Search PubMed⌕ Search

Biomedical subjects

L Borghi

Publications and source records attributed to L Borghi.

At least 73 records · Page 4Linked to original sources
PubMed1980

The influence of renal function on the elimination kinetics of sulbenicillin in man.

Serum concentration and urinary excretion following a single i.v. dose of 1 g Sulbenicillin (SB) have been studied in 13 subjects with different degrees of renal insufficiency and 4 control subjects. With normal GFR, serum half-life averages 27 min, with GFR between 45 and 14 ml/min, 1,5 hours, with GFR below 8-10 ml/min, 4,6 hours (maximum 7 hours). The usually recommended dosage schedule is 1 g every 6 hours. Only when GFR falls below 8-10 ml/min, the interval between doses must be changed; 1 g every 8-12 hours should be given under these conditions. However, in cases of severe extrarenal or urinary tract infections due to antibiotic-resistant strains of E. coli, Ps. aeruginosa, Pr. morganii, a first dose of 2-4 g SB should be given, followed by maintenance half-doses (1-2 g SB) every half-life.

Adult↗
PubMed1980

[Na/K transport in red blood cells from normal subjects: methodological problems (author's transl)].

In this work we present a method which evaluates the facility of applying and reproducing ion fluxes in human cells using radioactive 22Na as a tracer. Intracellular sodium concentration, rate constants for total (oKNa TOT), ouabain-sensitive (oKNa OUABs) and ouabain-insensitive (oKNa OUABins), sodium efflux and relative effluxes obtained by multiplying the rate constant by the sodium concentration were measured in the red cells of 20 normal subjects. Our results have been shown to be comparable with those obtained in other reports and show a statistically significant relationship between intracellular sodium concentration and the rate constant for active sodium efflux: one would conclude that the intracellular sodium constant probably depends on the activity of the sodium pump genetically determined in each individual. Since such a method is precise can be exactly reproduced, it can be applied to the study of cellular metabolism of different clinical disorders characterized by significant fluid and electrolyte imbalances.

Adult↗
PubMed1980

[Na/K transport in red blood cells from severely burned patients (author's transl)].

The working of the Na/K pump in the red cells of 6 patients with extensive burns was analyzed using radioactive substances with the aim of comparing their red cells with those of 20 normal subjects. In the red cells of patients with extensive burns was found that the intracellular sodium concentration was clearly increased, that the rate constant of ouabain-sensitive efflux diminished, and that the total sodium efflux was augmented by the increase of the ouabain-insensitive part. It is likely that the intra and extra-cellular transportation defects produce an accumulation of sodium inside the cell which succeeds in stimulating the activity of the pump. Although this pump is impaired, the high sodium concentration obtains a new steady state characterized by apparently normal ouabain-sensitive sodium efflux and by an increased ouabain insensitive efflux. The pathogenesis of these defects of cellular homeostasis which are linked to the presence of various complex mechanisms (shock, calorie balance, fluid and electrolyte imbalances, the circulation of "toxic substances" etc), in cases of extensive burns, has not been completely elucidated.

Adult↗
PubMed1978

Studies on cell water and electrolytes in chronic renal failure.

Studies were carried out in 10 normal subjects and in 16 patients with moderately severe chronic renal failure (CRF) to determine the quantities of potassium (K), sodium (Na) and water in muscle tissue obtained by needle biopsy and in white cells (WBC) from peripheral venous blood. Depletion of intracellular K with high levels of Na and normal water were found in patients with CRF. Therefore, the cellular electrolyte pattern was not substantially different from that reported by others in patients with advanced uremia although there was no increase in intracellular water (as can occur in end-stage CRF). These data suggest that in end-stage CRF accumulation of intracellular water could be relatively independent of intracellular electrolyte balance.

Adolescent↗
PubMed1978

Studies on bicarbonate reabsorption in chronic renal failure.

The role of nephron loss, extracellular fluid volume (ECFV) expansion and body potassium stores on bicarbonate reabsorption in chronic renal failure (CRF) was evaluated. In 17 CRF and 3 control subjects, tubular HCO3 reabsorption was studied by HCO3 1M titration technique; ECFV (22Na space at 4th hour) and cell K content (muscle biopsy) were also determined. Nephron loss per se does not cause any change of HCO3 reabsorption rate per unit GFR. With ECFV expansion induced by HCO3 infusion, a Tm HCO3 is rapidly reached only in controls and in CRF patients showing a significant basal ECFV expansion. In these subjects reabsorbed HCO3/Na ratio is constant, suggesting that under these conditions, HCO3 reabsorption depends on the same mechanisms that control Na reabsorption. In cell K depleted CRF patients, HCO3 reabsorption rises more than in controls and no Tm HCO3 is detected, at least within the limits of isotonic ECFV expansion induced by titration; in these subjects HCO3 reabsorption does not appear to be limited by natriuretic factors. In CRF subjects with normal ECFV and cell K, there is a greater HCO3 tolerance to ECFV expansion induced by titration technique than in controls.

