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Biomedical subjects

F Leoncini

Publications and source records attributed to F Leoncini.

At least 37 records · Page 2Linked to original sources

Enterocytozoon bieneusi in AIDS: symptomatic relief and parasite changes after furazolidone.

AIMS: To investigate changes in morphology of the developmental stages of Enterocytozoon bieneusi and symptomatic relief observed in AIDS patients after treatment with furazolidone. METHODS: Six AIDS patients with symptomatic E bieneusi infection of the small intestine were treated with a course of furazolidone. All patients had a weekly monitoring of parasite shedding in stool by light microscopy during and after treatment. At the end of the treatment, duodenal biopsy specimens obtained from three patients were studied by transmission electron microscopy by two pathologists who were unaware of the patients' treatment. RESULTS: All patients showed both clinical and parasitological response with transient clearance or decrease of spore shedding in stool. After treatment, alterations in faecal spores were observed in all patients by light microscopy, and ultrastructural changes in E bieneusi at all stages of the life cycle were demonstrated in biopsy specimens of the three patients who underwent post-treatment endoscopy. CONCLUSIONS: The clinical benefit seen after treatment with furazolidone in six AIDS patients with E bieneusi intestinal infection may be due to damage to the developmental stages causing a partial inhibition to reproduction of the parasite.

AIDS-Related Opportunistic Infections↗

Chronic intestinal infection due to subgenus F type 40 adenovirus in a patient with AIDS.

A case of chronic intestinal infection due to adenovirus type 40 lasting for 13 months in a patient with AIDS is described. Adenovirus particles were detected by electron microscopy in biopsy samples taken from the duodenum 3 months after the onset of diarrhoea. The virus was identified as adenovirus type 40 in stool samples by ELISA monoclonal antibodies to adenovirus group antigen (MAd-g2) and types 40 and 41 (MA 40-1 and MA 41-1). No other enteropathogens were found. These data support a causal relationship between adenovirus 40 and the gastrointestinal symptoms of the patient. This is the first reported case of intestinal infection caused by adenovirus type 40 in a patient with AIDS.

AIDS-Related Opportunistic Infections↗

[Azithromycin combined with pyrimethamine in the treatment of neurotoxoplasmosis, in an AIDS patient].

We report one case of successful treatment of cerebral toxoplasmosis in acquired immunodeficiency syndrome (AIDS) with azithromycin combined with pyrimethamine. Toxoplasmic encephalitis had been diagnosed on the basis of multiple lesions exhibiting ring like contrast enhancement on double contrast Computed Tomographic (CT) scan of the brain. Thereby our patient had been treated with pyrimethamine 25 mg/die, after an attack dose of 100 mg in the first day, and clindamycin 2400 mg/die, because of sulfa-drug allergy, but clindamycin had to be discontinued because of rash development. At this point azithromycin, at a dose of 1000 mg/die for 21 days and 1500 mg a week for the following 50 days of follow-up, was added to pyrimethamine. Follow-up CT scan after 20 days of treatment (10 with clindamycin+pyrimethamine and 10 with azithromycin+pyrimethamine) revealed partial resolution of the brain lesions and subsequently (after 50 and 80 days of treatment) complete resolution.

AIDS-Related Opportunistic Infections↗

Morphological injury of the intestinal mucosa and infection in patients with AIDS. The role of combined tissue and stool examination.

AIMS: To define the relationship between morphological injury of the intestinal mucosa and infections in AIDS patients. METHODS: Forty-nine AIDS patients were examined by upper gastrointestinal (GI) endoscopy and 8 of them also by lower GI endoscopy. Biopsy specimens, taken from the lower duodenum, esophagus and rectum, were studied by light (L.M.) and transmission electron microscopy (T.E.M.). Stool examination for microorganisms was routinely performed in all patients. RESULTS: Microorganisms were detected in 37 of the 49 patients (75.5%) by combined tissue and stool examination. The histological study revealed villous atrophy, inter- and intra-enterocyte oedema and epithelial degenerative changes in most of the patients whether or not they had detectable microorganisms. CONCLUSIONS: Combined methods (endoscopy, L.M. and T.E.M., studies of tissue samples, microbiological study of stool samples) may be used to improve the documentation of infections and morphological injury of the intestinal mucosa in AIDS patients.

