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M Timio

Publications and source records attributed to M Timio.

At least 73 records · Page 4Linked to original sources
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[Historical Archives of Italian Nephrology: Scientific ideas and projects carried out by the history of medicine and nephrology].

Some recent historical celebrations of modern Italian nephrology offer the opportunity to write about the meaning of the history of medicine and nephrology. First of all, the question "what do we learn from history" is wrongly phrased. It is from trying to learn about history, from the effort required to achieve a historical and epistemological perspective, that we may learn how people as individuals or as a group solved the problems of meeting their common human needs. Medicine is itself an eminently historical endeavour. There is history in medicine as well as history of medicine. According to Paracelsus, the history of medicine is medical science and medical science is essential history in the widest sense of the word. The word "history" embraces the concepts of human nature, the world in which human nature is revealed and the thoughts guiding it through life. If the history of medicine and nephrology is observed in all aspects of their evolution, we can see how it had a beneficial role on the work of physicians by reminding them that, prior to the light of achievement, the discovery of all medical principles is preceded by errors and doubts. We report on nephrological debates, controversies and achievements and we call attention to the need to focus on the present through the involvement of medical historians in the analysis of contemporary health policy issues and clinical methodology.

Biomedical Research↗
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[Historical Archives of Italian Nephrology: The role of women in the history of Medicine and Nephrology].

The aim of the present survey of the history of medicine is to provide a series of succinct assessments of the role of women in the development of nephrology. The inadequate role played by women in some areas of medicine underlines the trend that considers health history as part of external history modulating the branches of science. If "external" or social history considers women's role as marginal in many segments of society, no wonder they play a marginal role in the history of medicine. Nonetheless, when women are offered the opportunity to map out new medical paths or handle new health systems they have always been excellent. Tratula, a doctor from Salerno's medical school, is just an example. Women have been excellent in nursing and popular medicine. Florence Nightingale (1823-1910), an English woman of rare ability and humanitarian enthusiasm, was the first to understand the role of women in organising nursing. In this area she had such a striking success that her method contributed to the founding of the first school of nursing in England and in the world. On the other hand, women doctors have had many difficulties in the medical area. The first modern woman to take her degree in medicine was Elisabeth Blackwell, who graduated from the Geneva Medical School of Western New York in 1849. She managed to open a private dispensary, which within a few years developed into a great hospital and training school for women. In the nephrology area a great Australian woman entered the universal history of medicine, Priscilla Kincaid-Smith. Her outstanding contribution was to improve the diagnosis and treatment of glomerulonephritis. Her positive attitude and the novelty of a woman being on the same scientific level as men, combined to secure her unique reputation in both her own country and the world. We hope that new social trends will develop in which women with scientific ideas will be able to completely express their medical ability and the tendency to eliminate the vestiges of old traditions will be reinforced through the granting of new scientific and academic opportunities. In Italian nephrology this tendency has been accelerating.

Australia↗
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[Historical archives of Italian nephrology: The history of instrumentation in nephrology. Part I: Theoretical bases].

Microscopes and artificial kidneys have greatly influenced both diagnosis and therapy of renal diseases. Nonetheless, in tracing the influence of instrumentation on nephrology, as revealed by daily activity, we have to recognise the influence of science upon medical instruments. It is for this reason that, besides strictly clinical factors, the scientific factors that contributed to the development of modern nephrology have received considerable attention. Nobody can use an artificial kidney without bearing in mind the contribution of many segments of science. Each segment has a hypothesis in its historical growth, development and decline. The notion that the advancement of science was made possible by the increasing reliance measurements and other quantitative procedure is hardly a novel one. Moreover, it is rather obvious that the experimental process and the use of instrumentation played an important role in the history of nephrology. Measurements, experiments and the use of instruments were interrelated and represented many phases of the improvements made in diagnosis and therapeutics. Naturally, in the history and epistemology of nephrology instrumentation we find conceptual mistakes and erroneous approaches to the biological reality. However, according to Popper's teachings, mistakes are good for science as they give an extra kick to its growth and development. Medical instrumentation is an assembly of scientific theories; it also controls medical theories and promotes the development of new ones. In addition, it changed our approach to the patient. In the pre-physical era, medical practice was almost entirely an intellectual process based on medical theories that the patient was not expected to understand. In the period of physical examinations the physician included the sensual dimension (oral and visual process) and made direct contact with the patient. In the instrumentation period we experience the third type of examination, in which the physician went back to the position of having less contact with the patient. This separation is reminiscent of the pre-physical diagnosis.

