[Paraquat poisoning; clinical toxicological aspects and a case description]. / Intossicazione da paraquat; aspetti clinico-tossicologici e descrizione di un caso.

The clinical course of a young woman following the ingestion of the herbicide Paraquat in a suicide attempts is reported. Clinical signs of intoxication consisted at first in alterations of hepatic and renal functions, and later in progressive pulmonary failure. The patient died in severe respiratory distress on the 8th day due to cardiac arrest, probably anoxic. Treatment was initially on standard lines, with cathartics with the aim to prevent the absorption of Paraquat in the plasma and its accumulation in the lungs. In addition, high doses of steroids, immunosuppressive agents, prophylactic antibiotics and cardiotonics were given. Peritoneal dialysis and haemodialysis were concomitantly assured. The Authors suggest that in Paraquat poisoning an adequate therapeutic treatment could consist in specific sorbents such as Fuller's earth and bentonite, haemoperfusion over a coated charcoal system or cation exchange resins. Administration of drugs such as corticosteroids, immunosuppressants (bleomycine) and the enzyme superoxide dismutase may be also indicated. On the contrary, oxygen therapy should be carefully monitored: in fact hyperoxic atmospheres, by increasing the rate of generation of superoxide radicals, enhance cellular toxicity of Paraquat.

Function of the kidney in adult patients with Cooley's disease. A preliminary report.

The function of the kidney in adult subjects with Cooley's disease has been hitherto inadequately investigated. In 10 patients suffering from thalassemia major, glomerular filtration rate, renal plasma flow, renal blood flow have been studied, together with urine concentration capacity. The authors emphasize certain pathological changes, such as the increase in renal plasma flow and the failure of the urine concentration ability. On the basis of renal biopsies, two pathogenetic theories are discussed: the functional impairment of the coutercurrent system and fibrosis of the medullary tissue.

Bone densitometry with L125 in the study of uraemic osteropathy: semeiological signifiance and limitations.

Bone densitometry using I125 is a very easy method of investigation; it may be used repeatedly and simultaneously at different bone levels without distress to patients. The problems involved were those of the value, semeiological significance and possible limitations of this method in the investigation of uraemic osteopathy. These problems were solved successfully in tests carried out on 87 patients of both sexes suffering from various degrees of chronic nephropathy and on chronic haemodialysis patients. The method is reliable: reproducibility tests in normal and uraemic subjects were satisfactory; the indexes remain constant, usually in normal subjects. The parameters are "Bone Mineral Content" and "Bone Index". Trabecular bone is more sensitive than cortical bone, although comparisons between the two types of bone produce interesting data. There are difference dependent on sex. The method which is more sensitive than others enables: 1) Normal and nephropathic subjects, to be distinguished from one another. The latter generally show a lower mineral content and bone index (clinical picture of osteomalacia, osteoporosis, hyperparathyroidism) seldom a higher or a normal one. 2) The same bone sites to be examined over a given period. 3) Treatment of patients to be monitored.