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Biomedical subjects

B De Vizia

Publications and source records attributed to B De Vizia.

At least 19 recordsLinked to original sources
PubMed2003

Short duration of breastfeeding and early introduction of cow's milk as a result of mothers' low level of education.

Inappropriate infant feeding including a lack of breastfeeding and the early introduction of cow's milk are the most common forms of infant feeding malpractice. To evaluate the hypothesis that infant feeding malpractices are associated with mothers' low level of education, questionnaires were administered to 400 mothers of infants below 12 mo of age divided into 3 groups according to their various educational levels. Items included the type of milk given at birth and at 1, 3 and 6 mo of age. To investigate the efficacy of paediatricians in orienting infant feeding, the same questionnaire was given to 30 paediatricians in primary paediatric healthcare, in hospitals or in private practices. Initiation of breastfeeding was similar in the three groups. An analysis of the data showed that an increasing number of infants born to mothers of low and intermediate educational level did not receive exclusive breastfeeding compared with those with a higher level of education, a difference that was significant as early as 1 mo of age. In infants aged 3 mo, the prevalence of exclusive breastfeeding was 37%, 40% and 65% in the three groups, respectively, in relation to progressively increasing levels of education. In infants of 6 mo, the respective prevalence rates were 13%, 15% and 48%. Early introduction of cow's milk showed a similar correlation with educational level. A greater number of infants born to mothers with a low level of education received cow's milk at 3 mo of age compared with those born to mothers with an intermediate education (12% vs 5%). A similar difference was observed between the latter group and infants born to mothers with a high educational level (0%). This pattern was supported by data for infants at 6 mo of age with prevalence rates for cow's milk feeding of 39%, 20% and 0% in the three groups in association with progressively increasing level of educational (p < 0.05). The analysis of the paediatricians' response to the questionnaire showed that while physicians know and correctly prescribe age-related infant nutrition regimens, they are unaware that a substantial number of mothers do not comply with what they prescribe. Overall, these data support the relationship between a low educational level and infant feeding malpractice and suggest that a more effective role should be played by paediatricians in supporting an adequate duration of breastfeeding and the use of formula rather than cow's milk protein.

Adult↗
PubMed2001

Effect of intragastric volume and osmolality on mechanisms of gastroesophageal reflux in children with gastroesophageal reflux disease.

OBJECTIVE: Both transient lower esophageal sphincter (LES) relaxations (TLESRs) and periods of low/absent LES pressure (LESP) are the main mechanisms of gastroesophageal reflux. These events are believed to be triggered by stimuli from different areas of the upper GI tract. We aimed at investigating the relationship between LESP profile and gastric emptying and distension after meals of different composition in 30 children with gastroesophageal reflux disease (median age 7.0 yr, range 12 months-12 yr). METHODS: Recordings of LESP and intraesophageal pH for 1 h fasting and for 2 postprandial h were performed with a perfused sleeve catheter and flexible electrode, respectively; gastric emptying and distension of antral area were simultaneously recorded with real-time ultrasonography. Ten patients had a standard meal (group A), 10 had a high-volume meal (group B), and 10 had a high-volume and osmolality meal (group C). RESULTS: Postprandial esophageal acid exposure was significantly higher in patients of groups B and C than in patients of group A (p < 0.01); it was also more prolonged in patients of group C than in subjects of group B (p < 0.05). A higher postfeeding rate of reflux episodes caused by TLESRs was detected in patients of groups B and C as compared with patients of group A (p < 0.01). This increase did not statistically differ in patients of groups B and C. Patients of group C exhibited a higher postprandial rate of reflux episodes associated with low/absent tone of the LES as well as a more prolonged gastric emptying time and a higher postfeeding gastric distension as compared with patients of groups A and B (p < 0.01). Finally, a significant correlation was only found between the postprandial rate of reflux events resulting from low/absent LESP and the degree of antral distension in patients of group C (p < 0.01). CONCLUSION: Gastroesophageal reflux is worsened by increasing the volume and osmolality of meals through significant changes of LESP. Meals of high volume and meals with high volume and osmolality cause a comparable increase of reflux episodes as a result of TLESRs. However, meals with high volume and osmolality cause the higher degrees of esophageal acid exposure than meals with high volume resulting from a higher rate of reflux episodes associated with low/absent LESP. This finding correlates with a high postfeeding antral distension.

Child↗
PubMed1997

Gut lavage IgG and interleukin 1 receptor antagonist:interleukin 1 beta ratio as markers of intestinal inflammation in children with inflammatory bowel disease.

