Outcome in Idiopathic Childhood Nephrotic Syndrome Andenmatten, Franziska; Bianchetti, Mario G.; Gerber, Heinz A. ...
Scandinavian journal of urology and nephrology,
03/1995, Letnik:
29, Številka:
1
Journal Article
112 patients with idiopathic childhood nephrotic syndrome have been referred from 1970 through 1989 at the Department of Pediatrics, University of Berne. One patient remitted spontaneously without ...medication. Ninety-eight patients responded to prednisone: 15 had a single bout of nephrosis, 47 developed a tendency towards relapses and 36 steroid dependence. In 28 patients with tendency towards relapses cure took place on either prednisone alone or prednisone plus cyclophosphamide. In 18 patients with steroid dependency cure took place on prednisone alone or prednisone plus cyclophosphamide. Thirteen patients failed to respond to steroids. The course of the disease was more benign in 68 patients with minimal change disease as compared with 14 patients with focal and segmental glomerular sclerosis. Immunofluorescence studies demonstrated mesangial IgM deposits in 14 out of 54 patients, but this finding was not a marker for poor steroid response or progression to renal failure. The course of the disease was especially unfavourable in patients with persisting nephrosis on completion of the initial course of steroid therapy. In conclusion it appears appropriate to define the disease in terms of steroid responsiveness as steroid resistant patients sometimes show normal glomeruli, steroid responsive patients sometimes have focal and segmental glomerular sclerosis or mesangial IgM deposits, and decisions depend more on the steroid responsiveness than on the histological features.
The efficacy and side effects of the new vasodilator carprazidil and the established vasodilator minoxidil were compared in 18 hypertensive patients inadequately controlled by 2 to 4 conventional ...drugs; the latter included diuretics, beta-blockers and/or sympatholytics and, in half the cases, vasodilators, such as hydralazine, diazoxide or the postsynaptic alpha-blocker prazosin. The vasodilators were withdrawn and, using a crossover design all patients received carprazidil (mean final dose 88 mg) and minoxidil (20 mg) for an average period of 5 to 6 months. The effects of the 2 agents appeared to be qualitatively and quantitatively similar. Both tended to cause sodium retention and an increase in heart rate, which required an increased dose of diuretic in one third of the cases or of a beta-blocker in a quarter. With this approach mean body weight and blood volume were not altered in the established phase of carprazidil or minoxidil treatment; heart rate and plasma norepinephrine tended to be only minimally increased, plasma renin was slightly increased, and plasma aldosterone and epinephrine were largely unchanged. Supine and upright blood pressure were reduced from initial values of 189/113 and 167/ 113 mm Hg, to 149/95 and 138/95 mm Hg (-18 and - 17%), respectively, during carprazidil, and to 154/95 and 141/96 mm Hg (-17 and - 15%) during minoxidil therapy. Hypertrichosis occurred with both agents in almost all patients, and limits their more prolonged use in females. No adverse side effects on haematological parameters, liver or renal function were observed, nor was antinuclear antibody detected. It is concluded that carprazidil and minoxidil are equivalent vasodilator agents in the treatment of severe hypertension, particularly in males.
Calciuria in Bartter's syndrome Bianchetti, M G; Oetliker, O H
Scandinavian journal of urology and nephrology,
1990, Letnik:
24, Številka:
3
Journal Article
Objective: To describe the epidemiology of psychotropic drug use in a sample of Italian outpatient psychiatric services. Methods: Drug-utilisation survey conducted within the framework of a broader ...prospective follow-up study with 67 Italian outpatient psychiatric services. Results: The data concern 2322 patients recruited over a 3-year period. Three-quarters of the cohort were prescribed antipsychotic drugs, one-half received benzodiazepines and nearly one-third received antidepressants. The trends in drug use from 1994 to 1997 show that for patients with schizophrenia there has been a decrease in the prescription of typical neuroleptics: the use of haloperidol passed from 56% to 42.4% and that of chlorpromazine dropped from 13.5% to 6.1%; during the same period, an increasing use of the atypical compound risperidone was observed. Among patients suffering from unipolar affective psychosis, the prescriptions of tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) have not changed in time, while the proportion of patients receiving neuroleptic drugs has increased from 41% to 45.2%. In addition, the use of antiepileptic drugs and lithium increased, irrespective of diagnosis. Almost 40% of the patients on psychotropic drugs received three or more drugs. Finally, a positive association was found between the number of prescribed compounds and the daily dose administered. Conclusion: These data indicate that in the absence of a rational approach to drug use, a symptomatic approach is generally adopted, by which common sense, experience, information provided by non-independent agencies and other cultural parameters play an important role in the prescription strategy. Pharmacoepidemiology should more often consider the use of drugs as a dependent variable, to be investigated within the context of other clinical, cultural, social and setting-related parameters; this approach would enable a more comprehensive assessment of prescribing practices and strategies in routine clinical care.PUBLICATION ABSTRACT
The protein components of the Photosystem II antenna system, isolated from spinach thylakoids, have been resolved by reversed-phase high performance liquid chromatography (RP-HPLC) using a ...butyl-silica stationary phase packed either into analytical or semi-preparative columns. Peak identification has been accomplished by a combination of various SDS-PAGE systems employing either Comassie (or silver) staining or immunological detection using polyclonal antibodies raised against LHC II and against CP29, CP26 and CP24 proteins and by aminoacid microsequence. Moreover, peak identification is consistent with the molecular masses determined by Electrospray Ionization Mass Spectrometry (HPLC-ESI-MS). The developed RP-HPLC method allows the resolution of all the protein components of the Photosystem II major Light Harvesting Complex (LHC II) and minor PS II antenna complex (CP24, CP26 and CP29) from grana membranes (BBY) and estimation of their relative stoichiometry in natural and stressed conditions, avoiding the expensive and time consuming separation procedure by sucrose-gradient ultracentrifugation and isoelectrofocusing.PUBLICATION ABSTRACT
The Early Stroke Trial (EST) is a randomized, double-blind, placebo-controlled trial to assess the effect of monosialoganglioside GM-1 in improving recovery in patients who experienced an ischemic ...supratentorial stroke.
Sixteen clinical centers recruited 805 patients, of whom 792 were confirmed to be eligible. Treatment, consisting of a first dose of either 200 mg GM-1 or placebo, was initiated within 5 hours of the onset of stroke; a second dose of either 100 mg GM-1 or placebo was administered 12 hours later. Thereafter, patients received a daily injection of 100 mg GM-1 or placebo intravenously from day 2 through 10 and intramuscularly from day 11 through 21. Patients were followed up for a total of 4 months.
Survival was similar in the two treatment groups. Improvement in neurological status, as measured by the change in Canadian Neurological Scale score between baseline and 4-month assessments, was greater in the group receiving GM-1; the observed difference between treatment groups was 0.22 (P = .06). A post hoc analysis in the subgroup of patients treated within 4 hours showed a statistically significant difference, with Canadian Neurological Scale mean improvement of 0.41 (P = .016). GM-1 use was not associated with differences in frequency, nature, or severity of adverse experiences.
These findings suggest that GM-1 is safe in the dose and treatment schedule used and that its efficacy in ischemic stroke is greater when given soon after onset of stroke.
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