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Biomedical subjects

F Giacchino

Publications and source records attributed to F Giacchino.

At least 55 records · Page 3Linked to original sources
PubMed1981

Effects of blood transfusion on cellular immunity.

To evaluate the effect of transfusion on immunity, 14 uraemic patients treated with 3 blood transfusions from a single donor, at weekly intervals, were studied: in 5 cases HLA-A,B were compatible, in 9 cases they were not. As markers of cellular and humoral immunity DNCB, PPD skin tests, spontaneous and active E-rosettes, EAC-rosettes, surface membrane immunoglobulins, C3, C4, C3d, serum immunoglobulins, circulating immune complexes and C-reactive protein were investigated. This protocol was applied before transfusions, 1 week after each transfusion (day +7, +14, +21) and 20 weeks later (day +80). Before transfusions 8/14 patients were DNCB negative; both spontaneous and active E-rosettes were below normal range. The other parameters were normal. On day +7 T and B lymphocytes were increased, while the other parameters were unmodified. On day +21 there was a significant reduction (p less than 0.5) in T lymphocytes in patients treated with compatible transfusions. On day +80 3/3 DNCB positive patients, treated with compatible transfusions, became negative and 1/3 DNCB positive patients, treated with random transfusions, also became negative. Three/fourteen patients showed a decrease in B lymphocytes. The other results were unchanged. Our preliminary results suggest that transfusions, either from an HLA compatible donor or not, can impair lymphocyte function.

Adult↗
PubMed1978

[The quarantined dialysis room for Australia-antigen-positive patients. Theoretical, normative, structural, operational, organizational and management aspects].

The technical features of dialysis facilitate the transmission of hepatitis B virus and the outbreak of possibly serious epidemics among patients and hospital staffs. Statistical, epidemiological and clinical data have been collected on many occasions. They serve to emphasise the problem and the need for quarantined centres. The establishment of such a centre for HBsAg-positive patients is discussed in the light of personal experience in the design and setting up of quarantined rooms. The underlying technical and structural requirements are also examined. Reference is also made to two years' experience in the running of a room of this kind. Stress is laid on the importance of having a room for these patients, not only from the clinical standpoint (lessening of contagion), but also from teh social and exonomic standpoint (reduced costs and length of hospital stay, greater rehabilitation).

Cross Infection↗
PubMed1977

[Hyperparathyroidism in endocrinology and nephrology].

The literature on primary and secondary hyperparathyroidism is surveyed in the presentation of an account of the present positon. Reference is also made to personal clinical experience, particularly in secondary cases. The physiopathology of parathormone, calcitonin and vitamin D is described; the last, in fact, has proved useful in the treatment of secondary forms. The usual symptomatological tests of performance are explained, together with their diagnostic value. The clinical symptoms and their physiopathological significance are also illustrated. Stress is laid on the importance of conservative management in secondary forms. Good results now enable parathyroidectomy to be avoided or delayed in many cases.

Bone Diseases↗
PubMed1976

[Initial results in the treatment with short-term dialysis].

Results observed during short-period dialysis management lasting 8 months in 80 patients are presented. There was no significant change in blood chemistry and clinical pictures, through intra- and interdialytic well-being improved. Six, out of 33 patients and to be transferred from 12 hr per week to more prolonged treatment periods due to the rapid onset of sub-dialysis symptoms. No patients receiving 15 hr per week required such a change. The reasons for failure in these six subjects are discussed, together with the indications for a choice of 12 or 15 hr periods.

Calcium↗
PubMedDate not supplied

Accuracy of an on-line urea monitor compared with urea kinetic model and direct dialysis quantification.

To verify the accuracy of a urea monitor (UM) to assess dialysis adequacy, it was compared with a modified direct dialysis quantification method (mDDQ) and with a Casino modified urea kinetic model (mUKM) algorithm. Simplified Jindal and Daugirdas formulas, an anthropometric body water Watson formula, bioelectric impedance analysis, and the Garred model have also been considered. Concerning urea removal, UM results are close to mDDQ, as are the predialytic blood urea nitrogen values obtained by UM in the initial equilibration test. Urea distribution volume results for UM, mDDQ, and bioelectric impedance analysis are similar, whereas it appears clearly overestimated by the Watson formula. Urea monitor clearances are not significantly different from mDDQ, unlike UM Kt/V, which is slightly higher than mDDQ reference value, although with a satisfactory degree of concordance. Rebound effect must be considered by sampling after the equilibration time (et) when mUKM or simplified Kt/V formulas are used: mUKMet Kt/V results are quite similar to mDDQ, as is the Daugirdas value. Regarding NPCR, UM results are neither significantly different from mDDQ nor from the Garred model, whereas mUKM results are significantly overestimated. When rebound is considered, NPCR by mUKMet and NCPR by mDDQ are identical. The UM approach is simple and practical, with a satisfactory degree of reliability for clinical practice.

