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Biomedical subjects

M Gentilini

Publications and source records attributed to M Gentilini.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Tuberculosis and HIV].

With the increased number of HIV infected patients, tuberculosis has become more frequent in Europe, USA and particularly in Africa. Impaired immunity, poor life conditions and high prevalence of tuberculosis in the general population facilitate the transmission of the disease. Tuberculosis is often seen early in the course of HIV infection and sometimes reveals the underlying immunodeficiency. Most of these cases are due to reactivation of earlier primo-infection when tuberculosis occurs later in the HIV disease, it may be secondary to a recent contagion. The infection may be localized in the lungs or in extrathoracic sites such as lymph nodes, liver, spleen, blood or meninges. The diagnosis is based on direct visualization of acid fast bacilli in gastric aspirate or BAL, on positive blood cultures or in histological findings which often show atypical granulomatous reaction without marked caseation. The role of the intracutaneous tuberculin test remain questionable as it often proves negative. A positive skin reaction can be useful for the diagnosis of tuberculosis, however, this is rarely observed. An early diagnosis is important in order to improve the prognosis and this justifies the frequent instauration of empiric treatment. The usual quadritherapy is efficacious and when started early permits in most cases a favorable outcome. The duration of treatment is poorly standardized but approaches 9-12 months in most instances. The drugs are not always well tolerated. A life-long maintenance therapy seems to have become necessary and primary prophylaxis might be of interest. The increased occurrence of drug resistant stains adds to the interest of preventing transmission, particularly in the hospital.

AIDS-Related Opportunistic Infections↗
PubMed1993

HIV-1-associated cognitive/motor complex: absence of neuronal loss in the cerebral neocortex.

We performed a postmortem morphometric study in six AIDS patients and six controls to determine if a neocortical neuronal loss occurs in HIV-1-associated cognitive/motor complex. Patients were selected during a prospective study including psychometric evaluation and neuroimaging, and none had focal lesions. Two had HIV-1-associated myelopathy with mild cognitive impairment, and four had HIV-1-associated dementia complex. Planimetry did not show any cerebral atrophy. Cortical thickness, mean neuronal size, and mean neuronal densities in Brodmann's areas 4, 9, and 40 were not statistically different in patients and controls. There were no significant changes in neuronal densities of columnar and laminar samples, indicating that there was neither global nor selective neuronal loss. HIV-1-associated cognitive/motor complex is not necessarily related to neocortical neuronal loss, but could be due to subcortical lesions or metabolic dysfunction.

Adult↗
PubMed1993

Intrathecal synthesis of beta 2-microglobulin and lysozyme: differential markers of nervous system involvement in patients infected with human immunodeficiency virus type 1.

beta 2-Microglobulin and lysozyme were determined in paired serum and cerebrospinal fluid samples from 137 patients, using immunofluorometry and ELISA, respectively. Of these patients, 54 were infected by human immunodeficiency virus type 1 (HIV1) (including 20 AIDS dementia patients), 73 were HIV1-seronegative with neurological diseases (meningitis (n = 10), multiple sclerosis (n = 29), other neurological diseases (n = 34)) and 10 were controls. Intrathecal synthesis of beta 2-microglobulin occurred in each group. Conversely, lysozyme intrathecal synthesis was found only in meningitis (10/10) and in HIV1-infection (24/54). A pathological increase in beta 2-microglobulin intrathecal synthesis (> or = 2 mg/l) was observed in 45 patients (34 HIV1-infected patients and 11 HIV1-seronegative patients with neurological diseases). Serum concentration and intrathecal synthesis of beta 2-microglobulin were correlated only in the 20 AIDS dementia patients. The cerebrospinal fluid beta 2-microglobulin and lysozyme concentrations were correlated in the 54 HIV1-infected patients only. Blood CD4 + T-cell count was correlated negatively with beta 2-microglobulin intrathecal synthesis but not with lysozyme intrathecal synthesis. These data suggest that in the absence of any central nervous system opportunistic process the increase of beta 2-microglobulin intrathecal synthesis (> or = 2 mg/l) may be a reliable marker of central nervous system involvement in HIV1-infected patients. Intrathecal synthesis of lysozyme was related principally to HIV1-encephalitis and central nervous system opportunistic processes.

