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Biomedical subjects

A Vierucci

Publications and source records attributed to A Vierucci.

At least 73 records · Page 4Linked to original sources
PubMed1995

Hemochrome parameters during the first two years of life in children with perinatal HIV-1 infection.

Monthly hemochrome parameters were obtained during the first 2 years of age in 22 children with perinatal human immunodeficiency virus type-1 (HIV-1) infection and in 58 exposed seroreverted children. Timing and predictive value of hemochrome modifications were investigated. Exclusion criteria were hemoglobinopathies and zidovudine (AZT) treatment in pregnancy. When AZT treatment was undertaken children were eliminated from the study. From the second month of life red blood cell (RBC) counts, hemoglobin (Hb) concentrations, and hematocrit values were significantly lower in infected than in uninfected children. RBC counts progressively diverged in infected and uninfected children, and mean values in the former group never reached 4.10(12)/L. No difference was observed in Hb content ratios and RBC size parameters. At 2 months RBC counts, Hb concentrations, and hematocrit values below reference values were associated with a 15.8 (95% confidence limits [CL]: 5.5-48.8) relative risk of being infected. In infected infants aged 5 months a decrease in these parameters was associated with an 11.2 (95% CL: 1.6-77.8) relative risk of developing eventual severe clinical outcome. Low RBC counts, Hb concentrations, and hematocrit values may be included among predictive criteria in infants of HIV-1 infected mothers.

Anemia↗
PubMed1995

Retrospective survey on the epidemiology of H. influenzae type B meningitis in Italy (1987-91).

A retrospective survey on the epidemiology of H. Influenzae type b (Hib) meningitis was carried out in seven Italian hospitals. During the period 1987-1991, 95 (16.3%) Hib meningitis cases out of 581 bacterial meningitis cases were observed. The proportion of Hib meningitis was lowest in 1987 (11.3%); elevated in 1988 (17.9%); thereafter it did not change. A male preponderance was observed (Sex ratio 1.6). The age distribution showed that 93.7% of cases occurred in subjects < 5 years, 53.7% of cases in those < 1 year. Although Hib meningitis accounts for a small proportion of all bacterial meningitis, it is also a major problem in Italy in early childhood, because nearly all cases occur in children < 5 years.

Child, Preschool↗
PubMed1995

Onset of clinical signs in children with HIV-1 perinatal infection. Italian Register for HIV Infection in Children.

OBJECTIVE: To investigate the timing of onset of each clinical sign in infants and children with HIV-1 perinatal infection. DESIGN AND METHODS: A total of 200 HIV-1-infected children followed-up from birth were studied. Failure and conditional probabilities were estimated by the Kaplan-Meier product-limit method. Cox proportional hazard analysis was used to evaluate independently associated factors. Results of 934 seroreverters were used to calculate reference values of CD4+ cell counts and predictivity of early signs. RESULTS: Median age at the onset of any sign was 5.2 months (range, 0.03-56 months). The probability of remaining asymptomatic was 19% [95% confidence interval (CI), 14-25.1] at 12 months and 6.1% (95% CI, 2.6-11.7) at 5 years. Lymphadenopathy (69.5%), splenomegaly (62.4%) and hepatomegaly (58.4%) were the most common signs in the first year of life. Peculiar to the first year of life (compared with subsequent ages) was the onset of primary HIV-1 hepatitis and diarrhoea (rate ratios, 23.3 and 15.2, respectively). When CD4+ cell counts in the asymptomatic stage (age, 2 months; range, 0.03-5.9 months) were below rather than above the fifth percentile in seroreverters, onset of signs was earlier [3 range, 0.03-19) versus 5 (range, 0.03-56) months]. Children manifesting signs before the 5.2-month breakpoint had a lower survival rate [74% (range, 65.9-82%) at 12 months and 45% (range, 32.9-57%) at 5 years] than children manifesting signs later [98% (range, 92.2-100%) at 12 months and 74% (range, 60.3-87.7%) at 5 years]. Children whose birthweight was < or = 2400 g had an earlier onset (24 months; range, 1-57 months) of severe conditions than children with higher birthweight (71 months; range, 1-71 months). Development of lymphadenopathy or hepatosplenomegaly within 3 months of life were reliable indicators of infection. CONCLUSIONS: This study describes the sequence of onset of signs in perinatal HIV-1 infection. Infection is shown to progress faster than in adults and in a different manner. Low birthweight, early decreased CD4+ cell counts, and early onset of signs are predictive of rapid progression.

