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Biomedical subjects

M Milan

Publications and source records attributed to M Milan.

61 records · Page 4Linked to original sources

Preliminary technical and clinical evaluation of a new hollow fiber dialyzer with a 5 microns thick cuprophan membrane.

In vitro and in vivo studies were performed on 10 dialyzers with 5 microns thick cuprophan membrane to evaluate hydraulic properties and permeability to solutes. Inlet and outlet pressures of the filter were measured at different blood flows to assess the resistance of the device and the end-to-end pressure drop. Hysolated ultrafiltration was performed to evaluate the spontaneous filtration at increasing blood flows, the ultrafiltration rate at different transmembrane pressures and, finally, the sieving coefficients for solutes. Standard hemodialysis was also performed to study the clearances throughout a 4-h session. During hysolated ultrafiltration the UF rate was increased up to 37 ml/min showing a very high hydraulic permeability of the membrane. The spontaneous filtration rates related to blood flow were quite low. Since the end-to-end pressure drop in the filter was also relatively low at high blood flow we may conclude that the geometry of the device is able to dissociate the influence of blood flow on the hydrostatic pressure inside the filter. This results in a easy modulation of the membrane permeability to water. Sievings were surprisingly high and clearances were stable along the dialysis session (BUN = 196 ml/min, creatinine = 161 ml/min and phosphate = 163 ml/min).

Blood Flow Velocity↗

Calcified synovial cyst of the cervical spine: CT and MR evaluation.

A case of calcified synovial cyst of the cervical spine was diagnosed by a combination of imaging modalities. Curvilinear calcification associated with posterior elements, well seen by CT, suggested the correct diagnosis. Magnetic resonance showed a curvilinear region of low signal intensity corresponding to the calcification.

Calcinosis↗

Complex segregation analysis in a sample of consecutive newborns with cleft lip with or without cleft palate in Italy.

The mode of inheritance of cleft lip with or without cleft palate (CL/P) has been extensively investigated, but the results are controversial. We report results of complex segregation analysis performed in the families of 636 consecutive newborns with CL/P registered in the northeast Italy and Emilia Romagna congenital malformation registries to test hypotheses regarding CL/P inheritance. The programs POINTER and COMDS have been used. POINTER could not distinguish between alternative genetic models, and only the hypothesis of no familial transmission could be rejected. COMDS results, after inclusion of the severity parameter, rejected the hypotheses of a single major locus and were consistent with the two-locus model with a major dominant locus and at least one modifier locus.

Cleft Lip↗

Technical and clinical evaluation of a new system for ultrafiltration control during hemodialysis.

A new system for ultrafiltration control during hemodialysis is described. The apparatus consists of a computer operated system of load cells that register variations in weight of the outlet dialysate versus inlet dialysate. Once the weight loss of the patient has been established, the gravimetric control operates on the dialysate circuit to obtain the transmembrane pressure adequate to achieve the desired ultrafiltration rate and patient weight loss. The system can be used as a complete dialysis machine or as a separate module that can be adapted to any standard dialysis machine. This module was tested in more than 220 dialysis sessions, using different membranes and ultrafiltration rates. The difference between the scheduled and the real weight loss was always less than 100 g at the end of the dialysis session. The number of technical interventions required were few, as was the rate of complications related to the system. The system is safe and reliable and offers a low cost opportunity to improve dialysis tolerance by accurate and progressive ultrafiltration during the session.

Body Weight↗

Total solute extraction versus clearance in the evaluation of standard and short hemodialysis.

The authors compared the efficiency of standard HD (t = 240 minutes, Qb = 300 ml/min, Qd = 500 ml/min) with short HD (t = 150 minutes, Qb = 500 ml/min, Qd = 700 ml/min). The study was carried out in 11 patients in two sequential dialysis sessions, utilizing the same high surface area hollow fiber dialyzers, after a 2 day interdialytic period. With short HD, as expected, the clearance (Cl) of BUN, creatinine (Cr), and phosphates (P) was significantly higher than in standard HD:Cl BUN = 331 vs. 225, Cl Cr = 286 vs. 193, and Cl P = 231 vs. 176 ml/min. No significant difference in the total BUN extraction (measured on the total amount of exhausted dialysate) was found between the two techniques. As to Cr and P, despite higher Cl in short HD, the total extractions were significantly lower. In conclusion, in the evaluation of short HD efficiency, instantaneous Cl can be adequate for small molecules, while for larger solutes, other parameters, such as total extraction, must be considered.

Blood Flow Velocity↗

Adult patients with the nephrotic syndrome: really at high risk for deep venous thromboembolism? Report of a series and review of the literature.

BACKGROUND: The reported incidence of thromboembolic episodes in people with nephrotic syndrome (NS) ranges from 6% to 44% and it has been ascribed to the presence of a hypercoagulable state, as suggested by abnormalities of several hemostatic parameters in these patients. However, the results of the studies are often contradictory and fragmented and are rarely based on prospective studies. To assess the incidence of venous thrombosis and the pattern of abnormalities of the hemostatic parameters in NS, we planned a prospective study of a group of patients with NS. PATIENTS AND METHODS: Thirty-six consecutive patients with NS were enrolled during a 9-month period. Every 4-6 months, clinical history was collected and physical examination was carried out. Blood samples for laboratory investigation were taken at entry into the study and 24 months later. A critical review of the literature was also carried out (Medline database and Current Contents). RESULTS: During the follow-up (mean 45.2 months), no thrombotic symptoms were recorded, PTT, PT, TT and mean AT-III levels were within the normal range, whereas fibrinogen, plasminogen, protein C and S, heparin cofactor II levels were significantly higher than normal both at entry into the study and 24 months later. No patient was positive for antiphospholipid antibodies. Slightly decreased levels of AT-III and heparin cofactor II were found in only two cases. CONCLUSIONS: Our study confirms neither the high incidence of thrombotic complications in NS nor the presence of abnormalities of hemostatic parameters commonly associated with venous thromboembolism.

Adolescent↗