Therapeutic Effectiveness of Nutrition Therapy in Pediatric Patients with Chronic Liver Diseases Awaiting Liver Transplantation

Abstract It is important to prevent protein/calorie malnutrition in children with end stage liver diseases prior to transplantation. This study involved 34 patients between the ages of 10 and 156 months (mean value 25.69 months 32.2) (13 females and 21 males) on the liver transplant waiting list. Data collected as of three months before transplant and up to ten months after the procedure concerned gender, age, weight, height, Pediatric End Stage Liver Disease Score, baseline pathology, type of nutrition, type of transplant, immunosuppression, pulse steroid therapy, length of stay, and post transplant complications. Linear regression analysis showed that the length of hospital stay was 24.5 days more for females than for males, but also that intensive nutrition therapy shortens this stay for both female patients (P = 0.085) and younger patients (P = 0.023). The study population was divided into two groups according to the different nutritional therapies adopted. The Student’s t-test and Mann-Whitney test evidenced that the group receiving intensive nutrition therapy grew taller compared with the group following an oral diet (mean -1.37 and Prob = 0.043); that females grew taller compared to males (mean -1.65 +/- 0.56); and that there was an increase in height among the children in the group receiving intensive nutrition therapy despite the presence (-1.37 +/- 0.56) or absence (-14.8 +/- 5.44 and Prob = 0.035) of complications, and despite the administration (-1.03 +/- 0.33) or non administration (-1.48 +/- 0.55 and Prob = 0.019) of steroids. Intensive nutrition therapy enhances the velocity of growth in height and shortens the length of hospital stay, thus optimizing the final prognosis of the baseline pathology

Testosterone and aggressiveness.

Aggressiveness is an ancestral behavior common to all animal species. Its neurophysiological mechanisms are similar in all vertebrates. Males are generally more aggressive than females. In this review, aggressive behavior in rodents, monkeys, and man and the role of testosterone and brain serotonin levels have been considered. Interspecifi c aggressiveness in rats has been studied considering the mouse-killing behavior; the neonatal androgenization of females increases adult mousekilling as does the administration of testosterone in adults. Intraspecifi c aggressiveness was studied by putting two or more male rats (or mice) in the same cage; the condition of subjection or dominance is infl uenced by testosterone. In monkeys, testosterone is related to aggressiveness and dominance and, during the mating season, increases in testosterone levels and aggressive attitude are observed. In men, higher testosterone levels were obtained in perpetrators of violent crimes, in men from the army with antisocial behaviors, in subjects with impulsive behaviors, alcoholics and suicidals, in athletes using steroids, and during competitions. Aggressive and dominant behavior are distinguished. Testosterone infl uences both of these, even if man is usually inclined to affi rm his power without causing physical damage. Testosterone receptors are mainly in some hypothalamic neurons, where it is aromatized into estrogens, which determine the increase in aggressiveness. A relation between testosterone levels and diencephalic serotonin has been shown: in fact, the lack of serotonin increases aggressive behaviors both in animals and man. Testosterone also increases ADH levels in the medial amygdala, lateral hypothalamus, and preoptical medial area, involved in aggressive behaviors

PLASMA MEMBRANE REDOX SYSTEM IN THE ERYTHROCYTES OF ROWERS: PILOT STUDY

Background: The oxidative stress results from a change in the physiological balance between oxidant and antioxidant species. The purpose of this study is twofold: first, to investigate the effects of long-term training in sports with high energy requirements on the redox balance which exists between the plasma vs. the erythrocytes; second, to study the activity of the PMRS (Plasma Membrane Redox System), which is a compensatory mechanism of cellular redox homeostasis, in the rowers’ erythrocytes in order to determine the rowers’ counteraction to oxidative stress. Methods: Venous blood samples was collected from rowers and control group; then FRAP (Ferric Reducing Activity Power) method has been used to determine the antioxidant capabilities both in the plasma and in the erythrocytes of 22 rowers vs. 26 sedentary subjects. For the same groups of subjects, the PMRS in erythrocytes has been also evaluated. Results: The plasmatic antioxidant activity was 21% lower in the group of rowers compared to the sedentary group (p = 0,02). In contrast, no significant differences were found in the reducing activity of the erythrocytes; however the erythrocytes of the rowers have shown values of the PMRS 35% higher than the untrained group (p < 0.0001). Conclusions: Rowing induces a significant oxidative stress in the plasma corresponding to the high intensity training, while this effect lacks in erythrocytes. At the same time an increased quantity of the PMRS has been observed in the erythrocytes. In conclusion, in well trained athletes this not lead to established an oxidative stress condition because long-term training adaptatively improves the efficiency of the antioxidant syste

Follistatin as potential therapeutic target in prostate cancer

Follistatin is a single-chain glycosylated protein whose primary function consists in binding and neutralizing some members of the transforming growth factor-β superfamily such as activin and bone morphogenic proteins. Emerging evidence indicates that this molecule may also play a role in the malignant progression of several human tumors including prostate cancer. In particular, recent findings suggest that, in this tumor, follistatin may also contribute to the formation of bone metastasis through multiple mechanisms, some of which are not related to its specific activin or bone morphogenic proteins’ inhibitory activity. This review provides insight into the most recent advances in understanding the role of follistatin in the prostate cancer progression and discusses the clinical and therapeutic implications related to these findings

