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Biomedical subjects

S Esposito

Publications and source records attributed to S Esposito.

At least 127 records · Page 7Linked to original sources
PubMed1990

In-vitro sensitivity of amoxicillin/clavulanic acid (Augmentin) to isolated beta-lactamases and in-vitro antibacterial activity.

The in vitro sensitivity of amoxicillin alone and combined with clavulanic acid (ratio 4:1) as been studied by a spectrophotometric method utilizing crude extract of the following enzymes: TEM1, TEM2, SHV1, SHV2, TLE1, HMS1, LXA, P99, ENT208. The in-vitro antibacterial activity of ampicillin, amoxicillin alone and associated with clavulanic acid was also determined by an agar dilution method. Clavulanate protects amoxicillin from the hydrolytic activity of plasmid mediated beta-lactamase, conferring a stability on the beta-lactam comparable with that of cefotaxime. The protection of amoxicillin by means of clavulanic acid reduces the minimal concentration of antibiotic necessary to inhibit most bacterial species and allows bacteria to remain sensitive to the drug which might otherwise be resistant.

Amoxicillin↗
PubMed1990

[Transcutaneous pulmonary fine-needle aspiration biopsy under fluoroscopic guidance. Our experience].

The authors report the radiological method and the cytohistologic and bacteriologic technique of percutaneous fine-needle aspiration biopsy of the lung under fluoroscopic guidance. The results are reported of 620 biopsies of benign and malignant lung lesions; the biopsies were performed from January 1981 to September 1989. Surgery, follow-up, and autopsy confirmed the high diagnostic accuracy of this method. The advantages of fluoroscopic guidance are discussed and compared with those of CT guidance.

Adolescent↗
PubMed1989

[Digital videoradiography applied to the study of stress urinary incontinence in women].

A digital videofluoroscopic unit was employed to evaluate 42 female patients with urinary stress incontinence, cystocele or endometrial neoplasms, using either voiding cystourethrography or colpo-cysto-urethrorectography (CCURG), with or without urethral metallic bead chain. The digital subtraction technique allowed the direct visualization (on a single frame) of the lowering of both bladder base and other pelvic structures, and of the modification of urethral angles during Valsalva and micturition. The demonstration of contrasted urethra during micturition and Valsalva in incontinent patients allowed CCURG to be performed without urethral chain, with encouraging diagnostic accuracy. The advantages of digital CCURG are emphasized.

Algorithms↗
PubMed1989

Renal artery stenosis detection by combined Gates' technique and captopril test in hypertensive patients.

We studied 11 hypertensive patients by a radionuclide technique using Gates' method with [99mTc]DTPA to investigate the acute effects of captopril on glomerular filtration rate (GFR). Five patients had hypertension with unilateral renal artery stenosis (RAS) angiographically documented and six patients had essential hypertension (EH). Total and split GFR were determined under control conditions and after oral administration of captopril (50 mg). In the patients with RAS, captopril induced a significant decrease of GFR in the stenotic kidneys (from 42.4 +/- 4 to 29.6 +/- 3 ml/min, p less than 0.01), while no changes were observed in the nonstenotic kidneys (from 61.2 +/- 3 to 61.6 +/- 5 ml/min, NS). Total GFR was 103.6 +/- 5 ml/min under control conditions and decreased to 91.8 +/- 6 ml/min after captopril (p less than 0.05). No significant changes of GFR were detected after captopril administration in patients with EH. In a separate group of ten patients with EH, good correlation between 24-hr creatinine clearance and fractional uptake of [99mTc]DTPA was obtained. Good reproducibility of this radionuclide technique was also shown. This study demonstrates that the computed radionuclide GFR determination coupled with the captopril test allows one to unmask angiotensin II-dependent renal function and hemodynamic changes. This technique can be useful in clinical practice for identifying patients with renovascular hypertension.

Adult↗
PubMed1989

[Digital cystography in the evaluation of vesico-ureteral reflux in childhood].