AIDS-Related Complex↗
PubMed1995

Diet regimen in the treatment of food allergy.

Adverse reactions to food may be mediated by immunological or non immunological mechanisms. The term "food allergy" describes an event in which a definite immunopathological process can be demonstrated and a cause and effect relationship must be present. Symptoms and signs of food allergy may appear in any organ system, depending in part on the age of the subject and on the allergen involved. At present it is generally agreed that the only effective therapy for food allergy is strict elimination of the offending food antigen. Institution of a food elimination diet should be considered comparable to prescribing a medication, which carries along definite risk-benefit ratio. Consequently, appropriate diagnostic measures base on history, skin test, or radioallergosorbent test (Rast) and blind food challenges, must be utilized before implementing special diets. The allergist and other health care professionals must recognize the advantages of elimination diets (improvement of symptoms) as well as disadvantages (increase of the time required to purchase food and prepare meals, impossibility to eat at restaurants, at friends' houses or at school with consequent possible social isolation, nutritional disorders) and choose the most appropriate elimination diet.

Child↗
PubMed1994

Pathogenesis of posttransfusion viral hepatitis in children with beta-thalassemia.

The pathogenesis of posttransfusion hepatitis was determined in 14 children with beta-thalassemia. All had blood samples obtained in 1980 or 1981, were vaccinated against hepatitis B virus in 1983 and had another serum sample collected in 1989. Seven children had detectable antibodies against hepatitis C virus before vaccination, and all were positive in 1989. With specific solid-phase enzyme immunoassays, all children had antibodies against hepatitis B virus, X and polymerase antigens in 1981, and six had one or both antibodies in 1989. Hepatitis B virus infection was confirmed by means of polymerase chain reaction, which demonstrated virus DNA in 13 of the 14 children. The amplification products spanning the X/precore region were smaller than expected, suggesting mutations in this region. Cloning and sequencing of these products revealed deletions spanning part or all of the X gene. The results show that these children were infected with hepatitis B virus even without other markers in serum, that hepatitis B persists years after vaccination and that such infections are associated with the presence of X deletion mutants. Coinfection with hepatitis B and C viruses, the former containing a new class of variants, is common in children with beta-thalassemia.

Adolescent↗
PubMed1994

The preventive effect of nedocromil or furosemide alone or in combination on exercise-induced asthma in children.

BACKGROUND: Recent evidence suggests that inhaled nedocromil and furosemide are effective in preventing asthma by ultrasonically nebulized distilled water, allergen, and exercise. There are, however, no studies that compare the effects of these two drugs. The aim of this study was to investigate the effect of inhaled furosemide (30 mg), nedocromil (4 mg), the combination of these two drugs, and placebo aerosol in preventing exercise-induced asthma. METHODS: Twenty-four children with exercise-induced asthma, aged 6 to 16 years, performed a treadmill test before and 20 minutes after a single dose of drug(s) in a double-blind trial. Lung function measurements were taken before drug administration, before the exercise test (20 minutes after drug administration), and then 2, 4, 6, 8, 10, 15, 20, and 30 minutes after the exercise test. RESULTS: Both active drugs performed significantly better than placebo. In fact, the exercise challenge resulted in a mean maximum fall in forced expiratory volume in 1 second of 28.46% +/- 13.84% after administration of placebo, but of only 15.42% +/- 8.35% after administration of nedocromil (p < 0.001) and of 11.37% +/- 9.14% after administration of furosemide (p < 0.001). When the two drugs were given together, there was a statistically significant additive effect because the mean maximum fall in forced expiratory volume in 1 second was 5.75% +/- 3.57% (nedocromil vs nedocromil + fluorsemide: p < 0.001; furosemide vs nedocromil + furosemide: p < 0.01). CONCLUSION: This study suggests that nedocromil and furosemide provide a comparable effect in preventing exercise-induced asthma in children. The combined administration of the two drugs significantly increases the protective effects, suggesting a potential therapeutic use.

