[Sepsis and peritonitis caused by Salmonella typhimurium in a patient splenectomized for pancytopenia].
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Aged↗
Biomedical subjects
A Lechi
Publications and source records attributed to A Lechi.
[Results of the use of a new aminoglycoside antibiotic, sisomicin, in gram negative bacterial respiratory infections].
Clinical efficacy of a new aminoglycoside antibiotic, sisomicin, was evaluated in 14 patients with acute chest infections (12 cases with pneumonia and 2 with bronchitis). They were selected taking into account the isolation of sisomicin-sensitive Gram-negative bacilli in a sputum specimen collected prior to therapy. Local predisposing factors were present in 4 patients whereas general predisposing factors were present in 4 patients whereas general predisposing factors were recognizable in 9. Klebsiella was isolated in 5 cases, E. coli in 5 cases, Proteus in 4 cases, P. aeruginosa in 2 cases, Ct-trobacter and Providencia each in one. In all patients the bacteriological finding was negative after the cycle of therapy; clinical outcome was uniformly favourable (11 patients healed, 3 got better). No significant adverse effects due to the antibiotic was noted.
Adult↗
Multicentre comparative trial of tienilic acid and hydrochlorothiazide in hypertensive patients.
To compare the clinical and metabolic effects of a new diuretic uricosuric agent, tienilic acid, with those of hydrochlorothiazide, a multicentre double-blind trial was performed in 56 hypertensive patients. Twenty-eight patients were randomly assigned to take tienilic acid and 28 to take hydrochlorothiazide. The diuretic and anti-hypertensive actions of the two compounds were similar. No significant differences were observed between tienilic acid and hydrochlorothiazide in their effects on urinary and serum electrolytes, hepatic and renal function tests, and fasting lipids. The patients who received tienilic acid showed a significant fall in serum uric acid, mediated by the uricosuric effect. The availability of an agent combining diuretic, antihypertensive and hypouricemic effects offers promise in the treatment of arterial hypertension.
Adolescent↗
An evaluation of tienilic acid, a new diuretic uricosuric agent, in the therapy of arterial hypertension.
1. Tienilic acid and hydrochlorothiazide were evaluated in a double-blind trial in order to investigate their antihypertensive and metabolic effects. 2. After 5 weeks, the decreases in blood pressure and the changes in plasma or serum electrolytes, urea, creatinine, glucose, cholesterol and triglycerides, and in creatinine clearance, did not differ in the two groups of patients. 3. In patients taking tienilic acid a significant decrease in serum uric acid and an increase in urate clearance was observed, whereas in patients receiving hydrochlorothiazide a slight increase in serum uric acid, with no modification of urate clearance, occurred. 4. The diuretic and antihypertensive actions of tienilic acid and hydrochlorothiazide are very similar. The uricosuric/hypouricaemic effect of tienilic acid could assume clinical relevance in long-term therapy of hypertensive patients.
Adolescent↗
Orthochromatic leukodystrophy with pigmented glial cells. An adult case with clinical-anatomical study.
The case history is reported of a woman who died at the age of 36, at the conclusion of 11 years progressive neurological and psychiatric symptomatology. The anatomical and histological examination demonstrated an orthochromatic leukodystrophy with pigmented glial cells. Attention is drawn to the difficulty of finding these cells, which serve to differentiate between the unusual and the "simple" form of the disease. In the reported patient the pigmented cells were found around the vessels and only in specific cerebral locations. It is emphasized that the form is extremely rare (this is the tenth case so far reported). The significance of whether the iron content should be considered as an incidental or necessary finding is discussed. Systematic research for pigmented casts of this kind is taken to be important for all brains presenting a diffuse sclerosis after a protracted clinical course, mainly in adult patients.
Adult↗
Fabry's disease with familial lymphedema of the lower limbs. Case report and family study.
The case of a 49-year-old man with Fabry's disease (FD), confirmed by histopathological findings of kidney and skin biopsies and enzymatic studies, is reported. Clinical symptoms mainly consisted in severe neurological involvement, and in conspicuous lymphedema of the lower limbs. Two decreased brothers of the patient were also affected with symptons strongly suggesting FD, as well as the lymphedema of the lower limbs. On the basis of these data, the association of FD with familial lymphedema of the lower limbs is discussed: a lipid accumulation in the lymphatic as well as the blood vessel wall is proposed as a possible explanation; the hypothesis of an inborn error in the development of the lymphatic system, controlled by a gene closedly associated with the FD gene on the same chromosome can also be advanced.
