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Biomedical subjects

D Docci

Publications and source records attributed to D Docci.

At least 55 records · Page 3Linked to original sources

Detection of glomerular bleeding by urinary-red-cell-size distribution.

Midstream urine specimens from 60 consecutive patients with hematuria were examined with an autoanalyzer to determine whether the source of bleeding could be predicted on the basis of the size distribution of urinary red blood cells. In 54 patients a definite diagnosis was made which correlated with the urinary-red-cell-size distribution in 93.7% (15/16) of cases for whom hematuria was considered to be glomerular and in 100% (38/38) of cases of nonglomerular hematuria. It is concluded that this method can greatly help the clinician in distinguishing between glomerular and nonglomerular bleeding in patients with hematuria and channeling such patients towards the most appropriate investigations.

Erythrocytes↗

Effect of different dialyzer membranes on serum angiotensin-converting enzyme during hemodialysis.

The effects of different dialyzer membranes on serum concentration of angiotension-converting enzyme (ACE) and white blood cells during hemodialysis were examined on a cross-over basis in 20 chronically uremic patients. Hemodialysis with cuprophane membranes was associated with a significant (p less than 0.001) fall in the mean leukocyte count during the 1st hour of treatment. The use of polymethylmethacrylate membranes resulted in a more attenuated form of leukopenia and with polyacrylonitrile membranes no change was observed during hemodialysis. Hemodialysis with each membrane caused a comparable, significant (p less than 0.005) increase in serum ACE, independent of the degree of leukopenia but significantly (p less than 0.001) correlated with the increases in serum proteins. We conclude that this increase in serum ACE concentration after hemodialysis does not reflect acute damage of the pulmonary vascular endothelium during treatment and most probably is a result of hemoconcentration. Therefore, serum ACE analysis is not an indicator of dialyzer membrane biocompatibility.

Acrylic Resins↗

Serum CA 19-9 and CA 50 antigens in hemodialysis patients.

Serum concentrations of monoclonal antibody-defined tumor markers CA 19-9 and CA 50 were measured in 64 uncomplicated hemodialysis patients (Group 1) and in 8 hemodialysis patients with cancer (Group 2) in comparison with corresponding CEA determinations. From our results in Group 1 patients it appears that both CA 19-9 and CA 50 maintained an excellent specificity in these patients. As to the sensitivity of these tests, our findings in Group 2 patients are comparable with those reported in patients with cancer and normal renal function. It is concluded that, unlike CEA, these new tumor markers maintain their clinical value in chronic renal failure.

Adult↗

Successful declotting of arteriovenous grafts with local infusion of urokinase in hemodialyzed patients.

Local infusion of urokinase was used in 15 cases of thrombotic occlusion of polytetrafluoroethylene grafts in 10 hemodialyzed patients. The treatment was successful in all patients except one in whom recurring thrombosis occurred because of junctional stenosis at the venous anastomosis. No relevant side effects were observed. Follow-up data show that such treatment can significantly prolong the survival of arteriovenous grafts in hemodialyzed patients with otherwise difficult access to the circulation.

Adult↗

Lack of evidence for the role of secondary hyperparathyroidism in the pathogenesis of uremic thrombocytopathy.

The possible relationship between platelet dysfunction and secondary hyperparathyroidism (HPT) in chronic renal failure was examined in 23 uremic patients on conservative therapy (group I) and in 27 patients on maintenance hemodialysis (group II). Platelet function was assessed by measuring the degree of aggregation in response to various concentrations of adenosine diphosphate. Secondary HPT was evaluated by means of serum biochemistry (parathyroid hormone, calcium, phosphorus, and alkaline phosphatase) and radiographic examinations (x-ray films of the hand skeleton). This study showed impaired platelet aggregation in group I patients, compared to either group II patients or controls. There were no significant differences when group II patients were compared to controls. No significant correlations between platelet aggregation and the hematochemical changes associated with secondary HPT were found. No differences in platelet aggregation were found with regard to the activity (alkaline phosphatase) and the severity (x-ray findings) of secondary HPT. Effective treatment of secondary HPT with 1,25-dihydroxycholecalciferol in both group I and group II patients was not associated with consequent changes in platelet aggregation. It is concluded that secondary HPT is probably not a major factor in the pathogenesis of platelet dysfunction in chronic renal failure.

Adenosine Diphosphate↗

Effect of ibopamine on the progression of chronic renal failure.

Persistent changes in the slope of the reciprocal of serum creatinine concentration against time after medical intervention are likely to reflect the influence of therapy on progression of chronic renal failure. This observation allowed us to demonstrate the ability of ibopamine, a new orally active dopamine-related drug, to improve renal function or at least to slow its deterioration in 20 patients studied over a period of 6 months. We also noted that the therapeutic response to the drug varied considerably according to the nature of the underlying nephropathy, with maximal benefit being observed in nonglomerular diseases.

Adult↗

Serum alpha-1-acid glycoprotein in chronic renal failure.

