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Biomedical subjects

A Lechi

Publications and source records attributed to A Lechi.

At least 109 records · Page 6Linked to original sources
PubMed1987

Regression of cardiac hypertrophy after antihypertensive therapy with nifedipine and captopril.

The effects of two antihypertensive agents, nifedipine (N) and captopril (C), on left ventricular (LV) mass and volume were studied in 16 patients with essential hypertension (8 treated with N and 8 with C for 6 months) by means of a complete M-mode echocardiogram monitored by two-dimensional echocardiography. Both N and C induced a significant reduction in end-diastolic, but not systolic, posterior wall and septum thickness and an increase in end-diastolic volume, but not in end-systolic volume. A significant increase in the contribution of rapid filling together with a simultaneous reduction in the contribution of atrial systole to end diastolic volume were also observed. The reduction in LV wall thickness and mass after both C and N might be attributed to an improvement in diastolic function and to a reduction in wall tension, rather than to an effective regression of LV hypertrophy.

Adult↗
PubMed1987

Antihypertensive activity of enalapril. Effect of ibuprofen and different salt intakes.

It has been suggested that angiotensin-converting enzyme (ACE) inhibitors may also act through the renal prostaglandin (PG) system; moreover, it has been shown that nonsteroidal antiinflammatory drugs (NSAIDs) are capable of reducing the antihypertensive activity of ACE inhibitors. Sixteen essential hypertensive patients (WHO stages, I-II, eight on a low-sodium diet and eight on a high-sodium diet) were treated with enalapril, 20 mg/day per os, for 4 days. On days 3 and 4, ibuprofen, 1,200 mg/day per os, was also given. Enalapril reduced blood pressure, particularly in the group on the low-sodium diet. Urinary 6-keto-PGF1 alpha, an indicator of renal PGI2 production (determined by HPLC-RIA), increased in the first few hours after enalapril in the low-sodium group. Ibuprofen did not reduce the antihypertensive effect of enalapril, nor did it affect plasma renin activity or plasma aldosterone. Only a slight reduction in 6-keto-PGF1 alpha excretion was observed after enalapril plus ibuprofen. It is suggested that the effect of enalapril on urinary 6-keto-PGF1 alpha excretion is largely dependent on factors such as sodium intake.

6-Ketoprostaglandin F1 alpha↗
PubMed1986

Penetration of ceftriaxone into human pleural fluid.

The pharmacokinetics of ceftriaxone were studied for seven patients with pleural effusion of various etiologies. All patients received 1 g of antibiotic, administered as an intravenous bolus. The pleural fluid had a high total protein content (6.0 g/dl). Ceftriaxone levels in plasma and in pleural fluid were determined by the agar well diffusion technique. Total and free drug concentrations in pleural fluid reached 7 to 8.7 and 3.8 to 2.3 micrograms/ml, respectively, in 4 to 6 h. The disappearance of the drug from the pleural fluid was very slow. In these patients, therapeutic ceftriaxone levels were present for at least 53 h in pleural fluid.

Adult↗
PubMed1986

Progressive multifocal leukoencephalopathy (PML): clinical and pathological findings in two short-duration patients.

The clinical features and neuropathological findings of two patients suffering from progressive multifocal leukoencephalopathy (PML) are reported. These patients had cancer and died two months and one month after onset of their neurological symptoms, respectively. In both demyelination was discovered only as a result of autopsy due to different reasons: the CAT-scan findings were misinterpreted in the first patient, while in the second diagnosis was overshadowed by the sudden progress towards a fatal outcome preceded by myoclonus and other encephalitis-like manifestations. The major findings were the extreme paucity of the mesodermal elements on the one hand, and the modest spread of the affected areas on the other. It is pointed out that, whatever the size of the lesions, characters were the same and that their formation could hardly be traced in time. The intriguing similarities between PML and several types of demyelination obtained experimentally using certain virus strains are remarked.

Aged↗
PubMed1986

Ceftazidime in patients with severe Pseudomonas infections.

