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Biomedical subjects

G Arrigo

Publications and source records attributed to G Arrigo.

45 records · Page 3Linked to original sources
PubMed1987

Tubular nephrotoxicity after intravenous urography with ionic high-osmolal and nonionic low-osmolal contrast media in patients with chronic renal insufficiency.

Nephrotoxicity of intravenous contrast media is more frequent and striking in patients with risk factors, the major one being preexisting chronic renal insufficiency. New nonionic low-osmolal contrast media allegedly have less nephrotoxicity than the traditional ionic high-osmolal ones. This was tested for two contrast media in a group of 18 patients with stable chronic renal insufficiency. The urinary excretion of two brush-border enzymes (alanine aminopeptidase, AAP, and gamma-glutamyl transpeptidase, gamma-GT) and of a lysosomal enzyme (N-acetyl-beta glucosaminidase, NAG), functional markers of tubular injury, were measured before and after intravenous urography with an ionic high-osmolal radiocontrast medium, meglumine sodium diatrizoate, or with a non ionic low-osmolal one, iopamidol. Urinary NAG excretion did not change significantly after administration of either contrast media. Urinary AAP and gamma-GT excretion increased significantly (p less than 0.01) after diatrizoate. After iopamidol, only gamma-GT excretion increased significantly (p less than 0.05). Our data suggest that the nonionic low-osmolal radiocontrast medium iopamidol is less toxic to tubules than the ionic high-osmolal medium diatrizoate and that the brush-border enzymes AAP and gamma-GT are sensitive markers for this toxicity.

Acetylglucosaminidase↗
PubMed1985

Pharmacokinetics of norfloxacin in chronic renal failure.

Norfloxacin is an antibacterial drug chiefly eliminated by the kidney and therefore useful in the treatment of urinary tract infections. To study its pharmacokinetics in chronic renal failure, we administered a single oral dose of 400 mg to 14 patients and 6 controls with normal renal function. Patients were divided into three groups according to the severity of renal failure. Norfloxacin was measured in serum and urine by bioassay. Serum half-life in controls was 3.87 hours and prolonged to 5.85 hours in group I (creatinine clearance 80-45 ml/min), 7.25 hours (p less than 0.05) in group II (creatinine clearance 44-20 ml/min) and 8.34 hours (p less than 0.01) in group III patients (creatinine clearance less than 20 ml/min). A good linear correlation between the elimination rate constant and creatinine clearance (r = 0.79, p less than 0.01) has been found. Total urinary excretion in the 72 hour period after administration achieves 40.4% in controls, falls to 23.5% (p less than 0.05), 15.6% (p less than 0.01) and 8.2% (p less than 0.01) of administered dose in groups I, II and III, respectively. Similarly, urinary concentrations decrease in all patient groups with respect to controls. Our data show that effective urinary antibacterial concentrations of norfloxacin after 400 mg single oral dose were obtained even in patients with severe renal failure. In these patients systemic accumulation after repeated dose administration is a probable event. Therefore, dosage adjustment is advisable in patients with creatinine clearance less than 20 ml/min, although it will inevitably cause lower urinary concentrations.

Adolescent↗
PubMed1984

[Nephrotoxicity of contrast media. Comparison of iopamidol and diatrizoate by measurement of urinary enzymes after urography].

An ionic (diatrizoate) and a non ionic (iopamidole) radiocontrast medium were compared as to their nephrotoxicity in a cohort of 21 patients with renal disease, 18 of which with normal renal function. The elevation of the urinary excretion of enzymes from renal tubular cells has been considered as a good index for renal tubular damage. We measured two lysosomal enzymes (NAG and beta glucuronidase) and a brush-border enzyme (gamma GT). In all patients we demonstrated an elevation of urinary excretion of the three enzymes already 12 hours after contrast medium administration. However, the elevation was statistically significant only after employment of the ionic contrast medium and concerned gamma GT and beta-glucuronidase; the urinary excretion of NAG did not vary significantly. Urinary enzymes levels returned to basal values 36 hours after intravenous pyelography. In conclusion, iopamidole showed a lower nephrotoxicity with respect to diatrizoate, as demonstrated by the lower levels of urinary enzymes excretion reached after its use.

Acetylglucosaminidase↗
PubMed1975

[Surgical treatment of cardiospasm].

Results obtained with Heller's operation in the management of 27 cases of cardiospasm are presented. The probable causes of oesophageal achalasia leading to dilatation and elongation of the wall are examined. These, in association with nervous changes, form the most marked features of the syndrome. The soundness of the operation employed is confirmed by the results achieved. These are most satisfactory when the disease is at the initial stages and dilatation is not excessive.

Adult↗
PubMed1975

[Our experience with peripheral arterial embolectomy].

