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Biomedical subjects

A Mazzi

Publications and source records attributed to A Mazzi.

16 recordsLinked to original sources
PubMed1996

Renal effects of captopril, indomethacin and nifedipine in nephrotic patients after an oral protein load.

BACKGROUND: In this study we investigated whether the increase in proteinuria induced by an oral protein load may be prevented by the angiotensin-converting enzyme inhibitor (ACEI) captopril in patients with nephrotic syndrome, and whether the effects of captopril on renal haemodynamics and/or glomerular selectivity are comparable to those obtained with the nonsteroidal anti-inflammatory drug (NSAID) indomethacin and the calcium-channel blocker (CaCB) nifedipine. METHODS: Twelve subjects underwent the following treatments: (1) low-protein meal (0.2 g protein/kg body wt), (2) high-protein meal (1.3 g protein/kg body wt), (3) high-protein meal plus oral captopril (50 mg), (4) high-protein meal plus oral nifedipine (10 mg), (5) high-protein meal plus oral indomethacin (50 mg). Urine and blood samples were obtained after meals and tested for total protein, immunoglobulin G and albumin. GFR and renal plasma flow (RPF) were calculated from iothalamate and p-aminohippuric acid clearances respectively. RESULTS: Mean arterial pressure decreased significantly after both captopril (-4%, P = 0.001) and nifedipine (-5%, P = 0.0019). Compared with the low-protein meal, mean values of GFR and RPF increased significantly after the high-protein meal alone (+21%, P = 0.0002; +10%, P = 0.0491 respectively), and after captopril (+18%, P = 0.0025; +24%, P = 0.0034 respectively) or nifedipine administration (+30%, P = 0.0001; +21%, P = 0.0036 respectively), whereas they remained unchanged after the high-protein meal plus indomethacin administration. FF did not change significantly under the five experimental conditions. The increase in urinary protein excretion induced by the meat load (total protein +18%, P = 0.0102; albumin +26%, P = 0.0316; IgG +28%, P = 0.0203) was entirely blocked by both captopril and indomethacin, whereas it was further increased by nifedipine administration. CONCLUSIONS: Both captopril and indomethacin, but not nifedipine, are able to prevent the increase in urinary protein excretion rate following a meat meal. The antiproteinuric effect of captopril is comparable to that of indomethacin, but the renal haemodynamic changes induced by these drugs differ considerably, because the filtration capacity and the renal functional reserve were preserved by captopril and decreased by indomethacin. The reduction in systemic blood pressure following administration of both captopril and nifedipine does not account for changes in proteinuria, since, with a similar degree of blood pressure lowering, urinary protein excretion is reduced by captopril and increased by nifedipine.

Adolescent↗
PubMed1996

Effectiveness of dietary protein augmentation associated with angiotensin-converting enzyme inhibition in the management of the nephrotic syndrome.

To determine whether the increase in proteinuria resulting from high dietary protein intake could be prevented by angiotensin-converting enzyme inhibition (ACEI), we performed paired studies on 8 nephrotic patients with normal GFR. They were fed sequential diets with a protein content of 0.8 (LPD) and 1.6 g/kg BW (HPD) each for 8 weeks. Patients on HPD received enalapril (ENAL) 10 mg/day. Despite the significant difference in protein intake, urinary protein excretion, at the end of the two dietary periods, was not statistically different. However, total serum protein and serum albumin increased significantly with HPD + ENAL treatment. The capability of ACEI to prevent the increase in proteinuria induced by HPD may be due to changes in glomerular hemodynamics, possibly mediated by changes in the activity of angiotensin II. Our study indicates that protein metabolism in nephrotic patients is better maintained with HPD + ENAL than with LPD alone.

Adolescent↗
PubMed1995

[Thoracic actinomycosis with lung, mediastinal and pericardial involvement. A case report].

A case of actinomycosis is reported in a 17-years-old woman with pleural and pericardial effusions and anterior mediastinal mass. Histopathological diagnosis of actinomycosis was performed by mediastinal mass biopsy. There was no evidence of immunodeficit or neoplasia. Probably a dental manipulation favoured the Actinomyces infection. Treatment with antibiotics resulted in a reduction of mediastinal mass and in a complete resolution of pleural and pericardial effusions.

Actinomycosis↗
PubMed1989

[Hamartomatous polyps of Brunner's gland. Presentation of 2 cases. Review of the literature].

Two uncommon cases of Brunner gland hyperplasia are reported. Both presented clinical symptoms simulating gastrointestinal disease caused by hyperacidity. In conjunction with clinical statistics, diagnosis based on aetiology was only formulated after a double-contrast radiological exam of the g-i tract. After treatment with antiacid and antisecretory drugs, remission of the clinical symptoms was obtained, and regression of the hamartomatous polypoid duodenal neoformation, thus confirming the hypothesis which states that hyperacidic gastric secretion is the main cause of Brunner gland hyperplasia.

Adult↗
PubMed1986

Knee arthrography: effects of various contrast media and epinephrine on synovial fluid.

