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Biomedical subjects

A Da Porto

Publications and source records attributed to A Da Porto.

13 recordsLinked to original sources
PubMed1995

Recombinant tissue plasminogen activator (rt-PA) as first-line therapy for declotting of haemodialysis access.

One of the most common complication in haemodialysis patients is thrombosis of the arteriovenous fistula (AVF). Thirty-five patients with a total of 42 thromboses of the angioaccess were infused via a small needle: (i) into the feeding artery (50% of the cases); (ii) into a AVF venous segment of the arteriovenous fistula (42.8%); (iii) directly into the thrombus (7.1%), by rt-PA. After an initial pulse of 5-10 mg, according to body weight, the drug was continuously infused by a pump with the speed automatically programmed in 30 Brescia-Cimino autologous AV fistulae and 12 polytetrafluoroethylene (PTFE) grafts. A complete thrombolysis with return of bruit and thrill was obtained in 71.4% of the cases using a mean drug dose of 21 mg and an infusion time of 3.8 h. All the successful cases underwent haemodialysis via AVF on the same day. No bleeding occurred at remote sites. Local bleeding occurred in 16% of the cases; in no case was it so severe as to require the suspension of the therapy or blood transfusions. The median cumulative duration of patency after thrombolysis was 32.4 months. Respectively 21, 12 and two patients had a functioning angioaccess after 3.6, 32.4 and 36 months from the lytic approach. Failure of the treatment was not related to the patients' gender or age, AVF age, route of administration of the drug, type of vessel (natural or artificial), or delay between the discovery of the fistula occlusion and the start of the therapy. In unsuccessful cases an organic lesion of the vessels was documented by angiography or echo colour Doppler. In summary, rt-PA local infusion provides a useful means of preservation of AV fistulae and may be used as the therapy of first choice in dialysis patients without active bleeding or high bleeding risk.

Adult↗
PubMed1992

Hepatitis C virus in dialysis units: a multicenter study.

Three hundred and eighty-seven chronic hemodialysis patients were evaluated, in a multicenter study, to investigate the epidemiology of hepatitis C virus. In anti-HCV seropositive patients, serum ALT values and blood transfusions were retrospectively compared; blood donors were studied for serum transaminases. In seropositive patients without previous blood transfusions, analysis of dialysis schedule was done. Eventually, the intrafamilial transmission of hepatitis C virus was studied in 104 family members. The prevalence of HCV infection in hemodialysis patients was 15.7%. The incidence of acute hepatitis was frequent, while chronic hepatitis incidence was less than expected (17.5%). Intrafamilial diffusion was low (1.9%). Blood-transfusion-related infections seem to be negligible, while cross-contamination in dialysis units seems to be very important.

Alanine Transaminase↗
PubMed1992

Comparison between first- and second-generation test for anti-hepatitis C virus antibodies in hemodialysis patients.

The serum of 387 hemodialysis patients from 9 dialysis units was checked for anti-hepatitis C virus antibodies with a 1st-generation ELISA (Ortho) test: 61 patients were repeatedly positive. In order to avoid false-positive results, these sera were tested with a 1st-generation confirmatory RIBA test, 2nd-generation screening ELISA test and 2nd-generation confirmatory RIBA test. The 2nd-generation ELISA test confirmed data obtained with 1st-generation ELISA, however, the 1st-generation confirmatory RIBA test underestimated the number of anti-HCV-positive patients.

Diagnostic Errors↗
PubMed1988

[Clinical use of IM-PH immuno-columns].

The results of plasma perfusion through immunoabsorbent columns were assessed in neuroimmunological conditions. The method is a modified plasmapheresis. The plasma is passed through a column of polyvinyl alcohol gel bound with phenylalanine. Three patients were treated by this method (two with acute polyneuropathies due to the Guillain-Barré syndrome, and the third with a polyneuropathy related to Hepatitis A). Each patient underwent 3 sessions, on alternate days for a six day period, with perfusion of 6-6.5 1 of plasma. No adverse effects were observed during treatment or changes in PAO values. Serum Na+-K+-Cl-Ca++-Gluc-Tot Prot-Alb-RBC-WBC-Hb-Urea and Creatinine were constant. Complete remission of the peripheral symptoms of the patients with the Guillain-Barré syndrome was observed whilst the third patient had a partial remission (in the left arm). These observations suggest that this method may be of therapeutic value in patients with acute polyneuropathy due to the Guillain-Barré syndrome.

Adult↗
PubMed1988

[Hypopotassemia and rhabdomyolysis. Description of 3 cases of different etiologies].

Three cases of rhabdomyolysis secondary to hypopotassaemia caused respectively by excess liquorice intake, the use of a nasal spray containing fluoroprednisolone acetate and a kidney tubular condition identified as distal tubular acidosis (ATR) are described. The aetiology of each case is discussed with a description of the clinical course and laboratory tests and particular emphasis on variations in the renin-angiotensin-aldosterone system.

Acidosis, Renal Tubular↗
PubMed1986

[Leptospirosis].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMedDate not supplied

[Mass transfer of magnesium in hemodialysis].

The rate of mass-transfer (MT) of magnesium during hemodialysis was studied in thirty-five patients with hypermagnesemia (Mg = 3.75 +/- 0.72 mg/dl) undergoing chronic hemodialysis. The aim of the study was to verify which is the best dialytical approach to remove the excess of magnesium. The concentration of Mg in the dialysate was of 1.82 mg/dl for all patients. MT was -0.51 +/- 0.36 g and no statistical difference was found between patients treated with cuprophan hollow fibers dialyzers, PAN and cuprophan plates. Mg MT is not correlated with dialysis duration (r = -0.23; p:ns), urea clearance (r = -0.08; p:ns), KT/V index (r = -0.03; p:ns), blood flow (r = -0.15; p:ns). In conclusion from our data, in agreement with other Authors, reduction of serum Mg levels is more convenient by obtained by a decrease in Mg concentration in the dialysate under 1.82 mg/dl, in order to increase the blood-dialysate concentration gradient.

Acrylic Resins↗