Granulocyte-colony-stimulating factor in patients treated by continuous ambulatory peritoneal dialysis.
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Biomedical subjects
Publications and source records attributed to P Zanon.
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We investigated 654 subjects of a small Lombardy (Italy) town between 15 and 64 years of age who were representative of the general population. By clinical examination, the sample included 535 normal subjects (164 normal smokers, 341 normal nonsmokers, 30 normal subjects with acute upper respiratory illness within 30 days before the challenge), 50 with chronic bronchitis, 26 with asthma, and 43 with allergic rhinitis. Subjects whose FEV1 was 75 percent or more than the predicted value (654) underwent methacholine bronchial challenge by means of 1 percent metered-dose solution. The test result was considered positive at a drop of more than 15 percent in FEV1 (compared with buffer). Normal smokers and all of the groups with disease had a significantly different distribution of reactivity compared with normal nonsmokers. The difference between asthmatic and these "normal" subjects was highly significant; nevertheless, a clear cut-off between the two groups does not appear to exist.
In order to evaluate and compare immunogenicity, reactogenicity and protection of a subunit vaccine and a whole virus vaccine 102 elderly subjects were vaccined against influenza in November 1986: 53 received the subunit vaccine and 49 were immunized with the whole virus preparation. Local and systemic reactions following immunization, as well as the presence of influenza clinical symptoms were recorded throughout the study period (November 1986 - June 1987). Antibodies against influenza were detected using the Single Radial Haemolysis (S.R.H.) technique on two serum samples obtained from volunteers prior to immunization and 1 month later. The subunit vaccine showed equal immunogenicity, equal protection and lower reactogenicity as compared with the whole virus preparation.
Mitral ring calcification is a frequent finding in geriatric patients. The aim of this study was: 1) to analyze clinical and instrumental features of patients with calcific mitral ring identified through M-mode echocardiography (group A: 96 pts) with respect to those observed in a control group (group B: 104 pts); 2) to define the sensitivity and specificity of M-mode echocardiography in the diagnosis of mitral ring and aortic valve calcification by means of comparison with autopsy findings. Data on arterial hypertension, previous myocardial infarction, heart failure, phosphoremia and calcemia values were similar in both groups. On the contrary, in group A, permanent or paroxysmal atrial fibrillation, aortic valve calcification and left atrial diameter was significantly higher then in group B (p less than 0.05; p less than 0.001; p less than 0.001 respectively). The prevalence of AV and IV cardiac blocks was similar in both groups. Twelve group A patients were restudied with M-mode echocardiography, after a variable period of time, to evaluate the velocity of calcification progression. An autopsy was carried out on the twenty-six pts who died within 3 months after the M-mode echocardiography study. The evaluation of the autoptic findings was performed with high resolution radiographic image, obtained from a heart transverse section containing mitral and aortic plane.(ABSTRACT TRUNCATED AT 250 WORDS)
The efficiency of some components of the host defense system has been evaluated in 32 atopic patients with rhinitis, asthma or asthma and rhinitis. No alterations in components of complement (C3 and C4), serum immunoglobulins (IgG, IgA, and IgM) and neutrophil functional parameters were found. As expected, serum IgE values were higher than in controls. A decreased percentage of total circulating T lymphocytes, an increased percentage of Ia1-positive cells, but normal values of OKT4- and OKT8-positive T lymphocytes were demonstrated. However, a greater heterogeneity in the distribution of the suppressor-cytotoxic subset was shown in atopic patients.
High-dose medroxyprogesterone acetate (HD-MPA) has been successfully employed in the treatment of hormone-related tumors, especially advanced breast cancer. However, progestins in general and MPA in particular are considered a useful treatment also in other types of tumors such as endometrial, prostatic and renal cancer. Furthermore, MPA has been evaluated in tumors which are not classically considered hormone-related, such as ovarian cancer. Therapy with one of a number of progestational agents has been the conventional approach to the management of endometrial carcinoma not amenable to surgery or radiation therapy. Among the various synthetic progestins, MPA has been the most widely employed both by i.m. and oral routes, according to a variety of doses and schedules. Objective responses have been obtained in a percentage of women varying between 30 and 50% in the different series. While the role of MPA in the palliative treatment of advanced disease is well accepted, opinion is divided on the role of progestins in the adjuvant setting. On the basis of available data, it should be concluded that the usefulness of adjuvant therapy with progestins in high risk, early-stage endometrial cancer has not yet been clearly demonstrated. As far as prostatic cancer is concerned, data coming from comparative trials show that MPA is less effective than diethylstilbestrol (DES), and therefore should not be considered the first choice for previously untreated patients. However, it can achieve responses in patients who no longer respond or who are refractory to DES, and represents the treatment of choice for those patients who, due to their cardiovascular conditions, cannot be given estrogens.(ABSTRACT TRUNCATED AT 250 WORDS)
Airways resistance and expiratory flow have been investigated in 6 healthy volunteers given single doses of indenolol, propranolol, atenolol and placebo in a randomized, double-blind, cross over study. The three active drugs significantly decreased the effort-induced rise in systolic pressure, and they also reduced the resting heart rate. The relative potency against exercise-tachicardia was propranolol greater than atenolol greater than indenolol. The double and triple product were significantly decreased, too, without any difference between the active treatments. After placebo or indenolol, an exercise-induced increase in the forced expiratory flow at low pulmonary volumes (MEF50 and MEF75) was observed. The two control beta-blockers caused a fall in exercise expiratory flow as compared to the resting values. The noncardioselective agent (propranolol) was more effective than the cardioselective compound (atenolol) in decreasing the expiratory flow. The mechanism of action of indenolol is discussed in the light of the lack of its acute effect on airways resistance.
