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C Defilippi

Publications and source records attributed to C Defilippi.

At least 19 recordsLinked to original sources
PubMed1997

Altered small bowel motility in patients with liver cirrhosis depends on severity of liver disease.

Abnormal small bowel motility has been described in patients with liver cirrhosis but the mechanisms involved are unknown. The aim was to investigate a possible relationship between the severity of liver failure and the intensity of small intestinal abnormalities. Motility was studied during fasting, by means of perfused catheters and external transducers, on 33 cirrhotics with different etiologies; 8 were at Child-Pugh stage A, 12 stage B, and 13 stage C. Both abnormalities of MMC and increased clustered activity were recorded. Absence of cycling activity was most frequently observed in Child-Pugh stage C patients compared to Child-Pugh stage A cirrhotics. A significant increase in clustered contractions from 4.7 +/- 0.4/hr in stage A patients to 11.3 +/- 1.1 in stage C was recorded. The frequency and amplitude of contractions was also increased from Child-Pugh stage A to stage C. Our findings might be related to a delayed transit time observed in these patients and a higher prevalence of bacterial overgrowth in cirrhotics with more advanced liver disease.

Adult↗
PubMed1997

Orthotopic liver transplantation improves small bowel motility disorders in cirrhotic patients.

Altered small intestinal motility has been observed in patients with liver cirrhosis. Its pathophysiology remains to be defined. Our aim was to investigate the effect of orthotopic liver transplantation on small intestinal dysmotility in patients with liver disease. Two patients were studied both before and after orthotopic liver transplantation. Abnormal migrating motor complex activity and prominent clustered contractions present preoperatively normalized within 6 months after the surgical procedure. This finding might represent an additional benefit of liver transplantation considering that altered motility may be involved in bacterial overgrowth and infections observed in these patients.

Adult↗
PubMed1996

[Effects of casein on small intestine motility in patients with liver cirrhosis].

BACKGROUND: Fasting small bowel motor abnormalities have been described in cirrhotic patients. AIM: To investigate the effects of orally administered casein in small bowel motor activity in cirrhotic patients. PATIENTS AND METHODS: Six healthy subjects and 23 cirrhotic patients were studied. Motility of the upper part of the small bowel was studied by means of perfused manometric catheters, during a basal period and after infusion of 30 g of casein in the stomach. RESULTS: Basal recordings showed a cyclical activity in all healthy subjects and in 9 cirrhotics (further considered as group 1). In 14 patients, basal cyclical activity was absent and were further considered as group II. Frequency of contractions after casein infusion was higher in group II patients than in group I and healthy controls (2.2 +/- 0.3, 1.3 +/- 0.2 and 0.9 +/- 0.2 cpm respectively). Intestinal motor index after casein infusion was also higher in group II. There was a progressive decline with time in motor activity after casein infusion, being maximal at 45 min, in healthy subjects and group I. This decline was not observed in group II. CONCLUSIONS: Patients with cirrhosis have an altered small bowel motor response to casein. Since group II of patients had a greater percentage of Child C patients, the abnormalities seem to be related to the degree of liver failure.

Adolescent↗
PubMed1995

Effect of casein and casein hydrolysate on small bowel motility and D-xylose absorption in dogs.

Food administration is followed by the appearance of a small intestinal pattern of irregular contractions. Studies on the relationship between intestinal motor activity, transit and absorption have yielded contradictory results. Since previous studies have shown that casein and casein hydrolysate led to a decrease of small intestinal motor activity and transit, the aim was to evaluate the effect of these nutrients on small intestinal motility and D-Xylose absorption. Studies were performed in five dogs with a duodenal fistula; motility was recorded by means of six infused catheters and external transducers. Three test solutions with the same osmolality, lactulose, casein and casein hydrolysate, were continuously infused through the duodenal cannula. D-Xylose was injected in the duodenum and plasma levels determined at regular intervals. Absorption of D-Xylose was greatest during the administration of casein hydrolysate, the lowest levels were seen with lactulose and intermediate levels were obtained with casein. The effect of casein hydrolysate on small intestinal motility was characterized by a decrease in the frequency of contractions. Propulsive contractions were decreased after the infusion of both casein and casein hydrolysate. Lactulose infusion was followed by the greatest motor activity of both frequency and propulsive contractions. These results suggest that the motor patterns observed with casein and casein hydrolysate lead to increased intestinal absorption of D-Xylose.

