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Biomedical subjects

M Romagnoli

Publications and source records attributed to M Romagnoli.

At least 37 records · Page 2Linked to original sources
PubMed1998

Novel method for processing respiratory specimens for detection of mycobacteria by using C18-carboxypropylbetaine: blinded study.

A novel method for processing respiratory specimens to improve culture and acid-fast staining of mycobacteria is introduced. This new method utilized N,N-dimethyl-N-(n-octadecyl)-N-(3-carboxypropyl)ammonium inner salt (Chemical Abstract Service no. 78195-27-4), also known as C18-carboxypropylbetaine (CB-18). In a blinded, five-center study, CB-18-based processing was compared to the standard method combining NALC and NaOH (NALC/NaOH). A total of 573 respiratory specimens were tested. Individual specimens were split approximately equally; the host institutions processed half of each specimen by the NALC/NaOH method, while the other half was processed with CB-18 at Quest Diagnostics--Baltimore. A total of 106 specimens were culture positive for acid-fast bacilli (AFB). Replacement of the primary decontamination agent with CB-18 caused changes in all diagnostic parameters. Aggregate culture sensitivity improved by approximately 43% (P < 0.01), and smear sensitivity improved by approximately 58% (P < 0.01). The sensitivity of smear relative to that of M. tuberculosis isolates exceeded 93% (P < 0.01) when specimens were processed with CB-18. The average times to a positive result were reduced by 7.3 days in liquid culture (P < 0.01) and 5.3 days on solid media (P < 0.05); however, the CB-18 method had a 20.8% contamination rate in liquid culture versus a rate of approximately 7.5% with NALC/NaOH processing. There were also unusual reductions in liquid culture sensitivity and smear specificity among CB-18-processed specimens. The characteristics of the latter parameters suggested that refinement of the CB-18 processing method should allow further improvements in culture sensitivity. This study showed that the CB-18 method has the potential to improve both smear and culture detection for these important human pathogens.

Bacteriological Techniques↗
PubMed1998

Safety of inducing sputum in patients with asthma of varying severity.

Inducing sputum using hypertonic saline is a noninvasive method to investigate airway inflammation in people with asthma. However, hypertonic saline may also induce bronchoconstriction in some patients. The aim of the study was to examine whether the overall safety of using hypertonic saline to induce sputum in patients with mild to moderate asthma could be extended to patients with severe and/or uncontrolled asthma. Nine control subjects and 64 asthmatic patients with varying severity of the disease (FEV1 40-126% predicted values) were studied. Twenty-one of those patients had uncontrolled asthma. Sputum was induced in a standardized manner using hypertonic saline. The safety of the procedure was evaluated by assessing the clinical response and measuring FEV1 just before and during sputum induction. The procedure was well tolerated in most patients, but it had to be stopped due to side effects in 11.6% of patients with severe asthma. None of the side reactions were severe. Few patients with uncontrolled (17.3%) or severe asthma (18.6%) had a drop in FEV1 of 10-20%. The fall in FEV1 was significantly greater in patients with severe asthma than those with mild disease (p < 0.02 Mann-Whitney U test). We conclude that hypertonic saline-induced sputum is a safe technique even in patients with severe asthma.

Adult↗
PubMed1997

Diffuse pulmonary calcinosis without calcium metabolism abnormalities in a renal transplant recipient.

Eighteen years after an uneventful renal transplantation, the chest radiograph of an asymptomatic 50 year old man showed diffuse bilateral infiltrations, predominately at the right apex. Computed tomography (CT) scan demonstrated a diffuse alveolar pattern, the alveoli being filled with a very dense material, with some tracheal calcifications. Bronchoalveolar lavage fluid analysis was normal, but bronchial and transbronchial biopsies revealed calcium deposits in the bronchial mucosa and in the alveolar septa. The diagnosis of diffuse pulmonary calcinosis was established, despite normal blood calcium, phosphorus and magnesium levels, based upon computed tomography scan and pathological findings at fibreoptic bronchoscopy, without the need for an open lung biopsy.

