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Biomedical subjects

A Valeri

Publications and source records attributed to A Valeri.

At least 55 records · Page 3Linked to original sources
PubMed1993

The epidemiology of peritonitis in acute peritoneal dialysis: a comparison between open- and closed-drainage systems.

We performed a prospective study to examine the epidemiology and microbiology of peritonitis complicating acute intermittent peritoneal dialysis (IPD) performed in an in-hospital setting for the management of acute and chronic renal failure and to see the effect of a closed-drainage system on altering the frequency and cause of peritonitis. Over a 15-month period, 79 patients were treated with acute IPD for a total of 136 treatments each ranging in length from 2 to 40 days (median, 4 days). The majority of cases had acute renal failure (ARF; 65%) and were treated in intensive care units (ICUs; 74%) with serious comorbid conditions (60%). About half were treated with a two-bag, ventable (open)-drainage system with unprotected spikes, and the other half were treated with a single-bag, spike-protected, closed-drainage system. There were 27 cases of peritonitis for a rate of 4.5 cases/100 patient-days at risk. About half were gram-positive infections; the remainder were gram-negative or mixed (25%) or Candida sp (25%). The use of a closed-drainage system reduced the incidence of system-related peritonitis from 3.6 to 1.5 cases/100 patient-days. There was a high rate of peritonitis in the first 48 hours of treatment, which fell to a low stable rate thereafter and remained so for up to 15 days of continuous IPD. The use of a closed-drainage system eliminated the early (< 48 hours) high rate of peritonitis and maintained a low constant rate of peritonitis throughout treatment. There was an association of ARF and severe comorbid disease with more virulent organisms (gram-negative, mixed, and Candida sp), which, in turn, were both associated with antecedent broad-spectrum antibiotic therapy. Random positive surveillance cultures showed a frequency distribution similar to that of peritonitis cases over the duration of treatment, but with less virulent organisms. Peritonitis in acute IPD occurs when large or repeated inocula of organisms from the prevailing flora overwhelm the peritoneal immune clearance mechanisms. Prolonged courses of broad-spectrum antibiotic therapy provide no protection, but shift the resulting infecting flora toward more virulent pathogens. A closed-drainage system provides one method to reduce the frequency of peritoneal contamination.

Adolescent↗
PubMed1993

Epidoxorubicin and high dose leucovorin plus 5-fluorouracil in advanced gastric cancer: a phase II study.

We conducted a multicentric phase II study on advanced gastric cancer to determine the efficacy and toxicity of treatment with epidoxorubicin (EPI) plus high doses of leucovorin (LV) and 5-fluorouracil (5-FU). Thirty-seven patients with measurable disease were enrolled into the trial and treated with EPI 75 mg/m2 on day 1 and LV 200 mg/m2 plus 5-FU 450 mg/m2 from day 1 to 3, the cycle being repeated every 3-4 weeks from a median of five cycles per patients. The response rate was 49% in 35 evaluable patients, with two complete remissions and 15 partial responses. Median response duration was 12.4 months; median survival for responding patients was 17.3 months, which was significantly longer than 8.7 months for non-responding patients. General toxicity was usually mild, myelotoxicity was moderate and there was no evidence of cardiac toxicity. These results show that EPI-LV-5-FU is an effective regimen for advanced gastric carcinoma. The efficacy of this combination should now be tested as an adjuvant therapy in resectable gastric cancer.

Adult↗
PubMed1993

[Scrotal temperature in 258 healthy men, randomly selected from a population of men aged 18 to 23 years old. Statistical analysis, epidemiologic observations, and measurement of the testicular diameters].