Adult↗
PubMedDate not supplied

Comparison of a modified urea kinetic model direct dialysis quantification and classic urea kinetic modeling.

In the classic urea kinetic model (UkM), the measurement of clearance (K) as a model input is onerous, and its result is higher than actual body clearance because of urea disequilibrium. Urea kinetics performed by direct dialysis quantification (DDQ), with an equilibrated post rebound sample, gives reliable results but is routinely impractical. The modified UKM (mUKM) method is based on the input of urea distribution volume (V), easily obtainable by several methods and more stable than clearance, and uses simple formulae derived from urea mass balance, avoiding iterative computation. Compared with DDQ, mUKM results are identical, provided that the V value obtained by DDQ is used as input. Compared with UKM, mUKM urea clearances are significantly lower (158.1 +/- 20.5 versus 180.7 +/- 26.8 ml/min), as are urea nitrogen generation rates (5.85 +/- 2.0 versus 6.41 +/- 2.14 mg/min), whereas V results are close (32,444 +/- 6301 versus 32,141 +/- 5293 ml): consequently, mUKM Kt/V is significantly lower than UKM Kt/V (1.07 +/- 0.17 versus 1.22 +/- 0.18). This is because both mUKM and DDQ take account of post dialysis urea rebound. Therefore, if UKM formulae are used with the DDQ body clearance and the equilibrated post rebound blood urea nitrogen value as input data, their results strictly approximate the reference DDQ (V = 32,457 +/- 6274; Kt/V = 1.07 +/- 0.17; G = 5.85 +/- 2.0), demonstrating the common mathematical basis of DDQ and UKM. Therefore, reliable results may be obtained by DDQ, by mUKM, and by "equilibrated" UKM; we suggest that the mUKM model, less cumbersome than DDQ, and more reliable than UKM because it avoids the clearance measurement and the need for iterative computation, could be useful for routine kinetics.

Blood Urea Nitrogen↗
PubMedDate not supplied

Quantitative EEG effects and drug plasma concentration of phenobarbital, 50 and 100 mg single-dose oral administration to healthy volunteers: evidence of early CNS bioavailability.

Single, 50- and 100-mg oral doses of phenobarbital and a matching placebo were administered double-blind to 8 young, healthy male subjects. Multilead electroencephalographic (EEG) samples were recorded prior to, and at regular intervals within the 2 h following administration. The EEG signal was processed by power spectral analysis; the drug plasma concentration was assessed concomitantly. Plasma peaks after the 50- and 100-mg dose were, respectively, 3.38 +/- 1.29 and 4.09 +/- 1.24 micrograms/ml. Despite the low drug plasma concentration, a systematic power increment of the EEG fast frequency spectral segments occurred at either dose on the anterior scalp areas from the 30- or 60-min postdrug control onward, and was preponderant on central electrodes; a significant correlation (Kendal's coefficient for ranked data) with the drug plasma concentration was observed limitedly to the anterior scalp areas. No correlation with plasma levels was observed for unsystematic EEG variations.

Administration, Oral↗
PubMedDate not supplied

[Epstein Barr viral load monitoring in mononuclear lymphocytes and serum of renal transplant recipients using a quantitative PCR protocol].

BACKGROUND: Post-transplant lymphoproliferative disorders (PTLD), ranging from lymphoid hyperplasia to clonal malignancy, are severe complications arising in solid organ transplant patients; their reported incidence ranges from 1 to 20%, according to factors such as type of transplanted organ and age of recipients. A strong correlation between Epstein-Barrvirus (EBV) infection, the grade and type of immunosuppression and the development of PTLD has been recognized. The detection and quantification of EBV-DNA load in peripheral blood have been utilized as prognostic markers for the development of PTLD, showing a correlation between high levels of EBV-DNA in the blood and the development of PTLD. In this study, we monthly monitored EBV viral load in 15 renal transplant recipients for six months. The number of EBV-DNA copies was measured in peripheral blood mononuclear cells (PBMC) and serum samples by a quantitative PCR protocol developed in our laboratory. METHODS: Our EBV-DNA quantification protocol employs a previous screening of samples containing a significant number of viral DNA copies (>=1000 copies/105 PBMC or 100 mL serum) by semi-quantitative PCR followed by a precise quantification of the only significant samples by quantitative-competitive (QC)-PCR. RESULTS: Our 15 renal transplant patients neither developed PTLD nor had recurrent acute illnesses or acute graft rejections during the study. The results obtained in the monthly follow up of EB viral load in PBMC samples confirmed its fluctuation in asymptomatic patients reported in the literature. In particular, 5/14 (35.7%) of EBV seropositive patients had an EBV-DNA load equal to 1000 EBV copies /105 PBMC, and 1/14 (7.1%) reached 5000 EBV copies /105 PBMC at least once in our study. In the EBV seronegative patient, EBV-DNA in PBMC samples was always undetectable (less than 100 DNA copies/105 PBMC). EBV-DNA load in all serum samples was less than threshold value of our quantification protocol (<100 DNA copies/100 mL serum). With regard to the immunosuppressive treatment, it should be noted that 66.7% of the six patients in whom EBV load reached values equal to or higher than 1000 DNA copies/105 PBMC, were on FK506 whereas only 33.3% of them were on CyA. CONCLUSIONS: Since the high positive predictive value of EB viral load in peripheral blood for diagnosis of PTLD reported by several Authors, and the described absence of correlation between the serological evidence of EBV reactivation and EB viral load, EBV viral load measurement in PBMC and serum samples using quantitative PCR techniques is a powerful diagnostic tool to monitor transplanted patients at risk of developing PTLD.

