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Biomedical subjects

A Roncoroni

Publications and source records attributed to A Roncoroni.

13 recordsLinked to original sources

Features of asthma in the elderly.

Asthma has been considered a rare disease in the elderly, but recent studies have shown that it is as common in the elderly as in the middle-aged population. Diagnosis of asthma is often overlooked in older patients, leading to undertreatment. Spirometry, determination of expiratory flow lability, and histamine challenge tests are tools that are as usefulfor the evaluation of elderly asthmatics as they areforyoungerpatients. Asthma is more severe in the elderly, especially in long-standing asthmatics. Treatment of asthma in the elderly should follow the same stepwise guidelines that are recommended for all age groups, though it will require more intense monitoring. An aggressive treatment approach to mild and moderate asthma in young people is the best hope of changing the future trends of asthma in the elderly.

Aged↗

Assessment of respiratory function: influence of spirometry reference values and normality criteria selection.

The purpose of this study was to determine the impact upon classification of patients of the choice of reference equation and the criterion defining the lower limit of the normal range in clinical practice. One thousand consecutive spirometries were checked to calculate the predicted values [forced vital capacity (FVC) and forced expiratory volume in sec (FEV1)] in accordance with the equations by Morris, Cherniack, Crapo, Knudson and the Economic Community for Coal and Steel (ECCS). We quantified the difference between the predicted values obtained for each individual and each equation, determined the percentage of individuals whose classification might have changed from normal to abnormal when using a different equation and defined the lower limit of the normal range in accordance with the determination of 1. the 90% confidence interval or 2. 80% of predicted, comparing their differences. The greatest differences found were between the values given by Morris and Crapo's equations for male FEV1, between Morris and Cherniak for female FEV1 and male FVC and between Morris and Knudson for female FVC. Using 80% of predicted value for female FEV1, up to 35% of tests changed their classification from 'normal' to 'abnormal' upon changing the equation used. A high percentage of tests showed a lower limit of normal defined by the confidence interval under 80% and 70% of predicted value. This study emphasizes the importance of choosing the appropriate reference equation. We do not consider it acceptable to use a fixed percentage of the predicted value as the lower limit of normal because of the great number of patients found to be inappropriately classified.

Adolescent↗

Dynamic aortomyoplasty: clinical experience.

Dynamic aortomyoplasty has been the subject of experimentation for the treatment of congestive heart failure during the last few years. This method consists of diastolic counterpulsation of the ascending aorta through the stimulation of the latissimus dorsi wrapped around it. This report describes the results of aortomyoplasty in a patient with dilated cardiomyopathy resulting from Chagas' disease and contraindications for heart transplantation or cardiomyoplasty.

Aorta↗

Acute CNS infection by Trypanosoma cruzi (Chagas' disease) in immunosuppressed patients.

Acute CNS involvement by Trypanosoma cruzi is uncommon. We report 2 immunosuppressed patients, 1 adult who developed an acute meningoencephalitis, and 1 child who presented with the tumor-like form of the disease. Both patients acquired the disease through blood transfusion. Blood donors migrating from endemic areas can transmit the disease in nonendemic countries if they are not routinely screened for antibodies to T cruzi.

Acute Disease↗

Congenital aneurysm of the left atrium.

Left atrial aneurysm is a rare condition. Only 29 cases have been reported, to our knowledge. We report 1 such case in a 24-year-old man who complained of dyspnea and arrhythmias. Diagnosis was suspected on review of chest roentgenogram and confirmed by echocardiography and cardiac catheterization. Surgical repair was achieved without complications, and preoperative symptoms disappeared completely. According to the literature, these patients are almost always asymptomatic. When present, the most common symptoms are arrhythmias, heart failure, emboli, and chest pain. This lesion is seen mainly in young adults (mean age, 23.5 years). The diagnosis should be confirmed by echocardiography, nuclear imaging, and cardiac catheterization. A review of the literature indicates that surgical repair can be accomplished with low mortality and that arrhythmias usually disappear postoperatively.

Adult↗

[Infection of a cerebrospinal fluid shunt system by Bacillus circulans and Bacillus larvae].

A two episodes case of CSF ventriculo-atrial shunt infection due to B. circulans and B. larvae is presented. B. circulans was first isolated from 4 blood cultures and CSF (shunt valve tap). The patient showed a brain damage syndrome reversible with antibiotic treatment. Lethal toxin production was demonstrated for the B. circulans strain in a mouse model. This strain was found to be a variant of Gordon's description as it produced urease and was tolerant to 7% NaCl. The patient recovered after cefotaxime, cotrimoxazole and rifampicin treatment. A second infection due to B. larvae was detected two months later. The shunt system was removed due to obstruction and a scanning electron microscopy study was performed. Confluent masses of white blood cells and rods were observed on the inner surface of the catheter. As for as we know, this is the first case of human infection due to B. larvae.

Adolescent↗

Effect of ouabain on the renal response to furosemide.

The aim of this work was to investigate whether the natriuretic effect of furosemide can be wholly explained by the inhibition of a ouabain-sensitive Cl transport in the thick ascending limb of Henle. For this purpose 6 dogs undergoing moderate saline diuresis received 100 mug ouabain/kg into the left renal artery followed by 2 mg furosemide/kg IV. Urine was collected from both kidneys and blood samples taken at regular intervals. Ouabain produced a unilateral increase in Na excretion and little change in CCR and water and K excretion. IV furosemide increased Na, K and water excretion in both kidneys. Since Na excretion in the left kidney was already exhanced by ouabain the increment was lesser than in the right kidney. As a result water and electrolyte excretion became similar in both kidneys. Although ouabain did not prevent the renal response to furosemide, the effects of both drugs were not additive. This suggests that in addition to the thick ascending limb, furosemide acts in some other tubular segment which is insensitive to ouabain. Since furosemide is known to also inhibit passive Cl movements, a second site of action could be in the thin ascending limb of Henle, which lacks any active transport mechanism but is highly permeable to Cl.

Animals↗

[Non-pigmented Serratia: utility of hydrolysis of Tween 80 in its identification].

The ability of Serratia sp. to hydrolyze Tween 80 and the usefulness of this test for differentiating it from other Gram negative bacilli was studied, comparing it with the capacity of production of DNAsa by the same strains using the O-Toluidine blue method. The total number of strains assayed was 88. The sensitivity obtained was 83.9% and specificity 91.3%, with a positive predictive value of 83.9% and a negative predictive value of 91.2%. Using this method to differentiate only non-pigmented Serratia from Klebsiella sp. and Enterobacter sp. the sensitivity and specificity obtained was 100%. Concerning the cost, this method proved to be 3.86 times cheaper than the DNAsa one.

DNA, Bacterial↗