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Biomedical subjects

S Esposito

Publications and source records attributed to S Esposito.

At least 109 records · Page 6Linked to original sources
PubMed1994

[Infections due to hard-to-treat germs. Endocarditis and nosocomial opportunistic infections].

The authors describe some aspects of "difficult to treat" infections, pointing out, on the basis of their experience, infective endocarditis (IE) and nosocomial infections in compromised host. Among difficult-to-treat IE, the authors stress: 1) the peculiar etio-epidemiological features and the frequent causative pathogens multiresistance on early post-surgical IE; 2) the problems in detecting and management of IE by HACEK group microorganisms; 3) the problems related to other unusual agents IE, with particular regard to nutritionally deficient variants of S. viridans and to Coxiella burnetii. Among nosocomial infections in compromised host, Authors underline the relationship between either nosocomial flora or surgical/instrumental practices and possible underlying immunodeficiencies. Clinical and diagnostic remarks of sepsis, pneumonitis, meningitis, enteritis in neutropenic patients are then stressed, pointing out their atypical presentations and severe prognosis.

Cross Infection↗
PubMed1993

[Arthrography in the diagnosis and treatment of idiopathic adhesive capsulitis].

The painful shoulder--i.e., adhesive capsulitis--present two basic symptoms: painful and impaired motion. Clinics allow the diagnosis to be made, but treatment is difficult. In our opinion, shoulder arthrography is very useful to distinguish idiopathic from secondary capsulitis involving bones and joints: moreover, in the patients with adhesive capsulitis, arthrography is useful when removing adhesions by repeated forceful distensions of the joint capsule. January 1990 through December 1991, forty-five patients with adhesive capsulitis were studied with shoulder arthrography; 19 patients with primary adhesive capsulitis underwent forceful distension with lidocain and contrast medium and the intraarticular injection of 40 mg of triamcinolone enantate to eliminate local adhesions. Arthrographic brisement yielded good results: improved motion was observed in all patients, lasting 2 to 7 months. Forceful joint capsule distension is easy to perform and complication-free and yields valuable results; all of the above make the procedure advisable as a good alternative to surgery in primary adhesive capsulitis patients.

Arthrography↗
PubMed1992

Topical ciprofloxacin vs intramuscular gentamicin for chronic otitis media.

Clinical and bacteriological efficacy of topical ciprofloxacin hydrochloride was compared with that of intramuscular gentamicin sulfate in two groups composed of 30 patients each, all of whom were affected by chronic otitis media in the acute stage. Antibiotics were randomly given for 5 to 10 days according to the following schedules: ciprofloxacin hydrochloride, four drops (250 mg/mL in saline solution) administered locally twice a day, or gentamicin sulfate, 80 mg administered intramuscularly twice a day. We admitted to the study only adult patients affected by chronic otitis media in the acute stage with perforation of the tympanic membrane, without cholesteatoma, whose bacteriological culture was positive for Pseudomonas susceptible in vitro to ciprofloxacin and gentamicin. The clinical and bacteriological response was stated 12 hours after the interruption of the treatment, and 2 and 3 weeks later (follow-up). A favorable clinical result was observed in 26 (87%) of 30 patients under ciprofloxacin treatment; in 30 patients receiving gentamicin, a favorable clinical response was observed in 20 (66%) and bacteriological eradication in 13 (43%). No relapse at the follow-up was observed. Topical ciprofloxacin seems to be more effective than intramuscular gentamicin in curing Pseudomonas-caused chronic otitis media in the acute stage.

Administration, Topical↗
PubMed1992

Surgical pathology of the mitral valve: gross and histological study of 1288 surgically excised valves.

