Integrating mHealth in Oncology: Experience in the Province of Trento.

Background: The potential benefits of the introduction of electronic and mobile health (mHealth) information technologies, to support the safe delivery of intravenous chemotherapy or oral anticancer therapies, could be exponential in the context of a highly integrated computerized system.

Objective: Here we describe a safe therapy mobile (STM) system for the safe delivery of intravenous chemotherapy, and a home monitoring system for monitoring and managing toxicity and improving adherence in patients receiving oral anticancer therapies at home.

Methods: The STM system is fully integrated with the electronic oncological patient record.

Plasma acid-base changes in chronic renal failure: a Stewart analysis.

The bicarbonate centered approach to acid-base physiology involves complex explanations for the metabolic acidosis associated with chronic renal failure. We used the alternate Stewart approach to acid-base physiology to quantify the acid-base chemistry of patients with chronic renal failure. We examined the plasma and urine chemistry of 19 patients with chronic renal failure who were predialysis and 20 healthy volunteers.

TINU syndrome associated with reduced complement levels.

The TINU syndrome (tubulointerstitial nephritis and uveitis) was first described by Dobrin et al. in 1975. Since then, more than 50 cases have been documented each with diverse immunopathogenetic and genetic characteristics.

Practice pattern and treatment options for kidney patients in a single North Italian nephrology center.

The experience and the current practice of a single center located in northern Italy is reported. The center of Vicenza is a self-standing nephrologic unit serving a population of about 300,000 individuals. The overall province counts approximately 800,000 individuals and some of them are referred to our center from peripheral hospitals for renal transplantation and/or particular pathologic conditions.

Double pass dialysis: a new method of renal replacement in patients with malfunctioning vascular access.

Several patients undergoing chronic renal replacement therapy present problems related to their vascular access. Low blood flows and high rates of recirculation are common in such patients in which, for this reason, it becomes difficult to apply highly efficient techniques or techniques where diffusion and convection are combined as in hemodiafiltration. In these patients we studied the possibility of partially recirculating the blood in the extracorporeal circuit in order to increase the flow rate per single hollow fiber; we defined our system "double pass dialysis".

A new blood module for continuous renal replacement therapies.

A new blood module for continuous renal replacement therapies has been utilized to perform CVVH in critically ill patients. The features of the new module named (HP300 and manufactured by Medica srl (Medolla, Modena) are the easy installation and transportability to the bedside, the simple and safe management and the continuous measurement of the pre and post filter pressure with automatic calculation of the end-to-end pressure drop inside the filter. The last feature permits to detect early malfunctions of the filter due to fibers clotting or due to the internal coating of the hollow fibers by plasma proteins.

Ultrafiltration and clearance studies in human isolated peritoneal vascular loops.

Eight samples of human peritoneal tissue were obtained from patients undergoing hemicholectomy for cancer. An artery and a vein were cannulated and perfused with blood in vitro with a special circuit able to provide different perfusion pressures. Ultrafiltration and clearance studies were performed in these samples.

Oxalate removal by differing dialysis techniques.

Secondary hyperoxalemia is a common feature in patients with chronic renal failure, but oxalate removal is not adequately accomplished by regular dialysis treatment. Oxalate removal in two groups of patients, 11 on continuous ambulatory peritoneal dialysis (CAPD) and 12 on hemodialysis (HD), was investigated. HD patients were studied during a regular bicarbonate dialysis and during hemodiafiltration (HDF) with a high convective component (UF = 66 mL/min) and AN69 filter (Hospal Filtral 12, 1.

Effect of dialysate and substitution fluid buffer on buffer flux in hemodiafiltration.

The effect of differing dialysate and substitution fluid buffer types and concentrations on acid-base balance have not been assessed in patients treated with hemodiafiltration for ESRD. To determine bicarbonate, acetate, lactate and total buffer flux, mass balance studies were performed in patients treated with hemodiafiltration using four different combinations of dialysate and substitution fluids. Driving force for bicarbonate flux was assessed in all treatments.

