[Estimation of total body water from routine urea kinetics]. / La stima dell'acqua corporea totale per la cinetica dell'urea di routine.

The comparison of total body water obtained by Watson formula with results of bioelectrical impedance (BIA) shows a fair approximation (Delta% = 1.0 +/- 8.45). However, when compared to other literature formulas the BIA values are higher (8 divided by 23%), and this discrepancy needs further analysis. Urea kinetics was computed using as input data for distribution volume both the Watson anthropometrical and the BIA TBW values: the clearance results do not differ significantly (Delta% = 0.74 +/- 8.35). The Kt/V index results are nearly identical (Delta% = 0.12 +/- 1.17), due to a mathematical loop: a wrong input of volume induces a comparable error of the clearance result, while their ratio is unchanged. For practical routine to monitoring dialysis adequacy the Watson anthropometrical formula has proven as a satisfactory simple approach. Periodical BIA determination provides useful informations mainly when the anthropometrical estimation are doubtful and the comparison of data may increase the kinetic reliability.

[Blastocystis hominis in Canavese: a retrospective study of samples received for fecal parasitological examination at the Ivrea- Castellamonte Hospital over 42 months]. / Blastocystis hominis in Canavese: uno studio retrospettivo sui campioni pervenuti per esame coproparassitologico all'ospedale di Ivrea-Castellamonte in un periodo di 42 mesi.

In the last ten years the interest in the controversial Blastocystis hominis microorganism of the intestine has greatly increased. The authors conducted a retrospective study of feces for parasitology investigations at the Ivrea-Castellamonte hospital. These investigations lasted 42 months (1/1/1988-31/6/1991) and the authors focused their attention on samples with 5 or more Blastocystis hominis at the microscopically examination with a 40X phase objective. During the study 2,138 samples of feces (belonging to 1552 patients) arrived. 284 samples (13.3%), corresponding to 200 patients (12.9%), proved to be positive for one or more parasites. In 155 samples (7.2%) regarding 109 patients (7.0%)--53 males, 56 females--Blastocystis was present. These patients were between 2 and 78 years of age. In 19 (17.4%) of these patients other parasites were associated, parasites such as Giardia lamblia (in 6 cases), Entamoeba coli (in 4 cases), Entamoeba spp. (in 2 cases), Entamoeba histolytica (in one case), Entamoeba hartmanni (in one case), Iodamoeba butschlii (in one case), Hymenolepis nana (in one case); helminths (in 3 cases). The most effect proved to be those patients between 21 and 50 years of age (53 of 98 patients). Few infants were affected. The greatest incidence of Blastocystis hominis infection occurred during the months of January to June. The authors conclude by considering how the incidence data of such parasitosis in the Canavese region can be superimposed on as much as has been observed in territories which are very different regarding social-economic and geoclimatic conditions. The authors think it is necessary to start a prospective clinical-epidemiological investigation in the Canavese region with a view to defining the clinical approach to the parasite under discussion in a better way.

[Community- and hospital-acquired bacteremia: a retrospective study in a regional hospital. II. Clinical observations]. / Batteriemie acquisite in comunità ed in ospedale: uno studio retrospettivo in un ospedale regionale. Nota II: Osservazioni cliniche.

A study was made of 92 bacteremia episodes among patients admitted to the Ivrea-Castellamonte Hospital (Turin, Italy) between June 1986 and September 1989. A single microorganism was isolated in 84 episodes (91.3%), the most common being: Staphylococcus aureus (21.7%), Escherichia coli (18.5%), Enterococcus (9.8%), Pseudomonas aeruginosa (6.5%), and Proteus mirabilis (5.4%). The episodes were of both hospital and community origin: 54.3% vs. 45.7%. Their main sources were: the urinary tract (16.3%), abdominal infections (14.2%), endocarditis (7.6%), and the respiratory tract (5.5%). No source could be identified in 26%. Brucellosis, salmonellosis and listeriosis together constituted 8.7% of the episodes. Abdominal infections were primarily responsible for the 8 cases (8.7%) of polymicrobial bacteremia. The overall mortality was 18.5% (6.5% community vs. 12% hospital episodes). Mortality directly due to bacteremia was 8.7%. Bacteremia was the direct or indirect cause of death in 22.6% of patients greater than or equal to 65, compared with 19% and 10% in those aged 35-64 and 15-44 respectively. The patient's clinical picture at the time of infection was a prognostic factor: mortality was much lower in subjects previously healthy or free from basic diseases (11.8%) than in those with non-rapidly-fatal diseases (21.7%) or rapidly-fatal diseases (54.5%). Bacteremia-linked mortality (direct and indirect) was higher in Gram-positive vs Gram-negative infections: 22.2% vs 15.8%. Mortality was 12.5% in the group of patients with polymicrobial infections.

