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Biomedical subjects

P Fabbri

Publications and source records attributed to P Fabbri.

At least 73 records · Page 4Linked to original sources
PubMed1996

[Nephropathy in non-insulin-dependent diabetics].

In the USA, diabetic nephropathy is involved in 34% of cases of end stage renal failure. In Europe, five-year survival of diabetics with end renal failure is 31%, compared with 55% in the non diabetic population. Three phenomena are involved in the development of nephropathy in non-insulin-dependent diabetic patients: glomerular hyperfiltration, elevation of urinary albumin excretion and high blood pressure, the latter sometimes being present before the discovery of diabetes. Even if control of blood sugar is improved, various prospective studies have failed to demonstrate any benefic effect in terms of reducing renal failure in non-insulin-dependent diabetic patients. Some data indicate that angiotensin-converting enzyme inhibitors can reduce the amount of proteinuria and slow the progression of diabetic nephropathy in insulin-dependent diabetic patients, but data remain controversial in non-insulin-dependent diabetic patients. Specifically, in these patients, there is no evidence pointing to an advantage of lowering blood pressure with angiotensin converting enzyme-inhibitors to reduce morbidity or mortality.

Diabetes Mellitus, Type 2↗
PubMed1996

Loss of the nocturnal decline in blood pressure in subjects with essential hypertension and microalbuminuria.

BACKGROUND: Microalbuminuria, a marker of early renal damage, predicts mortality in non-diabetic subjects. The loss of circadian blood pressure regulation is associated with the severity of essential hypertension and has been reported in hypertension due to renal disease. We therefore looked for a possible link between microalbuminuria and the smaller decrease in nocturnal blood pressure that occurs in essential hypertension.METHODS: The 24 h ambulatory blood pressure of 52 subjects with essential hypertension was measured and their urine tested for microalbuminuria (urinary albumin excretion of 30-300 mg/24 h). RESULTS: The subjects with (n = 10) and without (n = 42) microalbuminuria were comparable in clinical characteristics, antihypertensive treatments and serum creatinine. They had significantly different night-time systolic, diastolic and mean blood pressure decreases on ambulatory blood pressure monitoring. Two-factor analysis of variance showed that the day-night blood pressure decrease was linked to microalbuminuria status. The day-night blood pressure change of subjects with microalbuminuria differed from that of subjects without microalbuminuria independently from the daytime blood pressure level. CONCLUSION: Subjects with essential hypertension and microalbuminuria show a loss of nocturnal blood pressure decline. Whether microalbuminuria indicates a subtype of essential hypertension due to renal disease or severe hypertension with early renal damage remains to be clarified.

Journal Article↗
PubMed1996

[Decrease of nocturnal blood pressure in type II diabetic subjects with microalbuminuria].

The aim of this study was to evaluate the circadian blood pressure variations in subjects with or without microalbuminuria (Urinary Albumin Excretion (UAE) between 30 and 300 mg/24 h. Forty-nine non-insulin dependent diabetic subjects with essential arterial hypertension and without proteinuria (UAE < 300 mg/24 h) were consecutively recruited. Systolic (SBP) and Diastolic Blood Pressure (DBP) have been measured using a SpaceLabs 90207 ambulatory blood pressure monitor, every 15 minutes during daytime (7:00 a.m. to 22:00 p.m.) and every 30 minutes during nighttime (22:00 p.m. 7:00 a.m.). UAE has been measured by nephelometry on three 24 h urine collections. The group with microalbuminuria (n = 16) was not different from the group with normoalbuminuria (n = 33) for age, sex ratio, body mass index, known diabetes duration, proportion of anti-hypertensive treatment, serum creatinine and HbA1c. Daytime blood pressures (SBP/DBP: 144 +/- 15/83 +/- 8 vs 137 +/- 13/84 +/- 9 mmHg) and nighttime DBP (75 +/- 7 vs 74 +/- 9 mmHg) were comparable between both groups. In contrast, the nighttime SBP was higher in subjects with microalbuminuria than in those without (139 +/- 17 vs 129 +/- 17 mmHg; p = 0.016). If dippers are the subjects with a nocturnal blood pressure reduction (SBP and/or DBP) below 4%, there is a relationship between "non dippler" subjects and those with microalbuminuria (Chi-squared test = 5.67; p = 0.017). In conclusion, hypertensive non-insulin dependent diabetic subjects with microalbuminuria have a loss of nocturnal blood pressure decrease.

Aged↗
PubMed1995

Serum eosinophil cationic protein (ECP) in bullous pemphigoid.

