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Biomedical subjects

L Filippi

Publications and source records attributed to L Filippi.

At least 19 recordsLinked to original sources
PubMed2004

Prediction of early tolerance to enteral feeding by measurement of superior mesenteric artery blood flow velocity: appropriate- versus small-for-gestational-age preterm infants.

AIM: To evaluate whether serial Doppler measurements of superior mesenteric artery blood flow velocity could predict early tolerance to enteral feeding in preterm infants. METHODS: In a prospective study, 54 healthy preterm neonates were assigned to one of the following groups: neonates with birthweight appropriate for gestational age (group 1), neonates small for gestational age without (group 2) and with prenatal haemodynamic disturbances (group 3). We studied Doppler blood flow velocity and resistance index before and after the first feed. RESULTS: Contrary to patients of group 3, infants in groups 1 and 2 showed a significant increase in blood flow velocity and a significant decrease in resistance index from the preprandial values after the first feed. At each postprandial time, we found significant differences in all velocity and resistance measurements between patients of group 3 and patients of both groups 1 and 2. In all patients, we found that the value of mean velocity measured 30 min after the first feed was the most predictive of early feed tolerance, with 95% sensitivity and 94% specificity when mean velocity >0.38 m/s. CONCLUSION: Small-for-gestational-age preterm infants with prenatal haemodynamic disturbances have an unusual intestinal haemodynamic response to the first feed. In the whole group of preterm infants, the value of mean velocity measured 30 min after the first feed is a good tool for the clinician in predicting early enteral feeding.

Blood Flow Velocity↗
PubMed2003

Redox status in very-low birth-weight newborns.

Inborn metabolic diseases, such as disorders in pyruvate metabolism, in gluconeogenesis or in the respiratory chain, may present with lactic acidosis in newborn infants. A simple tool to screen for the efficacy of mitochondrial oxidation reduction activity is the detection of the redox status through simultaneous measurements of plasma lactate, pyruvate and ketone bodies, which are strongly influenced by feeding and stress. We present the redox status values of 55 very-low birth-weight infants under different nutritional conditions. We were able to demonstrate that the redox status values are not dependent on the type of nutrition (oral feeding or continuous enteral nutrition). Instead we observed a strong difference between newborns with intrauterine growth retardation and newborns with appropriate growth. Newborns with intrauterine growth retardation show lower preprandial values of glucose and ketone bodies than newborns with appropriate weight, but higher levels of lactate and pyruvate; nevertheless the lactate/pyruvate and beta-hydroxybutyrate/acetoacetate ratios are normal. The results of the redox status study could suggest the reduced activity of gluconeogenesis and, probably, of beta-oxidation in very-low birth-weight newborns with intrauterine growth retardation.

3-Hydroxybutyric Acid↗
PubMed2003

Plasma bilirubin level and oxidative stress in preterm infants.

OBJECTIVE: To assess the hypothesis that changes in plasma total bilirubin levels (Btot) can influence the antioxidant system and oxidative stress in preterm infants. METHODS: Twenty two healthy preterm infants who presented with visible non-haemolytic hyperbilirubinaemia were studied at the mean (SD) age of 3.7 (1.5) days. Btot, plasma total hydroperoxide concentration (TH), plasma protein SH group concentration, and total antioxidant capacity of the plasma (TAC) were measured at study entry and after 24 hours. RESULTS: Btot did not correlate with TH, TAC, or protein SH group concentration, but a significant correlation was found between TH and TAC, TH and protein SH groups, and TAC and protein SH groups, both at study entry and after 24 hours. CONCLUSION: The decrease in plasma bilirubin was contemporary with an increase in plasma antioxidant capacity and decrease in oxidative stress in preterm infants. This may be the result of the pro-oxidant effect of haem oxygenase, mediated by iron release, which may outcompete the antioxidant properties of bilirubin.

Antioxidants↗
PubMed2002

Pharmacokinetics of oxatomide in preterm infants.

The pharmacokinetics and tolerability of oxatomide oral suspension were investigated in preterm infants to evaluate the feasibility of planning a further study to assess its antiinflammatory effects and its effectiveness in preventing chronic lung disease (CLD). Following the administration of oxatomide 1 mg/kg, the peak plasma concentration (Cmax), the elimination half-life (t1/2), the volume of distribution (Vd), and the area under the curve (AUC) 0-36 h were measured and the following results were obtained: 42.2 +/- 15 ng/ml at 2 h after oxatomide administration, 41.4 +/- 2.0 h, 37.4 +/- 4.2 l/kg, and 468 +/- 52 ng/ml/h, respectively. Our study, therefore, demonstrated that a dose of 1 mg/kg/day oxatomide was effective in reaching therapeutic plasma levels in preterm infants without inducing adverse effects.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2000

Provisioned Parastrachia japonensis (Hemiptera: Cydnidae) nymphs gain access to food and protection from predators.

