Aortofemoral graft infection: the usefulness of 99mTc-HMPAO-labelled leukocyte scan.
Explore the source record for details and available documents.
Aorta, Abdominal↗
Biomedical subjects
C Santini
Publications and source records attributed to C Santini.
Brief report: healed myocarditis as a cause of ventricular repolarization abnormalities in athlete's heart.
In the past myocarditis has been suggested as a possible cause of repolarization abnormalities in sportsmen, but, to our knowledge, no direct in-vivo demonstration of this relationship has so far been found. We report the cases of three professional athletes with repolarization changes at rest and/or during exercise and mild segmental wall motion anomalies in the left ventricle on echocardiography, in whom myocarditis was diagnosed by non-invasive and invasive clinical investigations, including endomyocardial biopsy. We think that probably the frequency with which myocarditis is responsible for electrocardiographic and echocardiographic abnormalities in athletes has so far been underestimated, and that caution must be employed when interpreting minor segmental wall motion abnormalities on resting and exercise echocardiograms in trained subjects as being due to athlete's hart, especially when they present with repolarization changes.
Adult↗
Dobutamine stress testing in the cardiac catheterization laboratory.
Dobutamine stress ventriculography is a safe test that appears to separate groups of patients with and without significant coronary artery stenoses. In this study, all 7 patients with significant coronary artery stenoses who reached a heart rate > or = 110 beats/min had a positive stress test, whereas 9 of 10 control patients had a negative stress test.
Adult↗
Selection of phage-displayed peptides mimicking type 1 diabetes-specific epitopes.
Phage display technology represents a powerful tool for the identification of peptides reacting with disease-related antibodies present in human sera. The application of this technology to type 1 diabetes could provide a set of novel reagents for diabetes prediction and could also lead to the identification of novel autoantigens or even of environmental factors possibly causing the disease. In the present study, sera of prediabetic and high risk individuals were used to select candidate peptides from phage-displayed random peptide libraries. Diabetes specific phage clones were then identified from these through screening and counter screening, using sera from diabetic and non-diabetic individuals. The results presented in this paper demonstrate the feasibility of this methodology to identify peptides reacting preferentially with antibodies present in the serum of diabetic patients.
Adolescent↗
Selection of biologically active peptides by phage display of random peptide libraries.
Random peptide libraries displayed on phage are used as a source of peptides for epitope mapping, for the identification of critical amino acids responsible for protein-protein interactions and as leads for the discovery of new therapeutics. Efficient and simple procedures have been devised to select peptides binding to purified proteins, to monoclonal and polyclonal antibodies and to cell surfaces in vivo and in vitro.
Animals↗
Echocardiographic size of conductance vessels in athletes and sedentary people.
The purpose of the present study was to assess the size of great and medium caliber arterial and venous vessels (conductance vessels) in athletes of different sports and sedentary people. Vessel size was measured by two-dimensional echocardiography in 15 professional cyclists, 15 highly-trained long-distance runners, 15 professional volley-ball players, 10 wheelchair basketball players, 11 wheelchair distance runners and 20 sedentary controls. The following vessels were imaged and measured: aortic arch, left carotid and left subclavian artery, right pulmonary artery, abdominal aorta and mesenteric artery, superior and inferior vena cava. Vessel size was considered in absolute value and normalized for body surface area (BSA). Among the able-bodied athletes, both cyclists and long-distance runners showed a generalized increase in vessels size in respect to controls, either absolute or normalized for BSA. The increase was highly significant for normalized inferior vena cava: cyclists, mean 15.1 mm, 95% confidence intervals 14.2 to 15.8 mm; long-distance runners, 15.8 mm, 15.3 to 16.4; controls, 10.5 mm, 9.8 to 11.3. Volleyball players also showed larger vessels than controls, but this feature was clearly related to their greater body size because statistical differences were attenuated or abolished by normalization for BSA. Wheelchair athletes exhibited significantly larger upper-body vessels but significantly smaller lower-body vessels than controls when normalized for BSA. In addition, wheelchair distance runners, who trained more intensively, had larger abdominal aorta and inferior vena cava than wheelchair basket players. Long-term endurance training leads to a generalized increase in arterial and venous conductance vessels size.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
[The spread of oxacillin-resistant Staphylococcus aureus].
