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1.
J Appl Microbiol ; 124(1): 188-196, 2018 Jan.
Article in English | MEDLINE | ID: mdl-29080227

ABSTRACT

AIMS: To evaluate the levels of unicellular and filamentous fungi in ice cubes produced at different levels and to determine their survival in alcoholic beverages and soft drinks. METHODS AND RESULTS: Sixty samples of ice cubes collected from home level (HL) productions, bars and pubs (BP) and industrial manufacturing plants (MP) were investigated for the presence and cell density of yeasts and moulds. Moulds were detected in almost all samples, while yeasts developed from the majority of HL and MP samples. Representative colonies of microfungi were subjected to phenotypic and genotypic characterization. The identification was carried out by restriction fragment length polymorphism (RFLP) analysis of the region spanning the internal transcribed spacers (ITS1 and ITS2) and the 5·8S rRNA gene. The process of yeast identification was concluded by sequencing the D1/D2 region of the 26S rRNA gene. The fungal biodiversity associated with food ice was represented by nine yeast and nine mould species. Strains belonging to Candida parapsilosis and Cryptococcus curvatus, both opportunistic human pathogens, and Penicillium glabrum, an ubiquitous mould in the ice samples analysed, were selected to evaluate the effectiveness of the ice cubes to transfer pathogenic microfungi to consumers, after addition to alcoholic beverages and soft drinks. All strains retained their viability. CONCLUSIONS: The survival test indicated that the most common mode of consumption of ice cubes, through its direct addition to drinks and beverages, did not reduce the viability of microfungi. SIGNIFICANCE AND IMPACT OF THE STUDY: This study evidenced the presence of microfungi in food ice and ascertained their survival in soft drinks and alcoholic beverages.


Subject(s)
Beverages/microbiology , Food Contamination/analysis , Fungi/growth & development , Ice/analysis , Yeasts/growth & development , DNA, Fungal/genetics , Fungi/genetics , Fungi/isolation & purification , Microbial Viability , Yeasts/genetics , Yeasts/isolation & purification
2.
Phys Med ; 32(12): 1690-1697, 2016 Dec.
Article in English | MEDLINE | ID: mdl-27720692

ABSTRACT

AIM: To investigate late gastrointestinal toxicity in a large pooled population of prostate cancer patients treated with radical radiotherapy. Normal tissue complication probability models were developed for late stool frequency and late rectal pain. METHODS AND MATERIALS: Population included 1336 patients, 3-year minimum follow-up, treated with 66-80Gy. Toxicity was scored with LENT-SOMA-scale. Two toxicity endpoints were considered: grade ⩾2 rectal pain and mean grade (average score during follow-up) in stool frequency >1. DVHs of anorectum were reduced to equivalent uniform dose (EUD). The best-value of the volume parameter n was determined through numerical optimization. Association between EUD/clinical factors and the endpoints was investigated by logistic analyses. Likelihood, Brier-score and calibration were used to evaluate models. External calibration was also carried out. RESULTS: 4% of patients (45/1122) reported mean stool frequency grade >1; grade ⩾2 rectal pain was present in the TROG 03.04 RADAR population only (21/677, 3.1%): for this endpoint, the analysis was limited to this population. Analysis of DVHs highlighted the importance of mid-range doses (30-50Gy) for both endpoints. EUDs calculated with n=1 (OR=1.04) and n=0.35 (OR=1.06) were the most suitable dosimetric descriptors for stool frequency and rectal pain respectively. The final models included EUD and cardiovascular diseases (OR=1.78) for stool frequency and EUD and presence of acute gastrointestinal toxicity (OR=4.2) for rectal pain. CONCLUSION: Best predictors of stool frequency and rectal pain are consistent with findings previously reported for late faecal incontinence, indicating an important role in optimization of mid-range dose region to minimize these symptoms highly impacting the quality-of-life of long surviving patients.


