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Biomedical subjects

L Neri

Publications and source records attributed to L Neri.

At least 19 recordsLinked to original sources
PubMed2003

Alternative site blood glucose testing: a multicenter study.

The aim of this study was to compare glucose measurements between fingertip and forearm using the blood glucose (BG) monitoring system One Touch Ultra (LifeScan), an electrochemical sensor that requires only a very small drop of blood (1 microL). Patients with type 1 or type 2 diabetes were identified in five outpatient diabetes clinics. Participants were requested to use the One Touch Ultra at home for 1 week for the measurement of BG levels from both sites. Patients filled in a questionnaire about their experience with testing blood samples from fingertip and forearm. The agreement between the measurements from the two sites was assessed using linear regression analysis, mean absolute relative error (MARE), the Bland-Altman method, and Error Grid Analysis (EGA). Overall, 112 patients were recruited, of whom 58% had type 1 diabetes. Linear regression analysis showed an intercept of 17.7, statistically different from 0 (p<0.0001). The slope was 0.956, and the Pearson correlation coefficient was 0.95. A MARE of 12.1% (SD=11.8%) was obtained, with a greater deviation of the forearm values from the fingertip ones in the hypoglycemic range (MARE=22.3%; SD=21.7%). The Bland-Altman bias plot showed a mean bias of 10.2 mg/dL (SD=23.1), with no correlation between mean difference and average BG levels (r=0.02). The EGA showed that 89.2% of the values fell in zone A, 10.4% in zone B, and 0.4% in zone C. The vast majority of patients (71%) declared that the collection of blood from the forearm caused no pain or less pain than the traditional site. Only 17% of the patients declared that it was impossible to obtain any blood from the forearm, while 63% reported with satisfaction that the quantity requested was small. At the end of the study period, 32% of the participants indicated the forearm as the preferred test site. Alternative site testing on the arm, with a BG meter that requires only a very small drop of blood, is feasible and reliable under routine clinical conditions. When testing with the express purpose of detecting hypoglycemia, the finger still remains the recommended test site.

Adolescent↗
PubMed2001

Improved function of rat islets upon co-microencapsulation with Sertoli's cells in alginate/poly-L-ornithine.

The purpose of this study was to assess whether Sertoli's cells would improve functional performance of homologous pancreatic islets within microcapsules. Purified rat Sertoli's cells were co-enveloped with islets in microcapsules that had been fabricated with alginic acid and poly-L-ornithine. Confocal laser microscopy was used to determine any mitogenic effects of Sertoli's cells on islets beta-cells. Insulin secretion from islets, with or without Sertoli's cells, was examined, and grafts of Sertoli's cells with islets in microcapsules into diabetic mice were carried out. Co-incubation of Sertoli's cells with islets resulted in a significant increase in the islet beta-cell mitotic rate, which was coupled with significantly higher insulin release under glucose stimulation, as compared to controls. Grafts of co-microencapsulated Sertoli's cells with islets resulted in prolongation of the achieved normoglycemia in the animals receiving Sertoli's cells with islets as compared to controls that received islets only. Sertoli's cells do promote mitogenic activities upon in vitro co-incubation with islets, whose in vitro functional and in vivo post-transplant consequences were evident. Sertoli's cells could, therefore, be co-microencapsulated with islets for transplantation in diabetic recipients.

Alginates↗
PubMed2001

Alloxan decreases intracellular potassium content of the isolated frog skin epithelium.

Alloxan has been widely used to provoke diabetes mellitus. This compound induces necrosis of the beta-pancreatic cells and the renal tubules. However, the mechanism of this action has not been fully established. There is some evidence that this drug may act by an alteration of several ionic transport mechanisms. Nevertheless, there is scant information on the effect of alloxan on these ionic transport mechanisms of the membrane in epithelial cells. We reported that this drug induces a decrease in sodium transport in the frog skin. In order to obtain information about the mechanism involved in the sodium transport diminution provoked by alloxan, in this study the function of Na+-K+ ATPase enzyme on transepithelial sodium transport altered by alloxan is explored. We measured changes in the short circuit current and in the intracellular content of sodium and potassium under conditions of maximally stimulated enzyme activity. Short circuit current was not modified by the treatment with alloxan during the period of highest activity of the enzyme, suggesting a site of action independent of this ATPase. Cell potassium was reduced in alloxan-treated epithelia, without significant changes in Na+ content. This finding points out the existence of an alteration induced by alloxan of some modulator mechanisms of the intracellular K+ concentration. The treatment of the frog skin with cesium chloride, a K+ channel blocker, prevented the decrease of Na+ transport produced by alloxan. This result suggests an action of this diabetogenic drug on the K+ channels of the frog skin epithelium.

