Prevention of pre-eclampsia and placental insufficiency.
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Biomedical subjects
Publications and source records attributed to E Rossi.
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A high performance liquid chromatographic (HPLC) method was developed for the determination of zinc protoporphyrin (ZnPP) and protoporphyrin (PP) in whole blood. After adding the blood to dilute acetic acid, ZnPP and PP were extracted with dimethyl sulfoxide-acetone containing mesoporphyrin as internal standard. Following evaporation of the acetone, the haemin-free extract was analysed by HPLC. ZnPP and PP were separated on a reversed-phase column and quantitated by measuring fluorescence peak areas. The extraction method is simple, and applicable to batch analysis, and the HPLC separation is rapid and repoducible. The coefficient of variation for ZnPP was 5.6% and 3.3% for total red cell porphyrin levels of 3.5 and 10.2 mumol per litre RBC respectively. Results are discussed in patients with erythrohepatic protoporphyria, lead exposure, iron-deficiency and nonspecifically elevated total red cell porphyrins.
This study included 36 children with IgA-deficiency, increased susceptibility to infections and/or other disorders. Recurrent, usually bacterial infections were noticed in 23 out of 26 patients (88%) with complete and in 7 out of 10 patients (70%) with partial IgA-deficiency. All patients with severe infections had complete IgA-deficiency. Complete IgA-deficiency was also present in the six children who had autoimmune disorders associated with recurrent infections. In 22 out of the 36 patients studied the serum could be analysed for concomitant IgG subclass deficiencies: one patient had marked decrease of IgG2. In a second patient IgG4 was not detectable. Two patients had combined IgG2-IgG4-deficiency. In a girl with severe acute and chronic infections and relapsing idiopathic thrombocytopenic purpura, IgA-IgG2-IgG4-deficiency was found to be the prodromal stage of common variable immunodeficiency with panhypogammaglobulinaemia.
Megaloblastic anaemia in infancy is uncommon in western countries. We describe a case of an exclusively breast-fed monozygous twin with severe vitamin B12 deficiency with haematologic and neurologic abnormalities. Treatment with vitamin B12 resulted in a rapid haematological and clinical improvement.
The authors report a rare case of traumatic false aneurysm of the middle meningeal artery associated with a delayed contralateral extradural hematoma. The extradural hematoma was evacuated, and the pseudoaneurysm was removed to avoid delayed rupture. The literature on traumatic aneurysms is reviewed.
The synthesis of a new class of imidazole derivatives with the structure of 1-[2-(2,4-dichlorophenyl)-2-tert.amino]ethylimidazoles is described. Preliminary data on their antimicrobial activity are reported.
In a randomised, multicentre study intravenous IgG was compared with oral corticosteroids in 108 children with untreated acute immune thrombocytopenic purpura. IgG was an efficient treatment with no severe untoward reactions. The effects of corticosteroids and IgG were identical for rapid responders, who accounted for 62% of all patients. In contrast, patients requiring more than initial treatment responded better if randomised to IgG. The serum IgG level increased two-fold after IgG. A significant rise in IgM levels was observed after both IgG and corticosteroids. The platelet-associated IgG index was high in 75% of all patients. No significant differences between the two treatment groups were found, but rapid responders had a smaller mean initial platelet-associated IgG index which returned more rapidly and more permanently to normal than that of slow responders.
Twenty-five adults with previously treated acute leukemia were treated with 4-demethoxydaunorubicin (Idarubicin) with a daily dose of 8 mg/m2 for 3 days intravenously. Complete remission was achieved in 3 of 18 patients with acute nonlymphoblastic leukemia (ANLL) and 2 of 6 with lymphoblastic leukemia. Complete remissions were observed in two of eight ANLL patients refractory to cytarabine, anthracycline, and m-Amsa (amsacrine), indicating a lack of cross-resistance between these drugs and Idarubicin. The median duration of remission was 8 weeks. The main major toxicity of Idarubicin therapy, severe myelosuppression, cannot be considered a toxic effect because it was desired in this case list. Our preliminary results indicate that Idarubicin has significant activity against refractory adult acute leukemia.
Markers of hepatitis B virus (HBV) and delta agent were prospectively tested in sera of 107 intravenous drug abusers with acute hepatitis positive for hepatitis B surface antigen (HBsAg) associated with delta infection and compared with the findings in addicts with acute classical hepatitis B. On the basis of the presence and titer of IgM antibody to hepatitis B core antigen, 86 of the addicts with delta infection had simultaneously acquired HBV and delta agent, and 21 were chronic carriers of HBsAg experiencing acute delta superinfection. The frequencies of biphasic and severe hepatitis were significantly higher (P less than .05) in delta agent-infected patients than in controls, but the acute clinical and biochemical features of the two varieties of delta disease were not distinguishable. However, in analogy to the clinical outcome of classical hepatitis B, all patients with nonfatal acute HBV/delta coinfection had self-limited illness, whereas 20 of 21 HBsAg carriers superinfected by delta agent developed chronic active hepatitis.
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2 cases of acute renal failure associated with diclofenac therapy are reported. In the 1st case no other risk factors but diclofenac administration were identified. Renal biopsy showed patchy interstitial infiltration of mononuclear cells and polymorphonuclear leukocytes. In the 2nd case preexisting nephropathy and heart failure were underlying illnesses. In both cases renal function returned to the basal values after stopping the drug.
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Hydrochloric acid extraction of feces in the presence of ether yields an extract suitable for spectrophotometric estimation of total porphyrin and for further separation by "high-performance" liquid chromatography (HPLC) or thin-layer chromatography. A total porphyrin reference interval of less than 200 nmol/g dry weight of feces was established from data on 106 normal subjects on an unrestricted diet. Total fecal porphyrin values in 11 porphyria cutanea tarda patients were considerably higher than given by the widely used Rimington method (respective means, 652 and 239 nmol/g dry weight). Our HPLC method for separation of porphyrin methyl esters on a silica column, with quantification by fluorescence, is described. HPLC separations performed on 23 porphyria cutanea tarda patients gave the following mean proportions of total fecal porphyrins: dicarboxylics 21%, coproporphyrin 9%, isocoproporphyrins 28%, pentacarboxylporphyrin 9%, hexacarboxylporphyrin 11%, heptacarboxylporphyrin 18%, and uroporphyrin 4%.
I5HT levels were investigated in 14 children with Hemolytic Uremic Syndrome (HUS). Low levels of I5HT were demonstrated in all the children studied during the early phase of the disease, indicating reversible platelet aggregation and recirculation of degranulated platelets. Three months after the onset of HUS, only 2 children with a pathological picture of cortical necrosis and a mild degree of chronic renal failure had low I5HT levels. On the contrary, normal I5HT levels were present in the other children completely recovered from HUS and with a renal biopsy picture of thrombotic microangiopathy with predominant glomerular involvement. We conclude that normal values of I5HT, after the acute stage of HUS, are a good index of complete recovery from the disease. Further observations are required to assess the prognostic value of low I5HT levels in children with chronic renal failure secondary to HUS.
Ten patients with advanced, diffuse Hodgkin's and non-Hodgkin's lymphomas responding poorly to the most widely employed primary chemotherapy regimens were treated with a high-dose chemotherapy (HDC) followed by rescue with non-frozen autologous bone marrow infusion (ABMT). Complete remission (CR) was obtained in seven of ten patients (70%) and partial remission in two. Hemopoietic recovery occurred in nine cases. These preliminary results appear to indicate that HDC and non-frozen ABMT may be successfully used in patients with resistant or relapsed lymphomas.
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