Biomedical subjects
Publications and source records attributed to G Federico.
The influence of ofloxacin and pefloxacin on human myelopoiesis in vitro was investigated. Drug concentrations varied from 0.5 to 50 micrograms/ml, and the effect on granulomonocyte precursors was evaluated on cell cultures in agar. Our results indicate that ofloxacin and pefloxacin do not induce inhibition of myelopoiesis.
Osteoporosis, a recognized complication of insulin-dependent diabetes mellitus (IDDM), may be related to this complex metabolic disorder; moreover, some data emphasize an altered vitamin D metabolism or parathyroid hormone secretion. Mineral homeostasis was studied in 29 children with IDDM (18 males, 11 females; 2.6-18.0 years). In 17 patients a stimulatory test (low-calcium diet) was performed for PTH and 1.25(OH)2D. Bone mineral content (BMC) and BMC/BW were lower in respect to our normal values; bone mineral loss was directly related to HbA1c levels and insulin requirements. A significant decrease of ionized calcium (p less than 0.001) and magnesium (p less than 0.001) was found; intact PTH values were in the low normal range but decreased for the ionized calcium values. 1.25(OH)2D levels were not significantly different from normal levels. 1.25(OH)2D and intact PTH did not rise during stimulatory test. The lack of 1.25(OH)2D and intact PTH increase after the stimulatory test may be due to the parathyroid gland's hyporesponsiveness related to hypomagnesemia which impaired PTH release and/or PTH action. Our data confirm an involvement of 1.25(OH)2D and PTH regulation in diabetic osteoporosis.
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Reported are the results of a study on the incidence of nosocomial surgical infections in ten wards of the university hospital A. Gemelli, Rome. One thousand, five hundred five patients were studied and the overall incidence of surgical infections was 8.7%. Factors that influenced infection rates included age, immunosuppressive diseases, and immunosuppressive therapy. We assessed the inutility of antibiotic prophylaxis in clean operations and its usefulness in clean operations with insertion of prostheses or other devices. The importance of the duration of preoperative hospitalization and of the length of the operation were also noted. The most frequent etiological agents proved to be Pseudomonas aeruginosa, Staphylococcus aureus, and Escherichia coli. The average hospital stay for patients with surgical infection was more than double that of patients with no infection (25.7 days v 11.7 days).
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Ninety-two microbiologically documented staphylococcal infections were treated with cefamandole in an open comparative study on the clinical efficacy of this cephalosporin in the therapy of infections caused by both methicillin-susceptible and methicillin-resistant Staphylococcus aureus and coagulase-negative Staphylococcus spp. The majority of the episodes (86 of 92) were treated with cefamandole alone, and six were treated with cefamandole in association with other antibiotics. In the evaluable S. aureus infections, 34 of 46 (73.9%) due to methicillin-susceptible strains and 12 of 16 (75%) due to methicillin-resistant strains responded to therapy. In particular, among the patients infected by methicillin-susceptible S. aureus 6 of 9 cases of septicemia, 0 of 2 cases of endocarditis, 2 of 2 cases of pneumonia, 2 of 3 osteoarticular infections, 8 of 12 cases of peritonitis in patients with chronic renal failure in continuous ambulatory peritoneal dialysis (CAPD), 13 of 15 skin-soft tissue infections, and 3 of 3 urinary tract infections responded to therapy. Among those due to methicillin-resistant strains, cure was achieved in 2 of 4 cases of septicemia, 0 of 1 case of endocarditis, 9 of 10 skin-soft tissue infections, and 1 of 1 urinary tract infection. In the evaluable infections caused by coagulase-negative staphylococci, 9 of 11 (81.8%) due to methicillin-susceptible and 15 of 17 (88.2%) due to methicillin-resistant strains responded to therapy. In particular, among patients infected by methicillin-susceptible, coagulase-negative staphylococci, 4 of 4 cases of septicemia, 0 of 1 case of endocarditis, 1 of 1 case of pneumonia, 1 of 1 case of peritonitis in CAPD, 2 of 3 infections of skin-soft tissue, and 1 of 1 urinary tract infection responded to therapy. Among patients infected by methicillin-resistant, coagulase-negative staphylococci were cured 5 of 6 cases os septicemia, 6 of 6 cases of peritonitis (in CAPD), 4 of 4 infections of skin-soft tissue, and 0 of 1 urinary tract infection.
