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Biomedical subjects

G Bassotti

Publications and source records attributed to G Bassotti.

At least 19 recordsLinked to original sources
PubMed1992

Abnormal rectosigmoid myoelectric response to eating in patients with severe idiopathic constipation (slow-transit type).

Pathophysiologic mechanisms responsible for severe chronic constipation are poorly understood. In particular, most of the published studies have lumped together patients having different subtypes of constipation, with different and often conflicting results. We studied six patients complaining of severe idiopathic constipation and displaying homogeneous clinical and pathophysiologic features (i.e., patients with slow-transit type constipation) to evaluate their myoelectric spiking responses to food ingestion. Ten healthy subjects acted as controls. The constipated patients failed to show the increase in myoelectric spiking activity that was seen in controls immediately following the meals, suggesting the possibility of a neurogenic defect in this condition.

Action Potentials↗
PubMed1992

Esophageal motor disorders in patients evaluated for dysphagia and/or noncardiac chest pain.

During the period January, 1983-October, 1990, 429 subjects were referred for functional evaluation of dysphagia and/or noncardiac chest pain. Of these, 304 (70.8%) were shown to have some kind of esophageal motor abnormality. The most frequent motor abnormality of the esophagus was represented by nonspecific motor disorders (31%), followed by achalasia (13%), whereas the other dysfunctions accounted for a smaller percentage. In particular, diffuse esophageal spasm was shown to be quite rare. It is concluded that esophageal manometry may provide a high diagnostic yield in patients presenting with dysphagia and/or noncardiac chest pain.

Chest Pain↗
PubMed1992

Intestinal pseudoobstruction secondary to hypothyroidism. Importance of small bowel manometry.

Hypothyroidism may lead to secondary pseudoobstruction. We report a patient with intestinal symptoms from hypothyroidism in which previous conventional examinations were negative. Gastrointestinal manometry disclosed features of pseudoobstruction, and we discuss the importance of performing functional studies in selected cases, in as much as symptoms seemed to resolve on replacement therapy.

Aged↗
PubMed1992

Impaired colonic motor response to eating in patients with slow-transit constipation.

Because little is known about the pathophysiological mechanisms responsible for chronic idiopathic constipation, we studied colon motor response to eating, one of the most physiological and reproducible stimuli, in a clinically homogeneous group of severely constipated subjects. Fifteen patients (14 women, one man) with slow transit constipation (average duration of symptoms 18 +/- 2 yr) entered the study. After colonoscopic positioning of a manometric probe, 2-h basal and 3-h postprandial (1000 kcal standard mixed meal) recordings were obtained. Comparison of tracings with those of 29 healthy volunteers showed that motor response to eating was decreased in constipated subjects. Patients' response was characterized by a shorter duration of contractile activity in all three colon segments studied, after ingestion of the meal, and significantly less high-amplitude propagated contractions (7% vs. 45%). We conclude that several mechanisms are involved in the pathophysiology of colon contractile motor function of patients with chronic idiopathic constipation.

Adult↗
PubMed1992

Isolated hypertensive lower esophageal sphincter. Clinical and manometric aspects of an uncommon esophageal motor abnormality.

The hypertensive lower esophageal sphincter is an infrequent primary esophageal motor disorder characterized by elevated mean lower esophageal sphincter pressure (greater than or equal to 3 SD from that of controls), sphincter relaxations greater than 75%, and normal peristaltic activity in the esophageal body. This disorder is frequently associated with the nutcracker esophagus. We report our clinical and manometric experience with the isolated hypertensive lower esophageal sphincter (i.e., unassociated with other motor disorders), which constituted 2.7% of all patients who complained of dysphagia or chest pain referred for manometry during the period from October 1982 to February 1991.

Adult↗
PubMed1992

Extensive investigation on colonic motility with pharmacological testing is useful for selecting surgical options in patients with inertia colica.

Three women with idiopathic severe chronic constipation and inertia colica, who failed to respond to medical treatment, were extensively investigated for gut motor function, especially that of the colon. Twenty-four-hour manometric recordings disclosed that motility was severely reduced throughout the entire colon and response to eating was minimal. One of the patients also was tested for esophageal, gastric, and small bowel motor activity, which gave normal results. Edrophonium chloride stimulation (10 mg iv) provoked no increase in colonic contractile activity in any patient. On these grounds, the patients were submitted to surgical intervention (total colectomy with ileorectal anastomosis two, and left hemicolectomy the other) with fairly good results at follow-up. These results indicate the wisdom of carrying out extensive functional investigations in severely constipated patients before surgery is contemplated.

