[Letter: Hemochromatosis with positive alpha-feto-protein. A further case].
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Biomedical subjects
Publications and source records attributed to J Emerit.
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OBJECTIVE: To determine if asymptomatic stable chronic hyperlactatemia in human immunodeficiency virus (HIV)-infected patients under highly active antiretroviral therapy (HAART, including nucleoside analog reverse transcriptase inhibitors (NRTI)) could be improved by antioxidant supplementation. DESIGN: To match two groups of patients taking NRTI for at least 24 months: 15 without and 15 with antioxidant supplementation (vitamin E, beta-carotene, N-acetylcysteine, selenium, Gingko biloba extracts and nutritional supplements). For both the groups, the supplementation by antioxidants or its lack was carefully assessed. Venous lactatemia, blood oxidative stress markers (plasma lipid peroxidation, enzymatic and non-enzymatic antioxidants), CDC revisited classification, CD4 count and viral load, NRTI (with or without stavudine) and other antiretroviral drugs used, lipoatrophy, central fat accumulation were assessed. RESULTS: Patients were not statistically different with respect to the CDC classification, CD4 count, viral load and characteristics of antiretroviral therapy. Blood oxidative stress markers, i.e. vitamin E, vitamin A and beta-carotene tended to be higher in the supplemented group. The difference observed in venous lactate concentration between the two groups was significant (1.37 +/- 0.10 vs. 1.82 +/- 0.19 mmol/l in the supplemented and non-supplemented groups, respectively P = 0.04). CONCLUSION: Antioxidant supplementation improves the asymptomatic stable chronic hyperlactatemia observed in HIV-infected patients taking HAART including NRTI for a long time. Controlled studies are needed to demonstrate the efficacy of this supplementation on mitochondrial toxicity observed during HAART and the possible usefulness of its combination with mitochondrial cofactors like carnitine, riboflavine, coenzyme Q, alpha-lipoic acid.
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From chromosome breaks observed in lymphocyte culture of patients with auto-immune diseases, the authors study the factors favouring the onset of these breaks, (clastogenic factor and superoxide radicle) and those which appear able to reduce them (D-penicillamine and dismutase superoxide). The therapeutic implications of these findings will be the object of later publications.
OBJECTIVES: Determine the oxidative stress status and its significance in elderly subjects. METHODS: Six parameters marking oxidative stress evaluated in 52 elderly patients (mean age 85 +/- 6 years; range 74 to 98) admitted to a medium-term and long-term nursing home (n = 30) or a hospital ward (n = 22) were compared with those in 30 disease-free young subjects (age range 20-40 years). Plasma levels of thiobarbituric acid reactive substances vitamin E and selenium and activity of free-radical protective enzymes (erythrocyte superoxide dismutase, plasma and erythrocyte glutathione peroxidase) were assessed. RESULTS: Thiobarbituric acid reactive substances were higher and superoxide dismutase, erythrocyte and plasma glutathione peroxidase, and plasma selenium were lower in elderly patients than in young controls. There was no difference in vitamin E levels. In the nursing home population, erythrocyte superoxide dismutase was correlated with erythrocyte glutathione peroxidase and vitamin E, plasma glutathione peroxidase with erythrocyte glutathione peroxidase, vitamin E and selenium and erythrocyte g peroxidase, vitamin E and selenium and erythrocyte glutathione peroxidase with vitamin E. Only the correlation between erythrocyte and plasma glutathione peroxidase was found in the hospitalized population. These levels remained unchanged for a 30 day period in individual patients. CONCLUSION: "Oxidative stress" assessed by six parameters was thus observed in the elderly population and could be considered as a "biological marker of ageing". Supplementation with selenium or other anti-oxidants could be proposed.
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