[Tolerability to terizidone (TZ) in the treatment of pulmonary tuberculosis in dialyzed patients]. / Tollerabilità del terizidone (TZ) nel trattamento della tubercolosi polmonare in pazienti dializzati.

Six dialysed patients affected by tuberculosis involving the respiratory apparatus were included in the study. Antimycobacterial treatment consisted of polychemiotherapeutic combinations using terizidone (TZ). The need to resort to this drug may be explained by the need to exclude normally used drugs (R/AMP, INH, SM) due to resistance, allergy or organ meiopragia. Five patients received terizidone at a dose of 600-900 mg/day for the entire course of treatment, whereas it was necessary to abandon treatment in one patient due to the onset of depressive symptoms which then rapidly regressed following the suspension of TZ therapy. The good level of tolerance demonstrated in the 5 remaining cases confirm the inclusion of this drug in the treatment of a limited number of cases of tuberculosis in dialysed patients.

[The current epidemiologic profile of the drug resistance of Koch's bacillus to antitubercular antibiotic chemicals]. / Attuale profilo epidemiologico della farmacoresistenza del bacillo di Koch ai chemioantibiotici antitubercolari.

The study was conducted on patients with initially diagnosed tuberculosis encountered in 1986-87. A series of 269 bacterial antibiograms performed on sputum [correction of excreate] and other materials was examined in order to ascertain the resistance of Koch's bacillus to R/AMP, INH, SM and EMB. Primary drug resistance was found in 64 cases (23.79% of the total) and was isolated in 32 (11.89%), multiple in the rest. The response to the individual antibiotics was a follows resistance to INH was isolated in 11 cases (4.08%), combined with resistance to other drugs in 27 (10.03%); resistance to SM was isolated in 13 cases (4.81%) multiple in 24 (8.92%); resistance to R/AMP was isolated in 4 cases (1.48%), multiple in 14 (5.2%); resistance to EMB was isolated in 4 (1.48%) multiple in 19 (7.06%). Comparison with earlier studies in the Turin area highlights that the incidence of TB, in decline up to 1979, significantly increased in the period considered.

[Different rates of theophylline clearance. A statistical study of a group of asthmatics]. / Studio delle diverse velocità di clearance della teofillina. Studio statistico su un gruppo di asmatici.

In standard clinical practice the pharmacokinetic profile of theophylline is monitored by measuring blood levels of the drug. However a more accurate picture of the metabolic pattern over time can be obtained by monitoring theophylline clearance. This technique was applied to 40 lung disease patients most (55%) of them slow metabolisers as described in the literature. In the light of this findings, cautious dosing is advisable when no data are available or clearance (difficult to apply outside a strictly specialist environment).

[Clinical aspects of respiratory pathology in scleroderma. Case reports]. / Aspetti clinici della patologia respiratoria nella sclerodermia. Contributo casistico.

Six cases of scleroderma with pulmonary involvement, either isolated or accompanied by other visceral signs, observed between 1985 and 1987 have been examined. Patients were undergoing treatment with cortisone drugs in 4 cases and azathioprine in 2. Chest X-ray documented a picture of nodular opacities in 3 cases, reticular in 2 and miliariform in 1. B.A.L. revealed a picture of prevalently neutrophil alveolitis in all subjects, while transbronchial biopsy showed a finding of macrophagic infiltration in 2 cases, and one of fibroblastic proliferation in 4. The anatomoclinical damage was reflected adequately by spirometric tests and above all by the DLCO, while Gallium 67 scan and measurement of the A.C.E. were not very sensitive.

The release of thromboxane B2 and 6-keto-PGF1 alpha following pulmonary embolism.

It has been shown in animals that acute obstruction of pulmonary artery branches is followed by an early but shortly lived increase in blood levels of thromboxane B2 and a subsequent longer-lasting increase in blood levels of 6-keto-PGF1 alpha. Our study was conducted on twelve patients with acute pulmonary embolism. Nine were treated with urokinase; three could not be given thrombolytic or anticoagulant drugs due to bleeding peptic ulcer (2 cases) or recent cerebral hemorrhage (1 case). HPLC and RIA tests were performed on arterial blood samples at diagnosis and after 1, 6, 12 and 24 hours. Findings were compared with those in a control group of 6 healthy subjects. There was a difference in prostanoid behaviour between the untreated and urokinase treated patients. Among the former mean TxB2 was significantly raised at clinical onset and began to decline after 6-12 hours, approaching the mean level found among the controls after 24 hours. In contrast 6-keto-PGF1 alpha was raised after 1 hour and gradually declined thereafter. In the subjects treated with urokinase TxB2 was already close to the mean control level after 1 hour; 6-keto-PGF1 alpha had increased after 1 hour but had returned near the control level after 12. The behaviour of prostanoids appears to match the clinical course.

[Lung diseases associated with silicosis. Study of 618 cases]. / Pneumopatie associate a silicosi. Indagine su 618 casi.

