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Biomedical subjects

L Borghesi

Publications and source records attributed to L Borghesi.

9 recordsLinked to original sources

Gastric emptying in trauma patients.

BACKGROUND/AIM: The aim of this study was to obtain quantitative data on gastric emptying following trauma. METHODS: In order to assess gastric emptying for early enteral feeding, we evaluated the absorption of an amino acid, L-[1-(13)C]phenylalanine, within 24 h of admission and 7 days later in 14 trauma patients (injury severity score 36 +/- 2). Following nasogastric administration of 100 mg L-[1-(13)C]phenylalanine, the plasma L-[1-(13)C]phenylalanine enrichment at 30 and 60 min and the expired (13)CO(2) for 1 h in the breath were used to measure the degree of gastric emptying. RESULTS: The plasma L-[1-(13)C]phenylalanine enrichment concentration at 30 min was 0.53 +/- 0.23 mmol/l during the first study and 2.46 +/- 0. 62 mmol/l during the second study (p = 0.006, a fivefold increase). The L-[1-(13)C]phenylalanine plasma level in historic controls was 4. 57 +/- 1.48 mmol/l. The percent of the dose oxidized and expired as (13)CO(2) in 1 h was 0.51 +/- 0.17 during the first 24-hour study compared to the second study of 3.37 +/- 0.68 (p = 0.0008) 7 days later (an over sixfold increase). The percent of the dose oxidized in 1 h in 37 normal historic controls was 7.08 +/- 0.33. CONCLUSION: These data indicate delayed gastric emptying with limited recovery in 1 week. We conclude that gastric feeding should not be employed, and the route for early nutritional intervention should be transpyloric for the trauma patient.

Adult↗

Blood cell precursors in context. Composition of the bone marrow microenvironment that supports B lymphopoiesis.

New molecular approaches are rapidly yielding information about the composition of bone marrow and culture studies suggest possible functions for many molecules in that organ. However, the marrow is extraordinarily complex with respect to interactions between cells and their behaviour may not be adequately modeled in culture. It is becoming apparent that post-translational modifications and function of proteins can be highly influenced by the cellular and extracellular environment. Therefore, in vivo studies will continue to be important for understanding this remarkable organ.

Apoptosis↗

Cell interaction molecules utilized in bone marrow.

Many aspects of blood cell formation can now be modeled in culture and rapid progress is being made in understanding how blood cell precursors interact with unique components of their environment. This brief review considers some cell interaction molecules that may be important for controlling the position of cells within, as well as their egress from, bone marrow.

B-Lymphocytes↗

Impact of enteral feeding of a glutamine-supplemented formula on the hypoaminoacidemic response in trauma patients.

Plasma amino acid concentrations were measured during fasting and after 3 days of enteral feeding in 16 trauma patients on a glutamine-supplemented diet and 14 patients on an isonitrogenous control diet. During fasting, total amino acids, including glutamine, were depressed by 50% and this was attributed to a reduction in both essential and nonessential amino acids. The essential amino acid concentrations increased in both groups after feeding. The nonessential amino acid concentrations also increased in the control group but not in the glutamine group during feeding. Repletion of the glutamine extracellular pool was not evident after an average intake of 27.1 g per day of glutamine for 3 days. Nitrogen balance was similar for the two groups during feeding. We conclude that in this study, enteral glutamine did not increase the glutamine plasma concentration. In addition, both formulas improved the hypoaminoacidemia of essential amino acids but only the control diet improved the nonessential amino acids plasma concentration.

Adolescent↗

[Indicators of atherosclerosis risk. Evaluation with coronary angiography in non diabetic men with total cholesterol levels equal to or below 240 mg/dl].

