Biomedical subjects

D Musso

Publications and source records attributed to D Musso.

14 recordsLinked to original sources

PubMed2005

The effect of a venous filter on the embolic load during medullary canal pressurization: a canine study.

BACKGROUND: Acute intramedullary stabilization of femoral shaft fractures in multiply injured patients is controversial. Intravasation of medullary fat during canal pressurization has been suspected to trigger adult respiratory distress syndrome. The goal of the present study was to evaluate the effect, on the lungs, of a filter placed into the ipsilateral common iliac vein during medullary canal pressurization in a canine model. METHODS: With use of an established model of fat embolization, twelve mongrel dogs were randomized into two groups. In six dogs, a special filter was inserted percutaneously into the left common iliac vein while the dogs were under general anesthesia. In all dogs, the left femur and tibia were then pressurized by injection of bone cement and insertion of intramedullary rods. Hemodynamic measurements and echocardiographic images were recorded throughout the experiment. After one hour, the animals were killed and the lungs were harvested for histomorphometric analysis. RESULTS: Without the filter, the mean pulmonary artery pressure increased by 11.8 +/- 2.1 mm Hg (p < 0.001). With the filter, the mean pulmonary artery pressure increased by only 2.2 +/- 0.8 mm Hg (p < 0.02). Without the filter, there was a significant increase in the index of pulmonary vascular resistance as compared with the baseline value (p < 0.05). With the filter, there was no such increase. Histomorphometric analysis demonstrated that the presence of the filter reduced the absolute area of embolization and the volume percentages of lung and pulmonary vasculature embolized. CONCLUSIONS: In this canine experiment, temporary placement of a venous filter prior to medullary canal pressurization reduced the embolic load and minimized its hemodynamic effects.

Animals↗

PubMed1998

Isolation of blood-borne Mycobacterium avium by using the nonradioactive BACTEC 9000 MB system and comparison with a solid-culture system.

We conducted a 12-month prospective study comparing two approaches to the detection of Mycobacterium avium in the blood of human immunodeficiency virus type 1-infected patients, namely, a lytic centrifugation system combined with Middlebrook solid culture medium (the conventional procedure) and the nonradiometric BACTEC 9000 MB system. Species identification relied on 16S rRNA probe hybridization and cell wall fatty acids chromatography. M. avium was isolated in 17 of 345 (5%) blood specimens by the BACTEC 9000 MB automated system and in 14 of 345 (4%) blood specimens by the conventional procedure (nonsignificant, chi2 test). Detection time was 16 +/- 6 days by the BACTEC 9000 MB automated system and 27 +/- 3 days by the conventional procedure (P < 0.001, Student t test). Non-M. avium mycobacteria were not recovered during the study period. Contamination rate was 8% (30 specimens) by the BACTEC 9000 MB system and 0% by the conventional procedure, indicating the necessity of using an antibiotic mixture (PANTA, consisting of polymyxin B, amphotericin B, nalidixic acid, trimethoprim, and azlocillin). Working time was 1 min 30 s by the BACTEC 9000 MB system and 8 min by the conventional procedure, which was 1.8 times more expensive than the BACTEC system. Use of the BACTEC 9000 MB system increased the sensitivity of M. avium detection and reduced detection time in blood culture.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Pseudo-outbreak of listeriosis elucidated by pulsed-field gel electrophoresis.

Listeria monocytogenes was isolated from three patients hospitalized in two departments of the same hospital over a two-week period. A nosocomial outbreak of listeriosis was suspected. Patients presented with tenosynovitis, central venous catheter infection, and bacteremia. The first patient had a community-acquired infection, the second a nosocomial infection, and the source of the third patient's illness was uncertain. Epidemiological investigations failed to identify a common source of contamination within the hospital. The three strains were nontypeable by phage typing, but Smal macrorestriction analysis and pulsed-field gel electrophoresis yielded three distinct profiles. Therefore, the three cases seemed to represent a cluster of sporadic cases as opposed to an outbreak of listeriosis. Rapid typing of isolates is essential in the early investigation of potential outbreaks of listeriosis and may prevent the initiation of expensive and time-consuming epidemiological investigations.

Aged↗

PubMed1997

Aortoabdominal aneurysm infected by Yersinia enterocolitica serotype O:9.

