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G Marasca

Publications and source records attributed to G Marasca.

14 recordsLinked to original sources
PubMed1998

Major liver resection for non-Hodgkin's lymphoma in an HIV-positive patient: report of a case.

A very unusual clinical presentation of non-Hodgkin's lymphoma (NHL) of the liver is reported herein. The patient was a 35-year-old male who had been HIV-positive since 1987. Following an episode of acute pain in the right upper abdominal quadrant, ultrasonography (US) and computed tomography (CT) were performed, revealing a nodular lesion, 2.5 cm in diameter, localized in the eighth segment of the liver. Despite the fact that the lesion became significantly enlarged over a 6-month period, three repeated percutaneous biopsies proved negative. Finally, his increasing pain and the lack of a definitive diagnosis prompted us to perform a right hepatectomy. The patient had an uneventful postoperative course and is well 1 year after his operation. Establishing a diagnosis of extranodal lymphoma can be difficult, especially in HIV-positive or AIDS patients. Thus, performing a laparotomy is justified to confirm a diagnosis and decide upon the most appropriate treatment. However, in about 10% of these patients, only surgical resection allows for the diagnosis. In accordance with other reports, our experience confirms that, in contrast with AIDS patients, HIV-positive patients have a similar prognosis as non-HIV patients, and are suitable candidates for even major surgical procedures.

Adult↗
PubMed1997

Multicentre study on the prevalence of symptoms and symptomatic treatment in HIV infection. Central Italy PRESINT Group.

We investigated the prevalence and intensity of symptoms and the use of drugs for symptom control among all HIV-infected patients reporting to the outpatient clinics or wards of 15 clinical centres in central Italy, recording clinical and epidemiological data on three consecutive days. A total of 1128 patients were observed and tabulated. Their most frequent symptoms were asthenia (65%), anorexia (34%), cough (32%), pain (29%), and fever (29%). Opioid analgesics were used in 3% of these patients and non-opioid analgesics in 13%. A large majority of HIV-infected patients presented with symptoms regardless of the stage of their disease. Pain was present in fewer than one third of patients but nonetheless seemed to be undertreated. Pain was more frequent and more intense among intravenous drug users. Based on our study, a greater effort to control symptoms in HIV patients seems to be warranted.

Analgesics↗
PubMed1996

Symptom profile in terminally ill AIDS patients.

A study protocol to record prospectively, frequency and intensity of symptoms in terminally ill AIDS patients was developed. Other information included mode of transmission, active intravenous drug use, regular visits of family/friends to the ward, the use of symptom-control drugs, and death without family or partner. The study population was selected from patients admitted to the wards or followed in the Clinic or Day Center of the Department of Infectious Diseases of the Catholic University, Rome. Inclusion criteria were diagnosis of AIDS prior to 12 months and advanced stage AIDS (defined with standardized criteria). To standardize the analysis of data, the terminal phase was considered to start 3 months before death (T1). From January 1, 1993 to December 12, 1993, 266 patients (208 males, 58 females) were enrolled. By June 30, 1995 168 patients had died and were considered for analysis. The most frequent symptoms at T1 were anorexia (63.1%), fatigue (60.1%), pain (60.1%), fever (47.6%), and cough (37.5%). At the end week (T6) the most frequent symptoms were fever (81.5%), fatigue (70.2%), dyspnea (68.1%), and pain (58.9%). In two-thirds of the patients, symptom-control drugs were used, most frequently nonopioid analgesics (39.9% at T1 and 56.5% at T6) and antipyretics (38.7% at T1 and 53.6% at T6). Opioid analgesics were used in 19% of patients at T1 and in 28.6% at T6. Almost one-third of the patients (29.2%) died alone without having family, their partner, or a friend near. Considering the high frequency of treatable symptoms in terminally ill AIDS patients, the use of palliative therapy should be emphasized. Flexibility and patient-directed care should be used in deciding care plans to avoid overhospitalization and promote alternative care.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Fluconazole for primary prophylaxis of AIDS-associated cryptococcosis: a case-control study.

