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Biomedical subjects

R Maserati

Publications and source records attributed to R Maserati.

70 records · Page 4Linked to original sources
PubMed1985

Liver abscess caused by Edwardsiella tarda.

Edwardsiella tarda, among other Enterobacteriaceae, is a rare isolate from clinical specimens in man. A liver abscess caused by E. tarda was found in a middleaged woman without overt epidemiologic exposure to known reservoirs of this organism. While the most likely source of infection was the bowel, we failed to demonstrate a gut carriage of E. tarda or to show any local condition predisposing to the development of the liver lesion.

Enterobacteriaceae Infections↗
PubMed1985

In utero sonographic diagnosis of semilobar holoprosencephaly.

Since its early diagnostic application in the study of pregnancy, ultrasonography (US) has been widely employed in the detection of fetal malformations. Head abnormalities, recognized through the evaluation of brain and skull structures, accounted for the majority of these observations. We report here on a case of holoprosencephaly, a rare malformation (incidence is around 1/16,000 live births according to Roach et al. [1975]) diagnosed and monitored up to delivery by multiple US examinations.

Adult↗
PubMed1984

Rifampicin in collections of pus--a kinetic study in human abscesses.

Most of the successful non-surgical management of abdominal abscesses is based upon the presence of therapeutic amounts of effective antibiotics within the collection. However few data are currently available concerning antimicrobial levels in human purulent lesions. To study the relationship between serum and pus concentrations of rifampicin, 11 patients with deep-seated abscesses were given 900 mg intravenously of rifampicin daily; after 3, 8 and 20 h from injection, an ultrasound-guided percutaneous aspiration of the collection was performed. Samples were obtained on the first day of therapy in six cases, while in other six the aspiration took place on the third day. Rifampicin levels of therapeutic value were present after 8 h from the first injection. From this time antibiotic amounts in pus, ranging from 1.6 to 5.8 mg/l, were consistent with a long persistence of rifampicin in abscesses, without any evidence of accumulation.

Abscess↗
PubMed1984

Management of staphylococcal endocarditis in drug addicts. Combined therapy with oral rifampicin and aminoglycosides.

Staphylococcal endocarditis is a condition affecting intravenous drug abusers at increasing rates, and its treatment is still controversial. We used, successfully, high doses of rifampicin, associated with an aminoglycoside, for the treatment of two heroin addicts. In the first we found a left-sided endocarditis with metastatic abscesses in brain, both kidneys, liver and spleen; in the other the finding of bilateral lung abscesses was related to embolic episodes from a diseased tricuspid valve. Since the isolated strains of Staphylococcus aureus were tolerant to methicillin, we used oral rifampicin (20 mg/kg/day) plus an aminoglycoside (amikacin in the former and gentamicin in the latter), after in-vitro testing had proved these combinations to be effective. We achieved, in both cases stable bactericidal concentrations in the serum and a lasting clinical recovery.

Adult↗
PubMed1983

[Current clinical aspects of leptospirosis].

Leptospirosis is still endemic in the Po valley. It has an extremely protean clinical picture. In a series of 79 cases diagnosed at Pavia in the period 1970-79 hepatonephritic forms were the most common (29.1%), followed by febrile or pseudo-influenza forms (25.3%), hepatitis (20.2%), nephritis (17.8%), and meningitis (7.6%). Febrile hepatonephritis was always accompanied by the most severe pictures. Timely antibiotic management with penicillin or ampicillin, and above all the early use of peritoneal dialysis (carried in 10 subjects) enable a final cure to be obtained even in these cases. The only death in that series did not appear to be ascribable to the disease itself.

Adolescent↗
PubMedDate not supplied

Sparfloxacin therapy for experimental endocarditis caused by methicillin-resistant Staphylococcus aureus.

Sparfloxacin, a new difluorinated quinolone antibiotic, was employed in the treatment of catheter-induced endocarditis in rabbits infected with a methicillin-resistant strain of Staphylococcus aureus (MRSA). Animals (n = 12) in the study group received sparfloxacin, 25 mg/kg body weight every 12 h intravenously. Comparison groups were untreated controls (n = 9) and animals injected with vancomycin (n = 13) at the same dosage. MICs and MBCs of the test organism were both 1.56 mg/l for vancomycin and 0.15/0.30 mg/l for sparfloxacin. Antibiotic treatments started 24 h after bacterial challenge and lasted 4 days until sacrifice. In comparison with no treatment, both sparfloxacin and vancomycin significantly reduced the bacterial counts in aortic vegetations, while no significant difference was found between the two antibiotics. Combination of the two antibiotics, tried in a smaller group of rabbits (n = 3) showed no advantages over either single-drug therapy. Our results suggest that sparfloxacin is a potentially useful agent, at least in the rabbit model, for treating MRSA endocardial infections.

Animals↗
PubMedDate not supplied

Antiviral potency of HAART regimens and clinical success are not strictly coupled in real life conditions: evidence from the MASTER-1 study.

