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Biomedical subjects

R Tornaghi

Publications and source records attributed to R Tornaghi.

At least 19 recordsLinked to original sources
PubMed1996

Etiology of acute otitis media in human immunodeficiency virus-infected children.

BACKGROUND: Acute otitis media (AOM) is one of the most common infections that are implicated as significant contributors to morbidity in HIV-infected children. To establish the optimal antibiotic therapy tympanocentesis is indicated as the first line diagnostic procedure, because unusual pathogens may play a role in advanced stages of deficient humoral or cellular immunity. METHODS: The microbiology of 60 episodes of AOM diagnosed in 21 symptomatic HIV-infected children (ages 9 months to 12 years) was compared with that of 121 episodes of AOM occurring in 113 immunocompetent HIV-negative children (ages 6 months to 12 years) in the last 5 years. RESULTS: The prevalence of the three most common pathogens (Streptococcus pneumoniae, Haemophilus influenzae and group A beta-hemolytic Streptococcus) was similar in HIV-infected and in normal children (56.5% vs. 54.9% of the ears). Staphylococcus aureus was significantly more frequent in AOM diagnosed in severely immunosuppressed stages. A significantly lower proportion of middle ear effusions obtained in HIV-infected children yielded no bacteria compared with normal children. Beta-lactamase production among isolates of H. influenzae was a rare phenomenon, both in HIV-infected and in normal children. No penicillin-resistant S. pneumoniae was found. CONCLUSIONS: In HIV-infected children with absent or moderate immunosuppression empiric antibiotic therapy should be based on the recommendations given for immunocompetent children of the same geographic area. In severe immunosuppressed stages, given the possible role of Staph. aureus, extended spectrum antibiotics should be considered.

Bacterial Infections↗
PubMed1994

HIV-1 reverse transcriptase codon 215 mutation and clinical outcome in children treated with zidovudine.

OBJECTIVE: In HIV-infected adults prolonged monotherapy with zidovudine may be associated with the appearance of HIV strains with decreased zidovudine sensitivity, owing to specific mutations in the reverse transcriptase (RT) gene, and this has been suggested to be a reason for reduced zidovudine efficacy. This study was undertaken to determine the appearance of mutation at codon 215 of the RT gene in proviral DNA from PBMCs in HIV-infected children. DESIGN: A prospective, open study. SETTING: A University Pediatric Department. PATIENTS AND METHODS: Nineteen HIV-infected symptomatic children were treated with zidovudine for a median of 24 months. Clinical and laboratory controls for HIV infection status were performed monthly. Mutant proviral sequences were evaluated at the start of therapy, every 3 months during the first 6 months of therapy, and every 6 months thereafter. Clinical outcome was defined as stable or deteriorating. RESULTS: No child had proviral sequences mutant at codon 215 before starting zidovudine. Ten of 13 children who had received zidovudine for more than 6 months developed mutant proviral sequences. All the children (10 of 10) with mutant proviral sequences had a deteriorating clinical condition, compared to none of those (0 of 9) without mutation at codon 215. CONCLUSION: The appearance of HIV-1 codon 215 mutation seems to be strongly associated with zidovudine therapy and with clinical progression of HIV disease in children.

Base Sequence↗
PubMed1993

Identification of the chromosome 14 origin of a C-negative marker associated with a 14q32 deletion by chromosome painting.

A constitutional chromosome 14 rearrangement was observed in a female with a psychodevelopmental disorder. Karyotype analysis using a variety of chromosome techniques, QFQ, GTG, CBG, Ag-NOR and DA-DAPI, showed a deletion of chromosome 14q32.1-qter region in association with a supernumerary marker chromosome. The marker, resembling a submetacentric, approximately half the size of a G group chromosome is C band and Ag-NOR negative. The heteromorphism of the satellites showed that the deleted chromosome 14 is paternal in origin. Chromosome painting using an Alu-PCR probe specific for the human chromosome 14 and fluorescent in situ hybridization (FISH) showed that the marker contains chromosome 14q32 sequences. It is likely that the marker was generated from the deleted chromosome 14 region through a complex rearrangement.

Abnormalities, Multiple↗
PubMed1993

Ranitidine treatment in newborn infants: effects on gastric acidity and serum prolactin levels.

