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Biomedical subjects

D Festi

Publications and source records attributed to D Festi.

At least 91 records · Page 5Linked to original sources
PubMed1977

[Results of chenic acid therapy in patients with cholesterol calculi].

58 patients suffering from cholesterol gallstones were treated with chenodesoxycholic acid at a dose of 2-15 mg/Kg/die for about 15 months so as to determine its effettiveness and establish a minimum effective dose. 8 of these patients presented stones in the common bile duct. The results showed: a complete dissolution of the stones in 16 of the 50 patients considered to be suffering from cholecystic lithiasis; partial dissolution in 15; no change in the remaining 19. Of the 8 patients with bile duct stones, 3 presented complete dissolution, 2 partial, and 3 no change. An improvement in digestive function was observed in most cases. The liver function tests carried out in each patient before, during and after treatment with chenodesoxycholic acid were completely normal.

Adult↗
PubMed1977

[Correlation of malabsorption of bile acids, bile lipid composition and calculi].

The relation between malabsorption of bile acids, the bile lipid composition, and biliary stones was examined in 8 patients subjected to ileal resection (particularly for Crohn's disease), 6 with ileal bypass for morbid obesity, and 10 healthy controls. The 1-14C-cholylglycine breath test was employed to detect of the absorption and deconjugation of bile acids. Bile lipid composition was expressed according with Metzger's saturation index. Healthy subjects gave normal findings in all respects, whereas ileal resection was accompanied by malabsorption, increased deconjugation, and faecal loss of 14C. These changes, particularly malabsorption, were more evident after ileal bypass. Preoperative saturation values rose to more than 1 in all cases, especially after resection. Liver disease (steatosis and cirrhosis) 6 months after bypass, together with cholesterol lithiasis in 2/6 patients.

Adult↗
PubMed1977

Development, validation, and application of a single-tube radioimmunoassay for cholic and chenodeoxycholic conjugated bile acids in human serum.

A single-tube radioimmunoassay for both cholic acid and chenodeoxycholic acid conjugates in serum is based on the use of [1-(14)C]glycocholic acid and [H-3H]glycochenodeoxycholic acid as tracers. The assay was shown to be specific, sensitive, accurate, and precise (CV = 13% at low concentrations, 5.5% at higher concentrations) when used for serum samples from subjects and patients with increased bile acid in the serum because of liver disease, and results correlate well with those by gas chromatography (r = .99).

Carbon Radioisotopes↗
PubMed1977

Determination of 14CO2 in breath and 14C in stool after oral administration of cholyl-1-[14C]glycine: clinical application.

Twenty patients with intestinal bacterial overgrowth and 20 control subjects were investigated for bile acid deconjugation, by measuring 14CO2 in the breath after cholyl-1-[14C]glycine administration. 14CO2 output/24h was 11.0 +/- 5.2% (mean +/- SD) in controls and 54.2 +/- 14.0% (mean +/- SD) in bacterial-overgrowth patients (P less than .001). 14CO2 excretion rate in 12h, when normalized to 100% of the dose at the 12th hour, gave an even finer discrimination between the two groups (no false responses). 14C in stool, analyzed in 20 malabsorption patients and 20 controls by two different techniques, was 6.6 +/- 4% and 31.38 +/- 21.7% (mean +/- SD), respectively. Results by the two different techniques described here correlated well (r = .99). Bile acid malabsorption was in reasonable agreement (r = .67) with percentage of "chenoid" (chenodeoxycholic acid plus ursodeoxycholic acid) in the stool by gas-liquid chromatography; a poorer correlation was observed when "chenoid" plus "choloid" (cholic acid plus its epimers) were plotted vs. -4C in stool (r = .57, n = 15).

Bacterial Infections↗
PubMed1976

The estimation of phospholipids in bile.

Total and lipid phosphorus were measured in the duodenal aspirate of 24 fasting subjects following an injection of cholecystokinin. The lipid phosphorus values were lower than the total phosphorus, a difference most pronounced in dilute samples. Storage at -20 degrees C over 4 weeks resulted in a loss of over 50% lipid phosphorus. Such alterations in the lipid phosphorus affected the calculation of biliary phospholipid and hence the saturation index of cholesterol in bile causing it to be erroneously elevated. It is concluded that analysis of bile samples should be undertaken on freshly obtained samples and include a preliminary step for the extraction of lipids.

Bile↗
PubMed1976

The medical treatment of cholesterol gallstones: experience with chenodeoxycholic acid.