Forty patients suffering from severe Pseudomonas infections (13 urinary tract infections, 8 of which complicated, 16 cases of pneumonia, 3 cases of sepsis, 1 case of sepsis with osteomyelitis, 2 cases of osteomyelitis, 1 case of ophthalmitis, and 4 cases of peritonitis) were treated with ceftazidime (1-6 g/die). Most cases presented with severe underlying conditions associated with, or predisposing to, infection (surgical intervention, neoplasia, immunodepression, etc.). Both microbiological results (38 out of 43 strains eradicated) and clinical outcome (28 infections cured, 10 improved, and only 2 unchanged) proved highly satisfactory. The authors advocate the empirical use of ceftazidime as first-line single-drug therapy in severe hospital acquired infections in high-risk patients.

Adolescent↗
PubMed1986

Ketoconazole: clinical evaluation in severe fungal infections.

Ketoconazole, a new imidazole-derivative antifungal agent, has been studied in sixteen patients with systemic fungal infections. Seven patients had deep localized infections (three cases with pneumonia and one case each with urinary infection, osteomyelitis, endophthalmitis and peritonitis); three patients suffered from granulomatous or acute mucocutaneous infections and six patients had fungal septicemia. All patients suffered from severe underlying diseases and/or predisposing factors such as antibiotic treatment, immunosuppressive therapy or indwelling catheters. Candida albicans was isolated in 13 cases, C. parapsilosis (septicemia), Aspergillus (ophthalmitis) and Mucor (pneumonia) in the other three cases. Ketoconazole was administered orally at daily dosages of 400-800 mg; 5-fluorocytosine was associated in four cases. Out of the ten patients with localized infections, seven were cured and three improved. Two of the six septic patients were cured, one improved who subsequently died from Pseudomonas septic shock and three patients showed no improvement. Two relapses were recorded, both followed by further eradication. The tolerance of the drug was always excellent. Ketoconazole proved a very effective and well-tolerated drug in systemic infections, caused by opportunistic fungi in high-risk patients.

Adolescent↗
PubMed1985

Successful treatment of subacute cerebellar degeneration in ovarian carcinoma with plasmapheresis. A case report.

Subacute cerebellar degeneration is a rare complication of some neoplasms, and is generally resistant to therapy. A case of subacute cerebellar degeneration in a 50-year-old woman with a Stage II grade 3 serous ovarian adenocarcinoma is reported. The onset of the neurologic symptoms preceded the diagnosis of cancer and progressively worsened during and after four cycles of chemotherapy. A quick, partial improvement of the neurologic syndrome was documented after three weekly treatments with plasmapheresis. The contribution of circulating factors in inducing subacute cerebellar degeneration can be postulated. A trial using this new type of treatment should be performed in patients who have this therapeutically refractory clinical condition.

Acute Disease↗
PubMed1985

Kinetics of bumetanide-sensitive Na+-K+ co-transport in erythrocytes of essential hypertensive patients.

Outward bumetanide-sensitive Na+-K+ cotransport was studied in the erythrocytes of 51 subjects, 24 normotensive subjects and 27 hypertensive patients, matched for sex and age. Three kinetic parameters of this cation transport system were considered: velocity of efflux at saturating internal sodium (Nai) concentrations (Vmax.), apparent affinity for sodium (K 50%) and index of co-operativity among Nai sites (Hill's n). We correlated these values with clinical and laboratory data determined routinely in hypertension. There were no significant differences between normotensive and hypertensive subjects for the values considered and we did not find any significant correlations between co-transport and clinical data.

Adolescent↗
PubMed1984

Increased leukocyte aggregation in patients with hypercholesterolaemia.

Leukocyte aggregation induced by N-formylmethionyl-leucyl-phenylalanine (FMLP) has been measured in a group of patients with hypercholesterolaemia (n = 22) and in a group of control subjects (n = 26), age- and sex-matched. When hypercholesterolaemic patients were divided into two groups, with a discriminatory level of 7.7 mmol/l of plasma cholesterol, FMLP-induced leukocyte aggregation of patients with greater than 7.7 mmol/l of plasma cholesterol was significantly higher compared both with control subjects and patients with plasma cholesterol levels less than 7.7 mmol/l. A positive significant correlation was found between leukocyte aggregation and plasma cholesterol, whereas no correlation was observed between leukocyte aggregation and plasma triglycerides or APO-B levels. These findings provide further support for the hypothesis that elevated plasma cholesterol levels may induce a cellular membrane abnormality responsible for the increased leukocyte aggregation and, subsequently, endothelial damage.

