bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lipid-Lowering Therapy and Coagulation/Fibrinolysis Parameters in Patients on Peritoneal Dialysis
Authors: Yorioka N. , Masaki T. , Ito T. , Kushihata S. , Nishida Y. , Taniguchi Y. , Oda H. , Yamakido M. 
Published: March 2018

Patients on continuous ambulatory peritoneal dialysis (CAPD) often have abnormalities of lipid metabolism or coagulation and fibrinolysis, these patients may thus be more susceptible to atherosclerosis than those on hemodialysis. It has been reported that hypercoagulability and hyperfibrinolysis are correlated with abnormalities of lipid metabolism. Therefore, we investigated the effect of a decrease in lipids on the coagulation and fibrinolysis system in CAPD patients with hyperlipidemia who received lipid-lowering therapy. The patients included 5 men and 13 women, with a mean age of 52.5 years. Pravastatin sodium (10 mg/day) and ethyl icosapentate (1800 mg/day) were administered concomitantly for 8 weeks. Lipid levels and coagulation/fibrinolysis parameters were measured before and after therapy. The patients were divided into two groups depending on their response to therapy: responders showed a decrease in total cholesterol or triglycerides by at least 20% and non-responders showed less improvement. In the responders, the levels of protein C, tissue plasminogen activator/plasminogen activator inhibitor-I complex, factor XIII, α2-plasmin inhibitor, and D-dimer were significantly lower after therapy than before therapy. Protein C, factor XIII, and α2-plasmin inhibitor were also significantly decreased after therapy in non-responders, but the extent of the decrease was smaller. The plasminogen level was significantly increased after therapy in non-responders. These findings suggest that a decrease in lipid levels and/or some other action by lipid-lowering agents may correct abnormalities of coagulation and fibrinolysis in CAPD patients. (Int J Artif Organs 2000; 23: 27–32)
Photopheresis in Cutaneous T-Cell Lymphoma: Five-Year Experience
Authors: Crovetti G. , Carabelli A. , Berti E. , Guizzardi M. , Fossati S. , De Filippo C. , Bertani E. 
Published: March 2018

Background Cutaneous T-cell lymphoma (CTCL) includes several lymphoproliferative disorders involving mature T-lymphocyte proliferation initially confined to the cutis. These affections, after variable periods, may progress to the blood, limph nodes and visceral organs. Mycosis fungoides (MF) is the most frequent form of CTCL and has an indolent clinical course. The therapy of CTCL depends on the stage of the disease and the patient's general conditions. For advanced cases it includes chemotherapy, retinoids, and interferon-α. Since 1987 extracorporeal photochemotherapy (ECP), a novel immunomodulatory approach based on apheresis and photo-irradiation of leukocytes, has been successfully introduced for the treatment of advanced CTCL. It can prolong survival of patients with erythrodermic CTCL without significant side effects. Objective: To review our five-year experience with ECP in CTCL. Methods Since June 1994, 33 CTCL patients have been recruited for ECP, using two different regimens: two procedures on two consecutive days at four-week intervals for six months, or at two-week intervals for three months with progressive tapering in the second three-month period for the more severe forms. Six patients received ECP with IFN-α. ECP was done using the photopheresis UVAR system and UVAR XTS (Therakos, West Chester, Pa) and always with 8-MOP liquid formulation injected directly into the buffy coat bag. Lymphocytes in peripheral blood were immunophenotypically characterized for each patient and every ECP session. Results All patients tolerated ECP well, without significant side effects. Thirty patients are clinically evaluable (at least three ECP cycles). A favourable clinical response was obtained in 80.9% (16/21) of MF patients (complete response 33%, partial response 47.6%) and in 66% (6/9) of patients in the Sézary's syndrome phase (complete response 33.3%, partial response 33.3%). Five of the six patients given IFN-α as adjunctive therapy had a PR and one a CR. Four patients are in CR without therapy at follow-ups of 46, 20, 10 and 8 months. There have been no changes in the peripheral lymphocyte immunophenotype during the follow-up. In 19/30 patients the CD95 antigen, correlated with cellular apoptosis, was expressed and was frequently associated with a good clinical response. Conclusions: In our experience ECP achieved favourable clinical responses in 73% of patients, in monotherapy or in combination with IFN-α, without significant side effects. (Int J Artif Organs 2000; 23: 55–62)
Effect of Adequacy of Dialysis and Nutrition on Morbidity and Working Rehabilitation of Patients Treated by Maintenance Hemodialysis
Authors: Stefanović V. , Stojanović M. , Djordjević V. 
Published: March 2018

