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Biomedical subjects

F Caputo

Publications and source records attributed to F Caputo.

At least 37 records · Page 2Linked to original sources
PubMed1999

Nutritional status and body fluid distribution in chronic alcoholics compared with controls.

BACKGROUND: At present few data are available on the total body water (TBW) content and in particular on the distribution of water in the intra- and extracellular compartments (ICW and ECW) of alcoholics. The aim of this study was to evaluate TBW, ICW, and ECW in chronic alcoholic patients. METHODS: Thirty-six alcoholics meeting DSM-III-R criteria for diagnosis (20 men, 16 women; body mass index [BMI] 22.3+/-2.57 kg/m2) were enrolled. Fifty-four healthy social drinkers (31 men, 23 women; BMI 23.7+/-1.68 kg/m2) matched for age and height were used as controls. Systolic and diastolic blood pressure was measured for all cases. All patients were assessed using specific anthropometric measurements. The waist-to-hip ratio (WHR) was used as an indicator of body fat distribution. TBW was measured by isotopic dilution by giving 100 microCi of tritiated water. ICW and ECW were assessed by multifrequence bioelectric impedance analysis (BIA). Basal metabolic rate (BMR) was measured by indirect calorimetry. RESULTS: Body weight was lower in the alcoholics than in the controls (61.9+/-5.5 kg vs. 65.8+/-5.2 kg;p < 0.01), essentially due to a reduction in fat mass. Significantly higher WHR values were found in both male (p < 0.001) and female (p < 0.001) alcoholics than in healthy subjects. A higher ECW/TBW ratio was found in the alcoholics compared with the controls, both as a whole (0.53+/-0.04 vs. 0.41+/-0.03; p < 0.0001) and separated by gender (p < 0.001). CONCLUSIONS: The increased ECW could derive from an increase in cellular permeability related to endothelial damage linked to the vasoconstriction present in the alcoholics and/or to a direct toxic effect of ethanol on cellular membranes. In addition, because the high ECW volumes correlated positively with WHR in the alcoholics, a potential association of these two factors in determining an increased risk of liver disease, hypertension, and cardiovascular disease may exist. Finally, the lower TBW characteristic of women may be one of the reasons for the observed greater rate of toxic effects of ethanol that occur in women.

Adult↗
PubMed1998

Gamma-hydroxybutyric acid in the treatment of alcoholism: dosage fractioning utility in non-responder alcoholic patients.

Gamma-hydroxybutyric acid (GHB) has recently been introduced in clinical practice for alcoholism management, due to its utility in inducing abstinence from alcohol. In the present study we investigated the usefulness of greater dosage fractioning of GHB in non-responder alcoholics to the usual three administrations per day. A total of 154 alcoholics were admitted to the study and were treated with GHB (50 mg/Kg orally administered three times per day) for 8 weeks (phase 1); the patients who continued to drink alcohol in phase 1 were administered the same dose of GHB divided into six times per day for another 8 weeks (phase 2). Of the 154 patients, 115 completed phase 1; 78 (67.8%) of these began and maintained abstinence (group A) while 37 subjects (32.2%) continued to drink alcohol (group B) showing a craving significantly higher than group A at the end of phase 1 (P < 0.001); in these patients the major fractioning of the drug in phase 2 caused a significant reduction in craving (P < 0.005) and 26 (70.2%) began and maintained abstinence. Moreover no significant differences in final craving score between group A and B was observed. Within the limits of an open study, our data show that non-responder subjects to the conventional fractioning of GHB seem to benefit from the greater fractioning of the drug and seem to indicate the need for a slow-release form of GHB with a prolonged action.

Adult↗
PubMed1998

Three months of abstinence from alcohol normalizes energy expenditure and substrate oxidation in alcoholics: a longitudinal study.