Animals↗
PubMed1995

[Effect of casein on D-xylose absorption assessed by H2 breath test].

UNLABELLED: Different experimental studies suggest that the presence of food in the alimentary tract, promote small intestinal absorption. The mechanisms involved are not completely understood and might be related to motility changes or to humoral factors. Since studies have shown a decrease of small bowel motility after casein administration, the aim was to analyze the effect of this protein on small intestinal absorption and orocecal transit time. The hydrogen breath test was used to estimate d-xylose absorption. H2 production is dependent on the amount of this carbohydrate reaching the colon, and therefore inversely proportional to d-xylose absorption. Six normal volunteers ingested 25 g d-xylose and 25 g d-xylose + 30 g casein, and alveolar breath samples were obtained at 15 min intervals. RESULTS: by adding casein to d-xylose solution a statistically significant decrease of maximal H2 concentration was observed from a mean of 40 +/- 11 ppm to a mean of 26 +/- 8 ppm. Similarly the area under the curve (which reflects the amount of xylose that was not absorbed) was also significantly decreased from a mean of 3281 +/- 1399 ppm to mean of 1394 +/- 700 ppm of H2. The orocecal transit time was significantly prolonged from 85.5 +/- 40 min to 112 +/- 38 min. Our results suggest that casein increases d-xylose absorption in normal subjects and that this effect might be related to a slower transit time.

Adolescent↗
PubMed1994

[Thymic hyperplasia. Description of a clinical case].

Thymomegaly, which was in the past considered as predisposition to sudden death infants, is judged today as paraphysiological. The study achieved on a 10 months' patient shows the complexity in determining the diagnosis of simple thymic hyperplasia, when together with a massive thymus enlargement are conditions which divert to other pathologies, as in this tested clinical case.

Cortisone↗
PubMed1993

Short report: effect of two prokinetic drugs on the electrical and motor activity of the small bowel in dogs.

The effects of trimebutine and domperidone, on the electrical and motor activity of the upper small bowel in dogs, were studied simultaneously by means of a suction electrode and a manometric catheter. Trimebutine, given during phases I and II of the migratory motor complex, was followed by a period of regular spike potentials and contractions; the increased motor activity was significantly greater when the drug was given during phase II. Domperidone, when injected in phase I, was followed by an irregular pattern of spike potentials and contractions of low amplitude. By contrast, activity was not augmented when the drug was given during phase II. We conclude that the effects of drugs, such as trimebutine and domperidone, on the canine small bowel are influenced by the phase of the migratory motor complex.

Animals↗
PubMed1993

[Pulmonary complications after bone marrow transplantation].

Pulmonary toxicity occurs in approximately 10 to 50% of patients undergoing bone marrow transplantation (BMT). Bacterial pneumonia very commonly affects patients within the first 6 months post-BMT. Etiologic factors include neutropenia and the presence of graft-versus-host disease (GVHD). Pulmonary fungal infections, due to candida and aspergillus, may develop in 16% of patients receiving BMT, with a high mortality rate, being about 80%. A prolonged neutropenia as well as GVHD and associated immunosuppressive treatments are important factors in predisposing a patient to develop fungal pneumonitis. Interstitial pneumonitis occurs in 10-40% of patients; herpes viruses are the most commonly documented cause, with cytomegalovirus (CMV) being the most common pathogen. No causative organism is identified in up to 60% of the cases. It is likely that some of these cases may result from drug or radiation toxicity. Lung shielding and fractionation of the dose have decreased the incidence of interstitial pneumonitis to less than 5%. Patients with GVHD are predisposed to lung infections because of the immunosuppression that accompanies GVHD and its treatment. In addition, GVHD itself appears to have a direct effect on pulmonary epithelium. Cultural and serologic studies as well as radiographic investigations and other diagnostic procedures (ie bronchoalveolar lavage) are needed for appropriate management of pulmonary complications.

Bone Marrow Transplantation↗
PubMed1993

Abnormalities in proximal small bowel motility in patients with cirrhosis.

