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Biomedical subjects

V Cambi

Publications and source records attributed to V Cambi.

At least 19 recordsLinked to original sources
PubMed1991

The rôle of adsorption in beta 2-microglobulin removal.

BK-PMMA 2.1 m2 surface dialysers were used in vivo and in vitro for evaluation of their capacity for beta 2-M removal by both adsorption and elimination through the membrane. As expected, in vivo, beta 2-M plasma concentrations were more effectively reduced when the dialyser was used in haemofiltration, rather than in haemodialysis. However, the mass recovered in the ultrafiltrate could not account for the observed difference in beta 2-M removal. In vitro tests demonstrated that membrane adsorption of beta 2-M is greater when the dialyser is used in convection than in diffusion. Therefore, the greater beta 2-M removal during haemofiltration depends on both increased adsorption and membrane elimination by convection. Thanks to adsorption, beta 2-M removal by haemodialysis was greater than for other synthetic membranes, but was insufficient to obtain beta 2-M removal corresponding to the estimated generation.

Adsorption↗
PubMed1990

Pharmacokinetics of iopamidol in adults with renal failure.

The pharmacokinetics of iopamidol 370 (Iopamiro), a non-ionic water soluble organic iodine compound, were studied in adults with different degrees of chronic renal failure and in healthy volunteers. After 50 ml were administered i.v., plasma and urine levels were determined. The main pharmacokinetic parameters were calculated on the basis of bi-compartimental open model. There were significant differences from healthy volunteers in t1/2 beta, which increased with the degree of renal failure as the clearance values decreased. t1/2 beta was equal to 1.67 h in healthy volunteers, 4.24 h in patients with mild renal failure and 10.03 h in patients with severe renal failure. The clearance decreased as follows: 0.11 (l/h kg) in healthy volunteers, 0.06 (l/h kg) in patients with mild renal failure and 0.02 (l/h kg) in patients with severe renal failure. No significant differences were found in distribution volume values nor in t1/2 alpha.

Adult↗
PubMed1989

Glucose metabolism and larger molecule removal in long-term high efficiency hemofiltration.

High efficiency hemofiltration (HF) was carried out for 9 months in 6 patients on hemodialysis (HD). Comparative studies on carbohydrate metabolism and 500- to 1,500-dalton serum solute concentrations were performed during HD and HF. After 5 months of HF, intravenous glucose tolerance tests showed an improved peripheral glucose utilization, with unchanged insulin secretion. Larger solute concentrations, measured by gel chromatography, simultaneously dropped in serum suggesting that HF removes some toxic substances that inhibit peripheral insulin action. After 9 months of HF, an unexpected increase in the larger solute concentration coincided with an impaired glucose tolerance, stressing the probable toxic rule of such solutes. Changes in other glucoregulatory hormone secretions were not unequivocal. On account of the later increase in 500- to 1,500-dalton solute concentrations, HF failed to prevent larger toxic molecules accumulating in uremic sera.

Anuria↗
PubMed1989

Pre-postdilution haemofiltration.

Postdilution haemofiltration is a treatment indicated for patients who are unable to tolerate standard dialysis. However, its duration is uncomfortably prolonged in cases of low blood flow from the vascular access. In a predilution mode greater clearance rates can be reached even if a greater amount of sterile and pyrogen-free solutions are required. Although an in-line solution-producing system lowers the cost, theoretical calculations indicate that a predilution mode is not advantageous, in terms of the amount of infused solutions, if urea clearances greater than 150 ml/min at 300 ml/min blood flow are required. Theoretically, the combination of predilution and postdilution is the best system to utilise relatively small amounts of sterile solution in order to enhance treatment efficiency at low blood flow. However, the predilution mode may ultimately be preferable because of easier utilisation of the hardware. The results of clinical application of pre-postdilution haemofiltration indicate that at a 400 ml/min blood flow, a urea clearance of more than 220 ml/min can be obtained, and the duration of treatment can be reduced to only 3 h in the majority of patients.

Anuria↗
PubMed1986

Danger of an unnecessarily prolonged dialysis session: carpal tunnel syndrome.

