Arnaldo de Villanova, was a Catalan Physician, born in Villanova de Grau, a suburb of Valencia - Spain about 1235. He died off the coast of Genoa in 1311 during a sea voyage departing from Messina in Sicily, during a diplomatic mission by... more
Arnaldo de Villanova, was a Catalan Physician, born in Villanova de Grau, a suburb of Valencia - Spain about 1235. He died off the coast of Genoa in 1311 during a sea voyage departing from Messina in Sicily, during a diplomatic mission by Pope Clement V in Avignon on orders by the King of Sicily. He was a so famous and clever scientist of the thirteenth century, to give his name to the Universitary Hospital of Montpellier - France. His interests ranged from theology, to politics, medicine, and anymore alchemy. He was an adviser and physician of Kings of Aragon, like Peter III the Great (1276-1285) and James II the Right (1285-1327), of Robert of Angi (1309-1343) of Naples, and of Popes, like Innocenzo V (1276), Bonifacio VIII (1294-1303), Benedetto XI (1303-1304), Clemente V (1305-1314), and of the King of Sicily Federico II of Aragon (1296-1337). For the Pope Bonifacio VIII, suffering from renal colic due to kidney stones, he prescribed Hydrotherapy with Fiuggi Thermal water, that ...
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Pz woman of 62 years comes to P.S.G. for fatigue, low-grade fever, diuresis present. A history of hypertension refers to therapy for about five years, diabetes mellitus for about two years in therapy with Metformin 1gr x 3 gg / day. Blood... more
Pz woman of 62 years comes to P.S.G. for fatigue, low-grade fever, diuresis present. A history of hypertension refers to therapy for about five years, diabetes mellitus for about two years in therapy with Metformin 1gr x 3 gg / day. Blood tests: BUN 195 mg / dL, creatinine 8.0 mg / dl, Ph 6877, HCO3 5.1 mmol / L BE -29.1 mmol / l. Rapid clinical deterioration with occurrence of arterial hypotension - 85/60 mmHg, stupor. Start therapy Bicarbonates ev, is positioned in Urgency CVC and it undergoes AFB with infusion of bicarbonates 2000 ml / h for 4 hours, blood flow rate 250 ml / min., the hemodynamics has been supported with dopamine infusion 200 mg: 2 vials in 250 cc of physiological vel 30 - 40 ml / h, The pc after undergoing three AFB, interrupted the dialysis for resumption of diuresis spontaneous and progressive improvement of renal function and blood pressure. Monitored, after discharge, the parameters of renal function decreased to within normal limits, clearance compatible wi...
Research Interests: Medicine()
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In the ancient times urine was considered a sacred element and were related to Hindu’s ceremonies and to Tantric religious traditions (1). Urine was not considered as a waste product of the body but a distilled product selected from the... more
In the ancient times urine was considered a sacred element and were related to Hindu’s ceremonies and to Tantric religious traditions (1). Urine was not considered as a waste product of the body but a distilled product selected from the blood. The Sanskrit book Shivambu’ kalpa Vidhi (5000 years bC) reported that urine can be useful product for the humans. Sumerian doctors were the first to use uroscopy as depicted in graphic clay tablets (4000 years bC) , whereas AssyrianBabylonian mixed the urine of woman with alcohol to diagnose pregnancy (1). Egyptians were the first to diagnose diabetes using “urine excess”. Libri Ermetici of God Thoth, Egyptian source from the late second century bC, reported the description of the different urine characteristics as white, black, fat, foggy, and foamy (1).
