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Biomedical subjects

M G Bianchetti

Publications and source records attributed to M G Bianchetti.

At least 73 records · Page 4Linked to original sources
PubMed1997

Conditions currently associated with erythema nodosum in Swiss children.

UNLABELLED: A review was made of the 36 paediatric patients in whom the diagnosis of erythema nodosum had been established between 1977 and 1996 at the Department of Paediatrics, University of Bern, Switzerland. Infectious diseases were associated with erythema nodosum in 20 (including 10 streptococcal infections) and non-infectious inflammatory diseases in 8 patients. None of the 36 patients had tuberculosis or had been exposed to sulphonamides, phenytoin or hormonal contraceptives. There were eight patients in whom either the associated disease was not diagnosed, or there was no other disease. CONCLUSION: Most cases of erythema nodosum are nowadays caused by non-mycobacterial infectious diseases or by non-infectious inflammatory diseases.

Adolescent↗
PubMed1997

Free plasma magnesium following glucose loading in healthy humans.

The recognized existence of a circadian pattern in extracellular magnesium balance might mirror either an inherent rhythm in the homeostasis of this ion or dietary factors. Since in vitro insulin enhances cellular magnesium uptake, the circadian rhythm in extracellular magnesium metabolism might be modulated at least in part by carbohydrate intake. To assess this hypothesis, the effects of oral glucose loading on plasma total and ionized magnesium were investigated in lean healthy humans with a negative family history for essential hypertension and diabetes mellitus. Plasma total and ionized magnesium was similar before glucose loading and 30, 60, 90, 180, and 210 min thereafter. It is therefore concluded that in healthy humans the circadian pattern of extracellular magnesium is not modulated by the metabolic and hormonal mechanisms that adjust the concentration of glucose.

Administration, Oral↗
PubMed1997

Screening for complement deficiency in bacterial meningitis.

Seventy-seven children with bacterial meningitis were screened for complement deficiency. Both the classical and the alternate pathways were normal in 75 patients. Transiently reduced total haemolytic activity of the classical pathway was documented in a boy with meningococcal meningitis. Total haemolytic activity of both the classical and the alternate pathways were reduced in another patient with pneumococcal meningitis: individual complement components determination indicated predominant activation of the alternate pathway.

Adolescent↗
PubMed1997

Acute metabolic alkalosis in cystic fibrosis: prospective study and review of the literature.

Between January 1993 and April 1994, 5 patients with cystic fibrosis, aged 4-9 months, were admitted to the Department of Pediatrics, University of Berne, Switzerland, with acute, severe metabolic alkalosis (sodium < 133 mmol/l, plasma potassium < 3.5, chloride < 85, bicarbonate > 35.0 mmol/l, blood pH > 7.43). 87 cases of acute metabolic alkalosis complicating cystic fibrosis reported in the literature between 1951 and 1995 were also reviewed. Our cases and those described in the literature demonstrate that acute metabolic alkalosis occurs in patients aged 2 years or less. Anorexia, vomiting, respiratory exacerbation, fever, and body weight loss often precede metabolic alkalosis. Furthermore, metabolic alkalosis is a common initial presentation of cystic fibrosis, suggesting that this diagnosis should be considered in the context of unexplained metabolic alkalosis.

Acute Disease↗
PubMed1997

Extracellular magnesium depletion in pediatric patients with insulin-dependent diabetes mellitus.

It is unclear whether insulin-dependent diabetes mellitus is a state of magnesium depletion. This is a relevant question, since magnesium deficiency has been implicated in the pathogenesis of diseases that develop to an increased extent into diabetes mellitus. Total plasma magnesium was not statistically different in 76 pediatric patients with insulin-dependent diabetes mellitus (0.77 [0.73-0.81] mmol/l; median and interquartile range), 59 healthy adults (0.80 [0.77-0.83] mmol/l) and 19 healthy children (0.80 [0.78-0.83] mmol/l). In contrast, plasma ionized magnesium, the most interesting form with respect to physiological and biological properties, was significantly lower in diabetic patients (0.50 [0.48-0.53] mmol/l) when compared with healthy adults (0.53 [0.50-0.56] mmol/l; p < 0.01) and healthy children (0.54 [0.51-0.56] mmol/l; p < 0.02). Our report confirms recent findings of reduced circulating ionized magnesium but normal circulating total magnesium in adults with non-insulin-dependent diabetes mellitus.

