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Biomedical subjects

G Iacono

Publications and source records attributed to G Iacono.

At least 73 records · Page 4Linked to original sources
PubMed1992

Ultrasonography and gastric emptying: evaluation in infants with gastroesophageal reflux.

We have applied ultrasonography to the evaluation of gastric emptying in children. Two different populations have been investigated: normal children and children with gastroesophageal reflux. All the patients were less than 6 months of age. The diagnosis of gastroesophageal reflux was defined by 24-h pH measurement. The technique, used to measure gastric emptying, is the one described by Bolondi et al. In this research we used the simplified method. All children had been submitted to the examination after 4-h fasting. The standard meal was the usual milk formula, 300 ml/m2 body surface area (BSA). A cross-section area of the gastric antrum was determined before a meal and every 15 min for 2 h. The examination was concluded after two measurements were equal to the basal one. The normal gastric emptying curve was determined by a control group. Patients with gastroesophageal reflux showed three different kind of gastric emptying: (a) normal gastric emptying in 20% of cases, (b) abnormal gastric emptying in 15% of cases, and (c) intermediate cases in which the plateau curve is abnormal but the end time of gastric emptying is normal. We defined these three kinds of curves as type I or normal, type III or abnormal, and type II or intermediate. The estimate of frequency in patients with gastroesophageal reflux is similar to the reported data of the literature.

Gastric Emptying↗
PubMed1992

Gastric emptying in infants with gastroesophageal reflux. Ultrasound evaluation before and after cisapride administration.

The present study aimed to evaluate gastric emptying in children with gastroesophageal reflux (GER) by means of real-time ultrasonography, on the basis of measurements of the cross-sectional area of the gastric antrum. Twelve children with GER were studied (seven males, five females; age range, 3-13 months) and compared with 12 normal control children (six males, six females; age range, 3-13 months). The diagnosis of GER was confirmed by 24-h esophageal pH-monitoring. The GER patients had a significantly greater antral area than the controls at 90, 105, and 120 min after eating a standard meal (cow's milk formula, 300 ml/m2 body surface area); in addition, final gastric emptying time was significantly greater in the patients than in the controls (145 +/- 36.9 versus 78.7 +/- 19.3 min; p less than 0.0025). After 8 weeks of treatment with cisapride (0.3 ml/kg, three times a day) 24-h esophageal pH-monitoring and ultrasonography studies were repeated in the patients. The total percentage reflux time was significantly lower (p less than 0.038), and ultrasonography showed a decreased antral area at all the various study times, with no significant difference between patients and controls; final gastric emptying time was also significantly lower than before treatment (p less than 0.009). Furthermore, in the GER patients there was a significant correlation between gastric emptying time and the sum of the various reflux times recorded in the 2 h after all meals over the 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Cisapride↗
PubMed1992

[Evaluation of the effectiveness of cisapride in the treatment of gastroesophageal reflux].

To evaluate the effectiveness of administration of oral cisapride in patients with gastro-esophageal reflux, we studied 25 children, aged 1 month-7 years (mean 16.2 months) affected with GER. At the time of diagnosis and 8 weeks after treatment, patients were clinically evaluated and underwent a 24-hour continuous esophageal pH-monitoring. After treatment a complete regression of symptoms was observed in 20/25 patients. Moreover we recorded a significant reduction in the percentage of reflux time (p < 0.0001) and in the Jolley score (p < 0.0001), a very accurate scoring system to evaluate the pH-metric tracing, after treatment. It is concluded that cisapride is a useful agent both for the relief of symptoms and for the improvement of pH-metric parameters in children with GER disease.

Child↗
PubMed1992

A new ELISA assay for islet cell surface antibodies determination in type 1 diabetes mellitus of recent onset.