Because altered intestinal motility could be involved in the pathogenesis of small intestine bacterial overgrowth observed in some patients with cirrhosis, we investigated fasting proximal small bowel motility in 16 cirrhotic patients and 8 healthy controls. In addition, the effects of oral tetracycline administration on duodenal motility were investigated in seven cirrhotic patients with evidence of bacterial overgrowth. The mean duration and characteristics of the migrating motor complex were analyzed. Cyclic activity was observed in all healthy controls. It was absent in two cirrhotic patients showing a prolonged phase 2-like pattern. The duration of cycles was significantly longer in the remaining 14 patients with cirrhosis (166 +/- 19 min) compared with controls (81 +/- 14 min; p < 0.02). This difference was caused by a prolonged phase 2 (138 +/- 19 min in patients with cirrhosis vs. 52 +/- 11 min in controls; p < 0.02). Marked changes in the contraction pattern during phase 2 were noted in cirrhotic patients. They were characterized by multiple clusters (frequency, 12 +/- 1/hr; duration, 38 +/- 3 sec) of contractions (frequency, 11 +/- 1 cpm) separated by quiescent periods (duration, 2.4 +/- 0.2 min). This motility profile filled up 58% +/- 8% of the total duration of phase 2, and it was observed in patients with and without bacterial overgrowth. Treatment with tetracycline was followed by only mild modifications, such as a reduction of the fraction of phase 2 occupied by multiple-clustered contractions. In conclusion, an altered proximal small bowel motility has been observed in patients with cirrhosis. These disturbances appear not to be dependent on the presence of bacterial overgrowth.

Adult↗
PubMed1992

[Are disturbances of small intestinal motility associated with hyperglucagonemia in patients with liver cirrhosis?].

Patients with liver cirrhosis develop marked abnormalities in small bowel motility and high plasma glucagon levels. Disturbances in small intestinal motor activity could be related to hyperglucagonemia. To investigate the relationship between fasting plasma glucagon levels and changes in small bowel motility in patients with liver cirrhosis, eighteen cirrhotic patients and ten controls were studied. Plasma glucagon was measured by RIA. Mouth to cecum transit time was estimated by lactulose hydrogen breath test. Fasting small bowel motility was investigated by means of intraluminal manometry. Plasma glucagon levels were significantly higher in patients with cirrhosis (61 +/- 5 pmol/l) than in controls (32 +/- 3 pmol/l); p < 0.01. In patients with liver disease, plasma glucagon levels were not significantly correlated to mouth to cecum transit time (r: -0.32), duration of migrating motor complex (r: -0.24), nor to the frequency of multiple clustered contractions (r: -0.26). The degree of small bowel dysmotility is not related to plasma glucagon levels in patients with hepatic cirrhosis. These results do not support the hypothesis that hyperglucagonemia plays an important pathogenic role in the abnormalities of gut motility in cirrhosis.

Adult↗
PubMed1992

[Effect of casein on the temporo-spatial organization++ of the contractile activity of the small intestine in the dog].

Some observations in man and experimental animals have demonstrated that casein decreases intestinal transit speed. However, its effects on intestinal motility have not been studied previously in a systematic fashion. The aim of this work was to study the temporospatial distribution of small bowel motility before and after the administration of calcium caseinate. Studies were performed in fasting dogs using 6 catheters perfused with a pneumo-hydraulic system. After the administration of 300 ml of a 10% solution of calcium caseinate, a global decrease in motor activity was observed, specially of grouped propulsive contractions, they were reduced in 64.9 to 19.5%. On the contrary, a significative increase, in 1.4 to 22%, of individual wave, non propulsive motor activity was observed. These quantitative changes in contractions, specially in their organization and temporo-spatial distribution, may be responsible for the decrease in intestinal transit after the administration of casein.

Animals↗
PubMed1992

[Treatment of acute secretory diarrhea with casein: an effect of beta-casomorphins?].

A patient with acute secretory diarrhea refractory to conventional therapy received calcium caseinate as sole nutrient, based on the recognized development of constipation and fecaloma in patients receiving this agent. Complete remission of diarrhea followed within 10 days. An inhibition of intestinal motility mediated by B-casomorphins released after hydrolysis of casein in the intestinal tract may be the mechanism involved in this effect. These exorphins have varying effects upon the opioid receptors of the intestinal tract.

