[Can thymostimulin influence the course of malignant subacute hepatitis?].
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Biomedical subjects
Publications and source records attributed to C La Cascia.
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Early diagnosis of PHC development in cirrhosis is sometimes difficult through common tests excluding invasive diagnostic procedures; liver biopsy as a routine periodical control during the course of the disease is not advisable and AFP monitoring as a diagnostic test is preferable. The present study shows the results of a screening for AFP levels in a series of 113 cirrhotic patients aged over 50. 11.5% of them presented increased levels of serum AFP, indicating development of PHC. AFP elevated values resulted in 76.5% of cases associated with a previous HBV infection, and the risk of PHC development resulted sixfold greater in anti-HBc positive male cirrhotic patients. In patients with elevated AFP levels the prevalence of complications of cirrhosis resulted up to tenfold greater than in AFP negative patients.
Habitual heterosexual contacts of chronic HBV infection carriers show high prevalence of infection markers that does not result to be sex related, and results significantly associated to increase of age, presumably as a consequence of duration of exposure. Concomitance of habitual sexual contacts does not represent in an infected family setting a risk factor of higher prevalence of HBV infection, in respect of multitude of occurrences of unperceivable expositions to contagion.
Anti-HBc prevalence in alcoholics, chronic hepatotoxic drugs users, exposed to both these factors, and not exposed to alcohol and drugs cirrhotic patients was compared. Anti-HBc prevalence was significantly higher both in alcoholics and in hepatotoxic drugs users cirrhotic patients, and no statistically significant difference was found between the prevalence of anti-HBc in these two groups. In male cirrhotic patients the risk of HBV infection was 4.4 times higher in chronic hepatotoxic drugs users, 4.7 times higher in alcoholics, and 6.9 times higher in patients exposed both to alcohol and drugs. These results support the hypothesis that also chronic consumption of hepatotoxic drugs may be associated with a greater prevalence of HBV infection.
Prevalence of HBV infection markers and its association with some risk factors has been studied on hospital staff of the University Polyclinic of Palermo. The results show that male sex, job category (technicians, nurses, cleaners) and age are significantly associated with a higher prevalence of HBV infection markers; length of service and working in departments with a presumably higher exposure to blood did not result as a risk factor of higher prevalence of HBV infection when submitted to multiple regression logistic analysis. It is suggested that results of this study may be affected by the elevated spread of HBV infection in this area, and extra risk associated to hospital exposure is too small to be demonstrated.
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Aim of this study was to evaluate the prognostic value of sMAO activity, assayed by benzylamine colorimetric method. Has been studied the correlation between clinical signs of portal hypertension (splenomegaly, ascites and varices) and sMAO levels; there was a significant increase of enzyme activity in chronic active hepatitis (CAH) with splenomegaly vs. CAH without, and in liver cirrhosis (LC) with splenomegaly and/or varices vs. LC without; there was also a correlation between sMAO and gamma-globulins levels in CAH and not in LC patients. In conclusion has been discussed the prognostic value of sMAO activity in CAH.
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In 38.6% of 88 patients without anamnesis of alcoholism and/or chronic exposure to hepatotoxic drugs, selected among 120 cirrhotic subjects subsequently observed, the illness was HBV related. Markers indicating active viral replication (anti-HBc, HBsAg, HBeAg or anti-HBe) were detected in 48% of patients with active cirrhosis, and in 26% with inactive cirrhosis. It is suggested that high titers of CF antibodies anti-HSV and anti-CMV observed in several patients, indicate either reactivation of latent infections or over-infections. The absence of alcoholism and/or chronic exposure to hepatotoxic drugs, and the absence of viral markers, suggest in 61% of the 88 cirrhotic subjects either a nonA-nonB viruses etiology of the illness, or other etiological factors that escape available diagnostic and prophylactic procedures.
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Technique of counterimmunoelectrophoresis (CIEP) on cellulose acetate membrane (Cellogel) is described for diagnosis of (human and canine) visceral leishmaniasis (VL). Various lots of antigen were grossly obtained from the liquid phase (10, 20 and 30 tubes respectively) of cultures of Leishmania donovani by repeated freezing and thawing. Sera from patients (and, in a few cases, dogs) with confirmed VL, other parasitic and non-parastic diseases (especially blood disorders and hepatosplenomegaly) and from blood donors were tested. Positive results were obtained in 91-93% (according to various lots) of the patients with VL. All sera from infected dogs gave positive results. No precipitin lines were detected in the control sera. Antigens from 30 (or 20 tubes) showed better results with regard to the evidence of the precipitin lines. Clarity of the precipitin bands appears to be in relation to: 1. the protein concentration of the antigens; 2. the antibody levels of the sera. CIEP on cellulose acetate membrane combine the features of good sensitivity, specificity and speed of performance and appear available for use also in epidemiological research.
A comparison between a BCG antigen and various batches of an antigen extracted at different times from leishmania cultures in the fixation of complement reaction is reported. A better response was obtained with BCG (further confirmation on a larger series is being sought), whereas the leishmania antigens were difficult to prepare and their batch titres were not constant.
Technique of counter current immunoelectrophoresis (C.I.E.P.) was employed for the diagnosis of V.L. using an antigen grossly extracted (by means of repeated freezing and thawing) from culture of Leishmania. 6 lots of antigen were prepared - in various time - at the same way. Positive results are obtained in V.L. from 83.3 to 94% (according to various lots of antigens). Few false positivity (from 1.4 to 8.8%) are obtained in sera from patients with other diseases (especially) cirrhosis and blood disorders. No positivity in controls (blood donors). The reproducibility of results appear satisfactory. Our results suggested that C.I.E.P., rapid and less sophisticated test, can be applied for the diagnosis of V.L. But false positivity and false negativity limit the value of these test.
The utility of complement-fixation test with an antigen from commercially lyophilized BCG was investigated in the diagnosis of leishmaniasis. The following results were obtained: Visceral leishmaniasis: 4 positivity on 5 cases; Oriental sore: 3 positivity on 6 cases; Canine leishmaniasis: 6 positivity, at high level, and 2 negativity; Other diseases: 5 positivity, on 17 sera of tbc; No positivity in sera from patients with various diseases, in control and in normal dogs. The results are compared with those quoted in medical literature and discussed. The meaning of the reaction is also briefly discussed, and the hypothesis of the presence of partigens between BCG and leishmania, or presence of autoantibodies is prospected.
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Technique of counter immunoelectrophoresis (CIEP) was employed for the diagnosis of V.L. (human and canine) using strips of cellulose acetate and an antigen grossly extracted (by means of repeated freezing and thawing) from culture of Leishmania. 4 lots of antigen was prepared, in various time, at the same way. Positive results were obtained in V.L. from 81 to 90% (according to various lots of antigen). False positivities (from 1 to 4.5%) occur in patient with other diseases (especially cirrhosis and blood disorders). None positivity in controls (blood donors). Present results and those obtained with same technique in agar, suggested the validity of method and encouraged the production of antigen in a "kit" form for use in the field.