Search PubMed⌕ Search

Biomedical subjects

A Durante

Publications and source records attributed to A Durante.

At least 19 recordsLinked to original sources
PubMed1998

Clinical predictors of Pneumocystis carinii pneumonia, bacterial pneumonia and tuberculosis in HIV-infected patients.

BACKGROUND: Clinicians are frequently faced with the differential diagnosis between Pneumocystis carinii pneumonia (PCP), bacterial pneumonia, and pulmonary tuberculosis in HIV-infected patients. OBJECTIVES: To identify features that could help differentiate these three pneumonia types at presentation by evaluating the clinical characteristics of the three diagnoses among patients at two urban teaching hospitals. DESIGN: Retrospective chart review. METHODS: Cases were HIV-infected patients with a verified hospital discharge diagnosis of PCP (n = 99), bacterial pneumonia (n = 94), or tuberculosis (n = 36). Admitting notes were reviewed in a standardized manner; univariate and multivariate analyses were used to determine clinical predictors of each diagnosis. RESULTS: Combinations of variables with the highest sensitivity, specificity, and odds ratios (OR) were as follows: for PCP, exertional dyspnea plus interstitial infiltrate (sensitivity 58%, specificity 92%; OR, 16.3); for bacterial pneumonia, lobar infiltrate plus fever < or = 7 days duration (sensitivity 48%, specificity 94%; OR, 14.6); and for tuberculosis, cough > 7 days plus night sweats (sensitivity 33%, specificity 86%; OR, 3.1). On regression analysis, independent predictors included interstitial infiltrate (OR, 10.2), exertional dyspnea (OR, 4.9), and oral thrush (OR, 2.9) for PCP; rhonchi on examination (OR, 12.4), a chart mention of 'toxic' appearance (OR, 9.1), fever < or = 7 days (OR, 6.6), and lobar infiltrate (OR, 5.8) for bacterial pneumonia; and cavitary infiltrate (OR, 21.1), fever > 7 days (OR, 3.9), and weight loss (OR, 3.6) for tuberculosis. CONCLUSIONS: Simple clinical variables, all readily available at the time of hospital admission, can help to differentiate these common pneumonia syndromes in HIV-infected patients. These findings can help to inform clinical decision-making regarding choice of therapy, use of invasive diagnostic procedures, and need for respiratory isolation.

AIDS-Related Opportunistic Infections↗
PubMed1994

Electroretinographic findings in congenital oculomotor apraxia (Cogan's syndrome).

We performed visual evoked potential testing and electroretinography in five patients with Cogan's oculomotor apraxia. The visual evoked potentials were normal, confirming previously reported data. Electroretinograms were abnormal in two of the five patients examined. A previous study showed normal electroretinogram responses bilaterally in one patient. Our findings suggest the existence of two variants of the syndrome; the one with electroretinogram anomalies has a worse visual prognosis.

Apraxias↗
PubMed1994

Single-sweep analysis using an autoregressive with exogenous input (ARX) model.

Single-sweep visual evoked potential analysis would be useful in clinical electrophysiology practice because it would make possible the evaluation of transient phenomena, but recording single-sweep visual evoked potentials is difficult because of the low signal-noise ratio. To increase this ratio we used a filter based on an autoregressive with exogenous input model. We studied a group of 12 diabetic patients matched with a control group of 14 normal subjects. The model, in most cases, allowed us to extrapolate the P100 component from each single sweep of visual evoked potential. The visual evoked potential values obtained by means of averaging were not significantly different in the groups studied, but single-sweep analysis showed different distribution of the P100 component amplitude. The preliminary results of our study evidenced differences in the amplitude and latency distribution of normal and diabetic subjects, thus confirming the power of this new technique and its ability to obtain some information that is masked by the averaging method.

Adult↗
PubMed1994

Assessment of visual contrast sensitivity in hyperbaric oxygen.

Hyperbaric oxygen therapy is used in ophthalmology in ischemic pathologies of the anterior and posterior segments. Our experiment was done on a healthy group of volunteers aged between 10 and 50 yr. We examined the subject's vision before and after acute HBO exposure (60 min at 2.5 atm abs with pure oxygen) to verify whether vasoconstriction induced by hyperoxemia can influence eyesight. We measured the psychophysical determination of the threshold contrast according to Maione-Maffei's zebra test. The results demonstrated that contrast sensitivity is significantly improved for almost all the studied frequencies in normal subjects after acute HBO exposure. We hypothesize that the visual system has a reserve which is activated by an improvement of retinal oxygenation.

