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Biomedical subjects

G Gilli

Publications and source records attributed to G Gilli.

At least 55 records · Page 3Linked to original sources
PubMed1978

Effect of vitamin D on growth in experimental uremia.

Acceleration of growth of uremic children after administration of vitamin D has been demonstrated by various authors. This has been attributed to healing of skeletal lesions. Clinical observations suggest that vitamin D has also an effect on food intake perhaps associated with improvement of vitality. This could be confirmed in an experimental study in which uremic rats (subtotal nephrectomy) with and without vitamin D supplementation were compared with sham-operated pair-fed control rats with and without vitamin D supplementation. In uremic animals supplemented with vitamin D, weight gain and growth were significantly greater than in uremic animals on the control diet. Both with and without vitamin D supplements, weight gain and growth rate were greater in sham-operated pair-fed control than in the corresponding uremic animals. Histological abnormalities in the growth zone of uremic rats were markedly reduced by vitamin D. Since food intake was greater in vitamin D-treated uremic animals than in nonvitamin D-treated uremic animals, the increase in growth rate under vitamin D cannot be attributed exclusively to the skeletal effects of vitamin D. This study demonstrates important extraskeletal actions of vitamin D which may be associated with or causally related to the improvement of growth.

Animals↗
PubMed1978

Protein restriction in the conservative management of uremia.

Protein-restricted diets are widely used in the dietary management of uremia. These diets are undoubtedly effective in ameliorating many aspects of the uremic syndrome. However, there is no consensus as to whether diets providing less than 0.6 g/kg per day of protein are nutritionally adequate and capable of preventing the wasting syndrome. Wasting is common in the adult patient with renal insufficiency as is growth failure in the uremic child. There is some evidence that wasted patients do less well on hemodialysis and are more prone to infection. Experimental studies in uremic animals point ot diminihsed efficiency of utilization of protein, increased gluconeogenesis from animo acids, and increased catabolism of protein in the fasting state; in addition, the metabolism of a number of individual amino acids is altered in uremia. In view of these multiple abnormalities, it would seem unwise to routinely provide less than the Recommended Daily Allowances of protein. More recent developments, i.e., supplementation of essential amino acids and perhaps alpha keto acids, may provide useful alternatives. One important aspect of dietary management, i.e. prevention of hyperlipidemia, has attracted surprisingly little attention so far. Therapy with protein restricted diets in nondialyzed uremic patients has to compete with other modalities of treatment currently available, i.e., hemodialysis and transplantation, in providing optimal medical rehabilitaiton of the patient.

Adult↗
PubMed1978

Dialysis and renal transplantation of children in Europe, 1975.

The number of new paediatric patients accepted for treatment by regular dialysis and transplantation increased more slowly than in previous years. Survival in children above 10 years appeared to be better with all modes of therapy than in younger children. The only improvement in survival noted among the different treatments was in patient and graft survival of living donor transplants. A quarter of all children transferred to home dialysis were less than 10 years of age. Nephronophthisis and Henoch-Schönlein nephritis emerged as major primary renal diseases. In 1975 the proportion of retransplants in children rose and living donor grafts from fathers were more common than from mothers. Evening dialysis was practised more frequently in both hospital and home dialysis and rehabilitation in these patients seemed to be better than for those dialysed at other times. Renal osteodystrophy was present in at least half of all children dialysed for more than 1 year. The degree of grouth retardation was affected by sex, chronological age and the primary renal disease. Body height on dialysis and after transplantation progressively reduced in the majority of children. Growth seemed to be more impaired in boys than in girls on dialysis. Bone age advanced faster than height age especially in girls. The pubertal growth spurt was usually delayed and depressed on long-term dialysis and the development of genitalia and pubic hair as well as menarche was retarded.

Bone Development↗
PubMed1977

Skeletal growth in uremia.

Stable long-term chronic renal failure in the growing Sprague Dawley rat causes marked bone disease with impaired mineralization (i.e. rickets) and evidence of increased parathyroid hormone activity. Although significant bone disease is present, the rate of longitudinal growth is not diminished in preterminal renal failure. However, it is significantly diminished in terminal renal failure, when uremic rats are compared with sham-operated control rats at identical levels of food intake. At identical levels of food intake, weight gain is also diminished in rats with terminal uremia as compared with sham-operated control rats, suggesting increased calorie cost for growth.

Adolescent↗
PubMed1977

Skeletal changes and growth in experimental uremia.