AIDS-Related Opportunistic Infections↗

Human parvovirus B19 infection within a family and risk for pregnant women.

During an outbreak of parvovirus B19 infection among four related families at least 70% of the household contacts, including a woman at the 33rd week of pregnancy, became infected. Twins were born at the 39th week of pregnancy, both with B19 infection. B19 DNA was detected in their sera by a nested PCR, anti-B19 IgM was detectable only by an immunofluorescence assay, and low levels of maternal anti-B19 IgG were demonstrable by an immunoenzymatic test in the serum of both children. All the haematological parameters were normal at birth and 6 months later, when B19 DNA and anti-B19 antibody were no longer detectable in serum samples. This observation emphasizes the high risk of B19 infection among household contacts and the possibility of a favourable outcome of the foetal infection, possibly related to infection late in the pregnancy.

Adult↗

Human polyomaviruses DNA detection in peripheral blood leukocytes from immunocompetent and immunocompromised individuals.

Peripheral blood leukocytes from immunocompetent and immunocompromised individuals were analyzed for human polyomarivus BK and JC DNA presence. A nested polymerase chain reaction which amplify the transcriptional control region of the genome of both viruses was employed. The immunocompromised patients included bone marrow transplantation recipients and AIDS patients. BKV sequences were detectable in 52.8-62.5% of the individuals included in this study, whereas the percentage of individuals with JCV sequences in peripheral blood lymphocytes varied from 38.8% to 50%. The frequency of reactivations of BKV and JCV were also determined by detection of shedding in urine of viral DNA. The highest frequency of reactivations of either BKV or JCV was demonstrable in the group of bone marrow transplantation recipients, but reactivations occurred also in immunocompetent individuals. JCV sequences amplified from urine samples showed a restriction pattern similar to the archetype one, whereas sequences obtained from lymphocytes showed rearranged pattern as well as archetype pattern. Finally all JCV sequences from cerebrospinal fluid seemed to be rearranged. These observations suggest that peripheral blood lymphocytes have a fundamental role in the persistence of polyomaviruses infection and in the dissemination at least of JCV within the organism allowing that rearranged variants, better adapted to grow in brain tissue, emerge.

Acquired Immunodeficiency Syndrome↗

[Progressive paralysis. A case report].

STUDY OBJECTIVE: A fairly uncommon case of neurosyphilis is reported in a not immunocompromised patient. CASE REPORT: A case of general paresis in a 40 year-old male with the recent onset of mania is described. Psychiatric anamnesis was negative. Neurologic examination was negative. Laboratory tests were performed and serologic tests for syphilis were positive. Cerebrospinal fluid (CSF) examination showed 80 leukocytes/mm3, a reactive Venereal Disease Research Laboratory (VDRL) and normal protein concentration. CSF gamma globulin with an oligoclonal pattern and abnormal IgG index were found. A test for antibodies to Human Immunodeficiency Virus (HIV) was negative. The patient underwent a high dose intravenous penicillin G regimen for two weeks. A follow-up six months later showed a normal CSF even though the IgG index was still abnormal and the mental status was unchanged. CONCLUDING REMARKS: The authors suggest that patients with neurologic and/or psychiatric symptoms with a recent onset and a reactive VDRL should undergo a CSF examination to exclude a possible neurosyphilis.

Adult↗

CAG triplet analysis in families with androgen insensitivity syndrome by capillary electrophoresis in polymer networks.

The potential use of capillary zone electrophoresis in polymer networks (linear polymers above the entanglement threshold, added to the background electrolyte for sieving purposes) for analysis of DNA fragments amplified by a polymerase chain reaction, is shown. In typical runs, the capillary is filled with Tris-borate-EDTA buffer, at pH 8.3, containing 6% linear polyacrylamide as a dynamic sieving matrix. Such formulations allow replenishing the capillary with fresh sieving solution when resolution decays after prolonged use (typically > 30 injections per capillary are obtained). The DNA fragments are detected by their intrinsic absorbance at 254 nm. This system has been applied to the analysis of CAG triplet polymorphism in families carrying the androgen insensitivity syndrome. While easy separation is obtained for fragments 139 base pairs (bp) and 160 bp (in families carrying a difference of 7 CAG repeats) even more difficult cases (such as those of families exhibiting fragments of 136 and 139 bp, thus differing by only one CAG repeat) are resolved with precision and diagnostic value.

