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Biomedical subjects

Giuseppe Famularo

Publications and source records attributed to Giuseppe Famularo.

At least 19 recordsLinked to original sources
PubMed2006

Acute pancreatitis.

Explore the source record for details and available documents.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed2005

Probiotic lactobacilli: an innovative tool to correct the malabsorption syndrome of vegetarians?

Vegetarians may have subtle nutritional deficiencies which have been related to the occurrence of an unrecognized malabsorption syndrome. The excess phytate content in cereals, nuts, legumes and oilseeds which represent the mainstay of their food intake, seems to play a central role in the pathogenesis of this malabsorption syndrome as an inverse relationship has been shown to link the phytate content of the diet with the intestinal absorption of trace minerals and proteins. We postulate that manipulating the endogenous digestive microflora of subjects on a vegetarian diet through administering probiotic lactic bacteria would represent an innovative tool to counteract the occurrence of the malabsorption syndrome dependent on the high phytate content of their diet. Even though there are no data about the composition of endogenous digestive microflora in subjects on a vegetarian diet, we expect that probiotic lactobacilli can interact with or affect distinct yet interrelated components within the intestinal milieu, such as epithelial cells, enteric flora, and/or mucosal immune cells. This would ultimately translate into the correction of the unregulated mechanisms implicated in the altered intestinal absorption of trace metals and proteins commonly seen in vegetarians. Clinical experience with probiotic therapy of patients with inflammatory bowel disease fully agrees with this view. One additional point of interest is that probiotic lactobacilli, and other species of the endogenous digestive microflora as well, are an important source of the enzyme phytase which catalyses the release of phosphate from phytate and hydrolyses the complexes formed by phytate and metal ions or other cations, rendering them more soluble ultimately improving and facilitating their intestinal absorption. The regular intake of probiotic preparation, may represent a cheap and safe tool in order to convert a diet with a low potential for bioavailability of trace minerals and proteins, such as the vegetarian diet, into a diet with a high bioavailability potential. The benefit of such an approach would not be restricted to vegetarians.

Diet, Vegetarian↗
PubMed2005

A patient with cerebral Whipple's disease and a stroke-like syndrome.

The central nervous system (CNS) may be affected in up to 50% of patients with Whipple's disease and this can occur even with little or no gastrointestinal involvement. We describe a 63-year-old patient in whom CNS involvement with Whipple's disease had the clinical and imaging features of a brain infarction. Treatment with aspirin and ceftriaxone followed by trimethoprim-sulfamethoxazole resulted in a good neurological recovery and complete remission of the malabsorption syndrome. Cerebral Whipple's disease resembling a stroke syndrome has so far been reported in only two other patients and in both cases it represented the first presentation of the disease. Arterial or arteriolar fibrosis, thrombosis and thickening associated with the inflammation of adjacent brain parenchyma and leptomeninges, and cerebral vasculitis caused by the hematogenous spread of Tropheryma whippelii to the brain may all be important triggers of brain infarction in patients with Whipple's disease. Our case report highlights the important point that cerebral Whipple's disease with the features of a stroke syndrome, if recognized early and treated aggressively with antibiotics, could have a favorable course with no long-term disability sequelae.

Anti-Infective Agents↗
PubMed2004

Severe acquired hemophilia with factor VIII inhibition associated with acetaminophen and chlorpheniramine.

OBJECTIVE: To report a case of acquired hemophilia with a high-titer factor VIII inhibitor associated with the use of acetaminophen and chlorpheniramine in combination. CASE SUMMARY: An 83-year-old woman presented with a severe bleeding disorder 2 weeks after she was prescribed acetaminophen and chlorpheniramine for treatment of a flu-like illness. Laboratory studies showed severe anemia with greatly reduced factor VIII activity and the presence of a high-titer factor VIII inhibitor at 228 Bethesda units. Treatment with high-dose corticosteroids, transfusion of several units of red blood cells, and repeated infusions of factor VIII bypassing activity was successful. Complete clinical and laboratory remission was achieved after 4 weeks of treatment. Use of the Naranjo probability scale suggested a possible association between this adverse event and treatment with acetaminophen and chlorpheniramine. DISCUSSION: Acquired hemophilia due to factor VIII inhibitor(s) has been associated with the use of drugs such as thioxanthenes, interferon, and fludarabine. As of this writing, to the best of our knowledge, no other case has been reported among patients receiving acetaminophen or chlorpheniramine. CONCLUSIONS: We suggest that acquired hemophilia due to factor VIII inhibitor(s) should be considered in the appropriate setting when patients present with unexplained and even minor bleeding while on treatment with acetaminophen or chlorpheniramine alone or combined.

Acetaminophen↗
PubMed2004

Oxidative stress and mitochondrial glutathione in human lymphocytes exposed to clinically relevant anesthetic drug concentrations.

STUDY OBJECTIVE: To evaluate the potential of compounds commonly used in anesthesia practice to affect the intracellular oxidant-antioxidant homeostasis of peripheral blood lymphocytes at clinically relevant concentrations; and to study the changes in reactive oxygen species production and measure the mitochondrial glutathione content. DESIGN: Prospective, in vitro study. SETTING: Experimental medical research laboratory at a University Hospital. MEASUREMENTS: Lymphocytes were isolated from the peripheral blood of 15 healthy donors and incubated for 12 hours at 37 degrees C with the following drug concentrations: thiopental sodium 20 mmoL/mL, droperidol 130 micromol/mL, propofol 60 mmoL/mL, and succinylcholine 17 mmoL/mL. Reactive oxygen species (ROS) generation was determined by hydroethidine and 2',7'-dichlorofluorescein diacetate methods. Mitochondrial glutathione level was assessed using monobromobimane staining. MEASUREMENTS AND MAIN RESULTS: Thiopental-treated lymphocytes exhibited an overgeneration of ROS, but no change was detected in mitochondrial glutathione quantity. Propofol and droperidol could not induce any perturbative effect on the oxidative state of T cells, whereas succinylcholine was found to markedly affect lymphocyte oxidative state both by impairing glutathione content and promoting exaggerated production of ROS. CONCLUSION: Drugs commonly used in anesthesia practice may significantly alter the oxidative state of peripheral T cells. This mechanism could contribute to the immune suppression that occurs transiently in the early postoperative period.

Anesthetics↗