Research Interests: Medicine()
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Contrast-enhanced ultrasound (CEUS) is one of the most interesting and promising clinical applications of imaging and ultrasound. Thanks to the absence of ionizing radiation, the lack of nephrotoxicity and low cost it has the potential to... more
Contrast-enhanced ultrasound (CEUS) is one of the most interesting and promising clinical applications of imaging and ultrasound. Thanks to the absence of ionizing radiation, the lack of nephrotoxicity and low cost it has the potential to become a reference in imaging of the kidney. This review, besides providing a brief description of the proper methodology, presents possible applications of CEUS in nephrology and urology, including renal ischemia, the differential diagnosis of cystic and solid lesions, follow-up of ablative therapies, kidney trauma, kidney transplant, inflammatory diseases, ischemic nephropathy and vesicoureteral reflux.
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The patients in terminal uremia show anxiety and depression correlate with anagraphic and dialytic age, here evidenced trought the Hospital Anxiety and Depression Scale (HADS). In a cohort of 120 patients, only 100 have been selected,... more
The patients in terminal uremia show anxiety and depression correlate with anagraphic and dialytic age, here evidenced trought the Hospital Anxiety and Depression Scale (HADS). In a cohort of 120 patients, only 100 have been selected, because of incompatibility (11.6%) or refusal (5%). The pool composed of 100 patients (59 men, 41 women; mean age of 70.8±12.07 years; 30% mean age of 74.27±3.12 and mean time on dialysis of 55.03±70.12 months, was treated with Bicarbonate High Flux, Hemodialysis Filtration(HDF), Hemofiltration Replacement (HFR), Acetate Free Hemofiltration (AFB), in Ultrapure, 40% in dialysis <24 months. Analyzing the data, the 58% (25% men, 33% women) presented level of anxiety and depression of IV° Likert, versus 16.6% of the general population. The correlation of variables indicates that among the patients under HD, the increase of anagraphyc age correlates with an increase at IV° of anxiety and depression, seen in 36% of patients with a mean age of 78.61± 5.95 ...
Internal jugular vein cannulation has become increasingly widespread. Compared to the left internal jugular vein (LIJV), the right internal jugular vein (RIJV) is the preferred choice for the placement of central venous catheter (CVC) for... more
Internal jugular vein cannulation has become increasingly widespread. Compared to the left internal jugular vein (LIJV), the right internal jugular vein (RIJV) is the preferred choice for the placement of central venous catheter (CVC) for hemodialysis, mostly due to the major technical difficulties and higher rate of complications of the LIJV approach. We aimed to investigate whether variability in the direction of the LIJV/brachiocephalic vein (BV) axis on the frontal plane could be a decisive factor in determining CVC dysfunctions. Retrospective cohort study. From our Register, a total of 1489 consecutive patients (age 69 ± 9 years, males 60%) in whom a CVC for hemodialysis was placed from January 2012 to June 2014 were selected. LIJV cannulation, compared with RIJV, was associated with a higher rate of catheter dysfunction during an observational period of 2 weeks after catheter placement (16 vs.12%; p = 0.005). This complication was strongly correlated with the amplitude of the ...
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Background The coexistence of a double superior vena cava (SVC) and a partially left inferior vena cava (PLIVC) with a circumaortic collar, associated with other congenital malformations, was not described previously. Case Description We... more
Background The coexistence of a double superior vena cava (SVC) and a partially left inferior vena cava (PLIVC) with a circumaortic collar, associated with other congenital malformations, was not described previously. Case Description We present a 33-year-old woman in hemodialysis with complete exhaustion of the brachial routes for vascular access, admitted to our Nephrology Unit for a long-term central venous catheter (CVC) implant, usually by us performed under EchoScopic Technique (EST), an echographic venipuncture followed by continuous radioscopic control of guidewire and catheter in all the steps of implant. An intraoperative venography showed a complete stop of right internal jugular vein, a right SVC, a persistent left SVC, a left inferior vena cava in the iliac and subrenal tracts, a circumaortic venous collar in the renal tract, and normal right suprarenal and hepatic tracts. Conclusions The double SVC was related to the persistence of the caudal part of the anterior cardi...