PURPOSE: To compare in a real clinical setting the largely unknown midterm clinical effectiveness of two protease inhibitor (PI)-based highly active antiretroviral therapy (HAART) regimens with different potency and tolerability profiles in naïve patients. METHOD: This study was a multicenter, open-label, randomized trial in naïve patients with less than 400 CD4+ cell count/microL, regardless of viral load. Treatment arms were hard gel capsule saquinavir (HGC-SQV)-based HAART (Arm A), with an expected more favorable tolerability profile, and indinavir (IDV)-based HAART (Arm B), with more potent virologic activity. While viro-immunological surrogate markers and World Health Organization (WHO) grade III toxicity (secondary endpoints) were regularly monitored, primary endpoints of the study were clinical and defined as any AIDS-defining event, AIDS-related death, WHO grade IV toxicity, drop outs, and protocol violations. RESULTS: 262 consecutive patients were enrolled in the study from March 1, 1997 to December 31, 1997, in 24 different Italian clinical centers (132, Arm A; 130, Arm B). After 24 months of follow-up, patients who were enrolled in Arm B showed a significantly higher rate of virological success (75% had viremia below 500 copies/mL, CI = 12.9%, in the on-treatment analysis) and immunological gain (mean CD4+ cell count increase of 274 CD4+ cells/microL, SD = 234) when compared to patients enrolled in arm A (57%, CI = 15.5% and 223 CD4+ cells/microL, SD = 192; p =.0353 and.026, respectively). Despite the significant difference observed in surrogate markers, the number of total primary endpoints did not differ in the two groups (55 out of 132 in Arm A vs. 58 out of 130 person-years in Arm B; p =.86). CONCLUSION: Our results suggest that, after 24 months of follow-up in a real clinical setting, a PI-based HAART induces significant clinical benefits in naïve patients even in the absence of a complete suppression of viral replication. However, the long-term clinical impact of the possible accumulation of viral mutations in the presence of low-grade viral replication remains to be elucidated.

Adult↗
PubMedDate not supplied

Hydroxyurea in the treatment of HIV-1 infection: toxicity and side effects.

Hydroxyurea has been used in numerous clinical trials for the treatment of HIV-1 infection, almost always in combination with didanosine with or without other antiretrovirals. Due to its inhibition of DNA synthesis, the main side effect of hydroxyurea is myelosuppression. When administered at the dosage of 1000 mg/day in asymptomatic, moderately-immunosuppressed HIV-1 infected patients, its tolerability profile appears to be quite favourable, with rare, reversible episodes of peripheral blood cytopenia that seldom require therapy discontinuation. Higher dosages of hydroxyurea and its use in advanced, heavily-pretreated patients may increase the likelihood of more severe side effects or newer toxicities developing. So far hydroxyurea-containing long therapy courses, up to 3 years, have not elicited any significant toxicity and appear to be safe as in onco-hematologic patients.

Anti-HIV Agents↗
PubMedDate not supplied

[Pathogenesis and clinical aspects of AIDS].

Infection by Human Immunodeficiency Virus (HIV) is the recognized cause of the Acquired Immunodeficiency Syndrome (AIDS) and related syndromes, all characterized by a devastating and progressive impairment of immunity. What ensues is the onset of opportunistic infections, neoplasms, both central and peripheral nervous system alterations and other conditions as well. Current therapeutic options, either with antiretroviral and anti-infective drugs, are only credited to prolong survival while not assuring definite cure. A significant improvement in the clinical management of these patients could be anticipated only after a better understanding of HIV life-cycle and its pathogenetic mechanisms.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Bone marrow morphology and proliferative activity in acquired immunodeficiency syndrome.

Peripheral cytopenia has been reported in a number of patients with the acquired immunodeficiency syndrome (AIDS), but the mechanism of bone marrow (BM) failure is unclear. We have examined the BM morphology and cytokinetics of 16 untreated HIV-positive patients whose clinical condition ranged from asymptomatic (stage 1 WR and II CDC classifications) to overt AIDS (stage 6 WR and IV CDC classifications). BM aspirates and iliac crest threphine biopsies were obtained for myelogram and histologic examination, as well as for propidium iodide flow cytometric (FMC) DNA analysis. FCM data were compared with those from the BM of patients with solid tumors without BM involvement. Four patients had normal peripheral blood counts, 2 were anemic, 2 had granulocytopenia, 2 thrombocytopenia, 4 bicytopenia and 2 pancytopenia. BM cellularity was normal or increased, but only 2/16 patients had normal BM morphology. Ten patients had atypical lymphoid aggregates, relative plasmacytosis and eosinophilia, and 4 had typical myelodysplastic changes. There was no correlation between morphology and WR or CDC grade. The mean proliferative fraction (i.e. the percentage of cells in the S phase of the cell cycle) of the HIV-positive patients was 11% (range 5.5-18.3%). The mean value for the control patients was 15.1% (range 7.7-26.9%) (p less than 0.05). All patients had modal diploid DNA content without aneuploid clones. These data suggest that the mechanism of BM failure in HIV-positive patients lies in a reduced proliferative activity whose exact cause is still unclear.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Risks of AIDS among health personnel (physicians, nurses, obstetricians)].

Health-care workers are exposed to risk of HIV infection. Blood and body fluids containing blood are the most important sources of HIV and the major risk for health-care workers occurs by incidental parenteral contact with these fluids. Therefore, the risk can be minimized by taking care to prevent injuries and by using protective barriers for mucous membranes and skin. However, the number of cases reported in literature with occupational HIV infection is extremely low.

Acquired Immunodeficiency Syndrome↗