Reactivation of hepatitis B in AIDS.
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Biomedical subjects
Publications and source records attributed to D Bassetti.
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The ability of papaverine to inhibit human immunodeficiency virus (HIV) replication in H9 cell line and in peripheral blood mononuclear cell (PBMC) culture was examined. HIV-infected H9 cells were exposed to different concentrations of papaverine for 20 days. Reverse transcriptase (RT) activity and the presence of p24 in the supernatant were determined to assess the level of viral replication in treated and control cultures. The most effective concentration of papaverine in the culture medium was 10 micrograms/ml, a dose that did not significantly affect cell proliferation. At this drug concentration the treatment resulted in no RT activity or p24 expression in the supernatant and no virus antigen detection at the cellular level as demonstrated by Western blot (WB) analysis. The activity of the drug occurred in a short period of time (60 hours) as shown by radioimmunoprecipitation (RIP) assay and affected the synthesis of the env precursor protein gp160. The drug was also effective in inhibiting HIV replication in PBMC cultures and influenced specific viral markers, namely, RT and p24. Evidence of the efficacy of papaverine treatment was enforced by the finding in the treated PBMC cultures, compared with the untreated ones, of a reduced percentage of cells forming syncitia and of the inhibition of the virus-induced decrease in the number of cells. When an equal number of virus-infected H9 cells exposed or unexposed to papaverine was analyzed for HIV-specific proteins, a marked decrease in the expression of the viral proteins was observed in the treated cultures. At the same time, one cellular protein of molecular weight 69,000 was not inhibited by papaverine. This may indicate that, at least for one protein, synthesis may not be affected by the drug. Our data suggest that papaverine merits attention as a possible nontoxic candidate for the treatment of HIV infection.
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Sixty pediatric patients (27 males and 33 females) between the ages of 7 months and 11.7 years (mean age = 4.3 yr) were treated with parenteral sulbactam plus ampicillin (1:2 ratio) for lower respiratory tract infections (29 cases), upper respiratory tract infections (4 cases), urinary tract infections (25 cases) or skin/soft tissue infections (2 cases). The infection was mild in 6 cases, moderate in 44 and severe in 10. The infection was acute in 57 patients, recurrent in 1 (cystitis) and was a flare-up of a chronic infection in 2 (pyelonephritis and cystitis). The children received an average dose of 48 mg/kg/d of sulbactam plus 96 mg/kg/d of ampicillin by the i.m. route (43 cases) or by i.v. drip (17 cases) in 3-4 divided doses. The length of treatment ranged between 3 and 10 d (mean duration = 6 d). At the end of therapy, clinical cure was achieved in 53 patients (88.3%), while 6 (10%) had a marked improvement. Only 1 patient, with a lower respiratory tract infection, did not respond to therapy. All 25 patients with urinary tract infection experienced bacteriological cure at the end of treatment. No side effects were reported. Mild and transient changes in laboratory parameters from baseline values were observed in 10 patients (eosinophilia, elevation of SGOT or SGPT) without clinical consequence. Sulbactam plus ampicillin was effective and safe in the treatment of bacterial infections in children and appears to be useful in the treatment of those infections in which beta-lactamase-producing organisms are involved.
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Twenty-five children (16 females and 9 males) aged from 8 months to 10 years with clinical and laboratory evidence of UTI were treated with sulbactam + ampicillin (SBT/AMP). Twenty-four of them were suffering from cystitis and one from pyelonephritis. Four of them were treated unsuccessfully prior to entry in the trial. The mean final dose of SBT/AMP was 47.69 mg/kg/die (ratio of SBT-AMP was 1:2). The patients were treated for 3 to 8 days (mean: 4.76 days). 84% were treated by i.m. route. No side effects or adverse experience were reported. Clinical cure was achieved in 25 patients (100%).
Twenty patients with maxillary sinusitis were treated with cefotetan (1 g, i.m.) twice a day. Samples of blood and maxillary sinus mucous membrane were taken in eight patients 2 h after dosing during the third day of therapy to evaluate drug concentration. Results show the excellent clinical and bacteriological effectiveness of cefotetan, as well as its high tissue penetration.
We studied the activity of cefotaxime both microbiologically and clinically. 138 blood cultures positive for gram-positive cocci were evaluated (90 strains of Staphylococcus aureus, 25 of Streptococcus faecalis, 13 of Streptococcus alpha and ten of Streptococcus mutans). Cefotaxime showed good activity against all strains with the exception of S. mutans, of which only 30% were sensitive. Ten cases of gram-positive infections were studied clinically: six sepsis cases and one endocarditis case due to S. aureus, two sepsis cases caused by Streptococcus alpha and one Enterococcus endocarditis case. Therapy was successful in nine; the S. aureus endocarditis failed. The local and general tolerance of cefotaxime was good.
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Untoward reactions induced by antimicrobial chemotherapeutic agents have had an increasing frequence in recent years. Lung and respiratory tract reactions are generally underestimated in comparison with those affecting other anatomical areas. The pathogenic mechanisms are reviewed under four headings, 1) toxic effects, 2) allergic reactions, 3) damage due to the antibacterial activity itself, and 4) lesions due to different causes. The various chemotherapeutic agents involved are thus mentioned in connection with these mechanisms.
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Changes in the ecology of Salmonella organisms impose the use of highly specific chemotherapeutic agents both in animals and in attempts ot combat salmonella typhi in man. An examination of inhibition achieved by the use of a number of antibiotics against strains isolated from 52 hospitalized patients in our clinic, over the past three years, has shown the majority of strains to be sensitive to gentamicin (78%), followed by nalidixic acid, nitrofurantoin, chloramphenicol (44%) and other chemotherapeutic agents, including the combination of sulphamethoxazole and trimethoprim (28%) and ampicillin (11%).