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Biomedical subjects

M Rinaldi

Publications and source records attributed to M Rinaldi.

At least 163 records · Page 9Linked to original sources
PubMed1994

Infections due to Cunninghamella bertholletiae in patients with cancer: report of three cases and review.

Limited information is available regarding the pathogenesis and clinical manifestations of infection with Cunninghamella bertholletiae. In this report, we describe the clinical courses of three patients with leukemia and fatal C. bertholletiae infection and review the literature. In all patients, the infection developed in the setting of severe neutropenia following high doses of cytotoxic chemotherapy. Clinical presentation always consisted of fever and pneumonia and could be associated with dissemination to numerous organs. The course of infection was very rapid, and the diagnosis was made around or after the time of death. The most important risk factors for C. bertholletiae infection described in the literature include corticosteroid administration and prolonged severe granulocytopenia. Four infectious syndromes due to Zygomycetes have been described: rhinocerebral, pulmonary, cutaneous and soft tissue, and disseminated. The outcome of disseminated infection with C. bertholletiae has been almost uniformly fatal. Most previously described patients, however, did not receive aggressive treatment consisting of amphotericin B administration, resection of infected tissues, and, most importantly, control of the underlying disease.

Aged↗
PubMed1994

Successful treatment of systemic and local infections due to Exophiala species.

We report the successful treatment of three cases of infection due to Exophiala species. These organisms belong to the heterogeneous group of dematiaceous (darkly pigmented) fungi. Two cases of infection occurred in organ transplant recipients who were receiving immunosuppressive medications. Both of these infections remained localized to the subcutaneous tissues and were successfully treated with surgical excision of the lesions. We also describe what is to our knowledge the first reported case of prosthetic valve endocarditis due to Exophiala castellanii that was managed with a combination of medical and surgical therapies. Exophiala species remain an uncommon cause of infection. However, as the population of immunocompromised patients continues to grow and further improvements in the microbiological techniques for identification of these fungi occur, these organisms will be recognized with increasing frequency as a cause of human disease.

Adult↗
PubMed1994

[HCV infection and risk of transfusion in the area of Tivoli and its surroundings].

The positivity of the anti-HCV antibody has been studied by means of an immuno-enzymatic solid phase method, on 1.605 blood samples. They were drawn from 5 groups of people, during the period from February 1 to October 31, 1992: a) all blood donors who made the donation at the Transfusion Service of Tivoli Hospital during that period; b) all intravenous drug users who came to Tivoli Hospital for control; c) all patients in the Contagious Disease Section with suspected liver disease, always during the same period; d) all patients with suspected liver disease from other Sections of our Hospital; e) all out-patients who came to our Service during the same period to have their hepatitis markers studied. The highest prevalence of HCV Ab positivity was in the drug users, with a prevalence of 80.9%; far from this value, the next two groups were the patients from the Contagious Disease Section (positivity: 23.4%), and from the other hospital Sections (positivity: 20.1%). In the out-patient group only 9.7% were positive and among blood donors only 0.35%. In all 5 groups the HCV-positive subjects were in many cases positive for B hepatitis too; and very often they presented high levels of ALT. These results confirm that in some the percentage of positive-subjects for C hepatitis or for B & hepatitis; very high; therefore the authors underline the great importance to exclude all members of these groups from the donation of blood, its components, and organs too, even if the tests are negative.

Adult↗
PubMed1994

[The noninvasive demonstration of functional reinnervation after heart transplantation].

Although RR interval variability appears to be an ideal method for assessing reinnervation after heart transplantation, it has been shown that respiratory sinus arrhythmia is caused by the mechanical effect of respiration on the right atrium. The neck-suction induces heart rate changes only by means of nervous reflex and its hemodynamic effect is local and hence appears as a useful method for assessing reinnervation. We tested the presence of autonomic reinnervation in 18 heart transplant recipients, compared to 12 donor-age-matched controls. We measured the power of RR interval low- (LF, around 0.1 Hz) and respiratory fluctuations (HF) before and during rhythmic neck-suction stimulation at 0.1 Hz and at a frequency (0.20 Hz) similar to, but distinct from, that of respiration (controlled at 0.25 Hz), before and during 0.04 mg/kg atropine infusion, using autoregressive spectral analysis of RR interval, respiration and neck pressure signals. The relationship between pairs of signals at each frequency was quantitatively assessed by bivariate coherence function. All transplanted subjects showed low-amplitude HF, related to respiration. Detectable LF (whose power was lower than in controls: 1.15 +/- 0.39 versus 6.08 +/- 0.27 1n-ms2, p < 0.001), non coherent with respiration, were present in 11/18 transplanted subjects, and correlated with months since transplantation (r = +0.59, p < 0.05). HF neck suction induced the presence of a 0.20 Hz fluctuation in 12/12 controls, distinct from and greater than the 0.25 Hz respiratory component (7.28 +/- 0.26 versus 6.69 +/- 0.74 1n-ms2, p < 0.01); this was not seen in any of the transplanted subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[The planning and intervention for bilateral lift augmentation of the sinus floors in implant surgery. A case report].

