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Biomedical subjects

C Castelnovo

Publications and source records attributed to C Castelnovo.

32 records · Page 2Linked to original sources
PubMed1990

Long-term incidence of peritonitis in CAPD patients treated by the Y set technique: experience in a single center.

Our experience of peritonitis in 156 patients over an 8-year period represents 186 episodes of peritonitis and 4,964 patient-months of CAPD. The incidence of peritonitis was significantly greater (1 episode every 8.6 patient-months) when the Oreopoulos technique was used and dropped to 1 episode every 43.3 patient-months when the Y set system was used. Of the 109 patients using the Y set system, 88 (80.7%) never had episodes of peritonitis, whereas only 7 (16.7%) of the 42 patients using the Oreopoulos technique were free of peritonitis. For 23 patients shifted from the Oreopoulos to the Y set technique, the incidence of peritonitis dropped from 1/9.8 to 1/35.2 episodes/patient-months.

Bacterial Infections↗
PubMed1990

Staphylococcus aureus exit-site and tunnel infection in CAPD.

Fifty-six S. aureus episodes of catheter exit-site tunnel infections were diagnosed in 40 out of 163 patients treated by CAPD for 30 +/- 22 months, with standard double-cuff Tenckhoff catheters. The rate of infection was 1 episode every 29 patient/months. Local care and antibiotic therapy were effective in 52% of the cases. Whereas in 29 episodes in which the medical therapy failed to eradicate the infection the entire area of granulation tissue and cellulitis was excised then the outer dacron cuff was shaved from the silicone catheter. With this treatment 13 episodes (48%) were cured while, in the remaining 14 patients the catheters were removed because of peritonitis in 10; and for failure to eradicate the infection in 4.

Catheters, Indwelling↗
PubMed1990

Clinical significance of peritoneal dialysate IgG levels in CAPD patients.

To assess the normal range and the clinical significance of peritoneal IgG, the levels of these proteins were measured in 24 hour dialysates of 69 patients. The mean + SD of IgG levels was 7.2 +/- 4.3 mg/dl. Two patients had peritoneal IgG concentrations below and 6 above the mean +/- SD range. There were no significant correlations between peritoneal IgG levels and sex, previous hemodialysis, age, time of dialysis, number of peritonitis or estimated daily protein intake. In 29 of these patients dialysate IgG levels measured again one year later did not show significant differences between the first and the second determination of IgG (from 6.3 +/- 3.3 to 6.6 +/- 3.2 mg/dl), but changes of 10% or more were observed in 14 of these patients. Our data show no relation between peritoneal IgG and peritonitis episodes. Therefore by these results dialysate IgG cannot be used as a reliable index to decide which patients are at high risk for peritonitis.

Cross-Sectional Studies↗
PubMed1989

Beta-2 microglobulin in patients on peritoneal dialysis and hemodialysis.

Serum beta 2 microglobulin (beta 2 mu) levels were determined in 62 patients on chronic dialysis, divided according to the type of dialysis--cuprophane hemodialysis, chronic ambulatory peritoneal dialysis (CAPD), or CAPD started after 76 +/- 47 months on cuprophane hemodialysis--and to residual urine output greater than 400 mL/day or less than 10 mL/day. In addition, for patients on CAPD, peritoneal excretion, peritoneal clearance, and urinary excretion of the protein were determined. In anuric patients serum beta 2 mu levels were significantly higher in HD than in CAPD. In patients with residual urine output, serum concentrations of the microprotein were similar in HD and in CAPD. Significant differences were observed in beta 2 mu serum levels and peritoneal clearances in patients switched to CAPD from hemodialysis as compared to those starting with CAPD. Peritoneal clearances of the microprotein was slightly and non-significantly greater in patients with urine output than in anuric patients.

Amyloidosis↗
PubMed1989

Phosphatidylcholine administration in continuous ambulatory peritoneal dialysis (CAPD) patients with reduced ultrafiltration.

To evaluate the possible role of oral phosphatidylcholine administration in improving peritoneal ultrafiltration sixteen continuous ambulatory peritoneal dialysis (CAPD) patients with a reduced ultrafiltration rate (less than 500 mL/4 h after a standard 3.86% glucose exchange) were studied. Three patients spontaneously stopped phosphatidylcholine due to gastric side effects. Three out of the remaining 13 patients showed a mild increase of standard ultrafiltration, which was not followed by any increase in daily dialysate output. No differences in glucose, sodium, potassium, urea and creatinine equilibration curves were seen. In conclusion, in our series oral phosphatidylcholine is not free of side effects, and its efficacy in improving ultrafiltration is scanty, with no clinical relevance in increasing daily ultrafiltration.

Administration, Oral↗
PubMed1988

Intermediary metabolism and glycemic control in insulin-dependent diabetic uremic patients treated by continuous peritoneal dialysis.

