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Biomedical subjects

C Feletti

Publications and source records attributed to C Feletti.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Diagnostic imaging for the study of popliteal masses in dialyzed patients].

A new type of amyloidosis, secondary to the massive deposition of beta 2-microglobulin, has been identified which is peculiar to long-term (greater than or equal to 5 years) hemodialysis. Popliteal masses have recently been described as a possible manifestation of this type of amyloidosis. We report the results of a clinical-radiologic study of the popliteal region in 28 patients (14 males, 14 females; age 52.9 +/- 12.6 years) undergoing chronic hemodialysis for 60-212 months (mean 127 +/- 40). We aimed at determining the role of diagnostic imaging (conventional radiography, ultrasonography, Computed Tomography) in this pathologic condition. Clinics detected popliteal masses in 4 patients (bilateral in 1). US allowed 2 more cases to be detected and demonstrated the cystic nature of the lesion. Ultimately, popliteal masses could be demonstrated in 6 (bilateral in 5) of 28 patients (incidence 21.4%). In the 3 patients who were investigated by CT, cysts were seen to communicate with the joint cavity (Baker's cysts). In 1 case, immunocytochemical analysis showed diffuse beta 2-microglobulin positive amyloid deposition within the synovial wall of the surgically removed cyst. All the 6 patients experienced some of the major features of dialysis-related amyloidosis: carpal tunnel syndrome (6 cases), destructive arthropathy (5 cases), carpal and shoulder bone radiolucencies (5 and 4 cases, respectively). These findings, while documenting the high prevalence of popliteal cysts among long-term hemodialysis patients and the strong correlation with dialysis-related amyloidosis, stress the importance of diagnostic imaging in the detection and follow-up of such lesions.

Adolescent↗
PubMed1990

Elevated serum levels of C-reactive protein in hemodialysis patients.

Serum C-reactive protein (CRP) levels were measured by nephelometry in 30 healthy subjects (controls) and in 99 patients with uncomplicated terminal uremia on conservative therapy (group 1, n = 30) or chronic hemodialysis (group 2, n = 69). Whereas there was no difference between controls and group 1, both the mean concentration of CRP and the incidence of elevated levels were significantly higher in group 2 in comparison with both controls and group 1. Moreover, the degree of increase in these patients was directly correlated with the duration of hemodialysis. The abnormality, therefore, is somehow related to chronic hemodialysis per se. From a practical standpoint, we concluded that this test cannot be recommended as an acute-phase reactant in this clinical setting.

Adolescent↗
PubMed1990

Elevated acute phase reactants in hemodialysis patients.

The incidence of elevated acute phase reactants, measured by nephelometry, was examined in 69 otherwise uncomplicated hemodialysis patients in comparison with 30 healthy subjects. Increased C-reactive protein was found in 40.6% of the patients (p less than 0.001 vs controls) and the degree of increase was correlated with the duration of hemodialysis. Haptoglobin was increased in 33.3% (p less than 0.01 vs controls). High levels of alpha-1-acid glycoprotein and alpha-1-proteinase inhibitor were present in 15.9% and 2.9%, respectively; these frequencies were not significantly different from controls. No differences between pre- and postdialysis values were observed. It is concluded that, unlike C-reactive protein, both alpha-1-acid glycoprotein and alpha-1-proteinase inhibitor maintain an excellent specificity in hemodialysis patients. Vice versa, haptoglobin may be unreliable as an acute phase reactant in these patients because of the unacceptably high false-positive rate.

Acute-Phase Proteins↗
PubMed1990

Immune response to a recombinant hepatitis B vaccine in hemodialysis patients.

A 20-microgram dose of a recombinant hepatitis B vaccine was given at 0, 1, 2 and 6 months to 24 hemodialysis patients. From month 7 (i.e., 1 month after the fourth injection), 58.3% (14/24) of the patients had developed protective levels of antibodies against hepatitis B surface antigen (anti-HBs). In patients responding to vaccination, the fourth injection led to an abrupt rise of the anti-HBs titres which reached their maximum 2 months later, that is, in month 8. At that time, the geometric mean titre of anti-HBs was 145.79 mlU/ml. Eighteen months after the start of vaccination, 50% (12/24) of the patients were maintaining protective levels of anti-HBs antibodies. It is noteworthy that these results could be obtained with a considerably lower dosage than previously recommended.