AIDS Dementia Complex↗
PubMed1993

A new approach to combatting iodine deficiency in developing countries: the controlled release of iodine in water by a silicone elastomer.

OBJECTIVES: Four hundred million people or more may be exposed to iodine deficiency worldwide, in developing countries in particular. Because of the practical problems with existing methods for the large-scale prevention of iodine deficiency, the authors developed a new approach to collective prophylaxis. METHODS: This approach relies on the controlled diffusion of iodine into water from a silicone elastomer. Silicone matrices installed in a bore well released iodine at a rate sufficient to permit the daily per capita intake of at least 100 micrograms of iodine, the amount recommended by the World Health Organization. The matrices were tested over 1 year in a village in Mali, West Africa, an area in which goiter was highly endemic. The effects on the well water and population were compared with those of a placebo system in a control village. RESULTS: An increase in urinary iodine levels was observed in the treated population, and after 12 months the incidence of goiter had fallen from 53.2% to 29.2%. CONCLUSIONS: This new concept, adaptable to all sources of water supply, may contribute to the eradication of iodine deficiency.

Adult↗
PubMed1993

A randomized trial of ivermectin versus albendazole for the treatment of cutaneous larva migrans.

In an open study, we compared the efficacy of single doses of oral ivermectin (12 mg) and oral albendazole (400 mg) for the treatment of cutaneous larva migrans. Twenty-one patients were randomly assigned to receive ivermectin (n = 10) or albendazole (n = 11). All patients who received ivermectin responded and none relapsed (cure rate = 100%). All but one patient in the group receiving albendazole responded, but five relapsed after a mean of 11 days (cure rate = 46%; P = 0.017). No major adverse effects were observed. We conclude that a single 12-mg dose of ivermectin is more effective than a single 400-mg dose of albendazole for the treatment of cutaneous larva migrans.

Administration, Oral↗
PubMed1993

The phospholipids in Enterocytozoon bieneusi: an electron spectroscopic imaging study.

The treatment with ferriosmium of meronts and sporonts of the microsporidian Enterocytozoon bieneusi has shown the lamellar organization of the membranes of the endoplasmic reticulum and of the nuclear envelope. The Electron Spectroscopy Imaging (ESI), (Ottensmeyer and Andrew 1980) of unstained ultrathin sections of meronts showed the presence of phosphorus in the lamellar structures thus confirming their phospholipidic composition. Phosphorus was also detected in the lamellar polaroplast of the spore.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Prevalence of rheumatic manifestations in human immunodeficiency virus infection].

UNLABELLED: Various rheumatic manifestations have been reported in HIV infected patients, but the prevalence of these manifestations is not well known. Therefore, we have designed a prospective study to define the rheumatic manifestations in those patients. METHODS: 121 patients (stage IV of CDC classification) were assessed by physical examination and biological tests. RESULTS: arthralgia was found in 12.4%; painful articular syndrome occurred in 4.1%; arthritis was present in 6.6%; out of 8 cases of arthritis, only 2 had spondylarthropathy. The articular manifestations were mostly oligo- or polyarticular, rarely invalidating, sometimes recurrent. No septic arthritis, no myositis and only 1 case of vasculitis was found. Raynaud's phenomenon prevalence was 17.4%, 43% of which appeared after HIV seropositivity was known. Lacrymal hyposecretion assessed by Schirmer's test was found in 49.6%. However, this did not prove the existence of a Sjogren's syndrome as no histological examination was performed. Back pain reached 38.6%. Sciatic neuralgias were noted in 17.6%. Biological and immunological results were unspecific. Low levels of antinuclear antibodies were found in 11.1% cases. They were more frequently found when articular manifestations existed. A higher level of CD8 lymphocytes was also noted when articular manifestations were present. No statistical link existed between the different rheumatic manifestations. CONCLUSION: our results show that the prevalence of rheumatic manifestations in HIV infection is slightly increased (24.7%). This study is the first to emphasize the frequency of Raynaud's phenomenon and lacrymal hyposecretion in HIV patients.

Acquired Immunodeficiency Syndrome↗
PubMed1993

In situ hybridization of HIV-1 RNA in retinal vascular wall.

