Biomedical subjects
Publications and source records attributed to G Mosconi.
We describe a case of acute hepatonephritis in a worker of a pharmaceutical factory, due to sporadic and short exposures to chloroform at levels even 70 times higher than its TLV.
Multielemental analysis, using neutron activation, was carried out on the urine, whole blood, pubic hair and toenails of thirty subjects occupationally exposed to hard metal dusts. A high concentration of Co, W and Cr was observed in all samples analysed. The concentrations determined, when subjected to statistical analysis using pattern recognition techniques (e.g. cluster analysis), indicated a positive correlation, at p = 0.001, for the pair (Co, W) in urine and blood, as well as a possible influence of Cr on this pair.
We measured the serum concentration of alpha-1-acid glycoprotein (AAG) in 30 healthy subjects (controls), in 54 patients with various degrees of residual renal function (group I), and in 98 patients in the terminal phase of chronic renal failure (CRF) on both conservative and dialytic therapy (group II). A positive correlation between the logarithm of serum AAG and serum creatinine levels was found in group I. Serum AAG increased significantly when serum creatinine rose above 10 mg/dl. This fact would indicate that a retention of the substance occurs as the renal function falls. The mean serum concentration of AAG was significantly higher in group II patients, with no difference between those on conservative therapy and those on maintenance hemodialysis. However, levels above normal were present in only a minority of cases. We conclude that the serum AAG measurement maintains its diagnostic value as an acute phase reactant also in the terminal phase of CRF.
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Abnormalities in the amino acid patterns are a constant finding in chronic renal failure and can be regarded as one of the typical biochemical alterations of uremia. This paper evaluates the long-term effects of various artificial substitutive treatments and renal transplantation on plasma and tissue amino acid patterns in chronically uremic patients. Fifty-three patients were included in the study: 35 on artificial treatments (9 on hemodialysis, 9 on hemofiltration, 4 on hemoperfusion, 6 on continuous ambulatory peritoneal dialysis, and 7 on intermittent peritoneal dialysis) and 18 with well-functioning renal transplants. Complete plasma aminograms were performed in all patients before starting the treatment, and repeated every 3 months up to 1 year (artificial therapies) and 3 years (renal transplantation). The amino acid composition of the bone was also determined in 8 dialysis patients and 9 transplant patients. None of the artificial therapies was associated with normal plasma patterns either in the short- or in the long-term, whereas successful renal transplantation led to normalization of the plasma profile within 2 to 4 months in all patients. However, bone amino acid composition remained altered both in artificially treated and in transplanted patients.
The present report deal, a year after its beginning, with the results of a programme for health control regarding 592 ex-employees of Società Bergamasca Industrie Chimiche. Azo dyes were obtained from benzidine and beta-naphthylamine in this factory from 1947 to 1968. The report analyses the organizing difficulties and the troubles which caused a scarce performance of the programme at different levels: the subjects interested in the control, the Commission responsible for the district, the doctors in charge, the laboratories, the hospital division. In the end some proposals are advanced referring to the provision of the ministerial circular letter no 46, dated june 12, 1979, about the medical control of workers who leave the hazardous working job.
When administered orally Ibopamine, the diisobutyric ester of N-methyldopamine, has pharmacological properties similar to intravenous dopamine: in particular, both renal blood flow and the urinary excretion of sodium and water increase. The drug also enhances creatinine clearance, both in normal subjects and in patients with impaired renal function. Twenty-eight patients affected with chronic renal insufficiency were treated with oral Ibopamine (100 mg/day) for 4-56 weeks. They were divided into 2 groups according to whether the creatinine clearance was more or less than 15 ml/min: Group 1 contained 21 patients (mean clearance 29.09 ml/min) and Group 2 7 patients (mean clearance 8.42 ml/min). Ibopamine treatment was ineffective in Group 2, while in Group 1 patients there was a statistically significant increase in creatinine clearance (+23% after 3 months, +31% after 6 months). Drug tolerance was excellent from both clinical and laboratory points of view.
Serum ferritin, measured by radioimmunoassay in 65 dialysis patients (mean time of dialysis 38.9 months), was significantly higher (247.9 +/- 224.5 ng/ml) than in controls (p less than 0.001), inversely correlated with dialytic age (p less than 0.05), and had no difference as far as sex or underlying nephropathy were concerned. With regard to the other hematological parameters, serum ferritin correlated inversely with total transferrin and directly with percentage of total transferrin only. In 28 patients, an intravenous iron load (0.6 g in one month) induced a further increase in serum ferritin (p less than 0.001), rather disomogenous and not clearly correlated with initial levels. The change in hemoglobin concentration after iron administration was in close relationship with initial serum ferritin levels (r = -0,72, p less than 0.001). A significant increase in hemoglobin could be detected in all the patients with serum ferritin less than 65 ng/ml and in most patients with serum ferritin less than 160 ng/ml, while hemoglobin change was negligible when serum ferritin levels in dialysis exceeded this value. Thus, although serum ferritin levels in dialysis patients may reflect not only iron overload but also an abnormal metabolism, serum ferritin measurement remains a reliable guide to iron requirement. We suggest maintaining serum ferritin levels between 65 and 160 ng/ml, to avoid iron stores depletion and on the contrary, iron overload.
1 Pharmacological and experimental studies have shown that ibopamine (SB 7505, di-isobutyric ester of N-methyldopamine) is capable of increasing renal blood flow, diuresis, urinary sodium, potassium and creatinine excretion. 2 SB 7505 was given to twelve volunteer patients, six of whom had normal renal function and six with various degrees of chronic renal impairment. 3 In both groups the drug yielded a prompt increase in urinary excretion of water, sodium and potassium, while creatinine clearance was also seen to increase. 4 Heart rate and arterial pressure were unaffected by SB 7505 in all patients. 5 Results seen encouraging and call for further study on the proper use of the drug in clinical nephrology.
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