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Biomedical subjects

M Andreoni

Publications and source records attributed to M Andreoni.

At least 73 records · Page 4Linked to original sources
PubMed1996

Rhodococcus equi infection in HIV-positive subjects: a retrospective analysis of 24 cases.

Rhodococcus equi causes a rare infection in immunocompromised hosts. We describe 24 cases of infection in patients with AIDS-related complex (ARC)/acquired immunodeficiency syndrome (AIDS). Pneumonia was always the first manifestation of R. equi infection, but extrapulmonary involvement was also observed. The main sources of bacteria were sputum, bronchial washings and blood. The strains isolated were mainly susceptible to erythromycin, vancomycin, teicoplanin, rifampicin, imipenem and aminoglycosides. Initial treatment should involve an intravenously administered antibiotic combination therapy including imipenem or vancomycin or teicoplanin, followed by orally administered maintenance combination therapy. Drug combinations should be investigated for serum bactericidal activity in vitro. Surgery does not increase survival time and should only be performed in cases that do not respond to antibiotic treatment. Presumptive risks of infection (contact with horses or farm dust, or cohabiting with people affected by R. equi infection) were present in more than 50% of patients. This finding, and the frequency of bacteria in the sputum, are not sufficient proof of transmission between humans, but do suggest the need for respiratory isolation of patients affected by R. equi pneumonia.

AIDS-Related Complex↗
PubMed1996

A randomized controlled trial of a protease inhibitor (saquinavir) in combination with zidovudine in previously untreated patients with advanced HIV infection.

This study assessed the activity and tolerability of an HIV-protease inhibitor, saquinavir, alone or in combination with zidovudine. A total of 92 previously untreated HIV-infected patients with CD4 cell counts < 300 cells/mm3 participated in a parallel, randomized double-blind study. Patients were randomized to receive one of five treatments, each three times a day: 600 mg of saquinavir; 200 mg of zidovudine; 75, 200 or 600 mg of saquinavir in combination with 200 mg of zidovudine. The primary treatment period was 16 weeks, with monthly extensions in patients who did not show major disease progression or toxicity. The main measures of the efficacy of therapy used were changes in CD4 cell counts and in the concentration of HIV-1 RNA in the plasma (as determined by quantitative polymerase chain reaction). The 600 mg dose of saquinavir in combination with zidovudine induced a 1.6 log (after 4 weeks) and a 0.7 log (after 16 weeks) median reduction in plasma RNA concentration; this reduction was greater than those seen in the other four treatment groups. The combination of 600 mg of saquinavir with zidovudine also resulted in a larger and more sustained improvement in the CD4 cell count than either saquinavir or zidovudine monotherapy or the other combination therapies. In the group receiving 200 mg of saquinavir in combination with zidovudine, the maximal median change in CD4 cell count occurred at week 2 (85 cells/mm3), and by week 16 had fallen to 15 cells/mm3. In the group receiving 600 mg of saquinavir plus zidovudine, the median change in CD4 cell count remained high for the 16-week period (median change of 48 cells/mm3 at week 2 and 61 cells/mm3 at week 16). Saquinavir was safe and very well tolerated, either alone or in combination with zidovudine. The incidence of adverse events was greater in the four groups receiving zidovudine therapy, and all the most commonly reported adverse events have previously been associated with zidovudine therapy. Few changes in laboratory values occurred during the study, except for known zidovudine-associated toxicities. The most frequent abnormalities were raised aspartate aminotransferase and alanine aminotransferase levels, depressed calcium levels, and abnormally high or low phosphate levels. Despite the low oral bioavailability of saquinavir, combined virological and immunological data show definite antiviral activity in vivo for the combination of saquinavir at 600 mg plus zidovudine at 200 mg (each three times daily). The combination of drugs with different mechanisms of action represents an advance in the treatment of HIV infection.

Adult↗
PubMed1994

High rate of HIV isolation from plasma of asymptomatic patients through polyethylene glycol (PEG) treatment.

