PubMed Health⌕ Search

Biomedical subjects

L Neri

Publications and source records attributed to L Neri.

At least 37 records · Page 2Linked to original sources
PubMed1994

Serum lipoprotein(a) and coronary artery disease in uremic patients on chronic hemodialysis.

There is convincing clinical and experimental evidence to support the notion that lipoprotein(a) [Lp(a)] is atherogenic. Patients undergoing chronic hemodialysis have an increased risk of atherosclerotic cardiovascular complications. In the present study, we investigated the possible relation between the alteration, if any, in serum Lp(a) and coronary artery disease in such patients. The mean serum concentration of Lp(a) tended to be higher in the 64 hemodialysis patients than in the 30 normal controls (15.1 +/- 15.2 vs. 9.7 +/- 10.4 mg/dl). However the difference did not reach statistical significance. The prevalence of levels above 30 mg/dl was 14% (9/64) and 10% (3/10), respectively, and the difference was also not statistically significant. Eleven hemodialysis patients with coronary artery disease had a significantly higher mean serum concentration of Lp(a) than the unaffected 53 (33.7 +/- 18.4 vs. 11.1 +/- 11.2 mg/dl, p < 0.001). Elevated levels were present in 63.6% (7/11) and 3.8% (2/53), respectively (p < 0.01). Other parameters of lipid metabolism were not different between the two groups. We observed statistically significant positive correlations of Lp(a) to total cholesterol, LDL cholesterol and apolipoprotein B in controls, in hemodialysis patients as a whole and in those without coronary artery disease. No such correlations were obtained when hemodialysis patients with coronary artery disease were analysed separately. It is concluded that firstly, high serum levels of Lp(a) in hemodialysis patients are strongly associated with coronary artery disease, as well as in the general population; and secondly, abnormalities in the metabolism of Lp(a) may underlie atherogenesis in these patients, independently of alterations in other lipid constituents.

Adult↗
PubMed1993

Combined treatment in Wegener's granulomatosis with crescentic glomerulonephritis--clinical course and long-term outcome.

This study reports on 9 patients suffering from Wegener's granulomatosis (WG) with crescentic GN and severe systemic manifestations. On admission the mean serum creatinine was 10.9 +/- 5.1 mg/dl (4-20 mg/dl); 8 patients were oliguric and required dialysis treatment. Renal biopsy showed crescents in all cases, involving 66 to 100% of glomeruli. Patients were treated with a protocol including: a plasma exchange (PE) course; methylprednisolone; cyclophosphamide; and an antithrombotic agent (defibrotide). Clinical picture and renal function progressively improved in all patients within the first 4 weeks of treatment. After 1 month serum creatinine was 2.7 +/- 0.8 mg/dl and dialysis was no longer needed in any patient. Five relapses occurred in 3 patients 12-26 months after the onset of the disease, while they were still receiving immunosuppressive treatment. At follow-up (22 to 112 months: mean 71) all patients were alive with no clinical signs of disease activity. One patient was on regular dialysis while the others had a serum creatinine of 1.2-2.8 mg/dl (mean 1.9). Our results confirm that crescentic GN associated with WG can be successfully treated even when associated with severe clinical picture and suggest that PE can contribute to control the disease without increasing immunosuppression.

Adult↗
PubMed1992

Plasma exchange treatment in rapidly progressive glomerulonephritis associated with anti-neutrophil cytoplasmic autoantibodies.

This study reports on 12 patients with acute renal failure due to biopsy-proven rapidly progressive glomerulonephritis and signs of systemic disease in whom antineutrophil cytoplasmic autoantibodies (ANCA) were detected by indirect immunofluorescence (IIF) on alcohol-fixed neutrophils and assessed in serial determinations by ELISA. The diagnosis was: Wegener's granulomatosis in nine patients who showed a diffuse cytoplasmic pattern at IIF (c-ANCA), and microscopic polyarteritis in three where a perinuclear pattern (p-ANCA) was seen. All patients underwent a course of plasma exchange - PE - (3-10 sessions per patient) associated with steroids and cyclophosphamide. The ANCA titer dropped steeply during PE in all cases and was followed by disappearance of systemic symptoms and renal function improvement within four weeks. After a follow-up period of 50 +/- 31.2 months all patients were alive without signs of disease activity; ten had stable renal function, with serum creatinine 1.8 +/- 0.7 mg/dl; two had entered regular dialysis treatment after 44 and 82 months. Our results suggest that the rapid removal of ANCA by means of PE can help control disease activity and reduce the risk of death or end-stage renal disease.