Numerous studies have demonstrated a correlation between adequacy of hemodialysis (HD) and patient mortality. In this study we evaluated the effect of adequacy of dialysis and nutrition on morbidity and working rehabilitation. Single center experience carried out in 1998 in an outpatient university-affiliated dialysis facility was presented. A total of 181 patients, on HD over 3 months, was included in the study; mean age 54.5 years, mean duration of HD 5.4 years. Thirthy-two patients were hospitalized in 1998. Patients with an eKt/V < 0.8 had significantly more frequent and extended hospitalizations than patients with eKt/V > 1.2. In the regression model eKt/V had a significant effect on hospital days. Serum albumin, as an index of nutrition, was also found to significantly influence hospitalizations. Patients with a BMI < 20.0 kg/m2 were found to have significantly more frequent hospitalizations, more hospital days/patient, and hospital days/hospitalized patient/year than those with a BMI > 25.0 kg/m2. BMI < 20.0 kg/m2 was associated with a significantly lower dialysis adequacy (eKt/V and URR) and more severe anemia. However, regression model failed to confirm a statistically significant association of BMI with hospital days. The best working rehabilitation (stage 1), according to the EDTA criteria, was obtained in patients with significantly (p<0.05) higher eKt/V, URR, albumin, nPNA, and body fat than in patients at stage 6 (not able to work, and not able to take care of themselves). This study has established that dialysis adequacy and nutrition have an effect on morbidity (estimated through hospitalizations) and patient rehabilitation. (Int J Artif Organs 2000; 23: 83–9)
Nephrotic Syndrome and Plasmapheresis
Authors: Russo G.E. , Bonello M. , Bauco B. , Bosco M. , Tedaldi M. , Bisciglia M.F. , Vitaliano E. , Russo R. , De Paola A. 
Published: March 2018

We studied 15 patients suffering from nephrotic syndrome (NS) in bioptically-accertained primary and secondary glomerulopathies responding poorly to the common pharmacological treatment. They were monitored for one year by assessing their immunological and kidney functionality parameters, especially proteinuria. The patients underwent 3 apheretic sittings using the cascade double-filtration technique. After the third apheretic sitting the patients received metilprednisolone 300 mg/m2. This therapy was repeated every month for 6 months. At the end of the apheretic cycle it was shown that all patients had responded well to the therapy with a dramatic decrease in proteinuria, maintenance and/or recuperation of kidney functionality and improvement of lipidic asset; these data remained unchanged over time. Considering our preliminary results, we believe that therapeutic apheresis has a precise function in refractory nephrotic syndrome and, in particular, we propose the use of the cascade double-filtration technique. (Int J Artif Organs 2000; 23: 111–3)
Prevention of Nosocomial Transmission of Hepatitis C Infection in a Hemodialysis Unit. A Prospective Study
Authors: Djordjević V. , Stojanović K. , Stojanović M. , Stefanović V. 
Published: March 2018

Hepatitis C virus (HCV) infection in hemodialysis patients can be transmitted by transfusions and nosocomially. A high prevalence of HCV infection, over 50%, was demonstrated in our hemodialysis (HD) unit. In order to prevent the nosocomial spread of HCV infection in the HD unit a prospective study was begun separating anti-HCV positive patients from the negative ones. A total of 170 patients (83 anti-HCV positive) started this study in September 1994 and were followed for 4 years. A separate room and dedicated equipment were assigned to anti-HCV positive and anti-HCV negative patients. Of those 170 patients there were 15 hepatitis B virus (HBV) positive patients, 5 of whom were anti-HCV positive, who were treated in a separate room on dialysis equipment for anti-HCV positive or negative patients. Application of general precautions, as recommended by the Center for Disease Control and Prevention (CDC), was reinforced. During the first 12 weeks after implementing the precautions seven more anti-HCV positive patients were detected, and by December 1995 another two HCV infected patients were found. The follow-up included all changes in HD population treated until the end of 1998. The incidence of seroconversion to HCV was 12.9% in 1995, 7.1% in 1996, 5.0% in 1997, and 6.6% in 1998. The higher incidence of seroconversion in September to November 1994 was probably due to the nosocomial infection being in the incubation period at the time of isolation. This prospective study in a large HD unit with a high prevalence of HCV infection demonstrates a relatively successful prevention of HCV spread. Procedure-related transmission of HCV in hemodialysis could be prevented by rigorous application of universal precautions as recommended by the CDC. As a second line of prevention, in highly burdened dialysis centers, segregation of HCV positive patients can help control nosocomial transmission.
Extracorporeal Circulation in Ewe's Foetus: Towards a Reliable Foetal Cardiac Surgery Protocol a Comparison of two Cases
Authors: Grigioni M. , Carotti A. , Daniele C. , D'avenio G. , Morbiducci U. , Iannace E. , Albanese S.B. , Costa D. , Formigari R. , Ferretti E. , DI Donato R.M. 
Published: March 2018

