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Biomedical subjects

A Carroccio

Publications and source records attributed to A Carroccio.

118 records · Page 7Linked to original sources
PubMedDate not supplied

Evidence of transient IgA anti-endomysial antibody positivity in a patient with Graves' disease.

BACKGROUND: Anti-endomysial antibodies (EmA) have been shown to have a high specificity and sensitivity in celiac disease (CD) diagnosis, and their use is considered effective in improving the diagnostic accuracy of CD screening. AIMS: To report the clinical details of transient IgA EmA positivity in a patient with Graves' disease. METHODS: We screened 48 patients (7 males, age range 19-79, median 58.3 years) for CD. They were hospitalized for thyroid disorders (30 patients had autoimmune hypothyroidism and 18 had Graves' disease with clinical hyperthyroidism associated with diffuse goitre). CD screening was carried out on all patients by assaying serum anti-gliadin antibodies (AGA) and EmA. RESULTS: None of the 48 patients in our study were positive for IgA and/or IgG-class AGA and none showed IgA deficiency. Only 1 patient was positive for EmA; however, intestinal biopsy in this subject was normal both when thyroiditis was first diagnosed and subsequently after 2 and 3 years. Furthermore, EmA became negative after 2 years. New gastroenterological investigations performed 3 years after the diagnosis confirmed the normal intestinal histology and absorption capacity. Moreover, AGA, EmA and tissue transglutaminase antibodies were negative. CONCLUSIONS: This study underlines the possibility of transient EmA positivity without any signs of CD in patients with autoimmune thyroid disorders.

Aged↗
PubMedDate not supplied

Clinical evaluation of pancreatitis-associated protein as a serum marker of hepatocellular carcinoma: comparison with alpha-fetoprotein.

This study evaluated the significance of serum pancreatitis-associated protein (PAP) assay, as a marker of hepatocellular carcinoma (HCC), in comparison and combined with alpha-fetoprotein (AFP) assay. Sixty-five patients with HCC, 59 with liver cirrhosis (LC) and 68 asymptomatic controls (C) were studied. PAP and AFP values significantly increased from C to LC and HCC group (p < 0.0001). The area under receiver-operating characteristic (ROC) curve for the two markers was not statistically different. At 100% specificity, ROC analysis gave a cut-off level for AFP of 166 IU/l with 40% sensitivity, and a cut-off level of 240 microg/l for PAP with 23% sensitivity. Diagnostic accuracy of combined AFP and PAP assay was significantly higher than AFP alone. Sensitivity according to tumor size also improved using the combined assay, especially for tumors <5 cm. Stepwise logistic regression indicated that AFP, but not PAP, was associated with an increased risk of developing HCC. These data confirm that PAP production is increased only in some cases of HCC and that the combined PAP and AFP assays do not significantly improve specificity over AFP assay alone. Consequently, PAP assay can only be recommended in cases of justified suspicion of HCC with negative AFP.

Acute-Phase Proteins↗
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[Clinical and etiologic features of hepatocarcinoma in Sicily].

Hepatocellular carcinoma is a neoplasia with a high degree of malignancy and a quite unfavorable prognosis, and its frequency has tripled over the last 30 years. The aim of this study was to shed further light on some epidemiological and clinical aspects of hepatocellular carcinoma, on the basis of experience with a wide ranging patient population. We included 179 patients (127 males, 52 females, age range 31-86 years), diagnosed with hepatocellular carcinoma between January 1993 and December 1998. For each patient we recorded age, sex, coexistence and cause of cirrhosis, severity of cirrhosis, stage of hepatocellular carcinoma, serum markers of viral hepatitis (hepatitis B surface antigen and hepatitis C virus antibodies) and serum levels of alpha-fetoprotein. Hepatocellular carcinoma was associated with hepatitis C virus in 72% of patients, with hepatitis B virus in 10%, with combined infection in 3% and with negative viral markers in 15%. Mean age at diagnosis was significantly higher in the hepatitis C virus infection patients than in the combined infection patients (p < 0.04); the male/female ratio was 2.1:1 in the hepatitis C virus and 8:1 in the hepatitis B virus subjects. At hepatocellular carcinoma diagnosis, 175 out of 179 patients had liver cirrhosis with a significantly higher severity in patients with negative viral markers than in those with positive viral markers (p < 0.02). The stage of hepatocellular carcinoma at diagnosis was very advanced: in 103 out of 179 cases (58%) neoplasia was stage IV, with a stage I diagnosis in only 14 out of 179 (8%) cases. All the combined (hepatitis B and C virus) cases were diagnosed at stage IV, while hepatocellular carcinoma cases in patients with negative viral markers were diagnosed at earlier stages (66% stages I-II). Serum alpha-fetoprotein levels were above the normal limit (20 ng/mL) in 72% of patients; however, only 30% (54/179) had alpha-fetoprotein values > 400 ng/mL. These data confirm some previous epidemiological and clinical evidence concerning hepatocellular carcinoma (mean age at diagnosis, male/female ratio, severity of pre-existing liver disease, frequency of an associated hepatitis C and/or hepatitis B virus infection). Data based on such a large population, moreover, aid clarification of some still unresolved points such as the utilization of alpha-fetoprotein values in diagnosing hepatocellular carcinoma.

