Biomedical subjects

E Guastavino

Publications and source records attributed to E Guastavino.

At least 19 recordsLinked to original sources

PubMed1999

[Barrett's esophagus: diagnosis and coexistent diseases in childhood].

From 1990 to 1998, 12 patients with columnar metaplasia of the lower esophagus were diagnosed. Only 4 of them displayed a Barrett's epithelium (BE) with a specialized columnar epithelium and globet cells. As it is already published, a male predominance was observed. In three of these patients some predisposing factor to develop BE was detected (i.e. severe central nervous system damage, chronic pulmonary disease, esophageal atresia and chemotherapy). All patients had severe gastroesophageal reflux (GER) with abnormal pH probe. Diagnosis was suggested by characteristic endoscopy images in 2 patients and was confirmed by biopsy in all cases. All patients had been primary treated with proton-bomb inhibitors. Two patients were treated by a Nissen fundoplication, 4 and 6 month after diagnosis, respectively. One patient with severe neurological damage will undergo the same surgery soon. In another patient with caustic esophageal injury, the affected esophagus will be resected, restoring continuity with stomach or colon. In view of the potential oncogenous transformation of BE, the importance of not overlooking this anomaly in all patients with severe GER is highlighted. All cases with predisposing factors to develop BE should be closely followed by periodic examination and multiple biopsies.

Adolescent↗

PubMed1993

[Chronic idiopathic intestinal pseudo-obstruction: visceral myopathy. Report of 4 cases].

Chronic intestinal pseudo-obstruction is the term applied to a heterogeneous group of functional motility disorders sharing a common clinical expression: signs and symptoms of bowel obstruction in absence of mechanical occlusion. It is caused by ineffective intestinal propulsion. The chronic form of intestinal pseudo-obstruction may be primary or secondary. Primary pseudo-obstruction or chronic idiopathic pseudo-obstruction (CIIP) defines a group of propulsive disorders having no recognized underlying diseases. This study presents four female patients, aged between 4 months to 7 years, and makes a review of the literature. The symptoms, very similar in three of them, were bilious vomiting, abdominal distention and constipation, alternating with diarrhea and malnutrition. The fourth patient, different from the others in the age of onset and evolution, only had severe constipation and abdominal bloating. The diagnostic was made by full thickness biopsies during laparotomy, getting specimens by mapping, at different heights of intestine and stomach. Samples were studied by optic and electronic microscopy and visceral myopathies were found. None of them had urinary disorders. Medical treatment consisted of total parental nutrition and/or enteral nutrition. Cisapride was not effective in the two patients who received it.

Child↗

PubMed1993

[Correlation of IgA class antigliadin and antiendomysial antibodies (IgA-AGA-IgA-EMA) with intestinal histology in celiac disease].

The aim of this work was to establish the diagnostic and follow up value of IgA-class antiendomysium (IgA-EmA) and IgA-class antigliadin (IgA-AGA) antibodies in celiac disease. Correlation with the intestinal histology at the different stages of the disease was evaluated, as well as its therapeutic monitoring ability. Fifty six children, twenty seven girls and twenty nine boys, aged six months to twelve years old, were studied. Thirty nine celiac children were al different diagnostic stages of the disease. Seventeen children with malabsorption symptoms and with normal intestinal histology were used as controls. Sixty blood samples were obtained simultaneously with the small intestinal biopsy. IgA-AGA (ELISA method) and IgA-EmA (immunofluorescent test performed over lower third Rhesus monkey esophagus) were determined in every blood sample. In 34 serum samples from patients with total or subtotal villous atrophy, two were negative for IgA-AGA and only one was negative for IgA-EmA. In 26 samples from patients with normal intestinal histology, two were positive for IgA-AGA and four were positive for IgA-EmA. The results for IgA-EmA had sensitivity 97%, specificity 84.6%, positive predictive value 89.2% and negative predictive value 95%. In the case of IgA-AGA were: sensitivity 94.1%, specificity 92.3%, positive predictive value 94.1%, negative predictive value 92.3%. IgA-AGA and IgA-EmA showed a high correlation with intestinal histology and are in combination powerful tools for the diagnosis and follow up of celiac patients. Besides, they provide a useful aid in the indication of a jejunal biopsy and in close monitoring of the dietary treatment compliance.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies↗

PubMed1992

[The correlation of IgA-class antigliadin and antiendomysial antibodies (AGA-IgA--EmA-IgA) with the intestinal histology in celiac disease (CD)].

