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Biomedical subjects

A Fabbri

Publications and source records attributed to A Fabbri.

265 records · Page 15Linked to original sources
PubMedDate not supplied

Heart transplantation in patients over 54 years of age with triple-drug therapy immunosuppression.

Between April 1, 1986, and December 31, 1989, 206 patients received orthotopic heart transplants with triple-drug therapy immunosuppression (cyclosporine, azathioprine, prednisone). Forty-six patients were aged 55 years or more at the time of transplantation and 160 patients were less than 55 years of age; these two groups were compared. Selection criteria and treatment regimen were the same in both groups. In our experience, although both groups had good postoperative survival, older patients had higher mortality rates early after transplantation, particularly from rejection and infection. Patients over 55 years of age had similar nonfatal rejection rates and were no more likely to have infectious episodes than younger patients. As demand for heart transplantation increases and waiting lists lengthen, the age of potential recipients should be an important factor in deciding how to allocate scarce donated organs, although age should not be exclusive.

Adult↗
PubMedDate not supplied

Influence of recipient and donor gender on outcome after heart transplantation.

To investigate the effect of recipient and donor genders on the outcome after heart transplantation, a retrospective survey was undertaken of 356 patients (366 transplants: 316 males, 40 females) undergoing transplantation between January 1979 and December 31, 1989, at Papworth Hospital. Ninety-three organs came from female donors; 263 organs came from males. Twelve females (30%; 95% confidence interval 16% to 44%) and 51 males (16%; 95% confidence interval 12% to 20%) died in the early postoperative period (within 90 days of operation). To date, two females (5%) and 51 males (16%) have died in the late postoperative period. Comparison between recipient genders showed no statistically significant difference in early mortality rates from any cause or in actuarial survival overall, although fatal acute rejection was significantly more common in female recipients (7 of 40 female recipients versus 19 of 316 male recipients). The higher incidence of fatal rejection among female recipients was related to the higher proportion of female donors in this group, because recipients of female donor grafts had significantly higher mortality rates, particularly in the early postoperative period and as a result of acute rejection, than did recipients of organs from male donors. Death from rejection after the first 3 months and death from infection were not gender-related. Recipients of grafts from female donors did not suffer significantly more early morbidity, such as rejection and infection, or late morbidity in the form of coronary artery disease. Acute rejection episodes were more common in female recipients.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMedDate not supplied

[Nosocomial infections caused by methicillin-resistant Staphylococcus aureus in a pediatric intensive care unit].

We performed an epidemiological investigation owing to the appearance between February and March 1988, of subsequent MRSA infections in our ICU; we also started a checking scheme. At the same time we performed a retrospective-perspective study of 701 patients (310 newborns 391 not newborns) admitted into ICU from 1-1-1987 to 30-6-1988. This study allowed us to settle the presence of MRSA in ICU and the manner in which they become infected. From our study the 4.9% of our patients contracted hospital infections and the 34.2% of these were MRSA infections. The 39.7% of our colonized patients were MRSA. It is really significant the frequency of MRSA colonization (p less than 0.0005) among newborn patients compared with other age patients; in the meantime there is not statistical significance in the frequency of MRSA hospital infections among the two groups. The results of our study show that infections were probably transmitted by the hands of the members of staff and that the reservoir of MRSA are tracheostomized hosts or long term ventilated patients.

Age Factors↗
PubMedDate not supplied

[Non-epidermidis coagulase-negative staphylococci in infectious diseases of the compromised host].

Today Staphylococcus epidermidis has been recognized as the etiological agent of infectious diseases such as endocarditis, sepsis and meningitis that mainly come out in compromised hosts because of the breaching of the mechanical barrier (cardiosurgical, neurosurgical patients and central venous catheter carriers). Other "non-epidermidis coagulase negative Staphylococci" are more and more frequently isolated from patients at high risk of infection. Faced with these isolations, it is difficult for the clinician and the microbiologist to give these microorganisms their effective pathogenic role. The Authors present a case list of seriously compromised patients in whom non-epidermidis coagulase negative Staphylococci were repeatedly isolated: hemato-oncological patients: the Authors mark out 6 cases of sepsis that is, likely, to be linked to a central venous catheter. The isolated microorganisms were: S. warneri (3 cases); S. haemolyticus (1 case); S. hominis (1 case); S. xylosus (1 case); neurosurgical patients: in whom 3 cases of cerebro-spinal fluid infection were observed; 3 patients carried a ventriculo-peritoneal derivation; 1 patient carried an Ommaya's device. The etiological agents were S. haemolyticus in 2 cases, S. capitis in 1 case. The Authors point out the multiresistance of some strains (S. haemolyticus) and the oxacillin-methicillin resistance phenomenon. They also underline the need for a specific identification of coagulase-negative Staphylococci and the importance of a strict collaboration between clinicians and microbiologists in order to get a correct interpretation of the role played by these microorganisms in infectious diseases of the compromised host.

Adolescent↗
PubMedDate not supplied

[Asthma caused by Lucilia Caesar larvae: clinical and immunologic study].