A consecutive series of 1288 mitral valves surgically excised from 1981 through 1989 were studied macroscopically and histologically. The explanted valves were affected by: chronic rheumatic disease (1179, 91.5%), floppy mitral valve (84, 6.5%), bacterial endocarditis (19, 1.5%), and post-ischemic mitral incompetence (6, 0.5%). Among 1179 post-rheumatic cases, mixed mitral stenosis and incompetence was the most frequent malfunction (747, 58%). Isolated mitral incompetence was diagnosed in 72 (6.11%) cases only, and isolated stenosis in 360 cases. In 52 valves, excised because of chronic rheumatic disease, the histology showed unexpected signs of acute rheumatism of the leaflets and the papillary muscles. In these patients clinical symptoms and blood tests were negative for rheumatic disease. Mitral incompetence, possibly due to papillary muscle dysfunction, was the prevalent lesion (61.5%). A total of 181 patients (14.05%) with pure mitral incompetence underwent surgery. In 84 patients (46.4%), the floppy mitral valve was the most frequent cause of valve dysfunction, 72 (39.8%) had rheumatic disease, 19 (10.5%) infective endocarditis, and 6 (3.4%) ischemic heart disease. In the group with floppy mitral valve, males were more prevalent than females (51:33). The mean age of the 4 patients with Marfan's syndrome and non-Marfan patients was noticeably different (17 vs 49 yr). Moreover leaflet deformation, tendinous cord elongation and annulus dilatation were the most common causes of valve incompetence. Floppy mitral valve and infective endocarditis were the cause of cordal rupture in 43.5% of the cases. This was a severe complication which always required emergency surgery.

Adult↗
PubMed1992

[Surgical pathology of the aortic valve: a morphologic study on 912 surgically excised valves].

A consecutive series of 912 surgically excised aortic valves was evaluated by means of macroscopic and histologic study. Pure aortic stenosis was diagnosed in 203 patients (p.) (22.25%), pure incompetence in 125 (13.72%) and combined dysfunction in 584 (64.03%). The diseases affecting the valves were: a) chronic rheumatic disease (593 p., 65%); b) dystrophic calcifications (214 p., 23%); c) noninflammatory aortic root disease (NIARD) and/or myxomatous infiltration of aortic cusps, floppy aortic valve (FAV) (55 p., 6%) d) infective endocarditis (50 p., 5.5%). Males outnumbered females with a ratio ranging from 2.4 (dystrophic calcific disease) to 1.6 (infective endocarditis). The mean age ranged from 37 +/- 7.5 (NIARD) to 61.2 +/- 6.3 (dystrophic calcific disease). Chronic rheumatic disease was the most frequent cause of stenoincompetence (542 p., 91.4%) while isolated stenosis was prevalently due to dystrophic calcification (172 p., 80.4%). The diseases causing isolated aortic incompetence were (in order of frequency): a) NIARD and/or FAV (55 p., 44%); b) infective endocarditis (50 p., 40%); and c) rheumatic disease (30 p., 16%). The 55 patients with NIARD and or FAV were divided into 3 groups: a) 23 p. with aortic root dilatation and normal cusps; b) 20 p. with aortic root dilatation and FAV; c) 12 p. with FAV but undilated aortic root. Aortic regurgitation was caused by cusp derangement in rheumatic disease (shortening, retraction) and infective endocarditis (perforations, erosions). Cusps diastasis and prolapse were the cause of regurgitation in aortic root dilatation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Endomyocardial biopsy in heart transplantation: the experience of the Naples Center].

From January 1988 through August 1992, 38 cardiac transplants were performed. 385 endomyocardial biopsies (EMBs) from 32 cardiac allograft recipients were investigated. In 21 (5.45%) EMBs the specimens were inadequate for the diagnosis. In the remaining 364 EMBs the grades of acute rejection were: minimal in 213 (58.51%) EMBs, mild in 132 (36.26%), mild/moderate in 12 (3.3%) and moderate in 7 (1.93%). The most reliable histologic feature of acute rejection was the myocyte necrosis or damage in presence of pironinophilic mononuclear cell infiltrate, so our therapeutic protocol requires myocyte damage to perform an additional treatment, which was performed in 7 cases (1.93%). An intermediate grade mild/moderate, was introduced to classify the EMBs in which the myocyte necrosis was scant or not clear. In these patients another EMB was performed after 3 or 5 days. One patient died of chronic rejection 17 months after the transplant. Changes not related to acute rejection were: ischemic early or late necrosis; changes related to previous biopsy site; subendocardial infiltrate of mononuclear cells (Quilty's alteration); focal, diffuse or perimyocytic fibrosis and artefacts as contraction bands; nuclear or cytoplasmic vacuolar alterations. Some of these changes occasionally made the diagnosis hard or the specimens inadequate for the diagnosis. In spite of these diagnostic difficulties, the EMB is a safe and reliable invasive investigation which plays an important role in the management of rejection in cardiac allograft recipients.

