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P Stratta

Publications and source records attributed to P Stratta.

At least 55 records · Page 3Linked to original sources
PubMed1996

Renal transplantation in a case of mannosidosis.

Mannosidosis is an inherited autosomal recessive mucopolysaccharidosis. Patients affected accumulate mannose-rich compounds in various tissues and excrete an increased quantity of oligosaccharides with mannose as a component. A case of type II mannosidosis with end-stage renal failure is reported. The patient, after 6 years of regular hemodialysis treatment, received a kidney transplant. At the time this article was written, the graft was functioning well and thesaurismotic renal deposits had not been observed. The clinical course of mannosidosis was silent and the patient's quality of life was good. Although the risk of recurrence could not be excluded, it seems that renal transplantation can be safely offered to patients affected with mannosidosis type II, in the rare setting of chronic renal failure.

Adult↗
PubMed1996

Incidence of biopsy-proven primary glomerulonephritis in an Italian province.

Between January 1, 1970, and December 31, 1994, 1,926 cases of biopsy-proven primary glomerulonephritis (PGN) were diagnosed in an adult population (> 15 years of age) in a northwestern region of Italy with approximately 3.5 million inhabitants. The principal long-term changes were an increase in the absolute number of biopsies per year, an increase in the mean age of patients undergoing biopsy (from 29.3 +/- 12.2 years to 47.0 +/- 17.8 years), an increase in the percentage of patients older than 65 years (from 1.7% to 20.4%), and an increase in the percentage of isolated urinary abnormalities as an indication for biopsy (from 3.5% to 29.6%). In the total biopsy material, immunoglobulin A glomerulonephritis (IgA-GN) is the most frequent type (26%), followed by membranous glomerulonephritis (MGN; 20%). An incidence study was begun in 1990; this survey was restricted to the population of the province of Torino (approximately 2 million inhabitants) as only this area completely refers to the nephrologic centers that entered patients into this study. The overall incidence of PGN is 4.68 new cases/yr/10(5) population with a predominance of males (> 2:1); IgA-GN is the most common type (1.47/yr/10(5) population [34.5%]) in the overall population. In the elderly, cases of PGN are twice as high as in adults (8.19/yr/10(5) population v 4.02/yr/10(5) population in the 65 to 74 year and 45 to 54 year age groups, respectively); MGN mainly accounts for this high incidence (3.4/yr/10(5) population), while the nephrotic syndrome is the most common indication for biopsy (53.8%). A comparison with the incidence in the same area in the early 1970s is evaluable only for PGN, which was mainly registered in the age groups for which an unrestricted biopsy policy was already in place (15 to 35 years). In contrast with a misleading increase of all types of PGN, which is in reality due to the extension of the biopsy policy to older and asymptomatic patients, membranoproliferative glomerulonephritis type I shows a countercurrent decrease from 0.43 to 0.13/yr/10(5) population. Evidence of a simultaneous decrease in severe cardiac valvulopathy, due to rheumatic fever, is also provided. We feel that before epidemiologic conclusions can be reached, a clear understanding of one's own biopsy policy is essential. An apparent change in the PGN rate in our region over the last 25 years mainly depends on modifications in our biopsy policy, most probably coupled with a change in the threshold of detection of symptoms in the general population. At present, according to our experience, IgA-GN is the most common type of PGN in the total bioptic material, as demonstrated in other European countries, while the elderly show a peculiar pattern with a higher PGN incidence, mainly represented by MGN and heralded by the nephrotic syndrome. We also confirm that membranoproliferative glomerulonephritis type I is indeed decreasing in parallel with changes in the microbiologic environment.

Adolescent↗
PubMed1996

Scleroderma renal crisis is still a life-threatening syndrome.

