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Biomedical subjects

G Fatati

Publications and source records attributed to G Fatati.

18 recordsLinked to original sources
PubMed2005

Use of insulin glargine in patients with hyperglycaemia receiving artificial nutrition.

The purpose of this study was to verify whether it is possible to use insulin glargine (Lantus) subcutaneously in patients receiving artificial nutrition (AN) and if the analogue is capable of obtaining and maintaining good glycaemic control without inducing hypoglycaemia. The sample considers 25 patients receiving AN, diagnosed diabetics and non-diabetics, who had previously been prescribed traditional insulin therapy. All were to be given subcutaneous insulin glargine at a dosage equal to the average of insulin/day administered in the preceding days spent receiving AN. Twenty-five consecutive patients, not stratified in any way, were judged eligible in the last six months of 2004 and first two months of 2005. Four out of these 25 could not be evaluated, either because they did not begin or complete the treatment with Lantus (3/4) or because the proper number of glycaemic tests were not carried out (1/4); 21/25 patients, 84% of the sample with a mean age of 68.7 years (range 46-91 years), finished the study and could be evaluated. The mean glycaemic values after treatment with glargine were already better on the second day, and on the seventh day the difference was statistically significant. No hypoglycaemia requiring medical intervention occurred. This study confirms the possibility of using insulin glargine in patients receiving AN with hyperglycaemia regardless of the type of nutrition and whether or not the patient is diabetic.

Aged↗
PubMed2005

Continuous care in the treatment of obesity: an observational multicentre study.

OBJECTIVES: To investigate weight loss and reasons for attrition in obese patients on long-term continuous care. DESIGN: Observational study with 36 months of follow-up. Setting. Fifteen Italian obesity centres applying a continuous care model of medical treatment. SUBJECTS: One thousand treatment-seeking obese subjects (785 females, median age 45.1 years, median BMI 37.4 kg m(-2)). Weight loss expectations were systematically recorded at baseline. INTERVENTIONS: An initial intensive treatment period (3-6 months) was followed by a less intensive continuous care (a follow-up control every 2-4 months). Main outcome measures. Attrition, reasons for treatment interruption and BMI change. Data were recorded by telephone interview in dropouts. RESULTS: Only 157 patients (15.7%) were in continuous treatment at 36 months. The main reasons of attrition were logistics, unsatisfactory results and lack of motivation. The only basal predictor for continuous care was lower Expected One-Year BMI Loss (P = 0.016). The probability of dropout increased systematically for any 5% expected BMI loss (Hazard ratio, 1.05; 96% confidence interval, 1.01-1.09). The mean percentage weight loss was greater in continuers (5.2% vs. 3.0% in dropouts; P = 0.016). However, the dropouts satisfied with the results or confident to lose additional weight without professional help reported a mean weight loss of 9.6% and 6.5% respectively. DISCUSSION: Continuous care produces long-term weight loss only in a subgroup of obese patients seeking treatment in medical centres. The finding that subgroups of dropouts report long-term weight loss has implication for the treatment of obesity.

Adult↗
PubMed2001

Circadian rhythm of hunger sensation in obese patients: effects of a short-term, moderately hypocaloric diet with a substitutive meal.

This investigation deals with the circadian rhythm (CR) of hunger sensation (HS) in obese patients before and after a four-week, moderately hypocaloric diet with a substitutive meal. The study was performed on 25 non-diabetic obese patients (5 males and 20 females, mean age: 39.7 +/- 7, mean BMI: 27.9 1.4 Kg/m2), whose obesity was not associated with impaired glucose tolerance (IGT), binge eating, nor endocrine diseases. Their daily HS profile (orexigram) was analysed chronobiometrically. The moderately hypocaloric diet with a substitutive meal reduced the daily HS by about 10% by the fourth week. This reduction was apparently due to a tonic and amplitude modulation of the HS CR and was not accompanied by its disruption. No conclusions, however, could be drawn with regard to its orectic and clinical effects beyond four weeks.

