[HIV infection and nosocomial risk: experience at the ORL Clinic of Pisa]

The risk of nosocomial risk of HIV infection and the problem of preventative measures to adopt has been modifying how workers in the health field deal with patients. In fact, the increased spreading of HIV infections within our population has led to the establishment of a national protocol of preventative measures by which no patient can be considered "safe". Consequently, the likelihood that contact with any patient can lead to infection causes the health care worker to look upon the patient as a potentially dangerous enemy, thus leading to a decline in the quality of health care. On the other had, although the risk of a health care worker being infected by HIV during routine work is low, preventative measures must be taken both during examination and during surgery. Unanimous agreement exists in regard to what measures are to be taken to prevent cutaneous and mucosa exposure of workers whenever the risk of accidentally coming into contact with the blood and/or other biological fluids exists. On the other hand, the use of an anti-HIV screening for all patients in order to distinguish between infected and non infected subjects is still subject to debate. Some feel such screening is unacceptable because it would deny sero-positive patients adequate care and could give rise to both false positives and false negatives while others propose routine screening feeling it to be helpful both to those who are sero-positive and to health care workers.(ABSTRACT TRUNCATED AT 250 WORDS)

[Association of primary malignant neoplasms of the larynx and the lung. 12 years of clinical experience]

Laryngeal and pulmonary cancers present a certain agreement in regard to annual incidence. When studied separately these tumors show certain similarities and differences and they are of particular interest when they arise in the same subject. The association of laryngeal and pulmonary neoplasms is one of the most common associations among multiple primitive malignant tumors and represents an important problem in terms of prevention and diagnosis. The present study involves 18 cases of associated tumors observed from January 1, 1977 and December 31, 1988. All the subjects involved were males, average age 62 years, who had been treated for laryngeal cancers, mostly laryngeal epidermoid carcinoma. Pulmonary cancers (simultaneous, synchronous, metachronous) were diagnosed in all these subjects and one patient presented 2 autonomous bronchial lesions which arose in different periods. On the whole, 8 out of 18 patients (44.4%) are still alive and of these 6 (33%) enjoy good health more than 1 year after treatment for the pulmonary tumor. After reporting some considerations regarding the neoplastic association between the larynx and the lungs and about the increased risk of pulmonary neoplasm in those patients treated for supraglottic lesions, the authors hypothesize that these neoplasms are simultaneously present in both organs more frequently than previously thought. The authors assert that laryngeal tumor patients must be considered as a potential carrier of pulmonary cancer. Therefore, both before and after treatment (particularly in the first 6 months after surgery and/or radiotherapy) the patient must be carefully observed.

GABA content and synthesis in the aging rat brain

The content and synthesis of GABA were measured in the cortex and striatum of young adult (4 months), mature (14 months), and old (24 months) male Wistar rats. GABA synthesis was determined from the GABA accumulation induced by aminooxyacetic acid (AOAA). Aging did not affect GABA content in the cortex (1.03 +/- 0.04 mumoles/g in young and 1.06 +/- 0.04 mumoles/g in old rats), or in the striatum (1.63 +/- 0.04 mumoles/g in young and 1.56 +/- 0.05 mumoles/g in old rats). Aging did not significantly change the AOAA-induced GABA accumulation in the striatum (+34% in young, +16% in mature, and +28% in old rats), but significantly reduced it in the cortex where this process takes place to a greater extent than in the striatum: +164% in young, +116% in mature, and +120% in old animals. It can be concluded that while in the striatum aging did not affect AOAA-induced GABA accumulation, in the cortex this was less in mature than young rats, with no further change in the old ones. GABA content was not affected by aging in either region.

