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4. Nota introduttiva

Author

DE VIVO, F

Subjects
Settore L-FIL-LET/15, Dante, scienza, Dante, scienza, architettura, architettura
Published
2021

12. Improved outcome of pulmonary aspergillosis in heart transplant recipients with early diagnosis and itraconazole treatment

Author

UTILI, Riccardo, ZAMPINO, Rosa, DE VIVO F, MAIELLO C, ANDREANA A, MORMONE G, MARRA C, TRIPODI MF, SARNATARO G, CIONE P, CUCCURULLO S, COTRUFO M., Utili, Riccardo, Zampino, Rosa, DE VIVO, F, Maiello, C, Andreana, A, Mormone, G, Marra, C, Tripodi, Mf, Sarnataro, G, Cione, P, Cuccurullo, S, and Cotrufo, M.

Subjects
Adult, Male, Antifungal Agents, Postoperative Complications, Time Factors, Treatment Outcome, Lung Diseases, Fungal, Aspergillosis, Heart Transplantation, Humans, Female, Itraconazole, Middle Aged
Abstract

Pulmonary aspergillosis is a severe complication in heart transplant recipients. The drug of choice for this infection is amphotericin B, but its use is limited because of its side effects. We observed six cases of pulmonary aspergillosis in a group of 200 patients who had received heart transplants from January 1988 to January 1999. Predisposing factors such as previous rejection, neutropenia and/or cytomegalovirus reactivation were present in all patients. The clinical presentation was characterized by fever and a non-productive cough. X-rays showed monolateral or diffuse infiltrate with or without nodular lesions. The median interval between symptoms and diagnosis was 5 d (range 4-7). Diagnosis was made by culturing trans-tracheal aspirate samples. Aspergillus fumigatus was isolated in 3 patients and A. niger in the other 3. All patients were treated with itraconazole at 200-400 mg/day for 20-60 d and all recovered. One patient treated with the lowest dosage for the shortest term had a recurrence after 1 month and needed a second 30-day course of itraconazole at a higher dosage. No significant side effects were registered. Itraconazole is effective in the therapy of pulmonary aspergillosis, particularly when an early diagnosis is made.

Published
2000

14. [Pathology of heart transplantation.(Morphological study of 1246 endomyocardial biopsies from 167 transplanted hearts). Causes of early, intermediate, and late deaths]

Author

AGOZZINO, Lucio, THOMOPOULOS K, ESPOSITO S, AGOZZINO M, DE VIVO F, MAIELLO C, COTRUFO M., Agozzino, Lucio, Thomopoulos, K, Esposito, S, Agozzino, M, DE VIVO, F, Maiello, C, and Cotrufo, M.

Subjects
Cardiomyopathy, Dilated, Graft Rejection, Heart Failure, Male, Comorbidity, Middle Aged, Survival Analysis, Survival Rate, Death, Sudden, Necrosis, Postoperative Complications, Italy, Actuarial Analysis, Cardiovascular Diseases, Recurrence, Cause of Death, Neoplasms, Heart Transplantation, Humans, Female, Endocardium, Follow-Up Studies, Retrospective Studies
Abstract

