Minerva urologica e nefrologica = The Italian journal of urology and nephrology
To verify the hypothesis of a possible involvement of free radicals of oxygen in some aspects of ... more To verify the hypothesis of a possible involvement of free radicals of oxygen in some aspects of chronic renal failure, authors have executed, by high resolution liquid chromatography (HPLC), the measurement of plasmatic malondialdehyde (MDA) in 15 patients with chronic renal failure undergoing haemodialysis and in 15 healthy control subjects. The two groups were comparable for sex and age. Statistical analysis of the two groups resulted significant (p < 0.05). These results are according to literature data and show a problem of oxidative metabolism in subjects with chronic renal failure undergoing haemodialysis also if it might be useful to investigate the question with wider enumeration of cases, to clarify better the clinical significance of these alterations and to point out eventual correlations.
Some urinary enzymes (NAG, AAP, lysozyme) considered to be sufficiently sensitive and reliable ma... more Some urinary enzymes (NAG, AAP, lysozyme) considered to be sufficiently sensitive and reliable markers of renal damage were controlled in 20 patients with cirrhosis of the liver and in 20 healthy control subjects. The results, stated as mean +/- SD, showed a statistically very significant increase (p < 0.01) of NAG and lysozyme in cirrhotics. Furthermore, this increase could be at least in part related with the seriousness of clinical condition. On the basis of these results, we think the urinary dosage of NAG and lysozyme is, in the subjects with liver cirrhosis, a bloodless method to show an early renal damage.
The authors measured plasmatic beta 2-microglobulin in 42 type II diabetes patients, whose 23 mic... more The authors measured plasmatic beta 2-microglobulin in 42 type II diabetes patients, whose 23 microalbuminuria (group A) and 19 normal albuminuria (group B), and in 20 healthy control subjects (group C) comparable for sex and age. Beforehand, everybody was subject to diagnostic verification to exclude other simultaneous diseases. The glomerular filtration rate, measured by creatinine clearance did not show statistical significance between three groups as well as duration of diabetes and levels of glycosylated hemoglobin between group A and B. Plasmatic beta 2-microglobulin was 3.16 +/- 0.9, 2.1 +/- 0.6, 2.0 +/- 0.9 mg/L respectively in the groups A, B and C (p < 0.001 A vs B and A vs C). The authors think in type II diabetic subjects with microalbuminuria can be an early and mild decrease of FGR. The measurement of plasmatic beta 2-microglobulin rather than creatinine clearance could be a suitable method to show it.
The alterations in the normal biological oxide-reductive balance can be due both to an increase o... more The alterations in the normal biological oxide-reductive balance can be due both to an increase of the plasmatic concentration of the free radicals and to the less of the protective mechanism. These conditions lead to damage to cellular structure by the mechanism of lipoperoxidation, particularly in the liver, in the kidney and in the central nervous system. In this study we have studied the lipoperoxidative effects of the use of anesthetic drugs.
Several studies have lately been made to explain the pathophysiologic role of endothelin, a vasoc... more Several studies have lately been made to explain the pathophysiologic role of endothelin, a vasoconstrictive peptide, in some clinical syndromes. Within a larger plan of the probable role of this molecule in development of diabetic vasculopathy, we have preliminarily investigated the plasma endothelin-1 level in type II diabetic patients. 24 type II diabetic patients and 10 healthy control subjects comparable for sex and age were examined. Plasmatic ET-1 was determined by radioimmunoassay (Amersham, UK). The mean +/- SD was respectively 11.4 +/- 2.9 pg/ml in diabetic patients and 8.2 +/- 3.9 pg/ml in the control group. Statistical analysis showed a significant difference between two groups. These results suggest an involvement of endothelin in the vascular complications of diabetes. Nevertheless, to better explain the question, we think further and larger studies are required.
