Effectiveness, safety, durability and immune recovery in a retrospective, multicentre, observational cohort of ART-experienced, HIV-1-infected patients receiving maraviroc.

The aim of this retrospective, multicentre, observational study was to assess the durability, safety, immune recovery and effectiveness on viral suppression of antiretroviral therapy (ART) in a maraviroc (MVC)-based cohort. We collected clinical, demographical, immunological and virological parameters of adult HIV patients who were infected by CCR5-tropic virus and started an ART regimen containing MVC from 2005 to 2012. We created a longitudinal mixed model to assess the change over time of data. We enrolled 126 drug-experienced patients; the median duration of MVC treatment was 25 months. The probability of stopping ART at one year was 13.3%, and at three years was 27.3%. Statistically significant changes were observed for CD4+ cell count increase ( p < 0.001), HIV-RNA decrease ( p < 0.001) and total cholesterol decrease ( p = 0.005). Ninety-four patients (79.7%) had CD4 ≥ 200 cells/mm3 at baseline while nine of them reached this threshold at nine months (7.6%), 17 (13%) after nine months and six (5%) remained below 200 cells/mm3 at the end of the study. Overall, 114 patients (90.5%) achieved an HIV-RNA ≤ 50 cp/ml. A majority of patients maintained CD4 cell counts of ≥ 200 cells/mm3 and achieved an undetectable HIV viral load within three months. MVC-containing regimens are safe and appear to be a feasible therapeutic option for ART.

Late occurrence of pleural and peritoneal effusion due to Mycobacterium tuberculosis infection (TB) in a patient with posttransplantation recurrent HCV chronic hepatitis: safety of peginterferon and ribavirin treatment after recovery of TB:- a case report.

The late occurrence of a large and often long-lasting effusion in the pleural and peritoneal cavities after liver transplantation is an uncommon and poorly understood complication. Even rarer (<1%) is the incidence of Mycobacterium tuberculosis (MT) in Western world series. Herein we have described a case of massive pleural effusion and ascites due to MT occurring 22 months after liver transplantation for hepatitis C virus (HCV) cirrhosis. The infection was successfully treated with no hepatotoxicity or rejection, so that it was possible to start antiviral treatment with peginterferon and ribavirin for recurrent HCV without reactivation of MT infection.

[Ceftazidime in the treatment of Weil's disease] / Ceftazidime nel trattamento del morbo di Weil.

We present a case report of leptospirosis with acute renal failure and hepatic dysfunction. Aspecific clinical presentation and serologic tests do not help therapeutic choices. The patient received 18 sessions of hemodialysis and early treatment with intravenous ceftazidime 1 g tid (under the impression of Gram- sepsis). Third generation cephalosporins, ceftriaxone and cefotaxime, are highly active against Leptospira [10] while clinical experience with ceftazidime is lacking.

Interferon retreatment in chronic hepatitis C: which patients to choose, and what schedule to use.

UNLABELLED: OBJECTIVE; To evaluate the results of a large cohort of non-responder or relapsing responder patients with chronic hepatitis C retreated with various schedules of interferon (IFN). METHODS: Our study included 276 patients (158 non-responders and 118 relapsing responders) who underwent IFN retreatments. Among the non-responder group, 158 patients underwent further courses of IFN. In particular, 108 patients underwent one course of IFN retreatment, 40 patients underwent two courses, eight patients underwent three courses, and two patients underwent four courses. Regarding the relapsing responder group, the 118 patients were retreated with the same dosage for varying periods. In particular, 50 patients were treated for 6 months, 43 patients for 12 months, and 25 for 24 months. Patients in the subgroups of IFN retreatment were homogeneous as far as age and gender distribution, as well as virological and histological characteristics, are concerned. Qualitative and quantitative HCV-RNA was evaluated at baseline, at the end of treatment and at the last check-up of follow-up. HCV genotype was determined on baseline serum samples. Alanine transaminase (ALT) levels were tested monthly. RESULTS: Long-term biochemical (normal ALT levels) and virological (HCV-RNA negative) response was obtained in 2.6% of non-responder retreated patients, and in 33.9% of relapsing responder retreated patients. Evaluation of response on the basis of the duration of treatment showed that 48%, 19% and 16% of relapsing responder patients retreated for 24, 12 and 6 months, respectively, obtained long-term biochemical and virological response. CONCLUSION: Non-responder patient retreatment is inefficient especially in cirrhotic and/or genotype 1 b patients. IFN retreatment is warranted in relapsing responder patients. In particular, 24-month therapy induces significant long-term biochemical and virological response.

[Port malaria caused by Plasmodium falciparum a case report]. / Malaria portuale da Plasmodium falciparum: descrizione di un caso clinico.

A case of unusual transmission by Plasmodium falciparum malaria is reported. The patient, had not been travelling outside North-West of Italy for the previous 6 months, he was not drug abuser. He had spent the last two months prior his admission, partly in his home town, an urban area in the region of Piemonte, and partly in a resort area on the Ligurian sea. Neither place has ever been associated with unusual malaria transmission. The possible transmission way is through a live vector imported from endemic area in a port terminal near a resort area.

Pigment production from in vitro cultures of Alkanna tinctoria Tausch.

An in vitro culture of Alkanna tinctoria Tausch cells was set up in order to investigate the possibility of producing alkannin, a red naphthoquinone naturally present in the root bark of this plant. Furthermore, an in vitro culture of callusderived roots was established and the production of alkannin evaluated. In the different experimental conditions investigated, differences in the production of alkannin derivatives as well as in the type of pigments produced, were observed. The potential use of this technology is discussed.

