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Biomedical subjects

M Longo

Publications and source records attributed to M Longo.

At least 37 records · Page 2Linked to original sources
PubMed1997

In-vitro study of the synergy between beta-lactam antibiotics and glycopeptides against enterococci.

The synergy between glycopeptides and beta-lactams was studied using different techniques such as broth macrodilution, killing curves and agar dilution combined with agar diffusion. Two glycopeptide-resistant enterococci isolated from different clinical samples were used. Results showed different effects with significant changes in MICs. Antibacterial activity was related to the concentration of glycopeptide and beta-lactam for Enterococcus faecalis 8253, while for Enterococcus faecium 8072 a paradoxical effect was observed. With this strain, the best synergic effect was detected at teicoplanin concentrations of 1-4 mg/L, but antibacterial activity was reduced at concentrations of 8, 16 and 32 mg/L. No synergic effect was observed with vancomycin. The combination of agar dilution with agar diffusion techniques may constitute a simple method for routine detection of synergic effects between glycopeptides and beta-lactams.

Anti-Bacterial Agents↗
PubMed1997

[The surgical treatment of a rare primary cardiac tumor: hemangioma. A report of 2 cases].

Primary benign tumors of the heart are particularly rare; cardiac hemangioma is one of the most rare primary benign cardiac tumors. Natural history, symptoms and prognosis of the disease depend on the potential complications due to the location and diffusion of the mass. We report on 2 cases of cardiac hemangioma, diagnosed occasionally in the first patient or due to gastroenteric symptoms in the second patient. The diagnosis was obtained by 2-D-echo and magnetic resonance imaging. In both cases the hemangioma was located on the right ventricle. Both patients underwent tumor resection in hypothermic cardiopulmonary bypass. In one case, a graft to the right coronary artery was associated; in the other case, the right ventricular outflow tract was reconstructed with an infundibular patch. Histology showed mixed hemangioma in one case and cavernous hemangioma in the other. The postoperative course was uneventful. At a follow-up of 8 years and 1 year, respectively, both patients are classified as NYHA 1 and both 2-D-echo and magnetic resonance imaging did not show any residual tumoral mass. This experience demonstrates that, depending on their location, benign neoplastic masses may be radically resected with acceptable operatory risks and excellent long-term results.

Aged↗
PubMed1997

Role of ultrasonography in the early diagnosis of ovarian cancer.

BACKGROUND: Malign ovarian carcinomas are the main cause of death from gynaecological cancer. In fact, only in 30% of cases is it diagnosed at an early stage. In our study the possibility of an early diagnosis of the ovarian malignant neoplasia was evaluated. METHODS: One hundred and thirty-nine women with adnexal swelling were subjected to pelvic echography. The sample was selected during routine gynaecological checkups. RESULTS: All the cases showing a mass diameter exceeding 25 mm were classified as positive. Echotomography showed 129 cases of positive ovarian mass with an accurate diagnosis in 92.27%. Integrating the results of echography with those of radioimmunoassay an early diagnosis of ovarian cancer was achieved in 92.53 of the cases. CONCLUSIONS: A routine pelvic examination associated with pelvic echotomography represent an effective protocol for the diagnosis of ovarian cancer at an early stage.

Adult↗
PubMed1997

[Treatment of endometriosis with GnRH analogues].

BACKGROUND: Since a continuous administration of adequate doses of luteinizing hormone-releasing hormones (LHRH) or of an agonist leads to a hypogonadism-like condition, it is possible to use this effect for the treatment of endometriosis. The present study reports the results obtained in the Gynaecology and Obstetrics Institute of the Second University of Naples, with a long-acting formulation of a GnRH analogues (D-Trp6-LHRH) in biodegradable microcapsules, at monthly intervals. MATERIALS AND METHODS: The study was carried out on 40 women with endometriosis diagnosed by laparoscopy or laparotomy. The duration of treatment in patients in stage I-II was of 6 months, in patients in stage III or IV was of 9 months. RESULTS: After 12 months from the end of therapy, 27 patients did not show any sign of endometriosis with ultrasound and clinical examination; 13 patients still showing endometriosis were from III or IV stage. CONCLUSIONS: This long-acting formulation should offer a better approach for chronic treatment.

Adult↗
PubMed1996

Visual outcome in children with congenital hemiplegia: correlation with MRI findings.

