Epidemiology of imported malaria in a hospital in Milan, Italy.

The main epidemiological features of 47 cases of malaria imported into Italy and diagnosed in Milan during the period 1980-84 are reported. Plasmodium falciparum was the most frequently found species and caused two deaths. In P. falciparum infections, the importance for epidemiological and therapeutic purposes of the evaluation of chloroquine sensitivity, not only with in vivo tests but also with in vitro techniques, is stressed.

[Prevention of ischemic colitis following aortic reconstruction: personal experience of the role of transmural oximetry in the decision for inferior mesenteric artery reimplantation]. / Prevenzione della colite ischemica successiva a ricostruzione aortica. Nostra esperienza sul ruolo della ossimetria transmurale nella decisione del reimpianto dell'arteria mesenterica inferiore (AMI).

BACKGROUND: The colonic ischemic necrosis is one of the most serious complication in the surgical reconstruction of abdominal aorta aneurysm (AAA) due to surgical inappropriate binding of the inferior mesenteric artery (IMA). METHODS: A retrospective analyzed of a group of 118 infrarenal AAA surgically treated is presented. RESULTS: The most common cause of ischemic colitis (75% of cases) is the surgical binding of an opened IMA or its failed reimplantation. CONCLUSIONS: In this paper according to their personal experience and the literature data, the authors outline a diagnostic behaviour to select the patients needing the reimplantation of IMA; they suggest to complete the pre operative information with an instrumental evaluation during the surgical treatment.

[Indications for the surgical treatment of abdominal aortic aneurysms]. / Indicazioni al trattamento chirurgico degli aneurismi dell'aorta addominale.

BACKGROUND: On the basis of a literature review and of personal experience, the authors analyze the main indications and the best strategy for elective surgical repair of infrarenal abdominal aortic aneurysm (AAA). METHODS: Personal experience concerning elective surgical treatment of 110 patients with infrarenal AAA, is presented. RESULTS: No operative deaths have been observed and the postoperative recovery was regular in 108 patients. Two early complications (colon ischemia) and ten late postoperative complications (5 pseudoaneurysms, 5 sexual dysfunctions) occurred. CONCLUSIONS: The main therapeutic guidelines concerning the management of AAA should follow specific indications (aneurysm dimensions and growth rates). Indications for operative repair of aneurysms obviously should be judged in relation to the presence or absence of associated risk factors or concomitant medical conditions. In most cases, aneurysm repair can be performed safely, despite associated medical risks, by careful preoperative evaluation and preparation.

[Adrenal synchronous metastasis from non small cell lung carcinoma (NSCLC): combined surgical treatment? Case report and review of the literature]. / Metastasi surrenalica sincrona da carcinoma del polmone non microcitoma (NSCLC): trattamento chirurgico combinato? Case report e revisione della Letteratura.

The adrenal gland is a frequent site for metastases from non small cell lung carcinoma (NSCLC). Surgical strategy in patients with operable NSCLC with adrenal synchronous metastases is yet unclear. On the basis of a literature survey and of a personal case report, the authors analyze the main indications and the best strategy for solitary synchronous metastases in the adrenal gland from NSCLC.

Asymptomatic parasitic infections in renal transplant recipients and in haemodialysis patients.

One hundred and sixty-seven clinically asymptomatic renal transplant recipients and 119 patients on chronic haemodialysis were studied for the presence of intestinal parasites and for the prevalence of anti-Toxoplasma gondii antibodies. Intestinal parasitic infections were more frequently found in transplant recipients than in haemodialysis patients and in controls. Among transplant recipients, the prevalence rate of T. gondii antibodies at high titres was significantly increased, but in these subjects the positivity rate of specific IgM assays was reduced. This seems to indicate a greater occurrence of asymptomatic reactivated infections. Our findings suggest that parasitologic surveys of immunosuppressed patients should be periodically performed also in temperate climates, in order to prevent the possibility of disseminated infections.

Humoral immune responses in human loaiasis.

Some immunological parameters in three white patients who contracted loaiasis in endemic areas are reported. Microfilariae count in peripheral blood was elevated in one patient, discrete in another while in the third no microfilariae were detected. Serum IgE levels were elevated in two patients and normal in one of them. High eosinophils percentage (greater than 30%) and high titres of specific anti-filarial antibodies were detected in all patients. C3 and C4 levels fell between the normal values and C3PA was low in one patient. No circulating immune complexes were demonstrated. Two patients showed high anticomplementary activity. Our results are in accord with the possibility of a suppression mechanism in immune response in patients with high microfilaremia. Clinical features of loaiasis could be related to a type 1 (reaginic) reaction.