G.F.R. measuring with 99mTc-DTPA: limits in obstructive acute renal failure.

After a short introduction on the advantages and limits of G.F.R. determination with Ccr, the radioisotopic methods proposed by Schlegel and Gates for this parameter are described, and as well as ERPF and FF, without blood serial samples being necessary. In a severe renal failure case due to obstruction, the Authors have found a great mismatch in the results between the traditional methods and the radioisotopic ones. After the clinical case description, a possible explanation of this discrepancy is proposed: Schlegel and Gates' methods, which well correlate Ccr in chronic renal failure cases, in severe renal failure on obstructive basis, of recent onset, could not indicate the effective glomerular filtrate, but the nephronic mass, functionally blocked by the endocapsular hypertension secondary to the obstruction, but anatomically unaffected and so recoverable by a timely irradication of the obstruction.

[Cardiovascular response to sympathetic stimulation in normal subjects with or without familial hypertension]. / Risposta cardiovascolare ai test di stimolazione simpatica in soggetti normotesi con o senza familiarità ipertensiva.

UNLABELLED: The aim of our study was to seek out a possible different reactiveness to cardiovascular stimulation tests among normotensives with and without positive family history of essential hypertension. We have studied about 200 inhabitants of Ustica and 49 medicine students, all normotensives according to the World Health Organization and the Joint National Committee criteria. In an isolated room and in a supine position, blood pressure (BP) and heart rate were measured every 30 s for 15 min with an automatic sphygmomanometer. Averages of last 4 measurements were considered baseline values. Then we have carried out mental stress (MS), handgrip and active orthostatism test (AO) in the inhabitants of Ustica; cold pressor test and AO in students. Patients were divided in 2 groups, genetics and controls, on the basis of a positive family history of essential hypertension. The 2 groups, in every sample, were similar for sex, age, body mass index and alimentary and life habits. RESULTS: a preliminary estimation of Ustica sample showed a different prevalence of positive history between hypertensives and normotensives (63.9% vs 46.61%; p less than 0.05) and no difference between hypertensive and borderline patients (63.9% vs 64.2%); BP and heart rate were slightly higher in controls; there was no statistical difference between genetics and controls. CONCLUSIONS: our results can be explained in various ways: pressor dysregulation in candidates for hypertension may be masked in a large group of normotensives; exaggerated pressor response do not exist in genetics or this pressor dysregulation is impossible to find out with the cardiovascular stimulation tests we have used; other mechanisms are responsible for genetic hypertension.

Microproteinuria as an index of initial renal lesion in patients with rheumatoid arthritis.

Our investigation included 20 patients with rheumatoid arthritis and a negative routine (albustix) proteinuria test, and 20 healthy controls. The albustix test was compared with a method based on multifractional Cellogel RS electrophoresis of urinary proteins. The albustix test was found to be not reliable in patients with RA. Microproteinuria was in fact detected by the electrophoresis method in 12 out of 20 RA patients. Eleven patients showed glomerular type proteinuria (which was "selective" in 5 patients and "non-selective" in 6 patients), and 1 patient showed mixed type proteinuria. Electrophoresis failed to show microproteinuria in the controls. The high sensitivity, easy handling and low cost of multifractioned electrophoresis (which does not involve disturbing the patients) suggest its introduction as a routine test for all RA patients, thus achieving both accurate clinical assessment of proteinuria and a rational therapeutic approach.

[Validity of the use of penbutolol in essential arterial hypertension]. / Validità dell'uso del penbutololo nell'ipertensione arteriosa essenziale.

Thirty patients suffering from WHO I-II class slight-moderate essential arterial hypertension were treated with a beta-blocker (Penbutolol) alone and once a day to assess its antihypertensive effectiveness and its affect on heart frequency, lipid metabolism and kidney function. The drug proved highly effective in reducing P.A.S. and P.A.D. values and no negative influence was documented on lipid metabolism, kidney function or heart frequency.