Subject(s)
Feces , Models, Statistical , Pain/etiology , Prostatic Neoplasms/radiotherapy , Radiotherapy/adverse effects , Rectum/radiation effects , Humans , Logistic Models , Male , Multivariate Analysis , Radiometry , Rectum/physiopathology , Reproducibility of Results
3.
Minerva Anestesiol ; 79(7): 750-7, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23511364

ABSTRACT

BACKGROUND: Stroke is a leading cause of long-term morbidity and mortality affecting several hundred-thousand people annually in the Western Countries. Various panels of biomarkers of neural damage have been developed and validated. The primary objective of this investigation was to measure the correlation between the clinical severity of stroke and the serum/plasma concentrations of neural damage biomarkers. METHODS: A prospective investigation was conducted on a panel of biomarkers composed of S100ß, matrix metalloproteinase-9 (MMP-9), N-terminal pro-B-type natriuretic peptide (NT pro-BNP) and D-dimer at admission and after 24 hours, in a cohort patients with a confirmed diagnosis of stroke in an emergency setting (STROke-MArkers STROMA). RESULTS: A total of 58 consecutive patients were enrolled, no participant was excluded; according to clinical severity measured by National Institute of Health Stroke Scale (NIHSS) there were 29 minor strokes, 24 moderate, 3 moderate-severe, 2 severe. The Spearman's rank correlation test was used to assess the relationship between the baseline NIHSS value and the concentrations of the four biomarkers: all the studied biomarkers showed a statistically significant correlation with baseline NIHSS at 24 hours. A multivariate ordinal regression model was used to analyze the correlation of markers with stroke severity, stratified, according to NIHSS score: MMP-9 and S100ß showed a statistically significant correlation after 24 hours. CONCLUSION: MMP-9, S100ß, NT pro-BNP and D-dimer showed a good correlation with the clinical severity of stroke which may become an additional resource in the acute patient evaluation and potentially follow-up.


Subject(s)
Brain Ischemia/blood , Brain Ischemia/diagnosis , Fibrin Fibrinogen Degradation Products/analysis , Matrix Metalloproteinase 9/blood , Natriuretic Peptide, Brain/blood , Peptide Fragments/blood , S100 Calcium Binding Protein beta Subunit/blood , Stroke/blood , Stroke/diagnosis , Acute Disease , Aged , Aged, 80 and over , Biomarkers/blood , Brain Ischemia/complications , Female , Humans , Male , Prospective Studies , Severity of Illness Index , Stroke/etiology
4.
Med Phys ; 35(7): 3049-53, 2008 Jul.
Article in English | MEDLINE | ID: mdl-18697527

ABSTRACT

The high energy electrons produced by linear accelerators can generate several radioisotopes by means of photonuclear reactions. The activity produced in the head of a 15 MV Mevatron Siemens 77 medical linear accelerator was measured by high resolution gamma-ray spectrometry, during its decommissioning 1 year after the last clinical use. The activity of 54Mn, 57Co, 60Co, 181W, and 65Zn was measured while the activity of other radioisotopes which emit soft beta or gamma rays such as 59Ni, 63Ni, and 55Fe was inferred by appropriate scaling factors. The number of pieces requiring particular care is limited, their mass does not exceed some tens of kilograms, and their volume is of the order of some thousands of cm3. Moreover, these materials are metals and the emitted radiation can be easily shielded, so that storage should not create particular problems.


Subject(s)
Particle Accelerators , Radiation Oncology/methods , Radioisotopes/therapeutic use , Electrons , Equipment Design , Gamma Rays , Metals/chemistry , Models, Statistical , Photons , Radiation Oncology/instrumentation , Radiotherapy Dosage , Reproducibility of Results , Scattering, Radiation , Spectrophotometry/methods , Tungsten
6.
Radiol Med ; 89(5): 695-701, 1995 May.
Article in Italian | MEDLINE | ID: mdl-7617914

