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Biomedical subjects

P Rea

Publications and source records attributed to P Rea.

17 recordsLinked to original sources
PubMed2002

Domperidone is more effective than cisapride in children with diabetic gastroparesis.

BACKGROUND: Disorders of gastrointestinal motility are commonly detected in patients with insulin-dependent diabetes mellitus and are associated with significant morbidity. They contribute to poor metabolic control of diabetes. AIM: To assess the effect of an 8-week course of domperidone or cisapride on gastric electrical activity, gastric emptying time and dyspeptic symptoms in children with insulin-dependent diabetes mellitus and gastroparesis. METHODS: Dyspeptic symptoms were assessed by a score system, gastric emptying time was measured by ultrasonography and gastric electrical activity was obtained by electrogastrography. Fourteen children received domperidone and 14 received cisapride. The median (range) ages were 11.6 years (5-15 years) and 12 years (6-16.9 years), respectively. Symptom assessment, ultrasonography and electrogastrography were repeated at the end of the trial. Fasting and fed (180 min after feeding) glycaemia and haemoglobin A, C (HbA1c) levels were also measured. RESULTS: At the end of the trial both groups showed a significant decrease in symptomatic score; however, the score was markedly lower in the domperidone group than in the cisapride group (P < 0.01). Domperidone was significantly more effective than cisapride in reducing the gastric emptying time (P < 0.05), normalizing gastric electrical activity (P < 0.05) and decreasing the prevalence of episodes of gastric dysrhythmia (P < 0.01). Domperidone was also more effective than cisapride in improving diabetic metabolic control. No potentially drug-related adverse effects occurred. CONCLUSIONS: In children with insulin-dependent diabetes mellitus complicated by dyspeptic symptoms and gastroparesis, domperidone is superior to cisapride in reversing gastric emptying delay and gastric electrical abnormalities, as well as in improving dyspeptic symptoms and diabetic metabolic control.

Adolescent↗
PubMed2000

Helicobacter pylori seropositivity in children with atopic dermatitis as sole manifestation of food allergy.

A positive association between Helicobacter pylori antibodies and food allergy presenting with gastrointestinal symptoms has recently been reported. A subset of a H. pylori strain possesses an antigen, CagA, as a virulence factor. Anti-H. pylori and anti-CagA IgG titre have been determined in children with atopic dermatitis (AD) as the sole clinical manifestation of food allergy. In this study, thirty patients with AD as the sole clinical manifestation of food allergy were examined (group A). For comparative purposes, 30 patients affected by food allergy with gastrointestinal symptoms (group B) and 30 affected by atopic asthma (group C) were studied. Anti-H. pylori and anti-CagA immunoglobulin G (IgG) were determined in all individuals by means of the enzyme-linked immunosorbent assay. The anti-H. pylori IgG titre was significantly higher in group A and group B vs. group C (p < 0.05); no significant difference was detected between group A and group B (p > 0.05). No significant difference in anti-CagA titre was found between the groups. These data demonstrate a positive association between H. pylori antibodies and AD as the sole manifestation of food allergy. Further investigations are needed to evaluate the cause-effect relationship between H. pylori seropositivity and AD.

Antibodies, Bacterial↗
PubMed1999

Increased release of interleukin-6 by oesophageal mucosa in children with reflux oesophagitis.

OBJECTIVE: To evaluate the release of interleukin-6 (IL-6) by oesophageal mucosa and to establish the serum levels of IL-6 and C-reactive protein (CRP), and plasma fibrinogen in children with reflux oesophagitis. DESIGN: In a prospective study, IL-6 release by tissue fragments obtained from oesophageal biopsies was determined and serum IL-6 and CRP as well as plasma fibrinogen were analysed. METHODS: The study population comprised ten children with reflux oesophagitis, diagnosed on the basis of 24 h oesophageal pH monitoring and endoscopy with biopsies. Ten children with recurrent abdominal pain were studied for comparative purposes. Biopsy tissue fragments were processed to obtain a cell suspension and the release of IL-6 was determined in culture medium. Serum IL-6 levels were measured by ELISA, serum CRP by turbidimetry, and plasma fibrinogen by spectrophotometry. RESULTS: Oesophageal cells obtained from reflux oesophagitis patients synthesize and release in vitro a significantly higher amount of IL-6 than controls (71.26+/-19.5 versus 31.67+/-8.02 pg/10(6) cells; P<0.01). Serum IL-6, serum CRP and plasma fibrinogen levels were not statistically different between patients with reflux oesophagitis and controls. CONCLUSIONS: These results suggest a short-term action of IL-6 since its effects could be exerted only in the microenvironment of the oesophageal mucosa.

Adolescent↗
PubMed1998

Claudication on mastication following bilateral external carotid artery ligation for posterior epistaxis.

This case highlights a potentially disabling complication of intermittent claudication in the region of the masseter muscles on mastication, following bilateral external carotid artery ligation for epistaxis. Although there have been few reports of this complication this may be a reflection of the fact that the operation is rarely performed, and not because the complication is rare. Its potentially disabling nature, and its possible common occurrence after this procedure make awareness of it by surgeons who may carry out this procedure important.

Carotid Artery, External↗
PubMed1998

Positive association between Helicobacter pylori infection and food allergy in children.

