Biomedical subjects
D Dioguardi
Publications and source records attributed to D Dioguardi.
Increased burn patient survival with once-a-day high dose teicoplanin and netilmicin. An Italian multicenter study.
This is the final report of a large, controlled, multicenter Italian study on immuno- and chemotherapy in adult patients with burns affecting 20 to 95% of total body surface area (mean 35%). The antibiotic treatment of burn patients consisted of topical silver sulfadiazine, short-term antimicrobial chemoprophylaxis with pefloxacin (800 mg i.v. qd) for the first 4 days and polychemotherapy with teicoplanin (800 mg i.v. qd) together with netilmicin (300 mg i.m. qd) in one or more cycles of 5-12 days. At random, half of the patients received thymostimulin, 70 mg i.m. qd for the first month and every other day thereafter. The analysis at completion of 634 valid cases showed that when the results are stratified by means of the Roi risk index, 396 of the 530 patients who contracted wound infection (84%) after chemoprophylaxis were in the first three categories and a mean of 95% survived. Of the remaining 134 patients (Roi index 4-5) only 50% survived. There was no difference in survival of the immunotherapy group in comparison with the parallel group without thymostimulin. The short-term antimicrobial prophylaxis prevented wound infection in only 104 of 634 patients (16%) and they were at low risk (84% Roi index 1). Of the bacterial pathogens involved in septic complications Staphylococcus aureus and Pseudomonas aeruginosa were prevalent (86%): eradication was achieved in 43% of patients and clinical cure or improvement were seen with combination chemotherapy in 64% of all patients, mainly with only one treatment cycle. This value increased to 79% for the 395 protocol-complying patients and went down to 20% in the 135 non-compliers. The total survival of complier and non-complier patients was 447 of the 530 valid patients (84%). The overall mortality of the 634 evaluable patients was 13.1%, ranging from less than 2% to 68%. Burn mortality was directly proportional to the percentage of burned body surface area, to increasing age and other variables of the Roi index, a 50% mortality being associated with a 72.5% total body surface area burned. Normoergic burn patients had a mortality rate of 9.1% versus 35.7% in anergic patients.
Respiratory activity and growth of human skin derma fibroblasts.
A study has been made on the speed of growth and respiratory activity of fibroblast cultures from control derma, cheloid (hypertrophic) scar and stabilized scar taken from human skin. The speed of growth and the efficiency of plaque formation of fibroblasts from cheloid scar were greater in comparison with those of fibroblasts from stabilized scar and were stimulated by the addition to the culture medium of the exudate from post-traumatic ulcer. Measurement of the contents of cytochromes showed a decrease in the content of cytochromes b562 and c + c1 in the fibroblast culture from both cheloid and stabilized scar as compared to the fibroblast culture from control derma. Cytochrome aa3 content did not show significant difference among the three types of fibroblast cultures. The respiratory activities supported by pyruvate plus malate, succinate or ascorbate plus N,N,N',N'-tetramethyl-p-phenylenediamine did not show, however, significant difference among the three fibroblast cultures. These observations show that the speed of growth of skin fibroblasts does not depend on the overall respiratory capacity. The exudate stimulated the activity of cytochrome c oxidase in fibroblasts from control derma, and cheloid scar. This effect and the accompanying stimulation of fibroblast growth might be correlated with the balance of oxygen free radicals.
Permanent coverage of full skin thickness burns with autologous cultured epidermis and reepithelialization of partial skin thickness lesions induced by allogeneic cultured epidermis: a multicentre study in the treatment of children.
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Assessment of disinfectant topical agents in keratinocyte cell culture grafting technique in severely burned patients.
On the basis of previous experiences and of international literature data the authors emphasize the importance of making a "targeted" choice of the topical disinfectant in the therapy of burn wound infections. The objective of the investigation is to reach the highest rate of take of the autologous keratinocyte cultures in burn wounds.
Dermal-fat flaps in the treatment of large post-incisional hernias ("cross-over flap" technique).
The use of dermal fat flaps or "cross-over" flap offers unquestionable advantages, even when compared with free dermal grafts. An excellent aesthetic appearance is achieved, dut to the very low incisional line. Nor does this technique leave scars in other parts of the body.
Antigenic properties of human skin: anticomplementary effects developed in vitro on human sera by allogeneic extracts of normal and burned skin.
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CO2 laser surgery in recurrent tumors of the nose.
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Threaded tapes for the sutureless closure of skin wounds.
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HLA antigens in keloids and hypertrophic scars.
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[Consideeations on 80 cases of traumatic lesions of the nerves of the upper extremity].
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[Congenital cutaneous aplasia].
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[Aprotinin and induction of sarcoma with methylcholanthrene in rats].
Considering the immunodepressive properties of aprotinine, the influence of this protease inhibitor on the induction of methylcholanthrene sarcoma in rats has been investigated. The results of the investigation showed that aprotinine failed to modify the experimental tumour induction process. This observation provides further confirmation that immunodepression is not a position to favour the growth of a tumour as a result of chemically induced oncogenesis.
[Effects of aprotinin on the grafting of methylcholanthrene-induced sarcoma in rats].
The influence of aprotinin on the taking of MCA-induced sarcoma in the rat was examined. Local application resulted in involution of the tumour in animals in which the syngeneic graft tended to grow. Histological investigation showed that this biological reaction was due to marked activation of the macrophages.
Anticomplementary effects developed in vitro by two xenogeneic skin extracts on human sera.
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[Circulating immune-complexes in the serum of rabbits subjected to allogenic skin graft].
Increased levels of circulating immune-complexes were found in rabbits immunized by allogeneic skin graft or sheep erythrocytes. This result was more marked in rabbits submitted to both experimental procedures. This finding suggested that the phenomenon was conditioned by a major efficiency of immune response.
[Antigenic competition in rabbits submitted to skin allografts].
Antigenic competition was investigated in rabbits submitted to typhoid vaccine and skin allografts. While skin allografts were normally rejected, serum agglutinin responses to typhoid H and O antigens were lower than those of animals stimulated with thyphoid vaccine alone. It is concluded that the immune response to skin allograft resulted in antigenic competition for typhoid antigens.
[Course of skin allografts in rabbits immunized by heterologous red blood cells].
Skin allografts were done in rabbits previously immunized with sheep red blood cells at 1-10 day intervals. Results showed that mean allograft survival was not delayed, nor was accelerated rejection observed. It is concluded that antigenic competition between sheep erythrocytes and skin allografts does not exist.