1,720,990 research outputs found
IL DUPLEX SCANNER E L'ANGIOGRAFIA DIGITALIZZATA NELLA PATOLOGIA DEGLI ASSI CAROTIDEI
No full textThe Authors emphasize the Duplex-Scanner
validity in the diagnosis of sovraortic trunks
disease.
They compared 55 patients, examined first
with Duplex-Scanner, and after with Digita]
Su~btraction Angiography.
They found a significant agreement (max 20%
of stenosis percentage difference) in 87% of the
examined patients.
In Authors' opinion Duplex-Scanner - utilized
by ·an expert operator - is the choice
device for the screening of the sovraortic trunk
diseases, and in the follow-up of the operate patient
Cardiovascular risk factors in patients with chronic renal failure maintained on hemodialysis or continuous ambulatory peritoneal dialysis
No full textSevere preeclampsia in antithrombin III deficiency with no history of venous thromboembolism.
No full textComplications of pregnancy, such as preeclampsia, placental abruption, fetal growth retardation, still-birth and fetal death are associated with an increased frequency of pro-thrombotic abnormalities. We describe a case of severe preeclampsia and multiple placental infarctions in a 28-year-old woman at 31 weeks' gestation. Despite a negative personal history for venous thromboembolism, coagulation screening for thrombophilia detected an isolated antithrombin III deficiency. In view of the high prevalence of pro-thrombotic complications, laboratory screening for thrombophilia would be advantageous in women with complicated pregnancies, to ensure adequate management in high-risk situations, as suggested by larger-scale clinical investigations
SURGICAL APPROACH TO RECURRENT STENOSIS IN NATIV..E' A-V FISTULA: NEOANASTOMOSIS OR GRAFT INTERPOSITION?
No full textRecurrent stenosis ,usually located in the perianastomotic site,is the leading
cause of native (AVF) failure. Surgery is considered the treatment
of choice: usually a more proximal is created , but its drawback
is the loss of vessel sites available for puncture. Therefore we deviced to replace the stenotic tract with ainterposition and prospectively evaluated AVF restenosis rate and blood flow as compared to
AVF with the classical proximal neoanastomosi
Stenosis of Brescia-Cimino fistula (AVF): Early diagnosis and results of angioplasty (PTA)
No full textno availabl
Pregnancy in CKD stages 3 to 5: fetal and maternal outcomes
No full textBackground: Prognostic criteria to inform women with moderate to severe renal insufficiency who wish to bear children are not well established. Study Design: Longitudinal multicenter cohort study. Settings & Participants: Nondiabetic white women with pregnancies proceeded beyond the 20th week and estimated glomerular filtration rate (GFR) less than 60 mL/min/1.73 m2 (<1 mL/s/1.73 m2) before conception. Predictors: Baseline GFR and proteinuria (exposure); other clinical characteristics at conception (covariates). Outcomes & Measurements: Difference in GFR decreases before conception versus after delivery (mixed linear models); low birth weight (<2,500 g), and maternal renal survival (logistic and Cox regressions). Results: 49 women were studied. Mean serum creatinine and GFR at conception were 2.1 ± 1 (SD) mg/dL (186 ± 88 μmol/L) and 35 ± 12 mL/min/1.73 m2 (0.58 ± 0.2 mL/s/1.73 m2), respectively. Overall mean GFR after delivery was less than before conception (30 ± 13.8 versus 35 ± 12.2 mL/min/1.73 m2 [0.50 ± 0.23 versus 0.58 ± 0.20 mL/s/1.73 m2]; P < 0.001), but the rate of GFR decrease did not change (0.55 ± 0.8 versus 0.50 ± 0.3 mL/min/mo [0.0092 ± 0.013 versus 0.0083 ± 0.005 mL/s/mo]; P = 0.661). Independent of potential confounders, the combined presence of baseline GFR less than 40 mL/min/m2 (<0.67 mL/s/m2) and proteinuria with protein greater than 1 g/d, but not either factor alone, predicted faster GFR loss after delivery compared with before conception (1.17 ± 1.23 versus 0.55 ± 0.39 mL/min/mo; difference, 0.62 mL/min/mo; 95% confidence interval [CI], 0.27 to 0.96 mL/min/mo [0.020 ± 0.021 versus 0.0092 ± 0.007 mL/s/mo; difference, 0.10 mL/s/mo; 95% CI, 0.005 to 0.016 mL/s/mo]). The presence of both risk factors, but not either alone, also predicted shorter time to dialysis therapy or GFR halving (N = 20; hazard ratio, 5.2; 95% CI, 1.7 to 15.9) and low birth weight (N = 29; odds ratio, 5.1; 95% CI, 1.03 to 25.6). Limitations: Generalizability to other settings; study power. Conclusion: In women with renal insufficiency, the presence of both GFR less than 40 mL/min/1.73 m2 (<0.67 mL/s/m2) and proteinuria with protein greater than 1 g/d before conception predicts poor maternal and fetal outcomes
SURGICAL APPROACH TO RECURRENT STENOSIS IN NATIVE A-V FISTULA: NEOANASTOMOSIS OR GRAFT INTERPOSITION ?