The authors report a clinical case in which the inadequacy of bone to receive implants at the maxillary level was resolved by bilateral sinus elevation. In the reported case, two sinus elevations were performed as well as two isolations of the mental nerves and 10 osseointegrated implants under general anesthesia in a single session. In a preliminary approach, the patient was studied by CT using an acrylic mask to optimize the grafted sites and improve the interpretation of the CT scan imaging. A description is presented of the technique used for the sinus elevation. Clinical indications for this procedure are described as well as the replacement material. The sinus elevation procedure enlarges the area of utilization of osseointegrated implants and lends itself to a good application in the current studies on active molecules in the cell replication and in guided tissues regeneration.

Anesthesia, Dental↗
PubMed1993

Cannabinoid-receptor expression in human leukocytes.

Marijuana and many of its constituent cannabinoids influence the central nervous system (CNS), probably through the cannabinoid receptor, which has recently been cloned in rat and human. While numerous reports have also described effects of cannabinoids on the immune system, the observation of both mRNA and cannabinoid receptor has hitherto been exclusively confined to the brain, a reported detection in the testis being the sole example of its presence at the periphery. Here we report the expression of the cannabinoid receptor on human immune tissues using a highly sensitive polymerase-chain-reaction-based method for mRNA quantification. We show that, although present in a much lower abundance than in brain, cannabinoid receptor transcripts are found in human spleen, tonsils and peripheral blood leukocytes. The distribution pattern displays important variations of the mRNA level for the cannabinoid receptor among the main human blood cell subpopulations. The rank order of mRNA levels in these cells is B cells > natural killer cells > or = polymorphonuclear neutrophils > or = T8 cells > monocytes > T4 cells. Cannabinoid-receptor mRNA, which is also found in monocytic, as well as T and B leukemia cell lines but not in Jurkat cells, presents a great diversity of expression on these cells as well, B-cell lines expressing a much higher level than T-cell lines. The cannabinoid receptor PCR products from leukocytes and brain are identical both in size and sequence suggesting a strong similarity between central and peripheral cannabinoid receptors. The expression of this receptor was demonstrated on membranes of the myelomonocytic U937 cells using the synthetic cannabinoid [3H]CP-55940 as ligand. The Kd determined from Scatchard analysis was 0.1 nM and the Bmax for membranes was 525 fmol/mg protein. The demonstration of cannabinoid-receptor expression at both mRNA and protein levels on human leukocytes provides a molecular basis for cannabinoid action on these cells.

Animals↗
PubMed1993

Prevention of relapse of histoplasmosis with itraconazole in patients with the acquired immunodeficiency syndrome.

OBJECTIVE: To assess the efficacy and safety of itraconazole in preventing relapse of histoplasmosis after induction therapy with amphotericin B in patients with the acquired immunodeficiency syndrome (AIDS) and disseminated histoplasmosis. DESIGN: A prospective, multicenter, open-label clinical trial, with follow-up for at least 52 weeks. SETTING: Tertiary care hospitals participating in a clinical investigation sponsored by the National Institutes of Allergy and Infectious Diseases (AIDS Clinical Trial Group and Mycoses Study Group). PATIENTS: Forty-two patients with AIDS who had successfully completed induction therapy for disseminated histoplasmosis amphotericin B, at least 15 mg/kg body weight given over 4 to 12 weeks. INTERVENTIONS: Itraconazole, 200 mg given orally twice daily. MAIN OUTCOME MEASURES: Response to therapy, specifically prevention of histoplasmosis relapse, was the main outcome measure. Secondary end points were survival and the effect of therapy on Histoplasma capsulatum variety capsulatum antigen levels in urine and serum. Plasma itraconazole concentrations were measured to document drug absorption and compliance with therapy. RESULTS: The median follow-up was 109 weeks, and median survival was 98 weeks. Two relapses occurred (5%; 95% CI, 0.5% to 16%), one in a patient withdrawn from the study 18 weeks earlier and one in a patient who did not comply with the study therapy. Patients with elevated antigen levels at study entry showed clearance of antigen from urine and serum; urine specimens became negative in 43% of patients (CI, 26% to 59%), and serum specimens became negative in 75% of patients (CI, 56% to 94%). Only one patient discontinued treatment because of itraconazole toxicity (hypokalemia). CONCLUSIONS: Itraconazole, 200 mg twice daily, is safe and effective in preventing relapse of disseminated histoplasmosis in patients with AIDS. Antigen clearance from blood and urine correlates with clinical efficacy.