The usefulness of traditional methods of HIV plasma titration has been limited by poor detection capacity in the asymptomatic phase of HIV disease. We analyzed plasma samples from asymptomatic seropositive or early symptomatic patients, comparing the classic plasma culture method with the following techniques: phorbol 12-myristate 13-acetate treatment of target cells, centrifugal inoculation of the virus, heat treatment of cultures, addition of monocyte/macrophages to cultures, and polyethylene glycol (PEG) treatment of the plasma. Only PEG treatment significantly increased the percentage of HIV isolation. The increase of HIV isolation after PEG treatment is more evident in patients with higher CD4+ cell counts and those without detectable levels of p24 antigen. In the p24-negative samples, HIV was isolated in 17 of 24 (71%) with PEG treatment versus nine of 24 (37%) with the classic method (p < 0.01). A number of discordant samples were found using the classic and PEG methods. Combining the positive results obtained with either technique, we obtained an overall HIV detection rate of 76%. The increased sensitivity of the combination of PEG and classic methods may allow a wider use of plasma viremia as part of the virological evaluation of anti-HIV drug efficacy in asymptomatic patients.

Cells, Cultured↗
PubMed1992

Efficient and reproducible new semimicromethod for the detection and titration of HIV in human plasma.

A semimicromethod was established for isolating human immunodeficiency virus (HIV) in plasma using 48-well plates and a pool of peripheral blood mononuclear cells (PBMC) from several donors as targets for infection, which increases the efficiency of isolation by reducing the effect of variability due to diverse donor cell susceptibility to HIV infection. The addition of H9 cells to the PBMC cultures did not affect measurable titers. Nevertheless, it potentiated strongly virus replication in terms of p24 production in the supernatant of the wells with HIV isolates, thus facilitating interpretation of the results. The titration of a virus strain of a known titre and reverse transcriptase activity in parallel provided a constant parameter of efficiency and reproducibility within each experiment, permitting comparison with results from other laboratories. The reproducibility of the method was highly significant (r = 0.97, P < 0.001); 68% of the 22 plasma samples from HIV-infected individuals tested by this method were positive. The presence of plasma HIV titer correlated well (P < 0.02) with the low count of CD4+ cells of less than 300/mm3, but not with the presence of the p24 antigen in the serum.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Evaluation of intraventricular teicoplanin for the treatment of neurosurgical shunt infections.

Seven patients with staphylococcal neurosurgical shunt infections were treated with intraventricular teicoplanin. Two infants received 5 mg/d, three patients received 20 mg/d, and two patients received 20 mg every other day. Six of these patients also received intravenous antibiotics. Three patients had infections caused by methicillin-susceptible Staphylococcus epidermidis, and one patient had an infection caused by methicillin-resistant S. epidermidis. Three patients were infected with Staphylococcus aureus (one with a methicillin-resistant strain and two with methicillin-susceptible strains). The mean duration of intraventricular therapy was 16 days. Sterilization of cerebrospinal fluid (CSF) was obtained after an average of 4.4 days. All patients were cured both clinically and microbiologically. No significant adverse effects were observed in any patients. Penetration of teicoplanin into the CSF after intravenous administration was poor. However, after intraventricular administration, high and prolonged peak and trough levels of teicoplanin were detected in the CSF. Bactericidal activity of the CSF was remarkable, exceeding the 1:8 dilution in the majority of the cases. The alternate-day schedule of intraventricular administration of teicoplanin was as effective as the once-daily regimen.

Adolescent↗
PubMed1992

A double blind, placebo controlled trial of efficacy and safety of oral acyclovir (Zovirax) in the treatment of chickenpox in adults.

