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22. Renal Artery Thrombosis

Author

Pettenò, A., primary, Dotti, P., additional, Coluccio, A., additional, Dallavalle, F., additional, Gentilini, C., additional, and Tralce, L., additional

Published
2009
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29. Trombosi acuta dell'arteria renale: trattamento mini-invasivo endovascolare.

Author

Pettenò, A., Dotti, P., Coluccio, A., Dallavalle, F., Gentilini, C., and Tralce, L.

Subjects
THROMBOSIS, CARDIOVASCULAR diseases, THROMBOLYTIC therapy, FIBRINOLYSIS, ISCHEMIA
Abstract

The diagnosis of acute renal infarction is often delayed or failed due to the rarity of the disease and to its non-specific clinical presentation. Cigarette smoking, with its vasoconstrictive and prothrombo tic effects, is a known and sure risk factor for the development of the atheroembolic artery disease. CASE STUDY. This is the report of a case of acute renal infarction in a heavy-smoking patient, a 66-year-old man who arrived at our ward for right worsening backache with vomit and abdominal pain not reacting to the analgesic therapy. A urgent ultrasound showed excretory axes not dilated bilaterally. Therefore, we had to perform further diagnostic tests (CT and then angiography) which highlighted a case of a right massive renal infarction due to complete thrombo tic obstruction of the renal artery with patent contralateral ramification. We performed a PTA and then a local infusion of thrombolytic (metalyse 2 mg in 10'). After this treatment the patient showed an immediate stop of the hurting symptomatology, an improvement of the flow and an opacification of the parenchyma. (lower and medium part) with persistence of vision concerning endoluminal thrombosis. A CT angiography 20 days later, after home therapy with LMWH at therapeutic doses, confirmed a restored and normalized vascularization of the lower and medium part of the right kidney. CONCLUSIONS. In the light of these case results - good revascularization of the lower 2/3 of the right kidney, despite a prolonged time of ischemia from the beginning of the symptoms to the diagnosis and to the further thrombolytic therapy (about 14 hours) -, we assume that a wider use of the Doppler method can be of some usefulness, in case of recurring colics especially not reacting to analgesic therapy with negative ultrasonography check-up for the dilatation of the excretory routes, in order to considerably reduce the diagnosis time of renal diseases of vascular type. [ABSTRACT FROM AUTHOR]

Published
2009

37. The protonation constant of oxamic acid in aqueous solution and in water-tetrahydrofuran mixture, at different temperatures and ionic strengths

Author

Braibanti, A., Leporati, E., and Dallavalle, F.

Abstract

The protonation constant of oxamic acid, H2NCOCOOH, was determined potentiometrically and resulted to be log K1= 1.836 in 0.1 MKCl at 25.0 °C. No protonation or deprotonation is detectable in alkaline media. The calculation of the protonation constant has been carried out by a computer program based on the Sillén method. The estimated standard deviation of log K1has been determined from the statistical analysis of the distribution diagram of Δp[H] = p[Ho] -p[Hc] against p[Ho]. This method can detect systematic errors affecting the data.

Published
1970
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38. [The hemodynamics laboratory without cine film. A comparison between the production costs of 35-mm film and the recordable compact disk]

Author

Gian Battista Danzi, Fiocca L, Dallavalle F, Capuano C, Chioin R, Riva S, and Quaini E

Subjects
Compact Disks, Italy, X-Ray Film, Costs and Cost Analysis, Hemodynamics, Humans, Hospital Costs, Coronary Angiography, Laboratories, Hospital, Statistics, Nonparametric
Abstract

For more than 35 years, cine film has been used as the standard recording medium for coronary angiography. At present, the DICOM and the CD-R format have been established as the standard media for the transport of cardiac angiographic images in place of cine angiographic film. The aim of the study was to compare the media production costs between two cardiac catheterization laboratories, with and without cine film.We collected data from two different laboratories in the same geographic area which perform about 1000 procedures/year, using a similar digital x-ray imaging system. In one lab, images are recorded on 35-mm film at 25 frames/sec. In the other one, the image support is based on a CD-R. For each laboratory we considered both direct patient and variable equipment costs. Direct patient costs in the film-lab include: cine film, processing chemicals, processing labor, chemical disposal, maintenance; in the digital lab: CD-R costs and masterization time. Equipment costs in the film-lab include: cine camera, cine film processor and cine projector; in the filmless lab a DICOM formatter and a review workstation. The equipment amortization costs are considered over a three-year period.Total direct patient costs are 90,000 lira for the film and 14,000 lira for the CD-R. Equipment costs are 193,000,000 lira in the film-lab and 150,000,000 lira in the filmless one. Overall cost per patient is 154,300 lira for the cine film and 64,000 lira for the CD-R.This study shows that the media costs per patient for a digital DICOM CD-R format system are substantially less than for 35-mm film, permitting savings of more than 90,000,000 Italian lira per year in a mid-volume cardiac catheterization laboratory.

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