[Effects of alcohol on intestinal absorption].
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Biomedical subjects
Publications and source records attributed to A Celada.
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The effect of alcohol on inorganic and organic iron absorption was studied in 70 subjects, using a whole-body counter technique. The mean iron absorption of a test dose was 24.44%, while in the presence of whisky, absorption fell to 9.73% (P less than 0.0001). Absorption of a test dose in the presence of whisky without alcohol was 10.14% (P less than 0.0001). The alcohol in whisky, therefore, was not responsible for the diminished iron absorption (P greater than 0.20). The absorption of the iron contained in wine with alcohol was 73.31 microgram and wine without alcohol was 67.50 microgram. The difference was not statistically significant (P greater than 0.20). The absorption of inorganic iron contained in a test meal was 165.55 microgram and was not changed in the presence of ethanol (151.35 microgram) (P greater than 0.10). However, the presence of ethanol affected the absorption of heme iron: 538.68 microgram compared with 442.41 microgram with ethanol (P less than 0.0001). These studies show that the acute ingestion of ethanol does not influence the absorption of inorganic iron, while it does diminish the absorption of the organic form.
A precise although technically complicated method is described for the estimation of iron absorption. A steel chamber is used to measure the total radioactivity of the patients. A dose of 59Fe is administered orally and the retention of radioactivity is measured on the 14th day, this amount being equivalent to the amount absorbed. In our male group, the mean absorption of inorganic iron was 22.5 +/- 8%, and in females it was 43.3 +/- 11%. In 10 patients with iron deficiency anemia, the mean was 92.2 +/- 6% , in 10 with gastric achylia it was 4.6 +/- 4%, and in 12 chronic alcoholics a value of 13.9 +/- 7% was found.
A baby girl, born prematurely and with Down's syndrome, is hospitalized at the age of 51 days for a megaloblastic anemia. The anemia was caused by a selective malabsorption of vitamin B12 (Imerslund's syndrome), even in presence of intrinsic factor. The pathogenesis of different causes of vitamin B12 deficiency is discussed and the favourable development of this case after four years of treatment is shown.
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The effect of polytransfusion regimen is studied in two patients with thalassaemia major over a period of 74 and 56 months respectively. In both cases we have observed an improvement of the general condition in the growth as well as a reduction of hepatosplenomegaly and cardiomegaly. Furthermore a decrease of reticulocytes, erythroblasts and fetal hemoglobin values was obtained. The consequences of these frequent transfusions on iron storage metabolism are discussed. The advantage of giving HLA compatible blood is demonstrated by only a weal alloimmunization in one patient having received 77 HLA compatible transfusions and the lack of immunization in the second patient after 52 transfusions. In 6 other patients affected with thalassaemia major and 3 more with bone marrow aplasia, transfusion with incompatible HLA blood was followed by immunization of variable importance.
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The authors have investigated the assumption that alcohol increases iron absorption. Using the whole body counter technique, they show that iron absorption is lowered significantly by addition to the test dose of either normal or dealcoholized whisky, but that there is no difference between these two latter groups. Wine has a similar effect. The use of ethanol added to a test meal demonstrates that it is organic iron, and not the inorganic form, whose absorption is diminished by alcohol.
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A 75-year-old woman was hospitalized with autoimmune hemolytic anemia. During a period of 22 months the patient had six hemolytic crises which responded to treatment with prednisone and azathioprine. During the last admission the patient presented a sideroblastic anemia with 98% of 'ring sideroblasts' in the bone marrow. This association has never, to our knowledge, been reported before. It is possible that the immunosuppression played a definite role in the development of this sideroblastic anemia.
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Sera from 22 patients with systemic lupus erythematosus (SLE) were examined for the presence of hepatitis B antigen (HBsAG) by a complement fixation (CF) test, by an immunoelectrophoretic method (counterelectrophoresis-CEP), and by radioimmunoassay (RIA). The sera from 8 patients gave positive results using CF. However, the same sera and sera from 28 additional SLE patients, when tested with CEP and RIA, were not shown to contain HBsAG.