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Biomedical subjects

L Baldrati

Publications and source records attributed to L Baldrati.

At least 55 records · Page 3Linked to original sources
PubMed1987

Serum CA 19-9 and CA 50 antigens in hemodialysis patients.

Serum concentrations of monoclonal antibody-defined tumor markers CA 19-9 and CA 50 were measured in 64 uncomplicated hemodialysis patients (Group 1) and in 8 hemodialysis patients with cancer (Group 2) in comparison with corresponding CEA determinations. From our results in Group 1 patients it appears that both CA 19-9 and CA 50 maintained an excellent specificity in these patients. As to the sensitivity of these tests, our findings in Group 2 patients are comparable with those reported in patients with cancer and normal renal function. It is concluded that, unlike CEA, these new tumor markers maintain their clinical value in chronic renal failure.

Adult↗
PubMed1986

Successful declotting of arteriovenous grafts with local infusion of urokinase in hemodialyzed patients.

Local infusion of urokinase was used in 15 cases of thrombotic occlusion of polytetrafluoroethylene grafts in 10 hemodialyzed patients. The treatment was successful in all patients except one in whom recurring thrombosis occurred because of junctional stenosis at the venous anastomosis. No relevant side effects were observed. Follow-up data show that such treatment can significantly prolong the survival of arteriovenous grafts in hemodialyzed patients with otherwise difficult access to the circulation.

Adult↗
PubMed1986

Lack of evidence for the role of secondary hyperparathyroidism in the pathogenesis of uremic thrombocytopathy.

The possible relationship between platelet dysfunction and secondary hyperparathyroidism (HPT) in chronic renal failure was examined in 23 uremic patients on conservative therapy (group I) and in 27 patients on maintenance hemodialysis (group II). Platelet function was assessed by measuring the degree of aggregation in response to various concentrations of adenosine diphosphate. Secondary HPT was evaluated by means of serum biochemistry (parathyroid hormone, calcium, phosphorus, and alkaline phosphatase) and radiographic examinations (x-ray films of the hand skeleton). This study showed impaired platelet aggregation in group I patients, compared to either group II patients or controls. There were no significant differences when group II patients were compared to controls. No significant correlations between platelet aggregation and the hematochemical changes associated with secondary HPT were found. No differences in platelet aggregation were found with regard to the activity (alkaline phosphatase) and the severity (x-ray findings) of secondary HPT. Effective treatment of secondary HPT with 1,25-dihydroxycholecalciferol in both group I and group II patients was not associated with consequent changes in platelet aggregation. It is concluded that secondary HPT is probably not a major factor in the pathogenesis of platelet dysfunction in chronic renal failure.

Adenosine Diphosphate↗
PubMed1986

Effect of ibopamine on the progression of chronic renal failure.

Persistent changes in the slope of the reciprocal of serum creatinine concentration against time after medical intervention are likely to reflect the influence of therapy on progression of chronic renal failure. This observation allowed us to demonstrate the ability of ibopamine, a new orally active dopamine-related drug, to improve renal function or at least to slow its deterioration in 20 patients studied over a period of 6 months. We also noted that the therapeutic response to the drug varied considerably according to the nature of the underlying nephropathy, with maximal benefit being observed in nonglomerular diseases.

Adult↗
PubMed1985

Serum alpha-1-acid glycoprotein in chronic renal failure.

We measured the serum concentration of alpha-1-acid glycoprotein (AAG) in 30 healthy subjects (controls), in 54 patients with various degrees of residual renal function (group I), and in 98 patients in the terminal phase of chronic renal failure (CRF) on both conservative and dialytic therapy (group II). A positive correlation between the logarithm of serum AAG and serum creatinine levels was found in group I. Serum AAG increased significantly when serum creatinine rose above 10 mg/dl. This fact would indicate that a retention of the substance occurs as the renal function falls. The mean serum concentration of AAG was significantly higher in group II patients, with no difference between those on conservative therapy and those on maintenance hemodialysis. However, levels above normal were present in only a minority of cases. We conclude that the serum AAG measurement maintains its diagnostic value as an acute phase reactant also in the terminal phase of CRF.

Adult↗
PubMed1985

Lack of relation between secondary hyperparathyroidism and red blood cell osmotic fragility in chronic renal failure.

The possible relationship between red blood cell (RBC) osmotic fragility and secondary hyperparathyroidism (HPT) in chronic renal failure was examined in 23 uremic patients on conservative therapy and in 42 patients on maintenance hemodialysis. Secondary HPT was evaluated by means of serum biochemistry (parathyroid hormone, calcium, phosphorus, and alkaline phosphatase) and radiographic examinations (X-ray films of the hand skeleton). This study showed increased RBC osmotic fragility in uremic patients when compared with controls, with no difference between those on conservative therapy and those on maintenance hemodialysis. No correlation between RBC osmotic fragility and the hematochemical changes associated with secondary HPT was found. No difference in RBC osmotic fragility was observed with regard to the activity (alkaline phosphatase) and the severity (X-ray findings) of secondary HPT. Effective treatment of secondary HPT by either pharmacological means (1,25-dihydroxycholecalciferol) or surgical removal was not associated with consequent improvement in RBC osmotic fragility. It is concluded that secondary HPT is probably not a major factor influencing RBC osmotic fragility in chronic renal failure.

Adult↗
PubMed1985

Nonsecretory multiple myeloma. Presenting findings, clinical course and prognosis.