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The island of Pithecusa (Ischia) is a volcanic island in the Tyrrhenian Sea in the north end of the Gulf of Naples at about 30 kilometers from the same city. Pithecusa is very popular for its hot springs which even the ancients used. This... more
The island of Pithecusa (Ischia) is a volcanic island in the Tyrrhenian Sea in the north end of the Gulf of Naples at about 30 kilometers from the same city. Pithecusa is very popular for its hot springs which even the ancients used. This report aims to analyze the renal therapeutic benefits of the Pithacusa thermal mineral spring through a review of two different manuscripts: i) "Di Napoli il seno cratero"(The gulf of Naples) of Domenico Antonio Parrino (1642-1708) and ii) "De' rimedi naturali che sono nell'isola di Pithecusa oggi detta Ischia"(On the natural cures of the island of Pithecusa known today as Ischia)of Giulio Iasolino (1583-1622). These two manuscripts published during the 18th century and both manuscripts highlight the thermal virtues of the thermal springs of Pithecusa. In the past natural remedies were important in the treatment of different diseases including that of thermal springs dating back to ancient Rome. Thermal springs were used...
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Arnaldo de Villanova, was a Catalan Physician, born in Villanova de Grau, a suburb of Valencia - Spain about 1235. He died off the coast of Genoa in 1311 during a sea voyage departing from Messina in Sicily, during a diplomatic mission by... more
Arnaldo de Villanova, was a Catalan Physician, born in Villanova de Grau, a suburb of Valencia - Spain about 1235. He died off the coast of Genoa in 1311 during a sea voyage departing from Messina in Sicily, during a diplomatic mission by Pope Clement V in Avignon on orders by the King of Sicily. He was a so famous and clever scientist of the thirteenth century, to give his name to the Universitary Hospital of Montpellier - France. His interests ranged from theology, to politics, medicine, and anymore alchemy. He was an adviser and physician of Kings of Aragon, like Peter III the Great (1276-1285) and James II the Right (1285-1327), of Robert of Angi (1309-1343) of Naples, and of Popes, like Innocenzo V (1276), Bonifacio VIII (1294-1303), Benedetto XI (1303-1304), Clemente V (1305-1314), and of the King of Sicily Federico II of Aragon (1296-1337). For the Pope Bonifacio VIII, suffering from renal colic due to kidney stones, he prescribed Hydrotherapy with Fiuggi Thermal water, that ...
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The study was devised to understand the contribution to nephrology ofDe Medicina Methodicaof Prospero Alpini published in 1511, at a time when the fame of the professor reached the azimuth. We have analyzed the contents of chapters... more
The study was devised to understand the contribution to nephrology ofDe Medicina Methodicaof Prospero Alpini published in 1511, at a time when the fame of the professor reached the azimuth. We have analyzed the contents of chapters devoted to nephrology in that book of Prospero Alpini and the novelties of his message. Prospero Alpini (1563-1616) taught at the University of Padua (1594-1616), at the same time of Galileo Galilei, Santorio Santorio, and Girolamo Fabrizi dAcquapendente, when measurements (pulse, temperature, perspiration) were introduced into medicine. He was a travelling physician to whom we owe fundamental contributions to the use of urine to prognosticate life and death (De Praesagienda vita et morte aegrotantium libri septem, Venetiis, apud Haeredes Melchioris Sessae,1601). As prefect of the Botanical Garden - the first ever and a model in the world - he could turn the study of simples into cures(De Medicina Methodica Libri Tredecim. Patavi, apud Franciscum Bolzetta...
