PubMed Health⌕ Search

Biomedical subjects

S Bernardi

Publications and source records attributed to S Bernardi.

At least 19 recordsLinked to original sources
PubMed2005

Impact of medically assisted fertility on preterm birth.

Preterm birth is a frequent problem in women who undergo treatment for infertility. Many factors appear to contribute to the occurrence of this complication. Infertile women seem to have a predisposition to giving birth preterm and to having low birthweight babies. These complications also occur in women with a history of infertility who achieve pregnancy without treatment and who have singleton pregnancies. Assisted reproduction patients treated with in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) have a disproportionately high occurrence of preterm births even with singleton pregnancies. Spontaneous preterm labour may be related to underlying medical conditions of the female partner, as its occurrence is not increased in subjects treated with ICSI (i.e. when the infertility problem is associated with male reproductive dysfunction in normal female partners). Multiple pregnancy is the factor most likely to be related to preterm birth in infertile women. The administration of drugs to induce ovulation either alone or combined with intrauterine insemination causes a significant increase in multiple pregnancies. The occurrence of higher order multiple pregnancy is also increased. Multiple pregnancy in women undergoing IVF or ICSI is related to the number of embryos transferred at the end of treatment. The transfer of more than two embryos in women under 35 is not associated with an increased chance of conception, while the occurrence of multiple pregnancy is significantly increased. Women over 40 may benefit from the transfer of more than two embryos, with fewer risks of multiple pregnancy. Single embryo transfer is increasingly considered a workable clinical option, particularly in young women. Hopefully, a more cautious approach to infertility management will reduce the occurrence of multiple pregnancy, spontaneous preterm labour and the high number of low birthweight infants born after treating these women.

Female↗
PubMed2003

Pharmacokinetics and pharmacodynamics of nelfinavir administered twice or thrice daily to human immunodeficiency virus type 1-infected children.

We studied the pharmacokinetics and pharmacodynamics of nelfinavir administered 2 or 3 times per day to human immunodeficiency virus type 1 (HIV-1)-infected children receiving highly active antiretroviral therapy containing nelfinavir. The geometric mean trough concentrations of nelfinavir for the thrice- and twice-daily regimens were 1.55 mg/L and 1.11 mg/L, respectively (P=not significant). Nelfinavir concentrations did not correlate with total daily dose, dose per kilogram of weight, age, weight, previous protease inhibitor (PI) experience, or CD4(+) cell percentage. In the 25 PI-naive children, the virus load reductions at 24 weeks of treatment with the twice- and thrice-daily regimens were comparable. A significantly higher percentage of children in the twice-daily group had a trough concentration of nelfinavir of less than the inhibitory concentration of 95% (P=.042). The decrease in the virus load at 24 weeks of treatment was not correlated with the trough concentration of nelfinavir. The variability of trough concentrations was extremely high, particularly among recipients of the twice-daily regimen, resulting in a higher number of patients with subinhibitory concentrations of nelfinavir in this group.

Antiretroviral Therapy, Highly Active↗
PubMed2002

Serum leptin and CD4+ T lymphocytes in HIV+ children during highly active antiretroviral therapy.

OBJECTIVE: Because leptin, the adipocyte-derived hormone, affects thymocyte survival, proliferation of naïve T lymphocytes and the production of proinflammatory cytokines, we aimed to investigate the role of this molecule in immunoreconstitution during highly active antiretroviral therapy (HAART). DESIGN: Prospective longitudinal cohort study. A series of 20 HIV+ children were studied. The subjects were grouped by their increase in serum leptin levels after HAART. METHODS: All participants were weight-stable, free of endocrine disorders and opportunistic infections and equally distributed for sex (males, n=10; females, n=10). Body mass index (BMI), serum lipids, leptin, CD4+ T cells and HIV-1 RNA were measured before initiation of HAART and after a 2-year follow-up. RESULTS: Serum leptin concentration positively correlated with CD4+ lymphocyte number before treatment. HAART significantly reduced viraemia and increased serum levels of lipids in all patients, whereas a significant increase in CD4+ cells and serum leptin was observed in the majority of patients. Notably, in children where HAART was not effective in increasing CD4+ lymphocyte counts, serum leptin did not increase. CONCLUSION: To our knowledge, these findings reveal for the first time a novel link among CD4+ T lymphocytes, serum leptin and highly active anteretroviral theraphy.

Antiretroviral Therapy, Highly Active↗
PubMed2001

Kinetics of the T-cell receptor CD4 and CD8 V beta repertoire in HIV-1 vertically infected infants early treated with HAART.

