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Biomedical subjects

A Lupo

Publications and source records attributed to A Lupo.

At least 37 records · Page 2Linked to original sources
PubMed1997

Nutrition in general practice in Italy.

Since the early 1950s the health promoting qualities of the Mediterranean diet (characterized by low intakes of total and saturated fat and high intakes of fiber and complex carbohydrates) have been acknowledged. Unfortunately, this dietary pattern, effective in lowering the risk of coronary artery disease as well as oxidative stress and carcinogenesis, is widespread only in the southern part of Italy, whereas the eating style and morbidity pattern in northern Italy are similar to those in northern Europe. Moreover, trends in eating behaviors in southern Italy are at risk of impairing the comparative advantage given by the Mediterranean diet. The current eating profile in northern Italy and the trend in southern Italy are therefore a suitable field for educational interventions by general practitioners (GPs) to preserve and promote healthier dietary patterns. Nutrition training of GPs does not yet appear sufficient to enable them to tackle this need. The undergraduate curriculum used to include (and no longer does) only an optional course in basic nutrition; little more teaching is added during vocational training. In Piedmont, a north-western region around Turin, two four-hour seminars for vocational trainees deal with the topics of basic nutrition in children, adolescents, and adults; malnutrition in the elderly; and diet treatment of chronic renal failure. Continuing medical education covers the same topics and a further module deals with diet in the control of diabetes. An effort is needed in the nutritional training of Italian GPs to enable them to give to their patients more than merely commonsense advice.

Adolescent↗
PubMed1997

A prospective, randomized trial of two antibiotic regimens in the treatment of peritonitis in CAPD patients: teicoplanin plus tobramycin versus cephalothin plus tobramycin.

A multicentre, comparative, randomized study was performed to compare the efficacy and tolerability of two antibiotic regimens in the treatment of peritonitis in continuous ambulatory peritoneal dialysis (CAPD) patients: teicoplanin plus tobramycin versus cephalothin plus tobramycin. After informed consent had been obtained, 68 patients were randomized prospectively to receive either teicoplanin plus tobramycin or cephalothin plus tobramycin. Patients were followed throughout the study and for up to 4 weeks after the end of treatment, when clinical and microbiological parameters were assessed again. The incidence of clinical failure was 4.6 times higher in the cephalothin plus tobramycin group than in the teicoplanin plus tobramycin group (7/28 versus 2/37; P < 0.05). There was no significant difference in bacterial eradication between the two groups. Local and systemic tolerability were good for both regimens. The study shows that teicoplanin plus tobramycin is more effective than cephalothin plus tobramycin and might become a 'first-line' treatment for peritonitis in CAPD patients.

Aged↗
PubMed1997

Long-term prognosis of Henoch-Schönlein nephritis in adults and children. Italian Group of Renal Immunopathology Collaborative Study on Henoch-Schönlein purpura.

BACKGROUND: The aim of this multicentre collaborative study was to compare the progression of renal disease in children and adults with Henoch-Schönlein purpura (HPS) nephritis selected on the basis of IgA-dominant renal deposits and biopsy material available for review. METHODS: The analysis was performed in 152 patients (95 adults and 57 children < 16 years old at diagnosis) with a follow-up (> or = 1 year up to 20 years (4.9 +/- 3.4 years in adults and 4.8 +/- 3.9 years in children). RESULTS: Renal histology and clinical presentation were similar in both age groups: crescents were found in 36% of adults and 34.6% of children (in only 2.7% of adults and 1.9% of children involving > 50% of glomeruli), nephrotic-range proteinuria in 29.5% of adults and 28.1% of children and functional impairment in 24.1% of adults and 36.9% of children. The outcome was similar for both age groups (remission, 32.5% of adults and 31.6% of children; renal function impairment, 31.6% of adults and 24.5% of children). Endstage renal disease was observed in 15.8% of adults and in 7% of children. Renal function survival at 5 years was not significantly different in the two groups (85% in adults and 95% in children) and at 10 years it was approximately 75% in both groups. None of the children died and adult survival was 97% at 5 years. In adults at presentation, renal function impairment (P < 0.02) as well as proteinuria higher than 1.5 g/day (P < 0.02) and hypertension (P < 0.001) were negative prognostic factors. Multivariate analysis stressed the main statistical relevance of proteinuria (relative risk 2.37, P < 0.02). Conversely, in children no definite level of proteinuria, hypertension or other data were found to be associated with poor prognosis. CONCLUSIONS: Among patients with a clinical presentation which warrants renal biopsy, HSP nephritis has a similar prognosis in children and adults. The evolution is more predictable in adults than in children.

Adult↗
PubMed1996

Selenium status and plasma glutathione peroxidase in patients with IgA nephropathy.

