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Biomedical subjects

C Ferri

Publications and source records attributed to C Ferri.

At least 217 records · Page 12Linked to original sources
PubMed1989

Oncocytoma and low-grade oncocytic carcinoma of the kidney.

Oncocytoma is a term generally used to describe a neoplasm of the renal parenchyma consisting of well-differentiated cells with prominently eosinophilic granular cytoplasm. We report our experience with such tumors and with 4 cases of granular cell carcinoma (grade 2). We present the histopathology, surgical staging studies, treatment, and clinical outcome. Of the 10 patients, 7 are alive without evidence of tumor at a mean follow-up of 5 years from the initial treatment. Three patients have died, 2 from nontumor-related causes while the cause of death of the third patient is uncertain, possibly due to the tumor. Although well-differentiated oncocytic renal tumors are usually considered as uncommon when the diagnosis is made, nonaggressive behavior is expected. However, careful radiographic and pathologic examination is required to avoid the pitfall of overlooking a higher-grade, more lethal neoplasm which may be mixed with the well-differentiated oncocytic neoplasm and form a minority component. A wide resection, which in most cases is nephrectomy, is apparently curative and assures that complete pathological examination of the specimen can be accomplished. In more than 90% of the cases, the tumor is solitary and unilateral. Cases in which there are multiple tumors are often bilateral, and this finding may create diagnostic confusion.

Adenoma↗
PubMed1989

[Echography vs urography in the study of small-size renal carcinoma].

Since 1981 we have studied 34 patients with renal cell carcinomas smaller than 3 cm, diagnosed by US and IVP, to evaluate the diagnostic viability of these 2 procedures. Their respective results were compared to pathologic findings and tumor grading. No correlation was found between the type of sonographic patterns and the pathologic findings. On the contrary the correlation between the acoustic pattern and the grading, performed on small tumors and on a control group of large tumors, showed that most tumors in the former group (70%) had lower grading than those in the latter. We conclude that the introduction of US has changed the approach to the diagnosis of renal tumors, allowing their early recognition and characterisation. It is thus hoped that the clinical course of such tumors will be improved.

Adult↗
PubMed1989

[Sarcomatoid nephrocarcinoma. Correlation of radiological, histopathological and prognostic features].

Fifteen patients with sarcomatoid renal cell carcinoma were studied from 1975 through 1987. For each case the radiological, sonographic (US), and histopathological features were reviewed. Neither ivp nor US detected any specific patterns, though demonstrating frequently-necrotic and infiltrating masses. Angiography and/or CT were more useful because they allowed the staging of the tumors and the evaluation of their vascularity. In particular, a frequent correlation was observed between the degree of vascularity and the percentage of sarcomatoid component at histopathology. Sarcomatoid renal cell carcinoma were hypo-avascular in 7 cases and hypervascular in 8. Six of the 7 hypo-avascular cases had a high percentage of sarcomatoid tissue (greater than 50%) and were highly malignant. Seven of the 8 hypervascular neoplasms had a low percentage of sarcomatoid component and presented radiological features similar to clear/granular cell tumors. The survival of the patients with sarcomatoid tumors was much shorter than that of the patients with other kidney carcinomas. Among sarcomatoid tumors, prognosis was worst for the patients with hypo-avascular neoplasms.

Adult↗
PubMed1988

Effect of angiotensin converting enzyme inhibition on platelet angiotensin II content.

The effect of captopril treatment on platelet angiotensin II levels was evaluated in 12 patients with essential hypertension. Captopril significantly lowered (p less than 0.01) mean arterial blood pressure in seven patients (Group 1) and was ineffective in five (Group 2). In Group 1, a marked decrease in plasma angiotensin II levels in both the supine (from 5.5 +/- 0.5 to 2.8 +/- 0.9 pg/ml) and the upright positions (from 17.5 +/- 4.7 to 3.9 +/- 1.6 pg/ml; p less than 0.0025) and a significant increase in platelet angiotensin II levels (from 10.5 +/- 5.3 to 22.4 +/- 17 pg/ml; p less than 0.05) after captopril treatment was observed. In Group 2, no variation was found in plasma angiotensin II levels, whereas platelet angiotensin II levels increased slightly (from 10.8 +/- 3.1 pg/ml to 16.9 +/- 5.2 pg/ml; NS). These findings suggest that the decrease in plasma angiotensin II levels can lead to an increase in platelet angiotensin II receptors or can lead to angiotensin II production in platelets through activation of a feedback mechanism. The second hypothesis suggests that platelets have alternative enzymatic pathways leading to angiotensin II production not inhibited by captopril.