A double-blind placebo controlled trial of oral acyclovir in otherwise healthy immune competent young adults with chickenpox was conducted. One hundred males were recruited into the trial, fifty were randomised to receive acyclovir at a dose of 800 mg five times daily for 5 days and fifty to receive matching placebo. Acyclovir recipients experienced itching and required anti-pruritic therapy for a significantly shorter period of time (p less than 0.05); no significant effects of acyclovir therapy on overall rash progression were observed. In patients with a mild rash on entry the maximum daily temperature recorded was significantly lower in the acyclovir group as compared with placebo recipients on day 1 of therapy (p less than 0.01). Acyclovir was extremely well tolerated and no adverse events were reported. Studies with early oral acyclovir therapy in otherwise healthy children with chickenpox has demonstrated significant benefits, particularly in rash progression. It is postulated that the partial benefits shown in this study in adults reflect the high proportion of patients with mild disease and enrollment of the majority of patients more than 24 hours after the rash onset.

Acyclovir↗
PubMed1990

Treatment of bone and soft tissue infections with teicoplanin.

The use of teicoplanin was evaluated in a group of 33 patients, which included 18 prosthetic infections, seven with osteomyelitis, five skin and soft tissue infections, and three cases of septic arthritis. The bacterial pathogens isolated were 27 isolates of Staphylococcus aureus (methicillin sensitive 18; methicillin resistant 9), Staph. hominis (2), Staph. epidermidis (1), Staph. haemolyticus (2), Enterococcus faecalis (1), Streptococcus pyogenes (1), Peptococcus spp. (1). Eleven patients had polymicrobial infections (Gram-positive plus Gram-negative and/or anaerobic bacteria). In ten cases (nine polymicrobial infections) teicoplanin was used in combination with other antibiotics. Teicoplanin was administered intravenously 400 mg every 24 h in 26 cases, 200 mg every 24 h in six cases and 600 mg every 24 h in one case. The duration of the treatment ranged from 9 to 73 days with a mean of 27.3. Efficacy was evaluable in 30 patients, because in three patients treatment was stopped because of adverse reactions. Cure or improvement was noted in 28 patients (93%). Bacteriological cure occurred in 25 patients (83.3%).

Adolescent↗
PubMed1990

[Netilmicin in a single daily dose for treatment of systemic infections].

The Authors report the results obtained in 35 patients of either sex suffering from various systemic infections and treated with netilmicin. Netilmicin has been intramuscularly administered in once daily dose of 4.5 mg/kg (mean daily dose 294.3 mg) for a mean duration of 17.8 days. The clinical resolution of the infections has been achieved in 97.1% (34 patients) of the study population; only one patient showed failure. Thirty-three of the 35 baseline causative pathogens have been eradicated. The local and systemic tolerability was good. The serum pharmacokinetics showed bactericidal levels of netilmicin and no serum accumulation.

Adult↗
PubMed1989

A rapid microneutralization assay for the measurement of neutralizing antibody reactive with human cytomegalovirus.

We have developed a murine monoclonal antibody reactive with a major immediate early 72,000 dalton protein of human cytomegalovirus and utilized this reagent in a rapid virus titration and microneutralization assay. Because of the early expression of this virus encoded protein, both assays could be accomplished within 16 h following virus inoculation. In addition, both assays resulted in considerable savings of reagents because the assays were carried out in 96-well microtiter plates. These assays should prove useful in the preparation and study of neutralizing antibodies directed against human cytomegalovirus.

Antibodies, Monoclonal↗
PubMed1986

[Epidemiologic surveillance of influenza in Rome 1982-1984].

In the periods from July 1982 to June 1983 and July 1983 to June 1984, 31 strains of influenza virus, of which 19 A/H3N2 6 A/H1N1 and 6 type B, were isolated from 242 throat cultures obtained from patients with acute febrile respiratory disease. A seroepidemiological survey on 520 serum samples confirms significant activity of influenza viruses during the winterly period of 1983-1984. In the period July-August 1983 the evaluation of mortality from respiratory diseases presents an excess in respect of epidemic threshold probably ascribable to heat stroke.