Females of the shield bug Parastrachia japonensis Scott progressively provision nymph-containing nests with drupes of the host tree, Schoepfia jasminodora (Olicaceae: Rosidae: Santales). The majority of nests are 5-15 m from the host tree, a distance thought to have been a major impetus for the occurrence of provisioning in this species. However, the function of provisioning is not well understood. We carried out two field experiments to determine whether provisioning is nutritionally important and whether it affords protection against predation. Development of nymphs was significantly delayed and their survival was low in the absence of provisioning, even when nests were within the area of ground on to which the drupes fell, apparently because of the poor quality of the majority of the drupes. Selective provisioning of good-quality drupes by female P. japonensis, a semelparous species, was thus necessary for young nymphs to obtain enough food for their development. Furthermore, even without a female in attendance, having drupes in the nest significantly reduced early mortality in the presence of a predator. Copyright 2000 The Association for the Study of Animal Behaviour.

Journal Article↗
PubMed2000

Cephaloskeletal dysplasia (Taybi-Linder syndrome: osteodysplastic primordial dwarfism type III): report of two cases and review of the literature.

We report two unrelated infants with cephaloskeletal dysplasia or Taybi-Linder syndrome, also referred to as osteodysplastic primordial dwarfism Type III. They presented with peculiar facial features, microcephaly and skeletal and cerebral abnormalities documented radiographically and with cranial MRI and/or CT. Some dissimilarities were observed in the skeletal findings between the two patients, most likely reflecting phenotypic variability within the same disorder. Some radiographic features were shown to evolve with time in both patients. Also of interest is the unusually long survival of these patients, more than 4 years in the first and of over 6 years in the second.

Age Factors↗
PubMed2000

Distribution of food intake as a risk factor for childhood obesity.

OBJECTIVE: The purpose of our study was to assess the relationship between nutrient intake, partitioning of food intake, parents' overweight and adiposity in a group of children. SUBJECTS: 530 7-11-year-old children: 278 males, 252 females. METHODS: Energy intake, nutrient intake and percentage distribution of the intake of energy among the different meals were assessed by means of diet history. Body composition was obtained by measuring skinfold thickness. RESULTS: We identified the relationship between the children's adiposity and their parents' body mass index (BMI) mother: r=0.12, P<0.01; father: r=0.13; P<0.01), carbohydrate (r=-0. 15, P<0.001) and fat intake (r=0.14, P<0.002), and the proportion of energy taken at dinner (r=0.1, P<0.05). A multiple regression analysis was run with a stepwise procedure using relative adiposity as the dependent variable and parents' BMI, dinner intake (percentage of energy intake), EI/BMR ratio (an index of energy intake validity), and sex (dummy variable) as independent variables. All the independent variables, except percentage of fat intake, were included in the final model. The equation was able to explain approximately 19% (R=0.44, P<0.001) of inter-individual fat mass percentage variability. CONCLUSIONS: Diet composition did not contribute to explain the children's adiposity when the parents' overweight (BMI) was taken into account. However, the percentage distribution of the intake of energy among the different meals, particularly at dinner, contributed to explain inter-individual variance of fatness in children of both sexes. International Journal of Obesity (2000)24, 75-80

Body Composition↗
PubMed1996

Different neurologic outcomes in two patients with neonatal hyperinsulinemic hypoglycemia.

The authors report the cases of two patients with neonatal onset of hypoketotic hypoglycemia with hyperinsulinism and a poor response to diazoxide. Pancreatic venous sampling showed a diffuse pancreatic hyperplasia in one patient and a focal lesion in the other. The second patient, diagnosed after a significant delay, suffered severe long-term neurological sequelae, despite having more limited hyperplasia; the brain MRI also showed severe pathological changes in cortex and white matter, predominantly in the parieto-occipital region. Early and accurate diagnosis is critical in these patients in whom hypoglycemia is compounded by a lack of the ketone bodies which represent a vital alternative source of energy for the central nervous system.

