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Biomedical subjects

G Bucaneve

Publications and source records attributed to G Bucaneve.

30 records · Page 2Linked to original sources
PubMed1989

Norfloxacin prophylaxis for neutropenic patients undergoing bone marrow transplantation.

To prevent bacterial infections in the neutropenic post-transplant period, norfloxacin 400mg twice daily was administered as oral prophylaxis to 44 marrow recipients isolated in laminar airflow rooms (LAFRs). Patients had a mean age of 30 years (8-50) and a male/female ratio of 29/15. The mean duration of prophylaxis was of 41 days (20-80), that of neutropenia (PMN less than 1000 x 10(6)/l) of 31 days (6-76) and that of severe neutropenia (PMN less than 100 x 10(6)/l) of 19 days (10-55). All but two patients developed one or more febrile episodes (total episodes: 71), 33 of which were documented infections. Eighteen bacteraemias occurred and all were caused by Gram-positive cocci: five by coagulase-negative staphylococci (three methicillin resistant), four by coagulase-positive (one methicillin resistant), seven by streptococci (four S. sanguis, one S. milleri, one group B, one group C), and two by enterococci. All streptococcal and enterococcal strains, but only one MR coagulase-positive staphylococcus, proved to be resistant to norfloxacin. Norfloxacin was well tolerated and no prophylactic course had to be interrupted because of side effects. In conclusion, norfloxacin adequately prevents infections caused by Gram-negative bacilli in bone marrow recipients isolated in LAFRs, but Gram-positive infections still remain a problem in these patients indicating the need for improving this prophylactic regimen.

Adolescent↗
PubMed1988

Teicoplanin in empirical combined antibiotic therapy of bacteraemias in bone marrow transplant patients.

Teicoplanin in combination with amikacin and ceftazidime was used as empirical therapy in treating 46 febrile episodes in 34 consecutive patients undergoing allogenic bone marrow transplantation. All but four of these febrile episodes occurred in neutropenic patients and 50% of them proved to be bacteraemias (23/46). Cure was achieved in 90% of Gram-positive bacteraemias (18/20) and in six of them teicoplanin was the only antibiotic with activity in vitro against the infecting strain. All (3/3) Gram-negative bacteraemias were cured. Central venous catheter removal was required in five patients (three tunnel infections, one exit-site infection and one thrombophlebitis). Two failures occurred among Gram-positive bacteraemias and in one case the patient died of infection. Four instances of side effects were documented but only one was severe (hearing loss).

Adolescent↗
PubMed1988

Septicaemia due to gram-positive cocci in cancer patients.

Episodes of septicaemia caused by Gram-positive bacteria in five separate investigations of empirical antibiotic treatment for fever in patients with neoplastic disease have been analysed according to the antimicrobial agents administered and the outcome. The results suggest that the addition of an 'anti-staphylococcal agent', such as co-trimoxazole, vancomycin or teicoplanin, to the standard two-drug regimen (a beta-lactam antibiotic and an aminoglycoside) may be advantageous in improving the prognosis, particularly in Staphylococcus aureus septicaemia.

Adolescent↗
PubMed1988

Imipenem/cilastatin in the treatment of severe hospital infections.

Imipenem/cilastatin as a single agent or in combination with amikacin was used as empirical treatment of severe hospital infections. Twenty-five patients were evaluable for efficacy and the overall response rate was 62% with imipenem/cilastatin alone and 80% with imipenem/cilastatin in combination with amikacin. The highest response rate was obtained in urinary tract infection (75%) and in pneumonia (70%) and the lowest response rate (50%) was observed in bacteremia of unknown origin and in skin and soft tissue infections. Eight failures were observed and seven of them occurred in patients treated with imipenem/cilastatin alone. Two deaths occurred, both in patients with bacteremia. Imipenem/cilastatin treatment was interrupted early in 3 patients because the pathogen developed resistance during therapy and in 2 other patients because of side effects. In our study imipenem/cilastatin proved to be efficacious and well tolerated. The addition of an aminoglycoside to imipenem/cilastatin might improve its efficacy and prevent pathogens from becoming resistant during therapy. Therefore this association would seem to be advisable for the therapy of bacteremic infections and for those caused by difficult pathogens.

Adult↗
PubMed1987

Effects of the new glycopeptide antibiotic teicoplanin on platelet function and blood coagulation.

Teicoplanin, a new glycopeptide antibiotic, is structurally related to ristocetin, an antibiotic known to induce human platelet agglutination and, thus, thrombocytopenia and thromboembolic side effects. The aim of this study was to evaluate the effects of teicoplanin on platelet function in vitro and ex vivo and on blood coagulation ex vivo. In the in vitro studies, spontaneous platelet aggregation; platelet aggregation induced by ADP, collagen, and ristocetin; and the release of beta-thromboglobulin from platelets were assessed. Platelets from healthy subjects were incubated with teicoplanin at final concentrations of 100, 1,500, 5,000, and 10,000 micrograms/ml. The maximal achievable concentration with therapeutic doses is 100 micrograms/ml. When compared with saline, teicoplanin at concentrations of 100 and 1,500 micrograms/ml had no effect on platelet function, but at concentrations of 5,000 and 10,000 micrograms/ml, it induced greater spontaneous platelet aggregation (P less than 0.01) and inhibited platelet aggregation induced by ADP, collagen, and ristocetin (P less than 0.01). Teicoplanin at concentrations of 100, 1,500, and 5,000 micrograms/ml did not induce the release of beta-thromboglobulin, in contrast to teicoplanin at a concentration of 10,000 micrograms/ml and ristocetin at a concentration of 1.5 mg/ml (P less than 0.01). In the ex vivo studies, platelet count, bleeding time, plasma beta-thromboglobulin, platelet aggregation induced by ADP, ristocetin, and epinephrine, activated partial thromboplastin time, prothrombin time, thrombin clotting time, and serum fibrinogen degradation products were evaluated at days 0, 3, and 6 and at 72 h after the end of therapy. All subjects completed the study without evidence of side effects. When compared with the pretreatment values, none of the values from these assays showed a significant change at any time during and after treatment. We concluded that platelet function and blood coagulation are not affected by therapeutic concentrations of teicoplanin and that in vitro platelet function is affected only by concentrations of teicoplanin far in excess of those that are clinically achievable.