Foetal cardiac surgery is the ultimate goal in the treatment of congenital cardiac malformations. The aim of our research is to elucidate some of the features of the necessarily invasive experimental protocol to be used in an animal model of foetal cardiac surgery. In particular, we assessed the foetal placentar reactivity to prolonged cardiac bypass in steady-flow conditions. Methods Two cases were selected to show the outcome of prolonged (> 30 minutes) extracorporeal circulation (ECC) instituted without oxygenator under steady-flow assistance. Following the instrumentation of the animal (placement of pressure, flow and myocardial fiber length transducers) and the baseline recordings, a 60-minute bypass period was established with an axial turbopump (Hemopump 14 Fr), after systemic heparinisation and artero-venous cannulation. At the end of the circulatory assistance, the cannulae were removed and a 90 minute observation period followed. The cardiac function was assessed by means of indirectly obtained P-V loops. Results Case A showed a marked reduction in the end-systolic pressure-volume relationship (ESPVR) during ECC, corresponding to a rightward shift of the P-V loop, with a gradual recovery after the assisted circulation. On the contrary, case B was subjected to progressive placental dysfunction, as evidenced by haemogasanalytical data. Consequently, the haemodynamic data also outlined a negative outcome, with high ESPVR values after bypass. Conclusions The present study, while confirming the possibility of cardiac intervention in the foetus, underlines the critical role of minimally invasive protocol to limit both foetal stress and placental dysfunction.
Comparison of the Quality of Life in Hemodialysed (HD) and Peritoneally Dialysed (CAPD) Patients using the EORTC QLQ-C30 Questionnaire
Authors: Majkowicz M. , Afeltowicz Z. , Lichodziejewska-Niemierko M. , Debska-Slizien A. , Rutkowski B. 
Published: March 2018

Background The aim of the paper was to assess reliability and validity of the QLQ-C30 questionnaire in studying the quality of life in dialysed patients, and then to compare the life quality in patients on hemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD) and healthy controls. The present study included 65 HD patients, 22 CAPD patients and a group of 76 healthy volunteers. Methods Quality of Life Questionnaire (QLQ-C30), Hospital Anxiety and Depression Scale (HADS), Cantrill ladder. Results The EORTC QLQ-C30 questionnaire appeared to be a reliable and valid tool for assessing the quality of life in dialysis patients. HD patients had significantly poorer quality of life in the areas of physical, social, cognitive and emotional functioning in comparisons to the controls. CAPD patients were not significantly different life quality-wise from controls, except for their social and professional life.
Vasoconstrictive Eicosanoid Responses to Extracorporeal Circulation with or without an Oxygenator in Fetal Lambs
Authors: Kim W.G. , Lee J.R. , Kim C.S. , Choi J.Y. , Kim Y.J. 
Published: March 2018

