1
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Gagliotti C, Buttazzi R, Ricciardi A, Ricchizzi E, Lanciotti G, Moro M. Use of health databases to deal with underreporting of surgical site infections due to suboptimal post-discharge follow-up. J Hosp Infect 2020; 104:239-242. [DOI: 10.1016/j.jhin.2019.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 09/09/2019] [Indexed: 10/26/2022]
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2
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Biagini G, Stefoni S, Solmi R, Castaldini C, Buttazzi R, Rossetti A, Belmonte MM, Costa AN, Lannelli S, Borgnino L, De Sanctis L. Fibroblast proliferation over dialysis membrane: an experimental model for “tissue” biocompatibility evaluation. Int J Artif Organs 2018. [DOI: 10.1177/039139889401701202] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study reports on a biological model based on fibroblast proliferation applied to 3 different types of flat-plate dialysis membrane, in order to ascertain whether the artificial materials currently used in hemodialysis cause in vitro cellular proliferation. The study plan we followed involved plate membrane isolation from non-used dialyzers and used dialyzers, observed through scanning electron microscopy (SEM) both before and after testing with human fibroblasts by means of cell culture. Fibroblast growth was assessed by phase contrast light microscopy examination and cytometric DNA content evaluation. Our investigations proved that the artificial materials we considered interact with fibroblast cultures. Noticeable proliferative response was observed both after contact with unused material and on mediation by the protein layer absorbed on the membrane surface at the end of dialysis sessions. In this last case fibroblast proliferative activity appeared higher than that observed with unused membranes, showing that the soluble molecules entrapped in the protein layer appeared able to exert a biological activity even in in vitro tests
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Affiliation(s)
- G. Biagini
- Human Morphology Institute, University of Ancona, Ancona
| | - S. Stefoni
- Chair of Nephrology, University of Bologna, Bologna
| | - R. Solmi
- Histology and General Embryology Institute, University of Bologna, Bologna - Italy
| | - C. Castaldini
- Histology and General Embryology Institute, University of Bologna, Bologna - Italy
| | - R. Buttazzi
- Histology and General Embryology Institute, University of Bologna, Bologna - Italy
| | - A. Rossetti
- Histology and General Embryology Institute, University of Bologna, Bologna - Italy
| | | | | | - S. Lannelli
- Chair of Nephrology, University of Bologna, Bologna
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3
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De Sanctis L, Stefoni S, Cianciolo G, Colì L, Buscaroli A, Feliciangeli G, Borgnino L, Bonetti M, Gregorini M, De Giovanni P, Buttazzi R. Effect of Different Dialysis Membranes on Platelet Function. A Tool for Biocompatibility Evaluation. Int J Artif Organs 2018. [DOI: 10.1177/039139889601900705] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Intradialytic coagulative and platelet activation, one of the main consequences of blood-membrane contact, was studied in a group of 5 RDT patients with a comparative evaluation of 3 different dialytic membranes: Cuprophan (CU), Polysulfone (PS) and Cellulose Triacetate (CT). Each patient underwent 5 consecutive dialysis sessions with the above mentioned membranes. Intradialytic platelet activation was studied through a morpho-functional evaluation between the mean platelet volume (MPV) and Serotonin (S), ß-Thromboglobulin (ß-TG) and Platelet Factor 4 (PF4) serum levels. These determinations were made before HD (time 0) and after 30', 120’ and 240'. We also checked the intradialytic status of thrombogenesis and fibrinolysis determining aPTT, thrombin time, fibrinogen, antithrombin III (AT III), α-2 antiplasmin and plasminogen, at the same time intervals. All membranes tested (CU, PS, CT) caused appreciable intradialytic platelet activation, above all after 15’ and at the end of dialysis sessions, more marked for CU than PS or CT. In particular MPV showed a decrease throughout the session (-5% at 30’ and -9% at 240') while S, ßTG and PF4 peripheral blood levels showed a significant increase at the same intervals with CU membrane. Lastly coagulative and fibrinolytic parameters showed no significant differences among any of the membranes tested.
