Search PubMed⌕ Search

Biomedical subjects

S Mobarhan

Publications and source records attributed to S Mobarhan.

90 records · Page 5Linked to original sources
PubMed1983

[Determination of glutathione reductase activity in erythrocytes and whole blood as an indicator of riboflavin nutrition].

Recent developments in riboflavin statis assessment suggest the possibility of satisfactory replacement of the method based on the determination of glutathione reductase (GRe) (EC 1, 6, 4, 2) activity in erythrocytes by one on whole blood. The advantages would be the elimination of the steps of separation and washing of the erythrocytes, which may be of problematic execution under the difficult logistic conditions of field studies. In order to verify the interchangeability of the two methods, we have undertaken a comparison of the results obtained on 81 subjects. Our data show that the results of the whole blood method closely replicate those obtained on the erythrocytes and that all cases are correctly classified in terms of riboflavin status assessment. A linear regression analysis shows that the two methods overlap perfectly, with a highly significant (P less than 1%) correlation coefficient (r = 0.82). Sixty five percent of the variance of the dependent variable (CA GRsi) is accounted for by the variation of the independent variable CA GRe).

Adult↗
PubMed1983

Follow-up results of a new colomyotomy in the treatment of diverticulosis.

In the present study, we report upon the preliminary results of our technique of myotomy--combined colon-myotomy at L shaped or transversal T shaped--which includes a simultaneous incision of both longitudinal and circular muscle fibers, avoiding a large bloody area. Ten patients have been operated upon by this method, the results of follow-up examination of seven patients who were given roentgenologic and motility studies for a maximum of 24 months being reported upon. It appears that the technique is quite safe, with no mortality or morbidity being observed in the first ten patients operated upon. Even functional results are most satisfactory. On the basis of this preliminary study, the technique seems to offer better results than do other types of colomyotomies currently being used.

Adult↗
PubMed1982

Long-term results of Roux-en-Y hepaticojejunostomy and hepaticojejunoduodenostomy.

The results of the long-term follow-up of 202 patients with Roux-en-Y hepaticojejunostomy (Roux-en-Y HJ) and 19 with hepaticojejunoduodenostomy (HJD) are reported. The mortality, morbidity, and the incidence of postoperative anastomotic stenosis were comparable in both groups. One hundred forty patients with Roux-en-Y HJ and 19 with HJD were followed with barium meal and endoscopy. An incidence of 5% postoperative duodenal ulcer was noted in the first group, while no ulcer was seen in the patients with HJD. Preoperative and postoperative gastric acid secretion (basal acid secretion and maximal acid secretion) and serum gastrin levels (basal and after protein meal) were measured in 25 cases with Roux-en-Y HJ and 19 with HJD. The serum gastrin levels were similar initially and remained unchanged after surgery in both groups. However, the mean levels of basal and maximal acid output, which was similar before surgery in both groups, increased significantly only in patients who had Roux-en-Y HJ (p less than 0.001). In conclusion, HJD should be adopted as the preferred type of anastomosis in patients with benign pathology and long-life expectancy.

Adult↗
PubMed1982

Riboflavin status among rural children in Southern Italy.

A sample of 107 boys aged 7-10 in a rural area of Southern Italy was studied for riboflavin deficiency and its association with milk consumption. The boys represented 74 per cent of the total male population of that age group in the study area. The nutritional status was assessed by means of anthropometric indicators, dietary intakes by a 24-h recall method and the riboflavin status was evaluated by the assay of erythrocyte glutathione reductase activity. The nutritional status was found to be generally satisfactory with about one tenth of the children presenting stunting, wasting, or obesity. This picture is comparable to that recorded at the national level. The overall incidence of biochemical riboflavin deficiency was 13 per cent. No clinical sign of riboflavin deficiency was observed. None of the anthropometric indicators of malnutrition appeared to be related to biochemical evidence of riboflavin malnutrition. Dietary data showed that the children consumed a relatively small amount of milk and dairy products (mean 224 +/- 109 g/d). Thirteen out of 14 children with biochemical evidence of riboflavin deficiency belonged to the group who consumed less than 300 g/d of milk. However, only 15 per cent of the children consuming less than 300 g/d of milk and dairy products had biochemical evidence of riboflavin deficiency. It appears that the dietary pattern in rural areas with traditionally low milk consumption is compatible with a relatively satisfactory riboflavin nutriture. This finding suggests that milk and dairy products may occupy, under different dietary practices, a role less critical than usually attributed.