AIDS-Related Opportunistic Infections↗
PubMed1993

Antithrombotic activity of SR 46349, a novel, potent and selective 5-HT2 receptor antagonist.

SR 46349 (trans-4-[(3Z)3-(2-dimethylaminoethyl)oxyimino-3(2-fluorophe nyl) propen-1-yl] phenol, hemifumarate) is the first member of a newly-developed 5-HT2 antagonist series. SR 46349 potently inhibited serotonin-induced aggregation of rabbit and human platelets (IC50 = 1 and 3.9 nM respectively) but had no effect on the action of other platelet aggregating agents. SR 46349 was 118 and 25 times more potent than ketanserin against 5-HT+epinephrine-induced aggregation of rabbit and human platelets respectively. A single per os administration of SR 46349 (1 mg/kg) resulted in a strong inhibition of 5-HT+epinephrine-induced platelet aggregation in the rabbit as measured ex vivo (67% inhibition, 6 h after the administration). Intravenous or oral administration of SR 46346 inhibited in a dose-dependent manner venous thrombosis induced by ligature of the jugular vein of rabbits whose blood was made hypercoagulable by i.v. administration of tissue thromboplastin. The doses of SR 46349 which inhibited 50% of thrombus formation were 1.5 +/- 0.8 mg/kg and 17 +/- 0.5 mg/kg after i.v. or oral administration respectively. When given i.v. to rabbits, SR 46349 exhibited a dose-dependent antithrombotic effect in an arterio-venous shunt model. Significant increase of the bleeding time was observed after the i.v. administration of 5 mg/kg of SR 46349 (3-fold increase). In dogs, SR 46349 inhibited cyclic coronary artery blood flow variations, complete abolition of CFVs being achieved after the i.v. administration of 0.5 mg/kg. In conclusion, SR 46349 is a highly potent, selective antagonist of serotonin in vitro and is to be considered as a potent, orally active antithrombotic agent.

Animals↗
PubMed1993

Potentiating effect of clopidogrel and SR 46349, a novel 5-HT2 antagonist, on streptokinase-induced thrombolysis in the rabbit.

Current thrombolytic strategies have a number of important shortcomings including resistance to recanalization and development of acute reocclusion. The purpose of this study was to investigate whether the lysis of venous thrombi by streptokinase could be enhanced by SR 46349, a novel 5-HT2 receptor antagonist, or clopidogrel, an analogue of ticlopidine. The activity of these compounds was evaluated by following the lysis of radiolabelled fibrin under a continuous infusion of streptokinase (4,000 IU kg-1 h-1 over 4 h). Streptokinase alone induced 42% thrombolysis when compared to saline. The i.v. co-administration of SR 46349 or clopidogrel (10 mg/kg) enhanced significantly streptokinase-induced thrombolysis. Thrombolysis measured by [125I]-fibrinogen lysis increased to 65 and 59% respectively. This efficacy was achieved without additional prolongation of the template bleeding time observed with streptokinase alone. Thus, the concomitant use of a 5-HT2 receptor antagonist or an anti-ADP agent during streptokinase therapy may facilitate clot lysis.

Animals↗
PubMed1993

Control of neoplastic cell proliferation and differentiation by restoration of 4-hydroxynonenal physiological concentrations.

Several studies point to the existence of an inverse correlation between cellular lipid peroxidation and both cell proliferation and neoplastic transformation. In anaplastic cell lines products of membrane lipid peroxidation are very low or undetectable. Furthermore numerous results demonstrate effect of lipid peroxidation products on central biochemical pathways and intracellular signalling at physiological concentrations. 4-hydroxynonenal (HNE) is one of the most active products of lipid peroxidation. The restoration of HNE physiological concentrations in neoplastic cells may inhibit cell proliferation and modulate cell re-differentiation. This review try to summarize and critically discuss the effects of physiological concentrations of HNE on normal and neoplastic cell line.