34 cases of acute peripheral ischaemia examined in recent years at the University of Messina General Surgery Clinic are presented. 16 were subjected to embolectomy according to Fogarty. The remaining 18 received protracted medical therapy. Some successes were obtained. In other cases, gangrene necessitated amputation of the affected limb. Satisfactory results were observed in 70% of the operated series. Success was more marked when only a short interval was left between the embolic episode, with progressively poorer results as the penalty for delay. The long-term results of embolectomy are related to the nature of the underlying disease and the treatment given after surgery.

Aged↗
PubMedDate not supplied

Continuous urea monitoring in hemodialysis: a model approach to forecast dialytic performance. Results of a multicenter study.

BACKGROUND: A urea biosensor, inserted into the ultrafiltrate collection-line of paired filtration dialysis (PFD), not only allows on-line dialysis quantification, but also forecasts final (Cend) and 30 min equilibrated urea concentration (Ceq), the most reliable value for calculating dialysis efficiency. The urea biosensor processes plasma ultrafiltrate continuously, delivering a large amount of data to the computer, which estimates the parameters by a mathematical model, thus predicting the whole urea profile with rebound. METHODS: A multicenter randomized trial on 41 patients was conducted to ascertain the ability of a two-pool variable-volume urea model to forecast Cend and Ceq at 60 and 90 min after the start of dialysis. Two alternative dialytic treatments, A or B, were chosen, the latter being more efficient. Each treatment included six serial PFD. The accuracy of forecasting was evaluated through four indices based on forecast errors, calculated as the difference between observed and forecasted urea values: mean percent error (MPE) (%), mean absolute deviation (MAD) (mg/dl), mean absolute percent error (MAPE) (%) and root mean squared error (RMSE) (mg/dl). RESULTS: Forecasted urea concentrations were lower than those measured by the biosensor. MPE for Cend was negligible in A (+1.2%) and much higher in B (+7.2%); both values improved at 90 min, +1.0% and +5.8%, respectively. MAD for Cend was similar in both treatments and improved slightly at 90 min, ranging from 4.9 to 5.9 mg/dl. MPE for Ceq was +4% in A and and more than doubled in B (+11.5%); both values improved at 90 min, +3.7% and +9.7%, respectively. MAD for Ceq was 7.5 mg/dl in A and 8.5 mg/dl in B; both improved at 90 min, 6.7 and 7.4 m g/dl, respectively. The other indices, MAPE and RMSE, showed similar results. Comparison between the errors of the two treatments with analysis of variance (ANOVA) for repeated measures gave no significant results. CONCLUSIONS: Our model forecasts of urea concentrations were overall lower than the measured ones: the bias was negligible for A-Cend, greater for the A-Ceq and when the more efficient treatment B was used. The 60 min predictions improved at 90 min. The comparison between the prediction errors in the two treatments were not statistically significant. The recirculation measurement would probably reduce the bias if it were properly incorporated into the model.

Filtration↗
PubMedDate not supplied

[Alterations of cardiac output during bicarbonate hemodialysis and its relationship with other hemodynamic parameters].

PURPOSE: Time course of cardiac output (CO) and other hemodynamic parameters were measured during hemodialysis (HD). Our aims were to identify a characteristic CO profile and investigate the relationship with other hemodynamic parameters. PATIENTS AND METHODS: CO was measured with ultrasound dilution method in 45 chronic hemodynamically stable HD patients. Diabetics and patients with heart diseases were excluded. Ultrafiltration rate (UFR) was fixed at 649 +/- 244 mL/min. Pre/post statistical comparisons were performed for CO, cardiac index (IC), central blood volume (CBV) and total peripheral resistance (TPR). RESULTS: CO was pre 5.7 +/- 1.8 and post 4.5 +/- 1.4 L/min (p=0.001); IC was pre 3.2 +/- 0.9 and post 2.6 +/- 0.7 L/m2 (p=0.001); CBV was pre 1.28 +/- 0.39 and post 1.09 +/- 0.32 L (p=0.001). TPR increased from 18.7 +/- 5.6 to 22.7 +/- 6.1 mmHg/L/min (p=0.001). Maximal CO reduction rate was found at 60 min, thereafter it reduced progressively. Log(CO1) increased in a non-linear way with body weight gain and similarly it decreased during UFR. A negative correlation was found between log(TPR1) and log(CO1-QA). CO reduction was associated with UFR and not with age, dialysis duration, left ventricular hypertrophy, sex and hemoglobin (Hb) in a multiple regression model (r2 =0.31, p=0.05). Qa/CO1 was 0.16 +/- 0.12. CBV/CO increased from 0.23 +/- 0.06 to 0.25 +/- 0.07%. CONCLUSIONS: Progressive CO reduction and TPR increase appear to be the typical hemodynamic features of bicarbonate HD with a UFR of moderate degree. Volume overload and CO increase were related in a non-linear way. TPR1 was strongly correlated with CO1-Qa, suggesting that a large arterovenous shunt was associated with increased resistance.

Adult↗