
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Activated circulating T lymphocytes expressing HLA-DR (mean +/- s.d. 11.0 +/- 5.2%) or interleukin-2 receptor (IL-2R) (2.1 +/- 1.7%) were significantly increased in 63 children with chronic hepatitis B virus (HBV) infection when compared with 33 age-matched healthy controls (3.0 +/- 1.3%, P less than 0.01, and 0.1 +/- 0.4%, P less than 0.01). HBeAg-positive patients had higher percentage of DR (11.9 +/- 5.1%) or IL-2R (2.4 +/- 1.7%) positive T lymphocytes than anti-HBe-positive children (7.4 +/- 3.6% and 1.1 +/- 1.5%, P less than 0.01 and P = 0.02 respectively). Similarly, HBV DNA-positive patients had higher percentage of DR (10.5 +/- 3.3) or IL-2R (3.2 +/- 1.7%) positive T cells than HBV DNA-negative children (6.6 +/- 2.8% and 1.2 +/- 1.5%, P less than 0.01 for both). There was a positive correlation between percentage of DR positive T lymphocytes and levels of HBV DNA. Sixty-two per cent of the DR-positive T lymphocytes were cytotoxic/suppressor and 35% helper/inducer. The relationship between viral replication and T lymphocyte activation is discussed.
The authors, after a nosologic review of cryptorchidism, illustrate their positive diagnostic experience with ultrasound. Limits as well as clinical advantages, in relation to the diagnosis and follow-up, are also described.
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Various techniques for the reconstruction of the orbital floor are available when resecting the portion of the maxilla which includes the orbital floor. A composite muscle-bone flap of temporal muscle and coronoid process fills the defect satisfactorily and provides good support for the globe.
The role of adrenergic amines in the genesis of cardiac arrhythmias is well known. Electrophysiological techniques of recording intracellular potentials have led to a better understanding of the cellular mechanisms by which these amines may induce arrhythmias. Stimulation of beta 1-adrenoreceptors increases automaticity, shortens action potential duration (APD), and may enhance slow action potential (AP) formation in depolarized Purkinje fibers (PF). Excitation of alpha-adrenoreceptors prolongs repolarization and plateau phase in PF. On the basis of the spectrum of antiarrhythmic activity in vivo and qualitatively different transmembrane effects on the canine PF, beta-adrenoreceptor blocking drugs can be subdivided into two distinct categories. Recent evidence with two new highly selective beta blockers, PS-6 and mepindolol, also suggests that at least two subgroups of cardiac beta 1-adrenoreceptors can be differentiated: beta 1i for inotropic and beta 1c for chrontropic actions of catecholamines. The effects of PS-6 in 5 x 10(-5) M concentration on isolated rabbit atria showed that this agent atangonized ouabain-induced arrhythmias and contracture. PS-6 (8 x 10(-6) M or more) reduced AP amplitude, phase 0 depolarization, APD, and phase 2 plateau phase in paced canine PF. These data suggest that PS-6 exerts a direct transmembrane effect on the canine PF.
The Authors describe a case report of a girl of 7 years affected by visceral leishmaniasis (VL) complicated by herpes zoster (Hz). Hz infection is unusual in paediatric age, but it may complicate immunodeficiency states. VL causes, as well known, T cell immunity depression: Hz infection could be facilitated by this situation.
One hundred twenty one cases of oesophagitis by gastroesophageal reflux were observed through a retrospective study of 1250 endoscopies of the upper digestive tract. The oesophagitis was staged according to Savary-Miller classification. The prevalence (93.3%) of cases were in I and II stage. The Authors found that the most frequent associated diseases with oesophagitis by gastroesophageal reflux were: hiatal hernia, gastric and duodenal peptic disorders, gastric resection according Billroth II and biliary disorders. In 86.7% of cases, endoscopic diagnosis was confirmed by histological findings. From these data and from those reported in literature the authors can ascertain that endoscopy, associated with histological findings has an important role in diagnosing oesophagitis and in monitoring medical and surgical treatment used.
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