ABSTRACT

An automated system for the design and manufacturing of individual compensators has been implemented. The system based on computed tomography enables 3D compensation of missing tissue and tissue heterogeneities. The relationship between Hounsfield numbers and electron densities was obtained empirically. Compensator design is based on the calculation of the water equivalent thicknesses between the compensation plane and the patient surface. After calculation a styrofoam mould is cut by a computer driven machine and filled with bee's wax or tin granules. Compensator thickness is calculated by means of the conversion ratio tau, which is defined as t/x, where t is the compensator thickness equivalent to the missing tissue in the treatment geometry. Relations between tau and field size, depth of compensation plane and focus-compensation plane distance were assessed. The conversion ratio is a linear function of the missing tissue and depends markedly on field size; for a 10-cm-deep compensation plane at 1 m from the accelerator target the tau value, calculated for bee's wax, decreases by 25% from 7 x 7 cm2 to 23 x 23 cm2 field size. Conversion ratio rises by approximately 10% for a 3-cm increase in compensation plane depth and reduces by about 5% when increasing the focus-compensation plane distance from 100 cm to 140 cm. It must be stressed that a 10% variation of tau, for bee's wax, involves only a 2% dose variation in the compensation plane. Therefore, for compensator design it is enough to consider tau as depending on field size only. Compensation effectiveness has been tested by a film-densitometric technique using phantoms with tilted incident surfaces and heterogeneities. The results show that the compensators reduce the flatness of the beam profile below 4% and increase the relative dose uniformity on the compensation plane from 18% to 60%.


Subject(s)
Radiotherapy/instrumentation , Filtration , Physical Phenomena , Physics , Radiotherapy Dosage
7.
Radiol Med ; 89(5): 692-4, 1995 May.
Article in Italian | MEDLINE | ID: mdl-7617913

ABSTRACT

The small X-ray beam profiles produced by linear accelerators and used in stereotactic radiosurgery were studied. Circular focusing and not-focusing beams outlined by additional collimators (diameter ranging 10 to 30 mm) and square field outlined by the jaws (field size 10 to 30 mm) were measured. 6 and 18-MV X-ray beams from a dual energy accelerator and 6 and 15-MV X-ray beams produced by 2 single-energy accelerators were used. Measurements were carried out with Kodak X Omat V films in a perspex phantom in the same conditions for all the fields. To study the profile characteristics we introduced the V80/V20 = (R80/R20)3 ratio where R80 and R20 are respectively the mean distance of the 80% and 20% isodose lines from the beams axis. Measurement results show that 6-MV X-ray beams have a higher V80/V20 ratio than the ones obtained with the other energies. There is no significant difference between the beams produced with focused collimators and those produced with not-focused collimators. Square fields outlined by the jaws have a V80/V20 ratio greatly dependent on the accelerator used. This ratio is generally worse than the ones obtained with beams outlined by additional collimators.


Subject(s)
Photons/therapeutic use , Radiosurgery/methods , Radiation Dosage
9.
Ophthalmologica ; 207(4): 208-14, 1993.
Article in English | MEDLINE | ID: mdl-8115115

ABSTRACT

In a polycentric study, the influence of some of the most common variables capable of influencing the reliability of prekeratotomy pachymetry has been evaluated. The fluctuation in a sequence of measurements from the same point on the cornea, with the patient in different positions (orthostatic and clinostatic), during progressive drying of the lacrimal film and before and after corneal marking have been evaluated. Three operators, working randomized, used the same computerized pachymeter (DGH 1000) to make the measurements. The data obtained in this way were statistically analyzed by the Statgraphics personal computer program. Some interesting and useful considerations about the more correct methods to run the test and its real accuracy have emerged.


Subject(s)
Cornea/anatomy & histology , Adult , Aged , Anthropometry/instrumentation , Cornea/physiology , Diagnosis, Computer-Assisted , Female , Humans , Male , Middle Aged , Observer Variation , Random Allocation , Regression Analysis , Reproducibility of Results , Sensitivity and Specificity
10.
J Appl Bacteriol ; 73(3): 203-9, 1992 Sep.
Article in English | MEDLINE | ID: mdl-1399914

ABSTRACT

Microbiological developments during industrial meat fermentations (salami), made with and without commercial starter cultures, were followed at two factories in Germany and Italy. In the German product microbial growth was evident only for the first 48 h, followed by a gradual decline in numbers of most micro-organisms. The pH fell from 5.8 to 4.8 in the 28 d required for production. In Italy a similar situation was seen, except that a second period of bacterial growth began around 15 d, coincident with the appearance of intentional surface mould growth which reversed the pH fall, the final pH being 6.2. The German starter culture was a mixture of Lactobacillus plantarum and Staphylococcus carnosus, whereas in Italy only Staph. carnosus was used. The strain of Lact. plantarum used did not grow in the German product whereas the Staph. carnosus grew well in both products to form a substantial proportion of the final microflora.


