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Biomedical subjects

G Ruggieri

Publications and source records attributed to G Ruggieri.

At least 37 records · Page 2Linked to original sources

Cytomegalovirus infection with multiple colonic perforations in a renal transplant recipient.

Cytomegalovirus (CMV) continues to be potentially the most important pathogen affecting organ transplant recipients. Severe gastrointestinal complications have been reported to occur in about 10% of renal transplant recipients, sometimes with dramatic presentations. We report the case of a 57-year-old CMV-seropositive woman with end-stage renal failure who developed CMV-related colonic multiple perforation 30 days after cadaveric CMV-positive renal transplantation. CMV pp65 antigenemia test and CMV-PCR had always been negative on all the weekly controls routinely performed in the postoperative period. Only after the sudden onset of this complication did the antigenemia and PCR become positive. The relationship between infection and perforation has been established beyond any doubt, as the histology of the resected colonic segment revealed florid CMV infection with evidence of typical inclusions in both macrophages and endothelial cells. Colonic perforations are often fatal in transplant recipients because of inability to contain the perforation, and only a rapid diagnosis and an aggressive surgical treatment can improve the prognosis.

Antiviral Agents↗

Daily use of the physio dialysis system: long-term experience.

BACKGROUND: Hypovolaemia has been implicated as a major causal factor of morbidity during haemodialysis (HD). In order to avoid the appearance of destabilising hypovolaemia a biofeedback control system for intra-HD blood volume (BV) change modelling has been developed (Hemocontrol, Hospal Italy). It is based on an adaptive controller incorporated into a HD machine (Integra, Hospal Italy). The Hemocontrol biofeedback system (HBS) monitors BV contraction during HD with an optical device; furthermore, HBS modulates BV contraction rates (by adjusting the ultrafiltration rate--UFR) and the refilling rate (by adjusting dialysate conductivity--DC) in order to obtain the desired pre-determined BV trajectories. METHODS: Nineteen patients prone to hypotension (7 males, 12 females, mean age 64.5 +/- 3.0 SEM years, on maintenance HD for 80.5 +/- 13.2 months) volunteered for the prospective study which aimed to compare the efficacy and safety of bicarbonate HD treatmentequipped with HBS, as a whole (HBS),with the gold standard, bicarbonate treatment, equipped with a constant UFR and DC (BD). The study included one period of 6 months of BD always preceding a follow-up period of HBS treatment ranging from 14 to 30 months (mean 24.0 +/- 1.6). RESULTS: The overall occurrence of symptomatic hypotension and muscle cramps was significantly less in HBS treatment. Self-evaluation of intra- and inter-HD symptoms (the worst score was o and the best one 10) did reveal a statistically significant difference, as far as post-HD fatigue is concerned (6.2 +/- 0.2 in HBS vs. 4.3 +/- 0.1 in BD treatment, p < 0.0001). No difference between the two treatments was observed when comparing pre- and post-HD lying blood pressure, heart rate, body weights and body weight changes. CONCLUSIONS: HBS is an effective treatment. Hypovolaemia-associated morbidity occurs less in BD treatment than HBS. Furthermore, HBS is a safe treatment in the medium-term because these results are achieved without potentially harmful changes in blood pressure, body weight and serum sodium concentration.

Bicarbonates↗

[Health education].

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Environmental Health↗