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Biomedical subjects

A Terragna

Publications and source records attributed to A Terragna.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Ceftazidime plus amikacin versus ceftazidime plus vancomycin as empiric therapy in febrile neutropenic children with cancer.

Two antibiotic regimens, ceftazidime plus amikacin and ceftazidime plus vancomycin, were compared in a prospective, randomized clinical trial as empiric therapy in febrile granulocytopenic children with cancer. The rate of response was similar in the two groups (66% vs. 77%). The prevalence of secondary gram-negative bacteremia was higher--but not significantly higher--in the group receiving vancomycin. Adverse reactions also occurred more often in the latter group (35% vs. 4%). Mortality did not differ significantly in the two groups. Adjustment for independent predictors of response to treatment by means of multivariate analysis confirmed the lack of any remarkable difference between the responses to the two regimens. We conclude that the use of vancomycin instead of amikacin in combination with ceftazidime does not significantly improve the outcome of treatment of fever and infection in granulocytopenic children with cancer and that the use of vancomycin is associated with an increased frequency of both secondary infections due to gram-negative bacteria and adverse reactions.

Amikacin↗
PubMedDate not supplied

HIV-related thrombocytopenia: a therapeutical update.

HIV-seropositive patients who belong to the three major acquired immunodeficiency syndrome (AIDS) risk groups may develop an idiopathic thrombocytopenic purpura (ITP) which is related to the HIV infection. HIV-associated ITP clinically resembles classic ITP but, in spite of very low platelet numbers, bleeding is rarely severe, and moderate splenomegaly and lymphadenomegalies are seldom present. Treatment is the same as that given for classic ITP because the pathogenesis is in many ways similar. Immunosuppressors can be dangerous in the case of retrovirosis, and splenectomy may lead to AIDS. High doses of immunoglobulins often give an improved platelet count but this tends to be short-lived, and long-term periodical infusions usually lose therapeutical effect. Alpha interferon gives conflicting results and Danatrol is not usually effective. Specific anti-D immunoglobulins produce a high percentage of positive results and may be administered for long-term maintenance without side effects. Zidovudine (AZT) may produce a good platelet increase in a large number of patients, but there is no consensus for the use of this anti-retroviral drug in otherwise asymptomatic HIV-positive patients. In conclusion, since it is very unusual for bleeding to occur, moderate thrombocytopenia is best left untreated because a spontaneous increase in platelet count is possible. But if the platelet count is very low, or if bleeding is present, treatment is mandatory and must produce a rapid platelet increment with minimal side effects.

Danazol↗
PubMedDate not supplied

[The acquired immunodeficiency syndrome (AIDS) in childhood].

There is an increasing concern about HIV infection in paediatric age, due to its increasing incidence in some countries, especially in Europe, and due to its social aspects. HIV infection has particular features, while occurring during paediatric age: infection of child frequently occurs during pregnancy (perinatal form of HIV infection), a period characterized by the immaturity of the immune system of the host. Encephalopathy is a frequent manifestation of the disease, recurrent fever episodes have a different pathogenesis than in adults, LIP (lymphocytic interstitial pneumonia) is a common manifestation of the disease and there is a higher progression rate to AIDS. Antiretroviral therapy, as zidovudine (AZT) in paediatric age is still on clinical trials, and only few preliminary data are available.

Acquired Immunodeficiency Syndrome↗