Data about the use of ranitidine in the early postnatal period are lacking. In this study, 30 term newborn infants < 2 days old with bleeding erosions in their upper gastrointestinal tracts were treated with ranitidine by continuous i.v. infusion (0.2 mg/kg/h) for 48 h and thereafter by mouth (5 mg/kg b.i.d.) for 1 month. Mean gastric pH (SD) rose from 4.27 (1.62) to 5.70 (0.95) during i.v. infusion; after oral therapy it was still 5.55 (1.25). Serum ranitidine concentrations were 642.4 (376.5) and 321.5 (368.2) ng/ml after i.v. and oral therapy, respectively, with wide interindividual variations; the correlation between serum ranitidine and gastric pH was found to be weak. No untoward effect was observed either on the cardiorespiratory rate or on creatinine and aminotransferase values. Mean serum prolactin concentration after i.v. therapy was found to be lower, although within the reference range, than in control infants; no significant correlation was observed between serum ranitidine and prolactin concentrations. From these data, a < 0.2 mg/kg/h rate seems to be advisable for continuous ranitidine infusion in neonates, whereas the 5 mg/kg b.i.d. regimen could be considered adequate for oral therapy.

Administration, Oral↗
PubMed1992

Impaired response to hepatitis B vaccine in HIV infected children.

Eighteen human immunodeficiency virus (HIV) vertically infected children (HIV group) and 33 seroreverted children (SR group), who had completed hepatitis B vaccination (Engerix B, 20 micrograms dose) were studied. Four out of 18 (22%) HIV children failed to develop protective antibody levels (anti-HBs titres less than 10 mIU ml-1) compared with 1 out of 33 (3%) SR children (p less than 0.05). Magnitude of response among HIV children was significantly lower than among SR children. In HIV children the probability that anti-HBs titres persist above the protective levels was significantly lower than in the SR group at any time during the 24 month follow-up. These results show that HIV children have a suboptimal response to hepatitis B immunization and the protection is less durable. Further studies are needed to determine the optimal protocol for hepatitis B immunization in HIV children.

Child, Preschool↗
PubMed1991

Occurrence of infections in children infected with human immunodeficiency virus.

To evaluate the occurrence of infections in asymptomatic and symptomatic human immunodeficiency virus (HIV)-infected children we performed a prospective comparative cohort study. Twenty-seven HIV-infected children were individually matched with paired immunocompetent controls and followed up for a total of 543 months (mean per child, 19.4 +/- 11 months). Collected data were evaluated considering HIV-infected children both as a whole and as P1 and P2 patients according to the Centers for Disease Control classification. Twenty-seven HIV-infected children had 185 infectious episodes vs. 27 matched controls who experienced 118 infections. P1 children had a number of infections similar to those of normal controls (99 vs. 86) whereas P2 children had a significantly higher number of infections than did controls (86 vs. 32). Pneumonia and oral candidiasis occurred significantly more frequently in symptomatic HIV-infected children than in normal controls. Severe infections occurred almost exclusively in HIV-infected symptomatic children.

Child↗
PubMed1991

Acute otitis media in human immunodeficiency virus-infected children.

To evaluate the occurrence and outcome of acute otitis media (AOM) in human immunodeficiency virus (HIV)-infected children, a prospective comparative cohort study was performed. Twenty-seven HIV-infected children were individually matched with paired control subjects and followed up for 543 months (mean 19.4 +/- 11). Data collected were evaluated considering HIV-infected children both as a whole and as P1 and P2 patients according to Centers for Disease Control classification. During the observation period, 46 episodes of AOM were diagnosed in 15 HIV patients and 22 in 16 control children: 11 P1 had 27 AOM episodes vs 17 in 13 control children; 6 P2 had 19 AOM episodes vs 5 in 4 control children. Human immunodeficiency virus infection does not seem to modify the occurrence of AOM. Recurrent AOM (3 or more episodes in 6 months) was, however, significantly more common in P2 children. Amoxicillin, to which the bacteria isolated in P2 children were sensitive in vitro, cured 33 of 46 episodes in HIV-infected children compared with 20 of 22 in control children. Cure rate was similar in P1 children compared with control children but was significantly lower in P2 versus control children (47.3% vs 100%). Reasons for higher occurrence of failures in P2 children remain to be investigated.

Acute Disease↗
PubMed1990

Electrophysiological observations on the palmomental reflex in normal neonates.

The authors report normative data on the electrical response (EMG response) recorded from the mentoneal muscles by repetitive mechanical stimulation of the thenar eminence surface of the hand in 18 neonates, 1 to 6 days old: the so-called palmomental reflex (PMR) or palm-chin reflex. PMR potentials showed in most cases great variability in amplitude and duration but not in latency, and they were present in all but one of the cases. The PMR was monolateral in one case only. Evoked potentials from the scalp were also recorded after electrical stimulation of the thenar eminence. The afferent branch of the PMR is constituted of impulses originating mainly from median nerve, skin and muscle receptors. Such impulses may reach facial motor nuclei following corticofugal pathways throughout a long-loop circuit.

