HBV and HCV infection in i.v. drug addicts; coinfection with HIV.

A group of 122 drug addict patients were studied to evaluate the incidence of HIV, HBV, HCV infections and of laboratory findings of hepatic damage. Our data show that hepatic damage is more frequent in patients affected by HBV-HCV coinfection than those with HBV or HCV infection alone and that HIV positivity supports HBV-HCV coinfection.

Clinical experiences with Ro 15-1788 (anexate) in benzodiazepine and mixed-drug overdoses.

Benzodiazepine overdose is the most common of admission to the Toxicological Unit of the University of Florence. The aim of this study has been to evaluate the efficiency of Ro 15-1788 in benzodiazepine and mixed drug overdoses. The administration of Ro 15-1788 was followed by a quick reversal of central nervous system depression and was more effective in benzodiazepine overdoses than in mixed drug overdoses. The dose was titrated individually and the range 2-10 mg was effective according to the conditions of the patient. In some cases, the comatose state relapsed; further administration of Ro 15-1788 again promptly reversed the condition. On awakening, two patients displayed anxiety and restlessness.

Amanita poisoning: a clinical-histopathological study of 64 cases of intoxication.

In the last few years new and effective therapeutic schedules have been employed in the treatment of patients intoxicated by mushrooms of the genus Amanita. As a result, the survival rate has considerably increased and clinical-histopathological correlation studies, such as the present one, have become feasible. The fate of these patients was once wrongly considered to be either complete recovery (rarely) or death (frequently). According to the results of the present study, Amanita intoxication can also progress to chronic liver damage. This latter evolution of the disease seems to depend on the severity of the acute phase of the intoxication, as clinical, laboratory and biopsy findings of liver alteration testify. The correct evaluation of evolving liver damage involves histopathological investigations, which should be performed 6 months after the acute episode, in those patients who overcome a moderate to severe acute intoxication.

Expired hydrocarbons in patients with chronic liver disease.

Fifty patients with various types of liver disease and twenty-one healthy subjects were examined for lipoperoxidation in vivo by gaschromatographic assay of volatile hydrocarbons (ethane, ethylene, propane, n-butane, n-pentane) in breath gases. In 15 patients with alcoholic cirrhosis the amount of expired pentane was greater than in all the other groups examined. No significant increase of exhaled ethane, in contrast, was detected in the same patients. These results seem to indicate that pentane is a more sensitive index than ethane for ethanol-induced lipoperoxidation. This simple and non-invasive method opens up promising new opportunities for clarifying in humans, the role of lipoperoxidation in ethanol-induced liver damage, as well as in other chronic liver disease.

[Bromsulphalein dynamic tests in cholelithias patients before and after long-term treatment with chenodeoxycholic acid]. / Prove dinamiche con BSF in pazienti colelitiasici prima e dopo trattamento a lungo termine con acido chenodesossicolico.

The BSP loading and continuous infusion tests were performed in 31 patients with cholesterol gallstones before and after long-term (6-12 months) treatment with chenodeoxycholic acid. The following parameters were evaluated: 45th minute retention percentage, plasma disappearance rate during the first 16 minutes, compartmental transfer rates, transport maximum and storage. Our results, according to previous findings after short-term treatment, indicate that no cholestatic effects seem to be induced after long-term treatment with chenodeoxycholic acid.

[Dynamic BSP tests in cholelithiasis patients before and during chenodeoxycholic acid therapy; initial results]. / Prove dinamiche con BSF in pazienti colelitiasici prima e durante trattamento con acido chenodesossicolico; primi risultati.

The BSP loading and continuous infusion tests were performed in 7 patients before and after a two-week treatment with chenodeoxycholic acid (10 mg/Kg/die per os). The following parameters were evaluated: 45th minute retention percentage, plasma disappearance rate during the first 16 minutes, compartmental transfer rates, transport maximum and storage. Our results indicated that no cholestatic effects seemed to be induced during the first period of treatment with chenodeoxycholic acid.

[Acute toxicity of trichloroethylene. Description of a case series at the Autonomous Service of Toxicology of Florence during the 1977-1988 period]. / La tossicità acuta del tricloroetilene. Descrizione della casistica del Servizio Autonomo di Tossicologia di Firenze nel periodo 1977-1988.

The authors report the number of acute trichloroethylene intoxications admitted to the Toxicological Unit of Florence University from January 1977 to December 1988. The identification of the solvent metabolic pathway allowed to clarify the pathogenesis of hepatorenal dysfunction observed during acute intoxications. Together with gastrointestinal decontamination and cardiac arrhythmia control we have studied the effect of drugs supposed to act as blockers of trichloroethylene metabolism or as inactivators of the hepatotoxic free radical metabolite 2-2(1)-3 trichloroxirane. The prognostic modification related to new therapeutic protocols is reported and discussed.

[Contribution of glutathione to detoxification in alcoholism. Biochemical-clinical studies]. / L'apporto di glutatione nella detossificazione dell'alcolismo. Indagini biochimico-cliniche.

The effects of reduced glutathione (GSH) administration (1.2 g/day and 2.4 g/day intravenously) on erythrocyte glutathione levels, serum gamma-glutamyl transpeptidase activity (GGTP) and urinary glucaric acid elimination were studied in a population of 24 chronic alcoholics voluntarily admitted to a 30 day detoxification protocol in comparison to a 12 patient control group treated only with chlordiazepoxide (initial dose 75-100 mg/day). Glutathione treatment increases dose-dependently and in a significant way erythrocyte glutathione levels and hastens the recovery of serum GGTP and urinary glucaric acid elimination. The relationship between glutathione, GGTP and glucaric acid is discussed, suggesting the possible role of GSH against the oxidative damage of alcohol.

Pyrrolidone carboxylic acid in acute and chronic alcoholism. Preclinical and clinical studies.

2-Pyrrolidone-5-carboxylic acid (PCA) is a cyclic derivative of glutamic acid, physiologically present in mammalian tissues. We herein report preclinical pharmacology experiments showing that PCA releases GABA from the cerebral cortex of freely-moving guinea-pigs and displays anti-anxiety effects in a simple approach-avoidance conflict situation in the rat. In clinical pharmacology experiments, PCA significantly shortens the plasma half-life of ethanol during acute intoxication. In chronic alcoholics a treatment with PCA (2g/day per 30 days) significantly hastens the recovery to physiological values of plasma gamma-glutamyl transferase activity and of the urinary excretion of glucaric acid, which are considered suitable markers of the trend of the alcoholic disease. The evidence emerging from preclinical and clinical studies strongly suggests that, by combining central anxiolytic actions with the peripheral recovery of the antioxidant defense system in the liver, PCA should be further investigated as an interesting endogenous molecule possibly helpful in the therapy of alcoholism.

Effect of alcoholic cirrhosis on ethane and pentane levels in breath.

Lipid peroxidation can be monitored by measuring one or several highly volatile alkanes in exhaled air. The concentrations of ethane and pentane were determined in breath samples from patients with alcoholic and non-alcoholic cirrhosis as well as from healthy subjects. The greatest increase of exhaled pentane was found in 17 patients with alcoholic cirrhosis (2.85 +/- 2.37 pmol/ml) in comparison with 10 patients with non-alcoholic cirrhosis (0.71 +/- 0.33 pmol/ml) and 10 control subjects (0.59 +/- 0.41 pmol/ml). On the contrary, no significant difference was detected as far as exhaled ethane is concerned. These data suggest that: a) gas-chromatographic determination of exhaled pentane may play a significant role in detecting alcohol-induced liver disease; b) hepatic injury may be mediated by lipid peroxidation in these patients.