Adult↗
PubMedDate not supplied

[Fecal chymotrypsin and steatorrhea in chronic pancreatitis].

The aim of the present study was to evaluate in 56 patients (48 M, 8 F) with chronic pancreatitis: a) the diagnostic validity of fecal chymotrypsin (FCT) assay, performed both on random samples and from previously homogenized samples collected over 3 days; b) the correlation between chymotrypsin and fecal fat excretion. CTF was measured using Kaspar's colorimetric method and fecal fats using the Van de Kamer method. Mean values of chymotrypsin measured on random samples were very similar to those measured on previously homogenized feces, 17.9 +/- 16.7 U/g vs 17.1 +/- 15.3 U/g respectively. There was a highly significant correlation between these values (r = 0.77 p less than 0.0003) and a highly significant inverse correlation between fecal fat and chymotrypsin excretion, both when the latter was measured on random and on previously homogenized samples (p less than 0.0001). FCT assay was fairly good sensitive (54%) for the whole group of patients with chronic pancreatitis, but very good (91%) for the group of patients with steatorrhea. The results show that the fecal chymotrypsin assay on random fecal samples is as valid as that carried out on homogenized feces and that there is a good correlation between fecal chymotrypsin values and steatorrhea of pancreatic origin.

Adult↗
PubMedDate not supplied

[Serum pancreatic enzymes and fecal chymotrypsin before and after glyco-metabolic control in diabetic patients].

The aim of the present study was to ascertain whether secretory capacity of the pancreas, evaluated by assaying serum total amylase (TA) and pancreatic amylase activity (PA) and fecal chymotrypsin excretion (FCT), is impaired in diabetic and to what extent it is influenced by the degree of glyco-metabolic control. TA, PA and FCT were assayed in 40 patients affected with type II diabetes mellitus in secondary insufficiency, both at hospitalization and after metabolic control assessment; 43 hospitalized patients constituted the control group. A statistically significant difference was found between the metabolic failure phase values of diabetics patients and those of the control group for TA (p less than 0.0005), PA (p less than 0.025) and FCT (p less than 0.0005); between metabolic control phase values and control group fo TA (p less than 0.0005), and FCT (p less than 0.005) but not for PA values. PA values were statistically significant, within diabetic group, before and after metabolic control assessment. A statistically significant result was obtained by correlating C-peptide and FCT values (p less than 0.01), C-peptide and PA values (p less than 0.001); glycaemia and PA values (p less than 0.05). Our data suggest that in diabetic patients there is an impairment in secretory capacity of the pancreas and that the the PA is the more sensitive enzyme to the local levels of insulin.

Amylases↗
PubMedDate not supplied

[Incidence of anti-HCV positivity in a Sicilian population with liver diseases].

The discovery of virus C as an etiological agent of chronic liver disease (CLD) has modified previously-held concepts concerning the etiology of this disease. In a study of 581 consecutive patients with CLD, we confirmed that virus C was the sole agent responsible for it in 64.2% of all cases. Moreover, virus C was characteristically associated with virus B, alcohol consumption, and autoimmunity. When the various CLD were separated into subgroups, i.e., chronic persistent hepatitis (CPH), chronic active hepatitis (CAH), and liver cirrhosis (LC), virus C continued to be the main etiological agent, varying from 60.5% to 68.3%: this suggested constant evolution from milder to more severe forms of liver disease. Virus B alone was found less frequently, probably thanks to the virtual elimination of post-transfusion hepatitis B and the anti-B virus vaccination which is now widely administered. Frequency was 15.2% in the CPH group but lower in the LC and CAH groups (7.4% and 6.3% respectively), suggesting that evolution from the milder to the more severe forms of liver disease may not occur. Finally, we confirmed a statistically significant difference in mean age between hepatitis C virus positive men and women (p < 0.0001): in men, frequency was higher in the 20- to 50-year-old group; in women it was higher in the 50+year-old group.

