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Biomedical subjects

A Guerra

Publications and source records attributed to A Guerra.

143 records · Page 8Linked to original sources
PubMedDate not supplied

[Medical and dietetic management of congenital and inherited nephropathies (author's transl)].

The management of the congenital and inherited nephropathies is, still today, almost exclusively symptomatic. The authors relate the most important drugs and the dose used for the principal complications of these nephropathies: hypertension, hypo-dysprotidoemia, oedema, anemia, metabolic acidosis, polyuria, hypoevolutism, recurrent urinary infections. Particular care must be taken in order to provide an adequate caloric-protein allowance principally when the renal insufficiency is reached.

Acidosis, Renal Tubular↗
PubMedDate not supplied

[Arterial hypertension in childhood. Study of a school population].

Most Authors fix the upper limits of normal blood pressure at 90 degrees percentile according to age. Nevertheless in their investigations different instruments were used and they often didn't relate in detail the position of the subject during the measurement. Other factors, influencing blood pressure values, have been often left out: relation with meals, room temperature, pain, drugs, stress, etc. The prevalence of hypertension in pediatric age in literature is 0,6 - 12,4% with several intermediate values. The first very important research concerning the hypertension in pediatric age was carried out by Londe et Coll., conducted among 1593 children (785 males and 798 females); they estimated mean values and percentiles according to age and sex. In the present study the A.A. saw 346 children (161 females and 185 males), 11-15 years old, observed at school, in a comfortable room. Pressure measurement was done twice in the same morning with half an our interval. Systolic pressure, 4 degrees and 5 degrees Korotkoff tones, was noticed. 11% of the children had systolic pressure values under 50 degrees percentile, 35,3% between 50 degrees and 90 degrees percentile and 43,1% had values equal or greater than 90 degrees percentile at the first measurement. The third group went down to 30,6% (106 cases) at the control (after an half an hour). This reduction shows the importance of the emotional factors in the P.A. variations. The 106 children who had systolic and/or diastolic values equal or greater than 90 degrees percentile were controlled again after a week. 92 maintained the same values. They were called for the third sitting 1-6 months later. 45 subjects agreed to our invitation and it was possible to point out that high blood pressure values persisted in 31 children (that is 8,9% of all examined cases). Following correlations were observed: body weight-blood pressure values (either systolic or diastolic ones) and so cutaneous plica-pressure values (p less than 0,01); moreover 50% of the 31 hypertensive children had hypertensive parents; the most frequent subjective symptom (13 cases) was cephalalgia. None of the studied school children showed either clinic or biochemical abnormal data, so that it was possible to define their hypertension as "essential".

Adolescent↗
PubMedDate not supplied

[A thymus extract (thymomodulin) in the prevention of childhood asthma].

41 children aged 2-12 years affected with bronchial asthma, have been treated orally with a thymus extract for three months (sep.-oct.-nov. 1980); a further period of treatment has been repeated during the month of March 1981. The following immunologic tests have been performed before therapy, 2 months after therapy withdrawal and 12 months after the second therapeutical discontinuance: plasmatic immunoglobulins (P. Ig), C3-C4 complement's factors, E-rosette forming cells (both active and total), surface immunoglobulins (IgS), PHA lymphocyte stimulation. Periodic anamnestic and clinical controls of patients revealed a significant reduction of asthmatic attacks during the months of observation, in comparison with the crises remarked in the same period of the previous year (the mean number of crises per child being 6 and 0.7 respectively before and after treatment, P less than 0.001). The immunologic tests, despite the clinical results, did not show significant modifications at the 1st control. Nevertheless the control carried out 12 months after the second therapeutical withdrawal demonstrated: IgG and IgM plasmatic levels significantly increased (1097 +/- 63 vs 906 +/- 45 and 122 +/- 10 vs 104 +/- 10 respectively, P less than 0.02) while IgE, C3-C4 plasmatic levels significantly decreased (232 +/- 57 vs 396 +/- 71, 132 +/- 6 vs 162 +/- 7, 22 +/- 2 vs 30 +/- 2 respectively, P less than 0.005). No side effects have been seen in all the patients treated.

Asthma↗
PubMedDate not supplied

[Is it possible to improve the prognosis of congenital nephrosis?].