The abnormal proliferation of mesangial cells with IgA deposition in the glomeruli characterizes primitive mesangial glomerulonephritis (IgA nephropathy, IgAN); this disease reduces the normal renal parenchyma while renal function becomes progressively impaired. The possible role of selenium has never been considered in evaluating factors involved in the pathogenesis of IgAN. In this work we compared the Se status of 14 IgAN patients (8 with normal renal function, IgAN NRF; 6 with impaired renal function, IgAN IRF) to that of 14 normal individuals (CG NRF) before and after an oral supplementation with selenite (0.13 mol Se/kg b.w./day for 60 days). The following indices of Se status were measured: Se in plasma and urine samples by PIXE; glutathione peroxidase activity in the cytosol of platelets (PLTs-GSH-Px) and of erythrocytes (RBCs-GSH-Px). Both concentrations and activities of plasma glutathione peroxidase (pl-GPx), a selenoenzyme mainly synthesized in and secreted by the kidney, were measured in plasma samples and results compared among groups. IgAN patients showed lower pl-Se and lower activities of selenoenzymes than normal controls before Se supplementation (p < 0.001). These findings suggest that an impaired Se status coexisted with the proliferation of mesangial cells in patients. Selenite induced PLTs-GSH-Px activity in all individuals (p < 0.001), but no variation was observed in RBCs-GSH-Px activity or in the concentration of pl-GPx in the plasma. On the other hand, selenium induced pl-GPx activity in CG NRF (p < 0.001) and in IgAN NRF (p < 0.01), but poorly stimulated pl-GPx activity in IgAN IRF (p = n.s.). However, only 17% and 25% of the pl-GPx activity of normal controls was measured in the plasma of IgAN IRF and IgAN NRF patients, respectively (p < 0.001). In conclusion, selenite only partially restored a normal Se status in patients whose low pl-GPx activity probably reflects an impaired synthesis of this protein as a consequence of reduced normal functioning of the parenchyma in kidneys affected by IgA nephropathy.

Glomerulonephritis, IGA↗
PubMed1996

No evidence of a higher risk of progression to AIDS in patients with HIV-1-related severe thrombocytopenia.

The prognostic role of platelet (PLT) counts was evaluated in a cohort of 1,533 HIV-1-infected subjects followed for a median of 21 months. Thrombocytopenia (TCP), defined as a PLT count < or = 100 x 10(9)/L was present at enrollment in 11.2% of cases, with counts < or = 50 x 10(9)/L (severe TCP) in 5.3%. With the subjects with normal PLT counts (PLT >150 x 10(9)/L) as the reference group, the relative risk of developing acquired immunodeficiency syndrome (AIDS) was 0.8 [95% confidence interval (CI) 0.5-1.3, p = 0.4] for subjects with severe TCP, 2.1 (95% CI 1.4-3.1, p = 0.002) for those with PLT counts ranging from 51 to 100 x 10(9)/L (moderate TCP), and 1.6 (95% CI 1.2-2.1, p = 0.0004) for those with borderline PLT values (PLT ranging from 101 to 150 x 10(9)/L). Most of the risk increase associated with moderate TCP and borderline PLT values was explained by a higher prevalence of subjects with an older age and lower CD4+ cell counts. However, at multivariable analysis considering age, sex, risk group, and zidovudine (ZDV) treatment, the risk for subjects with severe TCP remained significantly lower than that for subjects with moderate TCP and borderline values. These results suggest the existence of different types of HIV-1-associated TCP and also suggest that severe TCP (which often arises in the early phases of infection) is not related to disease progression.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Altered thyroid in dialysed uremic patients].

Thyroid abnormalities were studied in 40 uremic patients half of whom were receiving hemodialysis and half peritoneal dialysis. The following parameters were examined in all patients: total and free thyroxinemia, free and total triiodothyroninemia, basal thyreotropinemia and levels 20 mins after releasing hormone (TRH) stimulation, reverse T3, thyroglobulinemia, antithyroglobulin , antimicrosomial and antithyroperoxidase antibodies; a thyroid echography was also performed. Numerous alterations were found in thyroid parameters, with a greater frequency in hemodialysed patients (65%) than those undergoing peritoneal dialysis (52.5%). Among the parameters examined it is worth noting that total thyroxinemia was significantly reduced compared to controls, and FT3 was very significantly reduced. Among those patients undergoing peritoneal dialysis thyreotropinemia was increased in 6 cases (15%), whereas among hemodialysed patients it was reduced in 2 cases (5%). Ten patients (25%) in all appeared to be free of thyroid alterations and 30 (75%) showed one or more alteration of the parameters examined. Of the latter, 1 case of toxic multinodular goiter, 1 case of Plummer's adenoma in a pretoxic phase, 1 case of hypothyroidism, 15 cases of "sick euthyroid of syndrome", 3 cases with high antibody levels and 2 cases of single node goitre were diagnosed. The study confirmed the high incidence of thyroid alterations in uremic patients and, surprisingly, allowed the authors to diagnose a case of toxic multinodular goitre and a case of Plummer's adenoma at a pretoxic phase. The authors discuss the rarity of thyroid hyperfunction in uremia and suggest the need to consider patients with chronic renal insufficiency as being at risk of hypo-, normo- and hyperfunctioning thyreopathy, and to use a routine thyreotropinemia assay in all uremic patients.