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The Study of urine from the outset has always aroused the interest of scientists and physicians all over the world, from ancient Greeks and Romans to Hindus , Hulcos in Mexico, Australian native etc. The urine in such case was considered... more
The Study of urine from the outset has always aroused the interest of scientists and physicians all over the world, from ancient Greeks and Romans to Hindus , Hulcos in Mexico, Australian native etc. The urine in such case was considered not only as a waste product but also as a therapeutic product. In the late XIX century scientific knowledge had already identified the function of substances that favor the increase of urinary output, and physicians over the centuries have always tried to analyze urine in various ways. In Cauchis work in 1933 all chemistry and pathophysiological knowledge of the time was condensed. Cauchi signed the preface as Member of the medical council of Malta. He was a medical doctor of the early20thcentury, He wrote about the physiopathology of urine ranging from chemical and physical behavior, to the analysis of sediments and the special reactions of the urine in various pathologies. In particular Cauchi emphasizes the main diseases of the time combines the ...
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The persistent left superior vena cava (PLSVC) is the most common venous thoracic congenital anomaly. The PLSCV generally drains into the right atrium, which it reaches through a dilated coronary sinus. Its presence is usually... more
The persistent left superior vena cava (PLSVC) is the most common venous thoracic congenital anomaly. The PLSCV generally drains into the right atrium, which it reaches through a dilated coronary sinus. Its presence is usually unrecognized, until a venous approach is performed. Abnormalities of the inferior vena cava (IVC) are rare (0.2-0.3% of healthy subjects and 0.6-2% of patients with cardiovascular defects). A single left IVC (LIVC) is very rare (11.9% of all the abnormalities) [1]. To the best of our knowledge, the coexistence of PLSCV and LICV has not been previously described. We present a case of a 32-year-old woman on hemodialysis for more than 12 years. An angiography demonstrated both a normal right SVC and a PLSCV and a single IVC with a lower left course, an intermediate circumaortic ring and an upper normal right course. The double SVC can be consequent to the failed development of the anastomosis between the anterior cardinal veins and the patency of the caudal part of the left anterior cardinal vein forming the PLSCV. As to the partially LIVC, its iliac and subrenal parts can be the results of the persistence of the left supracardinal vein. The circumaortic venous ring might indicate that a persistent intersupracardinal anastomosis receiving the left and the right renal veins was maintained around the abdominal aorta [2], while the superior part represents the normal right subcardinal and hepatic derivatives. The existence of anomalies should be considered, as they can have important implications in invasive procedures such as venous catheter placement, and may represent a speculative bridge between clinicians and embryologists.
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It has been reported that treatment with L-carnitine at a daily dose of 3 g orally may cause a rise in platelet aggregation and serum triglyceride concentration in hemodialyzed patients. The present double-blind cross-over study has been... more
It has been reported that treatment with L-carnitine at a daily dose of 3 g orally may cause a rise in platelet aggregation and serum triglyceride concentration in hemodialyzed patients. The present double-blind cross-over study has been performed to evaluate the influence of L-carnitine when compared with placebo on platelet aggregation and plasma concentrations of various factors involved in platelet activation. In addition, the concentration of triglycerides, cholesterol and HDL-cholesterol has been evaluated. 18 uremic patients on maintenance hemodialysis for at least 1 year were randomly allocated either to a control group receiving placebo or to a group treated with L-carnitine. Statistical analysis performed by means of ANOVA did not show any significant change in the serum concentration of cholesterol, HDL-cholesterol and triglycerides. Furthermore, platelet aggregation tests (performed with adenosine 5&#39;-diphosphate, epinephrine, thrombin and collagen) and plasma beta-thromboglobulin concentration did not show any statistically significant difference. In addition, the plasma concentration of several coagulation markers, such as factor VIIIc, antithrombin III, alpha 2-antiplasmin, and fibrinopeptide A, did not show any significant variation. The results suggest that under our experimental conditions L-carnitine neither increases the risk of thromboembolism nor alters the serum lipid content in uremic patients on chronic hemodialysis.