Two cases of congenital nephrotic syndrome (C.N.S.) with a prolonged survival are related. The AA. outline some clinical and immunological features which are already known but not currently employed to therapeutic ends. Probably due to metabolic disorders, the biological and clinical hypothyroidism is a prominent problem which worsens either poor skeleton maturation or neurological development of these patients; adequate doses of thyroid hormone produced a marked increase of the muscular tone, skeleton maturation and neuropsychological development in both patients. Periodic plasma administration (2-3 times monthly) during the first year of life, and a great care to avoid all extra-family contacts and infections in the same period, resulted to be the prevalent reason of the prolonged survival of these children (the plasma acting as a source of proteins and immunoglobulins). The immunologic assessment demonstrated in both children as marked depression of T-cells number and function, besides a hypogammaglobulinemia. This aspect of the immunocompetent system is similar in C.N.S. and nephrotic syndrome of the aged children and perhaps could approach the pathogenesis of the two diseases. The cases related demonstrate that a better assistance is possible and necessary in order to obtain the longest survival of these patients and therefore the best results in dialitic treatment and in transplantation programs.

Adrenal Cortex Hormones↗
PubMedDate not supplied

[Asymptomatic microhematuria].

Microscopic haematuria is an urinary finding more and more frequently observed in routine analysis in childhood; the diagnostic problems, most of which unresolved, are yet the principal questions of concern. We have studied 123 patients during five years from 1975 to 1980, and followed them for 1-8 years (mean 4 years). Our experience allowed us to consider "normal" or without remarkable pathologic significance a urinary finding less than or equal to 5.000 RBC/m' at the Addis count. Such findings were pointed out in 55 cases (44%); 27 patients (22%) had 5-10.000 RBC/m', 34 cases (27,6%) presented 10-50.000 RBC/m' and 7 cases (5,7%) had more then 50.000 RBC/m'. The familiar background, the clinical, biological and immunological data, the roentgenographic investigations and the renal biopsy carried out in the 4 groups of patients, led us to the following conclusions: 1) 26% of the 123 cases had a "unexplained;; microscopic haematuria with complete lack of anamnestic data, symptomatology and with normal biological findings. 2) in 65,8% of the cases it was possible to discover frequent upper respiratory tract infections (and allergy in 5,6% of them). 3) in 26% of the patients we discovered a previous or actual genito-urinary (10,5% and 15,5% respectively) infection: 9,4% of 96 urography demonstrated a variable degree of nephro-urological abnormalities. 4) 23 children (18,7%) was selected for renal biopsy, primarily by the hypocomplementemia and positive anti-DNA ab. test, and secondly by elevated degree of microhematuria. The histological and immunohistochemical studies demonstrated the presence of mesangial proliferation glomerulonephritis with IgG-IgA-C3 deposits in 7 cases (30% of the cases biopsied and 5,6% of the total), 69,6% of the cases had only minimal charges with negative immunofluorescence. 5) A mean follow-up of 4 years in two groups of patients (less than or greater than 6 years of age) has demonstrated that microscopic haematuria remains unchanged in 18-19% of both groups. A more marked improvement or normalization has been documented in the children more than 6 years aged (p less than 0,001) while a worsening has been observed in the children less than 6 years aged (p less than 0,005), with a statistically significant difference between the two groups considered.

Adolescent↗
PubMedDate not supplied

[Study of factors affecting the renin-angiotensin-aldosterone system in the premature infant].

Renin-angiotensin-aldosterone system (RAA), Na-K dietary intake and Na-K urinary excretion in 36 premature babies have been investigated. The plasmatic renin activity (PRA) and plasmatic aldosterone level (P-aldo) resulted significantly increased in comparison with children previously studied, 20 days - 23 months old (p less than 0,01). P-aldo demonstrated, in premature babies, a negative correlation with Na-K intake and urinary excretion (p less than 0,001 and less than 0,01 respectively); in the groups nourished with maternal milk or "adapted" formulae P-aldo mean value was significantly more elevated than in the group nourished with formulae "unadapted" (p less than 0,01). A different Na dietary intake seems to be the most important factor influencing P-aldo level also in premature babies. No correlation between PRA - electrolyte excretion was found in any group. The main factor influencing PRA seems to be the age of infants as well as, probably, other hemodynamic mechanisms.

Humans↗
PubMedDate not supplied

[Diagnostic and therapeutic problems in lupus nephritis].

A review of the SLE in the paediatric age in performed to underline the peculiarity of the disease in children: age, frequency, symptomatology, renal histology, clinical course, therapy and correlated side effects are reported according to literature data. The A.A. describe six cases of lupus nephritis, observed in the last few years, which confirm the diagnostic difficulties and the wide variety in the evolution of the disease. A favourable course of the disease was obtained in three cases, with corticosteroid and immuno-depressive treatment (used in association and/or alternatively); a fourth case developed some therapeutic complications among which an avascular bilateral bone necrosis, leucopenia, alopecia and herpes zoster. In two cases the SLE led to chronic renal failure owing to many relapses of the disease, enhanced by therapeutic break or dosage reduction. A careful surveillance of these patients is of fundamental importance in the management of the disease in order to obtain the longer survival and the lesser side effects.

