Iron chelating therapy in thalassemia: current problems.
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Biomedical subjects
Publications and source records attributed to G Russo.
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The intestinal tuberculosis is a rare disease in Europe and in North America. It is an important disease because some patients can develop intestinal stricture or subacute intestinal obstruction and, sometimes, tuberculous peritonitis. It is often difficult differentiate intestinal tuberculosis from Crohn's disease or intestinal tumors. The treatment is controversial and may be medical or surgical, but the response to medical therapy is not clear, especially in complicated disease. The authors report a case of ileal tuberculosis treated with surgical therapy.
The aim of our study was to evaluate the possibility of recording also sub-clinical alterations of the Central Nervous System during chronic uremia by means of the study of Pattern-Reversal Visual Evoked Potentials (P-R V.E.Ps) and Brainstem Acoustic Evoked Potentials (B.A.E.Ps), to study their behaviour in answer to different kinds of treatment and follow their possible modifications during the time. With this purpose the uremic patients were divided into therapeutic groups: only dietetic and pharmacological treatment, conventional hemodialysis, hemodiafiltration, peritoneal dialysis and well functioning kidney transplant. A first record of Evoked Potentials was made in 1985 and the values were compared with those obtained by an homogeneous control group. The same patients were evaluated 3 years later and the two records results were compared. In both cases the most important percentage of altered values were found in the group under only dietetic and pharmacological treatment, the less important in the transplanted patients and these data were stable at the follow-up. So that Evoked Potentials are a good test in chronic uremia and the best therapy able to hinder the alterations of Central Nervous System arising during chronic renal failure would seen to be kidney transplant.
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The interactions of 3 classical alpha-adrenergic antihypertensives of prevalently central type (St 155 or clonidine St 600; BR 750 or guanabenz) with the narcotic effects of pentobarbital have been investigated in the Mus musculus. Interferences between convulsant drugs and spontaneous and coordinatory motor activity were also analysed in comparative studies.
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A newly developed Transcranial Doppler system (TCD) has been used in a group of subjects without any cerebrovascular disease (CVD) in order to establish the standard criteria for transcranial basal cerebral arteries examination and settle normal velocimetric and hemodynamic parameters. TCD examination in patients suffering from CVD provides useful information for clinical management of such pathological conditions.
In 14 untreated informed patients (5 M, 9 F, mean age 62 yrs) with initial idiopathic Parkinson's disease AEPs, early (BAEPs) and long latency components (LLCs) were studied. In 10 subjects experimental session were carried out before treatment (L-Dopa plus Carbidopa, 0.25-0.50 g/die) and at 2, 6 and 12 months intervals. At the same time all patients underwent clinical assessment by Webster Rating Scale evaluation. BAEPs. The IPLs prolonged (greater than 2.5 SD) in 6 patients: in 3 the III-V, in 2 the I-V and in 1 the I-III. The absolute latencies were abnormally prolonged in 11 subjects: V wave in 4, III wave in 3, II wave in 2 and I wave in 3. The absence of one or more components were observed in 12 out of 14 patients, the most frequently absent was the II wave (12 patients). LLCs. The absolute latencies of P1 and N1 waves were prolonged respectively in 4 and in 3 subjects. The P1-N1 IPL was prolonged only in one patient. A follow-up study demonstrated transitory improvement of the AEPs previously observed abnormalities. The improvement was partially in agreement with clinical assessment.
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The count of bacteria in fresh, unstained, uncentrifuged urine specimens, using a phase-contrast microscope, magnification X400, and a hemocytometer chamber, is a simple method to exclude urinary tract infection. The specificity of this method is 94%, while the sensibility is 66%. We exclude an urinary infection when the count is less than 5 bacteria/0.1 ml. If we add to bacteria the evaluation of pyuria, the sensibility of this method does not change. On the contrary what we observe is an increase of the false positives. Bacteria more easily identified in urine specimens are E. Coli and Klebsiellae; the bacterioscopy has confirmed respectively 82% and 100% of positive urinecultures. The corresponding values for Protei and Streptococci are 23% and 20% respectively. This method is very simple also for teaching; it requires only a few minutes and is inexpensive. Its most useful utilization is the exclusion of urinary tract infection when the concentration of bacteria in the urine is less than 5 bacteria/0.1 ml.
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