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Biomedical subjects

M G Gentile

Publications and source records attributed to M G Gentile.

At least 19 recordsLinked to original sources
PubMed2005

Entrapment neuropathy in patients with spastic cerebral palsy.

OBJECTIVES: We performed nerve conduction and needle electromyographic tests in 29 patients with spastic cerebral palsy (SCP) and severe limb deformities. Nerve conduction abnormalities were detected in 32 of 400 sensory or motor nerves, while 11 of 29 patients (37.9%) showed abnormal nerve conduction, indicating one or more entrapment neuropathies. Patients with SCP develop severe joint contractures and deformities due to spastic muscle tone and limited muscle and joint use/flexibility; these contractures and deformities can, in turn, cause nerve damage, possibly as a result of the stretching, angulation or compression mechanisms in the anatomic fibro-osseous passages, where nerves are particularly susceptible.

Adolescent↗
PubMed2004

Time course of total and distrectual weight gain after refeeding in anorexia nervosa.

Anorectic patients who achieve complete recovery from the eating disorder can obtain a favorable psychosocial outcome but the long-term nutritional outcome is ill-defined. We investigated the time course of total and distrectual body composition during and after refeeding in 32 female patients with anorexia nervosa. Patients were enrolled at their lowest weight (T0) and re-examinated after a 15% weight gain (at a mean of 3 months, T1; n=17) and after 3 years of stable weight recovery (T2; n=8). At T2 patients were compared to a control group of 8 healthy females matched for age and body mass index. All subjects underwent dual X-ray absorptiometry and anthropometry at each visit. At T0, the 32 subjects were at 61%+/-8% of ideal body weight (IBW) with severe reductions in fat mass (FM; 7.1%+/-4.5%), fat free mass (FFM) and bone mineral content (BMC). At T2, the 8 subjects had gained 40% of initial weight, but remained at 85.1%+/-7.7% of IBW ( p<0.01 vs. controls), with a percent FM comparable to that of controls and an absolute FFM still deficient. BMC did not improve at T2 and remained 79% of that in controls. FM depletion was more severe in the limbs than in the trunk and at T2 the trunk/limb FM ratio remained greater than that in controls. These data strongly suggest that continued nutritional surveillance and support is necessary throughout these patients' lives, even after correction of the psychiatric illness and of severe underweight.

Anorexia Nervosa↗
PubMed1995

A self-administered semiquantitative food-frequency questionnaire with optical reading and its concurrent validation.

An improved semiquantitative self-administered food frequency questionnaire has been designed in order to investigate possible associations between diet and health, to plan nutrition education programmes, and to examine dietary compliance. The questionnaire consists of 16 printed forms and 16 pages with coloured photos of the most common foods and courses from the Italian diet. Instructions and other questions are included. The questionnaire uses optical reading from a scanner connected to a personal computer. The questionnaire was validated by comparing it with the seven-day weighed record method using 46 healthy adult volunteers. Significant correlations were found for all nutrients tested (Spearman rank correlation procedure), r ranging from 0.33 for ascorbic acid to 0.84 for alcohol. The two methods gave comparable results (Wilcoxon matched-pairs signed rank test) for all nutrients except riboflavin and alcohol. Similarity of the two methods in classifying relative intakes was examined by determining the frequency of similar classification into tertiles. Half of the subjects were correctly classified for most nutrients and for frequency of consumption of 18 food groups.

Adult↗
PubMed1995

Biochemical validation of a self-administered semi-quantitative food-frequency questionnaire.

The present study is a biochemical validation of a food-frequency questionnaire (FFQ) with optical reading, i.e. containing food portion photographs to help to assess quantities. Forty-four healthy subjects, non-smokers and not taking vitamin supplements, were recruited for the study. After completion of the questionnaire, subjects were asked to keep a 7 d weighed dietary record (7DR). Three 24 h urine samples were collected on 3 different days over the week of food recording for the analysis of urea-N, P and K. On the 4th day of food recording, blood was collected for determination of alpha-tocopherol, beta-carotene and ascorbic acid. N, P and K determined in urines and from 7DR were significantly correlated (Spearman rank correlation test), r values being 0.77, 0.57 and 0.42 respectively. The correlations with the FFQ were significant only for N (r 0.45) and P (r 0.39). Blood ascorbic acid and beta-carotene concentrations correlated with dietary intake when determined from 7DR (both r 0.44), but not when determined from FFQ. No correlation was found for alpha-tocopherol. The data obtained seem to prove the validity of the FFQ in defining eating patterns in terms of some nutrients, but not vitamins, at least as far as non-supplemented subjects are concerned. The way in which foods were grouped in the questionnaire could account for these results.