Biopsy↗
PubMed1997

Subcutaneous emphysema of the chest wall: a case with unusual presentation.

Subcutaneous emphysema (SE) is the presence of air or other gas in the subcutaneous tissue and is generally associated with pneumothorax and/or pneumomediastinum. We describe an unusual presentation of SE of the chest wall without radiological evidence of pneumothorax or pneumomediastinum, which aetiopathogenesis remains open to several hypotheses in spite of an accurate clinical study.

Adult↗
PubMed1996

Evaluation of inhA gene and catalase-peroxidase gene among isoniazid-sensitive and resistant Mycobacterium tuberculosis isolates.

The katG gene and the inhA gene of 30 INH-resistant (INH-R) and 28 INH-sensitive (INH-S) isolates of M. tuberculosis from Haiti and Maryland were analysed by PCR to establish the presence and frequency of two postulated mechanisms of INH-resistance, total katG gene deletion and inhA Ser94 to Ala94 amino acid substitution. Only two of 30 INH-R isolates (3%) appear to have total katG gene deletions. All 28 INH-S isolates (100%) produced a PCR product at both the 5' and the 3' ends of the katG gene. Gene deletion of katG is a rare mechanism of INH resistance. Allele specific oligonucleotide hybridisation analysis of the inhA PCR products from the same 58 isolates revealed no mutation at amino acid 94 or directly surrounding it. Other inhA gene mutations may be responsible for INH resistance in M. tuberculosis. Diagnostic strategies using katG gene deletion or inhA Ser94 mutations would fail to detect almost all INH-R isolates.

Antitubercular Agents↗
PubMed1996

A 4-week, double-blind, parallel-group study to compare the gastrointestinal effects of meloxicam 7.5 mg, meloxicam 15 mg, piroxicam 20 mg and placebo by means of faecal blood loss, endoscopy and symptom evaluation in healthy volunteers.

Meloxicam is a new non-steroidal anti-inflammatory drug (NSAID) which preferentially inhibits cyclooxygenase-2 (COX-2) over cyclooxygenase-1 (COX-1). Gastrointestinal (GI) tolerability of meloxicam 7.5 and 15 mg vs piroxicam 20 mg was evaluated in a 4-week, double-blind, parallel group, placebo-controlled study in 51 healthy male volunteers, using a combination of oesphago-gastro-duodenal endoscopy, faecal blood loss measurement and symptom evaluation. Analysis of covariance found no significant difference in faecal blood loss between the groups. However, significantly higher bleeding was found with piroxicam 20 mg compared with placebo using a Student's t-test on the weighted means. Endoscopy score were significantly higher with piroxicam than with meloxicam 7.5 mg or placebo (P < 0.01). A significant difference from baseline was observed in the meloxicam 15 mg and piroxicam groups (P < 0.05), but not in the meloxicam 7.5 mg and placebo groups. Six piroxicam-treated volunteers were withdrawn following a poor endoscopic score, but no such withdrawals occurred in the meloxicam and placebo groups (P < 0.01). Meloxicam 7.5 mg caused less GI damage compared with piroxicam 20 when administered to healthy young volunteers for 28 days; a possible dose dependency effect in GI tolerability was also suggested for meloxicam 7.5 and 15 mg, in relation to endoscopic findings.

Adult↗
PubMed1995

[Leukocytic procoagulant activity and chemotherapeutic drugs: the comparative effects of cisplatin and carboplatin on lympho-/monocytic procoagulant activity in vitro].