Cerebroside-Sulfatase↗
[Suppressor T-lymphocytes in mice and humans].
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Animals↗
Kidney 15-hydroxy-prostaglandin-dehydrogenase activity during the development of experimental hypertension in the rat.
15-hydroxy-prostaglandin-dehydrogenase (PGDH) activity was studied in rat kidney homogenates during the development of hypertension, within 20 days after left renal artery constriction by a solid silver clip. In the ischemic kidney PGDH activity increased at day 6, reached maximum at day 10, then progressively at day 15 and returned to normal levels at day 20. No difference was found between contralateral kidneys and kidneys of normotensive control rats. Variations of PGDH activity did not seem to be related to either renal perfusion pressure or renin production. Increased PGDH activity may be a consequence of an enzyme induction following increased PG-synthetase activity, or it could be viewed as a defence mechanism, according to the hypothesis of a prohypertensive effect of PG in the rat.
Animals↗
Urinary kallikrein excretion and plasma renin activity in patients with essential hypertension and primary aldosteronism.
1. The 24 h urinary excretion of kallikrein has been studied in 40 normotensive control subjects and in 74 age-matched patients with essential hypertension under similar conditions. By use of the renin-sodium index, hypertensive patients were divided into two subgroup: low-renin hypertension and normal-renin hypertension patients. Urinary kallikrein determinations were also obtained from six hypertensive patients with primary aldosteronism. 2. Urinary kallikrein was significantly lower both in patients with normal-renin and low-renin essential hypertension. Urinary kallikrein excretion was very high in the patients with primary aldosteronism. 3. In nine hypertensive patients beta-adreno-receptor-blocking therapy caused a significant decrease of plasma renin activity, but had no significant effect on urinary kallikrein excretion. 4. The results support the concept that low urinary kallikrein is likely to be a marker of essential hypertension. Under certain conditions its excretion is positively related to mineralocorticoid hormone concentrations but it is not primarily related to the renin-angiotensin system.
Adult↗
[Experimental study on hepatic encephalopathy: EEG and blood amino acid findings].
The AA. describe a method of gradual occlusion of the portal vein in the rat to induce a hepatic encephalopaty. This method allows to realise a condition of hepatic ischemia and a portal hypertensive state accompanied by spontaneous portal-systemic shunts. These two factors produce a hepatic encephalopaty like in cirrhotic state or in patients after portal systemic anastomosis. A part from similar behavior at the beginning of the encephalopaty it is possible to define two classes of animals: one showing a slow recovery and one showing a transient and slight improvement followed at the end by the death of the animal. The AA. found a definite correlation amoung the clinica, EEG's, serum aminoacids and biochemical data. Probably the different anatomical and phisiological aspects of the induced portal systemic shunts and the different ways of hepatic rivascularization may determine the two different evolutions of the animals.
Amino Acids↗
[Long-term treatment of hypertension with the combination of hydrochlorothiazine and amiloride. Results of a multi-center study of 277 patients].
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Adult↗
[Epilepsy and the driver's license].
143 older than 18 years epileptic patients have been considered under the concers of their driving licence. The 33,5% of them was already in hold it. Epilepsy was under different clinical forms. The majority of the subjects would suffer from generalized primary suizures, otherwise from partial fits, either elementar or complex. Subjects who already had the licence (37 over 75 men and 15 over 68 women) were presenting most scanty crisis, or since one year had non suffered from any at all. The frequency of crisis was very low for all the patients who had presented epilepsy before beingin permitted to drive; no question had been raised for them. Subjects without licence (25 men over 42 and 18 women over 53) had not been permitted to drive because of their illness. This group was mainly composed by patients either suffering from epilectic cerebropaty from very frequent fits, or from both. It is maintained as reasonable that italian laws conform to those within other E.E.C. countries for what concerns driving licence for epileptics; these patients, whether controlled, are assumed as well capable as accountable in mastering their condition, even when driving.
