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Biomedical subjects

L Baldini

Publications and source records attributed to L Baldini.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

Diagnosis and treatment of fungal infections in patients with hematologic malignancies.

A diagnosis of deep-seated mycosis was made in 54 patients with hematologic malignancies, severe neutropenia and fever, based on a set of clinical and laboratory criteria. Standardized antifungal treatment was started in 31 patients who seven days after onset of fever had not responded to antibiotics; the fungal infection was cured in 13, all of whom had a simultaneous remission of neutropenia, whereas the other 18 who did not respond to antifungal treatment, all had a falling or static neutrophil count. None of the 23 patients who were given no or inadequate antifungal treatment survived regardless of the neutrophil count and/or phase of the hematologic disease. We discuss the suitability of utilizing empirical criteria for a diagnosis of disseminated fungal infection as a basis for starting antifungal therapy in this type of patient.

Adolescent↗
PubMedDate not supplied

Severe Legionella pneumophila infection in a patient with hairy cell leukemia in partial remission after alpha interferon treatment.

Legionella pneumonia is an increasingly frequently reported complication in immunocompromised patients, particularly patients with hairy cell leukemia (HCL) in active phase. The most important predisposing factor seems to be the quantitative and qualitative defect of the monocytic-macrophagic system characteristic of HCL. We report a case of severe Legionella pneumophila infection with multisystem involvement in a patient with HCL in stable partial remission obtained after therapy with interferon. In our patient recovery of a normal monocyte count did not protect against a legionella infection, indicating that this pathogen should always be sought in HCL patients even those in clinical and hematologic remission. Early diagnosis and appropriate treatment may reduce the mortality of this serious complication.

Adult↗
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Binding of aminoglycoside antibiotics by degranulating mast cells.

The aminoglycoside antibiotics are polycationic at physiological pH and hence do not enter most cells. Indeed, when intact mast cells were incubated with gentamicin or tobramycin, extremely low concentrations of the two drugs could be measured. In contrast, when a controlled, specific degranulation of mast cells was induced by treating the cells with compound 48/80, Adriamycin or concanavalin A, a dose-dependent histamine release was observed and a significant increase of the intracellular concentrations of the aminoglycosides resulted. The uptake of gentamicin and tobramycin was not dependent on the type of stimulus, but was proportional to the quantity of histamine release. The aminoglycoside binding to granular material obtained from sonicated cells was similar to that of degranulating mast cells. These data suggest the occurrence of ionic interactions between the positively charged groups of the aminoglycosides and the negatively charged groups of granular matrix that are exposed as a consequence of exocytosis. The significant of this phenomenon is at present unclear but studies are in progress to clarify the fate of the aminoglycosides bound to mast cells.

Animals↗
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Terminal deoxynucleotidyl transferase, TdT, as a marker for leukemia and lymphoma cells.

Terminal deoxynucleotidyl transferase, TdT, was assayed in the mononucleate cells of blood and bone marrow from 121 patients with leukemias at the onset of disease and from 95 subjects with malignant lymphomas at diagnosis. This intracellular marker was also investigated by cytoimmunofluorescent tests in 17 other cases of initial leukemias and in 3 diagnosed lymphoblastic lymphomas. Generally, the TdT levels were significantly enhanced in the blasts of the following: acute undifferentiated leukemias; the more immature types of acute lymphoblastic leukemias i.e., the null, non-T non-B, common, early T and pre-B subgroups; a fraction of blastic crises in chronic myelogenous leukemias; and many lymphoblastic lymphomas. TdT might also be slightly increased in the mononucleate blood cells obtained from the most immature forms of acute myelogenous leukemias. Relapses with changes in cell phenotypes were occasionally observed in previously TdT-positive leukemias as a result of clonal evolution of the disease. The leukemias with blasts containing high levels of TdT were usually responsive to treatment with corticosteroids and vincristine. TdT is an oligoclonal marker characterizing several populations of undifferentiated or poorly differentiated blasts that tend to develop towards or along the lymphoid pathway. Together with specific immunological markers, this enzyme is useful to define the particular type of leukemic cells. It also serves to identify the quasi-lymphoblastic nature of the malignant clone, a helpful indication for the choice of therapy.

Acute Disease↗
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[Early diagnosis of intellectual deficiency].

The Author reports the results of some studies of the developing cognitive competences in infants. Utilizing the Hz-giris-Hunt's and the Brunet-Lezine's Scales in 18 infants during the two first months of life did not observe significant correlation between neurologic examination and development of cognitive competence. In an other study of 52 infants of less than two months old, with or without perinatal brain damage, the attentive motricity resulted to be predictive index of future cognitive abilities until twelfth month of age.

Age Factors↗
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Effect of lysosomotropic and membrane active substances on adriamycin uptake and histamine release.

