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F Rossetti

Publications and source records attributed to F Rossetti.

42 records · Page 3Linked to original sources
PubMedDate not supplied

Delta virus and childhood leukemia.

We studied 145 children with acute lymphocytic leukemia (ALL) in remission who had been off chemotherapy for at least 2 years, to assess the prevalence of hepatitis delta virus (HDV) infection, and to determine whether HDV infection was associated with more severe chronic liver disease. The prevalence of chronic HBV infection was 41.5% (60/145). The prevalence of HDV infection among these patients with chronic HBV infection was 50% (30/60). Eighty-five patients were HBsAg-negative. There was evidence that HDV-infected children had more severe chronic liver disease than did HBsAg-positive, anti-HDV-negative patients: (1) their serum ALT levels were significantly more likely to be elevated at long-term follow-up (27/30 vs. 10/26, p = 0.0001); (2) their mean ALT levels were significantly higher 3 years after the cessation of chemotherapy (128 vs. 84 IU/L, p = 0.001); and (3) they were more likely to have either chronic acute hepatitis or cirrhosis when liver biopsy was done (18/23 vs. 6/18, p = 0.0038). Children who were HBsAg-negative had the lowest alanine aminotransferase (ALT) levels and were least likely to have chronic active hepatitis or cirrhosis (3/31). We conclude that infection with HDV in children with ALL is associated with serious chronic liver disease. In long-term survivors, HDV infection is a major cause of morbidity and an adverse prognostic factor in terms of leukemia-free survival.

Antibodies, Viral↗
PubMedDate not supplied

High-dose cytosine arabinoside and viridans streptococcus sepsis in children with leukemia.

We report three cases of fulminant sepsis due to viridans streptococci in leukemic children treated with high-dose cytosine arabinoside (Ara-C). The major predisposing factors to this occurrence are the presence of oropharingeal mucositis, which is the entry of streptococci into the bloodstream, and the use of antibiotic prophylactic regimens against gram-negative bacteria. In order to avoid fatal events during viridans streptococci sepsis, specific measures such as penicillin prophylaxis or early antibiotic treatment are needed. We suggest that the prompt empiric use of a glycopeptide antibiotic in addition to the conventional association of a beta-lactam plus an aminoglycoside may significantly decrease the mortality rate due to fulminant streptococci sepsis while the patient is severely neutropenic. In this regard, our current policy considers the addition of an anti-gram-positive antibiotic to the first-choice fever treatment in neutropenic patients who have received high-dose Ara-C.

Child↗
PubMedDate not supplied

Fluconazole prophylaxis and Candida fungemia in neutropenic children with malignancies.

From March, 1990 to February, 1992, we administered fluconazole as antifungal prophylaxis at doses of 3-5 mg/kg/day to 40 patients with prolonged and severe neutropenia following intensive chemotherapy. Fungemia was observed in 3 out 40 patients, and all three of them were due to Candida non-albicans strains: two Candida parapsilosis and one Candida guilliermondi. In vitro sensitivity tests showed that all three isolated strains were susceptible to amphotericin. In one case, Candida guilliermondi was tested for sensitivity to fluconazole and found to be resistant. We conclude that fluconazole prophylaxis proved effective in preventing Candida albicans infections, but it could also contribute to the emergence of Candida non-albicans strains. It might be possible that fluconazole at higher doses could prevent the selection of less susceptible Candida strains.

Adolescent↗