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Biomedical subjects

L Colì

Publications and source records attributed to L Colì.

At least 37 records · Page 2Linked to original sources

Long-term comparative evaluation of synthetic and cellulosic membranes in dialysis.

A long-term retrospective evaluation (5 years) compares two groups of RDT patients (group 1 on continuous treatment with cellulosic membranes and group 2 with synthetic membranes) regarding survival, general clinical morbidity, and beta 2M-related morbidity. The results showed no significant long-term differences between the groups either for survival or general morbidity despite some differences in biocompatibility. The higher intradialytic removal of beta 2M by synthetic membranes did not lead to a reduction in either pre-dialysis beta 2M values or beta 2M related morbidity. The higher cost of synthetic over cellulosic membranes and the disappointing of many clinical expectations suggest that the use of such membranes, in association with alternative techniques, should take place only according to certain "elective" indications such as old age, diabetes, vascular instability or intradialytic disequilibrium syndrome.

Carpal Tunnel Syndrome↗

Epidemiology of hepatitis C in a population of hemodialysis patients.

A search for antibodies against hepatitis C virus (HCV) was performed in 185 patients on chronic hemodialysis by means of 1st and 2nd generation ELISA tests. Immunoblot assays were performed on positive sera. This study shows a 38% prevalence of HCV-positive patients in our dialysis population according to the 2nd generation ELISA test which shows a higher specificity and sensitivity when compared to the 1st generation one (38 vs. 20%). A correlation was found between the prevalence of HCV-positive patients and how long they had been on dialysis and how many blood transfusions they had received.

Cross Infection↗

Phosphate removal by resin hemoperfusion efficacy and biocompatibility of a new exchange resin.

A new coated anionic exchange resin for blood purification specifically designed to remove phosphates was experimentally employed in animals. 3 pigs, in which uremia had been surgically induced, underwent 6 extracorporeal hemoperfusion sessions (2 per pig) with a cartridge containing 100 gr of resin. The phosphate clearance proved satisfactory, values being 120 ml/min after 10' and around 80 ml/min after 2 hours. The biocompatibility of the resin and of the coating membrane was satisfactory. The negligible variation in pH and plasma bicarbonate during all sessions confirmed the low absorption by the tested resin of other blood anions competing with phosphate.

Animals↗

Hemoperfusion with a new anion exchange resin corrects the metabolic alkalosis in pyloric stenosis: an experimental demonstration.

An experimental model of hypertrophic pyloric stenosis was made by suture of the pyloric wall and gastrostomy in 10 rabbits under general anesthesia. Blood sampling indicated severe alkalosis and hypochloremia 3h 30 min after surgery. To correct the derangement, we tested an ion exchange resin (Dowex SAR), coated with a methacrylic hydrogel. A cartridge containing 18 g of this resin was inserted in an extracorporeal circuit. This chloride charged resin achieved uptake of HCO3- ions, and elution of Cl- ions. The electrolytic balance was fully restored after 10 min of treatment.

Alkalosis↗

Treatment of uremic patients with biofiltration: efficacy, biocompatibility and medium-term results.

The present report deals with a medium-term programme using biofiltration on a group of 10 patients, who underwent a regular reduced-time schedule (3 procedures per week, 3 hours duration each) lasting up to 12 months. A polyacrylonitrile AN 69 S membrane was used together with a substitution fluid containing Na and bicarbonate. Hematochemical and nutritional parameters were regularly checked to evaluate the efficacy of treatment. Biocompatibility of materials was evaluated by humoral and cellular immunological tests.

Acid-Base Equilibrium↗

Hemoperfusion in reduced-time programmes for chronic uremia. Long-term results.

This paper reports the Authors' 8 year experience in the clinical use of charcoal hemoperfusion as a means to reduce the weekly time of treatment in chronic uremic patients. Two different programmes were applied. Programme A (34 patients) which involved substituting the 3 procedures per week of standard dialysis (4 hours duration each) by 2 procedures of combined hemodialysis and hemoperfusion, again of 4 hours duration each. Programme B (18 patients) which involved substituting the 3 procedures per week of 4 hours duration by 3 procedures of 3 hours each, 2 of combined hemodialysis and hemoperfusion, 1 of conventional dialysis. The net weekly reduction was 33% for Programme A and 25% for Programme B. The efficacy of the two Programmes was evaluated by clinical, hematochemical, nutritional and instrumental parameters.

Adult↗

Present status of hemoperfusion/hemodialysis in Italy.

