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Biomedical subjects

A De Vecchi

Publications and source records attributed to A De Vecchi.

At least 55 records · Page 3Linked to original sources
PubMed1985

Controlled trial of two different methylprednisolone doses in cadaveric renal transplantation.

In a controlled trial the effects of two different methylprednisolone (MP) schedules were studied in 100 cadaver kidney adult recipients followed for 18-46 months. Group A patients were given 160 mg/day i.v. for 3 days, then oral MP (0.8 mg/kg/day), which was tapered by 4 mg/week to a maintenance dose of 16 mg/day up to the 6th month. Group B patients were given 80 mg/day i.v. for 3 days followed by 0.4 mg/kg/day oral MP; the dose was reduced by 2 mg/week to 16 mg/day. In both groups, the dose was further reduced bimonthly to a final dose of 8 mg/day. No significant differences were evidenced between the two groups in patients and kidney survival or in the incidence of complications. The number of patients with at least one rejection episode was significantly higher in the lower dose group.

Adult↗
PubMed1985

Autoimmune hemolytic anemia in a cadaveric renal transplant recipient treated with cyclosporine.

A case of autoimmune anti-c hemolytic anemia was observed in a cadaveric renal transplant recipient treated by cyclosporine. Severe anemia had been preceded by an episode of cholangitis followed within a few days by a viral infection. Anemia improved after three plasmaphereses and after cyclosporine therapy was substituted by azathioprine and steroid doses were increased. It is hypothesized that cyclosporine withdrawal may have favored the improvement of hemolysis by favoring the suppression of antibody-producing cells.

Adult↗
PubMed1983

Cutaneous manifestations in renal transplant recipients.

Out of 105 renal transplant recipients 100 had skin lesions: 55% iatrogenic, 74% infectious, 12% precancerous or cancerous and 4% miscellaneous. Many of these lesions were at least in part transient, and steroid-related skin lesions became less frequent as years progressed. The more frequent infections were the fungal ones, followed by viral and bacterial infections with different patterns of onset. All the precancerous lesions appeared late and were almost exclusively represented by actinic keratoses; 2 evolved into squamous cell epitheliomata. 2 patients died due to Kaposi's sarcoma and melanoma. The high incidence of skin cancers in transplanted patients and the rapid evolution of dyskeratoses into spinaliomas warrants close dermatological surveillance.

Adolescent↗
PubMed1983

Intravenous methylprednisolone pulse therapy in essential mixed cryoglobulinemia nephropathy.

In 15 patients with essential mixed cryoglobulinemia, 24 exacerbations of renal disease, characterized by an increase in plasma creatinine (13 episodes) and/or proteinuria (18 episodes), were treated by 3 intravenous pulses of methylprednisolone (1 g each), followed by oral prednisone (0.5 mg/kg/day). Plasma creatinine levels fell within a week (P less than 0.025), while a significant decrease in urinary protein excretion was observed only after one month (P less than 0.05). After therapy, plasma creatinine levels remained stable in 8/10 patients for 3 to 60 months. These beneficial results suggest that MP pulses may be useful in the treatment of cryoglobulinemic nephropathy.

Adult↗
PubMed1982

[Prevalence of HBsAg and anti-HBs in hospital personnel].

The prevalence of serum HBsAg and Anti-HBs was studied in 201 staff members from two Renal Dialysis Units, one Medical and one Dermatological Division from two Hospitals in the Milano area. The overall prevalence of HBsAg was significantly greater among staff members (8.9%) as compared to controls (4.9%). On the contrary, the prevalence of Anti-HBs was only slightly higher in hospital personnel than in controls. Non-medical staff members (nurses, technicians) showed a prevalence of HBV markers (HBsAg and/or Anti-HBs) twice as high as medical staff members (46.1% vs 23.2%). When the prevalence of HBV markers was correlated to the duration of work in the hospital, a steady increase in the prevalence of Anti-HBs was observed. On the contrary, the prevalence of HBsAg rose in the first 3 years and remained constant thereafter. The prevalence of HBV markers was significantly higher among staff members from Renal Dialysis Units (HBsAg+ and/or Anti-HBs+:50%) than in the personnel from the Medical and Dermatological Divisions (32.4%). However, the difference was solely related to a higher prevalence of Anti-HBs in the former (42% vs 23%). This may reflect a higher risk of infection in Dialysis Units as compared to other Hospital Divisions. However, the difference might be magnified by the frequent use of HBIG in the Dialysis Units personnel.

Adult↗
PubMed1981

Renal disease in essential mixed cryoglobulinaemia. Long-term follow-up of 44 patients.