Adult↗
PubMed1994

Effect of dietary protein restriction on the progression of renal failure: a prospective randomized trial.

One hundred twenty-eight patients with different renal diseases and chronic renal failure, stratified according to the underlying disease, were enrolled in a randomized controlled trial to investigate the effects on the rate of decline of renal function of two diets, a controlled protein diet (CPD) of 1 g protein/kg ideal body-weight (i.b.w.)/day, and a low-protein diet (LPD) of 0.6 g protein/kg i.b.w./day, given for 27.1 +/- 21.8 months. Dietary compliance was assessed by a dietary questionnaire, dietary interviews and measurement of 24-h urinary urea excretion. At the end of 6 months, actual mean protein intake was higher than expected (1.06 +/- 0.25 g/kg i.b.w./day) in CPD patients, and (0.80 +/- 0.21 g/kg i.b.w./day) in LPD patients: values were similar at 12 and 18 months after the time of enrollment. The end-point, defined as halving of creatinine clearance, was reached in 40% of patients on CPD, and in 28.6% of those on LPD (P = 0.038 by comparative life-table analysis). Multivariate regression analysis confirmed that CPD was associated with a higher risk of progression than LPD, and that two additional parameters (creatinine clearance at the time of randomization and average proteinuria during the follow-up) were significant independent risk factors, even more important than protein intake.

Diet, Protein-Restricted↗
PubMed1993

Influence of diet on lipid abnormalities in human renal disease.

The scarce literature on dietary manipulation of dyslipidemia in patients with nephrotic syndrome and in patients with chronic renal insufficiency is reviewed. Our favorable personal experience in both clinical conditions is illustrated as well. A special low-protein soy diet given for 2 or 4 months partially corrected hypercholesterolemia in nephrotic patients, and a low-protein diet also low in cholesterol and rich in polyunsaturated fatty acids corrected hypertriglyceridemia and hypercholesterolemia in patients with progressive renal damage. The soy diet had an additional favorable effect on proteinuria of nephrotic patients that might have been a direct consequence of the partial correction of the hypercholesterolemia. The addition of 5 g/d of fish oil to the soy diet did not modify the effects of the soy diet on proteinuria nor was it able to correct the hypertriglyceridemia of nephrotic patients. Dietary intervention should be the first-line treatment for the dyslipidemia of these renal diseases, since it can be used for long periods of time and is devoid of side effects so long as good nutritional status is maintained.

Cholesterol↗
PubMed1993

Treatment of hyperlipidemia in human renal disease.

Existing evidence suggests that dyslipidemia associated with long-lasting nephrotic syndrome and with chronic renal insufficiency may favor in the long run the occurrence of cardiovascular complications, and also aggravate glomerular damage with a pathological mechanism analogous to atherosclerosis. Correction of hypercholesterolemia and hypertriglyceridemia is therefore mandatory in both clinical conditions. This goal can be achieved with the combination of dietary intervention and the administration, even for long periods of time, of hypolipemic drugs (hydroxymethylglutaryl coenzyme A, HMGCoA, reductase inhibitors, to correct hypercholesterolemia in nephrotic syndrome, and fibric acids, to correct hypertriglyceridemia in uremic and dialyzed patients are the drugs of choice). In end-stage renal failure, the choice of the type of dialysis is also important. The value of extracorporeal LDL cholesterol removal is still to be proven.

Cardiovascular Diseases↗
PubMed1993

Treatment of proteinuric patients with a vegetarian soy diet and fish oil.

