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Biomedical subjects

P Ferrante

Publications and source records attributed to P Ferrante.

140 records · Page 8Linked to original sources
PubMedDate not supplied

rhG-CSF in severe chronic neutropenia: successful intermittent treatment in three infants.

We report three cases of infants affected by severe chronic neutropenia (SCN). All the patients were treated with recombinant human granulocyte colony-stimulating factor (rhG-CSF) to avoid or reduce recurrent fevers and severe infections. In order to obtain better compliance and reduce the costs of long-term therapy while achieving the same effectiveness of therapy, we decided to evaluate intermittent treatment in patients with SCN. With a single dose of 3-10 micrograms/kg/d subcutaneously every 3-7 days, the patient attained an absolute neutrophil count (ANC) of 0.5-1.5 x 10(9)/L, a reduction of infections, and no notable side effects.

Chronic Disease↗
PubMedDate not supplied

Henoch-Schönlein syndrome associated with human Parvovirus B19 primary infection.

We report a case of Henoch-Schönlein syndrome associated with human Parvovirus B19 primary infection. The patient, a 27-year-old Filipino woman, presented with an erythemato-papular-purpuric eruption localized to the lower limbs. General symptoms and signs included fever, hypotension, nausea, vomiting, abdominal pain, inguinal lymphadenopathy and polyarthralgia. Laboratory examinations showed leukocytosis, increase in total serum IgA, proteinuria and haematuria. Circulating IgA immune complexes were also present. The ELISA test for anti-human Parvovirus B19 IgM was positive. Histopathological examination revealed a leukocytoclastic vasculitis. This case confirms that also in adult patients, Henoch-Schönlein syndrome may be associated with human Parvovirus B19 infection.

Adult↗
PubMedDate not supplied

Ex-vivo purging of circulating monocytes results in immunovirologic improvement in partially HAART responder HIV-infected patients.

AIDS pathogenesis results from a complex array of immune alterations which include, among others, changes in the pattern of cytokine production. Some monocyte-derived cytokines, like TNFalpha play a major role in HIV pathogenesis. TNFalpha transactivates HIV NF-kB thereby inducing viral replication, potentiates HIV replication in lymphomonocytes TNFalpha is one of the main factors of HIV-induced cachexia and might be involved in HAART-associated lipodystrophy. In addition, monocytes are infectable by HIV in vitro and infected monocytes can be recovered from the blood of HIV infected patients. For these reasons, we tested whether renewal of the pool of circulating monocytes by selective monocyte apheresis may improve the immune reconstitution which follows treatment with highly active anti-retrovirals (HAART). HIV-infected HAART receiving (> 1 year) patients who were either virologically non-responders (HIV-1 RNA >50,000 copies/ml) or immunologically non-responders (CD4 counts < 200) were treated with a novel monocyte apheresis device (G-1 Adacolumn). Plasma HIV viral load, proviral DNA and phenotypic and functional immunological analyses were performed. G-1 apheresis was well tolerated, not accompanied by adverse responses, and followed by clinical improvement. TNFalpha production was suppressed and CD4 T cell counts increased. In one G-1 patient with elevated HIV-1 proviral DNA a significant reduction (from 1,500 to 40 copies/10(5) cells) was observed. Neither immunologic nor virologic parameters were modified in the control patients who received HAART alone. Thus, purging of circulating monocytes by G-1 apheresis has a dramatic suppressive effect on TNFalpha production and is followed by both clinical and immunovirological improvement. G-1 apheresis should be considered in patients in whom HAART is only partially effective.

Anti-HIV Agents↗
PubMedDate not supplied

Granulocyte/monocyte apheresis induces sustained increases in CD4 T cells in HIV-1 infected patients with poor CD4 T cell restoration after suppression of viral replication by HAART.

