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Biomedical subjects

G Zuccotti

Publications and source records attributed to G Zuccotti.

12 recordsLinked to original sources
PubMed1997

Once versus twice daily administration of didanosine in children with symptomatic HIV-associated disease who were intolerant to or clinically deteriorated on zidovudine. The Italian Pediatric Collaborative Study Group on Didanosine.

The objective of this study was to compare the safety, tolerability and clinical response of once- versus twice-daily administration of didanosine given at a dosage of 270 mg/m2/day in children with symptomatic HIV-associated disease who were intolerant to or clinically deteriorated on zidovudine monotherapy. We carried out a randomized, open-label multicentre trial. Didanosine was supplied in buffered tablets, which could be chewed or dispersed in liquid. The children were recruited from 16 paediatric departments participating in the Italian Register for HIV Infection in Children. A total of 53 children (median age 5.5 years) started trial treatment; 26 were given didanosine twice daily and 27 once daily; 85% had AIDS and 98% had clinically deteriorated while on zidovudine therapy. Similar safety and tolerability results were demonstrated for the two schemes of therapy. A total of 11 children (20.7%) required discontinuation of didanosine for severe adverse events (five children (19.2%) in the twice-daily group; six children (22.2%) in the once-daily group, log-rank P = 0.81). Severe hepatic toxicity was uncommon (5.6%) while mild to moderate hepatic dysfunction was demonstrated in about 17% of the participants, without any difference between the two groups. Haematological toxicity was common (about 40% of the children, 11 in the twice- and 19 in the once-daily group) but never severe. Clinical pancreatitis and retinal lesions were never demonstrated. There was no significant difference in progression to death or to a new opportunistic infection between the two treatment regimens (log-rank P = 0.54). The modification of surrogate efficacy parameters during the study period was similar in the two groups. However, weight gain was poorer in children treated once daily. This study suggests that the safety and tolerability of 270 mg/m2/day of didanosine given once daily is substantially similar to that of the traditionally recommended schedule of two divided doses. Owing to the small sample and to the severity of the clinical condition of the children enrolled, no definite conclusions on the comparative efficacy of the two regimens can be drawn.

Adolescent↗
PubMed1992

Noninvasive laser-based blood pressure measurement in rabbits.

To obtain serial blood pressure measurements without trauma in rabbits, we developed a laser-based method which permits noninvasive determination of systolic and diastolic arterial blood pressure. The ease and accuracy of this method were evaluated over a range of blood pressures in five New Zealand White rabbits. Laser-based pressures from the central ear artery were compared with cannula-based pressures from the contralateral central ear artery. Pressures were measured before and during infusions of saline (control), nitroprusside, or epinephrine, and following induction of anesthesia. Noninvasive measurements correlated highly with direct measurements (systole: r = 0.89; diastole: r = 0.93). The difference between the non-invasive and direct pressure measurements during saline, nitroprusside, and epinephrine infusions, and following anesthesia, respectively, were (mean +/- SD, systole/diastole): 4.2 +/- 2.4 (P = NS)/9.3 +/- 1.4 (P less than .001), 4.1 +/- 1.6 (P less than .02)/3.2 +/- 1.1 (P less than .01), 0.6 +/- 2.4 (P = NS)/-3.0 +/- 2.7 (P = NS), and -5.1 +/- 2.9 (P = NS)/0.3 +/- 1.3 (P = NS). The noninvasive method did not result in observable agitation of the animals. To optimize results, visual inspection was required to assure that the instrument's diaphragm was not deformed or dried from previous use, and that the diaphragm was placed over the center of the arterial lumen. It was also necessary to dim room lights and to direct heating lights away from the ears to avoid degrading light signal quality. These results, albeit involving a small number of animals, indicate the potential utility of this method in the study of chronic pathophysiological processes requiring long-term repeated determination of systolic and diastolic blood pressure.

Animals↗
PubMedDate not supplied

Domiodol treatment for bronchopulmonary diseases in the paediatric age group: a double-blind controlled clinical trial versus placebo.

