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Biomedical subjects

A Mamianetti

Publications and source records attributed to A Mamianetti.

At least 19 recordsLinked to original sources
PubMed2002

Total serum bile acids in renal transplanted patients receiving cyclosporine A.

BACKGROUND: A direct relationship between serum bile acids (SBA) and hepatic and hepatobiliary dysfunction has been demonstrated. However, there is little evidence that SBA are related to renal insufficiency. In a previous study, we showed that hemodialysis patients with advanced chronic renal failure (ACRF) have an increase of SBA in predialysis and a decrease in postdialysis. Consequently, it was assumed that the restoration of renal function in transplanted patients might decrease SBA levels. AIM OF THIS STUDY: Transplanted patients receiving cyclosporine A (CyA) were studied by monitoring CyA and SBA levels to determine if a probable relationship exists between renal function, CyA treatment and SBA levels. SUBJECTS. MATERIALS AND METHODS: SBA levels were determined in 15 recently transplanted patients receiving CyA for 18 months and longer. In addition, 22 renal patients transplanted not less than 6 years ago were also included in the study and were characterized as the stable group. Five patients from this group received mycophenolate or azathioprine instead of CyA as immunosuppressant. In addition to SBA and CyA, creatinine, cholesterol, y-GT, viral markers and triglycerides were also determined in all patients. RESULTS: A significant and constant increase in SBA levels was observed in the recently transplanted group. However, after 18 months, SBA levels gradually decreased to those of patients considered stable under CyA treatment. In both recently transplanted and stable patients who received CyA, SBA values remained higher than normal, but stable patients under mycophenolate or azathioprine treatment showed no such increase. CONCLUSIONS: In recently transplanted patients, in patients studied for 18 months post transplant and in stable patients receiving CyA, the increase of SBA levels might be related to CyA treatment. This effect might be attributed to its cholestatic effect and also to a modification in uptake, metabolism, synthesis and excretion of SBA in the hepatocyte. These conclusions are supported by the results obtained in stable transplanted patients without CyA treatment showing normal SBA levels.

Adult↗
PubMed2000

Serum bile acids and pruritus in hemodialysis patients.

BACKGROUND: Chronic renal failure (CRF) patients usually suffer from pruritus. The pathophysiology of pruritus is still incompletely understood. SUBJECTS, MATERIALS AND METHODS: In this paper we determined serum total bile acids (STBA) in hemodialysis patients with advanced CRF (ACRF) in order to obtain STBA concentration in predialysis, to assess their probable relation among patients with pruritus and in postdialysis using a polysulfone membrane for dialysis. STBA were determined in 49 ACRF patients with chronic hemodialysis and values were compared to 20 control subjects. Hemodialysis patients were divided in two groups: with and without pruritus. In all these patients, month of renal replacement therapy, diabetic patients, dose of dialysis (Kt/V), viral markers, serum creatinine, serum glucose, aspartate and alanine aminotransferase, alkaline phosphatase, hematocrits and albumin were determined. The intensity of itching among pruritic patients was measured by a score system: mild (M), moderate (MO) and severe (S). RESULTS: No significant differences were found in patients with and without pruritus in months of renal replacement therapy, duration of dialysis or dose of dialysis (Kt/V). STBA were determined in all ACRF patients in predialysis and they showed significant differences compared to controls (p < 0.05), however, no differences were observed in the results obtained when control subjects were compared to ACRF patients without pruritus. Also in predialysis, pruritic patients showed significant differences in STBA compared to patients without pruritus (p < 0.001). STBA concentration showed a significant decrease in postdialysis using a polysulfone membrane in ACRF patients with and without pruritus. Finally, correlation with STBA and itch score of pruritus was significant (p < 0.02). CONCLUSION: Hemodialysis patients with ACRF and pruritus showed an increase of STBA in predialysis and a decrease in postdialysis.

Adult↗
PubMed1999

Fecal bile acid excretion profile in gallstone patients.