Explore the source record for details and available documents.
Humans↗
Three-dimensional structure of the higher-plant photosystem II reaction centre and evidence for its dimeric organization in vivo.
The three-dimensional structure of photosystem II (PSII) has been determined by conventional transmission electron microscopy and computerized three-dimensional reconstruction. Both the complete system and that lacking the oxygen-evolving complex have been analyzed. The PSII complex has a four-lobed structure with twofold symmetry. An estimate of the molecular mass and the results of Deriphat/PAGE analysis suggest that a reaction centre is present in each half of the structure resolved by electron microscopy. Stepwise removal of components of the complex showed that the removal of CP47 (a 47-kDa chlorophyll-protein complex) induces monomerization of PSII, which indicates the importance of this subunit for the dimeric structure.
Cell Membrane↗
High rate of oxacillin-resistant Staphylococcus aureus isolates in an Italian University Hospital.
We reviewed our routine clinical laboratory records from January 1990 to March 1993 to evaluate the rate of oxacillin-resistance among nosocomial isolates of Staphylococcus aureus. Of 265 clinically significant isolates, 174 (65%) were oxacillin-resistant S. aureus (ORSA). Most of these strains were obtained from surgery patients and/or were isolated from surgical wounds. The isolations of S. aureus increased during the study period: 45 in 1990, 50 in 1991, 130 in 1992 and 40 in the first trimester of 1993. The annual rates of ORSA among S. aureus isolated varied from 62 to 68% through these years. Most ORSA isolates proved resistant to ciprofloxacin, gentamicin and rifampicin, and susceptible to vancomycin, netilmicin and cotrimoxazole. Based on these results, the need for a stringent application of infection control measures is outlined.
Cross Infection↗
Infections by ampicillin-resistant enterococci: a case-control study.
We identified 17 (20%) of 83 consecutive enterococcal isolates from hospitalized patients with documented infection as high-level ampicillin-resistant enterococci (ARE). Of these, 16 isolates were identified as Enterococcus faecium and 1 isolate as Enterococcus raffinosus. A case-control study found no significant differences with respect to underlying diseases, central venous catheterization, nosocomial acquisition of the infection and sites of infection. Patients with ARE infection were older and had a higher inhospital fatality rate than those with ampicillin-susceptible Enterococcus (ASE) infection. Hospitalization in a surgery service (usually for an abdominal procedure), prolonged hospital stay, prior treatment with antibiotics (in particular imipenem and metronidazole), were also more frequent among patients with ARE infection. ARE isolates were more frequently resistant to imipenem, ciprofloxacin and streptomycin than ASE isolates.
Adult↗
A case of brain abscess due to Brucella melitensis.
Explore the source record for details and available documents.
Adult↗
Role of myocarditis in athletes with minor arrhythmias and/or echocardiographic abnormalities.
We report the clinical and instrumental data, including the endomyocardial biopsy findings, of six young athletes presenting with minor arrhythmias and/or echocardiographic abnormalities. In one of them, a left ventricular dilation with moderate depression of the systolic function had been attributed to an athlete's heart. A diagnosis of arrhythmogenic right ventricular dysplasia had been made in three others, one with right ventricular dilation and apical hypokinesia, and two with ventricular arrhythmias with QRS morphology of left bundle branch block. A myocarditis could be unequivocally established in four athletes (two with and two without fibrosis). In the remaining two, with a clinical history strongly suggesting a previously acute myocarditis, the endomyocardial biopsy specimen revealed a nonspecific fibrosis compatible but not definitely pathognomonic of a healed myocarditis. Our report suggests that a myocarditis may be a cause of minor rhythm disturbances and/or echocardiographic abnormalities in athletes. A prevalent localization of the inflammatory process in the right ventricle with or without the occurrence of ventricular arrhythmias with left bundle branch block morphology can mimic an arrhythmogenic right ventricular dysplasia. An early diagnosis of myocarditis in athletes is useful to avoid the risk of fatal arrhythmias, also considering that rest still keeps on being one of the most effective strategies in myocarditis management.