Thirty children (25 males, five females), mean age 9.33 +/- 2.57 years, with acute infectious pulmonary diseases or acute flare-ups of chronic bronchitis, were randomly treated with either domiodol or placebo. The study was conducted between November 1986 and February 1987. Domiodol was administered orally for 14 days in doses of 0.5 mg/kg three times daily. Subjective symptoms (cough, sputum viscosity, difficulty in raising sputum and sputum characteristics) were assessed semi-quantitatively. They were all reduced significantly in the group treated with domiodol compared to those given placebo. Spirometric measures of vital capacity and peak expiratory flow rate were also improved in patients given domiodol compared with placebo. Conversely, no differences were noted in forced expiratory volume in 1 s, Tiffenau index, or mid-expiratory flow. There were no clinical side-effects and no changes in any other parameters measured; in particular, levels of thyroid hormone and thyroid stimulating hormone were unchanged. Thus, domiodol proved effective in reducing the symptoms of infection of the lower respiratory tract and in improving the consistency of mucus in children.

Adolescent↗
PubMedDate not supplied

Treatment of respiratory tract infections in children: a study of a combination of amoxycillin and clavulanic acid.

In an open study, 70 in-patients and 23 out-patients aged between 1 and 14 years with sinusitis (n = 1), perforated otitis media (n = 4), pharyngotonsillitis (n = 25), tracheobronchitis (n = 30) or broncho-pneumonia (n = 33) were treated daily with a combination of 40 mg/kg amoxycillin and 10 mg/kg clavulanic acid in three equal doses for between 6 and 15 days. Purulent specimens were cultured when obtainable and pathogenic organisms identified were Staphylococcus aureus, beta-haemolytic streptococcal group A, Pseudomonas aeruginosa, Pseudococcus species and Klebsiella pneumoniae infections, of which 45.7% were beta-lactamase-producing and 54.3% were ampicillin-susceptible. After treatment, only one beta-lactamase-producing Streptococcus and one Staphylococcus infection persisted. Side-effects (vomiting, nausea, diarrhoea, maculopapular exanthema, rash) occurred in 16 patients and treatment was withdrawn in eight. It is concluded that the amoxycillin--clavulanic acid combination is a suitable first choice for the treatment of respiratory tract infections in children in whom the pathogenic organism may not have been established.

Adolescent↗
PubMedDate not supplied

Clinical and pro-host effects of cefaclor in prophylaxis of recurrent otitis media in HIV-infected children.

The aim of this study was to evaluate the efficacy of cefaclor in the prophylaxis of recurrent acute otitis media (AOM) in human immunodeficiency virus (HIV)-infected children. The study was carried out in children born between 1 January 1986 and 31 December 1996 who had been vertically HIV infected Patients who had experienced recurrent AOM between October 1997 and March 1998 (period 1) were eligible for the trial. Recurrent AOM was defined as the occurrence in the same patient of three or more episodes of AOM within 6 months of the observation period. Patients recruited for this trial received cefaclor at a dose of 20 mg/kg once daily for 6 months between April and September 1998 (period 2). Clinical observation was carried out in periods 1 and 2 and for the first 6 months after prophylaxis, i.e. October 1998 - March 1999 (period 3). Natural killer-cell activity, phagocytosis and myeloperoxidase activity were determined before and at the end of the prophylactic period. For each period, CD4-cell count measurement and CD4-positive cell class were recorded. Seventeen children were recruited for this trial. No significant differences were observed in natural killer-cell activity between periods 1 and 2, nor were any significant differences observed in CD4-positive cell class or CD4-positive cell count between the three periods. However, cefaclor administration was associated with a reduction in the number of AOM episodes in 100% of cases and a mean increase in myeloperoxidase activity in 57% of cases. This suggests that cefaclor may be useful in the prophylaxis of recurrent AOM in HIV-infected children.

Acute Disease↗
PubMedDate not supplied

[Pulmonary pathology in HIV seropositive children. 4 clinical cases].

Pulmonary infections in children with acquired immunodeficiency syndrome are very common. The lung, having a very important immunological function (because in it a very important part of the secretory immunological system is present), is one of the more involved apparatus in the course of AIDS. We report 4 cases of pulmonary disease (one case of Cytomegalovirus pneumonia, one case of Pneumocystis Carinii pneumonia, and two cases of interstitial lymphoid pneumonia) found in HIV positive children followed at the 5th Pediatric Department - Regional Center, Milan.

Child, Preschool↗