Rivista europea per le scienze mediche e farmacologiche = European review for medical and pharmacological sciences = Revue européenne pour les sciences médicales et pharmacologiques
The alterations of the normal biological oxidoreductive balance can be due both to an increase of... more The alterations of the normal biological oxidoreductive balance can be due both to an increase of the plasmatic concentration of the free radical and the loss of the protective mechanisms. These conditions lead to the damages of cellular structure by the mechanism of lipoperoxidation. We have studied the lipoperoxidative effects of anesthetic drugs and the possible protective effect of the taurine. Two groups of 30 patients subjected to general anesthesia for a time of about 160 minutes, have been studied. The taurine has been administered in the second group, intravenously, before and during anesthesia. Blood samples were drawed in all patients in order to determinate plasmatic Malondialdehyde (MDA) and Glutathione peroxidase activities both in erythrocyte lysate and plasma. Our results revealed an increase of values of MDA and Glutathione peroxidase activities in the first group (without taurine). We think that this increase has been caused by the anesthetic drugs administration and that a protective cellular effect is developed by the taurine administration.
Thrombophilia is characterised by elevated thrombotic and embolic risk and may be caused by conge... more Thrombophilia is characterised by elevated thrombotic and embolic risk and may be caused by congenital or acquired coagulating inhibitor deficit. A young man was repeatedly admitted to Emergency Medicine Units because of pain, oedema and slight functional impairment of the left leg, and recurrent thrombophlebitis was diagnosed. During the most recent hospitalization, vena cava thrombosis was diagnosed and therapeutic management consisted of application of a caval filter and administration of dicoumarin anticoagulants. This case can be classified as a hereditary protein S deficiency with APC-resistance. However, non-strenuous, protracted and repeated physical trauma may have acted synergically with the congenital coagulation inhibitor deficiency, determining the thrombotic episodes, which are probably provoked by transient and functional alterations of the non-thrombogenic properties of the endothelium.
The authors describe a case of hereditary angioedema characterised by abdominal pain accompanied ... more The authors describe a case of hereditary angioedema characterised by abdominal pain accompanied by ascites. Ultrasound (US) examination performed after acute abdominal attack implied the presence of increased splenoportal axis calibre and reduced blood flow. According to the authors, this may confirm the pathogenic role of C1-inhibitor deficiency induced oedema that is capable of creating major haemodynamic involvement also of abdominal vessels. US findings of transient appearance, especially related to the specific treatment, may help physicians make early diagnosis and avoid dangerous invasive procedures resulting from incorrect diagnosis of acute abdomen.
This paper describes a case of drug-induced hepatitis that onset in a patient who was hospitalise... more This paper describes a case of drug-induced hepatitis that onset in a patient who was hospitalised in our department after administration of calcium heparin. The rarity of the case was shown not only by the very short time elapsed between cause (drug administration) and effect (bio-humoral changes detected), but also by the histology results of the liver biopsy. This latter confirmed that mechanisms of idiosyncrasy, which may cause liver cell necrosis, can occur after administration of any drug.
Schwannomas are benign, slow-growing tumors arising from nerves. Those originating from the sympa... more Schwannomas are benign, slow-growing tumors arising from nerves. Those originating from the sympathetic cervical chain are rare. The clinical presentation, surgical treatment and outcomes of a patient with this pathology personally observed, are described.
Numerous experimental findings have underlined the relationships between liver damage and product... more Numerous experimental findings have underlined the relationships between liver damage and production of oxygen-derived free radicals during inflammation. In chronic hepatitis C liver disease this damage may be attributed to altered oxide-reductive balance and glutathione (GSH) depletion. Moreover, it may be linked to chronic inflammation provoked by the replicative activity of the hepatitis C virus and its relationships with immune system cells. Our aim was to assess the effects of combined IFN + NAC treatment to compare the effects of interferon alpha-n1 associated with N-acetyl cysteine treatment with the results observed using interferon therapy alone. Experimental design: prospective randomised study. Ambulatory and hospitalised care. Patients: 77 selected patients affected by chronic C hepatitis. Interventions: our patients were investigated by laboratory tests (ALT values, RIBA test, HCV-RNA, oxide-reductive balance), liver biopsy and liver US. The recruited subjects were trea...
The case of a woman admitted to hospital various times because of the onset of a mantle-like oede... more The case of a woman admitted to hospital various times because of the onset of a mantle-like oedematous syndrome is reported. Observations revealed a narrowing at the level of the internal jugular and right subclavian veins with total obliteration of the right anonymous vein caused by previous thrombosis induced by intravenous implantation of a pace-maker.