Our aim was to determine whether a longer period of treatment with a vegetarian soy diet with addition of fish oil supplements would accentuate the beneficial effects on hyperlipidemia and proteinuria of nephrotic patients we found in a previous study. After an 8-week baseline period on free diet, patients were randomly allocated either on soy diet alone (SD) or to SD plus 5 g/day of fish oil (SD + FO) orally for two months. Then they crossed over to the other treatment for two additional months. They finally resumed eating the free diet for 3 months. We selected 20 outpatients with chronic glomerulonephritis, proteinuria in the nephrotic range, fasting serum cholesterol > 250 mg/dl, mean serum creatinine concentrations 1.75 +/- 0.23 mg/dl. Serum lipid profile, urinary protein loss and nutritional parameters were monitored. With the soy diet, we obtained a significant decrease both of hyperlipidemia and of proteinuria. The effect of the soy diet on proteinuria increased over the 4 months. The addition of a moderate amount (5 g/day) of fish oil in a randomized cross-over design had no further beneficial effect. Stability of serum albumin, transferrin and the body mass index documented good nutritional status. In conclusion, the dietary manipulation with our vegetarian soy diet confirmed the beneficial effects on hyperlipidemia and proteinuria of nephrotic patients. Such effects persisted and even ameliorated after 4 months of diet. The addition of moderate oral supplements of fish oil did not potentiate the beneficial effect.

Diet, Vegetarian↗
PubMed1992

Effect of vegetarian soy diet on hyperlipidaemia in nephrotic syndrome.

Nephrotic patients with persistent proteinuria also have various lipid abnormalities that may promote atherosclerosis and more rapid progression of renal disease. We aimed to find out whether dietary manipulation can correct the hyperlipidaemia found in these patients. After a baseline control period of 8 weeks on their usual diets, 20 untreated patients with chronic glomerular diseases, stable long-lasting severe proteinuria (5.9 [SD 3.4] g/24 h) and hyperlipidaemia (mean serum cholesterol 8.69 [3.34] mmol/l) ate a vegetarian soy diet for 8 weeks. The diet was low in fat (28% of total calories) and protein (0.71 [0.36] g/kg ideal body weight daily), cholesterol free, and rich in monounsaturated and polyunsaturated fatty acids (polyunsaturated/saturated ratio 2.5) and in fibre (40 g/day). After the diet period the patients resumed their usual diets for 8 weeks (washout period). During the soy-diet period there were significant falls in serum cholesterol (total, low-density lipoprotein, and high-density lipoprotein) and apolipoproteins A and B, but serum triglyceride concentrations did not change. Urinary protein excretion fell significantly. The concentrations of all lipid fractions and the amount of proteinuria tended to return towards baseline values during the washout period. We do not know whether the favourable effect of this dietary manipulation on proteinuria was due to the qualitative or quantitative modifications of dietary protein intake or was a direct consequence of the manipulation of dietary lipid intake.

Adolescent↗
PubMed1992

Feasibility of a long-term low-sodium diet in mild hypertension.

The present study set out to assess the feasibility of long-term moderate dietary sodium restriction in patients with mild hypertension in general practice. After screening and a run-in phase of 6-8 weeks, a total of 77 previously undiagnosed mildly hypertensive patients were identified. Half of them were randomized to receive a few simple dietary instructions from their general practitioners in order to reduce salt usage; the others were randomized to receive no advice. The patients were followed up for 12 months with quarterly visits. A total of 56 patients (72.7%) completed the study, 26 on a low-sodium diet (LD) and 30 on their usual diet (UD). At each visit in the diet phase, patients provided 24h urine, which was analysed for volume and sodium concentration in order to assess their sodium intake. Blood pressure, heart the rate and body weight were recorded. The mean urinary sodium excretion for all diet phase visits overlapped in the two groups (177.0 +/- 32.9 vs. 169.3 +/- 49.4 mEq/24h respectively in the LD and UD groups). Nevertheless the mean systolic and diastolic blood pressures for all diet phase visits were significantly lower in the LD than in UD group (144.2 +/- 11.1/91.6 +/- 6.4 and 148.0 +/- 13.7/95.6 +/- 4.7 mmHg respectively, P less than 0.01). Our data suggest that it is not feasible at present to reduce sodium intake in mild hypertensives with simple and inexpensive dietary instructions, the only ones suitable for widespread application in general practice.

