[Mepartricin versus placebo in the therapy of prostatic hypertrophy].
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Biomedical subjects
Publications and source records attributed to G Salvi.
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Since its first report in 1981, acquired immunodeficiency syndrome (AIDS) has attracted great interest among clinicians. Pediatric cases of AIDS were reported only two years later. Recently a review of the literature revealed about 300 pediatric patients with AIDS who are now tabulated separately by the Centers for Disease Control of Atlanta. The classification of the pediatric AIDS is based on epidemiologic, immunologic and virologic data. Subjects at risk include infants born to intravenous drug-addicted mothers and infants who have received blood transfusions or blood products. The diagnosis of pediatric AIDS may be established in a patient who has a polyclonal hypergammaglobulinemia and T-cell immunodeficiency associated with antibody to human immunodeficiency virus (HIV) or isolation of retrovirus.
The principle form of AIDS transmission are well known: sexually, blood and blood products, vertical transmission and in order to prevent HIV infections one must avoid these modes of transmission. Much has done to make more secure blood and blood products used for transfusions. It is furthermore, advised to those who must utilize intravenous drugs to employ the use of disposable syringes and more precisely, not to use the syringes of other persons. It is far more difficult to advise regarding the prevention of transmission of the virus through sexual contact, or to attempt to modify the sexual habits of certain categories of persons. Clearly, women with HIV infections should avoid pregnancy. Particular precautionary measures must be taken by those assisting patients with AIDS or HIV infections, thus avoiding infecting themselves and other patients.
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Our experiences at the "Centro di Profilassi Antirabbica" of the "Dipartimento di Pediatria" suggest to us some thoughts: though the seriousness of the lesions is important also for the patient's aestethics, mostly for girls, the physician must always take into consideration the infectious consequences of the bite itself. Among these bacterial infections mostly frequent enough are those overlapping the deepest wounds as the bites of cates are. Therefore adequate early preventive attendances (within the 24 hours) are necessary. The importance of prevention against rabies, luckily very rare in our country, but to be always afraid of and to be always taken into consideration because of its emotional impact, is to be highlighted.
We report a systematic-onset juvenile rheumatoid arthritis in an adolescent girl inadequately controlled by a prolonged course of conventional therapy. After ACTH in combination with elevated dosages of intravenous ascorbic acid therapy she rapidly improved, becoming afebrile. A complete clinical remission one month later was obtained, with no recurrences of the disease in five years followup. The excellent response to ACTH and ascorbic acid in our patient, suggests that a controlled trial of this therapy in juvenile rheumatoid arthritis should be considered.
Within the wide range of brain tumor types and their various radiotherapy treatments, quality assurance (QA) criteria play a major role. Attention should be paid to the definition of GTV, CTV, PTV, relevant to 3D stereotactic radiotherapy. In fact the need for delivering high doses with acceptable toxicity, requires an interdisciplinary evaluation of the clinical case as well as a millimetric precision and safety. Conventional treatments with collimated beams are however extensively studied and errors and deviations which may impact on treatment protocol, are identified. Possible GTV and CTV under-and overestimation is described by various authors who point out the useful support of sophisticated diagnostic and therapeutic equipment. It is stressed that follow-up helps in the reappraisal of the many items of a QA program to detect errors in set-up or implementation as well as possible inadequacies in the initial treatment planning.
External beam radiotherapy is a widely experimented treatment modality in prostatic cancer. Recently published studies have documented a close dependence of clinical results, in terms of local control and toxicity in particular, on radiation therapy quality. Efforts to improve results of conventional radiotherapy were directed towards the identification of new therapeutic modalities (conformal therapy, fast neutron radiotherapy, neoadjuvant hormonotherapy) as well as towards the optimization of treatment accuracy. In this respect, the following procedures have been particularly effective: 1. the systematic use of CT and retrograde urethrography in PTV definition; 2. immobilization systems which allow a significant reduction in positioning errors; 3. checks before and during treatment by "portal imaging" which allow the identification and correction of a relevant percentage of inaccuracies. The general evolution in treatment planning occurred in recent years has introduced into prostatic cancer radiotherapy new methods and calculation algorithms. While at present the use of new and at the same time complex techniques makes the need for quality assurance of radiation treatments increasingly critical, it is in any case a daily requirement even in most conventional routine treatments.
Infectious diarrhea is a common disorder in children in Italy, which may lead to hospitalization especially during infancy. In order to obtain data about epidemiology and clinic pictures of acute diarrhea, the carts of 1295 paediatric outpatients, hospitalized for this pathology in the time between 1990-1996 at the Children's Hospital "Meyer" of Florence, were analyzed. An offending organism could be isolate in 43.3% of patients; Rotaviruses are the leading cause of diarrhea, followed by salmonella spp. Furthermore the role of Campylobacter as common bacterial pathogen worldwide has been clarified.
The authors suggest an executive protocol for the infections due to the sting of a tick in a child. They report the experience they had observing 92 children in the period between spring and autumn in the year 1996.