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Biomedical subjects

D Docci

Publications and source records attributed to D Docci.

At least 73 records · Page 4Linked to original sources
PubMed1984

Hemodialysis-associated platelet loss: study of the relative contribution of dialyzer membrane composition and geometry.

To evaluate the relative contribution that dialyzer membrane composition and geometry make to hemodialysis-associated platelet loss, the effect of a single dialysis with three different types of dialyzers on platelet count was examined on a cross-over basis in 19 uremic patients on maintenance hemodialysis. Also, the plasma levels of antithrombin-iii before and after dialysis were measured, but no significant variations were found regardless of which dialyzer was in use. Our patients suffered significant platelet loss during cuprophan dialysis, but not polyacrylonitrile dialysis. More than 99% of initial circulating platelets were recovered at the end of polyacrylonitrile dialysis, whereas cuprophan dialysis did leave a significantly lower percentage of circulating platelets (p less than 0.05). The internal comparison of results obtained with the two cuprophan dialyzers used shows no difference as to the dialyzer geometry (flat plate or hollow fiber). This indicates that the membrane composition is the major factor influencing hemodialysis-associated platelet loss. We suggest that patients with low platelet count and/or with risk of bleeding may benefit from polyacrylonitrile dialysis.

Acrylic Resins↗
PubMed1984

[High levels of carcinoembryonic antigen (CEA) in the serum of uremic patients under hemodialysis treatment].

The serum concentration of CEA was measured twice, at intervals of 3 months, in 40 uremic patients on maintenance hemodialysis. None of them had evidence of malignancy or of any other non-malignant condition known to affect serum CEA. 111 normal adults acted as controls. The mean serum concentration of the substance was significantly higher in hemodialyzed patients (5.32 +/- 3.68 ng/ml) than in controls (1.98 +/- 1.1 ng/ml) (P less than 0.001). Levels above normal were present in 40% and in 4.5% of the cases respectively (P less than 0.0005). Comparable results were obtained at the second examination. No correlations with sex, age, underlying nephropathy, time on dialysis, or cigarette smoking were found. It is concluded that the measurement of CEA cannot be recommended as a reliable test in the screening of cancer among uremic patients on maintenance hemodialysis.

Adolescent↗
PubMed1983

Therapeutic response of idiopathic edema to captopril.

Idiopathic edema is a condition characterized by diurnal weight gain and intermittent swelling, affecting adult females without evidence of any other condition known to cause sodium retention. It has been suggested that an alteration in the aldosterone response to upright posture plays a pathogenetic role in orthostatic sodium and water retention peculiar to this syndrome. To test this hypothesis, the effect of captopril was evaluated in 4 women with idiopathic edema. The therapeutic response was impressive in all. In summary, we noted a remarkable decrease in morning to evening weight difference, an increase in both diuresis and natriuresis, and a definite symptomatic improvement. It is therefore possible to speculate that captopril, by reversing the basic abnormality acting in idiopathic edema, may prove of benefit in most patients with this peculiar syndrome.

Adult↗
PubMed1982

Long-term treatment of chronic renal insufficiency with Ibopamine (SB 7505), a new orally active dopamine-related drug.

When administered orally Ibopamine, the diisobutyric ester of N-methyldopamine, has pharmacological properties similar to intravenous dopamine: in particular, both renal blood flow and the urinary excretion of sodium and water increase. The drug also enhances creatinine clearance, both in normal subjects and in patients with impaired renal function. Twenty-eight patients affected with chronic renal insufficiency were treated with oral Ibopamine (100 mg/day) for 4-56 weeks. They were divided into 2 groups according to whether the creatinine clearance was more or less than 15 ml/min: Group 1 contained 21 patients (mean clearance 29.09 ml/min) and Group 2 7 patients (mean clearance 8.42 ml/min). Ibopamine treatment was ineffective in Group 2, while in Group 1 patients there was a statistically significant increase in creatinine clearance (+23% after 3 months, +31% after 6 months). Drug tolerance was excellent from both clinical and laboratory points of view.