Colon↗
PubMed1991

Efficiency of different criteria for selecting pharmacokinetic multiexponential equations.

Several statistical and empirical approaches have been proposed to select the multiexponential equation that best describes the time course of the plasma concentration of a drug. Recently, a new criterion (Ip) has been proposed according to which the model that best interprets a set of experimental data points is the one with the smallest area between the approximate confidence limits of estimated plasma concentration. We used large Montecarlo simulations to compare the ability of different selection criteria to select the correct model from data generated with an independent, normally distributed random error. The new criterion (Ip), Akaike's information criterion, the Schwartz test, and the F ratio test were studied. In this situation, the correct model was known and the performances of different selecting methods were assessed by examining their sensitivity to the number of exponential terms, the number of data points, and the size of the exponents in the true model. Mono-, bi-, and triexponential equations were studied. Overall mean percentages of right identification were 98.1 per cent for the new index, 82.8 per cent for Akaike's information criterion, 89.5 per cent for the Schwartz test, and 97.7 per cent for the F ratio test. The Akaike and Schwartz tests were not as efficient as the other tests with few (8-10) data points. The Ip and the F test raise the percentages of right identification of the model when the hybrid elimination rate macroconstants differ by at least a factor of four.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1991

Effects of parenteral diclofenac sodium on upper gastrointestinal motility after food in man.

In experimental animal models nonsteroidal anti-inflammatory drugs may influence gastrointestinal motility, but as evidence is lacking in man. The effect of diclofenac sodium 75 mg i.m. on the motor response of the upper gastrointestinal tract to food has been studied by manometry in 9 healthy volunteers. Diclofenac had no effect on the motor activity of the stomach, duodenum, or jejunum after a 605 kcal meal.

Adult↗
PubMed1991

Edrophonium chloride for testing colonic contractile activity in man.

The effects of cholinergic stimulation on the entire human colon are at present relatively unknown. For this reason, we evaluated the influence of a short-lived anticholinesterase agent, edrophonium chloride, on proximal and distal colonic contractile activity in man. Eight healthy volunteers of both sexes were studied with a multi-lumen manometric probe positioned with the aid of a colonoscope. Recordings were then obtained 30 minutes pre- and post-drug administration. Edrophonium chloride (10 mg intravenous) significantly stimulated both proximal and distal colonic contractile activity, and the maximum increase was observed within 10 minutes following injection, although some differences were observed between colonic segments in response to the drug. No important side effects were complained of after edrophonium. Due to the potent stimulatory property on colonic smooth muscle, to its short duration of action, and to the paucity of side effects, it is concluded that edrophonium chloride may be useful as a stimulating substance during manometric investigations of the human colon.

Adult↗
PubMed1991

Method for prolonged ambulatory monitoring of high-amplitude propagated contractions from colon.

This study monitored high-amplitude propagated contractions (HAPCs) in ambulating subjects over a 24-h period using a new ambulatory recording system. Twelve healthy volunteers aged 34 +/- 5.96 yr participated. Approximately 12 h after a Colyte bowel prep, a small catheter (OD less than 3 mm), containing three solid-state pressure transducers spaced 5 cm apart, was positioned by flexible sigmoidoscope at 40-50 cm from the anal verge. A battery-operated data recorder sampled the pressure at each port at 1 Hz and stored the values on all ports if any port exceeded 75 mmHg. At the conclusion of the 24-h period, an X-ray was taken to confirm the location of the catheter. Fifty-four percent of all HAPCs preceded a bowel movement by less than or equal to 1 h. Forty-nine percent of all HAPCs occurred within 1 h after a high-fat meal, and 33% occurred within 1 h of morning awakening. Reverse propagated waves, not previously described in the colon, were observed in three individuals. Spontaneous high-amplitude caudally propagated contractions occur 6.9 +/- 1.5 times/24 h in the sigmoid colon in ambulating asymptomatic individuals and are temporally related to defecation and meals. Peristaltic activity is decreased during sleep. This recording technique was reliable and well tolerated in all participants.

