PubMed Health⌕ Search

Biomedical subjects

A Sanduzzi

Publications and source records attributed to A Sanduzzi.

At least 37 records · Page 2Linked to original sources
PubMedDate not supplied

An acute bronchodilator test with tiotropium or salmeterol does not allow a subdivision of patients according to responses.

BACKGROUND: The possibility that individual chronic obstructive pulmonary disease (COPD) patients respond better to either tiotropium or salmeterol has been suggested and an acute bronchodilator test might help to guide the choice of therapy. OBJECTIVES: We explored the responses to tiotropium and salmeterol within the first 3 h using the recommended dosages (18 microg for tiotropium and 50 microg for salmeterol) in order to verify whether there are differences in the short-term bronchodilator effects between these two long-acting bronchodilators in patients with stable COPD. Moreover, we investigated whether these differences could discriminate between the two agents. METHODS: Forty consecutive patients with COPD, but in a stable phase of the disease, participated in this double-blind, double-dummy, randomized crossover study. The study involved a screening visit and 2 study days separated by at least 1 week. For determination of the onset of action, we measured FEV1 at 10, 20, 30, 60 and 90 min, and again 2 and 3 h after inhalation of single study drug. RESULTS: At all time points, both tiotropium and salmeterol caused significant (p< 0.001) changes from baseline. A mean increase of 12% above baseline was reached 66 min (95% CI: 45-87) after tiotropium and 59 min (95% CI: 41-77) after salmeterol. Nine patients after tiotropium and 5 patients after salmeterol did not have this type of improvement. A mean increase of 200 ml above baseline was reached 76 min (95% CI: 52-101) after tiotropium and 76 min (95% CI: 52-100) after salmeterol. Eighteen patients after tiotropium and 15 patients after salmeterol did not have this improvement. Twenty-one patients after tiotropium and 24 patients after salmeterol reached an improvement that was at the same time 12% and 200 ml greater than baseline. CONCLUSIONS: These data clearly show that the bronchodilator effects of tiotropium and salmeterol within the first hours after their acute administration are similar in patients with stable COPD when they are evaluated as mean changes from baseline in FEV1. Therefore, they question the direct therapeutic relevance of a subdivision of patients according to bronchodilator responses to tiotropium or salmeterol.

Administration, Inhalation↗
PubMedDate not supplied

Natural killer cells in Bal and peripheral blood of patients with idiopathic pulmonary fibrosis (IPF).

Idiopathic Pulmonary Fibrosis/ Usual Interstitial Pneumonia (IPF/UIP) represents the most important interstitial pneumonia. ATh2 cytokine pathway predominance, favoring collagen deposition, associated to a deficit in (IFN- gamma) network, seems to be involved in the pathogenesis of this disease. Nonetheless, few data are available about the potentially involved cells. Natural killer cells (NK), are one of the most important subsets implicated in the IFN-gamma network. The aim of this study was to assess NK cells, both in BAL and peripheral blood of 11 patients suffering from IPF (group A) with respect to 11 patients with other interstitial pneumonia (Group B). Our results did not show any statistically significant difference in NK percentage in BAL between group A and B. On the contrary, patients with IPF showed a higher percentage of NK cells (t = 2.41; p < 0.05) and absolute number of cells (t = 2.32; p < 0.05) in peripheral blood, as well as a strong positive correlation between circulating and BAL NK cells (r = 0.69; p < 0.05). This finding shows, for the first time, a relationship between peripheral and lung resident cell environments in humans suggesting a possible systemic involvement in the natural history of IPF.

Antibodies, Monoclonal↗
PubMedDate not supplied

Monocytes/macrophages in HIV infection and tuberculosis.

Mycobacterium tuberculosis (MTB) and human immunodeficiency virus type 1 (HIV-1) are virulent intracellular pathogens that enter and replicate within macrophages, which represent their reservoire. Public health problems are greatly compounded when the two diseases co-exist, and this is the reason why Acquired Immunodeficiency Syndrome (AIDS) and tuberculosis (TB) have been termed "the cursed duet", given the synergistic effect they exert one each other. With the depression of immunity caused by HIV-1 infection, latent MTB infection is much more likely to progress to clinically significant disease. On the other hand, TB results in activation of T cells and macrophages that may harbor latent HIV. Here some data are reviewed that can contribute to clarify the mechanisms involved in the concurrent infection, given that MTB infection has been shown to be able to: a) enhance HIV-1 replication in macrophages, b) augment CC-CKR5 (CCR5) expression on macrophage membrane, and, c) induce apoptosis in a portion of infected macrophages.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Risk factors for tuberculosis infection and disease.

