RESUMO
AIM: The aim of this study was to investigate the effect of plasma-enhanced chemical vapour deposition (PECVD) treatment on selected bacteria and spores and to contribute to the understanding of the synergistic effect of UV-directed plasma. METHODS AND RESULTS: The experiments were conducted on pure cultures of Aspergillus brasiliensis and Escherichia coli and on naturally contaminated pistachios that were exposed to pure oxygen-, pure argon- and to a mixture of oxygen-argon-generated plasma for different treatment times and at different micro-organism concentrations. Optical emission spectroscopy (OES) measurements were performed to observe the active species in the plasma. After exposure, the effectiveness of decontamination was assessed through microbiological techniques by calculating the growth reduction on a logarithmic scale. A treatment time of 30 min resulted in a 3·5 log reduction of A. brasiliensis using pure oxygen or argon, while treatment times of 5 min, 1 min and 15 s resulted in a 5·4 log reduction using a mixture of argon and oxygen (10 : 1 v/v). Treatment times of 1 min and 30 s resulted in a 4 log reduction of E. coli with oxygen and argon, respectively, which led to a complete elimination of the micro-organisms. Two-log reductions of fungi were achieved for pistachios after a treatment time of 1 min. CONCLUSIONS: These results suggest that this newly designed plasma reactor offers good potential applications for the reduction in micro-organisms on heat-sensitive materials, such as foods. The plasma that was generated with Ar/O2 was more effective than that which was generated with pure oxygen and pure argon. SIGNIFICANCE AND IMPACT OF THE STUDY: An improvement in the knowledge about PECVD mechanisms was acquired from the chemical and biological points of view, and the suitability of the method for treating dry food surfaces was demonstrated.
Assuntos
Aspergillus/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Pistacia/microbiologia , Gases em Plasma/farmacologia , Esterilização/métodos , Argônio , Temperatura Baixa , Oxigênio/química , Gases em Plasma/química , PressãoRESUMO
BACKGROUND AND AIM: Monitoring the efficacy of antituberculosis therapy is crucial. The aim of this work is to investigate the effect of tuberculosis treatment on interferon-gamma response using Quanti-FERON-TB Gold in tube (QFT-GIT). METHODS: A total of 216 new pulmonary tuberculosis (TB) cases were tested with QFT-GIT at the start of the treatment and, randomly, once or twice between 90 and 180 days afterwards. Data was analysed using the random effect regression model analysis. RESULTS: 63.4% of patients were positive at the QFT-GIT (> .35 UI cut-off). TB cases showed a significant log-linear increase in interferon-gamma (IFN-gamma) concentration, over time of treatment: IFN-gamma concentration increased by 78% after 6 months of treatment in acid-fast bacilli positive (A) and culture negative cases in culture confirmed cases the increase was 43% if A+ and 20% in A-. CONCLUSIONS: Effective therapy seems to restore cellular responses to Mycobacterium tuberculosis antigens. The potential use of interferon gamma release assay (IGRA) in monitoring response to TB treatment is hampered by the presence of active mycobacterial replication at baseline and needs further evaluation.
Assuntos
Antituberculosos/farmacologia , Interferon gama/imunologia , Interferon gama/metabolismo , Mycobacterium tuberculosis/imunologia , Adulto , Antígenos de Bactérias/imunologia , Técnicas Bacteriológicas/métodos , Feminino , Humanos , Imunidade Celular/imunologia , Imunoensaio/métodos , Modelos Lineares , Masculino , Monitorização FisiológicaRESUMO
OBJECTIVE: To assess the efficacy of a hereditary non-polyposis colon cancer (HNPCC) identification and surveillance policy. METHODS: Familial clustering of colorectal cancer (CRC) and extracolonic cancers (ECs) was investigated in 1520 consecutive CRC patients and relatives. HNPCC was identified by Amsterdam criteria, and individuals at risk were offered biennial colonoscopy and other examinations, starting from age 25 years. RESULTS: Twenty-two HNPCC families were identified. The CRC prevalence was 27.8% (121/435), decreasing from 59.4% in the first generation to 24.4% and 8% in the second and third generation, respectively. Twenty-nine patients had multiple CRC and 34 patients (in 12 families) had ECs.A total of 199/331 at-risk individuals accepted surveillance. The mean follow-up was 48+/-32 months. CRCs were detected at first surveillance in four out of 199 surveilled individuals (2%); in two surveilled individuals (1%), three CRCs developed during follow-up. The overall CRC incidence was 7/199 (3.5%) in surveilled individuals and 5/132 (3.7%) in unsurveilled individuals. CRCs were less advanced in surveilled than in unsurveilled patients. Eleven individuals had 22 adenomas (one with high-grade dysplasia). Three individuals had adenomas at first surveillance; two of them and eight more individuals during surveillance. Seven surveilled individuals and six unsurveilled individuals, all belonging to families with a history of EC, had EC during the study period. All patients with CRC detected by surveillance are alive. One of the unsurveilled patients who had CRC died 18 months after the diagnosis. CONCLUSIONS: Data confirm the importance of the family history collected in each patient with CRC for identification of HNPCC and support the efficacy of repeated colonoscopies for early diagnosis and prevention of CRC in at-risk members. Reasons for surveillance failure could be an accelerated progression of small adenomas and a lesion missing at colonoscopy. Longer follow-up is required to assess the efficacy of surveillance for EC.
