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Biomedical subjects

G Sau

Publications and source records attributed to G Sau.

9 recordsLinked to original sources
PubMed2001

Predilution haemofiltration--the Second Sardinian Multicentre Study: comparisons between haemofiltration and haemodialysis during identical Kt/V and session times in a long-term cross-over study.

BACKGROUND: The potential superiority of various renal replacement treatment modalities consisting largely of convective mass transfer as opposed to primarily diffusive mass transfer, is still a matter of debate. The objective of the present study was to evaluate acute and long-term clinical effects of varying degrees of convection and diffusion in a group of 24 clinically stable patients with end-stage renal disease. METHODS: The patients were prospectively assigned to three consecutive treatment schedules of 6 months each: phase I (HF1) (on-line predilution haemofiltration)-->phase II (HD) (high-flux haemodialysis)-->phase III (HF2; as phase I). We used the AK100/200 ULTRA monitor (Gambro), which prepares ultrapure dialysis fluid for HD and sterile, pyrogen-free substitution solution for HF. The membrane (polyamide), fluid composition, and treatment time were the same on HF and HD. The targeted equilibrated Kt/V was 1.2 for both treatment modes, creating a similar urea clearance. RESULTS: Fifteen patients, mean age 62.8+/-8.4 years, completed the study according to the above conditions. Urea kinetics, nutritional parameters, and dry weight were similar in the three periods. The frequency of intra-treatment episodes of hypotension/patient/month was significantly lower on HF1 (1.24) and HF2 (1.27) than on HD (1.80) (P<0.04). It decreased progressively on HF1, then increased on HD, and decreased again during HF2. Patients had fewer muscular cramps on HF than on HD (P<0.03) and required significantly less saline and plasma expander during HF than HD sessions. The prevalence of inter-treatment symptoms, including fatigue and hypotension, was lower on HF than on HD (score difference P=0.04). Quality of life, determined by the Laupacis method in all three periods, showed a tendency towards improvement during the study, reaching the best values during HF2. CONCLUSIONS: HF has a progressive stabilizing haemodynamic effect, producing a more physiological cardiovascular profile than HD. This long-term effect, observed in stable patients treated under strictly identical conditions, is probably due to the mechanism of convection, and is different from the acute effect observed mainly in unstable patients.

Blood Flow Velocity↗
PubMed2000

Masseter muscle activity during vestibular stimulation in man.

Experimental data report that vestibular afferents affect trigeminal system activity. The aim of this work was to evaluate whether static vestibular stimulation affects the excitability of trigeminal motoneurons in man. In order to assess this, voluntary EMG activity of masseter muscles as well as duration and latency of the early and late components of EMG exteroceptive silent period were evaluated while keeping the subject in vertical position and during 20 degrees static tilt. The experiments were performed on ten adult subjects with no orofacial, neurologic and otologic disorders. Each subject sat on a chair, which kept the complex head-jaw-neck-trunk and the limbs securely fixed, in order to minimize any interference due to the activation of somatosensory and proprioceptive afferents from these districts. The subjects were instructed to contract masseter muscles at 25% of their maximum bite force and the isometric force monitoring was used as visual feedback. Exteroceptive silent period (ESP) of masseter EMG was elicited by electrically stimulating the inferior inter-incisal gum. Results showed that static vestibular stimulation induced asymmetrical responses on voluntary masseter muscle activity, which was reduced to 70.3 +/- 16.1% (mean +/- S.D.) of the control value during ipsilateral tilt and increased to 128.8 +/- 13.0% during contralateral tilt. The duration of the early (ESP1) and late (ESP2) silent periods was also affected: during ipsilateral tilt ESP1 and ESP2 duration increased to 130.0 +/- 3.5% and to 122.1 +/- 2.1% of control, respectively; during contralateral tilt it was reduced to 76.8 +/- 1.2% and to 83.0 +/- 1.7% of control, respectively. On the contrary, changes in latencies were not significant. These data evidenced an asymmetrical effect exerted on trigeminal motor activity by static tilt. Since the influence of all receptors which could be activated by static tilt, except that arising from the macular ones, was minimized in this study, it is likely that the observed effects, induced by static tilt on masseter muscle activity, were of macular origin.

Adult↗
PubMed1999

The usefulness of the somatosensory evoked potentials of the pudendal nerve in diagnosis of probable multiple sclerosis.