Adolescent↗
PubMed1995

Characterization of a silencer that modulates transcription of the human distal aldolase A promoter.

Transcription from the distal promoter (pL) of the human aldolase A gene is driven by both positive and negative cis-acting elements. With footprinting and gel mobility assays we defined: (i) the position of the negative regulatory cis-element (AldA-NRE), which spans a GA-rich sequence; (ii) the sequence of AldA-NRE, which is critical for protein specific binding and is homologous to other silencer-like motifs. Removal of the negative cis-element fully restores the expression of the distal promoter. Insertion of the AldA-NRE upstream from a heterologous promoter results in a 6-fold decrease in CAT reporter gene expression, suggesting that AldA-NRE might be involved in a more general type of mechanism that mediates repression of gene transcription.

Animals↗
PubMed1995

Identification of p53 target genes through immune selection of genomic DNA: the cyclin G gene contains two distinct p53 binding sites.

An immune-selection procedure was employed in order to isolate p53-binding sites from rat genomic DNA. One such site was found to reside within the first intron of the cyclin G gene. Cyclin G mRNA levels are strongly elevated upon induction of wild type p53 activity in cells carrying a temperature sensitive p53 mutant. The cyclin G gene also carries a second p53-binding motif upstream to its transcriptional start site. The presence of two high affinity p53-binding sites may confer upon the cyclin G gene the potential to be activated very efficiently by p53. These data raise the possibility that cyclin G may be a downstream mediator of at least some of the biological effects of p53.

Amino Acid Sequence↗
PubMed1995

Red blood cell cation transports in uraemic anaemia: evidence for an increased K/Cl co-transport activity. Effects of dialysis and erythropoietin treatment.

This study examines the role of uraemia and the effect of different dialysis treatments on red cell cation transport. We evaluated the main cation transport systems in erythrocytes of non-dialysed end-stage renal disease (ESRD) subjects, of patients undergoing haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD), as well as the changes induced by human recombinant erythropoietin (r-HuEPO) administration. In uraemic undialysed and dialysed patients, we observed an increase in K/Cl co-transport activity and in shrinkage-induced amiloride-sensitive (HMA-sensitive) Na efflux (Na/H exchange) and a decrease in Na/K pump and Na/K/Cl co-transport activity, while Na/Li exchange was increased only in dialysed patients. In uraemic erythrocytes, we showed for the first time an increased K/Cl co-transport activity, which was cell age independent. Generally, the different method of dialysis (CAPD or HD) did not modify the cation transport abnormalities observed. During the treatment with r-HuEPO, all the systems, with the exception of the Na/K pump and Na/K/Cl co-transport, increased their activities following the increase of circulating young red cells. The changes produced under r-HuEPO administration were transient and cation transports returned to the baseline values within 100 days of treatment, indicating a primary and prominent pathogenetic role of uraemia in modulating the red cell membrane cation transport activities.

Anemia↗
PubMed1994

Growth-arrested dependence of aldolase A L-type mRNA expression in rodent cell lines.

Two ubiquitous (L- and F-type) and one muscle-specific (M-type) mRNA species are generated by the human aldolase A gene. Despite the high degree of sequence similarities in the promoter region between human and rodents, no L-type mRNA expression has yet been found in the latter. Here we demonstrate that L-type aldolase A mRNA is expressed during the differentiation of mouse myogenic C2.7 and rat oligodendrocyte precursor CEINGE C13 cells. The L-type mRNA expression is increased during differentiation and is associated with cell-growth arrest caused by nocodazole treatment or serum deprivation in C2.7 and CEINGE C13 cells, respectively. The L-type aldolase A mRNA is correctly processed at the L1-L2 junction.

Animals↗
PubMed1994

Long-term outcome in continuous ambulatory peritoneal dialysis: a 10-year-survey by the Italian Cooperative Peritoneal Dialysis Study Group.