From January 1988 through October 1997, 167 cardiac transplants were performed. 1246 endomyocardial biopsies (EMBs) from 138 cardiac allograft recipients were investigated and graded according to the Working Formulation (WF) criteria. The specimens were inadequate in 44 EMBs (3.5%), while 598 (48%) showed no rejection. The grade of rejection was: mild (grade 1A and 1B) in 531 EMBs (42.6%), mild/moderate (grade 2) in 38 (3.1%), and moderate (grade 3A and 3B) in 35 (2.8%). The indications for transplantation were: dilated cardiomyopathy (46.1%); ischemic disease (37.1%); valvular disease (12%); hypertrophic cardiomyopathy (1.8%); myocarditis (1.2%); congenital cardiopathy (0.6%), restrictive cardiomyopathy (0.6%) and chronic rejection (0.6%). The most reliable histologic feature of acute rejection was the myocyte necrosis or damage in presence of pironinophilic mononuclear cell infiltrate, so our protocol requires multifocal or diffuse myocyte damage (rejection grade 3A and 3B) to perform an additional treatment, which was required in 35 cases (2.8%). An intermediate grade mild/moderate 2, was introduced from the WF to classify the EMBs in which the myocyte necrosis was scant or not clear; this grade in our series generally resolves without any additional treatment; in order to monitor the rejection another EMB was performed 5 days after in these patients. The EMBs showed also the following lesions other than acute rejection: Quilty A (79 patients; 57.25%), Quilty B (24 pts; 17.39%), early ischemic necrosis (43 pts; 31.15%) and late ischemic necrosis (5 pz; 3.62%). Quilty B and late ischemic necrosis were correlated with acute rejection (grade 2), furthermore the patients with graft vascular disease showed 3 or more episodes of acute rejection. These findings confirm the relationship between acute and chronic rejection. Furthermore, a relationship between chronic rejection (4 pts) and infection from hepatitis C (antibodies positive 3 pts/4) and cytomegalovirus (antibodies positive 4 pts/4) was found in our series. In the follow-up period (117 months), a 30.72% death rate was recorded; the main causes of death were: early failure of the transplanted heart (30 pts) in 4 of them associated with pulmonary hypertension, infections (6 pts), sudden death (4 pts), graft's vasculopathy (4 pts), acute pancreatitis (1 pts) pulmonary embolism (1 pts), lung (1 pts) and ovary (1 pts) carcinoma, acute rejection (1 pts), others (2 pts). In the early period (1 month), the most frequent cause of death was the early failure of the transplanted heart, while in the late period (1 year) the chronic rejection following by sudden death and tumours. The actuarial survival curve drops to 83.13% after the first post-operative month, abates to 75.30 at the end of the first year, and progressively decreases to 70.48% at the end of the fifth follow-up year. The mortality rate was 38.7% in pts transplanted for ischemic disease and 24.7% for dilated cardiomyopathy. Cardioplegia seems to play an important role in the success of the heart transplant.

Published
1999

15. Renal reserve is normal in patients with dilative cardiomyopathy waiting for heart transplantation

Author

FRANGIOSA A, SPITALI L, MOLINO D, CIRILLO E, DE SANTO LS, MARRA C, MAIELLO C, DE VIVO F, PASCALE C, FAVAZZI P, DI LEO VA, DE SANTO NGRELATED ARTICLES, LINKS, ANASTASIO, Pietro, Frangiosa, A, Spitali, L, Molino, D, Cirillo, E, DE SANTO, Luca Salvatore, Marra, C, Maiello, C, DE VIVO, F, Pascale, C, Favazzi, P, Anastasio, Pietro, DI LEO, Va, DE SANTO NGRELATED, Article, and Links

Subjects
Adult, Cardiomyopathy, Dilated, Male, medicine.medical_specialty, Waiting Lists, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Renal function, Class iii, Dilative cardiomyopathy, Body weight, Kidney, Biochemistry, Renal Circulation, Reference Values, Internal medicine, Medicine, Humans, In patient, Heart transplantation, business.industry, food and beverages, Middle Aged, medicine.disease, Heart failure, Red meat, Cardiology, Heart Transplantation, business, Glomerular Filtration Rate
Abstract

Renal reserve was explored by means of an oral protein load (2 g/kg body weight) under the form of cooked red meat in a group of 9 patients with end-stage heart failure (ESHF), class III of the New York Heart Association receiving loop diuretics and angiotensin-converting enzyme (ACE) inhibitors, and in a group of 18 healthy controls (HC) matched for age, gender, and height under an identical dietary regimen providing 40 cal/kg per day, 1 g/kg body weight of protein per day, Na 120 mmol/day, and K 50 mmol/day. Baseline glomerular filtration rate averaged 109.5±9.89 ml/min×1.73 m2 in HC and 71.9±8.8 ml/min×1.73 m2 in ESHF. Renal plasma flow averaged 540±27 ml/min×1.73 m2 in HC and 235±47 ml/min×1.73 m2 in ESHF. The filtration fraction was significantly higher in ESHF (p2 in HC and 27.2±7.12 ml/min×1.73 m2 (not significant). Renal reserve averaged 123.9±2.9% in HC and 137.3±6.68% in ESHF (not significant). The filtration capacity was significantly higher in HC (p