OBJECTIVE: The aim of this study was to evaluate the energy expenditure, substrate oxidation, and body composition in alcoholics during addiction and after several months of abstinence. METHODS: A total of 32 alcoholics without liver cirrhosis and malabsorption were consecutively recruited. A total of 55 social drinkers, matched for gender and height, were studied as a control group. Anthropometry and bioimpedance analysis were performed to assess body composition, and indirect calorimetry was used to measure basal metabolic rate (BMR) and substrate oxidation. Total abstinence was then achieved in 15 subjects. At 1, 2, 3, and 6 months of abstinence, the metabolic variables and the energy intake were re-examined. RESULTS: At enrollment (T0) alcoholics compared to controls showed a significant decrease in body mass index (22.2+/-2.71 vs 23.6+/-1.3 kg/m2; p < 0.05), fat mass (14.1+/-4.5 vs 16.7+/-3.3 kg; p < 0.01), an increased BMR normalized by fat-free mass (34.5+/-3.7 vs 32.1+/-2.01 kcal/kg/day; p < 0.01), a lower nonprotein respiratory quotient (npRQ: 0.76+/-0.03 vs 0.83+/-0.03; p < 0.001), with a consequently higher lipid oxidation (0.08+/-0.02 vs 0.04+/-0.02 g/min; p < 0.01), and a lower carbohydrate oxidation (0.05+/-0.02 vs 0.10+/-0.03 g/min; p < 0.01). Although at 1 and 2 months of abstinence the metabolic parameters had improved, only after 3 months of abstinence did alcoholics show values of body mass index (23.2+/-2.6 kg/ m2), fat mass (17.0+/-5.34 kg), BMR/fat-free mass (33.1+/-2.78 kcal/kg/day), npRQ (0.82+/-0.02), lipid oxidation (0.05+/-0.03 g/min) and carbohydrate oxidation (0.11+/-0.04 g/min) comparable to those of controls; these values remained constant at 6 months. CONCLUSION: Three months of abstinence from alcohol could represent the minimum time necessary to obtain a normalization of the metabolic variables considered and of the nutritional status for these patients, probably related to a regression of the functional alterations of the microsomal ethanol oxidizing system and of mitochondria secondary to chronic ethanol abuse.

Adult↗
PubMed1998

[Primitive adenocarcinoma of the duodenum. Description of two clinical cases].

Two cases of a primitive adenocarcinoma of the duodenum are presented. Both cancers were localized near the papilla. Duodenocephalopancreatectomy was the surgical treatment for each patient. One patient died of myocardial infarction eight months after surgery, without any sign of recurrence of the cancer; the other is in good health three months after surgery. The rarity of such a tumor is underlined: in 44 papers published in various journals from 1971 to 1993, 88 cases of primitive adenocarcinoma of the duodenum were examined; the average number of cases per author was two. Between 1980 and 1993, an Italian multicenter study carried out in 36 hospital and university centers, showed only 89 cases of primitive duodenal adenocarcinoma.

English Abstract↗
PubMed1998

Plasma (total and ionized), erythrocyte and platelet magnesium levels in renal transplant recipients during cyclosporine and/or azathioprine treatment.

We evaluated total and ionized plasma magnesium levels, and erythrocyte and platelet magnesium concentrations from two groups of renal transplant recipients treated either with cyclosporine, azathioprine and prednisolone (group CAP, n = 8) or with azathioprine and prednisolone (group AP, n = 13), and in a group of age- and sex-matched healthy subjects (n = 10). Reduced plasma (total and ionized), erythrocyte and platelet magnesium concentrations were found in both CAP and AP groups with respect to controls (CAP: total plasma Mg median 0.61 vs 0.86 mmol/L, p < 0.01, ionized plasma Mg median 0.43 vs 0.58 mmol/L, p < 0.001, erythrocyte Mg median 2.18 vs 2.56 mmol/L, p < 0.05, platelet Mg median 1.75 vs 2.84 mmol/10(8) cells, p < 0.001; AP: total plasma Mg median 0.62 vs 0.86 mmol/L, p < 0.01, ionized plasma Mg median 0.48 vs 0.58 mmol/L, p < 0.001, erythrocyte Mg median 2.30 vs 2.56 mmol/L, p < 0.05, platelet Mg median 1.75 vs 2.84 mumol/10(8) cells, p < 0.001), while no difference was found between the two groups of transplant recipients as regards plasma and intracellular magnesium levels. Magnesium fractional excretion was higher in transplant recipients than in the control group (Mg fractional excretion median AP 18.6 per cent and CAP 12.8 per cent vs controls 3.5 per cent), whereas no difference was found between patients and control subjects for urinary magnesium 24h excretion. Moreover, in the whole group of transplant recipients (n = 21), urinary magnesium showed an inverse correlation with platelet (rs = -0.54, p < 0.05) and ionized plasma magnesium (rs = -0.48, p < 0.05), and time after transplantation showed a negative correlation with platelet magnesium concentrations (rs = -0.73, p < 0.001), and a direct correlation with fractional magnesium excretion (rs = 0.53, p < 0.05). Finally, a direct relationship between platelet magnesium and ionized plasma magnesium was also detected in the whole group of transplant recipients (rs = 0.47, p < 0.05). Both intraplatelet magnesium depletion and ionized plasma magnesium reduction induced by immunosuppressive therapy could be involved in the increased risk from atherosclerotic disease in renal transplant recipients.

