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Biomedical subjects

C Leonardi

Publications and source records attributed to C Leonardi.

At least 19 recordsLinked to original sources
PubMed1999

Clinical reactogenicity of intradermal bacille Calmette-Guérin vaccination.

Clinical, microbiological, and immunologic responses were evaluated in volunteers vaccinated intradermally with bacille Calmette-Guérin (BCG). Most volunteers (98%) developed ulcerative lesions that drained for a mean +/- SE of 4.3 +/- 0.29 weeks. Mycobacterial DNA was detected by a polymerase chain reaction-based amplification technique in biopsy specimens from BCG ulcers 2 weeks after vaccination and in blood specimens 3 days after vaccination. Mycobacteria were cultured from ulcer drainage 2 months after vaccination, demonstrating a prolonged potential risk of contact spread of the vaccine strain. The duration of ulcer drainage was inversely correlated with prevaccination lymphoproliferative (r = -0.515; P < .002) and interferon gamma (r = -0.841; P < .002) responses specific to mycobacteria and directly correlated with postvaccination increases in lymphoproliferative (r = 0.498; P < .002) and interferon gamma (r = 0.688; P < .02) responses specific to mycobacteria. These results demonstrate the clinical reactogenicity of BCG and the potential risk of contact spread of the vaccine strain and suggest that clinical reactogenicity is a trade-off for the induction of protective mycobacterial immunity.

Adolescent↗
PubMed1999

Concanavalin A-induced hepatitis in mice is prevented by interleukin (IL)-10 and exacerbated by endogenous IL-10 deficiency.

One single intra-venous (i.v.) injection of Concanavalin A (Con A) into mice provokes a cell-mediated immunoinflammatory hepatitis. We have presently evaluated the immunopharmacological effects of exogenous interleukin (IL)-10 and the role of endogenous IL-10 in this model by using exogenous IL-10, anti-IL-10 monoclonal antibody (mAb) and mice with disrupted IL-10 gene (IL-10 KO mice). Whilst exogenous IL-10 administered in a prophylactic (1 h prior to Con A) and even "early" therapeutic fashion (30 min after Con A) reduced the elevation of transaminase activities in plasma in a dose-dependent manner, observed in control mice, these biochemical markers of liver injury were significantly increased both in IL-10 KO mice as well as in those receiving anti-IL-10 mAb. Interestingly, doses of Con A lower than 20 mg/kg that were only capable of inducing slight serological signs of hepatitis in mice, exerted marked hepatitic effects when administered to either anti-IL-10 mAb-treated mice or to IL-10 KO mice. The disease modulating effects of exogenous IL-10 and either genetical or pharmacologically-induced IL-10 deficiency were associated with profound and opposite modifications of the Con A-induced increase in the circulating levels of IFN-gamma and TNF-alpha. Relative to control animals, the blood levels of these cytokines were diminished in IL-10-treated mice and augmented in both IL-10 KO mice and anti-IL-10 mAb-treated mice. These results prove the physiological antiinflammatory role of endogenous IL-10 in Con A induced hepatitis and the beneficial effects of IL-10 treatment to prevent this condition.

Alanine Transaminase↗
PubMed1998

Deoxyspergualin neither counteracts lipopolysaccharide (LPS) or Staphylococcus aureus enterotoxin-B (SEB) induced lethality in mice nor does it modulate the release of tumor necrosis factor-alpha.

To gain further insights into the immunopharmacological mode of action of the immunosuppressant antibiotic deoxyspergualin (DSP), its effects were evaluated in murine lethal endo- and exotoxemia. These are two cytokine-mediated macrophage and T cell dependent immunoinflammatory conditions that can be induced in D-Galactosamine (D-Gal) presensitized mice by the injections with either LPS or SEB, respectively. The results show that prophylactic treatment with DSP (2.5 or 5 mg/kg bd.wt. 48, 24 and 2 h prior to challenge) neither improved the rate of survival, nor influenced the massive increase in the blood levels of tumor necrosis factor-alpha which followed the challenge with LPS or SEB. In sharp contrast, these clinical and seroimmunological events were both markedly counteracted by prophylactic treatment with sodium fusidate, another immunosuppressive agent used as control.

Animals↗
PubMed1998

Diagnosis and treatment of a case of cutaneous cytomegalovirus infection with a dramatic clinical presentation.

A patient receiving long-term immunosuppressive treatment of systemic lupus erythematosus developed multiple large painful ulcers on her upper body. Histologic analysis showed cytopathic changes typical of cytomegalovirus infection that was confirmed by immunoperoxidase staining and polymerase chain reaction analyses. Treatment with ganciclovir and foscarnet resulted in clinical resolution. No recurrence was evident 6 months later.

Adult↗
PubMed1998

Human papillomavirus screening in pediatric victims of sexual abuse.