BACKGROUND: Whole gut lavage is currently used as preparation before radiological or endoscopic examination of the large bowel. AIM: To validate the gut lavage technique for the assessment of mucosal inflammation, by measuring intestinal IgG and interleukin 1 beta (IL-1 beta) in the fluid obtained. PATIENTS: Sixteen children with Crohn's disease (CD), 14 with ulcerative colitis (UC), and 22 age matched controls. METHODS: Isotonic, non-absorbable polyethylene glycol based lavage solution was given orally or by nasogastric tube. Clear fluid was collected, filtered, and treated with protease inhibitors. IgG, IL-1 beta and IL-1-receptor antagonist (IL-1-ra) were measured by sandwich enzyme linked immunosorbent assay (ELISA). RESULTS: In patients with UC and CD, IgG and IL-1 beta levels were significantly (p < 0.001) higher than in controls. A positive correlation (p < 0.05) was found with disease activity scores. IL-1-ra levels were not significantly different in UC and CD, when compared with controls, but the IL-1-ra:IL-1 beta ratio was significantly (p < 0.01) lower in patients with UC and CD, and negatively (p < 0.001) correlated with IgG levels in lavage fluid. CONCLUSIONS: Gut lavage fluid IgG and IL-1 beta levels and IL-1-ra:IL-1 beta ratio may provide objective discrimination between active and inactive disease in children with inflammatory bowel disease.

Adolescent↗
PubMed1996

Ultrasound measurement of gastric emptying time in patients with cystic fibrosis and effect of ranitidine on delayed gastric emptying.

Intestinal dysmotility is commonly reported in patients with cystic fibrosis (CF); however, gastric motor activity has rarely been investigated. We measured with real-time ultrasonography the antral distention and gastric emptying time of a solid-liquid meal in 29 patients with CF (age range, 5 to 17 years). A significantly prolonged gastric emptying time was present in 26 patients compared with 13 healthy control subjects (age range, 5 to 16 years); an exaggerated antral distention in the fed period was also detected. The patients with CF and delayed gastric emptying were randomly allocated to receive cisapride or ranitidine for 4 weeks. Twelve patients treated with ranitidine and 11 with cisapride completed the trial. There was a marked decrease in gastric emptying time, antral distention, and dyspeptic symptomatic score in patients receiving ranitidine but not in patients treated with cisapride. We conclude that gastric dysmotility is commonly detected in patients with CF and that H2 receptor blockers are more effective than prokinetics in improving dyspeptic symptoms and gastric emptying and distention.

Adolescent↗
PubMed1995

Iron status in breast-fed infants.

Iron status of 30 infants who had been breast fed until their first birthday and who had never received cow milk, medicinal iron, or iron-enriched formula and cereals was investigated; 30% were anemic at 12 months of age. The duration of exclusive breast-feeding was significantly longer among nonanemic infants (6.5 vs 5.5 months). None of the infants who were exclusively breast fed for 7 months or more and 43% of those who were breast fed for a shorter time were anemic. Infants who were exclusively breast fed for a prolonged period had a good iron status at 12 and 24 months.

Aging↗
PubMed1995

Metabolic alkalosis due to the use of an oligoantigenic diet in infancy.

A 7-month-old boy on an oligoantigenic diet because of multiple food intolerances presented with anorexia, failure to gain weight and severe hypochloremic metabolic alkalosis with hyperreninemia. Clinical symptoms and biochemical abnormalities disappeared after adequate dietary supplementation with potassium and sodium chloride. This case emphasizes that minimal daily mineral requirements must be provided in infant diets, and highlights the risk of nutritional deficiencies inherent in the prolonged use of oligoantigenic diets not adequately supplemented.

Alkalosis↗
PubMed1992

Thiamine transport by erythrocytes and ghosts in thiamine-responsive megaloblastic anaemia.

A 9-year study of thiamine metabolism and cellular transport was performed in two patients with thiamine-responsive megaloblastic anaemia associated with diabetes mellitus and sensorineural deafness, in their relatives, and in age-matched controls from the same area. The ratios between the content of thiamine and that of its phosphoesters in erythrocytes were within the normal range, whereas the absolute values of thiamine and thiamine compounds were reduced by about 40% as compared to controls. Thiamine pyrophosphokinase activity was about 30% lower than in controls. Thiamine treatment restored the levels of thiamine and thiamine compounds to normal values, whereas kinase was unaffected. Both the saturable (specific, predominant at low, less than 2 mumol/L, physiological concentrations of thiamine) and the non-saturable component of thiamine transport were investigated. Erythrocytes and ghosts from patients exhibited no saturable component, this abnormality being specific for the patients and not shared by their parents. It is concluded that the cells from thiamine-responsive megaloblastic anaemia patients contain low levels of thiamine compounds, probably due to their inability to take up and retain physiological concentrations of thiamine, as a result of the lack of the saturable, specific component of transport and reduced thiamine pyrophosphokinase.

