Pneumocystis carinii pneumonia in patients with malignant haematological diseases: 10 years' experience of infection in GIMEMA centres.

A retrospective survey was conducted over a 10-year period (1990-99) among 52 haematology divisions in order to evaluate the clinical and laboratory characteristics and outcome of patients with proven Pneumocystis carinii pneumonia (PCP) complicating haematological diseases. The study included 55 patients (18 with non-Hodgkin's lymphoma, 10 with acute lymphoblastic leukaemia, eight with acute myeloid leukaemia, five with chronic myeloid leukaemia, four with chronic lymphocytic leukaemia, four with multiple myeloma, three with myelodys-plastic syndrome, two with myelofibrosis and one with thalassemia) who developed PCP. Among these, 18 (33%) underwent stem cell transplantation; only two received an oral prophylaxis with trimethroprim/sulphamethoxazole. Twelve patients (22%) developed PCP despite protective isolation in a laminar airflow room. The most frequent symptoms were: fever (86%), dyspnoea (78%), non-productive cough (71%), thoracic pain (14%) and chills (5%); a severe hypoxaemia was present in 39 patients (71%). Chest radiography or computerized tomography showed interstitial infiltrates in 34 patients (62%), alveolar infiltrates in 12 patients (22%), and alveolar-interstitial infiltrates in nine patients (16%). Bronchoalveolar lavage was diagnostic in 47/48 patients, induced sputum in 9/18 patients and lung biopsy in 3/8 patients. The diagnosis was made in two patients at autopsy. All patients except one started a specific treatment (52 patients trimethroprim/sulphamethoxazole, one pentamidine and one dapsone). Sixteen patients (29%) died of PCP within 30 d of diagnosis. Multivariate analysis showed that prolonged steroid treatment (P < 0.006) and a radiological picture of diffuse lung involvement (P < 0.003) were negative diagnostic factors

On the content of nitrates and nitrites in various foodstuffs and on the change wich follow the cooking process

We tested the nitrate and nitrite content in animal and vegetable foodstuffs. We found the data we obtained to be comparable to that of other Authors, even in the degree of variation exhibited. For an evaluation of the real daily ingetiosn of nitrates and nitrites contained in foodstuffs, we emphasized the importance of the various kinds of manipulation which the food necessarily undergoes before being ingested; in particular we concentrated on the cooking process since many foodstuffs are consumed only after being so treated. Therefore we report the data obtained after cooking the foodstuffs in water with different nitrate and mineral levels. We always observed a reduction (over 50%) of nitrates in foodstuffs with a high nitrate content. The reduction was greater when there was less nitrate naturally present in the cooking water. The foodstuffs with a low nitrate content on the other hand, augmented their nitrate content in proportion to the quantity present in the water used for cooking. The saline content of the cooking water does not seem to exercise an important influence when the nitrate concentration is kept the same

Qualità delle acque dei fiumi marchigiani: situazione del fiume Metauro

The quality of the waters in the River Metauro was studied chemically, chemico-physically, bacteriologically, and biologically (biological mapping after a study of the benthic macroinvertebrate communities). The biological monitoring in the middle-coastward stretch evidenced a situation worse than that to be deduced from chemical analysìs, This discrepancy may be attributed to the presence of numerous wastewater treatment plants, which determine a significant decrease in the organic contént of the discharge before its being poured into the watercourse. The classical chemical parameters are therefore acceptable, while the macroinvertebrate communities are at the same time seen to be suffering. Furthermore, it should not be excluded that there is a discontinuity in the proper working of these plants, together with the occasional discharge of toxic waste that does not appear in the chemical sampling, but that nonetheless leaves its trace in the organisms living in the watercourse. For a correct reading of the state of pollution of the running waters. the need is thus felt to set up an integrative study, not just one confined to the classical chemical and bacteriological parameters but that includes biological indicators as well

Aspergillus niger infection in patients with haematological diseases: a report of eight cases

In this paper we analysed clinical, laboratory characteristics and outcome of patients with haematological diseases who developed an Aspergillus niger infection, in a multicentre study involving 14 Italian Haematological Divisions during a 10-year period. The study recorded 194 consecutive microbiologically documented aspergilloses, eight of which (4%) were due to A. niger, and were observed only in five of the participating centres. The primary localization of infection was lung in seven cases and paranasal sinus in one case. Seven patients died at the end of follow-up. The death was mainly attributable to A. niger progression in six of them. Our study that collected the largest number of cases of A. niger infection in haematological malignancies confirms that this infrequent complication is characterized by a high mortality rate

Progetto \u201cDialetto\u201d. Testimonianze dialettali nel maceratese

Realizzazione e progressivo arricchimento e aggiornamento di una Banca dati bibliografica (disponibile in rete all\u2019indirizzo http://dialetto.unimc.it/dialetto.htm); raccolta di specimina di parlato e registrazione di testi narrati, recitati o in musica, archiviati presso il Laboratorio di Fonetica sperimentale (LaFoS) del Dipartimento di Ricerca linguistica, letteraria e filologica e successivamente analizzati; raccolta di materiale bibliografico primario e secondario, introdotto presso la bibliotece del medesimo Dipartimento; pubblicazione di antologie dialettali e studi scientifici sul dialetto; coordinamento e sostegno delle attivit\ue0 svolte sul territorio riguardanti il dialetto. Il Progetto \ue8 attivo dal 2001; l'ultima Relazione annuale presentata agli Enti convenzionati \ue8 del 2009

Acute leukemia following a previous malignancy: do acute lymphoid leukemia and acute myeloid leukemia have common risk factors?

Introduction: Within the framework of the GIMEMA Study Group, the characteristics of acute lymphoid leukemia and acute myeloid leukemia occurring in patients who have suffered a previous malignancy were studied. Assessment was also made of the clinical course, laboratory features and overall outcome of these conditions. Materials and methods: A four-year, multi-center retrospective study was conducted to evaluate the effect of treatment for previous hematological malignancy on the development of secondary leukemia. The study collected in the GIMEMA Archive of Adult Acute Leukemia 3934 new cases of acute leukemia (2964 AML, 901 ALL, 60 acute biphenotypic leukemia). Among these cases, data were evaluated from patients with a personal history of a previous malignancy, and included inquiring into demographic data, history of neoplastic diseases in the 1st degree relatives, type and treatment of the previous malignancy, latency until the development of a secondary acute leukemia diagnosis, laboratory features, treatment and outcome at the onset of secondary acute leukemia. Results: Approximately 200 (5.1%) patients presented a previous malignancy. Twenty-one were affected by ALL and 179 by AML. The proportion of patients with secondary AML was higher than that of patients with secondary ALL (179/2964 vs 21/901, O.R. 2.69-95% C.I. 1.66-4.39, P < 0.001). The median latency, from the onset of the previous malignancy to the development of secondary ALL was 27 months and to the development of secondary AML was 52 months (P < 0.05). Furthermore, of patients who previously received chemotherapy more developed a second AML (66/127 sAML vs 5/21 sALL; O.R. 3.46-95% C.I. 1.10-11.56, P < 0.01). Conclusion: In most cases, chemotherapy treatment for a previous malignancy can play a role in the development of secondary AML. In almost all cases of secondary ALL, the role of previous drugs does not appear to be relevant. On the basis of our analysis, performed systematically for the first time on a large adult series of acute leukemia, we conclude that in these patients a biological predisposition to cancer may be suspected