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Biomedical subjects

G Civati

Publications and source records attributed to G Civati.

At least 55 records · Page 3Linked to original sources
PubMed1985

Is the dialysate fluid source of complement activating factors?

To distinguish between membrane-induced and dialysate-induced mechanism of complement activation attending hemodialysis (HD), the C3a plasma level and blood neutrophil count profiles have been determined during procedures performed with noncellulosic membranes, as PAN and PMMA (with minimal complement-activating potential) and, by comparison, with new cuprophane (that displays the greatest complement-activating potential). Furthermore, PAN and PMMA membranes have been used in 2 other blood purification methods: high efficiency hemofiltration (HEHF), in which there is no dialysate on the other side of the membrane, and hemofiltration without substitution fluid and with reinfusion of dialysis-regenerated hemofiltrate (HWSF), in which the dialysate is separated from the blood circuit by the hemofiltrate circuit. In addition, sequential dialysis-ultrafiltration (UFD) experiments with PAN membranes have been performed, where dialysate was present only in the second part of the procedure. In all the HD and UFD procedures LAL test assays were performed on dialysate at the same times as C3a and neutrophil determinations. Our findings seem to suggest that the dialysate can be a source of complement activating factors; complement activation detectable by C3a plasma levels can ensue when LAL test-positive material is present in the dialysate.

Blood↗
PubMed1985

Influence of technical factors and different immunosuppressive regimens on kidney graft survival. Retrospective analysis on 300 kidney transplants.

300 patients underwent kidney transplantation. Uretero-neocystostomy was performed by means of the Politano-Leadbetter technique in the first 185 patients and direct ureterovesical anastomosis in the other 115 patients. Immunosuppression included conventional therapy (steroids, antilymphocyte globulins, azathioprine) and the association cyclosporine A and steroids. Retrospective analysis on these 300 patients indicates that the improved 1 year graft survival rate (85% vs 64%) we observed in the latest years has depended to the same extent, on improved surgical technique and on advent of cyclosporine A in our therapeutic protocols. Cyclosporine A at low starting doses immediately adjusted on whole blood trough levels (200-400 ng/ml) proved to be superior to other therapeutic schedules reported in this study (1-year graft survival rate: 94% vs 84%-73%). Direct ureterovesical anastomosis was characterized by a net reduction of urologic complications (2.5% vs 9.7%).

Antilymphocyte Serum↗
PubMed1985

Haemofiltration without substitution fluid.

Haemofiltration at its best is able to give excellent clearances of solutes in a wide molecular weight range, but the need of large amounts of reliable substitution fluid makes this technique too expensive for more widespread application. In order to give an 'adequate' treatment by a safe, well tolerated, effective and comparatively cheaper method, haemofiltration without substitution fluid (HWSF) has been carried out. This method, consisting of the regeneration of appropriate amounts of pure convected plasma water by highly permeable, high surface area dialysis membranes, has been utilised for several months in four patients, with encouraging clinical results.

Adult↗
PubMed1983

Immune response to hepatitis B vaccine in staff and patients in renal dialysis units.

Anti-HBs response was detected in 96 per cent of staff members in three haemodialysis units after three 20 microgram doses of hepatitis B vaccine and in 82 per cent of adult patients treated with three 40 microgram doses. The percentage of responders and levels of antibody remained unchanged at 12 months from the beginning of the trial. Three out of six children injected with three 20 microgram doses in a paediatric haemodialysis unit remained free from markers of HBV infection and had high levels of anti-HBs after the second dose of vaccine. The other three children who developed serological markers of HBV infection seroconverted to anti-HBc within six months from the first dose and, in one of them, antigenaemia at three and four months was detected.

Adult↗
PubMed1983

Immunological monitoring of viral infections in renal transplant recipients.

Twelve viral episodes occurred in 54 antilymphocyte globulin-treated renal transplant recipients (two primary cytomegalovirus, seven cytomegalovirus reactivations, one chickenpox, two influenza). In 11 of 12 cases the ratio between peripheral T4 and T8 subsets fell (from 1.698 to 0.986, p less than 0.01) due both to a reduction of T4+ and to an increase of T8+ cells. T10+ and 5/9 subsets also increased. Suppressor T-cell function, as measured by two simultaneous assays, was enhanced. In antibody-negative CMV patients the reversal of T4/T8 ratio preceded the appearance of specific IgM. T4/T8 ratios rapidly returned to normal in mild episodes, but remained reverted in symptomatic CMV patients for several months, despite a reduction in the immunosuppressive regimen. Symptomatic viral episodes displayed marked imbalances in T cell subset numbers and function, while in asymptomatic cases the changes were less evident.

Chickenpox↗
PubMed1983

Hemofiltration in diabetic uremic patients.

