Role of the HLA-DP gene in susceptibility to lung granulomas.
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Alleles↗
Biomedical subjects
A Bisetti
Publications and source records attributed to A Bisetti.
Efficacy and tolerability of brodimoprim in respiratory tract infections.
Brodimoprim is a new diaminopyridine derivative suitable for oral therapy which shows good in-vitro activity against most Gram-positive and Gram-negative pathogens. The efficacy and tolerability of brodimoprim in acute lower respiratory tract infections was tested in controlled clinical trials in comparison with different classes of antibiotics. Acute bacterial infections or infective exacerbations of chronic obstructive bronchitis were included in the studies. Brodimoprim in a single dose was compared to different oral treatments which included co-trimoxazole (trimethoprim 160 mg+sulphamethoxazole 800 mg every 12 hours) and erythromycin (600 mg three times a day). In the studies criteria of efficacy such as daily temperature curve, intensity and frequency of cough, degree of dyspnea, intensity of thoracic pain, difficulty of expectoration, sputum production, thoracic semiology were examined. Brodimoprim was more effective than cotrimoxazole and erythromycin at the end of the treatment, induring a more significant and prompt reduction of axillary temperature, daily sputum volume, degree of dyspnea. There was no difference among treatments in the mean period of therapy to obtain the resolution of the infective process (8 days on average). Brodimoprim had a significantly lower percentage of side effects during the treatment in comparison with cotrimoxazole or erythromycin. Hence brodimoprim was better accepted by patients.
Adult↗
Antibody repertoire against the A60 antigen complex during the course of pulmonary tuberculosis.
The A60 antigen complex is a Mycobacterium bovis (BCG) highly immunodominant antigen containing both B and T-cell epitopes. Clinical-serological studies show that elevated anti-A60 titres are present during tuberculosis. We wished to analyze in detail antibody responses against A60 components during the course of tuberculosis. A mixed longitudinal study was designed including individuals at the onset of tuberculosis, during treatment and after resolution of the disease. The anti-A60 repertoire was analyzed using a western blot assay with A60 as the antigen. While PPD- normals recognized only the 65 kDa heat shock protein (HSP), PPD+ normal individuals displayed low levels of anti-A60 antibodies against dominant antigens. There were immunoglobulin M (IgM) and immunoglobulin G (IgG) consistent with response to a latent infection. Onset tuberculosis was characterized by IgM and IgG antibodies against 52 to 28 kDa antigens; IgM response being limited to earlier phases of the disease. In contrast, IgM antibodies against 25 to 14 kDa antigens appeared only 2-6 months after disease onset. The antibody repertoire of chemotherapy-treated, resolved tuberculosis was exclusively IgG in isotype, as for a memory-type response. Thus, western blot analysis with A60 identifies typical antibody patterns associated with different clinical phases of tuberculosis infection. Such approach may help in identifying new single antigens for serologic diagnosis of active tuberculosis.
Adult↗
[Mycobacterium tuberculosis. From the gene to the diagnosis].
Pulmonary tuberculosis still in on the list of the world major health problems. Tuberculosis has not been eradicated yet, from developing countries. Furthermore, its incidence is increasing in the industrialized world, due to the human immunodeficiency virus (HIV) epidemic. In this regard, atypical clinical presentation of tuberculosis in individuals who have a deficient immune system, such as those at risk of tuberculosis because of HIV infection, makes the diagnostic process more difficult. Tuberculosis cases are often diagnosed later in HIV individuals compared to non-HIV individuals. The ensuing greater risk of contagion thus requires rapid and sensitive diagnostic protocols. In this context, several biotechnological tools have been developed that can be applied to the diagnosis of tuberculosis. M. tuberculosis genes have been cloned, monoclonal antibodies against pure proteins have been produced, thus enabling researchers to generate molecular and biochemical probes. As a consequence, DNA hybridization and DNA amplification techniques have been applied to the detection of mycobacteria, and ELISA kits of high sensitivity are been already made available. In regard to the latter, it is likely that monospecific and highly sensitive immunoassays will be developed that are directed against "active disease" immunodominant antigens. It may thus be expected that future new technologies will supplement the traditional tools for the diagnosis of tuberculosis and rapid diagnosis protocols will be available to chest clinicians in a foreseeable future.
Antibodies, Bacterial↗
Sulbactam/ampicillin combination in the treatment of acute and chronic lower respiratory infections.
The clinical and bacteriological efficacy of a sulbactam/ampicillin combination was compared with piperacillin in a group of 50 patients suffering from acute or chronic lower respiratory infections: 26 were treated intravenously with piperacillin and 24 with sulbactam/ampicillin. The treatment was continued for at least 7 days for 24 patients at the dosage of 3 g sulbactam/ampicillin twice daily, for a further 24 patients at the dosage of 6 g piperacillin twice daily and for two patients at the dosage of 8 g piperacillin twice daily. In the patients treated with sulbactam/ampicillin, a rapid decrease in the fever with the concomitant reduction in cough and sputum production was observed, with cure in 18 cases and improvement in six. In the patients treated with piperacillin cure was observed in 14 cases and improvement in 12 cases. In both treatment groups safety was excellent. There was no significant difference, either in effectiveness or tolerability, between the two groups.