This paper describes 2 cases of a rare biliary cystic disease. A patient with Caroli's diseas... more This paper describes 2 cases of a rare biliary cystic disease. A patient with Caroli's disease and another with bile duct swelling that were initially diagnosed by ultrasound and power color Doppler. Diagnosis was later confirmed by additional instrumental examinations. The first case was totally asymptomatic and only identified by chance, while the second was symptomatic and determined severe pain and dyspepsia. In both pathologies US B mode imaging and power color Doppler examination revealed the characteristic lesions of the intrahepatic biliary tree diseases and ruled out their vascular nature and communication with the portal and arterial tree.
We report an unusual case of transfusion-transmitted malaria which remained undiagnosed for sever... more We report an unusual case of transfusion-transmitted malaria which remained undiagnosed for several months in an Italian woman splenectomised and polytransfused for thalassaemia major. The infecting species was Plasmodium malariae, and the patient developed acute renal failure, severe thrombocytopenia, and hepatic failure. Treatment with chlorochine was followed by a slow, but complete recovery of renal function.
Aims. To compare carotid artery intima-media thickness values, as a reliable marker of early athe... more Aims. To compare carotid artery intima-media thickness values, as a reliable marker of early atherosclerosis, in individuals with and without nonalcoholic hepatic steatosis, and to evaluate whether such differences are mediate by metabolic syndrome variables. Materials and Methods. Carotid intima-media thickness (by ultrasonography), hepatic steatosis (by ultrasonography), insulin resistance (by Homeostasis Model Assessment-HOMA), steatohepatitis (by histologic specimen) were measured in 54 non-alcoholic steatohepatitis, and 54 IGT, compared with 54 healthy subjects. Results. Subjects with nonalcoholic steatohepatitis had markedly greater carotid intima-media thickness measurements (1.38±0.12 vs 1.12±0.10 mm; p<0.001) than controls. The marked differences in carotid intima-media thickness that were observed between the groups were little affected by adjustment for age, sex, body mass index, waist/hip ratio, diabetes duration, blood pressure, lipids. Conclusions. These results sug...
European review for medical and pharmacological sciences
Homocysteine levels have been determined with Chromatography on HPLC column, between the 20th and... more Homocysteine levels have been determined with Chromatography on HPLC column, between the 20th and the 24th week of pregnancy, in women with analogous characteristics (a) normotensive, (b) with pregnancy-induced hypertension (PIH), low (LR), medium (MR), high risk (HR). The group they belonged to was confirmed after natural or caesarean delivery. All the patients were submitted to 24 hour blood pressure monitoring for the evaluation of further pressure risk parameters: mean arterial pressure (MAP), non dippers, percentages of pressure peaks. Homocysteine levels in normotensive pregnant women (5.8 +/- 1.7 microM) were low. Significant high levels of homocysteine were present proportionally to the risk degree of PIH. Higher levels of homocysteine statistically significant were present in non dippers of all groups (MR p < 0.05; HR p < 0.01). A direct correlation between plasmatic homocisteine levels and pressure profiles was found out in non dippers (r = 0.56, r = 0.55, r = 0.50 r...
European review for medical and pharmacological sciences
Hyperhomocysteinemia is widely recognised as an emerging risk factor of endothelial dysfunction a... more Hyperhomocysteinemia is widely recognised as an emerging risk factor of endothelial dysfunction and vascular damage. In this study we wanted to verify if it, when associated to arterial hypertension--traditional risk factor--represents a higher added risk of organ damage during menopause, which is a condition connected to a higher incidence of cerebrovascular diseases. A survey of 30 postmenopausal women with similar characteristics (BMI, age, absence of relevant pathologies such as diabetes, metabolic disorders and absence of smoking) was selected (menopause had occurred from 12 to 16 months at the moment of observation). At the moment of the observation they had not gone through any continuous pharmacological therapy. They were subdivided into 3 groups: normotensive; hypertensive (with 2nd degree hypertension: mild to moderate) without organ damage; hypertensive with organ damage (TIA, ischaemic heart disease, etc.). The carotid IMT, measured with ultrasound method, was considered...