The effect on metabolic control and on intermediate metabolism of continuous ambulatory peritoneal dialysis (CAPD) was evaluated in 6 insulin-dependent diabetic uremic patients treated by CAPD, in 6 nondiabetic uremic patients in CAPD and in 6 normal subjects. During the study, 4 dialysis exchanges with 1.36 g/dl dextrose concentration were performed daily; regular insulin was added to the bags in diabetic patients. Our data show a well-controlled mean blood glucose in CAPD diabetic patients by intraperitoneal insulin administration as well as higher insulinemic levels in comparison with those of normal subjects. Plasma lactate and serum glycerol levels were higher and butyrate levels were lower reflecting a continuous ketogenesis inhibition.

Adult↗
PubMed1985

High fluid intake or pharmacological therapy in recurrent stone former patients?

In order to evaluate whether therapy can reduce relapses of urinary stone formation, we have retrospectively analysed the long-term follow-up of 55 recurrent stone former patients either treated with high fluid intake and moderate low calcium and low oxalate diet alone (Group A 18 patients), or with the same dietetic advice plus hydrocholorothiazide, amiloride and allopurinol (Group B 37 patients). In group A, stone recurrence was completely abolished in 14 patients without hypercalciuria and hyperuricuria, but not in the four patients with hypercalciuria and hyperuricuria. In group B, no relapses were observed in 19 hypercalciuric and hyperuricuric patients during a cumulative follow-up of 91 years. Even if the other 18 patients had relapses during a cumulative follow-up of 89 years, they showed a significant decrease in stone/patient and stone/year rates. It is concluded that high fluid intake and diet can actually prevent stone recurrence in patients without hypercalciuria and hyperuricuria, but in hypercalciuric and hyperuricuric patients treatment with diuretic and allopurinol is better.

Allopurinol↗
PubMed1983

Relationship between sodium intake, proximal tubular function and calcium excretion in normal subjects and in idiopathic hypercalciuria.

Proximal tubular function was studied with maximal water clearance studies in 15 controls (C), 22 Ca stone formers with idiopathic hypercalciuria (IH) and 10 normocalciuric Ca stone formers (NC). Distal delivery of glomerular filtrate (ClDD) and Na excretion were higher in IH and NC than in C; NaCl loading (6 g/day) for seven days in C increased Na excretion and ClDD to similar levels as in IH and NC; the distribution of ClDD for any level of Na excretion was similar in C, NC and IH. NaCl loading in C slightly reduced renal phosphate threshold, which still remained higher than in IH on a free diet. It appears that reduced tubular reabsorption of glomerular filtrate in Ca stone formers is related to habitual high Na intake and is not peculiar to hypercalciuric patients. Habitual high Na intake is unlikely to be responsible for all the metabolic spectrum of idiopathic hypercalciuria.

Adolescent↗
PubMed1983

Acetohydroxamate in struvite stones: in vivo study.

This report describes the results obtained with a combination of acetohydroxamic acid (AHA) and antibacterial agents in 13 patients with recurrent struvite stones complicated by refractory infections with urease-producing bacteria. Intravenous antibiotic pulses plus oral AHA achieved urine sterilisation in all. Then oral chemotherapy plus AHA was given for a mean period of 10.8 +/- 5.4 months. In four patients, the urine remained sterile, but in all the patients urinary pH remained below 6.4 and urinary NH4+ below 40 mg/dl. Despite the persistence of urea-splitting bacteria, the radiographic data showed an arrest of stone growth during the first year of treatment.

Anti-Bacterial Agents↗
PubMedDate not supplied

Comparison of three different tests for assessment of hepatitis C virus in dialysis patients.

OBJECTIVE: To evaluate the relationship between hepatitis C virus antibodies (HCV-Ab) and viremia and to compare the prevalence of HCV-Ab and HCV viremia in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. DESIGN: Cross-sectional study. SETTING: Dialysis unit of a nephrology division in a public university hospital. PATIENTS: All dialysis patients who came for routine clinic visits during the study period. None denied informed consent. Forty-eight patients on HD and 79 on CAPD were examined. INTERVENTION: Blood samples were tested by second-generation enzyme-linked immunosorbent assay (ELISA II) and recombinant immunoblot assay (RIBA II) to look for HCV-Ab and by the polymerase chain reaction (PCR) to look for HCV viremia. RESULTS: ELISA II was positive in 52% of HD patients and in 14% of CAPD patients. RIBA II was positive in 48% of HD patients and in 11% of CAPD patients. HCV viremia was positive by PCR in 41.6% of HD patients and in 12% of CAPD patients. Two of these PCR-positive patients did not show HCV-Ab by ELISA II and RIBA II. The sensitivity and specificity of ELISA II were 93% and 92%, the sensitivity and specificity of RIBA II were 86% and 94%. CONCLUSIONS: Our data confirm a higher prevalence of HCV viremia in HD than in CAPD patients. The absence of Ab against virus C in 2 patients positive with PCR might be due to recent HCV infection or to weak virus replication or to a poor immune response.

Alanine Transaminase↗