Scrotal hyperthermia can induce certain alterations in spermatogenesis. The basal scrotal temperature used to define hyperthermia is usually 33 degrees C. However, no study, conducted according to a strict methodology has validated this mean measurement. We therefore randomly selected 258 men between the ages of 18 and 23 years from a population of 2,000 young French men seen at the National Service Selection Centre in order to measure the scrotal temperature over each testis and in the median raphe in order to determine the mean and median values for these temperatures. For a mean room temperature of 23 +/- 0.5 degrees C with a range of 18 to 31 degrees C, the mean right and left scrotal temperature was 34.2 +/- 0.1 degree C and the mean medioscrotal temperature was 34.4 +/- 0.1 degree C. Scrotal temperature was very significantly correlated to room temperature and its variations. It was therefore impossible to define a normal value for scrotal temperature. Only measurement of scrotal temperature at neutral room temperature, between 21 and 25 degrees C, is able to provide a reference value for scrotal temperature. In this study, the mean scrotal temperature under these conditions was 34.4 +/- 0.2 degree C, i.e. 2.5 degrees C less than body temperature. In the 12.9% of cases with left varicocele, left scrotal temperature was significantly higher than in the absence of varicocele and was also higher than right Scrotal temperature. The authors also determined the dimensions of the testes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Inguinal lymphatic metastasis of cancer of the testis: staging and therapeutic approach].

Inguinal lymph node metastases from testicular tumors are reported in 2% of cases. Between 1980 and 1990, two patients in a series of 54 testicular tumors, presented with inguinal node metastases. In there two cases and in the cases in the literature, it is well known, that testicular tumors in patients who have had the lymphatics disrupted by prior scrotal or inguinal surgery, or tumor-contaminated scrotum, can metastasize primarily to the ipsilateral inguinal nodes. Even in the absence of other retroperitoneal metastases, these testicular tumors must be considered to be stage IIA. Owing to the efficacy of primary or secondary chemotherapy, ipsilateral inguinal node dissection is not necessary in nonseminomatous testicular tumors. For testicular seminoma, an additional inguinoscrotal radiotherapy is necessary. Survival rate for testicular tumors with isolated metastatic inguinal nodes, particularly in tumor-contaminated scrotum, is not significantly different, compared to a group of patient without inguinal nodes.

Adult↗
PubMed1991

Acute and chronic renal disease in hospitalized AIDS patients.

We performed a retrospective chart analysis on 449 AIDS patients admitted to Bellevue Hospital Center from 1983-1986 to characterize the etiologies and clinical course of acute renal failure (ARF) and to define the incidence and clinical course of AIDS-associated nephropathy (AAN) in an unselected hospitalized AIDS population. Defining ARF as a rise from baseline serum creatinine of at least 2.0 mg%, we found 88 cases (a prevalence of almost 20%) or 14.5 cases per 100 admissions. Volume depletion was the most common etiology and was as severe a cause of ARF as other etiologies. There were 21 cases of ARF in 17 patients with a peak serum creatinine greater than or equal to 6.0 mg%. Volume depletion accounted for 7/21 of these cases. Baseline renal insufficiency existed in 9/17 patients (12/21 cases) and volume depletion was the cause of ARF in 3 of these cases. Only 4 cases required dialysis. There were 34 patients (prevalence of 7.6% or 3.0 cases per 100 patient-years) with otherwise unexplained chronic renal insufficiency and/or persistent qualitative or quantitative proteinuria and thus were defined on clinical grounds to have AIDS-associated nephropathy. Thirty-two of these patients (94%) had evidence of AAN at or within 1 year of presentation. Eleven patients (32%) reached ESRD (serum creatinine greater than or equal to 6.0 mg%); 9 patients did so within 1 year of presentation and 3 required dialysis. In those with adequate follow-up (9 cases), the mean survival from time of ESRD was 25.5 days and all cases died within 6 months of reaching ESRD.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Associated Nephropathy↗
PubMed1991

[Intrathoracic revascularization of the stomach in gastroplastic reconstruction of the esophagus].

