PubMed Health⌕ Search

Biomedical subjects

A Bucceri

Publications and source records attributed to A Bucceri.

10 recordsLinked to original sources
PubMed2000

The changing HIV epidemic in Italian pregnant women.

OBJECTIVE: To describe changes in the characteristics of HIV-pregnant women in Italy and the impact of strategies for prevention of HIV vertical transmission. STUDY DESIGN: Since 1985, HIV-infected women and their children are followed in 23 European centres in the European Collaborative Study (ECS), according to a standard protocol. Eight Italian Obstetric units participating in the ECS enrolled 815 patients. RESULTS: Overall use of zidovudine to reduce HIV vertical transmission has increased significantly since 1994 and between 1995 and 1997, 57% of Italian women were treated. However, 27% of babies received the infant component of the 076 regimen. Over the years, age at delivery has increased and their CD4 count at delivery decreased, most likely reflecting heterosexually infected women with a longer duration of infection. The increasing rate of elective caesarean section (42%) is not related to maternal, foetal or obstetrical indications, but its use as an intervention to reduce HIV vertical transmission. CONCLUSIONS: The identification of HIV-infected women during pregnancy or before delivery ensures the appropriate management of the woman and her child, and clinicians should be aware of the increasing number of women with heterosexual acquisition of HIV-infection who may be less easily identified.

Adult↗
PubMed1997

Pregnancy outcome among HIV positive and negative intravenous drug users.

OBJECTIVE: To analyze determinants of pregnancy outcome, among HIV infected and uninfected intravenous drug users. STUDY DESIGN: A total of 315 pregnant current intravenous drug users, IVDU (151 HIV infected and 164 HIV uninfected subjects) were referred to the Center for Pregnant Drug Addicts of the Mangiagalli Clinic, Milan, Italy, for internatal care and delivery between 1985 and 1993. RESULTS: HIV uninfected and infected mothers did not differ significantly according to type of pregnancy, gestational age at childbirth, mode of delivery, pregnancy outcome and newborn weight, height, head circumference, sex and Apgar at 1 and 5 min. Out of 133 children (born to HIV infected mothers) for whom HIV status was available, 20 (15%) were HIV infected or developed AIDS-related signs and symptoms during a 24 months follow-up. The distribution of HIV infected and non infected infants was not significantly different as regards maternal CD4 lymphocyte count, week of gestation at birth, mode of delivery, infant weight, height, head circumference and Apgar at 1 and 5 min. CONCLUSION: Our data show that HIV infected women in the early stages of HIV infection are not at a higher risk of adverse course of pregnancy than HIV uninfected women. Vertical transmission rates were not associated to newborn characteristics.

Adult↗
PubMed1993

Transmission of human immunodeficiency virus type 1 (HIV-1) from mother to child correlates with viral phenotype.

The aim of this study was to investigate if the risk of mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1) is influenced by the biological phenotype of the mother's virus. Virus isolates from 30 HIV-1 infected mothers and 12 infected children born to these mothers were analyzed for replication on several cell lines (Jurkat-tat, Jurkat, CEM, U937 clone 2, and MT-2). We show that mothers who harbor virus able to replicate in cell lines (rapid/high virus) have a significantly higher risk to infect their children than mothers with slow/low virus (P = 0.017). Children born to mothers with rapid/high viruses can be infected by slow/low as well as rapid/high viruses, while mothers with slow/low virus appear to transmit slow/low virus in every case. Our study shows that the biological phenotype of the mother's virus may serve as a complementary marker to CD4+ lymphocyte counts and p24 antigenemia in predicting the risk of transmission of HIV-1 to the child.

Cell Line↗
PubMed1991

Polymerase chain reaction, virus isolation and antigen assay in HIV-1-antibody-positive mothers and their children.

Diagnosis of perinatal HIV-1 infection is complicated by the persistence of maternal antibodies and the conflicting reports on polymerase chain reaction (PCR) reactivity in children born to HIV-1-seropositive mothers. We have compared PCR with other diagnostic methods for perinatal HIV-1 infection and have attempted also to identify maternal markers which correlate with risk of transmission. PCR was the most sensitive method for early diagnosis of perinatal transmission of HIV-1, but the PCR-positive children (n = 11) developed at least one additional sign of infection. The PCR-negative children (n = 76) were clinically healthy, virus isolation negative, and their serum was HIV-1-antigen-negative. All children who had become seronegative (n = 36) were both PCR- and isolation-negative. Antigenaemia in the mothers correlated significantly with higher risk of perinatal transmission of HIV-1, while no other parameters (clinical stage, lymphocyte subsets, PCR and isolation) showed such a correlation. This indicates that the level of virus expression may be of key importance for the risk of vertical transmission of HIV-1 infection.

