[Past and present of pneumonia].

A comparison is made between the most common types of pneumonias usually observed when Vincenzo Cuomo was active and those of the present day. Socially-transmitted pneumonias are contrasted with hospital-acquired pneumonias, mostly due to Gram negative bacteria, often multiresistant to antibiotics. Additional pneumonias are due to mycoplasmas, rickettsiae and Legionella and also to viruses, such as Cytomegalovirus, for example.

Peripheral T lymphocytes from patients with early systemic sclerosis co-cultured with autologous fibroblasts undergo an oligoclonal expansion similar to that occurring in the skin.

In recent years several reports have suggested that T cells may have a role in systemic sclerosis (SSc). The aim of our study was to investigate the dynamics of T cell repertoire in early SSc disease analysing a target organ, the skin, and the peripheral blood. To date, indeed, it is not clear if T cell expansions found in SSc reflect a general activation or result from specific antigen stimulation in the target organs.

Central diabetes insipidus and autoimmunity: relationship between the occurrence of antibodies to arginine vasopressin-secreting cells and clinical, immunological, and radiological features in a large cohort of patients with central diabetes insipidus of known and unknown etiology.

Central diabetes insipidus (CDI) is a rare hypothalamus-pituitary disease due to the deficiency of arginine vasopressin (AVP) synthesis from the hypothalamus and/or secretion from the neurohypophysis. The etiology of CDI is unknown in over one third of cases, classified as idiopathic CDI. The aim of this study was 2-fold: 1) to evaluate the occurrence of circulating autoantibodies to AVP-secreting cells (AVPcAb), and 2) to correlate it to clinical (sex, age of disease onset, disease duration, and degree), immunological (clinical history of autoimmune diseases and presence of related organ-specific autoantibodies), and radiological features (neurohypophyseal bright spot, pituitary stalk thickening, and empty sella) in a large cohort of patients with apparently idiopathic CDI or CDI of known etiology.

Relationship between total and allergen-specific IgE serum levels and presence of symptoms in farm workers sensitized to Tetranychus urticae.

Background: Clinical complaints in atopic subjects with asthma and rhinitis occur more frequently in the presence of high total and allergen-specific IgE serum levels. Here we report on the relationship between total and allergen-specific IgE serum levels and presence of symptoms in an unselected farmer population sensitized to Tetranychus urticae (TU).

Methods: Farmers were recruited as previously described.

Epidemiology of allergic occupational diseases induced by Tetranychus urticae in greenhouse and open-field farmers living in a temperate climate area.

Background: The role of Tetranychus urticae (TU) as an occupational allergen has thus far been investigated only in selected farmer samples.

Methods: The prevalence of TU-induced sensitization and occupational diseases in a randomized sample of farmers living in a temperate climate area was investigated. Occupational/nonoccupational symptoms, skin prick test (SPT) results with common allergens and TU, specific occupational test results, and greenhouse or open-field sources of TU exposure were assessed.

Long-term absence of sensitization to mepivacaine as assessed by a diagnostic protocol including patch testing.

Background: Prospective assessment of non-reactivity to local anaesthetics is a frequent reason for allergy consultation.

Objectives: To investigate the clinical profiles of subjects referred for allergy evaluation; to prospectively reduce the frequency of evaluation by assessing the persistence, during clinical use, of non-reactivity to contaminant/additive-free mepivacaine; and to determine the usefulness of a diagnostic protocol involving patch testing.

Methods: In a prospective study, 198 consecutive patients underwent collection of clinical data, skin prick tests and patch tests using allergens/antigens relevant for the investigation, and an intradermal/subcutaneous challenge procedure using contaminant/additive-free mepivacaine, as appropriate.

Antibiotic treatment in patients with altered pathophysiological pathways.

The pharmacokinetics of antibiotics are reviewed under particular physiological (senescence) and pathological (renal failure, liver failure) conditions. As regards the antibiotic management in the elderly, the main problems are related to the "immunosenescence" and to kinetic modifications, occurring even in the absence of an evident renal impairment. If manifest renal failure is present, the main issue is the correct dosage, and a careful consideration of the interest of the patient when they have to undergo hemodialysis.

Efficacy of human leukocyte interferon-alpha treatment in elderly patients with hepatitis-C virus-related chronic liver disease.

Sixty-seven aged patients (mean age 69, age range 67-73 years) with hepatitis C virus (HCV)-related chronic liver disease were treated with human leukocyte interferon-alpha at a dose of 9 mU/week for 9 months and then followed up for other 6 months. At the end of treatment, 39 patients (58.2%) showed normalization of alanine aminotransferase (ALT) levels; however, 24 responders (61.

[Changed etiopathogenic and clinical features of infective endocarditis].