Adult↗
PubMed2000

Diffuse idiopathic skeletal hyperostosis in diabetes mellitus, impaired glucose tolerance and obesity.

BACKGROUND: Diffuse idiopathic skeletal hyperostosis (DISH) is a rheumatic disease characterized by a significant association with metabolic alterations, such as an impaired lipidic profile. METHODS: One-hundred-thirty consecutive patients and 40 normal subjects were studied. The patients were affected by type 1 and type 2 diabetes mellitus, impaired glucose tolerance and obesity. The diagnosis of DISH was performed by clinical examination and X-ray study of the thoracolumbar spine. The determination of total cholesterol, triglycerides, HLD-cholesterol and LDL-cholesterol was realized by routine biochemical methods; an oral glucose tolerance test was performed in order to determine the levels of C-peptide and blood glucose. RESULTS: We demonstrate a high incidence of the disease in a cohort of patients affected by overt and non-overt diabetes mellitus (T1DM and T2DM) as well as in obese subjects and a correlation between this disorder and hypertryglyceridemia (T1DM, obese-T2DM and obese patients), hypo-HDL-cholesterolemia (obese-T2DM, non-obese-T2DM and obese patients) and hyper-LDL-cholesterolemia (obese patients). In obese-T2DM patients, as well as in obese patients, we observed 40% of DISH, in non obese-T2DM patients the presence of DISH was 30%, while in T1DM patients and impaired glucose tolerance 26.6% and 22.2, respectively. However, a correlation between DISH and the relative hyperinsulinemia in obese patients during an oral glucose tolerance test is not documented. CONCLUSIONS: Our study confirms the prevalence of DISH in diabetes mellitus and obesity, the association with an impaired lipidic profile and the low percentage of symptomatic patients.

Adult↗
PubMed1996

Hunger sensation in patients with compensated and and uncompensated type 1 and type 2 diabetes mellitus.

OBJECTIVE: Diabetic patients (DP) refer increased hunger sensation (HS) when hyperglycemic but not yet ketogenic. As HS shows a within-day (ultradian cyclicity) and intra-day (circadian cyclicity) repetitivity, its recursive pattern was investigated in patients with type 1 and type 2 diabetes mellitus (DM), in compensated and uncompensated metabolic stage. METHOD: HS was approached in its cyclic structure by means of spectral analysis (SA), and in its circadian rhythmicity by means of Single Cosinor analysis (SCA), applied to self-rated scores of HS given every 30 min to their HS (orexigram) by DP. RESULTS: Exaggerated periprandial, interprandial, and/or nocturnal peaks of HS were seen in the orexigram of both the type I and type II DP. Specific alterations in HS periodogram were detected, structurally denoting a relative prevalence of the ultradian components along with the deamplification and loss of the circadian harmonics. DISCUSSION: The increase of HS (hyperorexia) in nonketotic DM may be formally attributed to a mechanism of frequency multiplication and amplitude demodulation in the multifrequency bioperiodic structure which physiologically regulates the recursive pattern to the daily HS in human beings.

Adult↗
PubMed1991

A randomized trial of alternating chemotherapy versus best supportive care in advanced non-small-cell lung cancer.