Androgen-Insensitivity Syndrome↗

Separation and quantitation of reverse transcriptase polymerase chain reaction fragments of basic fibroblast growth factor by capillary electrophoresis in polymer networks.

In human ovarian carcinomas (epithelial and endometrial tumors) the presence of mRNA coding for the basic fibroblast growth factor (bFGF) was previously demonstrated by reverse transcription-polymerase chain reaction (PCR). For quantitation purposes, competitive PCR is adopted, using a competing fragment a sequence of a highly homologous bovine bFGF. However, separation and detection of the PCR products by slab gel electrophoresis and ethidium bromide staining gives poor quantitative data due to the nonstoichiometric binding of the dye. Thus, the only possible quantitation that can be obtained is via autoradiography with 32P-labeled primers. We report here a capillary electrophoresis protocol, in 6% linear, liquid polyacrylamide as a sieving system, able to fully resolve and quantify the undigested (354 bp) bovine and the digested (295 bp and 59 bp) human fragments, with peak ratios in good agreement with the autoradiographic data.

Adrenal Cortex↗

Use of furazolidone for the treatment of microsporidiosis due to Enterocytozoon bieneusi in patients with AIDS.

The efficacy of furazolidone for treatment of intestinal microsporidiosis due to Enterocytozoon bieneusi was studied in three patients with AIDS. All patients had chronic diarrhoea and weight loss. Mean CD4 cell count was 34.6/mm3. A course of furazolidone (100 mg orally four times a day) was given for 20 days. The drug was well tolerated and neither side effects nor alterations in the laboratory parameters were noted. Diarrhoea ceased within a mean of 12 days of starting treatment and clearance of microsporidian shedding in stool was observed. In one of the patients, however, symptomatic microsporidiosis recurred. Therefore furazolidone seems to have a transient but significant effect on intestinal infection due to Enterocytozoon bieneusi.

Acquired Immunodeficiency Syndrome↗

[An epidemiological study on blood viscosity and intraerythrocytic calcium in a group of high-school students selected according to their family histories].

An epidemiological study was performed in a group of secondary school students selected according to their family history to assess whether changes exist in blood viscosity and intraerythrocytic calcium levels in young healthy subjects with positive family histories of arterial hypertension or cerebral and cardiac ischemic vasculopathies, compared to a control group with a negative family history of these disorders. A population of 130 secondary school students without any pathologies were subdivided into 4 groups: 1) with a positive family history of ischemic cardiopathy (ICP); with a positive family history of cerebral ictus; 3) with a family history of arterial hypertension; 4) a negative family history of these diseases. Total blood viscosity, hematocrit, plasma fibrinogen and intraerythrocytic calcium was evaluated in all groups. The results show that these parameters were within the normal range, as was to be expected in healthy subjects. Blood viscosity was also normal in all groups; intraerythrocytic calcium levels were slightly higher in groups with histories of cardiovascular disease and in particular there was an increased percentage of cases with values above the threshold level. Higher fibrinogen levels were also recorded, but always within the normal range, in the group with a positive history of ICP. The epidemiological study is important to assess whether a family pattern of cardiovascular disease can also influence such independent risk parameters as blood viscosity and intraerythrocyte calcium, owing to the possible greater frequency of development of cardiovascular disease.

Adolescent↗

[Plasma Lp(a) levels: a comparison between diabetic and nondiabetic patients with the nephrotic syndrome and control subjects].

