Xylitol as osmotic agent in CAPD: an alternative to glucose for uremic diabetic patients?
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Biomedical subjects
Publications and source records attributed to A Fracasso.
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The natural history of untreated coarctation of the aorta may be complicated by dissection or aneurysms of the ascending as well as of the descending thoracic aorta distal to the coarctation. We report a case of coarctation of the aorta in a young man associated to bilateral aneurysms of the subclavian arteries, one of which of great size. In a review of the most recent and largest series of adult patients undergoing surgery for aortic coarctation we were unable to find a similar case. In such a condition complete repair may be accomplished quite safely, preferably employing a multi-stage technique.
Despite the great impact of continuous ambulatory peritoneal dialysis (CAPD) as an effective modality of treatment for uraemic patients, two limiting factors remain: the high incidence of peritonitis and the need for patients continuously to carry a bag. We have designed a new closed system with two bags connected to the permanent Tenckhoff catheter. Two clamps alternately allow outflow and inflow of peritoneal dialysate. When the exchange manoeuvre is finished the patient frees the whole system from the needle and discards it. Since December 1978, 24 patients have been treated with this technique. The results are similar to the Toronto series with a marked reduction in the incidence of peritonitis (22.5 pt/months).
A new technical approach has been described for the treatment of patients on CAPD. The new approach is based on the use of a two-bag system and closed connection by a connector to the Tenckhoff catheter. After each dialyzate exchange the patient discards the entire system and is completely bag-free, unlike the Oreopoulos CAPD technique. Using this new procedure we have markedly reduced the incidence of peritonitis and we have made the patient free from carrying an uncomfortable burden during the interval of solution exchange.
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