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Biomedical subjects

L D'Agostino

Publications and source records attributed to L D'Agostino.

At least 19 recordsLinked to original sources
PubMed2005

Effects of an appropriate oral diet on the nutritional status of patients with HCV-related liver cirrhosis: a prospective study.

BACKGROUND AND AIMS: In patients with liver cirrhosis, protein-energy malnutrition is a frequent finding and a risk factor influencing survival. The aim was to estimate the effects of an adequate diet on malnutrition and clinical outcome in patients with Child A or B HCV-related liver cirrhosis. METHODS: We enrolled 90 consecutive outpatients (M/F=52/38) with liver cirrhosis, 30 in Child class A and 60 in class B. Patients were evaluated by anamnesis, clinical examination, estimation of daily caloric intake and measurement of anthropometrical and biochemical indexes. Patients were randomized into two groups: group 1 with a 3-month oral controlled diet started one week after the first examination and this was followed by a 3-month of spontaneous dietary intake, and group 2 which started a 3-month spontaneous dietary intake followed by a 3-month of controlled diet. The follow-up was performed every month. RESULTS: During the period of controlled diet in patients of both groups, protein malnutrition assessed by midarm muscle circumference, creatinine-height index and serum albumin significantly improved independently of the Child class. Lipid malnutrition, assessed by triceps skin fold thickness values, did not improve during the course of the study. The compliance to the prescribed diet was very high in both groups, and no carry over effect of the previous dietary intake was observed during the follow-up period. CONCLUSIONS: The results emphasize the importance of both nutritional status evaluation and improvement in the Child A and B cirrhotic patients with HCV-related disease. The proposed nutritional approach was able to influence their protein malnutrition positively.

Anthropometry↗
PubMed2004

A life-threatening case of stenosing pill hypopharynx-oesophagitis caused by a tamsulosin capsule.

Pill oesophagitis is a frequent clinical entity that may induce dysphagia and exceptionally oesophageal occlusion. The mechanisms inducing mucosal inflammation are not completely defined, but oesophageal damage occurring when the caustic content of a drug remains in the oesophagus long enough to produce mucosal lesions seems to be a main factor. We report a case of a life-threatening stenosing pill hypopharynx-oesophagitis caused by the ingestion of a capsule of tamsulosin, a drug diffusely used for benign prostatic hyperplasia treatment.

Adrenergic alpha-Antagonists↗
PubMed2004

Osteoma of maxillary sinus: case report.

Cranio-facial osteomas are frequent in the nasal and paranasal sinuses, particularly in fronto-ethmoidal sites; other sinus cavities are more rarely affected. Although various theories (embryogenetic, traumatic and inflammatory) have been advanced to explain the pathogenesis, it is difficult to establish a specific cause-effect relationship. Nasal and paranasal osteomas are generally asymptomatic and are diagnosed on the basis of X-rays performed for other conditions, the onset of sinusitis-like symptoms or the appearance of complications due to sinus diseases. These cases require surgical removal to avoid the risk of short- or long-term complications or to solve any that may already exist. Herein, a rare case of osteoma of the maxillary sinus is described and the possible aetiopathogenetic role of traumatic and inflammatory factors described. The main clinical and therapeutic data concerning this lesion are examined.

Adult↗
PubMed2003

[Surgical treatment of malignant lip tumors. Personal experience].

The malignant tumours of the lip account for nearly 1-2% of the cervicofacial neoplasms. These lesions are frequently spinous cell carcinomas and basal cell carcinomas (25% of all oral cancers). The spinous cell carcinoma is mainly located in the lower lip, the basal cell carcinoma is more common in the upper lip. The incidence of lip cancer in males is much high than in females. The etiopathogenesis of these lesions is connected with exposure to sun, smoking, genetics predisposition (mutation of the p53 suppressor factor) and with the evolution of precancerous lesions (radiodermatitis, chronic cheilitis, xeroderma pigmentosum). Some Authors emphasized the viral etiopathogenesis: HPV16, HPV24, HSV1, HSV2. The treatment of lip carcinoma is surgical: excision and reconstruction. The numerous reconstructive techniques are mostly the cutaneous local sliding flaps and the rotation flaps. The lip reconstruction require a remarkable diligence for preserve, as much possible, the shape and functions of lip. The Authors report their experience about the surgical treatment of 19 patients with lip carcinoma (16 spinous cell carcinomas, 3 basal cell carcinomas) and describe the main surgical reconstructive techniques to preserve the feeding, phonation and mimic expression.