Adult↗
PubMed1988

[Papillary nephrocarcinoma: radiographic and echographic aspects].

Between 1976 and 1987, 395 patients with kidney tumors were studied with radiological techniques and sonography. In 37 cases (9.4%) histopathology diagnosed pure papillary renal cell carcinoma. Analyzing the radiographic patterns of these neoplasms, the authors observed constantly diminished vascularity (100%), frequent calcifications (35.1%) and necrotic areas (51.3%). Such X-ray features are not specific: nevertheless, their coexistence is strongly suggestive of papillary renal cell cancer. No consistent US pattern was found; however, necrotic areas were easily demonstrated in most cases. It must be stressed how patients with papillary carcinoma experienced a longer postoperative survival; it has not yet been established whether such favorable behavior is due to low biological aggressiveness or to earlier diagnosis.

Adult↗
PubMed1988

Captopril does not alter metabolic control in elderly hypertensive diabetics during secondary failure.

In elderly patients diabetes and hypertension play an important and synergistic role in the development of cardiovascular complications. For this reason therapy must reduce blood pressure without compromising blood glucose control. We investigated the question of whether captopril, an angiotensin converting enzyme inhibitor, can be used without interference to glucose metabolism in diabetics with secondary failure. Ten elderly hypertensive diabetics (diastolic blood pressure greater than 95 mmHg), maintained in good metabolic control using oral hypoglycaemic agents and insulin, were studied before and after 30 days of captopril at 100 mg/day. We measured the following parameters: blood pressure, heart rate, fructosamine and a daily profile for blood glucose and c-peptide. There was a statistically significant reduction in systolic and diastolic blood pressure. No difference was observed in the levels of blood glucose and fructosamine. Insulin secretion as determined by c-peptide levels was not modified, in contrast with findings reported for the use of beta-blockers, diuretics or nifedipine. It seems that captopril is useful and without side effects, even in secondary-failure diabetic patients characterized by unstable metabolic control.

Aged↗
PubMed1988

Effect of nicardipine on angiotensin II platelet content.

We evaluated the effect of nicardipine treatment on platelet angiotensin II content in 18 essential hypertensive patients. Nicardipine induced a decrease in platelet angiotensin II content in all patients (-14%), but particularly in 10 (P less than 0.05; -20.5%). No other differences were found between these patients and the others. Further investigations are required to determine whether platelet angiotensin II content reduction contributes to the prophylactic and therapeutic effects of calcium antagonists on atherosclerosis.

Aged↗
PubMed1988

Hypertensive emergencies in old age: effects of angiotensin converting enzyme inhibition.

Hypertensive emergencies, and to a certain extent their treatment, contribute to morbidity and mortality in elderly patients. We studied 22 hospitalized patients, aged 70-90 years, all of whom had moderate essential hypertensive. During acute hypertension, mean systolic and diastolic blood pressure rose to 230 +/- 24 and 120 +/- 22 mmHg, respectively. Symptoms of reduced tissue perfusion/oxygenation and/or organ failure occurred, forcing us to begin antihypertensive therapy. We administered 50 mg of the angiotensin converting enzyme (ACE) inhibitor captopril sublingually, and within 15 min, systolic blood pressure decreased by an average 60 +/- 16 mmHg and diastolic blood pressure by an average 25 +/- 14 mmHg. There was no significant change in the heart rate. In addition, we treated 22 comparable patients with 10 mg nifedipine sublingually and observed, in four cases, a greater fall in blood pressure (up to 90 mmHg) together with tachycardia. These results show the beneficial effects of captopril in the treatment of hypertensive emergencies in elderly patients. The absence of dangerous side effects indicates that ACE inhibitors can be used as first-choice drugs for the treatment of acute hypertensive crises, even in old age.

Administration, Sublingual↗
PubMed1988

Blood platelets and angiotensin II: angiotensin II release after platelet aggregation.

