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Biomedical subjects

V Rapisarda

Publications and source records attributed to V Rapisarda.

At least 19 recordsLinked to original sources
PubMed2006

Effect of enzymatic debridement with collagenase on acute and chronic hard-to-heal wounds.

OBJECTIVE: A large retrospective analysis was performed to assess the outcomes of burns and chronic ulcers treated with collagenase in an outpatient setting. No cost comparison was performed. METHOD: Of 979 patients entered into the analysis, 647 had burns affecting < or = 15% body surface area (BSA) and 332 had chronic ulcers of various aetiologies. AII were treated with collagenase-based ointments once daily (Noruxol or Iruxol, Smith and Nephew). Treatment was continued until complete healing was achieved. RESULTS: In burns patients the overall average healing time was 17.9 days in the paediatric population and 23.6 days in adults. Burn depth and presence of eschar were the main factors affecting healing probability. The chronic ulcers were predominantly of diabetic, venous and mixed aetiology. Average healing time was 15.4 weeks, with ulcers of mixed aetiology showing the shortest average healing time (9.2 weeks). There was a positive correlation between wound area and healing time. The topical application of collagenase-based ointments was well tolerated by patients and caregivers. CONCLUSION: This large retrospective analysis shows that collagenase treatments in outpatient clinics are effective and well accepted in patients with burns affecting < or = 15% BSA or with chronic ulcers of various aetiologies. Implementation of collagenase treatments in outpatient clinics has the potential to improve wound healing and may also decrease the cost of wound care.

Adolescent↗
PubMed2006

Effects of exposure to fluoro-edenite fibre pollution on the respiratory system: an in vivo model.

An increased standardised rate of mortality from pleural mesothelioma among the population of Biancavilla (Sicily, Italy) has been attributed to exposure to fluoro-edenite fibres. Our aim was to establish whether and how these fibres may induce pathological effects using an in vivo model. Lung tissue collected from 60 healthy sheep selected from six flocks habitually grazing near Biancavilla and from 10 control sheep was fixed formalin and paraffin-embedded; sections were stained with haematoxylin-eosin, Masson trichrome and Gomori argentic impregnation. Histochemical studies and immunohistochemical analysis for the localisation of TRAIL, DR5 and MMP13 were also performed. The lungs of exposed sheep exhibited fibrosis and loss of alveolar architecture with honeycombing of alveolar cavities. Fluoro-edenite fibres were detected close to the alveolar epithelium and interstitia. The parenchyma showed hyaline degeneration and strong PAS-positivity in the interstitium, proteoglycan alterations, reflecting a damaged basal membrane and an involvement of the interstitial matrix. MMP-13 was overexpressed, mainly in fibroblasts and epithelial cells, while positivity for TRAIL and DR5 was detected on alveolar surfaces and in the vascular stroma. The initial pathological event seems to involve first the alveoli and subsequently the interstitium, giving rise to classic honeycombing. The triggering event at the level of type I pneumocytes would damage the cytoplasmic membrane resulting in loss of cell elements and exposure of underlying capillaries, and eventually in a series of reactions including macrophage activation, possible release of growth factors and metaplasic reconstruction of lung alveoli. Immunopositivity for TRAIL and MMP-13 receptor suggests that apoptotic processes may also be activated by fluoro-edenite.

Air Pollutants↗
PubMed2001

Tetanus in a central Italian region: scope for more effective prevention among unvaccinated agricultural workers.

In 1997, Italy had the highest number of tetanus cases in the European Union; cases in the Marches region were more numerous than in France or Germany. In a retrospective study of the patients infected in Marches in 1996-1999, subjects or relatives were interviewed to ascertain disease severity, infection mode, occupation and immunization state at the time of infection. There were 32 cases, 29 (90.6%) females and three (9.4%) males, mean age 74.65 years (SD 9.06). The raw annual incidence was 5.6 per million and raw annual mortality 0.5 (n = 3). Twenty-seven patients (84.4%) were agricultural workers and five (15.6%) housewives; 25 (78.2%) had never been vaccinated, two (6.2%) had been immunized several years earlier and five (15.6%) had received only the first dose of vaccine at least 15 years earlier. In Italy, tetanus vaccination is compulsory for agricultural workers. Occupational health physicians should monitor workers' tetanus immunization state during their periodic surveillance visits.