Assuntos
Neoplasias Colorretais Hereditárias sem Polipose/diagnóstico , Adenoma/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos Clínicos , Colonoscopia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Neoplasias Colorretais Hereditárias sem Polipose/genética , Neoplasias Colorretais Hereditárias sem Polipose/patologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Vigilância da População/métodos , Medição de RiscoRESUMO
Forty patients with irritable bowel syndrome were randomly allocated to treatment with octylonium bromide (20 mg TID) or cimetropium bromide (50 mg BID) in a double-blind trial lasting for six weeks. Drugs were taken before meals, according to a double-blind schedule. Clinical evaluations were made of digestive and other symptoms, objective findings (pain at palpation, contracted colon, tympanites), and overall effectiveness of treatment. Statistically significant decreases in severity of abdominal pain and subjective scores for bowel habits were obtained in both groups. The only statistically significant differences between treatments were in nondigestive symptoms (asthenia, palpitations, tremor, headache, etc.), which improved more in the cimetropium bromide group. No severe side effects were observed in either treatment group.
Assuntos
Doenças Funcionais do Colo/tratamento farmacológico , Parassimpatolíticos/uso terapêutico , Derivados da Escopolamina/uso terapêutico , Adulto , Ensaios Clínicos como Assunto , Doenças Funcionais do Colo/fisiopatologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Compostos de Amônio Quaternário/uso terapêuticoRESUMO
INTRODUCTION: Interpretation of the tuberculin skin test (TST) may be complicated by prior bacille Calmette-Guérin (BCG) vaccination. The skin reaction to the vaccination interferes with the management of individuals who may be infected with Mycobacterium tuberculosis. OBJECTIVE: To discriminate between TST reactions due to infection and those due to vaccination in subjects with unknown BCG status. METHODS: Among 60200 subjects tested with 5TU PPD for screening purposes, 4987 contacts of infectious TB cases (Group A), 4962 BCG-vaccinated subjects (Group B) and 5000 subjects from the general population (Group C) were sampled. The frequencies of TST cut-off diameters were calculated for the three groups using a logistic regression model. The frequency of positive subjects in each group and the sensitivity, specificity and predictive values were also computed by means of these cut-offs. RESULTS: The risk of being a contact versus BCG-vaccinated increases 2.43-fold with every mm of TST diameter. The 11 mm cut-off point seems to be the best discriminating value. CONCLUSIONS: Using the traditional 10 mm cut-off, we can consider all vaccinated subjects with a positive TST to be infected. The TST remains a valuable tool for the evaluation of household contacts and suspected cases of tuberculosis in BCG-vaccinated subjects and in populations with high vaccination coverage.
