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Biomedical subjects

P Zucchelli

Publications and source records attributed to P Zucchelli.

At least 145 records · Page 8Linked to original sources
PubMed1985

Plasma noradrenaline and blood pressure in uremia.

To evaluate a possible correlation between sympathetic activity and blood pressure in uremia, catecholamines and blood pressure were determined in 81 uremic patients. In 34 of these 81 patients, thyroid hormones were also measured. In 16 patients on maintenance dialysis, a longitudinal study was performed to compare long-term blood pressure and catecholamine variations. No correlation was found between mean blood pressure and noradrenaline in the 81 patients as a whole, but when male and female patients were evaluated separately, a significant correlation was found in the former group. In the 34 patients, a correlation between mean blood pressure and noradrenaline was found only when hypothyroid patients were excluded. Variations in mean blood pressure induced by chronic dialysis were related to noradrenaline changes in the 16 patients studied. In conclusion, sympathetic activity seems to be correlated to blood pressure in uremic patients.

Adolescent↗
PubMed1985

Effect of eosinophilia on the heterogeneity of the anticoagulant response to heparin in haemodialysis patients.

The anticoagulant response to heparin was determined, during haemodialysis, in a group of seven patients with eosinophilia and in a control group. The heparin half-life was similar in the two groups, but the heparin effect index was lower in patients with eosinophilia. The dose-response curve showed a reduced sensitivity to heparin in patients with eosinophilia. In patients with eosinophilia a significant reduction in eosinophil count was observed during cuprophan dialysis, but not during polyacrylonitrile dialysis. The hyposensitivity to heparin might be related to eosinophil degranulation, during cuprophan dialysis, with release of a major basic protein that neutralises heparin.

Adult↗
PubMed1985

Plasma exchange therapy in rapidly progressive renal failure due to multiple myeloma.

Nineteen patients with severe renal failure due to multiple myeloma and with Bence Jones proteinuria greater than 1 gm/day were randomly assigned to group I or group II. Corticosteroids and cytotoxic drugs were given to all cases. The 9 patients of group I were also treated by peritoneal dialysis and the 10 patients of group II by plasma exchange and hemodialysis. Only 1 patient of group I, who was not oliguric at the onset, showed partial recovery from renal failure after 3 months of therapy, while 9 patients of group II (3 of whom were oliguric) had significant decrease in Bence Jones proteinuria and rapid improvement from the renal failure. In our experience, plasma exchange is more effective than peritoneal dialysis for reducing Bence Jones proteinuria and recovering from renal failure, even when there is oliguria.

Aged↗
PubMed1984

Controlled trial of methylprednisolone and chlorambucil in idiopathic membranous nephropathy.

Sixty-seven adults with idiopathic membranous nephropathy and the nephrotic syndrome were randomly assigned to symptomatic treatment only or to a six-month course of methylprednisolone alternated with chlorambucil every other month. Patients were followed for one to seven years. At the end of follow-up (mean of 31.4 +/- 18.2 months for the treated group and 37.0 +/- 22.0 for the control group) 23 of 32 treated patients were in complete or partial remission, as compared with 9 of 30 control patients (P = 0.001). Twelve of the treated patients were in complete remission, as compared with only two of the controls. In the treated group there were no changes in renal function during follow-up, whereas in the control group the reciprocal of the plasma creatinin level, which is proportional to the creatinine clearance, decreased significantly (P = 0.00017) after two years of follow-up. Side effects were minimal in all treated patients except two, who were dropped from the study because of peptic ulcer and gastric intolerance to chlorambucil. We conclude that steroid and chlorambucil treatment for six months favors remission of the nephrotic syndrome in adults with idiopathic membranous nephropathy and can preserve renal function for at least some years.

Adult↗
PubMed1984

An unusual manifestation of renal osteodystrophy.

Besides the more frequent aspects, an unusual manifestation of renal osteodystrophy occurred in a 19-year-old man on regular hemodialysis treatment. About 6 years after the start of hemodialysis, the patient, who had severe osteodystrophy, presented a brown tumor, localized to the jaw, which caused a serious deformity of the face. Pharmacological treatment for hyperparathyroidism did not reduce the volume of the mass. Only total surgical removal gave long-lasting success. Brown tumor is an unusual but serious complication of renal bone disease which can be treated successfully by surgical removal of the tumoral mass and by pharmacological treatment for hyperparathyroidism.

