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Biomedical subjects

S Lorenzi

Publications and source records attributed to S Lorenzi.

At least 19 recordsLinked to original sources
PubMed2003

Skin rash and splinter hemorrhages from ganciclovir.

Ganciclovir is a nucleotide-analogue similar to acyclovir, which has an in vitro activity against herpes simplex type 1, herpes simplex type 2 and varicella zoster virus. Numerous studies suggest that ganciclovir has clinical efficacy against cytomegalovirus disease, as well as an in vivo antiviral effect, and that this agent reduces morbidity of serious cytomegalovirus infections in immunocompromised patients. Generalised cutaneous rash associated with ganciclovir therapy has rarely been reported in literature.

AIDS-Related Opportunistic Infections↗
PubMed2000

Onychomycosis caused by nondermatophytic molds: clinical features and response to treatment of 59 cases.

BACKGROUND: Nail invasion by nondermatophytic molds (NDM) is considered uncommon with prevalence rates ranging from 1.45% to 17. 6%. OBJECTIVE: We report the clinical features and response to treatment of onychomycosis caused by these molds. METHODS: From 1995 through 1998 we performed a mycologic study on 1548 patients affected by nail disorders, and we diagnosed 431 cases of onychomycosis including 59 cases of onychomycosis caused by molds. These include 17 patients with onychomycosis caused by Scopulariopsis brevicaulis, 26 patients with onychomycosis caused by Fusarium sp, 9 patients with onychomycosis caused by Acremonium sp, and 7 patients with onychomycosis caused by Aspergillus sp. RESULTS: Onychomycosis caused by S brevicaulis, Fusarium sp, and Aspergillus sp may often be suspected by clinical examination. In fact 38 of 50 patients with onychomycosis resulting from these molds were affected by proximal subungual onychomycosis associated with inflammation of the proximal nailfold. In our experience mold onychomycosis is not significantly associated with systemic diseases or immunodepression. NDM are difficult to eradicate; by using and combining different treatments (systemic itraconazole, systemic terbinafine, topical terbinafine after nail plate avulsion, and ciclopirox nail lacquer) we were able to cure only 69.2% of patients with S brevicaulis onychomycosis, 71.4% of patients with Acremonium onychomycosis, and 40% of patients with Fusarium onychomycosis. Aspergillus onychomycosis, on the other hand, responded very well to therapy and all our patients were cured after systemic or topical treatment. Eradication of the mold produced a complete cure of the nail abnormalities in all the patients who responded to treatment. CONCLUSION: Clinical examination usually suggests diagnosis of onychomycosis resulting from NDM. Topical treatment can be more successful than systemic therapy to cure onychomycosis caused by S brevicaulis, Fusarium sp, and Acremonium sp.

Administration, Topical↗
PubMed1996

Onychomycosis due to Scopulariopsis brevicaulis: clinical features and response to systemic antifungals.

Six cases of Scopulariopsis onychomycosis, including four patients with onychomycosis exclusively caused by Scopulariopsis brevicaulis and two patients with a mixed nail infection (S. brevicaulis + Tricophyton rubrum and S. brevicaulis + T. interdigitale), are reported. Four patients presented with a typical distal subungual onychomycosis characterized by subungual hyperkeratosis and onycholysis of the distal nail plate. In two patients, Scopulariopsis infection produced a total dystrophic onychomycosis associated with painful periungual inflammation. Three patients were treated with four pulses of itraconazole, 400 mg daily for 1 week a month, and three patients with terbinafine, 250 mg daily for 4 months. The mycological examination 8 months after discontinuation of treatment showed that one patient was mycologically cured whereas the remaining five patients still carried S. brevicaulis in their nails. The clinical examination at the end of the follow-up period showed a complete cure of the nail abnormalities in only one patient.

Adult↗
PubMed1995

Left ventricular morphology and diastolic function in uraemia: echocardiographic evidence of a specific cardiomyopathy.

