S. Stuard - Academia.edu (original) (raw)

Papers by S. Stuard

Ankle sprains mainly caused by accidents or strenuous sport activities can often be quite painful... more Ankle sprains mainly caused by accidents or strenuous sport activities can often be quite painful and impair motility. If not treated immediately and correctly, sprains may lead to severe complications. The aim of the present study was to compare the efficacy and safety of topically applied ketoprofen versus orally administered ketoprofen in 20 patients with grade I ankle sprain and 34 patients with grade II sprain. The patients were divide into in two treatment groups and received either topically applied ketoprofen treatment (ketoprofen 10% spray-gel; Prontoflex; 360 mg/die) or orally administered ketoprofen treatment (ketoprofen tablets; 3x50 mg/die). Treatment duration was one week. After 3 and 7 days of treatment, reduction of spontaneous pain and pain on active movement in the Prontoflex group was significantly bigger greater in the oral treatment group, irrespective of sprain severity. Regarding secondary parameters as mobility impairment and ankle swelling topically applied ...

The aim of the paper was to describe a new formula (Antilip\uae) consisting of very low dosages o... more The aim of the paper was to describe a new formula (Antilip\uae) consisting of very low dosages of polyglucosamine, phytosterols and Monascus purpureus. It was given to subjects affected by high cholesterol levels

Table S3. Cumulative numbers of deaths, competing events and censored events in prevalent and inc... more Table S3. Cumulative numbers of deaths, competing events and censored events in prevalent and incident patients every 6â months throughout the study period. This table provides additional information to Table 5 and Fig. 1. (PDF 24 kb)

Biochemistry and Cell Biology, 1994

Thymocytes that express the complete CD3−T-cell receptor (TCR) complex are CD4− and CD8−. The CD4... more Thymocytes that express the complete CD3−T-cell receptor (TCR) complex are CD4− and CD8−. The CD4+ T-cell population can be subdivided into at least two quite distinct subsets, TH1 and TH2 cells, based upon cytokine expression. Interleukin-1 (IL-1) appears to be required for optimal proliferation of T cells in response to antigen and it seems that in the absence of IL-1, TH2 clones proliferate less in response to antigen. Tenidap is an antirheumatic agent that has an inhibitory effect on IL-1 production. In these studies, we show that isolated human peripheral blood mononuclear cells (PBMCs) treated in vitro with Tenidap (15 μg/mL) for 48-h incubations significantly (p

NDT Plus, 2011

Abstract INTRODUCTION AND AIMS: There is currently no consensus about the indications for therape... more Abstract INTRODUCTION AND AIMS: There is currently no consensus about the indications for therapeutic apheresis, also due to the lack of large clinical trials. A registry where all the data can be organized and analyzed therefore becomes a priority for all professionals ...

Background: Evidence suggests that online hemodiafiltration... more Background: Evidence suggests that online hemodiafiltration (OL-HDF) is associated with improved survival. Whether the dose-response relationship between convective volume and mortality may be confounded by selection bias or descends from practice patterns is not clear. We sought to evaluate the role of patients' characteristics and practice patterns on OL-HDF dose and mortality in a large private dialysis network in the Republic of Russia. Methods: In this multicenter, historical cohort study, we included adult incident patients on OL-HDF with at least 90 days of survival on renal replacement therapy in centers belonging to the Russian Federation Fresenius Medical Care network (January 1, 2011, to December 31, 2016). We evaluated predictors and outcomes (survival) of substitution volume target achievement (Qsub > 21 L/session). Results: Among 1,081 enrolled patients, the average Qsub was 22.9 (±3.2) L/session; the mean ultrafiltration volume was 1.6 (±0.8) L/session. The mean age was 55.8 ± 13.2; 42% were woman. Most common comorbidities were congestive heart failure (39.7%) and peripheral vascular disease (21.7%). The average hemoglobin was 9.3 ± 1.3. The case-mix adjusted center effect accounted for 20% of variance in Qsub. The top 10 most important variables associated with higher Qsub were effective Qb, serum protein, Charlson's comorbidity index, hemoglobin, year of dialysis initiation (proxy of high Qsub treatment policy in the clinic network), predialysis heart rate, serum bicarbonate, serum phosphate, age, serum sodium, and dry body weight. In addition, we found that the association of Qb with Qsub is moderated by year of enrollment, intradialytic weight gain, and coronary artery disease, whereas higher hemoglobin concentration moderated the relationship between treatment time and Qsub. Finally, Q< [...]