An antiprogesterone (RU-486) was administered to women undergoing voluntary interruption of pregnancy. Five patients received 100 mg 12 h before surgical interruption, 5 others received 100 mg twice, 24 and 12 h before interruption, respectively, and another 5 received no drug at all and served as controls. Placentas and deciduae were examined morphologically with the light microscope and by electron microscopy. No specific lesions were detected in placental tissue. With conventional histology, the deciduae showed various degrees of interstitial edema and necrosis, changes which did not enable a distinction between treated cases and controls, although stromal disintegration tended to be more marked in RU-486-treated patients. At the ultrastructural level, the endothelium of decidual capillaries showed striking hyperplasia of the endoplasmic reticulum. Morphometric evaluation showed a statistically significant difference between RU-486-treated patients (2 X 100 mg) and controls. A possible link between these morphological changes and the induction of prostaglandin synthesis by the antiprogesterone is suggested. However, the full significance of the observed lesions remains uncertain and does not allow definite conclusions concerning the abortifacient effect of RU-486.
Polymorphonuclear leukocytes (PML) represent the first step of defense against bacteria and fungi. Since many antimicrobial drugs have been reported to inhibit phagocyte function, we tested the interference of xibornol, a new antimicrobial agent, on phagocyte functions, in order to evaluate its possible use in chronic respiratory diseases. In the patients treated with xibornol (500 mg every 8 h for 7 days) we did not find any modification in phagocytosis frequency (PMF), phagocytosis index (PHI), nitroblue tetrazolium (NBT), reduction frequency (NRF), microbicidal activity and neutrophil mobility of PML, before, during and after the end of therapy.
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Literature was critically reviewed on the grounds of the ultrastructural and clinical observations made on three subjects carriers of Kartagener's syndrome. The relationship between the various ultrastructural aspects (lack of dynein arms and casual orientation of the central microtubular doublet) and the clinical evidence elicited in all the sites lined with ciliated epithelia (auditory apparatus, vestibular apparatus, genital organs and central nervous system). Attribution of the genesis of situs viscerum inversus to lack of ciliar motion was brought up for discussion again.
The authors evaluated bronchial hyperreactivity comparing two different methods for aspecific bronchostimulation (H2O ultrasonic mist and free running) and a bronchodilation test. The investigation had been carried out on three groups of subjects. The first included 15 nonsmoking normal subjects, the second 23 asthmatic patients and the third 16 rhinitic patients. All subjects were submitted to bronchodynamic tests in three different ways. The ventilatory parameters were FVC, FEV1, MMEF and Vmax25. In normal subjects no significant changes were found. In asthmatic patients the bronchodilation test was positive in 65% of the cases, regarding FEV1 and in 87% regarding the forced flows. The running test was positive in 26% of the cases (FEV1) and in 61% of the cases (forced flows). The ultrasonic mist caused a significant drop in FEV1 in 17% of the cases, while flows were significantly reduced in 30% of the cases. In rhinitic patients the bronchodilation test was positive in 25% of the cases both considering FEV1 and forced expiratory flows. Ultrasonic mist never induced a decrease of FEV1, while flows decreased in 12.5% of the cases. The free running test was positive in 12% of the cases regarding FEV1 and in 25% regarding forced flows.
The phagocytosis (in the absence of serum factors) of zymosan particles by peripheral leukocytes isolated from ten patients with acute leukemia (AMbL, AMoL, AMML, AUL, ALL and CML-BC) was studied at the electron microscope. An evident phagocytic activity was observed only in the cells in which cytochemical and ultrastructural features suggested that the blast elements belonged to the monocytic series. However, no phagocytosis by unclassifiable leukemic blasts was observed, even though they had some submicroscopic characteristics of the monocytic series. These findings suggest that phagocytic capacity develops during the course of cell differentiation, becoming striking only when the blast cell acquires the ultrastructural features of the pro-monocytic stage. Using the myeloperoxidase reaction, this study also demonstrates a morphological alteration in the degranulation process after the ingestion of zymosan particles in both the blasts and the mature PMN cells of leukemic patients. This defect could be related to the susceptibility to severe infections usually found in subjects with hematological malignancies.
Bleomycin is potentially capable of inducing a diffuse interstitial fibrosis of the lung, the pathogenesis of which has not yet been elucidated. The authors have demonstrated that after 48 hr of acute treatment, morphological and functional modifications could be seen in type II pneumocytes, which are responsible for surfactant production. This might be the earliest stage of pulmonary damage.
The results of preliminary research designed to prepare a method for using mouth measurements to identify alveolar air trapping phenomena which cannot be detected by normal techniques are reported. With a present rapid thermoconductivity CO2/He analyser, it was shown that even after the completion of a standard He wash-out process, it is possible to reveal the persistence in the expiratory air of bronchiolostenotic patients of residual traces of inert gases alongside CO2 originating from normally ventilating sectors. The information obtained from the mouths of patients corresponds with the results of measurements taken inside the lung. Finally it is shown that with adequate therapy the trapping phenomenon may be reversed.
A 22 weeks pregnant women was affected by a life-threatening pneumonia and a paresis of the proximal muscles with cerebrospinal fluid pleocytosis. Her past medical history had been unremarkable except for recurrent episodes of paraumbilical herpes zoster. The clinical findings suggested a dissemination of varicella-zoster virus without skin lesions. Acyclovir was added to the therapy, and the clinical picture began to improve. Varicella-zoster virus DNA was detected in placental tissue by DNA-hybridisation analysis.
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