Biomedical subjects
G Garini
Publications and source records attributed to G Garini.
An integrated programme of haemodialysis and peritoneal dialysis: a single two-litre exchange per night plus haemodialysis every four to six days.
Critical problems of CAPD: (a) protein loss; (b) peritonitis; (c) glucose overload; (d) intra-abdominal pressure, can be rationally managed by an integrated intracorporeal and extracorporeal approach. A single two-litre peritoneal exchange performed during the night in addition to haemodialysis every four to six days (HD-PD) reduces a, b, c and eliminates d. This HD-PD technique has been evaluated in eight uraemic patients over a total period of 20.5 patient months. Preliminary results show that this procedure can provide adequate biochemical control, with low protein losses and limited interdialysis weight gain.
[Mechanisms of transport and kinetics of the solutes in peritoneal dialysis].
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[Renal lesions in a case of tuberous sclerosis: association of angiomyolipoma, bilateral polycystic kidney and renal clear-cell carcinoma].
Association cases of tuberous sclerosis (ST) and renal displasia-tumors are infrequently seen in literature. These tumors are bilateral renal cystic displasia (RP) rare hamartomas, p.e. angiomyolipomas, and malignant neoplasms, p.e. renal clear cell carcinomas. There therefor as to the frequency of those pathological associations with ST, AML are frequently seen (50-80%). Reports of polycystic renal disease with ST are rare, whereas occasional associations of renal cell carcinomas with ST are founded out. By extensive literature examination of it's evident that the synchronous association of these pathological lesions is exceptional. This report describes one case of AML, RP and renal clear cell carcinoma in a female, 22 years old, with ST; the pathological, clinical and pathogenetic features are discussed.
[General remarks on the transport of drugs through the dialysis membrane].
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[Pharmacokinetics and antilipolytic effect of a derivative of nicotinic acid (sorbinicate) in dialyzed uremic patients].
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Critical appraisal of haemofiltration and ultra-filtration. The development of ultra-short dialysis: preliminary results.
The clinical experience obtained with 2 hours every other day recirculation dialysis, using 20-40 liters of dialysate, without sorbents, and standard cuprophane dialyzers of 1.0-1.5 sq.mt. is reported. So far, over 350 treatments in 8 patients have been performed. After 2 hours of treatment the removal of urea, creatinine, phosphate and uric acid, is similar to that obtained by 4-6 hours of haemofiltration. The alkalinazation of the patient through direct venous infusion of bicarbonate, makes predialysis acid-base significantly better than in standard haemodialysis and haemofiltration. Asymptomatic correction of severe fluid overload is easily obtained like in isolated ultrafiltration. The role of osmolality and vasopressors are discussed. A dry weight below the value obtained by previous dialysis treatment is achieved, and volume dependent hypertensions as in haemofiltration are corrected after 2-8 weeks. As an additional advantage, this method offers a highly semplified technical approach and a further reduction of the dialysis time.
Principles and clinical application of ultrashort dialysis.
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[The histocompatibility antigens (HL-A): their biological significance and clinical relevance].
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Production of HL-A antisera by planned immunisations. Three new HL-A factors.
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[Oral and i.v. iron therapy in haemodialysis patients (author's transl)].
Low serum iron level with a transferrin saturation below 16% is a crucial aetiologic factor of anaemia in haemodialysed patients. Current therapy usually is a correct dialytic and dietetic treatment and i.v. iron supply. Two groups of haemodialysis patients with low serum iron but a normal transferrin saturation, have been studied by comparing the efficacy of the i.v. and the oral iron supply. The serum iron of the two groups changed from low to normal level with highly significant difference. Haemoglobin and haematocrit did not change because of the normal transferrin saturation before the treatment. In conclusion, in uraemic patients treated by chronic dialysis, the oral and the i.v. iron therapy probably give the same result.
[Short dialysis in the old patient. Clinical and technological problems].
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[Persistence of lymphocytotoxic antibodies in multiparas examined several years after their last pregnancy].
Cytotoxic antibodies were searched in 422 pregnant women at different times after the last pregnancy (1 to 42 years). The percentage of antileukocytes isoimmunization was 12%. There was no correlation between cytotoxic antibodies and frequency of abortion. The role of cytotoxic isoantibodies during pregnancy is discussed.
Preliminary results obtained with short dialysis schedules.
The results regarding the treatment of 55 patients, 6 of them treated for, at least 10 months, with 1 sq. meter disposable dialyzers and a dialysis strategy of 3 hours every other day or 4 hours trice weekly have been presented. Clinical indexes especially regarding erythropoiesis and peripheral nerve status will be discussed. Th results show that this new method of treatment is feasible and may become in the future a routine strategy for chronic intermittent dialysis.
[Adherence to dietetic treatment, the nutritional metabolic status and the progression of chronic kidney failure].
Effects of two protein restricted diets on dietary compliance, nutritional and metabolic state, and progression of chronic renal failure (CRF) were investigated. Twenty-one patients with CRF were randomly assigned to either a conventional low protein diet (0.6 g of protein/kg b.w./day) or to a very low protein diet, providing 0.4 g of protein/kg b.w./day, supplemented with a mixture of essential amino acids which contained HIS, TYR and a high proportion of branched chain amino acids. Nutrition, assessed by body weight, anthropometry, serum protein levels and nitrogen balance studies, was maintained in all patients. Some metabolic abnormalities of CRF (i.e., secondary hyperparathyroidism, glucose intolerance) improved in both groups. The supplemented diet provided better adherence to protein prescription, corrected the depletion of VAL and LEU in muscle and was more effective than conventional diet in slowing the rate of progression of CFR.
[The chemical bases of the biocidal action of hypochlorites for disinfection of dialysis centers. Theoretical considerations and practical use].
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[Disinfection in dialysis, using aldehydes. Theoretical considerations and practical use].
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[Etiopathogenesis of membranous nephropathy: is there a correlation between experimental and human pathology?].
The Authors discuss the etiologic, pathogenetic and immunopathologic aspects of Heymann nephritis, in order to compare the numerous acquisitions concerning this nephropathy with the scanty knowledge of human membranous nephropathy, of which it represents the experimental counterpart. This rat disease can be obtained by inoculation of tubular brush border preparations (active form) or of the relevant antibodies (passive form); after an initial hypothesis of glomerular deposition of circulating immune complexes, studies on its pathogenetic mechanisms, instead demonstrated that in situ immunoaggregates, caused by an interaction between circulating antibodies and fixed glomerular antigens, are formed. Recent investigations have led to the identification of a major nephritogenic antigen (gp330), which is a tubular brush border glycoprotein expressed by coated pits located at the glomerular epithelial cell surface. Studies on antigen-antibody interactions at this level have demonstrated that there is a quick redistribution and accumulation of the so-formed immune complexes, and when polyclonal antibodies were utilized, growth of subepithelial electron dense deposits was observed. Although other tubulo-glomerular antigens, which can also be expressed by endothelial cells, play an uncertain role, they seem to favour transmembrane passing of anti-gp330 antibodies. Immune complex formation gives rise to the onset of proteinuria through complement system activation, without leukocyte involvement: in particular a MAC and C9 fraction lytic effect was demonstrated on cultured epithelial cells. In conclusion, studies on Heymann nephritis contribute to our understanding of the etiopathogenetic mechanisms regarding human membranous nephropathy, and emphasize a possible role played by tubular antigens and in situ formed immune complexes.