BACKGROUND: The importance of eosinophils in the pathogenesis of the major forms of pemphigoid (bullous pemphigoid, cicatricial pemphigoid, herpes gestationis) remains to be confirmed. METHODS: To evaluate the role of eosinophilic infiltrates in these diseases and to detect the presence and activity of eosinophils, we compared the serum levels of eosinophil cationic protein (ECP), an eosinophil-derived protein, in 11 healthy subjects and in 10 patients with pemphigoid diseases (8 with bullous pemphigoid, one with cicatricial pemphigoid, and one with herpes gestationis). The serum of two patients with epidermolysis bullosa acquisita (EBA) and one with linear IgA bullous dermatosis (LABD) were utilized as a further control. RESULTS: There was a significant difference between the mean of serum ECP levels in patients with pemphigoid diseases (25.1 +/- 12.3 micrograms/L, M = SD) and control subjects (2.30 +/- 2.41, micrograms/L +/- SD 2.41) (T = 4.272 P < 0.0001). The two patients with EBA (10.8 and 17.7 micrograms/L) showed contrasting results; the patient with LABD had normal ECP serum levels. The serum levels of ECP were not significantly correlated with the blood eosinophil count (R = 0.103; P = 0.777) in any of the cases. CONCLUSIONS: In pemphigoid disease, the serum levels of ECP seem to be correlated with the activated secreting and tissue-damaging eosinophils found in the dermis, supporting the concept of an active participation of eosinophils in generating cutaneous lesions.

Adult↗
PubMed1995

Discoid lupus erythematosus lesions developed on lupus erythematosus profundus nodules.

We describe this case of LEP for its unusual way of presentation. It first appeared with a LEP pattern, followed by a typical DLE of the skin, overlying the nodules only. Moreover, our histologic findings showed the typical pattern of lymphocytic lobular panniculitis, with hyaline necrosis of fat, the lymphoid nodule, and even the lymphocytic nuclear "dust." The epidermal changes, with the liquefaction degeneration of the basal cell layer, a moderate follicular hyperkeratosis, and a perivascular and periappendeal lymphocytic infiltrate, were also observed in the abdominal lesion that developed last without clinically evident DLE.

Adult↗
PubMed1994

Dendritic cells in cutaneous lupus erythematosus: a clue to the pathogenesis of lesions.

In view of the critical role of dendritic cells in immune mediated skin diseases, we have investigated the membrane antigen patterns and ultrastructure of cutaneous dendritic cells in eight patients with chronic discoid lupus erythematosus and five with subacute cutaneous lupus erythematosus. In the lesional epidermis, the expression of HLA-DR antigens by epidermal dendritic cells was reduced, as compared with perilesional, clinically normal skin. In addition, only few CD1a+ dendritic cells (Langerhans' cells), along with some CD11c+ and CD14+ cells (presumable precursors of Langerhans' cells), were found in atrophic areas of lesional epidermis. In contrast, the number of Langerhans' cells in non-atrophic areas of lesional epidermis was similar to that in perilesional skin. On electronmicroscopy, epidermal Langerhans' cells appeared depleted of organelles and dendrites and contained tubuloreticular inclusions. In the lesional dermis, both CD1a+ and CD36+ dendritic cells were found, associated with CD4+ and CD8+ T-cells, respectively. Moreover, CD11c+ and CD14+ cells were found around capillaries in the papillary dermis on electronmicroscopy. Indeterminate cells (dendritic cells with features of Langerhans' cell lineage, but apparently without Birbeck granules) and dendritic macrophages were found, associated with lymphocytes and mast cells. No cells with intermediate/transitional features between these two dendritic cell types were found. Conversely, peculiar dendritic cells--with short and blunt dendrites and cytoplasm containing many flat, rough cisternae, moderately well developed Golgi apparatus and no lysosomes--were found in the same location as the CD11c+ and CD14+ cells identified by light microscopy. These findings might be interpreted as follows: 1 the alterations in cytological differentiation and expression of functionally meaningful molecules by epidermal Langerhans' cells in cutaneous lupus erythematosus lesions suggest an impairment of their immunological efficiency; 2 in the lesional dermis of cutaneous lupus erythematosus, a CD4+ T-cell/CD1a+ dendritic cell-based, delayed-type immune response is possibly modulated by a suppressor T-cell circuit in which CD36+ dendritic cells may act as accessory cells; 3 CD11c+ and CD14+ cells with peculiar ultrastructure are possible precursors of both CD1a+ indeterminate cells and CD36+ dermal dendrocytes in the dermis.

Adolescent↗
PubMed1994

Structural alterations of basal keratinocytes and capillary loop in psoriasis during treatment with topical calcipotriol.

Recent research has demonstrated the activity of calcipotriol, effective as a potent inhibitor of cellular proliferation and known to increase differentiation in a number of cell lines in the topical treatment of psoriasis. Vit D3 receptors are expressed in keratinocytes and vascular endothelial cells. We studied the alterations in basal keratinocytes (stem cells or anchoring cells) and endothelial cell modification in 6 patients with psoriasis treated with calcipotriol ointment twice a day for 4 weeks. The samples were embedded in Epon resin for thin section and ultrathin section examination by electron microscopy. A normal pattern of distribution of the two different types of basal keratinocytes was observed before treatment. After treatment, only anchoring cells were detected. The alterations of endothelial cells in capillary loop disappeared after treatment, presenting normal aspects. Our morphological findings suggest that calcipotriol is therapeutically effective, due principally to an inhibition of cellular proliferation.

