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Biomedical subjects

G Pastore

Publications and source records attributed to G Pastore.

At least 109 records · Page 6Linked to original sources
PubMed1995

P24 antigen detection, viral isolation, DNA-PCR and in vitro antibody production for the diagnosis of HIV-1 latent infection in heterosexual women at high risk for HIV-1 infection.

INTRODUCTION: The report of the existence of at-risk seronegative subjects, latently infected with HIV-1 and producing "in vitro" HIV-1 specific antibodies, prompted the authors to evaluate extensively twenty-five heterosexual HIV-1 seronegative women at high risk for HIV-1 infection. MATERIAL AND METHODS: The capability of peripheral blood mononuclear cells from such subjects to produce "in vitro" HIV-1 specific antibodies after pokeweed-mitogen stimulation, was studied. Silent HIV-1 infection was investigated by HIV-1 DNA PCR, viral isolation and serum p24 Ag detection at entry and after 6 and 12 months. RESULTS: Three seroconversions took place within 12 months, but no HIV-1 infections were found in the absence of detectable serum anti HIV-1 antibodies, even in subjects who apparently produced such antibodies in vitro. The antibodies produced in vitro by the seronegative women studied appeared of narrow specificity, reacting mainly with gp 160/120 envelope glycoproteins. CONCLUSIONS: A strong concordance was found between the serological status and the other markers for HIV-1 infection, suggesting that the phenomenon of HIV-1 "latent infection" is a very rare event, if it occurs at all. Seronegative women sexually exposed to the virus may produce in vitro anti HIV-1 antibodies of narrow specificity in the absence of other signs of infection and this phenomenon might be related to an anamnestic response to the virus.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Drug injection in jugular veins: a new risk factor for vascular diseases in HIV-infected patients? A case report.

The authors describe a rare case of diffused thrombosis of the superficial veins in the whole body and periphlebitis with perivascular abscesses in an human immunodeficiency virus (HIV)-infected drug abuser who was using neck veins to inject cocaine and heroin. In addition the patient presented oral candidiasis, hepatitis C virus infection, bronchopneumonitis, and endocarditis of the tricuspid valve with valvular failure. The conditions of the patient needed repeated vascular catheterizations for therapy administration. Similar pathologies, in HIV-infected patients, highly increase the risk of opportunistic infections, especially in the encephalic territory; in addition the need for vascular catheterizations represents a further risk factor for bacterial infections.

Abscess↗
PubMed1995

[The ethical and deontological aspects of quality inspection and control (QC) in imaging diagnosis. A problem too of professional training].

The major changes undergone by the health service structure in Italy have urged an organic and logical reconsideration of the relationship between health service resources and health needs, between competences and new patterns of organization. The primary units of the health service (USL), as actual enterprises, should undergo the control and rating of productivity and quality in the rational and fruitful use of available resources. The application of quality controls in health care (HCQC) to diagnostic imaging should be aimed at assessing of the performance of: the single procedures; the radiologist; the general practitioner or the non-radiologist specialist. These are obviously many indicators but the health care quality assessed by studying the structure of the process and of the result should not miss out: the sensitivity, specificity and diagnostic accuracy of the single imaging techniques; the ROC curves to assess the radiologist's performance; the predictive value, with known sensitivity and specificity, of the procedures, for the professional reliability of the non-radiologist physician. At present, QC indicators in diagnostic imaging cannot rule out the problem of a "radiologic training" of the non-radiologist physician to be able to correctly select the patients to be referred to diagnostic imaging. On the other hand, the radiologist should receive a "clinical training" for the rational use of the available techniques to address the clinical issues raised by the colleague, keeping in mind the cost-benefit factor. The "professional training" experience of the Istituto di Radiologia of the Universitá Cattolica del Sacro Cuore is reported. The instruction of the undergraduate students from the training course of specialization follows two patterns of "objectives" and "problems". The trainee directly participates in a structure and productivity project playing a major role in the transition from the technological, organizing and functional approach to the clinical management of the patients. These changes cannot be separated from their ethical and deontological implications. The ethical issue begins at the patient's bedside and does not end with technical quality and feasibility, and with the economical opportunity in taking a precise legal and deontological responsibility.