Over a 10-year period, 1,990 end-stage renal disease patients in 30 centers were treated with continuous ambulatory peritoneal dialysis by the Italian Cooperative Peritoneal Dialysis Study Group. At the start of treatment, patients had an average age of 58.4 years, with a 66% prevalence of one or more clinical risk factors for premature death. Patient survival was 51% and 33% at 4 and 8 years on continuous ambulatory peritoneal dialysis, respectively, and technique survival was 62% and 48%, respectively. Occurrences of peritonitis progressively reduced until they reached an incidence of 0.50 episodes/yr in the last 5 years (1985 to 1989). Hernias and catheter-related problems did not influence the dropout rates. These Italian Cooperative Peritoneal Dialysis Study Group results demonstrate that continuous ambulatory peritoneal dialysis is a viable dialysis technique for long-term treatment of chronic renal failure and that it is an effective alternative to hemodialysis, especially for older and high-risk patients.

Adolescent↗
PubMed1994

Ten years experience of CAPD in diabetics: comparison of results with non-diabetics. Italian Cooperative Peritoneal Dialysis Study Group.

CAPD outcomes were compared between a group of 301 diabetic patients (mean age +/- SD, 58.9 +/- 12.7 years, 55.8% males) and a group of 1689 non-diabetic patients (mean age +/- SD 57.8 +/- 14.8 years, 55.9% males) treated in 30 centres participating in the Italian Cooperative Peritoneal Dialysis Study Group from 1980 to 1989, with follow-up observation periods of 444 years (mean +/- SD, 1.48 +/- 1.24) and of 3502 years (mean +/- SD, 2.07 +/- 1.91) respectively. CAPD was the first modality for 87.2% of diabetics and 78.1% of non-diabetics (P < 0.001). The percentage of patients who needed a partner for CAPD was 45.9% in diabetics and 30.2% in non-diabetics (P < 0.001). In diabetics compared with non-diabetics, cardiovascular diseases and cachexia were nearly twice and infections other than peritonitis more than three times as frequent in causing death. In diabetics, survival was significantly worse (P < 0.0001) and the relative risk of death 2.13 times higher (P < 0.001). The technique survival and the relative risk of drop-out were not significantly different in the two groups. Clinical problems were the most important cause of drop-out among diabetics. The probability and relative risk of drop-out due to peritonitis, as well as of the first peritonitis episode, were not significantly different between the two groups and between diabetics using or not using intraperitoneal insulin. Days per patient year of hospitalization, excluding the first, were 18.4 in diabetics and 14.3 in non-diabetics. CAPD-related problems caused hospitalization in a similar way in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Well being in patients on CAPD and hemodialysis.

In the present multicenter study, 120 pts who had been treated by both hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) for at least 6 months each, were invited to answer questions on 34 matters, to compare symptoms and their well-being while on the two treatments. Patients were invited to choose HD or CAPD and indicate the reasons for their choice. For 28 patients the first treatment was HD and for 92 CAPD. The mean time between the change of therapy and the study was 46 +/- 35 months. Their final choices were found to be strictly related to the present treatment (p < 0.001). The reasons for choice of CAPD were: more free time (21%), more freedom (67%), better well-being (44%), less worry (5%); for HD they were: more free time (53%), better well-being (39%), less worry (13%), no need for a peritoneal catheter and fewer clinical complications (19%). The catheter was considered more cumbersome than the A.V. fistula, the time involved was considered to be shorter on HD by 52 patients and on CAPD by 39, thirst and cramps were considered to be more frequent and severe on CAPD by half of the patients. The prevalence and severity of problems and symptoms and choice of treatment were not related to sex, job, education or age.

Adult↗
PubMed1994

Distribution of CII and CIII peptides in lipoprotein classes: methods and clinical significance.

We describe a method for measuring apolipoprotein (apo) C distribution between apo B-containing lipoprotein (apo B-LP) and non-apo B-LP. The procedure requires the precipitation of apo B-LP, the redissolution of the pellet, and the quantification of C peptides in the redissolved pellet. The ratio of apo C in non-apo B-LP to apo C in apo B-LP has been calculated for both CII and CII (R-CII and R-CIII, respectively). R-CII (0.49 +/- 0.25) and R-CIII (0.84 +/- 0.54) in patients on maintenance dialysis are significantly lower than in the control group (1.14 +/- 0.57 and 1.45 +/- 0.92, respectively), indicating that hypertriglyceridemia in these patients results from a reduced catabolism of triglyceride-rich LP (TGRLP). Patients with coronary artery disease (CAD) show a distribution of C peptides no different from the control group. Analysis of covariance reveals that the patterns of R-CII and R-CIII are not entirely predictable from the serum concentration of triglycerides. This result seems to support the hypothesis that the underlying metabolic defects involving TGRLP in dialysis patients are not the same as those in patients with CAD.

Adult↗