Adolescent↗
PubMed1977

The prognostic value of some clinical and histological parameters in membranoproliferative glomerulonephritis (MPGN): report of 112 cases.

112 cases of MPGN, whose diagnosis was made on light microscopy, were reviewed. Histological examination showed 66 cases of 'classical' MPGN, 33 of MPGN with a lobular pattern and 13 of MPGN with epithelial crescents. In 11 patients dense intramembranous deposits were observed. On immunofluorescence (95 cases) 62 patients showed deposits of C3 together with immunoglobulins, 20 had a predominant deposition of C3 and in 13 C3 alone was present. At the moment of biopsy 57 patients had nephrotic syndrome, 43 hypertension, 43 impaired renal function and 65 hypocomplementaemia. In 23 cases, one or more episodes of macroscopic haematuria occurred. The actuarial survival was 70% after 10 years and 50% after 20 years from onset. At last observation 25 patients were dead or on haemodialysis, 22 had impaired renal function, 62 had normal renal function and 2 were in complete remission. The histological variety with epithelial crescents had a significantly worse outcome. The presence of dense deposits or of any specific immunofluorescence pattern had no prognostic significance. Nephrotic syndrome, renal function impairment and hypertension indicated a poor prognosis: however, macroscopic hamaturia or hypocomplementaemia did not influence the outcome.

Adolescent↗
PubMed1977

Long term follow up of IgA mesangial deposits glomerulonephritis.

The clinical course of IgA Mesangial Deposits Glomerulonephritis (MDGN) has been investigated in 178 patients for 1 to 32 years (mean 6 years) from the onset of symptoms. Impairment of renal function occurred in 28 patients, 13 of whom required RDT or died in uraemia. Hypertension was observed in 67 patients. The actuarial survival rate at ten years was 91%. A significant correlation was observed between the occurrence of renal failure and the following features: absence of episodes of gross haematuria, early appearance of hypertension, marked proteinuria and sclerosing glomerular lesions. These data suggest that IgA MDGN has generally a very prolonged course, but in a few cases may evolve, sometimes early, to chronic renal failure.

Adolescent↗
PubMed1976

Immunofluorescence patterns in chronic membranoproliferative glomerulonephritis (MPGN).

90 patients, whose renal biopsies showed on light microscopy a pattern of MPGN, have been studied by immunofluorescence. 10 cases showed dense intramembranous deposits. Fluoresceinated antisera against IgG, IgA, IgM, C3, fibrinogen, IgD, IgE, C4, C1q, properdin and C3A were employed. Granular depostis of C3 were observed in all cases; IgG, IgM, properdin, C1q and C4 were found in 2/3 cases; IgA, IgE and C3A were rarely found. The localization of these deposits was parietal and often also mesangial. On the basis of glomerular deposition of C3 with or without immunoglobulins (Ig), we separated the cases into three groups: 1) C3 + Ig (59 cases), 2) predominant C3 (19 cases), 3) isolated C3 (12 cases). Most patients with dense deposits disease were classified in the third group. Deposits of C1q and C4 were found only in the first two groups. The localization of C3 deposits showed a more frequent mesangial extension in the second and third groups. Patients in these 3 groups also had different serum complement profiles. No significant differences in the major clinical features could be found in the 3 groups. Variable immunofluorescence patterns, in agreement with other serological parameters, confirm the heterogeneity of pathogenetic mechanisms in patients with MPGN.

Complement C1↗
PubMed1976

Serum and glomerular complement in 205 cases of glomerulonephritis.

In 205 cases of GN the glomerular deposits of C3, C1q, C4, and C3A and the serum levels of the same complement components at the time of biopsy were studied. Alterations of serum complement profile were found only in acute GN, membranoproliferative GN and lupus nephritis, while glomerular deposition was observed with a different incidence and intensity in all nephropathies. A strict correlation between the intensity of deposits and the degree of hypocomplementaemia was found only in early acute GN and in active lupus nephritis.

Complement C1↗
PubMed1976

Acute renal failure due to rifampicin (R-ARF).