Retrospective research has been carried out on the clinical reports of 618 cases of patients suffering from silicosis admitted to the S. Luigi Gonzaga Hospital in 1973-1987 (1.4% of all pneumopathy admittances). A comparative evaluation of the five-year periods 1973-77, 1978-82, 1983-87 showed a steady reduction in the percentage of silicosis to total cases (from 1.62% to 1.55% and 1.16%). Among the 618 cases assessed, the following pneumopathies were associated with silicosis either alone or in combination: chronic obstructive bronchopneumopathy (89.4%), pulmonary tuberculosis (22.2%), bronchogenic carcinoma (8.4%), acute aspecific infections (26.1%), mycosis (0.6%), sarcoidosis (0.3%), other pneumopathies (1.1%). Comparison between the three five-year periods shows an increase in the frequency of the silicosis-carcinoma association and a fall in the silicosis-tuberculosis and silicosis-COLD associations.

Examination of 41 cases of laryngeal tuberculosis observed between 1975-1985.

Forty one cases of laryngeal tuberculosis, accounting for 0.8% of all cases of tuberculosis observed in 1975-1985, are evaluated. The mean age was 53 yrs, the male/female ratio 9:1. In all cases current or earlier pulmonary tuberculosis was noted. The laryngeal sites affected were, in order of frequency: true vocal cords, epiglottis, false cords and laryngeal ventricles, arytenoid and interarytenoid area, subglottic area. The patients were usually treated with isoniazid, rifampicin, ethambutol for 6-12 months. Two cases required excision of laryngeal lesions. The results of chemotherapy were good.

Tuberculosis of the larynx. Today.

Forty-one cases of laryngeal tuberculosis accounting for 0.79% of the TB cases observed in 1975-85 are examined. The M/F ratio was 9.2:1; the mean age 52 years 9 months. In all cases current or earlier tubercular lesions on the pulmonary parenchyma were also noted. The laryngeal sites affected were as follows, in order of frequency: true vocal cords, epiglottis, false cords and laryngeal ventricles, arytenoid and interarytenoid area, subglottic area. The patients were treated with R/AMP, INH, EMB or SM, EMB with satisfactory results. Two cases required exeresis of laryngeal lesions and 3 tracheotomy.

[Comparison of protective effects induced by the ultrasonic mist of nicardipine + fenoterol versus nicardipine + fenoterol + ipratropium bromide]. / Raffronto tra la protezione nei confronti della nebbia ultrasonica indotta dalla nicardipina + fenoterolo versus quella indotta da nicardipina + fenoterolo + ipratropium bromuro.

A comparison is presented of the protective effect of ultrasound mist induced by nicardipine + fenoterol and nicardipine + fenoterol + ipratropium bromide in a group of 11 patients with chronic bronchial asthma in a phase of relative clinical stability. The data collected show that the three-drug combination was more effective than the use of nicardipine and fenoterol.

[Blood copper levels in a group of patients with asbestosis]. / Tassi sierici di cupremia in un gruppo di soggetti affetti da asbestosi.

Colorimetry was used to assay blood copper levels in 13 asbestosis patients (mean age 55.5) selected by excluding all cases with an evident clinical anamnesis of dietary imbalances or other significant pathologies. The results show increased blood copper in 11 out of 13 patients, the mean level in this group being significantly higher than that in a control group (p less than 0.01). The phenomenon, already described in other interstitial lung diseases, may well be attributable to enhanced reabsorption of the metal due to the intensified activity of a copper enzyme lysyl oxidase that is involved in collagen synthesis.

[Histo-radiological and histo-bronchoscopic correlates in neoplastic pathology of the lung. Personal case series]. / Correlazioni isto-radiologiche e isto-broncoscopiche nella patologia neoplastica del polmone. Casistica personale.

Data are presented on a series of 100 lung cancer patients, diagnosed histologically and encountered in 1984-87. The percentage distribution of the various histotypes and their relationship with radiological and endoscopic aspects were examined. The data obtained are then compared with those reported in the literature.

[Post-actinic pulmonary fibrosis. Longitudinal study of 279 cases]. / La fibrosi polmonare post-attinica. Indagine longitudinale su 279 casi.

The incidence and extent of postactinic pulmonary fibrosis was investigated in relation to the different types of radiation therapy. For this purpose, 131 patients treated with fast electron (for breast cancer) and 148 patients treated with TCT (for breast cancer and cancer of other nature) observed in the period 1976-1987 were followed up (from 13 months to 7 years). The frequency of postactinic fibrosis was much less in the first group of patients than the second (6.61% vs 18.99%); further, the functional damage in these patients proved less and developed in a less unfavourable way.

[Skin reactions with ubiquitous multiple antigens as a test of survival in patients with inoperable bronchogenic carcinoma]. / La cutireazione con antigeni plurimi ubiquitari come test di sopravvivenza nei pazienti affetti da carcinoma broncogeno inoperabile.

Fifty-three patients suffering from inoperable, non-microcytoma, bronchogenic carcinoma in which a skin reaction with ubiquitous antigens (tetanus, diphtheria, streptococcus, tuberculin, proteus, tricophyton, candida) had been carried out were followed up to check on the possible relationship between skin reactivity and survival period. A significant correlation was found between the degree of positivity and duration of survival, with mean survival values greater than 69.1 weeks being observed in patients positive to five or more antigens. Among preliminary tests, it would therefore appear that skin reaction with ubiquitous may provide indications for predicting survival.