Aged↗
PubMed2003

Continuing validity of pectoralis major muscle flap 25 years after its first application.

Surgical treatment of malignant cervico-facial tumours often includes vast demolition of mucosal, cutaneous, muscle and bone tissues, requiring immediate repair of the extensive loss of substance with reconstructive pedicled or revascularised free flaps. Still today, when it is not necessary to reconstruct the mandibular bone or in particular clinical situations as found in patients in whom microsurgery is contraindicated due to general conditions or in those cases of unsuccessful microsurgical flaps, use of the pedicled flaps is still indicated, particularly the myocutaneous flap of the major pectoral muscle described approximately 25 years ago, and quite rightly referred to as "work horse" or "spare wheel" of reconstructive surgery. Study population comprises 33 patients (27 male, 6 female, mean age: 61 years, range: 36-86) observed between 2000-2002. These patients were submitted to demolitive surgery on account of malignant cervico-facial neoplasias. The role of the major pectoral muscle pedicled flap is emphasised stressing that resection of the pedicle, even a few weeks after transplant, together with the subclavicular passage, may avoid the majority of the well-known functional and aesthetic problems related to this reparative technique.

Adult↗
PubMed2001

Primary Kaposi sarcoma of the bowel in a HIV-negative patient.

A case of Kaposi sarcoma with HIV-negative and sequence of HHV-8 positive and exclusive rectosigmoid and descending colon involvement without immunodeficiency is reported. Histologically, in addition to typical features of Kaposi sarcoma, Cowdry type A inclusions were seen. PCR analysis of the tumor showed positivity for human herpesvirus 8. Two of the six reported cases of Kaposi sarcoma limited to the bowel were from African men before the AIDS epidemic. J. Surg. Oncol. 2001;76:197-200.

Aged↗
PubMed2001

Oral glutamine in the prevention of fluorouracil induced intestinal toxicity: a double blind, placebo controlled, randomised trial.

BACKGROUND: 5-Fluorouracil (FU) in association with folinic acid (FA) is the most frequently used chemotherapeutic agent in colorectal cancer but it often causes diarrhoea. Animal and human studies suggest that glutamine stimulates intestinal mucosal growth. AIM: To determine if oral glutamine prevents changes in intestinal absorption (IA) and permeability (IP) induced by FU/FA. METHODS: Seventy chemotherapy naive patients with colorectal cancer were randomly assigned to oral glutamine (18 g/day) or placebo before the first cycle of FU (450 mg/m(2)) and FA (100 mg/m(2)) administered intravenously for five days. Treatment was continued for 15 days, starting five days before the beginning of chemotherapy. IA (D-xylose urinary excretion) and IP (cellobiose-mannitol test) were assessed at baseline and four and five days after the end of the first cycle of chemotherapy, respectively. Patients kept a daily record of diarrhoea, scored using the classification system of the National Cancer Institute (Bethesda, Maryland, USA). Duration of diarrhoea was recorded and the area under the curve (AUC) was calculated for each patient. RESULTS: Baseline patient characteristics and basal values of IP and IA tests were similar in the two arms. After one cycle of chemotherapy, the reduction in IA (D-xylose absorption) was more marked in the placebo arm (7.1% v 3. 8%; p=0.02); reduction of IP to mannitol was higher in the placebo arm (9.2% v 4.5%; p=0.02); and urinary recovery of cellobiose was not different between the study arms (p=0.60). Accordingly, the cellobiose-mannitol ratio increased more in the placebo arm (0.037 v 0.012; p=0.04). Average AUC of diarrhoea (1.9 v 4.5; p=0.09) and average number of loperamide tablets taken (0.4 v 2.6; p=0.002) were reduced in the glutamine arm. CONCLUSIONS: Glutamine reduces changes in IA and IP induced by FU and may have a protective effect on FU induced diarrhoea.

