1,720,989 research outputs found
Terapia anticoagulante in pazienti con fibrillazione atriale in dialisi : fra il rischio di emorragia e la calcificazione vascolare
No full textOral anticoagulant therapy (OAT) in patients with atrial fibrillation during dialitic treatment or suffering from severe chronic renal failure is not easy to mange. OAT interferes with the mechanisms of protection and prevention of vascular calcification and increases the risk of bleeding and of the development of vascular calcifications typical of these patients. The aim of this report is to highlight the complexity of the management and therapy in uremic patients, discussing the importance of OAT in order to prevent thrombo-embolic complications during atrial fibrillation episodes
Unsuccessful application of taurolidine in the treatment of fungal peritonitis in peritoneal dialysis
No full textFungal peritonitis (FP) is a serious complication for peritoneal dialysis (PD) patients, determining hospitalization, technique failure, catheter loss and death. In the 2005 update, treatment recommendations for FP from the International Society of Peritoneal Dialysis (ISPD) advocate catheter removal immediately after fungi are identified by microscopy or culture. The availability of more eff ective medical treatments could therefore be of great importance. The aim of this report is to describe a case of a 43-year-old, diabetic, HIV positive PD patient with fluconazole resistant Candida peritonitis, who was treated with an i.p. taurolidine solution. Taurolidine is a non-antibiotic antimicrobial, with broad bactericidal and fungicidal properties. It has been used during surgery for lavage of the peritoneum in cases of peritonitis. Its mechanism of action is related to direct toxic action on micro-organisms, through a chemical reaction between active taurolidine derivatives and structures on the cell wall. Treatment failed because the patient had severe burning pain during i.p. administration of the drug, limiting its dose. PD catheter removal allowed complete recovery. It remains undetermined if, with different doses and methodology, taurolidine could be more effective in treating bacterial and/or fungal peritonitis. Currently, catheter removal remains the most effective therapy of fungal peritonitis
Effetti sulla funzione renale dei trattamenti antipertensivi associati
No full textLa dimostrazione di nefroprotezione indotta da farmaci antagonisti del sistema renina-angiotensina-aldosterone nei pazienti con nefropatie proteinuriche ha determinato un uso alquanto estensivo di questi farmaci nei pazienti affetti da insufficienza renale cronica, con l’intento di rallentare la progressione della malattia renale. Recentemente è stato invece segnalato un peggioramento degli esiti renali in pazienti senza proteinuria, trattati con la combinazione di ramipril e telmisartan, rispetto alla terapia con solo ramipril. Alla luce di questi dati apparentemente contradditori, la rassegna ha lo scopo di fornire alcune indicazioni su come trattare i pazienti ipertesi con insufficienza renale cronica
Genetic models of arterial hypertension--role of tubular ion transport
No full textThe description of pathogenetic mechanisms underlying different genetic models of essential hypertension is a useful way of illustrating the logical sequence needed to dissect a complex phenotypic condition such as hypertension. The abnormalities in renal function observed in spontaneously hypertensive rats of the Okamoto strain and Milan strain will be emphasized. The description may proceed "downward" from alterations that affect the whole body function to cellular and subcellular levels. However, the identification in the Milan strain rats of a point mutation in the gene coding for adducin, a skeletal protein able to modulate transepithelial sodium transport, provides the opportunity to reconstruct, in an "upward" direction, the sequence of events leading from the single point mutation to the final complex phenotype of essential hypertension
Hexosaminidase activity of erythrocytes plasma membrane as a possible biomarker of oxidative stress and kidney conditions in old patients with chronic renal failure under renal replacement therapy
No full textThe hexosaminidase (Hex) and its isoformes are ubiquitous enzymes (1). Several studies underline strong relation between their levels in body fluids and pathologies or different degree of complications as shown for plasma levels of Hex in diabetes (2) or urinary Hex in nephropathy (3). Recently, Hexs are found and deeply studied in plasma membrane and in cytosol of human erythrocytes (4). Red cells are a useful model for investigating physio-pathological conditions; erythrocyte glycohydrolases, particularly the Hexosaminidase (Hex), are considerate new and sensitive oxidative stress markers (5). Renal replacement therapies (RRT) exposes patients to oxidative stress increasing the inflammatory state already present (6). We assessed Hex activity on erythrocyte’s plasma membrane in 11 Chronic Renal Failure (CRF) patients on conservative treatment, in 15 on peritoneal dialysis (PD), in 12 on haemodialysis, before (HD-pre) and after (HD-post) a treatment and compared these to 30 healthy controls to evaluate the role of different RRT on oxidative stress. Moreover, we compared for their behaviour Hex and total plasmatic antioxidant defences (LagTime) analyzed in our previous study. In CFR patients, Hex activity show a significant increase respect to controls (p<0.001). It’s remarkable that, with the progression of the pathology (and through different RRT), the activity decreased until, in HD patients, values similar to controls. This suggest, in HD patients, a minor oxidative stress exactly how indicated from Lag-time in our precedent study. Evidence strengthened by the negative correlation between Hex e Lag-time. Data confirmed the role of Hex as early biomarker of oxidative stress and consequent cellular damages and highlighted positive effects of RRTs suggesting HD how the least oxidant treatment as RRT for older patients. Results remark a possible role of this enzyme as a marker of kidney conditions and as a further signal to start RRT
Renal lithium clearance in the different stages of hypertension
No full textThis study investigated whether fractional lithium excretion (FELi), used as a marker of proximal fluid delivery, changes during different phases of essential hypertension. Forty-eight subjects were studied: 12 essential hypertensives (EH); 12 borderline hypertensives (BL); 12 normotensives with a positive family history of essential hypertension (NH) and 12 normotensives without a family history of essential hypertension (NN). Measurements were performed in the recumbent position, both in basal conditions and after a saline load (2% body weight in 1 h; 0.333 ml/min per kg body weight). In basal conditions, a moderate extracellular volume expansion was already present in the subjects. In these conditions, FELi of EH was significantly higher than that of all the other groups (P less than 0.01). After the saline load, fractional sodium excretion increased in all the groups (P less than 0.01), but to a significantly greater extent in EH (P less than 0.01). FELi rose significantly only in BL (P less than 0.05). The change in FELi of BL correlated positively (P less than 0.02) with the change in blood pressure in 10 of these subjects 3 years after this study. Moderate extracellular volume expansion may be able to either reveal or stimulate an increase of FELi in subjects with established hypertension. When a greater degree of extracellular volume expansion is induced, this increases FELi in BL and this effect may be related to the subsequent development of hypertension
Familial aggregation of cation transport abnormalities and essential hypertension
No full textThe maximal rate of activity of Na extrusion by the Na pump, Na-K outward cotransport, Na-Li countertransport and the rate constant for passive permeability to Na, K and Li were measured in the RBC of 24 normotensive subjects with both parents normotensive, 45 hypertensive subjects and 24 of their normotensive offspring. The Na extrusion by the Na pump and the passive permeability to Na, K and Li are equal. The hypertensives have significantly greater Na-Li countertransport and smaller Na-K cotransport when compared to the normotensives. Na-K cotransport and Na-Li countertransport are positively correlated, thus suggesting some relationship between the two systems. When arbitrary normal limits are set the hypertensives are divided in three groups: normal cotransport and countertransport (22.2%) high countertransport (31.1%) and low cotransport (44.4%). In nine hypertensive families studied if either alteration was observed in a hypertensive propositus, this was of the same kind as the one in case observed in any first degree relative, whether already hypertensive or young normotensive. The observed alterations are primitive to the development of hypertension and possibly related to its pathogenesis
alpha-adducin may control blood pressure both in rats and humans
No full text1. Previous studies on the pathogenetic mechanisms of hypertension in the Milan hypertensive strain of rat (MHS) showed that a polymorphism within the alpha-adducin gene is responsible for up to 50% of the blood pressure difference between MHS and their MNS normotensive control strain. A case-control study has shown also in humans an association between alpha-adducin locus and hypertension using 4 multiallelic markers surrounding the alpha-adducin locus. 2. With a multiple regression approach we provide an estimate of the contribution of the genotype for each marker to the blood pressure variability in comparison to that provided by sex, body mass index and age. 3. While sex, body mass index and age contributed by about 40-45% to the overall blood pressure variability, the inclusion of the genotype for the marker closer to the alpha-adducin locus provided a further increase of the variability explained of about 5%. 4. The contribution independently provided by the other markers decreased exponentially with the increase of distance from alpha-adducin locus
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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