Biomedical subjects

F Franzetti

Publications and source records attributed to F Franzetti.

9 recordsLinked to original sources

PubMed1992

Pseudomonas infections in patients with AIDS and AIDS-related complex.

We identified and reviewed retrospectively all the cases of infection by Pseudomonas and related genera in patients with AIDS and AIDS-related complex (ARC) who were hospitalized at our Institution over a 36-month period. We recorded 48 episodes of infection in 34 of 355 patients with AIDS, and in two of 73 patients with ARC: 25 pneumonias (9 community-acquired and 16 of nosocomial origin). 20 urinary tract infections, two soft tissue infections and one sepsis. In 14 of 16 patients with nosocomial pneumonia but in only one of nine patients with community-acquired pneumonia did we find coexisting opportunistic lung diseases. The following micro-organisms were isolated: P. aeruginosa in 41 cases, P. fluorescens in three cases, Xanthomonas maltophilia (P. maltophilia) in two cases, P. putida in one case. Comamonas testosteronis (P. testosteronis) and Comamonas acidovorans (P. acidovorans) in one case. Amikacin and ceftazidime, alone or in combination, appear to be the optimal choice of therapy for severe Pseudomonas infections in HIV-infected patients, although in our study six of 47 isolates were resistant in vitro to amikacin, and nine of 31 isolates were resistant to ceftazidime.

AIDS-Related Complex↗

PubMed1988

Raised serum beta 2 microglobulin levels in different stages of human immunodeficiency virus infection.

Serum beta 2 microglobulin (beta 2-M) levels were determined in patients with Acquired Immunodeficiency Syndrome (AIDS), AIDS Related Complex (ARC), Persistent Generalized Lymphadenopathy (PGL), healthy intravenous drug addicts (IVDA) and heterosexual controls. Seventy-eight out of 79 AIDS patients (98.7%) exhibited elevated beta 2-M levels. High levels of beta 2-M were also found in 83 of 100 (83%) of PGL/ARC patients and in 24 of 56 (42.8%) healthy IVDA. Patients with AIDS had significantly higher mean beta 2-M levels when compared with all other groups. The mean levels of PGL/ARC patients were significantly higher than those of healthy IVDA and the mean levels for healthy IVDA significantly differ from those of the heterosexual controls. After 2-24 months of follow up three out of four PGL/ARC patients whose serum beta 2-M was greater than 8.0 mg/l developed AIDS.

AIDS-Related Complex↗

PubMed1987

Role of PMN's candidicidal activity in the pathogenesis of AIDS-related systemic candidiases.

Phagocytic and fungicidal activity towards C. albicans spores were tested in 9 patients with AIDS-Related Complex (ARC), but without Candida infections, and in 13 patients with AIDS and deep candidiasis. No significant differences were observed between the two mentioned groups as far as PMN's phagocytosis and killing were concerned. PMN's migration in response to a "non-mycotic" chemoattractant was defective in both groups; although, from this point of view, patients with candidiasis were more severely affected. A significant difference was noted, instead, as far as mean T helper values were concerned; in fact, their number was significantly lower in patients with systemic candidiasis than in those with ARC or even AIDS, but oesophageal candidiasis only. In conclusion, defective PMN's activity towards C. albicans spores, as observed in vitro, does not seem in itself to predispose AIDS patients to candidiasis in vivo; mycoses may be rather due to defects of cell-mediated immunity as a whole.

AIDS-Related Complex↗

PubMed1986

Impairment of polymorphonuclear leucocyte function in patients with acquired immunodeficiency syndrome and with lymphadenopathy syndrome.

Granulocyte functions were studied in 20 patients with acquired immunodeficiency syndrome (AIDS), 20 subjects with lymphadenopathy syndrome (LAS) and 15 symptom-free drug addicts (SFDA). Polymorphonuclear leucocyte (PMNL) phagocytosis and killing of C. albicans appeared normal in homosexual men with AIDS, while drug addicts with AIDS or LAS and SFDA showed a significant defect of these functions as compared to healthy controls. Migration of PMNL in response to a chemoattractant was normal in SFDA, but markedly defective both in LAS and in AIDS patients. In the AIDS group no significant differences were evident between homosexual men and drug addicts. We conclude that defective PMNL phagocytosis and killing, unlike defective migration, are somehow related to drug abuse rather than to infection with the causative agent of the immunodeficiency.

AIDS-Related Complex↗

PubMed1984

Immunological status in heroin addicts: effects of methadone maintenance treatment.

In opiate addicts specific and unspecific immune responses were examined, before and after methadone treatment. Anomalous immune responses were characterized by compromised cellular immunity (functional deficits of polymorphonuclear leukocytes and T-lymphocytes) in association with efficient production of antibodies. After methadone treatment an elevation of leukocyte functions was noted. The presence of elevated titres of circulating immune complexes observed in all the patients tested could bring about a functional exhaustion of neutrophils. The defects of cellular immunity can be considered important risk factors in the pathogenesis of infectious diseases in addicts.