Adult↗
PubMed1987

Prospective randomized clinical trial of teicoplanin for empiric combined antibiotic therapy in febrile, granulocytopenic acute leukemia patients.

The increasing prevalence of bacteremia caused by gram-positive bacteria in granulocytopenic acute leukemia patients prompted us to evaluate, in a prospective randomized trial, the role of teicoplanin, a new glycopeptide antibiotic, when it was added to amikacin plus ceftazidime, as an empiric therapy of fever in these patients. Of 47 evaluable episodes, 22 were treated with the teicoplanin regimen and 25 were treated with the combination of amikacin and ceftazidime. The overall response to therapy of patients treated with teicoplanin was slightly better (82% improvement) than that obtained with amikacin plus ceftazidime (52%). The response rate of patients with gram-positive bacteremias was 80% (4 of 5) to the regimen that included teicoplanin; 25% (1 of 4) of the patients treated with amikacin plus ceftazidime responded to treatment; and for patients with gram-negative bacteremias, the response rates were, respectively, 100% (4 of 4) and 70% (7 of 10). The better results obtained with amikacin-ceftazidime-teicoplanin treatment were most evident in patients with profound (less than 100/mm3) and persistent neutropenia (83 versus 30% improvement). Furthermore, a good response rate of patients with gram-positive bacteremias (seven of eight; 87% improvement) was achieved in a small group of bone marrow transplant patients who were all treated with amikacin-ceftazidime-teicoplanin. No severe side effects were documented in any patient. Teicoplanin, as a drug administered as a single daily dose, seems to be a safe and useful anti-gram-positive agent when used in combination with amikacin-ceftazidime as an empiric therapy of febrile episodes in granulocytopenic acute leukemia patients.

Acute Disease↗
PubMedDate not supplied

Ceftriaxone versus aztreonam plus cefazolin for infections in cancer patients with adequate neutrophil counts.

In a prospective randomized trial, 154 febrile episodes in cancer patients with adequate neutrophil counts (greater than 1,000 cells/mm3) were treated with either ceftriaxone (72 episodes) or aztreonam plus cefazolin (82 episodes). Documented infections represented almost half of the febrile episodes. The overall response rates among the 144 evaluable episodes were similar for the two regimens: 76% (51/67) with ceftriaxone versus 82% (63/77) with aztreonam plus cefazolin (p = 0.41, not significant). Although not statistically significant, the response rate of the microbiologically documented infections was slightly better in patients treated with the double beta-lactam combination (85% vs. 65%, p = 0.16) and clinically documented infections showed a better response in the group of patients receiving monotherapy (87% vs. 59%, p = 0.12). No serious adverse effects were observed during this study and both regimens were well tolerated. Ceftriaxone or the combination of aztreonam plus cefazolin showed a similar efficacy as empirical therapy for infections in cancer patients with adequate neutrophil counts.

Adolescent↗
PubMedDate not supplied

Fatty acid pattern of red blood cell membranes and risk of ischemic brain infarction: a case-control study.

The fatty acid composition of red blood cell membranes (which reflects dietary fat intake) was studied in 28 male patients with recent (less than 3 days) ischemic stroke and 56 matched controls. Fifteen fatty acids were measured by means of chromatographic analysis. Percentages of linoleic, 22:5, and 22:6 acids were significantly lower in red blood cell membranes of stroke patients than in those of matched controls. The results suggest that a low unsaturated fatty acid diet could be an independent risk factor for ischemic brain infarction.

Adult↗
PubMedDate not supplied

[Adverse effects of corticosteroids].

Due to their anti-inflammatory and immunosuppressive properties, as well as their action on the hematopoietic system and the calcium phosphate turnover, corticosteroids are widely employed in the treatment of many diseases. However, the therapeutic use of these compounds is frequently associated with unwanted, mainly type A, effects that are directly dependent on the wide spectrum of their pharmacological activities. In this study these side effects are critically reviewed and classified on the basis of the organs and systems involved. Where possible, the incidence, pathogenesis, type of steroid, dose and schedule are reported, and the precautions that should prove useful in reducing the incidence and gravity of the side effects are given.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Whipple's disease: a continuous challenge.

Whipple's disease is a rare disease with protean clinical manifestations, often mimicking those of other pathological conditions. We describe two new cases, one admitted to hospital only after Giardia lamblia infestation had drawn attention to gut symptoms, and the other who was treated for a long time with steroids for suspected Horton's arteritis. Once again, we stress the importance of bearing this polymorph disease in mind, especially in older people.

Aged↗