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Biomedical subjects

F Radaelli

Publications and source records attributed to F Radaelli.

53 records · Page 3Linked to original sources

Low-dose heparin in thoracic surgery: effect on blood coagulation and fibrinolysis system.

Plasma kallikrein, antithrombin III and antiplasmin were determined with chromogenic methods in 29 patients pre-, per- and post-operatively in a controlled, randomized study. 16 patients received calcium heparin, 5000 IU s. c. every 8 hr for 7 days, the first administration given 2 hr before surgical procedure. 13 control patients received saline. A significant reduction of kallikrein and antiplasmin in per- and post-operative periods was observed in the control patients compared with the heparin-treated patients, while there was a significant reduction of anti-thrombin III in the control patients compared with the treated patients only in the per-operative period. The results obtained suggest that activation of the coagulation and fibrinolysis system occurs in patients undergoing thoracic surgery, and that it is inhibited significantly by calcium heparin prophylaxis.

Adult↗

[Pathogenic flora in hematology patients. Gram-negative germs and their in vitro sensitivity to antibiotics].

The results of microbiological research carried out on haematological patients admitted to the same ward are reported. The pathogenic flora observed consisted mainly of gram-negative germs (60%). Pseudomonas infections represented the most important problem because of their frequency and the consequent clinical problems. The in vitro sensitivity of 306 strains of gram-negative germs to 11 different antibiotics has been analysed. Amikacin proved to be easily the most effective antibiotic against isolated pathogens.

Amikacin↗

Abnormal platelet function in a case of megakaryoblastic leukaemia.

A platelet function study in a patient with megakaryoblastic leukaemia is reported. The abnormalities of the platelet function suggest a probable platelet membrane injury and a platelet release defect. The reduced platelet half-life and the non changing splenohepatic ratio confirm the clinical and histological features of the systemic disease.

Bleeding Time↗

Thrombolytic therapy for venous thrombosis in patients with gastro-intestinal diseases.

Venous thrombosis in 2 patients with gastro-intestinal diseases (chronic liver disease and ulcerative colitis) is reported. A good clinical improvement was obtained after thrombolytic (urokinase) therapy without any haemorrhagic side-effect. A decrease in the plasma of the fast-acting antiplasmin has been correlated with urokinase thrombolytic effect in vivo. These preliminary reports suggest that thrombolytic drugs are a safe tool for the treatment also of thromboembolic complications in patients with potential haemorrhagic diathesis.

Aged↗

Presence of circulating immune complexes in patients with chronic lymphocytic leukaemia. Correlations between clinical and immunological features.

The presence of circulating immune complexes (CIC) was evaluated in 60 untreated patients with chronic lymphocytic leukaemia with the polyethylene-glycol precipitation assay. The mean values of optical density (OD) in patients' sera was 0.161 +/- 0.121 compared with control values of 0.082 +/- 0.045 (P less than 0.001). Sera of 16 patients gave OD values higher than 0.172 (mean of controls plus 2 SD) and were considered positive for the presence of CIC. Using the new staging proposed by Binet for CLL we did not find any correlation between presence of CIC and stage of the disease. On the contrary, it was possible to correlate the presence of CIC with the stability of the disease: CIC were found in only 2 of the 22 patients (9.1%) with progressive disease but in 10 of the 30 patients (33.3%) with stable disease (P less than 0.05). CIC were present in 12 of the 38 patients in whom the only surface immunoglobulins present were IgM, but in only 1 of the 14 patients in whom both IgM and IgD were contemporaneously present on the lymphocyte surface. No correlations were found between levels of serum immunoglobulins and presence of CIC.

Adult↗

Empiric treatment of infections in granulocytopenic patients with acute leukemia: a study on amikacin-carbenicillin-cotrimoxazole.