Arteriosclerosis↗
PubMed1998

Investigation into the use of alcohol at thermal spas: can a spa represent a place for primary prevention?

Primary prevention is one of the most effective means used nowadays to make the general population aware of most of the problems connected with health, but information campaigns have not yet shown results of alcohol-related problems at thermal spas. The aim of this study was to assess the mean daily alcohol intake (grams/day) in a thermal spa population. The sample was conducted over a 6 month period and consisted of 290 subjects. The mean age was 59.01 years (range 23-89, SD +/-14.20) (150 males and 140 females). All of the subjects underwent a medical examination free of charge and an alcohol case history report. The medical staff working at the spa included two doctors, a biologist, a cardiologist, and a dietician. In the final 176 subjects studied, the mean daily alcohol intake was 32.33 g/day, significantly higher in the males than the females (p < 0.001). The 176 subjects were subsequently divided into three subgroups according to their daily alcohol intake: group A, <40 g/day; group B, 40 to 79 g/day; group C, > or =80 g/day. The number of subjects in group A was significantly greater than in group B and group C (p < 0.001). It is important to emphasize that 33.5% of the subjects studied presented a mean daily alcohol intake of > or =40 g/day and therefore were more exposed to the risk of the onset of alcohol-related problems. In view of these results, thermal spas should thus be considered an additional place in which to identify subjects at risk for problematic use of alcohol and represent an environment in which primary prevention campaigns could be started.

Adult↗
PubMed1998

[Cesarean section in a patient with cerebral ischemic pathology. Spinal anesthesia].

The choice of anaesthesia for Caesarean sections, in patient with recent cerebral ischemic-hemorrhagic injuries, is a big problem. A case is reported of a woman submitted to Caesarean section in spinal anaesthesia who, in the first quarter, suffered an ischemic-hemorrhagic cerebral injury. Spinal anaesthesia was made by hyperbaric bupivacaine 0.5% at 10 mg dose + fentanyl 25 micrograms using 24G Sprotte needle. Spinal anaesthesia guarantees a good neuroendocrine protection to surgical aggression and a good hemodynamic stability. Hypotension prophylaxis by pre-filled is necessary and its treatment with ephedrine must be timely carried out. Risk of post-dural puncture headache, by atraumatic and very thin needles, is negligible. Spinal anaesthesia avoids general anaesthesia which may cause cardiovascular damages due to oro-tracheal intubation leading to possible cerebral damage. Induction-delivery time is more dangerous: the use of alogenate, oppioids, and/or some medicaments which may control the mother's adrenergic response, exhibit the newborn to risks.

Adult↗
PubMed1998

[Rapidity of emergence from anesthesia with sevoflurane or isoflurane].

BACKGROUND: Sevoflurane, a new anesthetic agent recently introduced in Italy, is characterized by a low coefficient of distribution blood/gas that is associated both quick narcosis and fast emergence from anesthesia. Aim of this study is the comparison between two different anesthetic methods in patients submitted to general, gynecological and orthopedical surgical operations. METHODS: Thirty subjects randomized in two groups of fifteen patients each have been studied. In the first group (8 females, 7 males), sevoflurane as maintenance anesthetic was utilized; in the second group (5 females, 10 males), isoflurane was used. The final course of anesthesia were the same for both groups. ECG, FC, NIBP, FiO2, Paw, Spirometry, ETCO2, Fi-Alogenates, ET-Alogenates, MAC were monitored in all patients. In each group of patients the emergence time, extubation time, and dismission from operatory room were compared. Cardiocirculatory performance was evaluated monitoring arterial pressure and cardiac frequency in the same time of intubation and every 5 minutes following until extubation time. RESULTS: The incidence of some postoperatory collateral effects was recorded too. The three emergence times showed a significative difference in favour of patients submitted to sevoflurane narcosis. Both groups of patients showed also appearance of nausea, vomiting and shived in similar way. CONCLUSIONS: On the basis of the results obtained, the conclusion is drawn that sevoflurane is more rapidly eliminated than isoflurane, but both give a good cardiocirculatory performance.

Adult↗
PubMed1997

Chemoembolization versus chemotherapy in elderly patients with unresectable hepatocellular carcinoma and contrast uptake as prognostic factor.

