Search PubMed⌕ Search

Biomedical subjects

R Martinelli

Publications and source records attributed to R Martinelli.

At least 55 records · Page 3Linked to original sources

Circulating immune complexes and rheumatoid factor in schistosomiasis and visceral leishmaniasis.

Circulating immune complexes, measured by the C1q binding and Raji cell radioimmunoassays, were detected in 16 of 25 (64%) patients with schistosomiasis alone, in all 13 patients (100%) with schistosomiasis infection associated with prolonged bacteremia by salmonella organisms, and in 15 of 18 (83%) patients with visceral leishmaniasis. The C3 levels in the serum of patients with schistosomiasis, with and without prolonged salmonella bacteremia, were significantly lower in those with renal disease. Further, in patients with schistosomiasis alone, the absence of renal involvement was positively associated with C1q binding within the normal range (P = 0.015) and the presence of IgM rheumatoid factor in serum (P = 0.04). In six of eight patients with visceral leishmaniasis treated with a pentavalent antimonial, there was a fall in Raji cell binding, suggesting indirectly that the parasitic antigen may be involved in the pathogenic immune complexes in serum.

Adolescent↗

Cefamandole treatment of Salmonella bacteremia.

The efficacy of cefamandole in the treatment of 19 patients with salmonella bacteremia was evaluated. Although all of the salmonella strains isolated were highly susceptible to cefamandole in vitro, a therapeutic failure was observed in 7 (36.8%) of the 19 patients.

Cefamandole↗

[Gastric bezoars].

Gastric bezoars are concretions sometimes mistaken for cancer, because of their polymorphous symptoms. Previous gastric surgery modifies anatomy and functions of the stomach and favours the bezoar deposition. Digestive endoscopy allows a correct diagnosis and therapy. A wide review of the literature is given.

Aged↗

Amoxicillin-clavulanic acid in treatment of urinary tract infection due to gram-negative bacteria resistant to penicillin.

Twenty-two adult patients with urinary tract infections caused by penicillin-resistant bacteria completed treatment with amoxicillin alone or amoxicillin plus clavulanic acid in a randomized double-blind clinical trial. Of the 13 patients treated with amoxicillin plus clavulanic acid, the absence of bacteriuria within 7 days of therapy was observed in 85%, as compared with only 25% of the 8 patients receiving amoxicillin only. There were no significant side effects nor any clinical, biochemical, or hematological abnormalities related to either treatment. It was concluded that the combination of clavulanic acid and amoxicillin could be useful in the treatment of uncomplicated urinary tract infection caused by penicillin-resistant bacteria.

Amoxicillin↗

Value of beta 1C/1A globulin serum levels as an early index of glomerular involvement in Schistosoma mansoni infection.

In attempting the early detection of glomerular abnormalities in patients with the hepatosplenic form of Schistosoma mansoni infection, the serum concentration of beta 1C/1A globulin was determined in 17 patients without clinical evidence of nephropathy. Renal biopsies were obtained during splenectomy in all of them. The serum levels of beta 1C/1A globulin were below the normal limit in eight patients; of these, two had histological evidence of focal proliferative glomerulonephritis, two others had membranoproliferative glomerulonephritis, and one showed focal sclerosing glomerulonephritis. Of nine patients with normal serum levels of beta 1C/1A globulin, eight had no glomerular abnormalities demonstrated by light microscopy. Determination of the serum concentration of beta 1C/1A globulin proved to be a valuable index for the detection of early glomerulopathy in patients with hepatosplenic schistosomiasis, since a low level correlated well with the histologic demonstration of glomerular involvement by light microscopy.

Adolescent↗

Pharmacology of cefaclor in normal volunteers and patients with renal failure.

After a 500-mg dose of cefaclor, the mean peak plasma level was 12.4 mug/ml and after a 250-mg dose it was 5 mug/ml in normal volunteers. Food intake significantly reduced absorption. Probenecid prolonged plasma levels. Mean plasma half-life in normal volunteers was 0.8 h. Only about 50% of the dose was excreted in the urine within 4 h in normal volunteers. Plasma half-life in patients with renal insufficiency was only about 3 h, which suggests that cefaclor may be eliminated by nonrenal mechanisms in humans. Urinary levels of cefaclor were adequate to inhibit susceptible pathogens even in patients with moderately severe renal failure. Plasma half-life during hemodialysis was 2.1 h and rose to 2.8 h after dialysis.

