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Ascitic fluid cascade filtration and reinfusion in the treatment of tense ascites with a new device
EVENT-RELATED POTENTIRLS ENCEPHALOPRTHY OF FLUMRZENIL - THE EFFECTS
S~EC~PICITY OF THE ANTI-HCV ELISA ASSAY IN NORNAL PERSISTENTLY WITH HENOFmLIACS TFUNSAMINASES N.G. Rumi, M. Colmbo. R. Romeo. A. Gringeri. P-UNmnucci. Institute of Internal Wedicine and Hemophiliaand Thmbesis Center.Univ. Milsn.Italy swum
E.Ruzicka-.
V.Tes.aP,
HEPRTIC
__
Z.Mwecek and Medic::.-. I, Czechoslovakia
J.Petrtvl.
NeurOlOgy’ Departments of Charles University, Prague,
193 of 235 (82%) hesophiliecsin Milan had sntibody to hepatitisC virus (anti-WV.
IN
benzodiazepina the The effects Of antagonist flumazenil (Rnexate Roche) were with latent or 14 patients studied in stage 1 hepatic encephalopathy associated cirrhosis of various etiology. with liver event-related auditory Chanoes in prior to after and CERP) pote;ltials intravenous administration Of 0.5 mg of The maximal measured. were the drug reflected by resoonses to the treatment P300 wave latency occurred shortening of expressed deeply in within S-IO min, patients with more severe encephalopathy. The ERP reversed to pre-treatment LeUelS within 20-30 min. to be a sensitive tool ERP appeared for the eva?ua!ion of cognitive impairment cncephalopathy, especially as in hepatic the the assessment of an approach to therapy. Flumazcnil effects of drug seems to be suitable for CRnexate Roche) the treatment of encephalopathy in liver cirrhosis.
ELBA. Ortho DS). as a consenquence of repeat infusions with clotting factor concentrates.The
prevalenceof enti-HCVwss very high in patients with persistently(93%) end intermittently(90%) elevatedserum ALT values. However. the antibody was also found in a substantialproportion(N=Sl. M) of 81 patientswith persistentlynormsl ALT values over a period of 10 years. We wondered whether false positive reactionsmay have occurred in these patients who have frequentlyelevated IgG as a cmsequence of repeated clotting face&r infusions and HIV infection. Using a recosbinsnt
IlnunoblotAssay (MBA-NV test, Chiron Co.). anti-NV reactionwss confinnedin 47 (92%) sers; it was indeterminatein two (4%) which shaed optical density ratios of 2 and 2.9 in the originalELISA assay: and vss negativein two (4%) sharingOD ratio of 2 sod 2.2 in the original essay. Thus, this study confirms that the BLISA naction for anti-HCV that we found in hmophiliacswith normalALT were highly specific_
ASCITIC FLUID CASCADE FILTRATION AND REINFUSION IN THE TREATMENT OF TENSE ASCITES WtTH A NEW DEVICE
M..
.
di Gastroenterokgia.
Dfisikne Universita di Padova. Padova. Italy.
Ascitk fluid recirculation has been recently pruposad as a useful treatment for refractory ascites. However, side effects have been frequently observed, some of them serious. These probably are a result of the reinfuskn of farJe volumes of fluid and low aoleculci wergm prrogenk substances. We report a new development of the technique using a doubk ultrafilter-device (Xfbusave ST 902, Didaco and Hemofilter PanlSO, Ashai) that allows a more concentrated reinfusion of ascitic fluid (up to 95X of the exctracted initial volume). Simultaneous wash oul of fhe fillers is also possibfe to prevent plugging. We applied this procedure to 11 cirrhotic patients (2 F. 9 M; median age 55 y. range 39-69). Four had high crealinine levels. The procedure allowed: the elimination of the ascites. mean 6.7 L (4.0-13.3): the reinfusion of 0.5 L (0.1-1.0) of concentrated fluid rich in albumin (mean: 49.5 g. range 20-91): weight loss of 9.9 kg (4-14): 0.3 L increase in diuresis (mean of the differences between two days before and after the procedure; not sfgnifkant). No sfgnifkant variation in renal fun&on, serum albumin, and plasma and urinary electrolytes were observed. Mean time for the procedure was 2.9 hours. We observed side effects ftransbnt chills and fever) only in our first case, where the fflter was demonstrated to be defective with release of some molecular components in the circulation. The reinfusion of cascade filtrated ascites is a rapid, sale and effective treatment of tense ascites. It appears lo lower the side elfecls of lraditkmal devices and it avoids administration of heterologous plasma derivatives associated with paracenlesis. SllO
S~EC~PICITY OF THE ANTI-HCV ELISA ASSAY IN NORNAL PERSISTENTLY WITH HENOFmLIACS TFUNSAMINASES N.G. Rumi, M. Colmbo. R. Romeo. A. Gringeri. P-UNmnucci. Institute of Internal Wedicine and Hemophiliaand Thmbesis Center.Univ. Milsn.Italy swum
E.Ruzicka-.