Introduction This study measured levels of vasoconstrictive eicosanoids during ovine fetal cardiac bypass and compared the measurements between two groups: (1) a group in which the placenta functioned as the only source of oxygen supply during the bypass (the placenta group), and (2) a group in which an artificial oxygenator, instead of the placenta, was included in the bypass circuit (the oxygenator group). Materials and Methods A total of 16 fetal lambs were randomly assigned into either the oxygenator group or the placenta group. Following anesthesia, the fetal cardiac bypass procedure was performed. The placenta group used a centrifugal pump as the pumping device without an oxygenator during the bypass. The bypass circuit in the oxygenator group consisted of a roller pump and a membrane oxygenator. The fetal cardiac bypass procedure was performed for 30 minutes at normothermia in both groups. For the measurements of thromboxane B2(TXB2) and prostaglandin E2 (PGE2), blood sampels were taken before the bypass, at 5 minutes, 15 minutes, and 30 minutes after the start of cardiac bypass, and at 15 minutes after weaning from the bypass. TXB2 and PGE2 levels were determined by radioimmunoassay with PGE2(125I) and TXB2(125I) assay systems. Hemodynamic observations and arterial blood gas analyses were done every 10 minutes. Results The mean arterial pressure and heart rate ranged from 69.8 to 82.6 mmHg and 169 to 182/min during the bypass in the oxygenator group, and from 14.4 to 44.7 mmHg and 64.3 to 75/min in the placenta group. Arterial blood gas analysis showed severe hypercapnia and hypoxemia with acidosis during and after the bypass in the placenta group. Bypass flow rates were maintained at 140.3–164.0 ml/kg/min in the oxygenator group, while flow rates were suboptimal (74.3–97.0 ml/kg/min) in the placenta group. There were no statistically significant differences in PGE2 concentrations before, during, or after bypass, although the placenta group displayed a tendency to higher measurements during bypass, compared to the oxygenator group. The placenta group also showed higher TXB2 measurements than the oxygenator group during the bypass (p=0.0457). Conclusions We have demonstrated increase measurements of PGE2 and TXB2 in the placenta group when compared with the oxygenator group in an ovine fetal cardiac bypass model, although the PGE2 difference failed to reach statistical significance.
A Single Institution's Experience (1982–1999) with Plasma-Exchange Therapy in Patients with Fulminant Hepatic Failure
Authors: De Silvestro G. , Marson P. , Brandolese R. , Pittoni G. , Ongaro G. 
Published: March 2018

Fulminant hepatic failure is a rare, but often fatal complication of acute viral hepatitis. This condition, in absence of orthotopic liver transplantation (OLTx) surgery, is associated with a high mortality rate, despite the improvement of general intensive care. Plasma-exchange (PEx) therapy has been long used to treat FHF, in particular by removing toxic substances and correcting the severe coagulopathy. In this study we describe our experience with PEx treatment of FHF, beginning in 1982. Seventy patients affected with FHF due to various causes (HBV=40; cryptogenic/non-A, non-E=15; Amanita phalloides=8; other=7) were treated with PEx (altogether 348 sessions). Overall survival rate, comprising patients undergoing OLTx, was 51%, a little higher than what we observed in patients (N=49) treated solely by PEx, i.e., 41%. The best outcome predictor was FHF aetiology, owing to the good survival rate in patients with Amanita phalloides intoxication and the very poor prognosis of patients suffering from cryptogenic/non-A, non-E FHF. Moreover, the marked increase in prothrombin time and alpha-fetoprotein levels after 48 hours from admission was associated with a good prognosis, whereas the patient's age and coma grade were not clearly predictive of survival. Additionally, lymphocyte subpopulation, resulting in a CD4/CD8 ratio lower than 1.0 along with CD8 activation with HLA-DR strong expression, were associated with a high rate of mortality and morbidity. Our data indicate that PEx therapy can improve survival in patients with sufficient residual capacity of liver regeneration. Moreover, the identification of certain prognostic factors may be useful for the rational planning of therapeutic strategy in FHF.
A Feedback Controller for the Maintenance of FRC during Tidal Liquid Ventilation: Theory, Implementation, and Testing
Authors: Degraeuwe P.L.J. , Dohmen L.R.B. , Geilen J.M. , Blanco C.E. 
Published: March 2018

The necessity of controlling functional residual capacity (FRC) during tidal liquid ventilation has been recognized since the first description of this respiratory support technique by Kylstra et al in 1962. We developed a microcomputer feedback system that adjusts the inspired tidal volume (Vt,i) of a liquid ventilator based on the end-expiratory quasi-static alveolar pressure (Pa,ee), in order to maintain a stable FRC. The system consists of three subunits: (1) a tracheal pressure catheter to estimate breath by breath FRC changes, derived from Pa,ee changes, and (2) a roller pump interfaced with (3) a personal computer in which a closed-loop control is implemented. The regulator sets the actual Pa,ee against the corresponding desired value. Any discrepancy is offset by changes in Vt,i and the required change in pump velocity is communicated to the roller pump. The size of any change in pump velocity is determined to both the observed and target or desired Pa,ee (i.e., the error) and the (calibration) pressure-volume curve. To evaluate the efficacy of the controller, a set of laboratory bench tests were conducted under steady state and transient conditions. Closed-loop control was effective in keeping FRC and Pa,ee near the desired level, with an acceptable oscillatory behaviour. The feedback controller successfully compensated for transient disturbances of PFC liquid balance. The steady state stability was confirmed during a five hour period of liquid ventilation in five preterm lambs.
Changes in Erythrocyte Calcium and Potassium in Patients during HD and CAPD
Authors: Paraskevopoulos A. , Agroyannis B. , Kopelias L. , Tzanatos E. , Tsomi A. , Dalamanga A. , Katsoudas S. , Petras D. , Voudiclari S. 
Published: March 2018

