Therapeutical aspects and outcome of HIV/HCV coinfected patients treated with pegylated interferon plus ribavirin in an Italian cohort.

Background: One-third of HIV-infected individuals suffer from chronic hepatitis C virus infection (HCV) in Europe. Recommendations from HCV-HIV International Panel advise current treatment with pegylated interferon plus ribavirin. We assessed the impact of interferon and ribavirin combination in 43 patients between 2002 and 2006.

Characterization of RNA-binding proteins possibly involved in modulating human AT 1 receptor mRNA stability.

Angiotensin II exerts its cardiovascular effects mainly through the activation of AT(1) receptors. These receptors can be regulated at a post-transcriptional level, that is through the modulation of the mRNA stability. This regulation usually involves proteins which are able to bind the 3'UTR of the mRNA molecule.

A case of Cunninghamella bertholettiae rhino-cerebral infection in a leukaemic patient and review of recent published studies.

Cunninghamella bertholletiae infection occurs most frequently in neutropenic patients affected by haematological malignancies, is associated with an unfavourable outcome. We report a case of rhino-mastoidal fungal infection in a leukaemic patient. Bioptical tissue cultures yield the isolation of a mould with typical properties of Cunninghamella species.

Colistin and rifampicin in the treatment of multidrug-resistant Acinetobacter baumannii infections.

Objectives: The increased incidence of nosocomial infections by multidrug-resistant organisms has motivated the re-introduction of colistin in combination with other antimicrobials in the treatment of infections. We describe the clinical and microbiological outcomes of patients infected with multidrug-resistant Acinetobacter baumannii who were treated with a combination of colistin and rifampicin.

Patients And Methods: Critically ill patients with pneumonia and bacteraemia caused by A.

Soft-tissue infection with Absidia corymbifera and kidney complications in an AIDS patient.

We describe a case of primary cutaneous Absidia corymbifera infection in an AIDS patient with renal complications. The Sensititre YeastOne panel was adopted to determine antifungal susceptibility and liposomial amphotericin B was used which initially produced a significant clinical response.

Segmental resection, lymph nodes dissection and survival in patients with left colon cancer.

Background/aims: To evaluate retrospectively in patients who have undergone elective surgery for left colon cancer, if extent of segmental resection may affect postoperative outcome, lymph nodes dissection and long-term survival.

Methodology: With lesion localized at the sigma or descending colon, 129 patients were divided into two groups according to the length of operative specimens: group 1: 73 cases, length 8 to < or =25 cm, who were surgically treated with limited segmental resection; group 2: 56 cases, length >25 to >50 cm, who had undergone extensive segmental resection. In no patient was ligation at the root of the inferior mesenteric artery performed.

Bariatric surgery in adolescents: a long-term follow-up study.

Background: The benefits of bariatric surgery in adult obese patients are well known, but data are lacking regarding the outcome of the surgery in adolescents. The aim of this study was to retrospectively assess the operative morbidity and mortality, percentage of loss of initial excess weight, and the incidence of long-term complications and reoperations in a cohort of obese patients who underwent biliopancreatic diversion (BPD) before their 18th birthday.

Methods: A total of 76 adolescent subjects underwent BPD between 1976 and 2005.

Incidence, risk factors, and predictors of outcome of candidemia. Survey in 2 Italian university hospitals.

In recent decades, Candida spp. emerged as the fourth most common cause of nosocomial bloodstream infections. The incidence of candidemia was 0.

Antimicrobial use and resistance among Gram-negative bacilli in an Italian intensive care unit (ICU).

Gram-negative bacilli antimicrobial resistance remains a significant problem for patients in the intensive care unit (ICU). We performed a retrospective analysis of microbiological data and antibiotic consumption over a 4-year period (2000-2003) in an Italian ICU. Pseudomonas aeruginosa and Klebsiella pneumoniae represented approximately 40% of all isolates.

Specific effects of biliopancreatic diversion on the major components of metabolic syndrome: a long-term follow-up study.

Objective: Gastric bypass and biliopancreatic diversion (BPD) are known to have a beneficial effect on glucose metabolism superior to that of the other bariatric operations. Thanks to its excellent weight loss results and to its specific actions, BPD has proven able to guarantee permanent normalization of serum glucose, triglyceride, and cholesterol levels in the vast majority, if not the totality, of operated patients. However, clinical studies on the duration of these effects in large patient populations are still lacking.

Linezolid in the treatment of Gram-positive prosthetic joint infections.

Objectives: To investigate the clinical efficacy and safety of linezolid in the treatment of Gram-positive prosthetic hip and knee infections.

Materials And Methods: A retrospective evaluation of patients hospitalized in the Department of Infectious Diseases of San Martino Hospital in Genoa with the diagnosis of Gram-positive prosthetic joint infection and treated with intravenous and/or oral linezolid. Primary end points were the patient clinical outcome at the end of treatment and at long-term follow-up (up to 12 months after the end of treatment).

Liver damage in severely obese patients: a clinical-biochemical-morphologic study on 1,000 liver biopsies.

Background: Preoperative clinical and biochemical data and intraoperative liver biopsy of 1,000 obese patients submitted to biliopancreatic diversion (BPD) were analyzed, and correlations investigated.

