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H de Castro

Publications and source records attributed to H de Castro.

3 recordsLinked to original sources

An experimental model for testing von Willebrand factor function: successful SLA-matched crossed bone marrow transplantations between normal and von Willebrand pigs.

To assess the relative in vivo roles of von Willebrand factor (vWF) of different origins, we performed crossed bone marrow transplantations (BMTs) among normal pigs and pigs with the von Willebrand disease(vWF). The two groups were fully compatible immunologically according to typing by swine leukocyte antigen (SLA). After total-body irradiation (8-10 Gy), all pigs received 0.5X10(9) to 10(10)/kg mononuclear bone marrow cells without any immunosuppression. The nadir of aplasia occurred between days 5 and 7 after irradiation (white blood cell [WBC] count 0.6X10(9)/L, platelet [Plt] count 76X10(9)/L. Three weeks after the graft, WBC and Plt counts had returned to normal levels. Animals were followed for at lease 50 days, during which no bone marrow rejection occurred; no evidence of graft-vs-host disease (GVHD) was observed. Each BMT was confirmed by karyotype analysis. In the six homozygous pigs with vWD grafted with normal marrow, platelet vWF antigen (vWFAg) and platelet vWF activity rose from <3 to 450 U/dl with a normal multimeric pattern; plasma vF increases slightly. No correction of bleeding time was observed. In the five normal pigs grafted with bone marrow form pigs with vWD, platelet vWFAg and platelet vWF activity decreased from >100 U/dl to undetectable levels; bleeding time and plasma vWFAg remained unchanged. A derivative of normal porcine plasma, a concentrate containing factor VIII and vWF, was infused into a homozygous vWD pig before and after BMT from a normal pig. Co correction of bleeding time was obtained, even though plasma nd platelet vWFAg levels were normal. W concluded that crossed BMT among SLA-identical pigs is a feasible model of studying the synthesis and the roles of vWF in hemostasis and thrombosis.

Animals↗

[Treatment of infectious outbreaks in neutropenic patients with a piperacillin and amikacin combination].

Two hundred and fifty patients (mean age 39 years) were involved in a multicentric pilot trial aimed at evaluating the effectiveness of a piperacillin (P) + amikacin (A) combination in severe neutropenic patients (less than 500 PNN/microliters). In patients who failed to improve under this combination vancomycin (V) was added. Two hundred and thirty-five patients were assessable for response to P + A. The infection was microbiologically undocumented in 148 of them (63%) and documented in 87 (37%). Response rates were 64% and 53% respectively, rising to 73% in both groups after addition of vancomycin. Thirty p. 100 of the patients had bacteremia. The most frequently encountered pathogens were staphylococci, enterobacteria, streptococci and Pseudomonas aeruginosa. Sixty-six p. 100 of gram-negative and staphylococcal infections responded to the P + A combination, while the response rate of staphylococcal infections was 23%. Fifty-seven p. 100 of staphylococci resistant to P + A were controlled by P + A + V. Fifteen (6.4%) patients died of infection, 5 of them of fungal infection. Toxicity was mild, with 3% renal toxicity. The P + A combination is effective as first line therapy in febrile neutropenic patients. These results and epidemiological data suggest that this combination plus vancomycin would be a suitable second line therapy for patients who did not improve.

Agranulocytosis↗