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Biomedical subjects

R Soave

Publications and source records attributed to R Soave.

43 records · Page 3Linked to original sources

Bacterial invasion of pulmonary vessels. Pseudomonas bacteremia mimicking pulmonary thromboembolism with infarction.

Pseudomonas aeruginosa displays a curious propensity for invading blood vessels and causing vessel wall necrosis. This bacteremia-related "vasculitis" is often associated with hemorrhagic necrosis and infarction of surrounding organ parenchyma. With the exception of skin lesions, however, clinical manifestations of Ps. aeruginosa vasculitis seldom occur. In the patient we describe, fatal Ps. aeruginosa bacteremia was first manifested by a syndrome indistinguishable from pulmonary thromboembolism with infarction.

Adult↗

Comprehensive care revisited.

Although the term comprehensive care has gone out of fashion in medical education, the concept has had a resurgence in attempts to teach primary care and family practice. Review of the early experiments in the teaching of comprehensive care in the 1950s reveals that much that was learned then is not being applied today. Surveys of medical school teaching and graduate training in primary care make it seem likely that there will be insufficient practitioners in the foreseeable future to meet the public need for personal physicians. Restructuring of both medical curricula and the delivery systems for personal health services may be necessary to apply effectively what has long been known about the teaching and practice of comprehensive primary care.

Attitude of Health Personnel↗

Cryptosporidium and cryptosporidiosis.

Cryptosporidium is a newly recognized human pathogen associated with severe enteritis and, perhaps, cholecystitis in immunocompromised patients, particularly those with the acquired immunodeficiency syndrome, and significant, though self-limited, diarrheal illness in the immunocompetent host. As more physicians look for this pathogen, the number of reported cases of cryptosporidiosis continues to increase. Although the prevalence of cryptosporidiosis in humans is not yet known, recent studies suggest that it is a common cause of diarrhea worldwide, particularly in young children. The pathogenic mechanisms by which Cryptosporidium causes enteritis and the factors of human host defense essential for eradication of this parasite have not been delineated. Acid-fast staining of stool is a quick and reliable way of diagnosing cryptosporidiosis. Although a vast array of therapeutic agents has been tried for this disease, there is currently no known effective therapy for cryptosporidial infection.

Acquired Immunodeficiency Syndrome↗

Characterization of Encephalitozoon (Septata) intestinalis isolates cultured from nasal mucosa and bronchoalveolar lavage fluids of two AIDS patients.

Microsporidia are obligate intracellular protozoan parasites that can cause opportunistic infections in AIDS patients. Species from five genera of microsporidia are presently known to infect man. One species, Septata intestinalis originally was detected in stool specimens of individuals with chronic diarrhea and subsequently was found to disseminate to the kidneys, lungs, and nasal sinuses. This organism has since been reclassified as Encephalitozoon and in this study, we report the culture of Encephalitozoon intestinalis from a bronchoalveolar lavage specimen and a nasal mucus aspirate of two AIDS patients living in the USA. The bronchoalveolar and nasal microsporidian isolates grew in several continuous cell lines including RK-13, MDCK, HT-29, Caco-2, Vero, and I047. Transmission electron microscopy of the clinical and cell culture specimens revealed that the new isolates appeared to be E. intestinalis based on morphology and growth of organisms in septated membrane-bound parasitophorous vacuoles. The new E. intestinalis isolates were characterized and compared with the first isolated E. intestinalis that was cultured from stool to confirm their identity and to determine if there existed any minor differences, as seen in the closely related Encephalitozoon cuniculi strains. By the methods of sodium dodecyl sulfate-polyacrylamide gel electrophoresis staining for proteins and carbohydrates, Western blot immunodetection, and polymerase chain reaction-based methods with restriction endonuclease digestion, double-stranded DNA heteroduplex mobility shift analysis, and DNA sequencing of the ribosomal DNA intergenic spacer region, the new isolates were identical to each other and to the reference isolate of E. intestinalis. In addition, with any of these methods, the E. intestinalis organisms could be distinguished from the three E. cuniculi strains, Encephalitozoon hellem, and Vittaforma corneae, which is important for diagnostics, therapeutic strategies, and epidemiology.

AIDS-Related Opportunistic Infections↗

Reiter syndrome following protracted symptoms of Cyclospora infection.

Two large outbreaks of diarrheal illness associated with Cyclospora cayetanensis, a coccidian parasite, provided an opportunity to evaluate clinical syndromes associated with this enteric pathogen. Reiter syndrome, a triad of ocular inflammation, inflammatory oligoarthritis, and sterile urethritis, has been associated with enteric infections. We describe the first case of Reiter syndrome following protracted symptoms of Cyclospora infection.

Adult↗

The use of radionuclide bone and joint imaging in arthritic and related diseases.

Patients with arthritic complaints are seen frequently by podiatrists, who must establish a differential diagnosis. When combined with the patient's history, physical examination, joint aspiration, laboratory data, and radiographs, bone and joint scans provide a sensitive and objective means of arriving at an accurate diagnosis.

Adult↗