Adult↗
[Intracranial and spinal dermo-epidermoid tumours. Anatomoclinical study (author's transl)].
The authors review the previous report of intracranial or spinal dermo-epidermoid tumours, in concern with both nosographical and biological problems. They report their clinical and anatomical findings on a patient who presented the same tumours within the skull and in the vertebral canal. The authors underscore the rarity of such finding, the length of the course. albeit a few symptoms and no positive neuroradiological findings had been remarked, and the quite atypical eventual troubles.
Brain↗
[Petit mal status].
The historical evolution of P.M.S. nosography is pointed out, and his clinical features are exposed, mainly on the ground of the study performed by Lob and Coll., for the Tenth Marseilled Colloquium. Stress is laid upon the onset age of P.M.S., making reference to a review of 133 cases previously reported in the literature. Two paradigmatic cases are reported, selected between six P.M.S. observations we collected, and electroclinically investigated, from 1972 to 1975: a woman aged 34 who was suffering from P.M. and G.M. seizures since she was 12-years old, and also had some other P.M.S. episodes during past years; a woman aged 45 who suffered from a sudden P.M.S. attack, during a febrile illness: it seemed that it was the first occurrence, but an accurate catamnestic search suggested that previous P.M.S. manifestations had probably occurred during the infancy. Finally P.M.S. nosography is discussed for what concerns the variable features emphasized by our observations, the correlation between P.M. and P.M.S., and the problem of P.M.S. as the sole epileptic phenomenon.
Adult↗
Urinary and kidney kallikrein in hypertensive rats.
Urinary and kidney kallikrein were studied in rats with renal clip hypertension. The effect of protease inhibitors on urinary and kidney BAEE esterase activity was similar. Both hypertensive and not hypertensive operated rats excrete significantly less kallikrein than controls; in the ischaemic kidney kallikrein is diminished whereas is not increased in contralateral. Kallikrein is therefore related to renal functional mass but does not seem responsible for a natriuretic effect.
Animals↗
Urinary kallikrein excretion in Bartter's syndrome.
Urinary excretion of kallikrein has been studied in a patient with hypokalemic alkalosis, hyperplasia of the renal juxtaglomerular apparatus and hyperreninemia, secondary aldosteronism and resistance to the pressor effect of angiotensin II (Bartter's syndrome). Urinary kallikrein was found exceedingly high in several determination, whereas it was low in patients with essential hypertension and high in patients with primary aldosteronism. Urinary kallikrein decreased after spironolactone therapy. The rise of kallikrein excretion (which is not related to plasma renin) in this case is probably caused by a direct action of the chronic excess of plasma aldosterone; it could not be accounted for as secondary to natriuresis.
Adult↗
[Behaviour of urinary excretion of lysozyme in renal diseases and in urinary tract infections (author's transl)].
Urinary excretion of lysozyme was investigated in a group of 66 patients with various renal diseases, nephrolitiasis and urinary tract infections. The results obtained demonstrate that the amount of the enzyme excreted is related to the entity of tubular damage whereas is not with glomerular damage. No correlation was found between lysozyme excretion neither to the degree of proteinuria neither to the amount of leukocytes and bacteria in the urine. In patients with urinary infections urinary lysozyme increases only when there is a tubular injury of some entity. In 90 pediatric patients with urinary infection and pyelonephritis lysozyme in the urine was found only in two cases. Therefore urinary lysozyme determination cannot be considered for the detection of early tubular injury and is not a helpful diagnostic tool in urinary tract infections.
Adolescent↗
Adult metachromatic leucodystrophy: clinicopathological report of two familial cases with slow course.
Two cases of adult metachromatic leucodystrophy in one family are reported. The main clinical features in both were predominantly psychiatric with alcoholism and an extremely long duration of the illness. Neuropathological examination revealed a similar distribution of the lesions in both, and scanty metachromatic accumulation in the CNS and not at all elsewhere. The great variability of the lengths of the courses is stressed. The duration in no way seems to be linked to the age of onset, except in the typical infantile form. The authors argue that different lengths of history correlate with distinct neuropathological findings, and may possibly be related to qualitative differences in the involved enzyme disturbance. Therefore, the authors suggest that the classification based on the age of onset be enlarged with a further one distinguishing between 'rapid' and 'slow' course types.
Aged↗