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Biomedical subjects

E Vaccaro

Publications and source records attributed to E Vaccaro.

7 recordsLinked to original sources

Cyclosporin A in a pregnant patient affected with systemic lupus erythematosus.

Few data regarding the use of cyclosporin A (CyA) in pregnancy are available and those available refer mainly to transplant recipients and not to patients with connective tissue diseases. We report the case of a patient with systemic lupus erythematosus (SLE), taking CyA before, during and after her pregnancy at a dose of 4 mg/kg per day. CyA was effective in controlling SLE activity and no side effects were observed in mother or baby. The lack of teratogenicity in this case was in keeping with previous reports in experimental systems, animals and human transplant recipients. If our observation is confirmed by further studies, CyA might become useful in the treatment of pregnant patients with SLE.

Adult

[Evaluation of cardiac involvement in systemic lupus erythematosus. Clinical and echographic study].

Thirty-five consecutive patients with systemic lupus erythematosus were enrolled in a prospective study. Investigations included a physical evaluation, tests for antinuclear antibodies and antiphospholipid antibodies, an electrocardiogram, a plain chest film, a 2D echocardiogram and a Doppler study. Clinical cardiac manifestations and alterations of the electrocardiogram were infrequent (17% and 11% of patients, respectively) and no patients had abnormal chest film findings. In contrast, echocardiographic abnormalities were common (82% of patients), although moderate in most instances. Pericardial involvement was found in 15 patients (42.8%); a pericardial effusion was seen in 9 of the 14 patients with inactive disease (p < 0.003), whereas thickening of the pericardium was visible in 4 patients with active disease and 2 of the 21 patients with inactive disease. Valve abnormalities were found in 17 patients (48.5%), but were not related to the presence of antiphospholipid antibodies; valve alterations included verrucous endocarditis in one case, valve thickening in one case, mitral prolapse in five cases, and mild or moderate regurgitation in 15 cases (aortic in 2 cases, mitral in 7 cases, pulmonary in 3 cases and tricuspid in 7 cases). Alterations in ventricular chamber size and kinetics were also fairly common, albeit of uncertain pathogenetic significance. These data confirm the value of 2D echocardiography for identifying and monitoring cardiac involvement in systemic lupus erythematosus, even in patients with no overt clinical manifestations.

Adult

[Relations between athero-arteriosclerosis and chronic liver diseases. Anatomopathological and statistical studies].

Starting from well known anatomopathological premises and on the basis of relative physiopathological concepts, particularly lipid metabolism and the lipidaemic fractions in patients suffering from chronic hepatopathy and athero-arteriosclerosis, a statistical investigation was carried out into the relations between the two disease conditions on the basis of the anatomopathological material collected over a period of six years in the S. Giovanni and S. Giacomo Hospitals in Rome. The conclusion is that there is a smaller incidence of athero-arteriosclerotic pathology in patients suffering from chronic hepatopathy up to the sixth decade of life.

Adult

[Changes in some plasma parameters in the course of dextran 40].

Changes in certainplasma parameters (Hc, arterial and venous VP, creatinine clearance, potassium, PA and FC) induced by Dextran 40 perfusions (500 ml at 40 drops/min and 250 ml at 20 drops/min) were examined in 50 patients. The expander effect was more intense, though less protracted when the larger quantity was used. A rebound effect 24 hr after the test was also more frequent percentage-wise in this group. Significant changes in Hc were not observed for 24 hr and 96 hr respectively with the higher and the lower dose. The venous district was primarily concerned. There were also increases in blood potassium, FC and max PA, while min PA and blood proteins fell. No relation could be demonstrated between creatinine clearance and diuresis at the end of the test with respect to the amount of Dextran employed. None of these latter modifications was significant. There were no signs of intolerance.

Blood

[Changes of plasma renin activity during perfusion with dextran 40. Functional study; statistical evaluations and cl-nical considerations].

Changes in RAP, AP (max and min), Ht and R.R. induced by daily perfusion with 250 and 500 ml Dextran 40 in a 10% isotonic solution were examined in two groups of patients with peripheral obstructive arteriopathy. Systemic AP showed no appreciable changes, whereas RAP and Ht fell in direct proportion of the dose given. This effect tended to disappear after 96 hr. Administration of this plasma volume extender 4 days per week is recommended.

Adult