Disease Outbreaks↗
PubMed1985

Ceftazidime in the therapy of pseudomonal meningitis.

In this study we report about the efficacy and tolerability of ceftazidime in the treatment of 10 cases of pseudomonal meningitis (nine Pseudomonas aeruginosa and one Pseudomonas cepacia). The 10 patients had a pseudomonal infection of the central nervous system (CNS) complicating neurosurgical procedures or developed on a preexisting immunodepressing condition; four patients were of pediatric age. All isolates were sensitive to ceftazidime with MICs ranging from 0.39 to 3.12 micrograms/ml. Ceftazidime was given intravenously at the dosage of 100-150 mg/kg/day. In seven cases amikacin was associated by intralumbar or intraventricular instillation. The duration of ceftazidime treatment ranged from 9 to 49 days with a mean of 22.2. Eight cases out of ten were cured bacteriologically and clinically, while the remaining two were cured after treatment with other antibiotics. Concentrations of ceftazidime in serum and in lumbar and/or ventricular cerebrospinal fluid (CSF) were obtained in four cases; the mean concentration in lumbar CSF was 12.2 micrograms/ml and in ventricular 3.3 micrograms/ml. The study demonstrated that ceftazidime is effective in the treatment of Pseudomonal meningitis.

Adolescent↗
PubMed1984

Comparison of complement fixation, immunofluorescence and immunoenzymatic tests for routine detection of cytomegalovirus IgG antibodies.

Complement fixation (CF), immunofluorescence (IF) and immunoenzymatic (ELISA) tests by commercial sources were compared, for routine laboratory detection of cytomegalovirus IgG antibodies, on 120 serum samples from normal pregnant females. IF and ELISA were comparable in terms of specificity and sensitivity, but in our opinion ELISA showed some advantages with regard to need for facilities and trained personnel. CF could not detect some of low titer positive sera, so it can not be suggested where it is critical to know a previous contact with the virus, as in blood donors or transplant donors and recipients.

Antibodies, Viral↗
PubMed1984

[Epidemiologic surveillance of influenza in Rome (1981-1982)].

In the period from September 1981 to April 1982, one strain of influenza virus (A-H3N2) was isolated from 121 throat cultures obtained from patients with acute febrile respiratory disease. A sero-epidemiological survey on 520 serum samples and evaluation of excess mortality from respiratory diseases did not show significant activity of influenza viruses during the period from October 1981 to October 1982.

Adolescent↗
PubMed1982

[Clinico-epidemiologic study on 1258 cases of viral hepatitis admitted to Piedmont hospitals 1977-1979].

A clinical and epidemiological assessment of 1258 hospital patients in Piedmont in 1977-1979 showed that, at present, the frequency of hepatitis A and B can be regarded as virtually the same, that males are more frequently affected, that AVH A is more frequent in early life, whereas AVH B is significantly more common later, that urban areas are more frequently stricken than rural areas, that AVH A is more common in persons living in groups, whereas AVH B is more frequent among pensioners and the unemployed (the latter being primarily drug-addicts). Patients with AVH A, and hence a minor hepatitic involvement, had shorter hospital stays, while the immune response in both types of hepatitis is characterized by a more frequent increase in gamma-globulins, coupled with arise in IgM levels.

Adolescent↗
PubMed1982

[Pneumonia mortality in Italy over a 26-year period (1951-1976)].

During the period 1951-1976 the annual mortality rate due to pneumonia decreased from about 60 deaths/100.000 to about 26 deaths/100.000. By studying the pattern of mortality in relation to the age of population, it is shown that pneumonia deaths in the elder group (greater than 60 year-old) progressively diminished from 1951 (266/100.000) to 1966 (125/100.000). After this year mortality rates showed to stabilize their levels. Pneumonia mortality among people with age between 0-5 years and 5-60 years showed a progressive decline during all the period here examined. At this time elder people seem to contribute to more than 80% of mortality from pneumonia in Italy.

Adolescent↗