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S Grignani

Publications and source records attributed to S Grignani.

5 recordsLinked to original sources
PubMed1998

Urinary microscopy as seen by nephrologists.

Urinary microscopy is a diagnostic tool which is largely used by nephrologists. In the opinion of the authors the best results can be achieved when all the aspects concerning this test are properly taken into account. Thus, from the methodological point of view, proper patient guidance, proper urine collection and handling, adequate microscopic equipment, and knowledge of the factors which can influence the results are all necessary. All the elements of clinical importance have to be known, namely, erythrocytes (with their morphological subtypes), leukocytes, tubular cells, uroepithelial cells (both superficial and deep), lipids, casts, crystals, and microorganisms. Then, the urinary findings have to be interpreted and, whenever possible, also combined into urinary profiles (e.g., the nephritic sediment, the nephrotic sediment). This, combined with other laboratory tests, the pathologic findings, and the clinical data, allows for the definition and management of urinary tract diseases.

Humans↗
PubMed1997

[Hypertonic saline solutions in resuscitation in hemorrhagic shock. An experimental study].

The aim of the study was to evaluate the use of hypertonic solutions in restoring intravascular volume in a model of hemorrhagic shock. Eighteen pigs underwent general anesthesia and were instrumented with a carotid catheter to record mean arterial pressure (MAP), a pulmonary artery catheter for pulmonary arterial pressure (MPAP) and cardiac output (CO) monitoring and an electromagnetic flowmeter around the abdominal supraceliac aorta for aortic flow measurement (Vaor). Oxygen delivery (DO2) and oxygen consumption (VO2) data were calculated by standard formulas. The animals were hemorrhaged to a MAP of 45 mmHg, held for 1 hour. They were resuscitated during the following hour until the aortic flow regained its basal value, using three different solutions: normotonic saline (NS = NaCl 0.9%), hypertonic saline (HS = NaCl 7.5%), hypertonic saline added with dextran (HSDX = NaCl 7.5% + 6% dextran 70). An hour of autologous blood transfusion and a two hours follow-up concluded the experiment. Volumes infused were remarkably lower administering HS (13.70 +/- 1.44 ml/kg) and HSDX (9.11 +/- 1.20 ml/kg) compared to NS (90.32 +/- 24.83 ml/kg). MAP, CO and DO2 values resulted significantly higher in the HSDX animals, with lower MPAP levels. During the two hours follow-up only the animals reinfused with HSDX maintained hemodynamic and oxygen transport values at normal levels. We conclude that the administration of hypertonic saline solutions during hemorrhagic shock allows the saving of infusion volumes, thus diminishing the occurrence of interstitial edema formation. The adding of dextran to the solution prolongs the hemodynamic effects.

Animals↗
PubMed1995

Soluble interleukin-2 receptor (sIL-2R) levels in renal transplantation: comparison between clinical and laboratory analysis.

Soluble interleukin-2 receptor levels (sIL-2R) were retrospectively evaluated in 43 consecutive kidney transplant recipients (22 males, 21 females), from day 0 up to 90 days after transplantation. 11 pts were on CsA only, 13 on CsA + MP and 19 on CsA + MP + Aza. All graft-worsening episodes were then retrospectively analyzed, either according to clinical criteria only, or taking into account sIL-2R levels. On clinical grounds, 50 rejections were observed: "a posteriori" 5 turned out to be either infections or non-immunological worsenings of graft function (prevalence of misdiagnosis in the rejection set: 5/50, 10%). Of the 8 infections, 2 were actually treated as rejections (margin of error: 2/8, 25%). CsA toxicity was correctly diagnosed in 2/4 episodes. The analysis based on sIL-2R levels increase confirmed the clinical diagnosis in 52/79 cases (66%). The prevalence of misdiagnosis was: 21.2% in rejection, 2/3 in CsA toxicity, while infections were overestimated in 60% of cases. Isolated sIL-2R level increase was not associated with rejection in 87.5% of cases, while an associated increase of IL-2R and plasma creatinine had a 5% chance of being wrong. SIL-2R levels increased before any rise in plasma creatinine in late rejections (28 +/- 21 days after transplantation), while they increased after the rise of plasma creatinine in early rejections (10 +/- 5 days) (p = 0.014). In the rejection set, sIL-2R had a sensitivity of 83.4%, a specificity of 80%, a positive predictive value of 50.2% and a negative predictive value of 95.2%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