STUDY DESIGN: The aim of the study was to evaluate the sensitivity of pSEP in patients affected by probable MS. OBJECTIVES: Bladder dysfunction is the presenting symptom in 2% of patients affected by multiple sclerosis (MS) and may be present in up to 78% of them. Abnormalities of somatosensory evoked potentials of the pudendal nerve (pSEP) have been found by many authors in patients affected by clinically defined MS, but little is known of diagnostic reliability of pSEP in early stage of MS. METHODS: Sixteen patients, eleven females and five males, aged between 18 and 45 years old (mean age 28.9), affected by clinically probable MS, were studied. Six of them reported retention or urge incontinence. pSEP with P1 (P40) scalp wave was analyzed. All patients also underwent visual evoked potentials (VEP), SEP of median and tibial nerves (mSEP, tSEP), brainstem acoustic evoked potentials (BAEPs), MRI of the brain and cerebrospinal fluid (CSF) evaluation. Urodynamic study with simultaneous measurement of intravesical, intraurethral and abdominal pressures with external sphincter electromyography was performed. RESULTS: Abnormalities of the evoked potentials were found in all patients. Abnormalities of the pSEP were observed in all the symptomatic cases and in eight of the remaining ten patients; ten showed no responses from the scalp and four showed P1 increased latency. Urodynamic abnormalities were found in 12 patients and MRI showed demyelinating lesions in 13 patients and oligoclonal bands were found in eight of them. CONCLUSION: pSEP can be worthwhile as part of the initial diagnostic evaluation in patients affected by MS. It provides information of diagnostic relevance and plays a role in screening patients for urodynamic testing, which, however, is more specific for detecting urethrovesical dysfunctions and preventing urological complications.

Adolescent↗
PubMed1994

The skin response in evaluation of the sympathetic chains after retroperitoneal lymphadenectomy. Preliminary report.

The sympathetic skin response (SSR) permits recording of the sympathetic amyelinic fibres activity in relation to the function of sudoriparous glands. We recorded the SSR to check the efficacy of "nerve-sparing" technique in surgery of the sympathetic retroperitoneal postganglionic fibres following lymphadenectomy in nonseminomatous testis cancer. The results showed that SSR can be used to verify the integrity of the lumbar sympathetic chains after retroperitoneal lymphadenectomy.

Adult↗
PubMed1988

Incidence of multiple sclerosis in the town of Sassari, Sardinia, 1965 to 1985: evidence for increasing occurrence of the disease.

Prevalence studies carried out in Sardinia from 1975 suggest an increasing occurrence of MS. However, it is questionable whether this increase represents a real change in MS incidence or simply reflects longer survival. Data from 79 patients indicated the average annual incidence for the period 1965 through 1985 was 3.4 per 100,000. On December 31, 1985, the prevalence rate was 69 per 100,000. Evaluation of MS temporal trends showed a significant increase in MS incidence during the study period: values ranged around two per 100,000 in the triennial periods 1965-1967, 1968-1970, and 1971-1973, and around five in each triennium from 1977 onward.

Adolescent↗
PubMed1987

Sardinia, a high-risk area for multiple sclerosis: a prevalence and incidence study in the district of Alghero.

Findings from small descriptive studies carried out in the last few years in Sardinia suggest that this region is now of high rather than medium risk for multiple sclerosis. It is uncertain whether this high prevalence reflects a different approach in case finding over time or a true change in disease occurrence. We report the results of a prevalence and incidence survey conducted in the district of Alghero, a community of 78,000 people in northwest Sardinia. Based on data from 31 patients, the average annual incidence for the period 1971 through 1980 was 4.1 per 100,000. On December 31, 1980, the prevalence rate was 59 per 100,000. The results support the view that Sardinia is now a high-risk area for multiple sclerosis, and further suggest a rise in the occurrence of the disease in recent years.

Adolescent↗
PubMedDate not supplied

[Are convective treatments equivalent to the traditional ones? The Hemo Study and beyond (review)].

Dialysis treatments have allowed 'terminal patients' to live for years and years. However, life expectancy and quality are still consistently reduced in renal dialysis patients. Consequently, all efforts to device alternative treatments to the conventional ones are highly justified. Recently, the Hemo Study showed that neither the use of high flux membranes, nor the increase of the dialysis dose above the conventional, were capable to reduce significantly patient's mortality and morbidity, although 8% reduction of the risk of death was seen in patients treated with high flux vs. patients treated with low-flux dialysis. A relevant question is if convective treatments may offer an overprotection from morbidity and mortality, in comparison with low flux and high flux treatments. Data from the Registro Lombardo di Nefrologia e Trapianto published in 2000 showed a trend toward a better survival (RR= 90) and a significantly better protection from tunnel carpal syndrome (RR= 0.58; p= 0.03) in patients treated with convective treatments (hemofiltration and/or hemodiafiltration) vs. patients treated with diffusive dialysis. Except than a better cardiovascular stability observed on hemofiltration and an higher beta2-microglobuline clearance given by online hemofiltration and hemodiafiltration, evident clinical benefits of convective treatments, over the conventional high flux treatments, are not yet clearly demonstrated. Notwithstanding that, online convective treatments, that are performed with high flux compatible membranes and high technology machines, producing high quality water, offer at the moment the best bases for the improvement of clinical results of dialysis, especially in some category of patients.

Anemia↗