Administration, Inhalation↗
PubMed1994

AIDS appearance in children is associated with the velocity of disease progression in their mothers.

Thirty-four human immunodeficiency virus type 1 (HIV-1)-infected mother-child pairs were studied from delivery, and the association between velocity of disease progression in mothers and age at AIDS appearance in their children was analyzed. Four maternal disease stages were defined, and the velocity of HIV-1 progression was calculated. Maternal clinical conditions at delivery and intervals before starting zidovudine in women and children were included in the analysis. The relative risk of the child's developing AIDS for mother's disease progression of 1 stage/year was 3.004 (95% confidence interval, 1.37-6.58, P = .006) in stepwise analysis. A maternal CD4+ cell count < or = 400/mm3 appeared to be associated with a rapid disease course in both women and children. Thus, the faster HIV-1 progressed in the mother, the quicker AIDS developed in her baby. This suggests that HIV-1 strains with comparable virulence develop in mother-child pairs, perhaps because of their similar genetically driven immune responses.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Inhibition of exercise-induced-asthma (EIA) by nedocromil sodium and sodium cromoglycate in children.

Nedocromil sodium (Ned) 4 mg, sodium cromoglycate (SCG) 10 mg, and placebo were compared for their efficacy in preventing exercise-induced asthma. Nineteen asthmatic children aged six to 15 years performed a treadmill exercise test before and 20' after a single dose of drug in a double-blind trial. Both active drugs performed significantly better than placebo; in fact the exercise challenge resulted in a mean maximum fall in FEV1 of 26.1 +/- 14.9% after placebo, but only of 14.6 +/- 11.5% after SCG (P < 0.05), and 11.0 +/- 12.4% after Ned (p < 0.01). Measurements of PEFR gave similar results, while the effect of treatment on FEF 25-75 was significant for Ned alone (p < 0.05). Direct comparison between Ned and SCG at different time points demonstrated significant differences in FEV1 at 1 min (p < 0.05) with a better overall performance of Ned. In individual patients, complete protection was provided in 9 patients with SCG, in 14 patients with Ned and in 2 with placebo. No side effects were observed. This study suggests that at the dosages used there are only slight differences between SCG and Ned activity in the prevention of exercise-induced asthma.

Adolescent↗
PubMed1994

High levels of IgA in HIV-1-perinatally-infected children. Antigen specificity and possible role of increased substance P plasma levels.

The specificity of IgA against food, inhalant, bacterial and fungine antigens as well as for HIV-1 proteins was investigated in 14 HIV-1-infected children (CDC stage P-2) and 15 controls. IgA against food- and inhalant antigens as well as against tetanus toxoid were significantly more often present in the HIV positive children than in controls. No difference between the two groups was present for IgA against Candida albicans. A significant increase of substance P, a strong IgA synthesis inducing neuropeptide, was demonstrated in the plasma of HIV-1 infected children. In conclusion, high levels of IgA seem to reflect a complex immune dysfunction in which many factors are involved. The importance of neuroimmune dysregulation is discussed.

Antibody Specificity↗
PubMed1993

Gastroesophageal reflux and bronchial asthma: prevalence and effect of cisapride therapy.

We evaluated the prevalence of gastroesophageal reflux in 36 children, 22 (61.2%) male and 14 (38.8%) female (median age, 75.5 months; range, 18-178), with noncontrolled asthma by means of prolonged (22-24 h) esophageal pH monitoring. None of the children had gastrointestinal symptoms suggesting gastroesophageal reflux. Atopy was seen in 21 of 36 (58.3%) patients. Pathological gastroesophageal reflux was present in 27 (75%) children. All patients were given cisapride (0.2 mg/kg q.i.d.) for 3 months. A clinical and pharmacological score was determined, and a second pH-metric study was made at the end of the follow-up period. The following pH-metric parameters were evaluated: the total percentage of time pH was < 4, the number of reflux episodes, the number of reflux episodes lasting > 5 min, the length of the longest single reflux episode, and the percentage of time the esophageal pH was < 4 during sleep. The study was completed in 11 of 27 children. The percentage of time that esophageal pH was < 4 improved in nine of 11 (81.8%) patients (p = 0.013). The percentage of time that esophageal pH was < 4 during sleep showed the most significant decrease (p = 0.002) after treatment. Improvement in both clinical and pharmacological scores was highly significant (p < 0.0001) in 19 of 27 patients, eight of whom did not want to repeat the pH study. We conclude therefore that gastroesophageal reflux is frequently associated with noncontrolled asthma and that medical therapy for reflux may improve the further course of respiratory disease.

