Biomedical subjects
Publications and source records attributed to M Pastore.
Variations in tumoral markers (CA 125, CEA, AFP) in women with primary epithelial invasive ovarian cancer, after surgical operation for hysterectomy and chemotherapeutic treatment have been studied. The Authors stress the importance of alpha-fetoprotein monitoring in these women in order to evaluate a cytotoxic effect of the drugs used for the chemiotherapy on liver tissue.
The usefulness of the neutrophil blood cell count, the ratio of band forms to total neutrophils, the platelet count, the quantitative determination of serum IgM, C-reactive protein, alpha-1-acid glycoprotein and haptoglobin for the early identification of the serious neonatal infections was evaluated in 70 preterm newborns: 15 with sepsis, 2 with serious infections, 53 without infections. None of these tests has proved sensitive and predictive enough to be used as a single measure. The combination of 2 or more of them had improve the sensitivity (76.4%) and the predictive value of negative test (91.6%). The authors suggest that the greatest potential value of the tests is to exclude infections, with a more than 90% probability, if they are negative.
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Numerous studies have identified perinatal risk factors of neonatal sepsis. Some authors have attempted to develop a score system and have shown that babies with septicemia usually had a significantly higher score than healthy newborns and infants with other diseases. The aim of our study is to verify the validity of a scoring method based on the following items: maternal disease; e.g. diabetes, severe toxemia, infection; rupture of the membranes more than 24 hours before the delivery; foul-smelling amniotic fluid; complicated delivery; Apgar score less than 7; umbilical catheterization; respiratory distress and other neonatal diagnoses leading to operative procedures. We have evaluated four groups of babies, full-term AGA and SGA and preterm AGA and SGA, 84 with septicemia, 105 with other diseases and 210 healthy newborn infants. None of the perinatal risk factors or neonatal diseases was sufficiently predictive of neonatal septicemia. Only the incidence of umbilical catheterization was significantly higher (p less than 0.01) in preterm AGA (37.1%) and SGA (64.7%) babies with septicemia than in preterm healthy AGA (2.8%) and SGA (7.7%) babies; on the contrary, no statistical differences were found between preterm AGA (37.1%) and SGA (64.7%) infants with septicemia and preterm AGA (42.8%) and SGA (66.6%) infants with other neonatal diseases. A score of 1 was assigned for each of the considered items. In the full-term infants a score of 1 or less was found in 100% of the healthy infants. A score of 2-3 was found in 26% of the septicemic infants and in 42% of the infants with other diseases.(ABSTRACT TRUNCATED AT 250 WORDS)
All cases of neonatal bacteremia occurring at Neonatal Department of Pediatric Clinic, Catholic University of Rome, from January 1976 to December 1983 were examined retrospectively. Twenty-seven (30%) newborn infants with positive blood cultures for coagulase-negative staphylococcus were identified. Seven (25.9%) of the 27 infants were born at term, 4 AGA and 3 SGA; mean birth weight was 2,804 gm (range 2,280-3,670). All of these neonates had clinical evidence and laboratory signs of sepsis, and one had the cerebrospinal-fluid culture positive for coagulase-negative staphylococcus. In the remaining 20 infants (74.1%) the mean birth weight was 1,445 gm (range 810 - 2,400) and mean gestational age was 32 weeks (range 27 - 36). In 15 of the 20 preterm infants clinical signs of septicemia were associated with positive blood culture, and sixty percent of these had received an umbilical artery catheter. An half of coagulase-negative staphylococci isolated from our neonatal sepsis were DNAse-positive and/or phosphatase-positive and/or mannitol-positive. Two full-term infants, one with Down syndrome and one with cardiac malformation, died at 9 days and at 2 weeks of age, respectively. Three of 15 preterm infants with coagulas-negative staphylococcal septicemia died; deaths were among infants of very low birth weights and immature gestations who had severe respiratory syndrome. These data show that coagulase-negative staphylococcus can be important cause of septicemia in patients with compromised host defenses as newborn infants, and especially in the premature babies receiving invasive procedures.
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The metabolic basis and clinical application of the aminopyrine breath test (ABT) as a measure of liver function is reviewed in this article. Several papers have been published in the 20 years that have elapsed since the test was validated in man by Hepner and Vesell. Nevertheless, even if the aminopyrine breath test has been shown to be a non-invasive, reliable and semiquantitative liver function test with diagnostic and prognostic accuracy, it is not yet extensively used in clinical practice, probably because it is not widely known to clinicians. The aminopyrine breath test, like other newer tests (phenacetin, caffeine and erythromycin breath tests), allows the effects of drugs on hepatic cytochrome P-450 to be explored both in normal subjects and in liver patients. This interesting field of application is sure to expand the appeal of the aminopyrine breath test in the future.