Adult↗

The effect of acute uremia on liver mitochondrial activity.

The effect of acute uremia on the liver mitochondrial activity was studied in Swiss albino mice subjected to complete urethral obstruction and sacrificed at different time intervals. The specific respiratory coefficient (measured as microliters of oxygen utilized per milligram of total proteins X 10(-1)) was similar in uremic and sham-operated control groups. The utilization of succinate as substrate was also similar in uremic and controls. There was a tendency for decreasing utilization of alpha-glutarate as substrate by the uremic group, particularly after 48 h of total urinary obstruction. There was no correlation between the retention of urea and the degree of mitochondrial respiratory inhibition.

Acute Disease↗

Influence of regional factors in the distribution of the histologic patterns of glomerulopathies in the nephrotic syndrome.

Analysis of 47 renal biopsies performed on adult patients with nephrotic syndrome in Bahia, Brazil, shows a peculiar distribution of the histologic types with a preponderance of membranoproliferative glomerulonephritis. The possibility of a regional influence is discussed, particularly with regard to Schistosoma mansoni infection which is endemic in this area and probably an important cause of glomerulopathy.

Adult↗

Renal involvement in prolonged Salmonella bacteremia: the role of schistosomal glomerulopathy.

Renal involvement has been well documented in patients with hepatosplenic schistosomiasis and in patients with prolonged Salmonella bacteremia (PSB). Whether there is a specific renal lesion related to PSB or the chronic bacterial infection aggravates a pre-existing schistosomal glomerulopathy has been a matter of controversy. To analyze the clinical manifestations and histopathological findings of the renal involvement, 8 patients with hepatosplenic schistosomiasis and PSB (group I) were compared with 8 patients with schistosomal glomerulopathy (group II) matched by sex and glomerular disease. The mean age in group I was 17.7 years. All patients presented with hematuria, in 4 cases associated with non-nephrotic proteinuria. In group II the mean age was 23 years; nephrotic syndrome was the clinical presentation in 7 of the 8 patients in the group. All patients in group I experienced remission of the clinical and laboratory abnormalities as the salmonella infection was cured; in group II the patients had persistent, steroid-resistant, nephrotic syndrome. On histological examination, no difference was noted between the two groups, except for pronounced glomerular hypercellularity and interstitial mononuclear cell infiltration in group I. These observations strongly suggest that PSB exacerbates a pre-existing sub-clinical schistosomal glomerulopathy by the addition of active lesions directly related to the prolonged bacteremia.

Adolescent↗

Is rhabdomyolysis an additional factor in the pathogenesis of acute renal failure in leptospirosis?

Leptospirosis is an important cause of acute renal failure in our environment. Although several mechanisms are implicated, the role of rhabdomyolysis in the pathogenesis of acute renal failure in leptospirosis has not been analysed. Sixteen patients with the diagnosis of leptospiroses consecutively admitted to the hospital were prospectively studied. The disease was characterized by sudden onset in all patients and, at admission, jaundice, conjunctival suffusion and myalgias. Mild to moderate proteinuria with unremarkable urinary sediment was recorded in 37.5% of the patients and abnormal levels of urea creatinine were found in 87.5% and 74.0%, respectively. Increased levels of aminotranspherase were documented in all 12 and CPK in all 10 patients studied. Serum myoglobin levels greater than 120 micrograms/l recorded in 56.2%. A correlation between myoglobin and renal failure or severity of disease, however, could not be established.

Acute Kidney Injury↗

Tetanus as a cause of acute renal failure: possible role of rhabdomyolysis.

To study the frequency and examine the role of rhabdomyolysis in the acute renal failure in tetanus 18 patients with the diagnosis of generalized tetanus consecutively admitted to the infectious disease hospital were evaluated. Of these 14 were male and 4 female with mean age of 31.8 +/- 2.0 years. Except for mild proteinuria recorded in 9 patients, the urinalysis were unremarkable. Serum creatinine higher than 1.4mg/dl was recorded in 39% of the patients, abnormal levels of CPK in 87,5% and serum myoglobin greater than 120 micrograms/l in 39% of the patients. Oliguria was documented in one patient and none required dialysis therapy. No correlation was found between renal failure and myoglobin and/or CPK serum levels. Acute renal failure in tetanus was not infrequent; usually it was non-oliguric, mild and transient and not related to the severity of the disease or to serum levels of myoglobin and/or CPK.