Changes in synovial fluid leukocytes, total protein, and total complement were studied in 58 patients after they underwent single contrast material-enhanced knee arthrography with ionic (sodium iothalamate, sodium meglumine diatrizoate, meglumine iothalamate) and nonionic (iopamidol, iohexol) contrast media. In 30 of 58 cases, 0.3 mg epinephrine was also injected. In patients examined without epinephrine, a significant increase in the number of leukocytes was observed when sodium iothalamate and sodium meglumine diatrizoate were used. When administered with epinephrine all ionic compounds produced significant leukocytosis; articular reactions were most evident in patients examined with sodium salts. No inflammatory changes in the synovial fluid were observed when nonionic compounds were used. These data suggest that sodium-containing compounds produce a greater reaction in the joint compared with other contrast media, nonionic compounds are better tolerated by the joint, and epinephrine increases the articular reaction to ionic contrast media.

Adolescent↗
PubMed1985

Double-blind multicentre study of the activity of S-adenosylmethionine in hip and knee osteoarthritis.

A randomized double-blind multicentre clinical trial was carried out to verify the effectiveness and tolerance of S-adenosylmethionine (SAMe) versus ibuprofen in 150 patients with hip and/or knee osteoarthritis. Both drugs were given orally 400 mg thrice daily for 30 days. SAMe exhibited a slightly more marked activity than the reference drug in the management of the various painful manifestations of the joint disease. Minor side-effects developed in five patients of SAMe group, and in 16 patients of ibuprofen group. No drop-outs occurred. No changes were observed in the routine laboratory tests.

Aged↗
PubMed1985

[Ioexol in arthrography].

Single contrast knee arthrography was performed in a group of 50 patients, using either Urografin or Ioexol as contrast agents. Both contrast media were well tolerated clinically and no significant difference was found to exist as far as image quality is concerned. However, while Urografin produced a significant increase of the white cells in the synovial fluid, no inflammatory change was observed in the synovial fluid after Ioexol. So we believe that Ioexol is a significantly preferable contrast medium in arthrography, especially in patients with inflammatory joint diseases.

Adolescent↗
PubMedDate not supplied

[Adherence to dietetic treatment, the nutritional metabolic status and the progression of chronic kidney failure].

Effects of two protein restricted diets on dietary compliance, nutritional and metabolic state, and progression of chronic renal failure (CRF) were investigated. Twenty-one patients with CRF were randomly assigned to either a conventional low protein diet (0.6 g of protein/kg b.w./day) or to a very low protein diet, providing 0.4 g of protein/kg b.w./day, supplemented with a mixture of essential amino acids which contained HIS, TYR and a high proportion of branched chain amino acids. Nutrition, assessed by body weight, anthropometry, serum protein levels and nitrogen balance studies, was maintained in all patients. Some metabolic abnormalities of CRF (i.e., secondary hyperparathyroidism, glucose intolerance) improved in both groups. The supplemented diet provided better adherence to protein prescription, corrected the depletion of VAL and LEU in muscle and was more effective than conventional diet in slowing the rate of progression of CFR.

Adult↗
PubMedDate not supplied

[Bronchial carcinoma at the Zadar Medical Center 1982-1986].

In the period between 1982-1986, 2132 neoplasms were registered in the Zadar Medical Center, out of them 164 (7.7%) were primary bronchial carcinomas of which 138 (84.1%) were morphologically verified. The difference between the number of the registered and verified bronchial carcinomas is due to the difference in the registration criteria. The annual average incidence rate of the verified carcinomas was about 30 which is lower than in the Zagreb area and Croatia as a whole. The average number of cases diagnosed in other institutions was about 20 percent. An analysis by sex revealed a prevalence among males aged 55-75. Morphologically, the most common type of carcinoma was planocellular, followed by anaplastic, small cell carcinoma and adenocarcinoma. The greatest majority of the positive findings was obtained by bronchoscopy and sputum examination. The average number of sputa obtained per patient was 3.5; 63 percent of these were adequate and 40 percent of them were positive. In 86% of cases the diagnosis was established from the first three sputa. The most frequently used bronchoscopic method of material obtained was aspiration and the best diagnostic results were obtained by puncture biopsy and excision. The high percentage of positive results obtained by transtracheal biopsy justifies its use.

Aged↗
PubMedDate not supplied

[Radiological lesions of the hands in rheumatoid arthritis with rheumatoid factors and antinuclear antibodies].

Hand radiograms of 119 consecutive patients affected with rheumatoid arthritis (RA) were examined. The patients were distributed in different groups: 46 with (RF+) and 73 without (RF-) rheumatoid factor; 23 with (ANA+) and 96 without (ANA-) antinuclear antibodies. We found that RF+ group significantly differs from the RF- in order to the presence of symmetrical erosions of proximal interphalangeal joints (PIP) and the presence of monolateral erosions of metacarpophalangeal joints (MCP), particularly of the 2nd. We also observed that the frequency of MCP erosions, particularly of the 2nd was higher in ANA+ than in ANA-, and that monolateral PIP erosions were higher in ANA- than in ANA+ group. Moreover, the patients having both RF and ANA more frequently show erosions of symmetrical PIP and monolateral MCP as well as monolateral of the carp. It is therefore suggested that in RA patients having RF or ANA the articular lesions of the hand are different from those of the patients who don't show such serological markers.

