ABSTRACT
Gitelman syndrome (GS) is a heritable renal disorder characterized by hypokalemia, hypomagnesemia, metabolic alkalosis and hypocalciuria. Patients with GS usually have mild symptoms as muscular weakness and cramps, and they often are diagnosed in older age during routine investigation. We report a 11 year old boy with GS.
Subject(s)
Alkalosis/complications , Alkalosis/diagnosis , Calcium/urine , Hypokalemia/complications , Hypokalemia/diagnosis , Kidney Diseases/complications , Kidney Diseases/diagnosis , Magnesium/blood , Alkalosis/metabolism , Child , Diagnosis, Differential , Humans , Kidney Diseases/genetics , Male , Muscle Cramp/complications , Muscle Cramp/diagnosis , Muscle Weakness/complications , Muscle Weakness/diagnosis , Syndrome , Time FactorsABSTRACT
BACKGROUND: 5-Fluorouracil (5-FU), doxorubicin and methotrexate (FAMTX) and cisplatin, epirubicin, leucovorin and 5-FU (PELF) have both been reported to be superior to the combination 5-FU, doxorubicin and mitomycin C (FAM) in advanced gastric carcinoma. On the basis of the presence and dose intensity of the included agents, we hypothesised that PELF would be superior to FAMTX. PATIENTS AND METHODS: Two hundred patients with untreated advanced gastric carcinoma were randomised to receive PELF or FAMTX for a maximum of six cycles or until disease progression. RESULTS: The complete response (CR) rates to PELF and FAMTX were, respectively, 13% [95% confidence intervals (CI) 6% to 20%] and 2% (95% CI 0% to 5%; P = 0.003), and the objective response rates [CR plus partial response (PR) rates] 39% (95% CI 29% to 49%) and 22% (95% CI 13% to 30%; P = 0.009), thus significantly favouring the PELF combination. The survival rates after 12 months (30.8% versus 22.4%) and 24 months (15.7% versus 9.5%) were also higher among patients receiving PELF, but these differences were not statistically significant. The toxicities were qualitatively different but quantitatively similar. Both regimens seem to be feasible provided that careful patient monitoring is assured. CONCLUSIONS: PELF is significantly more active than FAMTX and deserves further research in the adjuvant setting.
Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/pathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cisplatin/therapeutic use , Doxorubicin/therapeutic use , Epirubicin/therapeutic use , Fluorouracil/therapeutic use , Leucovorin/therapeutic use , Methotrexate/therapeutic use , Stomach Neoplasms/drug therapy , Stomach Neoplasms/pathology , Adult , Aged , Confidence Intervals , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Italy , Male , Middle Aged , Neoplasm Invasiveness/pathology , Neoplasm Staging , Probability , Prognosis , Stomach Neoplasms/mortality , Survival Analysis , Treatment OutcomeABSTRACT
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.
