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Biomedical subjects

G Damia

Publications and source records attributed to G Damia.

At least 73 records · Page 4Linked to original sources

Parenteral nutrition of injured patients: Effect of manipulation of aminoacid infusion (increasing branched chain while decreasing aromatic and sulphurated aminoacids).

Sixteen critically ill injured patients received parenteral nutrition providing nitrogen (0.34 g kg(-1) day(-1)) and glucose (32 kcal kg(-1) day(-1)) for 5 days. They were randomly divided into two groups with respect to aminoacid supply: an essential aminoacid solution vs the same solution enriched in branched chain amino acid (BCAA) content and decreased in phenylalanine and methionine content (mean BCAA intake, 0.55 vs 0.69 g kg(-1) day(-1)). Basal values of nitrogen metabolism without treatment showed no difference between the two groups. Nitrogen losses and 3 methylhistidine (3-MEH) excretion were elevated; the plasma aminoacid pattern was altered by the trauma and except for phenylalanine, aspartate and glutamate, plasma aminoacid concentrations were decreased below normal values. Net muscular aminoacid output was demonstrated by femoral arterio-venous (av) differences that were all negative except for glutamate and citrulline TPN with both solutions improved the nitrogen balance and reduced the negative aminoacid balance across the leg. Adjusting a TPN regimen to increase the BCAA content without altering the total nitrogen infused, had no effect on overall nitrogen balance, but exerted a beneficial effect on body protein catabolism, as assessed by the urinary 3-MEH excretion rate, and a transient improvement in the aminoacid balance across the leg at the peak of the infusion. The short-lived effect of BCAA suggest a metabolic effect of these aminoacids which deserves further study.

Journal Article↗

The main determinants of nitrogen balance during total parenteral nutrition in critically ill injured patients.

Factors influencing nitrogen balance during total parenteral nutrition have been investigated in 34 critically ill injured patients studied during the first 6 days after trauma. Basal nitrogen balance was severely negative (-0.26 +/- 0.12 (SD) g X kg-1), but improved consistently during treatment. Nitrogen intake proved to be the major determinant of a positive, or less negative, nitrogen balance, only secondarily followed by total energy intake corrected to predicted basal energy expenditure, according to multiple regression analysis. The amount of non-protein calories and the non-protein calorie to nitrogen ratio appeared to have little significance on nitrogen balance, when corrected for the two former variables.

Adolescent↗

Ovarian reticular cell sarcoma of the mouse (M5076) made resistant to cyclophosphamide.

Resistance of mouse M5076 (M5) ovarian reticular cell sarcoma to cyclophosphamide (CTX) was obtained in vivo by repeated drug treatment followed by transplantation of the regrowing tumor. After 16 passages, we obtained an M5 subline resistant to CTX (M5-CTX-16R). Median survival times were approximately 29 and 39 days for M5 and M5-CTX-16R, respectively. Survival of M5-bearing mice given a single i.p. dose of 200 or 300 mg/kg was 160 and 168% of controls, respectively, whereas in M5-CTX-16R it ws 103 and 123%, respectively. The resistance was not reversible after 14 additional passages with no further CTX treatment. M5 and M5-CTX-16R appear similar in histological features, pattern of metastasis formation, and DNA content, as assessed by flow cytometry (hypotetraploid). Metastases of M5-CTX-16R were also resistant to CTX. Flow cytometry studies 12 and 24 hr after CTX treatment revealed a block in S and G2-M phases in both tumors. After 48 hr and at subsequent times, no cytokinetic pertubation was evident in M5-CTX-16R, whereas in M5 marked accumulation of cells in G2-M was observed at 48, 72, 96, and 120 hr. Cross-resistance was found between CTX, L-phenylalanine mustard, chlorambucil, and hexamethylmelamine. M5-CTX-16R was sensitive, but less so than M5, to cis-platinum, 1,3-bis(2-chloroethyl)-1-nitrosourea, and imidazole-4-carboxamide,5-(3,3-dimethyl-1-triazene). Adriamycin was equally active on M5 and M5-CTX-16R, while 4'-demethylepipodophyllotoxin-9-(4,6-O-ethylidine-beta-D-glucopyranoside) was inactive. This model appears to be suitable for studies on the mechanism of resistance to CTX and alkylating agents and for screening new, non-cross-resistant drugs.

Animals↗

Treatment of acute respiratory failure with low-frequency positive-pressure ventilation and extracorporeal removal of CO2.

Terminal respiratory failure was reversed in three patients with a combination of extra-corporeal CO2 removal through a membrane lung and oxygen diffusion into the diseased lungs between mechanical breaths induced at a frequency of 2-3/min. The technique seems to prevent the pulmonary barotrauma and extrapulmonary derangements caused by conventional mechanical ventilation.

Acute Disease↗

Hemodynamics and renal function during low frequency positive pressure ventilation with extracorporeal CO2 removal. A comparison with continuous positive pressure ventilation.

Six lambs were anesthetized and connected venovenous mode to a Membrane Lung for Extracorporeal CO2 removal. The animals underwent several hours periods of continuous positive pressure ventilation (CPPV), at 5 cmH2O positive end expiratory pressure (PEEP), alternated with several hours periods of low frequency positive pressure ventilation (5 cmH2O PEEP, 2 b.p.m.) with extracorporeal CO2 removal (LFPPV-ECCO2R). During LFPPV-ECCO2R compared with CPPV, cardiac output increased by 26%, pulmonary vascular resistances and systemic vascular resistances decreased by 28% and 22% respectively. The renal function improved significantly during LFPPV-ECCO2R compared with CPPV, i.e. urinary flow, creatinine clearance and osmolar clearance increased by 50%, 37% and 52% respectively. In these experiments LFPPV-ECCO2R, a form of completely artificial ventilation, seems to prevent hemodynamic and renal complications of CPPV.

Animals↗

[Phalloidine intoxication. Results of various forms of treatment in 47 patients].

The effectiveness of three plasma cleansing techniques (exchange transfusion, peritoneal dialysis and plasmapheresis) is studied in the treatment of phalloides intoxication. The severity of the latter is dependent upon the amount of toxin ingested, with can now be measured by radio-immunology, as well as the fixation of the toxin in the liver. Methods to ensure its elimination must be instituted as soon as possible. Thus in 43 patients who had consumed more than 50 g of fresh fungi, there were no deaths amongst those treated during the first 36 hours and 7 deaths out of 22 patients treated late. It is not yet possible to define the respective values of each method.

Adolescent↗