Research Interests: Statistical Analysis, Lipids, Humans, Platelet aggregation, Female, and 14 moreHemodialysis, Male, Statistical Significance, Thromboembolism, Medical Physiology, Platelet activation mechanism, Clinical Sciences, Middle Aged, Adult, Renal Dialysis, Control Group, Serum lipids, Randomized Controlled Trials as Topic, and Carnitine
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In the management of anemia in patients with chronic kidney disease stage 5 undergoing dialysis (CKD-5D), maintaining hemoglobin (Hb) within the range recommended by the guidelines is challenging. The CARISMA study aim was to evaluate the... more
In the management of anemia in patients with chronic kidney disease stage 5 undergoing dialysis (CKD-5D), maintaining hemoglobin (Hb) within the range recommended by the guidelines is challenging. The CARISMA study aim was to evaluate the efficacy, safety and tolerability of a once-monthly continuous erythropoietin receptor activator (CERA) for the treatment of anemia in CKD-5D patients. In this single-arm, multicenter, open-label, phase IIIb study, we screened adult patients from 66 centers in Italy receiving intravenous epoetin alfa or beta or darbepoetin alfa. Eligible patients entered the CERA dose titration phase (DTP), followed by an efficacy evaluation period (EEP) and a long-term safety period (LTSP). Patients were analyzed by intention-to-treat (ITT), per protocol (PP) and safety populations. The rate of patients maintaining Hb within the range 10.0-12.0 g/dL throughout the EEP was 63.22% (220/348), and concentration from baseline to any postbaseline time point. CERA may thus offer a convenient and effective treatment 73.94% (122/165) in the ITT and PP population, respectively, periods in both populations. The rate of patients requiring a dose change was higher during the DTP (69.2%) and the LTSP (73.0%) than during the EEP (54.5%), as expected. CERA treatment was generally well tolerated. Once-monthly CERA administered to CKD-5D patients was associated with negligible changes in mean Hb option for these patients.
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Research Interests: Health()
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Contrast-enhanced ultrasound (CEUS) is one of the most interesting and promising clinical applications of imaging and ultrasound. Thanks to the absence of ionizing radiation, the lack of nephrotoxicity and low cost it has the potential to... more
Contrast-enhanced ultrasound (CEUS) is one of the most interesting and promising clinical applications of imaging and ultrasound. Thanks to the absence of ionizing radiation, the lack of nephrotoxicity and low cost it has the potential to become a reference in imaging of the kidney. This review, besides providing a brief description of the proper methodology, presents possible applications of CEUS in nephrology and urology, including renal ischemia, the differential diagnosis of cystic and solid lesions, follow-up of ablative therapies, kidney trauma, kidney transplant, inflammatory diseases, ischemic nephropathy and vesicoureteral reflux.
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Arterial hypertension and proteinuria are risk factors for chronic kidney disease. A mobile clinic was parked in a central plaza of 11 Italian cities to check blood pressure (BP), prescribe antihypertensive drugs, assess for proteinuria,... more
Arterial hypertension and proteinuria are risk factors for chronic kidney disease. A mobile clinic was parked in a central plaza of 11 Italian cities to check blood pressure (BP), prescribe antihypertensive drugs, assess for proteinuria, and provide awareness about hypertension. Among 3757 ...
Research Interests: Health Promotion, Medicine, Italy, Humans, Hypertension, and 15 moreFemale, Male, Incidence, Awareness, Clinical Sciences, Aged, Middle Aged, Adult, Prognosis, Health surveys, Proteinuria, Chronic Kidney Failure, mass Screening, Cardiovascular medicine and haematology, and Medical biochemistry and metabolomics
A sensitive method for detecting isoenzymes of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) in human liver biopsy specimens by simultaneous starch gel electrophoresis is described. All the currently recognised hepatic... more
A sensitive method for detecting isoenzymes of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) in human liver biopsy specimens by simultaneous starch gel electrophoresis is described. All the currently recognised hepatic isoenzymes of ADH and ALDH which are concerned with ethanol metabolism can be identified. The method is suitable for amounts of liver biopsy material weighing as little as 2.5 mg and also allows spectrophotometric assay of ADH activity (at pH 8.8 and 11.0) and of ALDH.