Adult↗
PubMed1998

Increased burn patient survival with once-a-day high dose teicoplanin and netilmicin. An Italian multicenter study.

This is the final report of a large, controlled, multicenter Italian study on immuno- and chemotherapy in adult patients with burns affecting 20 to 95% of total body surface area (mean 35%). The antibiotic treatment of burn patients consisted of topical silver sulfadiazine, short-term antimicrobial chemoprophylaxis with pefloxacin (800 mg i.v. qd) for the first 4 days and polychemotherapy with teicoplanin (800 mg i.v. qd) together with netilmicin (300 mg i.m. qd) in one or more cycles of 5-12 days. At random, half of the patients received thymostimulin, 70 mg i.m. qd for the first month and every other day thereafter. The analysis at completion of 634 valid cases showed that when the results are stratified by means of the Roi risk index, 396 of the 530 patients who contracted wound infection (84%) after chemoprophylaxis were in the first three categories and a mean of 95% survived. Of the remaining 134 patients (Roi index 4-5) only 50% survived. There was no difference in survival of the immunotherapy group in comparison with the parallel group without thymostimulin. The short-term antimicrobial prophylaxis prevented wound infection in only 104 of 634 patients (16%) and they were at low risk (84% Roi index 1). Of the bacterial pathogens involved in septic complications Staphylococcus aureus and Pseudomonas aeruginosa were prevalent (86%): eradication was achieved in 43% of patients and clinical cure or improvement were seen with combination chemotherapy in 64% of all patients, mainly with only one treatment cycle. This value increased to 79% for the 395 protocol-complying patients and went down to 20% in the 135 non-compliers. The total survival of complier and non-complier patients was 447 of the 530 valid patients (84%). The overall mortality of the 634 evaluable patients was 13.1%, ranging from less than 2% to 68%. Burn mortality was directly proportional to the percentage of burned body surface area, to increasing age and other variables of the Roi index, a 50% mortality being associated with a 72.5% total body surface area burned. Normoergic burn patients had a mortality rate of 9.1% versus 35.7% in anergic patients.

Adolescent↗
PubMed1996

[Bromperidol decanoate in the residual phase of schizophrenia].

We assessed the safety and therapeutic efficacy of bromperidol decanoate in a six-month open trial on 21 patients (13 males and 8 females), mean age 41.3 years, who were no longer in the acute phase and were being treated as outpatients. The recommended initial dosage was 150 mg bromperidol (one 3 ml ampoule), and this did not in fact have to be increased during the trial. The scores for psychotic symptom rating scales (SAPS, SANS, BPRS, HAM-D and social adaptation scale) were analysed by analysis of variance, which indicated that bromperidol decanoate was effective on almost all parameters. Adverse reactions were reported for 14.3% of the patients, indicating that the drug was very well tolerated; only three patients complained of a total of seven adverse events. In conclusion, bromperidol decanoate was effective in the treatment of residual schizophrenia, with significant differences between before and after treatment ratings for symptoms. The drug was well tolerated, only one patient dropping out on account of adverse reactions.

Adolescent↗
PubMed1995

Rapidity of onset of the antidepressant effect of parenteral S-adenosyl-L-methionine.

A possible method of reducing the delay in antidepressant response is to use S-adenosyl-L-methionine (SAMe), a naturally occurring compound that appears to have a rapid onset of effect in the treatment of depression. In this open, multicenter study, 195 patients were given 400 mg of SAMe, administered parenterally, for 15 days. Depressive symptoms remitted after both 7 and 15 days of treatment with SAMe, and no serious adverse events were reported. Further studies with a double-blind design are needed to confirm this preliminary indication that SAMe is a relatively safe and fast-acting antidepressant.

Adolescent↗
PubMed1994

The efficacy and safety of tianeptine in the treatment of depressive disorder: results of a controlled double-blind multicentre study vs. amitriptyline.