Diagnostic Imaging↗
PubMed1995

Treatment with natural IFN of hepatitis C patients with or without antibodies to recombinant IFN.

The purpose of this study was to evaluate if a retreatment with natural human interferon alpha could lead to a recovery of the therapeutic responsiveness in non-responder patients with chronic hepatitis C who did (9 cases) or did not (14 cases) develop anti-interferon neutralizing antibodies while on treatment with recombinant interferon alpha2a. During retreatment, no patient developed detectable levels of neutralizing antibodies to natural interferon. At the end of retreatment, 6/9 positive patients showed a complete response to natural interferon therapy, while only 1/14 negative patients had a partial response. These data suggest that a second course of treatment with the natural preparation may be useful in patients who failed to respond to an earlier course of recombinant interferon, particularly the anti-interferon positive patients who showed hepatitis reactivation after an initial response concomitantly with antibody appearance. Conversely, a second course of natural interferon therapy might be useless in cases in which the lack of response is not associated to antibody development.

Antibodies↗
PubMed1995

Cyclospora in AIDS patients: not always an agent of diarrhoic syndrome.

The present study reports the clinical features of two AIDS patients infected by Cyclospora. According to our observations, Cyclospora in AIDS can be responsible both for gastroenteritis and for asymptomatic infections with spontaneous rapid clearance. In addition, and undiagnosed circulation of this agent in Italy could be hypothesized: neither patient had a past history of foreign travel. These are the first two cases in AIDS described in Italy.

AIDS-Related Opportunistic Infections↗
PubMed1995

Intestinal microsporidiosis in AIDS patients with diarrhoeal illness in Apulia (south Italy)

Microsporidia are intracellular parasitic protozoa very common in immunocompromised patients in many parts of the world. There is a scarcity of data on the prevalence of these parasites in Italy. In this study we examined stool samples of 56 HIV+ patients with diarrhoea to find microsporidial spores, using the light microscopy Ryan modified trichrome stain. Microsporidia were found in one out of 56 patients, who was Cryptosporidium coinfected. Intestinal microsporidiosis seems to be less frequent in AIDS patients from Italy than in those from other countries.

AIDS-Related Opportunistic Infections↗
PubMed1994

The biological phenotype of HIV-1 is usually retained during and after sexual transmission.

The biological phenotype of HIV-1 isolates from 21 subjects with primary HIV-1 infection was determined in primary lymphocytes and monocyte-derived macrophages as well as in three T-cell lines (MT-2, HUT78, and C8166). Seven isolates (33%) replicated on at least one cell line and were classified as rapid/high (n = 6) or intermediate (n = 1), while 14 isolates (67%) did not replicate in cell lines and were classified as slow/low. All isolates replicated in primary monocyte-derived macrophage cultures. Studies on 10 pairs consisting of index case and seroconverting sexual partner showed that the biological phenotype of HIV-1 was unchanged in nine transmissions, including 5 pairs where a rapid/high virus was transmitted. Most individuals (5 of 6) infected by a rapid/high virus retained this phenotype after seroconversion. These individuals also had significantly lower CD4 lymphocyte counts 1-3 years after infection. Thus, in contrast to what has been suggested by others, we found that HIV-1 variants with rapid/high phenotype were usually not suppressed, neither during sexual transmission nor after seroconversion in the new host. These findings have important implications for the understanding of HIV-1 transmission and pathogenesis as well as for vaccine design.

Cell Line↗
PubMed1994

Body mass index defines the risk of seasonal energy stress in the Third World.