Acute Kidney Injury↗
PubMed1991

Cost evaluation of chronic schizophrenic patients during the first 3 years after the first contact.

This study was performed in Italy, where mental health care is largely provided by the Government-financed Italian National Health Service (INHS). Since 1978, outpatient services and psychiatric beds in general hospitals have replaced psychiatric hospitals, which have not been permitted to admit new patients. The direct costs of three cohorts of 20 chronic schizophrenic patients were evaluated according to incidence data for a 3-year period. The analysis focused in particular on services provided by public institutions. The average cost per patient during this period following first contact-admission was $9,612 (1989 U.S. dollars), which is low compared to costs in other countries. The cost distribution between inpatient and outpatient services was different from other studies and showed that, in Italy, hospital expenses covered approximately 50 percent of total direct INHS costs. The length of time between onset and first contact-admission showed a significant association (p less than 0.01) with INHS costs during the 3 years. A significant association (p less than 0.05) also was found between the Scale for the Assessment of Positive Symptoms (SAPS) global symptom "delusions" evaluated after 5 to 7 years and the average INHS costs during the 3 years of the study.

Adult↗
PubMed1991

Glucose regulation of guinea-pig sperm motility.

Washed guinea-pig spermatozoa from the vas deferens re-acquired progressive motility within 1-2 min of incubation in minimal culture medium containing pyruvate and lactate. When glucose was added, either at the beginning or after 15 min of incubation, the cells showed stimulated motility (increased straight-line velocity, linearity and beat-cross frequency, P less than 0.01). Re-acquisition of progressive motility was preceded by a significant (P less than 0.005) transient increase in sperm concentration of cyclic adenosine 5'-phosphate (cAMP) with or without glucose in the medium. Papaverine caused another large significant (P less than 0.001) increase in cAMP concentration; and 5.56mM glucose with papaverine caused a further stimulation in cAMP beyond that with papaverine alone (P less than 0.005). Although 0.05 or 5.56mM glucose plus alpha-chlorohydrin stimulated sperm motility, they did not further stimulate the increase in cAMP after 30 s of incubation. Thus, there was no apparent correlation between the glucose-stimulating effect on sperm motility and the enhancement of cAMP at 30 s. However, there was a close correlation between glucose-stimulated motility and enhancement of ATP (P less than 0.05) by glucose even under incubation conditions in which glucose caused the Crabtree effect (decrease in respiration rate).

Adenosine Triphosphate↗
PubMed1988

Lymphocyte micronuclei and sister chromatid exchanges among Canadian federal laboratory employees.

Blood lymphocytes from 59 federally employed Canadian laboratory workers, 137 nearby office employees, and 11 workers with a mixed employment history were examined for the presence of sister-chromatid exchanges and micronuclei. These laboratory workers were exposed routinely to a host of organic solvents and had previously voiced complaints regarding the adequacy of the ventilation system in their building. Overall, no relationship between laboratory work and either cytogenetic endpoint was observed. The two tests were only weakly correlated, but in a multivariate analysis, both were associated with recent and past smoking. Within-person variation was measured for the sister-chromatid exchange assay, and it and other possible sources of variation are discussed.

Abortion, Spontaneous↗
PubMed1984

Diagnosing metastases of differentiated thyroid carcinoma with 201 thallium scan: a case report.

A case of supraclavicular metastatic follicular carcinoma which occurred 7 years after the patient had undergone total thyroidectomy is presented. By means of whole body 210-thallium scan, a precise diagnosis was made, while the whole body 131-I scan was negative. The thyroglobulin serum levels were high before surgery but significantly decreased after lymphadenectomy. The clinical use of this tracer to detect functioning and non-functioning metastases of thyroid carcinomas is discussed.

Adenocarcinoma↗
PubMed1981

Autoradiographic studies of the smooth muscle cells in human arteries.