OBJECTIVE: To evaluate for the presence of subclinical human papillomavirus (HPV) in cases of suspected sexual abuse in children. DESIGN: Prospective data collection via interviews, physical examination, colposcopic examination, and tissue sampling by a surface swab technique. SETTING: A total of 40 pediatric patients ranging in age from 1 to 16 years who were referred to the Special Assessment and Management Clinic at Cardinal Glennon Children's Hospital, St Louis, MO, for probable or confirmed sexual abuse. INTERVENTIONS: In addition to colposcopic examination for physical signs of abuse, the patients were screened for evidence of sexually transmitted diseases, including syphilis, gonorrhea, and Chlamydia. At that time, surveillance sampling of the throat, vaginal introitus, and/or rectum by a simple, rapid surface swab technique was performed to detect the presence of HPV. MEASUREMENTS: Template DNA was extracted from cotton swabs and analyzed using polymerase chain reaction analysis. RESULTS: Human beta-globin sequences were detected in 58 (83%) of 70 specimens obtained from 40 patients, indicating successful processing had occurred. Using a consensus L1 primer-probe set capable of detecting multiple HPV genotypes, 2 (3%) of 58 samples from 2 (5%) of 40 patients were positive for HPV 16. None of the other 56 specimens yielded evidence of HPV. Appropriate positive and negative controls were included in each assay. CONCLUSIONS: Our results suggest that subclinical HPV infection is possible, but not commonly associated with sexual abuse in children from St Louis, MO. In this group of children without condyloma, HPV 16 was the only type identified.

Adolescent↗
PubMed1998

[Intensive intravenous chelation in thalassemic patients with iron overload].

The effects of an alternative chelation program in thalassemic patients with severe iron overload are investigated. The schedule of treatment, feasible at home, consists in the administration of deferoxamine intravenously (100 mg/kg/die 8 hours 10 days a month), followed by 50 mg/kg/die subcutaneously in the remaining 20 days of the month. The results in 34 patients who underwent this program over 8 months are reported. After intensive chelation therapy serum ferritin and transaminase levels were significantly lower, and daily urinary iron excretion values were significantly higher when compared to the levels observed before the treatment. After the period of study, echocardiography revealed an ejection fraction (EF) significantly higher in 15 out of 34 cardiopathic patients. In conclusion, the alternative chelation program is effective in reducing iron overload of thalassemic patients, protecting them also against cardiac disease.

Adolescent↗
PubMed1995

Hemodialysis-related lesions of the hand.

Chronic hemodialysis patients often have lesions of the hands characterized by distinctive etiopathogenic mechanisms and functional consequences. We conducted a prospective cross-sectional study in 116 patients with a mean age of 55.9 years and a mean hemodialysis duration of 8.17 years. Carpal tunnel syndrome was present in 28.4% of patients. Median nerve entrapment was bilateral in a large proportion of cases. Wasting of the lateral thenar muscles was often present at diagnosis, denoting advanced nerve compression. Amyloid was demonstrated in the carpal tunnel in 74% of cases of carpal tunnel syndrome. Digital flexor tendon lesions responsible for trigger finger or restriction of active flexion were seen in 21.5% of patients. Erosive arthropathy manifesting as deformities, pain and loss of function affected the distal interphalangeal joints in 11% of patients and the proximal interphalangeal joints or trapeziometacarpal joint in a smaller proportion of patients. Thirty per cent of patients had bony cysts located in the carpometacarpal area, carpal bones, or distal forearm bones; communication with the adjacent joint space was seen occasionally, and intracarpal derangement was a feature in some patients. Most patients had several types of lesions. The rate of occurrence of hand lesions increased markedly after ten years on hemodialysis, with devastating functional consequences.

Adult↗
PubMed1995

Percutaneous balloon mitral valvuloplasty: early and late results according to surgical risk and echocardiographic score.

OBJECTIVE AND DESIGN: Early results, complications and follow-up of 70 patients undergoing percutaneous balloon mitral valvuloplasty (BMV) were retrospectively analyzed to establish whether an increased surgical risk or an unfavourable echocardiographic score influenced the results. PATIENTS: The patients were divided into two groups according to the presence (group A, n = 31) or absence (group B, n = 38) of high surgical risk factors. The patients were also divided into two other groups according to the presence (group C, n = 46) or absence (group D, n = 20) of favourable mitral valve anatomy. Group A (high surgical risk) included patients fulfilling at least one of the following criteria: 65 years of age or older; previous surgical commissurotomy; depressed left ventricular function; respiratory or hepatic insufficiency; or previous aortic valve replacement. Mitral valve anatomy was classified as 4 to 16, according to the echocardiographic score established by Abascal et al. Group C patients had echocardiographic score below 8 and group D had echocardiographic scores of 8 or greater. INTERVENTIONS: Mean mitral valve gradient (MVG) and area (MVA) were Doppler-estimated immediately before and 48 h after the BMV. MAIN RESULTS: There were no differences in the early results and complications between groups A and B (MVA 1.8 +/- 0.5 versus 1.9 +/- 0.4 cm2). Final MVA was significantly greater in group C than in group D (MVA 1.9 +/- 0.4 versus 1.6 +/- 0.4 cm2; P = 0.03). There was no difference in the incidence of complications. Over a follow-up period averaging 19.1 months (range 1 to 55), 90.7% of the patients were in New York Heart Association functional class I or II. Four patients had a mitral valve replacement, one had a surgical commissurotomy and one had a second BMV. Two unrelated deaths occurred. There were no differences in the characteristics of the study population and the incidence of events in the follow-up period between groups. CONCLUSIONS: The results and outcome of BMV were unrelated to the general surgical risk, suggesting that this procedure may be used with particular benefit in this group of patients. In contrast, mitral valve anatomy must be considered as an important determinant of the results.