Subject(s)
Fermentation , Food Microbiology , Lactobacillus/growth & development , Meat Products/microbiology , Staphylococcus/growth & development , Bacteriophages/isolation & purification , Germany , Hydrogen-Ion Concentration , Italy
12.
Klin Monbl Augenheilkd ; 198(5): 340-3, 1991 May.
Article in French | MEDLINE | ID: mdl-1886351

ABSTRACT

Maintaining successful mydriasis is essential during cataract extraction. The use of nonsteroidal anti-inflammatory drugs in order to inhibit trauma induced miosis has been advocated by many authors. Indomethacin 1% has proved his efficacy since many years. Flurbiprofen has been introduced more recently and has been accepted largely because of a better patient comfort. He proved his efficacy against placebo. We conducted a randomized double blind study in order to verify if there is any difference in efficacy between these two drugs. 40 cases were randomly assigned to a pretreatment, not known by the surgeons, with Indomethacin 1% (Indoptic) or Flurbiprofen 0.03% (Ocuflur). Measurements were taken at the beginning of surgery, after nucleous extraction and after irrigationaspiration of lens cortical material. Sodium hyaluronate and epinephrine were not used during this study. After nucleous extraction, the mean pupillary constriction was 1.53 mm in the Indomethacin group and 1.23 mm in the Flurbiprofen group (p greater than 0.1). After aspiration of cortical material, the mean pupillary constriction was 2.27 mm in the Indomethacin group and 2.00 in the Flurbiprofen group (p greater than 0.1). Cumulative results of patients who constricted the pupil more than 2 and 3 mm showed a better result in the Flurbiprofen group. Flurbiprofen has proved in this study his efficacy compared to an other nonsteroidal anti-inflammatory drug in inhibiting trauma induced miosis.


Subject(s)
Cataract Extraction/methods , Flurbiprofen/administration & dosage , Indomethacin/administration & dosage , Miotics , Pupil/drug effects , Aged , Double-Blind Method , Humans , Premedication , Prospective Studies
13.
Pediatr Med Chir ; 13(1): 91-3, 1991.
Article in Italian | MEDLINE | ID: mdl-2052463

ABSTRACT

Disseminated intravascular coagulation (DIC) is a frequent complication of meningococcal sepsis in children. The clinical course variability, the severity of manifestations and the need of an early diagnosis for appropriate treatment, guides us to report a case of meningococcal sepsis and DIC. The patient, male, prematurely born, 11 months years old, presented himself with high fever of sudden onset, malaise, diarrhea, diffuse skin rash with abdominal petechiae, and no clinical evidence of meningitidis. Initial hematochemical findings, peripheral leukocytosis, quantitative and qualitative changes in plasma coagulation factors, liquoral hypocellularity together with the development of signs of meningeal irritation (stiff neck and back) were considered diagnostic clues for meningococcal sepsis associated with DIC. A gram-negative diplococcus was cultured from liquor. Primary goals of the treatment of this life-threatening clinical picture were the elimination of the bacterial component, the correction of clotting disorders and careful control of shock and metabolic acidosis often related with DIC. The patient then received a wide spectrum Cephalosporin, fresh frozen plasma, appropriate electrolyte solutions and eventually heparin, which led to a complete control and resolution of symptomatology.