In order to verify whether fluconazole has a prophylactive effect against the occurrence of cryptococcosis in HIV-infected patients and to identify other factors capable of increasing or reducing the risk of this infection, we arranged a case-control study of 17 patients with cryptococcal infection. 34 controls were selected, matched by presence of an AIDS-defining event, CD4 cell count, and date of T-cell phenotyping. No significant difference in exposure to fluconazole, in total days of treatment, or in total dose administered was observed between cases and controls. However, control patients took a significantly higher average daily dosage of fluconazole and a linear tendency in risk reduction (p = 0.04) in relation to increasing dosage was observed. Antiretroviral therapy and an average daily fluconazole dose exceeding 150 mg both each reduced the risk of a cryptococcal infection.

AIDS-Related Opportunistic Infections↗
PubMed1993

Prognostic factors of early fatal outcome and long-term survival in patients with Pneumocystis carinii pneumonia and acquired immunodeficiency syndrome.

Fifty-five episodes of Pneumocystis carinii pneumonia (PCP) in AIDS patients were evaluated to assess clinical and laboratory risk factors predicting the probability of surviving the acute episode of PCP and the long-term survival after PCP. Age > 45 yrs, PaO2 < 50 mmHg, AaPO2 > 50 mmHg, and LDH > 800 IU/L correlated strongly with early mortality; patients who needed mechanical ventilation had a significantly lower PaO2 and serum albumin, and higher AaPO2 and LDH compared to the patients who did not. Neither age nor PaO2, AaPO2, LDH, albumin, days from onset, time for recovery, CD4+ cell count correlated with long-term survival of AIDS patients with PCP. Informations obtained at initial presentation of PCP may predict early outcome and influence therapeutic approach, improving chances for survival.

AIDS-Related Opportunistic Infections↗
PubMed1986

Length of survival of patients with acquired immune deficiency syndrome in the United Kingdom.

An analysis of the lengths of survival of patients with the acquired immune deficiency syndrome presenting with different opportunistic diseases was performed using epidemiological data routinely collected at the PHLS Communicable Disease Surveillance Centre. The overall crude case fatality rate was 55.4% (93/168). The median survival times were: 21.2 months for Kaposi's sarcoma, 12.5 months for Pneumocystis carinii pneumonia, and 13.3 months for other opportunistic infections. The shortest median survival time (6.6 months) was found for those with both Kaposi's sarcoma and P carinii pneumonia. There were significant differences between durations of survival of patients with Kaposi's sarcoma and those with all other diseases, which indicated impaired cellular immunity apart from opportunistic infections. This analysis shows that those with Kaposi's sarcoma alone have the most favourable prognosis.

Acquired Immunodeficiency Syndrome↗
PubMed1986

National prevalence survey of hospital-acquired infections in Italy, 1983.

In 1983 a national prevalence survey was conducted in Italy to discover the general distribution of infection among patients in public hospitals. Thirty-four thousand, five hundred and seventy-seven acute patients were surveyed in 130 hospitals spread throughout the country: 6668 patients (19.3%) had an active infection at the time of the survey; the infection was hospital-acquired in 2361 (6.8%) and community-acquired in 4307 (12.5%). The urinary tract was the site most frequently involved in hospital infection (30.2% of patients with hospital-acquired infection). The respiratory tract was the site most often involved in community infections (35.7% for the lower tract and 9.1% for the upper). Hospital-acquired infections were more frequent in intensive care units (12.4%) and in geriatric (11.6%), orthopaedic (8.2%) and surgical wards (7.6%). The prevalence of urinary tract infection was 10.4% among the 9.4% of patients who were catheterized compared with a prevalence of 2.6% in the uncatheterized. Thirty-five point five per cent of patients were receiving an antimicrobial on the day of the survey.

Adolescent↗
PubMed1984

AIDS in Italy.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

General epidemiology of tuberculosis.

An outline of the history of tuberculosis is offered for consideration including the present estimated incidence world-wide. The epidemiology of the disease with respect to its etiology is described focusing on the risk of infection, the development of clinical manifestations subsequent to the exposure to the bacillus, and the risk of reactivation. The situation of the epidemiology of tuberculosis in Italy is analyzed based on available information after the closure of TB dispensaries following the introduction of National Health Service in 1978. In last years over 5000 cases of tuberculosis per year have been notified; however what percentage of the real incidence of TB this data represents, is unknown.

AIDS-Related Opportunistic Infections↗