Acute Kidney Injury↗

[Increase in the frequency of norfloxacin and ciprofloxacin resistance of bacteria isolated from urine culture].

OBJECTIVE: To assess time trends in the frequency of norfloxacin and ciprofloxacin resistance of bacteria isolated from urine culture. METHODS: Results of all urine cultures with a bacterial growth of at least 10(5) colony-forming units per milliliter, performed at the Renal Service of the Federal University of Bahia, Brazil, from 1983 to 1994 were analyzed. The bacteria considered for this analysis were those most often isolated: Escherichia coli (n = 668), Klebsiella spp. (n = 286), Staphylococcus spp. (n = 186), Proteus spp. (n = 135) and Enterobacter spp. (n = 129). RESULTS: The frequencies of norfloxacin resistance for the periods 1983-1986, 1987-1990 and 1991-1994 were 3.2%, 5.9% and 9.1%, respectively (p-value < 0.05). The most pronounced increases in the frequencies of norfloxacin-resistance were observed for Klebsiella spp. and Enterobacter spp. The frequency of ciprofloxacin resistance was 7.4% in the period 1985-1989 and 16.5% in the period 1990-1994 (p-value < 0.05). This time trend in ciprofloxacin resistance was more striking for Enterobacter spp. and Staphylococcus spp. CONCLUSION: The results show a gradual increase in the frequency of norfloxacin and ciprofloxacin resistance of the bacteria most commonly isolated from urine cultures. The influence of previous treatment with quinolones and characteristics of the infecting bacteria on these findings are important questions to to be addressed in future investigations.

Anti-Infective Agents↗

Anti-beta2 glycoprotein I and anticardiolipin antibodies in leptospirosis, syphilis and Kala-azar.

OBJECTIVE: Reports have shown that anticardiolipin (aCL) antibodies present in patients with autoimmune diseases are dependent on the cofactor,beta2 glycoprotein I (beta2 GPI), as opposed to aCL antibodies seen in infectious diseases such as syphilis, HIV hepatitis C, etc. The assay for anti-beta2GPI antibodies has been reported to be more specific for antiphospholipid syndrome (APS). However, the prevalence of these antibodies in diseases such as leishmaniasis and leptospirosis remains unknown. The aim of the present study was determine the prevalence of antibodies to cardiolipin and to beta2GPI in patients with different infectious diseases, including leptospirosis, syphilis and leishmaniasis. METHODS: Samples from patients with Kala-azar (visceral leishmaniasis), syphilis or leptospirosis were tested for IgG and IgM anticardiolipin and IgG anti-beta2GPI antibodies by ELISA. RESULTS: In patients with Kala-azar the prevalence of IgG aCL, IgM aCL and anti-beta2GPI was 6% (2/30), 3% (1/30) and 53% (16/30), respectively. In syphilis the prevalence was 18% (14/74), 13% (10/74) and 10% (8/70), respectively. In leptospirosis the frequency of these antibodies was 23% (9/39), 10% (4/39) and 17% (6/34), respectively. There was no statistical correlation between aCL and anti-beta2GPI antibodies in these diseases. DISCUSSION: This study clearly shows a significant prevalence of anti-beta2GPI antibodies in leptospirosis and leishmaniasis and syphilis. This indicates that the assay for antibeta2GPI antibodies should be thoroughly validated before it is introduced as a definitive tool for the diagnosis of APS, testing a larger number of sera from patients with a wider range of clinical conditions.

Adolescent↗

[Evaluation of risks of biomechanical overload of the upper limb in physical kinesis therapists].

Physical therapists are at risk for work-related musculoskeletal disorders (WMSDs). Contributing risk factors are job-task, mental stress and biomechanical overload, due to fixed and incorrect postures of neck, upper limbs and back. The purpose of this study was to investigate, by questionnaire and the use of muscle superficial EMG recording and analysis, the workload in the physical therapist activity, in order to provide suitable preventive measures.

Arm↗