Recent studies have demonstrated the presence of angiotensin II (Ang II) in human platelets. The aim of the present study was to determine whether in vitro platelet aggregation induces Ang II release. We studied 20 healthy volunteers, and found that some aggregant stimuli can cause the platelet to release this peptide. Release of Ang II was greater with thrombin (40.7%) than with ADP (29%), while N-ethylmaleimide was almost ineffective. The release of Ang II following in vitro aggregant stimuli suggests that this may be one of the mechanisms through which platelets can locally modulate vascular tone and perhaps promote atherogenesis.

Adenosine Diphosphate↗
PubMed1987

Sarcomatoid carcinoma of the kidney.

Among 315 cases of parenchymal renal carcinoma resected between 1975 and 1985, 19 cases (6 per cent) of sarcomatoid carcinoma were identified. All patients were symptomatic or had a palpable mass in the flank at hospitalization. Tumor stage generally was advanced at operation and metastases were detected in 8 patients (Robson stage IV), all of whom died after an average postoperative survival of 8 months. In 3 patients there was tumor invasion of the renal vein (Robson stage IIIA), and they died after an average postoperative period of 11 months. Of 4 patients with perinephric fat invasion (Robson stage II) 2 died of cancer after an average survival of 15 months and 2 are alive with no evidence of disease for an average of 73 months postoperatively. In these later 2 cases the sarcomatoid areas constituted less than 5 per cent of the entire tumor and the remaining tumor was low grade carcinoma. In 3 patients adequate followup is not available and 1 was lost to followup. This histological variant of parenchymal cell carcinoma is a high grade malignancy with a poor prognosis. Operative treatment appears to be ineffective in modifying the behavior of the tumor.

Aged↗
PubMed1986

Lung function abnormalities in different connective tissue diseases.

Lung volumes, forced expiratory flow-volume curves, diffusing capacity indexes, and arterial blood gases were measured in 72 non-smoking patients with various connective tissue diseases (13 with rheumatoid arthritis, 17 with systemic lupus erythematosus, 25 with progressive systemic sclerosis, 10 with primary Sjögren's syndrome, 4 with polymyositis, and 3 with mixed connective tissue disease). Small airways disease and a diffusion capacity impairment were the most frequent and marked functional abnormalities in the whole group, and were often present in asymptomatic patients. Different lung function defects seemed to be present in each disease group. In fact, large airway obstruction was prevalent in progressive systemic sclerosis, diffusion capacity impairment in systemic lupus erythematosus, and small airways disease in rheumatoid arthritis. In contrast, primary Sjögren's syndrome appeared to be the connective tissue disease in which lung function abnormalities were less frequent and less pronounced.

Adolescent↗
PubMed1986

Treatment of the renal involvement in mixed cryoglobulinemia with prolonged plasma exchange.

Nine patients with mixed cryoglobulinemia and severe membranoproliferative glomerulonephritis were treated with plasma exchange alone or in combination with medium to low amounts of corticosteroids, but never with cytotoxic drugs. In 5 patients renal function and/or proteinuria improved after plasma exchange, and no clinical relapse usually occurred when the procedures were reduced or discontinued. These procedures seemed of particular effect in the presence of histologically active and not irreversible lesions and rapid deterioration of renal function. While cryocrit almost invariably decreased, circulating immune complex or complement levels were unpredictably affected by plasma exchange. Cryocrit, but not immune complex or complement levels, was the serological parameter which most often closely correlated with signs of renal involvement (i.e., proteinuria and/or serum creatinine). Thus, plasma exchange might be a safe and useful tool in the treatment of an often drug-resistant and rapidly progressive renal involvement occurring in patients with mixed cryoglobulinemia.

Adult↗
PubMed1986

Long-term griseofulvin treatment for progressive systemic sclerosis.

Thirty-three patients with progressive systemic sclerosis (PSS) (24 women and 9 men, 27 with diffuse scleroderma and 6 with CREST syndrome) were treated with griseofulvin alone (375-500 mg/day) for 12-84 months (mean 33). Clinical and functional assessment of the results included: a self-evaluation (general status, skin toughness, cold sensitivity, dysphagia), a physical examination (fingerprint areas, chest expansion, mouth widening, grip strength) routine laboratory tests, electrocardiogram, glomerular filtration rate (GFR), esophagus and chest X-rays. After griseofulvin, a significant improvement was noted in 28/33 patients (85%) regarding subjective condition and skin thickening and elasticity, particularly in the trunk and proximal limbs (p less than 0.05 for chest expansion), and of GFR (p less than 0.01). Lung and esophageal involvement, on the whole, remained unchanged during the treatment, which does not appear to modify the progression of PSS myocardiopathy. No patient stopped using griseofulvin because of side effects. The present results show that griseofulvin is a safe drug for PSS treatment and that it can influence the skin and renal involvement.

