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Biomedical subjects

R D'Elia

Publications and source records attributed to R D'Elia.

At least 19 recordsLinked to original sources
PubMed2003

Environmental risk factors for type 1 diabetes in Rome and province.

BACKGROUND: In subjects genetically susceptible to type 1 diabetes, exposure to environmental factors during the gestational period, the neonatal period, and the first years of life is thought to play an important role in triggering the immune process leading to beta cell destruction. AIMS: To investigate risk factors for inhabitants of continental Italy. METHODS: A case-control study of 150 type 1 diabetes cases and 750 control subjects (age range 6-18 years) was carried out in Rome and its province, measuring the exposure to environmental risk factors. RESULTS: Three environmental factors were found to occur significantly more in the diabetic group than in the controls. During the mothers' pregnancies, the one risk factor which proved to be higher in diabetics than in controls was maternal infectious disease. During the neonatal period, no risk factors associated with the disease were detected. During early life, eczema and a short duration of breast feeding (less than three months), occurred significantly more in diabetic cases than controls. CONCLUSION: Eczema and breast feeding for less than three months are risk factors for type 1 diabetes in a southern European population. The type, duration, and mode of treatment for infectious diseases during pregnancy need additional investigation as risk factors for type 1 diabetes.

Adolescent↗
PubMed1998

HIV: mother to child transmission, current knowledge and on-going studies.

It is estimated that approximately 6000 women of childbearing age, mostly living in the developing world, acquire HIV infection every day. Taking into account that approximately 98% of HIV infected children have acquired HIV from the mother, during pregnancy, at delivery or through breastfeeding, therefore, prevention of mother-to-child transmission (MTCT) is a major health priority. Several studies have showed how MTCT of HIV may be prevented using antiretrovirals. Results from a study conducted in Thailand have also recently showed how a short oral zidovudine course during pregnancy and labor may reduce the risk of HIV transmission by approximately 50%. These findings represent a major challenge for the International Health Agencies and Organizations that will have the major obligation to provide HIV tests, counseling and antiviral drugs in settings with high HIV prevalence.

Acquired Immunodeficiency Syndrome↗
PubMed1994

The use of antibiotics in the treatment and prevention of infection in HIV-infected children.

Children with HIV infection have an unusual susceptibility to bacterial infection, related to several immune abnormalities. Selection of initial antibiotic therapy must be individualized in these children. Patients with community-acquired disease are most likely to have infection by polysaccharide-encapsulated bacterial organism, most commonly Streptococcus pneumoniae and less frequently by Haemophilus influenzae type b. If it is possible to treat the patients at home, the use of amoxicillin-clavulanic acid might be appropriate. Other authors propose management with parenteral ceftriaxone because of the better compliance and the malabsorption. In hospitalized patients, concern for Gram-negative enteric pathogens other than polysaccharide-encapsulated organisms requires initial therapy with a third-generation cephalosporine in combination with an aminoglycoside. Trimethoprim-sulfamethizole is the most common drug used in HIV-infected children because it is recommended for the initial therapy and for prophylaxis of pneumocystis carinii pneumonia, which occurs in as many as 42% of these children.

AIDS-Related Opportunistic Infections↗
PubMed1994

Paediatric AIDS: a new child abuse.

In relation to youth rights, a new view has been created in recent decades that is included in the fundamental law of the child: the recognition of the right to education and the chance to develop a mature personality capable of creativity and liberty. Because of HIV infection it is very important to pay particular attention to the rights of the seropositive child and children born to seropositive mothers, which may be hampered not only in developing countries but also in the industrial world. HIV-affected children and their families are becoming abused and at high risk of becoming abused and this encroaches upon youth rights. As a consequence, in 1991 the Italian Society of Paediatrics issued a "Charter for the rights of seropositive children", which became an important document for all health care and social workers who deal with HIV-affected children. In this paper, we also consider the impact of HIV infection on the three main rights of children: the right to live, the rights of security and the rights of socialization.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Prognostic factors and survival in children with perinatal HIV-1 infection. The Italian Register for HIV Infections in Children.

The signs that may arise after perinatal infection with human immunodeficiency virus type 1 (HIV-1) have been classified by the Centers for Disease Control, but the clinical usefulness of the classification system and the prognostic importance of each disease pattern have not been established. We sought to address these issues by analysing data from the Italian Register for HIV infection in children. We studied 1887 children born to HIV-1-seropositive mothers. 1045 were identified at birth and the others were registered later (median age 4.8 [range 0.4-72] months). HIV-1-associated signs developed in 433 (81.8%) of 529 seropositive infected children at a median age of 5 (0.03-84) months. These signs appeared significantly earlier in the 102 children who died of HIV-1-related illness than in those who are still alive (median 3 [0.03-55] vs 6 [0.03-84] months; p less than 0.001). The cumulative proportion surviving at age 9 years was 49.5% (95% confidence interval 27-65%) and the median survival time was 96.2 months. Separate analysis of the 112 seropositive infected children followed from birth and older than 15 months gave similar results. Hepatomegaly, splenomegaly, lymphadenopathy, parotitis, skin diseases, and recurrent respiratory tract infections formed the mildest disease pattern. Lymphoid interstitial pneumonitis and thrombocytopenia were signs of intermediate disease. By contrast, in multivariate analysis specific secondary infectious diseases, severe bacterial infections, progressive neurological disease, anaemia, and fever were significant and independent negative predictors of survival. Growth failure, persistent oral candidosis, hepatitis, and cardiopathy were associated in univariate analysis with significantly shorter survival. Our findings suggest that the outlook for children with perinatal HIV-1 infection is better than previously thought and that a new clinical staging system of single disease patterns is needed.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Pharmacokinetics of cefonicid in children.

