Search PubMed⌕ Search

Biomedical subjects

M Miglioli

Publications and source records attributed to M Miglioli.

234 records · Page 13Linked to original sources
PubMedDate not supplied

Wernicke's encephalopathy during total parenteral nutrition: observation in one case.

A patient operated for toxic megacolon secondary to ulcerative colitis developed a Wernicke syndrome (thiamine deficiency) during the postoperative period despite the administration of the usually recommended doses of vitamin B1 during total parenteral nutrition (TPN) treatment. Vitamin B1 deficiency should be checked in order to evaluate the patients' nutritional condition before starting TPN, especially those suffering from severe chronic malnutrition. Routine administration of vitamin B1 in repletion doses may be reasonably proposed in order to avoid the development of a Wernicke syndrome which is potentially lethal in a short time if not recognized and corrected in time.

Adult↗
PubMedDate not supplied

Morphologic and cytoproliferative patterns of duodenal mucosa in two patients after long-term total parenteral nutrition: changes with oral refeeding and relation to intestinal resection.

The morphologic and cytoproliferative patterns of the duodenal mucosa of two adult patients, one of whom had a short bowel, were evaluated after more than 2 months of postoperative total parenteral nutrition and 2 and 12 months after the resumption of oral alimentation. Morphometric analysis was performed on routinely processed duodenal biopsies. Cell proliferation was evaluated by means of in vitro bromodeoxyuridine uptake. The results were compared with those obtained in five healthy controls. After parenteral nutrition, patients showed significantly lower villus height and crypt depth than those of controls and a normal bromodeoxyuridine labeling index. After 2 months of refeeding, villus and crypt returned to normal, and the labeling index was increased. After 12 months of oral refeeding, labeling index, villus height, and crypt depth were similar to those of controls. The patient with the short bowel showed a number of cells per unit length of villus and crypt significantly greater than those of the controls and of the patient who underwent shorter intestinal resection. In human duodenal mucosa, (1) hypoplasia develops after long-term total parenteral nutrition; (2) mucosal recovery occurs through an increased cell proliferation after oral refeeding; and (3) extensive small bowel resection determines the development of relative hyperplasia.

Adult↗
PubMedDate not supplied

Helicobacter pylori infection and cytotoxic antigen associated gene "A" status in short children.

BACKGROUND: Helicobacter pylori is now an accepted gastroduodenal pathogen and is being investigated for possible implications in nongastroenterological conditions such as growth impairment. Subjects infected by cytotoxic Cag-A positive strains seem more likely to develop serious gastroduodenal diseases but the possible role of Cag-A positive strains in non gastroenterological diseases has not been fully investigated. OBJECTIVE: 1) To evaluate the prevalence of Helicobacter pylori infection and Cag-A positivity in short children compared to auxologically normal children. All the subjects were without gastro-intestinal symptoms and were not obese or significantly underweight. 2) To verify the reliability of the ELISA assay for H. pylori. SUBJECTS: H. pylori infection was assessed in 338 children, 182 auxologically normal and 156 short children, with and without deficiency in growth hormone, by the determination of specific IgG antibody. In 79 subjects (all seropositive and a random sample of seronegative children), 13C-urea breath test and cytotoxic Cag-A positive strains were examined. RESULTS: The overall seroprevalence of H. pylori infection by IgG antibody was 18/156 (11.5%) and 13/182 (7.1%) in short and auxologically normal children respectively. The 13C-urea breath test was positive in 29 children: 17 (10.9%) short and 12 (6.6%) auxologically normal. Western blotting documented infection by cytotoxic Cag-A positive strains in 12/17 (70.6%) and 8/12 (66.6%) of short and auxologically normal children respectively. None of the differences between the two groups were significant. CONCLUSIONS: 1) We found a similar prevalence of H. pylori infection and Cag-A positivity in two large pediatric populations of short or auxologically normal children. Therefore: 1) Our data did not confirm a role of H. pylori infection in short stature in children. 2) We found a high reliability of ELISA assay for the detection of IgG antibodies compared to breath test.

Adolescent↗
PubMedDate not supplied

Bacteria in biopsies of human hypochlorhydric stomach: a scanning electron microscopy study.

A long-lasting condition of hypochloridria leads to a bacterial growth both in the gastric lumen and biopsies of human stomach. Some of these bacteria are probably involved in gastric carcinogenesis, due to their capacity of nitrosation. This study was carried out on biopsies taken during endoscopy from both gastric antrum and the body of patients with or without hypochloridria. Scanning electron microscopy observation shows that bacteria, other than Helicobacter pylori, found in hypochloridria, can be located not only over but also into and under the mucus layer covering the gastric epithelium. In such areas, mechanical and biochemical damage may occur.

Achlorhydria↗
PubMedDate not supplied

Effect of omeprazole on interdigestive gastroduodenal motility of patients with ulcer-like dyspepsia.

