Holotranscobalamin Is a Useful Marker of Vitamin B12 Deficiency in Alcoholics

Background. Measurement of serum cobalamin (Cbl) levels is the standard investigation for assessing vitamin B12 deficiency. Falsely increased values of Cbl can be caused by alcoholic liver disease. Measurement of total vitamin B12 serum levels might be misleading in alcoholics, because a tissue metabolic deficiency is possible even with normal serum Cbl levels. Holotranscobalamin (HoloTC), the Cbl metabolically active fraction, is considered as a better index of vitamin B12 deficiency. Methods. For assessing vitamin B12 status, we evaluated 22 adult alcoholic male patients by measuring in parallel serum Cbl, serum folate and red blood cell folate levels, HoloTC levels by the AxSYM assay. Results. HoloTC values were reduced in 3 alcoholics with borderline-low Cbl values. Significant positive correlations were found between serum Cbl and HoloTC levels, serum Cbl and gamma-glutamyl transpeptidase (GGT). Conclusion. HoloTC measurement is a useful option for assessing vitamin B12 status in alcoholics, particularly in the subjects with borderline Cbl values and may be considered an early marker of vitamin B12 deficiency

Preferential patterns of myocardial iron deposit by multislice multiecho T2* CMR in thalassemia major patients

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Long-term treatment with deferiprone enhances left ventricular ejection function when compared to deferoxamine in patients with thalassemia major

Transfusion and iron chelation treatment have significantly reduced morbidity and improved survival of patients with thalassemia major. However, cardiac disease continues to be the most common cause of death. We report the left-ventricular ejection fraction, determined by echocardiography, in one hundred sixtyeight patients with thalassemia major followed for at least 5 years who received continuous monotherapy with deferoxamine (N = 108) or deferiprone (N = 60). The statistical analysis, using the generalized estimating equations model, indicated that the group treated with deferiprone had a significantly better left-ventricular ejection fraction than did those treated with deferoxamine (coefficient 0.97; 95% CI 0.37; 1.6, p = 0.002). The heart may be particularly sensitive to iron-induced mitochondrial damage because of the large number of mitochondria and its low level of antioxidants. Deferiprone, because of its lower molecular weight, might cross into heart mitochondria more efficiently, improving their activity and, thereby, myocardial cell function. Our findings indicate that the long-term administration of deferiprone significantly enhances left-ventricular function over time in comparison with deferoxamine treatment. However, because of limitations related to the design of this study, these findings should be confirmed in a prospective, randomized clinical trial

Auditory cortex hypoperfusion: a metabolic hallmark in Beta Thalassemia

Abstract Background Sensorineural hearing loss in beta-thalassemia is common and it is generally associated with iron chelation therapy. However, data are scarce, especially on adult populations, and a possible involvement of the central auditory areas has not been investigated yet. We performed a multicenter cross-sectional audiological and single-center 3Tesla brain perfusion MRI study enrolling 77 transfusion-dependent/non transfusion-dependent adult patients and 56 healthy controls. Pure tone audiometry, demographics, clinical/laboratory and cognitive functioning data were recorded. Results Half of patients (52%) presented with high-frequency hearing deficit, with overt hypoacusia (Pure Tone Average (PTA) > 25 dB) in 35%, irrespective of iron chelation or clinical phenotype. Bilateral voxel clusters of significant relative hypoperfusion were found in the auditory cortex of beta-thalassemia patients, regardless of clinical phenotype. In controls and transfusion-dependent (but not in non-transfusion-dependent) patients, the relative auditory cortex perfusion values increased linearly with age (p < 0.04). Relative auditory cortex perfusion values showed a significant U-shaped correlation with PTA values among hearing loss patients, and a linear correlation with the full scale intelligence quotient (right side p = 0.01, left side p = 0.02) with its domain related to communication skills (right side p = 0.04, left side p = 0.07) in controls but not in beta-thalassemia patients. Audiometric test results did not correlate to cognitive test scores in any subgroup. Conclusions In conclusion, primary auditory cortex perfusion changes are a metabolic hallmark of adult beta-thalassemia, thus suggesting complex remodeling of the hearing function, that occurs regardless of chelation therapy and before clinically manifest hearing loss. The cognitive impact of perfusion changes is intriguing but requires further investigations

Recenti acquisizioni di ceramica italiota da Gravina in Puglia

I ritrovamenti recenti di ceramica italiota nei contesti funerari del territorio di Gravina in Puglia (Bari), affiancati alla documentazione già nota proveniente da vecchi scavi, segnalano con sempre maggiore evidenza il ruolo di primo piano della Peucezia interna nel processo formativo della tradizione figurata italiota. Tra la seconda metà del V secolo a.C. e i primi decenni del IV, una committenza qualificata ed economicamente forte si afferma non soltanto nei principali centri del territo..

Documenti di arte musiva in Puglia. I mosaici della villa di Mola di Bari

Angela Ciancio, Documenti di arte musiva in Puglia. I mosaici della villa di Mola di Bari, p. 259-302. Una villa di età romana, scoperta nel litorale adriatico della Puglia, tra Bari ed Egnazia, presenta un ricco campionario di pavimentazioni musive riferibili ai primi decenni del I secolo a.C, epoca del primo impianto dell'edificio, la cui durata si inoltra fino alla seconda metà del I d.C. L'analisi tecnica e stilistica della documentazione rivela aspetti interessanti. Gli ambienti della pars urbana della villa sono pavimentati con tessellati bianco-neri e con rivestimenti in opus scutulatum arricchiti da scaglie policrome entro l'ordito tessellato. Una sala tricliniare presenta, inoltre, al centro dello scutulatum, un emblema con rosetta e foglie di acanto in opus vermiculatum, derivante da modelli ellenistici. Il cubiculum a doppia alcova riprende anch'esso lo schéma ellenistico «a tappeto cen- (v. retro) trale», con cornici di inquadramento in vermiculatum policromo che ripropongono motivi decorativi di tradizione ellenistica. La documentazione acquista maggiore rilevanza se inserita nel quadro archeologico della Puglia centrale, che finora si è rivelato povero di dati relativamente al periodo romano-repubblicano.Ciancio Angela. Documenti di arte musiva in Puglia. I mosaici della villa di Mola di Bari. In: Mélanges de l'École française de Rome. Antiquité, tome 106, n°1. 1994. pp. 259-302