Gastric inhibitory polypeptide release after oral glucose: relationship to glucose intolerance, diabetes mellitus, and obesity.

Hypersecretion of immunoreactive gastric inhibitory polypeptide (IRGIP) has been reported previously in patients with diabetes mellitus (DM) and obesity. To ascertain the relative contribution of glucose intolerance and obesity to the abnormalities of IRGIP secretion, 114 subjects were studied during a standard oral glucose (75 g) tolerance test; responses of glucose, insulin, C-peptide, IRGIP, and glucagon were evaluated. The subjects were divided into six subgroups according to body weight and the degree of glucose intolerance. In normal weight subjects, the IRGIP response to oral glucose was significantly higher in the patients with impaired glucose tolerance (IGT) and DM than in the healthy control subjects (P less than 0.05). In the obese subjects, no significant differences in mean IRGIP responses could be detected among control, IGT, and DM subjects. In spite of similar IRGIP responses, the obese IGT patients did release more insulin than the obese control subjects, suggesting that incretin factors other than GIP may be operative in this condition. When obese and nonobese patients were compared, the obese subjects with normal glucose tolerance released a greater amount of IRGIP and insulin than the normal weight controls, whereas no significant difference between obese and nonobese could be found within the IGT and DM groups. We conclude that in the absence of obesity, glucose intolerance may induce IRGIP hypersecretion. On the other hand, obesity is associated with IRGIP hypersecretion, and glucose intolerance has no further effect, indicating a different pathogenetic mechanism for the IRGIP abnormalities. In both the obese and nonobese diabetic groups, IRGIP hypersecretion was associated with a failure of plasma glucagon levels to fall after oral glucose; this effect might be related to the glucagonotropic action of this peptide.

Effect of dietary oils containing different amounts of precursor and derivative fatty acids on prostaglandin E2 synthesis in liver, kidney and lung of rats.

The availability of the fatty acids which are precursors of prostaglandins is affected by dietary intake. We have studied, in particular, the effects of dietary intake of lipids with different amounts of precursor and derivative fatty acids on the synthesis of prostaglandin E2 (PGE2) in rat liver, kidney and lung. Fifteen-month-old rats were fed for 3 months diets containing different amounts of oleic, linoleic, alpha linolenic, gamma linolenic and stearidonic acids. The fatty acid compositions of total phospholipids and prostaglandin E2 levels of liver, kidney and lung were investigated. In the organs studied, the intake of lipids at different amount of precursor/derivative fatty acids caused variations in the fatty acid composition of phospholipids. PGE2 showed different values which did not seem directly affected by tissue availability of arachidonate but by the effect of dietary lipids on the metabolic pool of polyunsaturated fatty acids (PUFAs).

Optimal nutritional indexes in gastroenterology.

Malnutrition in gastrointestinal disease can result from several pathogenetic mechanisms. The resulting clinical and laboratory features of malnutrition vary according to the specific pathogenetic factors involved. Many of the causes of malnutrition in gastroenterology are similar to those found in other acute and chronic diseases. However, certain disorders, specific to gastroenterology, may alter nutritional indices independent of the usual causes of malnutrition. These include small bowel bacterial overgrowth and protein-losing enteropathy. The impact of these disorders on the indexes of nutritional status is discussed.

Effect of chemically defined formula diets on pancreatic mass in the rat.

To establish the effect of chemically defined formula diets on pancreatic mass, 58 male Wistar rats, weighing approximately 200 g, were fed orally one of the following diets for 20 days: standard diet; partially hydrolyzed diet; elemental diet. The diets were isocaloric and provided 73 cal/day per rat. At the end of the experiment, the rats were killed and pancreas removed to assess wet weight and DNA and RNA content. Compared to the controls, the elemental diet caused a reduction in pancreatic wet weight (p less than 0.005), pancreatic DNA (p less than 0.001), and RNA content (p less than 0.001). In the group fed partially hydrolyzed diet, only pancreatic DNA content showed an highly significant reduction when compared with the reference group (p less than 0.001), whereas the value of RNA failed to reach the statistical significance. We found an increase of the ratio mg RNA/mg DNA in the partially hydrolyzed and elemental diet groups. These results suggest that long-term nutrition with the partially hydrolyzed diet, and more strongly with the elemental diet, may induce pancreatic hypoplasia.

The economic impact of hospitals in rural communities.

This article presents how to assess the economic impact of a hospital on a rural community. The economic impact is identified by assessing the direct, induced, and indirect impacts that result because of the presence of a hospital in a rural community. The methodology utilizes survey data and estimation procedures for four rural hospitals. The economic impact estimates are based on microdata. Income multipliers are estimated for each of the rural communities. The research demonstrates that rural hospitals do make significant economic contributions to the communities they serve. Community leaders can use the model presented to evaluate the economic impact of their local hospital.