Administration, Oral↗
PubMed1982

[The alpha-1-acid glycoprotein (alpha-1-ag) in serum of uremic patients in maintenance hemodialysis].

To evaluate the role, if any, of alpha-1-ag in the pathogenesis of dislipidemia in hemodialysis patients, serum alpha-1-ag levels were measured in 31 patients during maintenance hemodialysis. The mean serum alpha-1-ag concentration was higher in the dialysis patients (117.58 +/- 36.65) than in controls (98.32 +/- 19.5) (p greater than 0.05), with an unexplained significant difference between males and females (p less than 0.01). Serum alpha-1-ag levels were above normal in 6 patients (19.3%) and below normal in no one. A further significant increase in the mean alpha-1-ag concentration was observed following a single dialysis (132.19 +/- 37.12) (p less than 0.001). No correlation with dialytic age or underlying nephropathy was noted. Serum alpha-1-ag levels did not correlate with serum triglycerides, nor was there any difference between normotriglyceridemic and hypertriglyceridemic patients. Therefore it seems unlikely that a deficit in alpha-1-ag due to uremia per se or secondary to dialysis may have a role in pathogenesis of dislipidemia in uremic patients during maintenance hemodyalysis.

Adolescent↗
PubMed1982

[Serum ferritin and iron therapy in patients treated with periodic hemodialysis].

Serum ferritin, measured by radioimmunoassay in 65 dialysis patients (mean time of dialysis 38.9 months), was significantly higher (247.9 +/- 224.5 ng/ml) than in controls (p less than 0.001), inversely correlated with dialytic age (p less than 0.05), and had no difference as far as sex or underlying nephropathy were concerned. With regard to the other hematological parameters, serum ferritin correlated inversely with total transferrin and directly with percentage of total transferrin only. In 28 patients, an intravenous iron load (0.6 g in one month) induced a further increase in serum ferritin (p less than 0.001), rather disomogenous and not clearly correlated with initial levels. The change in hemoglobin concentration after iron administration was in close relationship with initial serum ferritin levels (r = -0,72, p less than 0.001). A significant increase in hemoglobin could be detected in all the patients with serum ferritin less than 65 ng/ml and in most patients with serum ferritin less than 160 ng/ml, while hemoglobin change was negligible when serum ferritin levels in dialysis exceeded this value. Thus, although serum ferritin levels in dialysis patients may reflect not only iron overload but also an abnormal metabolism, serum ferritin measurement remains a reliable guide to iron requirement. We suggest maintaining serum ferritin levels between 65 and 160 ng/ml, to avoid iron stores depletion and on the contrary, iron overload.

Adult↗
PubMedDate not supplied

[Pre-dialysis arteriovenous fistula results in better patency rate].

BACKGROUND: The timing of creation of the first permanent vascular access is crucial to the clinical history of haemodialysis patients. Our strategy is to create vascular access early enough to allow its maturation before the start of the treatment. METHODS: Aim of the study is to evaluate patency of primary A-V fistulas in patients treated between 1985 and 2000 in our dialysis unit. One hundred and thirty A-V fistulas created before haemodialysis treatment (range 10-540 days) and used at its beginning (pre-HD group) are compared with 74 A-V fistulas created and/or used after the start of the haemodialysis treatment (post-HD group). RESULTS: Pre-HD group fistulas resulted in higher patency rate than the post-HD group, immediately at the start of the treatment (94.6% vs. 86.5%, p<0.05), at 6 months (89.2% vs. 75.6%, p<0.025), at 12 months (84.5% vs. 64.6%, p< 0.005), at 24 months (77.2% vs. 54.8%, p< 0.005). CONCLUSIONS: A-V fistula is to be preferred in the choice of primary vascular access for chronic haemodialysis patients. It should be created early enough before the beginning of the treatment (when serum creatinine reaches 6 to 7 mg/dL). This planning avoids central venous catheter placement, preserves vessels and the choice of the best surgical option thus resulting in a better fistula survival.

Aged↗