Listeria monocytogenes meningitis and multiple brain abscesses in an immunocompetent host. Favorable response to combination linezolid-meropenem treatment.
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Acetamides↗
Biomedical subjects
S Sabbatani
Publications and source records attributed to S Sabbatani.
[Syphilis in sixteenth-century in Bologna. Health care and social assistance (Part one)].
Syphilis arrived in Bologna in the summer of 1495, after Fornovo's battle on the Taro where Charles VIII's army, following the invasion of Naples, fought against the anti-French league who faced up to the invaders as they withdrew. It was the battle-weary Bolognesi, prisoners, deserters and probably some prostitutes following the French and mercenary army who introduced the infection into the city. At the beginning of the syphilis epidemic, the disease was very aggressive with particularly visible symptoms and many resulting deaths. Subsequently, contemporaries mention an abatement of this aggressivity in time spans that varied, but in no cases exceeded 60 years. In 1507 Bologna lost its political autonomy, becoming dependent on Rome. This was symptomatic of the upheavals throughout Italy in the sixteenth century. In this situation of economic and institutional crisis the Bolognesi were able to react with decision to the epidemic, re-converting the municipal hospital dedicated to S. Maria dei Guarini during the sixteenth century. This hospital, specializing in treating syphilis, was called "Ospedale di San Giobbe". It was closed in 1798, after the entry of the French army into Bologna. In 1560 the Bolognesi, realising that the most important causes of the spread of syphilis were social degradation, prostitution and poverty, founded another institution for the poor and for the prevention of prostitution. This institution was developed by the Opera dei Mendicanti and provided hospitality during the 1590 famine, in a city of 55,000 inhabitants, for as many as 1400 poor and sick. We also present the cure (guaiac and mercury) that they used at the time against syphilis. In such a difficult historical period beset with political and economic problems, the Bolognesi established two important institutions and showed that social solidarity is a value for the whole population.
Catholicism↗
[Syphilis in sixteenth-century in Bologna. Health care and social assistance (part two)].
Syphilis arrived in Bologna in the summer of 1495, after Fornovo's battle on the Taro where Charles VIII's army, following the invasion of Naples, fought against the anti-French league who faced up to the invaders as they withdrew. It was the battle-weary Bolognesi, prisoners, deserters and probably some prostitutes following the French and mercenary army who introduced the infection into the city. At the beginning of the syphilis epidemic, the disease was very aggressive with particularly visible symptoms and many resulting deaths. Subsequently, contemporaries mention an abatement of this aggressivity in time spans that varied, but in no cases exceeded 60 years. In 1507 Bologna lost its political autonomy, becoming dependent on Rome. This was symptomatic of the upheavals throughout Italy in the sixteenth century. In this situation of economic and institutional crisis the Bolognesi were able to react with decision to the epidemic, re-converting the municipal hospital dedicated to S. Maria dei Guarini during the sixteenth century. This hospital, specializing in treating syphilis, was called "Ospedale di San Giobbe". It was closed in 1798, after the entry of the French army into Bologna. In 1560 the Bolognesi, realising that the most important causes of the spread of syphilis were social degradation, prostitution and poverty, founded another institution for the poor and for the prevention of prostitution. This institution was developed by the Opera dei Mendicanti and provided hospitality during the 1590 famine, in a city of 55,000 inhabitants, for as many as 1400 poor and sick. We also present the cure (guaiac and mercury) that they used at the time against syphilis. In such a difficult historical period beset with political and economic problems, the Bolognesi established two important institutions and showed that social solidarity is a value for the whole population.
Combined Modality Therapy↗
Bartonellosis: light and shadows in diagnostic and therapeutic issues.
Cat-scratch disease involves a prolonged and/or complicated course, and lymph node drainage is usually required. Culture and molecular techniques often yield negative results, but immunofluorescence assays may give early information, and elevated antibodies may persist for months. Cat-scratch disease should be suspected in patients with prominent swelling of lymph nodes draining from the upper limbs, limited systemic involvement, and typical epidemiological-clinical features. The temporal antibody response during the sub-acute course remains unknown. Although biomolecular assays are available, the time between onset and investigation is an obstacle to positive results. The role of surgical debridement and the unpredictable activity of antimicrobial agents warrant further investigation.
Animals↗
[Attempts to fight paludism and malaria in the middle ages. Role of Benedictine and Cistercian monks in the rise of monastic medicine and in land reclamation during the Middle Ages].