Three hundred in- and outpatients suffering from depressive disorder, as diagnosed using DSM-III criteria were treated for 6 weeks under double-blind conditions in a multicenter controlled study of tianeptine vs. amitriptyline. Both groups presented steady improvement of depressive syndrome from day 7 up to the end of the treatment, as shown by all evaluation scales: HDRS, SAD, CGI. Furthermore, anxiety linked to the depressive syndrome decreased equally in both groups, as shown by the HARS measurements. In addition to the improvement of mood, the tianeptine-treated patients presented less somatic complaints and side effects when compared to the reference antidepressant. These results confirm previous findings that tianeptine is an effective antidepressant with a lower side effect profile than amitriptyline.

Adolescent↗
PubMed1992

A double-blind multicentre study of paroxetine and amitriptyline in depressed outpatients. Italian Paroxetine Study Group.

A comparative double-blind study of paroxetine and amitriptyline in the treatment of depressed hospital outpatients was undertaken at 15 centres in Italy. Three hundred and nine patients of either sex were admitted to the study. The starting dose of paroxetine was 20 mg daily and of amitriptyline 75 mg daily in divided doses; at week 3 these doses could be increased at the investigators' discretion. Efficacy was measured on the Hamilton Depression Rating Scale and on Clinical Global Impression. Both treatment groups showed significant improvement at week 6 with no significant between-group differences. Significantly fewer patients receiving paroxetine reported adverse events compared with those on amitriptyline (44% vs 62%; p < 0.01 in favour of paroxetine).

Adult↗
PubMed1988

Rolipram versus imipramine in inpatients with major, "minor" or atypical depressive disorder: a double-blind double-dummy study aimed at testing a novel therapeutic approach.

Unlike conventional antidepressants, rolipram stimulates both the presynaptic as well as the postsynaptic component of monoaminergic transmission. Several double-blind comparative trials are on the way to assess the clinical efficacy and safety of this novel compound. The present study was a randomized double-blind double-dummy comparison with imipramine in inpatients with major, "minor" and atypical depressions (DSM III). Results show no relevant differences between rolipram and imipramine regarding efficacy and safety.

Adolescent↗
PubMed1987

[Psychometric evaluation of the effects of an almitrine-raubasine combination in the intellectual deterioration of aged subjects. A double-blind controlled trial versus placebo].

The clinical and psychometric evaluation of a drug to be used against the intellectual deterioration associated with cerebral aging is of obvious interest when carried out on ambulatory subjects, since the symptoms likely to be reduced are found in elderly people usually living at home. Thirty-six patients (18 male, 18 female; mean age 65.5 +/- 1.7 years) were selected and allocated at random to two treatment groups. They received during 2 months 80 drops per day in two doses of either an almitrine-raubasine combination or a placebo. Patients definitely entered the trial when Hachinski's score for ischaemia was equal or inferior to 7. They were evaluated at zero, 1 and 2 months by means of 3 performance tests (Toulouse-Pieron test, Tapping test, numbers memorization test) and 2 mood tests (Hamilton's scale, Zung's questionnaire). All mean scores of recognition tests were statistically improved in the almitrine-raubasine group after 2 months of treatment. Compared with the placebo group, the improvement in the almitrine-raubasine group was significant at 1 month for 3 medium scores (symbols omitted, taping, numbers in normal order) and for all scores at 2 months. The psycho-behavioural symptoms evaluated by the two mood scores were significantly improved in the almitrine-raubasine group (P less than 0.001) and in comparison to the placebo group after 1 and 2 months (P less than 0.001). These results concerning intellectual performance and mood demonstrate that the almitrine-raubasine combination is useful in the treatment of intellectual deterioration in elderly people living at home.

Aged↗
PubMed1985

Interhemispheric transfer of visual information in schizophrenics.

Groups of 12 male schizophrenic inpatients and 12 normal controls of the same age, sex, and schooling underwent a tachistoscopic test. Each subject was shown an alphabetical letter which he subsequently had to recognize among various other alphabetical letters also shown tachistoscopically. The visual hemifields of the two displays were ipsilateral and crossed. Relative to the normal group the schizophrenics showed higher perceptual thresholds, lower over-all mean performance, and greater lateralization. The results are discussed in terms of rigidly and poorly integrated systems of analysis of information between one hemisphere and the other for schizophrenic patients.

Adolescent↗