Subject(s)
Disseminated Intravascular Coagulation/diagnosis , Meningococcal Infections/diagnosis , Acidosis/diagnosis , Acidosis/etiology , Acidosis/therapy , Combined Modality Therapy , Disseminated Intravascular Coagulation/etiology , Disseminated Intravascular Coagulation/therapy , Humans , Infant , Male , Meningococcal Infections/complications , Meningococcal Infections/therapy , Shock, Septic/prevention & control
14.
Radiol Med ; 80(4 Suppl 1): 122-6, 1990 Oct.
Article in Italian | MEDLINE | ID: mdl-2251399

ABSTRACT

Criteria of choice in the utilization of fast electrons in radiotherapy on the basis of 2400 cases and 13 years of experience in the radiotherapy department of Cancer Institute in Milan are discussed. In the opinion of the authors fast electrons represent the most rational treatment to homogenize or differentiate the dose distribution according to space as a complementary technique after first time treatments by different ionizing radiation. Authors demonstrate also that fast electron treatment is the most rational technique for metastases in the retina and for recurrence of rhinopharynx cancer. Radiotherapy by fast electrons allows to deliver to the patient's body on integral dose lesser than with ionizing radiation of other type. Sequelae are regarding in most of the cases soft tissues and are caused by an unrecognized distribution of dose delivered by the ionizing radiations of other type in the first time treatment more than by difficulty im dosimetry of post-electrons.


Subject(s)
Electrons , Neoplasms/radiotherapy , Head and Neck Neoplasms/radiotherapy , Humans , Radiation Injuries/prevention & control , Radiotherapy/adverse effects , Radiotherapy/methods , Radiotherapy Dosage
15.
Int J Radiat Oncol Biol Phys ; 19(3): 743-9, 1990 Sep.
Article in English | MEDLINE | ID: mdl-1976614

ABSTRACT

Pulmonary function tests (standard vital capacity, SVC; total lung capacity, TLC; forced expiratory volume in 1 second-forced vital capacity ratio, FEV1/FVC; carbon monoxide transfer factor, DLCO) were prospectively evaluated in patients (median age 25 years, 13-52 years; median follow-up 20 months, 6-51 months) with Hodgkin's disease (15 patients), non-Hodgkin's lymphoma (9 patients), and inflammatory breast cancer (3 patients) treated with sequential high-dose therapy comprising the following phases over approximately 2 months: a) cyclophosphamide (7 g/m2); b) vincristine (1.4 mg/m2), methotrexate (8 g/m2), and cisplatinum (120 mg/m2) or etoposide (2 g/m2); c) total body irradiation (TBI; 12.5 gy, 5 fractions over 48 hours), intravenous melphalan (120-180 mg/m2), and transplantation of autologous peripheral blood and/or bone marrow hematopoietic stem cells. Within 2 months after transplantation, 12 patients also received 25 Gy radiotherapy boost to mediastinum and clavicular regions. In vivo dosimetry evaluations of fractionated TBI treatments showed that mean radiation dose absorbed by lungs was 12.18 Gy (97.4% of TBI dose). Despite such a high radiation dose, we observed only transient and subclinical decrease of SVC, TLC, and DLCO. The decrease of SVC, TLC, and DLCO was more evident and prolonged in patients receiving radiotherapy boost. All parameters progressively recovered to normal values within 2 years after transplantation. In contrast, FEV1/FVC remained within normal limits in all patients, thus demonstrating the absence of obstructive ventilatory changes. In addition, no interstitial pneumonia was observed.


Subject(s)
Breast Neoplasms/therapy , Hodgkin Disease/therapy , Lung/physiopathology , Lymphoma, Non-Hodgkin/therapy , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/epidemiology , Breast Neoplasms/physiopathology , Combined Modality Therapy , Female , Hematopoietic Stem Cell Transplantation , Hodgkin Disease/epidemiology , Hodgkin Disease/physiopathology , Humans , Italy/epidemiology , Lung/drug effects , Lung/radiation effects , Lymphoma, Non-Hodgkin/epidemiology , Lymphoma, Non-Hodgkin/physiopathology , Male , Melphalan/administration & dosage , Melphalan/therapeutic use , Middle Aged , Prospective Studies , Pulmonary Gas Exchange/drug effects , Pulmonary Gas Exchange/physiology , Pulmonary Gas Exchange/radiation effects , Total Lung Capacity/drug effects , Total Lung Capacity/physiology , Total Lung Capacity/radiation effects , Transplantation, Autologous , Whole-Body Irradiation
16.
Klin Monbl Augenheilkd ; 196(5): 346-50, 1990 May.
Article in French | MEDLINE | ID: mdl-2366470

