[Exogenous risk factors for parenchymal carcinoma of the kidney]. / Fattori di rischio esogeni per il carcinoma parenchimale del rene.

In the last decades incidence rates for renal cell carcinoma have been constantly increasing, especially in western European and Scandinavian countries and North America. Several epidemiological studies observed an increased relative risk of this tumour linked with some exogenous and/or environmental factors. The following exposures have been more consistently associated with renal cell carcinoma: tobacco smoking; occupational exposures (asbestos, aromatic hydrocarbons, chemical solvents); dietetic factors such as high energy intake, consumption of fried meats and poultry, and reduced intake of fruit and vegetables; iatrogenic factors such as analgesics and amphetamines; common diseases like obesity and hypertension. An effective preventive strategy for renal cancer could be carried out reducing the exposure to such risk factors.

Burkholderia (Pseudomonas) cepacia epidemiology in a cystic fibrosis population: a genome finger-printing study.

In patients with cystic fibrosis, infection with Pseudomonas cepacia is associated with poor outcomes. However, the epidemiology of Burkholderia cepacia is still unclear. The aim of this study was to investigate the epidemiology of Burkholderia (Pseudomonas) cepacia colonization among cystic fibrosis patients attending the Verona CF Centre, a large specialized unit to which patients from different parts of Italy are admitted. We used a genome finger-printing system to analyse the nucleotidic structure of B. cepacia isolates from 60 colonized cystic fibrosis patients. Forty-two different finger-printing patterns were identified. Thirty-two patients were colonized by individual B. cepacia strains (53.3%). The remaining 28 subjects were divided into 10 different subgroups, each exhibiting a distinct strain of B. cepacia (46.7%). Nevertheless, direct, person-to-person transmission was evident in only 10 cases (16.7%). The stability up to 12 months, of the B. cepacia colonizing strain was documented in 36 individuals. Consistent with other reports, risk of B. cepacia transmission between cystic fibrosis patients through intimacy or nosocomial contact was found in our study. However, besides low contagiousness, our data suggest that the environmental reservoir of B. cepacia outside the hospital seems to play an important role in B. cepacia infection of our cystic fibrosis population.

Field inversion gel electrophoresis on Pseudomonas cepacia strains isolated from cystic fibrosis patients.

Genome fingerprinting by field inversion gel electrophoresis (FIGE) was utilized to typify 129 isolates of Pseudomonas cepacia (Pc) from 59 patients with cystic fibrosis (CF) and from environmental cultures in the CF ward. The aim of this study was to assess whether a segregation policy avoided colonization of CF patients by nosocomial strains and contamination of the environment by colonized individuals, whether or not an 'epidemic strain' was present in the ward and whether cross-colonization occurred in CF individuals subjected to prolonged close contact. The Pc strains of each patient remained unchanged over time; 78% of the genome finger printings (GFP) were individual, whereas the others gave rise to 9 GFP groups. A spirometer was probably contaminated by a newly colonized patient. Adequate sanitary measures and avoidance of excessive promiscuity are helpful for limiting but are unable to eliminate Pc transmission in the CF ward. Direct or indirect transmission, however seems, more frequent in CF patients in contacts outside the hospital.

Isolation and identification of Encephalitozoon hellem from an Italian AIDS patient with disseminated microsporidiosis.

Microsporidia are primitive mitochondria-lacking spore-forming eukaryotic protozoa that infect a wide variety of animals and also humans. Of the five genera (Encephalitozoon, Enterocytozoon, Septata, Nosema and Pleistophora) that cause infections in humans, Enterocytozoon bieneusi, Septata intestinalis, and Encephalitozoon hellem are being increasingly identified in patients with acquired immunodeficiency syndrome (AIDS). E. bieneusi causes gastrointestinal disease, S. intestinalis causes gastrointestinal and disseminated disease, and E. hellem causes ocular as well as disseminated disease. We have established in continuous culture a strain of microsporidia isolated from the urine and throat washings of an Italian AIDS patient and identified it as Encephalitozoon hellem, based on its ultrastructural morphology, antigenic pattern, and polymerase chain reaction-amplified small subunit ribosomal RNA. We believe that this is the first time that a strain of microsporidia has been isolated from the throat washings of a patient with microsporidiosis.

Oral itraconazole plus nasal amphotericin B for prophylaxis of invasive aspergillosis in patients with hematological malignancies.

The use of oral itraconazole (200 mg daily) plus nasal amphotericin B (10 mg daily) for prophylaxis of invasive aspergillosis was evaluated in 164 patients with hematological malignancies at risk due to presence of neutropenia and/or steroid therapy. This prophylactic regimen was evaluated for a period of two years. Two hundred and ninety patients with similar characteristics who were observed over the three-year period prior to the introduction of prophylaxis served as historical control group. Environmental surveillance during the study period showed constant contamination of the air with Aspergillus. Prophylaxis significantly reduced the incidence of proven invasive aspergillosis from 12/290 to 0/164 (p = 0.004), and reduced the mortality rate from 8/290 to 0/164. The incidence of proven plus probable aspergillosis amounted to 34/290 in the control group and 8/164 in the study group (p = 0.01); the mortality rates were 11/290 (3.7%) and 2/164 (1.2%) respectively. All nasal cultures in the study group were negative for Aspergillus. The prophylactic regimen was well tolerated. Larger studies assessing each agent alone and in combination are necessary to confirm these observations.

