[Posologic adaptation of antibiotics in patients with renal insufficiency].
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Biomedical subjects
Publications and source records attributed to F De Rosa.
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A clinical epidemiological survey of Legionella pneumophila infections occurring in Italy between 1 December 1985 and 31 May 1986 was carried out to evaluate the incidence of sporadic, epidemic and nosocomial L. pneumophila pneumonia. A total of 355 cases of pneumonia were studied of which 11.5% were due to Gram positive bacteria, 11% were due to Gram negative bacteria, 7.9% were due to Mycoplasma pneumoniae, 4.5% were due to L. pneumophila and 8.5% were due to sundry aetiological agents. The remainder (45.6%) could not be diagnosed accurately. In addition, the anti L. pneumophila antibody titres were assessed. The results are discussed in terms of the occurrence of the disease in Italy and regarding the importance of considering the possibility of legionellosic aetiology when diagnosing pneumonia.
Diltiazem (0.3 mg/kg body weight intravenous in 2 minutes) was administered to 40 patients (24 males, 16 females, mean age 51.55 years) with paroxysmal supraventricular tachyarrhythmias: 7 patients with atrial fibrillation, 6 patients with atrial flutter, 25 patients with paroxysmal supraventricular tachycardia, 2 patients with uncommon atrioventricular reciprocating tachycardia. In patients with atrial fibrillation intravenous diltiazem produced a significant decrease of ventricular response (from 160 +/- 11 to 113.57 +/- 10.34--p less than 0.01). In patients with atrial flutter intravenous diltiazem produced variable effects: an increase in atrio-ventricular block (from 2:1 to 3:1 atrio-ventricular conduction (2 patients); conversion to sinus rhythm (1 patient); change to atrial fibrillation (1 patient); no appreciable change of the basic rhythm (2 patients). In paroxysmal supraventricular tachycardia patients conversion to sinus rhythm occurred in 20/22 patients (91%) treated with intravenous diltiazem (mean conversion time 4.69 minutes). In the 2 patients with uncommon atrioventricular nodal reciprocating tachycardia diltiazem increased P'-R and R-P' intervals without appreciable change of the basic rhythm. No serious side effects from drug administration were noted. Intravenous diltiazem appears to be as a highly effective medication in conversion or control of paroxysmal supraventricular tachyarrhythmias.
The authors report their experience with mebendazole in human hydatid disease. Following a WHO-controlled protocol, 25 patients with hydatidosis were treated with mebendazole, 50 mg/kg/die for 4-8 months. A further 2 patients were treated with mebendazole 30 mg/kg/die for 6 months, outside the WHO protocol. The evaluation of the results was performed by clinical, radiological (X-ray, ultrasounds, computerized tomography) and immunological investigations (monitoring of indirect haemoagglutinating antibodies, specific IgE, lymphocytic blastization, circulating immune complexes, etc.). The results were encouraging and the side-effects were not important; nevertheless, many questions remain to be elucidated.
A case of voluntary intoxication by clonidine (3.9 mg per os for a suicide purpose) is reported. The drug caused subjectively sleepiness and headache. Cardiovascular symptoms consisted of a marked bradycardia which was well controlled by atropine (1.04 mg i.v.) and a moderate decrease of the blood pressure. A "discontinuation syndrome" during 72 hours after the intoxication was not observed.
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The 4th case of plasma cell neoplasm associated with a hypereosinophilic syndrome is described and compared with the previous reports. Hypereosinophilia in the present patient displayed some borderline traits with eosinophilic leukemia. Myeloproliferative disorders of the eosinophilic line often present as a precancerous state, but sometimes they seem to acquire malignant independence. In our patient the occurrence of a plasmocytoma with a dramatic course leads to suspect an underlying complex genetic aberration.
An equation for predicting endogenous creatinine clearance (CrCl) in adults and children (with both stable and unstable renal function) from serum creatinine concentration is presented. The predictions are compared with four other available estimating methods, bases on values in 110 subjects with renal impairment of widely differing degrees. In patients with stable and with unstable renal function the corelaion between measured and predicted CrCl was better with the new equation. In patients with rapid changing renal function the new equation resulted in accurate predictions CrCl within a few hours after the change, as opposed to several with the other methods. The elimination rate constant of the aminoglycoside antibiotic amikacin correlated more precisely with CrCl values estimated from the new equation that with those measured doing 24 hr or with the other prediction methods.
The AA, report the results of virological and serological investigations performed during an epidemic of acute respiratory diseases in Umbria. The epidemic was associated with Respiratory Syncytial Virus; other virus infections were sporadic.
The Authors studied neutralizing antibodies against poliomyelitis wild viruses in a sample of Umbria population. The number of seronegative results for each virus strain was very low (less than 1%). The geometric mean titres were 21.07, 26.72, 19.13 for poliovirus types 1, 2, 3, respectively. The results of this seroepidemiological study shows that the Umbria population is satisfactory protected against the poliomyelitis.
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Trifluralin, a widely used herbicide (Rahman, 1977), may act via interaction with plant microtubule protein (Hess and Bayer, 1974, 1977). In trifluralin treated seedlings of Trifolium repens, root tips increased in diameter and decreased in length, cell elongation was decreased, cell wall deposition was abnormal, root hairs were deformed, and a marked reduction was seen in the number of infection threads induced by the bacterial symbionts. Our observations support the hypothesis that trifluralin (at low concentrations, from 2 x 10(-6) M) interferes with microtubule-based morphogenetic processes in developing seedlings and adversely affects the establishment of the bacteria-legume symbiosis.
Since 1957, when the first cases of the so-called shoe-makers' toxic polyneuropathy were reported, nearly 400 cases have been described in the Italian literature. The substance that was considered to be responsible for the disease was triorthocresylphosphate (TOCP) contained in glues, artificial leathers, and some types of paints. However numerous chemical analyses of glues and leathers taken from factories where cases of the disease occurred have shown that in almost all instances little or no TOCP was present. In addition the disease manifests itself more frequently during winter and spring and this is not consistent with the absorption of the causative agent through the skin and/or gastrointestinal tract. In order to clarify the aetiology of the disease 122 workers in the shoe industry affected by toxic polymeuropathy during the period 1971-74 were studied. Workplaces where cases of polyneuropathy had occurred were visited and samples of glues and solvents were taken for chemical analysis. The polyneuropathy chiefly affects workers engaged in glueing and in the cleaning process, but it also affects those who do not have direct contact with glues or solvents. The disease is more common in women (68%) than in men (32%) and, in its more severe form begins with overwhelming prevalence during winter and early spring regardless of the job performed. No direct relationship has been found between the severity of the disease and the number of years of work in the shoe industry or of specific exposure (that is the number of years of work in the activity performed at the onset of the disease). The polyneuropathy is found almost exclusively among workers of the artisam type in small shoe factories, where standards of hygiene are low. Chemical analysis of glues and cleaning fluids collected from five different factories, where 20 cases of polyneuropathy occurred, showed the presence of paraffin hydrocarbons with a low boiling point (pentane, 2-methyl-pentane, 3-methyl-pentane, n-hexane, etc.) in concentrations of more than 80% by weight.
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