Scleroderma renal crisis (SRC) was known as a rare and catastrophic syndrome responsible for acute renal failure (ARF) in a context of widespread microvascular disease occurring in progressive systemic sclerosis (PSS). Following pathogenetic hypoteses, angiotensin converting enzyme (ACE) inhibitors, plasma infusions (PI), and plasma-exchange (PE) have been employed in SRC with favorable results. Our purpose was to verify whether these therapies have consistently changed the fatal prognosis of SRC, even in our experience. In the last 10 years, SRC was diagnosed in eight patients (all eight with histologic data). The first five cases were treated with steroids, antihypertensive-cocktail, and PI: all five died, two within 48 hours, three after 10, 15, and 300 days, respectively. Three other patients were treated with ACE inhibitors, PI, and PE: all three died after 1, 9, and 12 months of HD. Clinical-histological correlations showed a strong relationship between the extent of glomerular involvement and the degree of renal failure, while arterial lesions seem to be more related to the past history of PSS, independently from the previous existence of hypertension. We conclude that "true" SRC diagnosed by restrictive criteria is still a rare life-threatening syndrome, and, unfortunately, no clear predictive biochemical or clinical signs could be identified; vascular renal involvement correlates to the duration of PSS independently of previous clinical evidence of renal failure or hypertension; a glomerular pattern similar to that reported for hemolytic-uremic syndrome (HUS)/thrombotic thrombocytopenic purpura (TTP) syndrome is directly related to the degree of acute renal involvement; SRC may occur even in the absence of hypertension, mainly if cardiomyopathy is present: in our experience. ACE inhibitors and plasma therapies have changed the short-time prognosis of SRC, but they may be unable to provide recovery from dialysis and do not avoid further evolution of extrarenal PSS exiting in late death.

Adult↗
PubMed1996

Is pregnancy-related acute renal failure a disappearing clinical entity?

The actual disappearance of pregnancy-related acute renal failure (PR-ARF) is a common "feeling" for nephrologists. The aim of this study was to exactly quantify this event by evaluating epidemiology and the extent of renal damage in PR-ARF. From 1958 to 1994, 84 cases of PR-ARF were observed (5.8% of total number of ARF needing dialysis). In four successive periods (1956-67, 1968-77, 1978-87, 1988-94), the incidence of PR-ARF fell from 43% to 0.5% with respect to the total number of ARF, and from 1/3000 to 1/18,000 with respect to the total number of pregnancies. Maternal mortality in the past was high (31%), but no cases of death in the last period were seen. Irreversible renal damage was recorded in 11.1% of PR-ARF, and, in particular, in 18.7% of cases of preeclampsia-eclampsia (PE-E). The worst maternal and renal prognosis occurred in PE-E that was complicated by abruptio placentae (AP). Neither disseminated intravascular coagulation (DIC), microangiopathic hemolytic anemia, nor prostacyclin imbalance were significantly related to the severity of renal damage. Heparin therapy did not modify DIC evolution and renal outcome and was aggravated by severe hemorragic complications. Support therapy with plasma infusion, antithrombin III, and antiplatelet agents seems to be helpful. In conclusion, PR-ARF has become a rare occurrence and, in our experience, no cases of death or irreversible renal damage were observed in the last 7 years. The most important reasons for this favorable evolution seem to be an improved medical care and more effective measures of careful prevention, mainly regarding tempestive delivery.

Abruptio Placentae↗
PubMed1995

Assessment of the efficacy of buspirone in patients affected by generalized anxiety disorder, shifting to buspirone from prior treatment with lorazepam: a placebo-controlled, double-blind study.

Forty-four patients with DSM-III-R generalized anxiety disorder participated in this double-blind, randomized study. Patients were on a benzodiazepine before the study and were stabilized on 3 to 5 mg/day lorazepam for 5 weeks (weeks 0 to 5). Thereafter, they were randomized to 15 mg/day buspirone or placebo for the following 6 weeks (weeks 6 to 11). During the first 2 weeks of double-blind, randomized treatment (weeks 6 to 7), lorazepam was tapered off. During weeks 12 to 13, patients received single-blind placebo. Assessment included the Hamilton Rating Scale for Anxiety, the State-Trait Anxiety Inventory, the Zung and Eddy Self-Rating Scale of Anxiety Symptoms, the Hamilton Rating Scale for Depression, and the Rome Depression Inventory, completed at weeks 0, 5, 6, 7, 8, 9, 11, and 13. Side effects were assessed through the Dosage Treatment Emergent Symptoms at the same times. The benzodiazepine-withdrawal syndrome was evaluated through a 27-symptom checklist (Clinical-Rated Benzodiazepine Withdrawal Symptom Schedule) at weeks 0, 5, 6, 7, 11, and 13. The results showed that buspirone was more effective than placebo and comparable to lorazepam. Buspirone-treated patients showed no rebound anxiety or benzodiazepine-withdrawal syndrome compared with placebo. Buspirone caused fewer side effects than lorazepam and was not different from placebo in this respect. Finally, buspirone maintained its anxiolytic effect for at least 2 weeks after the discontinuation of treatment.