Administration, Oral↗
PubMed2001

[Rhinoscleroma with extramaxillary extension: report of a clinical case].

Rhinoscleroma is a chronic, granulomatous infection most frequently affecting the respiratory tract mucosa. The disease is endemic in some geographic areas and is sporadic in Italy, where medio-facial granulomatoses must be differentiated from malignant naso-sinus neoplasms. The present work describes a case of rhino-sinus scleroma with extramaxillary extension, defining the most important clinical characteristics and the treatment performed.

Aged↗
PubMed2000

Histamine plasma levels and elimination diet in chronic idiopathic urticaria.

OBJECTIVE: The aim of this study was to evaluate the effects of an oligoantigenic and histamine-free diet on patients affected with chronic idiopathic urticaria (CIU). DESIGN: Ten patients with chronic idiopathic urticaria were prescribed an oligoantigenic and histamine-free diet for 21 days, followed by serial and controlled reintroduction of foods during a further 70 days. Modification in clinical illness as well as histamine plasma levels, post-heparin plasma diamine oxidase (DAO) and intestinal permeability were evaluated. RESULTS: The oligoantigenic and histamine-free diet induced a significant improvement of symptoms (P<0.05). Moreover, CIU patients on free diet showed higher histamine plasma levels (P<0. 05 vs post-diet and vs controls) that fell to control levels during the oligoantigenic and histamine-free diet. Post-heparin plasma diamine oxidase values were slightly reduced and were unchanged during the diet as well as intestinal permeability, which was always normal in all patients. CONCLUSIONS: These data suggest that histamine plays a major role in chronic idiopathic urticaria. The finding of normal intestinal permeability suggests that a morphological damage of intestinal mucosa should be excluded in these patients. However, the presence of low levels of post-heparin plasma diamine oxidase may indicate a subclinical impairment of small bowel enterocyte function that could induce a higher sensitivity to histamine-rich or histamine-producing food. European Journal of Clinical Nutrition (2000) 54, 155-158

Adult↗
PubMed2000

A case of sclerosing cholangitis managed by a percutaneous approach.

In 1992, a 61-year-old man who complained of recurrent episodes of fever and jaundice was diagnosed as having sclerosing cholangitis. In the three years that followed, the clinical picture progressively worsened; and, in 1995, the patient was hospitalized again for biliary obstruction. A liver transplantation was excluded because of concomitant severe coronary heart disease. A percutaneous transhepatic cholangiogram showed several critical strictures of the intrahepatic biliary tree and a temporary internal-external biliary drainage was placed to relieve the obstruction. After 40 days, a two-step percutaneous biliary balloon dilation was performed followed by topical steroid treatment through the catheter. After 45 days, the catheter was removed and steroid treatment tapered orally. In the three years that followed, the patient was well. He experienced only about 1-2 episodes of ascending cholangitis per year requiring antimicrobial therapy. Laboratory analysis showed a gradual improvement in hepatic chemistry, serum bilirubin, and erythrocyte sedimentation rate (ESR). In our patient, the association of percutaneous balloon dilation and topical steroid treatment improved both the clinical and radiological picture, without significant side-effects. This approach should be considered a valuable and cost-effective option in primary sclerosing cholangitis, mainly for patients not eligible for liver transplantation.

Anti-Inflammatory Agents↗
PubMed1999

Interaction of putrescine with nuclear oligopeptides in the enterocyte-like Caco-2 cells.

