PubMed Health⌕ Search

Biomedical subjects

T Cerrai

Publications and source records attributed to T Cerrai.

25 records · Page 2Linked to original sources
PubMedDate not supplied

Results of a national epidemiological investigation on HCV infection among dialysis patients. (Survey by the Italian Branch of EDTNA/ERCA).

The Italian Branch of EDTNA-ERCA organised a retrospective epidemiological investigation on the spread of HCV infection in dialysis. A questionnaire was sent to 830 Italian dialysis centres to collect information about prevalence and incidence of HCV infection among patients and staff, anti-HCV testing, presumed sources of infection, sanitation procedures and dialysis strategies adopted to prevent or reduce the transmission of HCV infection. Twenty-seven percent of the dialysis centres responded to the questionnaire. The answers confirmed the decline in HCV prevalence and incidence. At variance with official health organisation recommendations, isolation of anti-HCV-positive patients is still used in many centres (25%) despite the fact that it is not advisable in view of the high cost and uncertain benefit. Dedicated machines for anti-HCV-positive patients should be adopted, at least in units with a high prevalence of these cases.

Hemodialysis Units, Hospital↗
PubMedDate not supplied

Results of a national epidemiological investigation of HCV infection in dialysis patients.

The Italian Branch of EDTNA/ERCA organised a national, epidemiological, retrospective study to collect data and implement preventative measures for the spread of HCV infection in dialysis units. A questionnaire was sent to staff in 830 dialysis centres to collect information relating to 1996. Data are presented on incidence/prevalence of HCV infection, antibodies, viraemia and mortality, and comparison of the management of HCV between centres. At variance with the recommendations of the Official Health Organisations, dedicated machines and separate rooms are used in many centres and this paper concludes with recommendations for units, in particular those units with a low prevalence of anti HCV positive patients.

Cross Infection↗
PubMedDate not supplied

[On-line hemodiafiltration without acetate].

PURPOSE: The suitably filtered dialysate which is currently reinfused during on-line hemodiafiltration (HDF-OL) contains bicarbonate and small doses of acetate. The trend of acetataemia During "forced" convective treatments has never been studied. The gain in acetate secondary to the considerable quantities of fluids infused might have clinical significance in relation to the well-known side effects of this anion. METHODS: In this pilot study 12 patients underwent HDF-OL with reinfusion in predilution of 40 L of substitution fluids containing or not 3 mmol/L of acetate. Apart from this variable, all the other treatment parameters were the same in both procedures. The treatments were carried out in two short consecutive intervals in a random sequence. RESULTS: During HDF-OL the use of dialysate containing small doses of acetate is associated with levels of acetataemia 5-6 times higher compared to the basal. HDF-OL without acetate cancels out this increase. The acetate gained by the patients is significant, on average 75 mmol, and accounts for over 1/3 of the global base gain. Consequently, the bicarbonataemia levels at the end of treatment are significantly higher in HDF-OL with acetate than in the treatment without. Two hours after the end of the treatments the IL-6 levels tend to grow in both methods, but numerically less in HDF-OL without acetate; the difference verges on meaningfulness. CONCLUSIONS: The acetate gain is significant during forced convective treatments carried out with standard dialysate. This acetate gain can trigger cytokinin activation. These events are cancelled out by eliminating the acetate from the dialysate. The absence of this anion will be compensated with appropriate increases in the concentration of bicarbonate in the dialysis fluid.

Acetates↗
PubMedDate not supplied

[Natural history of HCV infection and risk of death in a cohort of patients on long-term hemodialysis].

BACKGROUND: HCV infection represents the major cause of chronic liver disease in hemodialysis and renal transplant patients. The clinical course of liver disease in hemodialysis patients is generally asymptomatic. Only few studies describe the natural history of HCV infection in haemodialysis patients, showing an association between HCV infections and poor survival. METHODS: A prospective cohort study of our haemodialysis population was conducted to define the natural history of HCV infection and its relation to mortality. 77 patients on haemodialysis were enrolled, 24 (31%) of whom were anti-HCV and 53 (69%) anti-HCV-negative. RESULTS: The HCV-RNA was positive in 18 of the 24 anti-HCV-positive subjects (75%). None of the anti-HCV-negative subjects was HCV-RNA-positive. Eight of the 18 HCV-RNA-positive patients (40%) developed cirrhosis with portal hypertension and ascites within 7 years after the first increase of GPT. Seven of these died, nobody developed hepatocarcinoma (HCC). During 58+/-37-follow-up months mortality rate was higher among anti-HCV-positive patients than among anti-HCV-negative. Besides, the 6 deaths occurred only among anti-HCV-positive and HCV-RNA-positive patients. CONCLUSION: in our haemodialysis patient population the presence of antibodies anti-HCV and HCV-RNA is associated with an increased risk of developing liver cirrhosis and of death, in comparison to anti-HCV-negative patients. Our data show that anti-HCV-positive patients have an accelerated course towards chronic hepatopathy and cirrhosis.

Aged↗