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Biomedical subjects

P Zucchelli

Publications and source records attributed to P Zucchelli.

At least 163 records · Page 9Linked to original sources
PubMed1983

Controlled trial of monthly alternated courses of steroid and chlorambucil for idiopathic membranous nephropathy.

Forty-nine patients with membranous nephropathy (MN) and nephrotic syndrome (NS) were randomly allocated to supportive or specific therapy. The latter consisted of steroids or chlorambucil given in alternate months for a cumulative period of six months. Three patients in the experimental group were dropped from the study because of therapy related side-effects. At the end of follow-up there were significantly more patients in complete or partial remission in the experimental group than in the controls. The mean serum creatinine did not change in treated patients, but it significantly increased in controls.

Chlorambucil↗
PubMed1983

The presence of J chain in mesangial immune deposits of IgA nephropathy.

In order to identify polymeric IgA in the mesangial IgA deposits of 33 patients, the presence of J chains by a PAP method was investigated. In 9/27 cases of primary IgA nephropathy (PIgANP) and in 4/4 cases of Henoch-Schönlein glomerulonephritis (HSGN) J chains were absent. The remaining cases, two of them with IgA glomerulonephritis associated with alcoholic cirrhosis (ACIgAGN), were J-positive. The two groups, PIgANP J-positive and PIgANP J-negative, were compared according to clinical features. The only difference detected was the time length between the disease onset and the renal biopsy, being shorter in the negative group.

Adult↗
PubMed1983

Short-term plasmapheresis in acute lupus nephritis.

This study reports 11 cases with acute lupus nephritis who underwent short-term plasmapheresis treatment combined with immunosuppressive therapy. 68 plasma exchanges (mean/patients: 6.2) were performed by either centrifuge or membrane filter, exchanging 80% of total plasma volume per session. A rapid improvement of clinical symptoms was observed in all cases treated. 5 patients with renal insufficiency at the beginning of treatment, showed a reduction in serum creatinine and proteinuria after plasmapheresis. Immunological investigations demonstrated a rapid decreasing of circulating immune complexes and anti-DNA antibodies and an improvement of lymphocyte function, studied by E rosettes and Con A induced suppressor activity.

Acute Disease↗
PubMed1983

Plasma exchange in renal allograft rejection.

Circulating anti-HLA antibodies against mismatched donor antigen have been found in 7 patients during acute rejection episodes, where renal biopsy showed severe vascular lesions. 4 patients were submitted to combined therapy with plasmapheresis and cyclophosphamide, while the other 3 were treated by cyclophosphamide alone. In the 4 patients treated plasmapheresis induced a rapid disappearance of circulating cytotoxic antibodies, which remained negative in 3 cases where cyclophosphamide was continued after plasmapheresis. No change in antibody occurred in the three cases treated by cyclophosphamide alone. Renal function showed an improvement in 3 of the 4 patients treated by plasma exchange; all patients on drug therapy alone showed a rapid and progressive impairment of renal function and returned to RDT within 2 months.

Adolescent↗
PubMed1983

Dopaminergic control of sympathetic activity and blood pressure in haemodialysis patients.

Bromocriptine was used to test the hypothesis that the abnormality of the dopaminergic system described in haemodialysis patients may cause enhanced sympathetic activity and high blood pressure. Bromocriptine significantly reduced supine mean blood pressure and plasma noradrenaline. Moreover, although the increments in plasma noradrenaline during tilt tests were reduced by bromocriptine there was a significant improvement in the response of blood pressure. These results suggest that dopaminergic control of sympathetic activity may be impaired in haemodialysis patients and may be a cause of high blood pressure. Moreover, a restoration of a normal relationship between noradrenaline and adrenergic receptors would be consistent with the present results.

Adult↗
PubMed1983

Blood pressure behaviour in hemodialysis patients treated for 10 years.

A longitudinal analysis of blood pressure was performed in 30 patients on hemodialysis for at least 10 years, in order to clarify the long-term outcome of hypertension in dialysis patients. Before the start of the dialysis treatment 22 (73.3%) patients were hypertensive, while, after 10 years, only 5 (16.6%) were still hypertensive. Body weight tended to decrease progressively throughout the period of observation. Hypertension disappeared in the younger patients while it remained/appeared in those who were order showing the characteristics of systolic hypertension. Except for hematocrit no significant differences in metabolic findings were found between normotensive and hypertensive patients. ECG abnormalities were found to be more frequent after 10 years of dialysis than before the start of treatment. High blood pressure tends to disappear progressively in hemodialysis patients and to be no longer a problem in long-term survivors.

Adolescent↗
PubMed1982

[Prevention and clinical course of polycystic kidney disease in adults. Examination and case report of 134 patients].

Adult polycystic kidney disease is inherited in an autosomal dominant fashion and it ranks third as the cause of end-stage renal disease, with 9% of patients in dialysis treatment. It is possible to achieve an effective primary or secondary preventive action because of its clinical, evolutive and hereditary features. We studied 134 patients with different degrees of renal function, considering the beginning and the evolution of the disease. The collected data were compared with other reports. Furthermore the finding of cysts in organs other than the kidney, the coexistence of intracranial aneurysms, high blood pressure and pregnancy were examined. We report a study carried out on 17 families of patients in hemodialysis because of MPRA, which included 118 subjects. We were only able to examine 40 adults (34%) completely and among these five patients were discovered to have MPRA. For 29 of the subjects (41%) didn't complete the examinations or refused further investigations. The contemporary presence of suggestive family history and data obtained by urography, nephrotomography, nephrosonography and the study of renal function permit a reliable diagnosis. The incidence of the disease could only be reduced by a constant prevention, but there are considerable difficulties caused by the little attention given to the disease by the medical class and people in general.