The loss of low-lying farm-land to marshes and swamps was a striking phenomenon in Italy and other regions of Europe after the fall of the Roman Empire. Throughout the Middle Ages extensive fertile agricultural lands were abandoned due to increased marshiness and the risk of the spread of malaria diffusion. In economic and social terms, this was a further source of decline. In this scenario of progressive abandonment which supported the spread of disease, Benedictine and Cistercian monks performed extensive land reclamation (relying on channels, dams and embankments), leading to a progressive control of seasonal flooding by rivers and basins. Inside the abbeys monastic medicine flourished, which in some regions often represented the main reference point for health care for all residents (whether the common people, nobles or clergy), in the "Dark Ages". Many monks paid with their own lives: malaria and malnutrition were the most frequent causes of morbidity and mortality. Benedictine and Cistercian monks, who had embraced the Benedictine rule, today deserve high consideration, as the major supporters of Europe's recovery, which took place on the continent from the 13th century onward. Their motto, "Pray and work" (Ora et labora) and "That God may be glorified in all things" (Ut in omnibus glorificatur Deus) supported their daily life and action. For centuries inside abbeys and fortified farmsteads known as grancie monks added prayers to work, in their attempt to reclaim land. Nature often treated them badly, at despite such difficulties, the monks never shrank from danger.
Animals↗
Voriconazole proves effective in long-term treatment of a cerebral cryptococcoma in a chronic nephropathic HIV-negative patient, after fluconazole failure.
Although being a rare occurrence, brain cryptococcoma may represent an emerging issue, because of its relationship with a broadening range of risk factors, including malignancies, neutropenia, end-organ failure, bone marrow and solid-organ transplantation, and multiple underlying causes of primary-secondary immunodeficiency. A cerebral cryptococcoma in a chronic nephropathic HIV-negative subject with homocystinuria, completely cured with neurosurgery and voriconazole after fluconazole failure, is described.
Antifungal Agents↗
Capnocytophaga spp. brain abscess in an immunocompetent host: problems in antimicrobial chemotherapy and literature review.
The fourth case report of a brain abscess due to the fastidious Gram-negative organism Capnocytophaga spp. is described and discussed on the grounds of clinical, microbiological, and therapeutic evidence. A probable origin from a cat bite and/or an underlying severe mandibulary granuloma is suspected. Due to lack of clinical and neuroradiological response to neurosurgery and a combination of imipenem-amikacin-clindamycin-fluconazole, second-line empiric llnezolid treatment proved rapidly successful, in the absence of further microbial isolations. In vitro antimicrobial susceptibility testing is often unpredictable for Capnocytophaga spp., and agents usually active on Gram-positive organisms may also be effective, both in vitro and in vivo. Due to its favorable brain penetration and its dual mode of administration, linezolid may be an alternative option for patients with multiple risk factors, brain abscess of suspected polymicrobial origin, and lack of response to empiric or culture-driven therapeutic attempts.
Adult↗
[First attempts at smallpox engrafting (variolation) in the18th-century in Bologna].
In Bologna in the mid 18th century some brilliant doctors were among the first in Italy to carry out smallpox engrafting (variolation), obtaining interesting results. Academics and Scientific Establishment censured the activities of these experimenters, such that one of them had to continue his work in Padova, where he went to teach and continued the practice of variolation. However, Bologna's Curia pronounced a positive theological judgement on such experiments. Forty years later, in 1801, Bologna's Senate called upon Luigi Sacco to organize campaigns to vaccinate and thereby smallpox infection. Bologna had been scourged by a new epidemic that year. What happened in Bologna during the 18th century regarding scientific research reflected the demographic, economic and political situation that the city was experiencing. This trend was to come to an end only with the unification of Italy.
Disease Outbreaks↗
[A case of cerebral coenurosis].
In this article the authors describe a case of cerebral coenurosis, a rare infection caused by the larval stage of the tapeworm Taenia multiceps, encountered during their professional practice. The specific epidemiological elements, linked to the parasitic lifecycle in dogs, will also be covered. The authors consider the diagnostic, pathologic and clinical elements that allow differential diagnosis with respect to neurocysticercosis, a parasitic infection caused by the larval form of other Cestoda, discussing possible medical therapeutic approaches (albendazole or praziquantel) and neurosurgical intervention. They emphasize the need to obtain a correct hystopathological diagnosis in order to achieve a differential diagnosis versus the other larval parasitosis. According to current public health regulations this diagnosis must be reported to the Health Official to allow the necessary epidemiological interventions to be planned.
Albendazole↗
[Potential antibiotic pharmaceutical cost reduction in an operative unit of infectious diseases. Projects for making savings and improvements].