It is well known that a number of chemotherapeutic agents are able to induce procoagulating activity not only in neoplastic cells but also in normal, monocyte/macrophage cells, and some of them, including cisplatin, even increase procoagulating activity of the factor already expressed, providing a further example of the possible co-participation of chemotherapy in the onset of thrombotic complications in cancer patients. Carboplatin is an analogue of cisplatin but differs strikingly in terms of its collateral effects, in particular being less oto- and nephrotoxic. To the authors' knowledge there are no data regarding the possible effect of carboplatin on lympho/monocyte procoagulating activity. This study shows that not only platin but also carboplatin is able to increment the levels of lympho/monocyte procoagulating activity in vitro, with a dose-dependent effect, and to synergize with bacterial endotoxin in increasing this leukocyte activity, although the synergic effect is significantly greater in the case of carboplatin. The importance of these findings at a practical and clinical and clinical level still remains to be defined, in particular in the light of the different pharmacokinetic behaviour of these two chemotherapeutic agents and in the context of those neoplastic diseases for which cisplatin and carboplatin treatment is most frequently used.

Blood Coagulation Factors↗
PubMed1994

Captopril treatment of chronic heart failure in the very old.

BACKGROUND: The safety and efficacy of angiotensin-converting enzyme inhibitors for very old patients with chronic heart failure have been less well documented than for younger patients. METHODS: A prospective, randomized double-blind, placebo-controlled study of captopril, 25 mg twice daily, was designed. Fifty patients (mean age 84.2 +/- 5.2) participated. The degree of chronic heart failure (according to the Boston Study Group rating), the distance walked in 6 minutes, and the occurrence of uncontrolled heart failure and adverse reactions were used as main outcome measures. RESULTS: Significantly more patients receiving placebo developed uncontrolled heart failure than patients receiving captopril (p = .022). In an intention to treat analysis, the first and last evaluations of the degree of chronic heart failure were compared. A significantly different evolution was observed between the two treatment groups (p < .001), with a significant improvement only in the captopril-treated patients (p < .001). The distance walked in 6 minutes improved significantly only in the captopril group (p = .004). The only adverse reaction was rash in two patients receiving captopril. CONCLUSIONS: The study gives further evidence that angiotensin-converting enzyme inhibitor treatment for very old patients with chronic heart failure is useful.

Aged↗
PubMed1994

[Leukocyte procoagulant activity and chemotherapeutic agents: comparison between the effects of adriamycin and epiadriamycin on the procoagulant lympho/monocytic activity in vitro].

It is well known that a number of antineoplastic agents are able to induce procoagulant cellular activity and tissue factor not only in neoplastic cells but also in normal, monocyte/macrophage cells, and some of them, including adriamycin, even increase procoagulating activity of the factor already expressed, providing a further example of the possible co-participation of chemotherapy in the onset of thrombotic complication in cancer patient. Epirubicin is an analogue of adriamycin but differs strikingly in terms of its collateral effect, in particular being less cardiotoxic. To the authors' knowledge there are no data regarding the possible effect of epirubicin on lympho/monocyte procoagulant activity. This study shows that not only adriamycin but also epirubicin is able to increment the level of lympho/monocyte procoagulant activity "in vitro", with a dose-dependent effect, and to synergize with bacterial endotoxin in increasing this leukocyte activity, although the effect is significantly greater in the case of adriamycin. The importance of these findings at practical and clinical level remains to be defined, in particular in the length of the different pharmacokinetic behavior of these two chemotherapeutic agents and in the context of those neoplastic diseases for which adriamycin and Epirubicin treatment is most frequently used.

Blood Coagulation↗
PubMed1992

Epstein-Barr virus-related persistent erythema multiforme in chronic fatigue syndrome.

BACKGROUND: Erythema multiforme (EM) has been rarely reported in Epstein-Barr virus (EBV)-associated diseases; this includes patients with chronic fatigue syndrome who have chronic or recurrent and disabling illness and an abnormal antibody reactivity to EBV. We describe a patient fulfilling the chronic fatigue syndrome diagnostic criteria who had developed an unusually persistent EM resistant to corticosteroids therapy. The EBV DNA was studied in skin EM lesions, throat washings, peripheral mononuclear cells, and plasma. The EBV antigens were studied in skin EM lesions and in mononuclear cells. The patient was followed up to 2 years. OBSERVATIONS: The patient had abnormal titers of antibodies against various EBV antigens and by immunofluorescence she disclosed the EBV nuclear antigen and the viral capsid antigen in the blood vessels of the affected skin. The dot blot hybridization assay detected viral DNA in throat washings and mononuclear cells, but not in plasma. The presence of the viral genomic content in lesional skin is suggested by the autoradiographic signal and by the difference from appropriate control specimens. Skin lesions and constitutional symptoms cleared after acyclovir sodium therapy and recurred after discontinuation of this therapy. CONCLUSIONS: This is the first EM case in which evidence of the EBV causal role has been provided. The association with chronic fatigue syndrome suggests the EBV role in selected cases of this syndrome.

