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Biomedical subjects

B Galanti

Publications and source records attributed to B Galanti.

At least 37 records · Page 2Linked to original sources

Prolonged treatment of children with chronic hepatitis B with recombinant alpha 2a-interferon: a controlled, randomized study.

A prospective study was conducted to evaluate the efficacy and tolerance of alpha-interferon in 20 children with biopsy-proven HBsAg/HBeAg/HBV-DNA-positive, anti-delta-negative chronic hepatitis. Patients were randomized to receive alpha 2a-interferon (INF), 3 MU im three times weekly for 12 months, or no treatment (10 patients per group). Five patients receiving IFN showed a marked decrease or negativization of HBV-DNA during treatment. At the end of the study (after 18 month), three patients lost HBV-DNA permanently, and two of them seroconverted to HBeAb 10 and 11 months after disappearance of HBV-DNA with normalization of aminotransferase values. In the control group, one patient had spontaneous clearance of HBV-DNA with conversion to HBeAb and normalization of aminotransferase levels. All treated patients had a febrile reaction in the first month of treatment. The dose of IFN had to be decreased in two patients and was discontinued for persistent intolerance in one of them. Patients who showed a decreased viral replication had higher initial biochemical and histological activity than nonresponders. The data suggest that IFN treatment may favorably influence the progression of chronic B hepatitis in children with a history of acute hepatitis and active chronic disease.

Adolescent↗

[Prevention of congenital toxoplasmosis].

Toxoplasma gondii can be transmitted from mother to fetus during primary maternal infection acquired after or, possibly, slightly before conception. The incidence of congenital infection is highest in the third trimester, while severity is greatest when maternal infection is acquired during the first trimester. About 50 per cent of mothers who acquire the infection during gestation, if not treated, will give birth to infected infants. Incidence of congenital toxoplasmosis varies from 0.5 to 6.5 cases per 1000 live births. Serologic screening before or very early in pregnancy is required to identify seronegative women who are at risk to acquire the infection during pregnancy. Prevention of congenital toxoplasmosis is obtained by educating pregnant women at risk about how to prevent the infection and by diagnosing acute infection of mother. Every mother who demonstrates seroconversion for toxoplasmosis during pregnancy has to be treated as soon as possible. Therapy is based on spiramycin that achieves high concentrations in the placenta; if the fetus is infected pyrimethamine plus sulphonamides are administered since fourth month. Chemotherapy of the infected pregnant mother reduces the incidence of congenital toxoplasmosis and the severity of the disease in the newborn. Intrauterine infection can be detected by fetal blood sampling, by amniocentesis and ultrasound examination; prenatal diagnosis is mandatory if an abortion is being considered.

Adult↗

[Congenital cytomegalic disease. Current possibilities and prospects of prevention].

Congenital CMV infection occurs frequently as a consequence of primary maternal CMV infection during pregnancy: clinical abnormalities are present at birth or may become apparent later in about 25% of infected infants. Transmission of CMV to the fetus occurs less frequently as a consequence of CMV reactivation in immune mothers, and is rarely associated with clinical manifestations at birth or long-term sequelae. The incidence of congenital CMV infection can be reduced by avoiding primary infection during pregnancy and knowledge of the epidemiology of CMV infection allows physicians to inform pregnant women on major risk factors. Since vaccination of nonimmune women could prevent congenital disease, the development of a suitable and safe CMV vaccine would be desirable. New anti-viral agents with anti-CMV activity are expected to be lifesaving in infants with disseminated visceral disease; moreover, if safe, they could be used to treat CMV disease prenatally. If effective anti-CMV drugs were available the development of simple, rapid and inexpensive methods for the early diagnosis of congenital CMV infection would become more urgent. Instruction of parents, family doctors and all those involved in child care can improve prevention of congenital CMV infection.

Antibodies, Viral↗

Levels of anti-albumin autoantibodies in acute and chronic hepatitis B virus infection.