Lucilia Caesar larvae (LCL) are used as live fish bait by anglers. Five cases of asthma and rhinoconjunctivitis following exposure to LCL are reported. Three had work-related asthma as they were working on a fish bait farm or shop and two had asthma when they went fishing. In one subject exposure to LCL caused asthma, rhinoconjunctivitis and contact urticaria. In four subjects peak expiratory flow rate (PEFR) was monitored during exposure to LCL. In three out of four subjects there was evidence of LCL-related asthma. In one subject it was not possible to record PEFR during exposure to LCL, as he had not gone fishing since 1985. Two extracts of LCL were prepared: one was the PBS (phosphate-buffered saline) washing fluid of LCL, the other was the PBS extract of homogenized LCL. Positive cutaneous prick tests to both LCL extracts were detected in three out of four symptomatic subjects. Specific IgE against both LCL extract antigens were found by the RAST method in four out of five subjects with LCL-related asthma. One subject had both negative skin tests and RAST. Specificity and potency of LCL-IgE binding was shown by RAST inhibition method performed on the serum pool of four patients with positive RAST results. Significant inhibition of more than 50% by LCL washing fluid at a dilution extract was found at a dilution of 1:10 and by homogenized LCL extract at a dilution of 1:100. No significant inhibition of LCL-IgE binding by dermatophagoides, parietaria and milk antigens was found. This study demonstrated that LCL emanations are potent sensitizers and elicit IgE-mediated asthma.

Adult↗
PubMedDate not supplied

[Occurrence of hospital infections in a department of pediatric heart surgery].

The incidence of nosocomial infections (NI) and the related risk factors in a Department of Pediatric Cardiovascular Surgery were studied, during a 6 months period. 155 successive admissions were considered. Nosocomial infections were 17 (11%), nosocomial colonizations 18 (11.6%). The most important risk factors for nosocomial infections were: age, cyanosis, duration of hospitalization, hospitalization in Intensive Care Unit and central venous catheter only as a risk factor for sepsis. The most important risk factors for nosocomial colonizations were: tracheal intubation and central venous catheter. In 4 cases the NI was related to nosocomial colonization (2 sepsis, 1 pneumonia, 1 wound infection). The most frequently isolated microorganisms were Pseudomonas aeruginosa and Staphylococcus spp. The Authors found that a longer than 5 days period of antibiotic prophylaxis did not reduce the incidence of nosocomial infections.

Adolescent↗
PubMedDate not supplied

[Combination of antifungal chemotherapeutic agents in experimental candidiasis in mice].

For the valuation of therapeutical activity of many new recent antifungal drugs, these were employed in the various possible associations in the experimental candidosis of the mouse. From the results obtained calculated on the survivance percentage, was concluded that the best antifungal is the 5 fluorocytosine + amphotericin B association.

Amphotericin B↗
PubMedDate not supplied

[Bacterial, mycotic and protozoal cholangitis in childhood].

The Authors present the cases of cholangitis in childhood observed in the Institute of Infectious diseases of Genoa from 1973 to 1982. Cholangitis rarely starts by alone, whereas it appears usually in association with hepatic underlying disease. In childhood the symptomatological triad (fever, jaundice, pain) is infrequent: only jaundice is a common sign of disease. Polymicrobial aetiology of cholangitis is very usual, but Streptococci and E. coli are the aetiological agents most frequently observed; sometimes also anaerobic organsimee, fungi and protozoa cause cholangitis.

Adolescent↗
PubMedDate not supplied

[Granulomatous hepatitis. Apropos of a case with difficult etiological diagnosis].

Hepatic granulomatosis is an anatomo-pathologic feature, rising from the aspecific answer of the liver to various antigenic, toxic and infectious noxae. One of the most frequent symptoms of this disease is a some weeks lasting fever. The most frequent etiology is proved to be infectious, particularly tuberculosis, and sarcoidosis. In this paper an analysis of the various diseases which can produce hepatic granulomas is presented, as well as the clinical case of patient with fever and hepatic disease for whom it has been possible to get to an etioilogic diagnosis of tuberculosis only through an hepatic biopsy and culture of liver tissue.

Biopsy↗
PubMedDate not supplied

Lipoperoxide plasma levels in patients with liver cirrhosis.

BACKGROUND/AIMS: Oxygen free radicals might play a role in the pathogenesis of tissue damage in many pathological conditions, including liver diseases where antioxidant tissue systems are reduced. The leading mechanism of free radical toxicity is the peroxidation of membrane phospholipids. Lipoperoxide hydrolysis produces aldehydes -the most represented being malondialdehyde-which reacts with thiobarbituric acid and whose concentration is considered a marker of lipid peroxidation. MATERIALS AND METHODS: We developed a fast and cheap HPLC method for measuring malondialdehyde concentration in plasma using a 3 mm C18 Baker column (4.6 x 50 mm). Thiobarbituric acid-reacting substances were eluted isocratically with a mobile phase containing methanol/KH2PO4 (35/65), and detected fluorometrically. The whole analysis lasts 2.5 minutes. The fasting levels of thiobarbituric acid-reactive substances were measured in 30 non-smoking blood donors and in 45 patients with liver cirrhosis. RESULTS: In control subjects they were on average 0.84 [SD 0.41] mumol/L and were increased to 1.59 [SD 1.23] mumol/L in patients with cirrhosis, where they inversely correlated with hepatocellular function. CONCLUSIONS: The method compares favorably with previous techniques in terms of cost and analytical time. It can be used for serial measurement of plasma lipoperoxide concentrations in response to oxidative stress or following drug administration. Our preliminary data confirms the presence of an oxidative stress in cirrhotic patients. Normal lipoperoxide levels in subjects with very advanced disease may be due to polyunsaturated fatty acid deficiency and/or enzyme defects.

Chromatography, High Pressure Liquid↗