Aldehydes↗
PubMed1993

Emergency and elective cardiac retransplantation.

Among 265 patients transplanted at our Institution, 7 underwent cardiac retransplantation. There were five emergency retransplantations, the indication being graft failure in one case and acute rejection in four cases. Two patients, retransplanted because of acute rejection, had a positive panel reactivity antibody and a negative donor crossmatch. In the rejection cases immunosuppression was enhanced by perioperative plasmapheresis and a postoperative 1-month course of cyclophosphamide. In two cases emergency retransplantations were successfully performed despite a highly positive prospective crossmatch. Two patients underwent elective retransplantations for chronic rejection 12 and 41 months, respectively, after the primary transplants. The overall early and late survival rates are 71% and 57%, respectively, with a mean follow-up of 48.5 months. The early and late mortality for elective retransplantation is zero. Our experience confirms both the high operative risk for emergency retransplantation and the excellent results for elective retransplantation. The use of plasmapheresis and cyclophosphamide allowed us to undertake retransplantation successfully in 2 cases with positive donor crossmatch. Both hyperimmunized patients in our series were retransplanted because of irreversible acute rejection despite a negative crossmatch with the primary donor. The meaning of negative crossmatch in patients with preformed cytotoxic antibodies is therefore questionable.

Adult↗
PubMed1993

Phase II study of continuous intravenous infusion of recombinant interleukin-2 in patients with advanced renal cell carcinoma.

BACKGROUND: The goal of this study was to evaluate the therapeutic efficacy and toxicity of recombinant interleukin-2 (rIL-2) administered by continuous intravenous (CIV) infusion to patients with metastatic renal cell cancer (RCC). PATIENTS AND METHODS: Thirty patients with RCC were given rIL-2 18 MIU/m2/d CIV. The schedule consisted of two induction cycles and four maintenance cycles with a 3-week rest period between cycles. Each induction cycle consisted of two infusion periods lasting 120 and 108 hours, respectively, separated by a 6-day rest period. Each maintenance cycle consisted of a 120-hour infusion period. RESULTS: Among 29 assessable patients, the objective response rate was 14% (95% confidence interval, 2% to 26%); one patient achieved a complete response, and 3 partial responses. Ten patients (34%) had stable disease (SD). Median survival was 11 months. Toxicity was generally manageable. Hypotension was universal, but required dose reduction in only 2 patients. Increase in serum creatinine levels was observed in 20 patients, and returned to normal in all but 4 patients after discontinuation of treatment. CONCLUSION: Results confirm the efficacy of rIL-2 in patients with RCC and the feasibility of the treatment in a normal oncology ward. However, responses are observed in a minority of patients, and treatment-related toxicity, as well as technical problems, may be troublesome to many patients.

Adult↗
PubMed1993

Effect of topical ketanserin administration on intraocular pressure.

The effect of topical ketanserin on intraocular pressure (IOP) in normotensive and hypertensive eyes was evaluated. The study was performed on 10 healthy volunteers and 10 glaucomatous patients. Systolic arterial blood pressure (SBP), diastolic arterial blood pressure (DBP), heart rate (HR), IOP, tonographic outflow facility, pupil diameter, corneal thickness, and tear secretion were recorded at baseline and at 1 hour intervals for 12 hours after topical administration of 0.5% ketanserin or placebo, given in a randomised, double masked, crossover fashion. The alternative treatment was given 1 week later. In all subjects ketanserin significantly lowered IOP, while no variations in SBP, DBP, HR, pupil diameter, corneal thickness, and tear secretion were found. When subjects received placebo no significant variations of IOP occurred. Total outflow facility, measured by conventional tonography, increased significantly after drug administration in all subjects. Ketanserin is effective up to 6 hours in control subjects and 9 hours in glaucomatous patients. The placebo did not induce any change in this component of the aqueous humour dynamic in normal or in glaucomatous eyes. The findings indicate that topical ketanserin might be added to the list of antiglaucomatous agents.

Administration, Topical↗
PubMed1993

Growth of immature lung transplanted into an adult recipient.

