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Biomedical subjects

V Bonomini

Publications and source records attributed to V Bonomini.

At least 163 records · Page 9Linked to original sources
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

Effect of calcitonin on bone lesions in chronic dialysis patients.

The effects of synthetic salmon CT, administered subcutaneously and intermittently (1 MRC U/kg/day for 15 days/month over 6 months) were investigated in 15 uremic patients on regular dialysis treatment (RDT), all presenting various degrees of osteodystrophy. Clinically, osteoarticular pain disappeared in 8 out of 10 cases; 1 patient with rib fractures had a rapid calcification of the bone fracture repair tissue. No significant changes were found in serum calcium and PTH levels. Phosphotemia showed a significant decrease within the first 20 days. The varying individual hypophosphatemic response proved to be related to the initial level of phosphatemia. The alkaline phosphatase, when increased, showed a decrease to the normal range. A significant decrease in osteoclastic hyperactivity (active resorption surface, osteoclast index) and a slight increase in osteoblastic pool (active osteoid surface) were documented. No change was noted when osteomalacia predominated. Side effects included: anorexia, nausea, vomiting, face flushing. Our data suggest that salmon CT may be usefully employed in chronic uremic patients on RDT, when secondary hyperparathyroidism predominates.

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↗
PubMed1975

Serial histomorphometric and histochemical bone biopsy studies in dialysis and transplantation.

A serial bone biopsy longitudinal study has been undertaken to asses the effects of Dialysis and Transplantation on uremic osteodystrophy. The clinical material consists of: normal (24 cases, 61 biopsies), patients with moderate renal failure on free diet (50 c., 61 b.), patients on Low Protein Diet (146 c., 251 b.), patients on Regular Dialysis Treatment (114 c., 256 b.), patients submitted to Transplantation (50 c., 84 b.). A significant correlation has been documented between duration of low protein diet and bone changes. In long-term dialysis patients remarkable differences have been found in "late" dialysis starting time (mean value of creatinine clearance at the beginning of treatment 2.04 +/- 1.7) in respect to "early" starting-time (mean value 13.1 +/- 3.9). In late group bone histomorphometry showed quite evident signs of secondary hyperparathyroidism and hyperosteoidism which remarkably worsened 3-4 years after dialysis. The aminoacids composition of the bone showed an increase in the total amount of aminoacids during dialysis, expecially for proline, hydroxyproline and glycine. In early group both basic values and progression rate of bone lesions were less severe. In transplanted patients with good renal function (serum creatinine less than 1.4 mg%) bone histomorphometric analysis showed a rather rapid disappearance of uremic bone lesions. A significant correlation was found between serum PTH, renal function and bone histology. On some occasions signs of secondary hyperparathyroidism were documented even after 16 months. A good correlation between inactive bone surfaces and immunosuppressive regimen was found.

Adolescent↗