Atrophy↗
PubMed1996

Biochemical evaluation of a patient with a familial form of leucine-sensitive hypoglycemia and concomitant hyperammonemia.

A case of a child with recurrent episodes of severe hypoglycemia since the age of 6 months is reported. Biochemical evaluation extended to the first-degree relatives is consistent with a familial form of hypoglycemia due to a leucine-sensitive hyperinsulinism. In addition, this patient has a persistent elevation of serum ammonia levels of uncertain etiology that is more pronounced after meals. Urea cycle defects, organic acidurias, and beta-oxidation defects have been ruled out, as well as a possible excessive deamination of glucogenetic amino acids. This unexpected hyperammonemia, which was also detected in the mother, might be related to leucine hypersensitivity.

Adult↗
PubMed1996

Cryptogenic hepatitis masking the diagnosis of ornithine transcarbamylase deficiency.

We describe three children with transaminase elevations and hepatic insufficiency who were given the diagnosis of cryptogenic hepatitis after the more common viral and metabolic diseases of the liver had been excluded. However, further laboratory investigations showed hyperammonemia, low blood urea levels, elevated plasma glutamine levels, and low citrulline levels. Urinary excretion of orotic acid was higher than normal, with absent urinary homocitrulline and normal fractional tubular reabsorption of lysine, ornithine, and arginine. These findings suggest the diagnosis of ornithine transcarbamylase deficiency. We emphasize the importance of investigating possible urea cycle disorders by determining ammonia plasma levels, both at baseline and after a protein load; urinary and plasma amino acids; and urinary orotic acid in all patients with liver disease of indeterminate etiology.

Absorption↗
PubMed1994

Dental and craniofacial findings in a child affected by glycogen storage disease type III.

This paper reports on previously undescribed dentofacial features a child suffering from Glycogen-Storage Disease type III with hepatomegaly and hypertransaminasemia with muscular involvement. Deficient craniofacial development, reduced width of the upper jaw resulting in posterior cross-bite, and taurodontism of the primary dentition were found. Pathogenetic basis for craniofacial abnormalities is discussed. Cooperation between pediatricians and pediatric dentists is strongly recommended for an early diagnosis and treatment of the dentofacial defects of the syndrome.

Cephalometry↗
PubMed1992

[Metabolic and water-electrolyte changes as postoperative complications in aneurysms of the anterior communicating artery].

A study was performed on hydroelectrolytic changes in neurosurgical patients operated for clipping anterior communicating artery aneurysm. The patients were observed during a seven day period in ICU, between the preoperative day and the sixth post-operative day. No statistically significant changes were observed, except for hyponatriemia on the day of surgery. The etiology of this phenomenon is not clear: it could be a change of ADH or "cerebral salt wasting syndrome". A wider number of patients and repeated haematological tests are necessary.

Adult↗
PubMed1984

Clinical effects of digoxin on sinus node and atrioventricular node function after pharmacologic autonomic blockade.

The effects of digoxin on sinus node and atrioventricular (AV) node function were studied in 18 patients (mean age 53.6 years) with normal intrinsic heart rates. Electrophysiologic testing was performed both during basal state and after autonomic blockade with propranolol and atropine. Full digitalization was achieved by intravenous administration of digoxin (0.02 mg/kg) given in three divided doses over a 24-hour period. The following day, after a basal recording, autonomic blockade was again induced and the study was repeated. During basal state, digoxin significantly prolonged the sinus cycle length (SCL) (p less than 0.01) and the AH interval (p less than 0.01). However, when the intrinsic sinus node functions were compared (i.e., the values obtained after autonomic blockade), digoxin did not produce significant changes in intrinsic SCL, corrected sinus node recovery time, and sinoatrial conduction time. No significant changes were noted even in the intrinsic AH interval and AV nodal refractory periods. These findings suggest that: (1) intravenous administration of digoxin in therapeutic doses does not produce any depression of the intrinsic functions of the sinus node and AV node; and (2) the depressant effects induced by digoxin during basal state appear to be mediated through the autonomic nervous system.

Adult↗
PubMed1984

The role of the autonomic nervous system on sinus node function in patients with intermittent sinoatrial block.

