Excessive number of skin cancers in an Italian renal transplant recipient.
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Biomedical subjects
Publications and source records attributed to A Barba.
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A rapid gas chromatographic method for determination of residue levels of one insecticide (chlorpyrifos) and four fungicides (penconazole, fenarimol, vinclozolin and metalaxyl) in grapes, must and wine is described. An on-line microextraction method was used. The matrix, once extracted with a mixture of acetone-dichloromethane (1:1, v/v) was filtered and concentrated. Electron-capture detection for chlorpyrifos, penconazole, fenarimol and vinclozolin and mass-selective detection in the selected-ion monitoring mode for metalaxyl were utilised. No clean-up was necessary because there were no interferences in the area of interest of the chromatogram. Linearity of both detectors, in the range 0.02-2 ng/microliter, was checked. In all cases, the correlation coefficient was the same or superior to 0.997. Recoveries from spiked grapes, must and wine ranged from 78% to 101% (fortification level, 0.1-1 mg/kg). Limits of determination were between 0.01 mg/kg for metalaxyl and 0.001 mg/kg for vinclozolin.
The effect of wine-making procedures on the concentrations of six pesticides (chlorpyrifos, penconazole, fenarimol, vinclozolin, metalaxyl, and mancozeb) in red wines has been studied. During maceration stage (4 days), the percentage remaining of chlorpyrifos, penconazole, and metalaxyl was approximately 90%, whereas that of fenarimol, vinclozolin, and mancozeb is somewhat smaller (74-67%). The residual levels found in pressed must were </=20%, except for metalaxyl (69%). From the whole concentration of chlorpyrifos in must, 85% is eliminated from the racking step; clarification (bentonite plus gelatin) eliminates 43% of the product found in the decanted wine, and with filtration, all of the residue is eliminated. Penconazole and mancozeb are retained on the lees in proportions of 43 and 31%, respectively. The eliminated percentage of vinclozolin after racking is 29%, whereas clarification and filtration reduce its proportion in the wine to 33 and 28%, respectively. Finally, fenarimol and metalaxyl are eliminated in smaller proportion with the realization of these processes.
The influence of pesticide residues on the aromatic composition (major and minor volatiles) of red wines made from Vitis vinifera (Monastrell var.) was studied by comparing the concentration of aromas in wines made from grapes subjected (or not) to phytosanitary treatment with chlorpyrifos, fenarimol, mancozeb, metalaxyl, penconazole, and vinclozolin, according to the agricultural practice of the area. The analytical determination of the major volatiles was made by gas chromatography using a flame ionization detector, while the minor volatiles were determined by adsorption-thermal desorption gas chromatography using a mass selective detector. There were significant differences between the ethyl acetate, methanol, isobutanol, and diethylacetal levels of the control wine and that containing chlorpyrifos residues, although only the ethyl acetate exceeded the olfactory threshold. With regard to the minor volatiles, significant differences were detected in the concentrations of some esters, aldehydes, and acids. However, only isoamyl acetate exceeded the olfactory threshold in wines containing residues of chlorpyrifos, fenarimol, and vinclozolin.
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We have investigated some possible risk factors for cutaneous warts in a consecutive group of renal transplant recipients treated with three different immunosuppressive regimens: prednisolone + azathioprine (PA), prednisolone + azathioprine + cyclosporin (PAC), prednisolone + cyclosporin (PC). Kaplan and Meier analysis showed an earlier onset of warts in the PAC and PC groups than in the PA group (p < 0.0001), which might be related to the different immunosuppressive action of the pharmacological treatments including cyclosporin. Seven patients had skin cancer: 4 of them also had multiple warts on the cancer site. In 2 patients, histological examination demonstrated the neoplastic transformation of a wart. Maintenance posology of azathioprine, cyclosporin and prednisolone may be an important risk factor for cutaneous warts; on the other hand HLA-B mismatch and HLA-A11 seem to have no effect.
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We present a review of the current literature on skin diseases in renal transplant recipients (RTR) and the results of a 5-year follow-up of 285 patients. Many skin diseases are only an aesthetic and functional cause for interest, but HPV infections and skin cancers are significantly more frequent in RTR than in immunocompetent subjects and can affect a patient's prognosis. For this reason, we feel dermatological surveillance of RTR is necessary for early diagnosis and treatment of all high-risk lesions.
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INTRODUCTION: Acral persistent papular mucinosis is an uncommon skin disease with characteristic mucin deposits in the medial layer of the derma. In the Rongioletti and Rebora classification, this disease belongs to the group of specific cutaneous mucinoses. CASE REPORT: A 14-year-old girl consulted for symmetrical papular lesions on the back of the hand and wrists. The first manifestations had occurred at the age of 3 years. Laboratory tests were positive for antinuclear antibodies at 1/320. The histology and the clinical presentation led to the diagnosis of acral persistent papular mucinosis. DISCUSSION: This case shows that manifestations of acral persistent papular mucinosis can occur early in childhood. This disease may be a single clinical entity or an attenuated clinical expression of papular mucinosis. Clinical and laboratory observation were required for our patient.