The use of digital subtraction in voiding cystourethrography allows an accurate evaluation of the continence-micturition cycle. Fifty-two children with recurrent urinary tract infections were studied. The examination was easily performed, and it resulted useful in both detecting and characterizing vesicoureteral reflux. Even though it does not increase diagnostic sensitivity, digital voiding cystourethrography is useful in demonstrating the onset of vesicoureteral reflux, as related to the different phase of micturition. As far as radiation exposure is concerned, the technique, so far performed on children, appears to be a valid alternative to urodynamic studies.

Adolescent↗
PubMed1989

Pharmacokinetics of ciprofloxacin in impaired liver function.

The pharmacokinetics of ciprofloxacin after a single 500 mg oral dose was studied in one group of healthy volunteers and in patients affected by liver cirrhosis and classified into three groups according to Child-Turcotte criteria. The serum concentrations were determined by an agar well diffusion assay 0.5, 1, 3, 6, 12 and 24 h after the administration of the drug. No significant differences were noticed in Cmax, Tmax, T1/2 and AUCtot in the group A and B of patients and in the control group. Class C patients showed on the other hand a Cmax 15-25% higher than in other groups (2.74 mcg/ml), a T1/2 1.12-1.42 hours longer than in other groups and a consequent much higher AUCtot (17.70 mcg/h/ml). The concomitant administration of diuretics of anti-H2 drugs was also evaluated as possible factors affecting the ciprofloxacin pharmacokinetics, but no significant differences were noticed. A mild or moderate impairment of the liver function did not affect the pharmacokinetics of ciprofloxacin, but the severe impairment of the liver function could affect its Cmax and serum half-life, so that further studies with multiple doses will be needed to evaluate if any dosage adjustment would be required in these patients.

Adult↗
PubMed1989

Activity of ciprofloxacin in the treatment of experimental intra-abdominal abscesses in mice.

The therapeutic efficacy of ciprofloxacin in the treatment of experimental intra-abdominal abscesses in mice caused by a strain of Staphylococcus epidermidis was compared with that of ampicillin and clindamycin. The abscesses were produced by intraperitoneal administration of a bacterial suspension obtained by bacterial culture of S epidermidis diluted to 10(8) CFU/ml mixed with sterilized rat feces and barium sulphate in male BALB/C mice. The following doses of antibiotics were given twice a day for seven days: ciprofloxacin, 1 microgram/100 microliters; clindamycin, 1.5 micrograms/100 microliters; and ampicillin, 3.6 micrograms/100 microliters. The antibiotic serum and pus concentrations were also determined by an agar well diffusion assay. The maximum serum concentrations were obtained 30 minutes after intraperitoneal administration (ciprofloxacin, 2.7 micrograms/ml; clindamycin, 9.0 micrograms/ml; ampicillin, 3.9 micrograms/ml). The penetration inside the abscess was also satisfactory (ciprofloxacin, 0.51 microgram/ml; clindamycin, 3.4 micrograms/ml; ampicillin, 3.8 micrograms/ml). A favorable clinical and bacteriologic response was obtained in 69% of the mice following the ciprofloxacin treatment and in 56% following ampicillin. The efficacy of ciprofloxacin was much higher than that of clindamycin and ampicillin, presumably because of its much higher intrinsic potency against the pathogen rather than for its pharmacokinetic characteristics and its penetration inside the abscess.

Abdomen↗
PubMed1988

Efficacy and safety of ciprofloxacin in the treatment of UTIs and RTIs in patients affected by liver diseases.

