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C Spisni

Publications and source records attributed to C Spisni.

At least 19 recordsLinked to original sources
PubMed2000

[Comparison of mammographic and industrial films in dialysis patients].

PURPOSE: To optimize the technique for radiographic studies of bone and joint damage in renal osteodystrophy. MATERIAL AND METHODS: Sixty-four patients with chronic renal failure on dialysis for 0-10 years, were divided into two homogeneous groups and submitted to two different radiographic examinations of the nondominant hand. Group A patients were examined with a conventional radiological unit and an industrial film and a conventional radiological unit with a mammographic film with a dedicated screen, while group B patients with a mammographic with an industrial film and a conventional radiologic unit with a mammographic film with a dedicated screen. The examinations were evaluated by three radiologists in a double-blind fashion. RESULTS: Bone conditions such as osteoporomalacia, trabecular rarefaction, channel enlargement and intracortical absorption were equally demonstrated by mammographic films and the mammograph with industrial films. The mammographic film was superior to the mammograph with an industrial film in 8 cases, comparable in 25 and inferior in 6, but when compared with the conventional radiological unit with an industrial film it was superior in 19 cases, comparable in 2 and never inferior. CONCLUSIONS: The industrial film without a screen combined with a mammograph is considered the gold standard to study fine bone alterations in renal osteodystrophy. However the conventional radiological unit with a mammographic film with a dedicated screen provides the same results with lower irradiation doses and can therefore be considered a good alternative.

Adult↗
PubMed1999

Low concentrations of glucose degradation products in peritoneal dialysis fluids and their impact on biocompatibility parameters: prospective cross-over study with a three-compartment bag.

The side effects of glucose degradation products (GDPs) in conventional peritoneal dialysis (PD) fluids are well described. Using the three-compartment bag concept--that is, in situ preparation of concentrated glucose solution into a standard ionic solution--a GDP-free solution can be processed. To investigate the possible impact of this product on biological and clinical parameters, we carried out a prospective cross-over study with 31 patients, comparing the short-term effects of conventional PD and GDP-free PD solutions. Classical peritoneal parameters and ultrafiltration rate did not change during the study. After three months and after six months with the three-compartment bag, cancer antigen 125 (CA125) concentration in overnight fluid increased significantly (p < 0.001) from 24.4 IU/mL to 44.4 IU/mL and 41.1 IU/mL respectively. CA125 decreased significantly (p < 0.01) to 21.7 IU/mL after three months with the conventional solution. No change in hyaluronan concentration was observed. A slight increase of procollagen III N-terminal peptide in overnight effluent with the GDP-free solution was followed by a significant reduction after three months with standard solution. In summary, our data show that the GDP-free PD fluid improves mesothelial cell mass and turnover even after a short-term period of three months. A better quality of PD solution is obtained by using the three-compartment bag.

Biocompatible Materials↗
PubMed1992

Serum epidemiological trial on the prevalence of the anti-cytomegalovirus antibodies in patients under substitutive treatment with hemodialysis and CAPD.

The detection of IgG and IgM anti-cytomegalovirus is very important when movements of serum transaminases are noted in absence of positivity for virus of hepatitis in uremic patients on substitutive treatment; in our patients, we have noted a positivity of 67% for the IgG class. Cytomegalic infection must be taken into consideration for the high parenteral transmissibility in addition to the high grade of immunodepression of uremic patients.

Adult↗
PubMed1988

Electrophysiological aspects of nervous conduction in uremia.