Polymerase chain reaction amplification and restriction enzyme typing as an accurate and simple way to detect and identify human papillomaviruses.

A simple and economic method for the detection and identification of human papillomaviruses (HPV) is described. The method has been developed with cloned HPV DNA and DNA from clinical samples. Genomic fragments were obtained from several different HPV types, including the ones most frequently encountered in the genital tract by polymerase chain reaction (PCR) amplification directed by degenerate general primers. The amplification fragments were identified by a form of miniature fingerprinting, with a set of restriction enzymes that gave a unique digestion pattern for each HPV type. Different strategies are proposed, based on PCR and restriction analysis, and this approach to identification was compared with more classic methods such as Southern hybridisation.

Comparative evaluation of some methods for detection of M. pneumoniae antibodies.

Various methods of detection are available for measuring antibodies specific to M. pneumoniae. We examined over 600 sera of patients with clinical diagnosis of M. pneumoniae infection using complement fixation (CF) test. 91 gave positive reaction and were therefore selected for a comparative analysis with other methods such as metabolic inhibition (MI), mycoplasmocidal (MC) and radioimmunoprecipitation (RIP) methods. MC and RIP test gave antibody titers comparatively higher than MI and CF. Comparative studies on the sensitivity of the various methods considered were also carried out on 6 paired sera collected from the same patients at 10 days intervals. The increase in antibody titers were much higher when MC and RIP tests were considered. When RIP and MC methods were compared, the first appeared more sensitive in all cases studied.

[About the frequency and variety of yeasts found in pathologic materials (author's transl)]. / Osservazioni sulla frequenza e varietà dei lieviti nei materiali patologici.

The AA. propose a comprehensive view of the yeasts found out in pathologic materials in the Institute of Microbiology of the Udine General Hospital during the first six mounts of the year 1978. They compare their achieved results with the data collected in other italian and foreign areas by other students, pointing out the prevalence of Candida albicans over other species of yeasts, in the people gravitating on the Hospital of Udine. They formulate at least the hypothesis that some species of yeasts able to live in human organism are not evenly distributed in every country and that such an irregular distribution mai explain and justify that percentage of not better identifiable yeast-like fungi that every A. must include in his statistics.

Evaluation of the use of "thermoresistant" antigen Patoc 1, in the diagnosis of human and animal leptospirosis. Preliminary report.

The macroagglutination test, according Mailloux, was investigated for its feasibility in the rapid diagnosis of human and animal leptospirosis. Suspected sera examinated by Mailloux test, were also examinated by Complement Fixation and Microagglutination; the results suggest that: Mailloux macroagglutination is the serological test of choice, for screening of animal and human sera, mostly if it is not needed to know the infecting serovar.

[A miniaturized method for some biochemical tests of bacteric identification (author's transl)]. / Prove biochimiche di identificazione batterica: presentazione di un metodo miniaturizzato in piastre microtiter.

A miniaturized method for some biochemical tests of bacteric identification was presented. Results of quality control and comparisons with traditional method were reported.

[The role of anaerobic bacteria in meningeal infections (author's transl)]. / Il ruolo dei batteri anaerobi nelle infezioni meningee.

The finding is described of a Gram-negative bacterium in cerebrospinal fluid of a patient suffering from internal hydrocephalus and taken in the hospital of Udine with symptoms of meningitis. The isolated bacterium belongs to the genus Bacteroides. The cases of meningitis are indicated in which the bacteriological examination of the cerebrospinal fluid for anaerobes is recommended.

[Septicaemia caused by fungus: technical data and cases (author's transl)]. / Setticemia da miceti: rilievi tecnici e casistica.

The Authors describe a technique suitable for isolating fungus from haemocultures. Although it is not frequent to find a description of septicaemia caused by fungus in hospital practice besides the Candida type, many kinds of yeasts and filamentous fungus have been occasionally isolated from the blood. It is the Author's opinion that if suitable techniques were always used, the evidence of fungus in haemocultures would be more frequent and above all one could also isolate filamentous fungus.

[An antigenic extract analyzed by bidimensional immunoelectrophoresis (author's transl)]. / Analisi immunoelettroforetica di un preparato antigene aspergillare

An antigenic extract from broth culture of Aspergillus fumigatus has been analyzed by bidimensional immunoelectrophoresis of Clark and Freeman against rabbit antiserum. The analysis has show the extract to be constituted by seven different antigens.

[Considerations on the bacterial flora in patients with infections of the respiratory tract and in immunosuppressed patients (author's transl)]. / Considerazioni sulla flora batterica e micetica bronchiale nei pazienti con infezioni delle vie respiratorie e nei pazienti trattati con immunosoppressori

Epidemiological features of pathogenic mycetes have been investigated with regard to their relationship with bacterial flora in patients with acute and chronic bronchopulmonary diseases and in immunosuppressed patients. Opportunistic mycetes (Candida and Aspergillus) have been found frequently associated with Gram-negative pathogenic bacteria. In immunosuppressed patients, the plenty of mycetic flora is related to the degree of immunoglobulin deficiency especially to the IgG and IgA levels.