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E Finocchiaro

Publications and source records attributed to E Finocchiaro.

7 recordsLinked to original sources
PubMed2006

Prevalence of home artificial nutrition in Italy in 2005: a survey by the Italian Society for Parenteral and Enteral Nutrition (SINPE).

AIM: To determine the prevalence (cases per million inhabitants) of home artificial nutrition (HAN), enteral (HEN) and parenteral (HPN), in Italy, grouped according to administrative regions, patient age and primary disease, and to analyze the impact both of the presence of an HAN regional regulation and of demographic characteristics. METHODS: In April 2005, the Regional Coordinators of the Italian Society for Parenteral and Enteral Nutrition (SINPE) recorded all the ongoing cases of HAN using a structured questionnaire and were asked to estimate the representativeness of the collected sample with respect to the total expected HAN. RESULTS: A total of 6955 cases of HAN (93.5% adults, 6.5% pediatric patients < or = 18 years) were recorded in 16 of the 20 Italian regions (80% of the Italian population; sample representativeness 78%). HAN prevalence 152.6 (83.9% HEN, 16.1% HPN); the HAN range among the regions was: prevalence 28.1-519.8; oncological disease 13.8-75.7%, neurological disease 15.5-79.9%, intestinal failure 1.3-14.0%. An HAN regulation was present in 11 regions. A positive association (P=0.012) was found between the number of years since the regulation was issued and the HAN prevalence, and also between the % neurological patients and the population density (P=0.130) and the % inhabitants > or = 75 years (P=0.040). CONCLUSIONS: The need for HAN regards a great number of patients throughout the country; there are substantial differences between the regions with respect to both the prevalence and the use of HAN in various disease categories. A specific regulation may favor the development of HAN.

Adult↗
PubMed2001

Conformational study of proteins by SAXS and EDXD: the case of trypsin and trypsinogen.

The radius of gyration (Rg) of bovine trypsinogen and beta-trypsin was measured by an energy-dispersive X-ray technique (EDXD) and by small-angle X-ray scattering (SAXS), under different solvent conditions. Both techniques gave superimposable results. The experimental evidence demonstrated that: (1) no structural modifications and/or damage occurred during the data acquisition by EDXD; (2) at pH 4 the active enzyme has one class of chloride binding sites in common with the zymogen, whereas the latter protease shows an additional class able to reverse the effects on Rg induced by chloride at low concentration; and (3) the pH profile of the Rg of both proteases does not resemble at all the pH effect on beta-trypsin activity, a result in line with the finding that the electrical potentials induced by surface charge are small in absolute magnitude and produce no gradient across the active site.

Animals↗
PubMed1999

Safety and factors related to survival after percutaneous endoscopic gastrostomy in ALS. ALS Percutaneous Endoscopic Gastrostomy Study Group.

Percutaneous endoscopic gastrostomy (PEG) has been proposed as symptomatic treatment of dysphagia in patients with ALS. Safety and factors related to survival after PEG were analyzed in 50 consecutive ALS patients. No major acute or long-term complications were observed. Stabilization or increase in weight were observed after PEG. Median survival after PEG was 185 days, with a worse outcome in patients with weight loss > or =10% healthy body weight and forced vital capacity <65%. PEG may be a useful option in the symptomatic treatment of dysphagia in ALS.

Adult↗
PubMed1993

[Trace nutrients in total enteral nutrition: the basal status and longitudinal course].