Female↗
PubMed1990

[Significance of serum levels of beta-2-microglobulin in dialysis patients].

beta 2M has been shown to be a major constituent of the amyloid deposits developing in uremic patients undergoing long-term hemodialysis. In this study, serum levels of beta 2M were determined in 67 hemodialysis patients and a mean +/- SD concentration of 57.8 +/- 18.5 mg/L was obtained. There was no difference in the concentration of the substance between the patients with evidence of dialysis-related amyloidosis and those without it. Moreover, no correlation between beta 2M levels and duration of hemodialysis was found. Interestingly, the patients with residual diuresis had a significantly lower mean beta 2M concentration than the anuric patients (35.0 +/- 13.1 vs 62.8 +/- 15.8 mg/L, p less than 0.001). Not surprisingly, a significant decrease in the predialysis serum concentration of the substance was obtained after changing treatment from cuprophan hemodialysis to hemodialysis with high-permeable membranes (delta beta 2M = -16.1 +/- 14.4 mg/L at month 6, p less than 0.01). These results suggest the possible long-term use of these membranes to reduce risk of dialysis-related amyloidosis.

Adult↗
PubMed1985

Hormonal abnormalities in renal transplantation.

It is generally maintained that the variety of endocrine disorders which occur in uraemia and persist in dialysis (above all hormones whose production and/or metabolic clearance are pertinent functions of the kidney) usually abate after successful renal transplantation. However, a retrospective analysis of long-term results in 71 out of 275 cases serially studied by regular checks, indicates that this event occurs in no more than 2/3 of successfully transplanted patients. In the other patients various endocrine abnormalities may be documented: some seem apparently 'inherited' from uraemia (hyperparathyroidism, sexual dysfunction, growth retardation); some are mainly related to steroids (hyperinsulinism), and some have a de novo origin (erythrocytosis, reno-vascular hypertension). These endocrine abnormalities may occur with a normal or reduced graft function, have a baseline or stimulated expression, a clinical or subclinical course, and a reversible or irreversible outcome. A proper grasp of these events in renal transplantation is of clinical significance particularly for the long-term patient and graft prognosis.

Adult↗
PubMed1984

Early dialysis.

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Humans↗
PubMed1982

Serum antibody profile against herpesviruses in renal transplant recipients.

Forty-eight renal allograft recipients who had received a kidney graft 2 months to 8 years previously, were followed for the presence of serum antibody against Cytomegalovirus (CMV), Epstein-Barr virus (EBV), Herpes simplex virus (HSV), and Varicella-Zoster virus (VZV). These investigations were performed over a 6 months period and in at least two serum samples from each patient, obtained at intervals of 2-3 months. The presence of serological signs of recent or active infection were observed in 31 patients for CMV, in 22 patients for EBV (18 patients were positive both for CMV and EBV) and only in 3 patients for HSV, while no patients showed serological signs of recent or active infection by VZV.

Adolescent↗
PubMed1982

Progression rate of residual renal function in conservative treatment and early dialysis.

A retrospective comparative study was carried out in patients with chronic renal failure on conservative treatment (26 cases) and early dialysis (23 cases). The two groups were well matched for age, sex, etiology of renal disease and residual Ccr. In contrast with other papers, patients on dialysis showed a gentler deterioration rate of residual renal function than those on conventional low protein diet regimen. Between the two groups statistically significant differences concerned the control of blood pressure, serum phosphate and uric acid.

Adolescent↗
PubMed1980

Atherosclerosis in uremia: a longitudinal study.

The ways by which uremia may lead to atherosclerosis are still unknown. Furthermore, whether atherosclerosis is accelerated with prolonged hemodialysis is still under debate. The results of a longitudinal study carried out in 47 selected patients who were treated first with dietary regimen followed by dialysis and then transplantation indicate: 1) The longer the duration of uremia on low protein diet, the worse are the clinical and metabolic problems of atherosclerosis. 2) In subsequent regular dialysis treatment 2 distinct clinical and metabolic pictures may emerge, slowly progressive or comparatively accelerated, according to whether dialysis is initiated early or late. 3) In subsequent transplantation the avoidance of risk factors largely depends on the time at which regular dialysis begins. 4) Early direct transplantation without dialysis proves similar to transplantation in patients treated with early dialysis as far as prevention of accelerated atherosclerosis is concerned.

Angiotensin II↗