Adolescent↗
[Tuberculosis and mycobacteriosis in HIV-1 infection].
Tuberculous and mycobacterial infections and diseases increase now everywhere. Patients HIV-1 infected or with AIDS get more and more a mycobacterial complication. The clinical and radiological features of this event are: the bilateral extension in the lung, the importance of these lesions, the atypical appearance of radiological shadows, the frequency of other concomitant opportunistic pneumopathies of non-mycobacterial origin. Tuberculosis are almost always induced by drug-sensible mycobacteria which usually allows clinical healing or clinical improvement.
Acquired Immunodeficiency Syndrome↗
Immunohistologic analysis of mycobacterial antigens by monoclonal antibodies in tuberculosis and mycobacteriosis.
Four monoclonal antibodies (MoAbs), 60.15, 61.3, 105.10, and 2.16, directed to different proteins of Mycobacterium tuberculosis were used by an indirect avidin-biotin complex peroxidase-antiperoxidase method to detect mycobacterial antigens in lung, lymph node, and joint tissue specimens of tuberculous patients. Using MoAb 60.15, which recognizes a broad range of cross-reactive mycobacterial proteins with a molecular mass of 28 kilodaltons (kD), scattered materials (mycobacterial in origin) were observed, many of which were located within phagocyte cytoplasm. With MoAb 61.3, which reacts with a 35 kD protein present in M tuberculosis, Mycobacterium africanum, and Mycobacterium bovis, many clumped particles similar in size and shape to acid-fast bacilli were observed within the phagocyte cytoplasm (lung tissue) and positive macrophages with lysosomes were distributed throughout the cytoplasm (bronchoalveolar lavage). The specificity of this MoAb (61.3) was confirmed by the negative staining of positive lymph node specimens obtained from a patient infected with Mycobacterium kansasii. MoAbs 105.10 and 2.16 bind to the cross-reactive 65 kD heat shock protein that is present in mycobacteria and stain scattered particles and dark clumps of bacilli within the phagocyte cytoplasm. On the basis of this study, immunohistochemical detection of mycobacterial antigens appears to be useful in establishing the mycobacterial etiology of caseating granulomas and in avoiding the false-negative results obtained by traditional staining methods.
Antibodies, Monoclonal↗
Pulmonary surfactant and respiratory infections.
The main data concerning the defensive role of pulmonary surfactant and respiratory infections are reported on the basis of recent knowledge on this topic. The opportunity to reintegrate the altered surfactant (in an exogenous way or by means of pharmacological agents) is also stressed.
Animals↗
Hyperprealbuminemia, euthyroid hyperthyroxinemia, Zollinger-Ellison-like syndrome and hypercorticism in a pancreatic endocrine tumour.
Prealbumin, one of the main thyroxine transport proteins, has recently been shown to be a valuable immunohistochemical marker of neuroendocrine tumours. We report the case of a multisecretory pancreatic endocrine tumour whose prealbumin secretion was so high that it produced a peak on routine serum protein electrophoresis and induced a euthyroid hyperthyroxinemia. The maximal binding capacity of prealbumin for thyroxine was indeed markedly increased, whereas its affinity for this hormone was normal. The tumour was associated with gastric hyperacidity and hypergastrinemia thereby evoking a Zollinger-Ellison syndrome. The secretin stimulation test and gastrin tumoural immunohistochemistry were, however, negative. We suggest that the concomitant tumoural production of gastrin-releasing peptide was responsible for the gastric hyperacidity and hypergastrinemia. This hormone probably also accounted for a moderate hypercorticism.
Adrenocortical Hyperfunction↗
Identification of subpopulations of bronchitic patients for suitable therapy by a dynamic rheological test.
The rheological properties of bronchial mucus samples, collected from randomly selected patients with chronic bronchitis by protected expectoration, under steady-state conditions without any exacerbation, were investigated in a double-blind multicentre study before and after five days of treatment with 4.5 g/day carbocysteine or with glucose as a placebo. Viscous and elastic properties of the mucus were measured with a rheometer fitted with coaxial cylinders set up in an oscillating instead of a rotating mode. The shapes of the ellipses obtained characterized the rheological properties of each bronchial mucus sample before and after treatment. Two different rheological patterns were observed. In the group of patients with initial viscosity greater than or equal to 10,000 mPa.s-1, carbocysteine treatment reduced viscosity and elasticity more than those of the placebo-treated patients. In the group of patients with viscosity lower than 10,000 mPa.s-1, the rheological modifications were the same for both groups. These results are discussed in terms of both the efficacy of carbocysteine and the necessity of rheological characterization of the patients before treatment into different groups, according to the rheological properties of their secretions, for better and targetted therapy with mucus modifying drugs.
