PubMed Health⌕ Search

Biomedical subjects

S Landini

Publications and source records attributed to S Landini.

At least 37 records · Page 2Linked to original sources
PubMed1984

Restoration of ultrafiltration capacity of peritoneal membrane in patients on CAPD.

Among 55 uremic patients who entered our CAPD program, 7 of them showed a reduction or loss of the ultrafiltration capacity (UF) of the peritoneal membrane (PM). They have been treated with high dose of Furosemide (F) to force residual urine output. Four appeared "responders" to drug administration with a significant increase in urine volume, Na excretion and, within a week period gained their dry body weight (BW). In the remaining 3 patients drug therapy resulted ineffective, and fluid removal was obtained by hemofiltration (HF). In both groups we noted an increase in the UF capacity of PM when their dry BW was obtained either by pharmacological or technical approach. These results support the assumption that the over-hydration status of the PM plays a major role in maintaining the UF process.

Body Weight↗
PubMed1984

Spontaneous plasma exchange by gravity.

Lysagth et al have reported a semplified model of spontaneous plasmapheresis by placing between an A-V shunt a conventional plasmafilter. On the basis of this experience we tried to make a further semplification of this apparatus using a single venous puncture, obtaining by gravity sufficient transmembrane pressure for plasma separation. By alternatively lowering and elevating the system, plasma is separated from the blood and packed red cells are reinfused after a new pass through the filter with FFP or plasma substitutes.

Acute Disease↗
PubMed1983

Muscle biopsy studies in chronically uremic patients: evidence for malnutrition.

Evidence for muscle protein wasting and abnormal muscle metabolism is common in uremia. Muscle DNA content is considered a reliable reference standard in normal and undernourished adults. Muscle RNA content rapidly changes during starvation and refeeding. The ratio of noncollagen alkali-soluble proteins (ASP) to DNA is considered to be an estimate of the cytoplasmic volume of a single cell, and the RNA: DNA ratio is an index of the ribosomal capacity for protein synthesis. Muscle DNA, RNA, ASP, water, and fat content were determined in muscle biopsy specimens from chronically uremic patients receiving conservative treatment (CT), maintenance hemodialysis (two centers), or CAPD. Nutrient intake was low and the anthropometric indices were decreased in all groups of patients, except in the hemodialysis patients from one center. Serum proteins and muscle ASP: DNA and RNA: DNA ratios were decreased. The nutritional status was reassessed in some malnourished CAPD patients after about one year of careful nutritional advice and was unchanged. These results suggest that chronically uremic patients on CT are often malnourished, primarily because of an inadequate protein and/or energy intake. Muscle nucleic acid and protein content are useful tools for nutritional assessment at a cellular level in humans with chronic renal failure and can be used to monitor the response to nutritional therapy.

Adult↗
PubMed1983

Hemodynamic evaluation during plasma-exchange with intermittent flow.

Plasma-exchange (PE) represents an effective therapeutic approach employed in several immunological nephropathies, poisonings and various other diseases. Hemodynamic changes during intermittent flow PE were studied--using the thermodilution technique--in 8 patients (3 male and 5 female) aged between 36 and 73 years (mean 46.4). The mean values for the following parameters were measured before, during every cycle--exchanging about 300 ml of fresh frozen plasma--and at the end of the session: mean arterial pressure (MAP), heart rate (HR), cardiac index (Cl), stroke index (SI), total peripheral resistence (TPR), central venous pressure (CVP), pulmonary arterial pressure (PAP) and pulmonary capillary wedge pressure (PCWP). During the first exchange the systemic circulation showed hemodynamic changes similar that of an acute hemorrhagic condition: decrease in MAP (from 106 to 97 mmHg), Cl (from 4.27 to 3.7 L/m'/m2), SI (from 53 to 49 ml/beat/m2) and CVP (from 6.9 to 4.4 mmHg); increase in TPR (from 1230 to 1339) dynes/sec/cm-5), while HR showed only mild changes. In the following cycles all the parameters progressively returned toward the previous values. During the first cycle the pulmonary circulation showed a decrease in PAP (from 15.5 to 13 mmHg) and PCWP (from 8.9 to 6.6 mmHg). PAP also increased constantly in the following cycles reaching at the end of the session levels which were higher than the initial ones. Our data demonstrate that in PE treatment especially when is employed a low volume of fluid, has to be substituted at every cycle in order to prevent the major hemodynamic complications i.e. hypovolemic shock and heart failure.

Adolescent↗
PubMed1983

Cold as cardiovascular stabilizing factor in hemodialysis: hemodynamic evaluation.

Vascular instability represents the most frequent intradialytic complication of uremic patients. Catecholamine impairment, changes in plasma sodium or osmolality and, more recently, temperature (T) of dialysate have been proposed to explain this phenomenon. In order to evaluate the role of T in hemodynamic stability, we studied the effect of cooling dialysate in 5 patients (3 m, 2 f), who often experienced hypotension during dialytic sessions. Dialysate T was lowered, leading to a body T decrease of 1.5 degrees C, measured by a thermistor in the pulmonary artery. Ultrafiltration was kept constant during both "warm" (W) and "cold" (C) hemodialysis (HD). Systemic and pulmonary hemodynamic parameters were studied by thermodilution technique. The evaluation was performed in the same patients during W-HD and C-HD with the same dialysate composition. MAP showed a significant reduction during the first hour under both dialysis conditions. Subsequently a further decrease of MAP was observed in W-HD, while it remained stable in C-HD. CI and SI demonstrated similar trends, whereas HR showed no major changes. TPRI appeared significantly higher during C-HD compared to W-HD, with no clinical symptoms of hypotension. Similarly pulmonary parameters resulted in a better cardiovascular stability during C-HD. Our hemodynamic study confirms the important role played by T on intradialytic vascular stability and may explain the better control observed during hemofiltration compared to standard W-HD.

Adult↗
PubMed1982

Thyroidal status in uremia - effects of hemodialysis and CAPD.

Thyroid function was explored in 27 CAPD patients and 25 HD patients. Dialysis was associated with low T3 and T4 levels, increased rT3 concentrations, normal T4 : T3 and reduced T4 : rT3 ratios, normal FT3 and Thyroglobulin concentrations. TSH levels increased during dialysis but still fell within normal limits. The data rule out a condition of primary hypothyroidism and point out to increased thyroidal dismission associated with the block T4-T3 in peripheral cells. Also the increased FT4 levels in CAPD patients could be due to de novo dismission of thyroidal T4.

Adult↗
PubMed1980

[Transcutaneous renal needle-biopsy guided with ultrasonics].

Authors performed percutaneous renal biopsy guided by ultrasounds in 10 patients in whom urography was dangerous or did not provided good renal images. The advantages of this method are in the directional and dimensional accuracy of ultrasound scanning, so that the exact topography of the kidney can be established. The use of ultrasonically guided renal biopsy is mainly recommended in iodine medium idiosyncrasy, in myelomas and renal failure. This method can be preferred in order to establish the exact topography of kidney, in acute anuric renal failure, in chronic failure (when high doses of iodate contrast are needed), and in the presence of cyst.

Adult↗