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Biomedical subjects

A Zucchini

Publications and source records attributed to A Zucchini.

At least 19 recordsLinked to original sources
PubMed1994

A study of 500 cases of acute renal failure (1978-1991).

A retrospective study of 500 consecutive cases of acute renal failure (ARF) in a period covering 1978 through 1991 is presented. A total of 316 females and 182 males with an average age of 46.4 years (14 to 84) had a global survival rate of 68%. Oligoanuric ARF was present in 77% of the patients and, except in 13 cases, all were dialyzed with varied techniques. The treatment plan consisted of early and repetitive dialysis, rational use of antibiotics, and parenteral and/or oral nutritional support. The patients have been divided into three main categories according to etiology: gyneco-obstetric, medical, and postsurgical cases, the latter having the poorest survival rate. With regard to ARF post-septic abortion, we strongly believe that a hysterectomy should not be carried out except in the presence of gangrene or proven uterine perforation, as surgery increases the morbomortality rate in these septic patients.

Abortion, Septic↗
PubMed1993

Pseudopseudohypoparathyroidism associated with idiopathic growth hormone deficiency. Role of treatment with biosynthetic growth hormone.

A case is presented of a prepubertal girl with the characteristic somatic features of Albright's hereditary osteodystrophy, including severe short stature, cataracts and shortening of all metacarpals and metatarsals and of the second middle hand phalanges, whose diagnosis of pseudopseudohypoparathyroidism (PPHP) was confirmed by laboratory evaluation (normocalcemia, normophosphatemia, normal levels of circulating PTH and normal response to exogenous PTH). Since an isolated idiopathic GH deficiency has been diagnosed at the age of 9.7 yr, by an abnormal GH response to standard provocation tests, a poor spontaneous nocturnal GH secretion and a blunted response to GHRH test, our patient was treated with biosynthetic GH during a 3.5-year period. Although a good improvement of growth velocity was obtained when comparing pretreatment height velocity (4 cm/yr) with growth velocity evaluated during GH treatment (6.6, 6.2 and 5.9 cm/yr in the first, the second and the third year of therapy, respectively), bone age advanced more rapidly than chronological age, so that it is uncertain whether the growth acceleration promoted by GH administration really improved final height, which remained below the third centile. Our patient is the first described case of PPHP associated with idiopathic GH deficiency, and the second report of long-term GH treatment in a subject with PPHP. Further observations are necessary to define the frequency and significance of GH deficiency and the role of GH replacement therapy in pseudohypoparathyroidism- and PPHP-associated short stature.

Child↗
PubMed1993

Acid maltase deficiency in childhood. Early diagnosis and clinical follow-up of late-onset glycogen storage disease type II.

A case is described of late-onset glycogenosis type II presenting with an isolated rise in serum transaminase levels. Histological, histochemical, ultrastructural and biochemical examinations performed on muscle biopsy showed the typical laboratory features of late-onset glycogenosis type II, which was diagnosed more than four years before the first appearance of disease-related signs and symptoms. A heterozygote status for the same defect was also demonstrated by enzyme assays in both parents, thus confirming the autosomal recessive mode of inheritance of the disorder. Even though an elevation in transaminases and other serum enzymes of possible muscle origin has been previously described as a diagnostic clue in some unsuspected muscular diseases in childhood, as far as we know no other patient with a sporadic form of glycogenosis type II has been identified when still completely asymptomatic. The possibility of silent primary metabolic diseases and myopathies should be carefully considered when evaluating children with persistently elevated serum transaminases, even in the absence of suggestive anamnestic, familial and physical findings, in order to obtain an early diagnosis and to provide an appropriate genetic counselling.

Age of Onset↗
PubMed1992

[Schoenlein-Henoch syndrome and salmonella infection: a new association?].

Schoenlein-Henoch's disease has a immunological pathogenesis (mediated by immunocomplexes), is characterised by a number of differently associated signs and symptoms, and leads to the possible involvement of the cutis, joints, abdomen and kidneys. Two cases of Schoenlein-Henoch's disease associated with acute salmonella enterocolitis were recently brought to our attention. In two girls, aged 2 years and 8 months and 13 months respectively, the onset of diarrheic alvus was followed, after an interval of 4-5 days, by the sudden appearance of pompho-erythemato-hemorrhagic and petechial cutaneous lesions localised symmetrically on the extensor surfaces of the lower limbs and buttocks, and accompanied in the first case by intense abdominal pain and in the second by diffuse arthralgia, with predominant involvement of the tibio-tarsal joints. Laboratory tests showed slight alterations of phlogosis indexes and high levels of serum IgA (182 and 204 mg/dl respectively). The examination of feces showed the presence of occult blood and salmonella (belonging to C and D groups respectively) were isolated in the coproculture. Other culture and serological tests carried out while in hospital were negative. The clinical manifestations gradually resolved within the space of two weeks following the normalisation of the alvus obtained after a few days using dietary regulation. After two months the girls were found negative on clinical examination; in the second case described there was a positive response to Widal's reaction with high antibody titres against both O and H antigens, whereas the coproculture continued to be positive for Salmonella.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1991

[An open comparative study of sulbactam/ampicillin vs mezlocillin in adult and pediatric patients. Efficacy and tolerability].