BACKGROUND: Age is considered one of the important contraindications to surgery for hepatocellular carcinoma (HCC) in cirrhosis patients. We therefore evaluated the safety and prevalence of side effects in endoarterial therapy (EAT) in subjects aged over 65 years compared with younger treated patients. METHODS: Thirty-eight patients with HCC aged 65 years and over underwent transcatheter arterial chemoembolization (TACE) (n = 28) or intraarterial chemotherapy (IAC) (n = 10). The survival rate was calculated using Kaplan-Meier's method with respect to a control group consisting of younger treated subjects (44 TACE; 21 IAC) comparable for stage of HCC and severity of the underlying cirrhosis. RESULTS: The comparison between the two groups regarding side effects, procedure-related death, and survival did not show any difference considering the whole EAT procedure. TACE in elderly subjects reached a statistically lower outcome with respect to younger patients (p < .025) but remained statistically superior in survival versus both older and younger patients treated with IAC (p < .05, respectively). Stratifying the patients following the degree of Lipiodol uptake of tumor mass in the three groups (Group I, > 75%; Group II, 50-75%; Group III, < 50%), in the young subjects a higher probability of survival was strictly correlated to a degree of uptake over 75%, while in the elderly patients an impregnation over 50% was sufficient to obtain a satisfactory survival curve. CONCLUSIONS: EAT is a reliable and safe therapeutic option for the geriatric patient with HCC, with TACE showing a better efficacy than IAC, requiring a lesser degree of Lipiodol uptake to achieve an improvement of outcome.

Adult↗
PubMed1997

Splenic function and alcohol addiction.

Severe hyposplenism has been recently documented in alcoholic liver disease, and it has been suggested that alcohol itself is important in the derangement of splenic function, despite a lack of evidence of a direct toxic effect of alcohol on the spleen. The aim of the present study was to assess splenic function in alcoholic patients without severe liver disease and to correlate these data with the degree and duration of alcohol intake. Fifty-two alcoholics, 31 subjects with current alcohol abuse (group A)-13 abstinent from alcohol for 1 to 6 months (group B) and B abstinent from alcohol for 6 months to several years (group C)- and 26 healthy social drinkers were studied. Splenic function was assessed by counting the percentage of pitted red cells. An in vitro experiment was performed to verify whether the presence of pitted red cells could be due to an effect of alcohol on red cell morphology. The percentage of pitted red cells in subjects from group A was significantly higher than in subjects from group B (p < 0.01), from group C (p < 0.005), and from controls (p < 0.001). There was no significant difference between group B, group C, and controls. Ten subjects from group A and 1 from group B and no subject from group C had evidence of splenic hypofunction. There was no significant correlation between the percentage of pitted red cells and daily alcohol intake or years of alcohol addiction. In conclusion, our study shows that, in patients with alcoholism but without any severe liver damage, a significant but slight increase in pitted red cells is present. Further studies are needed to clarify whether this is due to a mild form of splenic hypofunction or merely indicates erythrocyte membrane alterations.

Adult↗
PubMed1996

An open multicentric study evaluating 4-hydroxybutyric acid sodium salt in the medium-term treatment of 179 alcohol dependent subjects. GHB Study Group.

We report the results of an "open' multicentre study evaluating the use, tolerability and therapeutic efficacy of the sodium salt of 4-hydroxybutyric acid (GHB) for the medium-term treatment of withdrawal symptoms in 179 patients with alcohol dependence followed up as outpatients. The follow-up of patients was 6 and 12 months after drug discontinuation. Following a daily oral administration of 50 mg/kg for approximately 6 months, no serious systemic or single-organ consequences leading to drug discontinuation were reported, and tolerability was fair in all patients. Eleven subjects (10.1%) showed craving for the drug and voluntarily increased their doses (6-7 times the recommended levels). GHB led to complete abstinence during drug administration in 78.0% of the patients. A significant reduction of compulsive desire ("craving') was observed in parallel, as deduced from evaluation of a specific questionnaire, the Alcohol Craving Scale. At follow-up examination, 43 of the treated subjects remained abstinent at 6 months, and 30 subjects were abstinent for 1 year after drug discontinuation.

Adolescent↗
PubMed1996

HDL subfractions distribution in renal transplant recipients: lack of evidence of a reduction of HDL2 particles.