CD4 Antigens↗
PubMed1990

Perinatal outcome in HIV-infected pregnant women.

We have observed 74 HIV-seropositive and 48 HIV-seronegative drug-addicted women and 22 HIV-seropositive nondrug-addicted pregnant women during pregnancy and we report their perinatal outcome. 8 out of 96 HIV-seropositive patients had hematological signs of immunodeficiency and 2 of these patients were symptomatic belonging to CDC class III. We recorded 2 early and 3 late spontaneous abortions, no intrauterine fetal death and 3 neonatal deaths. Seropositive patients had 3 malformed babies, seronegative patients had 1. All these women had a high incidence of premature delivery and intrauterine fetal growth retardation: seropositive patients had a higher incidence of fetuses small for gestational age and a lower incidence of preterm delivery compared to seronegative patients, but the difference was not statistically significant. The incidence of malformation was comparable to the general population: 3 malformed babies were born to HIV-positive drug-addicted mothers, and 1 to a seronegative drug-addicted mother. These findings do not support the hypothesis of a direct detrimental effect of HIV on perinatal outcome. Consequences of fetal exposure to maternal HIV infection involve mostly postnatal life and development of acquired immunodeficiency.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Prenatal immune status of fetuses of HIV-seropositive mothers.

Human immunodeficiency virus (HIV) has been isolated from fetal tissues as early as 13 weeks and later from fetal blood. These findings have raised the possibility of prenatal diagnosis of infected fetuses by identification of the virus in the fetal compartment. Study of the fetal immune status has proved reliable in prenatal diagnosis of congenital immunodeficiency, and we have tested the possibility to diagnose acquired immunodeficiency in utero by this approach. We studied T lymphocyte subsets and their mitogenic response in fetal blood obtained after elective termination at midgestation in 8 cases and at delivery in 26 cases of maternal HIV infection. Results have been compared to appropriate normal controls. No significant difference was found in terms of total lymphocytes, CD4 and CD8 populations and phytohemagglutinin responses. This indicates either that immunological parameters currently used to assess postnatal immunodeficiency are not reliable during intrauterine life or that the intrauterine environment and the transplacental passage of maternal antibodies interfere with development of prenatal immunodeficiency.

AIDS Serodiagnosis↗
PubMed1989

Cisapride and gastric emptying of a solid meal in dyspeptic diabetics without autonomic neuropathy and in healthy volunteers.

Gastric emptying was studied in 10 insulin-treated, long-standing, diabetic out-patients with upper gastrointestinal, dyspeptic symptoms. Autonomic neuropathy, mucosal lesions and chloropeptic hyposecretion were excluded. Gastric emptying of a labelled solid meal (99mTc-sulphur colloid-infiltrated chicken liver) was clearly delayed by comparison with normal subjects: the mean gastric emptying half-time was almost 5-times longer (245.6 vs 52.5 min), and the gastric emptying rate at 120 min was 75% slower. Cisapride 10 mg i.v. significantly accelerated both parameters, and placebo had no effect upon them. In conclusion, gastroparesis may be present in diabetics without autonomic neuropathy, and cisapride may improve gastric emptying in such patients.

Adult↗
PubMedDate not supplied

[Role of ultrasonography in abdominal surgical emergencies. Our experience].

OBJECTIVE: To assess the sensitivity, specificity, and predictive value of ultrasonography in surgical patients in abdominal emergency in regard to the indication for immediate operation, delayed abdominal exploration, or conservative treatment. DESIGN: A retrospective study was conducted after consecutive sampling of 98 patients in a control trial. SETTING: The study was conducted at the University Hospital of Catania (Italy), which serves as a general community hospital. PATIENTS: All patients with acute upper abdominal pain or blunt abdominal trauma were eligible for the study. A total of 110 patients were observed from 1990 to 1994, after plain X-ray of the abdomen in 12 patient was diagnosed visceral perforation and they went for immediate operation. The remaining 98 patients were divided into two groups: acute upper abdominal pain (56 patients) and blunt abdominal trauma (42 patients). INTERVENTION: Ultrasonography in the emergency department. MAIN OUTCOME MEASURES: Conservative or operative treatment based on ultrasonographic and clinical findings. RESULTS. Ultrasonography showed a sensitivity of 100%, a specificity of 52.6%, a positive predictive value of 100%, and a negative predictive value of 100% in regard to the indication for surgery in cases of surgical abdominal emergency. CONCLUSION: Ultrasonography saves time and money, can be performed in the emergency department, shows high sensitivity and specificity, and is the method of first choice in the evaluation of blunt trauma.

Abdomen, Acute↗