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Biomedical subjects

M Giovannini

Publications and source records attributed to M Giovannini.

At least 145 records · Page 8Linked to original sources
PubMed1997

Effect of technological treatments on digestibility and allergenicity of meat-based baby foods.

OBJECTIVE: When suitability prepared according to particular characteristics of hygiene and digestibility, meat is an important food for human weaning. The present knowledge on meat digestibility and allergenicity are not enough to justify removal of meat from a child's diet when there is risk but no clinical evidence of allergy. Based on these considerations, the role of technological treatments on digestibility and allergenicity of meat-based baby foods is considered. SUBJECTS: Eight children (five males and three females) suffering from atopic dermatitis (AD), aged 3.8 to 7.1 years (mean age 4.86 +/- 1.10 years). STUDY DESIGN AND METHODS: An in vitro multienzymatic digestibility assay was used to evaluate proteolysis in meat samples (from four different animal species). The experimental design included raw, steam-cooked (home-made and industrial cooking), homogenized (strained) and freeze-dried meat samples. Skin prick test (SPT) was performed to evaluate positive responses to meat samples (raw, cooked, strained and freeze-dried) from four animal species. RESULTS: Our data indicate that enzymatic attack is strongly affected by heat treatment as shown in steam-cooked meat samples. On the other hand, blending, homogenization and freeze-drying processes are able to partially reverse the phenomenon. Data on modification of sodium dodecyl sulfate-polyacrylamide gel rlectrophoresis (SDS-PAGE) protein pattern during the multienzymatic assay are reported. Cooking and technological treatments reduce positive responses obtained in SPT. CONCLUSIONS: Technological treatments improve digestibility and reduce antigenicity of meat products.

Animals↗
PubMed1997

Meat allergy: III--Proteins involved and cross-reactivity between different animal species.

BACKGROUND: Although relatively infrequent, meat allergy represents a serious problem for children both because it is generally associated with intolerance to other protein sources and because of the suggested role of meat in stimulating the gastrointestinal development during weaning. OBJECTIVE: With these considerations, the aim of our work was to improve biological-biochemical knowledge of meat allergy. METHODS: This study was performed using in vivo skin prick test (SPT) and in vitro (electrophoresis associated with the immunoblotting technique) tests. RESULTS: Bovine serum albumin (BSA) and actin were the proteins most frequently involved in binding with the circulating IgE. BSA involvement was confirmed by SPT; the high number of positive responses observed with actin in immunoblotting was not confirmed by SPT data. Cross-reactivity between serum albumins from different animal species was demonstrated. Our studies show that in this group of children, the correspondence between the percentage of sequence identity (phylogenetic similarity) and the number of positive responses was surprisingly high. CONCLUSIONS: Although further studies are necessary, the data reported here provide new biochemical data on meat allergy.

Actins↗
PubMed1997

Developmental quotient at 24 months and fatty acid composition of diet in early infancy: a follow up study.

AIM: A follow up study of developmental quotient (DQ) at 24 months of toddlers whose diets in early infancy differed in fatty acid composition, and in whom an association between diet and DQ was observed at 4 months. METHODS: 81 toddlers were distributed among three groups according to early type of diets standard infant formula (SFo, n = 30); long chain polyunsaturated fatty acid (LC-PUFA) enriched formula (LCPFo, n = 26); human milk (HM, n = 25). DQ at 24 months was assessed by Brunet-Léxine's psychomotor developmental test. A subgroup (n = 20; SFo 8; LCPFo 6; HM 6) was tested for erythrocyte phosphatidyicholine and phosphatidylethanolamine. RESULTS: No DQ differences were found by analysis of variance. Neither DQ nor erythrocyte docosahexaenoic acid at 4 months were predictors of DQ scores at 24 months. Phosphatidylcholine arachidonic and docosahexaenoic acid correlated positively, and phosphatidylcholine linoleic acid and phosphatidylethanolamine eicosapentaenoic acid negatively, with DQ. Multiple regression analysis including these variables explained 52% of inter-individual DQ variance. A strong association was found between the erythrocyte phosphatidylcholine arachidonic/ linoleic acid ratio and DQ (r = 0.75; p = 0.0001). CONCLUSIONS: The diet/DQ association found at 4 months was not predictive of DQ scores at 24 months. Irrespective of dietary or genetic factors, there appears to be a strong correlation between the LC-PUFA composition of the red cell membrane and higher neurodevelopmental performance.

Breast Feeding↗
PubMed1997

Characteristics of the new milks for infants: fatty acids, nucleotides, selenium.

