[Colonic polypectomy--late results].
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Biomedical subjects
Publications and source records attributed to A Bonetti.
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As part of some research into certain aspects of glycolipidic metabolism in chronic renal insufficiency, a study has been made of alterations in glycaemia, insulinaemia, free fatty acids and triglycerides during and following brief periods of dialysis by glucose-free bath in 26 subjects: within this group, 50 g of glucose were administered to 8 patients at the 2nd hour of dialysis and 100 g to another 8 at the end of therapy. The following findings were made during glucose-free dialysis: marked hypoglycaemia starting from the first hour until the end, marked increase in FFA and marked fall in TG upon the lipolytic action of heparin. In the post-dialysis period, immediate normalization in glycaemia, steady diminution in FFA and notable increase in TG as early as the 1st hour. Administration of glucose during dialysis prevents hypoglycaemia by altering FFA and TG behaviour in the post-dialysis period. Administration of glucose at the end leads to hyperglycaemia and hyperinsulinaemia with marked fall in FFA and TG. During dialysis, the phenomena observed depend on the action of heparin, acetate and the absence of glucose. This absence brings on hypoglycaemia with secondary glycogenolysis and-or neoglucogenesis during dialysis; in the post-dialysis period, hepatic neosynthesis of TG in the presence of normal glycaemic and insulinaemic values. Glucose per os determines hyperglycaemia and secondary hyperinsulinaemia with FFA esterification at the level of adipose tissue and a fall in serous TG.
Referring to the results of a "pilot" nutritional investigation carried out in a representative mixed sample of a small community of Parma district (Langhirano), the AA. underline the clinical and metabolic implications resulting from the not quite correct nutritional behaviour observed. In fact, in agreement with the national average data reported for italian population from ISTAT, caloric excess, particularly of dietary fat and proteins, was confirmed in this community too. Nevertheless, want of vitamins (D, B1, B2), and minerals (Ca) was paradoxically found. Considering in detail the results some immediate clinical and metabolic consequences come out: namely, want of Ca is prevailing in women and just in the critical age classes (20-40 and 50-59 years, that is in fertile and climacteric ages). When the recommended intake levels are higher. Ferthermore in male-populations, in the class aged 30-50 (that is more vulnerable as to atherosclerosis), was found the highest caloric intake besides in fat and particularly in cholesterol, as to the recommended safety levels. The A.A. conclude pointing out the importance and the necessity of a nutritional notions wide spreading, involving the various responsible public health and social politic organisation of the Country.
Report on a patient with osteomalacia due to renal phosphate loss. At onset the patient was aged 43 years. No other tubular defects were detected except glycinuria. The patient was followed over a period of 12 years. 3 years after treatment with oral phosphate and vitamin D3 persistent hypercalcemia developed with highly elevated levels of parathyroid hormone. After removal of one enlarged parathyroid gland serum calcium normalized, but elevated parathyroid hormone levels still persist. The spontaneous occurrence of hypophosphatemic osteomalacia in an adult male and its connections with the development of hyperparathyroidism are discussed.
Ten patients with progressive CRF were studied for the major indices of glycolipid metabolism during the first application of peritoneal dialysis. From the 2nd hour the concentration of dialysis fluid is 4.5g%, while the electrolyte content is unchanged. During treatment a constant increase of glycemia and insulinemia with a fall of plasma-free fatty acids and serum triglycerides was observed. The authors attribute such modifications to hyperglycemia and consequently to the high glucose of the dialysis bath.
The main indices of glycolipid metabolism were examined during and after dialysis in 11 patients receiving chronic treatment. Each dialysis period lasted 3-4 hr and was carried out on alternate days with individual machines and Coil UF2, Coil UF100 and Dasco SP75 dialysers. The liquid contained 35 mEq/l sodium acetate and 2 g glucose and flowed at 500 cc/min. Heparin was injected in the arterial line in a single initial dose. During treatment, there was an increase in free fatty acids and a decrease in serum triglycerides. Blood sugar and insulin were unchanged. The first 4 hr after treatment were marked by decreased fatty acid and increased trigylceride values. Blood sugar and insulin were again constant. The part played by sodium acetate and heparin in these changes is discussed.
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Micellar electrokinetic capillary chromatography (MECC) was applied to the determination of water-soluble vitamins (WSV) in pharmaceutical preparations. The analytical procedure employed in the WSV separation by MECC showed a satisfactory average column efficiency (195,000 N) and resolution (more than 100 theoretical peaks separable). The mean reproducibility in the retention time of consecutive and day-to-day runs was 1.1% and 5.1%, respectively. Analyses were performed after extraction of active ingredients by solid phase extraction. Recoveries (92-103%) and relative variation coefficients (less than 5%) confirmed the potential of MECC in the field of pharmaceutical analysis.
The antiretroviral activity, tolerance and toxicity of two different antiviral drug combinations were assessed and compared in a randomized, crossover pilot study in 16 HIV-1 p24 antigenaemic subjects with asymptomatic HIV infection. Oral zidovudine 250 mg twice daily was combined with either oral acyclovir 800 mg twice daily or lymphoblastoid interferon-alpha 1.5 x 10(6) IU administered subcutaneously three times weekly. The 12-week treatment period was followed by a 4-week washout period and a further 12-week crossover phase. During the entire treatment period a decline in p24 antigen was observed in all patients. No significant differences were found between the two treatment regimens. No patient showed clinical progression of HIV infection. Three patients were withdrawn from the study, one due to serious anaemia and two due to severe clinical adverse events. Long-term efficacy and tolerance data in asymptomatic HIV-infected patients with these regimens would be valuable.
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