PubMed Health⌕ Search

Biomedical subjects

M Paola

Publications and source records attributed to M Paola.

11 recordsLinked to original sources
PubMed1996

Elderly patients on dialysis: epidemiology of an epidemic.

The increase in the incidence of elderly patients starting dialysis has been as sharp, during the 1980s-1990s, as an epidemic (+70%, +150% in different settings). According to this study, performed in Piemonte, northern Italy, the process is still ongoing. During the period 1981-93, according to the Regional Registry of Dialysis and Transplantation (RPDT: data on 100% of centres and patients), the cohort on treatment increased by 79.5% and the annual incidence by 48.3%; the increase is limited to older people and is greater in males. Nephroangiosclerosis/ischaemic renal disease and diabetes mellitus are the main diagnoses. Since the increase of elderly patients is still ongoing, forecasts are difficult; according to a computer simulation, a plateau of patients on treatment is reached only if incidence is stabilized, While it is impossible to exclude a decrease in hidden selection or an increase in referral, complex modifications at the overall population level are presumably at the basis or the increase of elderly patients on dialysis. Despite the increase in average age, however, survival improved throughout the period; this confirms the interest towards the open dialysis system adopted in Piemonte, which is characterized by easy shifts among treatments and by the widespread use of high tolerance techniques.

Adult↗
PubMed1995

Mid-dermal elastolysis: an ultrastructural and biochemical study.

Mid-dermal elastolysis (MDE) is a particular elastic tissue disorder in which selective loss of elastic fibres occurs in the mid-dermis. It is clinically characterized by the appearance of fine wrinkling of the epidermis and perifollicular protrusion which gives the skin an aged appearance. It is sometimes associated with an inflammatory event such as urticaria while other cases are regarded as idiopathic. The pathogenesis of MDE is still obscure. Some authors have underlined the role of macrophage activation and others have imputed UV radiation. We report here a typical case of MDE arising after several attacks of solar urticaria. Electron microscopic and biochemical studies were carried out. Ultrastructural examination showed active elastophagocytosis by macrophages and mast cells, often degranulated, near phagocytosing cells. Biochemical studies demonstrated that fibroblasts derived from lesional skin of the MDE patient produced high levels of elastase and cathepsin G compared with fibroblasts from a healthy sex- and age-matched control. Phagocytosis of morphologically normal elastic tissue is a noticeable characteristic feature of MDE. In our case mast-cell activation and the abnormal synthesis and/or release of fibroblast elastolytic enzymes seemed to play a role in the pathogenesis of the MDE.

Adult↗
PubMed1979

[Basic aspects and current trends in iatrogenic kidney diseases. Correlations between their physiopathological mechanisms and clinical findings for the general practitioner].

Iatrogenic origins may be assigned to any form of kidney disease. Of the pathogenetic mechanisms involved, increasing importance is now attached to immunological responses and intravascular coagulopathies, though other processes long known to medicine have not ceased to play their part. Moreover, recent advances in the improvement of drugs and the standardisation of their use have given a better idea of the potential damage to the kidneys from many substances. A re-examination is made of the main findings in this field with a view to offering a simple summary of the underlying physiopathogenetic mechanisms, and drawing the diagnostic and clinical conclusions therefrom, so as to aid the general practitioner rather than the specialist. An account of the various medical interventions that may lead to kidney lesions, and the circumstances in which such interventions are most likely to be harmful, is followed by an analysis of recent opinions on the correct way of administering drugs in patients with kidney disease, so as to limit their potentially harmful effects as far as possible.

Biological Products↗
PubMedDate not supplied

Leukocyte behaviour in chronic uraemic patients undergoing regular dialysis.

A review of the literature is followed by the presentation of data obtained during a study of white blood cell kinetics in patients undergoing regular dialysis treatment. It was found that contact between white blood cells and the dialyzer results in a very prompt 'neutropenia-neutrophilia' stage and the deposition of billions of white blood cells on the membranes at the end of each treatment. A comparison of intradialytic leukocyte behaviour and the mean baseline white blood cell values was made in a total of 49 patients subdivided in four groups: 1. patients using coil and parallel flow dialyzers; 2. patients using dialyzers of different surface area; 3. patients of different dialytic age; 4. patients employing monoused or re-usable filters. No differences were noted in groups 1 and 4. In contrast, employing large dialyzers and the increasing dialytic age led to a variety of white blood cell patterns. Contrary to the information in the literature on leukocyte adhesion, it was observed that the cell deposits on the membranes and on the bubble trap filters, while predominantly composed of neutrophils, also contained monocytes and lymphocytes in proportions similar to those of the normal differential blood count.

Adult↗