Adolescent↗
PubMed1986

Lymphocyte subpopulation in essential mixed cryoglobulinemia.

Lymphocyte subpopulations were evaluated in 31 patients affected by essential mixed cryoglobulinemia, using OKT3, OKT4, and OKT8 monoclonal antibodies in a cytotoxic assay. The patients with essential mixed cryoglobulinemia had a normal number of OKT3+ and OKT4+ cells but significantly lower values of OKT8+ cells compared to healthy controls. When the OKT4+/OKT8+ ratio was considered, patients could be subdivided into 3 main subgroups: 6 patients had a low OKT4+/OKT8+ ratio, 10 patients had a normal ratio, and 15 had a high ratio. This ratio did not correlate with age, sex, disease duration, low corticosteroid therapy or serological hallmarks of the disease. In contrast, purpura and liver involvement were more prevalent in patients with a normal or high OKT4+/OKT8+ ratio, while lung involvement was more prevalent in patients with a low ratio.

Aged↗
PubMed1985

Noninvasive evaluation of cardiac dysrhythmias, and their relationship with multisystemic symptoms, in progressive systemic sclerosis patients.

Fifty-three patients (34 who had diffuse scleroderma, and 19 who had CREST syndrome [calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasias]) were studied by noninvasive procedures, including resting electrocardiogram (ECG), continuous 24-hour Holter ECG monitoring, M-mode echocardiography, and 2-dimensional echocardiography. Only 22 patients (42%) had abnormalities such as conduction defects, supraventricular or ventricular arrhythmias, or ST-T changes detected on resting ECG. In contrast, using Holter monitoring, the number of conduction abnormalities seen increased from 10 to 16 patients and transient ST-T changes increased from 2 to 18 patients. Forty-eight patients had ventricular arrhythmias, with multiform ventricular premature beats in 21 (40%), pairs of runs of ventricular tachycardia in 15 patients (28%), and 1 or more runs of ventricular tachycardia in 7 (13%). Echocardiography detected asymmetric septal hypertrophy in 10 patients, impaired ventricular function in 9 patients, congestive cardiomyopathy in 2, mitral prolapse in 4, and pericardial effusion in 3 patients. Multiform and/or repetitive ventricular premature beats occurred more frequently in patients with echocardiographic abnormalities, but were also present in patients who had normal findings on echocardiographic examination. Cardiac involvement was not correlated with clinical variants of scleroderma (CREST syndrome or diffuse scleroderma), nor with other signs and symptoms of the disease. Thus, cardiac involvement is found much more frequently than would be expected from clinical symptoms or from results of resting ECG alone; therefore, Holter monitoring and echocardiography should be included in the routine workup of patients who have scleroderma.

Adolescent↗
PubMed1985

Hypotensive effect of plasma exchange in immune complex nephritis.

The effect of plasma exchange (PE) on blood pressure (BP) in 20 hypertensive patients (9 with mixed cryoglobulinemia, 7 with systemic lupus erythematosus, and 4 with idiopathic glomerulonephritis) was evaluated retrospectively. In each PE 1.5-2.5 L of plasma was replaced with an equal volume of 4% albumin polysaline solution. The frequency of PE was three times per week for the first 2 weeks and twice per week subsequently. Sixteen patients were on hypotensive treatment at the onset of PE. Their systolic/diastolic BP was 171 +/- 4.7/102 +/- 3.0 mm Hg (mean +/- 1 SEM). After 4 weeks, BP decreased to 141 +/- 2.8/89 +/- 2.3 mm Hg (p less than 0.001), although in 10 patients antihypertensive drug therapy had been reduced or discontinued. The most marked decrease of BP occurred after the first week (152 +/- 5.3/92 +/- 2.9 mm Hg), and this decrement correlated remarkably well with pressure levels before PE despite the great heterogeneity of the individual patients (for diastolic BP, r = 0.87, p less than 0.001; for systolic BP, r = 0.60, p less than 0.01). A mild decrease of serum creatinine was observed during PE, but its time course was different from that of BP, and did not correlate with this parameter.

Adolescent↗