From April 1985 to September 1988, 128 patients with advanced non-small-cell lung cancer (NSCLC) were enrolled in a prospective randomized trial evaluating chemotherapy (arm A) versus best supportive care (arm B). Chemotherapy consisted of cyclophosphamide 500 mg/m2 intravenously (IV) day 1, epirubicin 50 mg/m2 IV day 1, and cisplatin 80 mg/m2 IV day 1 (CE'P regimen) alternating every 4 weeks with methotrexate 30 mg/m2 IV day 1, etoposide 200 mg/m2 IV day 1, and lomustine (CCNU) 70 mg/m2 orally day 1 (MEC' regimen) until progression. Of the 123 patients (62 treated and 61 controls) eligible for survival, 115 were fully evaluable for response (58 treated and 57 controls). Response rates were 21% partial response, 53% stable disease, and 26% progressive disease in arm A, and 47% stable disease and 53% progressive disease in arm B. Median survival was 34.3 weeks (range, 4.3 to 218.6+ weeks) in arm A versus 21.1 weeks (range, 4.3 to 188.6 weeks) in arm B; the difference was not significant at P = .153 (Mantel-Cox). Subgroups of patients retrospectively analyzed by age, performance status, stage M0/M1, and weight loss or not showed no significant difference in survival. Poor-risk patients (at least two of the following: poor performance status, stage M1, weight loss) of arm A survived significantly longer than poor-risk patients of arm B (23.6 weeks v 12.4 weeks, Mantel-Cox P = .008); a significant difference in survival was also observed between nonsquamous cell patients of arm A and those of arm B (median survival, 38.6 weeks v 16.7 weeks; Mantel-Cox P = .041). Toxicity on the chemotherapy arm was hematologic (World Health Organization [WHO] grade greater than 3) in 12% of CE'P and in 13% of MEC' courses and gastroenteric (WHO grade greater than 3) in 24% of CE'P courses and in 8% of MEC' courses. Our alternating treatment was not significantly superior to supportive care. It is likely that certain subgroups of the NSCLC category may have an advantage with chemotherapy.

Adult↗
PubMed1991

[Obesity among patients admitted to a medical department at the Terni Hospital].

The Authors report the results of a study intended to asses the prevalence of obesity in Terni's medical department. Body mass index (BMI) was used as a measure of obesity: it can easily be calculated from weight and height (W/H2) for any individual. A sample of 1195 patients (569 males and 626 females) was studied; obesity was found in 30% of the females and in 10% of the males.

Female↗
PubMed1989

Phase II trial with alternating two drug schedules, CAP/MEC', for advanced (stage III Mo/M1) non-small-cell lung cancer.

Sixty-eight evaluable patients with advanced squamous cell carcinoma (48), large cell carcinoma (2) and adenocarcinoma (18) of the lung were treated with a six-drug regimen delivering two monthly alternated combinations. The combinations were cisplatin, adriamycin and cyclophosphamide (CAP) and methotrexate, etoposide and CCNU (MEC'). Following a minimum of two courses, the overall response rate was 22% (confidence limits, 12% to 32%) (15/68, 2 complete responses and 13 partial responses); 47% (32/68) had stable disease and 31% (21/68) had progressive disease. The responses lasted a median of 3 months (range, 1-15 months). The actuarial median survival was 11 months in responsive patients, 10 months in stable disease patients, and 5 months in progressive patients. The overall median survival obtained was 9 months (range, 2-28+ months). Toxicity was minimal, and subjective tolerance of the treatment appeared good. However, this alternating program did not improve response rate or survival.

Actuarial Analysis↗
PubMed1988

Non small cell lung cancer (NSCLC). A prospective randomized trial with alternating chemotherapy CEP/MEC' versus no treatment.