Adolescent↗
PubMed1984

Cerebral mycosis: clinico-pathological report of four cases observed in fifteen months.

Cerebral mycosis is a rare condition, difficult to diagnose in life, but is not easily missed at post-mortem examination. We report clinical and pathological findings in four patients with long duration prodromes, seizures and psychiatric symptoms. All of them had been misdiagnosed. Actinomycotic granules in two and Aspergillus filaments in the other patients were ascertained at histological examination. Two of the patients were in their twenties and apparently healthy. We suggest that the possibility of mycotic infection should be considered even in cases where no lowering of the body's defences can be postulated. Cell mediated immunity defects may be assumed as underlying these infections. Therefore we would suggest the importance of immunological tests for type IV immune responsiveness in all intracranial infective processes of undefined etiology.

Actinomycosis↗
PubMed1984

Increased sodium-lithium countertransport in red cells of patients with Bartter's syndrome.

Erythrocyte sodium-lithium countertransport was evaluated in three adult patients with Bartter's syndrome, diagnosed on clinical and histopathological basis and on laboratory tests. As compared with age-matched control subjects, lithium effluxes to both sodium medium and to sodium-free medium were high in two patients and Na+-Li+ countertransport was significantly greater in all three patients. The relationship between increased Na+-Li+ countertransport and the proposed primary disorder of Bartter's syndrome (i.e., a primary tubular defect of chloride reabsorption) is not apparent. However, this finding favours the hypothesis of a generalized cellular membrane dysfunction of ion transport in Bartter's syndrome.

Adult↗
PubMed1984

Pseudomonas septicaemia. A review of 60 cases observed in a university hospital.

Epidemiological, clinical features and the pathogenesis of 60 cases of pseudomonas septicaemia, observed over a period of 7 years from 1975 to 1981, are described. The mean frequency of occurrence was 0.40 episodes per 1000 admissions and an incidence of 66 per cent was observed in patients with serious underlying diseases, such as haematological malignancies and neoplasia. Thirty-seven patients had received cytotoxic and immunosuppressive therapy and showed a marked leukopenia, and whenever the leukocyte count fell below 2000/mm3, the prognosis was significantly worse. The most common portals of entry were the respiratory and gastrointestinal tracts. The overall mortality was very high (75 per cent) and mainly related to septic shock. Apart from the very high frequency of this complication (24 patients, 40 per cent of all cases), a typical clinical picture, distinguishing pseudomonas from other Gram-negative septicaemias, did not emerge.

Adolescent↗
PubMed1984

Carbenoxolone and prostaglandin E2 and F2 alpha gastric juice levels in man.

The purpose of the present study is to evaluate the effect of carbenoxolone after a non-oral administration on the levels of prostaglandins E2 and F2 alpha in gastric juice. The gastric secretion of 6 healthy volunteers (in basal conditions and after administration of a stimulus of 6 micrograms/kg weight of pentagastrin i.m.) was studied before and after seven days of treatment with 150 mg b.i.d. of carbenoxolone suppository. Concentration and output of prostaglandins E2 and F2 alpha (measured by radioimmunoassay), hydrochloric acid, pepsin and N-acetylneuraminic acid in gastric juice were determined. Compared to control values, no statistically significant difference in acid, pepsin or prostaglandin F2 alpha content, or in gastric juice volume, was observed after treatment. However a significant increase was observed in the concentration and output of prostaglandin E2 after administration of pentagastrin. The concentration and output of N-acetyl-neuraminic acid increased significantly only in basal conditions in carbenoxolone-treated subjects. The present study suggests that the cytoprotective action of carbenoxolone on gastric mucosa in man could be due to an increased prostaglandin E2 activity. This effect is observed after rectal administration, therefore suggesting that carbenoxolone also has a systemic action.

Carbenoxolone↗