Killing rate and serum bactericidal activity of oxacillin, rifampin and ciprofloxacin against Staphylococcus aureus

The bacterial activity of oxacillin, rifampin and ciprofloxacin was examined at two concentrations by the serum bactericidal rate (SBR) technique against 5 strains of methicillin-susceptible Staphylococcus aureus. The activity of oxacillin plus ciprofloxacin and oxacillin plus rifampin was also determined for 5 strains of staphylococci examining in vitro the SBR and the serum bactericidal activity (SBA). We simulated SBR and SBA in vitro using pooled human serum containing know concentrations of antimicrobial agents. The rate at which the antibiotics kill S. aureus did not rise by increasing the concentrations over the MBC. The oxacillin-ciprofloxacin combination was indifferent when tested by the rate of killing, whereas an antagonistic interaction was frequently observed with the oxacillin-rifampin combination. The SBA was determined by two methods: the technique of the Mayo Clinic that uses Mueller-Hinton broth (MHB) as the diluent and the method of Stratton in which the diluent was prepared with MHB supplemented with Ca++ and Mg++ and combined with 50% pooled human serum. The activities of oxacillin and rifampin were decreased in the presence of human serum. These results were attributed to the high protein binding of these antibiotics. Rifampin in combination with oxacillin showed antagonism against S. aureus also by the SBA method. The inhibitory activity of drugs in combination remained substantially the same as the single more active one.

Indirect immunofluorescence (IFA) on kinetoplasts of Trypanosoma theileri for serological diagnosis of systemic lupus erythematosus (LES) in the dog

An indirect immunofluorescence technique was developed to detect antibodies to ds-DNA in a dog affected by Systemic Lupus Erythematosus (LES). The assay was based upon the use of the antigen substrate Trypanosoma theileri, isolated from samples of bovine blood and maintained in culture tubes. Slides were prepared by the drop method and maintained at -20 degrees C until used. This T. theileri immunofluorescence test, evaluated with positive and discriminant results in a previous study on human sera affected by LES, was used for the first time in the diagnosis of canine LES. The results indicate that T. theileri IFA is specific and reliable.

Eosinophilia, granuloma formation, migratory behaviour of second stage larvae in murine Toxocara canis infection. Effect of the inoculum size

Experimental infection of mice with Toxocara canis provides one of the best models for immunological and pathological studies of the visceral larva migrans syndrome. Blood eosinophilia, the migratory behaviour of second stage larvae and granuloma formation were studied in Swiss mice infected with Toxocara canis. Eosinophilia, spleen, liver and lung indexes were followed during a primary infection with different inoculum sizes (500 and 1500 eggs) while the migratory behaviour of larvae was studied in a primary infection with 1500 eggs over a period of 4 months. In mice infected with three challenges of 1500 eggs in order to elicit a strong inflammatory reaction in the tissues, a histopathological study was carried out. The results showed that eosinophilia, spleen and lung indexes (but not the liver index) were influenced by the parasite inoculum size. The migratory behaviour study showed that larval recovery was maximal three days post-infection, from the liver and lungs; the peak recovery from the skeletal muscles and brain being on days 15 and 30 post-infection, respectively. The histopathological study revealed the formation of granulomas in all the tissues examined (liver, lungs, kidneys, spleen, lymph nodes, myocardium etc.) but not in nervous tissue or in the retina of the eye. Granulomas in the lungs were larger than those found in the liver. The implications of these results are discussed considering host-parasite inter-relations.

Breathing pattern assessment in normocapnic and hypercapnic patients in chronic obstructive pulmonary disease

Thirty-six patients, 24 normocapnic (mean age +/- SD: 60 +/- 10) and 12 hypercapnic (mean age +/- SD: 64 +/- 9) were compared with a control group (10 volunteers, mean age +/- SD: 46 +/- 8) for the following patterns of respiratory drive and respiratory timing: (1) mean inspiratory flow (Vt/Ti); (2) mouth occlusion pressure 100 ms after the onset of inspiration (P 0.1) and minute ventilation (Ve); (3) inspiratory duty cycle Ti/Tt). The data suggest COPD "respiratory patterns" which may be characterized by the following features: (1) increased mean inspiratory flow (Vt/Ti); (2) increased P 0.1 (in absolute values), P 0.1/Ve and P 0.1/Vt/Ti; (3) reduction in inspiratory duty cycle (Ti/Tt). Changes are more evident in inspiratory duty cycle among hypercapnic pts. When respiratory obstruction becomes worse and hypercapnia appears, the Ti/Tt decrease could be explained by a reduction in diaphragm muscle work, that can prevent the failure of diaphragmatic contractility.