Anemia, Megaloblastic↗
PubMed1992

Calcium and phosphorus metabolism in full-term infants.

Appropriate intake of dietary calcium and phosphorus is essential for the maintenance of mineral homeostasis and support of adequate bone mineralization in growing infants. Disturbances of calcium homeostasis such as newborn hypocalcemia, have been shown to be secondary to high oral phosphate intake. The incidence of hypocalcemic tetany has changed from epidemic proportions in newborns, who were formerly fed evaporated cow's milk formula, to the present sporadic occurrence in newborns who are now fed humanized cow's milk formula, with a calcium concentration of about 50 mg/dl and a phosphorus concentration of about 35 mg/dl. Human milk, provided vitamin D intake is adequate, has been shown to maintain calcium-phosphorus homeostasis and support adequate bone mineralization at least in the first 6 months of life. After this, the phosphorus content of breast milk could limit mineral accretion in exclusively breast fed infants. The present concentration of calcium and phosphorus in the humanized cow's milk formulas support adequate mineral homeostasis and bone mineralization throughout the first year of life. As bone calcium content is proportional to calcium intake, feeding whole cow's milk from early infancy onward is associated with abnormal bone mineralization. The adequacy of bone mineralization in infants fed soy formula is still controversial.

Bone Density↗
PubMed1989

Studies on thiamine metabolism in thiamine-responsive megaloblastic anaemia.

We have investigated thiamine metabolism and transport in the erythrocytes of two patients from unrelated families with thiamine responsive megaloblastic anaemia associated with diabetes mellitus and sensorineural deafness. Both patients had low concentrations of thiamine compounds in plasma and red blood cells. When erythrocytes were incubated with thiazole-[2-14C]-thiamine or [35S]-thiamine in vitro, the concentration of label within the cells was markedly reduced compared with controls. In addition, thiamine pyrophosphokinase activity was deficient in haemolysates prepared from the patients. Some relatives of the patients showed abnormal parameters of thiamine status and transport. In both patients treatment with a lipophilic compound corrected the haematological abnormalities and diabetes and in one patient has so far prevented the progression of deafness. We propose that the disorder is caused by an inherited defect of thiamine transport, possibly related to deficient pyrophosphokinase activity, leading to intracellular depletion of active thiamine metabolite derivatives.

Anemia, Macrocytic↗
PubMed1985

Iron malabsorption in giardiasis.

Among 10 children with giardiasis, eight had iron deficiency; iron deficiency anemia was the main complaint in three. Evaluation of iron absorption by the oral iron load test demonstrated a subnormal response (i.e., increase in serum iron levels of less than 100 micrograms/dl) in all eight patients with iron deficiency. In contrast, in two iron-sufficient patients with giardiasis the response to an oral iron load was normal. Xylose absorption was abnormal in five of the 10 patients. After metronidazole dosing, iron absorption became normal in seven patients but remained abnormal in one patient, who also had IgA deficiency. Xylose absorption became normal in all five patients who underwent a second test, but remained abnormal in the patient with IgA deficiency. Concomitant morphologic-studies of jejunal biopsy material from these patients revealed moderate changes in the intestinal mucosa of two patients. We conclude that malabsorption of iron is a complication of giardiasis.

Anemia, Hypochromic↗
PubMed1984

High frequency of lactose absorbers among adults with idiopathic senile and presenile cataract in a population with a high prevalence of primary adult lactose malabsorption.

22% of a group of adult Neapolitans were found to have persistent high lactase activity, and 16% were lactose absorbers as indicated by measurement of breath hydrogen concentration and rise in blood glucose after oral lactose administration. Among adults in the same area with idiopathic senile or presenile cataract 49% were identified as lactose absorbers with the breath hydrogen test and 55% by the rise in blood glucose. These results suggest that adults able to absorb galactose from a lactose-containing diet are especially susceptible to senile or presenile cataract.

Adult↗
PubMed1984

Chronic diarrhea and failure to thrive in an infant with Campylobacter jejuni.