Absorption↗
PubMed1978

[Thienylic acid, a new drug with saluretic and uricosuric activity. Preliminary data].

The effects of ticrynafen (250-500 mg) on salt-water and uric acid metabolism have been studied in 18 patients with no haemodinamic abnormalities or salt-water repletion (cardiac failure, oedema). The main results are: -- an effective natriuresis is observed in the first days and is attenuated thereafter. In subjects with a reduced GFR, a negative salt balance is obtained altough the volume of diuresis is not significantly increased. -- The potassium loss is variable according to dosage (maximum at 500 mg), renal function (low when reduced). -- The increase of urinary uric acid excretion and the lowering of blood uric acid concentration are rapid and prolonged. In conclusion, we confirm the effective natriuretic and uricosuric properties of ticrynafen.

Adult↗
PubMed1977

[Aspects of glycolipid metabolism in chronic renal insufficiency: interference of oral glucose administration during and after dialysis with changes induced by short dialyses with glucose free dialysate].

As part of some research into certain aspects of glycolipidic metabolism in chronic renal insufficiency, a study has been made of alterations in glycaemia, insulinaemia, free fatty acids and triglycerides during and following brief periods of dialysis by glucose-free bath in 26 subjects: within this group, 50 g of glucose were administered to 8 patients at the 2nd hour of dialysis and 100 g to another 8 at the end of therapy. The following findings were made during glucose-free dialysis: marked hypoglycaemia starting from the first hour until the end, marked increase in FFA and marked fall in TG upon the lipolytic action of heparin. In the post-dialysis period, immediate normalization in glycaemia, steady diminution in FFA and notable increase in TG as early as the 1st hour. Administration of glucose during dialysis prevents hypoglycaemia by altering FFA and TG behaviour in the post-dialysis period. Administration of glucose at the end leads to hyperglycaemia and hyperinsulinaemia with marked fall in FFA and TG. During dialysis, the phenomena observed depend on the action of heparin, acetate and the absence of glucose. This absence brings on hypoglycaemia with secondary glycogenolysis and-or neoglucogenesis during dialysis; in the post-dialysis period, hepatic neosynthesis of TG in the presence of normal glycaemic and insulinaemic values. Glucose per os determines hyperglycaemia and secondary hyperinsulinaemia with FFA esterification at the level of adipose tissue and a fall in serous TG.

Administration, Oral↗
PubMedDate not supplied

Free amino acids in plasma and skeletal muscle of patients with liver cirrhosis.

Free amino acids were measured under postabsorptive conditions in plasma and intracellular water of skeletal muscle obtained by needle biopsy in nine healthy controls and 14 subjects suffering from clinically stable liver cirrhosis. The aromatic amino acids phenylalanine and tyrosine in cirrhotics were elevated to the same extent in plasma and in muscle water. Branched-chain amino acids were uniformly reduced in plasma, but in muscle water only valine was significantly lower (222 +/- 92 mumoles per kg intracellular water vs. 368 +/- 82, p less than 0.001), while isoleucine (142 +/- 63 vs. 103 +/- 30), leucine (223 +/- 88 vs. 226 +/- 36) and branched-chain amino acids as a whole (589 +/- 186 vs. 681 +/- 88) were normal or elevated with an increased muscle:plasma ratio (3.12 +/- 2.03 vs. 1.41 +/- 0.37, p less than 0.05 for isoleucine; 3.00 +/- 1.28 vs. 1.85 +/- 0.27, p less than 0.025 for leucine; 2.24 +/- 0.64 vs. 1.69 +/- 0.13, p less than 0.05 for total branched-chain amino acids. Our data show that, in cirrhosis, plasma concentrations of branched-chain amino acids do not reflect their levels in muscle cellular water; only the intracellular pool of valine is severely depleted. This suggests that higher amounts of valine supplementation may be useful in nutritional treatment of liver cirrhosis. The elevated muscle:plasma gradients for branched-chain amino acids may result from abnormalities in their transport through muscle-plasma membrane.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

Acute polyradiculoneuropathy occurring after hymenoptera stings: a clinical case study.