Computers↗
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[Historical Archives of Italian Nephrology. The history of instrumentation in nephrology. Part II: microscope and haemodialyzer].

Medicine in the technological era acquired many of the characteristics that concurrently marked other fields. So, by adopting procedures based on information obtained with instruments and devices, medicine developed an approach to illness that transformed it into a special form of technology. The collective effect of instrumentation deserves consideration and offers the historian opportunities for interpreting the interaction between physician and his patients in other than scientific and technological terms. The very construction of instruments and devices depends on the Author's ideas assembled with the basic theories of the time. For instance, at the end of the nineteenth century, when medical instruments became essential, the bacterial origin of diseases revolutionised their construction and application. In this context, the invention and use of the microscope became an outstanding feature of the clinical approach by disclosing the cellular universe. The microscope had become crucial in locating some major causes of physical suffering and death in man, and was considered the pre-eminent diagnostic instrument in medicine. In the nephrological field, the microscope drew the physician into a universe of physical changes that were concealed to the naked eye. The microscope made possible the verification of some of Bright's brilliant ideas, something that helped physicians classify glomerulonephritis. Many nephrologists confessed "how few things are established in this subject (nephrology) and how many more difficulties are established, we have learned by experience with the microscope". The modesty of this claim is striking. In nephrology, as in other fields, the admission of ignorance proved to be the beginning of wisdom. This wisdom, based on the admission of ignorance and assembled through the commitment and ingenuity of the pioneers of the dialysis treatment, led to the treatment of end-stage renal disease and the guarantee of success. The technique of haemodialysis has been enriched by the new lexicon, which expresses different ways and ideas on the removal of the solute.

Anatomy↗
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[Emerging risk factors and prevention of atherosclerosis in uraemia].

A high rate of cardiovascular morbidity and mortality in uremic patients was documented early in the 1970s, and this remained unchanged according to more recent European and U.S. American registry report. In large cross-section studies of uremic patients, traditional cardiovascular risk factors such as hypertension and hypercholesterolemic have been found to have low predictive power, while emerging factors such as markers of inflammation and malnutrition, are strongly correlated with cardiovascular mortality. In addition, retained uremic solute such as b-2-microglobulin, advanced glycosylated end product (AGE), homocysteine, cysteine, sulfate may contribute to the pro-atherogenic milieu of uremia. Exhaled alkanes such as isoprene, increased during and after hemodialysis sessions, have been identified as accelerating factors of the atherosclerotic process. In patients with renal disease, even when GFR is still normal, increased sympathetic activity is demonstrable. The rising catecholamines turnover is a risk factor for cardiovascular disease for the high sensitivity of the heart and the arteries to increased sympthetic activity.

Arteriosclerosis↗
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[Historical archives of Italian Nephrology. A historical review of Colucci's theories on nephropathy in pregnancy].

BACKGROUND: A review of segments of C. Colucci's detailed 1947 report on nephropathy in pregnancy is undertaken. In his paper, Colucci underlined the prevailing theories and concepts of nephropathy in pregnancy, questioned treatment guidelines, and used a modern epistemological approach to develop appropriate therapy. His outstanding achievement of the use of flux and reflux theories in nephropathy in pregnancy, such as the neuro-hypophysis overfunction theory, was further strengthened by the great physician Nicola Pende. CONCLUSIONS: The Author underlined new perspective regarding nephropathy in pregnancy, its etiology, and the prioritization of treatment aimed at curing function rather than struggling to understand vague and sometimes undefined hemodynamic parameters.

Female↗
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[Historical Archives of Italian Nephrology. Virchow's theories on atherosclerosis and related kidney disease].

This article concerns the development of theories about atherosclerosis and its changing manifestations, some of which, such as renal artery disease and ischemic nephropathy, have been clearly defined only in recent times. An anatomical consequence of atherosclerosis is the stenosis of the renal artery, which opens an unexpected clinical response in blood pressure (nephrovascular hypertension) and in kidney function (ischemic renal disease). Today's historian, no less than the clinician, is called on 'to demand the consideration of basic definitions and nomenclature.' It is impossible to overrate Virchow's theory of artherosclerosis and his great contribution to the concept of artery insudation and thrombosis process. But even Virchow did not expressly stress the concept of atherosclerosis as an autonomic non-inflammatory entity; he called the condition 'chronic endoarteritis deformans.' However, his hypothesis introduced some inflammatory factors that today are the basis of novel atherosclerosis theory. Although Anitschkow introduced the theory of the influence of cholesterol on atherosclerotic development, his theory has been partially contradicted by widespread epidemiological data. Currently, a re-emerging theory on the role of inflammation and infection in atherosclerosis seems to explain many clinical facts taken in small account by other theories.

