[Environmental diffusion of Legionella spp and legionellosis frequency among patients with pneumonia: preliminary results of a multicentric Italian survey]. / Diffusione ambientale di Legionella spp e frequenza di legionellosi in pazienti affetti da polmonite: primi risultatidi uno studio multicentrico italiano.

A multicentric Italian investigation on legionnaires' disease is in course to clarify host factors as well as pathogen associated characteristics involved in the infection/disease. The main goal of the research plan is to account for some critical aspects concerning identification and prevention of legionellosis. To improve knowledge on factors associated with Legionella spp colonisation in hot waters, to detect cases and to characterize risk factors in subjects which develop pneumonia are specific objectives of the research programme. Preliminary results show that hot waters of houses and hotels are frequently contaminated (22.6% and 54.6%, respectively), mainly by L. pneumophila. Microbial concentrations were low in domestic waters (<1.000 ufc/l), but higher in samples from the hotels (geom. mean 1.85 x 10(3) ufc/l). Warming system, age of the plant, type of building were risk factors significantly associated with Legionella spp positivity. The active surveillance on patients affected by pneumonia with search for Legionella urinary antigen allowed the identification of 34 cases, 3 of which of nosocomial origin, corresponding to 4.2% of the screened pneumonia. After informed consent, 26 subjects were recruited for a case-control-study to clarify risk factors for the disease.

Yield and collection efficiency.

Yield and collection efficiency are two important and strictly related aspects of an apheresis system. We have examined the various formulas, dwelling upon a few particular aspects of the collection of platelets, granulocytes and stem cells.

Plasma exchange in systemic lupus erythematosus.

Plasma exchange (PE) was performed in 8 of 14 patients with systemic lupus erythematosus (SLE) PE was instituted as an additional therapy during active disease in patients who did not respond to conventional therapy. The best results were obtained in plasmapherized patients; in fact, immune complex serum levels disappeared rapidly, whereas anti-DNA antibodies decreased slowly. The changes observed indicate that PE may be beneficial, especially when it is associated with drugs that can block antibody rebound. A variety of "technical factors" may influence PE therapy which therefore must be monitored appropriately.

Plasma-exchange in the treatment of cryoglobulinemia.

Plasma-exchange was used in 10 patients with mixed cryoglobulinemia. The procedure was used as a primary therapeutic tool to reduce cryoglobulin levels, and in combination with prednisone and cytotoxic drugs. The results show that PE alone is detrimental, although it may be an important adjunct to conventional therapy in MCG with progressive deterioration in the clinical condition, and in those patients who do not respond to drug therapy alone. The weak response to PE in MCG may be due to many technical variables, but mainly to the low percentage of circulating cryoglobulins removed.