Diagnostic and therapeutic strategies in malignant pleural mesothelioma.
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Biomedical subjects
Publications and source records attributed to G Varela.
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In the present study we evaluated lactose malabsorption (LM) after ingestion of three dairy products in 53 healthy institutionalized elderly people. A preliminary screening with milk (250 ml, 11 g lactose) was carried out to select the LM subjects using the H2 breath test. The effect of consuming an equivalent amount of lactose contained in yogurt and fermented-then-pasteurized milk (FPM) was then assessed in LM subjects. Results indicated that 36% of the elderly population studied was considered as LM and that breath H2 excretion was significantly higher after ingestion of milk than after ingestion of yogurt. This beneficial effect was partially eliminated when FPM was tested. Moreover, breath H2 excretion was significantly higher (p less than 0.05) 3 hours after ingestion of FPM compared to the normal yogurt. These results demonstrate a high prevalence of LM in the elderly and confirm the positive effect of yogurt on lactose absorption, whereas pasteurized yogurt did not cause the same effect.
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Gut epithelial cell autoantibodies have been considered a hallmark of autoimmune enteropathy, a disorder occurring in children with protracted diarrhea of unknown etiology. Four patients (two male and two female) with such autoantibodies were studied. Immunofluorescence analysis showed two different disjunctive staining patterns: complement-fixing apical (three of four) and cytoplasmic (the remaining fourth one), which are shown to be directed against different structures. All three patients positive for complement-fixing apical gut epithelial cell autoantibodies had abnormal T-cell responses in vitro, one of them with an immunoglobulin G2 immunoglobulin deficiency and another with an immunoglobulin A deficiency. An immunoglobulin A deficiency without T-cell alterations was also diagnosed in the cytoplasmic gut epithelial cell autoantibody-positive patient. These findings suggest that different immunologic alterations (either a T-cell abnormality or immunoglobulin deficiency) may favor the appearance of gut epithelial cell autoantibodies (complement-fixing apical or cytoplasmic, respectively). Furthermore, these autoantibodies should not be considered a specific marker of autoimmune enteropathy, because they may not always be associated with such a disease: two patients with apical gut epithelial cell autoantibodies showed no signs of intestinal lesion or diarrhea.
The effect of long-term administration of acetaminophen to rats on the dietary protein utilization was investigated using protein-sufficient and protein-deficient diets. Fat digestibility, food efficiency and some hepatic parameters were also determined. Results showed that there was a significant decrease in the nitrogen metabolic utilization in the protein-sufficient treated animals compared to the untreated group (0.59 +/- 0.03 vs. 0.75 +/- 0.03, p less than 0.001). The protein-deficient diet and the administration of the drug resulted in lower nitrogen metabolic utilization in either of the two metabolic balances (days 4-11 and 36-42). These changes were not accompanied by variations in the nitrogen digestibility coefficient.
The possible relation between the amount and composition of fat in the diet of different regions and provinces in Spain and the mortality caused by different types of cancer is studied. The quantitative information about fat intake comes from a publication entitled "Nutrition Study" (1985) which was performed by our Nutrition Department together with the National Institute of Statistics (INE). The study sample is formed by 23,972 families and is representative of the whole country and of each of the Provinces and Autonomic Communities in it. Each family is surveyed for seven days for the "Family Direct Survey". The dietetic parameters studied have been the following: total energy intake, total lipids, total fat and fatty acids as a percentage of total caloric intake, cooking fat/total fat ratio, vegetable fat, animal fat, fish fat, saturated fatty acids, monounsaturated, polyunsaturated, and cholesterol. These parameters have been correlated with mortality date due to the following tumors: malignant tumors in general, breast, uterine neck, uterus, ovary, prostate, and testicle, in each of the provinces in our country, expressed per 100,000 inhabitants, data which was obtained from the INE publication (1986). Similarly, the corresponding correlations have been carried out between dietetic parameters and breast cancer adjusted mortality rate. From our study we can conclude that there is a statistically significant negative correlation between mortality due to testicle cancer and some dietetic parameters. However, breast, prostate, and ovary neoplasias are only affected by certain parameters. These results agree with those obtained by other authors. No statisticaly significant correlation is found when adjusted rates are used.
