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Biomedical subjects

A Bartoli

Publications and source records attributed to A Bartoli.

At least 73 records · Page 4Linked to original sources

Tumor necrosis factor as an autocrine and paracrine signal controlling the macrophage secretory response to Candida albicans.

We have previously demonstrated that the hyphal form of Candida albicans (H-Candida), but not the yeast form (Y-Candida), acts as a macrophage-stimulating agent. The early response (1 to 3 h) of the macrophage cell line ANA-1 to H-Candida results in enhanced tumor necrosis factor (TNF) transcription and production. Here we show that when coincubation times are prolonged (3 to 24 h), Y-Candida also exhibits stimulatory properties. This phenomenon has been ascribed to the occurrence of the dimorphic transition, as demonstrated by microscopic evaluation of the cultures and by experiments in which both killed Y-Candida and the agerminative strain C. albicans PCA-2 failed to induce cytokine production. TNF produced in response to H-Candida acts as an autocrine and paracrine signal controlling the macrophage secretory response to C. albicans. In fact, addition of anti-TNF polyclonal antibodies to the coculture of ANA-1 macrophages and H-Candida results in a marked and time-dependent decrease of TNF transcript levels. Moreover, pretreatment of macrophages with recombinant TNF for 3 h enhances TNF and induces interleukin-1 production in response to both forms of Candida, while pretreatment for 18 h renders macrophages refractory to any stimuli. Interestingly, the kinetics of interleukin-1 transcription and secretion in response to H-Candida are delayed with respect to those of TNF. Overall, these data indicate that TNF, produced by macrophages in response to H-Candida, regulates its own production as well as that of other soluble factors, thus suggesting that this cytokine plays multiple roles in the immune mechanisms involved in Candida infection.

Animals↗

The pharmacokinetics of oxcarbazepine and its active metabolite 10-hydroxy-carbazepine in healthy subjects and in epileptic patients treated with phenobarbitone or valproic acid.

The kinetics of oxcarbazepine (OXC) and its active metabolite 10-hydroxy-carbazepine (10-OH-CZ) after a single oral OXC dose (600 mg) were compared in healthy control subjects and in epileptic patients treated with phenobarbitone or sodium valproate (n = 8 in each group). In all groups, serum 10-OH-CZ concentrations were much higher than those of the parent drug. In patients on valproate, the kinetics of OXC and 10-OH-CZ did not differ significantly from those observed in controls. In patients on phenobarbitone, AUC values of both OXC and 10-OH-CZ were lower than in controls (2.9 +/- 0.4 vs 5.1 +/- 0.7 microg ml(-1) h and 89 +/- 7 vs 119 +/- 10 microg ml(-1) h respectively, means +/- s.e. mean, P < 0.05), whereas 10-OH-CZ half-lives were only marginally shorter (17 +/- 1 h vs 20 +/- 2 h, NS). These data indicate that the biotransformation of OXC and 10-OH-CZ may be accelerated by concomitant treatment with phenobarbitone but that the magnitude of this effect is unlikely to be of great clinical significance.

Administration, Oral↗

Vigabatrin-induced decrease in serum phenytoin concentration does not involve a change in phenytoin bioavailability.

The possibility that vigabatrin (VGB) decreases serum phenytoin (PHT) concentration by lowering the oral bioavailability of PHT was investigated in 21 patients with epilepsy. Each patient was switched from oral to intravenous PHT for 5 days before and after combined treatment with VGB. After VGB (2-3.5 g day(-1) for at least 5 weeks), serum PHT concentrations decreased slightly from 87 +/- 25 to 76 +/- 31 micromol l(-1) (means +/- s.d., P < 0.05), but in a subgroup of seven patients the decrease was more prominent (from 72 +/- 22 to 49 +/- 17 micromol l(-1), P < 0.005). At baseline (before VGB), serum PHT remained unaffected (85 +/- 30 micromol l(-1)) after switching PHT dosage to the intravenous route, indicating that the oral availability of the drug was virtually complete. During VGB treatment, serum PHT was also unchanged (74 +/- 34 micromol l(-1)) after switching from oral to intravenous therapy, and this was also true for the subgroup of patients showing a prominent interaction (48 +/- 18 micromol l(-1)). The urinary recoveries of PHT and its metabolites pHPPH and mHPPH remained constant throughout the study. It is concluded that the oral availability of PHT is unaffected by VGB and that the VBG-induced decrease in serum PHT is mediated by alternative mechanisms.

