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Biomedical subjects

L Minetti

Publications and source records attributed to L Minetti.

At least 91 records · Page 5Linked to original sources
PubMed1984

Glomerular disease and pregnancy. A study of 123 pregnancies in patients with primary and secondary glomerular diseases.

The clinical course of 123 pregnancies in 86 patients with biopsy-proven glomerular diseases have been studied. In 35 women the onset of nephropathy occurred during pregnancy. No complications were observed in more than half of the pregnancies. In the others, one third of the complications were obstetrical or fetal accidents, one third were renal manifestations (hypertension or deterioration of renal function) and one third were both causes. The lowest incidence of complications was observed in patients with membranous nephropathy and the highest in membranoproliferative glomerulonephritis patients. There were 6 spontaneous late abortion, 6 stillbirths and 5 neonatal deaths. 17 deliveries were preterm and 7 fetuses were small for gestational age. Hypertension appeared in 24 pregnancies, in 13 of which it was reversible and related to superimposed preeclampsia and in 11 it persisted after delivery (5 of these 11 pregnancies were in patients with IgA nephropathy). Renal function deteriorated in 10 cases during pregnancy. The deterioration was reversible in 6 and progressive in 4 (2 of whom had membranoproliferative glomerulonephritis). It is suggested that in most patients pregnancy does not change the natural history of glomerular disease.

Diabetic Nephropathies↗
PubMed1984

Blood pressure in patients with four different primary glomerulopathies.

It is well known that patients with different kidney diseases have different prevalence of hypertension, independent of renal function. To investigate whether a lesion of some portion of the glomerular tuft, without renal insufficiency, is associated more frequently with high blood pressure, we undertook a retrospective study on 189 patients analyzing by means of multiple regression analysis as independent variables : type of glomerulopathy (IgA Nephropathy, Acute Glomerulonephritis, Membranous Glomerulonephritis and Focal Glomerulosclerosis), sex, age, body weight, plasma creatinine, plasma and urinary proteins, plasma urate, time interval first symptom-renal biopsy and steroid therapy. The dependent variable was a Principal Component formed by Mean Blood Pressure and an Antihypertensive Therapy score, calculated with a computer program. Focal Glomerulosclerosis patients had a higher prevalence of hypertension and a higher Principal Component value than patients of the other 3 groups. Plasma urate was correlated and time interval first symptom-renal biopsy was inversely correlated to Principal Component. These observations suggest that sclerosis of the glomeruli is the lesion most often associated with hypertension. On the other hand, since plasma urate is correlated with blood pressure also in "essential" hypertensives, it seems likely that hyperuricemia is a phenomenon secondary to hypertension.

Adult↗
PubMed1984

Comparison of three different methods of monitoring unwanted effects during antihypertensive therapy.

In a double-blind, randomized, crossover, multicenter study performed in 227 hypertensive outpatients, two antihypertensive drugs, oxprenolol and chlorthalidone, were investigated to determine unwanted effects. Three main methodologic procedures were applied: the conventional evaluation of unwanted effects by the physician and involving the whole patient population, the checklist, and the free questionnaire. The latter two were assigned by randomization to the patients themselves. The study showed that unwanted effects seem to be frequently overreported when a checklist is used, whereas the free questionnaire gives more information about the symptoms of the disease than about the tolerance of the drug. The conventional method, when physicians are well-informed and sensitized to the problem, seems to provide more reliable information about unwanted effects of a drug.

Adolescent↗
PubMed1984

Effects of moderate salt restriction in hypertensive patients treated with oxprenolol or chlorthalidone.

Ninety-five hypertensive out-patients, whose lying diastolic blood pressure was still greater than or equal to 95 mm Hg after a 4-week treatment with oxprenolol slow release 160 mg/day or chlorthalidone 25 mg/day, restricted their daily sodium intake for a 4-week period, while continuing to receive the previous pharmacological therapy. The dietary intervention, appositely formulated to moderately restrict sodium intake, resulted in a high patient compliance as assessed by the significant (p less than 0.01) reduction in the 24-hour urinary sodium excretion. At the end of the 4-week dietary period, a significant (p less than 0.01) decrease in lying and standing systolic and diastolic blood pressure was observed in both the oxprenolol and chlorthalidone treated groups. These results suggest that a moderate reduction in sodium intake, obtained from a low sodium diet characterized by high patient compliance and easily followed in everyday life, is effective in lowering blood pressure in hypertensive patients who don't respond satisfactorily to pharmacological therapy alone.

Adult↗
PubMed1983

Immune response to hepatitis B vaccine in staff and patients in renal dialysis units.

