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1.
Ital J Pediatr ; 45(1): 133, 2019 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-31666107

RESUMO

BACKGROUND: Invasive meningococcal disease is a serious global health threat in the world; in 2016, the European Centre for Disease Control and Prevention reported 3280 confirmed cases (including 304 deaths) of Invasive Meningococcal Diseases in Europe. In Italy, in 2017 were reported 200 cases 41% of which due to menB serogroup. From January 2013 the European Medicines Agency (EMA) has authorized the marketing of the meningococcal B vaccine 4CMenB. METHODS: The study aimed to evaluate and complement the safety profile of 4CMenB in high risk children accessing the vaccine service of the Bambino Gesù Children's Hospital. All individuals aged six weeks or more receiving the meningococcal 4CMenB (Bexsero®) vaccine that approached the vaccine Centre at the Bambino Gesù Children's Hospital in Rome, were asked to participate. All parents or caregivers of vaccinated individuals in the study period, were recruited and requested to answer to a questionnaire on adverse events following immunization (AEFI) observed after 7 days, starting from the date of vaccination. RESULTS: During the study period (October 2016-October 2017), we collected 157 completed questionnaires (out of 200 distributed). Of those 132 were first doses and 25 were booster administered doses. The median age of the study population was 4.5 years (range 0.29 to 26.8 years), the majority of subjects were high-risk individuals (64%) with chronic health conditions. Overall, 311 adverse events were reported in the 7 days after vaccine administration. In particular 147 events (47%) after administration of first dose and 58 (19%) after the booster doses. A large majority of those events, were of little clinical importance and concentrated in the 24 h after vaccine administration. No hospitalizations or Emergency Department access were reported. CONCLUSIONS: Results of our study demonstrated that the Bexsero® vaccine is almost well tolerated, with a low incidence of severe AEFIs. Our results also shown that the occurrence of AEFIs is similar within healthy and high risk children.


Assuntos
Doença Crônica/epidemiologia , Infecções Meningocócicas/prevenção & controle , Vacinas Meningocócicas/administração & dosagem , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Itália/epidemiologia , Masculino , Infecções Meningocócicas/epidemiologia , Vacinas Meningocócicas/efeitos adversos
2.
J Periodontal Res ; 52(1): 122-126, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27018040

RESUMO

BACKGROUND AND OBJECTIVE: Periodontal disease has been described as playing a role in the atherosclerosis process, and its relation with intimal thickness and vascular endothelial function (EF) has been investigated. The present study sought to determine whether there are differences in parameters of arterial stiffness and EF between patients with and without severe periodontal disease (SPD). MATERIAL AND METHODS: Patients referred to the School of Dentistry University of Buenos Aires, were assessed. Demographic characteristics, atherogenic risk factors and concomitant pathologies were recorded. Patients with known cardiovascular pathology were excluded. Using carotid Doppler ultrasound an operator assessed arterial stiffness parameters: compliance, elastic modulus (EM), ß stiffness index (ßSI) and vascular EF by brachial artery flow-mediated dilatation. The patients were divided into two groups: with and without SPD. RESULTS: Forty patients were included; 60% were women; 15 were in the SPD group and 25 in the group without SPD. Respective results of the studied variables were: age 56.53 ± 17.58 vs. 51.12 ± 12.97 years (NS); probing depth 2.53 ± 1.30 (95% CI 1.81-3.25) vs. 1.25 ± 0.51 (95% CI 1.31-1.73) p = 0.02; clinical attachment level 4.80 ± 2.00 (95% CI 3.69-5.91) vs. 1.72 ± 0.93 (95% CI 1.33-2.11) p = 0.001; intimal thickness 0.10 ± 0.17 (95% CI 0.095-0.11) vs. 0.82 ± 0.18 (95% CI 0.074-0.98) (NS); EM 48.33 ± 12.53 vs. 38.86 ± 7.69 (p = 0.005); ßSI 4.21 ± 1.03 vs. 3.64 ± 1.02 (p = 0.004); EF 16.13 ± 5.02 vs. 22.76 ± 4.50 (p = 0.0003). Correlation between: EM and clinical attachment level r = 0.58 (p < 0.001), ßSI and clinical attachment level r = 0.66 (p < 0.001), EF and clinical attachment level 0.59 (p < 0.001). CONCLUSIONS: Parameters of arterial stiffness and EF were worse in patients with SPD and correlated moderately with clinical attachment level. Correlation with compliance and EF was negative.