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Affiliation(s)
| | | | | | - L. Colì
- Institute of Nephrology Bologna - Italy
| | | | | | | | - M. Bonetti
- Central Laboratory, St. Orsola University Hospital, Bologna - Italy
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4
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Giufrè M, Ricchizzi E, Accogli M, Barbanti F, Monaco M, Pimentel de Araujo F, Farina C, Fazii P, Mattei R, Sarti M, Barozzi A, Buttazzi R, Cosentino M, Nardone M, Savini V, Spigaglia P, Pantosti A, Moro ML, Cerquetti M. Colonization by multidrug-resistant organisms in long-term care facilities in Italy: a point-prevalence study. Clin Microbiol Infect 2017; 23:961-967. [PMID: 28412380 DOI: 10.1016/j.cmi.2017.04.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/30/2017] [Accepted: 04/06/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To determine prevalence and risk factors for colonization by multidrug-resistant organisms (MDROs) in long-term care facility (LTCF) residents in Italy. Genotypes of MDRO isolates were investigated. METHODS A point-prevalence study was conducted at 12 LTCFs located in four Italian cities (2 February to 14 March 2015). Rectal swabs, faeces and nasal/auxiliary swabs were cultured for extended-spectrum β-lactamase (ESBL)- and/or carbapenemase-producing Enterobacteriaceae, Clostridium difficile and methicillin-resistant Staphylococcus aureus (MRSA) respectively. Antimicrobial susceptibility testing, detection of ESBL and/or carbapenemase genes and molecular typing of MDROs were performed. Risk factors for colonization were determined by univariate and multivariate analysis. RESULTS A total of 489 LTCF residents aged ≥65 years were enrolled. The prevalence of colonization by ESBL-producing Enterobacteriaceae, MRSA and C. difficile was 57.3% (279/487), 17.2% (84/487) and 5.1% (21/409) respectively. Carriage rate of carbapenemase-producing Enterobacteriaceae was 1% (5/487). Being bedridden was a common independent risk factor for colonization by all MDROs, although risk factors specific for each MDRO were identified. ESBL-producing Escherichia coli carriage was associated with the sequence type (ST) 131-H30 subclone, but other minor STs predominated in individual LTCF or in LTCFs located in the same city, suggesting a role for intrafacility or local transmission. Similarly, MRSA from LTCF residents belonged to the same spa types/ST clones (t008/ST8 and t032/ST22) commonly found in Italian acute-care hospitals, but infrequent spa types were recovered in individual LTCFs. The prevalent C. difficile PCR ribotypes were 356/607 and 018, both common in Italian acute-care hospitals. CONCLUSIONS MDRO colonization is common among residents in Italian LTCFs.
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Affiliation(s)
- M Giufrè
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - E Ricchizzi
- Health and Social Agency, Emilia-Romagna Region, Bologna, Italy
| | - M Accogli
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - F Barbanti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - M Monaco
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | | | - C Farina
- Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - P Fazii
- Spirito Santo Hospital, Pescara, Italy
| | - R Mattei
- Campo di Marte Hospital, Lucca, Italy
| | - M Sarti
- S. Agostino-Estense-Baggiovara Hospital, Modena, Italy
| | - A Barozzi
- S. Agostino-Estense-Baggiovara Hospital, Modena, Italy
| | - R Buttazzi
- Health and Social Agency, Emilia-Romagna Region, Bologna, Italy
| | - M Cosentino
- Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - M Nardone
- Campo di Marte Hospital, Lucca, Italy
| | - V Savini
- Spirito Santo Hospital, Pescara, Italy
| | - P Spigaglia
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - A Pantosti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - M L Moro
- Health and Social Agency, Emilia-Romagna Region, Bologna, Italy
| | - M Cerquetti
- Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
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5
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Stefoni S, DeSanctis LB, Nanni-Costa A, Iannelli S, Borgnino LC, Buscaroli A, Buttazzi R, La Manna G, Todeschini P, Giudicissi G. Dialysis and the immune system. Contrib Nephrol 2015; 113:80-91. [PMID: 7712725 DOI: 10.1159/000424217] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- S Stefoni
- Nephrology Institute, University of Bologna, Italy
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6
