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Biomedical subjects

M Campanini

Publications and source records attributed to M Campanini.

At least 19 recordsLinked to original sources

[Hepatosplenic cat-scratch disease in the immunocompetent adult].

Atypical manifestations of cat-scratch disease have been described in children and immunosuppressed adults. We report the first case of hepatosplenic cat-scratch disease in an immunocompetent subject, demonstration of diversity of this infection. A 33-year-old man presented with prolonged fever, lymphadenopathy and multiple hypodense lesions of liver and spleen in ultrasonographic imaging. The hepatic biopsy showed non-specific inflammatory reactions including granulomata and stellate necrosis. Anti-Bartonella antibodies have been found. The therapy with clarithromycin and doxycycline for many weeks was effective for hepatic lesions. A month ago a history of a cat contact with the presence of a skin lesion has been reported.

Adult↗

[Hemorrhagic syndrome during high-dose ampicillin treatment].

In high doses, the beta-lactams--particularly cephalosporins--can cause bleeding from impairment of prothrombin formation. We report a case of hemorrhagic syndrome in a 63-year-old woman during therapy with high doses of ampicillin for Listeria monocytogenes meningitis.

Ampicillin↗

Familial clustering of IgA nephropathy: further evidence in an Italian population.

Several lines of evidence suggest that genetic factors have an important role in the pathogenesis of immunoglobulin A (IgA) nephropathy. We report the prevalence of familial IgA nephropathy in a referral center in northern Italy and present the data on HLA genotypes in the families identified. Twenty-six of 185 patients (14%) with IgA nephropathy investigated in Brescia, Italy, were related to at least one other patient with the disease. Restriction fragment length polymorphism (RFLP) analysis of HLA-DR beta and HLA-DQ alpha and beta genes, as well as polymerase chain reaction-based oligonucleotide typing, was performed in family members. The 26 patients with IgA nephropathy belonged to 10 families. Familial relationships between the patients varied greatly, ranging from parent-child to sib-pair to more distant familial relationships. No common nephrotoxic factor was identified in the families. The intervals separating the apparent onset of disease in relatives with IgA nephropathy varied from 8 months to 13 years. In patients with a family history of IgA nephropathy, there was an increased incidence of HLA-DRB1*08 compared with those with sporadic IgA nephropathy. The study shows that a significant number of the patients with IgA nephropathy followed up in Brescia had a family history of disease. The fact that the Italian population, an ethnic group not previously examined, also presents an increased familial susceptibility to IgA nephropathy suggests that familial predisposition is a very common finding for IgA nephropathy. Thus, clinicians should become aware that IgA nephropathy may aggregate within families in a substantial number of cases. In addition, this subgroup of patients with IgA nephropathy offers an ideal opportunity to elucidate the molecular genetics of this disease.

Adolescent↗

Portal and mesenteric thrombosis in protein S (pS) deficiency.

Portal and/or mesenteric thrombosis is a rare occurrence, and often an underlying hypercoagulable state can be found. We describe a case in which a mesenteric infarction due to mesenteric venous thrombosis occurred as the first manifestation of an inherited type I deficiency of protein S, whereas signs of portal thrombosis emerged later.

Adult↗

Which treatment for which patient in the future? Possible modifications in CAPD.

On 578 unselected new patients followed from 1981 through 1993, 51% on CAPD and 49% on HD, long-term patient and method survivals, cause of death, and drop-out in the two methods were compared. Survival, adjusted for patient selection biases, was not different on CAPD and HD up to 10 years. 50% of the patients were still in their first treatment after 3.5 years on CAPD and after 7 years on HD, and 5 and 28% respectively, after 10 years. Patient survival on CAPD was not falsely improved by drop-outs. Drop-out is increasing for CAPD, mainly due to patient/partner burn-out, which should be relieved by a more liberal application of automated PD. Malnutrition is more frequent on CAPD than on HD but not for the elderly. In a 3 year prospective study on 60 CAPD and 34 HD patients serum albumin, nPCR and nutritional status, as assessed by SGA did not influence survival in each modality. Survival was similar with K(p,r)t/V > or = 1.7/week on CAPD and Kt/V > or = 1/treatment on HD, and worse below these values. On CAPD, a Kp,rt/V > or = 1.96 gave better survivals.