No full textRecurrent stenosis usually located in the perianastomotlc site, is the leading cause of native arterio-venous fistula (AVF) failure. Surgery is, considered the treatment of choice: usually a more proximal, neo-anastomosis is, created, but its drawback is the loss of vessel sites available for puncture
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
Un caso di insufficienza renale acuta secondaria a malattia di MC-Ardle ad esordio tardivo. [A case of acute renal failure secondary to late-onset McArdle's disease].
No full textINTRODUZIONE: La malattia di McArdle, o glicogenosi tipo V, è una malattia autosomica recessiva dovuta alla carenza della fosforilasi muscolare, un enzima che gioca un ruolo chiave nella demolizione del glicogeno durante un esercizio fisico, ed è caratterizzata da affaticamento, mialgia, crampi e debolezza muscolare con un importante aumento nei livelli ematici di creatinchinasi e rabdomiolisi con mioglobinuria, che può portare ad insufficienza renale acuta. La malattia di McArdle generalmente si manifesta tra i 15 ed i 30 anni; una comparsa tardiva è davvero inusuale.
CASO CLINICO: riportiamo il caso di un paziente, maschio, di 68 anni, giunto in pronto soccorso per astenia, vertigini, diarrea ed oligoanuria. Il paziente è stato sottoposto a cinque sedute emodialitiche consecutive, con successiva ripresa della diuresi e ripristino della funzione renale. Il nostro paziente soffriva di astenia e dolore muscolare sin dalla giovane età: questi dati anamnestici, insieme ai persistenti livelli elevati di CPK ed in assenza di cause tossiche od infettive, ci hanno portato al sospetto di un disordine metabolico non comune, poi confermato dalla biopsia muscolare.
CONCLUSIONI: sino ad oggi non esistono specifiche terapie per la glicogenosi tipo V. Una dieta ricca in proteine e saccarosio, la supplementazione di vitamina B6 e di creatina non hanno portato risultati brillanti. La terapia piu’ adatta sembra essere una moderazione dell’esercizio fisico, che migliora la tolleranza all’attività muscolare e l’afflusso di sangue ai muscoli, provvedendo all’aumento di glucosio ed acidi grassi alle fibre muscolari.
INTRODUCTION:
Mc Ardles disease, also known as Type V glycogen storage disease, is a rare deficiency of the enzyme glycogen phosphorylase in muscle cells, inherited as an autosomal recessive trait. In the absence of this enzyme, muscles cannot break down glycogen during exercise, so in patients affected by McArdles disease even moderate physical activity produces cramps, pain and fatigue. Anaerobic activity leads to severe fixed contractures and rhabdomyolisis with myoglobinuria and raised serum creatine-kinase, which, in turn, can lead to acute renal failure. Disease onset is usually in early childhood, although diagnosis is often not made until the second or third decade.
CASE REPORT:
We present the case of a 68-year-old man who presented to the Emergency Room with fatigue, vertigo, diarrhea and oliguria. The patient underwent five daily hemodialysis sessions, diuresis reappeared and there was progressive recovery of renal function. The patient described episodes of fatigue and muscular pain occurring since childhood: the positive personal history, together with persistently raised CPK levels in the absence of any infective or toxic cause of myositis, led us to suspect the presence of this rare metabolic disease, which was subsequently confirmed by muscle biopsy.
CONCLUSION:
To date, there is no specific treatment for type V glycogenosis, although a diet rich in protein and saccarose, vitamin B6 supplementation and creatine administration are generally recommended. Moderate physical activity can help manage symptoms by improving exercise tolerance and blood supply to the muscles, ensuring provision of glucose and free fatty acids for the muscle fibers
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