Sulbactam is a beta-lactamase inhibitor that, when combined with ampicillin, extends its antibacterial activity against beta-lactamases producing organisms. The clinical efficacy and safety of the sulbactam/ampicillin (S/A) combination versus mezlocillin (M), was assessed in a prospective comparative randomised study. Sixty-five patients (12 children), with lower respiratory tract infections (40), UTIs (20), and skin/soft tissue infections (5), were treated with S/A (32) or M (33 patients), given IV or IM. The two treatment groups did not significantly differ in types of infection, infecting organisms, and severity of underlying disease. Explicit criteria were used to define infections, clinical response, local and systemic tolerability, and adverse effects. A total of 33 organisms were isolated; 3/33 were resistant to S/A, 7/33 to M, and 15/33 to A alone. A successful clinical outcome (cure + improvement), was obtained in 29 out of 30 assessable patients in the S/A group, and in 30/31 in the M group. Both treatments resulted 100% effective in eradicating infecting pathogens: this confirms their high bactericidal activity, also against bacterial species showing remarkable antibiotic resistance patterns, and in variously immunocompromised hosts. Both S/A and M; therapeutic courses were well tolerated; only four out of the 61 assessable patients (2 in S/A, and 2 in M group), experimented mild, transient side-effects, that did not require modification of the treatment regimens. We conclude that both S/A and M appeared very safe and effective drugs; in regard to clinical and microbiological effectiveness and local and systemic tolerability, no statistically significant differences (p greater than 0.05) between the two groups were observed, in treating various bacterial infections, in both adult and paediatric age.

Adolescent↗
PubMed1990

[Peritonitis in continuous ambulatory peritoneal dialysis. Microbiological and clinical evaluation].

In 1976, Popovich et al. described a technique of peritoneal dialysis using bottled dialysate. Later Oreopoulos et al. modified the technique by using plastic bags. But peritonitis still is a major and potentially serious complication of peritoneal dialysis. We have evaluated a) microbiologic diagnostic methods for infectious peritonitis, b) incidence of etiologic agents, and c) the evolution during antimicrobial treatment. Eighteen patients with chronic renal failure of diverse causes were followed from initiation of the CAPD program since January 1981 until June 1988. There were 80 episodes of infectious peritonitis during 17 patient-years of dialysis with an overall incidence of peritonitis of 4.7 episodes/patient-year. The total volume centrifuged technique and culture of sediment showed a sensibility of 85% in 73 episodes where cultures were obtained. The 59.1% of episodes of peritonitis were caused by gram negative bacilli; 11.6% were due to Acinetobacter calcoaceticus and Gram positive cocci accounted for 37.3%. These results are different from those found in other countries because most of our patients had received antimicrobial agents which probably changed their body flora, some did not have manual ability, others were of bad hygienic habits and finally, all of them had frequent contact with hospital environment. The species most frequently isolated were coagulase negative staphylococci (12.8%), probably from patients' skin flora. (ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Growth hormone (GH) and the immune system: impaired phagocytic function in children with idiopathic GH deficiency is corrected by treatment with biosynthetic GH.

Thirty-seven prepubertal children evaluated for severe growth retardation were studied by assessment of total granulocyte, monocyte and lymphocyte count, lymphocyte subsets CD3+, CD3+Dr+, CD3+Dr-, CD4+, CD8+, CD8+CD57+, CD8+CD57-, CD16+, CD20+ and CD23+, serum immunoglobulin concentrations, and phagocytic activity of circulating neutrophils and monocytes (by a flow cytometric assay). Idiopathic GH deficiency was diagnosed in 21 of 37 patients; the remaining 16 healthy subjects served as controls. Fourteen patients received biosynthetic GH (rhGH), and their immune parameters were assessed at baseline and after 6 months of therapy. Phagocytic function mediated by both polymorphonuclears and monocytes was significantly impaired in GH-deficient subjects compared to controls (p < 0.003 for neutrophils, p < 0.007 for monocytes), while a significant increase of phagocytic activity was obtained during long-term rhGH replacement therapy (p < 0.02 for neutrophils, p < 0.001 for monocytes), thus suggesting that GH may affect the functional activity of circulating phagocyte cells. No significant differences were found in total granulocyte, monocyte and lymphocyte counts, T- and B-lymphocyte subsets and immunoglobulin levels, between GH-deficient patients and controls, and between values observed before and during rhGH substitution treatment.

Adolescent↗
PubMedDate not supplied

CD90.

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Amino Acid Sequence↗
PubMedDate not supplied

[Clinical and diagnostic approach to children of low stature. Evaluation of a 24-month hGH treatment of patients with growth impairment of diverse etiopathogenesis].

Growth retardation represents a frequent reason of consultation of Clinical Centers interested in Pediatric Endocrinology. Short stature is a problem especially considered by patients and their families, either because of fear of organic pathologies possibly underlying growth retardation, or because of psychological implications, frequently related to growth retardation and short stature. The Authors describe their clinical and diagnostic approach to short stature; general data from 302 patients followed and treated for growth delay are presented. Clinical experience with recombinant growth hormone (hGH) is discussed in detail: a total of 61 prepuberal children (9 with classic GH deficiency, 26 with partial GH deficiency, 18 with neurosecretory deficit, 6 "short normals", one patient with Turner's syndrome and one case of skeletal dysplasia) have been treated with hGH for a period ranging from 12 to 24 months. Height velocity (expressed as cm/year) increased significantly in all considered groups during the first and the second year of treatment, while considering standard deviation values for chronological age, all treated subjects increased significantly their stature after one year of therapy, but only patients with total GH deficiency appeared to obtain a significant gain after a 2-year course with hGH. No significant adverse effects attributable to hGH administration were observed.

Child↗