Longitudinal growth; bone and growth zone histology; growth cartilage and bone mineralization (tetracycline technique); bone Ca content (neutron activation analysis); bone radiology; serum and urine chemistry; urinary cAMP and serum 25-OH-vitamin D3 were studied in a long-term model of experimental uremia in the rat. Uremia was induced by two-stage subtotal nephrectomy with irradiation of the remaining parenchyma. Ccr in the experimental group was 113 +/- 5.8 micron1/min X 100 g (19.8% of controls) and serum creatinine 1.67 +/- 0.04 mg% (5.1 X control value). Uremic animals were pair-fed with sham-operated controls. In the proximal tibia delayed transformation of cartilage into primary spongiosa with appearance of chondro-osteoid and delayed transformation of primary spongiosa into secondary spongiosa was observed (rickets). Increased amounts of osteoid were present although 25-OH-vitamin D3-levels were high. There were only modest signs of secondary hyperparathyroidism (osteoclast counts; urinary cAMP). In spite of the presence of bone disease, longitudinal growth was not reduced in uremic animals as compared with pair-fed sham-operated animals, but was significantly reduced as compared with ad lib fed control animals. In contrast, weight gain was significantly diminished in uremic animals as compared with pair-fed sham-operated control animals. It is concluded that diminished intake of food is the major determinant of growth retardation in preterminal experimental renal failure.

Alkaline Phosphatase↗
PubMed1977

Hemolysis and blood loss in children with chronic renal failure.

Erythrocyte life span was determined in 19 children with chronic renal failure on conservative treatment and in 12 children on regular hemodialysis. Erythrocytes were labeled with 111Indium. Blood loss was measured using a special counting chamber. Erythrocyte life span decreased with increasing blood urea nitrogen. Blood loss into the intestine and into the dialysis equipment was found to be a major cause for anemia of children with chronic renal failure. Daily intestinal blood loss amounted to 6 ml/m2 BSA on conservative treatment and 11 ml/m2 on hemodialysis. Mean blood loss in the dialysis equipment was 8 ml/m2 per dialysis, almost half being lost in the connecting tubing systems.

Adolescent↗
PubMed1976

[Management of slipped epiphyses in renal osteodystrophy (author's transl)].

Epiphyseal slipping in uraemia differs strikingly from juvenile epiphyseal slipping with respect to pathology and therapy. Based on our own experience with the treatment of 8 uraemic children with epiphyseal slipping, an effort was made to establish the respective indications for conservative and surgical treatment. Mechanical stabilization of slipped epiphyses was achieved within a few weeks without any surgery and usually without parathyreoidectomy by vitamin D3 alone. The initial dose was 10,000 to 30,000 I.U./day, the total curative dose 1.8 to 5.6 millions I.U. Prolonged immobilization was unnecessary. Rising urinary calcium excretion was a valuable indicator of vitamin D intoxication even in advanced renal failure. In one case, pronounced metaphyseal deformations (distal femur, distal tibia) required surgical correction before the ability to walk normally was restored. - The following therapeutical approach is recommended: metabolic bone disease must be cured by vitamin D therapy with or without parathyreoidectomy. Osteotomy to correct metaphyseal deformities or coxa vara epiphysaria never should be performed before metabolic bone disease is healed.

Adolescent↗
PubMed1976

Indolic tryptophan metabolism in uraemia.

Tryptophan and some indolic metabolites were studied in urine, plasma and dialysate of uraemic patients using thin-layer- and high-pressure liquid chromatography. Some new metabolites: indole-3-carboxylic acid, indole-3-carbaldehyde, indolelactic acid and N-acetyltryptophan were detected. Levels of the latter two metabolites in urine, dialysate and especially plasma suggest increased transamination of tryptophan and a possible defect in renal amino acid acylase in uraemia.

Aldehydes↗
PubMed1975

[Blood levels of lead and erythrocyte ALA-dehydrase in 200 employees of a Turin metallurgical plant. Analysis of variables connected with alcohol drinking and smoking habits].

The relationships between blood value of Pb and activity of Ala-dehydrase erythrocyte enzyme were studied in relation to the following variables: age, activity, residence, smoking habits, drinking habits. 200 adults, subdividable into occupationally exposed were examined. The data obtained showed a relationship between smoking and Aladehydrase; a relationship was also found to exist between alcohol and blood Pb and inhibition of Ala-dehydrase activity.

Adult↗
PubMed1975

Slipped epiphyses in renal osteodystrophy.

Clinical, biochemical, roentgenological, and histological features of slipped epiphyses (epiphysiolysis) in 11 out of 112 children with renal osteodystrophy have been analysed. Characteristic age-related patterns of involvement of different epiphyses are described. Quantitative measurements of iliac bone histology, serum parathyroid hormone levels, and clinical history show the presence of more advanced osteitis fibrosa in children with epiphysiolysis than in those without. A good correlation was found between serum parathormone levels and osteoclastic resorption, endosteal fibrosis as well as osteoid. Histological studies show that the radiolucent zone between the epiphyseal ossification centre and the metaphysis in x-rays is not caused by accumulation of cartilage and chondro-osteoid (as usually found in vitamin D deficiency rickets) but by the accumulation of woven bone and/or fibrous tissue. The response to vitamin D therapy in most cases was good. Parathyroidectomy was required in only one case.

Adolescent↗