Animals↗
PubMed1982

New approach to esophagocardiomyotomy: report of forty cases.

The major postoperative complications of esophagocardiomyotomy (ECM) for achalasia are peptic esophagitis due to gastroesophageal reflux and recurrence. According to other authors, the incidence of postoperative esophagitis is 15% ot 25%. We report the results obtained in 40 patients treated by our own surgical technique, which is based on precise anatomic and physiopathological criteria. With this technique an ECM without esophagogastric mobilization is performed via a lower thoracotomy with partial perihiatal phrenotomy. There were no intraoperative or postoperative deaths. Two patients had postoperative basal pleurisy which was cured easily in a short time. In 36 of these patients, a follow-up ranging between 15 years and 6 months revealed a complete remission of dysphagia. The patients had significant and speedy improvement in their general condition. Seven patients had substernal pyrosis when lying down, but this was relieved in a few months in six of them. In only one patient did it persist for 4 years after the operation. Ph-manometric serial control studies performed in all the patients revealed, except in one case, normal pressure and pH values in the lower esophagus. Because of these results, we consider our ECM technique very effective in the treatment of achalasia.

Adult↗
PubMed1981

Evaluation of the relative dose response test for vitamin A nutriture in cirrhotics.

The rise in serum vitamin A 5 h after a 450 microgram oral dose of the vitamin (retinyl palmitate) was used to assess vitamin A nutriture in patients with alcoholic cirrhosis. The test was carried out on 21 hospitalized male patients and 12 normal age and sex-matched control subjects. The relative dose response (RDR), expressed as percentage, was calculated as A5 - A0/A5 X 100 where A0 = the fasting serum retinol level and A5 = the serum retinol 5 h postdosing. Vitamin A-deficient patients (those with serum retinol levels less than 30 microgram/dl and an abnormal dark adaptation test or RDR greater than or equal to 14%) were treated with 4 wk of oral vitamin A (10,000 microgram/day), then repeat RDR and dark adaptation tests were carried out. Among eight cirrhotics with abnormal dark adaptation, the mean +/- SEM RDR was 21 +/- 9 versus 3 +/- 3% in patients with normal dark adaptation (p less than 0.01). RDR tests of patients with normal dark adaptation did not differ from those of 12 normal age and sex-matched control subjects (normal RDR response 0 to 14%). Among patients found to be vitamin A-deficient, treatment with vitamin A resulted in the mean +/- SEM RDR declining from 21 +/- 9 to 5 +/- 2%. However, this fall failed to reach statistical significance (p = 0.06). The RDR test appears to be useful as a predictor of vitamin A deficiency, even among patients with far advanced hepatic disease.

Dark Adaptation↗
PubMed1975

Use of blood component therapy for gastrointestinal bleeding in patients with cirrhosis of the liver.

A prospective study was designed to compare the administration of available fresh blood and component therapy in the treatment of gastrointestinal bleeding in patients with cirrhosis of the liver. Fifty bleeding cirrhotic patients were randomly assigned to treatment: 17 patients recieved 51 percent fresh blood (Group 1), 16 patients received 22 percent fresh blood (Group 2), and 17 patients received 25 percent component therapy consisting of packed cells, fresh frozen plasma, and platelet concentrate (Group 3). The mortality rate was unaffected by the type of blood replacement. Neither the blood replacement requirement (Group 1:51 plus or minus 0.9 units Group 2:5.5 plus or minus 0.8 units, Group 3:7.1 plus or minus 1.1 units) nor the duration of bleeding (Group 1:39 plus or minus 0.8 days, Group 2:6.3 plus or minus 2.4 days, Groups 3:5.8 plus or minus 1.0 days) were significantly different. There was no correlation between the mean age of blood or plasma received and the units of blood replaced or the duration of bleeding. Patients with severe coagulation abnormalties had a significantly increased mortality. Component therapy was as effective as the fresh blood regimen in cirrhotic patients with acute gastrintestinal hemorrhage.

Blood Transfusion↗
PubMedDate not supplied

Depletion of liver and esophageal epithelium vitamin A after chronic moderate ethanol consumption in rats: inverse relation to zinc nutriture.