Cyclosporine↗
PubMedDate not supplied

[Epstein-Barr virus infection and immunoglobulin abnormalities in renal transplant recipients].

The relationship between immunoglobulin abnormalities and EBV infection has been investigated in 65 renal transplant patients. Immunoglobulins abnormalities were demonstrated in 44 (68%) patients, 8 of them (18%, 12% of all patients) had a monoclonal component. Up to now no lymphoproliferative disorder has been observed in these patients. All patients were EBV seropositive at the beginning of the study and in 22 of them (33%) a reactivation of EBV infection could be demonstrated. No relation has been observed between immunoglobulin abnormalities, EBV reactivation, age or sex. By contrast, a significant relation was found between EBV reactivation and immunosuppressive treatment: patients under triple therapy with Azathioprine, Cyclosporine A and Prednisone had less EBV reactivation compared to those under Cyclosporine A treatment.

Adolescent↗
PubMedDate not supplied

[Infection by human herpesvirus type 6 (HHV-6) and renal transplantation].

Human herpes virus type 6 (HHV-6) infection was serologically investigated in renal transplant recipients. Before transplantation, 75.5% of patients was seropositive for HHV-6 and no correlation with age, sex and time on dialysis was found. During the first month after transplantation 66% of patients showed a variation in serological status against HHV-6 (seroconversion or fourfold increase of antibody titer). All patients who seroconverted had received the kidney from a HHV-6 seropositive donor, furthermore, in 11/13 (84.6%) pairs of patients receiving the kidney form the same seropositive donor, both members or had HHV-6 active infection or had no infection. The frequency of HHV-6 active infection in seropositive patients is almost the same in case of seronegative or seropositive donor. Comparing HHV-6 and CMV infections, they resulted independent as CMV infection in these patients occurs in a following period (II-III month). Notwithstanding a higher frequency of kidney rejection in patients with active HHV-6 infection, no significative correlation was found.

Adult↗
PubMedDate not supplied

[Anti-CMV antibody affinity in renal transplant recipients].

Variations in anti-CMV antibody affinity have been studied in 106 renal transplant patients. Maturation of immune response has been followed during two years after transplantation evaluating antibody affinity by ELISA before and after urea denaturation treatment. In primary infections while the antibody titer rises, the resistance to denaturing treatment rises as well, indicating an increased antibody affinity. In patients already seropositive at transplantation, the increase of antibody affinity has also been found: comparing the affinity index (AI) at transplantation and one year later, only 16.5% of patients showed an AI value between 80 and 100 at transplantation, whereas after one year 62.3% of patients reached such AI values (p = 0.0001).

Antibodies, Viral↗
PubMedDate not supplied

CMV-specific polymeric and monomeric IgA antibodies in serum of renal transplant patients.

CMV-specific IgA, IgM and IgG antibodies were detected by ELISA in sera from 81 renal transplant patients. Twenty-seven patients were followed from transplantation; 6 patients who underwent on transplantation before the beginning of the study were followed during admissions for graft failure or acute illness; 48 outpatients were periodically monitored. One of the patient followed from transplantation experienced a primary CMV infection, serologically demonstrated by the appearance of specific IgM and IgG. Specific IgA appeared at the same time as IgM and lasted for about six months. A specific IgA response was observed in all but five recurrent CMV infections too, even when specific IgM were not present. In all outpatients periodically monitored for CMV serology specific IgA were not found. About specific IgA polimerization, a transient marked polymeric IgA (p-IgA) response was observed in only the primary infection whereas in all the other IgA positive patients, specific IgA were represented by monomers (m-IgA).

Adult↗