The aim of this study was to evaluate Lp(a), total, HDL and LDL cholesterol, triglycerides, Apo A and Apo B100 plasmatic concentrations in patients affected by nephrotic syndrome that is known able to increase the ratio of the risk of cerebral and cardiovascular events, in comparison with a group of healthy patients homologous for sex and age. In the group of patients with nephrotic syndrome we have compared the variables between diabetic mellitus type I patients and non diabetic patients. All the variables, in exception of HDL cholesterol, were significantly increased in the group of patients with nephrotic syndrome compared with the control group. HDL-cholesterol concentration was significantly higher in controls than in nephrotic patients. Diabetic and nephrotic patients showed increased levels of Lp(a) concentration than non diabetic patients and the difference was statistically confirmed. These data suggest that Lp(a) acts really like a risk factor for atherosclerotic disease, being elevated in patients characterized for increased risk for cerebral and cardiovascular events because of the presence of nephrotic syndrome. Moreover we can suppose that elevated plasmatic Lp(a) levels in nephrotic patients could be linked to increased synthesis of proteins in the liver as physiological reaction to severe proteinuria.

Aged↗

Amplification of 18 dystrophin gene exons in DMD/BMD patients: simultaneous resolution by capillary electrophoresis in sieving liquid polymers.

Duchenne (DMD) and Becker (BMD) muscular dystrophies are the two most common myopathies described so far. In the late 80s, Chamberlain et al. and Beggs et al. proposed two PCR assays allowing detection of over 98% DMD/BMD deletions. Since each of them is based on specific co-amplification of 9 dystrophin gene exons, a method attempting simultaneous analysis of DMD/BMD should offer unambiguous resolution and identification of 18 DNA fragments ranging in size from approximately 100 to 500 bp. We have developed a novel capillary electrophoresis method that allows simultaneous analysis of the two PCR sets with full diagnostic value. It consists of (a) an ultrastable inner capillary coating based on a novel acrylamide monomer (N-acryloyl amino ethoxy ethanol); (b) a very low viscosity (barely 70 mPa) sieving polymer solution, formed by short-chain (average mol wt of 230,000, 55,000 Mn) polyacrylamides; (c) substitution of four fragments in the classical multiplex reaction (181 and 535 bp in the Beggs, 416 and 459 bp in the Chamberlain) with four new fragments of different lengths (170, 313, 154 and 88 bp, respectively). These new conditions allow resolution and unambiguous identification of all 18 PCR-amplified fragments in a single electrophoretic run. The set of 18 fragments comprises the following: 88, 113, 139, 154, 170, 196, 202, 238, 268, 271, 313, 331, 357, 360, 388, 410, 506 and 547 bp.

Acrylic Resins↗

Unusual clinical aspects of oral non-Hodgkin lymphomas in patients with HIV infection.

Patients with HIV infection are at greater risk of developing malignancies. We report two HIV-seropositive patients with primary oral manifestation of a B-cell non-Hodgkin lymphoma (NHL). Localisations of tumours were the palate, with an unusual bifocal origin, and the tongue which is rarely the primary site of NHL. Ulcerations and extensive tissue necrosis were observed. Histologically both cases were high grade malignant lymphomas, immunoblastic. Epstein-Barr virus DNA was detected with in situ hybridisation in 1 patient.

Adult↗

[Lp(a) and lipid order in a group of secondary school students selected according to their family anamnesis].

In this study we evaluated the several risk-factors, Lp(a) and lipids order, related to the family history for ischaemic cardiovascular disease (CHD) atherosclerotic cerebrovasculopathy and arterious hypertension, in a healthy adolescent group, to stress possible early and significant alteration of the lipids order and Lp(a); we also considered which of these parameters may be considered the risk factor most closely related to family history. We studies 130 healty high school students, mean age 16.5 +/- 5.5 years, selected in four groups related to the family history: the first one composed of 34 subjects with positive family history for CHD; the second one of 32 subjects with positive family history for cerebral infarction (CI); the third by 32 subjects with family history for arterial hypertension and the last group by 30 control subjects. Mean value of all variables considered was in the normality range. Lp(a) resulted in the normality range with the exception of the group with positive family history for CHD. Also the traditional risk factors (Total-Col., LDL/Col. and Triglycerides) were increased in this group. Besides the differences between the mean of Lp(a) and Total/Col. in the group with positive family history for CHD and in the control group were statistically significant. The results showed that Lp(a), even if it cannot replace the family history in the screening of coronary atherosclerotic disease, might be considered a risk marker of early atherosclerotic disease.

Adolescent↗