A method has been devised to quantify the effect of seasonal environmental stress on nutritional well-being and to estimate the proportion of Third World populations at risk of functional deterioration. An Index of Agro-Climatic Seasonality, IACS--a measure of potential agricultural biomass availability--has been developed from agro-climatic data. IACS was found to be highly correlated with the seasonal weight loss of adults in rural Third World communities. This relationship was then used to predict the existence and severity of seasonal energy stress incurred by the adult population of Third World countries at any given body mass index (BMI). The average weight loss recorded in all seasonality studies was calculated; this value was used to specify, in combination with BMI, a condition of moderate seasonal energy stress. This grade of energy stress involved a loss of about 2% fat-free mass. The risk of greater energy stress, with larger losses of lean tissue, was specified as severe when predicted weight changes exceeded the maximum losses of weight recorded--at any given BMI--in Third World rural communities. The global dimensions of seasonality were then calculated by enumerating the individuals who--by the combined criteria of the BMI and the IACS of the habitat--fell into the categories of moderate and severe seasonality risk. On this basis, 65% of the rural adult population in the Third World run the risk of at least moderate seasonal energy stress, while 45% fall into the severe stress category. Of these 25% qualify as true seasonal 'casualties' because their body weight loss shifts their BMI from the normal range of nutritional status into the category of chronic energy deficiency.

Agriculture↗
PubMed1994

[Relations between ventricular late potentials and ventricular arrhythmias in mitral valve prolapse].

BACKGROUND: The aim of the present study was to assess the prevalence and the clinical significance of ventricular late potentials in mitral valve prolapse. METHODS: Two hundred subjects (126 women and 74 men) with mitral valve prolapse, and a mean age of 37 +/- 17 years, were studied. Fifty eight per cent of them exhibited signs of mitral regurgitation at Doppler analysis of mitral flow. A 24-hour Holter recording and a signal-averaged electrocardiogram were performed in all the patients. Late potentials were considered present if the filtered QRS complex was > 110 ms and the root-mean-square amplitude in the last 40 ms of the filtered QRS was < 25 microV after 25 Hz filtering and respectively > 114 ms and < 20 microV after 40 Hz filtering. The duration of low-amplitude signals < 40 mV had to be > 38 ms. RESULTS: Ventricular late potentials were detected in 45 patients (22.5%) and were unrelated to subjects age, sex and electrocardiographic ST-T changes. Fourty one per cent of the subjects exhibited lown class > or = 3 ventricular extrasystoles at Holter ECG monitoring, while the remaining subjects (59%) had Lown classes < 3 ventricular arrhythmias. Complex ventricular arrhythmias were more common in the subjects who exhibited late potentials (55.5%) than in the remaining population (36.7%) (p < 0.03). A higher frequency of late potentials was found in the patients with mitral regurgitation (34.7%) than in those without (5.8%) (p < 0.0001). In the 55 subjects who manifested mitral regurgitation and complex ventricular arrhythmias, the prevalence of late potentials was 43.6%, while in the 61 without complex arrhythmias the prevalence was 26.6% (p = 0.05). CONCLUSIONS: In subjects with mitral valve prolapse the signal-averaged electrocardiogram allows to identify a subgroup of patients with more serious ventricular arrhythmias. Mitral regurgitation seems to be the main determinant of the arrhythmogenic substrate present in these patients.

Adolescent↗
PubMed1994

[Nonpalpable lesions of the breast. Diagnostic and therapeutic considerations].

The early detection of breast cancer is of primary importance, as one method which many reduce the unacceptably high mortality rate associated with this disease. In fact, it is well stated that the most concrete possibility of therapeutic success in the treatment of breast cancer is represented by early treatment, while the disease is still localized. Then a screening program is necessary in asymptomatic women, to diagnose the disease as early as possible even in case of non palpable lesion. Mammography is nowadays the most specific and sensitive investigation for clinically occult breast cancer. In this study we searched for mammographic findings with the best predictive value for cancer and we tested the most careful techniques for preoperative localization and surgical biopsy of nonpalpable breast lesions. Seventy-one asymptomatic women (age range: 31-76 years, mean: 53.6) underwent stereotaxic needle localization to perform surgical biopsy of mammographically suspicious but nonpalpable breast lesions. Mammographic findings were classified as: a) well defined and smooth bordered opacities (11.3% of cases); b) poorly defined, irregular, spiculated and stellate opacities (32.4% of cases); c) lowly suspicious microcalcifications, larger, rounder, fewer in number (19.7% of cases); d) highly suspicious microcalcifications, with irregularities on shape, density and size described as clustered and polymorphic (36.6% of cases). Cancer was found in 22 cases (31%); 12 of those (54.5%) were associated with highly suspicious microcalcifications, 10 of those (45.5%) were associated with stellate and poorly defined opacities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