Current antiretroviral regimens (HAART) are generally effective in reducing viral replication to undetectable levels and inducing a raise in CD4 T cells. However, in approximately 5 to 15% of patients suppression of viral replication is not followed by an increase in CD4 T cells. Such patients may be at increased risk for opportunistic infections. Here we report the results from a phase II open label randomised trial on 30 patients classified as poor responders to HAART who were either subjected to eight consecutive cycles of selective monocyte apheresis or maintained under HAART alone. The results show that monocyte apheresis results in increased CD4 T cell counts which are maintained for at least 31 weeks after last apheresis. This effect was observed only on patients with complete suppression of viral replication. Other effects of monocyte apheresis included a strong reduction of TNF-alpha production in patients with high baseline levels of this cytokine and activation of resting T cells during the apheresis cycles. In two patients with high cellular HIV DNA load apheresis was followed by a 98% reduction, suggesting purging of infected cells. There was no evidence of increased viral replication during or after the apheresis cycles. The data show that monocyte apheresis is safe, well tolerated and may be indicated in patients who respond poorly to HAART.

Adult↗
PubMedDate not supplied

[Serum and cerebrospinal fluid antibodies against measles virus in patients with multiple sclerosis].

Measles c.f.a. and h.i.e. were titrated in sera and, when possible, in the cerebrospinal fluids of 183 SM patients and in sera from a control group of subjects. No significative difference was found by the h.i. test, whereas significantly higher was the frequence of positives by the c.f. test in the SM group, with no correlation with the therapy to which the patients were subjected. The presence of c.f.a. in 13 of 48 cerebrospinal fluids tested, together with a low value of the serum/CSF antibodies ratio and with the lack of CSF antibodies against other viral antigens tested (HSV, rubeola), could indicate an intra CNS production of measles antibodies. To sum up, our results suggest an involvement of measles virus at least in some of the MS patients considered.

Adult↗
PubMedDate not supplied

[High-dose chemotherapy and peripheral hemtopoietic cells (PBPC) in solid tumors].

High-dose chemotherapy is a policy which is increasing in the field of solid tumors both in Europe and in North America. Hundreds of patients undergo ABMT or PBPCT in Europe every year especially for breast carcinoma. Waiting for the results of several ongoing trials, high-dose chemotherapy has shown to be of extreme interest in the adjuvant setting of patients with high risk breast cancer in phase II trials. The best results had been reported by Peters and Gianni; with a minimum follow-up of 5 years 65 and 56% of their patients with ten or more axillary lymph nodes are alive disease free. These results are better than any others with standard doses. The only one published trial (from South Africa) on advanced disease clearly favours high-doses of cyclophosphamide, mitoxantrone and etoposide versus standard doses of cyclophosphamide, mitoxantrone and vincristine in terms of overall survival and time to relapse. The use of PBPC replacing ABMT has allowed an easier tolerability of the procedure and a reduction of the costs. There is a clear reduction of the toxic death rate to 1% in 1995 for breast cancer patients compared with 20% of fifteen years ago. Germ cell tumors in responding relapse after salvage chemotherapy seem to be ideal candidates for ABMT/PBPC programs with an expected 40% disease free survival. The clinical impact of the PBPC contamination by tumor cells is still nowadays a matter of debate at least for breast carcinoma and neuroblastoma. This review will focus on the present situation of high-dose chemotherapy for solid tumors with some insights to new technologies and their applications.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Identification by polymerase chain reaction fingerprinting of Cryptococcus neoformans serotype AD.

Seventy-three Cryptococcus neoformans isolates and eight other yeast strains were studied. Fingerprints produced by priming with (GACA)4 differentiated C. neoformans from all other yeasts tested and identified the five C. neoformans serotypes. Four major bands of molecular size 800, 540, 475 and 410 bp were recognized for serotypes A, AD and D. Two of them were specific for serotype A and the other two for serotype D isolates. Serotype AD strains were identified by five different genotypic patterns in which at least one of the two bands specific for serotype A and D were present in different combinations. On repeated and simultaneously performed genotype and serotype testing of nine strains, the genotypic pattern did not change, whereas serotyping was unstable in three cases. PCR-fingerprinting using (GACA)4 as a primer proved more stable than serology in discriminating among C. neoformans serotypes A, D and AD and was able to distinguish among serotype AD strains.

Base Sequence↗
PubMedDate not supplied

Abdominal pain and acute nephritis in a man with a recent renal transplant.

We describe a patient with renal transplant who developed abdominal pain and acute nephritis in the course of the follow-up. A biopsy of colon lesions revealed CMV inclusions, renal biopsy revealed acute glomerulonephritis with positive CMV-DNA on polymerase chain reaction. The renal disease and bowel symptoms completely resolved after antiviral treatment.

Abdominal Pain↗