INTRODUCTION: Previous studies demonstrated deficiencies of selenium and other micronutrients in patients receiving total enteral nutrition (TEN). The content and bioavailability of trace elements in enteral formulas can be suboptimal. MATERIAL AND METHODS: Basal blood levels of some trace elements (copper, iron, selenium, zinc) and vitamins (B12, folic acid) were determined in twenty patients at the beginning of TEN. Vitamin E was measured in 7 patients. Primary diagnosis was cancer (no. = 13) and organic brain syndromes (no. = 7). Commercially available polymeric and oligomeric enteral formulas were used, containing respectively, as a percent of RDA in 1500 kcal, 65-39% of copper, 180-135% of iron, 80-100% of zinc. Selenium was not indicated; determinations in our laboratory gave a content of 78-63% of the minimum recommended intake. Blood levels of copper and zinc (no. = 6), selenium (no. = 5), iron, transferrin and ferritin (no. = 13) were measured after two months of TEN (mean intake of 30 +/- 3 kcal/kg/day). Copper, selenium and zinc were measured with atomic absorption; iron with the complessometric method: vitamin B12 and folic acid with RIA; vitamin E with HPLC. RESULTS: Mean values, expressed as mean +/- SD (range) were: copper: 129 +/- 23 (82-300) micrograms/dl; iron: 37 +/- 18 (16-89) mg/dl; selenium: 53 +/- 20 (22-93) micrograms/dl; zinc: 85 +/- 34 (44-185) micrograms/dl; vitamin B12: 632 +/- 450 (140-1575) pg/ml); vitamin E: 5.4 +/- 1.5 (3.3-7.8) mg/dl; folic acid: 11 +/- 8 (2-20) ng/ml. Values below the lower normal limit were found in 100% (vitamin E), 89% (selenium), 60% (iron), 35% (zinc), 24% (vitamin B12) and 14% (folic acid) of the patients studied. Copper was higher than the upper normal limit in 31% of cases; no data below normal range was found. Mean blood levels of depleted subjects were at the 28%, 43%, 54% and 63% of the mean normal value respectively for iron, selenium, vitamin E and zinc. Blood iron (p < 0.05) and selenium (p < 0.001) were significantly lower in more malnourished patients (weight loss > 20% vs < 20% on usual body weight). After two months of TEN, a reduction of 33% of mean blood selenium was observed in 4 of 5 patients studied. Blood copper and zinc remained stable in 6 subjects with initial normal or higher than normal values. Blood iron increased nonsignificantly, ferritin remained stable, transferrin increased significantly (p < 0.05). No clinical deficiency syndromes were observed. CONCLUSIONS: A careful monitoring of micronutrients during TEN is recommended. Selenium content of enteral formulas, unless supplemented by the producers, seems to be insufficient to maintain the initial blood level in two months of TEN.

Aged↗
PubMed1993

[Percutaneous endoscopic gastrostomy].

Surgical gastrostomies were first performed in the middle of the 19th century and modified during the following years, but the most important technical improvement was percutaneous endoscopic placement (PEG), in 1980 by Ponsky and Gauderer. This technique doesn't require anesthesia and it in possible also in patients with contraindications to surgical gastrostomy. The simple procedure involves a shorter hospitalization, lower risks and reduced costs. Many authors already reported the good results of this new technique, that can be performed on a day-hospital regimen as well. The main indications are head and neck cancers, neurologic diseases involving food intake capacity, cancer cachexia, obstruction of the GI tract when there is enough space for an endoscopic procedure. Every disease that can compromise food intake for a period longer than 60 days can find an indication in placing a percutaneous gastrostomy. The advantage for the patient is a much better psychological tolerance compared with a naso-gastric tube. Also the incidence of mechanical complications of a PEG is much lower. In our experience from October '90 to July '92 we followed 34 patients with PEG, 22 males and 12 females, with mean age of 69 years (range 41-88). We used 9-French tube placed using the pull-method technique. All patients received antibiotic therapy for 5 days. About 12 hours after PEG placement all patients began using the gastrostomy, initially with the administration of electrolyte solutions and later with enteral polymeric formulas. The constant increase led all patients to a 1500 non protein calories daily intake in 3-4 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Enteral nutrition in the elderly].

Elderly is particularly at risk of malnutrition: he is not able to feed himself adequately, it is then important to attain correct intakes using also artificial enteral nutritional techniques (nasogastric tube, gastrostomy, etc.). These techniques may lead to complications (ab ingestis pneumonia, metabolic complications, alvus disorders): the use of artificially nutrition in the elderly must be carefully evaluated. 257 patients (M = 180, F = 77) aged 65 or more, mainly affected by neoplastic diseases (n 195) and by neurological and vascular diseases (n 62). The feeding route were evaluated in this study: 74% by nasogastric tube, 13% by gastrostomy, 11% by jejunostomy. In a group of 55 patients similar concerning clinical and nutritional conditions we evaluated at the beginning of enteral feeding and four months later, caloric/protein intake, body weight and plasmatic albumin. In patients fed by nasogastric tube a mean intake of 1300 +/- 365 Kcal n.p./die, with a protein rate of 58.5 +/- 16.9 g/die was attained; by gastrostomy 1450 +/- 324 Kcal n.p./die and 65.5 +/- 16 g/die; by jejunostomy 1219 +/- 398 Kcal n.p./die and 53.3 +/- 21 g/die. The compliance to enteral nutrition was well in 37% of patients night administration was performed. Clinical complications: nausea and vomiting were observed in 9 patients with nasogastric tube, in 1 patient with gastrostomy and in 3 patients with jejunostomy; diarrhea has been noticed in 6 patients with nasogastric tube and in 1 patient with jejunostomy. Mechanical complications; nasogastric tube (n 189): 35 displacements, 7 breakages, 4 obstructions; pharyngostomy (n 6): 2 displacements and 1 obstruction; gastrostomy (n 33): 3 displacements; jejunostomy (n 29): 2 misplacements.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