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Biomedical subjects

M A Romeo

Publications and source records attributed to M A Romeo.

At least 37 records · Page 2Linked to original sources

Immune status and immune response to diphtheria-tetanus and polio vaccines in allogeneic bone marrow-transplanted thalassemic patients.

We evaluated the immune status against diphtheria (D), tetanus (T) and polio viruses (PV) and the immune response to re-administration of the respective vaccines in a series of 23 transplanted homozygous beta-thalassemic patients, aged 5-17 years (mean age 12.1 +/- 3.1 years). They had been given compulsory DT toxoids and types 1, 2 and 3 PV vaccine in infancy and had been successfully submitted to allogeneic BMT 2-6 years previously. Prior to revaccination, a high percentage of subjects (from 48% for type 2 PV to 83% for D) had antibody levels below the protective levels and low geometric mean titers (GMTs). After revaccination (three doses of DT toxoids and of inactivated PV vaccine) the percentage of subjects with protective levels of antibodies rose to 86-100% and the GMTs increased markedly. We conclude that: (1) the protection afforded by compulsory DT and PV vaccines administered in infancy is almost entirely lost in beta-thalassemic patients for several years after BMT, (2) revaccination is necessary in these subjects, and (3) at least three doses of DT and PV vaccines must be administered to recover adequate protection.

Adolescent↗

Prenatal diagnosis of thalassemia: the viewpoint of patients.

Twenty-eight young people with thalassemia major expressed their opinion about prenatal diagnosis. All of them stated that they intended to marry and have children; thirteen of them (46 per cent) said that they would have also accepted a thalassemic carrier as a partner and that if married to a carrier they would have undergone prenatal diagnosis and selective abortion. All but one refused the prospect of an affected child. When asked if they would have preferred that before their birth their parents had undergone prenatal diagnosis and abortion, 19 patients (68 per cent) gave an affirmative answer. These results clearly indicate that even people affected by thalassemia major, who are the potential victims of prenatal diagnosis and selective abortion, largely accept prenatal diagnosis as a means of preventing their disease.

Abortion, Induced↗

Immunological changes in beta-thalassemia major patients positive for HTLV-III antibodies.

Antibodies to HTLV-III were found in 6 of 206 Sicilian patients with thalassemia major, aged 1 to 30 years. None of the patients showed clinical signs related to immuno-deficiency syndromes. Immunological investigations carried out in all positive patients showed alterations similar to those found in thalassemic patients without antibodies to HTLV-III. These immunological changes could not depend on the HTLV-III infection, but could be related to the thalassemic condition.

Adolescent↗

Leukocyte alkaline phosphatase (LAP). A useful marker of zinc status in beta-thalassemic patients.

Intensive desferrioxamine treatment may negatively affect zinc stores in thalassemic patients. Two groups of young thalassemic patients, with good and poor compliance to desferrioxamine treatment, and a control group were investigated. Leukocyte alkaline phosphatase (LAP), zinc content in neutrophils, plasma zinc levels, and urinary zinc excretion were determined. LAP score, and neutrophil zinc and plasma zinc levels of the good compliance patients were statistically lower than those seen in the controls and in the poor compliance patients. Urinary zinc excretion was statistically higher in good compliance patients than in controls and poor compliance patients only during high-dose intravenous desferrioxamine. On the contrary, poor compliance patients had LAP scores, neutrophil zinc, plasma zinc, and urinary zinc excretion values within the normal range. We conclude that high-dose desferrioxamine produces a reduction of zinc stores in thalassemic patients. LAP scores determinations, which are a reliable and inexpensive marker of body zinc, could become a routine test for monitoring thalassemic patients undergoing hypertransfusion programs.

Adolescent↗

Intravenous digital subtraction angiography by peripheral injection.

We describe a technique for performing intravenous digital subtraction arteriography by peripheral injection and review our experience of 504 studies in 469 patients. The technique gave adequate opacification for anatomical definition of vessels in 93% of patients studied and was suitable for studies of the pulmonary arteries and left ventricle as well as the major systemic arteries. The chief causes of failure were impaired cardiac performance (2.4%) and poor patient cooperation (1.4%). Premature termination was caused by angina pectoris in 1.6% of our cases. These limitations apply also to central venous injection.

Adult↗

[Prevalence of anti-LAV/HTLV III antibodies in groups at risk of infection and in donors blood in the province of Catania].

The prevalence of anti-LAV/HTLV III antibodies in serum samples of individuals at high risk for AIDS and of healthy individuals living in the province of Catania is reported. Serum samples were collected over the period 1983-86 from 220 drug addicts adults, 339 from multitransfused thalassemia patients, 71 from hemophiliacs, 22 from subjects of the hospital staff who had had contacts with positive subjects, 9 from family contacts of positive multitransfused thalassemics and 7270 from blood donors. Prevalence of antibodies among drug addicts was 14% and a positive subject was found as early as 1983. This result suggested that LAV/HTLV III was already present in Catania at that year. Among the thalassemics and the hemophiliacs the prevalence was 2.3% and 21% respectively. No positive subject was found among hospital staff nor among family contacts of positive thalassemic subjects. Three positive cases have been found among the blood donors and even though these are drug addicts, it is important to underline the necessity of a regular screening of the blood units to prevent LAV/HTLV III diffusion.

Adult↗

Microbiological basis for the use of fosfomycin trometamol as single-dose therapy for simple cystitis.

Fosfomycin trometamol (FOT), a new soluble salt of fosfomycin, was developed especially for single-dose treatment in uncomplicated urinary tract infections. In this study, the minimum inhibitory concentrations (MICs) of FOT were measured both in nutrient broth and human urine and compared with calcium fosfomycin, pipemidic acid and cotrimoxazole. A total of 300 bacterial strains of different species from recent urinary infections were studied. Staphylococcus aureus showed the lowest MIC (0.38 micrograms/ml) and Pseudomonas spp. the highest (50 micrograms/ml) with fosfomycin salts in nutrient broth. The MIC of fosfomycin resulted in being higher than those for pipemidic acid and cotrimoxazole against Escherichia coli and Proteus rettgeri and lower for all the other species considered. The MIC values increased about ten times when urine was used as medium. No differences were observed between the two fosfomycin salts. The fosfomycin concentrations of 137-1500 micrograms/ml, easily obtained in urine of healthy adult subjects after a single dose of FOT (3g of fosfomycin), were able to kill all the strains, with the exception of Streptococcus faecalis. The bacterial adhesion of a resistant microorganism (P. aeruginosa) to the cells of the urinary tract, showed a 50% reduction after FOT treatment.

Bacteria↗