Levels of anti-albumin autoantibodies (AAA) of the IgG class were determined by ELISA in sera of patients with acute and chronic hepatitis B virus (HBV) infection. Mean AAA levels were higher than normal in both acute and chronic hepatitis patients. AAA levels were higher than the upper normal limits in practically all patients with acute self-resolving hepatitis, and decreased to normal levels when the patients recovered. Enhanced IgG AAA levels were observed in many patients with chronic hepatitis and serological markers of HBV replication. Elevated AAA levels were not associated with either more elevated transaminase levels or more severe histological forms of chronic hepatitis. The results of this study suggest that the interaction of albumin with HBV determinants is involved in AAA elevations, probably by mediating an increase in albumin immunogenicity. Moreover, the fall in AAA levels in the recovery phase of acute hepatitis, the coexistence of elevated levels with HBeAg and HBV-DNA, and the lack of correlation between AAA levels and different evolutive forms of chronic hepatitis, seem to exclude AAA from playing a relevant role, be it protective or damaging, during HBV infection.

Acute Disease↗

[Prospective study of HBV circulation and long-term evaluation of anti-hepatitis-B vaccination in patients undergoing hemodialysis].

Hemodialysis patients were screened and monitored for HBV markers and at renal unit (identification EDTA 13ND) Palermo. Eighty-five patients received the hepatitis B vaccine (Haevac B Pasteur); fifty-three were followed up for more than three years; they received one of the three following schedules: 5 micrograms at 0, 1, 2 and 14 months; 5 micrograms at 0, 1, 2, 3, and 14 or 10 micrograms at 0, 1, 2, and 14 months. The best result was obtained by third schedule with a sero-conversion to anti-HBs of 83% at one month after the booster doses; and with the same percentage of anti-HBs positivity two years after the booster dose. During the study time (January 1984, March 1989) no new HBV events in patients and in the hemodialysis staff, who was also on monitoring, were observed.

Adolescent↗

Subclass characterization of IgG anti-S.typhi lipopolysaccharide antibodies with commercial monoclonal antibodies.

We have evaluated several commercial monoclonal antibodies, specific for human IgG subclasses, for their reactivity in an ELISA test for the characterization of subclasses of IgG anti- Salmonella typhi lipopolysaccharide (LPS) antibodies. Four monoclonals, each specific for a single IgG subclass, were chosen for their good reactivity. In 19 typhoid and non-typhoid serum samples, the sum of the ELISA values obtained with the four subclass-specific monoclonals was highly correlated with the ELISA values obtained with a monoclonal anti-total IgG. Moreover, there was no competition among the various IgG subclasses of anti-LPS antibodies. These data indicate that the subclass distribution of IgG anti-LPS antibodies, calculated on the basis of ELISA values in the subclass-specific assays, is likely to reflect the actual distribution of the different subclasses in whole serum. Different subclass patterns of IgG anti-LPS antibodies were observed in serum samples from 11 patients with typhoid fever, with IgG1 and IgG2 being the most represented subclasses. The ELISA method described here will be useful to elucidate the factors that influence the anti-LPS subclass profile during the humoral immune response to Salmonella typhi.

Adolescent↗

The role of surgery in transmitting "post-transfusion hepatitis".

The role of surgery as an additional risk in transmitting "post-transfusion" hepatitis was investigated in a retrospective study on acute hepatitis occurring in 77 transfused patients, 293 transfused and operated patients and 243 hepatitis cases with history of surgery without transfusion. Hepatitis A patients admitted to the same centres in the same period were utilized as controls. In transfused patients the percentage of NANB hepatitis was higher than that of type B (61.0% vs. 36.4%), while in the operated not transfused group the percentage of type B was twice that of type NANB (63.4% vs. 32.5%). In transfused and operated cases intermediate values were observed. The age-adjusted measures of association between exposures and the different hepatitis types showed a lack of effect of transfusion and a dominant role of surgery in transmitting type B hepatitis. In contrast, NANB "post-transfusional" cases were actually a mixture of post-transfusional and post-surgical cases, since both these exposures were found to be significantly associated with the disease. Our results suggest that studies on the incidence and the etiology of post-transfusion hepatitis should take into account the risk of surgical exposure which might have occurred.

Hepatitis A↗

Sensitive ELISA for IgG and IgM anti-albumin autoantibodies not influenced by HBsAg-associated polyalbumin receptors.

