[The osteocondensing variety of multiple myeloma. Review of the literature and description of a case]. / La varietà osteocondensante del mieloma multiplo. Rassegna della letteratura e descrizione di un caso.

A case of IgG myeloma with eburnation of the femoral and ileoischiopubic bones is described. A review of the literature confirmed the rarity of osteosclerotic myeloma, especially if other possible causes of bone eburnation or the typical contemporary existence of osteolysis are excluded. The hypothesis that osteosclerotic myeloma may constitute an autonomous form of the disease, probably related to the type and/or extent of the proliferating bone is discussed.

[Ceftriaxone, a long-acting cephalosporin. Microbiological, kinetic and clinical study]. / Ceftriaxone, cefalosporina "long acting". Ricerca microbiologica, cinetica e clinica.

Ceftriaxone effectively inhibited 332 out of 452 (73.45%) bacterial strains in vitro tests. 291 out of 365 (79.69%) gram negative and 41 out of 87 (47.12%) gram positive strains were inhibited. The tests showed ceftriaxone to be more effective than cephalothin, cephotaxime, cephuroxime, cephamandol and cephoxitin. Kinetic tests showed that cephtriaxone has a plasmatic half life of 7.25 hrs. 24 hours after administration of a 1000 mg venous bolus the drug was still present in the blood. Urinary elimination over a 24 hr. period amounted to means 486.8 mg (48.68%). The drug has liquor transfer capacity. 37 of the 38 patients treated showed complete clinical or clinicobacteriological cure. Improvement was noted in the 38th.

[Streptococcal seroepidemiology: comparison of 3 methods]. / Sieroepidemiologia streptococcica: tre metodologie a confronto.

Streptococcal antibodies survey in adult population. In a series of 1609 hospitalized adult patients, without symptoms of acute or chronic streptococcal rheumatism, the level of antistreptococcal antibodies was measured, using three technical methods: the traditional one, i.e., antistreptolysim titer (ASLO); streptozyme titer (STZ) and the anti-C-polysaccharide technique (Microstreptokit, MSK); by the mutual comparison of these three antigens it was possible to ascertain some differences of the antibody response. In a mass survey it appears useful the use of two methods, i.e., ALSO and MSK; in investigations aiming at recognizing the cases with cardiac or rheumatic silent lesions the couple MSK-STZ appears to be more reliable. To ensure a more sure covering of the whole field of streptococcal silent infections, the three methods should be used together.

[Piperacillin: microbiological and clinical studies]. / Piperacillina: ricerca microbiologica e clinica.

A microbiological and clinical study of the action of piperacillin is presented. The drug showed an excellent in vitro antibacterial action on gram positive and gram negative microorganisms. Its in vitro action on Ps. aeruginosa (70.8% of strains inhibited) was also extremely interesting, making it the second most effective of the antibiotics tested after polymyxin B and colistin, polypeptides unsuitable for clinical use. In vivo, the administration of piperacillin achieved a clinical and bacteriological cure in 35 out of 40 patients and a clinical cure in 2 out of 40. It was only therapeutically unsuccessful in 3 cases. It is concluded that its microbiological, kinetic and tolerance features make piperacillin suitable for a wide range of therapeutic purposes.

[Microbiological, kinetic and clinical study on a new cephamycin: cefotetan]. / Ricerca microbiologica, cinetica e clinica su una nuova cefamicina: cefotetan.

Microbiological, kinetic and clinical studies were conducted on a new cephamycin, cephotetan. In vitro the antibiotic was found to be very effective against all strains tested. It had a particularly strong action against Gram negative bacteria too. Kinetically speaking, an intravenous bolus produced a high plasmatic concentration with a half life of about 4 hours. Elimination via the kidneys was fastest in the first 3 hours after administration (49.82%) and the slowed down. 82.76% of the dose administered was excreted within 24 hours. This antibiotics is particularly indicated in cases of urinary, respiratory and biliary infections.

[Lymphocytic and lymphocytoactive components in the etiopathogenic mechanisms of systemic lupus erythematosus. An analysis of the literature]. / Componenti linfocitarie e linfocitoattive nel meccanismo etiopatogenetico del lupus eritematoso sistemico. Un'analisi della letteratura.

Lymphocyte populations play an important role in the mechanism of autoantibody induction, mainly of antinuclear ones, in such collagen diseases as S.L.E. Aetiology and pathogenesis of SLE are multifactorial: genetic predisposition, lupogenic factors (among them the hormonal ones) with direct and indirect action on B and T lymphocytes, conditioning the production of lymphocytotoxins and antibodies against blood cells. Subjects carrying the HLA DRW3 antigen have three to four times more probabilities to get a S.L.E. In the serum of SLE patients as well as in their relatives auto-or heterolymphocytotoxic antibodies are present, directed against the antigens of the HLA complex. There is evidence that antilymphocyte antibodies appear in patients with procainamide induced SLE, as well as anti-IgG - and antierythrocyte antibodies; this fact is due to the impairment of the immunologic regulation. Concerning the circulating immunocomplexes (CIC) in idiopathic S.L.E., it was observed that they increase in patients with active SLE, but there is no statistical evidence of a significant inverse proportional rate of these parameters. The role of CIC in SLE induction is bound with T lymphocyte subsets.

[Aerobic bacterial flora in cutaneous lesions and in venous catheters of severely burned patients]. / La flora batterica aerobica nelle lesioni cutanee e nei cateteri venosi dei grandi ustionati.