Adolescent↗

Neuropsychological abnormalities in AIDS and asymptomatic HIV seropositive patients.

Neuropsychological and immunological parameters were studied in 36 AIDS patients with early disease and without clinical, laboratory, and neuroradiological signs of CNS impairment, and also in 33 asymptomatic HIV seropositive subjects. Many AIDS patients performed abnormally on timed psychomotor tasks, tasks involving sequencing and "set-shifting", and memory tasks stressing attention, learning, active retrieval, and monitoring of information. Asymptomatic HIV seropositive subjects as a group did not perform significantly worse than controls. However, on the basis of a cut off number of pathological performances on neuropsychological tasks, 52.8% of AIDS and 30.3% of asymptomatic HIV seropositive subjects had cognitive impairment, compared with 3.9% of HIV seronegative controls. Low values of CD4+ cells and of CD4+/CD8+ ratio and high titres of P-24 antigen in the blood prevailed among subjects with cognitive impairment, especially in the asymptomatic HIV seropositive group.

Acquired Immunodeficiency Syndrome↗

Candida albicans hyphal form enhances tumor necrosis factor mRNA levels and protein secretion in murine ANA-1 macrophages.

We have demonstrated that Candida albicans in its hyphal form (H-Candida) acts as a stimulating agent in the cloned macrophage population ANA-1. Both tumor necrosis factor (TNF) mRNA levels and secreted biological activity augment in ANA-1 macrophages exposed to H-Candida. Such effects are observed at an effector-to-target cell ratio of 1:1 and occur after 1 and 3 hr of coincubation, respectively. The phenomenon is independent of the metabolic status of the fungus, since viable as well as heat-killed H-Candida are comparable in inducing TNF mRNA levels. The extent and kinetics of H-Candida-mediated effects are similar to those observed following exposure of ANA-1 macrophages to lipopolysaccharide (LPS). This implies that C. albicans in its hyphal form is a potent macrophage modulator; whether it acts through the same mechanism(s) as LPS remains to be elucidated.

Animals↗

Intracerebral transfer of an in vitro established microglial cell line: local induction of a protective state against lethal challenge with Candida albicans.

An in vitro generated BV-2 microglial cell line has been transferred intracerebrally into syngeneic immunocompetent mice prior to local challenge with Candida albicans. The transfer resulted in the establishment of local protection against a lethal dose of C. albicans, which was accompanied by an impairment of yeast growth in the brain and kidneys. Upon histological examination of brain sections from BV-2 cell-pretreated mice, it was found that the size and number of granulomas was reduced as compared to untreated controls receiving Candida alone. These observations provide direct evidence that microglia play a crucial role in the local defense against intracerebral infections.

Animals↗

A rapid objective immunofluorescence microassay. Application for detection of surface and intracellular antigens.

An indirect immunofluorescence microassay, which permits automated reading, has been employed for simple, rapid and objective detection of surface and intracellular antigens. Initially, the cells, spun in microplates, are fixed with glutaraldehyde (0.25% v/v in PBS). Following fixation, the cells can be stored at 4 degrees C for up to 2 weeks before being used in the immunofluorescence microassay. The fixed cells are then stained according to standard procedures using appropriate first and fluorescein-conjugated second antibodies. An automated and quantitative evaluation of the fluorescence intensity of the cell samples was achieved using the Titertek Fluoroskan II automatic reader. This microassay was shown to be suitable for the detection of the surface MAC1 antigen and intracellular v-myc protein in the GG2EE macrophage cell line.

Animals↗

Multiple sclerosis. Magnetic resonance imaging, evoked potentials and cerebrospinal fluid analysis.

We have studied 27 patients with multiple sclerosis (22 definite, 5 probable) by magnetic resonance imaging (MRI), visual evoked potentials (VEPs), brainstem auditory evoked potentials (BAEPs), and oligoclonal bands (OBs) in cerebrospinal fluid (CSF), MRI was altered in 92.5% of the cases, the presence of OBs in CSF was revealed in 73.1% of the examined patients, the frequency of evoked potentials (EPs) alteration was VEPs = 59.3% and BAEPs = 29.6%, at least one of the two EPs occurred positive in 66.6% of the cases. Our data confirm the more sensitive value of MRI compared with OBs and EPs studies in assessing MS, and stress the utility of the combined use of these tests.

Adolescent↗

The clinical significance of elevated CSF and plasma histamine in cerebral aneurysm surgery utilizing cardiopulmonary bypass with total circulatory arrest.

