Ofloxacin in the treatment of genito-urinary tract infections.
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Biomedical subjects
Publications and source records attributed to L Minoli.
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Recent evidence would suggest that HTLV-III may be neurotropic. We have found oligoclonal IgG bands by isoelectric focusing in the CSF of a homosexual man with AIDS and encephalitis. Subsequent analysis revealed that such bands contained anti-HTLV-III activity, suggesting that neurologic symptoms in AIDS patients may be caused by replication of HTLV-III inside the CNS.
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Chromosome analysis in a 31-year-old woman referred for primary amenorrhea, revealed a very high incidence of chromosome aberrations. She had microcephaly and immunodeficiency. Her healthy parents were consanguineous (1/32) and a younger sister, also with primary amenorrhea, died when 20 years old with a malignant lymphoma. Chromosome studies were performed on lymphocytes and fibroblasts and in both tissues a high proportion of metaphases with multiple chromosome aberrations was found. Clonal and sporadic rearrangements, consisting of balanced and unbalanced translocations and dicentric chromosomes were more numerous than chromatid and chromosome breaks. In the lymphocytes the same unbalanced translocation t(8q;21q) was present in about 59% of the metaphases. Rearrangements involving chromosomes 7 and 14, similar to those described in patients with ataxia-telangiectasia were found, but with a lower frequency. Sister Chromatid Exchanges were not increased. Chromosome and chromatid abnormalities were enhanced after exposure of cells to mitomycin C but not after exposure to the radiomimetic drug bleomycin. Clinical and cytogenetic characteristics of the patient are compared with those of syndromes (Ataxia-Telangiectasia and Werner's syndrome) or isolated cases (Weemaes et al. 1981, Sperling 1983, Spinner et al. 1985) whose features are similar to those of our patient. This case might represent a new chromosome instability syndrome due to a recessive mutation.
In this study we report about the efficacy and tolerability of ceftazidime in the treatment of 10 cases of pseudomonal meningitis (nine Pseudomonas aeruginosa and one Pseudomonas cepacia). The 10 patients had a pseudomonal infection of the central nervous system (CNS) complicating neurosurgical procedures or developed on a preexisting immunodepressing condition; four patients were of pediatric age. All isolates were sensitive to ceftazidime with MICs ranging from 0.39 to 3.12 micrograms/ml. Ceftazidime was given intravenously at the dosage of 100-150 mg/kg/day. In seven cases amikacin was associated by intralumbar or intraventricular instillation. The duration of ceftazidime treatment ranged from 9 to 49 days with a mean of 22.2. Eight cases out of ten were cured bacteriologically and clinically, while the remaining two were cured after treatment with other antibiotics. Concentrations of ceftazidime in serum and in lumbar and/or ventricular cerebrospinal fluid (CSF) were obtained in four cases; the mean concentration in lumbar CSF was 12.2 micrograms/ml and in ventricular 3.3 micrograms/ml. The study demonstrated that ceftazidime is effective in the treatment of Pseudomonal meningitis.
Since its early diagnostic application in the study of pregnancy, ultrasonography (US) has been widely employed in the detection of fetal malformations. Head abnormalities, recognized through the evaluation of brain and skull structures, accounted for the majority of these observations. We report here on a case of holoprosencephaly, a rare malformation (incidence is around 1/16,000 live births according to Roach et al. [1975]) diagnosed and monitored up to delivery by multiple US examinations.
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Leptospirosis is still endemic in the Po valley. It has an extremely protean clinical picture. In a series of 79 cases diagnosed at Pavia in the period 1970-79 hepatonephritic forms were the most common (29.1%), followed by febrile or pseudo-influenza forms (25.3%), hepatitis (20.2%), nephritis (17.8%), and meningitis (7.6%). Febrile hepatonephritis was always accompanied by the most severe pictures. Timely antibiotic management with penicillin or ampicillin, and above all the early use of peritoneal dialysis (carried in 10 subjects) enable a final cure to be obtained even in these cases. The only death in that series did not appear to be ascribable to the disease itself.
Among 210 cases of imported malaria, officially notified in Lombardy from 1976 to 1980, we have selected 142 hospitalized patients and, about these, we got detailed informations on the stay in malaria endemic areas, on chemoprophylaxis and on their principal clinical data. We have found statistically significant correlations between P. falciparum infection and all the most frequent values in every class of epidemiological parameters considered, particularly with provenience from tropical African countries, touristic motivation, stay less than 30 days in winter season, onset of the illness within 20 days after the return in Italy, diagnostic lag shorter than 10 days after the onset and fever remission 2 or more days after starting specific treatment. There is also a tight correlation between these clinical parameters and the absence of individual chemoprophylaxis. The definition of these factors of risk is particularly useful to plan out some programs of prevention that should managed by regional Centers.
Morphological, cytochemical and ultrastructural studies of mast cells were carried out in a patient affected with systemic mastocytosis. Neoplastic mast cells showed morphological features between classic tissue mast cells and circulating basophils. They showed strong granule metachromasia after toluidine blue, faint positivity to Hotchkiss reaction, strong positivity to chloroacetate esterase, while they were negative to alkaline phosphatase. Ultrastructural observations showed heterogeneity of granules, most of which had homogenous fine dotted contents. The origin and linkage between mast cells and circulating basophils are discussed.
The diagnostic protocol for lymph node toxoplasmosis presented in this study is based on the following sequence: 1. specific serologic tests (IHAT, IFAT, IgM-IFAT) on total serum and on purified IgM serum fraction, performed twice, within a time interval of 21-28 days; 2. Lymph node biopsy for histologic studies and for isolation of the parasite in mice (biologic test). A critical analysis is reported for 20 cases submitted to this protocol in the course of the year 1980.
Programs to prevent congenital toxoplasmosis based on the evaluation of serologic tests can be performed at three periods: 1. before pregnancy (serologic, epidemiologic screening of "at risk" women); 2. during pregnancy (detection by seroconversion); 3. at delivery (diagnosis of evident or latent congenital infection). The screening devices, the IHA, IFA, and IgM-IFA tests, should be performed first and after 3 weeks possibly repeated. During pregnancy the observation of seroconversion or, in any case, an increase in serologic titer at the second blood withdrawal and, at delivery, high serologic titers are signs of fetal risk. The significance of the data has furthermore to be evaluated by specific IgM quantification on pure serologic fractions and by in vivo isolation of Toxoplasma gondii from amniotic fluid, placenta, or the newborn CSF, blood, and/or tissue. This data may suggest the necessity of therapeutic termination of pregnancy or application of a specific chemoprophylaxis/chemotherapy.
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