Assuntos
Vacina BCG/administração & dosagem , Teste Tuberculínico/métodos , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/prevenção & controle , Adolescente , Adulto , Estudos Transversais , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Probabilidade , Estudos Retrospectivos , Medição de Risco , Sensibilidade e Especificidade , Tuberculose Pulmonar/imunologia , Vacinação/métodosRESUMO
OBJECTIVES: To assess the impact on compliance of three invitation methods, as well as the acceptability and efficacy of two bowel preparation regimens, for endoscopic screening in the general population. METHODS: 1170 subjects (men and women aged 55 to 59, in the rosters of a sample of general practitioners (GPs) in Turin), were randomly allocated to one of three invitation groups (A: personal letter, signed by GP, with a pre-fixed appointment; B: same as for A + letter supporting the study by a well known scientist; C: letter signed by the study coordinator, NS) and two preparation regimens (i: one enema, self administered at home two hours before the test; ii: two enemas, administered the night before and two hours before the test). A postal reminder was mailed to non-attenders. A sample of non-responders was contacted for a telephone interview by a trained nurse. Written consent was obtained from all subjects undergoing the test. RESULTS: A total of 278 subjects attended for sigmoidoscopic screening. An invitation from the GP alone produced the highest response rate (compliance: A = 29.3%; B = 24.9%; C = 26.8%). A single enema was as effective as two enemas in achieving satisfactory preparation for the test: the proportion of subjects invited to repeat the test was 8.1% in the single enema group, and 9.6% in the group receiving two enemas. CONCLUSIONS: Compliance with this screening procedure tends to be low. One enema, self administered two hours before sigmoidoscopy, can ensure a satisfactory bowel preparation.
Assuntos
Neoplasias Colorretais/prevenção & controle , Programas de Rastreamento/métodos , Sigmoidoscopia , Neoplasias Colorretais/diagnóstico , Enema/métodos , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Recusa do Paciente ao TratamentoRESUMO
The aim of this double blind trial was to compare omeprazole 20 mg once daily with ranitidine 150 mg b.i.d. in treatment of benign gastric ulcer, evaluating both rates and histological aspects of the ulcer healing process. Eighteen patients were randomized, 9 to each treatment; one patient (ranitidine group) was excluded from the analysis because of malignant ulcer. Omeprazole appeared to be more effective than ranitidine in healing gastric ulcer. A more rapid relief of symptoms was observed in the omeprazole group than in the ranitidine group. Both drugs reduced chronic atrophic gastritis (with a trend in favour of omeprazole), while omeprazole showed a prompter activity on the components of acute inflammation.
Assuntos
Omeprazol/uso terapêutico , Ranitidina/uso terapêutico , Úlcera Gástrica/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Método Duplo-Cego , Esquema de Medicação , Avaliação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Omeprazol/administração & dosagem , Ranitidina/administração & dosagem , Úlcera Gástrica/patologiaRESUMO
BACKGROUND: The aim of this study was to assess the feasibility and safety of laparoscopic surgery for colorectal diseases. METHODS: A retrospective review was undertaken of all patients undergoing a laparoscopic colorectal procedure (LCP) for large bowel disease. All operations were performed by a single experienced team. Patients were divided chronologically into three consecutive groups (G1, G2, and G3). Data collection included the incidence and cause of both "proper" and "mandatory" conversions to laparotomy, the incidence and type of early and late postoperative complications, incidence of operative mortality, and the length of hospital stay. The incidences of conversion to laparotomy and of early and late postoperative complications were also determined as related to diagnosis, type of LCP attempted, and chronological group. RESULTS: Between January 1996 and December 2001, a total of 108 patients (49 men and 59 women) with a mean age of 65.1 years underwent an LCP for colorectal disease. Proper conversion to open surgery was necessary in five patients (4.6%), whereas a mandatory conversion was needed in 10 with patients advanced cancer (9.2%). The overall morbidity rate was 11.9%. There were no anastomotic leaks. In two patients (1.85%) developed a complication requiring reoperation. Postoperative mortality was nil. Mean postoperative hospital stay was 7.2 days. The rates of conversion and of early and late complications decreased through the three chronological periods. No trocar site recurrences were observed in the cancer patients. CONCLUSION: Laparoscopic colorectal surgery performed in experienced centers is safe; the observed morbidity and mortality rates are low and acceptable and compare favorably to those observed after standard open surgery.