A 78-year-old-man was hospitalized for surgical treatment of a Yersinia enterocolitica serotype O:9 infected primary aortoabdominal aneurysm which ruptured soon after admission. Infection of aneurysm is an unusual manifestation of yersiniosis, especially in patients with no predisposing underlying condition. This case, and review of the literature, highlights that serotype O:9 has a predilection for vascular tissue. Cross reaction with Brucella spp. may be responsible for misdiagnosis of Y. enterocolitica O:9 infected aneurysms.

Aged↗

PubMed1997

Serological cross-reactions between Coxiella burnetii and Legionella micdadei.

Coxiella burnetii and Legionella micdadei are both gram-negative bacteria potentially responsible for identical clinical syndromes resembling upper respiratory infections. These infections, quite common in immunocompromised patients, are usually diagnosed by serology with a microimmunofluorescence assay. We found that 34.5% of Q fever patients had a significant titer of antibodies against L. micdadei. Cross-reactions involved immunoglobulin G antibodies and were demonstrated by a cross-adsorption study and protein immunoblotting. Western blot analysis performed after treatment with proteinase K indicated that cross-reactions were probably due to both protein and lipopolysaccharide antigens. It is critical that the existence of this cross-reaction be recognized, as misdiagnosis of either condition may lead to incorrect and ineffective treatment.

Antibodies, Bacterial↗

PubMed1996

Sequence of quinolone resistance-determining region of gyrA gene for clinical isolates and for an in vitro-selected quinolone-resistant strain of Coxiella burnetii.

We report the sequence of the quinolone resistance-determining region of the gyrA genes of either susceptible or low-level-resistant clinical isolates of Coxiella burnetii. The sequences of low-level (MICs, 4 micrograms/ml) and high-level (MICs, 8 and 16 micrograms/ml) resistant strains stepwise selected in vitro were also determined. The gene sequences of all of the clinical isolates and that of the in vitro-selected low-level-resistant strain were identical. Sequence analysis of the in vitro-selected high-level-resistant strain revealed a nucleotide mutation leading to an amino acid substitution of Gly in place of Glu at position 87 of the GyrA amino acid sequence. These results indicate that high-level resistance to ciprofloxacin is associated with a nucleotide mutation in gyrA, whereas low-level resistance to quinolones is not.

Amino Acid Sequence↗

PubMed1995

Lack of bactericidal effect of antibiotics except aminoglycosides on Bartonella (Rochalimaea) henselae.

Bartonella (Rochalimaea) henselae is a cause of peliosis hepatis and bacillary angiomatosis, and one of the putative agents of cat scratch disease. Specific therapy for B. henselae infections is not available. Treatment failures and relapses are frequent, especially following brief antibiotic courses, and this contrasts with the in-vitro susceptibility of B. henselae to most antibiotics. We decided to test the antibiotic susceptibility of B. henselae associated with murine macrophage-like cells (P388 D1) and a human endothelial cell line. We carried out a bactericidal assay in this model and in axenic broth. In both models, only aminoglycosides were bactericidal. These results suggest that aminoglycosides may be effective in the treatment of B. henselae infections.

Aminoglycosides↗

PubMed1995

Coxiella burnetii blood cultures from acute and chronic Q-fever patients.

Q fever, a worldwide zoonosis caused by Coxiella burnetii, may present as either an acute or a chronic disease. We correlated the results of 844 C. burnetii blood cultures with serological, clinical, and therapeutic data. C. burnetii was isolated from 17% of untreated patients with acute Q fever and from 53% of untreated patients with chronic Q fever. C. burnetii was not isolated from patients who were receiving antibiotics active against C. burnetii. For seven culture-positive patients with acute Q fever, serology was negative when C. burnetii was isolated. One patient with acute Q fever had a positive blood culture 25 days after the discontinuation of specific antibiotic therapy, and another had a positive blood culture after the resolution of symptoms. In one case of chronic Q fever, a positive blood culture resulted from noncompliance with treatment. The culture method described in this report is suitable for all laboratories with cell culture facilities. Our findings suggest that blood samples must be collected prior to the initiation of an antibiotic regimen if C. burnetii is to be successfully isolated.

Acute Disease↗

PubMed1994