The increasing number of Diabetic Uremic Patients (DUP) starting the substitutive treatment (ST) constitutes a difficult and often disappointing problem in terms of efforts, clinical results and side-effects. While treatment of these patients by C.A.P.D. is well documented, the adoption of Hemofiltration (HF), has been, up to now scarcely considered. In order to define the potentialities of a HF policy in the treatment of these patients, data from 6 DUP treated with postdilutional HF for a 10.6 months/patient period were collected on a multi-center basis and retrospectively examined. Good results were achieved in terms of vascular stability, control of arterial hypertension and of retinopathy, clinical complications and hospitalization rate. Although C.A.P.D. may represent a first choice treatment for DUP with residual function, satisfactory glicemic control, difficult blood access and a motivation to full autonomization, HF may constitute a logical alternative when C.A.P.D. should be unmanageable (visus impairment, history of repeated peritonitis and dismetabolism, considerable weight gain): an integration of HF and C.A.P.D. can assure PDU with a continuative treatment.

Blood↗
PubMed1980

[Sequential scintigraphic evaluation in renal transplantation (author's transl)].

In a series of 57 renal transplantation of a sequential scintigraphy was carried out within the tenth day from surgical operation. According to the various scintigraphic findings and on the basis of the possible acute renal failure, the patients were subdivided into 7 groups and the data were correlated with clinical and hystological findings.

Acute Kidney Injury↗
PubMed1978

[Treatment with antilymphocyte globulin (ALG) and evolution of renal transplant: observations of 42 cases].

42 necrokidney transplants, performed in Renal Unit of "Niguarda - Ca' Granda" Hospital in Milan, since 1972, have been examined. Hystocompatibility score and previous transfusions and/or pregnancies apparently did not correlate with three months transplants survival. Our patients have been separated into two groups according to treatment with or without ALG: the group treated with ALG showed a better percentage survival of the kidney at three months a lower incidence of rejection episodes during the same period. The usefulness of ALG treatment is reaffirmed; we consider that a better prognosis at three months probably means a more favorable clinical course.

Adolescent↗
PubMed1976

Acute renal failure due to rifampicin (R-ARF).

Five episodes of acute renal failure due to rifampicin (R-ARF) were observed in four patients and the clinical and histological data were compared with the records of 52 episodes reported in the literature. The bulk of data supports the assumption that the by far most frequent renal injury responsible for R-ARF is acute tubular necrosis produced by a vasomotor mechanism. Nevertheless a few data, above all immunohistological findings, suggest the local presence of allergic process. It may be, that the development of an immunological renal lesion is prevented or blunted by the consequences of vasomotor effects.

Acute Kidney Injury↗
PubMed1975

Drug induced hypersensitivity nephritis.

Drug-induced hypersensitivity nephritis may show several histological and clinical patterns. In most of these microscopic vascular involvement of the kidney seems to be very frequent. On immunofluorescence, deposits of C3 in mesangium and in arterioles were observed in almost all cases, independently of histological features on light microscopy. The pointing out of clinico-histological relationship seems to be the best rational approach to diagnosis of these conditions.

Adult↗
PubMedDate not supplied

Advantages of short-time ureteric stenting for prevention of urological complications in kidney transplantation: an 18-year experience.

We retrospectively studied the incidence of urological complications in a consecutive series of 590 patients (group B) who received a kidney transplant (KT) with a ureteral stent from January 1994 to December 2002. The ureteral stent was sewn to the bladder catheter during the surgical procedure and left in situ for a mean time of 10 days (range 8 to 12 days). The results were compared to a consecutive series of 414 patients who received a KT from March 1986 to December 1993 without a ureteral stent (group A). The two groups were comparable in terms of donor and recipient gender, ischemia time, delayed graft function, and chronic rejection incidence, but differed in mean donor age (44.1 vs 36.0 years), mean recipient age (45.4 vs 39.1 years), living/cadaveric donor rate (19.8% vs 11.9%), arterial lesions and bench reconstruction rate (11.1 vs 3.5%), as well as acute rejection episodes (11.7% vs 29.2%). Complications were seen in nine patients in group B (1.5%) and 17 patients in group A (4.1%) (P < .0001). Urinary leaks presented in two patients in group B (0.3%) and 11 patients in Group A (2.6%; P < .0001), while stenosis was present in six patients in group B (1.5%) and 7 in group A (1.2%) (P = NS). Urological complications such as urinary tract infection and macroscopic hematuria were similar in both groups. Time to presentation of a leak was within 2 weeks from KT in 10 patients (92.3%), while stenosis presented early in four patients (one in group B and four in group A). Of the stenoses, 69.3% presented late (beyond 12 weeks) in five patients in group B and three in Group A. In conclusion, our data suggest that routine use of double pigtail ureteral stent significantly decreased the incidence of leaks and early stenoses, but it did not modify late stenosis incidence. In the last decade, risk factors for urological complications have been increasing over time, namely, older donors and older recipients, living donation, length of dialysis, and the use of grafts with arterial lesions. Therefore we believe that a ureteral stent should be routinely considered to afford the advantage to protect the urinary anastomosis in the early postoperative period when the incidence of complications is highest, without the need of cystoscopy for its removal.

Female↗