Five episodes of acute renal failure due to rifampicin (R-ARF) were observed in four patients and the clinical and histological data were compared with the records of 52 episodes reported in the literature. The bulk of data supports the assumption that the by far most frequent renal injury responsible for R-ARF is acute tubular necrosis produced by a vasomotor mechanism. Nevertheless a few data, above all immunohistological findings, suggest the local presence of allergic process. It may be, that the development of an immunological renal lesion is prevented or blunted by the consequences of vasomotor effects.

Acute Kidney Injury↗
PubMed1975

Complement deposition in glomerular diseases.

Biopsies from 400 patients affected by glomerular diseases, both "primary" and secondary to systemic diseases, have been studied by immunofluorescence. Staining was performed for immunoglobulins fibrogen and C1q, C4, C3 and C3A. C1q, C4 and C3 were positive in a high percentage of cases in focal glomerulosclerosis, membranoproliferative glomerulonephritis, lupus nephritis and essential cryoglobulinaemia glomerulonephritis. C1q and C4 were very rarely present in focal proliferative glomerulonephritis and rheumatoid purpura glomerulonephritis. C3A was found frequently only in acute glomerulonephritis. Results are discussed with reference to their diagnostic value and to information about mechanisms of complement activation.

Complement C1↗
PubMed1975

Drug induced hypersensitivity nephritis.

Drug-induced hypersensitivity nephritis may show several histological and clinical patterns. In most of these microscopic vascular involvement of the kidney seems to be very frequent. On immunofluorescence, deposits of C3 in mesangium and in arterioles were observed in almost all cases, independently of histological features on light microscopy. The pointing out of clinico-histological relationship seems to be the best rational approach to diagnosis of these conditions.

Adult↗
PubMedDate not supplied

Serum anti-p53 antibodies in lung cancer: comparison with established tumor markers.

As reported earlier, p53 antibodies are detected in the sera of patients with different types of cancer, including lung cancer. In contrast, in the serum of healthy subjects the presence of anti-p53 antibodies is extremely rare. We collected the venous blood samples of 109 patients affected with lung cancer (LC): 57 patients (46 M, 11 F) with non-small-cell carcinoma (NSCLC), 52 others (40 M, 12 F) with small-cell carcinoma (SCLC). Serum p53 antibodies were assayed using ELISA method and all positive sera were confirmed by Western-blot method. In addition, using IRMA methods we assayed serum CEA, TPA, CYFRA21-1 and NSE. Serum p53Ab are detectable (p53Ab-positive) in 35/109 (32.1%) patients with lung cancer. About 17/57 (29.8%) patients affected with NSCLC and 18/52 (34.6%) with SCLC were p53Ab-positive. CEA, TPA, CYFRA21-1 and NSE sensitivity in LC patients (NSCLC+SCLC) is 50.5%, 58.7%, 42.2%, 35.8%, respectively. The lower sensitivity (32.1%) of serum p53Ab is connected with the higher specificity and diagnostic accuracy (100% and 69%, respectively). Out of 35 patients p53Ab-positive, five (14.3%) exhibit only serum p53Ab, while serum values of the established tumor markers were lower than cut-off. Serum p53Ab assessment is a simple and a low-cost assay with a good specificity and diagnostic accuracy that in LC patients can be used at least in association with established tumor markers.

Aged↗
PubMedDate not supplied

Serum concentration of free T3, free T4 and TSH in healthy children.

OBJECTIVE: It is rare that manufacturers report age-related FT3, FT4 and TSH normal ranges in healthy children. STUDY DESIGN: Using a solid phase time-resolved fluoroimmunometric method, we determined serum FT3, FT4 and TSH in 3,360 healthy children, age 2-16 years, that we grouped into two age ranges (2-7 yr and 9-16 yr). RESULTS: Boys' and girls' mean serum thyroid hormone values substantially overlap in all age groups. In the age range 2-7 yr, FT3, FT4 and TSH values were 0.10-0.67 ng/dl (mean 0.37 ng/dl), range 0.45-2.29 ng/dl (mean 1.18 ng/dl) and 0.10-5.9 microU/ml (mean 2.2 microU/ml), respectively. In the age range 9-16 yr, FT3, FT4 and TSH values were 0.11-0.53 ng/dl (mean 0.35 ng/dl), 0.69-1.69 ng/dl (mean 1.07 ng/dl) and 0.20-6.1 microU/ml (mean 2.3 pU/ml), respectively. CONCLUSION: Our results represent a useful set of reference values in children and can help physicians in the management of thyroid diseases.

Adolescent↗