Enzymuria in carboplatin nephrotoxicity

Urinary excretion of N-acetyl-beta-glucosaminidase (NAG) is an early marker of nephrotoxicity. NAG activity was assayed by the fluorimetric method of Leaback and Walker in 17 patients treated (22 courses) with carboplatin (CBDCA, 220-550 mg/m2) before infusion and 24, 48, 72 and 96 h after. Increased excretion of NAG, a sensitive index of renal tubular damage, was observed following 10 of the 22 courses. A transient increase in plasma creatinine and/or abnormal proteinuria was observed in 6 cases. Impaired renal function prior to therapy seems to be a predisposing factor to the nephrotoxicity.     

Evaluation of a screening test for detection of IgA antigliadin antibodies in coeliac disease

The reliability of antigliadin antibodies of IgA and IgG classes for the diagnosis and follow-up of coeliac disease was evaluated by ELISA tests. Forty coeliac patients, 41 patients with other gastrointestinal diseases and 50 healthy subjects were studied. IgA antigliadin antibodies were detected in all patients on unrestricted diet and in those on a challenge with a gluten-containing diet. A low incidence of positivities was found in patients on a gluten free-diet, while no positivity was found in controls or gastrointestinal patients. IgG determination, in contrast, showed poor specificity. Our data suggest that a positive IgA antigliadin test may be a reliable marker for the presence of active coeliac disease, which should be confirmed by intestinal biopsy; it is, moreover, a good marker for monitoring patients, since elevated values might suggest non-compliance with the diet.     

Clobetasol vs. testosterone in the treatment of lichen sclerosus of the vulvar region]

The paper describes a study carried out in 40 patients affected by lichen sclerosus (LS) of the vulva. The mean age of patients was 60.9 years (range 27-83) and 31 were in menopause. Patients were divided randomly into two groups of 20. The symptoms (itching, burning, pain, dyspareunia), clinical aspects (atrophy, hyperkeratosis, sclerosis) and histological alterations (atrophy of the epithelium, edema, inflammatory infiltrate, fibrosis) were quantified in each patient by a score. The mean scores relating to the three parameters examined were then calculated for each group. One group was treated with testosterone propionate 2% and the other with a strong synthetic corticosteroid, clobetasol dipropionate 0.05%. After 24 weeks of treatment patients were again evaluated in relation to clinical (symptoms and clinical aspects) and histological parameters, following the procedure used before the start of treatment. The mean scores obtained were then compared with those before the start of treatment. Statistical analyses were performed using Student's t-test. Testosterone was found to be effective in relation to symptoms but no significant change was observed in relation to clinical aspects and histological alterations. It also caused major secondary effects which led to the suspension of treatment in one patient. Clobetasol was shown to be highly effective both in relation to symptoms and in terms of clinical aspects and histological alterations, and did not cause any noteworthy collateral effects, especially contact dermatitis. In the context of the objective parameters examined in this study, sclerosis and hyperkeratosis were easily modified by corticosteroid treatment in comparison to atrophy, especially in those patients with a longer duration of disease.(ABSTRACT TRUNCATED AT 250 WORDS)