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C Pozzi

Publications and source records attributed to C Pozzi.

100 records · Page 6Linked to original sources
PubMedDate not supplied

[Rhabdomyolysis as a complication of Parkinson's disease].

BACKGROUND: Rhabdomyolysis is known as one of the possible causes of acute renal failure and can be triggered by different situations. In recent years, Parkinson's disease emerged as a condition that can be complicated by the development of rhabdomyolysis and consequently, in some cases, of acute renal failure. We report two cases of rhabdomyolysis, one of which complicated by an oligo-anuric renal failure, which occurred in patients affected by Parkinson's disease and admitted to our Division. METHODS AND RESULTS: The first case occurred in a 90-year-old Parkinsonian woman, under treatment with Levodopa-Benserazide and Bornaprine. She developed rhabdomyolysis (CPK 1746 U/L with MB isoenzyme 3.5 ng/ml, LDH 610 U/L, GOT 78 U/L) after she had been found lying on the floor, in a state of mental confusion, after 24 hours in which her relatives had not heard from her. During the first two days of hospitalization, the patient also had a fever (axillary temperature between 37 degrees C and 38 degrees C), accompanied by mild leukocytosis (WBC 13000/mm3) on entrance. The second case occurred in a 78-year-old Parkinsonian woman, under treatment with Levodopa-Carbidopa, Levodopa-Benserazide and Pramipexol. She developed a severe rhabdomyolysis (CPK 34800 U/L with MB isoenzyme 771 ng/ml, LDH 2133 U/L, GOT 785 U/L) complicated by acute renal failure with anuria, after two days characterized by several episodes of vomit and diarrhea. In the following days we learned that in the last 20 days before admission to hospital the patient had increased the dose of her anti-Parkinson therapy and was almost always disturbed by severe choreiform and dystonic movements. CONCLUSIONS: Regarding the first case, the clinical conditions in which the patient was found, the simultaneous presence of fever and leukocytosis and the absence of any reasonable explanation for a hypothetical fall to the floor induced us to think that this was a case of rhabdomyolysis in the context of an akinetic hyperthermic crisis. This is a syndrome that can develop in Parkinsonian patients after discontinuance or simply reduction of therapy with dopaminergic agents and is characterized also by rhabdomyolysis. The fact that the patient was living alone would confirm this hypothesis. On the other hand, the second case of rhabdomyolysis must probably be related to the severe choreiform and dystonic movements that the patient developed in the days just prior to admission. These movements were surely caused by the increase of the substitutive therapy with Levodopa by the patient herself. In conclusion, these two clinical cases, together with others previously reported by other Authors, show how the circumstances leading to the development of acute episodes of rhabdomyolysis in Parkinson's disease can be different and, at the same time, how these circumstances are always somehow related to the treatment of the basic disease with dopaminergic drugs.

Acute Kidney Injury↗
PubMedDate not supplied

[Immunosuppressive therapy in IgA glomerulonephritis with chronic renal failure: case study presentation and literature review].

Immunosuppressive treatment of IgA Nephropathy (IgAN) with chronic renal failure (CRF) is still a controversial issue, because of scepticism on expected results and possible side effects of therapy. There is a "point of no return" (serum creatinine of 3 mg/dL), after which the deterioration of renal function becomes inevitable. We report the case of a 24-year-old woman, with advanced IgAN (serum creatinine > 3 mg/dL), who experienced remission of proteinuria and long-lasting stabilisation of renal function, after treatment with a 6-month steroid course. Literature information on the therapy for advanced phases of IgAN is inadequate. Our multicenter randomised controlled trial, aimed at evaluating the effects of a 6-month steroid course, included 18 patients with mild CRF at baseline. The ten patients that we treated experienced better renal survival than the eight patients who received no steroids, with an expected renal survival of 29.5 and 6.5 years, respectively. In a prospective study of patients with serum creatinine of 1.6 - 2.9 mg/dl, Ballardie and Roberts compared 19 patients treated with immunosuppressive drugs and 19 control patients: renal survival at 5 years was 72% in treated and 5% in control patients. Goumenos et al. retrospectively evaluated 39 patients treated with steroids and azathioprine and 22 untreated patients: a non-progressive course was observed in 79.5% of treated patients and in 36% of untreated patients. Tsuruya et al. retrospectively examined 26 patients treated with steroids and cyclophosphamide and 19 untreated patients: the expected renal survival was of 5.2 years in treated and 4.8 years in untreated patients, respectively. Prospective controlled trials are essential for evaluating the real effectiveness of immunosuppressive therapy in IgAN patients with impaired renal function. We have recently proposed a study to compare steroids alone and steroids plus azathioprine, because it is mandatory to look for safe and effective therapies that delay as much as possible the start of dialysis, also in patients with already established CRF.

Adult↗
PubMedDate not supplied

Infusional therapy for post-surgical biliary stones.

A variety of effective non-surgical forms are used for dealing with retained and recurrent biliary stones. These are endoscopic papillotomy, infusional therapy, intraductal laser or electrohydraulic lithotripsy and extracorporeal shock waves. Saline washout or chemical stone dissolution is currently used in high-risk subjects or in cases in which endoscopic papillotomy fails. For many years now drugs that should dissolve stones topically have been tested by direct infusion into the biliary tract. This approach has given better results over the last ten years with the adoption of Monooctanoin (Mo) and more recently Methyl tertbutyl ether (MTBE). Both preparations have their pros and cons, which are weighed.

Caprylates↗
PubMedDate not supplied

[Pros and cons of chemical litholysis in bile duct calculi].

Chemical litholysis of biliary stones is currently performed using monooctanoin (Mo) and methyl tert-butyl ether (MTBE). These two solvents dissolve cholesterol gallstones at different speeds due to their viscosity, high for Mo (47 cps) and low for MTBE (0.2 cps). A third compound was recently used which was produced by combining the previous two agents, Mo and MTBE, at a ratio of 2:1 v/v. The mixture has an intermediate viscosity (2.8 cps) and has shown good tolerability, management and efficacy with a 90% success rate in the treatment of post-surgical gallstones in 28 patients.

Adult↗
PubMedDate not supplied

Dissolution of bile duct stones with monooctanoin: in vitro study.

Mono-octanoin (Mo) is the drug of choice in the topical litholytic treatment of residual gallstones following cholecystectomy. Although this drug does not produce significant side effects, it requires a lengthy period of treatment (15-20 days). The purpose of this study was to verify the in vitro efficacy of the mixture Mo + 10% H2O vs pure Mo in human cholesterol stones. The findings indicate that this mixture can reduce dissolution time by 15.8% and increase the dissolution rate by 27.9% vs pure Mo. A further significant reduction (p = 0.0001) in dissolution times can be obtained by constant exchange of the solvent at the surface of the stone (stirring).

Bile Duct Diseases↗
PubMedDate not supplied

Osteoblastic cell lines are not susceptible to HIV-1 infection.

Osteoblastic cells are in direct or indirect contact with lymphocytes and bone marrow cells that are the main targets of HIV-1. Therefore we analysed whether HIV-1 could infect these cells using three bone cell lines (HOS, MG-63, U2 OS) as a model. These cells were infected with HIV-1 (strain NL4-3) and the supernatants were harvested every day for 20 days for p24 antigen measured using an ELISA immunoassay. The DNA of infected cells was extracted at days 3, 9, and 12 and the PCR for gag gene was performed using Jurkat cell line as a negative control and ACH-2 cell line as a positive control. Our results demonstrated that HOS, MG-63 and U2 OS are not infected by HIV-1. These data were confirmed using PCR that is currently the most sensitive procedure available.

HIV Infections↗