Reconstruction of the thoracic esophagus after esophagectomy is usually achieved using the stomach which, after gastrolysis through an abdominal approach, is pulled into the right thoracic cavity and anastomosed to the esophagus. After gastrolysis by conventional methods, the blood supply of the stomach exclusively depends on the right gastric and epiploic arteries. In some cases, these arteries cannot ensure sufficient blood supply to the fundus of the stomach, which is at higher risks from a vascular point of view, since it depends on the intraparietal capillary anastomoses between the gastric branches on the left inferior gastric artery, the intraparietal rami of the short gastric arteries, which have been cut, and the parietal rami of the anterior cardiotuberous artery. When macroscopic signs of ischemic disorders of this area are observed intraoperatively, resection of the fundus of the stomach would considerably reduce the length of the organ that could be used for gastric esophagoplasty. To avoid this, we have been implementing an intrathoracic revascularization technique consisting in anastomosing the left gastric artery, either directly with the right internal mammary artery, or through a shunt with the saphenous vein between the subclavian artery and the left gastric artery itself. Finally, the intensification of the venous circle is performed by anastomosing the left gastric vein and the azygos vein. Details of the surgical technique, as well as the results obtained, are illustrated.

Aged↗
PubMed1990

Long-term effects of pindolol and a thiazide diuretic on plasma lipids and blood pressure in patients with essential hypertension.

A retrospective analysis was made from the charts of 53 patients with mild to moderate essential hypertension to determine the effects of pindolol (PIN) monotherapy, hydrochlorothiazide (HCTZ) added to PIN monotherapy, and PIN added to HCTZ monotherapy on serum lipids and blood pressure. PIN monotherapy (Group I, n = 24) resulted in a significant decrease in systolic and diastolic pressure of 12.0 and 9.0 mmHg at three months and 14.0 and 11.0 mmHg at 12 months, respectively. Serum triglycerides, total cholesterol, low density lipoprotein and high density lipoprotein cholesterol fractions remained unchanged. The addition of 25 mg of HCTZ to PIN (Group II, n = 7) resulted in a significant decrease in both systolic and diastolic pressure of 21.0 and 11.0 mmHg at three months and 24.0 and 11.0 mmHg at 12 months, respectively. No change in serum lipids was noted. Adding PIN to 25 mg HCTZ (Group III, n = 22) resulted in a significant decrease in systolic and diastolic pressure of 18.0 and 9.0 mmHg at three months and 20.0 and 10.0 mmHg at 12 months, respectively, with no change in serum lipids noted. These data indicate that long-term administration of PIN, a drug possessing intrinsic sympathomimetic activity, alone or added to a low dose of a thiazide diuretic does not adversely affect serum lipids. The addition of a small dose of a thiazide diuretic to PIN has no long-term effect on plasma lipids.

Adult↗
PubMed1989

The hyperlipidemia of the nephrotic syndrome.

Lipid abnormalities in patients with the nephrotic syndrome have long been recognized. However, the significance of these lipid abnormalities, the mechanisms producing them, and their potential treatment have all been a cause of debate. Recent data have helped clarify each of these areas of controversy. Studies of the lipoprotein abnormalities of patients with the uncomplicated nephrotic syndrome have shown that many will have elevated levels of total and low-density lipoprotein cholesterol, whereas only a few will have elevated levels of high-density lipoprotein cholesterol. If these lipid abnormalities have the same significance in this population as in other populations studied, then some patients with unremitting nephrotic syndrome will be at high risk for cardiovascular disease. The elevated cholesterol levels noted in the nephrotic syndrome are caused primarily by enhanced hepatic synthesis, with lesser contributions by decreased clearance and altered enzyme activities. The signal for enhanced hepatic lipogenesis may relate to changes in plasma albumin concentration, plasma oncotic pressure, a local effect of viscosity at the hepatic sinusoidal level, or a loss of urinary proteins or other liporegulatory substances. Recently, a number of short-term studies in nephrotic patients have documented the safety and efficacy of lipid-lowering drugs such as the bile acid-binding resins, probucol, and the HMGCoA (hydroxymethylglutaryl coenzyme A) reductase inhibitors.

Animals↗
PubMed1988

The lymphatic route. V. Distribution of human natural interferon-beta in rabbit plasma and lymph.