Humans↗

Behaviour of Listeria monocytogenes during the maturation of naturally and artificially contaminated salami: effect of lactic-acid bacteria starter cultures.

The antimicrobial activity of a bacteriocin-producing Lactobacillus plantarum MCS strain against Listeria monocytogenes in naturally and artificially contaminated salami was evaluated in comparison with that of other non bacteriocin-producing lactic-acid bacteria (i.e., L. plantarum MCS1 mutant strain and two commercial starter cultures). In salami not inoculated with lactic-acid bacteria, moderate L. monocytogenes growth was observed after 7-14 days. The addition of the starter cultures prevented growth, but not always the survival of Listeria. During the maturation of artificially-contaminated salami, Listeria counts tended to decrease, but no significant differences were observed between samples inoculated with L. plantarum MCS or with the MCS1 bacteriocin-negative mutant strain. However, at the end of the maturation period, in naturally-contaminated salami, differences in the survival of Listeria (recovered by enrichment) were observed in the batches inoculated with the different lactic-acid bacteria: Listeria appeared to be absent only in salami inoculated with the L. plantarum MCS strain.

Bacteriocins↗

[Microalbuminuria: theoretical bases and new applications].

The constant presence of albumin, as detected by common biochemical methods, in multiple urine samples of a patient, was first considered by Bright, in 1836, as a cardinal sign of renal disease ("clinical proteinuria"). Since then this view was widely adopted for studying the clinical evolution of the patients with diabetes mellitus, whose high risk to develop proteinuria and subsequently a progressive decline of renal function was well known. Thus the finding of "clinical proteinuria" by traditional, merely biochemical techniques, has been considered for more than one century as the opening event in the onset of diabetic nephropathy, and a distinctive sign of glomerulopathy in general. More recently, this view has been deeply criticized, mainly because it lies on the implicit assumption that the sensitivity limits of the biochemical tests for the detection of urinary protein concentrations (about 300 mg/dl), coincide with the ones that can distinguish non nephropathic from nephropathic patients (either diabetic or not). Indeed new techniques, that detect urinary proteins down to 1 microgram/ml, have shown that the upper limit of protein excretion in healthy people is well below the minimum concentration detectable by all the traditional tests. Therefore a new clinical entity, named "microproteinuria" has been defined, meaning the urinary excretion rate ranging between the "physiological" and the "clinical" proteinuria; its pathophysiologic, diagnostic and prognostic significance has been extensively evaluated in the last 20 years. Microproteinuria has been shown to represent a crucial event in the natural history of the diabetic nephropathy; in diabetic patients it is strictly related to the risk of future (months to years) development of overt nephropathy and chronic renal failure, and it may predict the risk of macroangiopathic complications. More recently new settings have been proposed for the study of microproteinuria, as an early and sensitive marker of cardiovascular diseases in hypertensive non diabetic patients and even in non hypertensive non diabetic elderly people. The role of microproteinuria in the diagnosis and follow-up of many non-diabetic glomerulopathies is a very interesting though still unexplored field.

Albuminuria↗

[Current aspects of the diagnosis of arterial hypertension].