BACKGROUND/AIMS: As omeprazole, an antisecretory drug, is largely used in the treatment of acid-related diseases, we investigated its effects on the interdigestive gastroduodenal motility of ulcer-like dyspepsia. METHODOLOGY: Gastroduodenal motility was recorded manometrically in 9 patients complaining of ulcer-like dyspepsia with normal gastric emptying at scintigraphy, without ulcerative lesions and H. pylori infection at endoscopy, and without diseases known to affect gut motility (group ULD), and in a group of 9 healthy subjects as control (group C). After a period sufficient to record two consecutive phases III of the migrating motor complex (MMC) in patients of group ULD, omeprazole 20 mg was infused intravenously 30 min after the end of the last duodenal phase III and the recording was continued to the next one. RESULTS: With respect to the control group, the group ULD showed a significantly longer MMC cycle duration, a frequent absence of gastric phases III and a shorter duration of duodenal phases III. Omeprazole administration in group ULD was followed after 18.9 +/- 8.5 min by a typical gastroduodenal phase III and, consequently, the duration of the omeprazole-related cycle was significantly shortened. These omeprazole-related phases III started from the stomach in nearly all cases and showed a significantly longer duration at the duodenal level with respect to the spontaneous ones. CONCLUSIONS: Patients with ulcer-like dyspepsia showed a decrease in frequency and duration of gastroduodenal phases III. The omeprazole intravenous administration induced the anticipated appearance of an apparently normal gastroduodenal phase III, probably by suppressing the inhibitory action of acid secretion.

Adult↗
PubMedDate not supplied

Correlation between endoscopic features of gastric antrum, histology and Helicobacter pylori infection in adults.

BACKGROUND: Helicobacter pylori induces histologic inflammation of mucosa variably correlated to different macroscopic features. Recent studies highlight that the presence of Helicobacter pylori could be assessed on the basis of the macroscopic pattern only, in particular nodularity. The present prospective study has correlated this and other endoscopic features, defined by Sydney classification of gastritis, both to Helicobacter pylori presence and histological patterns. RESULTS: Out of 532 patients, 364 were evaluable. The prevalence of Helicobacter pylori was 51.1% with a different distribution between the endoscopic features. Nodularity showed the highest positive predictive value in detecting the Helicobacter pylori presence (69.9%). The histological findings were: normal 26.9%, non atrophic gastritis 55.2%, atrophic gastritis 17.9%. There was a significant difference between abnormal endoscopic features in detecting the histologic gastritis, with endoscopic atrophy and nodularity showing the highest positive predictive value which reaches 96.7% and 91.8%, respectively. Helicobacter pylori infection and histologic gastritis were also present in 30.9% and 41.8%, respectively, of endoscopically normal subjects. Multivariate analysis has strictly correlated age with all abnormal endoscopic features, metaplasia with endoscopic atrophy, and chronic inflammation (gastritis) with nodularity. CONCLUSIONS: The single endoscopic features are poorly correlated with histologic changes and Helicobacter pylori status. Biopsies are mandatory in all cases. The causes of the different macroscopic findings are not yet fully understood.

Adolescent↗
PubMedDate not supplied

[Changes caused by mineral water on gastrointestinal motility in patients with chronic idiopathic dyspepsia].

BACKGROUND: The antidyspeptic property of mineral waters has been based for ages on empirical data. In the present paper the effects of one of them (Tettuccio, Montecatini) on gastrointestinal motility of patients with dyspepsia has been evaluated. METHODS: The study was carried out on 24 patients with idiopathic dyspepsia and delayed gastric emptying at scintigraphy and 18 healthy subjects with normal gastric emptying. The gastric emptying of this mineral water was studied with a scintigraphic method in comparison with tap water, while its effects on gastroduodenal contractions were evaluated by of manometry. RESULTS: The gastric emptying of this mineral water was significantly faster than that of tap water, both in dyspeptic patients and in normals. Manometric examination showed that the administration of mineral water induced a brief decrease of phasic motor activity, followed by a progressive increase, which in some cases ended in an activity front of the Migrating Motor Complex. CONCLUSIONS: This mineral water has a stimulating effect on both gastric emptying and interdigestive cyclic motor activity of the gastroduodenal tract. Both these effects could be useful in the treatment of chronic idiopathic dyspepsia and impaired gut clearing.

Adolescent↗
PubMedDate not supplied

Requirements for the use of intestinal action antibiotics in the treatment of ulcerative colitis.

The causes of ulcerative colitis are still unknown and above all the circumstances which can lead to inflammatory episodes are unclear. Antibiotic therapy has not provided encouraging results so far but it is possible that the pathogenesis of this disease may involve bacterial species which have not yet been identified. The use of an antibiotic with specific colic activity therefore seems to be justified.

Colitis, Ulcerative↗
PubMedDate not supplied

Cell renewal and cancer risk of the stomach: analysis of cell proliferation kinetics in atrophic gastritis.

We examined cell proliferation kinetics of gastric mucosa in 28 patients affected by chronic atrophic gastritis by means of autohistoradiography of biopsies incubated with tritiated thymidine. The results have been compared with those obtained from 12 patients with normal gastric mucosa. In chronic atrophic gastritis, patients showed a proliferative pattern similar to controls. The remaining patients had an increased number of replicating cells together with an expansion of the proliferative compartment towards the surface of the mucosa. These results suggest that in chronic atrophic gastritis, as far as cell proliferation is concerned, two subgroups of patients with two different levels of risk of developing gastric cancer exist. The first one, showing an expansion of the proliferating area, probably is at higher risk. As a matter of fact, such an abnormality expresses an alteration of cell growth control similar to that observed in preneoplastic conditions of the colon and in gastric mucosa of animals treated with carcinogenic substances.

Adult↗