Adult↗
PubMed1991

Transoval administration of opiates into trigeminal cistern for cancer pain. Preliminary report.

A new method for administration of opiates into the ventriculo-cisternal system for intractable pain due to cancer is presented. Five patients suffering from such pain underwent the permanent implantation of a subcutaneous reservoir connected to a thin catheter inserted into the trigeminal cistern. The indications are those of the intraventricular way. Percutaneous trigeminal opiates administration (PTO) proved to be a valid and simple alternative method to intrathecal and intraventricular morphine.

Analgesia↗
PubMed1991

Cefodizime (HR221) versus norfloxacin for treatment of urinary tract infections.

Cefodizime is a stable new beta-lactamase cephalosporin chemically related to cefotaxime and with a long half-life. Its clinical efficacy and tolerability were compared with those of norfloxacin in patients with intercurrent urinary tract infections plus chronic liver diseases. Cefodizime (2 g, once a day, i.v.) and norfloxacin (400 mg, twice a day, p.o.) were randomly given to two groups of 20 patients each with urinary tract infections caused by organisms sensitive in vitro to these drugs. Cultures of midstream bladder urine, urinalysis and blood biochemical tests were performed before and after each antibiotic treatment. Clinical resolution was observed in 100% of the patients at the end of the treatments, but bacteriological eradication was obtained in 90% of the patients treated with cefodizime and 85% of those treated with norfloxacin, because of the development in five patients of asymptomatic bacteriuria (superinfections).

Adolescent↗
PubMed1991

Enoxacin therapy for experimental pseudomonas keratitis.

Pseudomonas keratitis is difficult to treat and aminoglycosides, the drugs now used for this purpose, are not always effective. New drugs are thus needed to cure gentamicin resistant pseudomonas ocular infections. Enoxacin, a new quinolone, active in vitro against Pseudomonas aeruginosa, was evaluated in experimental ulcerative keratitis produced by a gentamicin resistant isolate of Pseudomonas aeruginosa in rabbits. Our study shows that enoxacin eye drops eliminated pseudomonas infection of the cornea and achieved therapeutic levels in the aqueous humor. Supplementation with parenterally given enoxacin augmented this effect. Enoxacin did not penetrate the vitreous. Enoxacin eye drops may be evaluated for their clinical usefulness in case of keratitis caused by Gram-negative bacilli.

Animals↗
PubMed1991

Subarachnoid hemorrhage from multiple neurofibromas of the cauda equina: case report.

The authors report a case of spinal subarachnoid hemorrhage caused by neurofibromas of the cauda equina. An examination of the literature revealing 13 similar cases and an analysis of this case showing three neurofibromas of the cauda equina prompted an hypothesis emphasizing the origin of bleeding and the difficulties associated with a correct diagnosis.

Cauda Equina↗
PubMed1991

Antibacterial activity of ciprofloxacin administered intravenously in a pharmacodynamic in vitro model.