Sera from 46 newly diagnosed type 1 diabetic patients and from 100 normal controls were screened for ICA Cf ICA (standard immunofluorescence test) and for ICSA (ELISA assay) detection. Among 46 patients, 33 (71.7%) were ICA positive (16 of them also Cf ICA positive) and 21 resulted ICSA positive (45%). No correlation was found between ICSA, ICA and Cf ICA respectively. Therefore the ICSA detection, by a new and sensitive ELISA assay, in addition to ICA immunofluorescence determination, may be of significant diagnostic value in IDDM of recent onset.

Adolescent↗
PubMed1992

CD11B lymphocytes in type 1 diabetes mellitus of recent onset.

To evaluate the behaviour of CD8+ cells (suppressor/cytotoxic T lymphocytes) and CD8+Leu15+ cells (CD11B, suppressor T lymphocytes) in type 1 diabetes mellitus, 27 newly diagnosed diabetic patients and 47 normal controls were studied. CD8 cells were significantly increased in 6 patients, decreased in 9 and unchanged in 12. In all diabetic patients was present a lack of CD8+ Leu15+ cells. These results show that in newly diagnosed type 1 diabetes mellitus, suppressor T lymphocytes are reduced independently from the number of CD8 cells.

Adolescent↗
PubMed1991

Severe infantile colic and food intolerance: a long-term prospective study.

To determine the relationship between infantile colic and cow's milk protein intolerance (CMPI) in formula-fed infants, 70 infants (38 male, 32 female) were selected, with mean age 30.2 +/- 21.4 days, with severe colic (duration of crying greater than 4 h per day for 5 days per week). In 50 of the infants in the study group (71.4%) there was a remission of symptoms when cow's milk protein (CMP) was eliminated from the diet. Two successive challenges caused the return of symptoms in all these 50 infants. There was a positive anamnesis for atopy in 9 of 50 of the patients with CMP-related colic and in 1 of 20 of those with non-CMP-related colic (p greater than 0.05). A follow-up period of 18 months' mean duration showed that 22 of 50 (44%) of the infants with CMP-related colic and 1 of 20 (5%) of those with non-CMP-related colic developed an overt alimentary intolerance (p less than 0.02). We conclude that a considerable percentage of the infants with severe colic also have CMPI and that in these cases, dietetic treatment should be the first therapeutic approach.

Colic↗
PubMed1991

Transient gluten hypersensitivity.

We report a case of transient gluten hypersensitivity, demonstrated by jejunal histology at diagnosis, normalization after gluten-free diet, and acute clinical and histological relapse after a challenge with gluten powder at the age of 1 year, resembling that observed in cow's milk protein intolerance. Subsequent provocation tests did not show any alteration. Cases of supposed transient gluten hypersensitivity are rarely reported; our patient is characterized by the acute reaction to gluten challenge associated with a damaged histological picture and depressed levels of complement.

Duodenum↗
PubMed1991

Steatocrit test after a standard fatty meal: a new simple and sensitive test to detect malabsorption.

The steatocrit test, a simple semiquantitative method for determining fat content in stool, was performed after a standard fatty meal to detect malabsorption in patients with celiac disease. Thirty-seven children (mean age 2.6 +/- 2.1 years) with total atrophy of the intestinal villi and 79 controls (mean age 3.5 +/- 2.8 years) were studied. All subjects underwent a small-bowel biopsy, a D-xylose absorption test, a rapid triglyceride absorption test, and a steatocrit determination first on an uncontrolled diet and then again after a standard fatty meal. The steatocrit test after a fatty meal did not detect any false-positive or false-negative results, while the D-xylose test showed two false-negative and four false-positive results, and the rapid triglyceride absorption test found two false-negative and 23 false-positive results. We conclude that the determination of steatocrit after a standard fatty meal is a useful, simple, and noninvasive test to identify patients with total intestinal villous atrophy.

Biopsy↗
PubMed1991

Exocrine pancreatic function in children with coeliac disease before and after a gluten free diet.