Adolescent↗
PubMed1982

Heart rate control in hypertensive patients treated by captopril.

1 The effect of captopril on autonomic reflex functions has been investigated in fifteen patients with essential hypertension by examining their responses to tests of baroreceptor function (Valsalva's manoeuvre and upright posture), sympathetic nervous system reactivity (cold pressor and mental stress tests) and parasympathetic reactivity (diving test) before and after 3 weeks' treatment with captopril. 2 Captopril significantly reduced arterial blood pressure and resting heart rate but did not affect cardiovascular responses to Valsalva's manoeuvre, upright posture, cold pressor and mental stress tests. 3 The bradycardia associated with the diving reflex test was significantly enhanced by captopril (P less than 0.01). 4 These results indicate that treatment with captopril is associated with increased parasympathetic tone but without inhibition of baroreceptor or sympathetic reflexes.

Adult↗
PubMed1982

Renal scintigraphy versus renal vein renin activity for identifying and treating renovascular hypertension.

This paper compares renal scintigraphy (RS) with renal vein renin activity (RVRA), intravenous pyelography (IVP), and peripheral plasma renin activity (pPRA) in a population of hypertensive subjects with suspect renovascular hypertension (RVH), of whom 30 underwent surgery, in order to evaluate (a) screening ability of RS for RVH, and (b) surgical prognosis of RS for RVH. RS agreed with arteriographic findings of arterial stenosis in 91% of patients and proved more sensitive as a screening test than IVP and pPRA. The false-negative rate of RS was 9% and the false-positive rate was 10%. In the patients who underwent surgery RS was positive in 89% and RVRA in 85% of those who benefited from surgery. In this series false-negatives for RS occurred only in the presence of extensive collateral circulation, where RVRA also gave the same result. In patients who had been operated on, the sensitivity and specificity of RS, compared to RVRA, were very high. Our work supports the view that RS is a good screening test in RVH; moreover, it seems to be as accurate as RVRA as a surgical prognostic method for curable RVH.

Adolescent↗
PubMed1982

Therapeutic effects of 25-hydroxycholecalciferol and sodium etidronate on renal osteodystrophy.

The effects of long-term treatment with 25-hydroxycholecalciferol (25OHD3) and disodium ethane-1-hydroxydiphosphonate, or 25OHD3 alone on biochemical parameters, and radiographic and quantitative histomorphometry of bone tissue were evaluated in 17 dialysis patients. They all displayed evidence of bone disease consisting of osteitis fibrosa and defective mineralization of varying degree and predominance. 100 micrograms/day of 25OHD3 significantly improved the state of bone mineralization in many patients with a pronounced fall in the osteoid volume and surface and produced a small reduction in the active resorption surface. Serum parathyroid hormone (iPTH) and alkaline phosphatase levels decreased in some patients. The combination of 25OHD3 with EHDP caused the healing of bone mineralization as did 25OHD3 alone and produced a significant fall in serum alkaline phosphatase and iPTH. The mean magnitude of the reduction in iPTH was higher in patients treated with 25OHD3 and EHDP than with 25OHD3 alone. Treatment with 25OHD3 and EHDP seems more effective for the improvement of osteitis fibrosa than is 25OHD3 alone.

Adult↗
PubMed1982

[Parathyroid function in Paget's disease of bone].

The serum level of parathormone (PTH) measured in 151 cases of untreated Paget's bone disease was found to have increased 23 times (15 p. cent). This increase in PTH is associated with a significant reduction in the calcemia and the calciuria noted in Paget's disease patients having a high PTH, but it was not linked to the spread or to the biological activity of the disease. Th involvement was clearly a case of secondary hyperparathyroidism (HPT), linked to the increased calcic requirements of pagetic bone. This might explain the great frequency of appearance of primitive HPT during the course of Paget's disease, and could be a factor in relative resistance to antiosteoclastic therapy calcitonin or diphosphonates.

Adult↗
PubMed1981

The effects of captopril on blood pressure in essential hypertensive patients with low or normal plasma renin activity. Interference with autonomic nervous system.

Captopril was administered to 12 essential hypertensive patients with low or normal plasma renin activity in order to evaluate its effectiveness in decreasing blood pressure and to determine whether the inhibition of converting enzyme could interfere with sympathetic neural activity. Captopril, at the doses of 150-450 mg/die, normalized blood pressure in 5 patients (responders) and had no effect on 7 patients (non responders). A significant decrease in heart rate was observed in all patients. Captopril failed to significantly increase plasma renin activity in all patients. Supine plasma levels of catecholamines were significantly higher in responders compared with non responders and decreased significantly after treatment with captopril. The physiological study we performed on all patients suggests an overall integrity of the baroreceptor reflex arc and vascular reactivity to stress before as well as after treatment with captopril. On the contrary, the bradycardia induced by diving test was significantly greater after treatment than before therapy. These findings suggest that the antihypertensive effect of converting enzyme inhibition may be partly due to interference with sympathetic neural activity. Moreover captopril seems to exert an important effect on parasympathetic activity irrespective of blood pressure changes.

Adult↗