The antibacterial activity of ciprofloxacin against Gram-positive and Gram-negative bacteria was evaluated in an in vitro model by simulating its pharmacokinetics following a single 100 or 200 mg administration intravenously. The one compartment open model described by Grasso and coworkers was used for these experiments. Ciprofloxacin concentrations in the model were reproduced by calculations based on the concentration-time curve in human volunteers as reported by Wise and others. The maximum reduction of viable cell count for Enterococcus faecalis and Staphylococcus aureus was from two-to three-orders of magnitude; for Pseudomonas aeruginosa and Enterobacter cloacae from four to seven orders. A rapid killing was recorded both for Gram-positive and Gram-negative bacteria, but the initial killing was more prolonged and more pronounced for the higher dosage. The last did not interfere with regrowth that occurred for all strains after eight hours.

Bacteria↗
PubMed1990

[Transluminal percutaneous angioplasty in renovascular hypertension caused by monolateral fibromuscular dysplasia].

The authors, following recent observation of two cases of renovascular hypertension, one related to single right renal artery stenosis and the other to fibromuscular dysplasia of the left renal artery, examine the value of the Captopril-Test and treatment with Percutaneous Transluminal Angioplasty (PTA), in the diagnosis and therapy of this form of hypertension. According to the latest experience, reported in the literature, the Captopril-Test yields valid information as regards the dependence of hypertension on the renin-angiotensin system, while PTA represents the primary procedure in the treatment of renovascular hypertension when some conditions are satisfied as in our cases.

Adult↗
PubMed1990

Topical and oral treatment of chronic otitis media with ciprofloxacin. A preliminary study.

The clinical and bacteriological efficacy of ciprofloxacin was studied in three groups composed of 20 patients each, all of whom were affected by chronic otitis media in the acute stage. Ciprofloxacin was randomly administered according to the following schedules for 5 to 10 days: 250 mg orally twice a day (group A); 3 drops (250 micrograms/mL in saline solution) locally twice a day (group B); and both of the previous treatments twice a day (group C). A high percentage of favorable clinical response (100% and 95%) and bacteriological eradication (95% and 85%) was observed in groups B and C. A low percentage of patients (65% and 40%) were clinically and bacteriologically cured by the oral therapy (group A). No worsening of the audiometric and vestibular function was observed after local therapy. The results of this preliminary study suggest that the use of topical ciprofloxacin is effective in curing chronic otitis media, even when it is caused by Pseudomonas (47% of the total bacterial detections).

Administration, Oral↗
PubMed1990

Effect of salicylates on antibiotic sensitivity.

The effect of sodium salicylate (SA) or acetylsalicylate (ASA) on sensitivity to two different antibiotics on porin-deficient Gram-negative bacteria was investigated. Neither SA nor ASA nor any combinations of the two drugs within the therapeutic range altered minimum inhibitory concentrations (MICs) or minimum bactericidal concentrations (MBCs) of mezlocillin and ciprofloxacin against Pseudomonas aeruginosa, Serratia marcescens and Proteus vulgaris strains. It is concluded that SA and ASA do not seem to interfere with antimicrobial therapy of Gram-negative porin deficient bacteria.

Anti-Bacterial Agents↗
PubMed1990

Oral ciprofloxacin for treatment of acute bacterial pharyngotonsillitis.

The clinical efficacy and tolerability of ciprofloxacin orally administered at the dosage of 250 mg twice a day was evaluated in 25 patients affected by acute bacterial pharyngotonsillitis. All patients were non-responders to previous conventional antibiotic therapies due to in vitro resistance of the responsible bacteria, or possibly the low antibiotic concentration at the infection site. None of the patients had infections caused by group A beta-haemolyticus streptococcus. Treatment with ciprofloxacin lasted for 5-10 days (mean 6.7). A favorable clinical response was observed in 92% of patients (15 resolutions and 7 improvements) at the end of the therapy and two weeks later (follow-up). One patient was not evaluable because of the unfortunate onset of glossitis that caused the interruption of the treatment. No other side-effects were recorded in the other 24 patients. The bacteriological response was excellent: 83% bacteriological eradication, 13% persistence and super-infection in only one patient (4%). Ciprofloxacin administered orally at low dosages is highly effective in the treatment of bacterial pharyngotonsillitis and is also well tolerated.

Administration, Oral↗