Adult↗
Bone and renal components in hypercalcemia of malignancy and responses to a single infusion of clodronate.
Increased bone resorption (BR) and increased renal tubular reabsorption of calcium (TRCa) may both be involved in the pathogenesis of hypercalcemia of malignancy (HM). We have evaluated the relative importance of these two mechanisms in 33 patients with HM after extracellular volume expansion and after single infusion of clodronate (C12MDP: 500 mg iv over 8 h). The fasting urine Ca/creatinine ratio was taken as an index of BR (BRI). An index of TRCa was calculated (TRCaI) from a nomogram based on the relationship between urine Ca excretion per unit of glomerular filtration rate and plasma Ca (PCa). Mean (+/- SEM) PCa fell from 3.29 +/- 0.07 to 2.69 +/- 0.05 mmol/l three days after C12MDP (n = 33, p less than 0.001), a response similar to that obtained with repeated daily iv injections of 500 to 1000 mg C12MDP. The pathogenesis of hypercalcemia varied according to the type of neoplasm. BRI was the highest in multiple myeloma and breast tumors. TRCaI was markedly increased in squamous-cells lung, bladder, kidney and liver carcinomas, reaching levels observed in primary hyperparathyroidism. TRCaI was normal in most cases of multiple myeloma. Breast tumors appeared to be heterogeneous with respect to TRCaI. The fall in PCa in response to a single infusion of C12MDP was usually most marked in cancer patients with elevated BRI and normal TRCaI. It was very modest in patients with high TRCaI and slightly elevated BRI. In conclusion, this study confirms that stimulation of bone resorption is not the only mechanism of the maintenance of hypercalcemia of malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)
Bone Resorption↗
Acute hepatitis complicating Mycoplasma pneumoniae infection.
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Acute Disease↗
[New therapeutic strategies in influenza infections in patients at risk. Controlled study of ribavirin].
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Aged↗
[Pseudomembranous colitis caused by the ingestion of colocynth].
A 61-year-old woman presented with an acute condition involving confusion, abdominal cramps and bloody diarrhea six hours after accidental ingestion of colocynth mistaken for zucchini. Colonoscopic examination revealed pseudomembranous colitis though the patient had no condition known to be associated with pseudomembranous colitis. Within ten days the mental state returned to normal and the colitis resolved completely. It is suggested that the colitis was caused by the ingestion of colocynth.
Cathartics↗
Recurrent, fatal pulmonary embolism despite inferior vena cava interruption with the Greenfield filter.
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Aged↗
[Hemolytic anemia secondary to taking cyanidanol: demonstration of the mechanism of the erythrocyte damage].
A 36-year-old patient with chronic active hepatitis developed Coombs direct positive acute hemolytic anemia 2 weeks after a second course of cyanidanol (Cy). The patient's serum agglutinated control 0 Rh- erythrocytes only in the presence of Cy. Human anti-globulin test showed that the red cells were covered with IgG as well as C3 and C4. Control erythrocytes previously treated with Cy were also agglutinated by the patient's serum (dilution 1:64). Upon addition to the serum of Cy (concentration up to 10 micrograms/ml), the agglutination was enhanced up to a serum dilution of 1:256. Further increase of the Cy concentration (greater than 10 micrograms/ml) was followed by a decreased reaction. These results indicate that red cell damage in this patient was mediated by both mechanisms, i.e. with immune complexes acting on "normal" red cells and also with antibodies acting on cyanidanol-coated red cells.
Adult↗
Clinical study on bronchodilation induced by a metered aerosol of fenoterol in combination with ipratropium bromide.
The response to an aerosol preparation containing 100 micrograms fenoterol and 40 micrograms ipratropium bromide per puff (Duovent) was compared with a placebo in 18 asthmatic patients in a double-blind cross-over fashion. We measured changes in lung function tests and pulse rate. Duovent induced a significant improvement in lung tests with statistical relevance for VEMS and Raw in comparison with placebo. The combination of fenoterol and ipratropium bromide also provided a long-lasting bronchodilatation without side effects.
Aerosols↗
[Occult gastric adenocarcinoma with pulmonary carcinomatous lymphangitis and microangiopathic hemolytic anemia in a young adult].
The case is reported of a 19-year-old patient with gastric carcinoma, in which clinical presentation (intermittent fever, myalgia, proximal muscle weakness and diffuse nodular-trabeculated infiltration of both lungs) was very unusual. The patient developed further complications (microangiopathic hemolytic anemia with disseminated intravascular coagulation) and died of subdural hematoma. Bone-marrow biopsy showed metastatic mucin-producing adenocarcinoma, but the gastric primary site of the tumor could only be demonstrated at autopsy.
Adenocarcinoma, Mucinous↗