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Biomedical subjects

P Maggi

Publications and source records attributed to P Maggi.

At least 37 records · Page 2Linked to original sources
PubMed1997

Epidemiological, clinical and therapeutic evaluation of the Italian cholera epidemic in 1994.

In the period between 18 October and 4 December 1994, 12 indigenous cases of cholera were registered in the southern Italian region of Puglia, 10 of them were diagnosed in our Departments of Infectious Diseases. All patients were infected by consumption of raw fish or mussels. The patients had an elevated mean age and most were affected with systemic pathologies. The clinical course was mild and rarely complicated, although frequently the characteristic riziform diarrhoea was absent. In all patients V. cholerae serotype Ogawa biotype El Tor, was isolated; one patient was co-infected by Salmonella typhi. All strains showed resistance to cotrimoxazole and tetracycline. Nine of ten patients were treated with oral ciprofloxacin at 1 g/day for 10 days resulting in disappearance of the symptoms within a median of 36 hours and negative fecal cultures within a median of 24 hours. Our data suggest that Italy is at high risk of infection imported from nearby nations. The resistance to commonly used antibiotics for treatment of cholera and the good response to ciprofloxacin suggest including fluoroquinolones among the drugs of first choice geographical areas involved in the circulation of resistant strains of V. cholerae O1.

Adult↗
PubMed1997

Giardiasis in HIV: a possible role in patients with severe immune deficiency.

We report the epidemiological, clinical and therapeutic characteristics of giardiasis in a population of HIV-infected patients with diarrhoic syndrome. During the period between 1988 and 1995, 720 HIV-patients with diarrhoic syndrome were evaluated. Fecal specimens were submitted to parasitological examination according to the Ritchie formalin-ethil acetate centrifugal sedimentation method and stained with iodine. Samples also underwent modified Ziehl-Neelsen staining and standard bacteriologic testing. Cystis of G. intestinalis were identified in stool sample of 25 patients. Two patients were classified as in stage A2 and 23 in C3. Mean CD4 values of patients with giardiasis (26.9 cells/mmc) were compared with those of 65 patients from whom, during the study, was isolated Cryptosporidium parvum (63.12, cells/mmc): the difference resulted highly significant (p < 0.001). Among the patients with full-blown AIDS, giardiasis occurred following a single previous AIDS-defining event in 13 inividuals, in seven and in five subjects giardiasis was the 3rd and, respectively, the 4th relevant AIDS-defining condition. Death occurred within the following 2 months in nine patients and within 6, 12 and 24 months in seven, six and two patients, respectively; at present only three AIDS patients are still alive. In general, G. intestinalis in HIV+, is not considered a major cause of enteritis; nevertheless, in our experience enteritis due to G intestinalis is a frequent event among AIDS patients, especially in the most advanced stage of disease, irrespectively of the risk factor. The increase in mean survival of AIDS patients will probably lead to a progressive emergence of this pathogen which could determine a severe diarroic syndrome with hydro-electrolytic impairments.

AIDS-Related Opportunistic Infections↗
PubMed1997

In vitro antimicrobial properties of azidothymidine (AZT).

In addition to the activity against a number of retroviruses, azidothymidine (AZT) has antibacterial activity against many bacteria. The effect of AZT on 224 bacterial species, including 25 strains of Salmonella spp. isolated from HIV-positive patients, was tested. AZT had no activity against all the strains of tested Gram-positive bacteria and Pseudomonas species (MIC > 128 micrograms/ml), whereas a different activity against Enterobacteriaceae (MIC range, 128 to 0.06 micrograms/ml) was found. In particular 76% of Salmonella spp. isolated from HIV-positive patients showed MICs > 1 microgram/ml, whereas similar MICs value were found in 50% of the Salmonella strains isolated from HIV-negative subjects. In addition, strains of Salmonella isolated from stools were more resistant to AZT when compared to strains isolated from blood even if this difference was not statistically significant. No correlation was found between length of therapy and Salmonella resistance to AZT in HIV-positive patients and a low incidence of Salmonella relapses in subjects treated with AZT was observed. The possibility that AZT may have an ancillary benefit in controlling some bacterial infections in AIDS patients is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Choreoathetosis in acquired immune deficiency syndrome patients with cerebral toxoplasmosis.

The aim of our study was to evaluate both the incidence and the pathologic and clinical features of extrapyramidal disorders in a population of acquired immune deficiency syndrome (AIDS) patients with cerebral toxoplasmosis. Of 240 AIDS patients evaluated in the 1985-1994 period, 50 of them were diagnosed to have cerebral toxoplasmosis on the basis of the following criteria: occurrence of specific antibodies, computed tomography and/or magnetic resonance imaging (MRI), and regression of the symptoms after specific therapy. Three of 50 (6%) had hemichoreoathetosis. In the first case, the disorder began as a dyskinesia of the left hand that subsequently spread to the whole ipsilateral arm and assumed the features of choreic athetotic movements. The other two cases were characterized by left hemisomatic distal choreic movements. Therapy with pyrimethamine and sulfadiazine led to a complete recovery of the extrapyramidal signs in two cases and to improvement in the third. According to our observations, the onset of these movement disorders could not be related to the dimension of the lesion or to the edema, but to a specific localization in subthalamic nucleus, in subthalamic/pallidal, and pallidal/thalamic pathways. MRI seems the elective tool to perform a more accurate study of the anatomic areas involved in this pathway and to verify their integrity. Cerebral toxoplasmosis in AIDS can be considered as a new etiopathogenic cause of choreoathetosis.