Ten patients of a population of 319 on chronic intermittent treatment with Cuprophan dialyzers have undergone surgery for carpal tunnel syndrome (CTS). Since 1971 the dialysis schedule for all patients has been 4 m2/h three times per week. All patients were anuric. The operated patients represent 16% of the total population. In comparison with a dialysis population in other units described in the literature (12), 8 m2/h performed three times per week, with similar dialysis aging and a CTS incidence of 47%, it appears that the duration of the dialysis session per se increases the frequency of CTS and leads to the problem of the consequences of blood membrane interaction.

Adult↗
PubMed1979

Long-term use of a "stable" bicarbonate containing dialysate.

We present an original method for the preparation of "stable" dialysate containing 35 mEq/l of bicarbonate. The dialysate was utilized with 4 patients for periods ranging from 4 months to 1 year according to a short-term recirculated dialysis schedule in closed circuit (20-40L) (2-2 1/2 hrs) on alternate days. Preliminary results are reported here with respect to the tollerance of the dialytic run and correction of the acid-base balance equilibrium. The clinical tollerance is excellent despite high dehydration rates even in patients particularly sensitive to ultrafiltration. The acidosis correction would seem to be much better with bicarbonate than with traditional dialysis. The difference is even higher if we consider the brevity of the dialysis. During the bicarbonate dialysis we do not observe any fall of the PCO2 or significant difference in PO2 in the patient's blood. The correction of acidosis probably causes the normalization of pre-dialytic potassiemia in spite the "net" removal of K with short dialysis is considerably less.

Acidosis↗
PubMed1979

[Parathyroidectomy for secondary hyperparathyroidism: anatomo-surgical observations on experience in 16 treated cases].

The authors, on personal experience, based on parathyroidectomies for secondary hyperparathyroidism, relate the surgical anatomic findings after a brief discussion on indications. They relate beside some atypical seats of parathyroid glands, observed in 11 glands of the 59 removed. Finally they emphasize the importance of accuracy of surgical exploration because that cannot be helped by instrumental methods or by gross pathologic observation.

Adult↗
PubMed1978

Hemodynamic studies, acid-base status and osmolality in different hemodialysis procedures.

Three patients on maintenance dialysis were each treated with three different procedures: A) twenty-liter recirculation dialysis with bicarbonate buffering, B) recirculation-adsorption dialysis and C) single-pass dialysis. Hemodynamic parameters were measured invasively and procedures A, B and C were compared for each patient. In this intraindividual comparative study, the authors attempted to establish a relationship between the varying hemodynamic parameters and the changes in osmolality and acid-base status. There were indications of some causal relationship to circulatory stability: in A and B, there were peripheral resistance increases of 24.5% and 38.4%, respectively, with stable circulation; in C, there was a 6.1% increase and unstable circulation. Additionally, the influence of acidosis is shown in B, with disproportionately strong reductions of cardiac output (21.9%) and pulmonary artery pressure (44.9%); In spite of a decrease of osmolality (A: 15.6 mOsm/L), stable circulation could be achieved if the peripheral resistance was substantially increased and acid-base status was equalized.

Acid-Base Equilibrium↗
PubMed1978

Critical appraisal of haemofiltration and ultra-filtration. The development of ultra-short dialysis: preliminary results.

The clinical experience obtained with 2 hours every other day recirculation dialysis, using 20-40 liters of dialysate, without sorbents, and standard cuprophane dialyzers of 1.0-1.5 sq.mt. is reported. So far, over 350 treatments in 8 patients have been performed. After 2 hours of treatment the removal of urea, creatinine, phosphate and uric acid, is similar to that obtained by 4-6 hours of haemofiltration. The alkalinazation of the patient through direct venous infusion of bicarbonate, makes predialysis acid-base significantly better than in standard haemodialysis and haemofiltration. Asymptomatic correction of severe fluid overload is easily obtained like in isolated ultrafiltration. The role of osmolality and vasopressors are discussed. A dry weight below the value obtained by previous dialysis treatment is achieved, and volume dependent hypertensions as in haemofiltration are corrected after 2-8 weeks. As an additional advantage, this method offers a highly semplified technical approach and a further reduction of the dialysis time.

Bicarbonates↗