Loin pain haematuria syndrome 1967-2020: a review.

The purpose of this retrospective review is to question the validity of the condition 'loin pain haematuria syndrome' (LPHS). We highlight the possibility that most patients regarded as having LPHS have a psychiatric/psychological basis for their symptoms, particularly loin pain. Because of this, and because it recurs despite treatment, the review also questions the use of treatments that are invasive, expensive, and carry considerable morbidity.

Refeeding syndrome as described in 1507 by Antonio Benivieni in Florence.

In 1981, Weinsier and Krumdieck described death resulting from overzealous total parenteral nutrition in two chronically malnourished, but stable, patients given aggressive total parenteral nutrition. This was the birth of what is now called the refeeding syndrome, a nutrition-related disorder associated with severe electrolyte disturbances. The purpose of this work is to demonstrate that refeeding syndrome was first described medically in Florence by Antonio Benivieni in 1507 in his book On Some Hidden and Remarkable Causes of Diseases and Cures. What we now know as refeeding syndrome was described in Report No. LVII of that book. The condition occurred as a result of the famine that affected Florence in 1496. The report documents (i) death due to starvation, (ii) death due to ingestion of deteriorated/toxic foods (inevitable in times of famine when healthy food is scarce), (iii) death caused by excessive food ingestion after forced, prolonged abstinence from food in adults, (iv) the death of breast-fed children and of their starved mothers eating to satiety and (v) the more favourable clinical outcome of those admitted to hospitals. It is possible that Benivieni was inspired by the description of the deaths of starved deserters in the book The Jewish War (70 AD) by the Romano-Jewish historian Flavius Josephus. Nevertheless, Benivieni wrote the first medical account of the central clinical features of refeeding syndrome. The main, broad clinical aspects of refeeding syndrome, described by Weinsier and Krumdieck in 1981, had been documented in medical literature four centuries earlier by Benivieni.

Carmelo Giordano (1930-2016): a giant in Nephrology.

Carmelo Giordano (Carmine, Louis, Joseph Giordano) was born in Naples on August 23, 1930 in the house of Rafael and Anna Tirone He received the MD cum laude in 1954. He was Fellow and assistant to Professor Flaviano Magrassi and studied nephrology at the Peter Bent Brigham Hospital, University of Harvard in Boston, under the guidance of John P. Merrill (1958-1960). He was nominated Professor of Nephrology at the University Federico II, Naples in 1975 and Professor of Medicine at the Second University of Naples (1986-2002). The National Institutes of Health of the United States in Bethesda financed his research for more than 20 years. He started low protein alimentation (Giordano-Giovannetti diet according to Geoffrey M. Berlyne) with or without addition of amino acids and ketoacids and devised formula diets for CKD infants and children. He demonstrated that 85% of CKD patients receiving a 25 g protein diet were in positive nitrogen balance. Later he introduced the concept of energy load from dialysate in CAPD and the assessment of amino acid losses during hemodialysis and peritoneal dialysis. He also researched the minimum protein requirement under CAPD regimens. He synthesized, with Professor Renato Esposito, oxystarch and oycellulose and introduced the use of carbon at low temperature and its regeneration at 90°C. He introduced wearable and portable artificial kidneys. He died in Naples on May 12, 2016.