Hymenoptera stings may be responsible for both local and systemic reactions; these can be immediate or delayed, depending on the time between the sting and the development of signs or symptoms. Delayed clinical reactions have been reported, although unusual, due to serum sickness and/or affecting organs or systems generally not involved in the immediate reaction, such as heart, kidneys, central and peripheral nervous systems. This paper describes the clinical and immunological findings in a 51-year-old subject, who, after two stings of paper wasps, the second one after the third venom immunotherapy (VIT) injection, presented immediate large local and systemic allergic reactions which quickly improved after e.v. methylprednisolone administration. About 40 hours later, he developed acute polyradiculoneuropathy with muscle weakness, paresthesia, difficulties in standing up and walking. Skin tests and specific IgE determination showed allergy to paper wasp. The activation, by wasp venom, of peripheral blood mononuclear cells in primary culture, evaluated by tritiated thymidine incorporation proliferation assay, showed an important hypersensitivity to wasp venom. Therefore our results suggest the hypothesis that the polyradiculoneuritis causative etiopathogenetic mechanism might be a delayed immunological response to wasp antigens followed by an allergy-triggered autoimmune reaction, as previously suggested by other authors; they found lymphocytic infiltrates in demyelinization areas and at perivascular levels, by histologic examination of autoptical and bioptical material of patients with nervous system lesions after hymenoptera stings.

Acute Disease↗
PubMedDate not supplied

[Acid-base modifications induced by treatment with concentration-reinfusion of ascitis fluid in cyrrhosis (author's transl)].

In 9 cyrrhotic patients with ascites we have studied the acid base status and the renal acidogenic capacity (urinary titrable acidity, ammonia) before, during and after reinfusion of concentrated ascitic fluid. Acid-base parameters have been evaluated also in the ascitic fluid and in the concentrated reinfusion fluid. The treatment does not determine any significant variation of acid base equilibrium in the cyrrhotic patients, while there is a remarkable loosing of CO2 with lowering of pCO2 in the concentrated ascitic fluid. We discuss the main physiopathological factors involved in such a type of treatment.

Ascitic Fluid↗
PubMedDate not supplied

[Post-acute long stay and extensive rehabilitation: study of the first year of work at a long stay university hospital unit].

Long stay is a new type of hospital admission geared to internal medicine patients requiring long-term stays in hospital and prolonged treatment for the purposes of stabilization or clinical rehabilitation. Given the lack of specific experience, we monitored the progress of a Long-Stay Unit with the aim to estimate the clinical and organizational impact. We studied 263 patients (59.3% females, 40.7% males; mean age 76.3 +/- 11.5 years, 42.2% all in their late eighties) coming from medical wards (75%) and from surgical wards (25%). The clinical complexity was prospectively estimated by a form divided into 3 sections: the first part was filled out at the time of transfer, the second part at set intervals throughout the period and the third at the end of the stay. Mean length of stay for medical patients was 33.2 days, for surgical patients 28.6 days (NS). Main transfer diagnosis: 50% of the patients fell into two diagnostic groups: malignant neoplasm (33.1%) and cerebral ictus (17.5%). Some data evidenced remarkable clinical complexity: 93.9% of the patients had one or more secondary diagnoses; when initially admitted 89.4% already presented with complications or serious outcomes; while in the Long-Stay Unit 83.3% required medical treatment and extensive nursing care; 87.1% had further major complications; 56.3% was totally dependent; 42.6% was totally bedridden and 35.4% died. In conclusion, the majority of long-stay patients in a medium-to-large polyclinic hospital present with several concomitant diseases, with extremely invalidating complaints, characterized over the short-to-mid term by serious clinical complications. They require a great deal of competent medical/nursing care as well as highly qualified internal medicine specialists.

Acute Disease↗
PubMedDate not supplied

[Evaluation of prognostic parameters in colorectal carcinoma. I. Histopathological variability].

A careful histopathological analysis was performed on a series of 244 unselected surgically removed primary colonic and rectal cancers. Tumours were staged according to the TNM system. Tumour type (adenocarcinoma or mucinous carcinoma), grade of differentiation, character of invasive margin, degree of peritumoural lymphocytic infiltration, venous and neural invasion were found to be correlated with the clinico-pathological stage and in some ways interrelated. As a whole our results seem to suggest that histological evaluation of the variables examined may provide information of clinical relevance in the management of patients with large bowel cancer.

Adenocarcinoma↗
PubMedDate not supplied

[Intravenous leiomyomatosis of the uterus. Report of a case].

A clinicopathological study of a case of intravascular leiomyomatosis was performed, recalling the rarity of this pathology and the necessity of a careful follow-up. Microscopically the intravascular tumor resembles the benign leiomyoma. Authors have taken into consideration the most likely differential diagnoses: endolymphatic stromal myosis and low-grade leiomyosarcoma, they study the problem of the so-called "benign metastasizing leiomyoma" and emphasize that intravenous leiomyomatosis is frequently underdiagnosed.

Adnexa Uteri↗