Anti-HBs response was detected in 96 per cent of staff members in three haemodialysis units after three 20 microgram doses of hepatitis B vaccine and in 82 per cent of adult patients treated with three 40 microgram doses. The percentage of responders and levels of antibody remained unchanged at 12 months from the beginning of the trial. Three out of six children injected with three 20 microgram doses in a paediatric haemodialysis unit remained free from markers of HBV infection and had high levels of anti-HBs after the second dose of vaccine. The other three children who developed serological markers of HBV infection seroconverted to anti-HBc within six months from the first dose and, in one of them, antigenaemia at three and four months was detected.

Adult↗
PubMed1983

T-suppressor cell abnormalities in type I membranoproliferative glomerulonephritis.

Twelve patients with type I membranoproliferative glomerulonephritis (MPGN) have been studied. All had normal renal function, none a nephrotic syndrome, and none was on therapy. In 7/12 serum C3 and/or C4 were low. T cell subsets were analysed with OKT monoclonal antibodies and Ts function (TsF) was studied by the Concanavalin-A Enhancement test (Con-A E) and with a new assay where native OKT8+ cell function only is explored (OKT8-DEP PWM test). OKT4/OKT8 ratio was lower than controls (p less than 0.025). TsF, as studied by the Con-A E was unchanged, while OKT8-DEP PWM test showed a marked decrease (p less than 0.005). Hypocomplementaemic patients (H), as compared with normo-complementaemic patients (N), had lower OKT4/OKT8 ratio (p less than 0.01) while TsF was unchanged in both groups. These results are consistent with a functional defect of Ts activity in type I MPGN. Increased OKT8+ cells may be a compensatory response, and hypocomplementaemia may be a marker of this defect.

Adult↗
PubMed1983

Immunological monitoring of viral infections in renal transplant recipients.

Twelve viral episodes occurred in 54 antilymphocyte globulin-treated renal transplant recipients (two primary cytomegalovirus, seven cytomegalovirus reactivations, one chickenpox, two influenza). In 11 of 12 cases the ratio between peripheral T4 and T8 subsets fell (from 1.698 to 0.986, p less than 0.01) due both to a reduction of T4+ and to an increase of T8+ cells. T10+ and 5/9 subsets also increased. Suppressor T-cell function, as measured by two simultaneous assays, was enhanced. In antibody-negative CMV patients the reversal of T4/T8 ratio preceded the appearance of specific IgM. T4/T8 ratios rapidly returned to normal in mild episodes, but remained reverted in symptomatic CMV patients for several months, despite a reduction in the immunosuppressive regimen. Symptomatic viral episodes displayed marked imbalances in T cell subset numbers and function, while in asymptomatic cases the changes were less evident.

Chickenpox↗
PubMed1983

Hemofiltration in diabetic uremic patients.

The increasing number of Diabetic Uremic Patients (DUP) starting the substitutive treatment (ST) constitutes a difficult and often disappointing problem in terms of efforts, clinical results and side-effects. While treatment of these patients by C.A.P.D. is well documented, the adoption of Hemofiltration (HF), has been, up to now scarcely considered. In order to define the potentialities of a HF policy in the treatment of these patients, data from 6 DUP treated with postdilutional HF for a 10.6 months/patient period were collected on a multi-center basis and retrospectively examined. Good results were achieved in terms of vascular stability, control of arterial hypertension and of retinopathy, clinical complications and hospitalization rate. Although C.A.P.D. may represent a first choice treatment for DUP with residual function, satisfactory glicemic control, difficult blood access and a motivation to full autonomization, HF may constitute a logical alternative when C.A.P.D. should be unmanageable (visus impairment, history of repeated peritonitis and dismetabolism, considerable weight gain): an integration of HF and C.A.P.D. can assure PDU with a continuative treatment.

Blood↗
PubMed1983

Plasma exchange in acute renal failure by cortinarius speciosissimus.

Mushroom poisoning by Cortinarius speciosissimus (C. spec.) leading to irreversible renal failure has been described; in a recent report, an expected bad prognosis has probably been overcome as a result of the very early use of hemoperfusion. In Sep. '81, a healthy couple of wife and husband, both aged 38, had gastrointestinal symptoms 2 days after ingestion of C. spec. On day 8 an acute renal failure developed and the same day, before dialysis, plasma exchange (PE) was undertaken. Renal biopsies disclosed a common pattern of tubular necrosis, scattered infiltrates and interstitial edema. Diuresis and partial recovery started in the man on day 10, while failure persisted over six months in the woman. Further to individual sensitivity to C. spec. toxins, renal damage, once established, may be irreversible, irrespectively of early treatment. Limited usefulness of PE in C. spec. poisoning is probably related to the long latency between ingestion and occurrence of the first renal symptoms.

Acute Kidney Injury↗