The role of neurotransmitters in the genesis of uremic encephalopathy.

To classify the influence of neurotransmitters in the genesis of uremic encephalopathy we studied cerebrospinal fluid (CSF) and plasma (P) amino acid (AA) concentration, in patients undergoing various dialytic treatments (hemodialysis = HD, intermittent and continuous peritoneal dialysis = IPD and CAPD). HD causes a significant decrease in CSF/P ratios of branched chain AA (BCAA) and a significant increase in CSF Glycine/Valine ratio, suggesting an augmented brain uptake of Glycine at detriment of Valine. In IPD the general trend of Aromatic AA/BCAA ratio suggests a preferential transport of Aromatic AA through the blood brain barrier.

The significance of the HBeAg/anti-HBe system in hemodialysis patients. A multicenter study.

The HBeAg/anti-HBe system was studied as a marker of infectivity and chronic progressive liver disease in 460 hemodialysis patients. The importance of HBeAg as an index of infectivity was confirmed in that it was present simultaneously with specific DNA polymerase (31 patients) and by the presence of widely diffuse core particles in the hepatocyte nuclei (revealed by biopsy in six patients). In contrast, HBeAg showed no useful correlation with progressive liver disease, the absence of which was confirmed in all cases by biochemical and histological studies.

Anatomical bases of peritoneal permeability: a reappraisal. Anatomy of peritoneum.

The peritoneal membrane consists of flat mesothelial cells linked together with digitations and containing vesiculae with pinocytic capacity, of endothelial cells (containing Weibel-Palade's bodies and vesiculae) and of an interstitial tissue consisting of a network of watery channels. The cellular structures of mesothelium and endothelium are characterized by tight and gap junctions or perhaps by macular junctions. The visceral peritoneum shows a prevalence of gap junctions, the pericysic veins contain only tight junctions while both types can be found in the arterioles.

Pharmacokinetics of intravenous and intraperitoneal cefuroxime during peritoneal dialysis.

We investigated the pharmacokinetics of cefuroxime sodium, a new parenteral beta-lactam antibiotic, in 15 patients with stable chronic renal failure during intermittent peritoneal dialysis (IPD). Eight patients were administered 1 g cefuroxime as an intravenous bolus 1 h before the start of dialysis. Mean plasma levels of cefuroxime fell from 80 mcg/ml at 1 h to 40 mcg/ml at 6-8 h.

Studies on brain density in hemodialysis and peritoneal dialysis.

30 patients on hemodialysis or peritoneal dialysis have been investigated by computerized tomographic (CT) scan. To evaluate possible cerebral alterations induced by dialysis, CT examinations were carried out before, immediately after and 6 h after the end of dialysis with an Evaluskop, which provides an objective precise evaluation of even slight variations in brain density. No morphological variations were noted after dialysis, while the brain density fell significantly during and after the treatment.

Changes of cerebral density in dialyzed patients.

CT studies were made on 38 patients receiving different dialytic treatment, 10 patients with chronic renal failure not yet dialyzed, and 15 healthy subjects. No morphological modifications were observed. On the contrary, significant changes of density were demonstrated after a dialysis session in the population treated intermittently.

Acid-base balance on peritoneal dialysis.

Forty studies of acid-base balance during intermittent peritoneal dialysis (IPD) and during continuous ambulatory peritoneal dialysis (CAPD) were performed on 20 patients who were receiving IPD with acetate buffer (5 patients), IPD with lactate buffer (5 patients), CAPD with acetate buffer (5 patients) and CAPD with lactate buffer (5 patients). Measurements of acetate, lactate and pyruvate levels in blood and dialyzate were taken at different times during dialysis; blood samples for blood gas analysis were drawn at the same times. Calculations of the kinetics of acetate, lactate and bicarbonate during IPD and CAPD were carried out according to the method of Tolchin [1977] but modified for PD.

[Investigation of drug users reported to the juvenile court of Rome].

After illustrating the new set of rules in matter of stupefacient and psychotropic drugs, introduced in Italy on December 1975, and the duties assigned by the law to the judicial power, the findings are set forth here of an investigation carried out on 40 youths whose addiction to the use of drugs had been reported to the juvenile court of Rome up to April 30, 1977. Anamnestic, social, judicial and clinical data on such subjects were obtained. Even with the obvious reservations resulting from the extremely small sample, some findings are observed that appear to be significant: a considerable portion of the minors addicted to the use of drugs was the recipient of other interventions by the juvenile court in the civil, administrative and criminal sphere; for the males, the prevailing anamnestetic and social data correspond to the characteristics of the other subjects, with whom the court usually deals at the "re-educational" or criminal level, while, with regard to females, the picture is remarkably different.

Experience with a new vascular prosthetic device (Sparks mandril) for periodic haemodialysis.

In eighteen months, eleven Sparks mandrils have been implanted in ten patients who presented serious vascular access problems. So far nine mandrils have been anastomosed and six are functioning. In one patient the apparatus, inserted in the right leg, clotted after 108 dialyses and was reinserted in the left arm; after a further forty dialyses the patient died from causes not connected with dialysis.