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Biomedical subjects

C Giordano

Publications and source records attributed to C Giordano.

At least 181 records · Page 10Linked to original sources
PubMed1982

Metabolic aspects of continuous ambulatory peritoneal dialysis with reference to energy-protein input and growth.

Glucose utilization from the dialysate of up to 140 g/day was found during CAPD therapy in 5 children on short and long term studies. The energy input via the dialysate was associated with increased insulin secretion as indicated by the daily insulin response calculated from analyzing the area under the insulin curve during 5 daily exchanges of dialysate. After 6 months glucose tolerance was normal with normal values for early and late insulin response as well as for glucose disappearance rate during an intravenous glucose tolerance test. Nitrogen balance on free diets (energy input 100% RDA and protein input 133% RDA) showed that CAPD is an anabolic technique since the balance was positive when measured during 42 days out of 12 months in each child. Growth was normal in one boy and in addition a girl reached her final height; it was unsatisfactory in the other children. It is concluded that CAPD is an anabolic technique which favourably affects many factors associated with growth retardation in children with end stage renal failure and therefore it represents an interesting tool for defining a more rationale approach for research in this field.

Adolescent↗
PubMed1982

Thyroidal status in uremia - effects of hemodialysis and CAPD.

Thyroid function was explored in 27 CAPD patients and 25 HD patients. Dialysis was associated with low T3 and T4 levels, increased rT3 concentrations, normal T4 : T3 and reduced T4 : rT3 ratios, normal FT3 and Thyroglobulin concentrations. TSH levels increased during dialysis but still fell within normal limits. The data rule out a condition of primary hypothyroidism and point out to increased thyroidal dismission associated with the block T4-T3 in peripheral cells. Also the increased FT4 levels in CAPD patients could be due to de novo dismission of thyroidal T4.

Adult↗
PubMed1981

Development of means to augment peritoneal urea clearances: the synergistic effects of combining high dialysate temperature and high dialysate flow rates with dextrose and nitroprusside.

By combining: a) nitroprusside (4.5 mg/L); b) dextrose concentration of 42.5 gm/L; c) dialysate temperature of 42 degrees C and d) dialysate flow rates of 3.5 L/hour in seven uremic subjects on CAPD, it was possible to increase peritoneal urea clearance up to 35.6 +/- 3.8 ml/min/1.73 m2 (range 30.3 to 42.2). This effect in six out of seven cases was associated with a fall in blood pressure and an increase in heart rate. This study is the first which deals with a combination of these factors and demonstrates that this approach is easy to handle, does not require the use of mechanical devices, and is available at any bedside.

Adult↗
PubMed1981

L-glutaminase and L-asparaginase by extracorporeal route in acute lymphoblastic leukemia therapy.

Use of L-asparaginase by the extracorporeal route in the therapy of acute lymphoblastic leukemia (ALL) has been proposed. Results, however, are not so satisfactory as i.v. administration of this enzyme, because the levels of L-asparagine do not fall for a sufficient length of time due to the antagonistic action of the L-asparagine-synthetase. To avoid the L-asparagine rebound we have utilized, by extracorporeal route, L-glutaminase together with L-asparaginase, in order to reduce L-asparagine and L-glutamine levels. We have therefore performed a series of experiments in vitro and in vivo either using L-asparaginase alone or together with L-glutaminase. Results show that, contrary to what happens when L-asparaginase is used alone, L-asparagine levels decrease and remain low even after 24 hours from the treatment, when L-glutaminase is added to the system. Thus a lowering of L-glutamine levels, which seems to play an important role in the therapy of ALL, is obtained.

Animals↗
PubMed1981

Kinetics of amino acids equilibration in the dialysate during CAPD.

The equilibrium between plasma and peritoneal dialysis fluid has been studies for 23 amino acids during peritoneal exchanges at dwell times up to 8 hours in patients on CAPD. It is demonstrated that equilibration is a particular process typical for each amino acid which after 8 hour is nearly complete only for Glycine, Alanine and Asparagine.

Adult↗
PubMed1981

Studies on amino acids in diabetic patients undergoing CAPD.

Studies in patients with uremia due to diabetes mellitus treated with CAPD show that the kinetics of amino acid equilibration between dialysate and plasma behave differently from those in patients with uremia of different etiology. Diabetics also have larger amino acid losses in dialysate.

Adult↗
PubMed1981

Amino acid losses during CAPD in children.

Plasma aminograms and daily amino acid losses in the dialysate were studied in 5 uremic children undergoing CAPD for 6-8 months. Amino acid losses averaged 10,000 muM/day, 25% of which under the form of essential amino acids. CAPD therapy did not correct the uremic profile of plasma amino acid concentrations.

Adolescent↗
PubMed1980

Modulated nitrogen intake for patients on low-protein diets.

In order to overcome malnutrition and poor palatability associated with long lasting low-protein intakes, a diet was devised based on modulated nitrogen intake and energy supply of at least 155 KJ/kg a day. Each patient underwent three different regimens (A, B, C) of protein intake. In period A, the protein intake was 0.33 g/kg a day. In period B, the patients were given 0.33 g/kg a day during day 1, 2, 3, 5, 6 and 1.00 g/kg a day during day 4 and day 7 of the week. In period C the daily protein intake was the mean of the weekly value from day 1 to 7 of period B. Data obtained show that in period A the urea appearance rate was equal to that in period B and lower than that in period C.

Adult↗
PubMed1980

Amino acids and ketoacids--advantages and pitfalls.

The work provides a critical evaluation of current knowledge on the use of ketoacids and essential amino acids in patients with chronic renal failure. It is demonstrated that there are not enough data to support any positive benefits of ketoacids over essential amino acids. On the contrary, data on nitrogen balance in children and weight increments in infants clearly indicate that essential amino acids are preferable to ketoacids. Research on ketoacids should be better designed particularly with regard to controlling calorie intake, performing comparisons with isonitrogenous diets, and evaluating interactions of drugs and these diets.

Amino Acids, Essential↗
PubMed1980

Further studies on the realization of a cold carbon portable artificial kidney.

Optimal conditions have been determined for the realization of a closed-loop, cold carbon, portable artificial kidney to depurate the dialysate of urea and other catabolites. It has been noticed that a dialysate flow rate of about 250 ml/min represents an optimal compromise between urea mass transfer through the dialytic membrane and its mass adsorption on cold carbon. Under this condition, the use of a 2-kg carbon column to remove urea is satisfactory for a routine dialysis treatment. Our experiments have been performed on simulated dialysis. A portable cold carbon artificial kidney requires a cooling unit and a heat exchanger to recover the power necessary to produce the 0 degrees C temperature. A flat heat exchanger, consisting of three superposed plates, with a heat exchange surface of about 0.09 m2 and a total coefficient of thermal exchange Ht, of 380 Kcal/m2-degrees C-hour has been chosen. With heat recovery, the cooling power required is 1/3 hp to allow for parasitic cold losses and the power necessary to reach a steady state. All mechanical parts necessary for heating and cooling weigh about 12 kg.

Adsorption↗