The amikacin-carbenicillin-cotrimoxazole combination was used as an empiric treatment for febrile episodes in patients with acute leukemia and severe granulocytopenia. The choice of drugs was based on the finding in our institute that the majority of infections are caused by gram-negative rods, particularly Pseudomonas, with high percentage of strains resistant to gentamycin and tobramycin. Granulocyte transfusions were given to the patients who did not show satisfactory clinical improvement 48 h after start of antibiotic therapy. There were cures in 84.6% of the febrile episodes treated with this antibiotic combination, including five of eight episodes of microbiologically confirmed bacteremia. Survival after 21 days of antibiotic therapy amounted to 89.1%. Renal toxicity occurred in 10.9% of the episodes treated. The prompt use of this antibiotic combination seems to be a safe and efficacious therapeutic tool for treating these high-risk patients.

Acute Disease↗

Diagnosis and treatment of fungal infections in patients with hematologic malignancies.

A diagnosis of deep-seated mycosis was made in 54 patients with hematologic malignancies, severe neutropenia and fever, based on a set of clinical and laboratory criteria. Standardized antifungal treatment was started in 31 patients who seven days after onset of fever had not responded to antibiotics; the fungal infection was cured in 13, all of whom had a simultaneous remission of neutropenia, whereas the other 18 who did not respond to antifungal treatment, all had a falling or static neutrophil count. None of the 23 patients who were given no or inadequate antifungal treatment survived regardless of the neutrophil count and/or phase of the hematologic disease. We discuss the suitability of utilizing empirical criteria for a diagnosis of disseminated fungal infection as a basis for starting antifungal therapy in this type of patient.

Adolescent↗

Severe Legionella pneumophila infection in a patient with hairy cell leukemia in partial remission after alpha interferon treatment.

Legionella pneumonia is an increasingly frequently reported complication in immunocompromised patients, particularly patients with hairy cell leukemia (HCL) in active phase. The most important predisposing factor seems to be the quantitative and qualitative defect of the monocytic-macrophagic system characteristic of HCL. We report a case of severe Legionella pneumophila infection with multisystem involvement in a patient with HCL in stable partial remission obtained after therapy with interferon. In our patient recovery of a normal monocyte count did not protect against a legionella infection, indicating that this pathogen should always be sought in HCL patients even those in clinical and hematologic remission. Early diagnosis and appropriate treatment may reduce the mortality of this serious complication.

Adult↗

[A severe case of bronchial pneumonia due to Mycoplasma pneumoniae accompanied by immunosuppression, thrombophlebitis and hepatitis resolved with human immunoglobulins].

We present a case of severe pneumonia by Mycoplasma pneumoniae, whose clinical course was complicated by immunodepression, hepatitis and deep venous thrombosis. Treatment with pepsin-treated human immunoglobulins was unsuccessful, whereas prompt recovery was obtained by infusion of human immunoglobulins treated at pH 4.

Adult↗

[Radiological aspects of invasive pulmonary aspergillosis].

The radiological features of invasive pulmonary aspergillosis, observed in 20 patients with hematologic malignancies, are reported. From the analyses of the initial signs and their modifications in the course of the disease it was possible to identify some aspects strongly suggestive of the mycotic nature of the pulmonary lesions. Rounded pneumonia and hemorrhagic infarction often complicated by cavitation with or without intracavitary nodule are the most suggestive aspects, and the latter carry good prognostic significance.

Adolescent↗

Essential thrombocythemia in pregnancy: report of four cases.

We report four pregnancies in four patients with essential thrombocythemia (ET). In two cases pregnancy resulted in spontaneous abortion at 6 and 11 weeks of gestation, respectively. The other two had a full-term, normal delivery; one of them received no therapy during the pregnancy, whereas the other was treated with acetylsalicylic acid from 11 weeks for signs of threatened abortion. No thrombotic or hemorrhagic complications were observed in any of the patients during pregnancy or the post-partum period. We believe that pregnancy in patients with ET represents a risk. Close monitoring is therefore indispensable and antiaggregant therapy might be of benefit.

Adult↗