Several studies have focused on the composition of macro- and micro-nutrients of human milk in order to define a gold standard for the composition of infant formulas. Human milk contains animal-fats mainly characterized by the presence of long-chain polyunsaturated fatty acids (LCPUFA) of both the n-6 and n-3 series which have structural and functional roles, particularly in preterm infants. It is still discussed whether dietary LCPUFA may have positive effects on the neurodevelopmental steps of term infants too. Nucleotides are low-molecular weight compounds. They seem to enhance the intestinal growth and maturation as well as the immune function, and play a role in energy metabolism. Selenium is involved in protective reactions. Despite there is no scientific consensus to support the use of LCPUFA in term formulas, it is advisable to improve formulas just to approach more closely the composition of human milk. As long as nucleotides are concerned further studies must be carried out in order to define their efficacy and safety. The potential generation of hydroxy radicals from the new molecules added to formulas point out also the protective role of antioxidant molecules such as selenium in infant nutrition.

Animals↗
PubMed1997

[Endosonography in the preoperative evaluation of cancers of the esophagus].

OBJECTIVE: To assess the diagnostic accuracy of endoscopic ultrasonography (EUS) for the local and regional staging of esophageal cancer, and its possible alteration resulting from the performance of preoperative chemoradiation. METHODS: Prospective study of 85 consecutive patients with esophageal cancer evaluated by EUS and operated on between January 1992 and December 1995. 28 of these patients had received previous induction therapy. In all cases, EUS examination was performed by the same physician not informed about the results of previous morphological explorations. Histopathological analysis of all operative specimens was performed by the same pathologist, not informed about the results of EUS. Data were collected by another independent observer. RESULTS: EUS examination resulted in incomplete staging in 8 patients (9.5%) with severe stenosis precluding endoscope passage. The accuracy, specificity and sensitivity of EUS in detecting the depth of esophageal involvement (T0-2 vs. T3-4) were 82.3%, 78%, and 86% respectively, and 72%, 70%, and 73% respectively for lymph node metastasis. The overall accuracy of EUS in identifying the preoperative stage was 67%, with a clear-cut alteration when patients had received induction therapy (61% vs 72%). On the other hand, 7 (64%) of the 11 patients thought to have a complete response at endosonography had no residual tumor. CONCLUSION: EUS provides precise information for the preoperative identification of locally advanced esophageal tumor, even after induction therapy. The latter alters the diagnostic accuracy of EUS, although complete responders could be identified in two-thirds of cases.

Adult↗
PubMed1997

[Recurrence after surgical treatment of epidermoid cancers of the esophagus. Therapeutic approach in 19 patients].

OBJECTIVES: The aim of this study was to report the management of 19 patients with recurrence of esophageal squamous cell carcinoma after surgical treatment. PATIENTS-METHODS: Nineteen patients with loco-regional recurrent invasion (n = 13) or metastasis (n = 6) of esophageal squamous cell carcinoma were included. Four of the 13 patients with loco-regional recurrent invasion had tracheal involvement. The treatment of the recurrence was a combined radiochemotherapy (n = 12) for loco-regional recurrent invasion in 11 cases and for metastasis in 1 case, associated with a tracheal prosthesis in 1 patient. The other treatments were chemotherapy alone (n = 5), esophageal prosthesis (n = 1) and surgical treatment (n = 1). RESULTS: There were 7 objective responses among the 12 patients treated with combined radiochemotherapy and none in the group treated with chemotherapy alone. Grade 3-4 toxicity was noticed in 2 cases (severe mucositis). Survival rate of the 19 patients was 52.6% at 1 year and 13.1% at 2 years; it was linked with general health (P = 0.09) and with tracheal involvement (P = 0.04). Survival rate of the 12 patients treated by combined radiochemotherapy was higher: 66% at 1 year and 22.2% at 2 years (median survival time = 16 months). CONCLUSION: Active medical treatment of recurrence of esophageal squamous cell carcinoma by combined radiochemotherapy can provide a median survival time of 16 months, with a moderate toxicity.

Adult↗
PubMed1997

[Induction treatment of locally advanced operable cancers of the esophagus. Prognostic significance of the histologic response].

