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Biomedical subjects

S Federico

Publications and source records attributed to S Federico.

31 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↗
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↗
PubMedDate not supplied

Thyroid function and morphology after a successful kidney transplantation.

Although thyroid disorders related to the end-stage renal disease (ESRD) are well known, there are discordant data on the function and morphology of the thyroid gland after renal transplantation (RT). The objective of this cross-sectional, case-control study was to investigate the prevalence and risk factors for disorders in the thyroid function and morphology after a successful RT. Fifty consecutive patients (25 females, 25 males) with fully functioning allograft were enrolled. Their age at transplant ranged from 23 to 44 yr (median, 38) and their post-RT follow-up lasted 15-86 months (median, 23). One hundred healthy subjects matched for sex, age and body mass index (BMI) were included as controls. Serum free thyroid hormones, TSH, thyroglobulin, thyroid hormone-binding globulin (TBG) and iodine urinary excretion were determined; ultrasonographic exam of the thyroid gland was performed in all subjects. Age, gender, time elapsed from RT, dialysis duration, kidney function, type of immunosuppression and corticosteroid dose were considered as possible influencing factors for the thyroid function. Hypothyroidism was found in 6% of patients, "low T3 syndrome" in 52%, while another 26% had free T3 (FT3), free T4 (FT4) and TSH in the lowest third of the normal range, suggesting inhibition of the whole hypothalamic-pituitary-thyroid (HPT) axis. Iodine excretion and prevalence of anti-thyroid antibodies were similar in both patients and controls. There was no significant difference in the thyroid function according to different immunosuppressive regimens. In patients, an ultrasonographic exam revealed a very variable thyroid volume ranging from 7.2 to 24.8 ml. Solid nodules were detected in 12 (24%) cases and cystic lesions in another four (8%); they were proven negative at cytological examination. Dialysis duration was longer in patients with thyroid nodules than in those without (p<0.05). Inhomogeneous hypoechoic pattern typical for chronic thyroiditis was more frequent than its biochemical expression. In conclusion, a high prevalence of abnormal thyroid morphology was found in patients after a successful RT, being partly related to a previous uremia. Abnormalities in the thyroid function are likely an expression of the post-transplant general and immunological conditions. Endocrinological follow-up is advisable in patients after RT, in order to discriminate thyroid dysfunctions which need specific treatments from those that can only be followed-up, avoiding inappropriate treatments of biochemical abnormalities.

Adult↗
PubMedDate not supplied

[Anderson-Fabry's disease: diagnostic problems, therapeutic relevance, and clinical experience in the treatment of the disease with enzyme replacement therapy in nephropathic patients].

Aim of this study was to confirm the initial results of a clinical trial on the treatment of Fabry's disease carried out in 13 Italian Nephrology Units. Fabry's disease is a rare, X-linked inherited disease, characterized by a-galactosidase (a-GAL) deficiency, a lysosomial enzymatic activity that results in the accumulation of neutral glycosphingolipids in the endothelial cells of the whole body, and causes painful crises, acroparesthesiae, angiokeratomas, corneal and lens dystrophy, and progressive damage to kidneys, heart and central nervous system, as well as potentially leading to death. The present availability of the recombinant form of a-GAL allows us to prevent or stop the long-term complications of this disease. A clinical trial, generously supported by Genzyme, was started on February 2001. In this trial 20 patients affected by Fabry's disease were periodically treated with agalsidase-beta, the commercial form of the enzyme. The initial results of the trial have indicated that the drug is capable of reducing both the number and intensity of painful crises, improving the patient's sensation of well-being, thus suggesting that this therapeutic approach might theoretically increase life expectancy in these patients.

Chromosomes, Human, X↗
PubMedDate not supplied

[A clinical case of a giant lymphocele (LC) in a patient with a recent renal transplant is described].

BACKGROUND: The lymphocele (LC) described was associated with a sharp increase in plasma creatinine values, in the absence of any clinical symptoms. A open laparotomy procedure determined the resolution of the LC and the slow recovery of renal function. The huge dimensions of the LC (volume >3000 cc) and its pelvic localization, which dislocated both the bladder and the transplanted kidney, make this case unique, since the LC mimicked a particularly dilated bladder. CONCLUSIONS: We discuss how therapies, rejection episodes, follow-up modalities, and surgical procedures may influence the onset of this frequent complication of renal transplantation.

Humans↗