Biomechanical Phenomena↗
PubMed1990

T-cell subsets and serum immunoglobulin levels in infants born to HIV-seropositive mothers: a longitudinal evaluation.

T-lymphocyte subsets and serum immunoglobulins were assayed in 27 neonates and 12 infants younger than 6 months, all born to HIV-seropositive mothers. No differences in T-lymphocyte subsets between the 27 seropositive and 34 seronegative infants were found at birth. Twelve seroreverted and 14 infected children were followed. CD4+ cell counts were significantly lower in the latter at 3 and 24 months of age. Serum immunoglobulin levels and CD8+ percentages became higher in the infected group, starting from the sixth month, while CD4+ percentages and CD4+/CD8+ ratios became lower, starting from the twelfth month.

Child, Preschool↗
PubMed1990

Immunological study in newborns at risk for HIV-1 infection.

We have performed an isoelectric focusing study (IEF) to detect the presence of oligoclonal bands (OB) in serum and in 5 of the correspondent cerebrospinal fluid (CSF) from 14 HIV-seropositive mothers and their newborns. CB were also searched in serum from 4 newborns every 3 months over a period of 12 months. OB were present in 8/14 sera and in 3/3 CSF obtained from the mothers; CSF OB were different from the correspondent serum indicating an intrathecal synthesis. OB were also visualized in serum, but not in CSF, from 3 newborns studied at birth: two of them died respectively at 4 and 5 months of age. One of the 4 newborns that were serially studied showed the appearance of OB at 12 months of age. A comparative study between sera obtained at the moment of delivery from the mother and her newborn showed that oligoclonal banding patterns were superimposable. Our data indicated that: 1) the IgG forming OB in the newborn's serum derive from a passive filtration from mother's serum; 2) the presence of OB seems to be an unfavourable prognostic feature in infants at risk for HIV-1 infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Early diagnosis of HIV infection in infants.

Eighteen infants born to anti-HIV-positive mothers were tested bimonthly for immunoglobulin M (IgM) anti-HIV by Western blot and HIV p24 antigen (Ag) by enzyme-linked immunosorbent assay (ELISA) in order to determine the role of these markers in the early diagnosis of HIV infection. Twelve healthy infants were also studied as a control group. In 11 out of 18 children (61.1%) an IgM response was demonstrable, in 13 out of 18 (72.2%) IgM anti-HIV and/or p24 antigen (Ag) were detected. Two patterns of IgM response were identified: a precocious IgM positivity (group of five children positive at birth) and a later appearance of IgM, always within the third month (six cases). Early p24 antigenemia occurred in one infant. Three out of four children who developed antigenemia after birth were symptomatic within the sixth month. No clinical or immunological abnormalities were found among the three children who were persistently negative for both IgM anti-HIV and p24 Ag. Serial IgM anti-HIV and p24 Ag testing may be helpful in the early identification of HIV-infected patients.

AIDS Serodiagnosis↗
PubMed1984

Polymorphonuclear leucocytes functions from premature infants after prevention of respiratory distress syndrome with betamethasone and ambroxol.

An increase in the infection rate both in mother and newborn after antenatal administration of corticosteroids for prevention of RDS has been shown. The aim of this study was to compare PMN functions in two groups of premature infants whose mothers had received betamethasone or ambroxol for prevention of RDS. Blood samples were collected within the first four days of life from 40 newborns. Thirteen infants received antenatal administration of 6 mg of betamethasone acetate and 6 mg sodium phosphate i.m., which was repeated 24 hours later. Twelve received antenatal administration of ambroxol, 1 g i.v. every day for 5 days. Fifteen did not receive any antenatal treatment. Mean gestational age and mean birth weight was not significantly different between the betamethasone group (33 +/- 3.1 weeks and 2080 +/- 567 g) and the ambroxol group (32.9 +/- 3.4 weeks and 2164 +/- 793 g). Phagocytosis and killing ability was significantly lower in the betamethasone group in comparison to the ambroxol group (21.3% +/- 2.2 rather than 48.4% +/- 15; p 0.01 and 11.4% +/- 1.7 rather than 20.5% +/- 6.1; p 0.01 respectively). Immunoglobulin or complement levels were not significantly different in the three groups.

Ambroxol↗