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Biomedical subjects

L Arisi

Publications and source records attributed to L Arisi.

At least 19 recordsLinked to original sources
PubMed2000

Tacrolimus is highly effective in both dual and triple therapy regimens following renal transplantation. Spanish and Italian Tacrolimus Study Group.

This open, multicenter, randomized, parallel-group study evaluated the efficacy and safety of tacrolimus-based dual and triple therapy regimens. For this 3-month study (with 12-month follow up), 491 adult renal transplant patients were randomized and received either dual therapy (tacrolimus/corticosteroids; 246 patients) or triple therapy (tacrolimus/corticosteroids/azathioprine; 245 patients). Patient survival rates at months 3 and 12 were 99.2 (dual) vs 99.6% (triple) and 97.8 vs 98.7%, respectively. Graft survival rates at months 3 and 12 were 94.1 (dual) vs 95.4% (triple) and 92.8 vs 93.3%, respectively. After 3 months, the incidences of treated acute rejection were 28.8 (dual) and 29.7% (triple); and 7.6 (dual) and 5.4% (triple) for corticosteroid-resistant acute rejections. Between months 4 and 12, three new first rejections were reported, (dual: 2, triple: 1). For leukopenia (1.3 vs 11.7%; P < 0.001) and anemia (14.8 vs 23.0%, P = 0.026), significantly higher incidences were reported in the triple therapy group. The incidence of de novo insulin-dependent diabetes was 5.6 (dual) and 4.0% (triple) at month 3. In terms of efficacy, no difference between the treatment groups was observed.

Acute Disease↗
PubMed1997

A randomized study comparing three cyclosporine-based regimens in cadaveric renal transplantation. Italian Multicentre Study Group for Renal Transplantation (SIMTRe).

Whether it is better to treat renal transplant patients with cyclosporine alone, combined with steroids, or combined with steroids and azathioprine is still unclear. After initial therapy with cyclosporine and steroids, 354 cadaver renal transplant recipients were randomly assigned at the post-transplant day 5 to cyclosporine alone (monotherapy), cyclosporine plus steroids (double therapy), or cyclosporine plus steroids plus azathioprine (triple therapy). Monotherapy patients, after a second acute rejection, were switched to either of the two alternative therapies. According to intention-to-treat (ITT) analysis, the 4-year patient survival was 97% in monotherapy, 91% in double therapy, and 96% in triple therapy; the graft survival including death was 84%, 77%, and 88%, respectively; and the pure graft survival was 87%, 85% and 91%, respectively (P = not significant). Acute rejections were diagnosed in 79 patients in monotherapy, 58 in double therapy, and 59 in triple therapy (P < 0.01). Of the patients on monotherapy, 52% were switched to double or triple therapy. In these patients, the 4-year graft survival including death was 68%, and the pure graft survival was 72%, in comparison with 93% and 94%, respectively, for patients who continued on cyclosporine alone. Patients with renal polycystic disease as a cause of renal failure and with low plasma creatinine at the time of randomization (5 days after transplant) had a higher probability of remaining on monotherapy, wherease those with glomerulonephritis or systemic lupus erythematosus (SLE) and with high plasma creatinine levels at randomization had a higher probability of being switched to double or triple therapy. According to ITT analysis, there were fewer ocular (P < 0.0001), osteomuscular (P < 0.002) and cardiovascular complications (P = 0.05) and fewer patients with hypercholesterolemia (P < 0.0028) in the monotherapy group, with no difference between double and triple therapy. Creatinine clearance at 3 years was lower in monotherapy, but no attrition of renal function was seen over the years in any of the groups. Cyclosporine, however used, provided good results in cadaveric renal transplantation. Triple therapy and monotherapy offered a nonsignificantly better patient and graft survival than double therapy. Patients on monotherapy had a higher risk of acute rejection but had fewer adverse events than those on double or triple therapy. Patients maintained on cyclosporine alone had the best graft survival, whereas those who were assigned to monotherapy and had to add steroids because of multiple rejections had the worst outcome. Therefore, it seems reasonable to limit the choice of monotherapy to patients without immune-mediated renal diseases and with good graft function in the early post-transplant period.

Adolescent↗
PubMed1994

[Lymphoma and renal failure].

The Authors examine the main causes of renal failure in lymphoma (infiltration of kidneys, glomerulonephritis, paraproteinemic nephropathy), the difficulties for a correct diagnosis with ultrasonography, urography and CT scan, the importance of renal biopsy. The histologic examination should be promptly performed in patients with sudden renal failure of unknown aetiology and clinical suspicion of malignancy, because renal function can improve dramatically with aggressive chemotherapeutic treatment of lymphoma.

Antineoplastic Agents↗
PubMed1993

Reflections on Four Years' Activity of an Interdisciplinary Centre for the Treatment of Obese Patients.

Since 1988, there has been an interdisciplinary center for obesity treatment in Stradella's Hospital's Surgery Department,. Patients are followed by a group of surgeons, anesthetists and dietitians, who choose the proper treatment for the patient. The surgical treatments are two: (1) vertical banded gastroplasty; and (2) a new technique consisting of biliopancreatic diversion plus a vertical banded gastroplasty with stomach ad hoc. The authors explain the new surgical procedure showing positive results, without giving final conclusions because of the small number of patients treated.

Journal Article↗
PubMed1990

Protein-induced changes in kidney function depend on the time of administration but not on the dietary source.

