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P Gilli

Publications and source records attributed to P Gilli.

At least 73 records · Page 4Linked to original sources

[Behavior and significance of phalangeal bone changes in uremic patients under periodic hemodialysis treatment].

Bone damage in hand phalanges has been evaluated with reference to age and duration of hemodialysis (on the basis of 248 radiological observations), in 93 cases with chronic renal failure (age: 20-59 years). These patients were on regular dialytic treatment (RDT) from 1 to 138 months. 72% of the patients underwent several periodic (annual) controls using the mammographic technique. The radiologic evaluations have been arranged into groups according to age. Skeletal damage was more evident when RDT was prolonged. Bone damage increases with age in the first 48 months; afterwards, on the contrary, bone changes were more evident in middle aged patients. At the beginning of RDT, acroosteolysis was the most important change always present. Both subperiosteal and intracortical resorption are more evident increasing age and duration of RDT. Radiological changes give a clear picture of the possible histo-morphologic pattern that characterizes uremic osteodystrophy.

Adult↗

Early skeletal changes of the hand phalanges in patients with chronic renal failure.

Appearance time and the severity of skeletal changes in patients with chronic renal failure are still not well defined. In 61 patients with incipient to advanced renal insufficiency (glomerular filtration rate 70 to 5 ml/min X 1.73 m2), bone alterations (acro-osteolysis, subeperiosteal and intracortical resorption) were mammographically studied in hand phalanges. A high correlation (p less than 0.001) was found between the radiological score and the severity of the renal insufficiency. The earliest changes of renal osteodystrophy occurred in the tufts. Biopsy specimens were taken from the iliac crest in 22 patients. Qualitative bone histology correlated significantly (p less than 0.001) with the total radiological score. Mammography offers an effective and non-invasive means of studying early skeletal changes in patients with chronic renal failure.

Adult↗

Exercise-induced urinary abnormalities in long-distance runners.

The post-exercise urine samples from 122 long-distance runners showed evident abnormalities upon microscopic examination in 95% of all subjects. Proteinuria, alone or with microscopic hematuria, was frequently found. Macroscopic hematuria was a rare occurrence. The urine samples collected in 30 runners before, immediately after the race, and 6, 12, 24, 36, and 48 h later showed a significant post-race decrease in the osmolarity and a significant increase in gamma-glutamyl transferase and N-acetyl-beta-glucosaminidase enzyme activity. Plasma renin activity and plasma aldosterone, determined before and after the race in nine runners, showed a significant increase in the post-race samples. The abnormal urinary findings disappeared in all cases within 24-36 h. It can be concluded that urinary abnormalities are very common after exercise. These abnormalities are most often of a "renal" origin, probably due to a temporary hemodynamic impairment, partially of glomerular but principally of tubular function.

Acetylglucosaminidase↗

Serum aluminum levels and peritoneal dialysis.

Serum aluminum levels, significantly higher in dialysis patients than in normal subjects, were also found to be significantly higher in patients on PD than in those on HD. This could be related to a higher AI transport rate across membrane during PD than during HD. The easier contamination of PD dialysates and their acidic pH could account for this trend to a positive AI balance in PD. On the basis of our observations, however, the significance of the serum aluminum level could be very low, since aluminemia does not seem to reflect the cumulative amount of AI ingested and might not readily help predict the risk of AI intoxication.

Adolescent↗

Cognitive function and regular dialysis treatment.

The purpose of this investigation was to assess the intellectual function of patients on regular dialysis treatment by using neuropsychological tests such as the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Memory Scale (WMS). Studies were performed on 54 patients; 21 patients were retested after at least 12 months. We found no relationship between the neuropsychological scores and the blood levels of small molecules, the hemoglobin concentrations, the serum aluminium levels, and the levels of formal education. We found, however, an impairment of neuropsychological performance, mainly for memory function, related to the duration of dialysis and, possibly, to parathormone levels. We conclude that standard hemodialysis strategies are not able to prevent the development of intellectual impairment in uremic patients and that the WMS could be used as a sensitive objective measure of the comparative adequacy of various long-term dialysis treatments.

Adult↗

Uremic neuropathy: correlations between electroneurographic parameters and serum levels of parathyroid hormone and aluminum.

An electrophysiological investigation on 29 dialysis patients was performed with the aim of verifying whether serum parathyroid hormone (PTH) and aluminum (Al) levels may play a role in the pathogenesis of uremic neuropathy. All patients except 1 showed electrophysiological abnormalities. Both PTH and Al levels were found to be significantly correlated with the time on dialysis. On the contrary, the values of each single electroneurographic parameter did not show any correlation with the duration of dialysis, PTH levels and Al levels. The authors conclude that PTH and Al does not seem to play a role in the etiology of uremic neuropathy.

Adult↗

Oral aluminum and neuropsychological functioning. A study of dialysis patients receiving aluminum hydroxide gels.

Nine dialysis patients with significantly increased serum-aluminum levels due to chronic ingestion of aluminum hydroxide gels and eleven dialysis patients with normal serum-aluminum levels were tested neuropsychologically for generalized functions (intelligence, reasoning, memory) and for more specific abilities (visual memory, verbal and reading fluency, manual dexterity). All tests did not reveal any significant difference in neurophyscholigical functioning between the two groups. This finding seems to indicate that oral aluminum is not neurotoxic for man, even under circumstances of renal failure. This contradicts the idea that oral aluminum plays a role in etiology of dialysis dementia. However, the possibility cannot be excluded that aluminum overload in the present sample was not sufficient to induce changes in CNS functioning. Thus, until the importance of oral aluminum has been decided, it seems wise to keep all sorces of aluminum overload as low as possible.

Aluminum↗

Ureterosigmoidostomy and cancer of the colon. Report of a case.

A possible and quite frequent complication of uretero-sigmoidostomy can be the late development of a colic cancer at the site of the ureteric reimplantation. On the basis of the literature and of a personal observation, the accent is put on what can be done to discover the tumor in any early phase; the possibility that the increased risk of cancer should limit the colic urinary diversions for an exstrophy of the bladder is also discussed.

Adenocarcinoma↗

Response of plasma aldosterone to sequential ultrafiltration, dialysis and conventional hemodialysis.

The response of plasma aldosterone to sequential ultrafiltration dialysis has been studied during 16 sessions and compared with the response to 12 conventional sessions of hemodialysis. During the isolated ultrafiltration phase an important and significant increase in plasma aldosterone and plasma renin activity was observed. There was a substantial removal of extracellular fluid, but no change in plasma biochemistry. During conventional hemodialysis over the same time scale the concentration of plasma aldosterone decreased significantly, plasma renin underwent a small increase and plasma osmolality and plasma potassium decreased. Several possible pathophysiological mechanisms are discussed. We conclude that rapid isosmotic ultrafiltration without change in plasma potassium or sodium, the maintenance of plasma potassium at normal elevated values, and the increase of angiotensin II are factors favoring aldosterone biosynthesis.

Adult↗