Arterial blood pressure (BP) is widely believed to be a main risk factor for cardiovascular diseases. The chance to develop some kind of vascular injury is almost exponentially and continuously related to BP values at a given age. In accordance, the WHO stated the upper limits for diastolic and systolic BP beyond which it is reasonable to anticipate a clear statistic advantage from the hypotensive treatment (of either pharmacologic or other kind). However many studies have shown that the relation coefficient between BP values and the occurrence of cardiovascular diseases is on the whole quite weak, even under rigorously controlled conditions. This could be, at least in part, due to the fact that the severity of the cardiovascular damage depends on the "global" hypertensive load continuously charging the patient's cardiovascular system along the whole life: the "random" measurement of the BP is indeed a poor statistical index of such load because of the wide variability of BP with time. Thus many sources of BP variability have been studied, in order to develop multiple-measurement methods of BP monitoring hopefully with more prognostic power. In this article we review the major problems inherent to the methodological development of the serial full-automatic sphygmomanometric ambulatory BP monitoring, such as its concordance with different more traditional techniques, the statistic effectiveness of intermittent (versus continuous) sampling, the psychological impact of multiple cuff inflations during the day and the night.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

Acute cholestatic hepatitis during simvastatin administration.

Simvastatin, recently introduced in clinical practice for pharmacological treatment of hypercholesterolemia, has been found to cause minor and reversible elevations of serum transaminases. We report a case of acute cholestatic hepatitis during simvastatin therapy. Clinical, biochemical, immunological, and histological findings were consistent with a simvastatin-induced liver damage through an immunological-mediated mechanism. This case suggests a careful monitoring of liver function tests during simvastatin therapy, and caution in continuing simvastatin administration when elevations of serum transaminases take place.

Acute Disease↗

[Sensitization to ethylene oxide: a possible cause of reactions in hemodialysis patients].

147 hemodialyzed patient were studied for the presence of allergic reactions related to the dialytic treatment. Total IgE and specific IgE to common inhalants, ethylene oxide and phthalic anhydride were determined in all patients. The same determinations were also performed in two control groups. Specific IgE to ethylene oxide were detected in 7 sera. Among these 6 had a high total IgE level and 2 had a positive Phadiatop. Only 3 among the 7 positive patients had adverse reactions related to the hemodialysis (one suffered from itching, one from urticaria and the third from angioedema and hypotension). The resolution of the symptoms was obtained utilizing a gamma-rays sterilized filter. Therefore ethylene oxide sensitization may be a cause of some problems during hemodialysis. We couldn't find a relationship between atopic status and sensitization to ethylene oxide in as much in only 2 out of 7 patients sensitized to ethylene oxide, specific IgE to common inhalants were detected.

Aged↗

Risk factors for first operation in Crohn's disease.

We studied 267 consecutive Italian patients (146 male, 121 female) with Crohn's disease. Median time from the first symptom to diagnosis at our center was 21 months (range 1-372), whereas median follow-up from the first visit was 38 months (range 1-180). The disease affected the small bowel in 93 (35%) cases, the ileum and colon in 76 (28%), and the colon in 98 (37%). Forty-nine percent of the patients underwent major abdominal surgery for the disease at least once. The cumulative probability of abdominal surgery was 36% and 55%, 60 and 120 months after the onset of symptoms, respectively. Univariate analysis indicated that patients with colon involvement (p less than 0.0001), those with a longer interval between first symptom and diagnosis (p less than 0.0001), and those at an older age at diagnosis (p less than 0.0003) had a significantly greater probability of escaping abdominal surgery. The interval between first symptom and diagnosis, the site of disease, and the age at diagnosis were confirmed as risk factors for surgery, in decreasing order of importance, by multivariate analysis with Cox's proportional hazard model. A prognostic index for first operation based on these variables is proposed.

Adolescent↗

[Determination of zinc and copper in patients with liver cirrhosis of diverse clinical severity].

Zinc and copper levels in the blood and urine of 44 liver cirrhosis patients and 10 healthy volunteers are reported. The clinical severity of the liver disease (according to the Child classification system) was correlated with the levels of the two metals. An attempt was also made to break down the parameters on which the Child System in based in order to contribute to the pathogenic interpretation of changing zinc levels in liver disease patients. The results show a significant reduction in zinc in the blood but an increase in the urine in the various degrees of liver damage. A connection was also noted between low blood zinc and encephalopathy.

Copper↗