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Biomedical subjects

B Rocca

Publications and source records attributed to B Rocca.

45 records · Page 3Linked to original sources
PubMed1985

[Anomalies of the membrane receptors of blood phagocytic cells in nosocomial pulmonary infections].

Patients in intensive care units have frequent and severe opportunistic bacterial pneumoniae, even if they were previously free from respiratory disease. A search was made in these patients for possible immune deficiencies. Granulocyte and monocyte phagocytic activities were studied separately in 17 patients with bacterial bronchopneumonia (male: 13, female: 4; age: 41 +/- 5 yr). The ability of three types of particles (opsonized zymosan, immunoglobulin coated and glutaraldehyde-treated sheep red cells) to trigger ingestion was measured. Cells were tested either in normal AB serum or in the presence of patient's serum. A substantial 40% decrease of the fraction of granulocytes ingesting zymosan was found in our experimental conditions (p less than 0.001). Activity with the other particles was not significantly altered. Patients' sera were at least as efficient as a pool of normal sera in opsonizing zymosan. Furthermore, no phagocytic inhibitor was found in the patients tested. Underlying mechanisms for these abnormalities remain unknown, but a better understanding of the aetiology of the altered bactericidal function of phagocytic cells is required before suggesting immunomodulating treatments.

Adult↗
PubMed1984

[Surgery and circulating antiprothrombinase-type anticoagulant in the Soulier-Boffa syndrome].

A case is reported of a young female patient with a circulating lupus anticoagulant. The illness, associated with several spontaneous abortions, is characterized as a "Soulier and Boffa syndrome". No severe bleeding occurred when she underwent several major operations. The clinical picture of lupus anticoagulant is discussed, as well as the perioperative management of such patients. The presence of a lupus anticoagulant, if not associated with other hemostatic defects, is not a contraindication to surgery. The risks and benefits of postoperative heparinization are recalled. Thrombin time seems to be the best coagulation test for adapting heparin doses.

Abortion, Habitual↗
PubMed1984

[Cerebral immunoblastic lymphoma and the acquired immunodeficiency syndrome].

A case of acquired immune deficiency syndrome (AIDS) is reported in a young homosexual Venezuelan male. It is of special interest to note the association of cytomegalovirus polyvisceral infection, frequent during AIDS, and a brain immunoblastic lymphoma, an infrequent tumour in that pathology.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Cell-mediated cytotoxicity to autologous hepatocytes in HBsAg positive liver disease: an analysis of the killing specificity and of the clinical use of the test.

The specificity of a system measuring cell-mediated cytotoxicity as effector-induced target cell detachment from plastic recently adopted to study autologous hepatocyte killing in liver disease, was examined in 17 HBsAg positive liver patients whose hepatocytes (after biopsy digestion with collagenase) were incubated in Terasaki plates with the corresponding blood lymphocytes over two days. The hepatocyte viability and the specificity of the effectors were evaluated as determinants of the clinical value of the test. We found that: (a) hepatocytes in all experiments showed membrane damage owing to the lytic action of collagenase on the small liver core; (b) patients' lymphocytes detached diseased autologous hepatocytes more efficiently than did normal lymphocytes with healthy hepatocytes; (c) in eight patients cytotoxicity appeared equally distributed between a population enriched in T cells and one enriched in non-T cells; yet the mean cytotoxic index of the latter subset was higher than that of the former; (d) cytotoxicity was not blocked by the addition of either aggregated IgG or purified HBsAg; (e) protein synthesis seemed required to promote hepatocyte detachment, for lymphocytes treated with Actinomycin D were no longer active. Poor target viability detracts from the specificity and the clinical value of the test, that therefore turns out to be a major problem of liver cell culture.

Adolescent↗
PubMed1983

[Catheterization of the axillary vein in intensive care. Analysis of a series of 151 cases].

In order to lower the risks of infection and other complications during prolonged venous catheterization, percutaneous axillary venepuncture is advocated as an access route to the superior vena cava. This study relates the results of 151 attempts. Most of the patients were tracheostomized and under controlled ventilation. Catheterization was successful in 79% of the cases (119 cases). In 92 cases access to the superior vena cava was sought and in 27 cases the pulmonary artery. No major complication was observed. Bacterial contamination of the catheter tip was found in 21% of cases. Percutaneous catheterization of the axillary vein appeared to be a safe and reliable technique, especially for prolonged catheterization in high risk patients.

Adolescent↗
PubMedDate not supplied

An assessment of paramedic performance during invasive airway management.

OBJECTIVE: To assess the performance of paramedics, in a newly-initiated prehospital program, during invasive airway management. METHODS: An audit of paramedic call reports for a 12-month period from January to December 1997 was performed. Call reports that documented invasive airway management were retrieved and relevant data were extracted using a preformulated data-entry form. RESULTS: Paramedics attempted tracheal intubation in 453 patients and were successful in 408 (90.1%); 331 of the patients were in cardiopulmonary arrest with vital signs absent (VSA), 101 had medical emergencies, and 21 had trauma-related problems. In the VSA cohort, the tracheas of 96% of the patients were intubated successfully; 80.1% on the first attempt, 10.6% on the second, 4.5% on the third, and 0.9% after more than three attempts. In the medical cohort, the tracheas of 74.3% of the patients were intubated; 60.4% on the first attempt, 11.9% on the second, and 2.9% on the third. In the trauma cohort, 71.4% of the intubations were successful; 66.6% on the first attempt, 26.6% on the second, and 6.6% on the third. There was a difference (p < 0.001) in the incidence of successful intubations comparing the VSA cohort with the medical/trauma cohorts. There was also a difference (p < 0.001) between the success rate for nasal intubations (43 of 68, 63% of patients successfully intubated) and that for oral intubation (365 of 385, 94% of patients). CONCLUSION: This study demonstrated a difference in the paramedics' success rates for tracheal intubation in VSA patients compared with those with preserved airway reflexes and a lower success rate for nasal vs oral tracheal intubation. These differences may be due to inadequate training, technical difficulties experienced in the field, or lack of sufficient exposure to medical/trauma scenarios to gain management experience. Future training to address these issues, both in the initial training phase and in the continuing education program, may be beneficial in improving performance.

Emergency Medical Services↗
PubMedDate not supplied

Patterns of natural killer cell function activation in response to interferon in chronic HBsAG positive hepatitis: relationship with the state of viral infection and with the early clinical response.

In an effort to define immunobiological parameters identifying "responders" vs "non-responders" to IFN among hepatitis patients, 16 patients with chronic active hepatitis were screened for changes of Natural Killer cell activity (NK). 10/16 patients replicated the hepatitis B virus (HBV-DNA positive) whereas 6/16 replicated the defective B virus associated delta virus (HDV-RNA positive). Patients received 9 MU/3x/weekly/3 months of recombinant IFN alpha A. Mean NK activity of the HBV-DNA patients rose significantly from 29.9 +/- 5.3 to 45 +/- 4.7 during therapy, whereas the 6/16 HDV-RNA positive patients did not show any significant increase of NK activity. Interestingly, individual HDV-RNA positive patients exhibiting boosted NK activity also showed improvement of disease confirmed by clearance of intrahepatic delta antigen at one year. No such a correlation was found amongst the HBV-DNA positive patients. These data indicate that in spite of widespread individual variability, IFN-mediated NK boost may herald delta clearance and help in identifying "responders" and "non-responders" in IFN trials.

Adult↗