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Your search keyword '"Spazzoli, Alessandra"' showing total 4 results
Start Over Author "Spazzoli, Alessandra" Publisher societa italiana di nefrologia
4 results on '"Spazzoli, Alessandra"'

1. [New Perspectives in Post-Surgical Acute Kidney Injury During Sepsis].

Author

Zambianchi L, di Nunzio M, Cignesi D, Cristino S, Angelini ML, Spazzoli A, Americo C, Lifrieri MF, and Buscaroli A

Subjects
Humans, Risk Factors, Risk Assessment, Sepsis complications, Acute Kidney Injury etiology, Acute Kidney Injury prevention & control
Abstract

Postoperative acute kidney injury (PO-AKI) is a common complication of major surgery that is strongly associated with short-term surgical complications and long-term adverse outcomes. Risk factors for PO-AKI include older age and comorbid diseases such as chronic kidney disease and diabetes mellitus. Sepsis is a common complication in patients undergoing surgery and is a major risk factor for the development of acute kidney injury (SA-AKI). Prevention of AKI in surgery patients is largely based on identification of high baseline risk, monitoring, and reduction of nephrotoxic insults. Early identification of patients at risk of AKI, or at risk of progressing to severe and/or persistent AKI, is crucial to the timely initiation of adequate supportive measures, including limiting further insults to the kidney. Although specific therapeutic options are limited, several clinical trials have evaluated the use of care bundles and extracorporeal techniques as potential therapeutic approaches., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)

Published
2023

2. [Discovering uncommon nephropathies: a case of acute kidney damage from malaria].

Author

Chiappo F, Zambianchi L, Spazzoli A, Lifrieri MF, Cristino S, De Fabritiis M, Americo C, Angelini ML, Fabbrizio B, Cenacchi G, and Mosconi G

Subjects
Female, Humans, Plasmodium falciparum, Kidney Glomerulus pathology, Malaria diagnosis, Malaria epidemiology, Malaria parasitology, Malaria, Falciparum complications, Malaria, Falciparum diagnosis, Malaria, Falciparum epidemiology, Acute Kidney Injury etiology, Acute Kidney Injury pathology
Abstract

Malaria is one of the most common infectious diseases in the world with a high prevalence in developing countries. Renal impairment occurs in 40% of Plasmodium falciparum infections; glomeruli, tubules or interstitium can be involved with different pathophysiological mechanisms. We describe a case of severe acute renal failure caused by P. falciparum malaria in a young woman from the Ivory Coast. Renal biopsy revealed severe and widespread acute tubular necrosis and the presence of blackish pigment granules in the glomerular and peritubular capillaries, negative for iron histochemical staining; in electron microscopy we found rounded-oval-shaped structures containing cytoplasmic organelles, electrondensic granules and cellular debris, likely of infectious origin, within monocyte-macrophages located in the tubular lumen. Specific Antigen for P. falciparum and malarial parasite in blood were positive, with very rare trophozoites and gametocytes compatible with Plasmodium falciparum. Steroid therapy and specific antiparasitic therapy were set up with progressive functional improvement until complete recovery. This case highlights the importance of paying maximum attention to low incidence pathologies in our country, considering the continuous migratory movements of these years that can cause an increase in these diseases; anamnestic data are essential for a timely diagnosis which can contribute to a rapid remission avoiding severe complications., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

Published
2022

3. [Resilience in COVID-19 times: general considerations on the recovery of a 93-year-old patient on haemodialysis treatment].

Author

Mosconi G, Spazzoli A, Bruno PF, Angelini ML, Cristino S, Lifrieri MF, Americo C, De Fabritiis M, Ambri K, Dirani G, Semprini S, Sambri V, and Zambianchi L

Subjects
Aged, 80 and over, Antibodies, Viral blood, COVID-19, COVID-19 Testing, Calcitriol therapeutic use, Clinical Laboratory Techniques, Comorbidity, Coronavirus Infections diagnosis, Coronavirus Infections drug therapy, Drug Therapy, Combination, Female, Heparin therapeutic use, Humans, Hydroxychloroquine therapeutic use, Immunoglobulin G blood, Immunoglobulin M blood, Nasopharynx virology, Platelet Aggregation Inhibitors therapeutic use, Pneumonia, Viral diagnosis, Pneumonia, Viral drug therapy, SARS-CoV-2, Time Factors, COVID-19 Drug Treatment, Betacoronavirus immunology, Betacoronavirus isolation & purification, Coronavirus Infections complications, Pandemics, Pneumonia, Viral complications, Renal Dialysis, Survivors
Abstract

We report the case of a 93-year-old woman on haemodialysis treatment for more than 30 months and with multiple comorbidities who recovered from a Covid-19 infection without any significant clinical problems. The patient has shown a delay in viral clearance with swab test negativization (confirmed) after 33 days; after testing positive again, she has resulted persistently negative, (confirmed after 49 days). After the first negative swab, IgG and IgM antibodies have been found; these have remained persistently positive after a month. As well as highlighting an unexpected resilience in an extremely fragile context, the analysis of this case draws attention to patients' management and, potentially, to the need to arrange dialysis treatments in isolation for some time after their "laboratory recovery"., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

Published
2020

4. [Membranous glomerulonephritis (MGN), ongoing studies].

Author

La Manna G, Baraldi O, Cunia V, Corradetti V, Aiello V, Busutti M, Gasperoni L, Spazzoli A, and Comai G

Subjects
Adrenocorticotropic Hormone therapeutic use, Adult, Antibodies, Monoclonal therapeutic use, Antibodies, Monoclonal, Humanized therapeutic use, Autoantibodies immunology, Autoantigens immunology, Bortezomib therapeutic use, Calcineurin Inhibitors therapeutic use, Clinical Trials as Topic, Complement Activation, Cyclophosphamide therapeutic use, Glomerulonephritis, Membranous complications, Glomerulonephritis, Membranous epidemiology, Glomerulonephritis, Membranous immunology, Humans, Immunosorbent Techniques, Multicenter Studies as Topic, Nephrotic Syndrome etiology, Observational Studies as Topic, Podocytes immunology, Randomized Controlled Trials as Topic, Receptors, Phospholipase A2 immunology, Rituximab therapeutic use, Glomerulonephritis, Membranous drug therapy
Abstract

The membranous nephropathy (MN) is the major cause of nephrotic syndrome in in the adult, account for 20% of cases with annual incidence is 1 in 100.000. In the past 10 years, the role of podocytes has been identified; environmental triggers in genetically predisposed patients can activate podocytes to exhibit antigenic epitopes (receptor of phospholipase A2, thrombospondin type 1) that become targets of specific autoantibodies with subsequent complement activation. The discovery of this mechanisms has opened new horizons in the therapy of MN and novel drugs are available with more specific mechanism of action. Rituximab, a monoclonal antibody directed against CD20 expressed by lymphocytes B, has been used in several trials and appears able to induce remission of nephrotic syndrome in 60% of patients (GEMRITUX trial) with similar risk profile. Nowadays it remains to define the most effective therapeutic pattern. In MN, the concept of targeting disease control, has permit novel therapies with specific blocking mechanisms (belimumab) and non-specific (ACTH) and new therapeutic options, such as ofatumumab, bortezomib and eculizumab, that have allowed to recognize pathological processes involved in the glomerular diseases., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

Published
2017

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