Assuntos
Doenças do Colo/cirurgia , Laparoscopia/estatística & dados numéricos , Doenças Retais/cirurgia , Idoso , Anastomose Cirúrgica/estatística & dados numéricos , Colectomia/métodos , Colectomia/estatística & dados numéricos , Neoplasias Colorretais/cirurgia , Doença Diverticular do Colo/cirurgia , Feminino , Seguimentos , Humanos , Complicações Intraoperatórias/epidemiologia , Itália/epidemiologia , Laparotomia/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do TratamentoRESUMO
Fasting and after meals serum gastrin levels were determined in healthy subjects and patients with different gastroenterological diseases (duodenal and gastric ulcer, hiatal hernia with gastroesophageal reflux, Billroth II gastric resection, atrophic gastritis, Zollinger-Ellison, Ménétrier, chronic calcifying pancreatitis, gastric carcinoma and lymphoma). The results pointed to the usefulness of evaluating both fasting levels and "gastrin curve" after meals as an expression of the rapidity of response of hormone-secreting gastric cells. Calculation of the I.G.O. (Integrated Gastrin Output) must also be carried out to provide a parameter from which the overall ability of G cells to secrete in response to feeding can be assessed.
Assuntos
Gastrinas/sangue , Gastroenteropatias/sangue , Úlcera Duodenal/sangue , Gastrite/sangue , Refluxo Gastroesofágico/sangue , Hérnia Hiatal/sangue , Humanos , Pancreatite/sangue , Neoplasias Gástricas/sangue , Síndrome de Zollinger-Ellison/sangueRESUMO
The results of protein deficiency in major burn cases are examined. They include diminished organ resistance, deleyed wound haeling, proneness to infection, and increased sensitivity to liver-toxic substances, leading to the protracted course of the patient's conditions. Since his caloric intake also needs to be increased, the importance of protein replacement is apparent. A standardised 15-day treatment with daily administrations of 1000 cc of a 7.5% natural amino acid solution was experimented during the period following shock, to prevent loss of amino acids through the vessel walls, since permeability is high in this periodo. Marked improvement in blood proteins was noted, with normalisation in some instances. No chagens in blood chemistry attributable to the treatment were noted.
Assuntos
Aminoácidos/uso terapêutico , Queimaduras/tratamento farmacológico , Aminoácidos/administração & dosagem , Queimaduras/complicações , Queimaduras/metabolismo , Humanos , Deficiência de Proteína/etiologia , Choque Traumático/tratamento farmacológico , Soluções , Equilíbrio Hidroeletrolítico/efeitos dos fármacosRESUMO
On the basis of some experimental observations of hypergastrinemia in animals chronically intoxicated with ethanol, both fasting and after meals serum gastrin were determined in patients affected by chronic alcoholic pancreatitis. A significant increase in serum gastrin levels was observed in patients with chronic pancreatitis compared with controls, both in basal conditions and following food stimulation. The physiopathological hypotheses and possible aetiopathogenetic implications suggested by such gastrin behaviour are discussed.
Assuntos
Alcoolismo/complicações , Gastrinas/sangue , Pancreatite/sangue , Adulto , Idoso , Doença Crônica , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite/etiologiaRESUMO
Serum GOT, GPT, LDH, CHE, MDH, SDH, PK, GLDM, LAP and amylase levels and serum ammonia were determined in 49 major burn cases with 2nd and 3rd degree lesions covering 25% to 80% of the body surface. GOT, GPT, LDH, CHE and gamma-GT have above normal in all cases. Limited and inconsistent movements were noted for the remaining enzymes. Blood ammonia was constantly increased and it is felt that the enzyme picture may be of considerable prognostic value in major burn cases.
Assuntos
Queimaduras/enzimologia , Adolescente , Adulto , Idoso , Amilases/sangue , Superfície Corporal , Colinesterases/sangue , Feminino , Humanos , L-Lactato Desidrogenase/sangue , Leucil Aminopeptidase/sangue , Malato Desidrogenase/sangue , Masculino , Pessoa de Meia-Idade , Choque Traumático/enzimologia , Succinato Desidrogenase/sangue , Transaminases/sangueRESUMO
Radiation treatment using low power laser beams is recommended for chronic or recurring lesions. Personal experience is reported with emphasis on the fact that He-Ne laser treatment should be employed when topical or surgical therapy fails.
