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Biomedical subjects

M Usberti

Publications and source records attributed to M Usberti.

At least 37 records · Page 2Linked to original sources
PubMed1983

Long-term follow-up of minoxidil therapy in refractory hypertension. A prospective trial in patients with various degrees of renal insufficiency.

Thirty patients with various degrees of renal insufficiency (4 on dialysis treatment) and severe hypertension refractory to conventional agents were treated with minoxidil and followed for up to 182 weeks. BP averaging 203 +/- 8.8/125 +/- 4.1 mm Hg supine and 194 +/- 7.8/125 +/- 3.9 upright before treatment, fell to 155 +/- 6.2/92 +/- 3.4 and 146 +/- 6.3/92 +/- 3.2 respectively within 1 week with 5 to 30 mg daily of minoxidil and remained stabilized around these normal values for three years or more. However, increasing doses of the drug became necessary after 52 weeks of therapy. Serum creatinine increased slightly during long-term treatment in most patients suggesting that the fall in renal function with time should be attributed to the natural progression of normotensive chronic renal failure. Adequate dialysis (in the 4 dialyzed patients) and high-ceiling diuretics prevented fluid imbalance during minoxidil therapy, while beta-blocking agents allowed complete control of reflex tachycardia.

Adolescent↗
PubMed1983

Water excretion in nephrotic syndrome. Relationship between blood volume and plasma vasopressin.

In order to verify whether or not an increased secretion of ADH may cause the water retention commonly observed in nephrotic syndrome, 12 nephrotic patients and 11 normal subjects were studied in basal conditions and following a water load or iso-osmotic blood volume expansion. A significant direct correlation was observed between plasma ADH and Posm in controls but not in nephrotics. Plasma ADH was inversely correlated with BV in nephrotics but not in controls. Blood volume expansion in nephrotic patients was effective in reducing plasma ADH and promoting a water diuresis. These results demonstrate a sustained volume mediated secretion of ADH in nephrotic syndrome, which is responsible for the impairment in water excretion.

Blood Volume↗
PubMed1982

A study of the pathology of the crush syndrome.

Subsequent to the earthquake which occurred in Southern Italy in November 1980, 19 patients were admitted to the University of Naples--II Medical School with crush syndrome. Clinical and biochemical studies were carried out in eight of them. The most interesting observation was the inconstant relation between the type of lesion and the clinical course, leading to the assumption of two diverse physiopathologic mechanisms--one for crush and the other for compression. The timely recognition of the two syndromes is difficult; an elevated creatine-creatinine ratio has been found in those patients with an irreversible crush syndrome. We believe this to be the only element which would permit a prompt distinction between the two pathologic states and which would provide an indication for early, life-saving amputation.

Adolescent↗
PubMed1980

[Treatment of arterial hypertension with minoxidil in renal insufficiency].

Minoxidil was administered to 13 patients with arterial hypertension resistant to ordinary antihypertensive drugs and with various degrees of renal failure. Four patients were followed in this way for 50 weeks. Blood pressure values fell from 208 +/- 9.8/124 +/- 4.8 to 153.1 +/- 7.8/86.9 +/- 2.6 at the end of the treatment period. Propanolol and furosemide were used to offset sodium retention and reflex tachycardia. There was no decrease in renal function. In patients examined for the longest period, the minoxidyl dose, after an intermediate reduction stage, reached the 8th week value. Hypertrichosis was the most disturbing side-effect, especially for the female patients. The question of pericarditis is discussed.

Adult↗
PubMed1979

Relationship between serum albumin concentration and tubular reabsorption of glucose in renal disease.

