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Biomedical subjects

M Moroni

Publications and source records attributed to M Moroni.

At least 145 records · Page 8Linked to original sources
PubMed1995

High prevalence of human T cell lymphotropic virus type II infection in patients affected by human immunodeficiency virus type 1--associated predominantly sensory polyneuropathy.

The etiopathogenesis of peripheral neuropathy (PN) that frequently affects human immunodeficiency virus (HIV) type 1-positive patients remains undefined. Forty-seven HIV-1-positive patients with PN (8 with inflammatory demyelinating polyneuropathy and 39 with predominantly sensory polyneuropathy [PSP]) and 266 controls with symptomatic HIV-1 infection without PN were screened for antibodies to human T cell lymphotropic virus (HTLV) types I and II. The prevalence of antibodies to HTLV-II was significantly higher in patients with PSP than in controls (30.8% vs. 8.3%; P < .001). All seropositive patients with PN had HTLV-II DNA in their peripheral blood mononuclear cells by polymerase chain reaction (PCR) analysis. PCR analysis of tissues from 1 patient with PSP who died during the study showed HTLV-II proviral sequences in the femoral nerve and basal nuclei. These results support the hypothesis that HTLV-II represents an etiologic factor in the pathogenesis of a considerable proportion of PSP in patients infected with HIV-1.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Bacterial pneumonia in adult patients with HIV infection.

Patients with HIV infection are at increased risk for community-acquired bacterial pneumonias, due in part to their defects in B-cell function. Streptococcus pneumoniae is the commonest cause of community-acquired pneumonia, with the second most common bacterial agent being Haemophilus influenzae. These two organisms account for about two-thirds of community-acquired bacterial pneumonias. Frequently bacterial pneumonias appear difficult to distinguish from Pneumocystis carinii pneumonia or other opportunistic lung infections, because of their atypical clinical and radiologic presentations. Community-acquired pneumonias may be recurrent but have low fatality rates. In comparison, nosocomial pneumonias occur primarily in patients with AIDS and are usually due to Staphylococcus aureus, Pseudomonas aeruginosa and other aerobic gram-negative bacilli. Nosocomial pneumonias have high fatality rates. S.aureus is an important cause of morbidity and mortality in patients with AIDS and has emerged as a secondary opportunist in lungs of patients with opportunistic diseases. While appropriate laboratory study is being done, empiric antibiotic therapy should be directed against the microorganisms above described.

AIDS-Related Opportunistic Infections↗
PubMed1995

Increase of plasma transforming growth factor beta (TGF beta) during immunotherapy with IL-2.

Interleukin-2 (IL-2) is a lymphokine with pleiotropic activities on the immune system. When administered in vivo, besides inducing unrestricted tumor cytotoxicity, it is also responsible for the secondary release of other lymphokines, such as IL-1, TNF, and marrow growth factors, which may mediate some of the clinical toxicities (as well as therapeutic effects) seen during IL-2 immunotherapy. Among the clinical effects of IL-2, we previously reported thrombocytopenia and IL-2-induced in vitro inhibition of platelet aggregation accompanied by rapid secretion of alpha-granule components such as platelet factor 4 (PF4) and beta-thromboglobulin. Platelets constitute one of the largest storage forms of TGF beta. Preliminary evaluation of this factor in patients receiving IL-2 had indicated that plasma TGF beta activity increased in cancer patients following IL-2 therapy. We report a more detailed study of the quantitation of TGF beta activity in the plasma of 23 cancer patients treated with IL-2 immunotherapy. Of interest, we found that although elevation of the bioactive form of TGF beta occurred in most patients during IL-2 therapy, it was significantly higher in patients with clinical regression of tumor (p = .004). In the first 2 weeks of therapy increase of plasma TGF beta activity appeared to correlate with a decrease of platelet counts, suggesting that the factor may derive from the storage form of TGF beta contained therein.

Adult↗
PubMed1995

[Transurethral needle ablation (TUNA) of the prostate: preliminary results].

A multicentric prospective study was designed in Italy to verify the efficacy and the safety of TUNA-BPH patients treatment. The study is co-ordinate by Progress in Urology Association was started in January 1994. Thirty five patients were treated (Mean age 68.4 +/- 4.1 aa). All patients were selected and evaluated to respect the recommendations of the International Consensus Committee (Paris 1993). The procedure was performed with lidocaine 2.5% urethral gel, oral intake of 10 mg of diazepam and steroidal antiphlogistic drugs 1 hour before treatment. Maximal number of prostatic lesions were 6; in 2 BPH initial cases were done 2 lesions alone. The treatment was interrupted at the third lesion in 2 patients because uncomfortable. Hematuria was observed in all patients, but it was resolved within 12 hours. Irritative symptoms were referred by 10 patients (28.6%) and they spontaneously were insignificant within 24 hours. One patient had an acute prostatitis. In 15 patients (42.6%) was necessary to put a suprapubic cystostomy, but all except one voided within 36 hours. We noted narrow connection between prostatic lesions number and urinary acute retention after TUNA. The average follow-up is 3.2 months (range 0.5-6). At the follow-up urine culture was always negative and PSA values increased in the first month. The value of PSA was always higher than pre-treatment, but from 1 month to 3 months progressively reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1995

Sarcoidosis following beta-interferon therapy for multiple myeloma.

