Papers by Giuseppe Piccoli
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Archivio per le scienze mediche
Four thousand hemofiltrations have been performed in 22 patients with low tolerance to convention... more Four thousand hemofiltrations have been performed in 22 patients with low tolerance to conventional hemodialysis (20 cases), and severe arterial hypertension (2 cases). In comparison with hemodialysis, hemofiltration had a low incidence of intradialytic collapses, vomit and cramps, and allowed a better state of well-being during interdialytic periods. In hypertensive patients hemofiltration has accomplished a better control of arterial pressure and pharmacotherapy has been reduced. In this study, we report the data concerning metabolism, electrolytes, acid-base balance during our experience utilizing bicarbonate in the replacement fluid. Our experience further supports the impression that hemofiltration may have some advantages in patients with low tolerance to conventional dialysis and/or severe dislipemia and hypertension. The possibility to reduce dialysis duration to 3 hrs, stimulates further application of this new treatment in a wider number of patients on RDT.
Acta Diabetologica, 1992
... F. Giacchino, L. Comune (Ivrea), A. Ramello, M. Bruno (Pinerolo), C. Peona, P. Colombo (Verce... more ... F. Giacchino, L. Comune (Ivrea), A. Ramello, M. Bruno (Pinerolo), C. Peona, P. Colombo (Vercelli), P. Bajardi, R. Bergia (Biella), G. Verzetti, MC Barb6 (Novara), G. Cavagnino, A. Baroni (Borgomancro), PM Ghezzi, G. Dutto (Cuneo), PL Cavalli, F. Goia (Alba), G. Boccardo, G ...
Geriatric Nephrology and Urology, 1995
The authors review the literature data concerning different aspects of membranous glomerulonephri... more The authors review the literature data concerning different aspects of membranous glomerulonephritis (MGN) in the elderly and present a clinical analysis of 32 MGN patients aged more than 65 years followed in their own center.
Virchows Archiv. B: Cell pathology, Jan 29, 1976
A case of immune-complex glomerulonephritis with membrano-proliferative patterns in a patient wit... more A case of immune-complex glomerulonephritis with membrano-proliferative patterns in a patient with mixed IgG-IgM cryoglobulinemia has been investigated; particular attention has been payed to histological immunofluorescence, histochemical and electron microscopical findings in order to elucidate the nature of the intraluminal thrombi. The so called thrombi, strongly positive for IgG and IgM with the immunofluorescence, appeared to be clusters of mononuclear cells which, for their ultrastructural and histochemical (non-specific esterase activity) patterns have been considered as monocytes. They showed cytoplasmic vacuoles containing microtubular structures; the latter have been detected free in the capillary lumina and in the basement membranes as well. These structures have been considered as the ultrastructural counterpart of the IgG-IgM immune-complexes responsible of the nephropathy. Monocytes have been hypothesized to play a pathogenetical role, acting as cleaners of the cryopre...
Nephron, 1983
Continuous ambulatory peritoneal dialysis has been demonstrated to be a successful dialysis thera... more Continuous ambulatory peritoneal dialysis has been demonstrated to be a successful dialysis therapy for those patients who are emotionally, socially, and intellectually capable of safely performing the self-dialysis technique. Rapid expansion of the procedure, modification of the technique to reduce the incidence of peritonitis, development of experienced personnel and adequate funding by the government can serve to increase the home dialysis population, save tax dollars and free patients from the requirement of machine dialysis.