We report the case of an infant with chronic diarrhea and failure to thrive. Campylobacter jejuni was isolated from stools and treatment with erythromycin resulted in eradication of infection and prompt resolution of symptoms. A 22-month-old girl was referred to our University Hospital because of weight loss and chronic diarrhea, which did not respond to repeated dietetic trials that excluded milk, gluten, and other foodstuffs. Microscopic examination of the jejunal biopsy specimen revealed a mild degree of partial mucosal atrophy with inflammatory infiltrates in the lamina propria without any hallmarks of celiac disease. Repeated stool cultures on Butzler medium were positive for C. jejuni. This finding was associated with a high titer of specific serum antibodies. Erythromycin therapy without any other form of therapy led to prompt improvement, and the patient reached her "own" 50th centile as weight/height ratio. The aim of this report is to alert pediatric gastroenterologists of the possibility that Campylobacter may be associated with chronic diarrhea and failure to thrive.

Campylobacter Infections↗
PubMed1981

Development of brush border peptidases in human and rat small intestine during fetal and neonatal life.

The cytosol peptidase activities hydrolyzing glycl-L-leucine and L-leucyl-glycine as well as the activities of the brush border peptidases (oligoaminopeptidase, aminopeptidase A, gamma-glutamyl-transpeptidase, dipeptidyl-aminopeptidase IV, and carboxypeptidase) are present in rat fetuses during the early differentiation of the intestine (17th to 19th days of fetal life); they increase then at a different rate, reaching a maximum at various times, in the second and third wk after birth, and then decrease to the adult values during the first month of postnatal life. Only the oligoaminopeptidase activity increases steadily after birth, reaching maximal activity in the last decade of the first month. In human fetuses aged between 8 and 22 wk, the gamma-glutamyltranspeptidase was the only brush border peptidase found to be higher than in adults and children. On the other hand, the aminopeptidase A is remarkably reduced. The dipeptidylaminopeptidase IV and the carboxypeptidase are already at adult level in the youngest fetuses, and the oligoaminopeptidase increases during the period of fetal life studied; at the end of this period, the enzyme activity does not differ from the values found in children and adults. The small intestine of the term and preterm newborn should, therefore be able, with some possible exceptions, to efficiently digest peptides.

Animals↗
PubMed1975

Digestibility of starches in infants and children.

The digestibility of various starches has been studied in normal infants of different ages. During balance periods of 3 days, while the infants were receiving known dietary quantities of the starch to be tested, the fecal content of lactic acid, glucose, dextrins, and starch was measured. After the first year of life, children were able to absorb almost completely 170 gm/m2 of body surface of cooked wheat starch given in the form of biscuit or macaroni. A lower absorption coefficient was found for potato starch given in the form of biscuit. Cooked wheat, tapioca, corn, rice, and potato starch in amounts of 45 and 85 gm/m2/day, respectively, for 1- and 3-mo-old infants, were almost completely absorbed. In 1-mo-old infants larger amounts (110 gm/m2/day) of cooked rice starch were well tolerated; it should therefore be possible to provide a large part of the carbohydrate requirements of infants from the first month of life with cooked starches.

Animals↗
PubMedDate not supplied

Discriminant analysis for the diagnosis of childhood celiac disease.

A new statistical approach to the analysis of laboratory data has been introduced to optimize the use of absorption tests and gliadin antibody measurement for the diagnosis of childhood celiac disease. Serum antigliadin antibodies, as well as blood xylose, iron, and tryglycerides after oral load, were evaluated in 40 celiac children and 43 age-matched patients affected by other gastrointestinal diseases. Each test evaluated individually gave a considerable rate of false-positive and false-negative results. Discriminant coefficients produced for each test were used to compute a score that allowed correct classification of 99% of patients; 2.3% of false-positive and no false-negative results were recorded. This approach improves significantly the overall sensitivity and specificity for celiac disease of these laboratory tests and we propose its use for screening patients to be submitted to jejunal biopsy.

Adolescent↗
PubMedDate not supplied

Disorders of upper esophageal sphincter motility in children.

Dysfunction of the upper esophageal sphincter was found in five out of 44 children with gastroesophageal reflux. Three of the five children had mental retardation associated with Silver Russell syndrome, 5p syndrome, or minimal change myopathy. The five patients had swallowing disorders, vomiting, and failure to thrive; four also had pulmonary aspiration. Esophageal manometry showed incomplete upper esophageal sphincter relaxation in two patients, upper esophageal sphincter relaxation incoordinated with pharyngeal contractions in two other patients, and both incomplete and incoordinated upper esophageal sphincter relaxation in the last patient. Intensive and successful treatment of gastroesophageal reflux did not improve swallowing or symptoms of pulmonary aspiration in four children. The fifth patient underwent cricopharyngeal myotomy, with complete resolution of respiratory and swallowing symptoms. It is suggested that a dysfunction of the upper esophageal sphincter, either primary or secondary to neuromuscular disorders, may play a role in the swallowing disorders and respiratory symptoms of pediatric patients.

Child↗