Chenodeoxycholic acid has been administered to 50 patients with cholelithiasis and 8 with choledocholithiasis for a period of 15 months at doses varying between 2- and 15 mg/kg/day. Among the 50 patients with cholelithiasis, complete dissolution occurred in 16 and partial dissolution in 15 cases. Among the 8 patients with choledocholithiasis, complete dissolution occurred in 3 and partial dissolution in 2 cases. Lower doses were adopted in an attempt to determine the minimum effective daily dose required to produce gallstone dissolution and to lower the cholesterol saturation index (mean 1.52 +/- 0.73 before and 0.98 +/- 0.36 after treatment). Routine liver function tests were carried out before, during and after treatment; no significant alterations were produced by therapy. Studies of the antipyrine half-life, to estimate hepatic microsomial function were found to be normal (mean 13.61 +/- 2.62 before and 13.21 +/- 3.04 after treatment). In addition, histological investigations of the liver were described. This study confirms the efficacy of chenodeoxycholic acid in the treatment of cholesterol gallstones and gives an indication of the minimum effective dose (7.8 mg/kg/day). At the present doses, it has been shown that there are no substantial modifications in fundamental liver function.

Adult↗
PubMed1975

[Therapy of cholesterol lithiasis with chenodeoxycholic acid (Chenoxyl)].

Chenodesoxycholic acid (500-750 mg/day Chenoxyl) was employed over a period of 9 months in the treatment of 40 patients with radiotransparent calculi in a functioning gallbladder and 8 with choledochal lithiasis. Radiological examination and complete hepatological exploration were carried out before and after the treatment in all cases. Complete dissolution was obtained in 6 and 2 cases respectively, with reduction of size in 13 and 2, and no change in 21 and 4. No significant variations were notes in the blood lipid picture or in liver function. There were no cases of diarrhoea.

Adult↗
PubMedDate not supplied

Ursodeoxycholic acid vs. chenodeoxycholic acid as cholesterol gallstone-dissolving agents: a comparative randomized study.

Cholesterol gallstones are dissolved in man by chenodeoxycholic acid (CDCA) and ursodeoxycholic acid (UDCA). To test the comparative efficacy of these two cholelitholytic bile acids, 223 gallstones patients were randomly treated with either UDCA or CDCA at two different doses: 7 to 8 mg per kg per day and 14 to 15 mg per kg per day. Efficacy and factors influencing dissolution (dose, size of the stones, and time) were evaluated after 3, 6, and 12 months of treatment. UDCA was significantly more efficacious than was CDCA after 3 and 6 months of treatment, whereas after 12 months, no significant differences were observed. UDCA was equally effective at high and low doses, both on small and large stones. CDCA was significantly more effective at high doses and on small stones. Seventy-four per cent of the total dissolutions with UDCA and 42% with CDCA occurred within the first 6 months of treatment. Diarrhea and hypertransaminasemia occurred only in the CDCA-treated patients. We conclude that UDCA seems to be the bile acid of choice in dissolving cholesterol gallstones.

Adolescent↗
PubMedDate not supplied

Diagnostic effectiveness of serum bile acids in liver diseases as evaluated by multivariate statistical methods.

The aims of this study were to determine the diagnostic effectiveness of fasting and postprandial serum bile acid determinations in liver diseases, and to compare results with those of conventional liver function tests. In 322 patients with biopsy-proved liver disease and 93 healthy subjects, fasting and postprandial (2 hr) serum levels of cholic, chenodeoxycholic, and lithocholic acid conjugates and conventional liver function tests were evaluated. Data were subjected to variance and discriminant and factor analyses. Fasting serum bile acids were higher in patients when compared to controls and were significantly higher in severe than in mild liver diseases. Determination of cholic plus lithocholic acid provided the highest discrimination capacity. The percent of correct allocation was 75.4% for conventional liver function tests, 70.1% for fasting serum bile acids and increased to 79.6% when liver function tests plus serum bile acids were considered. Postprandial percentages were always lower than fasting. Factor analysis identified two factors possibly related to cytolysis and protein synthesis. The serum bile acid concentrations highly correlated with both factors. We conclude that serum bile acid determinations increase the diagnostic and discriminant capacities of liver function tests and are more sensitive and discriminant when obtained in fasting than postprandially.

Adult↗
PubMedDate not supplied

A population study on the prevalence of gallstone disease: the Sirmione Study.

The prevalence of gallstone disease (cholelithiasis and previous cholecystectomy for gallstones) in the population of the town of Sirmione, Italy, examined by ultrasonography, was 6.7% in men and 14.6% in women, ranging from 18 to 65 yr of age (overall prevalence = 11%). The prevalence of cholelithiasis in the same age span was 6.9% (4.5% in men and 8.9% in women). Prevalence of cholelithiasis increased with age in both sexes. Twenty-two percent of gallstone subjects suffered from biliary pain vs. 2% of subjects without gallstones. No difference was observed in the frequency of nonspecific symptoms between subjects with and without gallstones. Of the 132 gallstone subjects, 108 (82%) were not aware of having gallstones prior to the study. Prevalence of gallstone disease was found to be higher in obese and hypertriglyceridemic subjects and to increase with the number of pregnancies.