We studied 90 male non diabetic patients aged between 40 and 65 years old with a total cholesterol of less than 240 mg/dl and not receiving cholesterol reducing drugs, that were subjected to elective coronary arteriography. Weight, height, blood pressure and smoking habits were recorded and a fasting blood sample was drawn to measure total and HDL cholesterol, triglycerides, apoproteins A1 and B, Lipoprotein(a) and plasma cholesteryl ester transfer activity. Arteriography disclosed coronary lesions in 54 patients. Compared to patients without lesions, the former had lower HDL cholesterol (34 +/- 9.8 vs 40.2 +/- 11.6 mg/dl) and higher total cholesterol/HDL cholesterol and apoB/apoA1 ratios. No differences were found for lipoprotein(a) and plasma cholesteryl ester transfer activity. Univariate analysis showed that low HDL cholesterol had the best predictive capacity for atherosclerosis.

Adult↗

[Treatment of acute secretory diarrhea with casein: an effect of beta-casomorphins?].

A patient with acute secretory diarrhea refractory to conventional therapy received calcium caseinate as sole nutrient, based on the recognized development of constipation and fecaloma in patients receiving this agent. Complete remission of diarrhea followed within 10 days. An inhibition of intestinal motility mediated by B-casomorphins released after hydrolysis of casein in the intestinal tract may be the mechanism involved in this effect. These exorphins have varying effects upon the opioid receptors of the intestinal tract.

Acute Disease↗

[The effect of body weight change on cardiovascular risk factors].

Changes in cardiovascular risk factors and body weight were correlated in 568 professional males from 17 to 57 years of age. Measurements of weight, height, body mass index, blood pressure and fasting levels of blood sugar, triglycerides, total and HDL cholesterol were obtained in 1980 and again in 1985. A significant correlation was found between body mass index and blood pressure, total cholesterol, total/HDL cholesterol, HDL cholesterol (p < 0.005), triglycerides (p < 0.001) and blood sugar (p < 0.05). Changes in body weight during the study period were correlated to changes in total cholesterol (p < 0.001), triglycerides (p < 0.05) and diastolic blood pressure (p < 0.005). Thus, obesity is correlated to the presence of cardiovascular risk factors. Its modification may influence development of atherosclerotic cardiovascular disease.

Adolescent↗

[Use of propofol and buprenorphine for total intravenous anesthesia].

A study was carried out in 47 patients undergoing general surgery and elective gynecological surgery under totally endovenous general anesthesia. For this purpose, propofol and buprenorphine were used in controlled ventilation with oxygen and air, totally excluding the use of nitrous oxide and halogenate vapours. The following parameters were measured to evaluate the state and depth of anesthesia: arterial pressure (systolic, mean, diastolic), heart rate, sweating, lacrimation (Evan's PRST). The awakening from anesthesia was evaluated using Steward's test. The results of monitoring show that the method represents a valid alternative to anesthesia using inhalatory techniques. Nonetheless, the Authors underline the need for further research on the subject.

Adult↗

Parenteral nutrition in hyperemesis gravidarum.

Hyperemesis gravidarum (HG) is a clinical condition that threatens fetal viability and even the mother's life when the severity of symptoms almost completely prevents the intake of food. Parenteral nutrition (PN) is a possible alternative. We present eight patients with HG. There were 10 PN treatments because two of the patients required the treatment twice. There were 9 central venous and 1 peripheral treatment delivery. The average age of the patients was 27.5 yr. Gestational ages varied from 8 to 19 wk. PN treatments were formulated as amino acid and glucose solutions (fat emulsions in 2 of the 8 cases) blended with vitamins and electrolytes. These treatments lasted 5-16 days. Before PN deliveries were initiated, five of the patients presented some degree of protein-calorie and/or visceral protein malnutrition. All of them showed minor liver dysfunction, which did not change during PN. Newborns were term deliveries, except for one case of missed abortion. Results show that PN constitutes a therapeutic alternative in cases of HG that do not respond to the standard treatment of parenteral hydration and antiemetics. In fact, symptoms disappear promptly, and no significant complications arise.

Adult↗