OBJECTIVES: To determine the kinetics and the relationship between the T-cell receptor V beta (TCRBV) complementary determining region 3 length, the CD4 T-cell count and HIV viral load changes in HIV-1 infected infants treated early with highly active antiretroviral therapy (HAART) during 1 year of follow-up. DESIGN: Two HIV-1 vertically infected infants, two HIV-1 vertically exposed uninfected and two healthy controls were analysed by spectratyping. Evaluation of viral load, CD4 naive and memory cell counts and a proliferation test were also carried out. METHODS: Twenty-six families and subfamilies of the TCR on CD4 and CD8 T cells were analyzed by spectratyping. Flow cytometric analysis on peripheral blood mononuclear cells for CD4CD45Ra, CD4CD45Ro, CD8CD38, proliferation tests and plasma viral load measurements were performed at baseline, 1, 6 and after 12 months of therapy. RESULTS: HAART induced a marked reduction of viral load in both HIV-1 infected infants and an increase to normal CD4 T-cell count in the symptomatic infant. At baseline the TCRBV family distribution in the majority of CD8 and a few of the CD4 T cells was highly perturbed, with several TCRBV families showing a monoclonal/oligoclonal distribution. During HAART a normalization of the TCR repertoire in both CD8 and CD4 subsets occurred. TCR repertoire normalization was associated with a good virological and immunological response. CONCLUSION: These results suggest that complete and early virus replication control as a result of early HAART leads to a marked reduction of T-cell oligoclonality and is an essential prerequisite to the development of a polyclonal immune response in HIV-1 infected infants.

Antiretroviral Therapy, Highly Active↗
PubMed2001

Discrepancy between polymerase chain reaction assay and Western blot analysis in the assessment of CagA status in dyspeptic patients.

BACKGROUND: Infection with CagA-positive Helicobacter pylori may be diagnosed by detecting cagA gene by polymerase chain reaction assay (PCR) or serum antibodies against CagA by Western blot analysis. The aim of this study is to evaluate whether results of PCR and Western blot analysis are in agreement in CagA status assessment. PATIENTS AND METHODS: Thirty-six dyspeptic patients with unknown H. pylori status underwent upper gastrointestinal endoscopy to assess the presence of mucosal lesions and to collect six gastric biopsies (three from the antrum and three from the body) for evaluation of H. pylori infection (rapid urease test, histology and PCR for ureA gene) and gastritis. CagA status was assessed by PCR (cagA gene) on two biopsy specimens and by Western blot analysis of serum (CagA-antibodies) in each patient. RESULTS: At endoscopy, nine patients showed normal mucosa, 15 a duodenal ulcer and 12 antral erosions. Twenty-eight patients were found to be H. pylori-positive and eight H. pylori-negative. Of the 28 H. pylori-positive patients, 17 were CagA-positive and five were CagA-negative by both methods, five were CagA-positive by Western blot analysis but not by PCR and one was CagA-positive by PCR but not by Western blot analysis. Of the eight H. pylori-negative patients, none was CagA-positive by PCR, while six were CagA-positive by Western blot analysis. Therefore, the two tests agreed in only 24 patients (67%). In those patients in whom the PCR and Western blot analysis were not in agreement, the histological features appear to suggest that the results of the Western blot analysis should be considered false positives or false negatives. CONCLUSIONS: PCR and Western blot analysis failed to provide comparable data in many cases. Western blot analysis seems to be more likely to give misleading results than PCR. Thus, PCR seems to be the method of choice to assess CagA status.

Adult↗
PubMed2000

Variable use of therapeutic interventions for children with human immunodeficiency virus type 1 infection in Europe.

UNLABELLED: Although a range of antiretroviral drugs are available for use in children, the appropriate paediatric regimen remains unclear. In a survey to investigate policies and practices relating to the therapeutic management of children infected by the human immunodeficiency virus (HIV), a postal questionnaire was sent to a named paediatrician in 70 major HIV centres in 13 European countries in early 1998. A total of 64 paediatricians (91%) responded. Pneumocystis carinii pneumonia prophylaxis was found to be routine in all centres, although considerable variation existed regarding the time of starting and stopping therapy. Prophylaxis for fungal infections and recurrent bacterial infections was common, with cytomegalovirus prophylaxis being less frequent. Although most centres (89%) used all five currently available nucleoside analogues (ziduvodine, lamivudine, stavudine, didanosine, zalcitabine), there was considerable variability regarding the availability of protease inhibitors. Most respondents delayed initiation of antiretroviral therapy until evidence of disease progression was apparent. The initial prescription of 38% of clinicians was triple therapy and that of 57% prescribed double therapy. Policies varied regarding the modification to regimens in response to disease progression and emergence of side effects and drug resistance. Clinical practice was informed by a number of sources, including centre-specific and national guidelines. Most respondents affirmed the need for European guidelines. CONCLUSION: Approaches to the therapeutic management of paediatric human immunodeficiency virus infection differ across Europe.