Adult↗
PubMed1992

Effect of dietary manipulation on the lipid abnormalities and urinary protein loss in nephrotic patients.

We performed two trials. The former was a multicentric trial on 24 untreated patients with nephrotic syndrome due to membranous nephropathy to ascertain whether or not a long-term reduction of protein intake reduces urinary protein loss. In a randomized cross-over design the patients ate sequentially each for 3 months a normal protein diet (1.1 +/- 0.3 g/kg/day of proteins) and a low-protein diet (0.7 +/- 0.1 g/kg/day). Both diets were low in fat (< 30% of total calories). Neither urinary protein excretion nor serum albumin concentration were significantly different at the end of the low protein diet period or the normal protein diet period. We found that after 6 months of dietary manipulation serum total and LDL-cholesterol were reduced by 24 and 27% from the values at the beginning of the run-in period, also the mean 24 h proteinuria was significantly lower. In the later trial, after a baseline control period of 2 months on free diet, 20 untreated nephrotic patients were fed for two months a vegetarian soy diet, low in fat (28% of total calories) and in proteins (0.71 +/- 0.36 g/kg ideal body weight/day). At the end of the diet period all patients ate the same free diet as in the baseline period for 2 more months. The soy diet induced highly significant decreases in total serum cholesterol (28%). LDL-cholesterol (33%), apolipoprotein B (19%), urinary protein excretion (32%), that reversed on discontinuation of the diet.(ABSTRACT TRUNCATED AT 250 WORDS)

Dietary Fats↗
PubMed1991

Low-protein diet and glomerular size-selective function in membranous glomerulopathy.

We studied the effect of dietary protein restriction on glomerular function and proteinuria in nine patients with membranous nephropathy. Patients were randomly assigned to a 3-month period of a normal protein diet (NPD, 1.3 mg/kg/d) or of a low-protein diet (LPD, 0.6 mg/kg/d), in a cross-over design. Dietary protein restriction did not affect glomerular filtration rate (47.8 +/- 10.7 and 49.0 +/- 13.5 mL/min/1.73 m2, LPD and NPD, respectively) and renal plasma flow (456 +/- 119 and 499 +/- 161 mL/min/1.73 m2, LPD and NPD, respectively), nor did it significantly improve glomerular permselective function, as shown by urinary protein excretion (3.1 +/- 2.2 and 3.5 +/- 2.8 g/d, LPD and NPD, respectively) and fractional clearance of albumin, IgG, and neutral dextran molecules of graded molecular size (radii ranging from 2.8 to 6.0 nm). These results indicate that reduction of protein intake to 0.6 g/kg/d does not improve glomerular size selectivity in membranous nephropathy. Thus, in current clinical practice, a protein-restricted diet does not appear to be effective in reducing proteinuria in this category of patients.

Adult↗
PubMed1991

Effect of dietary proteins and lipids in patients with membranous nephropathy and nephrotic syndrome.

Twenty-four patients with idiopathic membranous nephropathy, long-lasting nephrotic syndrome and serum creatinine less than 2 mg/dl ate sequentially, in a randomized cross-over design, a normal protein diet containing 1.1 +/- 0.3 g/kg/day of proteins and a low protein diet containing 0.7 +/- 0.1 g/kg/day of protein, each diet for a period of 3 months. Both diets were low in fat (less than 30% of total calories) and cholesterol (less than 200 mg/day) content and rich in polyunsaturated fatty acids and in linoleic acid (10% of energy). Random assignment to one of the two 3 month diet periods was done after a RUN-IN period of at least one month on the hypolipidic normal protein diet. Glomerular filtration rate (inulin clearance), 24 hour urinary protein loss and serum albumin concentration did not significantly differ at the end of the two diet periods, indicating that long-term restriction of protein intake does not modify GFR or urinary protein loss in nephrotic patients. Serum total and LDL-cholesterol and daily proteinuria were significantly lower at the end of both diet periods than at the beginning and at the end of the RUN-IN period. We suggest that these changes were a consequence of the manipulation of dietary fat intake.

Adult↗