Adult↗
PubMed1984

Renal osteodystrophy in CAPD patients.

To assess the influence of continuous ambulatory peritoneal dialysis (CAPD) on the evolution of renal osteodystrophy, we studied 36 adult patients with end-stage renal failure before starting dialysis and after 7-30 months. 17 patients (12 males and 5 females) were treated by CAPD as first treatment and 19 (14 males and 5 females) received maintenance hemodialysis. The two groups were age- and sex-matched and no patient received vitamin D. All patients had adequate clinical and metabolic follow-up with a radiological survey and quantitative bone histology at the start of dialysis and at the end of the study. Serum phosphate concentrations were much easier to control in CAPD than in hemodialysis patients. There was no difference in the evolutive pattern of vascular and periarticular calcifications in the two groups. The 25-hydroxyvitamin D3 levels were frequently lower in CAPD than in hemodialysis patients. In some CAPD patients, there was a significant loss of trabecular bone volume at the end of the study. The radiological and histological appearances of secondary hyperparathyroidism improved or seemed to worsen to a lesser degree in CAPD compared to hemodialysis patients.

Adult↗
PubMed1983

Focal glomerulosclerosis in patients with unilateral nephrectomy.

To investigate whether proteinuria and focal glomerulosclerosis (FSG) might develop in humans as well as in experimental models following a reduction in renal mass, we performed a retrospective study of 24 patients previously nephrectomized for unilateral renal disease. None of the patients presented signs of systemic diseases. Alport syndrome, essential hypertension, reflux nephropathy, and other abnormalities on intravenous pyelography. At the time of the first observation seven patients had pathological proteinuria (group 1) while 17 presented a normal protein excretion (group 2). All patients in group 1 and only 4 of 17 in group 2 were male. No other significant differences were found between the two groups. The median age at nephrectomy of the proteinuric patients was 22.3 years, and proteinuria developed after a mean period of 12.2 years. A renal biopsy was performed in four patients and showed a constant pattern of FSG. After a mean follow-up period of 7.3 years from the onset, proteinuria remains unchanged and renal function is well preserved in all the patients. In conclusion our series suggests that also in humans proteinuria and FSG might appear in solitary kidneys due to nephrectomy. This glomerular damage may result from the association of glomerular overload with other unidentified factors.

Adult↗
PubMed1983

HLA in familial Hodgkin's disease.

We report HLA genotypes in four familial cases of Hodgkin's disease (HD), Nodular Sclerosis (NS) histological subtype, where all patients showed B18 antigen. This finding, although statistically not supported, confirms the possible correlation between HD and B18 antigen which carries a high relative risk in international data.

Adolescent↗
PubMed1983

Immunohistochemical staining on hydroxyethyl-methacrylate-embedded tissues.

Hydroxyethyl-methacrylate (GMA) embedding has recently been proposed for light microscopy studies. In the present investigation extracellular protein antigens were localized on GMA-embedded renal biopsy tissue. Conventionally frozen sections were compared with GMA sections from 55 renal specimens for the detection of extracellular protein antigens. Sections were directly stained with fluorescein- or peroxidase-conjugated antisera against immunoglobulin (Ig) G, IgA, IgM, C3, C1q, and fibrinogen. Results obtained using these two methods showed a 74-89% agreement, depending on the antigen under study. Some discrepancy between GMA and frozen sections was observed in three cases of renal amyloidosis and those cases presenting focal or trace reactions; the differences did not, however, influence the diagnosis. Prerequisites for antigen recovery on GMA sections were a) choice of fixative; b) abrupt dehydration of specimens; and c) treatment of sections with nonspecific protease. The improved localization and the lower background staining obtained led to easy and immediate detection of antigens on GMA sections despite the reduced antigenicity due to the embedding process.

Acrylates↗
PubMed1983

Berger's nephropathy: relationship between histological pattern, blood pressure and renin.

Vascular damage (VD), glomerular sclerosis (GS), renin (PRA) and blood pressure were assessed in 50 patients with Berger's nephropathy. GS was present in 5/15 patients without VD and affected more than 15 per cent of glomeruli in seven patients with minimal VD. Nine out of 19 patients with GS were normotensive. VD was present in 35 patients: 16 were hypertensive and 19 normotensive. Therefore hypertension is not the only mechanism responsible for VD. In the seven normotensive patients with high PRA, GS was not present while VD was absent or minimal.

Adolescent↗