Treatment of hyperhomocysteinaemia in haemodialysis patients at high cardiovascular risk.

OBJECTIVES: Cardiovascular disease (CVD) is the main cause of death among haemodialysis (HD) patients. Emerging cardiovascular risk factors such as oxidative stress and chronic inflammation are involved in these patients together with traditional risk factors. Here we investigate the effects of a short-term folate treatment on some markers of chronic inflammation in two groups of HD patients with and without vascular occlusive disease (VOD). PATIENTS AND METHODS: Homocysteine (HCy), C-reactive protein (CRP), Folate, fibrinogen and alpha1 acid glycoprotein (alpha1AGP) were dosed before and after a 3-month course of high-dose folate (25 mg intravenous calcium laevofolinate pentahydride once weekly) and again after a one-month washout in 15 HD patients with established VOD (group A) and in 15 comparable HD patients with no diagnosis of VOD (group B). RESULTS: Baseline HCy and CRP were significantly elevated in patients of both groups A and B compared to normal values. Folate treatment significantly reduced HCy in patients of both groups A and B and alpha1AGP only in patients of group A, while the other markers were not modified. After the one-month washout a significant raise of CRP could be observed in patients of group A; again, the other markers were not modified. CONCLUSIONS: Our results suggest that significant reduction of serum HCy can be achieved in both patients with or without VOD after administration of high-dose folic acid. Hence, folic acid supply is useful in the treatment of hyperhomocysteinemia in HD patients, although it is not sufficient to modify their chronic inflammatory status.

[Comparison of Merck and Pasteur plasma-derived hepatitis B vaccines in 2 populations of hemodialysis patients]. / Confronto tra la vaccinazione anti-epatite B con vaccini plasmaderivati Merck e Pasteur in due popolazioni di emodializzati.

In reporting the preliminary data on the anti-B hepatitis vaccination study, the paper compares the two plasma-derived vaccines on the market, Pasteur Hevac-B and HB-Vax M.S.D. in two groups of hemodialyzed subjects. It briefly described the properties of the two vaccines and examines the respective vaccination protocols, doses and administration methods. After reporting the data on the two groups considered and the results in each one, the paper concludes that the M.S.D. vaccine is the most efficacious for hemodialyzed subjects.

[Hepatitis B vaccination with the plasma-derived Hevac-B Pasteur vaccine. A comparison of 2 populations: hospital personnel and hemodialysis patients]. / Vaccinazione anti epatite B con vaccino plasmaderivato Hevac-B Pasteur. Confronto tra due popolazioni: personale ospedaliero ed emodializzati.

A vaccination experiment using plasma-derived Hevac-B anti-hepatitis vaccine was conducted on two groups at high risk of HBV infection: hospital staff and hemodialyzed subjects. The qualities of the vaccine and the most important directions on how to use it rare briefly presented with a report on the protocol and the results of the vaccine cycle in both groups. It is concluded that the Hevac-B vaccine is efficacious in healthy subjects at risk, but gives an unsatisfactory result in immune deficient subjects, like those under haemodialysis.

[Considerations on a series of malaria cases]. / Considerazioni su una casistica di malaria.

Stress is laid on the seriousness of malaria and the causes of its unusual clinical pictures. Results obtained in the evaluation of G-6-PD, PK, intracellular K and globular resistance, in addition to other parameters, suggest (as pointed out in the literature) that altered cell metabolism may be the primary cause of haemolysis. Attention is also drawn to the lengthy persistance of gametes after gametocidal management in some patients, and the risks that this involves.