AIDS Dementia Complex↗
PubMed1996

Molecular diagnosis of skin relapse in acute lymphoblastic leukemia.

Despite improved survival in childhood acute lymphoblastic leukemia (ALL), its recurrence and the recognition of extramedullary dissemination continue to be crucial issues in the management of affected patients. We report the case of a boy with ALL who presented with two skin nodules during maintenance therapy. As histological examination of the routinely stained sections and the study of the immunophenotype of the skin biopsy were not conclusive, molecular analysis was carried out. By means of the heteroduplex analysis of the amplified T cell receptor (TCR) gene products we assessed the clonality of the skin lymphoid infiltrate and showed the same pattern of TCR gamma recombination of the bone marrow at diagnosis. The patient was treated with allogeneic bone marrow transplantation and survives disease-free after 3 years. Since cutaneous relapse in ALL occurs rarely, molecular analysis can be helpful and conclusive in defining the nature of a skin infiltrate.

Adolescent↗
PubMed1995

Drug injection in jugular veins: a new risk factor for vascular diseases in HIV-infected patients? A case report.

The authors describe a rare case of diffused thrombosis of the superficial veins in the whole body and periphlebitis with perivascular abscesses in an human immunodeficiency virus (HIV)-infected drug abuser who was using neck veins to inject cocaine and heroin. In addition the patient presented oral candidiasis, hepatitis C virus infection, bronchopneumonitis, and endocarditis of the tricuspid valve with valvular failure. The conditions of the patient needed repeated vascular catheterizations for therapy administration. Similar pathologies, in HIV-infected patients, highly increase the risk of opportunistic infections, especially in the encephalic territory; in addition the need for vascular catheterizations represents a further risk factor for bacterial infections.

Abscess↗
PubMed1995

Cyclospora in AIDS patients: not always an agent of diarrhoic syndrome.

The present study reports the clinical features of two AIDS patients infected by Cyclospora. According to our observations, Cyclospora in AIDS can be responsible both for gastroenteritis and for asymptomatic infections with spontaneous rapid clearance. In addition, and undiagnosed circulation of this agent in Italy could be hypothesized: neither patient had a past history of foreign travel. These are the first two cases in AIDS described in Italy.

AIDS-Related Opportunistic Infections↗
PubMed1995

Intestinal microsporidiosis in AIDS patients with diarrhoeal illness in Apulia (south Italy)

Microsporidia are intracellular parasitic protozoa very common in immunocompromised patients in many parts of the world. There is a scarcity of data on the prevalence of these parasites in Italy. In this study we examined stool samples of 56 HIV+ patients with diarrhoea to find microsporidial spores, using the light microscopy Ryan modified trichrome stain. Microsporidia were found in one out of 56 patients, who was Cryptosporidium coinfected. Intestinal microsporidiosis seems to be less frequent in AIDS patients from Italy than in those from other countries.

AIDS-Related Opportunistic Infections↗
PubMed1993

Prevalence of cryptosporidiosis in HIV-infected patients with diarrhoeal illness.

Protozoans of the genus Cryptosporidium may cause serious diarrhoeal illness in immunocompromised hosts and especially in HIV-infected patients. In this study we have evaluated the frequency of Cryptosporidium in stools of 51 HIV-infected patients with diarrhoea. Laboratory diagnosis of cryptosporidiosis was performed of faecal samples concentrated by a formalin-ether sedimentation technique and stained by a modified cold Ziehl-Neelsen method. Results demonstrated that 17 (33.3%) of these patients were infected with Cryptosporidium. Moreover, Cryptosporidium infection was the first clinical marker of AIDS in 7 cases. Our data show that the prevalence of this parasitosis in HIV-infected people seems to be higher in our region (Apulia, South Italy), compared to other areas of the world.

AIDS-Related Opportunistic Infections↗
PubMed1992

HCV infection occupational hazard at dialysis units and virus spread, among relatives of dialyzed patients.

It was the purpose of this study to evaluate the spread of HCV infection among the staff at Dialysis Units and among relatives of anti-HCV-positive hemodialysis patients. 122 health-care workers and 52 relatives were screened for presence of anti-HCV Ab. The control groups consisted of 100 health-care workers from other wards and 30 relatives of anti-HCV-negative subjects. 2.45% of the health-care staff and 5.8% of the relatives were found to be anti-HCV Ab carriers. None of the subjects in the control groups were positive. In conclusion, the results of this study indicate that there is a real possibility of HCV spread through occupational exposure although the corresponding percentage in less than that presumably due to within-the-family contagion by the virus.

Adult↗
PubMed1990

[A case of human brucellosis caused by accidental injection of animal vaccine].

The Authors describe the case of an acute brucellosis in a young veterinarian due to accidental injection of animal vaccine. The past history of the patient and the serological follow-up of the animals contacted by the professional did not evidence other risk contacts. The case evidence the real possibility that attenuated Brucella melitensis strains used in animal's vaccination can represent a source of occupational risk for this infection. In addition, it is important to notify similar cases to monitor the real extent of this phenomenon.

Adult↗