Epidemiological studies have shown a positive association between cholesterol gallstones and colonic cancer. These two diseases may be somehow related with bile acids metabolic alterations. The aim of this study was to evaluate the profiles of fecal bile acid in gallstone patients, in order to estimate the quality and amount of fecal bile acids. A fecal bile acid profile of ten gallstone patients and ten controls was compared using high performance liquid chromatography. Total fecal bile acid excretion was significantly increased in gallstone patients compared with controls (692.7 mg/day (302.5-846.2) vs 165.7 mg/day (138.7-221.3), p < 0.01) as was the excretion of secondary free bile acids 562.9 mg/day (253.3-704.9) vs 99.9 mg/day (88.9-154.2), p < 0.01). Lithocholic and glycodeoxycholic acid percentages have also been found to show differences with controls of 55.4 (47.4-73.9) vs 24.6 (22.1-38.4) (p < 0.01) and 29.4 (3.3-41.7) vs 2.8 (1.0-3.8) (p < 0.03), respectively but deoxycholic acid has not shown differences between the two groups. Moreover, the percentage of ursodeoxycholic acid diminished significantly in gallstone patients (1.5 (1.0-2.8) vs 8.6 (6.0-10.39) (p < 0.001), and the decrease of chenodeoxycholic acid was also significant (20.0 (11.4-23.6) vs 8.9 (3.1-10.9) (p < 0.03) along with a rise in the ratios lithocholic/deoxycholic acids (1.8 (1.4-6.4) vs 0.9 (0.6-1.6) (p < 0.05) and glycine/taurine of deoxycholic acid (7.3 (4.1-46.6) vs 0.2 (0.1-0.5) (p < 0.01). In conclusion, we have observed a significant increase of total and secondary fecal bile acid excretion as well as a rise of LCA and GDCA percentages and a rise in the ratios of LCA/DCA and glycinet/taurine of DCA.

Adult↗
PubMed1995

[Acquired sideroblastic anemia and cholestasis in a hyperthyroid patient treated with methimazole and atenolol].

The authors describe a 62 year-old white male who was diagnosed as autoimmune hyperthyroidism and treated with methimazole and atenolol. Ten days later he showed itching, jaundice and choluria. All drugs were discontinued. The patient was given radioactive iodine. Two months later direct serum bilirubin levels reached 35 mg%. Endoscopic retrograde cholangiogram evidenced normal extrahepatic biliary ducts. The percutaneous liver biopsy showed marked cholestasis specially in the centrolobular zone with a slight infiltrate of mononuclear cells in the portal areas. Together with the liver disease the patient presented an anemic syndrome. Bone marrow aspiration showed rich cellularity, Perls staining showed 70% sideroblasts, with 10% ringed sideroblasts and increased extracorpuscular iron. The patient's evolution was satisfactory. Twenty months after the beginning of the disease clinical and biochemical tests were normal. A new bone marrow aspiration rendered normal. Hepatic cholestasis suffered by our patient was probably due to an adverse reaction of methimazole. Physiopathology of reversible sideroblastic anemia is discussed.

Anemia, Sideroblastic↗
PubMed1988

Relative risk of colorectal cancer after cholecystectomy. A multicentre case-control study.

The relative risk of developing colorectal cancer after cholecystectomy was assessed retrospectively in 493 patients with colorectal cancer (239 women, 254 men). The results were compared with a control group of patients matched for sex and age. The overall relative risk was 0.7 (90% confidence interval, 0.7-0.8). However, when the data were analysed for site significant differences were seen. In the caecum and ascending colon the relative risk of developing colorectal cancer after cholecystectomy was 2.8 (90% confidence interval, 1.0-9.4). In the rectum the relative risk was only 0.3 (90% confidence interval, 0.2-0.6) in both sexes. The results suggest a relative increased risk of developing right-sided colon cancer after cholecystectomy in women. However, they only partially support the hypothesis that prior cholecystectomy increases the relative risk of developing colorectal cancer in view of the data relating to the rectum.

Aged↗
PubMed1983

[Cholecystectomy and colorectal adenocarcinoma].

The relative risk of developing colorectal cancer after cholecystectomy was investigated retrospectively in 124 patients with colorectal cancer, 17 patients of which had undergone previous cholecystectomy. Another 124 patients without colorectal cancer were matched for sex and age; 19 patients of which had undergone previous cholecystectomy. Disregarding sex and cancer location the relative risk was 0.87 with a 90% confidential interval from 0.43 to 1.73. On the other hand considering cancer location the relative risk of suffering right-sided hemicolon cancer was 7 with a 90% confidential interval from 1.12 to 155.46 (P less than 0.05). The hypothesis that cholecystectomy increases the risk of suffering right-sided hemicolon adenocarcinoma however requires further evaluation.

Adenocarcinoma↗
PubMed1982

[Ursodeoxycholic acid in the treatment of gallbladder lithiasis].