Two separate experiments were carried out to study the effects of the same acute protein load given at different hours of the day and to assess the ability of proteins from different sources to induce hyperfiltration. In the first experiment, 9 healthy volunteers were kept at strict bedrest for 48 h, during which both a meat high-protein meal (protein load, PL) and a vegetable low-protein meal (control load, CL) were given either at lunch or at suppertime. As compared to a CL, PL determined a significant increase in GFR, total proteinuria (uTP), albuminuria (uA), and urinary retinol-binding protein (uRBP). These effects were much more significant after lunch PL than after supper PL, thus indicating an interaction between the PL and the time of the day. The existence of a circadian rhythm for GFR, uTP, uA, and uRBP was corroborated by spontaneous changes over baseline levels, which also were prominent after lunch CL as compared to those following supper CL. In the second experiment, 7 healthy volunteers ingested at lunch three protein-rich meals at 1-week intervals. The three protein loads consisted of about 80 g protein in the form of cooked red meat, cheese, and soya, respectively. The only significant differences between groups were urea appearance and urea clearance, lower and higher, respectively after soya load. These findings suggest that when evaluating the renal functional reserve after acute protein load both the spontaneous changes and the time-dependent sensitivity of kidney functions to acute challenges should be considered. Finally, the amount rather than quality of dietary proteins seems to be the determinant factor for protein-induced glomerular hyperfiltration.

Administration, Oral↗
PubMed1988

Time-dependent increase of glomerular filtration rate after oral protein load: evidence for diurnal variations in renal response.

Seven healthy male volunteers were studied to test the effect of timing of an oral protein load on renal function. Creatinine clearance (Ccr) was measured during the 4-h period after administration of 72 g of protein in the form of cooked red meat at 1200 hours (lunch protein load, PL) and at 2000 hours (supper PL) the next evening. A low-protein meal in the form of vegetables was given as a control load at 2000 hours on the first day (supper control load, CL) and at 1200 hours on the second day (lunch CL). The 12-h night-time Ccr at fasting was used as the baseline reference value. After the lunch PL, Ccr (mean 127 +/- 6.8 ml/min) was 45% (p less than 0.001) higher than the baseline value (mean 87.9 +/- 5.3 ml/min) and 33% (p less than 0.001) higher than lunch CL (mean 95.8 +/- 5.6 ml/min). After the supper PL, Ccr (mean 106.2 +/- 8.7 ml/min) was 20% (p less than 0.01) higher than the baseline value and 15% (p less than 0.01) higher than the supper CL (mean 93.0 +/- 9.3 ml/min). The differences between baseline and control load values were not statistically significant. In all seven patients, the protein load induced a maximum Ccr value at lunchtime, and Ccr after the lunch PL was 22% higher than Ccr after the supper PL (p less than 0.01). We conclude that in healthy individuals, the Ccr after an oral protein load is correlated to the hour of the day when the study is performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

[Acute cardiotoxicity of tricyclic compounds: remarks on a clinical case].

Tricyclic compounds have complex effects on the cardiovascular system, causing dangerous arrhythmias even in patients free of cardiac disease, especially after overdose. We report on a case of cardiac arrhythmia during low dosage therapy of post-herpetic neuralgia with Carbamazepine and Amitriptyline in a patient with chronic renal rejection and cirrhosis. Pharmacologic properties and side effects of these drugs are examined from the current literature. Both drugs prolong AV conduction, consequently You can observe AV blocks of various degrees of His bundle branch blocks also during low-dosage therapy in patients with hepatic failure. It seems to be judicious to provide to ECG monitoring during the complete period of therapy.

Adult↗
PubMed1987

Circadian rhythm of proteinuria in normal subjects but not in patients with glomerulonephritis.

The existence of circadian variations in the urinary excretion of total protein, albumin and creatinine was investigated in subjects with normal and impaired renal function. All individuals were kept at bedrest for 24 hours. Eight consecutive urine specimens were collected every 3 hours and examined. In normal subjects the urinary total protein, albumin and creatinine excretion showed a significant increase during the 12 daytime hours compared with the night-time. The diurnal variations with peak occurrence at 13.26 h (range 09.58-16.43 h) for total protein, at 12.37 h (range 10.33-15.18 h) for albumin, at 16.33 h (range 13.22-19.24 h) for creatinine are temporally related to the ingestion of meat. In patients, by contrast, total protein, albumin and creatinine excretion in the urine were not modified significantly throughout the 24 hours period. Thus, impaired renal function is associated with the loss of the physiological circadian rhythm.

Adult↗
PubMed1983

Short dialysis.

Explore the source record for details and available documents.

Adolescent↗
PubMed1983

An integrated programme of haemodialysis and peritoneal dialysis: a single two-litre exchange per night plus haemodialysis every four to six days.

Critical problems of CAPD: (a) protein loss; (b) peritonitis; (c) glucose overload; (d) intra-abdominal pressure, can be rationally managed by an integrated intracorporeal and extracorporeal approach. A single two-litre peritoneal exchange performed during the night in addition to haemodialysis every four to six days (HD-PD) reduces a, b, c and eliminates d. This HD-PD technique has been evaluated in eight uraemic patients over a total period of 20.5 patient months. Preliminary results show that this procedure can provide adequate biochemical control, with low protein losses and limited interdialysis weight gain.

Aged↗