The clinical efficacy and the safety of ciprofloxacin was studied in 92 patients (aged 26 to 83 years; mean 57.5 years) affected by urinary tract infections (UTI) and respiratory tract infections (RTI) suffering also with various liver diseases. Ciprofloxacin was given orally at different dose regimens: 500 mg b.i.d. (22 cases), 250 mg b.i.d. (20 cases), 500 mg s.i.d. (20 cases) for the treatment of UTIs; 500 mg b.i.d. (ten cases) and 250 mg b.i.d. (20 cases) for the treatment of RTIs. The doses were not correlated to the severity of the infections. Patients were treated for five to 15 days. All the bacteria isolated from sputum or urine before treatment were sensitive to ciprofloxacin (MIC range less than or equal to 0.015 mg/l to 8 mg/l). The clinical and bacteriological responses were favourable in a high percentage of patients both for RTIs and UTIs, irrespective of the dose. Side effects were infrequent (7%) and mild (nausea, gastralgia, oral candidosis), never requiring the interruption of the treatment. No change in the blood chemistry tests was observed at any dose.

Adult↗
PubMed1988

[Diagnosis of ischemic cardiopathy in hypertensive patients. Comparison of radioisotopic technics].

Exercise radionuclide ventriculography (ERV) is considered a superior non-invasive screening test for coronary artery disease (CAD). ERV showed, however, a low specificity in hypertensive patients (H). The diagnostic accuracy of ERV and thallium-201 myocardial scintigraphy (M) was evaluated in 23 patients (H) with chest pain and positive ECG-stress test. All patients underwent ERV and M, randomly, in different days. Finally, they all underwent coronary angiography: CAD was diagnosed in case of luminal narrowing greater than or equal to 70% in 1 major coronary artery at least. Eleven patients had severe CAD. ERV was considered positive for CAD in presence of ex-induced abnormality of wall motion and/or in case of ex-induced ejection fraction increase less than or equal to 5% respect to the basal values. M was considered positive for CAD when perfusion defects were observed in early images only. ERV showed low diagnostic accuracy. On the contrary M had both sensibility and specificity, and a high positive and negative predictive value in the diagnosis of CAD. M is thus suggested as the non-invasive methodology of choice in hypertensive patients with suspected CAD.

Coronary Circulation↗
PubMed1987

Efficacy and safety of oral ciprofloxacin in the treatment of respiratory tract infections associated with chronic hepatitis.

Twenty patients with lower respiratory tract infections presumably caused by ciprofloxacin-susceptible bacteria were admitted to a non-comparative, prospective clinical study. All patients were hospitalized for chronic hepatitis at various stages of the disease. Ciprofloxacin was given orally at a dose of 250 mg every 12 hours for five to 10 days. Patients had either acute bronchitis, chronic bronchitis in the acute phase, or acute tracheobronchitis. In 19 of 20 patients treated, there was a favorable outcome (15 cures and four improvements). In 17 patients, the presumably causative pathogen was eradicated. No side effect was observed except for oral candidiasis, which occurred in two patients. This study demonstrates the clinical and bacteriologic efficacy of ciprofloxacin in pulmonary infection in patients with severe impairment of liver function.

Administration, Oral↗
PubMed1987

Clinical efficacy and safety of sulbactam/ampicillin in patients suffering from chronic liver disease.

Sulbactam is a new beta-lactamase inhibitor with pharmacokinetic characteristics in humans similar to those of ampicillin. A total of 41 patients hospitalized in the Clinic of Infectious Diseases, University of Naples, for chronic liver diseases, were treated with sulbactam/ampicillin (ratio 1:2) for urinary, respiratory, biliary tract or soft tissue infections. Sulbactam/ampicillin was administered im or iv at a dosage of 3-9 g/day depending on the site and severity of the infection. All the patients treated with sulbactam/ampicillin had clinical signs and symptoms of infection, and all the organisms isolated were sensitive to sulbactam/ampicillin (MIC less than 16 mg/l). For both Gram-positive and Gram-negative bacteria the sulbactam/ampicillin MICs were much lower than the ampicillin MICs. In agreement with the favourable in-vitro results, we observed good therapeutic efficacy. 85% of the patients recovered or improved within a few days of therapy, with no clinical relapses, and in 81% of the infections the responsible bacteria were completely eradicated. We observed a low number of side effects (3/41 oral candidosis; 3/41 pain at the im injection site) and no change in the blood chemistry tests.

Adult↗