The aim of this work was to establish the diagnostic and follow up value of IgA-class antiendomysium (IgA-EmA) and IgA-class antigliadin (IgA-AGA) antibodies in celiac disease. Correlation with the intestinal histology at the different stages of the disease was evaluated, as well as its therapeutic monitoring ability. Fifty six children, twenty seven girls and twenty nine boys, aged six months to twelve years old, were studied. Thirty nine celiac children were all different diagnostic stages of the disease. Seventeen children with malabsorption symptoms and with normal intestinal histology were used as controls. Sixty blood samples were obtained simultaneously with the small intestinal biopsy. IgA-AGA (ELISA method) and IgA-EmA (immunofluorescent test performed over lower third Rhesus monkey esophagus) were determined in every blood sample. In 34 serum samples from patients with total or subtotal villous atrophy, two were negative for IgA-AGA and only one was negative for IgA-EmA. In 26 samples from patients with normal intestinal histology, two were positive for IgA-AGA and four were positive for IgA-EmA. The results for IgA-EmA had sensitivity 97%, specificity 84.6%, positive predictive value 89.2% and negative predictive value 95%. In the case of IgA-AGA were: sensitivity 94.1% specificity 92.3%, positive predictive value 94.1%, negative predictive value 92.3%. IgA-AGA and IgA-EmA showed a high correlation with intestinal histology and are in combination powerful tools for the diagnosis and follow up of celiac patients. Besides, they provide a useful aid in the indication of a jejunal biopsy and in close monitoring of the dietary treatment compliance.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗

PubMed1988

[Ulcerative colitis in children. Levels of salicylazosulfapyridine and sulfapyridine during treatment].

Salicylazosulfapyridine (SASP) is a drug used in the treatment of ulcerative colitis (UC) owing to the therapeutic action of the 5-aminosalicylic acid produced by the splitting of the molecule in the cecum, which also yields the absorbable compound Sulphapyridine (SP). The aim of our work was to assess the levels of the drug in blood (SASP and SP), to correlate them with undesirable effects in any, to verify their fluctuations in the dosing interval and to investigate the extent of the excretion of the drug in the children who were studied. 10 children (6 to 16 years) with UC, who were treated with SASP (dOsage schedule 0.5-2.0 g/day in a 12 hours interval), were studied. Blood levels of SASP and SP were assessed at 6 and 12 hours after doses, and total fecal excretion of SASP was determines in 24 hs specimens. All the determinations were performed according to Hansson and Sandberg. SP plasma levels were 17.7 +/- 9.0 ug/ml (range 6.8-36.3 ug/ml) at 6 hours after doses. and 14.1 +/- 7.2 ug/ml (range 5.7-25.0 ug/ml) at 12 hours after doses. SASP plasma levels were 15.5 +/- 15.4 ug/ml (range 2.1-53.4 ug/ml) at 6 hours after doses, and 14.0 +/- 20.4 ug/ml (range 3.9-70.7 ug/ml) at 12 hours after doses. The 24 hours fecal excretion was 17.4 to 236 mg. These values were correlated with the given doses (r = 0.88) calculated as SASP g/m2 body surface 24 hs. There was no statistical correlation between doses and SP or SASP levels in this group, and the respective levels of SASP and SP at 6 and 12 hours after doses showed no significative differences.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1987

[Fecal alpha 1-antitrypsin clearance in protein-losing enteropathies in pediatrics].