The use of charcoal hemoperfusion in the treatment of chronic renal failure has been proposed and applied by several authors. The availability of coating membranes of increased biocompatibility currently allows a safer and wider use of this purifying technique. It has been recently demonstrated that long-term treatment with combined hemodialysis/hemoperfusion yields an improvement of certain dialysis-resistant uremic signs in patients on regular dialysis treatment, while in selected patients it affords a marked reduction (up to one-third) in the overall time of treatment per week. The tolerance of long-term treatment is good. In line with these findings, a multicenter study has been carried out in Italy with two main aims: (1) to see whether long-term treatment with charcoal hemoperfusion is really safe and substantially free from side effects; (2) to verify in a larger and more varied population of patients whether such long-term treatment actually improves certain uremic signs persisting despite adequate dialysis treatment. A third phase of the multicentric study (reducing the weekly time of treatment) is currently being worked on. Five nephrology and dialysis departments took part in the study: in Bologna, Rome, Chieti, Ancona, and Lecce.

Clinical Trials as Topic↗

Effects of renal substitutive programs on amino acid patterns in chronic uremia.

Abnormalities in the amino acid patterns are a constant finding in chronic renal failure and can be regarded as one of the typical biochemical alterations of uremia. This paper evaluates the long-term effects of various artificial substitutive treatments and renal transplantation on plasma and tissue amino acid patterns in chronically uremic patients. Fifty-three patients were included in the study: 35 on artificial treatments (9 on hemodialysis, 9 on hemofiltration, 4 on hemoperfusion, 6 on continuous ambulatory peritoneal dialysis, and 7 on intermittent peritoneal dialysis) and 18 with well-functioning renal transplants. Complete plasma aminograms were performed in all patients before starting the treatment, and repeated every 3 months up to 1 year (artificial therapies) and 3 years (renal transplantation). The amino acid composition of the bone was also determined in 8 dialysis patients and 9 transplant patients. None of the artificial therapies was associated with normal plasma patterns either in the short- or in the long-term, whereas successful renal transplantation led to normalization of the plasma profile within 2 to 4 months in all patients. However, bone amino acid composition remained altered both in artificially treated and in transplanted patients.

Adolescent↗

Use of combined hemodialysis/hemoperfusion in chronic uremia.

The capacity of charcoal to absorb endogenous and exogenous toxins is well established. It removes substances of higher molecular weight than standard dialysis membranes. The regular use of charcoal hemoperfusion as an adjunct to hemodialysis in chronic uremia is a real prospect capable of improving the patient's clinical and laboratory condition and/or reducing the weekly time of treatment. In line with our previous experience, 5 consenting informed patients on regular dialysis treatment from 9 to 35 months (residual creatinine clearance 0-1.8 ml/min, mean diuresis 350 ml) were treated without interruption for 5-8 months according to a schedule including two combined hemodialysis/hemoperfusion procedures instead of the previous three hemodialysis sessions. Patients were on adequate dialysis and their clinical, metabolic and laboratory conditions were stable. In the hemodialysis/hemoperfusion procedure a cartridge containing 150 g of methacrylate-coated activated charcoal with high biocompatibility was inserted in the dialysis circuit in series with a flat plate or hollow fiber dialyzer. Clinical, laboratory and metabolic conditions remained unchanged in all patients despite the one third reduction in dialysis hours per week. The tolerance of treatment was good: platelets, white cells and fibrinogen were unaffected. The marked reduction in weekly time of treatment led to a more satisfactory personal and social rehabilitation, enabling more patients to be treated with the same facilities.

Adsorption↗

Ibopamine (SB 7505) in normal subjects and in chronic renal failure: a preliminary report.

1 Pharmacological and experimental studies have shown that ibopamine (SB 7505, di-isobutyric ester of N-methyldopamine) is capable of increasing renal blood flow, diuresis, urinary sodium, potassium and creatinine excretion. 2 SB 7505 was given to twelve volunteer patients, six of whom had normal renal function and six with various degrees of chronic renal impairment. 3 In both groups the drug yielded a prompt increase in urinary excretion of water, sodium and potassium, while creatinine clearance was also seen to increase. 4 Heart rate and arterial pressure were unaffected by SB 7505 in all patients. 5 Results seen encouraging and call for further study on the proper use of the drug in clinical nephrology.

Adult↗

Regular hemoperfusion in regular dialysis treatment. A long-term study.

The capacity of activated charcoal to remove toxins from the blood is well established. Its poor biocompatibility, inability to remove urea, electrolytes and water, and high cost have so far been the major objection to a wider use of charcoal with chronic uremic patients. The availability of a charcoal coated by a new highly hydrophilic methacrylate based on membrane enabled us to keep 18 uremic patients on a combined hemodialysis-hemoperfusion schedule for 4-52 weeks. Investigations concerned patients in whom relapsing signs of uremia occurred despite technically adequate dialysis, and other cases where dialysis was both technically and clinically adequate. In the first group of patients, the combined programme led to an improvement of the dialysis resistant clinical signs, while certain positive metabolic effects were also observed. In the second group, the hemodialysis-hemoperfusion treatment allowed a reduction of about 30% in time of treatment per week. Tolerance of the new coated charcoal was good throughout treatment in terms both of biocompatibility and of side effects.

Adult↗