Arteriosclerosis↗
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[Historical Archives of Italian Nephrology. Goldblatt, kidney and hypertension: three steps in the history of nephrology].

The existence of a clear relationship between renal ischemia and hypertension has been widely documented by Harry Goldblatt and his colleagues. In their original papers they showed that gross and persistent elevation of systolic blood pressure could be produced in dogs by clamping both renal artery, or one if the other kidney had been removed. If renal arteries constriction was not too severe, a stable hypertension unaccompanied by more than mild renal impairment was produced. Subsequently, Goldblatt showed that, with severe constriction, retinal changes, arteriolar impairment and left ventricular hypertension could occur. Goldblatt has remained steadily of the opinion that essential hypertension in man is similarly due to renal ischemia occasioned either by stenosis of a main artery, or by organic changes in the smaller renal arteries down to the size of the different glomerular arteries. At first sight, it might seem like a simple matter to correctly identify the chain of events that begins with renal artery constriction and ends with persistent hypertension. Observing that a link was missing in this chain of events, Goldblatt hypothesised that the link was a humoral mechanism. Tigersted and Bergman showed that renin was the missing link. Renal ischemia as cause of hypertension in dogs opened a new chapter in the connection between kidney circulation and blood pressure elevation. This quite unexpected connection is one of the most challenging issues today and clearly demonstrates that the development of Goldblatt's ideas on renal circulation is still important and has by no means ended. Goldblatt, in his epistemologic approach to hypertension scientific challenges, realised that ideas are the building blocks of science: not flights of fancy, not notions sculpted in snow, but enduring concepts. Goldblatt's lasting ideas are more than a function of time and place: they have inherent qualities that have survived up to the present day.

History, 20th Century↗
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[Historical Archives of Italian Nephrology. Diabetic nephropathy and insulin discovery: two parallel histories].

In 1936, Kimmelstiel and Wilson described the nodular glomerulosclerosis in patients with diabetes mellitus on insulin treatment. The nodular glomerulosclerosis is referred to as diabetic nephropathy. Fifteen years earlier insulin was discovered. This discovery at the University of Toronto (Canada) in 1921-22 by Banting, Macleod, Best and Collip was one of the most dramatic events in the history of the treatment of the disease. The impact of insulin was so sensational because of the incredible effect it had on diabetic patients. Those who first watched starved, sometimes comatose, diabetics receive insulin and return to life witnessed one of the genuine miracles of modern medicine. The discovery has became the "elixir of life" for millions of human beings around the world. Insulin had not emerged out of a vacuum but was the culmination of years of work by dozens of scientists in many countries. The Canadian scientists were the first to succeed in isolating insulin. Their work, however, was accurately constructed to confirm the ideas of earlier researchers, such as Murray, Paulesco, Allen, Minkowski, Derwitt, Zuelzer. These men, in addition to Banting, Macleod, Best and Collip, knew they were making medical history but paradoxically, with their "elixir of life" they allowed some complications of diabetes to emerge. Diabetic nephropathy was one of them. The struggle of the "Toronto quartet" for credit was inspired by man's desire to have a place in history, to have a sort of immortality open to him, an aspiration that is certainly legitimate. But perhaps the Canadian group misjudged both their situation and posterity's point of view. They probably failed to consider the unintentional effect of insulin treatment: diabetic nephropathy as a consequence of adding years to a diabetic's life.

Canada↗
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[When the history of nephrology changed that of medicine].

Medicine owes much to nephrology. Indeed many of the practical and doctrinal acquisitions, through nephrology have derived their first intuitions, explanations and applications which have become epochal conquests of scientific progress. This article is a historical reconstruction of six of the milestones which have marked the medical and scientific human progress: Galeno, the ligature of the ureters and the birth of experimental medicine; uroscopy and the introduction of laboratory exams; the synthesis of urea in the laboratory and the beginnings of biothecnology; the kidney and the introduction of systematic parenteral antibiotic therapy; the kidney and the first artificial organs; the kidney and the start of the transplantation era.

Artificial Organs↗