Sinus node (SN) function was analyzed with and without autonomic blockade (AB) in 31 patients (mean age: 57.6 +/- 12.8) with intermittent sinoatrial block. Twenty-one patients had organic heart disease; in the remaining ten signs of underlying heart disease were not present. Nineteen patients had dizziness or syncope. Sinus cycle length, sinus rate, corrected sinus node recovery time (CSRT) and sinoatrial conduction time (SACT) were analyzed. After control measurements, AB was produced by i.v. propranolol (0.2 mg/Kg) and atropine (0.04 mg/Kg). Measurements of electrophysiological parameters were then repeated. After AB sinus rate and CSRT did not show statistically significant differences, whereas SACT decreased significantly (P less than 0.001). When intrinsic heart rate (IHR) was abnormal (11 cases), intrinsic CSRT was always abnormal, whereas when IHR was normal, intrinsic CSRT was normal in 11 patients and abnormal in nine. In several cases, when sinus rate increased after AB, CSRT decreased and vice-versa. The parameters of intrinsic SN function were normal in 80% of patients with a normal heart and only in 14.2% of patients with organic heart disease. These data indicate that: (1) during the control period SACT is mainly conditioned by the vagal tone; (2) abnormalities in control CSRT are not uniformly abolished after AB in patients with normal IHR; (3) AB has a differential effect on the two variables of SN automaticity; i.e. sinus rate and CSRT; and (4) in patients without underlying heart disease, the SN dysfunction is almost exclusively related to alterations of the autonomic nervous system.

Adult↗
PubMed1984

Latent abnormalities of sinus node function in patients with organic heart disease and normal sinus node on clinical basis.

Sinus node (SN) function was analyzed in 22 patients (mean age: 46.2 +/- 12.9 years) with organic heart disease and normal SN on clinical basis (group I) and in 20 normal subjects (mean age: 43.9 +/- 15.6 years), (control group). Sinus cycle length (SCL), corrected sinus node recovery time (CSRT) and sinoatrial conduction time (SACT) were analyzed. After the control study, autonomic blockade (AB) was induced by i.v. propranolol (0.2 mg/Kg) and atropine (0.04 mg/Kg). Measurements of SCL, CSRT and SACT were then repeated. The mean SCL values were very similar in the two groups during the control state and after AB. There were no significant differences in SACTs between the two groups during the control state or after AB. On the contrary, the CSRT of group I was significantly longer than that of control group during the control state (344.8 +/- 78.9 versus 262.2 +/- 46.3 msec, P less than 0.001) and after AB (238.9 +/- 72.8 versus 166.8 +/- 39.3 msec, P less than 0.001). The analysis of real depression of SN automaticity (CSRT minus SACT) in the two groups shows that prolongation of CSRT in group I during the control study and after AB is related to an intrinsic abnormality of SN automaticity; on the contrary, no dysfunctions of the autonomic nervous system appear. These data indicate that the intrinsic abnormality of SN automaticity represents the earliest involvement of the SN in subjects with organic heart disease and normal SN on clinical basis, although this conclusion is speculative and requires experimental verification.

Adolescent↗
PubMed1984

[Electrophysiologic effects of propafenone in patients with sinus node dysfunction].

The electrophysiologic effects of intravenously administered Propafenon (1,5 mg/kg) were evaluated in 16 patients (mean age: 62,1 +/- 11 years) with sinus node dysfunction, shown by sinus bradycardia or intermittent sino-atrial block. The variations of sinus cycle length were not statistically significant (NS), (1137,1 +/- 244,9 msec versus 1191,9 +/- 321,1 msec). In one patient sinus rate markedly decreased from 36 to 28 beats/min. In 2 patients the cycle length of a junctional rhythm was comparable before and after drug administration; in both patients the rate of the junctional rhythm decreased and in one markedly (from 39 to 32 beats/min). Sinoatrial conduction time increased in 4 patients and decreased in 6. The variations were not statistically significant (223,8 +/- 76 msec versus 230,6 +/- 75,9 msec). In one patient the sinoatrial conduction time which was normal during the control study, could not be evaluated after Propafenon due to the appearance of a retrograde block between the atrium and the sinus node. Maximum corrected sinus node recovery time was prolonged by the drug in 9 patients and shortened in 5. In 2 patients the sinus node recovery time was prolonged to about 10 sec. The mean value of corrected sinus node recovery time increased from 883,6 +/- 995,8 msec to 1820,5 +/- 2894 msec (NS). Propafenon significantly prolonged the effective refractory period and the functional refractory period of the atrium, as well as the A-H, H-V and QRS intervals, the A-V node functional refractory period, the relative refractory period of His-Purkinje system and the ventricular effective refractory period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