Adult↗
PubMed1991

Blood-brain-barrier in a geriatric population: barrier function in degenerative and vascular dementias.

Albumin and IgG were determined in serum and cerebrospinal fluid (CSF) of patients with early-onset Alzheimer's disease (AD, n. 13), senile dementia of Alzheimer type (SDAT, n. 33), vascular dementia divided into multi-infarct (MID, n. 9) and probable vascular (PVD, n. 11) dementia. Albumin and IgG ratio and IgG index were calculated. CSF albumin and albumin ratio were significantly higher in MID patients indicating an increased BBB permeability. IgG ratio and IgG index did not show any significant difference among groups. These results do not provide evidence for BBB damage in AD/SDAT, while in MID the increase of CSF albumin and albumin ratio is suggestive of BBB dysfunction.

Aged↗
PubMed1990

[Mean high-amplification electrocardiogram during a submaximal exercise test following acute myocardial infarction].

The mean high-amplification ECG (MECG) used to detect delayed potentials (DPs) has so far been used only at rest and after exertion. In this article, the results are reported of recording the MECG at rest and during exercise (ER) obtained in 19 patients, the ER having been carried out at the subacute stage of myocardial infarction. Despite a significant increase in the background noise during exercise from 0.9 microV to 2.2 microV, it was possible to analyse the MECG recorded during exercise to detect DPs in all cases. In this small group of patients, no significant changes occurred with regard to the appearance or delayed potentials during exercise, although there was a reduction in the duration of HFQRS and an increase in the amplitude of RMS40 during exercise which was, however, much less marked in patients presenting DP.

Aged↗
PubMed1988

Inhibition of phytohemagglutinin (PHA) induced human T-cell colonies by methylprednisolone.

The mechanisms underlying the inhibition of T-cell proliferation by methylprednisolone (MPS) have been investigated using a T-cell colony assay. Cell fractionation experiments have demonstrated that MPS exerted its effects at the level of both T-cells and monocytes. Thus, monocytes treated with MPS released a soluble factor that had suppressor activity on T-cell proliferation. Moreover, MPS directly blocked the proliferative capacity of T-cells, as demonstrated by the finding that MPS-treated T-cells formed reduced numbers of colonies even under optimal culture conditions and in the presence of exogenous IL-2.

Antigen-Presenting Cells↗
PubMed1988

Inhibiton of the colony-forming capacity of human T-lymphocytes exerted by theophylline.

The effects of theophylline on T-lymphocyte colony formation were investigated both by in vitro studies (adding theophylline in cultures at three different concentrations--5, 15 and 30 micrograms/ml) and by in vivo experiments (after oral ingestion of 10 mg/kg time-released theophylline) in a group of young healthy volunteers. In vitro the drug showed a significant dose-dependent inhibitory effect on both peripheral mononuclear cells (PMNC) and purified T-lymphocyte colony formation. No significant differences in PMNC colony formation before and 12 h after the oral ingestion of theophylline was detected in the in vivo study, even if at the same time the plasma concentration of the drug remained at therapeutic level in every subject. In addition, in vitro experiments mimicking the in vivo conditions suggested that the apparent disagreement between the in vitro and in vivo results was due to experimental procedures (i.e. the inhibitory effect requires the constant presence of the theophylline in the culture medium). The experimental data provided in this study confirm, using different experimental procedures, the results of our recent investigations showing that theophylline exerts an inhibitory effect on T-cell proliferation.

Adult↗