A multicenter, selection-adjusted comparison of patient and technique survivals on CAPD and hemodialysis.

Four hundred and eighty CAPD and 373 HD patients started regular dialysis treatment between 1981 and 1987 in 6 dialysis centers. The CAPD patients were 6 years older, on average, than the HD patients and had more complicating conditions (43.3% with 3 or more coexisting risk factors versus 28.

Paired filtration dialysis: studies on efficiency, flow dynamics and hydraulic properties of the system.

Several strategies have been proposed to increase dialysis efficiency in order to reduce dialysis treatment time. Paired filtration dialysis (two-chamber technique) is a new technique combining the advantages of highly permeable membranes and convective transport with the high depurative efficacy of diffusion. The system operates with two units in series (hemofilter + dialyzer) with membranes of polysulfone and hemophan, respectively.

Pathophysiology of ultrafiltration in peritoneal dialysis.

Pathophysiology of peritoneal ultrafiltration is analyzed in the present study. Peritoneal equilibration test is the easiest procedure to study in detail the possible causes of failure to control the ultrafiltration rate in patients undergoing peritoneal dialysis. Membrane failure, reduction in peritoneal blood flow, excessive lymphatic reabsorption catheter malposition, and fluid sequestration are the most common causes of ultrafiltration loss.

New method of extracorporeal concentration of ascitic fluid as a treatment of refractory ascites.

A new piece of equipment for the treatment of ascites is described. Ascitic fluid is drained by gravity in a unit consisting of an Amicon D-30 ultrafilter and a bag used as transit reservoir placed below the patient. When the bag is full, it is raised to a height sufficient to let the fluid flow back through the filter to the peritoneal cavity.

Acid base correction in bicarbonate CAPD patients.

Bicarbonate has been proposed as buffer in CAPD solutions in recent years instead of lactate and acetate. The present study is designed to evaluate peritoneal bicarbonate kinetics using bicarbonate solutions. Seventy kinetic studies have been performed in 7 patients treated with 2 CAPD solutions containing 35 mmol/l (A) and 27 mmol/l (B) of bicarbonate.

Total solute extraction versus clearance in the evaluation of standard and short hemodialysis.

The authors compared the efficiency of standard HD (t = 240 minutes, Qb = 300 ml/min, Qd = 500 ml/min) with short HD (t = 150 minutes, Qb = 500 ml/min, Qd = 700 ml/min). The study was carried out in 11 patients in two sequential dialysis sessions, utilizing the same high surface area hollow fiber dialyzers, after a 2 day interdialytic period. With short HD, as expected, the clearance (Cl) of BUN, creatinine (Cr), and phosphates (P) was significantly higher than in standard HD:Cl BUN = 331 vs.

Technical and clinical evaluation of a new system for ultrafiltration control during hemodialysis.

A new system for ultrafiltration control during hemodialysis is described. The apparatus consists of a computer operated system of load cells that register variations in weight of the outlet dialysate versus inlet dialysate. Once the weight loss of the patient has been established, the gravimetric control operates on the dialysate circuit to obtain the transmembrane pressure adequate to achieve the desired ultrafiltration rate and patient weight loss.

The importance of ultrafiltration on acid-base status in a dialysis population.

The amount of fluid withdrawn by ultrafiltration in a dialysis session plays an important role in regulating the acid-base status of patients. It has been previously demonstrated that an interdialytic weight gain of 3 kilograms requires the removal of 3 liters, mostly of extracellular fluid, which may contain 60-70 mMols of bicarbonate. Such losses require an increase in the buffer mass transfer to achieve a good buffer balance.

Comparison of four different short dialysis techniques.

The goal of shortening dialysis treatment time has stimulated the development of new, highly efficient dialytic strategies. In this study the Authors compared four different short dialysis treatments in terms of efficiency, clinical tolerance, technological investment and costs: 1) Rapid bicarbonate dialysis with 1.5 sq.