OBJECTIVE: To see whether cardiac morphological and functional abnormalities in uraemic patients are determined by high blood pressure or if they are an expression of a specific cardiomyopathy. DESIGN: Cross sectional study. SETTING: City general hospital in Italy. SUBJECTS: 35 uraemic patients receiving haemodialysis (17 men, 18 women; mean age 60.3 (11.2); mean duration of dialysis 52 months) were selected from the 64 patients in Venice who were receiving dialysis; subjects with diabetes, haemochromatosis, valvar dysfunction, regional dyskinesias, and pericarditis were excluded. 19 control normotensive subjects (6 men and 13 women), matched for age. MAIN OUTCOME MEASURES: Echocardiographic measurements of left atrium, left ventricular end diastolic and end systolic volume, aortic root diameter, posterior wall and interventricular septum thickness, left ventricle mass index, and ejection fraction in controls and in patients according to whether they were normotensive (five men, eight women) or hypertensive (12 men, 10 women) on 48 hour ambulatory monitoring; left ventricular diastolic function by Doppler ultrasonography. RESULTS: Mean systolic and diastolic pressures, daytime systolic and diastolic pressures, and night time systolic and diastolic pressures were significantly higher in the hypertensive patients than in the normotensive patients. The normotensive patients had similar blood pressures to the controls. Left ventricular mass correlated significantly with the mean diastolic pressure and mean night time systolic and diastolic pressures. Parathyroid hormone concentrations were similar in the two groups of patients. Diastolic relaxation was impaired to the same degree in the two groups of patients. Parameters of diastolic function showed no relation to left ventricular mass, which was significantly higher in the hypertensive than in the normotensive patients. CONCLUSIONS: Uraemia is likely to induce specific changes in the relaxation properties of the myocardium. These changes are responsible for the impaired diastolic function independently of blood pressure, degree of hypertrophy, and metabolic changes, which suggests the existence of a specific cardiomyopathy. Hypertension remains a determinant of left ventricular mass.

Diastole↗
PubMed1995

A new approach to blood pressure and blood volume modulation during hemodialysis: an adaptive fuzzy control module.

The paper proposes a fuzzy logic based procedure able to control as far as possible the behaviour of the blood pressure of a patient during a dialysis session, allowing him to reach the foreseen dry weight. A PI discrete-time fuzzy control is used in order to compare the controlled variables concerning the (blood pressure and blood volume) to the reference values. Two different reference tables, concerning the pressure and volume errors and rates are introduced, then the proposed control actions are mixed in order to obtain the final value (net ultrafiltration rate). A smooth function of volemia acts on the second control variable, Na concentration in the dialysate. The adaptive control system was simulated on an IBM-PC, rules and terms were expressed by linguistic judgements like: IF "situation", THEN "action". A pre-processor converts the rules into the numerical values of the reference tables. The obtained simulation results are satisfactory, the introduction of the Na control allows reaching the target dry weight of the patient with a stable blood pressure.

Adult↗
PubMed1988

Male hypogonadism of uremic patients on hemodialysis.

Primary hypogonadism occurring among uremic men on hemodialysis has been widely investigated, yet few data are available concerning the general pattern of steroidogenesis. In 161 hemodialysis patients and in 83 healthy subjects, serum levels of gonadotropins (LH and FSH), prolactin (PRL), testosterone (T), androstenedione (A), estrone (E1), estradiol (E2), and dehydroepiandrosterone-sulphate (DHEA-S) were assessed through RIA methods. Mean +/- SD hormone levels were: LH 45.6 +/- 41.1 mIU/ml, FSH 16.3 +/- 16 mIU/ml, PRL 42.4 +/- 69.1 ng/ml, A 0.83 +/- 0.27 ng/ml, E1 64.3 +/- 31.7 pg/ml, all higher than controls; T 289 +/- 125 ng/100 ml, E2 11.8 +/- 3 pg/ml, and DHEA-S 1.4 +/- 1.4 micrograms/ml, all lower than controls. The A/T and E1/E2 ratios were also higher than controls and showed a good positive linear correlation (r = 0.40; p less than 0.001) between each other. The uremic damage acts at the testis level, impairing the activity of the enzyme 17-beta-hydroxysteroid-dehydrogenase (17-OHSD), even if a derangement of the peripheral interconversion between steroids cannot be excluded.

Adult↗
PubMed1985

Uremic neuropathy: clinical and neurophysiological investigation of dialysis patients using different chemical membranes.

A clinical and neurophysiological study was carried out in a group of dialyzed patients suffering from uremic neuropathy in order to determine whether the use of different dialysis membranes can influence their clinical and neurophysiological parameters. The patients were divided into two groups: one group was dialyzed with Cuprophan (CUP) the other with polyacrylonitrile (PAN) membranes. Comparison of the two groups showed that the PAN membrane was more effective than the CUP membrane, both at the clinical and at the neurophysiological (nerve conduction velocity) levels. The patients who used the PAN membrane were also found to have lower blood PTH and magnesium levels. This difference was statistically significant. These preliminary results seem to confirm the hypothesis of the neurotoxicity of middle molecules in uremic neuropathy.

Acrylic Resins↗