Adolescent↗
PubMedDate not supplied

[Correlation between plasma IgE and IgA in infant nephrosis and nephrotic syndrome].

A study on IgE - IgA plasmatic level has been carried out in the acute phase and in remission of minimal changes nephrosis (MCN) and in glomerulonephritis with nephrotic syndrome (NS). The results obtained are the following: 1) Mean values of Ig classes were impaired in comparison with the normal values of children of the same age, both in MCN and in NS. 2) IgE were increased, particularly in children over 6 years in the MCN acute phase; the values decreased within normal after the remission was achieved. 3) IgA, on the contrary, were decreased in the subjects over 6 years, in the MCN acute phase. 4) No significant correlation was found between the two Ig classes. 5) The modifications of the Ig plasmatic level during the remission, after corticosteroid therapy was characterized by IgE reduction; IgA were only slightly, but not significantly, decreased in the same phase.

Acute Disease↗
PubMedDate not supplied

Medial fractures of the femoral neck in the elderly treated by SEM bipolar prosthesis.

The authors present 335 cases of medical fracture of the femoral neck in the elderly patient (mean age 80.5 years) treated by SEM type bipolar prosthesis. A total of 93 patients (28.3%) were followed-up for a total of 98 hips submitted to surgery (5 bilateral) after a mean period of 42 months, minimum 12 months, maximum 96. Clinical follow-up included these parameters: pain, movement, walking, according to Merle D'Aubigné. Radiographic follow-up consisted in standard views and maximum adduction and abduction. Pain was present in 49% of cases, although it did not significantly invalidate movement (quotients 6 and 5 in 96% of cases); in 60% of the cases there were problems with walking mostly due to the general conditions of the patient. Wear phenomena in the acetabulum were present in 32 hips (32.6%) with no correlation with clinical data. Dynamic x-rays showed that only 31% of the implants maintained intraprosthetic movement. What emerges from the study is the importance of adequate measurement of the prosthetic cupola to improve acetabular fit.

Aged↗
PubMedDate not supplied

Specific antibiotic therapy by needle-aspiration for the treatment of osteomyelitis of the pubis. A description of two clinical cases.

The authors describe two cases of osteomyelitis of the pubis, that exemplify the difficulty of differential diagnosis, as symptoms at the onset are "masked" by previous urologic pathologies (aspecific acute epididymitis and, respectively, urethritis cystica in the sequelae of radical prostatectomy). The x-ray findings for osteolysis make a local biopsy necessary; the lesion may in fact, be mistaken for a neoplasm, particularly in patients who have previously been submitted to pelvic visceral surgery for the treatment of tumor. The needle-aspiration procedure and the execution of a cultural examination, in addition to a cytological one, provide unmistakeable data for diagnosis and treatment.

Anti-Bacterial Agents↗
PubMedDate not supplied

Human herpesvirus-7 DNA in cerebrospinal fluid.

An infection by HHV-7 with presence of virus DNA in the spinal fluid was ascertained in a twenty five month old boy with an epileptic syndrome shortly after birth. The child was frequently admitted to hospital due to his basal disease and frequent bacterial infections. In the occasion of one of these hospital admissions for bacterial infections in conjunctiva, spleen and a lung, virological investigations were also carried out disclosing the presence of HHV-7 DNA in a sample of spinal fluid and of serum and the absence of DNAs from the other herpesviruses. The patient's monitoring for HHV-7 showed the presence of HHV-7 DNA in a sample of serum and in various samples of peripheral blood lymphocytes and saliva, but not in the cerebrospinal fluid sample successive to that positive for HHV-7 DNA. Forty seven days before the diagnosis of HHV-7 infection, the patient received a human gamma-globulin therapy which obscured the humoral response mounted against the virus by the host, so, whether the HHV-7 presence in the central nervous system was associated with a primary or a reactivated infection remained uncertain. The absence of detectable HHV-7 serum IgM antibody, however, suggests the HHV-7 DNA finding on the occasion of a virus reactivation rather than a primary infection. The virological data suggest that HHV-7 may have possibly reached the central nervous system in the course of a viremia. The absence of HHV-6 and HHV-7 antibodies, present in the patient's serum at a high level, support the integrity of the blood-brain barrier. A possible pathogenetic role of HHV-7 in the child's disease seems unlikely, since the epileptic syndrome was pre-existing.

Antibodies, Viral↗