Some reports correlate the administration of all forms of interferon with the development or exacerbation of autoimmune phenomena and diseases, including sarcoidosis, because of the strong and complex immune action of interferons. We report on a case of sarcoidosis following beta-interferon treatment for multiple myeloma. Differently from what had been observed in all the 8 previously reported cases of associated multiple myeloma and sarcoidosis, where the plasmacellular malignancy followed the onset of the respiratory disease, in the case of our patient, sarcoidosis arose after multiple myeloma was first diagnosed.

Female↗
PubMed1994

The syndrome of acquired glucocorticoid resistance in HIV infection.

A certain number of HIV-infected patients (about 17% in our series) manifest symptoms of cortisol resistance--weakness, weight loss, hypertension, chronic fatigue and intense mucocutaneous melanosis--symptoms which are also typical of Addison's disease. The diagnosis of cortisol resistance is determined through the increased plasma and urinary cortisol values and limited increases in ACTH values. Compared with patients with primary glucocorticoid resistance, AIDS patients have no symptoms of mineral-corticoid or androgen excess, only of glucocorticoid deficiency at target tissues. Mononuclear leukocytes from these patients show receptor changes which consist of an increased receptor number and decreased receptor affinity for glucocorticoids. They also show defective glucocorticoid-induced inhibition of [3H]thymidine incorporation. Glucocorticoid-resistant AIDS patients have a characteristic persistent increase in interferon-alpha production. The inverse correlation between plasma values of interferon-alpha and the receptor affinity for glucocorticoids clearly suggests that interferon production is regulated by the glucocorticoid receptor: the smaller the glucocorticoid effect on lymphocyte cells is, the greater interferon production is. Owing to the antiviral effect of interferon-alpha, it is possible that glucocorticoid-resistant AIDS patients have greater defences against viral infection than other AIDS patients. As interferon-alpha is melanogenetic, its increased production may also explain the intense skin pigmentation found in patients with the glucocorticoid-resistance syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Allopurinol mouthwashes in the treatment of 5-fluorouracil-induced stomatitis.

This study was aimed at assessing the efficacy of allopurinol mouthwashes in the treatment of 5-fluorouracil-induced stomatitis. A randomized double-blind, placebo-controlled trial was thus designed to test its efficacy to treat oral mucositis in advanced cancer patients receiving 5-fluorouracil-containing chemotherapy. There were 44 patients randomized to receive allopurinol mouthwashes, or placebo, as soon as mucosal lesions were observed during any treatment cycle. Stomatitis was evaluated at the end of each 5-day treatment cycle. Allopurinol mouthwashes resolved stomatitis in 9 of 22 treated patients (40.9%), and diminished its intensity in 10 more patients (45.4%); stomatitis resolved completely in none of the 22 patients, and partially in 3 patients in the placebo group (p < .001 by chi 2 test). Duration of symptoms was also significantly different between the two groups (median: 4 days for the allopurinol group, 7.5 days for the control group; p < .0005 by Student's t-test). In conclusion, our results suggest that allopurinol mouthwashes can be effective to treat 5-fluorouracil-induced stomatitis.

Adult↗
PubMed1994

Metachronous occurrence of seminoma and Hodgkin's lymphoma in the same patient with late-onset colon cancer.

Testicular cancer and Hodgkin's disease are two malignancies sharing many epidemiological similarities, including age class and geographical distribution. However, the association of these tumours in the same patient is an exceptional event; to date, only 14 metachronous and three synchronous cases have been described in the literature. We report on a case of testicular seminoma and Hodgkin's lymphoma association, with the additional occurrence, nearly 20 years later, of a colon carcinoma.

Adult↗
PubMed1994

Computerized cry analysis in infants affected by severe protein energy malnutrition.

A new method of computerized cry analysis has been utilized to evaluate the cries of infants affected by severe protein energy malnutrition. We studied 17 Kenian babies affected by severe malnutrition for more than four months (9 cases of marasmus and 8 of kwashiorkor) and a control group of 17 well-nourished babies. The cries of the malnourished children showed lower inter-utterance variability, formants' frequencies and cry score, assigned by the Infant Cry Modulation Assessment Scale. The melodic pattern was more often flat, rising or falling-rising, when compared to the cries of the well-nourished babies. We hypothesize that these differences reflect the state of brain damage associated with protein energy malnutrition. No differences were found between the cries of infants affected by marasmus and those affected by kwashiorkor, between the cries recorded before and after nutritional therapy and between the first cries of malnourished children who subsequently died during hospitalization and those of infants who survived.

Acoustics↗
PubMed1994

Severe abdominal pain in patients with AIDS: frequency, clinical aspects, causes, and outcome.