Assuntos
Doenças Periodontais/complicações , Rigidez Vascular , Perda do Osso Alveolar/complicações , Perda do Osso Alveolar/diagnóstico por imagem , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/complicações , Estudos Prospectivos , Radiografia Dentária
3.
Niger J Clin Pract ; 18(3): 307-11, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25772909

RESUMO

AIMS: International adoption medicine is a relatively new specialty in pediatrics that has emerged to address the specific health care needs of internationally adopted children in high-income countries. This study ascertains the seroprotection rate for vaccine-preventable diseases, especially against pneumococcal diseases. PATIENTS AND METHODS: We evaluated 67 internationally adopted children that reached the International Adoption Unit of Bambino Gesù Children's Hospital, Rome-Italy. We collected demographic information, data from preadoption immunization records, results of laboratory testing for immunity to vaccine-preventable diseases (tetanus, pneumococcus, hepatitis B, hemophilus influenzae type b (Hib), measles), as well as results of screening for HIV, hepatitis C, quantiferon, immunological and nutritional status. RESULTS: For children that had received ≥3 vaccine doses of tetanus, overall protection was 94% of 31 vaccinated children; with 1-2 vaccine doses for hepatitis B and Hib respectively, protection was 45% of 29 vaccinated children and 63% of 8 vaccinated children, respectively. For children with one or more doses of measles vaccine, protection was 63% of 32 vaccinated children. Regarding pneumococcus vaccine (documented for eight children), 88% of children with one or more doses of vaccine had developed protective immunity. CONCLUSIONS: International adoptees without a valid vaccine record need to undergo a complete schedule in accordance with their age and should receive all the vaccines in the adoptive country's schedule.


Assuntos
Adoção , Imunização/estatística & dados numéricos , Criança , Pré-Escolar , Estudos Transversais , Feminino , Nível de Saúde , Humanos , Internacionalidade , Masculino , Cidade de Roma/epidemiologia , Vacinação/estatística & dados numéricos , Vacinas/administração & dosagem
4.
Br J Pharmacol ; 157(6): 1045-52, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19519726

RESUMO

BACKGROUND AND PURPOSE: We have investigated the therapeutic effects of the selective cyclophilin inhibitor D-MeAla(3)-EtVal(4)-cyclosporin (Debio 025) in myopathic Col6a1(-/-) mice, a model of muscular dystrophies due to defects of collagen VI. EXPERIMENTAL APPROACH: We studied calcineurin activity based on NFAT translocation; T cell activation based on expression of CD69 and CD25; propensity to open the permeability transition pore in mitochondria and skeletal muscle fibres based on the ability to retain Ca(2+) and on membrane potential, respectively; muscle ultrastructure by electronmicroscopy; and apoptotic rates by terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling assays in Col6a1(-/-) mice before after treatment with Debio 025. KEY RESULTS: Debio 025 did not inhibit calcineurin activity, yet it desensitizes the mitochondrial permeability transition pore in vivo. Treatment with Debio 025 prevented the mitochondrial dysfunction and normalized the apoptotic rates and ultrastructural lesions of myopathic Col6a1(-/-) mice. CONCLUSIONS AND IMPLICATIONS: Desensitization of the mitochondrial permeability transition pore can be achieved by selective inhibition of matrix cyclophilin D without inhibition of calcineurin, resulting in an effective therapy of Col6a1(-/-) myopathic mice. These findings provide an important proof of principle that collagen VI muscular dystrophies can be treated with Debio 025. They represent an essential step towards an effective therapy for Ullrich Congenital Muscular Dystrophy and Bethlem Myopathy, because Debio 025 does not expose patients to the potentially harmful effects of immunosuppression.


Assuntos
Colágeno Tipo VI/deficiência , Ciclofilinas/antagonistas & inibidores , Ciclosporina/farmacologia , Mitocôndrias/fisiologia , Músculo Esquelético/ultraestrutura , Doenças Musculares/patologia , Animais , Apoptose/efeitos dos fármacos , Apoptose/genética , Colágeno Tipo VI/genética , Ciclofilinas/fisiologia , Ciclosporina/uso terapêutico , Relação Dose-Resposta a Droga , Humanos , Células Jurkat , Camundongos , Camundongos Knockout , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/ultraestrutura , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/patologia , Doenças Musculares/tratamento farmacológico , Doenças Musculares/genética
5.
G Ital Med Lav Ergon ; 29(3 Suppl): 811-2, 2007.
Artigo em Italiano | MEDLINE | ID: mdl-18409975

RESUMO

The objective of the study is evalutation of the risk for ticks strings on foresters. The sample constituted by 325 foresters belong to Messina province as been submitted to medical examination venous tests. Whole sample had to answer to a questionnaire to consider. The prevalence of systemic and skin reactions and we have dose Immunoglobulines versus Brucella Melitensis, Rickettsie Conorii e Borrelia Burgdorferi. The results showed that the 19% has declared past stings of tick, and 4.9% reported symptoms probably deriving to a past infections determined by inquired microorganisms. The serum tests showed that 70% was positive for all microorganisms, instead only 31%. Was never infected by inquired microorganisms. In conclusion our study shows that zoonos is risk linked to stings of tick is relatively high in foresters.