It has recently been shown that adriamycin is accumulated in mast cells by an active transport system, which closely resembles the outward transport system of multidrug resistant (MDR) cells. The present study was undertaken in order to test the effect of substances which are known to limit or reverse resistance in MDR cells on adriamycin uptake and histamine release in rat peritoneal mast cells. The lysosomotropic amines chloroquine, nicotine, propranolol, atropine, methylamine, ammonium chloride and quinacrine were only slightly effective at very high concentrations; no effect could be observed with the lysosomotropic amine amantadine. The carboxylic ionophores monensin and nigericin were, on the contrary, extremely efficacious; in particular, the effect of monensin was more evident when mast cells were preincubated with the ionophore for 10 or 30 minutes while only a slight inhibition was evident when the two substances were added simultaneously. Removal of monensin from the incubation medium before challenge with adriamycin did not abolish the inhibitory action of the ionophore. Among the tested membrane active agents, Tween 80 and Triton WR-1339 were able to limit adriamycin uptake and histamine release. The microscopical examination showed that in mast cells treated with adriamycin, an intense fluorescence was present in cytoplasmic granules; on the contrary, mast cells preincubated with monensin showed hardly any fluorescence.

Amines↗
PubMedDate not supplied

Adriamycin-induced histamine release from rat peritoneal mast cells: role of free radicals.

The effect of pretreatment with various concentrations of catalase, superoxide-dismutase, D-mannitol, alpha-tocopherol, n-acetylcysteine and reduced glutathione on the release of histamine induced by adriamycin (100 micrograms/ml) on rat peritoneal mast cells was studied. Adriamycin caused an important histamine release in vitro which was not affected by pretreatment with the tested substances. Only n-acetylcysteine, at a very high concentration (1 X 10(-1) M) significantly limited this release. The substance was also active in inhibiting the release induced by a classic mast cell secretagogue, compound 48/80.

Acetylcysteine↗
PubMedDate not supplied

A cooperative study of epirubicin with cyclophosphamide, vincristine and prednisone (CEOP) in non-Hodgkin's lymphoma.

BACKGROUND: The purpose of our cooperative trial was to investigate whether epirubicin (EPI) at 90 mg/m2 in a CHOP-like combination (called CEOP) could increase complete response (CR) and survival rates in non-Hodgkin lymphoma (NHL) patients while maintaining a tolerable degree of toxicity. METHODS: Between September 1986 and July 1992, 218 patients from 12 Centers in Lombardy entered this study. The inclusion criteria were: a histological diagnosis of intermediate or diffuse large cell (DLC) NHL and no previous radio-chemotherapy. The patients in stages IA and IIA (both intermediate and DLC) received four CEOP courses followed by local/regional radiotherapy; those with intermediate NHL in stages IB, IIB, III A and B and IV A and B received six CEOP courses and, if they achieved CR, three further courses as consolidation. RESULTS: Among the 160 evaluable patients, CR was observed in 90% of the subjects with DLC-NHL (stages IA and IIA) and in 59% of those with intermediate-grade NHL (all clinical stages). If the clinical stages are considered separately, the CR rates were 92% for stages IA, IIA and 53% for stages IB, IIB, III A and B, IV A and B. Relapses occurred in 20% of the patients treated with four CEOP courses plus radiotherapy and in 31% of those who received nine CEOP courses because of the advanced stage of their disease. As of May 1994, the median follow-up was 42 months. If all of the patients are considered together, the 7-year overall survival (OS) probability was 64% and the 7-year disease-free survival (DFS) probability 67%. In comparison with stages III/IV, the patients in stages I-II had better DFS (7-year chance 77% vs 56%, p < 0.03). Hematological toxicity was acceptable, and a delay in the administration of CEOP chemotherapy was required in only three patients. No life-threatening infections were recorded. CONCLUSIONS: Our cooperative study of the use of the CEOP combination in NHL patients shows that response rates and the length of DFS are equal to the best results obtained with CHOP and more intensive programs, although further confirmation must be provided by means of a longer follow-up and a more careful analysis of prognostic factors according to the recently proposed international index. In our experience, an EPI dose of 90 mg/m2 has negligible toxicity (particularly on bone marrow), even in elderly patients. These findings are interesting since it is well known that myelotoxicity is the principal limiting factor for the majority of anthracycline-containing regimens used in the treatment of potentially curable NHL.

Adult↗
PubMedDate not supplied

Small fibre involvement in neuropathy associated with IgG, IgA and IgM monoclonal gammopathy.

A delta and C fibre function has been investigated in 18 patients affected by neuropathies associated with monoclonal gammopathies. Warm, cold and heat pain thresholds have been determined by means of a Somedic Thermotest, operating on the Peltier principle, in a room at constant temperature. Our results indicate that: 1) there is an involvement of A delta and C fibres in these neuropathies that might be difficult to quantitate only on clinical grounds 2) in IgG and IgA patients, all affected by a subclinical or mild axonal neuropathy, small fibres of both types are always involved 3) in IgM anti-MAG positive severe cases, A delta fibre involvement, suggestive of demyelination is evident, while in one anti-MAG negative patient only C fibres are damaged, probably reflecting a different pathogenetic mechanism.

Aged↗