BACKGROUND: In children Helicobacter pylori has been involved as a pathogenetic factor in gastritis and duodenal ulcer and as a cofactor in protein-losing enteropathy, chronic diarrhoea, short stature, and gastritis lymphoproliferative disease. A subset of an H. pylori strain possesses an antigen, CagA, as a virulence factor. In the present study we determined anti-H. pylori IgG and anti-CagA IgG titres in children with food allergy. METHODS: Ninety paediatric patients were studied: 30 with food allergy, 30 with atopic asthma, and 30 with inflammatory bowel disease. Anti-H. pylori IgG and anti-CagA IgG were determined in all children by means of a commercial enzyme immunoassay (ELISA). RESULTS: The anti-H. pylori IgG titre was significantly higher in allergic patients than in the other two groups. The anti-CagA IgG titre did not differ significantly between the patients. CONCLUSIONS: These findings show a positive association between H. pylori infection and food allergy in children. We hypothesize that virulence factors other than CagA may be involved in the pathogenesis of H. pylori infection in paediatric patients with food allergy.

Antibodies, Bacterial↗
PubMed1998

Increased levels of prostaglandins and nitric oxide in esophageal mucosa of children with reflux esophagitis.

BACKGROUND: Prostaglandin E2 (PGE2) is said to be both protective and detrimental for esophageal mucosal integrity. Nitric oxide (NO) controls several esophageal neuromuscular functions, including relaxation of the lower esophageal sphincter. The purpose of this study was to verify PGE2 and NO levels in esophageal mucosa of children with reflux esophagitis. METHODS: The patients were 10 children, age range 7 to 12 years, affected by reflux esophagitis. The control subjects were 10 children, age range 6 to 11 years, with recurrent abdominal pain. Tissue fragments obtained by esophageal biopsies were placed in a culture medium and processed to obtain a cell suspension. Cells were incubated for 24 hours at 37 degrees C. Thereafter, supernatants were collected and divided into aliquots to determine the amounts of PGE2 and NO metabolites. RESULTS: Esophageal cells obtained from reflux esophagitis patients synthesize and release a significantly higher (p < 0.01) amount of PGE2 and NO (PGE2 1.9 +/- 0.56 ng/10(6) cells per 24 hours; NO 124.94 +/- 18.36 microM/10(6) cells per 24 hours) than did the control group (PGE2 0.66 +/- 0.14 ng/10(6) cells per 24 hours; NO 68.03 +/- 12.3 microM/10(6) cells per 24 hours). CONCLUSIONS: These results suggest that in esophageal mucosa, PGE2 and NO, in low concentrations, are protective, whereas, at high doses, they can be harmful. Higher amounts of PGE2 and NO in the esophageal mucosa of reflux esophagitis patients suggest that similar noxious stimuli trigger the inducible forms of the respective enzyme.

Biopsy↗
PubMed1997

Exertional chest pain in child due to gastroesophageal reflux with a family history of rumination.

A child affected by exertional chest pain secondary to gastroesophageal reflux (GER) disease is reported. Family history revealed the presence of rumination in two members. In our patient, heart diseases as well as other causes of chest pain were excluded. An ultrasound examination of the gastro-esophageal junction, performed in the first 15 minute of the post-prandial period, showed a pathological number of GER episodes. The patient was treated with cisapride (0.2 mg/kg t.i.d. per os). At follow-up, after three months, he was symptom-free. We repeated an ultrasound examination, which resulted normal. Ours is the first paediatric case characterized by exertional chest pain secondary to GER disease.

Chest Pain↗
PubMed1996

Delayed gastric emptying in an infant with Sandifer syndrome.

The case of an infant with Sandifer syndrome is reported. Real-time ultrasonography showed delayed gastric emptying time, which returned to normal when the patient was asymptomatic. The importance of gastric motility investigations in Sandifer syndrome is stressed since delayed gastric emptying could play a role in the pathogenesis of this disease.

Female↗
PubMed1996

Irritable oesophagus syndrome as cause of chronic cough.

Case of an infant with chronic cough is reported. The most frequent causes of chronic cough were ruled out. Twenty-four hour oesophageal pH-monitoring showed a close correlation between gastro-oesophageal reflux episodes and cough attacks. The patient was successfully treated with cisapride (0.3 mg/kg t.i.d.). These findings show that irritable oesophagus syndrome can cause chronic cough.

Chronic Disease↗
PubMedDate not supplied

Primary gastro-oesophageal reflux disease and irritable oesophagus syndrome as causes of recurrent abdominal pain in children.

Cases of two adolescents with recurrent abdominal pain, localized in the periumbilical area, due to primary oesophageal disorders are reported. Food allergy or intolerance, as well as other paediatric causes, were not involved in the pathogenesis of recurrent abdominal pain in these two patients. Case 1 was affected by primary gastro-oesophageal reflux disease: upper endoscopy with biopsies and oesophageal 24-hour pH-monitoring showed mild oesophagitis and pathological reflux index, respectively. Case 2 was affected by "irritable oesophagus syndrome": upper endoscopy with biopsies was normal and oesophageal 24-hour pH-monitoring showed a close correlation between gastro-oesophageal reflux and recurrent abdominal pain episodes. Both patients were successfully treated with cisapride (0.2 mg/kg t.i.d.) and ranitidine (2.5 mg/KG b.i.d.). These reports suggest that primary gastro-oesophageal reflux disease and irritable oesophagus syndrome may cause recurrent abdominal pain in children.

Abdominal Pain↗
PubMedDate not supplied

Polychlorinated biphenyls and dichlorodiphenyl trichloroethane in human milk. A review.

Polychlorinated biphenyls (PCBs) and dichlorodiphenyl trichloroethane (DDT) are the most frequent chemical contaminants present in human milk. Factors involving the levels of PCBs and DDT in human milk are revised. Allowable daily intake of both contaminants is indicated as well as their effect on human exposure are discussed. Since available data suggest that these contaminants are available for redistribution to the lactating mammary gland, we stress the importance of a dietary regimen to breast fed mothers in order to prevent the mobilization of body fat stores for milk fat synthesis.

DDT↗