Assuntos
Mordeduras e Picadas/epidemiologia , Carrapatos , Animais , Anticorpos Antibacterianos/sangue , Mordeduras e Picadas/sangue , Mordeduras e Picadas/microbiologia , Borrelia burgdorferi/imunologia , Brucella melitensis/imunologia , Humanos , Pessoa de Meia-Idade , Rickettsia conorii/imunologia , Fatores de Risco
8.
Eur Heart J ; 18(4): 664-70, 1997 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9129899

RESUMO

AIM: To assess whether the are gender differences in cardiac adaptation to raised blood pressure levels in young subjects with borderline to mild hypertension. METHODS AND RESULTS: In 499 18-45-year-old stage I hypertensive subjects (377 men and 122 women) with a mean age of 33 +/- 9 years and office blood pressure of 146 +/- 11/ 94 +/- 6 mmHg, ambulatory blood pressure monitoring in duplicate, echocardiography and 24-h urinary catecholamines measurement were performed. RESULTS: The whole group was divided into quartiles of increasing daytime blood pressure and differences in left ventricular echocardiographic data were analysed in the two sexes separately. In men no left ventricular parameter differed across the quartiles, while in women left ventricular mass, posterior wall thickness and interventricular septum thickness showed a clear tendency to increase with increasing levels of systolic blood pressure. In multiple regression analysis, daytime systolic blood pressure explained only a small fraction of the variance in left ventricular parameters in men, while in women daytime systolic blood pressure was a main determinant of left ventricular mass and posterior wall and septal thicknesses. Body weight explained most of the variance in all dimensional parameters in men. In women weight was an important predictor of left ventricular mass and diameter, but was unrelated to left ventricular posterior wall and septal thicknesses. CONCLUSIONS: Daytime systolic blood pressure is the most important predictor of left ventricular mass and geometry in pre-menopausal women with stage I hypertension, while in men left ventricular dimensional indices are chiefly explained by body weight.


Assuntos
Monitores de Pressão Arterial , Hipertensão/diagnóstico , Hipertrofia Ventricular Esquerda/diagnóstico , Adolescente , Adulto , Volume Cardíaco/fisiologia , Catecolaminas/urina , Ritmo Circadiano/fisiologia , Diagnóstico Diferencial , Ecocardiografia , Feminino , Hemodinâmica/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
9.
Infez Med ; 5(2): 96-9, 1997 Jun.
Artigo em Italiano | MEDLINE | ID: mdl-14966394

RESUMO

A retrospective study on 357 children admitted to four Pediatric Infectious Disease Centers in Rome, affected by acute meningitis, during 10 years period, between January, 1, 1985 and December, 31, 1994 was carried out. Haemophilus influenzae type b was detected in 110 patients; all children aged between 1 month and 5 years; the maximum incidence (74.5%) was observed in patients under two years. The following diagnostic criteria were utilized: Gram stain of CSF; Latex test on CSF, blood, urine; CSF and blood cultures. The in vitro sensitivity of 65 isolates was tested by using the Kirby-Bauer method. We detected 15.3% of strains resistant to Ampicillin and 1.5% resistant to CAF. We also observed a high number of Hib strains resistant to Erythromycin and Cotrimoxazole. Only one strain Ceftriaxone resistant was isolated, confirming the high in vitro sensibility Hib to III generation cephalosporins that still remain the first choice drugs in Hib meningitis.

10.
Infez Med ; 5(2): 114-7, 1997 Jun.
Artigo em Italiano | MEDLINE | ID: mdl-14966398

RESUMO

Non tuberculous Mycobacterial (NTM) Infections mainly affect immunocompromised patients, appearing as disseminated or pulmonary disease. In immunocompetent children the most common form of infection with NTM is cervical adenitis. Ear infection seems to be a rare disease. We present a case of otomastoiditis caused by Mycobacterium avium in a 15 months old child, immunologically normal. Patient was referred for persistent right otitis unresponsive to routine medical therapy. TC scan of the ear and temporal bones revealed: soft tissue in external auditory canal, Eustachian canal, and middle ear overlying ossicles with erosion of tegmen tympani. Tuberculin skin test was positive with 5 units PPD and culture yielded M. avium. The patient undergo timpanomastoidectomy and medical therapy with antituberculous drugs and Steroids, subsequently he was given Clarithromycin and Rifabutin. M. avium is an ubiquitous low grade pathogen found in soil, water, dust and food. There is no evidence of direct transmission. Only a few cases of otomastoiditis due to M. avium have previously been reported. The case presented underlines the importance of microbiological investigations. When a NTM infection is suspected surgeons and infectious diseases specialists should cooperate to find an optimal treatment regimen of this unusual disease.