The authors studied the behavior of enzymes involved in the glycolytic pathway incubating intact ... more The authors studied the behavior of enzymes involved in the glycolytic pathway incubating intact reticulocyte and erythrocyte at 37C in the presence of ascorbic acid and Fe{sup 2+}. The results obtained have shown evidence that among the glycolytic enzymes the hexokinase activity shows a pronounced decay. For this reason the authors have investigated how the chromatographic profile of hexokinase changes
Nephrology Dialysis Transplantation, 2004
Background. Concerns about vascular access failure may have limited the widespread use of daily h... more Background. Concerns about vascular access failure may have limited the widespread use of daily haemodialysis (DHD). We assessed the incidence and type of vascular access complications during DHD and other schedules, both at home and on limited care haemodialysis. Methods. All patients were treated in a limited care and home haemodialysis unit with a stable caregiver team (November 1998-November 2002. Vascular access failure, surgical treatment, angioplasty and declotting were studied alone or in combination by univariate and multivariate models. We analysed the effects of age, sex, comorbidity, previous vascular events, schedule, setting of treatment (home, limited care), dialysis follow-up, vascular access (native vs prosthetic, first vs subsequent) and setting of vascular access creation. 'Intention to treat' and 'per protocol' analyses were performed. Results. In 2160 patient-months (home dialysis: DHD 400 months, non-DHD 655 months; limited care: DHD 208 months; non-DHD 897 months), 57 adverse events occurred (27 failures), in which 30 were at home (nine DHD) and 27 were in limited care (five DHD). The probability of remaining free from adverse events at 6 and 12 months was 89% and 80% on DHD and 79% and 76% on other schedules ('intention to treat'). Univariate analyses revealed a significant difference for the setting of the vascular access creation (lower risk of vascular access complications in our centre) and sex (male sex was protective). Logistic regression and Cox analyses confirmed the role for the setting of the vascular access creation. Conclusions. Although DHD did not appear as a risk factor for vascular access morbidity or failure at home or in a limited care centre setting, the setting of vascular access creation may influence its success.
Journal of Diabetic Complications, 1987
A test for the measurement of trace urinary albumin concentrations, which is suitable for the det... more A test for the measurement of trace urinary albumin concentrations, which is suitable for the detection of microalbuminuria, was developed. The technique is an indirect enzyme-linked assay (ELISA) in which a fixed amount of anti-albumin antibody is placed into polystyrene tubes coated with human albumin, together with the urine sample to be tested. The albumin in the test specimen competes with the solid-phase albumin for binding to the added antibody. The test is precise (inter-and intraassay coefficients of variation were 8.2% and 7.8%, respectively), accurate (mean recovery 102-106% for two human albumin preparations), and sensitive (detection limit 0.9 #g/ml). These characteristics are not dissimilar from those of the radioimmunoassay reported in the literature, with the advanta9es of being completely safe, easy to perform, and not requiring expensive equipment. Using this assay the urinary albumin excretion in 20 normal subjects was found to be 2.5 -t-2.2/.=g/mln (range 0.9-7.5/~g/min) after 8 hours of bed rest and 4.5 4-5.7 #g/min (range 1.5-2.0 #g/min) after 8 hours of moderate physical activity
Clinical Immunology and Immunopathology, 1997
in control rats injected with aggregated IgG; i.e., MTT Heavy alcohol intake and/or lipotrope-def... more in control rats injected with aggregated IgG; i.e., MTT Heavy alcohol intake and/or lipotrope-deficient diet values were more prolonged in rats given whiskey or induced hepatocellular injury and mesangial deposition LD diet than normally nourished rats (P õ 0.01). The of IgA and often IgG in Lewis rats. The experimental lipotrope-deficient diet and the chronic alcohol abuse animals showing more severe urinary abnormalities and per se seem to lead to critical changes in hepatic uptake histologic damage in the glomeruli had increased levels and catabolism of both an IgA and an IgG aggregate, of IgA antibodies to dietary antigens and altered intestiwhich could account in turn for the reported appearnal permeability. Based on human studies, the proance of renal immunoglobulin deposits in this experilonged circulation of IgA-containing complexes associmental model. Due to the comparable delay in removal ated with the liver disease could be envisaged as imof IgA and IgG probes in equally nourished animals, adportant for the development of mesangial IgA deposits. ditional factors are likely to be involved in the promi-In order to verify this hypothesis, four groups (G) of nent deposition of IgA. ᭧ 1997 Academic Press Lewis rats were studied: G1 received thrice a week an intragastric infusion of 1.5 ml/100 g body wt of whiskey; G2 rats were nourished with lipotrope-deficient diet; G3
Artificial Organs, 1985
Plasma exchange (PE) has recently been proposed for primary immunoglobulin (Ig)-A nephropathy (PI... more Plasma exchange (PE) has recently been proposed for primary immunoglobulin (Ig)-A nephropathy (PIgAGN) with progressive course. To develop suitable guidelines for PE in these cases, the authors evaluated the clinical usefulness of some immunological parameters in five patients with PIgAGN treated with PE combined with immunosuppressive drugs and small doses of corticosteroids. These parameters included the levels of IgA-containing immune complexes (IgAIC) by a specific conglutinin assay, the function of the mononuclear phagocyte system (MPS) by the in vivo clearance of IgG-sensitized erythrocytes, and complement activation as determined by C3d measurement. HLA types were also determined. Three patients had an acute nephritic syndrome with a rapidly progressive course, one of them showing sclerotic histologic changes. The two other cases had a relentless progression toward renal failure. In the patient with sclerotic PIgAGN, the MPS function was normal and the IgAIC and C3d levels were low throughout the treatment. In the other four cases, the high IgAIC and C3d levels and the MPS dysfunction found before treatment markedly improved after several PEs. The immunological parameters remained normal during the post-PE follow-up in two cases with acute nephritic syndrome and rapidly progressive course, but worsened again in two cases with a relentless course, particularly in one who possessed the B8/DR3 HLA type. Immunological monitoring including IgAIC, C3d, and MPS function is proposed, in addition to histological and clinical evaluation, as a guideline for PE in PIgAGN with evolving course.