The control of abstinence in the treatment of alcohol dependence: the use of Acamprosate in relapse prevention

"The alcoholism can also deal with drug treatments." This is the message that emerges from the press conference of presentation of Campral, trade name of acamprosate, a neuromodulator specifically indicated in the maintenance of abstinence in alcohol-dependent patients.Alcoholism is a disease characterized by: craving, loss of control, tolerance and physical dependence.For many years the prevention of relapse in use of alcohol after detoxification was supported almost exclusively by psychosocial procedures and techniques with modest success. Treatment with acamprosate is a valid tool to complement psychotherapy as it does not cause addiction, abuse or withdrawal of its suspension and does not interfere with other medications that patients often alcoholics must take.To evaluate the effectiveness, our study evaluated the effects of Acamprosate compared to GHB in clinical-physiological and social health in a way indicators of a possible therapeutic success in terms of abstinence from alcohol and social reintegration. The hypothesis of the project is that pharmacotherapy anticraving with acamprosate integrated with psycho-social support, can reduce relapse in alcohol together with the reduction of the risk of abuse arising from the use of GHB. This work purports to be an account of 11 months of observation of patients treated with acamprosate. Results: A total of 36 patients were observed, of which 5, 4 men and 1 woman at the Ser.T Alcamo and 31, 21 men and 10 women at the Ser.T of Palermo. In the fight against alcoholism, this therapy with acamprosate offers significant potential: decreases, in fact, the incidence, severity and frequency of relapses (Fig. 1). As regards the craving, during the period of treatment with acamprosate, there has been a change, in the sense of reduction, of craving for alcohol: if before therapy was in 68% of cases, medium-high, becomes after 3-4 months after therapy in low-nil in 89% of patients observed. It has been recorded that, after 3-4 months after receiving acamprosate, the clinical picture of the patient is greatly improved by referring to biological markers (Fig. 2). Conclusions: The study shows that treatment with acamprosate is an exciting opportunity within a project of integrated care for the treatment of alcohol addiction. The acamprosate may also be used early in the pharmacological treatment of dependence on alcohol to prevent the appearance of excitability neuronal associated abstinence.On the other hand, its use must have a duration sufficient to allow neuronal excitability to normalize in the most enduring possible: the treatment, in fact, is recommended for one year. In any case, the use can be continued even in the face of relapses, with the aim to reduce the frequency or severity.In particular, the strong point seems to be the ability for the user to experience a new sense of normalcy and to remove the desire for significant periods of alcohol

“Leptin and leptin receptor expression in asthma”

Background: The adipokine leptin is a potential new mediator for bronchial epithelial homeostasis. Asthma is a chronic inflammatory disease characterized by airway remodeling that might affect disease chronicity and severity. TGF-b is a tissue growth factor the dysregulation of which is associated with airway remodeling. Objective: We sought to determine whether a bronchial epithelial dysfunction of the leptin/leptin receptor pathway contributes to asthma pathogenesis and severity. Methods: We investigated in vitro the presence of leptin/leptin receptor on human bronchial epithelial cells. Then we studied the effect of TGF-b and fluticasone propionate on leptin receptor expression. Finally, the role of leptin on TGF-b release and cell proliferation was analyzed. Ex vivo we investigated the presence of leptin/leptin receptor in the epithelium of bronchial biopsy specimens from subjects with asthma of various severities and from healthy volunteers, and some features of airway remodeling, such as reticular basement membrane (RBM) thickness and TGF-b expression in the epithelium, were assessed. Results: In vitro bronchial epithelial cells express leptin/leptin receptor. TGF-b decreased and fluticasone propionate increased leptin receptor expression, and leptin decreased the spontaneous release of TGF-b and increased cell proliferation. Ex vivo the bronchial epithelium of subjects with mild, uncontrolled, untreated asthma showed a decrease expression of leptin and its receptor and an increased RBM thickness and TGF-b expression when compared with values seen in healthy volunteers. Furthermore, severe asthma was associated with a reduced expression of leptin and its receptor and an increased RBM thickness with unaltered TGF-b expression. Conclusions: Decreased expression of leptin/leptin receptor characterizes severe asthma and is associated with airway remodeling features

Adipokines in obesity and metabolic diseases

Adipose tissue secretes many adipokines that regulate important physiological functions. Growing studies have highlighted that these bioactive molecules may contribute to the development of metabolic and cardiovascular diseases. Adipokines exert systemic metabolic effects and independent activity on numerous cells of the cardiovascular system, including cardiomyocytes and vascular cell walls. Adiponectin shows anti-inflammatory and anti-atherosclerotic activity on blood vessels. Conversely, resistin is endowed with pro-inflammatory effects and stimulates the proliferation of smooth muscle cells, thus promoting the development of atherosclerotic plaque. Leptin plays an important role in cardiac remodeling and blood pressure regulation through the activation of the sympathetic system. Obesity is a pathological condition associated with hypertrophy of white adipose tissue, which stimulates the production of pro-inflammatory adipokines while, it reduces the production of anti-inflammatory adipokines. The delicate balance among the production of pro-and anti-inflammatory molecules generated by adipose tissue affects, not only the development of metabolic complications associated with obesity, but also the onset and progression of atherosclerosis. Therefore, adipokines may be regarded as potential agents of clinical interest in the treatment of a wide range of metabolic disorders and as potential biomarkers useful for early detection of metabolic, cardiovascular and inflammatory diseases