ABSTRACT

Several authors regard early vitrectomy as the best guarantee of success in cases of severe ocular injury. The present authors reviewed their own group of 27 patients, which included 13 cases with intraocular foreign bodies, 6 cases of blunt trauma and 8 with perforating injuries. Aside from cases which later developed retinal complications, vitrectomy was performed in 25 patients, though rarely more than a month after injury. The mean duration of postoperative follow-up was 22 months (minimum 6 month, maximum 66 months). The results and the need for silicone oil injection are discussed and compared with the literature. The timing of vitrectomy is of major importance.


Subject(s)
Eye Injuries/surgery , Vitrectomy/methods , Vitreous Hemorrhage/surgery , Adolescent , Adult , Aged , Eye Foreign Bodies/surgery , Eye Injuries, Penetrating/surgery , Female , Follow-Up Studies , Humans , Male , Middle Aged , Visual Acuity/physiology , Wounds, Nonpenetrating/surgery
17.
Radiother Oncol ; 18 Suppl 1: 105-9, 1990.
Article in English | MEDLINE | ID: mdl-2247631

ABSTRACT

The technique of total body irradiation (TBI) developed at Istituto Nazionale Tumori, Milan, Italy, is described. This technique consists of i) administration of 12.5 Gy and 14.85 Gy TBI for autologous and allogeneic bone marrow transplantation respectively; ii) in all cases in vivo dosimetry of absorbed TBI dose; and iii) radiation doses to lungs higher than previously described. As of June 1988, seventeen patients with Hodgkin's disease and four with lymphoblastic lymphoma received TBI and 120-180 mg/m2 melphalan. Respiratory function was prospectively evaluated demonstrating moderate and transient reduction of pulmonary function.


Subject(s)
Bone Marrow Transplantation , Hodgkin Disease/radiotherapy , Melphalan/administration & dosage , Precursor Cell Lymphoblastic Leukemia-Lymphoma/radiotherapy , Whole-Body Irradiation/methods , Adolescent , Adult , Child , Combined Modality Therapy , Hodgkin Disease/drug therapy , Hodgkin Disease/surgery , Humans , Italy , Melphalan/therapeutic use , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/surgery , Radiotherapy Dosage
18.
Pediatr Med Chir ; 12(1): 1-13, 1990.
Article in Italian | MEDLINE | ID: mdl-2198546

ABSTRACT

Bleeding defects are of great interest in pediatrics since the prevalence of congenital forms and the early appearance of acquired ones. The pathology itself and the therapy indeed can often interfere with the growing-up patients. Bleeding defects have been identified with an heterogeneous group of clinical disease that differs from one another in etiology, pathogenesis, epidemiology and incidence in population. Bleeding diathesis is the common symptom: bleeding tendency may be mild, moderate or severe, localized or generalized, cutaneous or mucosal, superficial or deep. Bleeding disorders may be classified as a) defects in the primary haemostasis, which include quantitative and qualitative abnormalities of platelets and vascular disorders and b) defects in secondary haemostasis, which include intravascular disorders (blood coagulation). Careful history and clinical examination are essential in diagnosis of bleeding disorders. History of patient should be taken a) to differentiate acquired from congenital disease and to know the way of hereditary transmission (family history); b) to know exactly the disease's start and the mutual relation with former or accompanying disease; c) mutual relation with drugs token. Subsequently a careful physical examination should be done. A specific hemorrhagic diathesis has been seen with a deficiency of primary or secondary haemostasis. A deficient or late haemostatic plug in small vessels can cause superficial, interstitial bleeding that may be intracutaneous or intramucosal and is called purpura. In coagulation factor deficiency the haemostatic plug cannot be consolidated by fibrin: spontaneous hematomas, hemarthrosis and ecchymoses often occurs. The initial laboratory work up for screening patients with bleeding disorders should include first step tests to differentiate bleeding disorders for bone-marrow malignancies; from virus infections carrying screening of major viruses and from hepatic diseases. Second step laboratory examination includes a) platelet count or estimation of platelet number on blood smear; b) bleeding time to test small vessel integrity and platelet function; c) aPTT, PT, AP to measure clotting activity; d) fibrinogen determination. With this battery of screening test it is usually possible to determine the general area of the defect (abnormalities of platelets number or function or congenital defect of one or more clotting factors activity). Acute idiopathic thrombocytopenic purpura is the most common bleeding disorders in childhood. Usually no therapy may be required no matter platelet count. Patients with a significant hemorrhagic tendency are treated either with prednisone (2 mg/kg orally in divided daily doses) for a period of 2 weeks or with a 5 days course of special polyvalent intact immunoglobulin (400 mg/kg/die) for intravenous use.(ABSTRACT TRUNCATED AT 400 WORDS)