Effect of ergolines on neurotransmitter systems in the rat brain

The interaction of nicergoline with various monoaminergic receptors and its effects on monoamine turnover were studied in specific rat brain areas in comparison with those of its metabolites, 10-methoxy-1,6-dimethyl-ergoline-8 beta-methanol (MMDL) and 10-methoxy-6-methyl-ergoline-8 beta-methanol (MDL). Nicergoline showed marked in vitro affinity for alpha 1-noradrenergic receptors (IC50 = 0.2 nM), less for alpha 2, S1 and S2 (IC50 about 10(-7) M). Its strong interaction with alpha 1-receptors was confirmed in vivo. The affinity of the other ergolines for alpha 1-receptors was lower than that of nicergoline. The level of monoamine metabolites (HVA and DOPAC for dopamine, MOPEG-SO4 for noradrenaline and 5-HIAA for serotonin) was taken as a measure of their turnover in the rat brain. A single dose of nicergoline (20 mg/kg, s.c.) strongly enhanced noradrenaline turnover, less that of dopamine. These effects, probably due to the interaction with alpha-receptors, were more marked after parenteral than oral administration. MMDL shared nicergoline's effect on dopamine and MDL that on noradrenaline, but they were less active than the parent compound. The most interesting results were obtained after chronic treatment (6-7 weeks) with rather low doses: 5 mg/kg b.i.d. of nicergoline and equimolar doses of the metabolites. Nicergoline and MMDL both enhanced dopamine turnover, especially in mesolimbic areas. In conclusion, the present report confirms and extends previous results on nicergoline's effects on catecholamine turnover and shows that its metabolite MMDL shares its effects on dopamine. Finally, it is particularly interesting that both ergolines were more effective in old than in young rats.

Flunarizine-induced parkinsonism: clinical report

We consider 24 cases of iatrogenic parkinsonism related to flunarizine, evaluating the clinical features of the syndrome and the improvement following withdrawal.

Effect of aging on monoamines and their metabolites in the rat brain

Concentrations of dopamine (DA), norepinephrine (NE), serotonin (5-HT) and their acid metabolites were assayed in specific brain areas of Wistar rats of various ages. DA and its metabolite 3,4-dihydroxyphenylacetic acid (DOPAC) were significantly lower in striatum and mesolimbic areas of old (24 mos) rats than young adult (3 mos), but not mature (12 mos) rats. The decrease of homovanillic acid (HVA) was significant in mesolimbic areas but not in striatum. Neither cortical NE nor its metabolite methoxyhydroxyphenylglycol sulphate (MHPG-SO4) were significantly changed by aging. 5-HT and 5-hydroxyindoleacetic acid (5-HIAA) in the brainstem showed a tendency to a decrease and increase respectively in aged animals compared with young adults, but the differences were not statistically significant. However, the ratio of 5-HIAA to 5-HT concentrations was significantly higher in aged animals. The conclusion can be drawn that, in these brain areas, DA is more vulnerable to aging than NE and 5-HT, the metabolism of the latter being even enhanced.

Brain dopamine autoreceptors in aging rats

The function of dopamine (DA) autoreceptors is evaluated in vivo in striatum and mesolimbic regions of young adult (4 months), mature (14 months) and old (26 months) male Wistar rats. gamma-Butyrolactone (GBL)-induced dihydroxyphenylalanine (DOPA) accumulation in rats also treated with an inhibitor of aromatic L-aminoacid decarboxylase was used to determine the presence of synthesis-modulating nerve terminal autoreceptors while its reversal with apomorphine served as an index of autoreceptor stimulation. GBL-induced DOPA accumulation in striatum is very high at all three ages (130-150% increase in comparison with controls) as is its reversal by apomorphine (65-80% decrease in comparison with GBL alone). In mesolimbic regions, GBL has much less effect than in striatum (31% rise at 4 and 26 months, 12% rise at 14 months), but apomorphine's effect is of the same order of magnitude (down 60-80%). The conclusion can be drawn that aging does not significantly affect DA autoreceptor function in striatum and mesolimbic areas.