Nephron, 1985
The acute effects of both acetate and bicarbonate hemodialysis on erythrocyte transmembrane sodiu... more The acute effects of both acetate and bicarbonate hemodialysis on erythrocyte transmembrane sodium fluxes were investigated in 15 patients with chronic uremia. We observed a significance (p less than 0.01) stimulation of the Na+,K+ pump in both procedures, with a significant correlation to the amount of fluid removed during hemodialysis (r = 0.56, p less than 0.03). Outward Na+ cotransport fluxes significantly rose (p less than 0.05) after acetate hemodialysis and decreased (p less than 0.05) after bicarbonate hemodialysis. Minor and not significant pre- and posthemodialysis bidirectional changes were observed as regards the intraerythrocyte Na+ and K+ concentration, passive Na+ and K+ permeability, and Na+,Li+ countertransport. Hemodialysis may acutely affect the erythrocyte sodium pump and cotransport fluxes, possibly through the modulation of hormonal factors triggered by the extracellular volume changes.
Nephron, 1982
32 patients (22 biopsed) with lupus nephritis (LN) were observed for circulating immune complexes... more 32 patients (22 biopsed) with lupus nephritis (LN) were observed for circulating immune complexes (IC). Solid phase C1q (SPC1q) and polyethylene glycol (PEG) precipitation tests were used. The patients were studied during the clinical follow-up in different phases of disease activity. Comparative studies between each histological class of LN and corresponding forms of idiopathic glomerulonephritis (IGN) were made: no significant differences were found between either mesangial LN and stalk mesangial IGN, or between focal proliferative LN an focal proliferative IGN. However, a significant difference was found for SPC1q data between diffuse proliferative LN and mesangiocapillary IGN, and between membranous LN and membranous IGN. LN, with an acute nephritic syndrome and hypocomplementemia, displayed SPC1q data significantly above the levels of IC found in IGN with similar clinical features. IC serum data would seem an important element for the diagnosis and the clinical management of patients affected by LN.
Nephron, 1987
In order to gain insight into the role of IgG Fc receptors in essential mixed cryoglobulinaemia (... more In order to gain insight into the role of IgG Fc receptors in essential mixed cryoglobulinaemia (EMC), we analyzed quantitatively the expression of such molecules on polymorphonuclear leukocytes (PMN) and assessed them, functionally, on PMN, tissue macrophages and circulating monocytes in 6 HLA-B8-, DR3-negative patients with EMC and glomerulonephritis. The Fc receptors expressed on PMN surface, as estimated by using AB 8.28 monoclonal antibody to PMN Fc receptor and 125I-labelled rabbit F(ab')2 fragments to mouse IgG as detecting system, were found to be quantitatively normal in EMC patients, whereas PMN Fc- receptor-mediated phagocytosis was reduced. Moreover, the patients were found to have prolonged macrophage clearance of IgG-sensitized autologous erythrocytes and reduced kinetics of ingestion of IgG-coated material by circulating monocytes. This impairment of Fc receptor function may play a remarkable role in the tissue localization of immune material in this disease.
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Papers by Giuseppe Piccoli