We measured the serum concentration of alpha-1-acid glycoprotein (AAG) in 30 healthy subjects (controls), in 54 patients with various degrees of residual renal function (group I), and in 98 patients in the terminal phase of chronic renal failure (CRF) on both conservative and dialytic therapy (group II). A positive correlation between the logarithm of serum AAG and serum creatinine levels was found in group I. Serum AAG increased significantly when serum creatinine rose above 10 mg/dl. This fact would indicate that a retention of the substance occurs as the renal function falls. The mean serum concentration of AAG was significantly higher in group II patients, with no difference between those on conservative therapy and those on maintenance hemodialysis. However, levels above normal were present in only a minority of cases. We conclude that the serum AAG measurement maintains its diagnostic value as an acute phase reactant also in the terminal phase of CRF.

Adult↗

Lack of relation between secondary hyperparathyroidism and red blood cell osmotic fragility in chronic renal failure.

The possible relationship between red blood cell (RBC) osmotic fragility and secondary hyperparathyroidism (HPT) in chronic renal failure was examined in 23 uremic patients on conservative therapy and in 42 patients on maintenance hemodialysis. Secondary HPT was evaluated by means of serum biochemistry (parathyroid hormone, calcium, phosphorus, and alkaline phosphatase) and radiographic examinations (X-ray films of the hand skeleton). This study showed increased RBC osmotic fragility in uremic patients when compared with controls, with no difference between those on conservative therapy and those on maintenance hemodialysis. No correlation between RBC osmotic fragility and the hematochemical changes associated with secondary HPT was found. No difference in RBC osmotic fragility was observed with regard to the activity (alkaline phosphatase) and the severity (X-ray findings) of secondary HPT. Effective treatment of secondary HPT by either pharmacological means (1,25-dihydroxycholecalciferol) or surgical removal was not associated with consequent improvement in RBC osmotic fragility. It is concluded that secondary HPT is probably not a major factor influencing RBC osmotic fragility in chronic renal failure.

Adult↗

[Hyperlipidemia in uremic patients in dialysis].

Serum concentrations of cholesterol, triglycerides, high density lipoprotein-cholesterol (HDL-C), apoproteins (apo) A and B were compared in 36 hemodialysis patients and in 20 normal controls. Hyperlipidemia was present in 22 patients (59.4%); 15 of them had simple hypertriglyceridemia and 7 had combined hyperlipidemia (i.e., hypertriglyceridemia and hypercholesterolemia). All hemodialysis patients, whether normo- or hyperlipidemic, had normal apo A and low HDL-C serum concentrations. Positive risk factors for atherosclerosis other than low HDL-C (high serum apo B concentration and low apo A/apo B ratio) were present in hyperlipidemic patients only, with no difference between those with simple hypertriglyceridemia and combined hyperlipidemia. These results suggest that the risk for atherosclerosis related to lipid abnormalities may be considered as substantial in hyperlipidemic hemodialysis patients, but not in normolipidemic ones, regardless of the cholesterolemic values.

Adult↗

Osmotic fragility of erythrocytes, cell deformability and secondary hyperparathyroidism in uremic patients on maintenance hemodialysis.

The possible relationship between erythrocyte (RBC) function and secondary hyperparathyroidism (HPT) was examined in 35 uremic patients on maintenance hemodialysis. Mechanical tests (i.e., osmotic fragility and deformability) were used to assess RBC function. Secondary HPT was evaluated by means of serum biochemistry (parathyroid hormone, calcium, phosphorus, and alkaline phosphatase) and radiographic examinations (X-ray films of the hand skeleton). Sixteen sex and age-matched normal volunteers acted as controls. This study shows that the mechanical properties of RBC were indeed markedly altered in hemodialysis patients when compared with controls. No significant correlations between either the osmotic fragility or the deformability of RBC and the hematochemical changes associated with secondary HPT were found. No differences in RBC function tests were found as far as the activity (alkaline phosphatase) or the severity (X-ray findings) of secondary HPT are concerned. Effective treatment of secondary HPT by either pharmacological means (1,25-dihydroxycholecalciferol) or surgical removal was not associated with consequent improvement in RBC function. These findings clearly speak against secondary HPT as a major cause of RBC dysfunction in uremic patients on maintenance hemodialysis.

Adolescent↗

Red blood cell deformability and secondary hyperparathyroidism in uremic patients on maintenance hemodialysis.

The possible relationship between red blood cell (RBC) deformability and secondary hyperparathyroidism (HPT) in 23 patients on maintenance hemodialysis was examined. Secondary HPT was evaluated by means of serum biochemistry (parathyroid hormone, calcium, phosphorus, and alkaline phosphatase) and radiographic examinations. This study showed that RBC deformability is markedly reduced in hemodialyzed patients when compared with normal controls. No significant correlation between RBC deformability and the hematochemical changes associated with secondary HPT was found. No difference in RBC deformability was observed as far as the activity (alkaline phosphatase) and the severity (radiographic findings) of secondary HPT are concerned. Effective treatment of secondary HPT by either pharmacological means (1 alpha, 25-dihydroxycholecalciferol therapy) or surgical removal was not associated with consequent improvement in RBC deformability. It is concluded that secondary HPT is probably not a major factor influencing RBC deformability in uremic patients on maintenance hemodialysis.

Adult↗