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Gagliotti C, Ricchizzi E, Buttazzi R, Tumietto F, Resi D, Moro ML. Hospital statistics for antibiotics: defined versus prescribed daily dose. Infection 2014; 42:869-73. [PMID: 24973982 DOI: 10.1007/s15010-014-0649-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 06/12/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE Defined daily doses (DDD) are widely used as a unit to measure drug use in hospital and community settings. However, discrepancies exist between DDD and actual prescribed daily dose (PDD). The present study aims at estimating an alternative PDD (PDD-proxy) to calculate rates of systemic antibiotic consumption and to compare these results with those obtained using DDD. METHODS The study considered a 9-year period (2004-2012) and included the 17 Health Trusts (HTs) in the Emilia-Romagna Region, Italy. Drugs under study were antibacterials for systemic use (group J01). Data were obtained from the database for hospital drug prescription of Emilia-Romagna Region. The PDD-proxy was estimated by averaging the doses of antibiotic prescriptions from a point prevalence survey for healthcare-associated infections and antimicrobial use, conducted in Emilia-Romagna hospitals in 2012. RESULTS Significant discrepancies between DDD and PDD were observed, especially for some antibiotics, resulting in DDD rates that were systematically higher than PDD-proxy rates. In 2012, HT median rates of antibiotic consumption were 90 DDD/100 bed days and 70 PDD-proxy/100 bed-days. However, PDD-proxy and DDD rates showed comparable trends within HTs, although some HTs ranked differently when one or the other measure was used. Interquartile ranges of DDD rates were systematically wider than those of PDD-proxy rates in most years in the period of interest. CONCLUSIONS Comparison of HT antibiotic consumption using DDDs may artificially increase observed differences and affect the true HT ranking. Therefore, an additional unit of measurement is useful for in-depth analysis at the local level.
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Affiliation(s)
- C Gagliotti
- Agenzia Sanitaria e Sociale Regionale Emilia-Romagna, Viale Aldo Moro 21, 40127, Bologna, Italy,
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7
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Morandi M, Buttazzi R, Marchi M, Morsillo F, Gagliotti C, Moro ML. P033: Incidence estimate of Clostridium difficile infection in Emilia-Romagna Region by linkage of administrative and laboratory data. Antimicrob Resist Infect Control 2013. [PMCID: PMC3688182 DOI: 10.1186/2047-2994-2-s1-p33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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8
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Moro ML, Gagliotti C, Marchi M, Buttazzi R, Cappelli V, Morandi M, Morsillo F, Pan A, Parenti M, Ricchizzi E. P212: Antimicrobial resistance and healthcare associated infections: one and only battle. Antimicrob Resist Infect Control 2013. [PMCID: PMC3688137 DOI: 10.1186/2047-2994-2-s1-p212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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9
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Gagliotti C, Pan A, Buttazzi R, Capatti C, Carretto E, Pedna F, Sarti M, Venturelli C, Moro ML. Increasing trends of Acinetobacter Baumannii infections in Emilia-Romagna, Italy. BMC Proc 2011. [PMCID: PMC3239724 DOI: 10.1186/1753-6561-5-s6-p292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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10
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Pan A, Buttazzi R, Marchi M, Gagliotti C, Resi D, Moro ML. Secular trends in antibiotic consumption in the adult population in Emilia-Romagna, Italy, 2003-2009. Clin Microbiol Infect 2011; 17:1698-703. [PMID: 21595784 DOI: 10.1111/j.1469-0691.2011.03500.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Antibiotic resistance is closely related to antibiotic use and Italy is a country with high levels of both antibiotic use and antimicrobial resistance. We analysed the trend in antibiotic use in the community among adults (≥15 years) and elderly, in the period 2003-2009, in Emilia-Romagna, Italy, a region with over 4 000 000 inhabitants. Data regarding antibiotic use were obtained from the regional public health system databases. Between 2003 and 2009 the antibiotic consumption increased from 15.4 to 18.7 defined daily doses/1000 inhabitants per day (DID) (+21.4%, p <0.0001). The prescription rate in 2009 was 2.19 prescriptions/1000 inhabitants per day, an increase of 13.8% compared with 2003. The highest increase in antibiotic use was observed among persons aged 20-59 years (+24.7%). The proportion of inhabitants receiving at least one antibiotic treatment was 36.4% in 2003 and 39.7% in 2009, and the proportions receiving at least three antibiotic treatments were 3.5% and 4.2%, respectively. The H1N1 pandemic was associated, in October and November 2009, with a 37-90% increase in antibiotic use among the 15-19-year and 20-59-year age groups compared with 2007 and 2008. No other difference was observed in any other age group. The analysis per antibiotic class showed increases for penicillin + beta-lactamase inhibitor (from 3.6 to 6.3 DID), quinolones (from 2.6 to 3.0 DID) and macrolides (from 3.1 to 3.7 DID), whereas cephalosporin use was stable (1.4 DID). A steady increase in antibiotic use in the adult population has been observed in the Emilia-Romagna: public health interventions are mandatory to counteract this trend.