The authors report their experience on etiological and clinical aspects of infective endocarditis (IE). A series of 182 consecutive patients, including 83 cases of medical IE, 73 cases of IE in intravenous drug abusers (DA), 22 cases of IE on late prosthetic valves and 4 cases of IE on early prosthetic valves were evaluated since 1976. Medical IE occurred frequently in the elderly patients and in most of the cases (80%) involved natural valves with underlying abnormalities, either rheumatic (42%) or degenerative (33%) or malphormative (25%).

[Infections due to hard-to-treat germs. Endocarditis and nosocomial opportunistic infections].

The authors describe some aspects of "difficult to treat" infections, pointing out, on the basis of their experience, infective endocarditis (IE) and nosocomial infections in compromised host. Among difficult-to-treat IE, the authors stress: 1) the peculiar etio-epidemiological features and the frequent causative pathogens multiresistance on early post-surgical IE; 2) the problems in detecting and management of IE by HACEK group microorganisms; 3) the problems related to other unusual agents IE, with particular regard to nutritionally deficient variants of S. viridans and to Coxiella burnetii.

[Mycoplasmas and mycoplasmosis: the etiopathogenetic problems and nosological, clinical and diagnostic advances].

Authors point out, on the basis of literature and of their own experience, the following aspects of Mycoplasma infections: 1) Genetical and biological progresses, especially related to pathogenetic aspects and diagnostic procedures. 2) Recent clinical and diagnostic findings of M. pneumoniae infections: "bacteria-like" pulmonary presentations by mycoplasmas (and, on the contrary, "virus-like" pulmonary presentations by bacteria); atypical kinds of pulmonary presentations by mycoplasmas; role of autoimmunity in extrapulmonary involvement.

[Microparticulate aerosols and respiratory allergy].

The assessment of allergenic activity in submicronic particles could explain some unknown aspects of pollinosis pathogenesis. Twenty-five 0.5 discs have been obtained using a high volume sampler (Hi Vol Andersen) equipped with 0.

[The epidemiology of adverse reactions to nonsteroidal anti-inflammatory drugs. Nimesulide is tolerated by patients with adverse reactions to NSAIDs and modulates in man the skin response to histamine and codeine].

We evaluated the tolerance to NIM in patients with adverse reactions to NSAIDs, expressed by urticaria-angioedema, bronchial asthma or erythema polymorphous on 92 patients among which 32 atopics affected by asthma, rhinitis or contact dermatitis. Challenge test has been performed with increasing amounts of NIM per os every 2 hrs to a maximum of 100 mg/dose. The last dosage was repeated every 12 hrs for 4 times more.

CD11B lymphocytes in type 1 diabetes mellitus of recent onset.

To evaluate the behaviour of CD8+ cells (suppressor/cytotoxic T lymphocytes) and CD8+Leu15+ cells (CD11B, suppressor T lymphocytes) in type 1 diabetes mellitus, 27 newly diagnosed diabetic patients and 47 normal controls were studied. CD8 cells were significantly increased in 6 patients, decreased in 9 and unchanged in 12. In all diabetic patients was present a lack of CD8+ Leu15+ cells.

Cefoperazone therapy of bacterial meningitis: a clinical trial.

Sixteen hospitalized patients, aged between 10 and 76 years (mean: 34.3 years), with bacterial meningitis were treated i.v.

Clinical experience with ofloxacin (DL-8280) in the therapy of various infections.

Thirty-four hospitalized patients with various infections: 19 with typhoid fever, 4 with gastroenteritis, 7 with lower respiratory tract infections, 2 with biliary tract infections, 1 with brucellosis and 1 with infection of necrotic ulceration of the feet, were treated with ofloxacin at a daily dosage ranging between 600 and 900 mg orally. Thirty-one of 34 patients (91.18%) completely recovered and pathogens were eradicated.

Clinical experience with pefloxacin in the therapy of typhoid fever.

Thirty hospitalized patients (22 men and eight women), aged between 15 and 41 years (mean = 25.4 years), with severe proven typhoid sepsis were treated with pefloxacin at daily dose of 1200 mg, divided in three doses, intravenously for the first five days and orally for the following ten days of treatment. All patients completely recovered from infection and pathogens were eradicated after 30 days of follow-up.

[Biological tumor markers].

The classification of tumor markers can at present be only provisional since in this field new acquisitions are reported daily. Nevertheless, during the last few years, a number of monographs and chapters in oncology texts have become available for students and physicians in which certain parameters (sensitivity, specificity, predictive value of individual markers) are illustrated, thus allowing for a more accurate evaluation of their diagnostic efficacy and offering indications as to which of these markers are most useful in relation to the site of the tumor. Although tumor markers are present throughout the organism, the above review is limited to those found in blood.

Clinical and pharmacokinetic study of cefotetan in biliary tract infections: preliminary report.

Twelve hospitalised patients, affected by biliary tract infections, were treated with cefotetan at dosages ranging between 4 and 6 g daily i.v. In only 11 patients was the aetiological agent identified.