Search PubMed⌕ Search

Biomedical subjects

G P Sancipriano

Publications and source records attributed to G P Sancipriano.

13 recordsLinked to original sources

Optimizing sodium balance in hemodialysis.

this paper develops and tests a mathematical model for Na+ kinetics applied to standard hemodialysis. The volume of distribution of exchangeable Na+, dialyzer surface area, blood and dialysis fluid flow rate, target weight loss, treatment duration and the Na+ diffusibility constant are taken into account. The model is used to compute the optimal hour by hour dialysis fluid Na+ concentration required to achieve the prescribed end-dialysis natremia and maintain a constant end-dialysis body Na+ pool, while providing a nearly uniform removal of Na+ over dialysis. The model was preliminary tested on 10 consecutive dialyses in a single patient using special dialyzer which generates a part of ultrafiltrate uncontaminated by dialysate.

Aged↗

[Evolution of the serum aluminum values in the Piedmont dialysis population. Dialysis Centers of the Piedmont].

The authors have evaluated the evolution of values of serum aluminium concentration (Als) in the whole pool of patients undergoing RDT in Piedmont in the years 1982-1990. We have compared the data of the Piedmont Regional Registry of Dialysis and Transplantation at the end of 1990 to those obtained in 1982, 1986 and 1989. A progressive reduction has been observed in the percentage of patients with Als > 100 micrograms/l, who were 13.5% of the pool in 1982 and 7.5% in 1986 and finally decreased to 1.5% in 1990. This is yet more evident for patients dialyzing at home as in 1982 43% of them had a Als > 100 micrograms/l, whereas in 1986 only 8.2% did and in 1990 this percentage had decreased to 3.6%. The values of Als (distinguished by type of treatment of chronic renal failure) show end confirm the improvement of the situation of aluminium accumulation, specially as regards bicarbonate HD where the percentage of patients with Als > 100 micrograms/l decreases from 10.5% in 1986 to 1.7% in 1990. These data point out the efficacy of prevention and control programs regarding aluminium pathology performed in the last years in Piedmont. This has led to a reduction of the severe accumulation syndromes observed in the first years of '80 and has allowed the nephrologist to prepare more correct therapeutic prescriptions.

Aluminum↗

[Artificial intelligence--the knowledge base applied to nephrology].

The idea that efficacy efficiency, and quality in medicine could not be reached without sorting the huge knowledge of medical and nursing science is very common. Engineers and computer scientists have developed medical software with great prospects for success, but currently these software applications are not so useful in clinical practice. The medical doctor and the trained nurse live the 'information age' in many daily activities, but the main benefits are not so widespread in working activities. Artificial intelligence and, particularly, export systems charm health staff because of their potential. The first part of this paper summarizes the characteristics of 'weak artificial intelligence' and of expert systems important in clinical practice. The second part discusses medical doctors' requirements and the current nephrologic knowledge bases available for artificial intelligence development.

Artificial Intelligence↗

[Role of tumor necrosis factor in hemodiafiltration].

The Authors review the mechanisms involved in the production of cytokines during substitutive extracorporeal treatment with particular reference to microbial contamination and possibility of backfiltration of bacterial constituents more likely to occur with high permeability membranes. Recent and on-going studies from our laboratory support the contention that patients treated with high permeability membranes may be chronically stimulated. Use of "ultrapure" solution indeed brings about a marked reduction in predialytic plasma levels of tumor necrosis factor (TNF) in regard to what observed when standard solutions are adopted.

Acrylic Resins↗

[Role of paired filtration dialysis in substitutive treatment].

The Authors have evaluated the possibilities of use of the PFD in the regular dialysis treatment. At first they have studied in 8 patients the advantages offered by this technique in terms of depuration of small molecules and of tolerance in comparison with HD and HDF. Subsequently, they have compared the performances obtained in HF in a second group of 7 patients with the results observed in PFD executed by using 2 dialyzers on line and, in a second phase, in parallel, extending the comparison parameters to a higher molecular weight solute such as the beta 2-M. The results obtained indicate the PFD as a technique which can offer (compared to HD) a better tolerance and higher depurative performances, which on their turn can eventually allow a reduction of the length of the treatment. Moreover the possibility of executing the PFD with 2 polysulfone dialyzers on line and in parallel, increasing the UF to 13.5 and 15 L, renders this technique competitive with the HF also for its capacity of removing the beta 2-M.

Blood Urea Nitrogen↗

[Regular dialytic treatment in the Piedmont region. Results and prospects].

The Piedmont planning for the prevention and treatment of chronic uremia started in 1976, with the purpose to extending full treatment of the whole region, through the development of home and self care dialysis and intensive use of hospital short dialysis. Hospital dialysis would be reserved either for new treatments or complicated or uncooperative patients. Thank to an intensive exploitation of the existing hospital centers, a 68.7% increment in the number of treated patients was achieved and costs were kept down to a limited acceptable range. With the development of home and self care dialysis, 27% of the patients were located in out-of-hospital centers, and 17% at home. The Piedmont planning concerned itself with the patients' data collected by the Regional Registry under the following items: a) characteristics of dialysis population; b) the present modes of treatment; c) the number of patients apt to varying treatments and renal transplantation; d) the epidemiology of uremia causing nephropathies. At the present time results are only preliminary. Nevertheless, the first observations showed a long and difficult work with good possibilities of success for computerized facilities in the field of dialysis, particularly in respect to regional areas which in the reformed Health Service are now considered to be operating as autonomous.

Adolescent↗