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Biomedical subjects

R Ragni

Publications and source records attributed to R Ragni.

At least 55 records · Page 3Linked to original sources

Three-year follow-up after withdrawal of iron therapy in uremic patients on regular dialytic treatment.

Iron supplementation is commonly recommended in uremic patients undergoing regular dialytic treatment in order to correct a presumed iron deficiency due to impaired absorption and dialytic losses. Serum ferritin levels show an iron overload in 83% of 136 patients on 1.25 g/year i.v. iron therapy. After the withdrawal of iron therapy, directly correlated ferritin levels and percentage transferrin saturation decreased slowly, except in carriers of HLA-A3 antigens and in polytransfused patients. In these latter patients, desferrioxamine reduced but did not normalize the iron balance. The 16 patients who never received iron therapy showed a normal iron balance over a 3-year follow-up. Despite iron-ferritin therapy, 11 patients with baseline ferritin values at the lower normal limits showed a tendency toward further depletion. Orally administered bivalent iron seems to be more promising in normalizing iron-deficient patients without potentially harmful overloading.

Adolescent↗

[Traumatic dislocation of the knee treated by early surgical repair (author's transl)].

The authors have treated twelve traumatic dislocations of the knee. Three were treated conservatively with one satisfactory result. Nine were treated by early surgical repair with seven satisfactory results. The technique of ligamentous repair is described. The authors emphasise the frequency and severity of associated vessel and nerve damage. They found acute lesions of the popliteal artery in five cases, three of which had to be operated upon immediately with arterial suture or graft. In one case, ischaemia appeared four days after dislocation and the thrombosed artery was repaired by a venous graft. In one case a lesion of the lateral popliteal nerve which did not recover was treated by palliative surgery. In one case, secondary skin necrosis was treated by skin flap transplantation using micro-surgical technique with a satisfactory result. It is concluded that ligamentous and vascular repairs should be undertaken at the same procedure after arteriography.

Adolescent↗

[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↗

[Progression of acquired renal cysts in patients undergoing dialysis].

In uremic and dialysed patients, acquired renal cystic disease (ARCD) and its possible neoplastic degeneration are well-known. The aim of the paper is to assess the incidence of this pathology among dialysed patients in our Renal Unit. Final results have been achieved after three years. The evidence is that this pathology increases in older patients with respect to age and/or to long-term dialysis; we confirm neoplastic degeneration in two patients.

Age Factors↗

[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↗