Assuntos
Terapia a Laser , Cirurgia Plástica , Queimaduras/cirurgia , Cicatriz/cirurgia , Edema/cirurgia , Hematoma/cirurgia , Humanos , Úlcera da Perna/cirurgia , Úlcera por Pressão/cirurgia , Transplante de Pele , Ultrassom/instrumentação , Cicatrização , Ferimentos e Lesões/cirurgiaRESUMO
Aspecific immunosuppression in neoplasia has long been known, even though all its biological aspects are not yet fully understood. Inhibition of leukocyte migration (LIF) was studied before and after the use of levamisole in vitro to determine whether changes occurred in cell reactivity. The results of the investigation are discussed in the light of modern immunopathological theories.
Assuntos
Fatores Inibidores da Migração de Leucócitos/análise , Levamisol/farmacologia , Neoplasias Pulmonares/imunologia , Linfocinas/análise , Humanos , Técnicas In VitroRESUMO
75% of duodenal diverticula occur in the second or descending portion where, in 60% of cases, a juxta-Oddian site is involved. In about 10% of cases, juxta-Oddian forms may be responsible for symptoms due to their own effects or those induced in the biliary and pancreatic area. Two cases in female patients are presented and the subject is examined from all aspects in the light of 85 cases from the literature. Exact preoperative diagnosis is difficult. Radiological examination of the digestive tract and bile ducts, though by no means conclusive, is the only effective instrumental aid. When the symptoms are clear or indicative, surgery is necessary to prevent complications. In the two reported cases, an unevenful course and complete recovery were observed after diverticulectomy combined with papillosphincteroplasty.
Assuntos
Doenças Biliares/etiologia , Divertículo/complicações , Duodenopatias/complicações , Pancreatopatias/etiologia , Idoso , Divertículo/diagnóstico por imagem , Divertículo/cirurgia , Duodenopatias/diagnóstico por imagem , Duodenopatias/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , RadiografiaRESUMO
The physiopathological premises for various methods of hepatic revascularisation are described and results wiht splenohepatoplasty in 40 rats are presented. This operation involves insertion of the upper pole of decapsulated spleen in the left hepatic lobe to create a new parenchymal supply and regenerate the liver cell. The clinical, functional and anatomopathological data are discussed. The experimental value of the procedure is asserted, though it is felt that no sure demonstration can be given of the establishment of newly formed vascular connections between the two organs.
Assuntos
Fígado/cirurgia , Baço/cirurgia , Animais , Fígado/patologia , Circulação Hepática , Regeneração Hepática , Masculino , Portografia , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/patologia , Ratos , Baço/patologia , Coloração e RotulagemRESUMO
1654 cases of tumour of the digestive tube operated on in the Department of General Clinical Surgery and Surgical Therapy of the University of Pavia, during the period 2nd half 1964--1st half 1977, have been considered. Four primary tumours (1 leiomyoma, 2 adenocarcinomas, 1 reticulosarcoma) and one secondary tumour (metastases of retroperitoneal sarcoma) occurred in the jejunum and their pathology is examined from the etiopathogenetic and anatomoclinical viewpoints.
Assuntos
Carcinoma , Neoplasias Intestinais , Jejuno , Linfoma , Adenocarcinoma , Adulto , Idoso , Feminino , Humanos , Linfoma Difuso de Grandes Células B , Linfoma não Hodgkin , Masculino , Pessoa de Meia-Idade , SarcomaRESUMO
Peritonitis encapsulans is a clinical interest on account of its rarity and the diagnostic difficulties caused by its aspecific symptomatology. A personal case is presented and its ambiguous clinical and instrumental picture is discussed. Diagnosis was finally obtained intraoperatively, after repeated episodes of mechanical ileus had made surgery mandatory.
Assuntos
Peritonite/patologia , Abscesso/etiologia , Idoso , Feminino , Humanos , Obstrução Intestinal/etiologia , Mesentério/patologia , Peritônio/patologia , Peritonite/diagnóstico , Peritonite/cirurgiaRESUMO
Immigration in Italy from developing countries is a recent problem and the possible consequences on public health must be taken into account. The present study reports the results of Tuberculosis control activities performed by the Dispensario di Igiene Sociale of Turin, related to this population. Up to now the available data suggest that the immigrant population (mainly from North Africa and Senegal), in spite of representing a small part of residents (approximately 33,000/1,000,000) contributes to one third of Tuberculosis cases. The consequences on Tuberculosis epidemiology in Italy and our operational experience on Tuberculosis control and prevention are discussed.