Acute Disease↗
PubMed1992

[The leukemia-lymphoma syndrome with gastrointestinal involvement in childhood. A case report].

The gastrointestinal tract is an uncommon site of presentation for acute lymphoblastic leukemia in children. We report a child who developed a leukemia-lymphoma syndrome with central nervous system and gastrointestinal tract involvement at the diagnosis. The patient received an intensive combination chemotherapy and is currently off-therapy in continuous complete remission 29 months after the diagnosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[Bacterial overgrowth in small intestine in patients with liver cirrhosis].

Hepatic encephalopathy, bacterial infections and endotoxemia in cirrhotic patients have been related to colonic flora. However, an abnormal small bowel bacterial content could also be implied. We investigated small bowel bacterial overgrowth (SIBO) by jejunal cultures in 14 cirrhotic patients and 5 control subjects, and indirectly by the lactulose H2 breath test in 22 patients with cirrhosis and 12 controls. SIBO was demonstrated by cultures in 64% of cirrhotic patients and 1 of 5 controls. The breath test was positive for SIBO in 45% of patients with cirrhosis and 8% of controls. No differences were noted between patients with alcoholic and non-alcoholic liver disease. According to fasting H2 breath levels, SIBO was significantly correlated with the Child-Pugh score for hepatic function (r = 0.45; p < 0.05). Also, patients with positive criteria for SIBO in jejunal cultures had worse hepatic function in comparison to cirrhotics with normal jejunal bacterial counts (p < 0.05). Thus SIBO is frequent in patients with hepatic cirrhosis and is associated with impairment in hepatic function.

Bacteria↗
PubMed1991

[Effect of hyperosmotic solutions on duodenal motility: a mechanism of resistance or of propulsion to the luminal flow?].

Infusion of hyperosmotic solutions into the duodenum lead to increased motility. To investigate the mechanism of this effect, 9 healthy volunteers received small infusions of hypertonic (1250 mOsm/kg) NaCl or glucose. Intestinal motility was registered using manometric system with multiple lumens 3 cm apart. Nineteen glucose infusions did not modify intestinal motility. Of 43 NaCl infusions, motility was increased in 24, 7 of them with a typical migratory complex, phase III. In 17 cases, non propagated contractions increasing in a cephalo-caudal direction were noted. The latter may be related to delayed gastric emptying associated to hyperosmotic loads.

Adult↗
PubMed1991

[Computer analysis of motility of small intestine in the dog].

Prolonged recordings at different levels of the small intestine have become necessary in motility studies. This has increased the number of motor events that are registered. The direct measurement of the numerous contractions is time-consuming, monotonous and rutinary. The use of computer analysis of this activity has been small. It is our objective to report our experience with this technique. Simultaneous recordings of small intestine motility were obtained on a polygraph and in a computer with an analogue digital converse system. The following parameters were compared: frequency, amplitude, motility index, and area under the curve. Excellent correlation of results obtained by both methods was observed. Computer analysis reduced the relation recording time/analysis time from 1/1.2 to 1/0.08. In our experience, the study of intestinal motility with analogue digital technique is very efficient and exact.

Animals↗
PubMed1990

Relationship between small intestinal fasting motility and vomiting in dogs.

Preceding vomiting, several changes in small intestinal motility have been described. They consist mainly of high-amplitude retrograde contractions and inhibition of motility before and after these contractions. The recordings of 94 episodes of emesis occurring spontaneously, during manometric studies of intestinal motility by means of infused catheters in dogs with gastric and duodenal cannulae, showed that 95.7% of all episodes developed during phase II of the migratory motor complex. In order to establish whether different phases of the fasting cyclic activity are associated with a different sensitivity to emetic stimulus, two agents, apomorphine, a centrally acting drug and copper sulfate, a peripherally acting agent, were administered at the beginning of phases I and II of the migratory motor complex. Coincident with spontaneously occurring vomiting, a statistically significative greater number of responses to both emetic agents was observed during phase II as compared to phase I. This finding suggests that cyclic changes of the small bowel motility are related to changes in the threshold of the vomiting center.

Animals↗