This study was designed to determine the extent of pancreatic insufficiency in untreated coeliac disease and whether pancreatic secretion is impaired after a prolonged gluten free period. Three groups of patients were studied: group A comprised 44 patients, mean (SD) age 4.0 (3.1) years, with coeliac disease and total or subtotal atrophy of the intestinal mucosa; group B comprised 67 patients, mean age 4.4 (3.0) years, with coeliac disease but with normal morphology of the intestinal villi (after 12.9 months of a gluten free diet); group C comprised 49 control subjects, mean age 3.2 (3.0) years, with normal jejunal histology. In all subjects exocrine pancreatic function was determined by the secretin-caerulein test; bicarbonate concentration and lipase, phospholipase, and chymotrypsin activity were measured after an intravenous injection of secretin 1 clinical unit (CU) + caerulein 75 ng/kg body weight. Faecal chymotrypsin concentration was also assayed. No significant difference was found between values of the duodenal output of pancreatic enzymes and bicarbonate obtained in the three groups; however, 10 of 44 untreated coeliac patients showed tryptic or lipolytic activity, or both, below the normal limit for our laboratory. The mean value of the faecal chymotrypsin concentration was significantly lower in untreated than in treated coeliac patients (p less than 0.0001) or in control subjects (p less than 0.0001). It is concluded that untreated coeliac patients may have pancreatic deficiency independent of a decrease in enterohormone release. No primary or secondary pancreatic insufficiency was found in coeliac patients where the intestinal mucosa had returned to normal.

Adolescent↗
PubMed1991

[Magnesium hydroxide and aluminum hydroxide in the treatment of gastroesophageal reflux].

Fifteen children with gastro-esophageal reflux took part in a treatment trial with a regimen of magnesium hydroxide and aluminium hydroxide for 8 weeks period (700 mmol/1.73 mq/die). All children were evaluated clinically and underwent a 24-hour continuous esophageal pH-monitoring both at diagnosis and after 8 weeks of treatment. After therapy 12/15 children were cured and 3/15 improved. Moreover the total percentage of time during which pH was less than 4, the number of reflux episodes and the number of refluxes lasting than 5' recorded during 24-hour continuous esophageal pH-monitoring were significantly reduced after treatment. The Authors conclude that antacids in large quantities are effective in medical treatment of gastro-esophageal reflux.

Aluminum Hydroxide↗
PubMed1990

The steatocrit test as a guide in the prevention of cow's-milk enteropathy following acute infectious enteritis.

This study was designed to evaluate the following in infants with acute enteritis (AE): the influence of different types of milk on the evolution of the acute phase of the diarrhea and whether the degree of steatorrhea during the acute phase might be a risk factor for developing cow's milk enteropathy (CME). We studied 90 infants with AE, divided into three groups and refed differently after the acute episode: group A was refed using a semielemental formula; group B was refed using a milk containing soy proteins and vegetable oils; and group C was refed using a common cow's-milk formula. Patients with pathological steatocrit values on hospitalization were randomly assigned to groups A and B; patients with normal steatocrit values were placed in group C. After 4 weeks, the patients included in groups A and B were challenged with cow's milk and their reactions were recorded. During the acute phase of the disease, we noticed a longer persistence of diarrhea in group A than in groups B (p less than 0.01) and C (p less than 0.0025). In addition, the number of evacuations per day and steatocrit values were higher in group A than in groups B or C, but these differences were not statistically significant. After 4 weeks, the patients in groups A and B were challenged with cow's milk, and eight of 60 patients had positive reactions; intestinal biopsy confirmed the diagnosis of CME. The mean age of these eight patients was 40.3 days.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1990

The interrelationship of cesium, intracellular sodium activity, and pacemaker potential in cardiac Purkinje fibers.

