ABSTRACT
The most effective treatment of end-stage renal disease is renal transplantation; its superiority to prolong the longevity of patients is well established. Patient and graft survivals have improved with more potent immunosuppression but this advance has been associated with an increased incidence of cancer. The aim of this study was to assess the prevalence of cancer among 265 kidney transplant recipients engrafted between 1968 and October 2004. The overall prevalence of de novo malignancies was 3%. The mean age at diagnosis was 53.3 years (range, 28-63 years) and the duration of the transplant was 11.6 years (range, 0.3-33 years). One patient among 127 (0.8%) who had a history of less than 3 years under immunosuppression, developed a posttransplantation lymphoproliferative disorder (PTLD). Among the 138 patients who had more than 3 years immunosuppression, 7 (5%) developed neoplasms of vulva, colon, native kidneys, prostatic gland, and ovary. One patient was affected by de novo carcinoma in the transplanted kidney. Compared with other published studies, our early cancer prevalence is low, possibly due to a careful history before grafting, good HLA matching, and abstinence from anti-T-cell therapy for treatment of acute rejection episodes. The low level of immunosuppression may account for the low prevalence of neoplasia. The risk of developing a malignancy increases with long-term immunosuppression, comparable with most reports.
Subject(s)
Kidney Transplantation/adverse effects , Neoplasms/epidemiology , Postoperative Complications/epidemiology , Adult , Aged , Female , Follow-Up Studies , Humans , Immunosuppression Therapy/methods , Kidney Transplantation/immunology , Lymphoproliferative Disorders/epidemiology , Male , Middle Aged , Neoplasms/classification , Retrospective Studies , Time FactorsABSTRACT
Oral cavity alterations are often indicative sign of chronic gastrointestinal disorders, such as malabsorption and malnutrition syndromes. The relationship between oral pathology and intestinal diseases is rarely a chance association. This prompted odontostomatological research to focus on the study of alterations of the oral cavity, hypotetical markers of intestinal disorders if they can be measured in terms of frequency and incidence, as a tool for the early diagnosis of the intestinal disease itself. This paper should be seen against this background since it examines the possible connection between celiac disease and the presence of oral alterations as an index of disease.
Subject(s)
Celiac Disease/epidemiology , Dental Enamel Hypoplasia/etiology , Adolescent , Antibodies/immunology , Celiac Disease/complications , Celiac Disease/diagnosis , Celiac Disease/immunology , Child , Dental Enamel Hypoplasia/diagnosis , Dental Enamel Hypoplasia/epidemiology , Dental Enamel Hypoplasia/immunology , Dental Health Surveys , Female , Gliadin/immunology , Humans , Italy/epidemiology , Male , Myofibrils/immunology , School DentistryABSTRACT
Twenty-nine patients (of both sexes aged between 8 and 18 years old) were referred to our attention with a probable history of celiac disease; intestinal biopsy was positive for the said pathology. Biopsies were compared to a second group of 29 age- and sex-matched control subjects not suffering from gastrointestinal diseases and/or disorders of the phosphocalcium metabolism. The aim of the study was to highlight the possible presence, frequency and extent of oral alterations in confirmed celiac subjects in order to evaluate their greater or lesser incidence compared to controls. The results obtained confirm that celiac patients are more likely to manifest oral pathologies.
Subject(s)
Celiac Disease/complications , Mouth Diseases/etiology , Adolescent , Celiac Disease/epidemiology , Child , Dental Caries/epidemiology , Dental Caries/etiology , Dental Enamel Hypoplasia/epidemiology , Dental Enamel Hypoplasia/etiology , Female , Humans , Incidence , Male , Malocclusion/epidemiology , Malocclusion/etiology , Mouth Diseases/epidemiology , Periodontal Diseases/epidemiology , Periodontal Diseases/etiologyABSTRACT
The anticatabolic properties of branched chain amino acids enriched protein solutions in 22 patients with multiple trauma have been evaluated. Nitrogen balance, nitrogen output, the daily change of blood urea nitrogen, plasma albumin and total protein levels were recorded daily. Each 2 days free amino acids and 3-methyl histidine urinary concentrations were measured. The results obtained in the study suggest that in trauma patients high ratios of essential amino acids/total nitrogen are needed and that amino acid solutions enriched in branched chain amino acids are most effective in preventing muscle catabolism and promoting protein synthesis.
Subject(s)
Amino Acids, Branched-Chain/administration & dosage , Nitrogen/metabolism , Wounds and Injuries/metabolism , Adult , Amino Acids, Essential/urine , Blood Urea Nitrogen , Dietary Proteins/administration & dosage , Humans , Serum Albumin/metabolism , Wounds and Injuries/diet therapyABSTRACT
The nutritional value of regimes enriched with branched chain amino acids has been evaluated in 22 adult patients suffering from acute post-traumatic renal failure. The study was carried out for 12 days. The following data were recorded and compared daily: nitrogen balance, daily blood urea nitrogen (BUN), BUN/creatinine ratio, and plasma albumin levels. Also after 6 days of dialysis and nutritional support, the plasma medium molecular weight compounds (uremic toxins) were studied. It was concluded that: (a) the combined use of parenteral and oral nutrition appears most adequate in this type of patient; (b) the nitrogen intake should provide an essential amino acid/total nitrogen ratio of greater than or equal to 4 and a branched chain essential amino acid ratio of greater than or equal to 0.5; and (c) caution is still necessary in interpreting analyses of middle molecular weight compounds in this type of patient.