We studied the riboflavin intake and biochemical status in a representative sample (20 males and 52 females) of institutionalized elderly people (aged 68-95) living in the Autonomic Community of Madrid. The riboflavin density of the diet was in general higher than the recommended amount, so the quality of the diet, related to riboflavin, can be considered satisfactory, and probably the caloric deficit is the major cause of the low intakes found. We found no correlation between the intake and biochemical status of riboflavin. The elderly with erythrocyte glutathione reductase greater than 1.2 are not those who have lower intakes. The cause of the deficit could be the different malabsorption problems and diseases that affect people as age increases.
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From January 1974 to December 1987, 45 cases of bronchial carcinoid were surgically managed at our Unit, 44 of which were evaluated. All patients but 2 were submitted to fiberoptic bronchoscopy prior to surgery. A standard resection was performed in 19 cases (13 lobectomies, 4 bilobectomies and 2 pneumonectomies). In 11 cases, pulmonary resection was complemented with a bronchoplastic technique (6 lobectomies, 2 bilobectomies, 2 pneumonectomies, 1 segmentectomy). Four cases were managed by minimal resections (2 segmental, 1 wedge, 1 enucleation) and 8 others by bronchotomy and local resection without the sacrifice of lung tissue. There were two major postoperative complications and no operative mortality. Mean follow-up has been 53 months and no local bronchial recurrence has been observed although 2 patients have developed distant metastases, with 1 death. The absence of local recurrence in a series in which more than 50% of patients were treated with some form of conservative surgery seems to indicate that resection of lung tissue should be avoided whenever possible.
The effect of a high protein diet (20% casein + D,L-methionine) administered to adult Wistar rats on some aspects of muscle RNA metabolism has been studied. Body weight increased in spite of lower intake. However, gastrocnemius muscle remained unmodified, although protein content increased. Total RNA decreased in the whole muscle although RNA/DNA ratio did not change. Protein synthesis capacity diminished 81% relative to controls in spite the fact that an excessive amount of available amino acids exists. RNA loss might depend on a high catabolism, since acid RNase activity increased over control values. Therefore, it may be concluded that a high protein diet leads to a lower protein synthesis capacity through an elevated RNA breakdown.
The effect of a high protein diet (20% casein + D,L-methionine) administered to Wistar rats during pregnancy on some aspects of cellular growth and RNA metabolism of progeny has been studied. Comparisons were made with well-nourished (10% casein + D,L-methionine) controls. Newborns individual weight, litter weight and number of newborns per litter were unmodified. However, neonate protein content dropped significantly when compared with controls. Both rate of DNA and number of nuclei were unchanged. Protein/DNA ratio (cellular size relative to protein) decreased, which might have led to an atrophy phenomenon, even if the newborn weight/number of nuclei ratio was not modified. Acid DNase activity rose, bringing about DNA breakdown. Total RNA content together with RNase activity fell in newborn from rats suffering high protein diet. Moreover, protein synthesis capacity (RNA/protein ratio) did not change. These results suggest that the administration of a high protein diet to pregnant rats lead to changes in newborn protein rate and nucleic acid turnover by modulating specific nuclease activity.
Nutritive utilization of protein was studied in three age weight rainbow trout (Salmo gairdnerii) groups fed on a 37.5% casein-protein diet. As to digestive efficiency age was found to have no influence on the apparent and true digestibility coefficient for protein. On the other hand Biological Value, Net Protein Utilization and Protein Productive Value decreased with age-weight increases, the results being significantly correlated (P less than 0.001) between these parameters and the age-weight of the animals. Relative intake, weight increment and Protein Efficiency Ratio also decreased with age-weight increases.
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A study was made of the Ca and P balance, Ca and P content in the femur, physical characteristics of the egg, mineral structure of the shell, and the number of eggs in quails treated with dieldrin (20 mg/kg of diet) for 48 days. The diet contained 3.24% Ca and 0.72% P. The Ca and P balance, the bone contents of Ca and P and the calcemia in the males were not changed by the pesticide. In the females, the pesticide decreased the amount of excreted Ca and Ca in the egg, for which reason the coefficient of nutritive utilization (CNU), the coefficient of corporal retention (CCR), and the Ca level in the femur were greater in treated laying quails. The calcemia remained stable, and the balance of P was not significantly modified by the dieldrin. The study of weight, size, and strength of the egg did not reveal any influence of the dieldrin, and egg production fluctuated throughout the test period.