The purpose of this study was to determine the changes in calcium and potassium content in the red blood cells (RBC) of uremic patients during a hemodialysis (HD) session and a 6/hrs CAPD exchange. RBC calcium and potassium were determined in 20 patients on HD in three blood samples collected at 0′-HD (pre-HD), 45′-HD and 240′-HD (end-HD), in 20 patients on CAPD, in two blood samples, collected at 0′ time (pre-inflow) and 120′, (solution in peritoneal cavity) during a 6/hrs exchange (4 exchanges / 24 h) and in 20 normal subjects. The mean value (±SD) of RBC calcium in controls was 15.6 ± 3.75 μmol/L, in hemodialysed patients at 0′-HD, 45′-HD and 240′-HD 51.5 ± 8.5, 70.4 ± 12.5 and 51.1 ± 10 μmol/L respectively and CAPD patients at time 0′ and 120 of an exchange 53.6 ± 23.4 and 70.6 ± 9.2 respectively. These values show that RBC calcium in hemodialysed patients is generally significantly higher (p < 0.0001) than in controls. The value at 45′-HD is also significantly higher (p < 0.0001) than at 0′ or 240′-HD. In CAPD patients, at 0′ and 120′ of a 6/hrs exchange, it is significantly higher (p < 0.0001) than in controls, as is the value at 120′ (p < 0.001) in comparison to 0′. The mean value (±SD) of RBC potassium at the aforementioned time measurements were 95.9 ± 3.34, 92.5 ± 4.32 and 93.85 ± 3.89 mmol/L respectively for patients on HD, 95 ± 3.3 and 94.6 ± 5.28 mmol/L respectively for patients on CAPD and 99.1 ± 3.70 mmol/L in controls. These values show that RBC potassium of hemodialysed patients is significantly lower in comparison to that of controls (0′-HD: p < 0.01, 45′-HD and 240′-HD: p < 0.001); also the value at 45′-HD and 240′-HD is significantly lower (p < 0.001, p < 0.01 respectively) when compared to that at 0′-HD. In patients on CAPD, at 0′ time and 120′ during 6/hrs exchange, potassium is significantly lower (p < 0.001) in comparison to that of controls. In conclusion, uremic patients present high erythrocyte calcium and low potassium with fluctuations during HD-sessions and CAPD 6/hrs exchange.
Conventional Gas Ventilation, Liquid-Assisted High-Frequency Oscillatory Ventilation, and Tidal Liquid Ventilation in Surfactant-Treated Preterm Lambs
Authors: Degraeuwe P.L.J. , Thunnissen F.B.J.M. , Jansen N.J.G. , Dormaar J.T. , Dohmen L.R.B. , Blanco C.E. 
Published: March 2018

This study was designed to compare the efficacy and potential protective or injurious effects of tidal liquid ventilation (TLV), liquid-assisted high-frequency oscillatory ventilation (LA-HFOV), and high PEEP conventional mechanical ventilation (CMV) in neonatal respiratory distress syndrome. Preterm lambs (124–126 days gestation), prophylactically treated with natural surfactant, were allocated to one of the treatment modalities or to an untreated fetal control group (F), euthanised after tracheal ligation. LA-HFOV animals received an intratracheal loading dose of 5 mL.kg-1 followed by a continuous intrapulmonary instillation of 12 mL.kg-1;h-1 FC-75 perfluorocarbon liquid. The ventilation strategies aimed at keeping clinically appropriate arterial blood gases for a study period of 5 hours. A histological lung injury score was calculated and semiquantitative morphometry was performed on lung tissue fixed by vascular perfusion. The alveolar-arterial pressure difference for O2 was significantly lower throughout the study in TLV compared to CMV lambs; at 1, 2, and 5 hours, oxygenation was better in TLV when compared to LA-HFOV. Total lung injury scores in TLV lambs were significantly lower than in either CMV or LA-HFOV animals, but higher when compared to F. CMV and LA-HFOV induced an excess of collapsed and overdistended alveoli, whereas in TLV alveolar expansion was normally distributed around predominantly normal alveoli. CMV and LA-HFOV, but not TLV, were associated with an excess of dilated airways. Thus, in the ovine neonatal RDS model, TLV compared favourably to either gas ventilation strategy by its more uniform ventilation, reduced lung injury, and improved gas exchange.