Recently there has been a renewed interest in the neurosurgical treatment of large cerebral aneurysms and AV malformations utilising cardiopulmonary bypass (CPB) and total circulatory arrest (TCA). However, the differing tolerance limits of coagulation and bleeding, pH control and fluid constraint are difficult to reconcile. Although clinical assessment, electro encephalogram (EEG) and intracranial pressure-monitoring assist in identification of cerebral damage, CPB and TCA inflict their own penalties with resultant uncertainty in post-operative neurological evaluation, and producing difficulties in interpretation and management. Additionally, an unanswered question is, to what extent the known cardiac and cerebral effects of circulating histamine might influence the post-circulatory arrest recovery in these patients, and whether this would further compromise the neurological result. We report our experience of 9 such cases who underwent this procedure, and were able to achieve a satisfactory neurological result in 7 patients with differing lesions. During the operation both CSF (from the open cranium) and blood (from the right internal jugular vein) were sampled at intervals for subsequent plasma histamine estimation. Despite markedly elevated histamine levels during CPB and TCA, this was not associated with an unfavourable neurological outcome. These early findings have given us encouragement to the useful role of CPB and TCA in these complex neurosurgical presentations, and raise interesting questions about the clinical importance of histamine-evoked cerebral ischaemia that has been demonstrated in experimental models.

Adult↗

Comparative in vitro activity of imipenem against gram-positive and gram-negative aerobic bacteria from clinical isolates.

Imipenem is a member of a new class of beta-lactam antibiotics, carbapenems, with a very broad antibacterial spectrum. In this work we evaluated the in vitro activity of imipenem against a variety of bacterial strains isolated from clinical specimens as well as the activity of other beta-lactam antibiotics. The results obtained with 501 bacterial strains show that imipenem is active on both gram-negative and gram-positive microorganisms isolated from different infections. The in vitro inhibitory activity is greater than that of aztreonam, cefotaxime, ceftriaxone, piperacillin, amikacin, and netilmicin, against the majority of strains tested.

Anti-Bacterial Agents↗

Coronary haemodynamic effects of short-term intravenous administration of gallopamil in patients with stable exertional angina.

The effects of short term intravenous administration of gallopamil on coronary haemodynamic variables were studied in 10 patients with stable exertional angina and angiographically confirmed coronary artery disease that affected the proximal portion of the left anterior descending artery. Blood flow in the great cardiac vein was measured by a thermodilution technique, both at rest and during ischaemia induced by atrial pacing, before and after intravenous administration of gallopamil (0.02 mg/kg as a bolus dose given over three minutes, followed by an infusion of 0.0005 mg/kg/min). Gallopamil significantly prolonged the mean (SD) duration of pacing that was tolerated (11 (2.6) vs 14.8 (2.4] min, significantly increased the mean (SD) peak heart rate attained during pacing (142 (15) vs 158 (11) beats/min), and reduced mean (SD) arterial pressure (133 (17) vs 116 (17) mm Hg). There were no changes in mean (SD) blood flow in the great cardiac vein (134.1 (57) vs 112.9 (38) ml/min, mean (SD) anterior regional coronary resistance (1.18 (0.6) vs 1.15 (0.5) mm Hg/ml/min), and mean (SD) anterior regional myocardial oxygen consumption (16.6 (6) vs 13.7 (4) ml/min). These data confirm that gallopamil is an effective antianginal agent and suggest that a reduction of myocardial oxygen demand is the predominant mechanism by which the drug exerts its beneficial effects.

Angina Pectoris↗

Effects of diltiazem on regional coronary hemodynamics during atrial pacing in patients with stable exertional angina: implications for mechanism of action.

To investigate the mechanism of the antianginal action of diltiazem in stress-induced myocardial ischemia, we studied 12 patients with stable exertional angina and disease of the proximal left anterior descending artery by measuring great cardiac vein flow (GVCF) and calculating anterior regional coronary resistance (ARCR) during myocardial ischemia induced by atrial pacing before and after intravenous administration of diltiazem (0.25 mg/kg in a bolus dose followed by continuous infusion of 0.005 mg/kg/min). Diltiazem increased the pacing time to angina from 6.9 +/- 3.5 to 10.7 +/- 4 min (p less than .001). At peak pacing heart rate was increased after diltiazem (from 128 +/- 17 to 145 +/- 17 beats/min, p less than .005), while mean arterial pressure was decreased (from 131 +/- 19 to 113 +/- 17 mm Hg, p less than .025), leaving the double product unaltered. At peak pacing no changes were observed in GCVF (from 115 +/- 46 to 119 +/- 46 ml/min, p = NS), ARCR (from 1.3 +/- 0.4 to 1.1 +/- 0.4 mm Hg/ml/min), or myocardial oxygen consumption of the anterior region (from 14.5 +/- 4.2 to 13.4 +/- 4.7 ml/min). Reduction of myocardial oxygen demand plays a major role in the antianginal action of diltiazem in patients with stress-induced myocardial ischemia.