Bearing in mind the complexity of the topic and its variability owing to the progress made in antibiotic management, and the development of many concepts concerning the pathogenesis and biochemistry of major burns, the already massive literature is supplemented by the addition of relatively recent data to enable comparisons to be made with regard to the quality and frequency of isolation of the bacterial flora observed in such patients, and above all their sensitivity to currently employed antibiotics. The investigation was conducted on patients admitted to the Turin CTO Major Burns Centre between 1972 and 1977. Initially (1972-1975), a microbiological examination was made of purulent secretions from wounds. Subsequently, management was prevalently directed to the early excision of injured surfaces, and attention was therefore directed to the indwelling venous catheters used in treatment and parenteral alimentation. In cases examined in parallel, moreover, there was often a substantial similarity between wound and catheter flora, and when only one species was present in the wounds, the catheter was often sterile. Furthermore, numerous data were collected from antibiograms relating to the most frequently encountered micro-organisms. These usually displayed wide resistance spectra, especially with respect to the most commonly used of historically oldest antibiotics, whereas their resistance to those recently introduced was generally lower. The question of provenance (from the patient himself, the hospital or its medical and paramedical staff) is also examined. Reference is made to a point that has recently become important in the treatment of burns, namely the ascertainment of the degree of contamination not only on the surface, but also in the immediate sub-surface of the lesions, so as to permit a suitable excision of the eschar and skin transplantation. When a sufficient number of findings exist to support this new concept, it will certainly give rise to further studies and research aimed at bringing new, important data to this so rich and multiform topic.

[Behavior of complement factors and plasma proteins in burns]. / Comportamento di alcuni fattori del complemento e di alcune proteine plasmatiche nella malattia da ustione.

The behaviour of three complement components (C3, C4 and C3 activator), alpha 1, alpha 2, IgA, IgG, IgM, total proteins, and gamma globulins was followed 114 patients at the C.T.O. Turin, Burns Centre with burns covering from 15% to over 70% of the body surface. Forty-two died within a relatively short time. In the remaining 72, the parameters were studied almost daily for over 30 days, or even until a final cure was obtained. The complement data and, more particularly, the distinct increased in alpha-globulins made it clear that burns can be acute inflammations. In addition, initial immune depression is followed by a prompt response of the complement system (responsible for aspecific immunity). That this change is vital in the progress of the disease may be deduced from the fact that complement component levels were constantly below normal in the patients who died.

[Streptococcus antibodies in various population groups with no apparent signs of streptococcal infection. Sero-epidemiological evaluation]. / Anticorpi streptococcici in vari gruppi di soggetti senza segni apparenti di infezione streptococcica. Indagine steroepidemiologica.

ASO- and streptozyme (STZ) antibodies were evaluated in about 2000 subjects: apparently healthy persons, persons in hospital, members of the armed forces, puerperae and their newborns. STZ antigen was found to be more sensitive than ASO; statistically much higher than STZ- and ASO+. The results were coincident (75%-90%) in subjects with normal antibody levels and those with "pathological" titres.

[Chronic hepatitis caused by B virus (HBV)]. / Le epatiti croniche da virus B (HBV).

Following a short review of the viruses underlying viral hepatitis and those which, as a secondary factory in the clinical picture, may cause fleeting liver damge, the subdivision of chronic hepatitis conditions on histopathological bases is described. Particular attention is paid to pathogenesis, with a study of the elimination of B virus, correlated to particular histopathological types. A series of 27 PCH and 49 ACH cases is reported. Of special significance was the observation of 14 ACH out of 17 biopsied drug addicts. The therapeutic problem of chronic hepatitis is then tackled.

[Anomalous immunoelectrophoretic behavior of ceruloplasmin in severely burned patients]. / Anomalo comportamento immuno-elettroforetico della ceruloplasmina nei grandi ustionati

Laurell's two-dimensional technique was employed in a study of the immunoelectrophoretic behaviour of caeruloplasmin in 10 major burn cases. A double peak was noted throughout the entire course. The second peak disappeared on recovery whereas it persisted and was well marked in the case of those who died. It is suggested that this pattern reflects the severe liver damage sustained by burn patients.

[Coagulation disorders due to burns. Disseminated intravascular coagulation (DIC) and its possible prevention]. / I disturbi coagulativi conseguenti all'ustione. La C.I.D. (coagulazione intravasale disseminata) e la sua possibile prevenzione

Coagulation data were studied in 77 patients with severe burns divided into two groups (A, 45 cases, and B, 32 cases). Increased PDF, platelet deficiency, enhanced fibrinogen turnover, and paracoagulation tests showing disseminated intravascular coagulation were frequent in both groups. Platelet deficiency was significantly more frequent in group A (64.9% of cases) than in group B (37.5%). Patients in the latter group received small subcutaneous doses of heparin from the moment of admission.

[Histopathology of the liver in patients with severe burns. Preliminary biopsy study]. / Istopatologia del fegato nei grandi ustionati. Studio bioptico preliminare

Liver histobiopsy was carried out in 21 patients with burns of from 25 to 75 percent, between the 2nd and 125th day following trauma. The most frequent type of lesion encountered was albuminoid degeneration and hydropic ballooning of the cytoplasm to the point that the parenchyma assumed a "vegetable" appearance. No steatosis intervenes until the 6th-8th day after the burn and where it was not present previously, is a sign that the patient's condition is worsening. Total, or nearly total, disappearance of glycogen from the sections is an indication that the patient is worsening; in effect in patients who died, biopsy carried out shortly beforehand revealed the extreme paucity of PAS-positive material in the hepatocytes.