[Case of primary hyperchylomicronemia].
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Biomedical subjects
Publications and source records attributed to O Giardini.
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Hemodialysis patients display increased oxidative damage to red blood cell (RBC) membranes, characterized by elevated levels of malonyldialdehyde (MDA), a short chain aldehyde produced by the oxidation of the polyunsaturated fatty acids (PUFA) in the RBC membranes. This is the result of a metabolic blockage of the pentose-phosphate shunt in uremic patients, which causes reduced detoxification of highly oxidative free radicals. The oxidative damage induces increased RBC rigidity and decreased RBC deformability, therefore favoring hemolysis. The aim of this work was to determine if a functioning renal graft would restore normal erythrocyte metabolism, reducing the oxidative damage. To this end, we have determined RBC MDA concentrations in 20 hemodialysis (HD) patients (RBC MDA 18.22 +/- 4.36 micrograms/ml packed RBC), 20 renal transplant (T) patients with well functioning grafts (serum creatinine less than 2 mg%) (RBC MDA 1.2 +/- 0.4 micrograms/ml packed RBC) (T vs. HD P less than 0.005) and 20 healthy controls (HC) (RBC MDA 1.44 +/- 0.6 micrograms/ml packed RBC) (HC vs. HD P less than 0.005; HC vs. T NS). Our findings show that a well-functioning renal graft restores normal RBC metabolism and eliminates the oxidative damage induced by uremia.
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The efficacy of amoxycillin-clavulanic acid combination in the treatment of urinary tract infections resistant, in vitro, to amoxycillin was studied in 42 children. Of the 24 children with urinary tract infection for the first time, combination therapy, dosing twice daily for 5 days (40 mg/kg.day), cleared the infection in 23 (96%) cases. Relapse occurred in four (17%) cases within 30 days. Of the 18 children who presented with recurrent urinary tract infections therapy, as above, cleared the infection in 16 (89%) cases. In these cases, long-term therapy was performed at a dosage of 20 mg/kg once daily. Tolerance was good; gastro-intestinal disorders in five (12%) cases which regressed by dosing at 8 h rather than 12 h intervals. In conclusion, amoxycillin-clavulanic acid can be considered a first choice treatment of urinary tract infections in children.
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A group of 210 children, aged one to twelve years (86 males and 124 females) were sent to our Clinic with the diagnosis of microscopic hematuria. Twelve children in which microhematuria wasn't confirmed were immediately excluded; thirty children were excluded because they showed pathologic findings. The remaining 168 children were put under diagnostic examination (hematologic exams, urinoculture, abdomen radiographic, family screening). The cause of microhematuria was identified in 52 of them. The group was selected down to 116 who were then monitored for a period ranging from 1 to 9 years with periodical clinical and biohumoral controls and with diagnostic exams. Biopsies were performed only in 16 cases in which a nephropathy was suspected. Nine cases presented significant histological lesions. Seventy five children were subjected to observation for a period of over one year. After few years hematuria gradually disappeared in twenty six children. After nine years microhematuria had disappeared spontaneously in 39.9% of cases. It remained in core of 33.6% of case, for which no cause could be found. With reference to the full group of 168 children, the following pathologies have been found responsible of microhematuria: a) urinary way infections: 25 cases (14.8%) b) nephropathies: 16 cases (9.5%) c) familiar hematurias: 14 cases (8.3%) d) lithiasis: 9 cases (5.3%) e) alteration of the coagulation system: 3 cases (1.8%) f) renal hypercalciuria without lithiasis: 3 cases (1.8%) Based on these observation, we believe that careful waiting is the best tactic in the cases of monosymptomatic microhematuria.(ABSTRACT TRUNCATED AT 250 WORDS)
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