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S Stefoni

Publications and source records attributed to S Stefoni.

At least 127 records · Page 7Linked to original sources
PubMed1981

Short-term thoracic duct drainage in drug resistant immunologically mediated glomerulonephritis. Evaluation of lymph and blood lymphocyte characteristics during drainage.

Thoracic duct drainage has so far been employed in clinical nephrology mainly in renal transplantation and in immunologically mediated glomerulonephritis. The effectiveness of duct drainage in producing immunosuppression has been widely demonstrated, and several authors have used long-term, and others short-term drainage. 12 patients suffering from drug resistant immunologically mediated glomerulonephritis were treated with short-term (mean 10 days) thoracic duct drainage. In order to define the time, type and evolution of changes in immunological status, humoral and cellular immunity were studied daily in all patients. Marked changes (mainly in the number of lymphocytes drained and in their nucleic acid content and E-rosette forming capacity) take place in the first (4-5) days of drainage. These findings, together with positive clinical and laboratory results obtained in our patients, suggest that satisfactory immunosuppression may be achieved by short-term drainage, which is simpler and safer than long-term drainage. The procedure might thus be extended to a wider number of immunological diseases where drug therapy fails to take effect.

Adolescent↗
PubMed1981

Combined hemodialysis-hemoperfusion treatment reduces the time of substitutive therapy in chronic uremia.

Charcoal hemoperfusion has long been used in chronic uremia as an adjunct or substitute for conventional hemodialysis. In this study a regular combination of hemoperfusion and hemodialysis was used to cut down the weekly substitutive sessions from 3 to 2. Ten RDT patients were treated with the reduced-time schedule for 5-56 weeks. Clinical and metabolic conditions remained stable in all patients and no sign of inadequate treatment appeared. Long-term charcoal hemoperfusion was confirmed to be a safe and risk-free procedure. No change in platelets, white cells, red cells, fibrinogen and other hematochemical parameters were detected.

Adult↗
PubMed1981

Effect of plasma exchange and thoracic duct drainage on immunological status in glomerulonephritis.

The effect of thoracic duct drainage (16 patients treated) and plasmapheresis (15 cases) on immunological status has been studied in patients suffering from immunological glomerular disease. Lymph drainage proved to affect mostly cellular immunity. Besides a marked reduction in peripheral lymphocyte count and changes in behaviour of E(T-RFC) and E(A-RFC), different functional behaviour was observed in lymphocytes from drainage and blood lymphocytes after mitogen stimulation. Plasmapheresis was associated with changes mainly in humoral parameters, i.e. rapid disappearance of circulating immune complexes. Some increased T suppressor activity was also documented in patients with active lupus nephritis.

Adult↗
PubMed1980

[Renal transplantation in Bologna].

From october '76 to march '79 at the Clinica Chirurgica I of the University of Bologna 50 renal graft have been performed with living donor in 8 cases and with cadaver donor in 42. In the living donor group there was one death for rejection and sepsis. The remaining 7 patients are all alive with normal renal function. Among the 42 patients with cadaver donor 6 died: 3 early (one for gastric hemorrage, one for necrosis of the ascending colon, and one for rejection) and 3 late (two following many rejection episodes and one for miocardial infarction). 6 more patients underwent transplantectomy (4 for acute and 2 for chronic rejection). The 27 remaining patients have normal renal function. The only early important surgical problem was one urinary fistula in the 15th postoperative day successfully reoperated. The major late surgical complication was a renal artery stenosis distal from the arterial anastomosis followed by difficult but effective surgical correction. The authors regret not having been able to use more than half of the possible cadaver donors for refusal of the relatives.

Cadaver↗
PubMed1980

Atherosclerosis in uremia: a longitudinal study.

The ways by which uremia may lead to atherosclerosis are still unknown. Furthermore, whether atherosclerosis is accelerated with prolonged hemodialysis is still under debate. The results of a longitudinal study carried out in 47 selected patients who were treated first with dietary regimen followed by dialysis and then transplantation indicate: 1) The longer the duration of uremia on low protein diet, the worse are the clinical and metabolic problems of atherosclerosis. 2) In subsequent regular dialysis treatment 2 distinct clinical and metabolic pictures may emerge, slowly progressive or comparatively accelerated, according to whether dialysis is initiated early or late. 3) In subsequent transplantation the avoidance of risk factors largely depends on the time at which regular dialysis begins. 4) Early direct transplantation without dialysis proves similar to transplantation in patients treated with early dialysis as far as prevention of accelerated atherosclerosis is concerned.

Angiotensin II↗
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↗
PubMed1979

Evaluation of a new coated charcoal for hemoperfusion in uremia.

A new coated charcoal for hemoperfusion in uremia was investigated in 14 patients with end stage renal disease who underwent hemoperfusion or combined hemodialysis-hemoperfusion (39 seances). Investigations concerned removal of small molecules, coagulation and hematological status and amino acids and some hormones equilibrium. Clinical observations were also made in all patients. The methacrylate-coated charcoal enabled the removal of "toxins" up to 5000 daltons and the total solute removal did not significantly differ from previous hemoperfusion systems. However, the new coating membrane showed improved biocompatibility, in terms of clinical side effects and/or platelet and fibrinogen alterations.

Biocompatible Materials↗
PubMed1976

Residual renal function and effective rehabilitation in chronic dialysis.

The results of a 1-7 years follow-up of multiple processed and recorded semiquantitative parameters in 148 cases of chronic uremia on regular dialysis treatment (RDT) are reported. Patients were grouped according to different levels of residual creatinine clearance (CCr) at the beginning of treatment (0-5, 5-15, and 15-21 ml/min). Regardless of a possible return to work and reasonable quality of life, patients on RDT with 0-5 ml/min CCr invariably present a worsening in various subclinical parameters semiquantitatively evaluated (bone biopsies; nerve conduction velocity; glucose A-V, etc.). In patients with 5-15 ml/min CCr better results are found. In patients with residual CCr above 15 ml/min, impairment in several parameters is hardly evident and even after several years of dialysis may still remain minimal. These results seem of importance as far as the effective and not the apparent dialysis rehabilitation is concerned.

Adolescent↗
PubMed1975

Survival and 'true' rehabilitation after dialysis and transplantation: a 7-year follow-up.

Serial follow-ups of processed and recorded semi-quantitative data (bone biopsies, nerve conduction velocity, glucose A-V, etc.) have been carried out in 152 chronic uraemic patients of which 39 underwent kidney transplantation. The comparative studies have been performed in order to evaluate the magnitude of survival/rehabilitation ratio due to dialysis and transplantation. After a minimum of five years, the overall survival rate is better on dialysis. The most important determining factors seem to be: type of donor in transplantation and the nature of renal lesions and residual Ccr in dialysis. 'True' or 'effective' rehabilitation has been documented only after transplantation. Dialysis does not reverse systemic uraemic changes and the rehabilitation in survivors may be 'apparent'. Dialysis may prevent systemic uraemia, provided that starting time of treatment is gauged earlier (residual Ccr greater than 10).

Disability Evaluation↗