[A proposal for the diagnosis, staging and therapy of epidemic Kaposi's sarcoma].
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Biomedical subjects
Publications and source records attributed to M Moroni.
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Drug addicts with persistent generalized lymphadenopathy displayed the following immunological abnormalities: an inverted OKT4/OKT8 ratio, a depressed in vitro blastogenetic response to phytohemagglutinin and pokeweed mitogen (PWM), a reduced ability of PMNL to phagocytose and kill Candida albicans spores and to migrate in presence of a chemotactic factor. Thymopentin treatment (50 mg s.c. 3 times/week for 3 weeks and repeated after 3 months at 50 mg s.c. once a week for 3 months) improved OKT4+ lymphocytes (p less than 0.05) and the blastogenesis to PWM (p less than 0.01); moreover, at the end of the first cycle, the chemotaxis of neutrophils was increased to normal values.
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Fosfomycin trometamol is a new fosfomycin salt with much improved intestinal absorbtion, thus providing high levels of the drug both in serum and urine. The range of activity and the pharmacokinetic characteristics of this new salt emphasize its usefulness in therapy of urinary tract infections (UTIs), either as a single dose or in short courses. In a multicentric, open, non-controlled trial, fosfomycin trometamol was employed in the treatment of 365 UTIs (84 males and 281 females, of whom 13 were pregnant). 144 UTIs were community acquired, while 221 were hospital acquired; 48 were diagnosed as asymptomatic bacteriurias, 201 as lower uncomplicated symptomatic UTIs, 49 as lower complicated UTIs, 59 as recurrent lower symptomatic UTIs, and 8 as cystopyelitis. The drug was administered as a single dose, i.e. 3 g at once, in 198 cases and in short courses, i.e. 3 g daily for 2-3 days (in a few patients, though, for 11 days) in 167 cases. High success rates were attained using the single dose in asymptomatic bacteriurias (78.1%), in lower uncomplicated symptomatic UTIs (89.5%), as well as in UTIs of the female (85.3%) and community-acquired UTIs (97.4%). In all these cases, the single-dose regimen seems to be the most rational form of clinical use, since the multiple-dose regimen did not add any further advantage. In infections of the male, or in hospital-acquired or complicated UTIs, short therapy courses gave better results. The drug was well tolerated, even by pregnant women, and clinically irrelevant side effects were recorded in a small number of patients.
The effect of thymopentin treatment on the immune defects in drug addicts with persistent generalized lymphadenopathy and HTLV-III infection was investigated. Thymopentin was administered subcutaneously at two different dose schedules: 50 mg three times a week for 3 weeks (first cycle) and 50 mg/week for 3 months (second cycle). After the first cycle an increased number of OKT4+ lymphocytes and an improvement of PWM-induced blastogenesis and IgG synthesis in vitro was observed. The second cycle was unable to modify the same immune parameters in vitro. The treatment had no effect on the PHA responsiveness and on PHA-induced interleukin 2 production. The significance and the prognostic value of these findings are discussed in terms of the clinical evolution of the syndrome.
Sera collected between 1978 and 1985 from 716 parenteral drug-addicts admitted to our Clinic with viral hepatitis were tested for antibodies to HTLV III. None of the patients was showing symptoms suggestive of LAV/HTLV III infection at the time of sera collection. Positivity for HTLV III antibody was found and confirmed (by ELISA) in 212 subjects (29.6%). The earliest positivity appeared in a serum sample collected in February 1979. These and other data point to Milan as to the actual source of the Italian PDAs-linked LAV/HTLV-III epidemic.
One hundred and sixty-seven clinically asymptomatic renal transplant recipients and 119 patients on chronic haemodialysis were studied for the presence of intestinal parasites and for the prevalence of anti-Toxoplasma gondii antibodies. Intestinal parasitic infections were more frequently found in transplant recipients than in haemodialysis patients and in controls. Among transplant recipients, the prevalence rate of T. gondii antibodies at high titres was significantly increased, but in these subjects the positivity rate of specific IgM assays was reduced. This seems to indicate a greater occurrence of asymptomatic reactivated infections. Our findings suggest that parasitologic surveys of immunosuppressed patients should be periodically performed also in temperate climates, in order to prevent the possibility of disseminated infections.
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To investigate the contribution of genetic susceptibility to infection with human immunodeficiency virus, 50 subjects with lymphadenopathy syndrome (LAS) and 7 subjects with acquired immunodeficiency syndrome (AIDS) and Kaposi's sarcoma were typed for HLA A, B, C, and DR antigens. The frequency of B35 was significantly higher in LAS patients who progressed to AIDS than in those who did not or in healthy controls. The association between DR5 and AIDS/Kaposi's sarcoma was also confirmed in these patients.
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