The mode of presentation of renal disease in 44 patients with essential mixed cryoglobulinaemia (EMC) was: acute renal failure (two patients), acute nephritic syndrome (six patients), nephrotic syndrome (eight patients), proteinuria and/or haematuria (28 patients). Renal biopsy, performed in 35 patients showed proliferative lesions in 33, while only minimal glomerular changes were seen in the remaining two. Immunofluorescence studies showed: IgG (85 per cent), IgA (36 per cent), IgM (90 per cent), C3 (90 per cent), C1q (47 per cent), and C4 (33 per cent) deposits, mainly located in subendothelial position. On electron microscopy, crystalloid structure of deposits and monocyte infiltration of capillary loops were the outstanding feature. The survival rate was 75 per cent at 10 years from the onset of clinical symptoms. Thirty-nine patients were followed for three to 146 months (mean 53.8). Twelve patients died, cardiovascular disease and infection being the commonest cause of death. Thirteen patients showed acute renal failure of acute nephritis syndrome: nine recovered completely, whereas the remaining four died during the acute renal episode. Three patients developed chronic renal failure, but only one period required chronic dialysis. The ominous significance of renal impairment in EMC should therefore be revaluated. The high prevalence of hypertension (28/44 patients) which was refractory to treatment in six, may be important to the clinical outcome.

Adult↗
PubMed1980

[Results of renal transplantation from cadavers in 200 patients].

We report our experience of 202 cadaveric renal transplant performed over a 9 year period. Actuarial patient survival rate was 87.5% at 1 year and 81% at 9 years; graft survival rate was 58.5% at 1 year and 43% at 9 years. In order to improve patient and graft survival, from September 1977 renal transplantation was performed only in patients with a previous careful clinical selection and who had received at least three blood transfusions. Out of 18 patient, actuarial patient and graft survival rate at 1 year were 100% and 76% respectively.

Adolescent↗
PubMed1980

[Prognostic significance of anuric acute rejection].

32 graft rejection episodes requiring dialysis within four days appeared in the first month after transplantation in 224 renal transplants. Our report shows that oliguric renal failure is not related to the severity of rejection but probably to the appearance of an acute tubular necrosis. Therefore graft renal failure requiring dialysis is not necessarily related to a bad prognosis.

Acute Kidney Injury↗
PubMed1979

Comparison between immunofixation and crossed immunoelectrophoresis for the detection of C3 activation products.

C3 breakdown products were measured in 51 fresh and stored sera and/or EDTA plasma samples from 18 healthy subjects, 8 patients affected by essential mixed cryoglobulinaemia, and 15 patients with miscellaneous glomerulonephritis, by simultaneous crossed immunoelectrophoresis and immunofixation. C3 splitting products, as determined by both methods compared well, and showed a highly significant correlation. The advantages and reliability of these two methods are discussed. Immunofixation seems to be the most suitable for routine use in clinical practice, being less expensive and more rapid to perform.

Complement C3↗
PubMed1978

Lipid disorders in renal transplant recipients.

Plasma cholesterol, triglyceride, lipoprotein and phospholipid levels were higher in 76 transplant recipients than in normal age-matched controls. 22 patients exhibited a normal lipid pattern; 12 a type IIa, 12 a type IIb, and 30 a type IV hyperlipidemia. Lipid abnormalities were not related to serum creatinine, parathyroid hormone (PTH), serum albumin, plasma glucose, transplant age, relative body weight or steroid administration schedule. Only plasma triglyceride level was related to mean prednisone dosage. In order to reduce the apparent cardiovascular risk posed by these changes in plasma lipid concentration, hypocaloric diet was administered to 16 patients with hypertriglyceridemia or mixed hypertriglyceridemia and hypercholesterolemia. With these dietary measures, plasma lipid concentrations returned to normal and remained stable during the period of observation (6--18 months).

Adolescent↗
PubMed1978

Serum complement pattern in essential mixed cryoglobulinaemia.

In twenty-six patients affected by essential cryoglobulinaemia, 188 determinations of serum complement components (SCC) were made. A peculiar pattern was observed which was characterized by: (a) low levels of early components (Clq, Cls and C4), (b) normal levels of C3 and high concentrations of late components (C5, C9) and (c) CH50 values significantly lower than normal. No relationship could be observed between early SCC and C3 levels. Thirty-three crossed immunoelectrophoreses were performed in thirteen patient's blood samples. The C3c peaks were not different from normal. Follow-up data (156 serum samples from twenty-four patients) during a 6-40 month period showed a non-homogeneous SCC behaviour. However, no relationship was found between the complement concentrations and clinical score. These findings suggest that SCC abnormalities are related to a complement hyposynthesis, which could be caused by a reduced C2 production or by a negative feedback effect of active components or their fragments.

Complement C3↗
PubMed1976

Primary proximal renal tubular acidosis; A therapeutical approach and long term follow-up.

This paper reports a case of proximal renal tubular acidosis followed during 4 years, in a 4-year-old girl. High doses of alkali could not be administered owing to gastric intolerance of the patient; diuretic therapy carries the risk of causing severe dehydration or hypotension. We administered such a dose of NaHCO3 to obtain a normal blood pH--with persistent hyperventilation-, subnormal bicarbonatemia, and acid urine. This treatment could cause an improvement of rickets, growth and laboratory data. At present, the biochemical data, including urinary excretion of bicarbonate with normal bicarbonatemia, are normal; this indicates a spontaneous recovery of the syndrome. We think that low doses of alkali are useful in the transient form of proximal renal tubular acidosis to prevent bone lesions and failure to thrive. But even in the irreversible form of this syndrome--when high alkali doses and diuretics cause dangerous effects--this therapy may be useful to treat some symptoms.

Acidosis, Renal Tubular↗