Intestinal cells are able both to synthesize and take up putrescine, the main compound of the metabolic polyamine pathway. Polyamine binding to nuclear macromolecules is thougth to modulate DNA synthesis and transcription. Our aim was to study the fate of putrescine when taken up from the medium in the enterocyte-like Caco-2 cells and to analyze its binding to nuclear proteins. After having incubated the cells with 14C-putrescine (0.8 microM), during cell replication and differentiation, the nuclei were separated by sequential centrifugations in a sucrose gradient. About 20% of the putrescine taken up by Caco-2 cells resulted in the nuclei in both proliferating and differentiated cells. The binding of polyamines to nuclear proteins was studied on nuclear extracts, separated by both alkaline polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate (SDS-PAGE) and gel permeation chromatography (GPC). No radioactivity was found in nuclear protein extracts when using the SDS-PAGE method. Conversely, in replicating cells, GPC showed that the greatest amount of radioactivity was present in the nuclear peaks corresponding to oligopeptides with a molecular weight of 4,800-8,000 daltons. High-performance liquid chromatography analysis showed the presence of putrescine and spermidine in the 8, 000-dalton protein peak, whereas in the 4,800-dalton peak spermine was found in addition to putrescine. The radioactive count in the HPLC separated polyamines showed that a small percentage of the radioactivity present in the 8,000 and 4,800-dalton GPC peaks was linked to spermine and spermidine, suggesting an interconversion of the supplemented putrescine. Conversely, in differentiated cells, the nuclear oligopeptides did not reveal any radioactivity or any polyamines, suggesting that the binding of polyamines to nuclear oligopeptides is exclusively concerned with replicating cells.

Binding Sites↗
PubMed1997

[Primary non-Hodgkin's lymphoma of the mandible: a description of a clinical case and review of literature].

The authors present a rare case of primary non-Hodgkin lymphoma (NHL) of the mandible in an 81-year old woman. The location of this NHL caused problems in making a differential diagnosis between periodontal and tumoral disease as they have similar symptoms (i.e. dental pain, swelling, ulceration and radiologically detected rarefaction). The present work emphasizes how important correct diagnosis and staging of the primary NHL are to good therapy. The patient was treated with a combination of chemotherapy and radiotherapy and is alive and disease-free 12 months after treatment.

Aged↗
PubMed1996

Effect of pregnancy on the clinical course of a cohort of women with inflammatory bowel disease.

The incidence of relapses of inflammatory bowel disease in pregnancy ranges from 20 to 35%. The effect of pregnancy on Crohn's disease and ulcerative colitis after pregnancy has been investigated here. During the survey period, 29 pregnancies occurred in 18 Crohn's patients, and 25 in 19 ulcerative colitis patients. Incidence of relapses during pregnancy and post-partum was 14 and 17% in Crohn's, and 36 and 12% in ulcerative colitis. Fourteen Crohn's patients (17 pregnancies) and 17 ulcerative colitis patients (19 pregnancies) were followed for 3 years before pregnancy and for 4 years after delivery. During the 3 years after pregnancy, the number of relapses/year was significantly lower compared to the 3 years before pregnancy and to the incidence in controls, both in Crohn's (p < 0.05) and ulcerative colitis (p < 0.005). Changes in nutritional status were recorded in 41% of Crohn's, but in none of the ulcerative colitis patients. The reduced incidence of relapses following delivery in Crohn's patients was more marked in the 10 with normal nutritional status at the time of conception (70% reduction in number of relapses, p < 0.05), while in the 7 significantly underweight patients, the reduction was slight (27% reduction in number of relapses, p = NS). In conclusion, the incidence of relapses in the first 3 years after pregnancy is lower than in the pre-pregnancy period. In Crohn's disease, the effect is more evident in patients with normal nutritional status at the time of conception than in malnourished patients.

Abortion, Spontaneous↗
PubMed1996

[Carcinoma in ectopic Warthin's tumor: a case study and review of the literature].