The authors intend to evaluate the results obtained from a pharmaco-economic project included in the 1999 and 2000 budgets. The objectives of the study are: 1) to establish whether there has been a saving in expenses for antibiotic therapy (T.A.) during the first half-year of 1999 and during the first half-year of 2000 and to ascertain the reasons for any positive result; 2) to evaluate the average hospital stay in the first half-year of 2000 and to observe how many times patients were been discharged early with shift therapy. Of the 286 patients (1999) and 309 (2000) considered, we focused attention on 187 (1999) and 190 patients (2000) who were treated with antibiotic therapy. A substantial cost saving was found in antibiotic use (-31%) in the first half-year of 2000 due to the early discharge and the continuation of home therapy for a fair number of patients and due to increased attention in the choice of medicine for less serious diseases. The second objective was not achieved with the reduction of average hospital stay even if the average length of antibiotic therapies (D.M.T.) fell from 13.1 days at 1st September to 9.8 days in the first half-year of 2000 (P:NS). These results suggest that projects designed to achieve financial savings and improvements require more cooperation between clinical U.O. and services that enable hospital stay to be shortened.
Anti-Bacterial Agents↗
[Relationship between malaria, environment, people and civilisation in central Italy. Reclamation of the Fucino plain].
In this article the incidence of malaria in the course of history is cited as a paradigmatic example of pathocenosis - emergence of new infectious diseases related to the environmental conditions or to the different ecology of the infected host - as malaria is affected by climatic variations and environmental deterioration. The incidence of malaria in the Mesolithic and Neolithic ages is briefly evaluated. Moreover, the finds from a necropolis in the Sele river plain established the effect that the land reclamation of the wetland during the Etruscan period induced on the porotic hyperostosis, an indirect index of malaria sustained by Plasmodium falciparum. In addition, we consider the reclamation in the area of the Fucino plain, a volcanic basin without outflow, whose shores were therefore unhealthy. In the reign of the Claudius, in the early years of the Roman Empire, a tunnel was built to provide an outflow, thereby draining the wetlands. The results of this engineering intervention lasted for six centuries. During medieval times the area was neglected, thus creating the pre-existing insalubrious environmental conditions. It was only during the Bourbon period in the 19th century that a new intervention was initiated, subsequently completed by Prince Torlonia, which allowed the wetlands to be definitively transformed into farmland.
Environment↗
[Pharmaco economics aspects of antibiotic therapy for AIDS patients in department of infectious disease].
The financial budget for public health care in Italy has been more and more restricted in the last few years, but, on the other hand, the care of AIDS patients is still very expensive and antibiotic therapy plays an important role in the management and cost of these patients. The antibiotic therapies and related costs have been evaluated in 99 patients affected by AIDS (59 pts), ARC (28 pts) or HIV serum positive (12 pts), all hospitalized or treated in Day Hospital for different bacterial infections in 1995 at the Department of Infectious Diseases, Ospedale Maggiore, Bologna, for a total of 7733 days of antibiotic therapy. The average cost for antibiotic therapy was about 400,000 Italian Lira, with no significant difference depending on the stage of HIV related disease. The crude cost for antibiotic treatment was not particularly high, but the high frequency of adverse events, registered in these patients, required additional medical support and/or a prolonged hospital stay, which increased substantially the total cost of management of bacterial infections.
English Abstract↗
[Survival time of AIDS patients resident in Bologna city and county. Recommendations for care planning].
The authors have analyzed the survival time of AIDS patients (resident in Bologna) in the period from 1984 to 1995. The study can allow accurate predictions to be made as to the likely volume of admissions to in-patients wards and Day Hospital, as well as helping Home Care planning for patients with serious social problems. The case histories studied were of 752 adult AIDS patients and 13 children. The adult AIDS patients had a mean survival time of 10.4 months (range 9.6-11.8). By breaking down the case histories into those notified between 1984 and 1987, 1988 and 1991 and 1992 and 1995, the greatest increase of survival time (mean) with respect to the previous four years period was achieved in the period covering 1988-1991: 5.23 months against 10.53 months (p<0.05). The life expectancy of persons above 40 years of age is lower than in the case of younger patients: 7.7 months against 11.37 months in the age bracket 26-39 years (P<0.05). The child cases of AIDS showed a survival time of 31.4 months (range 11.1-55.9).
English Abstract↗
[Cholera in Bologna in XIX century. A brief report on the scientific knowledge of the period].
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Journal Article↗
HIV-1-specific immunity in persistently seronegative individuals at high risk for HIV infection.