Some neurophysiological techniques have been employed in clinical nephrology to record abnormalities of nervous conduction in central and peripheral pathways. The electrical monitoring on the peripheral and central nervous systems has allowed the detection of uremic neural injury, the diagnosis of specific electrophysiological abnormalities, the evaluation of various treatments employed and the identification of those abnormalities that uremia can induce. A group of 156 subjects subdivided into four groups were examined: 100 healthy subjects (64 M, 36 F); 56 patients (21 glomerulonephritis, 14 pyelonephritis, 5 nephrolithiasis, 5 polycystic kidney, 4 nephroangiosclerosis, 7 undetermined) with chronic renal failure treated with a conventional low nitrogen diet (CLND, 0.6 g/kg b.w./d. of proteins), 8 of whom passed from CLND to a very low nitrogen diet supplemented with alpha-keto-analogues; a group of 22 of these 56 underwent a regular dialysis treatment for 12 to 15 hours/weekly for 40.5 +/- 10.2 months. Three patients of the CLND group and 13 patients underwent renal transplantation after a variable period of RDT. In the uremic patients we found different populations of motor unit potentials; a decreased MNCV was found in 35% of the CLND patients, RDT patients had slowed MNCV in 42%. The SNCV was compromised more frequently than the MNCV. An increased duration of evoked potentials was sometimes observed in CLND and RDT patients inducing us to consider this a hallmark of uremic syndrome. The alpha-keto-analogues and HD/HP treated patients showed an improvement in several features.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

The brainstem auditory evoked responses in Alport's syndrome.

Alport's syndrome is a "hereditary nephritis" associated with structural defects of basement membranes in kidneys, ears and eyes, with variable clinical expression. As the acoustic abnormalities are often subclinical, we studied the brainstem auditory evoked responses (ABR) and tonal audiometry in 12 patients (7 males, 5 females, mean age 32.50 +/- 16.70 years) with histologically documented renal lesions consistent with Alport's syndrome. ABR were used to document the altered acoustic-nerve conduction and transmission typical of the early stage of Alport's syndrome. In 11 patients (seven males, four females), we found bilateral delayed latency (I dx: 2.50 +/- 0.80 msec; III dx: 4.24 +/- 0.68 msec; V dx: 7.02 +/- 0.94 msec) and altered waveform I, III, V by ABR. By audiometry eight patients (six males, two females) showed a loss of medium-high tones, and this group included the patients with a negative ABR study. Therefore, the ABR is abnormal in Alport's syndrome; it may be positive in patients with normal tonal audiometry, usually all cochlear functions are grossly intact; the acoustic-nerve lesions in Alport's syndrome may precede the cochlear involvement and clinical hearing loss; the electrophysiological analysis does not identify the particular nervous structures involved in the acoustic pathways.

Adolescent↗
PubMed1985

Nucleotide deficit and functional platelet alterations in patients on regular dialysis treatment (RDT).

In RDT patients hemocoagulative changes are repeatedly found; of these the most important are platelets' functional defects. Biochemical and biophysical modifications responsible for this pathology have not been completely clarified. In 20 non-thrombocytopenic patients, dialyzed 3 times weekly for over 1 year, we evaluated, using standard methodology, platelet adhesivity and aggregation induced by collagen and ADP at varying dosages. All blood samples were collected after the longest interdialytic period and just before dialysis. At the same time we evaluated the basic metabolic pool and, after collagen stimulation, the intraplatelet functional storage pool of ATP and ADP. The dosages were obtained using simple, reproducible and modern bioluminescence technique, which utilises microorganism light emission (bioluminescence) due to the oxidation of the bacterial substrate by catalyzing enzyme (luciferase) (1251 Luminometer LKB). We compared this data with that obtained from 40 healthy subjects. In the patients examined, adhesivity and aggregation result altered. The intraplatelet content of all nucleotides in both pools is significantly reduced if compared to the control group. The ATP and ADP concentration of both metabolic and functional pools cannot be correlated to the following: serum creatinine, BUN, calcemia, PTH, Hb. On the contrary we found that basal metabolic ATP values are inversely related (p less than 0.01) to serum phosphate levels. An analysis of results of this preliminary study leads us to hypothesize that hyperphosphatemia could interfere with intraplatelet glycolysis inducing a reduction of intracellular ATP. As all platelet functions are ATP and ADP dependent, we could consider the nucleotide deficit a cause of "uraemic platelet" disfunction, not modifiable with RDT but perhaps only through an appropriate control of phosphate levels.