OBJECTIVE: The purpose of this study was to determine the prognostic significance of the histopathological response to preoperative radio-chemotherapy in patients with locally advanced oesophageal cancer. METHODS: Among the 57 patients included in this open prospective study, the disease-free survival of 48 patients (8 females 40 males; mean age: 56.6 years +/- 8.4) who underwent an oesophagectomy after induction therapy for oesophageal squamous cell (n = 38) or adenocarcinoma (n = 10) was correlated with the histopathological findings. Chemoradiation included 2 cycles associating continuous 5 FU from D1 to 5 and from D22 to 26, cisplatyl on D1 and D22, 15 Gy/5d from D1 to 5 and from D22 to 26. Histopathological response was assessed on the operative specimens by routine examination of serial thin sections each 5 mm along the full oesophageal length, the resection margins and the lymph node dissection. RESULTS: A wide interindividual variability was seen regarding tissue changes related to induction therapy, with a grading in tumor regression and the possibility of dissociated effects on the various treatment targets: tumor, adenopathy and vessel invasion. The 5-year probability of disease-free survival was 22% for the 48 resected patients. The presence of a complete histopathological response (n = 12) did not preclude metastatic spread in half the cases. Furthermore, it did not result in improved survival when compared to that of non-responder patients. Survival of patients who had a complete or major oesophageal response (n = 29, 35% at 5 years) was significantly lower than that of patients who were operated on during the same period for a superficial oesophageal cancer at presentation (n = 29, 57% at 5 years; P = 0.03). After multivariate analysis according to the Cox model, downstaging of the primary tumor was not identified as an independent predictor of disease-free survival. CONCLUSIONS: Pathologic assessment of tumor regression on the operative specimen provides little prognostic information.

Adenocarcinoma↗
PubMed1996

PAH deficiency in Italy: correlation of genotype with phenotype in the Sicilian population.

The results of the neonatal screening for phenylalanine hydroxylase (PAH) deficiency in Sicily show that its incidence is higher than previously reported for mainland Italians and that non-PKU HPA is in excess of classical and mild PKU. The latter finding suggests that a high number of non-PKU HPA mutations would occur in the Sicilian population compared to populations with an inverted PKU/non-PKU HPA ratio. Previous studies have identified 40 mutations accounting for the majority (98%) of mutant alleles underlying PAH deficiency in Sicily. In order to study the molecular basis of the distribution of PAH deficiency phenotypes in the Sicilian population, we have correlated 31 of those mutations with clinical and metabolic phenotypes in 12 mentally retarded patients, 14 treated patients with classic or mild PKU, and 13 subjects presenting the non-PKU HPA phenotype. The present study proposes a tentative classification for a large number (26) of PAH gene mutations which may represent an additional tool for establishing a differential diagnosis for PAH deficiency in the Sicilian population.

Amino Acid Metabolism, Inborn Errors↗
PubMed1996

Fatty acid metabolism in phenylketonuria.

Children treated for phenylketonuria (PKU) have a low intake of whole animal foods. Consequently, the dietary intake of long-chain polyunsaturated fatty acids (PUFA) is just a few milligrams per day, mostly represented by arachidonic acid (AA). In a consecutive series of studies, we assessed in treated PKU children their long-chain PUFA status, the AA-related eicosanoid synthesis and the effects of specific PUFA supplementations. We found that the good compliance with the dietary regimen negatively influences the long-chain PUFA status and serum eicosanoid release from platelets. Supplementation with either marine or blackcurrant oils modifies the long-chain PUFA status of PKU children without approaching the fatty acid pattern of a healthy control population. Good-compliant PKU patients have diet-related, low levels of circulating long-chain PUFA, whose clinical and functional consequences deserve further investigation. The effects of dietary supplementations with long-chain PUFA of both the n-6 and n-3 series should be carefully evaluated.

Adolescent↗
PubMed1996

Esophageal cancer resection in the elderly.

OBJECTIVE: Esophageal cancer is a disease whose prognosis is dismal and its surgery involves considerable risks, consequently the opportunity of esophageal resection in elderly patients with esophageal cancer is questionnable. The aim of this study was to analyze, with respect to their age, the outcome of 386 consecutive patients who underwent esophagectomy and simultaneous replacement for cancer. METHODS: A chart review of all patients with esophageal carcinoma admitted to our institution was undertaken for the period January 1979-December 1994. RESULTS: The portion of patients of 70 years of age and older (14.5%) has slightly increased during the period. Location to the lower third of the esophagus and adenocarcinoma type were prevalent in the 56 elderly patients (group I), but their postsurgical TNM staging was identical to that of the 330 younger patients (group II). Other clinical features, i.e. preoperative weight loss and the presence of co-morbid diseases, however, were comparable in the two groups. Pulmonary function, as assessed by spirometry, was significantly worse among the older patients, but blood gas determinations were not different. Operative mortality was comparable, between the two groups (10.7% vs 11.2%). Major morbidity included anastomotic leak (10.7% vs 13.6%) and pulmonary complications (17.9% vs 20.6%) in both groups. Excellent palliation of dysphagia was achieved in 92% of the 50 group I patients who survived the operation. Long-term survival was not different in elderly patients (5-year rate: 17%) when compared with that of younger patients (18.9%). CONCLUSION: These data suggest that esophagectomy can be performed safely in selected septuagenarian patients, thus allowing a substantial survival with excellent functional status in a portion of these patients.