22 patients with radiolucid stones and functioning gallbladder were grouped to establish ursodeoxycholic acid efficacy (i.e. gallstones dissolution) and innocuousness for gallbladder lithiasis. Methodological aspects were detailed, the dose determined (8 and 10 mg/k/d.) and the patients evaluated after a six months' treatment. 11 patients received "day-time" doses and the other 11 "overnight" dose. Only 7 subjects turned out to be evaluated for the study of biliary lipids, to the other 15 the development of their gallstones was followed up. Successful gallstone dissolution was achieved in 8 patients (53,3%), 2 reduced size and number. 5 out of these 8 patients received "day-time" doses and the other 3 "overnight" doses. From an attendance point of view, we do not consider biliary lipids study (bile cholesterol saturation rate) to be necessary.

Cholelithiasis↗
PubMed1981

[Hepatotoxicity of the ursodeoxycholic acid in hamsters. Evaluation by electronic microscopy].

To investigate ursodeoxycholic acid (Urso) action on liver histology, 30 male hamsters were allocated to 2 groups of 15 animals each; one group was treated with Urso, and the other one acted as control. Thirty days later, a light and electron microscopy study of the liver of all the animals was performed. All the group receiving Urso acid revealed minimal changes consisting in hepatocytic nuclear vacuolization around the centrelobulilla area; the vacuoles were homogeneous and contained a pale basofilic material. Neither inflammatory lesions nor hepatic cell necrosis was observed. Electron microscopy showed folding of the nuclear membrane corresponding to vacuoles observed under light microscopy. Further studies must be carried out to make clear the meaning of our findings and to confirm or otherwise rectify Urso inocuity on the liver of hamsters.

Animals↗
PubMed1979

[Biliary lipids and the cholesterol saturation rate in relation to lecithin administration by oral route].

Lecithin is, at present, a contradictory drug to increase the solubility degree of bile cholesterol. Our main purpose in this work was to study the lipidic bile composition of gallstone patients under lecithin treatment, in order to value its action on biliary lipids and cholesterol saturation rate. Men and women with gallstones and radiologically functioning gallbladder were included. They were divided into 2 groups: "A", including 12 patients and "B", 13. In both groups, percentage values of cholesterol, phospholipids, total bile acids and cholesterol saturation rate were determined, before and after the administration of lecithin, everyday during a period of 30 years, 8 grams on group "A" and 2 grams placebo, on group "B". No significant differences were found in the studied samples. Before and after the administration of 8 grams of lecithin orally. Total bile acids: 67--78 +/- 4,42, 72,07 +/- 4,61 p greater than 0,05; cholesterol; 15,88 +/- 2,29, 1689 +/- 2,87 p greater than 0,05; phospholipids 16,25 +/- 3,10, 12,04 +/- 2,29 p greater than 0,05; cholesterol saturation rate; 1,70 +/- 0,24, 2,10 +/- 0,36 p greater than 0,05. It is concluded that lecithin orally administered on patients with the established characteristics and diet and the used methodology results in a useless treatment to increase the solubility of bile cholesterol.

Administration, Oral↗
PubMed1978

[Gallbladder calculi: cholesterol concentration and its radiologic correlates].

Cholesterol concentration in the gallstones of 84 patients obtained by surgery is studied and radiologic correlation of the stones (lucency and opaqueness) is established with relation to cholesterol concentration. We conclude that 70% of gallstones in our population, contain greater than or equal to 80% of cholesterol and the radiographic appearance of stones in functioning gallbladder is a good method to predict cholesterol content in gallstones.

Adult↗
PubMed1978

[Bile lipid composition of cholecystectomized patients during fasting and in postprandial periods].

Fasting state, 1 and 3 hours postprandial biliary lipid periods are studied in 19 cholecystectomized gallstone patients. Methodological items togeher with the characteristics of the kind of diet: normocaloric; lipids, 15% (50% of which are obtained from animals); proteins, 25%; and carbohydrates, 60% are established. It is concluded that biliary lipids are not quantitatively modified in the subjects on established diet respect fasting, 1 and 3 hours postprandial periods, particularly pointing out that the biliary cholesterol saturation rate remains unchanged--supersaturated--for fasting state, as well as for postprandial periods. We believe that the lack of observable changes may be in relation with the characteristics of the employed diet, which is usually suggested to people suffering from cholecystopathies in Argentina.

Bile↗