BACKGROUND: The exact prevalence of abdominal pain in AIDS patients, as well as the entire spectrum of causative disorders, has not yet been well defined. In addition, the existing data derive almost exclusively from surgical series describing only those patients who have undergone emergency surgical procedures. METHODS: We reviewed our experience with patients presenting with severe abdominal pain from a large series of non-selected consecutive AIDS patients seen at our institution over a period of 4 years. RESULTS: Of 458 patients, 71 (15%) had severe abdominal pain, and its occurrence was associated with a reduced patient survival. Specific diagnoses were made premortem in 42 patients (59%), potential causes of pain were identified at postmortem examination in 23 patients (33%), whereas no specific causes were found in 6 patients (8%). Most of the causative disorders (65%) were AIDS-related, whereas HIV-independent pathologic conditions were found in only 18% of the patients. The predominant site of pain, combined with a few key symptoms, had a high predictive diagnostic value in nearly half of the patients. The indications for emergency laparotomy were limited and substantially similar to those of the non-HIV population. CONCLUSIONS: Severe abdominal pain frequently complicates the course of AIDS, and its occurrence is associated with reduced survival. In most patients it is due to disorders closely associated with the HIV infection. Specific causes of pain may be identified in most of the cases by an appropriate diagnostic evaluation.

AIDS-Related Complex↗
PubMed1994

Mycobacterial infections in AIDS: an overview of epidemiology, clinical manifestations, therapy and prophylaxis.

One of the most frequent complications of AIDS is Mycobacterial infections. The incidence of tuberculosis has dramatically increased in all countries as a result of the HIV epidemic. Lately, it has been found that the natural history of new Mycobacterium tuberculosis infection is accelerated by HIV disease. In a wide number of cases the emergence of Mycobacterium tuberculosis nosocomial outbreaks of drug-sensitive and drug-resistant strains has been reported in HIV infected patients. The inadequate efforts to provide complete therapy to this kind of patient has caused the emergence of multidrug-resistant tuberculosis, that is responsible for the increased mortality rate in AIDS patients. A renewed interest in mycobacterial infections has also been kindled by the occurrence of Mycobacterium avium infections in patients with acquired immunodeficiency syndrome. The role of Mycobacterium avium as a pathogen is actually confusing and controversial for clinicians who care for AIDS patients. Disseminated Mycobacterium avium infections occur in a high population of HIV infected patients with low CD4+ cell count. Recent studies reported that rifabutin significantly reduced the incidence of Mycobacterium avium bacteremia, although, new macrolides such as clarithromycin and azithromycin are also effective in the treatment of the infection. Therefore, because of the emergence of macrolides resistance, the use of combination therapy is highly recommended in the Mycobacterium avium infection management.

AIDS-Related Opportunistic Infections↗
PubMed1994

Long-term follow-up of zidovudine therapy in asymptomatic HIV infection: results of a multicenter cohort study. The Italian Zidovudine Evaluation Group.

In 1990 the results of a placebo-controlled study conducted within the AIDS Clinical Trials Group (ACTG 019) showed that in the short term, zidovudine was effective in slowing progression to advanced disease in HIV-infected asymptomatic patients with low CD4 cell counts. More recently, the preliminary results of the Concorde Trial suggested that while the data at 1 year agreed with those of ACTG 019, no sustained clinical benefit was detectable at 3 years for early versus deferred therapy. Therefore, the length of the clinical usefulness of zidovudine in this population is still to be determined. We evaluated the 2-year outcome of zidovudine therapy in asymptomatic patients through the prospective follow-up of a cohort of 936 subjects with low CD4+ (< 500/mm3) counts who strictly satisfied, at enrollment, the inclusion and exclusion criteria of the ACTG 019 trial. The clinical end point of the analysis was the development of AIDS. The majority (72.2%) of the individuals in the cohort acquired HIV infection through intravenous drug use; 26.6% were women. The median baseline CD4 cell count was 308/mm3. At 55 weeks of mean follow-up, the progression rate to AIDS (3.2 events per hundred person-years) appears to be comparable to that already reported at the same mean follow-up time for the ACTG 019 zidovudine-treated asymptomatic patients. After 124 weeks of mean follow-up, the overall rate of progression to AIDS was 5.2 per hundred person-years.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1994

Low doses of alpha 2B interferon in the treatment of hairy cell leukemia: results of treatment and mean follow-up at 18 months in 13 patients.

We treated 13 Hairy Cell Leukemia patients with rIFN a 2b. In case of complete/partial response, the patients were submitted to maintenance treatment, while, in case of minimal/no response, a second induction cycle was administered, followed by a maintenance one. The patients were followed, on an outpatients basis, for 18 months at least, obtaining a 100% overall response rate; one patient had complete response, 7 had partial response, and 5 only minimal response. Six patients (46%) relapsed an average of 13 months after the end of the treatment. The utility of a maintenance therapy is discussed.

Adult↗