Microalbuminuria, brain vasomotor reactivity, carotid and kidney arterial flow in Type 2 diabetes mellitus.

Diabetic microangiopathy produces widespread small vessel impairment which particularly affects renal glomeruli functions. Microalbuminuria is the earliest marker of microangiopathic kidney disease and has also recently been recognised as a marker of macroangiopathic cardiovascular involvement. To determine correlations between daily microalbuminuria, local microangiopathic kidney damage, systemic macroangiopathic involvement and functional brain microcirculation, 70 Type 2 diabetic subjects who were diagnosed more than 5 years ago underwent carotid (to determine index of macro- and microangiopathy) and interlobar kidney artery color Doppler (to determine microangiopathic involvement), transcranial Doppler (to determine alterations in brain vasomotor reserve), and evaluation of daily albumin excretion rate. All the indices of microcirculatory involvement in the kidney, brain and small vessels downstream-from the carotid arteries were closely related (for all p<0.001) but never correlated with the macroangiopathy index. Daily microalbuminuria correlated with all the micro- (p<0.0001) and macroangiopathic (p<0.005) Doppler indices. These findings confirm that microangiopathy is the main cause of the diabetic increase in the albumin excretion rate and support the view that microalbuminuria can be considered a powerful biomarker of widespread macroangiopathy. Our results suggest microalbuminuria may also identify cerebrovascular diabetic involvement, as it predicts both macroangiopathic carotid alteration and microvascular brain impairment.

[Visual representation of biological structures in teaching material]. / Representação visual de estruturas biológicas em materiais de ensino.

Parameters must be defined for presenting and handling scientific information presented in the form of teaching materials. Through library research and consultations with specialists in the health sciences and in graphic arts and design, this study undertook a comparative description of the first examples of scientific illustrations of anatomy and the evolution of visual representations of knowledge on the cell. The study includes significant examples of illustrations which served as elements of analysis.

HBV infection in hemodialysis patients: monitoring and prevention.

From 1986 to 91, 174 dialysis patients were studied. The prevalence of previous HBV infection and of chronic carriers was 33.3 and 4.6%, respectively. Immunization rate after vaccination (3 doses) was 63%. In 1991, we proposed a vaccination with 4 doses and recommend a 6-monthly anti-HBs evaluation to assess the timing of any booster dose needed.

Vaccination of pregnant cows with K99 antigen of enterotoxigenic Escherichia coli and protection by colostrum in newborn calves.

The immune response to the K99 was tested in 45 pregnant cows, subcutaneously vaccinated, for protecting the newborn calves. Serological tests were performed in the blood sera of all animals and in the milk and colostrum sera; hemogram, inhibition of the adhesion to the brush border and histological tests were performed. The calves from vaccinated cows survived the experimental infection after the suction of colostrum in spite of the fact that the calves from control dams died with diarrhea.

[Role of photon absorption densitometry of the bone in uremic osteodystrophy]. / Ruolo della densitometria ossea ad assorbimento fotonico nella osteodistrofia uremica.

The aim of this investigation is to evaluate the role of bone photonic densitometry in uremic osteodystrophy. Bone mineral content (BMC) and bone density (BD) have been measured in 80 hemodialyzed patients by double photonic emission densitometry. Photonic densitometry shows an higher sensibility to quantitative changes in bone mineral content than metacarpal index (IM). Photonic densitometry is unable to differentiate osteoporosis from osteomalacia; this differential diagnosis can be obtained by radiological analysis: low BD and low IM means osteoporosis, low BD and resorptive changes in cortical bone means osteomalacia and/or hyperparathyroidism. Photonic densitometry is particularly suitable for uremic osteodystrophy follow-up because of its easy repetitiveness and innocuousness and for its close correlation with iPTH variations.

Polycentric 384-month study of biofiltration (BF) with AN69s.

Polycentric 384-month study of biofiltration (BF) with AN69s. Since January 1984, 39 uremic dialyzed patients have been included in a randomized prospective study, to evaluate the clinical utility of BF. The trial lasted 9.85 months/pt (384.15 months of total observations) and patients admitted had some not well controlled clinical signs: major acidosis, intradialytic cardiovascular instability, intolerance to acetate dialysis, hypercatabolism, neuropathy, etc. We obtained some positive effects: the incidence of intradialytic hypotension decreased 26.6%; interdialytic body weight gain fell from 3.1 to 2.7 kg (p less than 0.05) and the dialytic time per week was reduced from 12.3 to 10.0 hours (p less than 0.01). At the same time dry body weight increased from 62.4 to 64.6 kg with worthwhile improvement of the acid-base status (ABS) in all patients. This controlled trial showed that BF is particularly useful for patients suffering from severe acidosis and/or cardiovascular instability.

Effects of chronic biofiltration with PAN membranes on acid-base status: polycentric study.

Effects of chronic biofiltration (BF) with PAN membranes on acid-base status (ABS): polycentric study. From the 39 cases in a polycentric study we selected 13 patients with metabolic acidosis (pH 7.23 +/- 0.03), marked reduction of plasma bicarbonate (15.4 +/- 2.2 mEq/l) and hyperkalemia (6.2 +/- 0.6 mEq/l). BF was performed with a continuous post-dilutional supply of HCO3 (85 mmol/h), and attained rapid normalisation of blood bicarbonates and serum potassium during the treatment. After 6 months of BF treatment the pre-dialytic ABS showed remarkable improvement, and values were normal after one year. The remaining 26 patients in the polycentric study, treated by chronic BF without severe acidosis, showed good dialytic tolerance. In 15 of them the supply of bicarbonate was too high (because of moderate post-BF alkalosis) and we had to reduce the buffer inflow to about 50 mmol/h.

A study of a herpesvirus isolated from dairy cattle with a history of reproductive disorders.

Three strains of herpesvirus were recovered from cows with vulvovaginitis. The three isolates (85/BH 16TV, 85/BH 17TV, 85/BH 18TV), when compared by cross serum neutralization (SN) tests, were found to be antigenically identical. They were serologically distinct from infectious bovine rhinotracheitis (IBR) virus and Bovid herpesvirus 2 (BHV2), while they cross reacted with bovine herpesvirus DN-599. Besides the serologic aspects, the three isolates appeared to share common biological, physical and morphological properties with the newly recognized bovine herpesviruses, of which DN-599 is a representative strain.

[Clinical, radiological and ultrasonic correlations in secondary hyperparathyroidism. Observations concerning 75 patients on dialysis]. / Correlazioni cliniche e radio-ecotomografiche nell'iperparatiroidismo secondario. Osservazioni su 75 pazienti dializzati.

The results of a US study on parathyroid glands, performed in 75 hemodialysed patients are reported. The correlation between morphological features of the glands, biochemical and radiological pattern of secondary hyperparathyroidism is stressed. The results show a significant link between gland volume and hematic level of PTH: less interesting appears the correlation with radiological pattern of uremic osteodystrophy.