Adult↗
PubMed1994

Three-dimensional in vivo planum temporale reconstruction.

We describe a new multistep technique for three-dimensional reconstruction and analysis of the in vivo planum temporale (PT) based on the manipulation of magnetic resonance raw data obtained with a special protocol. Measurements of left and right plana confirm previous neuroanatomical descriptions of a larger left planum temporale. This method can be easily adopted, allowing anatomically valid PT measurements.

Adult↗
PubMed1994

Magnetic resonance imaging findings of amygdala-anterior hippocampus shrinkage in male patients with schizophrenia.

Recent magnetic resonance imaging (MRI) studies found abnormalities of medial temporal lobe and basal ganglia structures. We used an inversion recovery (IR) protocol with the assistance of the Talairach atlas to identify neuroanatomical regions of interest in 19 male schizophrenic patients and 14 matched control subjects. The patient group showed smaller amygdala-hippocampus volume as compared with normal control subjects. This finding was more pronounced for the left side, although no diagnosis X side interaction was present. Third ventricle volume was also enlarged in schizophrenic patients. Trends toward an overall reduction of basal ganglia (striatum and lenticular nucleus) and limbic structures and toward an increase in ventricle-brain ratio were also seen. The study confirms previous evidence of mesial temporal lobe shrinkage, more evident on the left side in a group of relapsing noninstitutionalized male schizophrenic patients.

Adult↗
PubMed1994

Planum temporale asymmetry and thought disorder in schizophrenia.

Magnetic resonance imaging (MRI) was used to investigate the size and the asymmetry of the planum temporale (PT) in 22 schizophrenic patients and 23 strictly matched healthy volunteers. The degree of thought disorder was related to the reduction of the physiological PT asymmetry. When thought disordered patients were contrasted with non-thought disordered patients and healthy controls for a measure of PT laterality, those with thought disorder showed a statistically significant loss of PT laterality. This finding suggests that thought disordered schizophrenics may be characterized by an abnormal development of cerebral lateralization in a region crucial for language processing.

Adult↗
PubMed1994

Vitamin E supplementation in preeclampsia.

An oxidant/antioxidant imbalance has been suggested among the pathogenetic factors involved in preeclampsia. As vitamin E is one of the most important antioxidant body components, a nonrandomized controlled trial was undertaken in 36 preeclamptic patients in order to evaluate the effect of vitamin E supplementation (100-300 mg/day per os) on fetal and maternal outcome. Fetal mortality was similar in 14 patients treated with conventional therapy plus oral vitamin E supplementation (35%) and in 22 patients treated with conventional therapy only (36%). Furthermore, in both groups of patients proteinuria increased, and increased dosages of antihypertensive drugs were called for in order to control blood pressure. We conclude that, with these dosages and in case of an already established disease, vitamin E does not improve fetal outcome in severe preeclampsia. Furthermore, it does not show favorable effects on maternal hypertension and proteinuria.

Adult↗
PubMed1994

Information processing strategy to remediate Wisconsin Card Sorting Test performance in schizophrenia: a pilot study.

A modified procedure for administering the Wisconsin Card Sorting Test, focusing on a hypothesized deficit of organizational strategy in information processing, was used to administer the test to 20 schizophrenic patients. By using this procedure, 61.5% of the poor performers (eight of 13) were dramatically transformed into good performers without any task instruction or reinforcement. The results, albeit preliminary, support the hypothesis and the possibility of remediating the task performance of some schizophrenic patients.

Adult↗
PubMed1994

Oxygen free radicals are not the main factor in experimental gentamicin nephrotoxicity.