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Cardiovascular disease is one of the main causes of death in developed countries. Its incidence may be modified through dietary changes, this being supported by the low incidence of the disease among populations with high intake of fatty fishes. The aim of this work was to study the modifications on plasmatic levels of polyunsaturated fatty acids omega 3 after an additional supply of fish oils and to assess its effect on the metabolism of lipids and lipoproteins. The study was conducted on 8 healthy volunteers, their age ranging between 24 and 37 years. They received, during 30 days and in tablets of 500 mg, 7.5 gr/24 h of fish oil concentrate which supplied 2.5 gr/24 h of fatty acids omega 3. After 12 hours of fasting, blood samples were taken before and after the intake of this concentrate. Methyl esters from fatty acids omega 3 were assessed through gas chromatography; cholesterol, triglycerides, LDL, VLDL, HDLt, HDL2 and HDL3, through several enzymatic techniques; and lipoprotein(a) Lp(a), through ELISA. The statistical analysis was conducted using the Student's method for matched data. After 30 days of supplement, we observed: a significant increase in the plasmatic percentage of fatty acids omega 3 (EPA + DHA) along with a significant decrease of triglycerides, VLDL and HDL3 and a significant increase of HDL2, We did not observe any significant changes in cholesterol, LDL and HDLt. With respect to Lp(a), after one month of dietary supplement, its plasmatic levels did not change. Our results supports the clinical usefulness of the dietary supplementation with fatty acid omega 3 for the management of hypertriglyceridemias.(ABSTRACT TRUNCATED AT 250 WORDS)
Cyclosporin (CsA) and azathioprine (AZA) are useful immunosuppressive drugs in the management of kidney and liver transplant recipients. We investigated urinary mutagenicity in three groups of kidney transplant recipients after different immunosuppressive protocols. Urinary mutagenicity was detected in a base-pair strain, E. coli WP2uvrA, in a liquid incubation assay. No mutagenic activity was detected in the urines of patients treated with CsA (4.5 mg/kg); 85% of the urines in the second group treated with AZA (1.26 mg/kg) showed high mutagenic activity, whereas mutagenic activity was found in 40% of the urines of subjects treated with CsA and AZA (3.89 mg/kg + 1.15 mg/kg). These data suggest that immunosuppressive therapy with AZA carriers a high risk of urinary mutagenicity, while immunosuppressive combined treatment with CsA and AZA significantly reduces this risk.
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UNLABELLED: FOUNDATIONS: The dietary oil provides a significant portion of the caloric intake in the form of fat, although there is some controversy with respect to the potential positive action of each type of oil. In this study, the effect on the lipo-apoprotein profile of monounsaturated fatty acids (MUFA) provided by olive oil and the polyunsaturated fatty acids (PUFA) provided by girasol oil are compared in a population with high risk of arteriosclerosis, as it is the aged population. METHODOLOGY: 44 aged patients living in the same institution, 21 males and 23 females (age: 79 +/- 6 years), and following two different diets during 3 months, with olive and girasol oils, respectively, participated in the study. Both diets were isocaloric: 2.300 kcal/day, 17% proteins, 33% lipids (30 g/day of oil), and 50% carbohydrates. Plasmatic concentrations of cholesterol (C), triglycerides (TG), c-LDL, c-VLDL, c-HDL2, c-HDL3 and lipoprotein a (Lp[a]), as well as apoproteins A1, B, CII, CIII and E, were assessed. Applied statistics: Student's t test for matched samples. RESULTS: C and TG plasmatic levels did not changed, whereas levels of c-LDL decreased significantly, as well as levels of polyunsaturated fatty acids (135 +/- 43 and 124 +/- 33 mg/dl., p < 0.009) and levels of apo B (151 +/- 47 and 139 +/- 36 mg/dl., p < 0.009). Levels of c-HDL increased significantly (49 +/- 14 and 52 +/- 16 mg/dl., p < 0.01) as well as levels of apo A1 (190 +/- 32 and 205 +/- 41 mg/dl., p < 0.01). Levels of apo CIII (8.2 +/- 2.8 and 9.9 +/- 3.2 mg/dl., p < 0.008) and apo E (3.2 +/- 1.1 and 3.7 +/- 0.9 mg/dl., p < 0.01) also increased in men. Women did not showed any significant variations in lipoproteins, although apo A1 and apo E increased slightly and apo B decreased, although not significantly, with the polyunsaturated fat. The levels of Lp(a) did not changed. CONCLUSIONS: In the aged population following a standard diet, without overloads, the PUFAs induced positive changes in the lipoapoprotein profile when compared to a previous diet with MUFA. Those changes were more evident in men than in women.