The influence of tetracycline and cotrimoxazole on polymorphonuclear leukocyte (PMNL) chemiluminescence and adherence to nylon was investigated in vivo on healthy volunteers. A significant impairment of chemiluminescence and (although not statistically significant) an inhibitory effect on adherence to nylon was observed in subjects receiving tetracycline. Cotrimoxazole did not appear to have a significant influence on PMNL function.
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The results of a study on the incidence of nosocomial infections in a 1800 bed University hospital are reported. The study, carried out over a 9 months period, included: continuous microbiological surveillance, and a clinical and epidemiological survey. On the basis of the microbiological data collected and analyzed by a computer data system, developed and employed for the control of nosocomial infections, a weekly bed-to-bed survey was carried out by the staff of the Institute of Infectious Diseases. Among 2777 suspected nosocomial infections, as revealed by microbiological monitoring, 701 were confirmed after the bed-to-bed survey. The nosocomial infection rate was 6.75 per 100 discharges. It was higher in the surgical than in the medical wards (7.3 and 6 per 100 discharges, respectively). Nosocomial urinary tract infections were the most frequent (74.2%). The urinary infection rate was higher in the surgical than in the medical wards (5.3 and 4.6 per 100 discharges, respectively). Escherichia coli (19.4%), Pseudomonas aeruginosa (19.3%), Proteus spp. (18.4%) were the pathogens most frequently associated with nosocomial infections. They were followed by Klebsiella pneumoniae (7.8%) and Staphylococcus aureus (6.5%) in frequency. Among the risk factors, involved in nosocomial infections, the importance of catheterization was confirmed: among our patients with nosocomial urinary tract infections, 73.4% and 79.5%--in the medical and surgical wards, respectively--underwent urological instrumentation, mainly catheterization. An analogous and more detailed study is now in progress and will be extended in the next years.
Type 1 diabetes mellitus is thought to derive from organ-specific autoimmune reactions, probably triggered by environmental factors. In view of the possible involvement of mumps virus and reoviruses in the pathogenesis of autoimmune endocrine disease, serum antibody levels to these viruses were measured in newly-diagnosed diabetic patients aged 5 to 25 years and in matched control subjects. Diabetic patients showed a significantly lower prevalence and reduced titers of antibodies to mumps and reoviruses. By contrast, the antibody response to measles virus (a non-diabetogenic agent) was remarkably similar in the two groups. It is suggested that individuals with an impaired humoral response to some viral agents are at increased risk of developing diabetes when exposed to pancreotropic viruses.
IgG and IgM antibodies anti-Legionella pneumophila group 1 were detected by fluorescent-antibody technique according to Wilkinson et al. (1979) in the sera of 101 patients with pneumonia. Positive sera were tested by the same authors' modified technique (1981). Our results indicate a low specificity of the first method, since 43.7% of the IgG-positive sera and all the IgM-positive sera were negative when tested by the modified method. 8.9% of the sera were IgG-positive, confirming the relatively high diffusion of the microorganism. In none of the studied patients an increase on antibody titer or an IgM-positivity were observed; in none of the studied cases of pneumonia the aetiological agent was therefore Legionella pneumophila.
The authors assess the sensitivity and specificity of the antibody-coated bacteria assay for the localization of urinary tract infections. The results are compared with those obtained from cultures of urine samples taken from the upper tract either by ureteral catheterization or by direct puncture of the renal pelvis. In upper urinary tract infections the research of total immunoglobulins has proven positive in 71.4% of the cases; of the IgA class in 71.4%; of the IgG class in 57.1%; of the IgM class in 28.6% and of the secretory component of IgA in 60% of the patients. In case of lower urinary tract infections the research of total immunoglobulins was positive in 25% of the cases: that of the IgA class in 8.3%; of the IgG in 25%; of the IgM in 25% and of the secretory component of IgA in 22.2% of patients.