Published
1999

17. Le infezioni batteriche nel paziente con trapianto di cuore

Author

UTILI, Riccardo, ZAMPINO, Rosa, Mormone G, Tripodi MF, Ruggiero G, Cione P, Cuccurullo S, Maiello C, De Vivo F, Marra C, De Santo L, Cotrufo M., Utili, Riccardo, Zampino, Rosa, Mormone, G, Tripodi, Mf, Ruggiero, G, Cione, P, Cuccurullo, S, Maiello, C, De Vivo, F, Marra, C, De Santo, L, and Cotrufo, M.

Published
1999

18. Body impedance studies in end-stage heart failure

Author

STELLATO D, CIRILLO M, DE SANTO LS, CORVINELLI M, MARRA C, DE VIVO F, ANASTASIO, Pietro, FRANGIOSA A, CIRILLO E, COTRUFO M, DE SANTO NG, DI IORIO B., Stellato, D, Cirillo, Massimo, DE SANTO, L, Maiello, C, Marra, C, DE VIVO, F, Anastasio, P, Frangiosa, A, Cotrufo, M, DE SANTO, Ng, DI IORIO, B., Cirillo, M, DE SANTO, Luca Salvatore, Corvinelli, M, Anastasio, Pietro, and Cirillo, E

Subjects
Adult, Intracellular Fluid, Male, medicine.medical_specialty, Ejection fraction, business.industry, Endocrinology, Diabetes and Metabolism, Body water, Cardiac Output, Low, Hemodynamics, Middle Aged, medicine.disease, Biochemistry, Body Water, Reference Values, Male patient, Internal medicine, Heart failure, Electric Impedance, Cardiology, medicine, Humans, End stage heart failure, Extracellular Space, business
Abstract

This study adds another category of patients to those amenable to body impedance analysis (BIA). BIA measurements were obtained for the first time in 23 male patients with end-stage heart failure who were waiting for heart transplantation, and the data were compared with those obtained in 69 healthy controls matched for age, sex, height and weight. The data indicate that in end-stage heart failure there is an increased reactance (p

Published
1999

31. Le infezioni nel cardiotrapiantato: esperienza del centro napoletano

Author

UTILI, Riccardo, ADINOLFI, Luigi Elio, Dilillo M, Ruggiero G, Cotrufo M, De Vivo F, Cione P, De Luca L, Cuccurullo S, Di Nicuolo G., MARRONE, Aldo, Utili, Riccardo, Adinolfi, Luigi Elio, Dilillo, M, Marrone, Aldo, Ruggiero, G, Cotrufo, M, De Vivo, F, Cione, P, De Luca, L, Cuccurullo, S, and Di Nicuolo, G.

Published
1991

44. Complicanze infettive in pazienti sottoposti a trapianto di cuore

Author

UTILI, Riccardo, Ruggiero G, ADINOLFI, Luigi Elio, Dilillo M, De Vivo F, De Luca L, Cerasuolo F, Cotrufo M, Cione P, Cuccurullo S, Corsi G, Di Nicuolo G., MARRONE, Aldo, Utili, Riccardo, Ruggiero, G, Adinolfi, Luigi Elio, Dilillo, M, Marrone, Aldo, De Vivo, F, De Luca, L, Cerasuolo, F, Cotrufo, M, Cione, P, Cuccurullo, S, Corsi, G, and Di Nicuolo, G.

Published
1989

45. Indicazioni chirurgiche nella cardiopatia ischemica

Author

Cotrufo M, Accarino GC, De Vivo F, Caianiello G, Piazza L, d'Angelo A., SANTE', Pasquale, Cotrufo, M, Sante', Pasquale, Accarino, Gc, De Vivo, F, Caianiello, G, Piazza, L, and D'Angelo, A.

Published
1979

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