Alloxan↗
PubMed2001

Evaluation of drainage times and alarms with various automated peritoneal dialysis modalities.

This paper assesses the variation in total drainage time (TDT) and number of alarms due to low drainage volume (LDV) in automated peritoneal dialysis (APD) patients with varying catheter performance. Catheter performance was measured by drainage break point (DBP) in a supine position. Six patients with DBP > or = 80% underwent three types of APD: non tidal, 50% tidal, and 80% tidal. Six patients with DBP < 70% underwent two types of APD: non tidal and tidal fixed at 5% below DBP. In every case, the fill volume was 2.3 L. For the purpose of the study, each treatment was continued for seven consecutive nights. Home Choice Pro (Baxter Healthcare Corporation, Deerfield, Illinois, U.S.A.) was used to calculate the TDT and LDV. With both the non tidal and tidal treatments, TDT was higher in patients with DBP < 70% as compared with patients with DBP > or = 80%. In the latter group, 50% tidal was the most effective technique in reducing TDT. In patients with DBP < 70%, the tidal treatment reduced not only TDT, but also LDV alarms, as compared to the non tidal treatment. In conclusion, choosing the tidal method helps to reduce LDV alarms and TDT, especially in patients with a low DBP. The Home Choice Pro device is an effective aid in setting up and assessing the dialytic prescription.

Catheterization↗
PubMed2000

Ultrafiltration with icodextrins in continuous ambulatory peritoneal dialysis and automated peritoneal dialysis.

Icodextrins (Icos) produce constant linear ultrafiltration (UF). This effect allows Icos to replace glucose during long dwells in continuous ambulatory peritoneal dialysis [CAPD (nighttime)] and automated peritoneal dialysis [APD (daytime)]. However, the effectiveness of Icos in producing UF (IcoUF) is limited by lymphatic reabsorption, whose extent depends partly on posture and physical activity. This paper aims to assess whether the difference in posture and physical activity between daytime dwells in APD and nighttime dwells in CAPD affects IcoUF. Patients undergoing first treatment were retrospectively examined. Ten patients were on CAPD [4 males, 6 females; average age, 73.0 +/- 13.4 years; body surface area (BSA), 1.63 +/- 0.21 m2; total volume per day, 5.6 +/- 1.9 L], and ten were on APD (7 males, 3 females; average age, 67.7 +/- 9.8; BSA, 1.75 +/- 0.22 m2; total volume per night, 10.5 +/- 0.9 L). Ultrafiltration was assessed for seven consecutive days preceding a peritoneal equilibration test (PET) and collection of diuresis. In both groups, 3 patients had no diuresis, and the difference between CAPD and APD was not significant (625 +/- 762 mL vs 780 +/- 878 mL). Moreover, no significant difference was seen in 4-hour dialysate-to-plasma creatinine (D/P) between CAPD (0.65 +/- 0.12) and APD (0.64 +/- 0.05). Dwell times with Icos were shorter in CAPD than in APD (11.5 +/- 1.8 hours vs 14.8 +/- 0.5 hours, p < 0.0005), but the fill volume was not significantly different (1760 +/- 286 mL vs 1790 +/- 249 mL). Water excretion owing to diuresis and dialysis [total water excretion (TWE): 1619 +/- 497 mL CAPD vs 1762 +/- 736 mL APD] and dialytic UF (363 +/- 443 mL CAPD vs 748 +/- 479 mL APD), which is not linked to Icos, were not significantly different between the two groups. The IcoUF and the percentage of IcoUF to TWE were significantly higher in CAPD compared to APD [631 +/- 253 mL (44% +/- 27%) vs 234 +/- 215 mL (19% +/- 19%), p < 0.001 (p < 0.05)]. In conclusion, an upright posture and physical activity seem to produce less IcoUF in APD despite the longer dwell. These factors could, indeed, produce greater intraperitoneal pressure, resulting in increased lymphatic reabsorption during a daytime dwell.

Aged↗
PubMed1998

Calculation of Kt/V and creatinine [correction of creatine] clearance in APD.

