[Further studies of antidiuresis induced with carbamyldibenzoazapine and with ethyl parachlorophenoxyisobutyrate in diabetes insipidus].
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Biomedical subjects
Publications and source records attributed to A Novarini.
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A clinical case of clinostatic chyluria of unknown non-parasitic aetiology, is reported. Ascending pyelography showed the presence of lymphatic communications between right renal pelvis and homolateral lumbo-aortic lymph nodes. Aetiology, pathogenesis, prognosis and diagnostic tools of use in the syndrome are discussed. The problem of the possible lymphatic origin of benign proteinuria, in relation to anatomic considerations and to quality and quantity resemblances between individual protein fractions in chyluria and benign proteinuria encountered in the present case, is also discussed. In order to clarify the problem, emphasis is laid on the advisability of simultaneously studying urinary protein composition in postural chyluria and lipid composition in benign proteinuria.
Ten patients with progressive CRF were studied for the major indices of glycolipid metabolism during the first application of peritoneal dialysis. From the 2nd hour the concentration of dialysis fluid is 4.5g%, while the electrolyte content is unchanged. During treatment a constant increase of glycemia and insulinemia with a fall of plasma-free fatty acids and serum triglycerides was observed. The authors attribute such modifications to hyperglycemia and consequently to the high glucose of the dialysis bath.
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The main indices of glycolipid metabolism were examined during and after dialysis in 11 patients receiving chronic treatment. Each dialysis period lasted 3-4 hr and was carried out on alternate days with individual machines and Coil UF2, Coil UF100 and Dasco SP75 dialysers. The liquid contained 35 mEq/l sodium acetate and 2 g glucose and flowed at 500 cc/min. Heparin was injected in the arterial line in a single initial dose. During treatment, there was an increase in free fatty acids and a decrease in serum triglycerides. Blood sugar and insulin were unchanged. The first 4 hr after treatment were marked by decreased fatty acid and increased trigylceride values. Blood sugar and insulin were again constant. The part played by sodium acetate and heparin in these changes is discussed.
The behaviour of blood sugar, insulin plasma free fatty acids and glycerol was studied at various times after intravenous glucose loading in patients with chronic renal insufficiency and normal subjects. Conard's K (glycide assimilation) coefficient was also determined. A statistically significant difference was observed between the two groups in the case of the K values only. No difference was noted in the case of the other parameters. The existence of two distinct groups within the subjects with chronic insufficiency, one with normal and one with altered K values, was also noted. The main physiopathological mechanisms probably responsible for this are discussed. It is considered that glucose loading is less sensitive i.v. than per os in the study of glycolipid metabolism in chronic renal insufficiency.
The plasma concentration and urinary excretion after a single 500 mg dose of Aminosidine have been studied in 12 patients with different degrees of renal failure and 4 normal subjects. In normal subjects the plasma half-life is 2.47 hr; in patients with creatinine clearance (Ccr) of 30-60 ml/min, its 6.7 hrs.; in patients with Ccr of 10-30 ml/min, it is 16.7hrs.; in patients with Ccr less than 10 ml/min, it is 36.6 hrs. A dose of 0.5 g of Aminosidine should be given to normal subjects every 12 hr. When renal function is reduced, the interval (in hr) between doses should be the following: Ccr 60-40 ml/min: 19-28;Ccr 40-30 ml/min; 28-35; Ccr 30-20 ml/min: 35-47; Ccr 20-10 ml/min: 47; Ccr less than 10 ml/min: 76.
The present paper reports some aspects of glycolipid metabolism observed during and after dialysis of varying duration, and the effects of glucose content in dialysis fluid. Some substances used in dialysis interfere with glycolipid metabolism: heparin (Robinson and French, 1960; Wolff and Wolff, 1960); sodium acetate (Bloch, 1947; Ghosal et al, 1969; Mion et al, 1964); and glucose in high (Leonards et al, 1961; Mendelssonhn et al, 1967) or low concentrations (Drukker et al, 1964; Hagstam et al, 1969) or, more recently, completely eliminated (Alwall et al, 1970; Hubner et al, 1971).
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