Adenosine Diphosphate↗
PubMed1985

Intraocular pressure (IOP) changes induced by regular dialysis treatment (RDT).

It has been long known that uremia and RDT could alter the optical fibers of the Central Nervous System: we also previously demonstrated the persistence of a delayed P100 wave evoked by Visual Potentials (VEPs) in RDT patients. Our present study evaluates changes in IOP during RDT and possible correlations between electrophysiological and tonometrical modifications. In twenty patients undergoing RDT (12 hrs/weekly, mean age 42.05 +/- 10.80 yrs) we performed, just before and immediately after the dialytic session the tonographic recordings and serum osmolality. The pre-dialysis IOP of all 20 patients ranged from 9.00 to 27.19 mmHg with a mean of 16.40 +/- 7.20. Serum osmolality predialysis was 326.10 +/- 5.72 mOsm/l and post-dialysis 290.33 +/- 2.95 mOsm/l. Our studies suggest a correlation between decrease in plasma osmolality and increase in IOP during dialysis. The effect of RDT on IOP depends on the balance between the rise in IOP with the reduction of the concentrations of "waste products" and the extracellular volume reduction associated with ultrafiltration. The elevation of IOP may be due to a decrease in post-dialysis outflow facility inducing an osmotic influx of water into the eye because of hyperosmolality of intraocular fluids. These continuous modifications may be partially responsible for the defective propagation and the delayed transmission documented by VEPs.

Adult↗
PubMed1985

Evoked potentials in uremia: basal and follow-up data.

Various EPs have been employed to disclose even early-stage central and peripheral nervous system damage in uremia. This approach also gives the possibility to follow up alterations of many sensory functions during the sequential stages of uremia. Fifty-three subjects (35 male and 18 female, mean age 42.20 +/- 5.50 yrs, conventionally low nitrogen diet treated, on dialysis or transplanted) were followed-up by recording the EPs every year for seven years. The P100 wave latency and amplitude of VEPs were recorded and found abnormal in about 70% of the examined visual systems. The auditory EPs were abnormal in 53% of the cases for the peak latencies, interpeak times and peak ratios. The somatosensory EPs showed in 75% of the cases an altered latency and morphology of the waves registered in the lumbar, cervical and cranial loci. There is evidence suggesting that evoked cerebral biorhythms may provide sensitive and objective indexes of cerebral function in uremia. The persistence of abnormalities disclosed by EPs follow-up confirm the reliability of this technique in evaluating neuro-pathologic uremic situations and in supplying optimal uremia therapies.

Adult↗
PubMed1982

New electrophysiological assessments for the early diagnosis of encephalopathy and peripheral neuropathy in chronic uraemia.

The clinical manifestations of neuropathy in chronic uraemia are late in occurring. However, at an early stage it is possible to detect damage to either the central or peripheral nervous system by means of modern electrophysiological investigation methods. We examined 29 patients with CRF (plasma creatinine 7.0 +/- 4.0 mg%) on conservative diet. The following electrophysiological tests were carried out at least once: Electroencephalogram (EEG), Electromyogram (EMG), Motor Nerve Conduction Velocity (MNCV), Sensory Nerve Conduction Velocity (SNCV), Visual Evoked Potentials (VEPs) using the pattern reversal transient stimulation method. At the same time the following blood tests were performed: BUN, creatinine, uric acid, glucose, cholesterol, triglycerides, lipid electrophoresis, total protein (electrophoretic method), Na, K, Ca, P, red cells blood count and PTH. MNCV, SNCV and VEPs appeared to slow down early, sometimes even where there were no clinical symptoms. In addition, there is a direct correlation with decreasing renal function. MNCV and SNCV were correlated directly, reciprocally although the compromise of SNCV appeared an earlier phenomenon. The significant direct correlation between MNCV, SNCV and serum PTH suggests that the latter has an important peripheral neurotoxic role. VEP recording permits detection of early abnormalities in the central nervous system with residual renal function values around 40%.

Adult↗