Adolescent↗
[International harmonization of regular requirements for the registration of drugs: necessity, frena limitations].
Considering the necessity of internationalisation, the Pharmaceutical Industry fears the regulatory variations that may result from national evolutions, parallel or divergent, which sometimes impose on it some repeated works, hence causing an undesirable extension of development duration and also higher costs. Therefore it is quite evident to that Industry that a worldwide harmonization is necessary. For the whole collectivity, such an harmonization allows a better utilization of manpower, of animal experimentation, and also of the material means available for the new pharmaceutical products development. The strong interest showed by the Pharmaceutical industry in France for the International regulatory harmonization, confirms that this Profession has effectively taken into account the worldwide dimension for the medicinal products of the year 2000.
Humans↗
[Gestational diabetes: criteria for screening and diagnosis].
Gestational diabetes (GDM), defined as a carbohydrate intolerance of variable severity with onset of first recognition during pregnancy, is a significantly frequent condition, often pauci- or asymptomatic, which is associated with an increase of maternal, fetal and neonatal morbidity, plus an increased risk of later overt diabetes mellitus in the mother. Good glycemic control significantly reduces the risks of complications, so it is strongly recommended to detect GDM. The screening test suggested by the Workshop-Conference held in Chicago in 1991 and by the NDDG is the 50 g oral glucose load, venous plasma glucose measured 1 h later (OGCT) at the 24th-28th week gestation in all the pregnant women. The test may be administered earlier when factors of metabolic risks are present. If 1h-glycemia is > 140 mg/dl, a full diagnostic test, 100 g oral glucose load, venous plasma glucose fasting and 1, 2, 3 hours later, should be performed. Cut-off values are still controversial. WHO suggest to adopt for diagnosis the same method and criteria used in non pregnant adults: 75 g oral glucose load, venous plasma glucose fasting, 1 and 2 hours later. This load, followed by a 2 hours glycemia, is utilized for screening, too. Nevertheless, WHO detects an interesting status intermediate between GDM and normal tolerance the reduced glycemic tolerance. Outside a formal OGTT, a fasting glycemia > 140 mg/dl and/or a random plasmatic value > 200 mg/dl suggest diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Diabetes monitoring for the pregnant diabetic].
Diabetological care in pre-gestational (preGDM) and gestational (GDM) pregnant diabetic is an indispensable factor for the reduction of risk of mother, fetus and newborn complications. The adoption of an intensified therapy, aiming at maintaining almost normal glycemic values, and the improvement in fetal monitoring have led to a marked reduction, for instance, in fetal intrauterine death and in perinatal mortality rate in general. Furthermore, pregnancy programming allows good glycemic control since conception and a decrease in malformations. It is therefore, necessary to create interdisciplinary teams treating pregnant diabetics coordinately. Diabetological care involves the evaluation of risks from the first phases to the end of the pregnancy, therapeutical decisions on the basis of metabolic and non-metabolic parameters, the education of diabetic women, the coordination of the other specialized interventions and delivery programming together with the obstetrician and the neonatologist. The programs of checks to be executed on pregnant diabetics, during hospitalization and on outpatients, are here illustrated considering the meaning of: fasting glycemia and spontaneous glycemic curves, with goals both in preGDM and in GDM; HbA1c and fructosamine; glycosuria and ketonuria; plasmatic lipids and uricaemia; other non-metabolic checks, in particular blood pressure one.
Ambulatory Care↗
Aorto-femoral graft infections: a clinical and microbiological analysis.