This study was designed to determine whether chronic moderate ethanol ingestion alters the levels of vitamin A of liver and esophageal epithelium and if this is dependent on zinc nutriture. Forty male Sprague-Dawley 4-week-old rats were divided into five groups: zinc-deficient (0.9 ppm), ethanol-fed; zinc-deficient; zinc-adequate (25 ppm); zinc-adequate (25 ppm), ethanol-fed; and zinc-supplemented (50 ppm), ethanol-fed. All rats received liquid Lieber-DeCarli diet containing 4,000 IU per liter of vitamin A for 5 weeks. Zinc-deficient, ethanol-fed rats and zinc-adequate, ethanol-fed rats and zinc-supplemented, ethanol-fed rats received 15.5% of the caloric intake as ethanol while zinc-deficient and zinc-adequate rats received isocaloric amounts of maltose dextrin. All groups were pair-fed to zinc-deficient, ethanol-fed rats. In addition, a group of eight rats designated as weight-restricted controls were fed a diet similar to the one given to zinc-adequate rats but in the amount to obtain a final weight as in the zinc-deficient group. After 35 days, the liver histology was normal in all rats, and no fat accumulation was noted. Hepatic vitamin A concentration was significantly decreased in zinc-adequate, ethanol-fed rats (41 +/- 10 micrograms per gm) and further in zinc-supplemented, ethanol-fed rats (12 +/- 5 micrograms per gm) as compared to controls (137 +/- 49). A highly significant negative correlation between serum zinc and liver vitamin A was found in ethanol-fed animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Intraluminal fungal colonization of gastrostomy tubes.

Percutaneous endoscopic gastrostomy tubes are frequently colonized with fungal and bacterial organisms. This has not been previously reported. In our sample of 10 patients, nine percutaneous endoscopic gastrostomy tubes were colonized with fungi. This occurred as early as 1 week after placement. Candida tropicalis was isolated in five patients. It is hypothesized that a variety of fungi use components of the gastrostomy tube polymer, such as polymer additives, which contribute to the structural deterioration of the tube.

Aged↗
PubMedDate not supplied

Effect of enteral formula infusion rate, osmolality, and chemical composition upon clinical tolerance and carbohydrate absorption in normal subjects.

It is a common clinical practice to initiate enteral hyperalimentation using low flow rates or diluted formula. These adjustments are made in an effort to minimize patient intolerance. Using complex and elemental enteral formulas, we investigated whether various flow rates or osmolalities effected clinical intolerance or carbohydrate malabsorption in 20 healthy volunteers. Our infusion rates ranged between 50 and 150 kcal/hr and the osmolalities ranged between 325 and 690 mOsm/Kg of water. Even at the maximal flow rate and osmolality, our results show that both types of enteral formulas were well tolerated as assessed by the frequency of abdominal pain, bloating, passage of rectal gas and stooling. No carbohydrate malabsorption was detected as measured by breath hydrogen. In well nourished subjects, our findings do not support the common clinical practice of initiating alimentation with low flow rates or diluted formula.

Adult↗
PubMedDate not supplied

Determinants of nutritional status in hospital patients in Italy.

The prevalence of protein-calorie malnutrition (PCM) and micronutrient deficiency (MND) at the time of admission and discharge from hospital was evaluated in 91 patients consecutively admitted to the Surgery Clinic of the University Hospital of Rome. Anthropometric parameters and circulating levels of vitamins (A, E, C, B1, and B2) and visceral proteins [retinol-binding protein (RBP, prealbumin (PA), and transferrin] were measured. Twenty-one patients (23%) had moderate to severe PCM, and 70 patients (77%) had normal nutritional status (NNS) at admission. Two patients with PCM died in the hospital. At discharge, the prevalence of PCM was unchanged in the remaining 19 patients. Single or multiple MND was observed initially in 71% of patients with PCM and in 36% with apparently normal nutritional status. Despite vitamin supplementation, MND was present at the time of discharge in 73% of patients with PCM and 44% with NNS. Nutritional status at the time of admission was assessed in hospitals in six different Italian cities. The criterion for admission to the study was the diagnosis of chronic (greater than 1 yr duration) illness (excluding cancer and multiple organ disorders). Two hundred eighty-four patients (145 males, 139 females), ages 25-88 yr, were selected. The findings indicated a high prevalence of MND (64%). Also, in disorders that usually do not have significant alterations of digestion or absorption, such as uncomplicated cardiorespiratory disease, the prevalence of MND was high (9-38%). The prevalence of MND was not related to body mass index (BMI). PCM was more common among patients with chronic gastrointestinal disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Hypocarotenemia in patients fed enterally with commercial liquid diets.