Adolescent↗

PubMed1984

Polymorphonuclear leucocyte function during acute viral hepatitis.

Polymorphonuclear (PMN) phagocytosis was tested in three groups of 12 patients (non drug-addicts) hospitalized for acute A, B and non-A, non-B hepatitis. The same test was performed in 12 parenteral drug-addicts (P.D.A.) with non-A, non-B hepatitis, in 12 P.D.A. with type B hepatitis and in 30 P.D.A. without evidence of acute hepatitis. Percent of phagocytosis was evaluated at time of admission to hospital, at discharge and three months after the acute episode. A statistically significant reduction of phagocytosis was present in each of the non-addicts group at time of admission to hospital. At the discharge this reduction was confirmed for type B and non-A, non-B hepatitis, whereas an improvement was noted for type A hepatitis. Control tests carried out 3 months later evidenced that also in patients affected with type B and non-A, non-B hepatitis the percentages of phagocytosis had reached almost normal values. An increased percent of phagocytosis resulted from incubation of patients' PMN with normal human serum. Among drug-addicts the percentages of phagocytosis do not differ from the data recorded in non-addicts patients during the acute stage of the disease. However, three months after the acute episode, a deficit of phagocytic activity was still present in drug-addicts. These data would support the hypothesis that a serum factor impairing the PMN phagocytosis in acute hepatitis is present. Circulating immune complexes were found in the same sera. They might play an important role in inhibitory effect on neutrophils phagocytic activity.

Acute Disease↗

PubMed1984

Brachial paresis complicating acute non-A, non-B hepatitis.

We report a case of right arm paresis in a parenteral drug addict suffering from acute non-A, non-B hepatitis. His hepatic and neurological symptoms developed together with high level of circulating immune complexes, complement activation, and false VDRL positivity. Immunological abnormalities normalized with the resolution of acute hepatitis and improvement of paresis. These results suggest that neurological dysfunctions may complicate non-A, non-B hepatitis. Moreover, we postulate an immune-mediated mechanism for neuropathy, via a neuropathic activity of circulating immune complexes.

Acute Disease↗

PubMedDate not supplied

Diagnostic and prognostic significance of beta 2-microglobulin during HIV infection.

The serum levels of beta 2-microglobulin (beta 2-m) were determined in 80 intravenous drug addicts (IVDA) with acquired immunodeficiency syndrome (AIDS), in 128 HIV-positive IVDA with persistent generalized lymphadenopathy (PGL) and in 44 HIV-seronegative IVDA. Seventy-two out of 80 (90%) AIDS patients had elevated serum beta 2-m levels and high levels of beta 2-m were also found in 105 of 128 (82%) HIV-infected subjects without AIDS. The mean beta 2-m level was significantly higher in HIV-infected patients with PGL than in HIV-negative IVDA. Nine out of 64 (14%) PGL patients developed AIDS in a period of 24-54 months. In these patients the mean beta 2-m level (5.16 +/- 2.37 mg/l), obtained from sera stored at the first observation, was significantly higher than in the other PGL patients (3.40 +/- 1.03 mg/l); in particular, 5 out of 7 PGL patients with beta 2-m levels greater than 5.0 mg/l showed an advanced disease.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

[Antibiotic therapy in bronchopulmonary infections].

Because of difficulties in accurately determining an etiologic diagnosis, the ideal treatment for lower respiratory tract infections remains questionable. Suggested regimens are made on the basis of clinical and epidemiological data. However, the single most common pathogen responsible for pneumonia remains Streptococcus pneumoniae. Atypical pneumonia in younger patients is best treated with macrolides. Older patients without debility or immunodepression are best treated with amoxycillin-ampicillin, second generation cephalosporins or cotrimoxazole, on the basis of local susceptibility patterns of microorganisms. In the treatment of acute bacterial bronchitis in chronic bronchial disease, most antimicrobial agents with activity in vitro against Haemophilus influenzae and Streptococcus pneumoniae are clinically efficacious. Among new pathogens, the importance of Chlamydia pneumoniae is variable according to the studies, and Moraxella catarrhalis was considered almost exclusively responsible for purulent exacerbations of chronic bronchitis. Therapy for empiric treatment of nosocomial pneumonia must ensure coverage for aerobic Gram negative bacilli: the most frequently used includes a semisynthetic penicillin plus an aminoglycoside, but monotherapy with newer broad-spectrum antibiotics (imipenem, ceftazidime, ciprofloxacin, timentin, etc.) seems to be equivalent to combination regimens. The lung is the most common target organ for infectious complications in immunocompromised patients but the diagnostic methods employed in the traditional work-up of pneumonia are often of little or no use in this setting. By far the two most useful clues to management of pneumonia in the immunocompromised host are the underlying host defect and the radiographic pattern of the lung infiltrate.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Opportunistic Infections↗