In situ hybridization of human immunodeficiency virus-1 (HIV-1) has been performed on eight eyes from eight distinct acquired immune deficiency syndrome patients (three cases had a normal fundus examination and five presented with cytomegalovirus retinitis). The eyes were removed at autopsy and frozen immediately. Contiguous 10-mu cryostat sections were obtained and tested with a HIV probe labeled by nick-translation with [35S]-ATP. HIV-1 RNA was detected in the retina of two acquired immune deficiency syndrome patients. The first positive case presented with typical ophthalmological and histopathological cytomegalovirus retinitis, the second one was not related to cytomegalovirus, according to clinical or histopathological classical criterias. HIV-1 was localized in retinal vascular walls. This shows that there is an active replication of HIV in retina of some acquired immune deficiency syndrome patients.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Soluble antigens of intra-erythrocyte stages of Plasmodium falciparum: diagnostic and vaccinal value].

A wide variety of soluble antigens also called exoantigens or excretory-secretory antigens are released by asexual blood stages of P. falciparum at the time of schizont burst and subsequent merozoite invasion. At present, most of these soluble malarial proteins have been purified and have had their genes cloned; the primary sequence displays considerable polymorphism upon tandem repeats. However, its function and the relevance of the polymorphism for the induction of host immune response, predominantly IgM and T-cell-independent type, has yet to be determined. The potential of P. falciparum exoantigens as immunodiagnostic tools has been the focus of numerous studies. Enzyme immunoassays or radioimmunoassays for the detection of malarial antigens in blood of suspected peoples have been reported. Their development requires increasing both specificity and sensitivity. Recently, some P. falciparum exoantigens have been proposed as candidates for inclusion in an anti-disease vaccine which induces a clinical but not parasiticidal immunity against malaria. There is much interest in this concept and their efficiency remains to be confirmed, as new strategies are needed in the prevention of malaria.

Animals↗
PubMed1993

Disseminated Penicillium marneffei infection associated with human immunodeficiency virus: a report of two cases and a review of 35 published cases.

Penicillium marneffei, a dimorphic fungus that is endemic in southeast Asia, causes deep-seated infection in humans and rodents. About 20 cases have been reported among the local populations of China, Thailand, and Hong Kong, and 35 cases have now been described in patients infected with the human immunodeficiency virus (HIV). We present a review of the literature and report two additional cases. Both immunocompromised and apparently immunocompetent hosts tend to develop disseminated, symptomatic infection. HIV-infected patients having travelled to southeast Asia and presenting with fever, skin lesions, hepatomegaly, adenopathies, or lung disease should be investigated for Penicillium marneffei infection. The diagnosis is based on the demonstration of the organism in clinical specimens. Treatment with amphotericin B or itraconazole is generally successful, but maintenance therapy is warranted for patients with an underlying immunodeficiency.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Cutaneous signs of dengue. Apropos of 3 cases].

We report three cases of dengue with cutaneous signs that were observed in three women returning from Asia (and that were confirmed by serology). The exanthem has common characteristics: progressive appearance beginning on thewer limbs, macula-type elementary lesion associated with purpura, evolution in one single upward spread, confluent lesions with intervals of healthy skin, palmoplantar affection, disappearance of the eruption in an average of ten days, association with conjunctivitis in three cases, pharyngitis in two, epistaxis in two and haematuria in one. The lesions spread to the trunk in one patient only and another patient had pruritus. None of the patients showed signs of a state of shock. According to WHO and, despite the existence of haemorrhages and of a purpura, the three cases reported here cannot be considered as being dengue haemorrhagic fever due to the absence of hemoconcentration. The two types of cutaneous signs observed during the fever are described and their physiopathology is discussed.

Adult↗
PubMed1992

[Visceral leishmaniasis. Diagnosis by western blotting].

Using Western blotting, antibodies directed against a 94 kiloDalton Leishmania antigen are detectable in the sera of patients with visceral leishmaniasis. The absence of these antibodies in the sera of patients with other leishmaniasis, protozoiases, helminthiases, and fungal or bacterial diseases, makes it a biological marker of visceral leishmaniasis, and gives this method its value in immunodiagnosis.

Antigens, Protozoan↗