Antiviral Agents↗
PubMed2000

[Digital pacinian hyperplasia. Report of a case associated with foreign body reaction].

Digital Pacinian Hyperplasia is a non tumoral, very rare lesion. To date, only 31 cases have been reported, occasionally named Digital Pacinian Neuroma. Digital pain is usually associated to. Local trauma is reported in about half of the cases. We report a new case occurred in a 62 year-old male, associated with inflammatory and foreign body reaction. No recurrence was observed 6 months after surgical excision. Differential diagnosis and controversies about this lesion are discussed.

Fingers↗
PubMed1999

[Intraepithelial enteroendocrine cells in cecum and appendix from ovoalbumin sensitized rabbits].

Intraepithelial enteroendocrine cells (IEC) produce peptides which influence motility, secretion and absorption of nutrients. Recently the role of these cells in the immune mucosal system is under study. The aim of the present study was to evaluate the modifications in number of IEC in cecum and appendix from Ovalbumin (OVA) sensitized rabbits. Twenty adult New Zealand rabbits were separated in two groups: Group 1 (G1 = 10) not sensitized normal control. Group 2 (G2 = 10) were sensitized twice intraperitoneally with 70 mg OVA and 30 mg ALUM/ml (aluminium hydroxide). Anti OVA specific IgE was evaluated by means of PCA test (passive cutaneous anaphylaxis). Samples form cecum and appendix were fixed in buffered formaldehyde 10%, paraffin embedded and stained with anti-Chromogranin A for neuroendocrine cells. 400 high power fields were counted in each animal, referred as IEC/100 enterocytes. In cecum surface epithelium and crypt were considered. Surface epithelium, deep crypts and superficial crypts were evaluated in appendix. Results showed in cecum in G1:1,6 IEC/100 enterocytes in surface epithelium and 3/100 in crypts; G2 6 IEC/100 in surface epithelium and 12/100 in crypts. The difference between G1 and G2 was statistically significant (p < 0.05). In appendix surface epithelium from G1 showed 5.2/100 while G2 5.4/100. Superficial crypts 8.5 (G1) and 11.3 (G2) (p < 0.05) and deep crypts 4.9 (G1) and 8.5 (G2) (p < 0.01). The results showed that OVA-sensitized animals presented increment in the number of IEC in surface epithelium and crypts which may indicate a relationship between these cells and rabbit mucosal immune system.

Animals↗
PubMed1998

[Intraepithelial T cell population in ileum from ovalbumin sensitized rabbit].

We characterize the intraepithelial T cell population of terminal ileum from intraperitoneally OVA-sensitized New Zealand rabbit after oral challenge. High anti-OVA specific IgE levels elicited after sensitization were evaluated by positive passive cutaneous anaphylaxis (PCA) at 160 fold dilutions. Anaphylactic response in gut after the oral challenge was confirmed by evaluation of edema in villi and marked mast cell degranulatin. Total T cells (CD5+), T cells subset (CD4+) and MHC II R-DQ positive cells expressed as the number of positive cells/1000 nuclei, were analyzed for each tissue. Positive cells were counted in 30 villi by light microscopy. The number of CD5+ cells was 122.5 cells/1000 nuclei. Activated cells in small bowel epithelium 8 hours after challenge in experimental group, expressed by MHC II R-DQ showed an increase: 32.2 as compared to control group: 12.6 positive cells/1000 nuclei (p < 0.05) and compared to experimental group 1 hour after challenge 9.3 (p < 0.05). We demonstrated an increment of activated T cells in gut epithelium of terminal ileum in OVA-sensitized group after oral challenge.

Animals↗
PubMed1997

Mother to infant transmission of coinfection by human immunodeficiency virus and hepatitis C virus: prevalence and clinical manifestations.