Adult↗
PubMedDate not supplied

[Urinary infections in adults: clinical approach and therapeutic indications].

Urinary tract infections (UTI) are the most common of all the bacterial infections affecting humans during their life span. In adult patients, UTI may be categorized into the following groups: acute uncomplicated cystitis, acute uncomplicated pyelonephritis, recurrent bacterial UTI infections, asymptomatic bacteriuria, complicated UTI, acute and chronic bacterial prostatitis. In patients with uncomplicated cystitis, short-course (3 days) empirical therapy is more effective than single dose therapy. Recurrent cystitis can be effectively managed by continuous antimicrobial prophylaxis. Acute pyelonephritis in patients with anatomically normal urinary tracts should be treated with antimicrobial therapy for 10 to 14 days. Complicated infections require a full 10- to 14-day course of antimicrobial therapy. Urologic evaluation in patients with acute pyelonephritis or recurrent infections should not be routinely performed. Screening for asymptomatic bacteriuria is unnecessary in adults, except in particular circumstances. There is little evidence that UTI in adult patients lead to progressive chronic renal injury, unless complicating factors are concurrently present.

Acute Disease↗
PubMedDate not supplied

[Comparison of intradermal and prick tests based on samples of the most common allergens in the Zadar region].

The practical clinical problem of evaluating the significance of positive dermal tests is present in daily in vivo diagnoses in allergology and clinical immunology. Our research was aimed at a comparison of the two methods of dermal tests, namely, intradermal (i.d.) and prick tests, based on a sample of the most common allergenics in the Zadar region. The intradermal method was applied to a group of 664 patients, the prick test was used in a group of 641 patients, and 60 patients were examined using both methods. In the tests allergens from extracts of Dermatophagoides pteronyssinus, tree, weeds and grass pollens, dust, feathers, eggs, milk, flour, meat and fish from the Zagreb Institute of Immunology were used. A solution of histamine chloride and buffer saline containing 50% glycerol, prepared by the same Institute was used as a control. We considered a positive reaction to the intradermal test to have occurred when an urticaria of 5 or more mm radius with surrounding inflammation developed. A reaction to the prick method was considered to have taken place when an urticaria of 3 or more mm radius, together with surrounding inflammation resulted. A positive reaction was shown in 30% of those to whom the prick test was applied, and in 32% of those to whom intradermal tests were used, which represents 0.11-0.13% of the total adult population of the region of Zadar. A positive reaction to a single allergen was shown in 43% of the patients tested by i.d. test, and in 52% of the patients tested with the prick method. The most common oversensitivity with both methods was shown to Dermatophagoides pteronyssinus (86% i.d., and 56% prick, respectively). Among the pollen allergenics the most common reaction was to grass pollen (47% i.d., 65% prick). With patients who were tested with both methods (60 patients), there were also differences in results. An equal dermal reaction to both tests was shown in 32% of the patients, minor differences were present in 45%, and significant differences occurred with 23% of the patients. Regarding Dermatophagoides pteronyssinus, it is shown that the positive dermal reaction was statistically significantly larger with patients tested with i.d. than when the prick test was used (chi 2 = 17.39, p < 0.05). There was no statistically significant difference between the two methods regarding the allergenics of pollen and feather. These results lead to the conclusion that it is necessary to uniform the conditions for allergological tests. This implies the use of standardized allergenic preparations of similar concentrations, the selection of a uniform method and technique for testing, and compliance with other relevant factors.

Adolescent↗
PubMedDate not supplied

[The feasibility and current limits in the prevention of diabetic nephropathy].

Diabetic nephropathy is the leading cause of uremia in Italy and other industrialized countries: once diabetic nephropathy commences, it advances slowly but inexorably to uremia. Prevention begins with strict control of blood sugar to inhibit or normalize glomerular hyperfiltration, and control of blood pressure to prevent glomerular hypertension and decrease microalbuminuria. Pharmacological measures include ACE-inhibitors and calcium channel blockers, alone or in combination, to reduce proteinuria and preserve renal function. It is believed that some classes of anti-hypertensive drugs have a direct pharmacological depressive effect on cell growth factors that lead to mesangial sclerosis: ACE-inhibitors would thus depress angiotensin II, and the calcium channel blockers would inhibit the increase in intracellular calcium of the mesangial cells which increases gene expression of early growth. Dietary sodium restriction seems to correct the expansion of the sodium pool and related volemic expansion hypertension. A protein-poor diet limits the precapillary glomerular vasodilatation resulting from protein-induced hyperaminoacidemia. The earlier dietetic and pharmacological measures are taken, the more effective they become: while they cannot arrest diabetic nephropathy once it has commenced, they are able to delay evolution of the disease to uremia.

Diabetic Nephropathies↗