The present report gives information both on the clinical features at presentation and the clinical course of 7 consecutive patients with nonsecretory multiple myeloma. It provides evidence that the nonsecretory variant was closely associated with high tumor cell mass, as determined by severe anemia and/or multiple areas of bone destruction. The marked depression of normal immunoglobulins and the absence of both renal failure and hypercalcemia differentiated nonsecretory from typical myelomatosis. Finally, the survival length of patients with nonsecretory myeloma appeared to be similar to that of comparably staged patients with secretory myeloma.

Actuarial Analysis↗
PubMed1985

[Hyperlipidemia in uremic patients in dialysis].

Serum concentrations of cholesterol, triglycerides, high density lipoprotein-cholesterol (HDL-C), apoproteins (apo) A and B were compared in 36 hemodialysis patients and in 20 normal controls. Hyperlipidemia was present in 22 patients (59.4%); 15 of them had simple hypertriglyceridemia and 7 had combined hyperlipidemia (i.e., hypertriglyceridemia and hypercholesterolemia). All hemodialysis patients, whether normo- or hyperlipidemic, had normal apo A and low HDL-C serum concentrations. Positive risk factors for atherosclerosis other than low HDL-C (high serum apo B concentration and low apo A/apo B ratio) were present in hyperlipidemic patients only, with no difference between those with simple hypertriglyceridemia and combined hyperlipidemia. These results suggest that the risk for atherosclerosis related to lipid abnormalities may be considered as substantial in hyperlipidemic hemodialysis patients, but not in normolipidemic ones, regardless of the cholesterolemic values.

Adult↗
PubMed1984

[Radiological evaluation of the state of hydration in uremic patients under periodic dialysis].

Seventy-four uremic patients in chronic hemodialysis were studied by X-ray of the thorax before and after the same dialysis. Radiological signs and variables (originally proposed by Milne) related to hemodynamics of pulmonary and systemic circulation were evaluated in relation to fluid subtraction. The study demonstrated the high sensitivity and the clinical value of thoracic radiography in the follow-up of these patients and particularly in the evaluation of fluid overload.

Adolescent↗
PubMed1983

Effects of renal substitutive programs on amino acid patterns in chronic uremia.

Abnormalities in the amino acid patterns are a constant finding in chronic renal failure and can be regarded as one of the typical biochemical alterations of uremia. This paper evaluates the long-term effects of various artificial substitutive treatments and renal transplantation on plasma and tissue amino acid patterns in chronically uremic patients. Fifty-three patients were included in the study: 35 on artificial treatments (9 on hemodialysis, 9 on hemofiltration, 4 on hemoperfusion, 6 on continuous ambulatory peritoneal dialysis, and 7 on intermittent peritoneal dialysis) and 18 with well-functioning renal transplants. Complete plasma aminograms were performed in all patients before starting the treatment, and repeated every 3 months up to 1 year (artificial therapies) and 3 years (renal transplantation). The amino acid composition of the bone was also determined in 8 dialysis patients and 9 transplant patients. None of the artificial therapies was associated with normal plasma patterns either in the short- or in the long-term, whereas successful renal transplantation led to normalization of the plasma profile within 2 to 4 months in all patients. However, bone amino acid composition remained altered both in artificially treated and in transplanted patients.

Adolescent↗
PubMed1982

[Serum ferritin and iron therapy in patients treated with periodic hemodialysis].

Serum ferritin, measured by radioimmunoassay in 65 dialysis patients (mean time of dialysis 38.9 months), was significantly higher (247.9 +/- 224.5 ng/ml) than in controls (p less than 0.001), inversely correlated with dialytic age (p less than 0.05), and had no difference as far as sex or underlying nephropathy were concerned. With regard to the other hematological parameters, serum ferritin correlated inversely with total transferrin and directly with percentage of total transferrin only. In 28 patients, an intravenous iron load (0.6 g in one month) induced a further increase in serum ferritin (p less than 0.001), rather disomogenous and not clearly correlated with initial levels. The change in hemoglobin concentration after iron administration was in close relationship with initial serum ferritin levels (r = -0,72, p less than 0.001). A significant increase in hemoglobin could be detected in all the patients with serum ferritin less than 65 ng/ml and in most patients with serum ferritin less than 160 ng/ml, while hemoglobin change was negligible when serum ferritin levels in dialysis exceeded this value. Thus, although serum ferritin levels in dialysis patients may reflect not only iron overload but also an abnormal metabolism, serum ferritin measurement remains a reliable guide to iron requirement. We suggest maintaining serum ferritin levels between 65 and 160 ng/ml, to avoid iron stores depletion and on the contrary, iron overload.

Adult↗
PubMed1980

Regular hemoperfusion in regular dialysis treatment. A long-term study.

The capacity of activated charcoal to remove toxins from the blood is well established. Its poor biocompatibility, inability to remove urea, electrolytes and water, and high cost have so far been the major objection to a wider use of charcoal with chronic uremic patients. The availability of a charcoal coated by a new highly hydrophilic methacrylate based on membrane enabled us to keep 18 uremic patients on a combined hemodialysis-hemoperfusion schedule for 4-52 weeks. Investigations concerned patients in whom relapsing signs of uremia occurred despite technically adequate dialysis, and other cases where dialysis was both technically and clinically adequate. In the first group of patients, the combined programme led to an improvement of the dialysis resistant clinical signs, while certain positive metabolic effects were also observed. In the second group, the hemodialysis-hemoperfusion treatment allowed a reduction of about 30% in time of treatment per week. Tolerance of the new coated charcoal was good throughout treatment in terms both of biocompatibility and of side effects.

Adult↗