Minerva urologica e nefrologica = The Italian journal of urology and nephrology
To verify the hypothesis of a possible involvement of free radicals of oxygen in some aspects of ... more To verify the hypothesis of a possible involvement of free radicals of oxygen in some aspects of chronic renal failure, authors have executed, by high resolution liquid chromatography (HPLC), the measurement of plasmatic malondialdehyde (MDA) in 15 patients with chronic renal failure undergoing haemodialysis and in 15 healthy control subjects. The two groups were comparable for sex and age. Statistical analysis of the two groups resulted significant (p &amp;amp;lt; 0.05). These results are according to literature data and show a problem of oxidative metabolism in subjects with chronic renal failure undergoing haemodialysis also if it might be useful to investigate the question with wider enumeration of cases, to clarify better the clinical significance of these alterations and to point out eventual correlations.
Some urinary enzymes (NAG, AAP, lysozyme) considered to be sufficiently sensitive and reliable ma... more Some urinary enzymes (NAG, AAP, lysozyme) considered to be sufficiently sensitive and reliable markers of renal damage were controlled in 20 patients with cirrhosis of the liver and in 20 healthy control subjects. The results, stated as mean +/- SD, showed a statistically very significant increase (p &amp;amp;lt; 0.01) of NAG and lysozyme in cirrhotics. Furthermore, this increase could be at least in part related with the seriousness of clinical condition. On the basis of these results, we think the urinary dosage of NAG and lysozyme is, in the subjects with liver cirrhosis, a bloodless method to show an early renal damage.
The authors measured plasmatic beta 2-microglobulin in 42 type II diabetes patients, whose 23 mic... more The authors measured plasmatic beta 2-microglobulin in 42 type II diabetes patients, whose 23 microalbuminuria (group A) and 19 normal albuminuria (group B), and in 20 healthy control subjects (group C) comparable for sex and age. Beforehand, everybody was subject to diagnostic verification to exclude other simultaneous diseases. The glomerular filtration rate, measured by creatinine clearance did not show statistical significance between three groups as well as duration of diabetes and levels of glycosylated hemoglobin between group A and B. Plasmatic beta 2-microglobulin was 3.16 +/- 0.9, 2.1 +/- 0.6, 2.0 +/- 0.9 mg/L respectively in the groups A, B and C (p &amp;amp;lt; 0.001 A vs B and A vs C). The authors think in type II diabetic subjects with microalbuminuria can be an early and mild decrease of FGR. The measurement of plasmatic beta 2-microglobulin rather than creatinine clearance could be a suitable method to show it.
The alterations in the normal biological oxide-reductive balance can be due both to an increase o... more The alterations in the normal biological oxide-reductive balance can be due both to an increase of the plasmatic concentration of the free radicals and to the less of the protective mechanism. These conditions lead to damage to cellular structure by the mechanism of lipoperoxidation, particularly in the liver, in the kidney and in the central nervous system. In this study we have studied the lipoperoxidative effects of the use of anesthetic drugs.
Several studies have lately been made to explain the pathophysiologic role of endothelin, a vasoc... more Several studies have lately been made to explain the pathophysiologic role of endothelin, a vasoconstrictive peptide, in some clinical syndromes. Within a larger plan of the probable role of this molecule in development of diabetic vasculopathy, we have preliminarily investigated the plasma endothelin-1 level in type II diabetic patients. 24 type II diabetic patients and 10 healthy control subjects comparable for sex and age were examined. Plasmatic ET-1 was determined by radioimmunoassay (Amersham, UK). The mean +/- SD was respectively 11.4 +/- 2.9 pg/ml in diabetic patients and 8.2 +/- 3.9 pg/ml in the control group. Statistical analysis showed a significant difference between two groups. These results suggest an involvement of endothelin in the vascular complications of diabetes. Nevertheless, to better explain the question, we think further and larger studies are required.