The actions of cesium (Cs) on intracellular sodium activity (aiNa), membrane potentials, and force were studied in sheep cardiac Purkinje and myocardial fibers superfused in vitro. In Purkinje fibers, Cs (2 mM) decreased diastolic depolarization, aiNa (-6.7%, p less than 0.005), and force (-28.0%, p less than 0.01). The effects of 4 and 8 mM Cs were more pronounced. In quiescent fibers, Cs (2-4 mM) also decreased aiNa (-17.3%, p less than 0.005) and induced an initial hyperpolarization (+5.6 +/- 1.3%, p less than 0.005) followed by a return toward control. Diastolic depolarization was almost abolished by driving the fibers at 180/min (diastole was very short) but still Cs decreased aiNa (-15.4%). Tetrodotoxin decreased aiNa (-16.2%, p less than 0.025) and reduced the Cs-induced fall in aiNa (-2.2%, p less than 0.05). In zero [K]o, Cs decreased aiNa and caused repolarization. In 0.1 mM strophanthidin, Cs did not decrease aiNa any longer and affected the membrane potential little. In quiescent myocardial fibers, Cs (4 mM) decreased aiNa (-12.6%, p less than 0.05) and transiently hyperpolarized (+2.1%). Rubidium (2 mM) decreased aiNa and resting potential in Purkinje fibers and in myocardial fibers and also decreased diastolic depolarization in Purkinje fibers. Thus, cesium and rubidium decrease aiNa and modify the membrane potential but not through a block of the inward pacemaker current If.

Animals↗
PubMed1990

On the mechanism of the different sensitivity of Purkinje and myocardial fibers to strophanthidin.

The mechanism of the different sensitivity of Purkinje and myocardial fibers to strophanthidin was studied in these tissues isolated from the same hearts. Membrane potentials, force and, in some experiments, intracellular sodium activity were recorded under conditions that vary the sodium load in the absence and presence of strophanthidin. Strophanthidin (0.1-0.3 microM) increased force in percent terms more and at a faster rate in Purkinje than in myocardial fibers. Tetrodotoxin (TTX, 2 microM) markedly reduced whereas high [Na]o (176.6 mM) and veratridine (0.2 microM) potentiated strophanthidin inotropy in Purkinje but not in myocardial fibers. The rate of force development was augmented by high [Na]o and veratridine in Purkinje fibers but in myocardial fibers this effect was absent with high [Na]o and smaller with veratridine. Strophanthidin increased the action potential duration at plateau level in Purkinje and decreased it in myocardial fibers. The effects of TTX, high [Na]o and veratridine on the action potential were more pronounced in Purkinje than in myocardial fibers. TTX decreased far more and adding strophanthidin increased intracellular sodium activity (aiNa) less in Purkinje fibers. Strophanthidin increased aiNa to a similar extent in the presence of high [Na]o and veratridine in the two tissues. Thus, changes in Na influx modify the action potential duration, force and strophanthidin inotropy more in Purkinje than in myocardial fibers. This greater sensitivity of Purkinje fibers to strophanthidin does not appear to be related to a larger increase in aiNa, but rather to the changes in action potential (and consequent changes in calcium influx).

Action Potentials↗
PubMed1990

Steatocrit test: normal range and physiological variations in infants.

In order to define the normal values of steatocrit during the first 3 months of life and the normal correlation between fecal fat content and steatocrit values, 60 full-term healthy unweaned infants (30 bottle-fed, 15 breast-fed, and 15 mixed-fed) were studied. The steatocrit micromethod was performed in these babies at 7, 14, 21, 28, 45, and 90 days after birth. Steatorrhea often occurs during the first month and then decreases, as shown by the fall in the steatocrit curve from 7th to 28th day in our subjects; at 45 days, few babies have steatorrhea. The 90th percentile profile of steatocrit values shows a value of 25% at the first week of life and a value of 13% at the fourth week. After the end of the third month, babies with steatocrit values higher than 2% should be put under close observation. Moreover, fat absorption can be greatly influenced by diet; in breast-fed babies, steatorrhea disappears more rapidly and steatocrit values are lower at every age than in partly or totally formula-fed babies. The good correlation between steatocrit values and fecal fat content (r = 0.97) confirms that this micromethod can be used for monitoring steatorrhea instead of other more cumbersome and expensive methods.

Animals↗