Fourteen children with congenital hemiplegia were studied with a detailed assessment of various aspects of vision (linear acuity, stereopsis, visual fields) and MRI. The aim of this study was to evaluate the effect of a congenital lesion on visual function. The results showed a very high incidence (78%) of children who had abnormal results on at least one of the visual tests. Visual abnormalities were not correlated with the clinical severity of hemiplegia or with a specific pattern of lesion on MRI. Similarly no constant association could be found between visual structures (optic radiations and primary visual cortex) and visual function. Finally, our results would suggest that all the children with congenital hemiplegia need to be investigated irrespective of the clinical severity or of the type or the extent of the lesion. This would help to identify children with minor visual abnormalities which can affect everyday life performance.

Adolescent↗
PubMed1996

Rhodococcus equi infection in HIV-infected patients.

OBJECTIVE: To report clinical and microbiological features and response to treatment in HIV patients with Rhodococcus equi infection. DESIGN: Retrospective study. SETTING: Inpatients admitted to two Infectious Diseases Departments in a community-based hospital. PATIENTS: A total of 12 HIV-positive patients with R. equi infection. MAIN OUTCOME MEASURES: Clinical status, radiological finding, microbiological, haematochemical and immunological tests, and response to treatment. RESULTS: Twelve patients (11 men, six injecting drug users) were diagnosed with R. equi infection. Fever and cough were the principal clinical signs on presentation. Mean CD4+ count at the time of diagnosis was 47.67 x 10(6)/l (SD, 49.2 x 10(6)/l). In 58.3% of the cases the diagnosis of R. equi infection followed the appearance of an AIDS-defining illness. The most frequent radiological findings were cavitary lesions (41.7%) and lung consolidation (33.3%). In 83% of cases, R. equi was isolated from blood and in 33.3% cases from sputum. Test of chemosensitivity showed sensitivity to vancomycin (100%), teicoplanin (100%), ceftriaxone (80%), erythromycin (71%) and ciprofloxacin (66%). Clinical response alone with the disappearance of the presenting signs was observed in nine of the 12 cases (75%); complete response was observed in two cases. Seven patients died with a mortality rate of 58.3% and a mean survival of 5.75 months (SD, 6.48 x 10(6)/l). CONCLUSIONS: R. equi should be considered in the differential diagnosis of pulmonary of disseminated infections in patients with HIV infection. Blood culture may be the most sensitive means of diagnosis. Other studies are needed to determine the most effective choice and duration of antibiotic therapy.

AIDS-Related Opportunistic Infections↗
PubMed1996

Carboplatin monochemotherapy in elderly patients with nonoperable transitional cell carcinoma of the bladder: a two-stage, phase II study.

Elderly patients with nonoperable transitional cell carcinoma of the bladder need a rather active, but less toxic treatment than full-dose polychemotherapy. This study was designed to determine whether the cisplatin-analogue carboplatin (which is less nephrotoxic and less neurotoxic than the parent compound) has sufficient activity against T2-T4 neoplasms (both nonmetastatic and metastatic) to warrant further development in phase III trials. Carboplatin dose was adjusted according to creatinine clearance, with a maximum dose of 300 mg/m2. The patient selection for this screening for activity was adjusted by the use of the 'optimal' two-stage design. Seventeen patients were enrolled, with a median age of 78 years (range: 70-85), a median performance status of 80% (range: 70-90%); 13 patients were lymph node-negative (10 T2, 2 T3, 1 T4) and 4 had locoregional or distant node metastases. Nine patients had a complete response (3 in the first, 9-patient, stage, and 6 in the second, 8-patient, stage), demonstrating that carboplatin had sufficient activity (at the 'desirable' target level of 35%); almost all responses were observed in T2 patients. Six patients had stable disease, and 2 had disease progression during treatment. The toxicity was acceptable, with only 41% of patients having grade II-III hematologic toxicity. More than 30% of patients were estimated to be free from progressive disease (54% alive) at 24 months. In our opinion carboplatin is suitable to be tested-in a phase III testing versus full-dose radiation therapy-as adjuvant after initial transurethral resection of the prostate in elderly patients with T2 transitional cell carcinoma of the bladder considered radically nonoperable for medical problems.

Aged↗
PubMed1996

[Heart surgery with cardiopulmonary bypass in patients on chronic dialysis treatment: our experience].