Rivista europea per le scienze mediche e farmacologiche = European review for medical and pharmacological sciences = Revue européenne pour les sciences médicales et pharmacologiques
The alterations of the normal biological oxidoreductive balance can be due both to an increase of... more The alterations of the normal biological oxidoreductive balance can be due both to an increase of the plasmatic concentration of the free radical and the loss of the protective mechanisms. These conditions lead to the damages of cellular structure by the mechanism of lipoperoxidation. We have studied the lipoperoxidative effects of anesthetic drugs and the possible protective effect of the taurine. Two groups of 30 patients subjected to general anesthesia for a time of about 160 minutes, have been studied. The taurine has been administered in the second group, intravenously, before and during anesthesia. Blood samples were drawed in all patients in order to determinate plasmatic Malondialdehyde (MDA) and Glutathione peroxidase activities both in erythrocyte lysate and plasma. Our results revealed an increase of values of MDA and Glutathione peroxidase activities in the first group (without taurine). We think that this increase has been caused by the anesthetic drugs administration and that a protective cellular effect is developed by the taurine administration.
Thrombophilia is characterised by elevated thrombotic and embolic risk and may be caused by conge... more Thrombophilia is characterised by elevated thrombotic and embolic risk and may be caused by congenital or acquired coagulating inhibitor deficit. A young man was repeatedly admitted to Emergency Medicine Units because of pain, oedema and slight functional impairment of the left leg, and recurrent thrombophlebitis was diagnosed. During the most recent hospitalization, vena cava thrombosis was diagnosed and therapeutic management consisted of application of a caval filter and administration of dicoumarin anticoagulants. This case can be classified as a hereditary protein S deficiency with APC-resistance. However, non-strenuous, protracted and repeated physical trauma may have acted synergically with the congenital coagulation inhibitor deficiency, determining the thrombotic episodes, which are probably provoked by transient and functional alterations of the non-thrombogenic properties of the endothelium.
The authors describe a case of hereditary angioedema characterised by abdominal pain accompanied ... more The authors describe a case of hereditary angioedema characterised by abdominal pain accompanied by ascites. Ultrasound (US) examination performed after acute abdominal attack implied the presence of increased splenoportal axis calibre and reduced blood flow. According to the authors, this may confirm the pathogenic role of C1-inhibitor deficiency induced oedema that is capable of creating major haemodynamic involvement also of abdominal vessels. US findings of transient appearance, especially related to the specific treatment, may help physicians make early diagnosis and avoid dangerous invasive procedures resulting from incorrect diagnosis of acute abdomen.
This paper describes a case of drug-induced hepatitis that onset in a patient who was hospitalise... more This paper describes a case of drug-induced hepatitis that onset in a patient who was hospitalised in our department after administration of calcium heparin. The rarity of the case was shown not only by the very short time elapsed between cause (drug administration) and effect (bio-humoral changes detected), but also by the histology results of the liver biopsy. This latter confirmed that mechanisms of idiosyncrasy, which may cause liver cell necrosis, can occur after administration of any drug.
Schwannomas are benign, slow-growing tumors arising from nerves. Those originating from the sympa... more Schwannomas are benign, slow-growing tumors arising from nerves. Those originating from the sympathetic cervical chain are rare. The clinical presentation, surgical treatment and outcomes of a patient with this pathology personally observed, are described.
Numerous experimental findings have underlined the relationships between liver damage and product... more Numerous experimental findings have underlined the relationships between liver damage and production of oxygen-derived free radicals during inflammation. In chronic hepatitis C liver disease this damage may be attributed to altered oxide-reductive balance and glutathione (GSH) depletion. Moreover, it may be linked to chronic inflammation provoked by the replicative activity of the hepatitis C virus and its relationships with immune system cells. Our aim was to assess the effects of combined IFN + NAC treatment to compare the effects of interferon alpha-n1 associated with N-acetyl cysteine treatment with the results observed using interferon therapy alone. Experimental design: prospective randomised study. Ambulatory and hospitalised care. Patients: 77 selected patients affected by chronic C hepatitis. Interventions: our patients were investigated by laboratory tests (ALT values, RIBA test, HCV-RNA, oxide-reductive balance), liver biopsy and liver US. The recruited subjects were trea...
The case of a woman admitted to hospital various times because of the onset of a mantle-like oede... more The case of a woman admitted to hospital various times because of the onset of a mantle-like oedematous syndrome is reported. Observations revealed a narrowing at the level of the internal jugular and right subclavian veins with total obliteration of the right anonymous vein caused by previous thrombosis induced by intravenous implantation of a pace-maker.