Fecal alpha-1-antitrypsin clearance (A-1-At Cl) was performed on 47 pediatric age patients with various digestive diseases: 6 with ulcerative colitis, 5 with celiac disease, 6 with cow milk protein intolerance, 1 with intestinal lymphangiectasia, 1 with non specific diarrhea and the control group was composed of 10 children without digestive disease. The group of patients with digestive disease showed values of fecal A-1-At Cl significantly higher than the control and non specific diarrhea groups (p less than 0.05). Just 1 child with cow milk intolerance had A-1-At Cl within the range of values of the control group x = 2 S.D. All children with non specific diarrhea excepting one had values falling within the control range. The patient with thalassemia major had a very elevated value of A-1-At Cl. The cause of this finding remains unknown at present. The fecal A-1-At Cl. is a non invasive, cost saving, useful and simpler method than the traditional techniques for the diagnosis of protein losing enteropathy in childhood.

Adolescent↗

PubMed1986

[Determination of amylase creatinine clearance in children and adolescents].

UNLABELLED: 24 children whose ages ranged from 10 days to 14 years (x 5.5. ys.), 16 males and 8 females, hospitalized in our Service on account of extra-digestive were studied. Creatinine and amylase determination were performed on serum and 24 hs. urine specimens; lipase activity was measured only in serum. Amylase-creatinine clearance ratio varied between 1.3 and 5.8% (x 3.1 +/- 1.3). Serum amylase ranged from 36 to 460 U/l (x 123 U/l). Five patients had hyperamylasemia. 2 were urlian parotiditis, 2 were under clinical surveillance after surgery and the last one was a septic meningitis. All of them showed amylase-creatinine ratio values up to 2.5%. Serum lipase ranged from 6 to 197 U/l (x 79 U/l), falling into the normal interval. No abnormal clearance was found. CONCLUSIONS: hyperamylasemia is not specific for pancreatic disturbances in children; the serum lipase and the amylase-creatinine clearance ratio seem to be useful tools to rule out pancreatic involvement in hyperamylasemic patients.

Adolescent↗

PubMed1981

[Juvenile polyps in childhood].

61 children, from 12 months to 14 years old with colonic juvenile polyps were studied using double contrast radiology and conventional and fiber optic endoscopy. In all cases the tumor excision was performed without fulguration. 43 polyps were located within the rectal area and 17 in the colon. In one patient 4 polyps were found at different place in the colon. In 90 percent of the cases the symptom was fecal blood loss and spontaneous merging of the tumor across the anus in the remaining 10 percent. Histologic examination showed no atypic cell.

Adolescent↗

PubMed1979

[Rectal tonometry in the differential diagnosis of constipation in pediatrics].

Based on the difficulties regarding the clinical, radiological, and histological diagnosis of colonic aganglionosis, we resorted the motility studies. Sixty-two children (15 days-10 years of age) were studied by means of rectal motility without knowing the results of the other auxilary methods. We obtained a clear difference between aganglionic and other group formed by constipated functional or psicogenic. We conclude that rectal motility studies have the advantage of being rapid and non-aggressive, besides avoiding rectal biopsy.

Child↗

PubMed1978

[Gastric polypoid heterotopy in the small intestine].

We present a 14 year old girl with a two years' history of colicky abdominal pain associated with the palpation of a tumor in the left upper quadrant of the abdomen. During these two years, the pain and the tumor appeared and disappeared spontaneously several times. In the operation we found a jejunojejunal intussusception, the head being a sessile polyp placed 20 cm from the ligament of Treitz. The pathological examination showed a polyp formed by mucosa similar to the gastric one with chief and parietal cells. We discuss the clinical pictures that can be associated with this pathological entity in this uncommon localization in opposition to the more common settling in Meckel's diverticulum.

Adolescent↗

PubMed1978

[Radiologic diagnosis of Meckel's diverticulum].

This paper describes our experience with pre-surgical diagnosis of Meckel's diverticulum. We used a naso-jejunal-ileal tube, through which, we injected small amounts of radio-opaque fluid and air, thus utilizing double contrast. In seven children diverticulum was shown to be present by radioscopic and radiographic techniques; this was later confirmed during laparotomy. X-ray findings were compared with Tc99 scanning results.

Child↗

PubMed1977