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Affiliation(s)
- A Pan
- Area Rischio Infettivo, Agenzia Sanitaria e Sociale Regionale dell'Emilia-Romagna, Bologna, Italy.
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11
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Moro ML, Marchi M, Buttazzi R, Nascetti S. Progress in infection prevention and control in Italy: a nationwide survey. J Hosp Infect 2010; 77:52-7. [PMID: 21131101 DOI: 10.1016/j.jhin.2010.08.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Accepted: 08/03/2010] [Indexed: 10/18/2022]
Abstract
A national survey was conducted to describe the coverage and characteristics of infection prevention and control (IC) programmes in Italy and to evaluate progress during recent years. All regions, with one small exception, participated and the response rate was 88%. Nearly all 278 respondent public health trusts reported having an IC committee, 80% of the 615 respondent hospitals to have instituted an IC team, and 79% to have an IC nurse. However, when the presence of truly operating IC bodies was considered, the pattern was different: only 27% of IC teams met at least monthly, and variation by region was extremely large [coefficient of variation (CV): 1.06]. The IC programme characteristics with the greatest variation by region included: availability of qualified nurses and IC doctors (CV: 1.55 and 1.39 respectively); integration of IC activities and clinical risk management (CV: 1.05); IC programmes also involving community services (CV: 0.98); training of personnel at induction (CV: 0.82); and availability of written policies for the control of multidrug-resistant organisms (CV: 1.08). A relevant and statistically significant North-South gradient showed Southern Regions averaging 23 points less than Northern Regions on the IC score. Compared with a similar survey conducted in 2000, the distribution of several activities by region had improved significantly. Despite the noteworthy improvement observed over time, the situation in Italy is still unsatisfactory, due to significant variation in the development of IC organisations and initiatives by region and by type of hospital.
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Affiliation(s)
- M L Moro
- Agenzia Sanitaria e Sociale Regionale Emilia-Romagna, Area Rischio Infettivo, Bologna, Italy.
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12
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Nanni-Costa A, Scolari MP, Iannelli S, Buscaroli A, De Sanctis LB, Liviano D'Arcangelo G, Borgnino LC, Buttazzi R, Stefoni S, Bonomini V. Crossmatch testing in renal transplantation: comparative evaluation between an innovatory ELISA technique and two different standardised CDC methods. Transplant Proc 1997; 29:1449-50. [PMID: 9123376 DOI: 10.1016/s0041-1345(96)00561-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- A Nanni-Costa
- Institute of Nephrology, St Orsola University Hospital, Bologna, Italy
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13
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Nanni-Costa A, Scolari MP, Iannelli S, Vangelista A, Buscaroli A, Liviano D'Arcangelo G, Buttazzi R, de Sanctis LB, Todeschini P, Stefoni S, Bonomini V. ELISA anti-HLA antibody screening identifies non-complement-fixing antibodies responsible for acute graft rejection. A case report. Eur J Immunogenet 1996; 23:383-7. [PMID: 8909945 DOI: 10.1111/j.1744-313x.1996.tb00011.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We report on a kidney transplant recipient experiencing an unexpected early acute vascular graft rejection. Retrospective analysis of patient serum samples, utilizing a new ELISA HLA screening technique, revealed that the rejection crisis and the subsequent graft loss were due to a pretransplant donor-specific pre-sensitization caused by a non-complement-fixing antibody of IgG2 class. The case illustrates the clinical significance of non-complement-fixing anti-HLA antibodies. In addition it is shown that ELISA methods are suitable for detecting potentially harmful donor pre-sensitization in waiting-list patients not detectable by standard lymphocytotoxicity techniques. Hence ELISA could be an alternative to flow cytometry for this purpose. It is concluded that screening and cross-matching techniques which detect non-complement-fixing anti-HLA antibodies could improve graft outcome, and should form part of the immunological monitoring of kidney transplant waiting-list patients.