Adenocarcinoma↗
PubMed1996

De novo expression of transforming growth factor-alpha in parathyroid gland tissue of patients with primary or secondary uraemic hyperparathyroidism.

BACKGROUND: The factors involved in abnormal parathyroid cell secretory function and growth in patients with primary and secondary hyperparathyroidism are still incompletely understood. PATIENTS AND METHODS: We studied the expression of transforming growth factor-alpha (TGF-alpha), epidermal growth factor (EGF) and EGF receptor (EGF-R) at the gene message and the protein level in parathyroid tissue obtained from six patients with primary hyperparathyroidism, 15 patients with secondary uraemic hyperparathyroidism and five subjects with normal parathyroid tissue, using in situ hybridization and/or immunostaining technique. RESULTS: We found a consistent expression of TGF-alpha mRNA and protein in parathyroid endocrine cells of all six cases of primary parathyroid adenoma and in nearly all cases of secondary hyperplasia, in contrast to the absence of expression in normal parathyroid tissue. A marked expression of EGF-R mRNA and protein was also found in four of five tissue samples of primary parathyroid adenoma, in 13 of 15 tissue samples of secondary parathyroid hyperplasia and in most samples of normal parathyroid gland tissue. EGF mRNA and protein expression was undetectable in the majority of parathyroid tissue samples examined. CONCLUSION: Since TGF-alpha is known to bind to the EGF-R, the finding of an increased expression of TGF-alpha at the gene message and the protein level, together with a strong expression of EGF-R, in hyperplastic and adenomatous parathyroid glands suggests that this growth factor interacts with its receptor to promote parathyroid cell proliferation, perhaps by an autocrine mechanism.

Adult↗
PubMed1996

Early breastfeeding is linked to higher intelligence quotient scores in dietary treated phenylketonuric children.

Strict control of phenylalanine intake is the main dietary intervention for phenylketonuric children. Whether other dietary-related factors improve the clinical outcome for treated phenylketonuric children in neurodevelopmental terms, however, remains unexplored. We retrospectively compared the intelligence quotient (IQ) score of 26 school-age phenylketonuric children who were either breastfed or formula fed for 20-40 days prior to dietary intervention. Children who had been breastfed as infants scored significantly better (IQ advantage of 14.0 points, p = 0.01) than children who had been formula fed. A 12.9 point advantage persisted also after adjusting for social and maternal education status (p = 0.02). In this sample of early treated term infants with phenylketonuria there was no associated between IQ scores and the age at treatment onset and plasma phenylalanine levels during treatment. We conclude that breastfeeding in the prediagnostic stage may help treated infants and children with phenylketonuria to improve neurodevelopmental performance.

Breast Feeding↗
PubMed1996

[Surgical treatment of esophageal cancer in patients over 70 years of age].

As the population continues to age, septuagenarian patients with esophageal cancer are frequently referred for surgical treatment. The aim of this study was to analyze with respect to their age the outcome of 386 patients who underwent esophagectomy and simultaneous reconstruction from 1979 to 1994. The portion of patients of 70 years of age and older (14.5%) has slightly increased during the period. Location to the lower third of the esophagus and adenocarcinoma type were prevalent in the 56 elderly patients (Group I), but postsurgical TNM staging was identical to that of the 330 younger patients (Group II). Other clinical features, i.e., preoperative weight loss and presence of co-morbid diseases, however, were comparable in both groups. Pulmonary function, as assessed by spirometry, was significantly worse among the older patients, but blood gas determinations were not different. Operative mortality was comparable among the 2 groups (10.7% vs 11.2%). Major morbidity included anastomotic leak (10.7% vs 13.6%) and pulmonary complications (17.9% vs 20.6%) in both groups. Long term survival was not different in elderly patents (5-year rate: 17%) when compared with that of younger patients (18.9%). These data suggest that 1) esophagectomy can be performed in selected septuagenarian patients with an acceptable risk, and 2) long-term survival with excellent functional status is attainable in this age group in a portion of these patients.

Age Factors↗