Daily hemofiltration in severe heart failure.

We treated nine patients having severe heart failure (IV NYHA classification) with anuria resistant to diuretics who were on daily hemofiltration, and estimated their survival for a year. The total volume of liquids removed was estimated by means of an echographic determination of the caval collapsability index. Dry weight was obtained from 6 to 22 days. The fluid removed varied from 10 to 35 liters. Five patients at the end of the therapy took up diuresis again and recovered their sensitivity to diuretics. Three of these patients went beyond the 12 months of survival, and two patients died earlier. Four patients did not show the resumption of diuresis and they continued with daily hemofiltration. Three survived over 20 weeks; one died after 15 weeks. We conclude that daily hemofiltration is useful in patients with severe heart decompensation in that it increases their survival rate.

Role of the heart surgeon in the emergency treatment of diuretic resistant edema in grades III-IV heart failure.

Acute or chronic valvular diseases, acute myocardial infarction and its complications, dilated cardiomyopathies, all may became the cause of heart failure leading to different degrees of cardiogenic edema. Today cardiac failure is treated from its the early stage by medical and/or surgical therapy. Thereafter, in a small population of patients, heart failure may became unresponsive to any kind of standard medical treatment. Conventional surgical procedures are often inadequate and carry a high risk of perioperative mortality. This study analyzes the outcome of 139 patients with end-stage cardiomyopathy who underwent heart transplantation between January 1988 and October 1996. We found that patients transplanted while on severe decompensation are at a higher perioperative mortality due to irreversible multi-organ failure. The study also suggests that the implantation of a left ventricle assist device as a bridge to transplantation is a promising maneuver for the most severe patients.

A contribution to the history of common salt.

Salt has influenced human nutrition, health, politics, taxation, economy, freight, transport, and commerce throughout the ages. All human activities have been influenced by salt including economy, religious beliefs and practices, art, literature, psychoanalysis, superstitions, and exorcism. Salt is recognized as a symbol for friendship, hospitality, chastity, alliance, table fellowship, fidelity, fertility, blessing, curse and endurance, etc. The Bible is the first book of salt and contains no fewer than 24 references to this substance. In the Gospels the parable of salt is a central one. Many many church fathers have written on salt a substance, which up to 1969 was a relevant element in the rite of Baptism. This paper reviews the importance of common salt for human life, and by drawing from various scientific and literary sources makes a special discussion of its various symbolisms.