[Acute renal insufficiency caused by rifampicin: description of a case].
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Biomedical subjects
Publications and source records attributed to A Pagani.
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Determination of serum bile acids has long been regarded as the most sensitive indicator of liver function. An assessment was made of the clinical applicability of RIA evaluation of two of these acids, cholylglycine (CG) and sulpholithochocholyglycine (SLGG), on an empty stomach and 2hr after a cholecystokinetic meal in 109 liver patients ans 20 controls. After the meal test, both acids proved more sensitive than the usual liver function indices. Different mean values were observed for different diseases. They were in good correlation with the extent of histological damage. Values were highest in obstructive icterus, cirrhosis and neoplasia of the liver, fairly highly high in steatofibrosis, ACH and PCH, and normal in viral hepatitis in the course of resolution, aspecific reactive hepatitis, and steatosis. The meal test thus proved a good indicator of liver disease. Its wider use is to be hoped for in order that its limits and applications may be better understood.
The enhanced sorbitol synthesis in diabetic red blood cells can lead to a depletion of NADPH and, by limiting the amount of GSH produced in the glutathione-reductase step, can make the cell more susceptible to oxidant injury. Diabetic red blood cells have a shortened life span, as shown by the increase of creatine level. The osmotic resistance of diabetic erythrocytes was measured and the erythrocyte flexibility was studied using a filtration method in which the cells were forced, at a constant flow rate, through a polycarbonate membrane with 5-mu pores. The increased osmotic resistance and the impaired flexibility shown by diabetic red blood cells can be induced in normal cells by a treatment with SH-reagents (diamide). This points to a redox state-mediated decrease in deformability and survival of diabetic erythrocytes.
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A persistent defect of Aspergillus killing was observed in the neutrophils of a 6-year-old patient with a systemic A. fumigatus infection which was highly refractory to anti-mycotic therapy. Aspergillus phagocytosis in vitro was normal, but nearly 80% of the ingested organisms (versus 30% in the controls) survived intracellularly during the 2-hr assay period. The patient's neutrophils showed a subnormal frequency of nitroblue tetrazolium reduction and a subnormal hexose monophosphate shunt activation in response to phagocytosis. The metabolic responsiveness, however, was clearly superior to that of chronic granulomatous disease neutrophils tested for comparison. The immune status of the patient and the following properties of his neutrophils were found to be normal: random and chemotactic motility, killing of S. aureus and C. albicans, and the contents of several granula enzymes. Our findings suggest the existence of neutrophil factors or functions which are required for killing Aspergillus, but not S. aureus and C. albicans.
We have tested the effect of five aminoglycoside antibiotics (gentamicin, sisomicin, tobramycin, ribostamycin, and amikacin) on the candidacidal activity of human neutrophils in vitro; all of them are inhibitory and can be grouped into three significantly different levels of toxicity. Gentamicin in the most toxic and sisomicin is the least toxic.
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Two siblings with recurrent infections were found to have impaired neutrophil motility. The same association of infections (otitis media, bronchitis, chronic diarrhoea) has caused seven fatalities in the paternal side of the family, suggesting genetic implications.
Mepartricin, a polyene antibiotic with candidacidal and trichomonicidal activity, was found to be without toxic effects for human polymorphonuclear leucocytes; the drug seems to be unable to enter the human cells. Some synergism between the antifungal activities of mepartricin and of human leucocytes is seen if Candida cells are pre-incubated with sub-lethal concentrations of the drug.
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