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Biomedical subjects

M Strosselli

Publications and source records attributed to M Strosselli.

At least 19 recordsLinked to original sources

Outcome of hepatic amebic abscesses managed with three different therapeutic strategies.

Three different approaches to hepatic abscesses due to Entamoeba histolytica were compared in 51 patients. The three modes of therapy utilized were: medical therapy with nitroimidazoles (N = 11 patients), open surgical drainage (N = 9 patients), and percutaneous drainage using ultrasound guidance followed by intralesional nitroimidazole administration (N = 31 patients). The results with each form of therapy were assessed clinically and by abdominal ultrasound. Patients receiving combined US-guided drainage and intralesional chemotherapy experienced a faster and overall better clinical response, which was confirmed also by sonographic follow-up of the hepatic lesions. This better response was associated with faster resolution, fewer relapses, and less residual hepatic scarring than either with medical therapy alone or open surgical drainage combined with medical therapy.

Adult

HIV-related encephalitis presenting as convulsant disease.

Because of the growing incidence of neurological disorders in HIV-infected patients, an early detection of the disease seems to be of paramount importance, especially in asymptomatic subjects. By using electroencephalography coupled with computerized spectral analysis and "mapping" (EEG-CSA), paroxysmal sharp activity was detected in 26 patients belonging to different stages of HIV infection. Seven of them (27%) were also symptomatic, (table; see text) showing signs of convulsant disease. The presence of focal or generalized paroxysmal activity, often associated with seizures, might suggest an early localization of HIV in cortical structures.

AIDS Dementia Complex

A new therapeutic approach for hydatid liver cysts. Aspiration and alcohol injection under sonographic guidance.

The treatment of hydatid disease is still rather difficult; surgery is not always feasible, and there are no definite methods to evaluate the outcome of medical treatment. Although percutaneous needle aspiration of hydatid cysts has been discouraged because of potential complications, e.g., anaphylactic shock or spreading of daughter cysts, these risks have never been quantified. Therefore, it was decided to treat hydatid liver cysts by aspiration and alcohol injection under sonographic guidance using 95% sterile ethanol. Five patients are reported who were treated by this procedure without complications or relapses during a follow-up period ranging from 10-26 mo.

Adult

Parasitologic findings in percutaneous drainage of human hydatid liver cysts.

Percutaneous drainage under ultrasonographic guidance was carried out on 12 patients with liver cysts and 1 with an abdominal cyst. In 8 the cyst was proved to be of hydatid origin by means of direct detection of parasites in the aspirated fluid. In these individuals a 95% ethanol solution was subsequently introduced into the cystic cavity and slowly removed over 30 min. Direct observation, staining for viability assessment, and in vitro isolation attempts were done both before and after the injection of the alcoholic solution, thus making possible the immediate evaluation of the protoscolicidal properties of the solution used. The procedure seems to be therapeutically successful, safe, and feasible.

Adult

Therapy of entamebiasis.

Therapy of entamebiasis is critical in that, if untreated, the disease can be fatal. Recently, a new method for differentiating pathogenic and non-pathogenic amebae has been standardized. This method relies upon the electrophoretic analysis of 4 isoenzymes which allow the identification of 20 different zymodemes. It is now widely accepted that non-pathogenic strains of Entamoeba histolytica are not a hazard for humans and therefore don't need therapy. As a consequence, treatment must be addressed only toward infections caused by pathogenic strains. As there are different drugs available for treating amebiasis, from a therapeutical point of view the disease must be divided into two forms: intestinal and extraintestinal. For the former, drugs which reach therapeutical levels in the gut are required. The mainstay for the treatment of asymptomatic carriage of pathogenic strains is DILOXANIDE FUROATE, a very well tolerated luminal amebicide. METRONIDAZOLE and other 5-nitroimidazole compounds such as ORNIDAZOLE are indicated for the treatment of symptomatic intestinal infections as they reach good concentrations in tissues, including the bowel where ulcerations develop. In order to ensure the clearance of amebae from the gut, a subsequent cycle with diloxanide furoate is advisable. Extraintestinal forms include amebic abscesses which can develop in many sites, but most commonly in the liver. Metronidazole and related compounds are the drugs of choice; in case of liver abscess, the addition of CHLOROQUINE is indicated because of its good concentration in tissues. A subsequent cycle with diloxanide furoate is also indicated.(ABSTRACT TRUNCATED AT 250 WORDS)

Amebiasis

Usefulness of computerized electroencephalography in diagnosing, staging and monitoring AIDS-dementia complex.