The pharmacokinetics of cefonicid was studied in 17 children requiring antibiotic treatment for respiratory or urinary tract infections. After informed consent had been obtained from the parents, a single dose of cefonicid 50 mg/kg/body weight was given by intramuscular injection. The mean peak serum concentration of 212.63 micrograms/ml was reached at 1.00 h, as absorption occurred at a very fast rate with a mean constant of 3.24 h-1. Mean values for half-life, apparent volume of distribution (Vz), total body clearance (CL), and renal clearance (CLR) were 3.24 h, 0.21 l.kg-1, 16.67 ml.min-1 and 13.60 ml.min-1 respectively. There was an inverse relationship between age and Vz, whereas CL and CLR were positively correlated with age. Cefonicid concentrations in urine were many times higher than the MICs of susceptible strains of bacteria. The study demonstrated that i.m. cefonicid 50 mg.kg-1 gave serum concentrations well within the therapeutic range for susceptible bacteria, and that its pharmacokinetic properties allow single daily doses to be used to treat infections in children.

Absorption↗
PubMed1989

Characterisation of Escherichia coli adhesins in patients with symptomatic urinary tract infections.

The ability of bacteria to adhere to the epithelial cells of hosts has been shown to be mediated by adhesins. Many of these show readily demonstrable haemagglutinating activity. Of 109 Escherichia coli strains isolated from patients with symptomatic urinary tract infection, 11 (10.1%) were identified by their haemagglutinating properties as being P fimbriated, which was confirmed by the latex bead test. Other classes of adhesins, termed X and "other", were found in mannose resistant haemagglutinating E coli strains, which represented 4.6% (5) and 0.9% (1), respectively, of all the strains. Type 1 fimbriae were found in 40.4% (44/109) of E coli strains grown on colonising factor agar (CFA) medium. This incidence was 12.8% higher (53.2%, 58/109) when the strains were grown on CFA supplemented with urea, which suggested that urea may modulate the expression of type 1 fimbriae. Conversely, this phenomenon was not seen in P fimbriated E coli. Assays using trypsinised and non-trypsinised human erythrocytes showed no difference in the percentage of strains that haemagglutinated. Regarding the clinical correlation of fimbriated E coli strains, the X mannose resistant haemagglutinating adhesins were also found to be of clinical relevance. P fimbriated E coli strains were isolated from five out of the eight patients with pyelonephritis.

Adhesins, Escherichia coli↗
PubMed1989

[Blood testosterone in cryptorchid newborn infants: does it have a prognostic significance?].

Testosterone, LH, FSH, blood levels at birth were determined in 40 Italian true cryptorchid , 12 pseudo-cryptorchid and 71 healthy newborns. Testosterone concentrations were interpreted according to the localisation of the retained testicles. A greater incidence of spontaneous remission of the cryptorchidism was found in those subjects with: 1) testosterone plasma levels overlapping the neonatal range; 2) testicles placed in proximity to the external orifice of the inguinal tunnel. Follow-up of these infants up to 2 years of age will test the hypothesis.

Age Factors↗
PubMed1983

HBIG efficacy in preventing HBV infection in infants.

Previous studies have confirmed the superiority of HBIG versus ISG and multiple dose versus single dose of HBIG (Beasley) and the time of first HBIG administration in preventing HBV infection. In all studies many treated infants became HBsAg or anti-HBs positive after the HBIG stopped. The present study was undertaken to evaluate the efficacy of multiple dose HBIG therapy in preventing HBV infection, and to establish the optimal dose, the frequency of the dose, the time of administration during the first year of life and to control the occurrence of HBsAg or active anti-HBs during the first two years of life. Seven infants of mothers positive for HBsAg and HBeAg, or positive for HBsAg but negative for HBeAg and anti-HBe, or with hepatitis B in the last trimester of pregnancy, received HBIG at high titer at dose of 0.5 ml/kg from first day until near 5 months of life and then 0.5-0.3 ml/kg until 12 months of life. The interval between the administration was established on the basis of the anti-HBs titer lower than 32. It was not a fixed interval but variable in different cases. Passive anti-HBs antibodies were almost always above 32 during the treatment period with HBIG. All patients remained negative for HBV markers and for liver enzyme tests during the period of the study. HBIG, administered in the first year of life at high dose and at intervals depending upon serum anti-HBs titer (32) systematically controlled, is efficient in preventing the hepatitis B infection in infants at high risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1983

Vertical transmission of HBV from mothers HBsAg positive, anti-HBe positive.

Vertical transmission of HBV from HBsAg carrier mothers to their infants occurs frequently and very early in life. The HBsAg titer, the presence of HBeAg and acute HBV infection in the mother are usually considered facilitating factors; on the contrary anti-HBs and anti-HBe titer would be effectively protecting. However anti-HBc does not prevent HBsAg infection at all. In order to obtain information on the rate of HBV transmission in conditions considered at lower risk, we identified a group of pregnant women who were asymptomatic chronic HBsAg carriers and followed their children for several months after birth with clinical and laboratory examinations. All the 13 mothers were positive for HBsAg, anti-HBe, anti-HBc and negative for anti-HBs and HBeAg. All infants were controlled monthly in the first year of life and then at 16, 20, 24 months. The relatives controlled in the same period proved negative for HBV markers. All infants were negative for antigens at the birth and positive for anti-HBe and anti-HBc. These antibodies disappeared after 3-7 months after birth, indicating maternal transmission. All infants remained negative for HBsAg, HBeAg, anti-HBe and liver enzyme tests during the period of observation (24 months). These observations indicate that in our population the transmission of HBsAg from chronic carrier mothers to their children is not a frequent occurrence; probably the presence of anti-HBe has been protective.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