We have found that 12 patients requiring permanent enteral feeding secondary to cerebrovascular accident with adequate Vitamin A nutritional status had serum concentrations of various carotenoids which were only 8-17% of sex- and age-matched healthy controls. Their serum retinol levels were normal, but only 61% of their controls despite receiving two to three times the recommended daily allowance (RDA) in retinol equivalents. Commercial enteral formulas were found to contain only negligible quantities of the carotenoids and were the cause of the hypocarotenemia. To assess the ability of these patients to absorb beta-carotene, nine tube-fed patients were given 15 mg of beta-carotene (2.5 times the RDA) in a single dose. Serum concentration time curves showed that only four patients absorbed significant quantities of the beta-carotene and absorption was delayed compared to previously studied subjects taking enteral formulas as meals. These studies suggest that the efficiency of absorption of the fat soluble vitamins may be lower in tube-fed patients and that patients receiving long-term tube feeding are denied the possible protective effects of the carotenoids normally contained in the American diet.

Adult↗
PubMedDate not supplied

Treatment of acid maltase deficiency with a diet high in branched-chain amino acids.

Acid maltase deficiency in adults is associated with progressive muscle weakness and may effect respiratory muscles resulting in respiratory failure. The biochemical and clinical manifestations of acid maltase deficiency arise from a marked deficiency of the lysosomal enzyme alpha-glucosidase (acid maltase), which normally degrades glycogen to free glucose. In the past few years, high-protein diets have provided an alternative energy source for these patients and resulted in improved muscle strength. Recently, we treated a ventilator-dependent acid maltase-deficient patient with a general diet supplemented with branched-chain amino acids. Branched-chain amino acids are the principal amino acids involved in muscle protein synthesis and utilization. While on this diet, the patient had improvement of respiratory function and muscle strength and was able to be weaned from the ventilator during the day. In addition to his nutritional status, levels of serum branched-chain amino acids, showed improvement within 2 months after the diet started. This diet shows potential advantages over a high-protein diet without supplemented branched-chain amino acids for the treatment of acid maltase deficiency. These include theoretical sparing of amino acids required for muscle protein synthesis by providing higher concentrations of postprandial branched-chain amino acids in the circulation. Also, the liquid formula would be better tolerated by a ventilator-dependent or debilitated patient rather than a high-protein general diet. Further experience with branched-chain amino acid formulas will be needed to substantiate their efficacy in the treatment of acid maltase deficiency.

Adult↗
PubMedDate not supplied

Oral Candida colonizes the stomach and gastrostomy feeding tubes.

The lumen of gastrostomy tubes is frequently colonized with Candida. To investigate the source of this contamination, 20 consecutive malnourished patients undergoing placement of a percutaneous endoscopic gastrostomy tube and ten ambulatory controls having routine upper endoscopy performed had both their oral cavity and gastric antrum swabbed and cultured. Percutaneous endoscopic gastrostomy tube recipients who after several weeks were still under our care (9 of 20) had the lumen of their tubes cultured. Fungi were isolated from the stomach in 13 (65%) of 20 patients undergoing percutaneous endoscopic gastrostomy tube placement but in only 1 of 10 ambulatory patients (p < .01). The species isolated from the oral cavity, the stomach, and later the gastrostomy tube were identical in most cases. We conclude that gastrostomy tubes are probably colonized by oral organisms that have made their way into the stomach.

Aged↗
PubMedDate not supplied

Antioxidant agents and colorectal carcinogenesis: role of beta-carotene, vitamin E and vitamin C.

In consideration of findings reported in the literature and of our study, we examined the correlation between antioxidants (beta-carotene, vitamin C, vitamin E) and colorectal carcinogenesis. Although diagnostic progress has been made in the last decades, no significant improvements in death rates have been achieved in the western world. Exogenous factors might be responsible for a complex alteration process of might be responsible for a complex alteration process of normal colonic mucosa into adenoma and carcinoma. Free radicals and reactive oxygen metabolites, due to increased production or to reduced inactivation, following a decrease in the antioxidant burden in the mucosa, might cause damage to DNA, thereby resulting in genetic alterations. This might represent the cause of the transformation process: normal mucosa --> adenoma --> carcinoma. In a prospective study, we observed a reduction of beta-carotene levels in normal colonic mucosa in patients with polyps and colorectal cancer. We also showed that beta-carotene supplementation raises levels of this micronutrient in the colonic mucosa of these patients. Findings from the literature and our trials show a significant decrease in the antioxidant capacity of colorectal mucosa in patients affected by colorectal cancer, although there is a significant interindividual variability. Such results suggest a possible chemopreventive role of antioxidant agents in colorectal cancer.

Animals↗