This paper describes 2 cases of a rare biliary cystic disease. A patient with Caroli's diseas... more This paper describes 2 cases of a rare biliary cystic disease. A patient with Caroli's disease and another with bile duct swelling that were initially diagnosed by ultrasound and power color Doppler. Diagnosis was later confirmed by additional instrumental examinations. The first case was totally asymptomatic and only identified by chance, while the second was symptomatic and determined severe pain and dyspepsia. In both pathologies US B mode imaging and power color Doppler examination revealed the characteristic lesions of the intrahepatic biliary tree diseases and ruled out their vascular nature and communication with the portal and arterial tree.
We report an unusual case of transfusion-transmitted malaria which remained undiagnosed for sever... more We report an unusual case of transfusion-transmitted malaria which remained undiagnosed for several months in an Italian woman splenectomised and polytransfused for thalassaemia major. The infecting species was Plasmodium malariae, and the patient developed acute renal failure, severe thrombocytopenia, and hepatic failure. Treatment with chlorochine was followed by a slow, but complete recovery of renal function.
Aims. To compare carotid artery intima-media thickness values, as a reliable marker of early athe... more Aims. To compare carotid artery intima-media thickness values, as a reliable marker of early atherosclerosis, in individuals with and without nonalcoholic hepatic steatosis, and to evaluate whether such differences are mediate by metabolic syndrome variables. Materials and Methods. Carotid intima-media thickness (by ultrasonography), hepatic steatosis (by ultrasonography), insulin resistance (by Homeostasis Model Assessment-HOMA), steatohepatitis (by histologic specimen) were measured in 54 non-alcoholic steatohepatitis, and 54 IGT, compared with 54 healthy subjects. Results. Subjects with nonalcoholic steatohepatitis had markedly greater carotid intima-media thickness measurements (1.38±0.12 vs 1.12±0.10 mm; p<0.001) than controls. The marked differences in carotid intima-media thickness that were observed between the groups were little affected by adjustment for age, sex, body mass index, waist/hip ratio, diabetes duration, blood pressure, lipids. Conclusions. These results sug...
European review for medical and pharmacological sciences
Homocysteine levels have been determined with Chromatography on HPLC column, between the 20th and... more Homocysteine levels have been determined with Chromatography on HPLC column, between the 20th and the 24th week of pregnancy, in women with analogous characteristics (a) normotensive, (b) with pregnancy-induced hypertension (PIH), low (LR), medium (MR), high risk (HR). The group they belonged to was confirmed after natural or caesarean delivery. All the patients were submitted to 24 hour blood pressure monitoring for the evaluation of further pressure risk parameters: mean arterial pressure (MAP), non dippers, percentages of pressure peaks. Homocysteine levels in normotensive pregnant women (5.8 +/- 1.7 microM) were low. Significant high levels of homocysteine were present proportionally to the risk degree of PIH. Higher levels of homocysteine statistically significant were present in non dippers of all groups (MR p < 0.05; HR p < 0.01). A direct correlation between plasmatic homocisteine levels and pressure profiles was found out in non dippers (r = 0.56, r = 0.55, r = 0.50 r...
European review for medical and pharmacological sciences
Hyperhomocysteinemia is widely recognised as an emerging risk factor of endothelial dysfunction a... more Hyperhomocysteinemia is widely recognised as an emerging risk factor of endothelial dysfunction and vascular damage. In this study we wanted to verify if it, when associated to arterial hypertension--traditional risk factor--represents a higher added risk of organ damage during menopause, which is a condition connected to a higher incidence of cerebrovascular diseases. A survey of 30 postmenopausal women with similar characteristics (BMI, age, absence of relevant pathologies such as diabetes, metabolic disorders and absence of smoking) was selected (menopause had occurred from 12 to 16 months at the moment of observation). At the moment of the observation they had not gone through any continuous pharmacological therapy. They were subdivided into 3 groups: normotensive; hypertensive (with 2nd degree hypertension: mild to moderate) without organ damage; hypertensive with organ damage (TIA, ischaemic heart disease, etc.). The carotid IMT, measured with ultrasound method, was considered...
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Papers by Sergio Neri