Autoimmune hemolytic anemia in a cadaveric renal transplant recipient treated with cyclosporine

A case of autoimmune anti-c hemolytic anemia was observed in a cadaveric renal transplant recipient treated by cyclosporine. Severe anemia had been preceded by an episode of cholangitis followed within a few days by a viral infection. Anemia improved after three plasmaphereses and after cyclosporine therapy was substituted by azathioprine and steroid doses were increased. It is hypothesized that cyclosporine withdrawal may have favored the improvement of hemolysis by favoring the suppression of antibody-producing cells.     

Lymphocyte proliferation in neonatally thymectomized rats

Autoradiography has been used to evaluate lymphocyte proliferation in the neonatally thymectomized rat in comparison with the normal animal. The data obained show that the proliferative activity of lymphocytes is greatly increased in the thymus-dependent areas 4–6 weeks after thymectomy, whereas it is normal or slightly increased 3 months laters. It seems plausible to assume that a thymus factor or chalones in situ produced by specific cells normally regulate the proliferation of thymus-derived cells. The increase of the proliferative activity accounts for the repopulation of the thymus-dependent areas, which are completely replenished in the older animals. Recirculation of the thymus cells is not confined to the thymus-dependent areas.     

Toxic megacolon complicating ulcerative colitis and Crohn's disease

The clinical, laboratory and radiological data of 17 cases of toxic megacolon (TM) complicating either ulcerative colitis (UC) or Crohn's disease (CD), referred to the Department of Clinica Chirurgica II of the University of Bologna in a twenty year-period, are reviewed. The surgical strategies and results are compared and discussed, and the mortality and morbidity considered along with the important advances in resuscitative medicine and the employment of total parenteral nutrition (TPN).     

Small cell carcinoma of the lung: is there a place for surgery?

In many cases, surgery is not considered for anaplastic small cell carcinoma even in localized lesions. A review of the literature and the results obtained in our series of 30 patients prompt us to recommend surgery in stage I disease.     

In vitro selection of resistance to clarithromycin in Streptococcus pneumoniae clinical isolates

In this study the effects of exposure to serum, lung and breakpoint concentrations on Streptococcus pneumoniae susceptibility to clarithromycin, azithromycin, amoxicillin/clavulanate, levofloxacin and moxifloxacin were evaluated. Development of resistance was determined by multi-step and single-step methodologies. In the first experimental set, minimum inhibitory concentrations (MICs) were determined after 10 passages on antibiotic-gradient plates and 10 passages on antibiotic-free plates. Acquisition of resistance was defined as an increase of > or = 4-fold from the starting MIC. In single-step studies, the rate of spontaneous mutations was calculated after a passage on antibiotic-containing agar plates. Azithromycin and levofloxacin gave the highest number of strains with MIC increased of at least 4 times the starting value, followed by moxifloxacin and by clarithromycin which only at the lowest concentration tested selected for resistance in 5 strains. Amoxicillin/clavulanate never displayed > or = 4-fold MIC increase. Frequencies of mutation were lower for clarithromycin and moxifloxacin than for the comparators. At lung concentrations clarithromycin had limited potential to select for resistance.     

Onset of inflammatory bowel diseases during combined alpha-interferon and ribavirin therapy for chronic hepatitis C: report of two cases

We report two patients who developed an inflammatory bowel disease (IBD) shortly after beginning combined alpha-interferon and ribavirin treatment for HCV-related chronic hepatitis. The previous clinical history was negative for IBD in both patients, who developed diarrhoea and rectal bleeding 10 days and 6 months, respectively, after the initiation of therapy. The history, therapeutic management and the possible causal relationships of these cases are discussed.