Adult↗
PubMed1993

Human papillomavirus DNA in the dermis of condyloma acuminatum.

Condyloma acuminatum (CA) has high recurrence rates after local treatments. Why this lesion is difficult to eradicate is unclear. One possible explanation for recurrence after superficial destructive therapy is the presence of residual human papillomavirus (HPV) in the superficial dermis beneath the treated epidermis. Thirteen samples of CA were excised from 13 patients. Thirteen samples of basal cell carcinoma (BCC) were studied for purposes of control. Epidermis was separated from dermis by treatment with sodium bromide. DNA was extracted from both tissues and used sodium bromide solution and amplified for the presence of HPV DNA using the polymerase chain reaction. HPV DNA was detected in the epidermis of 11 samples of CA. HPV type 6 was seen in 7 specimens; HPV type 11, in 4. HPV DNA was found in the dermis of 3 specimens of CA; type 6 in 2 and type 11 in 1. Two samples were excluded because of contamination of the sodium bromide solution by HPV. HPV DNA was not detected in tissue samples from BCC. The presence of HPV DNA in the dermis of some condylomata may explain recurrence in sporadic cases.

Base Sequence↗
PubMed1993

Varicella-zoster virus DNA in granulomatous skin lesions following herpes zoster. A study by the polymerase chain reaction.

Granulomatous reactions at sites of previous cutaneous herpes zoster lesions occur, but their etiology is not known. Three tissue specimens from 5 cases identified clinically and histologically as post-zosteric granulomatous reactions were studied for the presence of varicella-zoster virus (VZV) deoxyribonucleic acid (DNA) by the polymerase chain reaction using specific primers for VZV. VZV DNA was detected in 1 of 3 cases where the granulomatous reaction occurred immediately in the wake of resolving vesicular herpes zoster lesions. Finding viral DNA in earlier reactions probably represents residue from the active herpetic process. VZV DNA was not identified in granulomatous reactions arising between 1 month and up to 4 years after resolved herpes zoster. The negative result in these cases supports the hypothesis that there is no association between persistence of VZV DNA and granuloma formation. How long VZV DNA is detectable at sites of resolved herpes zoster lesions could be the subject of further studies.

Aged↗
PubMed1993

[Surgery of the foot in equinus deformity in hemiplegic adults].

The authors report the results of surgical treatment of the equinus deformity of the foot in adult hemiplegia performed on 23 patients with a long term follow-up for 20 of them. Surgical treatment required two phases. Firstly, a spasticity correction by scopiform neurotomy of the posterior tibial nerve: this operation had to be done 14 times because of the importance of the spasticity. Secondly, a phase of truly orthopaedic surgery which involved successively, a treatment of the equinus deformity by lengthening of the Achilles tendon, a restoration of the dorsal flexion by anterior muscle transfer and some complementary operations on the forefoot. An astragalo-scaphoid arthrodesis was associated in the 13 most recent cases. Results were subjectively judged very good or good for 17 patients. Objectively, walking appliances have been reduced, gait was more secure and a greater autonomy has been reached. However, the goals of this surgery are limited as it has no incidence on central interferent lesions and neuropsychological troubles resulting from brain damage. The quality of the result is, in other respects, conditional upon the gait pattern of the whole limb, particularly upon the importance of the flexion of the knee during the step cycle.

Achilles Tendon↗
PubMed1993

Atrial natriuretic peptide response to postural changes and upright exercise in patients with venous valvular insufficiency.

To investigate the effects of postural changes and upright exercise on atrial natriuretic peptide release and renin-angiotensin-aldosterone system behavior in patients with venous valvular insufficiency, plasma ANP, plasma renin activity and aldosterone were measured in 11 patients with venous disease and in 11 age-matched controls. In patients with large varicose veins and venous valvular dysfunction, standing was associated with a greater fall in circulating ANP levels (p < 0.05) and upright exercise was accompanied by a smaller rise in ANP concentrations (p < 0.05) as compared with controls. A significant (p < 0.001) inverse relationship was found between the number of venous segments with reflux and both upright and exercise plasma ANP concentrations (r = -0.91; r = -0.84, respectively). In the two groups the response of the renin-angiotensin-aldosterone system to upright position and physical stress was similar. These results suggest that a decreased atrial stretch, due to a reduced venous return, could account for the blunted ANP response to erect posture and exercise in patients with venous valvular incompetency.

Adult↗