From April 1985 to September 1987, 92 patients with advanced NSCLC were randomized to receive cytotoxic chemotherapy, Arm A (treated), or supportive care, Arm B (control). Chemotherapy consisted of the CEP combination (cyclophosphamide 500 mg/m2 i.v. day 1; epirubicin 50 mg/m2 i.v. day 1; cisplatin 80 mg/m2 i.v. day 1) alternated every 4 weeks with the MEC' combination (methotrexate 30 mg/m2 i.v. day 1; etoposide 200 mg/m2 i.v. day 1; CCNU 70 mg/m2 per os, day 1) until progression. Eight-nine patients (44 treated and 45 controls) were eligible for survival and 77 evaluable for response (38 treated and 39 controls). Response rate was: in Arm A, 8/38 (21%) partial response, 20/38 (53%) stable disease and 10/38 (26%) progressive disease; in Arm B, 18/39 (46%) stable disease and 21/39 (54%) progressive disease. Median time to progression was 4 months (range = 1-14) for treated and 2 months (range = 1-9) for controls (P = 0.001). Median survival was 8.5 months (range = 1+ to 25) for Arm A versus 5 months (range = 1+ to 28+) for Arm B; this difference was not statistically significant (Breslow test: chi-square = 2.75, P = 0.097; Mantel-Cox: chi-square = 0.32, P = 0.56). Treatment related toxicity was gastrointestinal WHO grade 3 in 22/102 (22%) CEP courses and in 10/91 (11%) MEC' courses respectively. Other observed side-effects were not clinically important. From these data our treatment was not clearly superior to supportive care in prolonging survival. This suggests the need for the inclusion of a control group in future chemotherapeutic trials of NSCLC.

Adult↗
PubMed1984

[Beta thalassemia: motivation for screening in Terni].

There are no definitive data on the frequency of beta-thalassaemia in the Province of Terni; a mass screening programme has not been carried out. Preliminary studies confirm that there is a strong incidence of beta-thalassaemia heterozygotes. A theory can be put forward for the presence of beta-thalassaemia trait, based on the notion of the multicentric genesis of the disorder: the malaria may have been the dominant selective factor.

Heterozygote↗
PubMed1983

5-Fluorouracil, vincristine and hydroxyurea combination chemotherapy in metastatic colorectal cancer.

Twenty consecutive patients who had biopsy proven metastatic colorectal cancer were treated with combination chemotherapy. The drug regimen (FVH), in a 4 week cycle, consisted of 5-fluorouracil (600 mg/m2 i.v. on days 1, 8, 15 and 22), vincristine (1.4 mg/m2 i.v. on day 4), and hydroxyurea (2400 mg/m2 p.o. on days 3, 10, 17 and 24). Three of the 18 evaluable patients achieved an objective tumor remission (2 CR and 1 PR) and 15 patients had stable disease. The overall response rate to FVH was therefore not superior to that achieved in patients who received 5-fluorouracil alone, and the overall survival in this study was comparable to that of other studies involving patients with metastatic colorectal cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1980

[Bone scintiscanning in the diagnosis and follow-up of breast carcinoma].

Bone scans with Tc + 99m phosphate were performed in 87 patients with histological diagnosis of breast cancer, in order to evaluate whether this technique was suitable in detecting small metastasis both at first staging and in follow-up. The scans were considered as: a) "malignant", when an isotope uptake in usually inactive sites and/or an increased uptake in normally active areas were demonstrated; b) "equivocal", when the uptake in normally inactive and/or in normally active sites was only moderately increased; c) "benign", when only slight uptake increase in normally active structures was detectable. The scans have been carried out before or soon after mastectomy (early scans), and repeated at 6 month intervals (N+ patients and/or malignant or equivocal scans) or at 12 month intervals. A significantly greater incidence of malignant scans was observed in stages 2 and 3 as compared to stage 1, and in stage 4 as compared to all the other stages, as well as in premenopause versus postmenopause patients.

Adult↗
PubMed1979

Combination chemotherapy with 5-fluorouracil and methyl-CCNU for the treatment of advanced gastrointestinal cancer.

Sixteen patients with advanced gastrointestinal cancer (colorectal 12/16, gastric 4/16) were treated with a combination of 5-fluorouracil (5-FU) plus 1-(2-chlorethyl)-3(4-methyl-cycloexyl)-1-nitrosourea (Me-CCNU). The therapeutic program consisted of orally administered Me-CCNU (140 mg/m2) and intravenous 5-FU (9.5 mg/kg by bolus injection for 5 days). The cycles were repeated at 6-week intervals. At the beginning of the therapy, 11/16 patients were in performance status (PS) 0-1 and 5 patients in PS 2-3. Eight patients developed early progressive disease between the 1st and 2nd course of therapy. Only a minor tumor response was observed in the remaining 50% of the patients. However, the patients with stabilized disease lived longer (11.8 months) than non-responders (3.5 months).