An enzyme immunoassay for the detection of IgG and IgM anti-polymerized albumin autoantibodies (AAA) is described. It was found that polyalbumin receptors on HBsAg particles interfere in the detection of IgG AAA when polymerized human albumin (pHSA), but not polymerized bovine albumin (pBSA), is used as coating antigen. Polyalbumin receptors do not appear to interfere in the detection of IgM AAA, with either pHSA or pBSA as coating antigen. All normal sera showed evidence of AAA, of both IgG and IgM classes. Levels of IgG and IgM AAA in sera from most type A and type B acute hepatitis patients were above the range of normal controls. ELISA detection of AAA distinct from HBsAg reactivity can help in understanding the role of these autoantibodies in HBV infection.

Autoantibodies↗

Performance characteristics of an enzyme-linked immunosorbent assay for the determination of immunoglobulin M anti-Salmonella typhi lipopolysaccharide antibodies.

Some characteristics of an enzyme-linked immunosorbent assay for the determination of immunoglobulin M anti-Salmonella lipopolysaccharide antibodies have been assessed. Immunoglobulin M anti-lipopolysaccharide antibodies in serum samples from most patients with typhoid fever cross-reacted with S. typhimurium lipopolysaccharide. However, absorbance values with S. typhi lipopolysaccharide were always higher than with the heterologous antigens. Serum samples from two patients with S. paratyphi B infection failed to show significant immunoglobulin M binding to S. typhi lipopolysaccharide. Serum samples from six rheumatoid arthritis patients were negative in this immunoenzymatic assay with S. typhi or S. typhimurium lipopolysaccharide as coating antigen. Finally, interference by specific immunoglobulin G in the immunoglobulin M anti-S. typhi lipopolysaccharide antibodies determination was excluded.

Antibodies, Bacterial↗

Serodiagnosis of typhoid fever by enzyme-linked immunosorbent assay determination of anti-Salmonella typhi lipopolysaccharide antibodies.

Serum samples from 22 patients with proven typhoid fever, 60 febrile nontyphoidal patients, and 120 healthy subjects were tested for immunoglobulin A (IgA), IgG, and IgM anti-Salmonella typhi lipopolysaccharide antibodies by an enzyme-linked immunosorbent assay. The levels of all three classes of immunoglobulin anti-lipopolysaccharide were higher in typhoid patients than in controls; the test for IgM anti-lipopolysaccharide gave the best discrimination between typhoid and nontyphoidal sera. The absorbance values obtained with the enzyme-linked immunosorbent assay for IgM anti-lipopolysaccharide were highly correlated to the titers of anti-O agglutinins. However, the enzyme-linked immunosorbent assay was much more specific than the Widal test, and hence it could be a useful tool for the serological diagnosis of typhoid fever with a single blood sample.

Antibodies, Bacterial↗

Selectively increased adenosine deaminase levels in T cells during typhoid fever.

ADA and PNP levels were measured in T-enriched and T-depleted subpopulations of peripheral mononuclear cells from patients with typhoid fever. ADA activity was significantly increased in T-enriched, but normal in T-depleted preparations of typhoid patients. Elevated levels of ADA in T cells were observed from the initial phase up to 30 days from the onset of the disease. Unlike ADA changes, PNP modifications were transitory, and affected both T-enriched and T-depleted subpopulations. The usefulness of ADA determination in T cells to detect and follow up T-cell activation during typhoid fever is suggested.

Adenosine Deaminase↗

Immunosuppressive therapy in chronic active hepatitis (CAH). A multicentric retrospective study on 867 patients. A report from a study group for CAH of the Italian Association for the study of the liver.

We retrospectively reviewed the clinical, biochemical and histological features of 867 patients with biopsy-proven CAH observed in 12 Italian Liver Units for at least one year. Either HBsAg positive or HBsAg negative patients (473 and 394 patients, respectively) were left untreated, or were treated with one of the following regimens: a) prednisolone or prednisone 10 to 30 mg daily, referred to as Steroids; b) azathioprine 50 to 100 mg daily; c) prednisolone or prednisone 10 to 20 mg daily associated with azathioprine 50 to 100 mg daily, referred to as Combination. The outcome was evaluated on the basis of clinical, biochemical and histological parameters. Among the 473 patients with HBsAg positive CAH those treated with combination, as compared to those untreated, more frequently, improved (P less than 0.001), and less frequently deteriorated (P less than 0.001). Under Steroids or Azathioprine improvement was more frequent than in untreated patients, but deterioration was not prevented. The results were similar among the 394 HBsAg negative patients. The data indicate that combination is effective in treating either HBsAg positive CAH or HBsAg negative CAH.

Adolescent↗