METHODS: To determine the mortality and the morbidity of cardiac surgery in patients on chronic hemodialysis, we retrospectively reviewed eighteen adult patients (13 males and 5 females) with a mean age of 54.7 years (range: 30-67 years) who underwent cardiopulmonary bypass procedures between 1987 and 1995. The operations included: isolated coronary artery bypass grafting in 12 patients, coronary artery bypass grafting plus mitral ring annuloplasty in 1 patient, mitro aortic valve replacement in 2 patients, isolated aortic valve replacement in 1 patient, aortic valved conduit implantation in 1 patients and mitral valve replacement plus tricuspid annuloplasty in 1 patient. There were 10 and 3 patients in CCS functional classification III and IV respectively; 1 and 4 patients were in NYHA classification II and III respectively. All of them were hemodialyzed the day before surgery: the average time they had been on hemodialysis was 6.5 years. Anesthesia and the cardiopulmonary bypass (CPB) in these patients required attention in order to provide the optimal fluids and electrolytes balance: particularly intravenously administered fluids were kept to a minimum and drug dosages were reduced to recommended levels for anephric patients. An hemoconcentrator was used in all patients during the CPB and, in the last 4 cases, we used a dialysis filter and a sterilized perfusional solution to reduce the level of potassium and to put off postoperative dialysis. RESULTS: In three patients there were major bleeding problems resulting in reoperation; 5 perioperative deaths occurred: two of them due to myocardial infarction and three due to irreversible low cardiac output state. In our experience there were four late deaths: one patient died four months after surgery for chronic heart failure, another one died twelve months after surgery for dilated cardiomyopathy and two patients died respectively seventeen and seventy two months after discharge for myocardial infarction. Two of the remaining patients reported recurrence of angina while the others achieved symptomatic improvement. CONCLUSIONS: In conclusion, cardiac surgery is performed on chronic renal dialysis patients with high mortality and morbidity and it's indicated only if medical treatment is ineffective. The successful surgical results, obtained with an adequate management between surgeons, anesthesiologists and nephrologists, don't assure the long-term survival of the patients.

Adult↗
PubMed1994

Diagnosis of bronchopulmonary infections by quantification of microflora.

The quantification of bacteria and fungi in sputum or bronchoaspirate is of clinical value for the diagnosis of respiratory tract infections. We have developed an easy method to count the micro-organisms in patients with respiratory tract infections. This consists of the quantification of micro-organisms by subsequent streakings of a calibrated loop on agar. The correlation between microbiological quantitative data and the clinical status of patients with lower respiratory tract infections is discussed. The data seem to indicate that certain bacteria present in sputum or bronchoaspirate above a certain concentration may be responsible for lower respiratory tract infections. In patients with immunological disorders or chronic pathologies even lower concentrations of micro-organisms in bronchial secretions probably are enough to cause infections. The advantage of this counting method of the microbic species from the respiratory tract consists of their quantification: thus we can attribute an etiological role to a high concentration of the germs, while micro-organisms at low concentrations are probably contaminants. By this method isolated colonies are obtained after 12-18 hours. The bacterial quantification, by respiratory samples examination of the same patient in the following days, allows us to evaluate the efficacy of antibacterial therapy, producing a reduction of bacterial concentration.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Cystic hygroma: 2 case reports and review of the literature].

Cystic hygroma, an infrequent malformation of the lymphatic system (5 cases per 1000 abortions with CRL greater than 3 cm), was observed in 2 cases which prompted the present study. The Authors also present a brief review of the literature on this topic. After reviewing the hypothetic pathogenesis of the lymphatic obstruction which underlines this pathology, the paper focuses on the association of hygroma and anatomical and chromosomic alterations. The various anatomopathological and echographical findings are then described. Special attention is drawn to the diagnosis of cystic hygroma, after which the two case studies are illustrated. The prognosis of this pathology is pessimistic and the patient and specialist have to choose between immediate abortion or waiting for the inevitable outcome of gestation.

Adult↗
PubMed1994

Effect of subinhibitory concentrations of lomefloxacin on bacterial adherence.

We studied the effect of subinhibitory concentrations of lomefloxacin on bacterial adherence, assessing the presence of fimbriae in E. coli and the adherence to uroepithelial cells of Staphylococcus saprophyticus. The degree of inhibition of fimbriae in E. coli in the log-phase is directly proportional to subminimal inhibiting concentrations (sub-MIC). On the contrary, there is no effect when the bacteria are in a stationary phase. In the case of Staphylococcus saprophyticus the adherence to epithelial cells was observed at concentrations of 1/2 and 1/4 the MIC.

Anti-Infective Agents↗
PubMed1993

Familial unilateral and bilateral occipital calcifications and epilepsy.

No familial cases of epilepsy associated with bilateral occipital calcifications (EBOC) have been reported so far. This paper describes the clinical, electrophysiological and radiological study of two sisters affected by partial epilepsy, one with unilateral and the other with bilateral occipital calcifications. Celiac disease was excluded in both patients, even though they presented the same HLA pattern usually found in coeliac subjects.

Adolescent↗