Warthin's tumor is the second most common salivary gland tumor preceded only by pleomorphic adenoma. In most cases it involves the parotid gland and can, at times, be bilateral. It can also arise in ectopic salivary tissue in the latero-cervical and para-parotid lymph nodes. This neoplasm consists of two histologic components: one epithelial, the other lymphoid. Malignant transformation involving each of these tissues has been reported. However, few cases give clear-cut examples of the epithelial malignant change. Therefore, primary malignant transformation of Warthin's tumor is extremely rare. This event appears related to the initial time of tumor onset and/or past radiotherapy for other malignant cervico-facial lesions. The authors report a case of epidermoid carcinoma arising on an ectopic Warthin's tumor in a 57-year-old male. Physical examination revealed a recent, smooth tumor mass on the left, located near the laryngeal thyroid cartilage. Fine needle aspiration cytology was suspicious of a malignant epithelial neoplasm. Functional latero-cervical dissection, modified by excision of the digastric and sternohyoid muscles plus a 2 x 2 cm section of the overlying skin, was performed in this case. Histology and immunocytochemical tests on the surgical specimen revealed a 14 cytokeratin-positive, malignant epidermoid neoplasm arising from the adjacent 14 cytokeratin-negative, oncocytic epithelium. This relationship may rule out metastasis and may, therefore, be a case of Warthin's tumor associated with an epidermoid carcinoma or a case of branchial cyst.

Adenolymphoma↗
PubMed1995

Hypergastrinemia in rats with azoxymethane-induced colon cancers.

Gastrin has been suggested to be involved in the promotion and progression of colon cancer. Mice colon cancers and colon-carcinoma cell lines are stimulated to grow by gastrin, and gastrin receptors have been found in the majority of human colon-tumor specimens. High serum gastrin levels have been reported in patients with colon polyps and cancers, together with increased ornithine decarboxylase (ODC) activity. Since gastrin stimulates ornithine decarboxylase in colon cancer cells in vitro it has been suggested that increased synthesis of intracellular polyamines is one of the mechanisms activated by the hormone. In order to confirm the presence of hypergastrinemia in colon cancer and to investigate the relationship between plasma gastrin and tumor growth, we used an animal model of colon carcinogenesis that minimizes the possible bias of human studies, related to varying diet, age and environmental factors. We evaluated blood gastrin levels in 35 rats with colon cancer induced by the carcinogen azoxymethane (AOM), and we correlated gastrinemia with tumor proliferation, assessed by thymidine-labeling index (TLI) and ODC activity; 6 animals constituted the control group. Gastrin levels in rats with AOM-induced tumors were significantly higher than in controls. Significantly higher TLI and ODC activity were found in the tumors of hypergastrinemic rats than in neoplasms of animals with normal gastrin levels. Our data provide additional evidence of a role for gastrin as trophic hormone for colon neoplastic cells.

Animals↗
PubMed1994

Proliferation and differentiation of the small intestinal epithelium: from Petri dish to bedside.

The small intestinal epithelium is a continuously renewing cell system in which two main compartments can be defined: the crypt compartment and the villus compartment. The crypt compartment houses the proliferative cells (stem cells) that give birth to the four types of differentiated enterocytes (absorptive enterocytes, goblet cells, enteroendocrine cells, Paneth cells) that, with the exception of Paneth cells, populate the villus compartment. Enterocyte proliferation, differentiation and migration are regulated by a complex network of cell-cell and cell-matrix information, and modulated by growth factors, luminal factors and, possibly, hormones. The intimate mechanisms underlying the fascinating life of the enterocytes are the object of intensive investigation although insights have come from studies "in vitro" and in transgenic animals. The enormous proliferative potential makes the small bowel an extremely plastic organ, able to adapt to various injuries and adverse conditions and to completely recover even from extensive damage. Knowledge of the biologic mechanisms of adaptation has begun to affect therapeutic approaches to a number of intestinal diseases and the future will see a significant advancement in their management. More important, understanding the molecular mechanisms regulating the perfect equilibrium between proliferation and differentiation of the intestinal enterocytes will eventually help disclose the dark side of cancer.

Cell Cycle↗