Calcitriol↗
PubMed1991

The role of cyclosporine A in the treatment of pemphigus erythematosus.

Steroids are effective in the autoimmune bullous disease pemphigus; however, treatment may be difficult to sustain because of severe side effects. Cyclosporine A acts mainly on helper/inducer T lymphocytes and has few side effects at low doses. We report three patients with pemphigus erythematosus who had a relapse while receiving the maintenance dose of steroid therapy. All patients who were treated with both cyclosporine A (5 mg/kg/d) and prednisone (1 mg/kg/d) responded remarkably well to combined therapy. After clearing, prednisone was discontinued and cyclosporine A was reduced to 2 to 3 mg/kg/d. With this treatment, all patients have been virtually free of symptoms, have remained well, and have had normal laboratory values.

Adult↗
PubMed1990

Occupational dermatitis in animal feed mill workers.

In an epidemiological study of occupational dermatitis in 15 different northern Italian animal feed mills, 204 workers were interviewed, examined and patch tested to 34 allergens, selected from the additives most commonly used in the animal feed mills under consideration. The prevalence of occupational contact dermatitis was 13.7% (28/204): 7.8% (16/204) irritant contact dermatitis and 5.8% (12/204) allergic contact dermatitis from animal feed additives. Among the latter, there were sensitizations, to our knowledge hitherto unreported in the literature: to indigo carmine (2 cases), monensin sodium (1 case), thiabendazole (1 case), methylchlorpindol (1 case) and amprolium hydrochloride (1 case). 3.9% (8/204) of the workers complained only of pruritus sine materia on exposed areas of the body. Contact dermatitis increased with respect to duration of employment: the difference in the rate of contact dermatitis between workers employed in animal feed mill for greater than 10 years and those employed for less than 10 years was statistically significant (p less than 0.05). 6.8% (14/204) had latent sensitivity, which was more frequent in workers with less than 1 year of employment with respect to more experienced colleagues.

Adult↗
PubMed1990

[Heterogenicity of anti-basal membrane antibodies in pemphigoid. Research with the method of dermo-epidermal separation].

Twenty-one sera from subjects with bullous pemphigoid (BP), one from a subject with cicatricial pemphigoid (CP) and one from a subject with herpes gestationis (HG) were examined by indirect immunofluorescence with two substrata, intact normal human skin and human skin incubated in 1.O M NaC1 for 72 hours at 4 degrees C, that permit the dermal-epidermal separation at the lamina lucida layer. Eight of the 21 BP sera presented linear fluorescence in the dermal-epidermal junction of intact skin. On "separated" skin four of these eight sera showed fluorescence on the epidermal side, one on the dermal side, and one on both sides. The CP sera showed fluorescence at the dermal-epidermal junction on intact skin and on both sides on "separated" skin. The HG sera did not evidence fluorescent deposits with either of the two substrata. However, when examined by the complement fixation test, the HG sera showed linear fluorescence on the dermal-epidermal junction on intacty skin and a deposit on the epidermal side on "separated" skin.

Antibody Specificity↗
PubMed1990

[Granulocytic "deactivation" in cold urticaria].

Recent advance about pathogenesis of Idiopathic acquired Cold-induced Urticaria underline the role of Neutrophils that, drawn by a specific mast-cell factor (HMW-NCF) might characterise precise stages of disease and presumably specific histologic "subset". This factor together with the chemotactic factor for eosinophils (ECF) can determine the so called neutrophils' "deactivation". In this study we have valued the role of neutrophils in six patients with idiopathic cold-induced urticaria and in a group of control including both patients with other forms of urticaria and healthy controls. The results of our research show the absence of alterations either in cellular neutrophilic chemotaxis or the serum one. Furthermore we have been able to determine that this "deactivation" is specific for idiopathic cold-induced urticaria and that it does not happen in the other forms of physical or non urticaria.

Adolescent↗
PubMed1990

[Preliminary experiences with chemotactic activity of CGRP using the skin window test].

The neuropeptide CGRP (Calcitonin Gene-Related Peptide) develops in sensory fibers of the human skin a series of well proven biological effects and seems particularly correlated with the neurogenic inflammation. In the site of intradermic injection of 50 pmol of CGRP, neutrophilic inflammation was documented. For this reason we have studied using the skin window test the chemotactic actions of this neuropeptide in vivo. The apposition of CGRP (12.5 pmol) on the abraded skin modifies neutrophilic egress, increasing that effect in a significant way in comparison with controls. The action on neutrophils of CGRP helps to explain the importance of this neuropeptide in the genesis of the "Neurogenic inflammation".

Calcitonin Gene-Related Peptide↗