Methods: Of 2,645 patients submitted to BPD between May 1976 and November 2002, the last 1,000 consecutive obese patients with no history of alcohol consumption or infectious hepatitis were selected. Clinical data included: age, body weight, BMI, waist-to-hip ratio (W/H), arterial blood pressure, serum glucose, triglycerides, cholesterol, albumin/gamma-globulin ratio, total, conjugated and unconjugated bilirubin, gamma-GT, alkaline phosphatase, AST, ALT, and prothrombin time.

Long-term normalization of insulin sensitivity following biliopancreatic diversion for obesity.

Objective: Assess insulin sensitivity and metabolic status of obese patients with stable weight loss at long term following biliopancreatic diversion (BPD).

Material And Methods: The study was carried out in 36 nondiabetic severely obese patients undergoing BPD. Serum concentration of glucose, insulin and leptin were determined prior to and at 2 y following the operation.

Short-term liver function after biliopancreatic diversion.

Background: Liver failure after biliopancreatic diversion (BPD) has been reported. Although in our series of 2,515 BPD with a minimum follow-up of 12 months we have never observed this complication, a transitory and significant rise in serum AST and ALT has been detected in some cases, suggesting the occurrence of transient liver damage. To assess if risk factors for acute liver damage after BPD could be identified, we studied the evolution of hepatic biochemistry in a sample of our operated subjects.

Recovery of insulin sensitivity in obese patients at short term after biliopancreatic diversion.

Objective: To gain insight into the specific mechanisms by which biliopancreatic diversion (BPD) can improve insulin action.

Materials And Methods: Nondiabetic severely obese patients (n=20) undergoing BPD were included. Waist-to-hip ratio and serum concentration of glucose, insulin, and leptin were determined before, at 4-day, and at 2 months after the operation.

A new approach to the fashioning of the gastroenteroanastomosis in laparoscopic standard biliopancreatic diversion.

A retrocolic submesocolic approach was used for creating the gastroenteroanastomosis in 42 consecutive patients who underwent laparoscopic biliopancreatic diversion for obesity. The surgical technique is described in detail. The laparoscopic gastroenteroanastomosis was successfully performed on all the operated patients, with no intraoperative complications requiring conversion to open surgery and no immediate or late postoperative morbidity related to the anastomosis.

Efficacy and cost of risk-adapted follow-up in patients after colorectal cancer surgery: a prospective, randomized and controlled trial.

Aims: This paper aims to evaluate the diagnostic efficacy and costs of follow-up tailored according to risk of recurrence compared with minimal surveillance.

Methods: A total of 358 patients treated by surgery alone for colorectal cancer were prospectively divided into two groups of 200 and 158 patients considered at high and low risk of recurrence respectively, according to prognostic factors. They were further randomized into two subgroups: group 1, 192 patients undergoing risk-adapted follow-up, intensive and low-intensity; group 2, 145 patients undergoing minimal surveillance.

Gram-positive bacterial resistance. A challenge for the next millennium.

Penicillin G was first used in 1941. Since then, the trend in bacterial infections has changed. New antibiotics have been developed and bacterial resistance has spread as a consequence.

Laparoscopic standard biliopancreatic diversion: technique and preliminary results.

Background: A technique for standard laparoscopic BPD was developed.

Methods: Standard laparoscopic BPD was performed in 26 morbidly obese patients with mean BMI 43. Details of the technique, using 6 trocars, and instrumentation are described.

Laparoscopic standard biliopancreatic diversion: technique and preliminary results.

Background: A technique for standard laparoscopic BPD was developed.

Methods: Standard laparoscopic BPD was performed in 26 morbidly obese patients with mean BMI 43. Details of the technique, using 6 trocars, and instrumentation are described.

MR evaluation of coronary stents with navigator echo and breath-hold cine gradient-echo techniques.

The aim of this study was to evaluate coronary artery stents with MR. Thirty-eight patients underwent MR imaging 48.1 +/- 6.

The effect of formulary restriction in the use of antibiotics in an Italian hospital.

Objective: To compare the expenditure and usage of antibiotics at the San Martino Teaching Hospital, a 2500-bed hospital in Genoa, Italy, before and after the implementation of an antibiotic control program that streamlined the hospital formulary and the creation of a restricted group of antibiotics requiring approval before use.

Methods: Usage and expenditure data for all antibiotics were collected from 1996 to 1998. Antibiotic usage was standardised by defined daily doses (DDDs) per 100/patient-days.

Prognostic indicators of local recurrence in patients operated for rectal cancer.

Background/aims: To identify subgroups of patients at high risk of local relapse after curative surgery for rectal cancer.

Methodology: Thirty-five variables of 216 patients observed from January 1987 to December 1995 were retrospectively analyzed according to univariate and multivariate methods. Median follow-up was 38 months.

Linezolid treatment of prosthetic hip Infections due to methicillin-resistant Staphylococcus aureus (MRSA).

Prosthetic joint infection is an infrequent but serious complication of total joint arthroplasty. Complete removal of all foreign material is essential, however when prosthesis removal is not possible or contraindicated, suppressive antibiotic therapy with retention of the functioning hip arthroplasty may be considered. Linezolid, the first approved oxazolidinone, appears to be a promising new agent for the treatment of serious Gram-positive infections.