Since the high rate of cardiovascular disease in renal transplant recipients, alterations of lipoprotein profile in such patients were extensively evaluated, but the HDL subclass profile was not completely clarified. Renal transplant recipients usually show normal to high plasma levels of HDL cholesterol, even if some investigations suggested a persistence of low HDL2 levels: this was not useful in terms of cardiovascular protection. We designed this study in order to evaluate HDL subfractions distribution in renal transplant recipients. We studied 55 renal transplant recipients, treated with prednisone, azathioprine and/or cyclosporine, and 34 healthy normolipidemics as controls. In all subjects cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, apolipoproteins A-I and B levels and HDL subfractions, as determined by nondenaturing polyacrylamide gradient gel electrophoresis, were assayed. Renal transplant recipients had cholesterol, triglycerides, LDL cholesterol and apolipoproteins A-I and B levels significantly higher than controls; HDL cholesterol levels were slightly, but not significantly, increased in comparison with controls (respectively 51.1 +/- 15.5 and 46.1 +/- 10.8 mg/dl). Multivariate analysis showed that only the time since transplantation was significantly associated with HDL cholesterol levels. When HDL subfractions were analyzed, renal transplant recipients presented significantly lower levels of HDL3a and HDL3b and, in males, higher levels of HDL2b than controls. HDL cholesterol levels were positively correlated with HDL2b levels in both renal transplant recipients and controls, and negatively correlated with HDL3b in controls. In conclusion, in renal transplant recipients, we failed to demonstrate any decrease of HDL2 particles. On the basis of a nonatherogenic HDL profile, we suggest that the increased cardiovascular risk in renal transplant recipients might be accounted for by other risk factors.

Adult↗
PubMed1995

[Effects of cyclosporin A on various indices of cholestasis in kidney transplant recipients].

A cholestatic syndrome has been reported as one of the main side effects of CyA therapy. The aim of the present study was to evaluate frequency and degree of severity of the cholestatic syndrome in a group of patients with renal transplant treated with CyA. In 55 patients we evaluated both clinical: jaundice, pruritus, presence of biliary lithiasis and biochemical parameters: total serum biliary salts (TBS), total bilirubin (TB), alkaline phosphatase (AP), gammaglutamyl transpeptidase (GGT), transaminase (AST, ALT), cholesterol (CT), triglycerides (TG), HDL-cholesterol (HDL-C) and compared them with a control group matched for sex and age. In the transplant patients significantly higher values of TBS, TB, AP (p < 0.05) were found; 55% of the patients had above mean values of at least one of the classical parameters of liver function and an higher frequency of biliary lithiasis was also found, in the absence of the classical risk factors. However, none of the patients presented severe signs of hepatic disease and to date it has never been necessary to stop treatment. In conclusion, our study shows that the dosage of CyA used at present is quite safe; however, it is necessary to monitor in these patients some parameters of liver function to prevent the minor side effects we observed from progressing into more serious damage.

Adult↗
PubMed1993

Lipoprotein (a) levels in end-stage renal failure and renal transplantation.

Some previous studies have documented an increase in lipoprotein (a) [Lp(a)] levels in renal diseases. Here, we report data in subjects with end-stage renal failure treated with hemodialysis (HD) or with continuous ambulatory peritoneal dialysis (CAPD) and in renal transplant recipients (RTR), compared with a group of normolipidemic controls (C). Lp(a) levels were significantly increased in HD and CAPD patients in comparison with C, while they were only slightly increased in RTR. Both HD and CAPD patients showed Lp(a) levels higher than in RTR, but no difference was found between the subjects of the two dialysis procedures. The prevalence of Lp(a) levels > 25 mg/dl was significantly higher in HD and CAPD patients, but not in RTR, in comparison with C. Moreover, Lp(a) levels did not change after HD. When patients were divided according to their fasting lipid levels in normolipidemics and hyperlipoproteinemics, no difference was found for Lp(a) levels in any group. Mechanisms underlying the increase in Lp(a) levels in these patients are not known. It is possible to suggest an active role of the kidney in the Lp(a) metabolism or that uremic plasma contains some factors affecting Lp(a) metabolism.

Adult↗
PubMed1991

Cocaine in decomposed human remains.

From March 1988 through March 1990, at the Philadelphia Medical Examiner's Office toxicology laboratory, samples from 77 decomposed human bodies were tested for the presence of cocaine, employing gas chromatography/mass spectrometry (GC-MS). The material analyzed included decomposed soft tissue, bloody decomposition fluid, mummified tissue, maggots, and beetle feces. Twenty-two cases (28.6%) were positive for cocaine, many of these cases in states of advanced decomposition. These findings indicate the usefulness of testing decomposed tissue for cocaine in all cases where its presence is suspected. This is contrary to what might be expected, since cocaine is generally labile and rapidly broken down by both enzymatic and nonenzymatic mechanisms.

Animals↗