Biomedical subjects

A Micozzi

Publications and source records attributed to A Micozzi.

61 records · Page 4Linked to original sources

PubMedDate not supplied

Spontaneous pneumothorax complicating pulmonary mycetoma in patients with acute leukemia.

Pneumothorax caused by the rupture of a mycetoma into the pleural space is rarely reported in patients undergoing intensive cytotoxic therapy for hematologic malignancies. We reviewed 46 episodes of mycetoma that developed in 43 patients undergoing antineoplastic therapy; six (13%) of these episodes were further complicated by the occurrence of pneumothorax that developed after bone marrow recovery with return to normal granulocyte count. Etiologic agents included Aspergillus fumigatus, Aspergillus fumigatus plus Blastoschizomyces capitatus, and Mucor (one case each). No pathogen was detected in the remaining three cases of pneumothorax. Four of the six patients died (7, 10, 27, and 50 days after the onset of pneumothorax). Two of the six patients with pneumothorax died of massive hemoptysis, whereas only one of the 40 patients who did not develop pneumothorax died of hemoptysis. This suggests that both pneumothorax and hemoptysis may represent the clinical expression of a more destructive course of invasive fungal diseases.

Adult↗

PubMedDate not supplied

Cryptosporidiosis in patients with hematologic malignancies.

The clinical features of cryptosporidial infection in 20 patients with hematologic malignancies were assessed. Five patients had severe diarrhea, 10 had moderate diarrhea, and five were asymptomatic carriers of Cryptosporidium. Extraintestinal cryptosporidiosis with pulmonary involvement was observed in one case and relapse of cryptosporidiosis in four. All but one patient recovered from cryptosporidiosis whether or not spiramycin was administered. Cryptosporidiosis in T cell-depleted recipients of allogeneic bone marrow transplants did not appear more severe than that in patients undergoing autologous bone marrow transplantation or conventional chemotherapy.

Adolescent↗

PubMedDate not supplied

[Antibiotic prophylaxis in the control of infections in surgery: comparison of treatment in different types of surgery].

Despite the development of the most recent and powerful antimicrobic agents, surgical infections are to this day a constant threat to surgeons, rendering negative otherwise successful surgical results. It seems therefore essential that during surgical operations--which according to Altemeier's classification are defined as "contaminated" and "potentially contaminated"--patients undergo a perioperative antibiotic prophylaxis in order to assure elevated tissue levels of antibiotic as necessary. A perspective trial of two standard protocols of short term prophylaxis versus cefoperazone has been here outlined, given that in a recent study cefoperazone showed a positive effect in destroying the intestinal flora of patients even though this was carried out in experimental and not in clinical conditions. 177 patients were selected for this study with a breakdown of 26 and 42, that is twenty-six underwent potentially contaminated procedures and 42 contaminated procedures. Selecting at random, fifty percent of the first group was treated with cefoxitin, and the other half with cefoperazone; as far as the second group is concerned half the sample of patients was treated with cefoperazone and then compared with the other half who had been given an association of piperacillin and metronidazole. Primary septic complications amounted to 7.3% (13 cases); 7.6% in the first group (2 cases) and 21% in the second (9 cases). The different of sepsis between the two groups was not statistically significant although cefoperazone showed a higher septic result in contaminated surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗

PubMedDate not supplied

Ceftriaxone and amikacin as single daily dose in the empiric therapy for febrile episodes in neutropenic patients.

One hundred thirty-three febrile episodes in 115 neutropenic patients with hematologic malignancies were empirically treated with ceftriaxone and amikacin in a single daily dose. An indwelling central venous catheter (CVC) was present in 44 cases. Septicemia was documented in 18 (41%) patients with CVC (13 gram-positive, 5 gram-negative and 1 fungus) and in 30 (34%) patients without CVC (19 gram-positive, 10 gram-negative and 2 fungi). Coagulase-negative staphylococcus was observed in 10 out of 19 blood isolates in the presence of a CVC and in 6 out of 31 blood isolates in patients without CVC. Empiric therapy was successful in 56.4% of cases. Improvement after the addition of vancomycin or teicoplanin was observed in 38.6% of cases with a CVC and in 13.5% of those without (p less than 0.02). Only two patients died from gram negative septicemia, and the substitution of ceftriaxone with another beta-lactam was necessary in only 6% of the cases. Empiric therapy with single daily-dose ceftriaxone and amikacin appears to be effective in febrile neutropenic patients; our data, however, show the high incidence of Staphylococcus epidermidis septicemia and the frequent need to add an anti-gram-positive drug in patients with an indwelling CVC.

Agranulocytosis↗

PubMedDate not supplied

Spectrum of HIV infection and AIDS in a cohort of Italian hemophiliacs.

A group of 173 subjects affected by congenital clotting factor deficiencies was evaluated with regard to the impact of HIV infection. On the whole, 78 patients (45%) were found to be HIV Ab-positive. As of March, 1988, of the seropositive patients, 63 (80.8%) had an asymptomatic HIV infection (Group II/CDC), three (3.8%) had a persistent generalized lymphadenopathy (Group III/CDC). The 12 (15.4%) remaining patients could be classified in Group IV of the CDC classification due to their symptoms and signs; in particular, 10 came under surveillance case definition for AIDS. Assay for the HIV antigen was positive in 14 (17.9%) seropositive hemophiliacs. With regard to the immunological features, our data clearly show that a sharp decline in the number of CD4+ cells was associated with symptomatic forms of the disease. An evaluation of the time elapsed from seroconversion to the appearance of the symptomatic clinical condition showed an average incubation of 37 months.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Pefloxacin in the treatment of gram-negative infections in patients with hematologic diseases.

Quinolones are active against gram-negative strains. They are commonly used for selective intestinal decontamination in patients with hematologic malignancies and prolonged neutropenia due to chemotherapy. In our open study we used pefloxacin, a new fluoroquinolone, for the treatment of fifteen documented gram-negative infections in hematologic patients. Thirteen patients were mildly neutropenic, and in nine cases they received oral treatment as non-hospitalized patients. Cure was achieved in fourteen cases, with microbiological eradication of the offending pathogen.

Bacterial Infections↗

PubMedDate not supplied

Central venous catheterization in pediatric patients affected by hematological malignancies.

The objective of this retrospective study was to evaluate the significance and complications of percutaneous central venous catheterization in pediatric patients affected by hematologic malignancies. One hundred and fifty-eight central venous catheters were inserted in 125 pediatric patients (male/female 67/58; median age: 4 years; range 10 m - 6 y.) affected by hematological malignancies. Venous access was obtained by means of a tunnelled silicone rubber Groshong catheter inserted percutaneously in the subclavian vein (91.1%), the internal jugular vein or in the femoral vein. The medial duration of catheterization was 231.8 days (range 8-1014 days). The total number of catheter days was 33,792 (92.6 years). There were no complications related to catheter insertion. Only one patient developed significant post-operative bleeding. One hundred and nine catheters (68.9%) were removed when they were no longer needed and 49 (31.1%) were removed due to complications: 6 catheter occlusions (12.2%), 7 were accidentally withdrawn (14.3%), 3 for local infections (6.1%) and 33 for catheter-related infection (67.3%). A Groshong catheter seems to provide good access to the blood stream for a long period of time with a low incidence of complications in children with acute hematological malignancies.

Acute Disease↗