Urinary enzyme excretion and renal lactate dehydrogenase isoenzyme pattern in acute HgCl2 nephropathy of rat.

The activity of several enzymes with different intracellular sites was determined in urine at various times following nonfatal acute tubular necrosis induced by mercuric chloride administration. The excretion rate of all tested enzymes rose on the 1st and 2nd day; in the next observations (days 7-15) enzymatic values approached the basal values. The lactate dehydrogenase isoenzyme pattern of the renal cortical zone showed an early shift towards cathodic fractions and later (7 days) an increase of middle ones; the normal anodic zymogram recovered after a suitable time interval (30 days). The isoenzymatic changes are related both to the renal hypoxia and to the appearance of less differentiated cells. The behaviour of functional parameters (urine flow, osmolality, urea clearance, creatinine clearance) were well in agreement with the observed enzyme and renal isoenzyme changes.

Renal lactate dehydrogenase (LDH) isoenzyme pattern in short-term experimental obstructive nephropathy.

The lactate dehydrogenase isoenzyme pattern of different zones of rat kidney has been investigated at different stages after unilateral ureteral obstruction. In the obstructed kidney, the cortical tissue showed an early (3 days) progressive shift toward a cathodic zymogram; at 7 days LDH-5 isoenzyme was the predominant fraction (44.7 +/- 2.5). In the outer medullary tissue a similar change was observed even though middle fractions were always quite evident. No significant changes were found in the inner medullary tissue. The observed enzymatic abnormalities are related to renal hypoxia and to the occurrence of a less differentiated nephronic cell population. They represent a metabolic marker of the morphologic and functional alterations which occur in obstructive nephropathy.

Recovery of renal lactate dehydrogenase (LDH) isoenzyme pattern after obstruction relief in experimental hydronephrosis.

The release of ureteral occlusion leads to a progressive recovery in LDH isoenzyme pattern with gradual increase of anodic fractions and decrease of middle and cathodic ones. Our findings demonstrate that the recovery is accomplished on the 10-14th day, in agreement with morphological and metabolic observation.

[Isolated hepatosplenic tuberculosis: 1 case]. / La tuberculose hépato-splénique isolée: a propos d'une observation.

A 27-year-old woman presented with high spiking fevers, progressive malaise, weight loss, and marked hepatosplenomegaly. The clinical picture and laboratory findings (including hepatic scintiscan, coeliac arteriography and abdominal lymphangiography) prompted surgical exploration of hypochondriac organs. On laparotomy, both liver and spleen surface exhibited extensive inflammatory lesions. Histopathologic investigations on hepatic tissue showed microscopic caseating granulomata. Specific stains and cultures for mycobacterium, fungi etc. were negative in tissue preparations. Antituberculous and steroid therapy elicited a rapid response. Follow-up observations indicated the resolution of specific hepatic lesions.

[Type B viral hepatitis. Recent findings]. / Epatite virale di tipo B. Recenti acquisizioni.

The discovery of hepatitis B surface antigen by Blumberg in 1965 offered a specific marker that could readily be employed in the clinical, epidemiological and experimental investigation of type B viral hepatitis. It has since been followed by the continuous gathering of further knowledge concerning this disease. The morphology and immunological and biochemical features of virus B, the epidemiology and prevention of hepatitis B, and marker determination techniques are examined in an overview of the present situation.