Adult↗
PubMed1991

Prolonged (24-hour) manometric recording of rectal contractile activity in patients with slow transient constipation.

A periodic motor activity, named the rectal motor complex, has been recently described in the healthy human rectum. We studied the rectal contractile activity for 24 h by a low compliance manometric system in a group of 10 women with slow transit constipation. Analysis of the 24-hour manometric recordings showed that these subjects: (1) had overall scarce rectal motility; (2) display few rectal motor complexes (average, 3.3 +/- 1.3/subject/24 h) which are irregularly distributed over time, and (3) respond weakly to ingestion of a standard meal (average duration of the motor response 19 +/- 6 min). The observations suggest that an underlying neuropathic process may be involved in the pathogenesis of the impaired rectal motility in patients with slow transit constipation.

Adult↗
PubMed1991

Giardia lamblia infestation reveals underlying Whipple's disease in a patient with longstanding constipation.

Whipple's disease is an uncommon disorder, generally associated with gastrointestinal symptoms; of these, diarrhea is a common feature. We report a case of Whipple's disease associated with chronic constipation which was not diagnosed until after Giardia lamblia infestation had caused diarrhea. To the best of our knowledge this association has not previously been reported. The clinical, laboratory, endoscopic, and manometric aspects are described and discussed.

Adult↗
PubMed1991

Prolonged manometric investigation of the colon in research on chronic constipation.

We studied the whole colonic motility for 24 hours in controls and in constipated patients. In the patient group we found a significant reduction in the colonic mass movements (6.1 +/- 0.9 vs 2.6 +/- 0.7 controls vs patients, respectively). The constipated patients showed a reduction of the colonic motor activity after the ingestion of a standard meal. Moreover, they showed, compared with controls, a significant reduction of postprandial mass movements. On the other hand we were not able to find the so-called rectal motor complex described by others. In conclusion, we believe that prolonged colonic manometry would become an important step when evaluating the pathophysiology of constipated patients, particularly of those not responding to standard treatment.

Colon↗
PubMed1991

Diabetes and gastrointestinal motor activity.

The gastrointestinal tract is frequently involved by diabetes, especially when automatic neuropathy is present. Hollow viscera motor activity is especially effected; in particular, gastric and small bowel function may be severely impaired, due to gastroparesis and dysmotility, although motility of the entire gut may be abnormal. The present review focus on the various aspects of abnormal motility of single digestive viscera in diabetic patients.

Colon↗
PubMed1990

Manometric evaluation of jejunal limb after total gastrectomy and Roux-Orr anastomosis for gastric cancer.

Total gastrectomy with Roux-Orr anastomosis is frequently performed for gastric cancer. Since intestinal motility of the Roux limb has never been evaluated after this operation, pressure activity was investigated in the Roux limb of ten patients (aged 51-77 years) who had undergone total gastrectomy and Roux-Orr reconstruction. Investigations were carried out during a 6-h fast and 3 h after a 605 kcal mixed meal. During fasting only two patients had activity fronts and these were abnormal. All ten patients displayed non-propagating bursts of contractions and three had discrete clustered contractions and high amplitude jejunal contractions. The fed state was characterized by a severely reduced motor activity pattern and other abnormalities. Total gastrectomy with Roux-Orr anastomoses provokes a relatively severe disturbance in intestinal activity.

Aged↗
PubMed1990

Clinical and manometric aspects of diffuse esophageal spasm in a cohort of subjects evaluated for dysphagia and/or chest pain.

Manometric criteria for diffuse esophageal spasm have recently been restated. In this study, a cohort of 358 subjects was evaluated in a gastrointestinal motility laboratory for dysphagia and/or chest pain. Applying the recently proposed criteria of Richter and Castell, 18 subjects (5%) were diagnosed as having DES. Dysphagia was the major complaint (89%), while 44% of patients complained of chest pain and 33% of both symptoms. All patients shared more than 30% simultaneous contractions after wet swallows interspersed with normal peristaltic sequences. Associated manometric findings were repetitive (greater than 3 peaks) contractions (67%), high-amplitude contractions (33%), spontaneous activity (22%), prolonged duration (11%), and lower esophageal sphincter abnormalities (5%). Radiology disclosed significant abnormalities in only 27% of DES patients.

Adult↗