As a role for oxygen free radicals has been suggested in gentamicin (G) nephrotoxicity, we tested the hypothesis that exogenously administered glutathione (GSH), able to restore intracellular antioxidant potential, could be useful in reducing damage. Adult Sprague-Dawley rats were injected with saline (n = 30), subcutaneous (s.c.) G 100 (n = 23) and 150 mg/kg/day (n = 14), or s.c. G at the same dosages plus intraperitoneal (i.p.) GSH 1200 mg/kg/day (n = 24 and 14, respectively) for 7 days. In the G-100-day protocol, GSH-treated rats showed significantly lower renal G content (2.79 +/- 0.8 vs. 3.61 +/- 1.4 micrograms/mg prot) coupled with lower plasma urea (153 +/- 79 vs. 188 +/- 61 mg/dL) and creatinine levels (1.63 +/- 1 vs. 2.45 +/- 1 mg/dL). As to renal oxidant/antioxidant balance, local GSH was increased (0.32 +/- 0.01 vs. 0.19 +/- 0.01 microgram/mg prot) while lipid peroxidation, determined by production of thiobarbituric acid reactive substances (TBARS), was decreased (0.35 +/- 0.02 vs. 0.52 +/- 0.02 nmol/mg prot). In the G-150-mg protocol, GSH-treated rats showed no differences in renal gentamicin content or in blood urea and creatinine levels, in spite of a significantly lower renal TBARS production and a significantly higher GSH content. Urine enzyme excretion did not significantly change in GSH-treated vs. not-GSH-treated rats in both protocols. We conclude that: (a) GSH interferes with G nephrotoxicity mainly via a reduction in G uptake; (b) the oxidative renal stress is not crucial in inducing renal damage. In fact, when increased G dosages blunt the ability of GSH in reducing G uptake, no substantial protection is demonstrated.

Animals↗
PubMed1993

Cerebellar vermal size in schizophrenia: a male effect.

Magnetic resonance (MR) was used to examine the cerebellar vermis in 23 patients with schizophrenia and 16 matched controls. MR midsagittal images were processed with computerized image analysis to control partial volume effects as precisely as possible. No between-group differences were found for vermal-to-cerebrum ratio. When gender differences were examined, male patients showed a lower vermal-to-brain ratio than their female counterparts, mainly because of a reduction of the lobules I-V.

Adult↗
PubMed1993

Hemolytic-uremic syndrome during recombinant alpha-interferon treatment for hairy cell leukemia.

We report a case of hemolytic uremic syndrome in a patient suffering from hairy cell leukemia during recombinant alpha-interferon treatment. We believe that this is the first report of the occurrence of this peculiar kind of acute renal failure following alpha-interferon therapy. This association may suggest possible speculations regarding side effects of interferon treatment and pathogenesis of hemolytic uremic syndrome.

Biopsy↗
PubMed1992

Planum temporale in schizophrenia: a magnetic resonance study.

Magnetic resonance imaging (MRI) scans were used to examine the size and asymmetry of the planum temporale (PT) in 20 schizophrenic patients and 12 strictly matched healthy volunteers. PT lengths from coronal sections were measured and then summed to obtain an estimate of their areas. Schizophrenics showed the lack of the physiological PT area asymmetry evidenced in the control sample and a statistically significant diagnosis by side interaction was observed (F = 4.96; p less than 0.05). The study of PT asymmetry could permit us to better analyse the role of laterality in the pathophysiology of schizophrenia.

Adult↗
PubMed1992

Neuropsychological and clinical correlates of temporal lobe anatomy in schizophrenia.

Twenty-five DSM-III schizophrenic patients were assessed neuromorphologically and neuropsychologically. Reduced temporal lobes were found through magnetic resonance imaging (MRI) evaluation. In addition, in order to look for the neuropsychological correlates of temporal anatomy in schizophrenia, patients were divided into cognitive normal and abnormal schizophrenics, according to their Luria Nebraska Neuropsychological Battery profile. The latter group had statistically significant temporal lobe abnormalities as assessed by MRI, irrespective of medication, clinical picture or any other relevant variables. The implication of such findings in the light of the diaschisis model is discussed.

Adult↗