The calculation of Kt/V and creatinine clearance per 1.73 m2 of body surface area (CrCl/1.73 m2 of BSA) varies according to whether the post- or pre-nightly dialysis treatment (NDT) values of the serum urea (sUrea), serum creatinine (sCreat), and body weight (BW) parameters are used. The purpose of this paper is to determine the difference between Kt/V and CrCl/1.73 m2 of BSA, calculated using the pre- and post-NDT values, and any correlation of such differences with different automated peritoneal dialysis (APD) methods. We took into consideration patients on APD treated using the tidal method with four different techniques: NTPD (9 patients; no daytime dwell), NTPD-1 (12 patients; one daytime dwell of 4-7 hours), CTPD (10 patients; one daytime dwell), and CTPD-2 (8 patients; two daytime dwells). Body water (V) and body surface area (BSA) were calculated using the Watson and Du Bois formulas. The percentage difference between pre- and post-NDT using the various methods is not statistically significant, while all the post-NDT parameters are significantly lower than the pre-NDT parameters. Since this difference is greater for sUrea (8.8%) and V (1.1%) than for sCreat (4.1%) and BSA (0.8%), the nightly Kt/V variation (11.2%) is greater than the nightly CrCl/1.73 m2 of BSA variation (5.2%). These variations do not differ significantly among the various methods. For APD, therefore, increase is to be expected in the CAPD targets of 10% and 5% respectively for Kt/V and CrCl/1.73 m2 of BSA calculated using the post-NDT values of sUrea and sCreat and the pre-NDT value of BW.

Aged↗
PubMed1996

Renal transplantation in patients with microscopic polyarteritis and antimyeloperoxidase antibodies: report of three cases.

This paper reports on 3 patients on renal dialysis for crescentic glomerulonephritis associated with microscopic polyarteritis (MPA) and antineutrophil cytoplasmic autoantibodies specific for myeloperoxidase (MPO-ANCAs). They successfully underwent renal transplantation from a cadaver donor 6-63 months after the onset of the disease, despite the persistence of antibodies at high titer. A triple immunosuppressive regimen including steroids, cyclosporin and azathioprine was used. One patient underwent transplantectomy for surgical complications 3 months later, while the serum creatinine was 2.0 mg/dl (178 mu mol/l): the remainder have a well-functioning graft after 21 and 38 months, no clinical sign of disease recurrence, and a MPO titer within the normal range. We conclude that MPA patients can undergo renal transplantation even if ANCAs persist at a high titer in the circulation.

Adolescent↗
PubMed1995

Effects of different dialysis membranes on lipid and lipoprotein serum profiles in hemodialysis patients.

We measured the serum concentrations of a variety of lipid constituents--total cholesterol, triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein cholesterol, apolipoproteins A1 and B, and lipoprotein(a)--in well-matched uremic patients undergoing chronic hemodialysis with either cuprophane (n = 13) or polysulfone (n = 13) membranes. We found that the patients on polysulfone membrane dialysis had significantly higher mean HDL cholesterol and apolipoprotein A1 concentrations than the patients on cuprophane membrane dialysis. There were no significant differences in the other variables studied. Moreover, polysulfone membrane dialysis was associated with a lower prevalence of potentially atherogenic lipid abnormalities such as low HDL cholesterol levels and high total cholesterol/HDL cholesterol rations. We concluded that the use of more physiological dialysis procedure may improve, in the long term, lipid and lipoprotein profiles in hemodialysis patients, though the exact mechanism(s) remains unknown.

Aged↗
PubMed1995

Is Ace inhibitor treatment a possible cause of better cardiovascular remodelling in well functioning kidney transplant?

Diseases of the cardiovascular system are a common cause of death in renal transplanted patients. In this study we assessed the echocardiographic morphological and functional findings after renal transplantation of two homogenous groups of transplanted patients with normal renal function. The first (A) with spontaneously normotensive patients, the second (B) with moderate hypertension treated mainly with Ace inhibitors. Analysis of these data highlights two noteworthy results: the similar left ventricle hypertrophy found in both groups and the existence of better diastolic compliance among the hypertensive transplanted patients. If this is confirmed by studies currently in progress, the importance of Ace-inhibitors treatment in remodelling cardiac dysfunction after long term dialysis treatment might be seriously considered.

Adult↗