We have studied the kinetics of smooth muscle cell growth in the tunica media of human arteries obtained from 12 patients affected by obstructive vascular disease, and one case operated because of a trauma. The studies were carried out on arterial samples by autoradiography after in vitro labelling with 3H-thymidine. Different patterns of radioactive nucleotide uptake were detected. On nine elastic and muscular arteries without pathological changes it was demonstrated that the turnover of smooth muscle cells in human medias was very low, and similar to that found in experimental animals. The medias under atherosclerotic plaques showed variable levels of tritium uptake. Although the number of cases surveyed was limited, a possible explanation is that the different levels of uptake could depend on the different evolutive stages of the atherosclerotic process. It cannot, however, be excluded that the proliferative activity of the smooth muscle cells may be related to focal damages of the tunica media.

Adult↗
PubMed1978

Contribution to the surgical treatment of acute supratentorial subdural haematomas.

Acute traumatic subdural haematoma suspected of extending over an entire hemisphere must be treated with all speed. To obviate unnecessary skin incisions and subsequent craniectomies and craniotomies during the operation, we think it advantageous to plan a series of burrholes at set points in order to; a) begin to clear the haematoma; b) assess its extent and possible origin; c) decide whether a hemicranial or smaller craniotomy is called for.

Brain Injuries↗
PubMedDate not supplied

[Pre-dialysis arteriovenous fistula results in better patency rate].

BACKGROUND: The timing of creation of the first permanent vascular access is crucial to the clinical history of haemodialysis patients. Our strategy is to create vascular access early enough to allow its maturation before the start of the treatment. METHODS: Aim of the study is to evaluate patency of primary A-V fistulas in patients treated between 1985 and 2000 in our dialysis unit. One hundred and thirty A-V fistulas created before haemodialysis treatment (range 10-540 days) and used at its beginning (pre-HD group) are compared with 74 A-V fistulas created and/or used after the start of the haemodialysis treatment (post-HD group). RESULTS: Pre-HD group fistulas resulted in higher patency rate than the post-HD group, immediately at the start of the treatment (94.6% vs. 86.5%, p<0.05), at 6 months (89.2% vs. 75.6%, p<0.025), at 12 months (84.5% vs. 64.6%, p< 0.005), at 24 months (77.2% vs. 54.8%, p< 0.005). CONCLUSIONS: A-V fistula is to be preferred in the choice of primary vascular access for chronic haemodialysis patients. It should be created early enough before the beginning of the treatment (when serum creatinine reaches 6 to 7 mg/dL). This planning avoids central venous catheter placement, preserves vessels and the choice of the best surgical option thus resulting in a better fistula survival.

Aged↗
PubMedDate not supplied

[Improving the outcome of peritoneal dialysis in the long term: is it possible?].

Improving the results of peritoneal dialysis (PD) over time means reducing both the technique's drop out (TDO) and mortality rates. The PD mortality rate has diminished over the years, due to greater experience in using the technique and the reduction in mortality due to peritonitis making it comparable with the hemodialysis (HD) mortality rate. Moreover, improved control of the hydrosaline balance through the use of ambulatory peritoneal dialysis (APD) and icodextrin could further improve the survival rate in the future. The adequacy targets needed to reduce the mortality rate still appear to be debatable, as their importance seems conditioned by the presence of RRF and comorbidity. The TDO is higher in PD than in HD because PD is a self-administered treatment that uses a biological membrane as a filter. The most frequent causes of TDO are peritonitis (30-40%), dialytic inadequacy (11-27%), and subsequent inability and/or choice (10-32%). Peritonitis is the cause that has seen the greatest reduction over time due to the introduction of the Y-Set, but a further reduction could result from the prevention of ESI, and from improvements in the patient selection procedure designed to identify both clinical and psycho-social disposition peritonitis risk factors. Among the causes of TDO due to dialytic inadequacy, insufficient ultrafiltration (UF) could benefit from the diffusion of APD and icodextrin, while insufficient depuration could be reduced by new targets and optimization of the prescription. Finally, TDO due to social causes could be reduced by the use of APD, care support and appropriate patient selection.

Humans↗