Figure S1. Study design and definition of prevalent and incident patients. This figure illustrate... more Figure S1. Study design and definition of prevalent and incident patients. This figure illustrates the design of the study and visualizes how prevalent and incident patients were defined. The renal-replacement therapy initiation date was before 1 October, 2011 for prevalent patients and between 1 October, 2011 and 31 December, 2016 for incident patients. The study index date was the study start date (1 January, 2012) for prevalent patients and the date of first treatment in the Seriate dialysis unit (i.e., any time between 1 January, 2012 and 31 December, 2016) for incident patients. (PDF 8 kb)

Background. Transient nature of adhesive interactions occurring during cell margination is mainly... more Background. Transient nature of adhesive interactions occurring during cell margination is mainly dependent on expression of selectins which are shed by activ-ated cells. This shedding in the circulation may play an important role as anti-inflammatory mediator. Haemodialysis is also associated with P-selectin (CD62P)/sialyl-Lewisx (CD 15s) interactions which mediate platelet-leukocyte coaggregation. We further investigated the mechanisms underlying leukocyte mar-gination during haemodialysis. Methods. CD 15s, CDllb and CD61 expression on circulating leukocytes from patients dialysed on syn-thetic membranes (modified polyacrylonitrile (SPAN), polysulphone (PS), and polyacrylonitrile (AN69) was assessed by cytofluorometry in a prospective crossover trial. We measured plasma levels C3a/C3a desArg, soluble CD62P, and CD62E molecules obtained from patients and healthy individuals. Results. Expression of CD1 lb and CD 15s was upregu-lated on neutrophils from patients dialysed with SPAN an...

Botanical medicine in clinical practice, 2008

Oedema associated with long-haul flights and chronic venous insufficiency (CVI) and venous hypert... more Oedema associated with long-haul flights and chronic venous insufficiency (CVI) and venous hypertensive microangiopathy (VHM) have been treated with Pycnogenol® in prospective studies. Travel-related venous diseases (particularly flight microangiopathy and flight-related thrombosis) occur particularly in patients flying for more than 7-8 h. Preventive treatment with oral Pycnogenol® - considering that travel microangiopathy, in an acute form, resembles CVI - is an interesting model to test treatments for CVI. In long flights, Pycnogenol® prevents the formation of oedema (i.e. ankle and foot oedema) and may even prevent, in patients with varicose veins, CVI or high-risk levels of venous thrombosis, thrombophlebitis (superficial vein thrombosis). In CVI the control of oedema and the improvement in microangiopathy (observed evaluating microcirculatory parameters such as Laser Doppler values, transcutaneous PO2 and PCO2) can be obtained in patients with several degrees of venous disease...

Background: Stroke prevention in dial... more Background: Stroke prevention in dialysis-dependent patients with atrial fibrillation (AF) is an unresolved clinical dilemma. Indeed, no randomized controlled trial evaluating the efficacy and safety of oral anticoagulants in this population, has been conducted so far. Observational research on the use of warfarin in patients on dialysis has shown conflicting results. This uncertainty is mirrored by the wide variations in warfarin prescription patterns across centers. We sought to evaluate the association between the use of vitamin K antagonists (VKAs) and mortality among hemodialysis patient with AF and to assess potential factors affecting the risk-benefit profile of warfarin in this population. Methods: A total of 91,987 patients registered in the European Clinical Dialysis Database® system from January 2004 to January 2015. Of which, 9,238 patients were identified with a diagnosis of AF. After excluding ineligible patients, a 1:1 propensity score matched cohort of 1,324 warfarin users and non-users were assembled. Results: VKA use was associated with both increased 90-day survival (hazard ratio, HR 0.47, p < 0.01) and 6-year survival (HR 0.76, p < 0.01); however, a trend indicated a stronger early benefit (p for time-interaction <0.01). Moderation analysis showed that patients' age and clinical history of stroke strongly influenced warfarin-related benefits on survival. Conclusion: VKA may provide an early survival benefit; however, this is partially offset later during the follow-up. In addition, heterogeneous risk-benefit profiles were observed among subgroups of dialysis-dependent patients with AF, further emphasizing the complexities of tailoring stroke prevention strategies in this population.

Kidney international reports, 2018

Long-term inappropriate proton pump inhibitors use (PPIs) is a matter of concern because of the r... more Long-term inappropriate proton pump inhibitors use (PPIs) is a matter of concern because of the risks associated with their long-term use in older patients with chronic conditions. The risk of PPI treatment in hemodialysis patients remains unexplored. We assessed the relationship between the use of PPIs and the risk of death in hemodialysis patients throughout a retrospective multicenter propensity score-matched study. Information about demographic, hemodialysis treatment, laboratory data, and concomitant medication was obtained from the EuCliD database (Fresenius Medical Care). We studied 1776 hemodialysis patients on PPI therapy compared to 466 patients not receiving PPIs. The resulting population comprising 2 groups of 410 matched patients was studied. PPI use was associated with hypomagnesemia (Mg <1.8 mg/dl (0.75 mmol/l); odds ratio [OR] = 2.70, 95% confidence interval [CI] = 1.38-5.27, < 0.01). The exposure to PPIs in the full patient cohort was identified as an indepen...

