[Comparison of methodologies to reach 'dry weight']. / Metodiche a confronto per il raggiungimento del peso secco.

BACKGROUND: In clinical practice it is very difficult to determine a final weight that is the expression of normovolemia. In hemodialysis (HD), 'dry weight' is conventionally defined as the weight reached by the patient at the end of that hemodialytic session when the maximum quantity of fluids is removed without inducing any symptomatology. The determination of dry weight has been based on the application of clinical criteria. The use of artificial kidneys with blood volume (BV) sensors has allowed the determination of dry weight through the interpretation of changes in the intradialytic BV curve. Conventional bioimpedance analysis (BIA), or better, the vectorial BIA (BIVA) is a new method for determining dry weight. This study evaluated the use of the above-mentioned method for the proper governing of dry weight. PATIENTS AND METHODS: Twenty HD patients were observed for 4 weeks. In the 1st week, the clinical symptomatology of every patient was monitored during both HD sessions and interdialytic periods. During the 2nd week, intradialytic changes in the BV of each patient were observed on artificial kidneys. In the 3rd week, a cardiologist monitored patients before and after hemodialytic treatments. In the 4th week, the body composition of each patient was analyzed through bioelectrical bioimpedance. RESULTS: Patients, who had clinically shown symptoms of hyperhydration, to the contrary at BIA were dehydrated. Conversely, patients who had dehydration symptoms presented signs of hyperhydration at BIA. CONCLUSIONS: BIVA is the diagnostic instrument that more accurately demonstrates the hydration state of hemodialytic patients. It contributes in defining dry weight more efficiently.

[Non-Hodgkin's lymphomas of the salivary gland: analysis of prognostic factors in 28 cases]. / I linfomi non Hodgkin delle ghiandole salivari: analisi dei fattori prognostici su 28 casi.

Primary malignant lymphomas of the major salivary glands are rare and usually arise in the parotid gland (2% of all neoplastic disorders). In this report clinical records of 28 cases of NHL of salivary glands (27 in the parotid gland and one in the submandibular gland) are reviewed and problems related to diagnosis and management strategies are discussed. The 5-year overall survival rate was 72% and did non differ from the survival of other NHL of the head and neck. Statistical evaluation of prognostic factors (age, histology, clinical stage, grading, bulky and surgical approach--biopsy versus parotidectomy), are presented. Analysis of these factors showed that prognosis was not influenced by age, histology, clinical stage and grading of disease. Poor survival was significantly correlated to bulky lesions (tumor size greater than 6 cm). In our experience surgical treatment did not significantly affect survival rate. It is concluded that diagnostic surgical procedures in case of suspected NHL of the parotid gland are fine needle aspiration biopsy. (FNAB) or incisional biopsy. The treatment of choice is radiotherapy associated with chemiotherapy in cases of localized-bulky or disseminated disease.