We conducted a prospective study among patients with newly diagnosed pulmonary tuberculosis and their close contacts to identify clinical and socio-economic risk factors for tuberculosis infection and disease. Ninety patients and 277 contacts were enrolled. The prevalence of infection was 45% [95% confidence interval (CI): 39-51%] among contacts. Factors like age, gender, race, delay of diagnosis and treatment, presence of cavitation in chest radiograph, cough, unwillingness to cover the mouth, volume of air shared by close contacts and patients were investigated. Inclusion of all these factors in a multivariate logistic regression model showed that only delay in diagnosis is significantly associated to the increase of prevalence (p < 0.0002), documenting that delay in diagnosis of the case is a crucial factor for tuberculosis infection and/or disease.

Adult↗
PubMedDate not supplied

Detection and qualitative identification of mineral fibers and particles in alveolar macrophages of BAL fluid by SEM and EDXA.

Inorganic dust inhalation diseases represent one of the most important chapters in respiratory medicine because of their diagnostic, therapeutic, legal, ecological and social implications. While, in fact, toxic substances inhalation may be easily related to particular occupations, it is more difficult to recognize the potential damage represented by occasional and fortuitous exposition due to pollution of one's living environment. The aim of this study was to suggest a useful investigative method for detecting the presence of mineral substances (dusts and fibers) in the lung in pulmonary fibrosis of uncertain origin. We used scanning electron microscopy (SEM) and semi-quantitative energy-dispersive x-ray microanalysis (EDXA) on broncholaveolar lavage (BAL) and sputum samples of 10 patients, all males, aged 41-66 years, smokers, affected by interstitial lung disease. Two subjects had a negative professional anamnesis while the other 8 declared a potential exposition to inorganic toxic dusts: 2 subjects were involved in the production of asbestos-containing building materials, 2 were miners, 1 a ceramic worker, and 3 insulating materials handlers. Data are reported on the detection of asbestos bodies, vitreous fibers and silica content of alveolar macrophages in BAL fluid.

Adult↗
PubMedDate not supplied

[The role of bronchoalveolar lavage (BAL) in assessing pulmonary compromise in AIDS].

The severe immunologic alterations caused by HIV infection is at the base of respiratory tract infections, neoplasms and inflammatory complications which represent the most frequent cause of death in AIDS patients. The etiological diagnosis is difficult and often needs invasive procedures. Among those, BAL is surely the most useful method because of its lesser invasiveness and better tolerability and more for its sensibility and easier repeatability. Besides the etiological evaluation of lung infections, BAL allows to obtain and analyze immunologic and inflammatory cells from alveolar spaces consenting the acquisition of data regarding immunopathogenetic mechanisms related to pulmonary complications during AIDS. We report data about cytoimmunologic study of BAL fluid in 10 patients of ours.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[The microbiological aspects of AIDS-related respiratory infections].

Main etiologic agents of AIDS-related infections pneumonia and diagnostic tools useful to identify microorganism are discussed. Bronchoalveolar lavage (BAL) remains the most important performed technique to collect pulmonary secretions, but it needs to be completed by colorimetric, immunological (monoclonal antibodies), serological (ELISA vs. mycobacterial antigens), molecular (DNA probes) techniques. These tools are very useful to identify pathogen agents.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Clarithromycin in the treatment of bacterial relapses of chronic bronchitis.

Clarithromycin is a new semisynthetic macrolide, Erythromycin A derivative, which is bactericidal for the most of growing aerobic and anaerobic Gram-positive and Gram-negative organisms. The drug has also a potent activity against the pathogens surviving into intracellular medium and, just like all other macrolides, achieves its effect by inhibiting protein synthesis. Our study investigated the efficacy and tolerability of Clarithromycin in 11 ambulatory patients (8 m, 3f) suffering from bacterial relapses of chronic bronchitis. The macrolide was administered at the oral dosage of 250 mg twice daily for a period ranging from 7 to 11 days, only after microbiological evaluation of sputum. There was a withdrawal because one of the three bacteria isolated from sputum sample was resistant to Clarithromycin, 7 patients were clinically cured, 3 showed only clinical improvement. In all the ten patients there was eradication of causative agents. No adverse events or changes in biochemical and haematological tests were observed.

Adolescent↗