One hundred and one subjects, with various degrees of HIV infection, were enrolled in a longitudinal study aimed at evaluating the correlation between clinical and instrumental findings in the development of HIV-related subacute encephalitis. The method used was electroencephalography coupled with computerized spectral analysis (EEG-CSA) and mapping. The findings recorded by this method were compared with those obtained by computed tomography (CT) scan and neurological examination. The EEG-CSA findings were divided into four categories according to their severity. EEG-CSA was shown to be very sensitive in detecting the first signs of a forthcoming neurological disease. Following 11 months of observation, 22 out of 40 (55%) neurologically asymptomatic individuals who, at the beginning of the study showed some EEG-CSA abnormalities, had clinical evidence of a subacute encephalitis whereas only two out of 37 (5.4%) subjects who were previously free of EEG-CSA abnormalities had some signs of neurological disease (P less than 0.001) after the same period. Of those remaining who were already symptomatic when the study started, the neurological progression of HIV infection was also monitored by EEG-CSA.

Acquired Immunodeficiency Syndrome

Electroencephalography in the early diagnosis of HIV-related subacute encephalitis: analysis of 185 patients.

Of subjects with asymptomatic HIV infection or Lymphoadenopathy Syndrome, 185 were studied by means of electroencephalography coupled with computerized spectral analysis and mapping (EEG-CSA). Abnormal EEGs were found in 30 of 118 (25.4%) patients with asymptomatic infection (CDC Group II) and in 20 of 67 (29.9%) patients with Lymphoadenopathy Syndrome (CDC Group III). The most common EEG abnormalities were represented by theta slowing on the frontal and fronto-temporal lobes and, in some cases, by delta slowing and paroxysmal sharp activity on the forebrain. Among 50 patients with abnormal EEGs, 16 showed some abnormalities on neuropsychological testing, whereas mild signs of cerebral atrophy were evident on CT scan in only 12 patients. These findings suggest that EEG-CSA could be a useful and sensitive method in the early detection and monitoring of HIV-related subacute encephalitis.

Acquired Immunodeficiency Syndrome

Pathogenic and non-pathogenic Naegleria and Acanthamoeba spp.: a new autochthonous isolate from an Italian thermal area.

We performed an epidemiological survey of 17 thermal baths and the same number of mud-basins. This study aimed to ascertain the presence and incidence of small free-living amoebae, particularly species and/or strains of Naegleria and Acanthamoeba spp., occasional etiological agents of fatal meningoencephalitis and/or ocular infections in man. Over 51 samples of water and mud incubated at 37 degrees C and at 45 degrees C, 34 (66.7%) became positive at 37 degrees C and 33 (64.7%) at 45 degrees C. We isolated 7 (6%) strains of Naegleria spp., 6 (5.2%) of Acanthamoeba spp., 39 (33.6%) of Vahlkampfia spp., 28 (24.1%) of Hartmannella spp. and 36 (31.1%) strains of other species of free-living amoebae. 4 strains of Naegleria spp. and 6 of Acanthamoeba spp. proved pathogenic both in vivo, after experimental infection (meningoencephalitis) in the albino mouse, and in vitro, having previously contaminated monolayers of Vero cell line (cytopathic effect). Within the isolated pathogenic strains of Naegleria spp., a new strain of N. australiensis s.sp. italica was typified from an immunochemical point of view. This should be added to previous isolations reported by us.

Amoeba

Dynamic and ultrastructural studies of in vitro interaction between Toxoplasma gondii and cultured cell lines. I. Adhesion and cellular penetration.

Toxoplasma gondii is a protozoan parasite that requires an intracellular environment for growth and replication. This study describes the early phase of the interaction between the parasite and its host cell. With the aid of phase contrast microcinematography, it has been possible to observe adhesion to cell membrane, and the closely following intracellular penetration. This report also reviews the ultrastructural and biochemical grounds that could account for the infecting process.

Animals