Human natural interferon-beta (HuIFN-beta) was administered through different routes (intravenous [i.v.], intramuscular [i.m.], and subcutaneous [s.c.]) and its distribution in lymph and plasma was evaluated. After i.v. (bolus) administration the lymph/plasma ratio was about 0.35 but it significantly increased (11-fold) after i.m. administration. Addition of human albumin (ALB) to the IFN solution did not favor IFN absorption through the lymphatics. On the other hand, addition of ALB improved IFN absorption through the lymphatics after s.c. administration. These results are interesting because they clarify why IFN-beta can exert immunomodulatory activities in spite of very low plasma levels.

Animals↗
PubMed1986

Treatment of the hyperlipidemia of the nephrotic syndrome: a controlled trial.

The hyperlipidemia of the nephrotic syndrome is often associated with elevated total and low-density lipoprotein (LDL) cholesterol levels and low or normal high-density lipoprotein (HDL) cholesterol levels. This pattern of hyperlipidemia has been associated with an increased risk of accelerated atherosclerosis in other populations. Despite extensive studies of diet and drug therapy in other populations, few such therapeutic studies exist in patients with the nephrotic syndrome. To investigate the effect of diet and lipid-lowering drugs on the lipoprotein-lipid profile of patients with unremitting nephrotic syndrome and marked hyperlipidemia, we conducted a controlled trial using two such drugs: colestipol and probucol. Colestipol lowered the mean total fasting plasma cholesterol of seven patients from 397 +/- 27 to 317 +/- 37 mg/dL, a 20.2% decrease, and lowered the LDL cholesterol from 398 +/- 28 to 203 +/- 18 mg/dL, a 31.9% decrease. It did not affect the HDL cholesterol level, and thus lowered the LDL-to-HDL cholesterol ratio. Probucol lowered the mean total cholesterol from 439 +/- 72 to 339 +/- 60 mg/dL, a 22.6% decrease, and the LDL cholesterol from 282 +/- 43 to 215 +/- 26 mg/dL, a 23.8% decrease. Although the HDL cholesterol was lowered from 49 +/- 9 to 43 +/- 7 mg/dL by probucol, a 12.2% decrease, the LDL-to-HDL cholesterol ratio still declined. Both drugs were well tolerated and proved safe in this short-term trial. Antihyperlipidemic therapy may well be indicated in certain patients with unremitting nephrotic syndrome.

Adult↗
PubMed1985

Problems involved in the large scale production of biological products, such as beta-interferon, using diploid fibroblast cells as substrate.

The large-scale and continuous cycle production of Hu beta-IFN serves to indicate that with expansion of cell cultures, aspects such as the reliability of the growth media and the possibility of contamination of cultures may become critical and limiting factors for the production itself. Methods of growth media preparation are described, with particular stress on the problems related to bacterial contamination and water quality. Our production method involves the expansion of cellular cultures using roller bottles, and a final step using the microcarrier technique. The necessity of collecting the cultures in only two fermentors increases the possibilities of contamination. Methods employed in order to minimize these problems are discussed.

Cells, Cultured↗
PubMed1979

Tangential flow filtration of Bordetella pertussis submerse cultures.

A procedure is reported for the large scale separation of Bordetella pertussis microorganisms from liquid culture media by tangential flow filtration (cross flow filtration) using anisotropic membranes with a cut-off limit of 1 x 10(6) daltons, and microporous membranes with a pore size of 0.22 micrometer.

Bordetella pertussis↗
PubMed1978

Small subunit contacts in ribulose-1,5-bisphosphate carboxylase.

The arrangement of subunits of ribulosebisphosphate carboxylase in solution has been studied by exposing the enzyme to the cross-linking agents tetranitromethane, dimethyl suberimidate, and dimethyl adipimidate, and the cleavable cross-linking agent, methyl 4-mercaptobutyrimidate followed by gel electrophoresis in the presence of dodecyl sulfate. All these agents caused the formation of dimers of the enzyme's small subunit, independently of protein concentration. In addition, trimers and tetramers of small subunit were detected in the mercaptobutyrimidate-treated enzyme. The data show that small subunits are closely paired in the native enzyme and may be in layers of four, or a ring of eight.

Carboxy-Lyases↗