Adolescent↗
PubMed1993

Fish allergy in children.

Fish allergy is a relevant clinical problem in fish eating and/or processing communities but, because of the technologic advances of the preserved food industry, it may now be said to be a worldwide problem. Among 558 consecutive children referred for atopic diseases, 25 (4.48%) subjects skin test- and RAST- positive to cod were recorded and we extrapolated that about 4-5/1000 children have allergy to cod in our areas. As a group, children with cod allergy seem to manifest a higher atopic condition and more severe clinical manifestations. IgE level z-score (mean +/- SD) was significantly (P < .001) higher in 68 cod-positive children (14.27 +/- 3.87) than in 533 children positive to other inhalant and/or food allergens (8.12 +/- 4.06). In spite of a smaller median age (59 months), cod-positive children had a higher frequency of asthma (41/68 = 60.2%) than children with other allergies, and age at the onset of asthma was significantly (P < .001) younger in the former (32 months) than in the latter (41 months) subjects. In addition, urticaria-angioedema was more frequently recorded in cod-allergic children (23/68 = 33.8%) than in patients with allergy to inhalants (26/410 = 6.3%; P < .01), inhalants and foods different from cod (11/74 = 14.8%; P < .01), or foods different from cod (6/49 = 12.2%; P < .01). The male:female ratio in cod-allergic children (3.53) was significantly higher than that observed in children with allergy to inhalants (1.78; P = .037) or foods (0.68; P < .0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Hepatitis C virus antibodies in a long-term follow-up of beta-thalassaemic children with acute and chronic non-A non-B hepatitis.

The presence of antibodies toward hepatitis C virus (HCV) was examined in 78 polytransfused beta-thalassaemic children. The anti-HCV status was correlated with acute and chronic non-A non-B (NANB) hepatitis that developed during a follow up of about 13 years. Anti-HCV was present in 83.3% of children with acute NANB hepatitis and in 82.9% of those with chronic NANB hepatitis. The percentage of chronic evolution was 56.7% for acute anti-HCV positive NANB hepatitis and 50.0% for anti-HCV negative NANB hepatitis. The long-term persistence of anti-HCV antibodies did not correlate with chronic evolution of liver infection in thalassaemic patients. Histological features of chronic hepatitis showed little or no difference between HCV associated or non-associated liver disease. The multifactorial liver injury in beta-thalassaemic children explains the high prevalence of cirrhosis (about 30%) observed in these patients with NANB hepatitis. On the other hand, independent of liver disease, some patients never seroconverted during the follow up in spite of the high number of transfusions suggesting the existence of "non-responders".

Acute Disease↗
PubMed1992

Hepatitis B x antigen and polymerase antibodies in the serum of hepatitis B carriers with or without hepatitis delta virus infection. Effects of interferon treatment.

Previous work has shown that the hepatitis B x antigen (HBxAg) and antibodies directed against the polymerase of hepatitis B virus (anti-pol) are early markers of hepatitis B virus (HBV) replication in natural infections. The present study was carried out to test the hypothesis that the appearance of one or both of these markers signaled reactivation in chronic carriers with liver disease who were treated with alpha-interferon (IFN). The results show that HBV DNA decreased among the patients who responded to therapy, and that among these responders, neither HBxAg nor anti-pol became detectable in serum for 12 months after treatment, in contrast to controls. Hence, the loss of HBxAg and anti-pol correlate with decreased levels of HBV DNA in response to IFN therapy. However, different patterns of HBxAg and anti-pol were observed among alpha-IFN-treated HBV carrier patients who were also chronically infected with the hepatitis delta virus (HDV). The treatment of such patients often resulted in the loss of HDV RNA from serum and delta antigen from liver. Most of these patients had increased levels of HBV DNA in serum. HBxAg and/or anti-pol also became detectable in patients who lost markers of HDV, implying that the suppression of HDV by IFN is accompanied by the appearance of early markers of HBV reactivation in some of the treated patients.

Adult↗