Adult↗
PubMedDate not supplied

[Artificial nutrition in the patient with hyperglycemia].

The stress of critical illness evokes insulin resistance and hyperglycemia. Artificial nutrition is commonly considered one of the main causes of hyperglycemia in hospitalized patients. Patients with newly diagnosed hyperglycemia had a significantly higher mortality rate and a lower functional outcome than patients with a known history of diabetes or normoglycemia Intensive insulin treatment to normalize blood glucose during feeding has been shown to improve morbidity and mortality in patients in intensive care. Insulin glargine may contribute to improving the glycemic values in patients receiving artificial nutrition with hyperglycemia.

Critical Care↗
PubMedDate not supplied

Osteoporosis prevention: a reasoned examination of food habits and physical activities in a schoolchildren population in central Italy.

OBJECTIVE: The dietary intake of calcium is fundamental for prevention of osteoporosis, especially in the first three decade of age to gain a valid peak bone mass; moreover physical activity is important for the same reason. The objective of our research is to examine the food habits and the way to practice sport in a homogenous population of schoolchildren. MATERIALS AND METHODS: Data were collected by an original questionnaire in 500 schoolchildren (238 males, 262 females, 9-12 yrs) living in the centre of Italy. RESULTS: Data show that the calcium intake decreases while the age increases. According to the recommended daily calcium dose, the percentages of insufficient calcium intake were 21% in the 6 years old group, 35% in the 7 to 10 years old group and 52.5% in the 11 to 14 years old group. Milk and dairy products cover 57% of the calcium needs (17% and 40% respectively), water covers 24% and the other foodstuffs 19%; moreover most children (43.5%) practice non competitive sports with a preference (58.3%) for no-weightbearing sports (mainly cycling) over weightbearing sports (mainly football). CONCLUSIONS. This survey suggests that a high percentage of young people do not take the recommended daily dose of calcium (especially interesting that becoming older with consequent lower parental control over the diet, the higher the incidence of poor calcium intake increases), then it would be recommendable to establish a national health program promoting appropriate physical exercise plus a correct calcium intake as early as the primary school.

Adolescent↗
PubMedDate not supplied

Insulin glargine in patients with severe hepato-gastroenterology diseases and hyperglycemia receiving parenteral nutrition.

OBJECTIVE: The aim of this nonrandomized observational study is to verify and confirm whether it is possible to use insulin glargine (Lantus) subcutaneously in patients receiving parenteral nutrition (PN) and whether the analogue is capable of obtaining and maintaining good glycemic control without inducing hypoglycemia. MATERIALS AND METHODS: The sample is made up of 25 patients with severe hepato-gastroenterology diseases receiving parenteral nutrition, diagnosed diabetics and non-diabetics, who had previously been prescribed traditional insulin therapy. All were to be given subcutaneous insulin glargine at a dosage equal to the average of insulin/day administered in the preceding days spent receiving PN. RESULTS: Twenty-five consecutive patients, not stratified in any way, were judged eligible in the last six months of 2004 and first eight months of 2005. Four out of these 25 cannot be evaluated, either because (2/4) they did not begin or complete the treatment with Lantus or because the proper number of glycemic tests were not done (2/4); 21/25 patients, 84% of the sample with a mean age of 65.9 years (range 46-93 yr), finished the study and can be evaluated. The mean glycemic values after treatment with glargine were already better on the second day, and on the seventh day the difference was statistically significant. No hypoglycemias occurred which required medical intervention. CONCLUSIONS: This study confirms the possibility of using insulin glargine in patients receiving parenteral nutrition with hyperglycemia diagnosed diabetics or not diabetics.

Aged↗