[Physiopathological significance of renal blood flow reduction in patients with essential arterial hypertension]. / Significato fisiopatologico della riduzione della portata renale plasmatica nei pazienti con ipertensione arteriosa essenziale.

a group of 120 patients suffering from E.A.H. divided into three age Plasma renal flow was reduced on average in all three groups. It is t this fact could support the hypothesis that the change in renal per y a pathogenic role in E.A.H. ss F1/hlp F2/que F3/ext F4/can F5/nxt F6/ins F7/up F8/dwn F9/fin

[Different prevalence of some indices of cardiac and vascular impairment in normal weight and obese patients with essential arterial hypertension]. / Differente prevalenza di alcuni indici di compromissione cardiaca e vascolare in pazienti normopeso e obesi affetti da ipertensione arteriosa essenziale.

Certain physiopathological features that differentiate essential arterial hypertension in normal weight and obese patients are recalled. The results of a retrospective study carried out in 293 hypertensive patients admitted to the Clinic in recent years are reported with a view to evaluating the prevalence of certain parameters (ischaemic cardiopathy, left ventricular hypertrophy, renal, vasculo-cerebral and retinal impairment) in patients subdivided into two groups: normal weight and obese. The study showed in the first group a higher prevalence of signs of ischaemic cardiopathy; in the second a higher prevalence of left ventricular hypertrophy. This difference is accentuated in the subgroup of smokers as regards ischaemic cardiopathy and in non-smokers as regards left ventricular hypertrophy. The possible explanations for this different behaviour are discussed.

[Recurrent eosinophilic pneumonia. Bibliographical review, nosographic, pathogenetic and unitary setting reflections on the disease]. / Polmonite eosinofila recidivante. Rivista bibliografica, riflessioni nosografiche, patogenetiche e di inquadramento unitario della malattia.

The literature on the pathological conditions inherent in pulmonary eosinophilias is reviewed from the earliest clinical and radiological observations to the most recent studies on eosinophil function. A case of recurring eosinophilic pneumonia is considered. This is a pathological condition that differs both from Löffler's transient infiltrate, being longer lasting, and from chronic eosinophilic pneumonia due to the lack of symptoms and moderate eosinophilia. On the basis of the existence of progressively deteriorating pictures whose aetiopathogenesis is still uncertain but which is certainly immunological and inflammatory in character given the involvement of eosinophils, the presence of characteristic radiological pictures and the response to steroid treatment, it is therefore agreed that these various pathological conditions constitute a single disease whose more benign extreme is represented by the reported case of recurring eosinophilic pneumonia, its more severe extreme by forms presenting high levels of circulating eosinophils, hypereosinophilia, a prolonged course and more marked symptoms typified by the disseminated eosinophilic collagen disease reported by Dell'Acqua and Mori.

[Behavior of the turnover of I131-fibrinogen in various diseases of the connective tissue]. / Comportamento del turnover del I131-fibrinogeno in alcune malattie del connettivo.

It is generally admitted that alteration to the blood coagulation system, particularly the creation of fibrin from fibrinogen may play a pathogenetic role in the complex mechanism that characterises rheumatic diseases of the connective tissue. A study was therefore conducted to see whether accelerated fibrinogen turnover could be demonstrated in such patients. To this end the clearance of fibrinogen marked with I131 was assessed in 25 patients in various stages of connectivitis and 10 controls was measured. The results showed a distinct acceleration in fibrinogen turnover only in patients with highly active rheumatoid arthritis. In contrast patients with rheumatoid arthritis in the regressive phase or with stable progressive systemic sclerosis showed values similar to the control subjects. Finally the possible explanations for this behaviour are examined and the clinical interest of the technique employed is assessed.

[Treatment of chronic cerebrovascular insufficiency and chronic obliterating arteriopathy of the lower extremities with buflomedil hydrochloride]. / Trattamento dell'insufficienza cerebro-vascolare cronica e dell'arteriopatia obliterante cronica degli arti inferiori con buflomedil cloridrato.

Research has been carried out into the effects of a new vasoactive substance, buflomedil hydrochloride, on two groups of patients suffering from cerebrovascular insufficiency and obliterating arteriopathy at the lower extremities. Ten clinical parameters were assessed in the first group of patients (insomnia, headache, vertigo, tinnitus, asthenia, shaking, changes in reflexes, anorexia, memory disturbances, problems of concentration and character disturbances); in the second group, the muscular flow of the gastrocnemius as measured by the muscular clearance of NaI131 at rest, during standard exercise conditions, during ten minutes following exercise and in the post-ischaemic phase. The results can be considered satisfactory in both groups, especially after prolonged treatment and in the early stage of the disease. Drug tolerance was very good.