Evaluation of oral administration of folic and folinic acid to prevent folate deficiency in patients with inflammatory bowel disease treated with salicylazosulfapyridine.

In order to evaluate the efficacy of oral administration of a pharmacological dose of folic or of folinic acid to prevent the folate deficiency in patients with inflammatory bowel disease (IBD) treated with salicylazosulfapyridine (SASP) (1g twice daily at meal times), two groups of 15 patients with IBD received 15 mg/day of folic or folinic acid for one month. In both the groups there were ten patients affected by Crohn's disease and five patients affected by ulcerative colitis. Before starting the treatment, the plasma folate and the red blood cell (RBC) folate concentrations did not statistically differ between the two groups. After one month the mean increase in RBC folate concentration was significantly greater after folinic therapy then after folic acid therapy (910 +/- 383 versus 570 +/- 212 ng/ml; p less than 0.01), while no difference was observed in the mean increase of plasma folate level (19.8 +/- 6.6 versus 18.5 +/- 5.0 ng/ml). It was concluded that: a) both folic and folinic acid could restore and enlarge the body stores of folate in patients with IBD treated with SASP, when administered at the dose of 15 mg daily for one month; b) folinic acid seems to be more efficient in enlarging the body stores of the vitamin than folic acid.

[Pulmonary surfactants]. / I surfactanti polmonari

Reference is made to classic studies pointing to the existence of lung surfactants in the alveolar lining layer and more recent investigations of their chemical nature. Attention is also given to work on biochemical and lung elasticity modifications caused by the employment of various drugs.

[Position of cyticholine in pneumologic therapy]. / La posizione della citicolina nella terapia pneumologica

The position of cyticholine in lung lipid metabolism and hence in pneumological therapy (the subject of a personal hypothesis) is discussed. A summary is given of personal experimental work and papers read at the 1974 Padua meeting (11th December) held by the Societas Europae Physiologiae Clinicae Respiratoriae. It is shown that cyticholine may: 1) prevent the onset of acute neonatal respiratory distress; 2) improve chronic pneumogenous respiratory insufficiency; 3) prevent postoperative hypoventilation; 4) improve ventilation mechanics in hyperelastic lung syndromes; 5) increase the gas permeability of the air-blood barrier; 6) counterbalance the loss of surfactants caused by endobronchial aspiration in patients with tracheal tubes.

[Use of 48/80 in the diagnosis and therapy of allergic asthma]. / L'impiego del 48/80 nella diagnosi e nella terapia dell'asma allergica

A review of the relevant literature is followed by the presentation of experimental and clinical results obtained with intradermal administration of the histamine releaser 48/80. The value of this substance in the diagnosis and treatment of bronchial asthma is stressed.

[Current evaluation of beta-adrenergic agents in the treatment of bronchial spasm]. / Valutazione attuale dei beta-adrenergici nella terapia del broncospasmo

The current status of beta-adrenergics in the treatment of bronchospasm is discussed. Personal experience is reviewed with special attention being paid to associations of the drugs on aminophylline, atropine and bechlomethasone dipropionate.

[Asthma as a psychosomatic disease and its treatment with tranquilizing agents]. / A proposito dell'asma come malattia psicosomatica e del suo trattamento con psicofarmaci

On the basis of personal research and experience, it is concluded that the majority of asthmatics also suffer from psychoneurosis and that psychological alterations are primary and not secondary to dyspnoea. Some hypotheses are put forward relating the onset of asthma and psychoneurosis.

[Prognostic evaluation of cardiorespiratory insufficiency in chronic bronchitis]. / Valutazione prognostica della insufficienza cardiorespiratoria nella bronchite cronica

The course of chronic bronchitis is examined with particular stress on the most important clinical and functional factors for the purposes of the prognostic judgment on the disease. Phenomena of reoccurrence of cardiorespiratory insufficiency are also examined.

The role of community hospitals in the performance of local economies.

Many hospital administrators recognize an increasing need to educate the public on the important role their institutions play in the economic viability of the local community. Reasons include negative coverage by the press of increasing hospital costs, eroding philanthropy, managed care programs mandating out-of-area preferred providers, and declining city revenues, which have caused some municipalities to attempt to place not-for-profit health care facilities on the tax roles. This article reviews a technique that can be used by hospitals to build community support by demonstrating the favorable economic impact hospitals have on the communities they serve.

Calculating the economic impact of healthcare facilities on communities.

A methodology has been developed to calculate the direct, indirect, and induced spending effects of a healthcare facility on the community it serves. This methodology may be used by financial managers to produce data that demonstrate the effect of facilities on local economies. The data may be used by administrators to increase awareness of the pivotal economic role healthcare facilities play in communities among business and government leaders, economic development organizations, medical staff members, facility employees, trustees, and patients.