Nephrology Dialysis Transplantation, 2011

Background. In the aftermath of large natural and manmade disasters, the need for continuing main... more Background. In the aftermath of large natural and manmade disasters, the need for continuing maintenance haemodialysis (HD) in end-stage renal disease patients of the disaster area and care including dialysis for patients suffering from acute kidney injury (AKI) due to crush syndrome are the two most important nephrological problems. Methods. We report on how renal patients and renal care personnel faced emergency in the aftermath of the earthquake that struck the Italian town of L'Aquila and a surrounding district, on Monday 6 April 2009, causing 308 deaths, some 1500 injured and 66 000 people to be displaced. Results. The Dialysis Centre in the town did not collapse but was seriously damaged and out of action, making it necessary to move 88 patients on regular dialysis treatment to the closest available facilities to continue treatment. This was all the more urgent in that 45 patients of the Monday-Wednesday-Friday batch were coming off the long interdialytic interval, with possible medical problems (i.e. high increase in weight gain, blood pressure, etc.). In spite of manifold difficulties (including road interruption and shortage of means of transportation, problems in establishing contact between patients and care personnel due to failure of phone and electronic communication and the limited number of available dialysis posts), no patient missed any scheduled HD session. This was obtained thanks to the transfer of patients to neighbouring functioning units, often with extra dialysis shifts. In 3 days, a provisional Dialysis Centre was set up in an inflatable military-style tent, enabling 780 dialysis sessions to be performed safely on patients who had opted to return to L'Aquila. The tent facility was replaced by a rigid modular structure, insulated as living accommodation, containing 13 dialysis machines (20 from 17 November) functioning in HD or on-line haemodiafiltration. Ten cases of crush-related AKI needing dialysis treatment were recorded, the ratio of dialysed victims to number of deaths (32.4: 10 cases/308 deaths, 10003) being the highest value yet reported. Fasciotomy was performed in six patients but none of the patients had to be amputated. Intermittent HD was used in most cases as the single modality of renal replacement therapy. All patients survived and recovered renal function on discontinuing dialysis treatment. Serum creatinine returned to normal values upon discharge from hospital or during the follow-up period. Conclusions. Each earthquake is different and may pose issues that will require unanticipated response efforts. Advance planning and rescue coordination, flexibility and creativity in the emergency situation, as well as the hard work and dedication of the entire dialysis care community, contributed to the remarkably positive outcome of dialysis-needing patients in the aftermath of the Aquila earthquake.

Artificial Organs, 1999

The formation of platelet-leukocyte microaggregates has been observed in a variety of conditions.... more The formation of platelet-leukocyte microaggregates has been observed in a variety of conditions. When platelets and leukocytes coaggregate, in general, a reciprocal activation occurs when both cells are activated, and the interactions between activated platelets and leukocytes may be relevant in both hemostasis and inflammatory processes. The study of platelet-leukocyte interactions in hemodialysis offers the novel aspect of cellular-cellular interaction as a new parameter for evaluating the biocompatibility of dialyzer membranes. This article reviews the investigations of the interactions between platelets and leukocytes during hemodialysis and the pathophysiologic implications which may stem from such interactions.

Table S2. Use of medication at least once during the study period. This table provides informatio... more Table S2. Use of medication at least once during the study period. This table provides information about the medication use in our study population during the study period. (PDF 18 kb)

Table S1. Cause of renal disease of the study patients. This table provides information about the... more Table S1. Cause of renal disease of the study patients. This table provides information about the number and percentages of underling renal disease of the study participants. (PDF 17 kb)