Micropuncture studies in rats and dogs have provided evidence for a cause-and-effect relationship between peritubular protein concentration and proximal tubular reabsorption (PTR). If this effect is obtained in man, hypoalbuminemia in nephrotic syndrome should lead to a fall in PTR. Sodium excretion, however, is very low in nephrotic patients; but this sodium retention may be due to distal over-reabsorption. Glucose may be used as a marker of PTR. Because of the linkage between glucose and sodium, glucose reabsorption is expected to be suppressed when PTR of sodium is suppressed. Glucose titration studies were performed in 21 patients with chronic glomerulonephritis without renal failure divided in three groups: I (six patients) with serum albumin greater than 3 g/100 ml; II (five patients) with serum albumin of 2 to 3 g/100 ml; and III (10 patients with edema and nephrotic syndrome) with serum albumin less than 2 g/100 ml. The minimum threshold for glucose decreased in nephrotic patients (group III), and its fall was related directly to hypoalbuminemia. The splay of titration curve was markedly increased in group III when compared to the titration curves of patients without nephrotic syndrome (groups I and II). The splay point was 0.78 in group I, 0.52 in group II, and 0.37 in group III. These data provide evidence that glucose reabsorption is decreased in nephrotic syndrome and are consistent with a fall in PTR in nephrotic syndrome.

Adult↗
PubMed1977

Blood pressure control in end-stage renal disease in man: indirect evidence of a complex pathogenic mechanism besides renin or blood volume.

1. In twenty-three uraemic patients on regular dialysis, plasma renin activity and blood volume were measured before and after a single dialysis. Three groups were identified; the first had a low or normal plasma renin activity and a high or normal blood volume, the second had a high plasma renin activity and a low blood volume and the third had both variables above normal. 2. In spite of these differences, diastolic blood pressure before and after dialysis was the same in the three groups and multiple regression analyses failed to demonstrate any dependence of blood pressure on plasma renin activity, blood volume or body weight taken separately or together. 3. We conclude that other factors besides plasma renin activity and blood volume are important in maintaining arterial hypertension in terminal renal failure.

Adult↗
PubMed1976

Relationship of glomerular filtration rate and hypoalbuminaemia to renal glucose reabsorption.

Ten glucose titration studies were performed on 10 patients with chronic renal disease without renal failure. Six of them had nephrotic syndrome. The results show that patients with marked hypoalbuminaemia (i.e. patients with nephrotic syndrome) have a marked splay in the glucose titration curve. This observation is consistent with the hypothesis that physical factors play a main role in tubular reabsorption and indicate that proximal tubular reabsorption is decreased in nephrotic syndrome.

Absorption↗
PubMed1975

Short time personalised dialysis: good results in spite of high levels of small and middle molecules.

After almost two years of experience with 43 patients we believe that a short (3 X 4, 3 X 3 hr/week) personalised dialysis is a safe treatment that allows a high survival rate and a good rehabilitation of patients. Pre-dialysis levels of small and middle molecules, the latter only calculated, did not correlate with 5 typical uraemic parameters. Some patients, who formerly experienced standard dialysis, are now equally well or better, without evidence of increasing toxicity, in spite of their higher pre-dialysis levels of small and especially of middle molecules.

Adult↗
PubMedDate not supplied

[Clinical experience in HFR with a new resin-only sorbent cartridge].

Adsorbent therapies have become increasingly popular over the last several years as they permit an additional method to selectively or non-selectively remove toxins. Adsorbents offer a unique removal strategy as they have an extremely high adsorption capacity due to their great surface area. This paper describes experiments that utilized a synthetic divinylbenzene styrenic resin cartridge to remove uremic toxins from chronic renal failure patients. The resin-only cartridge was tested as an alternative after a small number of patients (primarily taking ACE inhibitors) experienced gastrointestinal problems using hemodiafiltration with on-line regeneration (HFR). Subsequent laboratory evidence suggested that the particular carbon used in the cartridge was able to activate contact phase activation. This could potentially cause problems in patients taking ACE inhibitors, as they are unable to degrade bradykinin efficiently. The resin-only cartridge was tested in at 6 centers throughout Italy and included patients that had experienced previous reactions to the carbon-resin cartridge. At the conclusion of the study, no adverse reactions were reported and the cartridge exhibited excellent removal of b2 microglobulin and angiogenin.

Adult↗