11.
Infez Med ; 5(3): 160-3, 1997 Jul.
Artigo em Italiano | MEDLINE | ID: mdl-15034315

RESUMO

Aim of study is the determination of concentrations of two important cytokines: TNF alfa and IL8 in children with bacterial meningitis to establish a correlation between infection, CSF concentration of cytokines and neurological sequelae. TNF alfa and IL8 concentrations in CSF have been measured by quantitative immunometric enzyme assay during the course of the disease. In the purulent meningitis we observed that CSF concentrations of these cytokines decreased to undectable values 24 to 48 hours after beginning of the antibiotic therapy. Conversely, in the 3 patients with mycobacterial meningitis (TBM) the concentrations of IL8 were higher for a longer period, being detectable in the CSF between 4 and 8 weeks after the beginning of the specific treatment. We found no significant differences of the values of IL8 in children with neurological sequelae compared with children without sequelae.

12.
Arch. med. interna (Montevideo) ; 18(1): 1-6, mar. 1996. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-189875

RESUMO

Se presenta la primer experiencia recogida en el primer consultorio interdisciplinario para el estudio integral de los factores de riesgo aterogenico (FRA) en la Argentina. Se analizan los resultados preliminares de esta accion medica en la prevencion primaria y secundaria de la enfermedad aterosclerotica y se realizan recomendaciones basadas en los hallazgos relevantes del estudio


Assuntos
Humanos , Masculino , Feminino , Aterosclerose/prevenção & controle , Doenças Cardiovasculares/prevenção & controle , Fatores de Risco , Argentina
13.
Circulation ; 90(6): 2870-6, 1994 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-7994832

RESUMO

BACKGROUND: This study was undertaken to assess whether ambulatory blood pressure (BP) in a population of stage I hypertensive individuals was lower in the subjects performing regular exercise training. METHODS AND RESULTS: The study was carried out in 796 young hypertensive patients (592 men) who had never been treated who took part in the HARVEST trial. The diagnosis of stage I hypertension was made on the basis of six office BP measurements. Subjects underwent noninvasive 24-hour ambulatory BP monitoring, 24-hour urine collection for catecholamine assessment, and echocardiography (n = 457). They were classified as exercisers if they reported at least one session of aerobic sports per week and as nonexercisers if they did not engage regularly in sports activities. Age (P < .0001), body mass index (P = .002), 24-hour heart rate (P < .0001), alcohol intake (P = .02), smoking (P = .02), and norepinephrine output (P = .04) were lower in the active (n = 153) than the inactive (n = 439) men. Physically active men exhibited a lower 24-hour and daytime diastolic BP than the inactive men, while there were no group differences in office BP or in nighttime diastolic BP and in ambulatory systolic BP. The between-group ambulatory diastolic BP difference remained statistically significant after adjustment for age, body mass index, alcohol intake, and smoking (P < .0001). Of the nonexercisers, 46.2% were confirmed hypertensives, compared with only 26.8% of the exercisers (P < .0001), on the basis of daytime diastolic BP. Echocardiographic left ventricular dimensional and functional indexes were similar in the two groups of men. Similar findings were shown by the 16 women who engaged in aerobic sports. CONCLUSIONS: These data suggest that participation in aerobic sports may attenuate the risk of hypertension in young subjects whose office BP is in the stage I hypertensive range at office measurement.


Assuntos
Monitorização Ambulatorial da Pressão Arterial , Pressão Sanguínea , Hipertensão/fisiopatologia , Educação Física e Treinamento , Adolescente , Adulto , Ecocardiografia , Feminino , Humanos , Hipertensão/diagnóstico , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Norepinefrina/sangue , Valor Preditivo dos Testes , Caracteres Sexuais
14.
G Ital Cardiol ; 18(2): 148-50, 1988 Feb.
Artigo em Italiano | MEDLINE | ID: mdl-3410202

RESUMO

A case of high take-off of the left coronary artery from the aorta in a patient with a large ventricular septal defect (VSD) is described. The preoperative detection of this coronary anomaly, enabled the surgeon to modify the technique of aortic cannulation in such a way that the anomalous left coronary artery could be adequately perfused with the cardioplegic solution. Furthermore, injury to the coronary artery during the operative procedure was carefully avoided by knowing the exact location and course of the left main coronary trunk, from the angiographic pictures. Other unfavorable pathophysiologic consequences of this anomaly may derive from the acute angle of origin of the coronary ostium relative to the aortic wall. This could limit coronary blood flow especially during exercise. It seems, therefore, reasonable to moderately restrict the physical activity of such individuals and to advise regular cardiological follow-up.


Assuntos
Aorta/anormalidades , Anomalias dos Vasos Coronários/cirurgia , Aorta/cirurgia , Aortografia , Pré-Escolar , Anomalias dos Vasos Coronários/diagnóstico por imagem , Anomalias dos Vasos Coronários/patologia , Humanos , Masculino
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