[Ultrasound evaluation of the bone tissue of the proximal phalanges of hands in patients with suspected type I osteoporosis]. / Valutazione del tessuto osseo con ultrasuoni (US) sulla falange prossimale delle mani nelle pazienti con sospetta osteoporosi di tipo I.

The authors assessed the effectiveness and reliability of a new ultrasound system for evaluating the quality of bone tissue in a series of female patients with suspected type I osteoporosis. Evaluation with ultrasound was performed at the distal metaphysis of the first phalanx of the long fingers of the non-dominant hand. The investigation involves the measurement of the AD-SoS and the evaluation of the screen trace of the US signal transmitted through the phalanx. The data supplied by US were compared with the measurement of BMC through DPA on the ultradistal radius performed on the same day. The study involved 94 patients of age 42 to 73 years. A positive correlation was found between AD-SoS and BMC, r = 0.75, and a negative correlation between AD-SoS and the age of the patients, r = -0.62. Ultrasound investigation enables correct identification in 78% of patients; in particular, none of the patients recognized as pathologic at ultrasound investigation figured as normal at DPA. The authors conclude that the system studied is reliable and supplies important information on the quality of bone tissue, and can usefully complement the methods for measuring BMC.

Intradialytic changes of the oxyhaemoglobin dissociation curve during acetate and bicarbonate haemodialysis. Possible interactions with haemodialysis-associated hypoxaemia.

In nine chronic haemodialysis patients, treated alternately with acetate and bicarbonate, the main critical factors in oxygen supply to the tissues were evaluated: Hb values, blood gas parameters, red cell 2-3 diphosphoglycerate (2-3 DPG), phosphataemia and P50 in vivo. Predialytic P50 was higher than in normal controls. During dialysis, arterial pO2 and pCO2 significantly decreased in acetate dialysis, whereas they were stable in bicarbonate dialysis. Rising alkalinisation was accompanied, both in acetate dialysis and in bicarbonate dialysis, by reduction of P50, while 2-3 DPG did not change. The acute increase in Hb-O2 affinity adversely affected peripheral oxygen release. In acetate dialysis this mechanism might magnify the effects of dialysis-induced hypoxaemia, affecting the clinical tolerance.

Hemorheology in biofiltration and acetate dialysis (preliminary results).

Hemorheological measurements were made in 8 stable chronic haemodialysis patients observed in conventional acetate dialysis (AD) with Cuprophan membrane and then in biofiltration (BF) with PAN AN69S membrane. Blood viscosity diminished at the beginning, both during BF and AD, reaching pre-dialytic values again at the end of treatment. Blood and erythrocyte filtration increased after 20 min in AD and throughout the session in BF. Preliminary results suggest an improvement of hemorheological parameters during dialytic treatment, more notable in BF than in AD.