Cotrimoxazole therapy of Toxoplasma gondii encephalitis in AIDS patients.

Twenty-four consecutive HIV-positive patients affected by Toxoplasma gondii encephalitis received trimethoprim-sulfamethoxazole (cotrimoxazole) as acute-phase treatment. Two dosage regimens of cotrimoxazole were used: 40 mg/kg/day (12 patients) or 120 mg/kg/day (12 patients) of total compound (trimethoprim plus sulfamethoxazole). Clinical and radiological responses to treatment were evaluated, and the product-limit method for survival data analysis was used. Eighteen of 24 patients showed both a clinical and radiological response (75% response rate). There were no differences in response rates between patients receiving the two dosage regimens of cotrimoxazole. Adverse reaction consisted of leukopenia (two cases) and skin rash (three cases) which led to the discontinuation of the drug in one case. These results suggest that a randomized, controlled clinical trial should be carried out comparing cotrimoxazole versus sulfadiazine-pyrimethamine in AIDS patients with Toxoplasma gondii encephalitis.

Neurological complications in HIV infection. Personal experience.

The personal experience on neurological disturbances associated with early HIV infection and AIDS is reported. Central nervous system (CNS) involvement occurred during the early stages in 3 cases: 2 patients with HIV-seroconversion (CDC category III) and one patient with persistent generalized lymphadenopathy (PGL, III group CDC, 1986). The patients had HIV acute meningitis. The neurological manifestations in AIDS had high incidence (49 of 83 cases), often with multiple aetiology in single patients. We remark the necessity of an early aetiological diagnosis to address the treatment.

[Augmentation of the biodisposition of simple sugars from sorghum biomass mediated with biotechnologic processes]. / Aumento della disponibilità di zuccheri semplici da biomasse di sorgo zuccherino mediante processi biotecnologici.

The results of the enzymatic hydrolysis of pectin, hemicellulose and cellulose in the biomass of sweet sorghum (Sorghum vulgare var. saccharatum, L.) are reported. Some commercial enzymatic preparations were used: Maxazym CL 2000 (with prevailing cellulase activity), Rapidase C 80 (with prevailing pectinase activity) Rohament PC (mainly with pectinase and cellulase activities) and Rohament O (mainly with pectinase and hemicellulase activities). The treatment with Rohament PC, Rohament O and Rapidase C 80 gives an increase of the glucose content higher than the effect induced by Maxazym CL 2000. On the other hand, the cellulase and pectinase combined treatment (Maxazym CL 2000 + Rapidase C 80 or Maxazym CL 2000 + Rohament O) shows a good synergistic effect in the degradation of the plant cell wall cellulosic material.

[Characterization of the biomass of the stems of sweet sorghum]. / Caratterizzazione della biomassa dei culmi di sorgo zuccherino.

In this study the amount of glucose, sucrose and fructose was determined in the water soluble fraction while cellulose, hemicellulose, pectin and lignin contents were determined in the alcohol insoluble fraction after hydrolysis. Stalks of sweet sorghum (Sorghum vulgare L., var. saccharatum) cv. Vespa, Soave, Roce and MN 1500 at the physiological ripeness stage were used. The results of the analysis of variance with the least significant difference method (LSD, = 0.05) show that cv. Vespa and Roce have a significantly higher total amount of glucose, fructose and sucrose and at the same time, a lower cellulose, pectin, hemicellulose and lignin content then cv. Soave and cv. MN 1500.

Control of ribonuclease and acid phosphatase by auxin and abscisic acid during senescence of Rhoeo leaf sections.

We report the effects of abscisic acid and auxin (alpha-naphthalene acetic acid) on regulation of enzyme synthesis during senescence of leaf sections of Rhoeo discolor Hance. Abscisic acid always accelerates the onset of and enhances the magnitude of the increase in activity of acid phosphatase; this is followed by an acceleration of the onset of a rapid increase in free space.RNase activity increases 2- to 5-fold after cutting of leaf sections. Abscisic acid increases RNase activity and inhibits the rate of incorporation of uridine and leucine in leaf sections removed from plants grown under stress but not favorable conditions. Auxin inhibits the increase in RNase and acid phosphatase and suppresses the effects of abscisic acid. The increase in activity of RNase and acid phosphatase is inhibited by inhibitors of RNA and protein synthesis. This and other evidence suggests that the increases in hydrolase activity could result from new enzyme synthesis. The possible significance of the results in respect of hormonal regulation of enzyme activity and senescence is discussed.

Senescense: association of synthesis of Acid phosphatase with banana ripening.

During ripening of banana (Musa sapientum L., var. Gros Michel or Valery) acid phosphatase activity increases 13-to 26-fold in the precipitate and 2- to 4-fold in the supernatant fraction of tissue homogenates. These increases are closely correlated with the onset and peak of the climacteric. The precipitate enzyme may be extracted with Triton X-100, CaCl(2) or NaCl; about 80% of it is in a 500g precipitate. Studies on effect of tonicity of the grinding medium indicate that the precipitate enzyme is desorbed from membrane or cell wall surfaces, and is not released as a result of lysis of membranes. The development of acid phosphatase during aging of tissue slices is the same as in intact fruit. Short term studies of tissue slices with cycloheximide and actinomycin D indicate that the increase in activity is owed to new enzyme synthesis, which is dependent upon synthesis of RNA. The possible effects of the increase in acid phosphatase on ripening are discussed.