Background: The majority of studies suggesting that online ... more Background: The majority of studies suggesting that online hemodiafiltration reduces the risk of mortality compared to hemodialysis (HD) have been performed in dialysis-prevalent populations. In this report, we conducted an epidemiologic study of mortality in incident dialysis patients, comparing post-dilution online hemodiafiltration and high-flux HD, with propensity score matching (PSM) used to correct indication bias. Methods: Our study cohort comprised 3,075 incident dialysis patients treated in 64 Spanish Fresenius Medical Care clinics between January 2009 and December 2012. The primary outcome of this study was to investigate the impact of the type of renal replacement on all-cause mortality. An analysis of cardiovascular mortality was defined as the secondary outcome. To achieve these objectives, patients were followed until December 2016. Patients were categorized as high-flux HD patients if they underwent this treatment exclusively. If >90% of their treatment was with online hemodiafiltration, then the patient was grouped to that modality. Results: After PSM, a total of 1,012 patients were matched. Compared with patients on high-flux HD, those on online hemodiafiltration received a median replacement volume of 23.45 (interquartile range 21.27–25.51) L/session and manifested 24 and 33% reductions in all-cause and cardiovascular mortality (all-cause mortality hazards ratio [HR] 0.76, 95% CI 0.62–0.94 [p = 0.01]; and cardiovascular mortality HR 0.67, 95% CI 0.50–0.90 [p = 0.008]). Conclusions: This study shows that post-dilution online hemodiafiltration reduces all-cause and cardiovascular mortality compared to high-flux HD in an incident HD population.

Minerva cardioangiologica, 2008

UNLABELLED Fingerprints (FP), characteristic of humans, are impressions due to skin marks (ridges... more UNLABELLED Fingerprints (FP), characteristic of humans, are impressions due to skin marks (ridges) on fingertips. Ridges are present on fingers/hands forming curved lines of different sizes/patterns. The point where a line stops or splits is defined typica' (their number/amount constitute identification patterns). FP are permanent and unique. This study compared FP patterns with cardiovascular risk factors: 7 main types of FP were used: 1. Arch: lines form waves from one site to the other side. 2. Tentarch: like arches but with a rising stick in the middle. 3. Loop: lines coming from one site returning in the middle to the same site. 4. Double loop: like loops but with two loops inside: one standing, one hanging. 5. Pocked loop: like the loop but with a small circle in the turning point. 6. Whorl: lines make circles. 7. Mixed figure: composed of different figures. There are two kinds of real typica: A. Ending line; B. Splitting lines (bifurcations). Several combinations may resu...

Background: Stroke prevention in dialysis-dependent patients with atrial fibri... more Background: Stroke prevention in dialysis-dependent patients with atrial fibrillation (AF) is an unresolved clinical dilemma. Indeed, no randomized controlled trial evaluating the efficacy and safety of oral anticoagulants in this population, has been conducted so far. Observational research on the use of warfarin in patients on dialysis has shown conflicting results. This uncertainty is mirrored by the wide variations in warfarin prescription patterns across centers. We sought to evaluate the association between the use of vitamin K antagonists (VKAs) and mortality among hemodialysis patient with AF and to assess potential factors affecting the risk-benefit profile of warfarin in this population. Methods: A total of 91,987 patients registered in the European Clinical Dialysis Database® system from January 2004 to January 2015. Of which, 9,238 patients were identified with a diagnosis of AF. After excluding ineligible patients, a 1:1 propensity score matched cohort of 1,324 warfarin users and non-users were assembled. Results: VKA use was associated with both increased 90-day survival (hazard ratio, HR 0.47, p < 0.01) and 6-year survival (HR 0.76, p < 0.01); however, a trend indicated a stronger early benefit (p for time-interaction <0.01). Moderation analysis showed that patients' age and clinical history of stroke strongly influenced warfarin-related benefits on survival. Conclusion: VKA may provide an early survival benefit; however, this is partially offset later during the follow-up. In addition, heterogeneous risk-benefit profiles were observed among subgroups of dialysis-dependent patients with AF, further emphasizing the complexities of tailoring stroke prevention strategies in this population.

http://ang.sagepub.com/content/54/5/531 The online version of this article can be found at: DOI: ... more http://ang.sagepub.com/content/54/5/531 The online version of this article can be found at: DOI: 10.1177/000331970305400502 2003 54: 531 ANGIOLOGY M. Griffin, I. Ruffini, G. Acerbi, M. Corsi, N.H. Riordan, S. Stuard, P. Bavera, A. Di Renzo, J. Kenyon and B.M. Errichi M.R. Cesarone, G. Belcaro, A.N. Nicolaides, A. Ricci, G. Geroulakos, E. Ippolito, R. Brandolini, G. Vinciguerra, M. Dugall, Randomized, Controlled Trial Prevention of Venous Thrombosis in Long-Haul Flights with Flite Tabs: The LONFLIT-FLITE

Biochemistry and Cell Biology, 1994

NDT Plus, 2011

Botanical medicine in clinical practice, 2008

Kidney international reports, 2018

Nephrology Dialysis Transplantation, 2011

Artificial Organs, 1999

Minerva cardioangiologica, 2008