Adult↗
PubMedDate not supplied

Cathepsin D, B and L circulating levels as prognostic markers of malignant progression.

Growing evidence indicates that lysosomal Cathepsins D (CD), B (CB) and L (CL) may promote carcinogenesis and tumor progression. Therefore, we evaluated their potential value as biochemical parameters of malignant progression in patients with benign diseases which may undergo malignant transformation, such as liver cirrhosis (LC) and chronic pancreatitis (CHP) as well as in hepatocellular carcinoma (HCC) and pancreatic cancer (DPC). CD, CB and CL serum levels were determined by immunoenzymatic assays in LC, CHP, HCC or DPC patients and correlated with a number of biochemical and clinical parameters of these diseases. CD serum levels were increased in LC, CHP and HCC, but not in the DPC group as compared to normal subjects (NS) (P < 0.01). Interestingly, higher levels of this enzyme were observed in LC patients compared to HCC patients ( P < 0.01). CB serum concentrations were increased in all patient groups (P < 0.01). However no difference was evidenced between benign and malignant diseases. CL serum levels were significantly increased only in DPC as compared to NS (P < 0.01) or CHP patients (P < 0.02) and in HCC as compared to NS (P < 0.01). The evaluation of CD, CB and CL serum pattern in LC, CHP, HCC and DPC patients may be useful as additional biochemical parameters in the differential diagnosis and therapeutic monitoring of these diseases. Prospective clinical investigations to assess the potential value of these enzymes as biochemical markers of malignant progression of LC or CHP are warranted by the present data.

Adult↗
PubMedDate not supplied

[Ultrasonographic assessment of gallbladder motility in obese subjects].

The reduction in gallbladder motility could play an important role in the pathogenesis of cholesterinic lithiasis by favouring the precipitation of cholesterol crystals, especially in obese subjects who, as is well known, present a greater biliary secretion of cholesterol. In the present study we evaluated, by ultrasonography, the emptying capacity of gallbladder following a liquid meal in 20 obese subjects (BMI 37.8 +/- 11.8 kg/m2) and in 20 control subjects (BMI 23.2 +/- 1.7 kg/m2). The base and residual volume of the gallbladder, expressed in ml, were significantly higher in the obese group than in the controls: 30.7 +/- 11.8 vs 22.0 +/- 6.7 (t = 2.88 p < 0.001) and 14.6 +/- 7.14 vs 10.2 +/- 4.7 (t = 2.14 p < 0.04), respectively. However, there was no significant difference between the percentages of gallbladder emptying in the two study groups, although in the obese subjects the minimum volume was reached at the 60th minute, while in the controls it occurred at 40 minutes. Our data, in agreement with most reports in the literature, indicate that the volume of the gallbladder is greater in obese subjects and they do not present an intrinsic defect in gallbladder contractility; therefore this condition can be excluded from the risk factors of biliary lithiasis in obese subjects.

Adult↗
PubMedDate not supplied

Transmission of hepatitis C virus: a study of the main risk factors in a Sicilian population of volunteer blood donors.

BACKGROUND/AIMS: The Hepatitis C virus (HCV) is quite widespread in Sicily, and in the absence of a vaccine, prophylaxis is important. In order to determine the most effective means of prophylaxis, we must first understand the main vectors of transmission. METHODOLOGY: We performed a case control study on 274 consecutive anti-HCV virus positive subjects and compared them with 548 anti-HCV negative subjects, matched for sex and age and selected from voluntary blood donors. The modes of transmission were investigated by means of a detailed questionnaire focused on the common risk factors of HCV contagion. RESULTS: Univariate analysis showed associations between HCV infection and transfusions (OR 23.0), surgery (OR 2.2), family history of chronic liver disease (OR 4.54), and drug addiction (OR 5.74). Multiple logistic regression indicated that transfusions (p < 0.0001), surgery (p < 0.002), family history (p < 0.0001), drug addiction (p < 0.002) and alcohol consumption (p < 0.002) are related to the development of HCV infection. CONCLUSIONS: The modes of transmission of HCV in an endemic area of Sicily do not greatly differ from those in other Italian regions; the subjects at greatest risk were those who had received blood transfusions or underwent surgery, alcoholics, drug abusers and those with a family history of chronic liver disease, who are probably more exposed to contracting the infection by non-conventional ways of transmission.

Adult↗