Triple-resonance spectroscopy on CH3OH far-infared laser lines

Intracavity triple-resonance spectroscopy in CH(3)OH far-infrared lasers has been extended to the microwave region. A triple-resonance signal at 13410.45(10) MHz was observed on the 224.5-microm CH(3)OH laser line optically pumped by a waveguide CO(2) laser. The results confirm the assignment proposed for this line and improve the knowledge of A-state splitting in the = 5 vibrational state.

Brain catecholamine content and turnover in aging rats

The content and turnover of catecholamines were evaluated in various brain regions of young adult (4-months) and aged (24-months) male rats. Turnover was assessed from the concentrations of acid metabolites and the decline of catecholamine content after synthesis blockade with alpha-methyl-p-tyrosine. Dopamine was reduced by aging in striatum, mesolimbic areas, and hypothalamus. Dopamine metabolites and turnover rate were significantly lower in striatum and mesolimbic areas of aged than of young animals. Hypothalamic norepinephrine content and turnover rate were unchanged in aged compared to young rats but its metabolite (MHPG-SO4) was increased in the cortex. These findings point to an extensive impairment of brain dopamine metabolism in aging rats, whereas norepinephrine seems to be less impaired.

Cross-resistance between methicillin and cephalosporins for staphylococci: a general assumption not true for cefamandole

The antibacterial activity of cefamandole was evaluated against 120 methicillin-susceptible and methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococcal strains, using both large (10(8) CFU per ml) and small (10(4) CFU per ml) inocula. Cefamandole appeared superior to cephalothin against methicillin-resistant strains, displaying at 10 micrograms/ml a bacteriostatic and for some strains a bactericidal action against a large inoculum of bacteria.

Effect of hypoxia and pharmacological treatment on some enzyme activities in dog brain areas

The effects of nicergoline on changes in enzymatic activities induced by hypoxia and post-hypoxic recovery were studied in various brain areas of young-adult and mature Beagle dogs. In different fractions (homogenate in toto, purified mitochondria, crude synaptosomes, SM1 and SM2 synaptic mitochondria) the maximal rate (Vmax) was investigated of the more representative enzymatic activities of: a) glycolysis, b) Krebs' cycle, c) electron transfer chain, d) amino acid and acetylcholine metabolism, e) lysosomal function. The physiopathological conditions caused alterations in different enzymatic activities depending on the area and subfraction investigated. Nicergoline tended to antagonize some of these alterations. Its action was mainly on non-synaptic mitochondria by a "braking" effect on some key enzyme activities of mitochondrial metabolism (i.e. citrate synthase, cytochrome oxidase and glutamate dehydrogenase) which suggests a sparing action in the brain.

Comparative study on the interstitial passage of cefuroxime, cefoxitin, cefotaxime and cefoperazone in man by the suction skin blister method

A comparative study was carried out on the concentration of cefuroxime, cefoxitin, cefotaxime and cefoperazone in serum and extravascular blister fluid. The results show that cefoperazone (which has the highest protein binding capacity) has a lower and slower extravascular penetration than the other cephalosporins examined.

Effect of protein concentration and blood clots on the "in vitro" anti-Pseudomonas aeruginosa activity of cefoperazone

The effect of the protein content in the medium and blood clots on the anti-Pseudomonas aeruginosa activity of cefoperazone was studied and its activity against strains of the bacteria in the blood clots investigated. Medium protein content, blood clots and the localization of the microorganism all appeared to effect the antibacterial activity of cefoperazone: the therapeutic implications of these findings are briefly discussed.