Syngeneic (Lewis-to-Lewis) and allogeneic (Brown Norway-to-Lewis) unilateral left lung transplants were performed between immature rats aged 6 wk (donors) and adult animals aged 4 mo (recipients). Transplanted animals were killed either 2 wk or 6 mo after operation. Right and left lungs were analyzed separately by quantitative light microscopic techniques, and findings were compared with control animals matched for age and strain. The immature transplanted left lung continued to grow to achieve its predicted adult number of alveoli. Six months after transplantation the alveoli and airways were larger than controls in allogeneic animals (P < 0.001) but were of normal size in syngeneic animals. After both syngeneic and allogeneic transplantation the recipient contralateral mature native right lung showed an increase in volume after 6 mo (P < 0.001), abnormal in a mature lung, due to an increase in size (P < 0.01 in allogeneic, P < 0.05 in syngeneic) and alveolar number (P < 0.02 in both). This study indicates that in rats, transplanted immature lungs can fulfill their growth potential even when transplanted into mature recipients.

Aging↗
PubMed1993

Ocular involvement correlated with age in patients affected by major and intermedia beta-thalassemia treated or not with desferrioxamine.

We examined 25 patients affected from Cooley's disease and five by beta-thalassemia intermedia. The mean age was 15 +/- 6.3 years. Fifteen patients, (18 years or older) three of them affected by beta-thalassemia intermedia, presented ocular abnormalities. So it was impossible to establish a correlation between laboratory data and ocular damages; their observation, with reference to untreated beta-thalassemia subjects, suggested that ocular abnormalities cannot be only attributed to desferrioxamine treatment.

Adolescent↗
PubMed1993

New heterocyclic structures. thiazolo[3,2-a][1,2,5] thiadiazolo[3,4-d]pyrimidine and [1,2,5]thiadiazolo[3',4':4,5] pyrimido[2,1-b][1,3]thiazine. biological assays.

6,7-Dihydro-9H-thiazolo[3,2-a][1,2,5]thiadiazolo [3,4-d]pyrimidin-9-one, 7,8-dihydro-6H,10H-[1,2,5]thiadiazolo[3',4':4,5]pyrimido [2,1-b][1,3]thiazin-10-one and its 3-methyl derivative were prepared by reacting 6,7-diamino-2,3-dihydro-5H-thiazolo[3,2-a]pyrimidin-5-one, 7,8-diamino-3,4-dihydro-2H,6H-pyrimido[2,1-b][1,3]thiazin-6-one or its 3-methyl derivative with N-thionylaniline. A reaction mechanism is proposed. The compounds and the sodium salts of (7-amino-2,3-dihydro-5H-thiazolo[3,2-a]pyrimidin-5-on-6-yl)sulfamic acid, (8-amino-3,4-dihydro-2H,6H-pyrimido[2,1-b][1,3]thiazin-6-on-7-yl) sulfamic acid and its 3-methyl derivative were tested for antimicrobial and antimycotic activity on a number of strains, namely: E. Coli, Proteus mirabilis, P. vulgaris, Pseudomonas aeruginosa, Salmonella spp, Staphylococcus spp, Streptococcus faecalis, Bacillus subtilis, Sarcina lutea, Candida albicans, and for antiviral activity on Herpes simplex virus type 1 and Vescicular stomatitis virus. None of the compounds showed antiviral activity or exhibited biological activity against gram-negative, gram-positive bacteria or against mycetes.

Animals↗
PubMed1993

[Induction of puberty and maintenance of secondary sexual characteristics in males with thalassemia major].

18 males with beta-thalassaemia major were studied; mean age was 17.6 flAF 4.3, 8 of 18 males evaluated were prepubertal (Tanner 1), 5 were early and mid pubertal (Tanner 2-3) and 5 were full pubertal (Tanner 5). All patients (pts) underwent GnRH test and 61% showed positive response. 8 pts. were treated with hCG; 2 were azoospermic, 6 were aspermic. The starting dose was 1000 IU twice weekly; dose adjustments were made basing on testosterone levels and clinical features. Clinical examination, testosterone assays, semen analysis were performed every 3 months during the treatment period. Therapy was started 18-48 months ago and it is still in progress. Within 12 months of treatment 4 pts progressed to Tanner stage 4, 3 pts to Tanner stage 5, 1 showed no response. Semen analysis showed an improvement in 6 pts: after 12 months of therapy 1 pts was aspermic, 5 were azoospermic, 1 was oligozoospermic. Our data showed that hCG administration is effective in inducing and maintaining secondary sexual character.

Adolescent↗