A 5-year experience of 19 aortic graft infections is reviewed. Of these, 13 (68%) had a late onset (more than 4 months after graft implantation) and usually presented with anastomotic pseudo-aneurysm or thrombosis. The remaining six infections (32%) had an early onset and presented more often with surgical wound infection. Aorto-enteric fistulae and inguinal sinus tracts were observed in both early and late onset infections. Coagulase-negative staphylococci (all slime negative, oxacillin susceptible strains) were the prevalent pathogens in both groups of infections and were isolated in six (32%) patients. Next most commonly seen were Pseudomonas aeruginosa in four (21%) patients, Enterococcus spp. in three (16%) patients, Staphylococcus aureus in three (16%) patients, other bacteria in six (32%) patients. No organisms were isolated in three (16%) patients. Mortality and major amputation rates were 47.3% and 31.6%, respectively. The therapeutic procedures included total graft removal (15 patients), partial graft excision (two patients), partial graft excision followed by total graft removal (one patient) and local treatment without graft removal (one patient). Six patients recovered, including two who underwent total graft removal associated with a non-conventional 'in situ' graft replacement and one patient treated conservatively with local treatment and antibiotics. The three patients undergoing partial graft excision showed signs of active infection of the residual graft.
Adult↗
Detection of aortic graft infection with leukocytes labeled with technetium 99m-hexametazime.
PURPOSE: To reduce the rates of morbidity and mortality in aortic graft infection, a new diagnostic approach is needed to help identify low-grade stages, specifically when there are minimal or no clinical signs of overt infection. The aim of this study was to evaluate the role of technetium 99m--hexametazime white blood cell scanning (99mTc scanning) in detecting aortic graft infection, particularly in the low-grade stages. METHODS AND RESULTS: Thirty-seven patients with suspected aortic graft infection were categorized into three groups according to their signs and symptoms on readmission. Ten patients (group A) had advanced graft infections that were correctly diagnosed by use of computed tomography (CT) scanning and 99mTc scanning and confirmed by intraoperative findings and culture results. Eighteen patients (group B) had nonspecific signs and symptoms of graft infection. Patients only underwent CT and 99mTc scanning for graft infection after standard clinical work-ups failed to reveal disease processes that accounted for the clinical symptoms. In this group of patients 99mTc scanning identified four cases of low-grade graft infection, which was confirmed by intraoperative findings and graft cultures. None of these four cases was confirmed by results of CT scanning. On an average 18-month follow-up in patients who did not undergo surgery graft infections developed. Nine patients (group C) had anastomotic aneurysms; CT scanning and 99mTc scanning correctly diagnosed five patients as being infected. The result of 99mTc scanning was false-positive in one patient. CONCLUSIONS: The diagnostic accuracy of 99mTc scanning in patients who did not have specific signs of graft infection (groups B and C) was 100% for sensitivity, 94.4% for specificity, 90% for the positive predictive value, and 100% for the negative predictive value. 99mTc scanning seems to be a useful diagnostic technique for detecting aortic graft infection, particularly in low-grade stages.
Aged↗
Intravenous ciprofloxacin for the treatment of severe infections.
Intravenous ciprofloxacin at a daily dosage of 400 mg divided in two doses was administered to 19 patients with severe infections caused by ciprofloxacin-susceptible bacteria. These infections included: 11 surgical would infections, 5 soft tissue infections, 2 respiratory tract infections, 1 urinary tract infection. The offending pathogens were: 8 coagulase-negative staphylococci, 3 Staphylococcus aureus, 3 Pseudomonas aeruginosa, 2 Proteus spp., 1 Escherichia coli, 1 Branhamella catarrhalis, 1 Klebsiella ozenae and 1 Serratia liquefaciens. Overall, 17 of 19 infections (89%) showed a satisfactory clinical response to trial therapy (15 cures and 2 improvements). Microbiological eradication was observed in 17 out of 20 isolated pathogens. Emergence of resistance to ciprofloxacin occurred in 1 coagulase-negative Staphylococcus and was associated with clinical failure. No side effects were observed. We conclude that intravenous ciprofloxacin may represent efficacious and safe therapy of severe infections; however close microbiological monitoring seems to be necessary to evaluate the emergence of resistance during quinolone therapy.
Adult↗