Aluminium (Al) overload has been recognised as a frequent complication in uraemic patients on regular dialysis treatment. We report how acute visual disorders occurred after performing a desferrioxamine (DFO) test in patients on regular dialysis treatment suspected of having aluminium overload. Fifteen patients on regular dialysis treatment for 132 +/- 73 (range 17-250) months, aged 61 +/- 10 (range 47-79) years were given DFO as a test at standard dosage. In the 13 patients who complained of visual disorders, we performed ophthalmologic examinations soon after DFO administration, and again 5 months later in 11 of them. A decrease in visual acuity and/or dyschromatopsia, transient or permanent, were present in ten patients. Four had permanent maculopathy and three also had a permanent alteration of VEP (visual evoked potential). Visual fields were normal in all patients except one who presented a permanent central scotoma. The EOG (electro-oculogram) was permanently impaired in five patients and some of them had fluoroangiographic alterations due to damage of the pigmented epithelium. Six to eight months after the DFO test four patients still complained of visual acuity reduction. We conclude that there is a high rate of visual disorders after giving DFO at the standard doses; therefore we stress the need to modify the doses commonly used and/or the mode of infusion.
This paper investigates the performance of timber-framed walls insulated with straw bales, and compares them with similar walls containing expanded polystyrene (EPS) instead of straw bales. First, thermal conductivity, initial water content, and density of the straw bales were experimentally measured in a laboratory set-up, and the dependence of the thermal conductivity of the dry material on temperature was described. Then, the two insulation solutions were compared by looking at their steady and periodic thermal transmittance, decrement factor, phase shift, internal areal heat capacity and surface mass. Finally, the acoustic performance of both wall typologies was analyzed by means of in situ measurements in two-story buildings built in Southern Italy. The weighted apparent sound reduction index for the partition wall between two houses and the weighted standardized level difference for the façades were assessed based on ISO Standard 16283. The results indicate that the dry straw bales have an average thermal conductivity of k = 0.0573 W/(m·K), and their density is around 80 kg/m3. In addition, straw bale walls have good steady thermal performance, but they still lack sufficient thermal inertia, as witnessed by the low phase shift and the high periodic thermal transmittance. Finally, according to the on-site measurements, the results underline that the acoustic performance of the straw bale walls is far better than the walls adopting traditional EPS insulation. Overall, the straw bales investigated are a promising natural and sustainable solution for thermal and sound insulation of buildings.
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