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Biomedical subjects

F Paolillo

Publications and source records attributed to F Paolillo.

9 recordsLinked to original sources

[The clinical implications of the use of an amino acid mixture without tryptophan in liver cirrhosis].

The ingestion of an amino acid mixture lacking tryptophan causes a rapid fall of plasma tryptophan in healthy subjects. This is because amino acids elicit protein synthesis and endogenous tryptophan is incorporated into new proteins. If protein synthesis is the mechanism through which tryptophan-free solution decrease blood tryptophan, it may be interesting to study tryptophan levels after a tryptophan-free mixture in subjects with impaired protein synthesis. In the present paper we show that in 27 cirrhotics the administration of a tryptophan-free solution caused a fall of total plasma tryptophan that began significantly later than in 14 control subjects, the delay being significantly proportional to the severity of the disease. The difference between control and cirrhotic subjects was due to the bound fraction of plasma tryptophan. The diagnostic and clinical usefulness of our findings are discussed.

Amino Acids

Decrease in plasma tryptophan after a tryptophan-free amino acid solution. A comparison between cirrhotic and control subjects.

In healthy subjects the administration of an amino acid mixture devoid of tryptophan causes a marked decrease of plasma tryptophan. This is because amino acid mixtures induce protein synthesis and tryptophan in blood is incorporated into newly synthesized proteins. We hypothesized that a tryptophan-free mixture could differently affect plasma tryptophan levels in subjects with an impaired protein synthesis such as chronic liver patients. We studied tryptophan levels after a tryptophan-free amino acid solution in controls and cirrhotics fasting 12 hours. Plasma total tryptophan fell to 91% of the initial level 60 minutes after the administration of the diet, to 71% after 120, and to 50% after 210' in controls. In cirrhotics the solution caused a decrease of plasma tryptophan that began significantly later than in controls, the delay being proportional to the severity of the disease. Cirrhotics were subdivided into two groups in accordance to the Pugh modification of the Child-Turcotte criteria. Total plasma tryptophan was 100% of base line levels after 60', 88% after 120', and 65% after 210' in less severe clinical condition; total plasma tryptophan was 102% of base line levels after 60', 98% after 120', and 75% after 210' in more severe clinical condition.

Adult

Liver iron overload and desferrioxamine treatment of porphyria cutanea tarda.

The aim of this paper is to evaluate invasive and non-invasive indices of iron store and compare the effectiveness of different ferrodepletive protocols in 150 patients with porphyria cutanea tarda (PCT). Iron removal was performed either by intensive phlebotomy (22 cases) or slow subcutaneous and high intravenous doses of desferrioxamine (18 and 5 cases, respectively), and several laboratory parameters were studied; among these, oligo-elements and urinary porphyrins (detected by HPLC) were taken into account before and after the treatments. Serum iron, transferrin saturation, ferritin (RIA) and nuclear magnetic resonance results were compared with invasive findings in order to detect the metal deposition in liver tissue (atomic absorption concentration, optic or electron-microscopic detection). Liver iron overload was observed in 95% of cases. Full normalization of the disease took place by all the treatments, even if it required slightly more time in the phlebotomy group. We may conclude that ferrodepletive treatments are highly effective in PCT and, considering the fact that siderosis and liver damage always accompany the disease, these treatments are proposed as first choice in such cases.

Bloodletting

[Perinatal listeriosis. A report of a case with a hydrocephalus outcome].

Perinatal listeriosis is a disease whose incidence has increased constantly in recent years. Like neonatal infection determined by B hemolyticus streptococcus, the disease appears in two forms: the first is the septicaemic form with early onset, the second form is meningoencephalitic with late onset. We describe a case of listeriosis with immediate onset in which, in spite of the prompt therapy and the normality of rachiocentesis, developed a purulent ventriculitis with outcome in hydrocephalus.

Combined Modality Therapy

Carotenoids and liposoluble vitamins in liver cirrhosis.

The role played by carotenoids, retinol and tocopherol in quencing oxidative cellular damage and combatting tumor growth is well documented, but little is known about their activity in human liver cirrhosis (LC), where oxidative damage and tumoral complications are common-place. We investigated 59 patients with LC of different etiology on admission to hospital and compared them with 32 healthy controls, matched for age and sex. Nutritional (cutaneous skinfolds, creatinine-height index) and serum parameters were determined; of these, alpha- and beta-carotene, cryptoxanthin, lycopene, retinol and alpha-tocopherol were detected by an high-performance liquid chromatographic (HPLC) technique, devised in our laboratory, which afforded an accurate and simultaneous resolution of all six compounds. The results point to a significant reduction in almost all the vitamin factors in LC, as well as in total serum lipids. In consequence, the ratio tocopherol/total serum lipids remains almost unchanged: 2.45 +/- 0.08 (m +/- se) in controls and 2.34 +/- 0.16 in patients. The effects of age, sex, nutritional habits, alcohol, malnutrition and the severity of the disease were also evaluated in relation to the vitamin-factor levels. It is suggested that the reduced levels observed in LC patients are due to a number of factors including portal hypertension and lymphatic circulation impairment, and it is concluded that thorough screening and improved diet are beneficial in the follow-up of LC.

Carotenoids

[Trisomy 18 (Edwards syndrome): two case reports].

Edwards (or trisomy 18) syndrome, with a frequency of about 1 over 8000 births, is commonly characterized by a very short survival; those rare cases reported with ages of 12 months or more, always were demonstrated to be chromosomic mosaicisms. Two affected children with completely different outcomes are here described; the first with a classic short-life evolution, in opposition to the second with long survival, the last a good example of all those various biological, psychological and social support interventions in these circumstances, very rare to match with, for this appears to be a trisomy 18 without mosaicism.

Chromosome Aberrations

[Hepatitis B: is the current vaccination policy the correct one everywhere?].

In this study we have tried to examine retrospectively all the babies born to HBsAg + mothers in the past nine years, in order to evaluate which is the real incidence of perinatal transmission of HBsAg, and then if the actual politic to vaccinate only these babies is right and sufficient. The results demonstrate that the perinatal transmission is not a major problem in our country, so we suggest that for improvement of public health is more advised the vaccination of all infants: those born to HBsAg + mothers at the birth, the others in the third month of life.

Adult