A growing number of reports indicates that certain groups of individuals who almost certainly have been exposed to human immunodeficiency virus (HIV), yet continue to exhibit no signs or symptoms of infection, often have subtle evidence of specific immunity. We studied such a high-risk (HR) cohort of persistently seronegative individuals with histories of long-term sexual exposure to an HIV-infected partner to look for evidence of both humoral and cellular immunity that might have been induced by exposure to the virus. Twenty-three heterosexual and four homosexual monogamous couples with discordant HIV status were included in the study. Twelve of the HR partners were studied for in vitro stimulation of peripheral blood mononuclear cells (PBMC) by HIV envelope-derived peptides. All 12 responded overwhelmingly to a peptide containing the fifth conserved region of gp120. By generating and cloning T cell lines specific for this peptide, we concluded that in these individuals the T cell response to the envelope is mainly focused on the carboxy-terminus region of gp120 and is characterized by an oligoclonal expansion of CD4+ T cells expressing the same TCR Eighteen HR partners and 37 HIV-1 seropositive subjects were tested for the presence of anti-CD4 antibodies (anti-CD4 Abs) using a recombinant CD4-based enzyme-linked immunosorbent assay (ELISA). Anti-CD4 Abs were detected in eight of the HR partners (six confirmed by Western blot) and in nine of the HIV-1 seropositive subjects (eight confirmed by Western blot). Results from binding competition assays with a panel of monoclonal anti-CD4 Abs suggested that the anti-CD4 Abs detected in the HR partners are directed toward epitopes that are induced by gp120 binding. Twenty-seven of the HR partners were tested for the presence of antibodies that cross-react with HLA class I and gp120 (anti-HLA Abs). Anti-HLA Abs were detected in 16 of the HR partner sera and in 4/94 sera from a control population of normal healthy blood donors. Taken together, the results suggest that in some individuals with a history of long-term exposure to HIV, specific immunity may develop in the absence of overt infection. The common trigger for these responses is gp120.
Antibodies↗
Heterogeneity of hepatitis C virus genotype 2 variants in West Central Africa (Guinea Conakry).
An overall anti-hepatitis C virus (HCV) prevalence of 6.7% was found in a sero-epidemiological study carried out in the town of Conakry (Guinea Conakry, West Central Africa) on 1421 subjects who were either blood donors, pregnant women or in- and outpatients receiving treatment for conditions other than liver disease. Seven HCV isolates from a subsample of 73 sterile sera from this population were studied for genetic characterization and classification. The 5'NCR was analysed by the Line Probe Assay. This method assigned the isolates to genotype 2. Analysis of the 5'NCR sequences alone was unable to give a more accurate classification. Comparison of NS5b region sequences (nucleotides 7575-8196), from Guinea isolates and genotype 2 database sequences, showed evolutionary distances in the range 0.15-0.26. There was a high level of subtype heterogeneity among the genotype 2 Guinea HCV isolates. Four of the subtypes were possibly new.
Base Sequence↗
[Home care service: a need for AIDS patients. Epidemiological and economical data].
The Authors present epidemiological and economic data, to demonstrate that in Bologna and in Emilia Romagna region the home care service is an important instrument to treat AIDS patients and in particular those who have psychological and social problems as the drug abusers. There are human, social, sanitary and economic reasons to realize an integrate home care assistance according to the law 135/1990. The serious epidemiological situation of Emilia Romagna strongly induces to apply the guidelines for the home care service in the city where they haven't been realized and to extend the program where it's inadequate.
English Abstract↗
[Analysis of operating costs during a year in an infectious diseases department (April '94-March '95)].
The Authors have analytically worked out the operating costs on the different pathologies for all the patients admitted at the Infectious Diseases department (USL Bologna City) from April 1994 to March 1995. The economic costs for one-year treatment of AIDS patients were very expensive for the community. In fact, for each patient, the average hospital admissions were 2.2 for year, and the average duration of hospitalization was 24 days each time. The Day Hospital had an important role for the majority of the patients with pathologies correlated with HIV infection (AIDS and ARC). The 75% of hospitalization days were spent by patients with HIV correlated pathologies. This group of patients caused 71% of diagnostic-therapeutic procedures. The number of admissions to hospital for patients with a pathology not correlated with HIV was lower than statistical expectations, probably because these patients preferred other medical services to avoid contacts with AIDS patients. The Authors have got the conviction that the existence of other kind of territorial assistance services such as House Care and Domiciliary Therapy Care would determine a great decrease of the operating costs.
English Abstract↗