The results of a clinical and epidemiological investigation on the differential characters of hepatitis A, hepatitis B and hepatitis non-A, non-B (NANB) are reported. A more accurate nosological definition of NANB hepatitis has showed the following characters: on incubation period intermediate between hepatitis A and hepatitis B; transmission similar to hepatitis B; onset of the disease and clinical features similar to hepatitis A; jaundice of lower intensity than hepatitis A; lower IgM levels than hepatitis A; a remarkable tendency to evolve towards chronic liver disease, higher than hepatitis A and hepatitis B.
The research of specific IgM anti virus A (anti HAV-IgM), by absorbtion of IgG with Staphylococcus aureus A protein, has been conducted in the sera of 49 patients with acute hepatitis non B (HBsAg negative). Twenty-nine of these patients (59.2%) were anti HAV-IgM positive and therefore were diagnosed as viral hepatitis A, while twenty (40.8%) were anti HAV-IgM negative and were considered as non A-non B hepatitis. In the present work the practical utility of the detection specific IgM by absorbtion with A protein is discussed also in respect of the more expensive and less sensitive technique of gel fractionation of the sera. In addition our preliminary results document a decreasing incidence of viral hepatitis A in all the cases seen in the period 1978-1979. This event, which needs further investigations, could also be due to a more significant incidence of non A-non B hepatitis, probably as consequence of increasing drug-addiction.
In the present work the Authors report the results of the research of HAAb in 383 subjects living in Rome with negative history for hepatitis (divided for age, sex and occupation) and in 64 acute non B hepatitis (HBsAg-). In the latter, the titer of HAAb was determined at the beginning and later during the course of the disease. A fractionation of 13 sera of these patients was done and the type of specific immunoglobulin was determined. Among the subject with negative history for hepatitis, 68.9% was positive during first 6 months of age 6.2% from 6 months to 5 y.o., 27.6% from 6 to 12 y.o., 45.4% from 12 to 17 y.o., 76.8% from 18 to 25 y.o., 82.2% from 26 to 45 y.o., 90.2% from 46 to 65 y.o.. There was no statistically significant difference either between males and females, or among various occupations. Among the 64 patients with non B hepatitis, 25 (39%) were hepatitis A (because they showed either a seroconversion for HAAb or a positive HAAb-IgM); 12 (18.7%) were non A-non B hepatitis because HAAb negative or HAAb positive but negative for HAAb-IgM; while 27 (42.2%) were impossible to classify because they showed a positivity for HAAb but not a seroconversion during the disease. The limit of the determination of HAAb and the utility of the research of IgM antibody for the diagnosis of hepatitis A are discussed.
The HBeAg-HBeAb system has been studied by means of the microimmunodiffusion technique on agar in patients suffering from acute hepatitis at various stages of the disease, in patients with chronic liver diseases and in asymptomatic carriers of HBsAg. The results correlate the presence of HBeAg with the state of the disease (initial phase of acute or chronic hepatitis) and the presence of HBeAb with clinical cure of an acute hepatitis or with the condition of healthy carrier. It is a personal impression also that an HBsAg + hepatitis can be cured more rapidly the better the immune response expressed by the appearance of HBeAb, and that a lacking or deficient immune response to HBeAg may underlie the chronic course of the disease. Emphasis is also laid on the early disappearance of HBeAb in patients with acute hepatitis, this being matched by its persistence in asymptomatic carriers of HBsAg. In this regard, the first results reported here on the identification of the immune globulin class to which the HBeAb belongs would appear to confirm the hypothesis that the anti-e response is of IgM type in acute hepatitis and of IgG type in HBsAg carriers.