Adolescent↗
PubMed1996

[Schoenlein-Henoch purpura: course in 139 children].

We evaluated the records of 139 pediatric patients with Schönlein-Henoch purpura (aged 0.4 to 15.1 years, median 5.4 years), referred from 1974 to 1993 to the University Children's Hospital, Berne. An acute febrile illness preceded Henoch-Schönlein purpura in 83 (60%) out of the 139 children. The purpuric papules were distributed over the lower extremities and the buttocks in 68 patients (49%), and more extensively in the remaining 71 (51%). Joint tenderness or swelling was observed in 110 patients (79%). Abdominal involvement occurred in 92 patients (66%): abdominal pain (n = 63), melena or hematemesis (n = 23), and intussusception (n = 6). The following rather rare features were observed: scrotal swelling (n = 11), neurologic involvement (n = 3), and stenosing ureteritis (n = 1). A remission lasting at least 4 weeks occurred within 4 weeks in 84, within 5-8 weeks in 19, and within 9-53 weeks in 18 out of 121 patients. A relapse was observed in 10 subjects. Renal involvement occurred in 60 patients. Severe renal involvement, defined as proteinuria exceeding 40 mg/[m2 X h], occurred in 18 of the patients with renal involvement. Progredient renal failure developed in one male. Children with renal involvement tended to be older (6.6 versus 4.1 years) and to have more prolonged extrarenal manifestations (6 versus 3 weeks). It is concluded that in children with Schönlein-Henoch purpura extrarenal involvement often lasts more than one month. Its outcome is almost always favourable. Children with heavy proteinuria tend in some cases to develop renal failure. For these patients, new treatment regimens aimed at preventing renal failure warrant evaluation in prospective controlled studies.

Abdominal Pain↗
PubMed1996

Rhabdomyolysis and anesthesia: a report of two cases and review of the literature.

Rhabdomyolysis occurred in two apparently healthy boys aged 9.5 and 5.5 years after general anesthesia with suxamethonium. Mild hyperkalemia and renal failure were observed in the first patient, who was subsequently diagnosed with Becker dystrophy. In the second patient, the clinical presentation was not classic for malignant hyperthermia and a muscle biopsy failed to disclose any pathological finding. A review of the literature revealed 66 pediatric cases (56 boys and 10 girls) of anesthesia-associated rhabdomyolysis. Forty-nine (74%) cases were caused by an underlying, mostly unrecognized congenital muscle disease, and 14 (21%) cases were caused by malignant hyperthermia susceptibility. Hyperkalemia (23 patients), cardiac arrhythmias (38 patients), renal failure (4 patients), and death (11 patients) were the most serious complications of anesthesia-associated rhabdomyolysis. The neuromuscular blocking agent suxamethonium had been used in at least 43 of the patients reported in the literature.

Anesthesia, General↗
PubMed1996

Plasma ionized magnesium during acute hyperventilation in humans.

1. Respiratory alkalosis accompanies the clinical syndrome of tetany, precipitates cardiac arrhythmias and predisposes to coronary vasoconstriction. Magnesium plays a critical role in the maintenance of membrane function, and magnesium depletion is often associated with cardiac arrhythmias or vasoconstriction. 2. As technology for detecting circulating ionized magnesium (the most interesting form with respect to physiological and biological properties) is now available in the form of new magnesium-selective electrodes, the effect of respiratory alkalosis induced by voluntary overbreathing for 30 min on circulating ionized magnesium was studied in eight healthy subjects. 3. The total plasma magnesium concentration was not modified by hyperventilation. On the contrary, hyperventilation was associated with a significant reduction in the ionized magnesium concentration of 0.05 (0.02-0.15) mmol/l (median and range) and in the free magnesium fraction of 0.06 (0.01-0.19). During hyperventilation the relative intravascular magnesium mass, calculated from changes in total plasma magnesium concentration and haematocrit, decreased significantly. 4. It is concluded that acute overbreathing reduces the circulating ionized magnesium concentration and the intravascular magnesium mass. It is therefore conceivable that extracellular magnesium deficiency is at least a subsidiary cause of the syndrome of tetany and the cardiac complications that are precipitated by hyperventilation.

Acute Disease↗