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Affiliation(s)
- A Nanni-Costa
- Institute of Nephrology, St. Orsola University Hospital, Italy
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14
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De Sanctis LB, Stefoni S, Cianciolo G, Colì L, Buscaroli A, Feliciangeli G, Borgnino LC, Bonetti M, Gregorini MC, De Giovanni P, Buttazzi R. Effect of different dialysis membranes on platelet function. A tool for biocompatibility evaluation. Int J Artif Organs 1996; 19:404-10. [PMID: 8841854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Intradialytic coagulative and platelet activation, one of the main consequences of blood-membrane contact, was studied in a group of 5 RDT patients with a comparative evaluation of 3 different dialytic membranes: Cuprophan (CU), Polysulfone (PS) and Cellulose Triacetate (CT). Each patient underwent 5 consecutive dialysis sessions with the above mentioned membranes. Intradialytic platelet activation was studied through a morpho-functional evaluation between the mean platelet volume (MPV) and Serotonin (S), beta-Thromboglobulin (beta-TG) and Platelet Factor 4 (PF4) serum levels. These determinations were made before HD (time 0) and after 30', 120', and 240'. We also checked the intradialytic status of thrombogenesis and fibrinolysis determining aPTT, thrombin time, fibrinogen, antithrombin III (AT III), alpha-2 antiplasmin and plasminogen, at the same time intervals. All membranes tested (CU, PS, CT) caused appreciable intradialytic platelet activation, above all after 15' and at the end of dialysis sessions, more marked for CU than PS or CT. In particular MPV showed a decrease throughout the session (-5% at 30' and -9% at 240') while S, beta TG and PF4 peripheral blood levels showed a significant increase at the same intervals with CU membrane. Lastly coagulative and fibrinolytic parameters showed no significant differences among any of the membranes tested.
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Affiliation(s)
- L B De Sanctis
- Institute of Nephrology, St. Orsola University Hospital, Bologna, Italy
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15
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Biagini G, Stefoni S, Solmi R, Castaldini C, Buttazzi R, Rossetti A, Mattioli Belmonte M, Nanni Costa A, Iannelli S, Borgnino LC. Fibroblast proliferation over dialysis membrane: an experimental model for "tissue" biocompatibility evaluation. Int J Artif Organs 1994; 17:620-8. [PMID: 7759141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The present study reports on a biological model based on fibroblast proliferation applied to 3 different types of flat-plate dialysis membrane, in order to ascertain whether the artificial materials currently used in hemodialysis cause in vitro cellular proliferation. The study plan we followed involved plate membrane isolation from non-used dialyzers and used dialyzers, observed through scanning electron microscopy (SEM) both before and after testing with human fibroblasts by means of cell culture. Fibroblast growth was assessed by phase contrast light microscopy examination and cytometric DNA content evaluation. Our investigations proved that the artificial materials we considered interact with fibroblast cultures. Noticeable proliferative response was observed both after contact with unused material and on mediation by the protein layer absorbed on the membrane surface at the end of dialysis sessions. In this last case fibroblast proliferative activity appeared higher than that observed with unused membranes, showing that the soluble molecules entrapped in the protein layer appeared able to exert a biological activity even in vitro tests.
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Affiliation(s)
- G Biagini
- Human Morphology Institute, University of Ancona, Italy
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