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Biomedical subjects

V Bonomini

Publications and source records attributed to V Bonomini.

At least 145 records · Page 8Linked to original sources
PubMed1983

Short-term plasmapheresis in acute lupus nephritis.

This study reports 11 cases with acute lupus nephritis who underwent short-term plasmapheresis treatment combined with immunosuppressive therapy. 68 plasma exchanges (mean/patients: 6.2) were performed by either centrifuge or membrane filter, exchanging 80% of total plasma volume per session. A rapid improvement of clinical symptoms was observed in all cases treated. 5 patients with renal insufficiency at the beginning of treatment, showed a reduction in serum creatinine and proteinuria after plasmapheresis. Immunological investigations demonstrated a rapid decreasing of circulating immune complexes and anti-DNA antibodies and an improvement of lymphocyte function, studied by E rosettes and Con A induced suppressor activity.

Acute Disease↗
PubMed1983

Plasma exchange in renal allograft rejection.

Circulating anti-HLA antibodies against mismatched donor antigen have been found in 7 patients during acute rejection episodes, where renal biopsy showed severe vascular lesions. 4 patients were submitted to combined therapy with plasmapheresis and cyclophosphamide, while the other 3 were treated by cyclophosphamide alone. In the 4 patients treated plasmapheresis induced a rapid disappearance of circulating cytotoxic antibodies, which remained negative in 3 cases where cyclophosphamide was continued after plasmapheresis. No change in antibody occurred in the three cases treated by cyclophosphamide alone. Renal function showed an improvement in 3 of the 4 patients treated by plasma exchange; all patients on drug therapy alone showed a rapid and progressive impairment of renal function and returned to RDT within 2 months.

Adolescent↗
PubMed1982

Immunological tubulo-interstitial deposits in IgA nephropathy.

Fifty-one patients with IgA nephritis and tubulo-interstitial lesions of various degrees were studied to define the frequency of tubulo-interstitial immunological involvement and whether or not it may hold any significance for the course of the nephropathy. The follow-up lasted 8 to 15 years from the first clinical sign of nephropathy. By immunofluorescence, tubulo-interstitial deposits involving 10 to 35% of proximal tubules were found in 19 patients, consisting of C3 in all patients, IgG and IgA in two patients, respectively, and IgM in four. Using electron microscopy dense deposits along the tubular membrane were not found in these patients. Mononuclear infiltrates and tubular basement membrane thickening were observed more frequently by light microscopy in patients with tubulo-interstitial deposits, but they did not correlate with glomerular immunofluorescence or with glomerular cellularity or sclerosis. Twenty-one out of the 51 patients studied presented a reduction in renal function at the end of the follow-up. A significant correlation (P less than 0.001) was found between the decrease in renal function and the presence of tubulo-interstitial deposits. Four of these patients progressed toward endstage renal failure in less than 5 years, despite moderate glomerular changes at the first renal biopsy, while severe tubulo-interstitial damage with immunoglobulin and complement deposition was present. Our results suggest that tubulo-interstitial immunological deposits may have a role in the evolution of IgA nephropathy.

Adolescent↗
PubMed1982

Use of combined hemodialysis/hemoperfusion in chronic uremia.

The capacity of charcoal to absorb endogenous and exogenous toxins is well established. It removes substances of higher molecular weight than standard dialysis membranes. The regular use of charcoal hemoperfusion as an adjunct to hemodialysis in chronic uremia is a real prospect capable of improving the patient's clinical and laboratory condition and/or reducing the weekly time of treatment. In line with our previous experience, 5 consenting informed patients on regular dialysis treatment from 9 to 35 months (residual creatinine clearance 0-1.8 ml/min, mean diuresis 350 ml) were treated without interruption for 5-8 months according to a schedule including two combined hemodialysis/hemoperfusion procedures instead of the previous three hemodialysis sessions. Patients were on adequate dialysis and their clinical, metabolic and laboratory conditions were stable. In the hemodialysis/hemoperfusion procedure a cartridge containing 150 g of methacrylate-coated activated charcoal with high biocompatibility was inserted in the dialysis circuit in series with a flat plate or hollow fiber dialyzer. Clinical, laboratory and metabolic conditions remained unchanged in all patients despite the one third reduction in dialysis hours per week. The tolerance of treatment was good: platelets, white cells and fibrinogen were unaffected. The marked reduction in weekly time of treatment led to a more satisfactory personal and social rehabilitation, enabling more patients to be treated with the same facilities.

Adsorption↗
PubMed1982

Multicentric experience with combined hemodialysis/hemoperfusion in chronic uremia.

A multicentric study was carried out to investigate the safety and effectiveness of long-term treatment of chronic uremic patients by a regular combination of hemodialysis and charcoal hemoperfusion. 39 RDT patients from five dialysis centers were treated for up to 12 months. The combined treatment proved to be safe, well tolerated and effective in improving certain dialysis-resistant uremic signs, mainly severe peripheral neuropathy, asthenia, anorexia, nausea, lack of well-being and relapsing pericarditis. There was also a marked decrease, after several weeks of combined treatment, in plasma values of urea, uric acid and creatinine.

Adult↗
PubMed1982

Progression rate of residual renal function in conservative treatment and early dialysis.

A retrospective comparative study was carried out in patients with chronic renal failure on conservative treatment (26 cases) and early dialysis (23 cases). The two groups were well matched for age, sex, etiology of renal disease and residual Ccr. In contrast with other papers, patients on dialysis showed a gentler deterioration rate of residual renal function than those on conventional low protein diet regimen. Between the two groups statistically significant differences concerned the control of blood pressure, serum phosphate and uric acid.

Adolescent↗
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

Long term study of mesangial proliferative glomerulonephritis with IgM deposits.

Twenty-six cases of Mesangial Proliferative Glomerulonephritis and diffuse IgM deposits were studied. Nine had nephrotic syndrome; 8 minimal urinary abnormalities; 7 asymptomatic proteinuria; 2 recurrent haematuria. Immunofluorescence revealed granular mesangial deposits in 14 cases and interrupted linear deposits in the others, chiefly along the capillary walls. In the latter group the clinical picture was mainly nephrotic syndrome or asymptomatic proteinuria. The clinical course is favourable: 7 cases recovered; 12 improved; 7 did not show any change. No progression of renal lesions was observed. Despite uniform histological features, this nephropathy is unlikely to be a unique disease, but in our opinion it should be considered separately from other glomerulopathies.

Adolescent↗
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↗