The prevalence and the clinical course of hepatitis C virus (HCV) infections were studied in 23 HIV-1-infected children, who were born to 22 mothers with HIV-1/HCV coinfection. During the follow-up only two children (8.7%) showed persistent anti-HCV antibodies and circulating HCV RNA. Both children, who were aged 10 and 10.6 years respectively at the end of follow-up, had chronically-evolving liver disease and autoimmune thrombocytopenia but no signs of progressive HIV disease. Based on our experience, vertically-acquired HIV-1/HCV coinfection is less frequent than is generally reported and may be associated with the development of chronic thrombocytopenia in addition to liver disease. Moreover, perinatal HIV-1/HCV coinfection appears to be associated with a slow progression of HIV disease.

AIDS-Related Opportunistic Infections↗
PubMed1996

Role of dental plaque in the transmission of Helicobacter pylori infection.

With regard to the role of dental plaque in the transmission of Helicobacter pylori infection, data from the literature vary greatly, owing to differences in sample collection and H. pylori-detecting techniques. Using the polymerase chain reaction (PCR), we have determined the incidence of H. pylori colonization in the dental plaque of 31 consecutive patients who underwent gastroscopy. The patients were divided into two groups on the basis of H. pylori infection, determined by Giemsa stain and the rapid urease test: group A made up of 21 H. pylori-positive patients and group B with 10 H. pylori-negative patients. Our PCR assay of dental plaque samples proved negative in all group A subjects but was positive in only one patient in group B. In our study, we found that H. pylori had a low prevalence (3.2%) in the oral cavity, with no significant relationship between gastric mucosa and dental plaque colonization. More comprehensive studies are needed to determine whether dental plaque is an important reservoir in the epidemiology of H. pylori-induced gastric disease.

Adult↗
PubMed1996

[Difficult digestive hemorrhage: angiodysplasia].

The authors report 7 cases of ileal and colonic angiodysplasia observed over a 3 year period (1992-1994). After a review of literature concerning etiology, pathology, diagnosis, and treatment emphasize the use of angiography for preoperatory diagnosis an intraoperatory localization of the lesion when this one is localized in the ileum. After review of usefull therapies, they stress the role of surgery as the most used therapy and only really complete.

Adult↗
PubMed1992

Relationship between corpus callosum atrophy and cerebral metabolic asymmetries in multiple sclerosis.

Corpus callosum (CC) atrophy by magnetic resonance imaging (MRI) is a common finding in multiple sclerosis (MS). In order to examine the relationship between CC atrophy and cortical brain metabolism, we compared the cerebral metabolic rates for glucose (CMRglc), measured by positron emission tomography (PET), of 8 MS patients with evidence of CC atrophy on midsagittal MRI, 8 MS patients without CC atrophy and 10 healthy controls. Results showed no significant differences in supratentorial CMRglc absolute values between the three groups, although a slight metabolic reduction was observed in both MS groups compared with normal controls. By contrast, only patients with CC atrophy showed greater directional metabolic asymmetry than normals, the left frontal, temporal and parietal association cortices being significantly lower than the right. Predominant left hemispheric metabolic reductions were not accompanied by a corresponding left-sided predominance in the extent of MRI-detected demyelinating lesions. Therefore our data suggest that CC atrophy interfers more with left than with right metabolic function.

Adult↗
PubMed1992

HLA determinants in familial multiple sclerosis.

HLA-A, -B, -C, -DR, -DQ antigens were studied in 11 multiplex MS families, 11 single-case MS families and 100 healthy subjects. The HLA DR4 was the most frequent antigen in all MS patients (p = 0.015). When the antigenic frequency in index familial cases was compared with that in single cases, the DR4 antigen was found to be more frequent (p = 0.01) in familial cases only. Furthermore, when the DR4 antigen was excluded from the analysis, we observed an increase in DR2 (p = 0.11) only in the familial MS cases. These results can be compatible with a multifactorial hypothesis according to which the HLA genes have an important role in MS susceptibility in familial cases.

Gene Frequency↗
PubMed1991

The influence of pregnancy on relapses in multiple sclerosis: a cohort study.

The influence of pregnancy on the relapse rate (number of relapses per person per year) in MS was analysed for 52 women who had a pregnancy during the disease. The relapse rate was lower during the pregnancy-year (9 months of pregnancy and 6 months immediately post partum) than the non-pregnancy time. There was a heterogeneous pattern during the pregnancy-year with a sharp decrease in the relapse rate observed during pregnancy and a slight non-significant increase in the puerperium: both these relapse rates were compared with figures observed in the same group of women during the non-pregnancy time. Pregnancy does not appear to be a period at greater risk for exacerbations but, on the contrary it seems to act, on the whole, as a protective event. These data allow physicians to provide reassuring counselling to women.

Adult↗