Adult↗

[Bioavailability of a delayed-action aminophylline preparation].

Absorption of theophylline from one commercial product labelled as aminophylline sustained release was compared to the absorption from an oral solution of aminophylline in a single-dose bioavailability study. Aminomal-R tablets had bioavailability (101.2 +/- 19) statistically indistinguishable from that of the standard but showed significantly slower absorption (peak times of 3.6 +/- 1.1 h vs 1.3 +/- 0.8 h) and lower peak plasma concentrations (16.8 +/- 4.7 mg/l/1 g aminoph. dose vs 21.1 +/- 4.2 mg/l/1 g aminoph. dose). Projections of plasma concentrations upon multiple dosing were made from single dose data: the dosage interval (every 12 h) concentration ratio which reflects both the frequency of dosing and the entry of the drug into and removal from the body was of 1.8 vs 3.1.

Administration, Oral↗

[Influence of administration of pyridoxine on circadian rhythm of plasma ACTH, cortisol prolactin and somatotropin in normal subjects].

The influence of vitamin B6 in a dosage of 300 mg X 2 in 24 hrs, on circadian rhythm of plasmatic ACTH, cortisol, prolactin and somatotropin have been studied in 10 normal women. After vitamin B6 24 hrs pattern of ACTH and cortisol is unchanged; prolactin levels are slightly lower, in a statistically unsignificant proportion the night peak of growth hormone is higher in a statistically significant proportion (p. 0.05). The effect of vitamin B6 is likely to me mediated by dopaminergic receptors at hypothalamic level as previous studies by other Authors appear to prove.

Adrenocorticotropic Hormone↗

Value of Doppler multi-level segmental pressure index in the diagnosis and hemodynamic characterization of totally occlusive aorto-iliac-femoro-popliteal lesions.

Four-level lower limb Doppler S.P.I. (upper thigh; above knee; below knee; above ankle) were evaluated in 275 limbs, 110 of which showed totally occlusive lesions at one or more levels of the aorto-iliac-femoro-popliteal axis on angiographic examination, 65 showed stenosis less than 50% (sclerotic controls) and 100 did not undergo arteriographic examination since they apparently had no lesions (healthy controls). Analysis of the results-carried out using the Student's t statistical method-showed a drop in the S.P.I. close to or over 0.30 between two adjacent levels and was indicative of the presence of an occlusion in the intermediate area. This method therefore allowed the presence and the position of an isolated lesion to be detected. In the case of multiple lesions in series, the proximal one is detected with certainty, whereas the more distal ones can be recognized but not their exact position and extension. Multiple lesions in series are more hemodynamically significant than isolated ones, and proximal lesions more than distal ones.

Aorta↗

Non-acid gastroesophageal reflux. Detection and evaluation by means of combined esophageal and gastric pH-monitoring.

One hundred and fifteen partially-gastrectomized patients were submitted to combined gastric and esophageal pH-monitoring with the aim of studying non-acid gastroesophageal reflux (GER). Since the detection of non-acid GER seems to be linked to the possibility of detecting entero-gastric reflux, only those patients (61) in whom entero-gastric reflux could be evaluated were considered. 37.7% of the patients showed non-acid GER according to the personal definition of such a reflux (any sudden esophageal pH change of 0.5 or more with earlier or simultaneous entero-gastric reflux). On the contrary, with De Meester and coworkers' criteria, only 21.3% of the patients were considered alkaline refluxers. Slight symptoms and slight endoscopical/histological changes were present in 20-30% of both non-refluxers and refluxers (whichever method of GER evaluation was considered). Therefore, correlations between GER and symptoms, endoscopical changes and manometric findings seemed poor using either method of GER evaluation. However, since the theoretical basis of combined gastric and esophageal pH-monitoring seems correct and the application of new techniques and the development of the parameters of "normality" can hopefully increase our understanding, the routine use of gastric and esophageal pH-monitoring should not be abandoned.

Adult↗