V.Tes.aP,
HEPRTIC
__
Z.Mwecek and Medic::.-. I, Czechoslovakia
J.Petrtvl.
NeurOlOgy’ Departments of Charles University, Prague,
193 of 235 (82%) hesophiliecsin Milan had sntibody to hepatitisC virus (anti-WV.
IN
benzodiazepina the The effects Of antagonist flumazenil (Rnexate Roche) were with latent or 14 patients studied in stage 1 hepatic encephalopathy associated cirrhosis of various etiology. with liver event-related auditory Chanoes in prior to after and CERP) pote;ltials intravenous administration Of 0.5 mg of The maximal measured. were the drug reflected by resoonses to the treatment P300 wave latency occurred shortening of expressed deeply in within S-IO min, patients with more severe encephalopathy. The ERP reversed to pre-treatment LeUelS within 20-30 min. to be a sensitive tool ERP appeared for the eva?ua!ion of cognitive impairment cncephalopathy, especially as in hepatic the the assessment of an approach to therapy. Flumazcnil effects of drug seems to be suitable for CRnexate Roche) the treatment of encephalopathy in liver cirrhosis.
ELBA. Ortho DS). as a consenquence of repeat infusions with clotting factor concentrates.The
prevalenceof enti-HCVwss very high in patients with persistently(93%) end intermittently(90%) elevatedserum ALT values. However. the antibody was also found in a substantialproportion(N=Sl. M) of 81 patientswith persistentlynormsl ALT values over a period of 10 years. We wondered whether false positive reactionsmay have occurred in these patients who have frequentlyelevated IgG as a cmsequence of repeated clotting face&r infusions and HIV infection. Using a recosbinsnt
IlnunoblotAssay (MBA-NV test, Chiron Co.). anti-NV reactionwss confinnedin 47 (92%) sers; it was indeterminatein two (4%) which shaed optical density ratios of 2 and 2.9 in the originalELISA assay: and vss negativein two (4%) sharingOD ratio of 2 sod 2.2 in the original essay. Thus, this study confirms that the BLISA naction for anti-HCV that we found in hmophiliacswith normalALT were highly specific_
ASCITIC FLUID CASCADE FILTRATION AND REINFUSION IN THE TREATMENT OF TENSE ASCITES WtTH A NEW DEVICE
M..
.
di Gastroenterokgia.
Dfisikne Universita di Padova. Padova. Italy.
Ascitk fluid recirculation has been recently pruposad as a useful treatment for refractory ascites. However, side effects have been frequently observed, some of them serious. These probably are a result of the reinfuskn of farJe volumes of fluid and low aoleculci wergm prrogenk substances. We report a new development of the technique using a doubk ultrafilter-device (Xfbusave ST 902, Didaco and Hemofilter PanlSO, Ashai) that allows a more concentrated reinfusion of ascitic fluid (up to 95X of the exctracted initial volume). Simultaneous wash oul of fhe fillers is also possibfe to prevent plugging. We applied this procedure to 11 cirrhotic patients (2 F. 9 M; median age 55 y. range 39-69). Four had high crealinine levels. The procedure allowed: the elimination of the ascites. mean 6.7 L (4.0-13.3): the reinfusion of 0.5 L (0.1-1.0) of concentrated fluid rich in albumin (mean: 49.5 g. range 20-91): weight loss of 9.9 kg (4-14): 0.3 L increase in diuresis (mean of the differences between two days before and after the procedure; not sfgnifkant). No sfgnifkant variation in renal fun&on, serum albumin, and plasma and urinary electrolytes were observed. Mean time for the procedure was 2.9 hours. We observed side effects ftransbnt chills and fever) only in our first case, where the fflter was demonstrated to be defective with release of some molecular components in the circulation. The reinfusion of cascade filtrated ascites is a rapid, sale and effective treatment of tense ascites. It appears lo lower the side elfecls of lraditkmal devices and it avoids administration of heterologous plasma derivatives associated with paracenlesis. SllO