[The hypotriglyceridemic effects of polyunsaturated fatty acids: pathogenetic hypothesis]. / Effetto ipotrigliceridemizzante degli acidi grassi polinsaturi: ipotesi patogenetica.

A large number of experimental and clinical studies focused the attention on the role played by omega-3 polyunsaturated fatty acids on the primary prevention of vascular diseases of atherosclerotic origin, especially influencing plasma triglycerides decrease. Aim of the present work was to investigate whether a relationship between triglyceride synthesis and human energy metabolism could exist, in order to explain the hypotriglyceridemic effect of omega-3 fatty acids that could be due to any thermogenic action. Eight male subjects aged 45 years (from 20 to 62) were studied, selected on the basis of high levels of triglycerides (536.7 +/- 204.3 mg/dl), normal or high levels of total serum cholesterol (219.4 +/- 51.2 mg/dl), normal or low HDL-cholesterol (33.6 +/- 6.3 mg/dl) and moderate obesity (BMI 30.3 +/- 1.7). Anthropometric parameters (body weight, height, waist to hip ratio), body composition measurements (fat free mass, fat mass), biochemical parameters were evaluated before and 10-days after PUFAs supplementation (student t paired test) at the compressive dose of 60 mg/kg BW bis in die. At the end of the observation significant decrease of triglycerides was documented (p < 0.005), while total and HDL-cholesterol did not vary significantly, although improved values were noticed. No change in anthropometric, body composition and energy metabolism parameters was demonstrated, except for respiratory quotient and substrates oxidation: a significant increment of respiratory quotient value (p < 0.05) due both to augmented carbohydrates oxidation (p < 0.05) and correspondent lipid oxidation reduction (p < 0.05) and correspondent lipid oxidation reduction (p < 0.05) without any change in the daily total calorie consumption. In conclusion, from a clinical point of view it is possible to hypothesize, even if in a small number of subjects, that PUFAs hypotriglyceridemic effect could derive from a reduced substrate availability, due to the higher carbohydrate oxidation. In other terms, considering the metabolic cascade of triglyceride synthesis, the augmented drug-induced carbohydrate consumption could provoke a reduced availability of products of intermediate metabolism useful to triglycerides hepatic synthesis.

[Is it possible to obtain a reduction of body weight exclusively via a loss in fat mass? Experience with d-fenfluramine]. / E possibile ottenere la riduzione del peso corporeo esclusivamente attraverso una perdita di massa adiposa? Esperienze con d-fenfluramina.

Aim of the study was to observe if the administration of an anorectic drug, d-fenfluramine, in addition to hypocaloric diet, could influence the body composition and adipose mass distribution during a weight decrease programme in 17 obese women. Drug's effects plus diet on body weight changes were compared with those of a "only-diet programme" in another group of 18 obese subjects, sex and age matched. Both groups were observed for a 6-month period. All subjects were selected on the base of Index Body Weight % within 120-200 and without any therapy for other diseases. Blood samples were drawn before, during (3rd month) and after the period of observation for the measurement of OGTT, serum lipids, liver and kidney function parameters, blood cells count. Body weight and height, body composition, waist-to-hip ratio were also evaluated. Results documented: 1) significant reduction of body weight in the group kept on the combined therapy; 2) significant variation of body composition with increment of fat free mass and adipose mass decrease; 3) significant improvement of glucose tolerance, liver and kidney function parameters. In conclusion, our data show beneficial effects of d-fenfluramine on appetite reduction, influencing the carbohydrates assumption and the consequent fat mass loss with a good tolerability of the drug.

Acute intestinal pseudo-obstruction: report of two cases.

Two cases of acute intestinal pseudo-obstruction diagnosed over a 6-year period are reported. One patient had acute colonic pseudo-obstruction (Ogilvie's syndrome) associated with severe cardiopulmonary disease and the other a rare idiopathic small bowel pseudo-obstruction: both were treated successfully. The various treatments and a short review of the literature are presented.