Adolescent↗
PubMedDate not supplied

A radioimmunoassay for lithocholic acid conjugates in human serum and liver tissue.

A sensitive and specific radioimmunoassay for glycine and taurine conjugates of lithocholic acid (CLCA) has been developed. 3H-glycolithocholic acid (S.A. = 17Ci/mmol) was used as tracer. Separation of free from antibody-bound bile acid was carried out using ammonium sulphate (saturated solution). The antiserum showed high specificity for both glyco and tauro conjugated lithocholate (100% cross reaction) and lithocholic acid (25% cross reaction). The sensitivity of the assay (1 pmole/tube), was adequate for measuring CLCA in peripheral blood and hepatic tissue in man.

Antibody Specificity↗
PubMedDate not supplied

Morphological and biochemical effects of intrahepatic alcohol injection in the rabbit.

The local and systemic effects, as well as the repair mechanisms, of sterile absolute ethyl alcohol injection were evaluated at a range of doses (0.1-2.0 mL/kg body weight) in rabbit liver in order to confirm the feasibility and safety of local treatment of tumours in man. Saline injection was used in the control animals. The animals were killed at varying intervals (range: 1-30 days after injection), and the liver was studied by gross and microscopic examination. The ethyl alcohol injection was well tolerated and did not induce significant systemic side-effects. All doses could induce necrosis and none proved to be lethal. The alcohol injection produced an area of coagulation necrosis, the size of which appeared to be dose-related, and which was surrounded by granulation tissue, gradually repairing the necrotic lesion; the adjacent tissue was intact, or had signs of mild steatosis. However, at higher doses (1.0 and 2.0 mL/kg bodyweight), necrotic lesions were observed in the liver both near and remote from the site of injection. Fine needle percutaneous alcohol injection is effective in producing necrotic lesions which appear to be dose-related; at higher doses, however, an unpredictable intrahepatic diffusion may occur.

Animals↗
PubMedDate not supplied

Treatment of hepatic encephalopathy with non-absorbable antibiotics.

Hepatic encephalopathy represents a well known neuropsychiatric syndrome in patients with either acute or chronic impaired liver function and is characterized by disturbance of consciousness, personality and intellectual capacity, altered neuromuscular activity and electroencephalographic abnormalities. The pathogenesis of the syndrome is still unknown, although important roles are ascribed to circulating gut-derived toxins of nitrogenous origin and to changing in central neurotransmission. Therefore, treatment is aimed to reduce the production and absorption of gut-derived toxins and to modify central neurotransmission balance. Among the different therapeutic approaches proposed for the management of hepatic encephalopathy, antimicrobial agents, alone or in combination with non-absorbable disaccharides, represent an important step, being able to reduce the production and absorption of ammonia, a compound of key importance in the pathogenesis of hepatic encephalopathy.

Ampicillin↗
PubMedDate not supplied

Breath tests with stable isotopes: have they a role in liver transplantation?

Evaluation of liver function is crucial in the overall management of patients with liver disease. In particular, patients with end-stage liver disease need accurate prognostic indicators to plan liver transplantation, and in this case, to manage their presence in the waiting list. Availability of predictors of clinical outcome is further essential after liver transplant, mainly to correctly diagnose and adequately treat complications, such as acute rejection, drug toxicity, liver dysfunction. Breath tests using labelled substrates selectively metabolized within the liver may represent an accurate diagnostic and prognostic tool in these clinical conditions, possibly with an adjuntive role to the most commonly used prognostic models (Child-Pugh and MELD scores). Promising results have been in fact recently obtained by the use of different substrates (aminopyrine, methacetin, erythromycin, methionine) which explore different metabolic function of the hepatocyte. The usefulness of breath tests has been documented in liver disease patients both before and after liver transplantation, in the early as well as in the late phase.

Breath Tests↗
PubMedDate not supplied

A radioimmunoassay of primary bile acid conjugates in human serum.

The fasting levels of chenodeoxycholic and cholic acid conjugates in various groups of patients [25 healthy subjects, 20 patients with chronic active liver disease (CALD), 21 patients with primary biliary cirrhosis (PBC) and 5 patients with cholesterol gallstones before and after chenodeoxycholic acid therapy] were determined by using a sensitive, accurate and precise radioimmunoassay. The results obtained with this method were compared with those of a gas-chromatographic method with methylation and acetylation of the bile acids using a 2 m x 0.4 cm glass column packed with 3% of AN 600 on Anakrom Q 110-120 mesh. The results obtained with both methods are in agreement; therefore the method used can be applied for quantitative analysis. In diagnosis, the measurement of serum bile acid levels, fasting or after meals, proved to be a very sensitive method, although further correlations are necessary with standard liver function tests.

Animals↗