Subject(s)
Hemorrhagic Disorders , Adolescent , Child , Child, Preschool , Hematologic Tests , Hemophilia A/therapy , Hemorrhagic Disorders/blood , Hemorrhagic Disorders/diagnosis , Hemorrhagic Disorders/therapy , Hemostasis , Humans , Infant , Infant, Newborn , Purpura, Thrombocytopenic/therapy
19.
Pediatr Med Chir ; 11(6): 607-15, 1989.
Article in Italian | MEDLINE | ID: mdl-2517639

ABSTRACT

Thanks to recent developments and evolution in prenatal diagnosis and early onset within the first year of life, hemophilia may now be considered a pathology of primarily pediatric interest. The treatment of hemophilia in children has furthermore undergone a number of changes that include 2 main events in therapy that have served to modify the quality of life of the hemophiliac. The first of these events regards blood products and the prevention of viral infections, hepatitis and HIV transmission. Prevention is based on various factors which include: donor selection, immunization, product testing and heat treatment of blood products. The second extremely important aspect of treatment in hemophilia is the concept of global assistance, which includes: the treatment of the bleeding episode itself, and an ongoing psycho-social support system. In this paper we suggest some practical treatment schedules for the therapy of bleeding episodes in addition to examining the severe side effects of HIV and Hepatitis viruses. The message which our paper attempts to transmit is that the hemophilic child must be ideally assisted in an exclusively pediatric environment.


Subject(s)
Acquired Immunodeficiency Syndrome/transmission , Hemophilia A/therapy , Hepatitis B/transmission , Hepatitis C/transmission , Hepatitis, Viral, Human/transmission , Hypersensitivity, Immediate/etiology , Transfusion Reaction , Adolescent , Child , Child, Preschool , Factor VIII/antagonists & inhibitors , Factor VIII/immunology , Hemophilia A/drug therapy , Hemophilia A/immunology , Home Care Services , Humans , Infant , Infant, Newborn , Prognosis
20.
Radiol Med ; 77(5): 530-4, 1989 May.
Article in Italian | MEDLINE | ID: mdl-2664919

ABSTRACT

At the Istituto Nazionale Tumori, Milan, total-body irradiation (TBI) is delivered by a 15 MV linear accelerator, with two lateral opposed beams. Maximum build-up at the skin is achieved by lateral slabs of perspex 3 cm thick. Attenuation filters or bolus are used for dose compensation, or reduction, to the head and lungs. The dose delivered to clinically relevant anatomic regions is determined by "in vivo" dosimetry. For this purpose, calibrated diodes are employed, which are positioned at the entrance and at the exit of the beams. "In vivo" dosimetry data show our TBI technique to allow an homogeneous irradiation of all body areas, with maximum deviation of the mean dose value from reference point dose of -11% in the posterior abdomen, at the spinal cord shielded by arms.


Subject(s)
Whole-Body Irradiation/methods , Humans , Particle Accelerators , Patient Care Planning/methods , Radiotherapy Dosage , Tomography, X-Ray Computed , Whole-Body Irradiation/instrumentation
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