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Biomedical subjects

A Piccoli

Publications and source records attributed to A Piccoli.

At least 109 records · Page 6Linked to original sources
PubMed1989

Serum aluminium level in the veneto chronic haemodialysis population: cross-sectional study on 1,026 patients.

A total of 1,026 patients undergoing haemodialysis as the only chronic treatment were studied in all the dialysis units of the Veneto region, Italy. Aluminium was determined in water, dialysis fluids, and patients' serum. Aluminium mean concentration was 9.1 micrograms/l in tap water and 13.3 and 15.7 micrograms/l in bicarbonate and acetate haemodialysis fluids, respectively. Patients' serum aluminium mean level was 52.0 micrograms/l with the following frequency distribution: 59.2% below 60 micrograms/l, 25.5% between 60 and 100 micrograms, and 15.3% above 100 micrograms/l. The mean serum aluminium level was higher in patients undergoing haemodialysis with aluminium concentration in fluids over 10 micrograms/l. This was true also in patients not receiving aluminium hydroxide. Furthermore, we found higher average serum aluminium in those treated with aluminium hydroxide more than 3 g/day. No relationship was found between serum aluminium and sex, age, dialytic age, parathyroid hormone, and vitamin D treatment. Moreover, the patients with serum aluminium above 100 micrograms/l had higher serum alkaline phosphatase and lower mean cell volume values. Thus, in our haemodialysis population aluminium overloading occurred in spite of low concentration in water and fluid, and it was a result more of fluid pollution (over 10 micrograms/l) than aluminium hydroxide ingestion (over 3 g/day).

Aluminum↗
PubMed1989

[Prognostic value of late exercise test after myocardial infarction].

The parameters of a maximal exercise stress test, without therapy, 30 to 186 days after myocardial infarction were related to cardiac death, recurrent nonfatal infarction, coronary artery by-pass surgery, development of angina pectoris and ST segment depression during subsequent stress test in 209 patients. During a follow-up period of 9.5 to 119 months (medium 52) 12 patients died, 14 developed recurrent nonfatal myocardial infarction, 4 were submitted to coronary surgery, respectively 53 and 69 patients presented angina and ST segment depression at the first test, 23 and 33 developed them subsequently. Among the exercise parameters only the systolic blood pressure less than 140 mmHg was predictive of future mortality. Angina and ST segment depression when present at the first stress test were significantly related between them and with low heart rate, low maximal systolic blood pressure and low work load, but not with cardiac mortality, reinfarction and by-pass surgery. Our results show a low predictive value of the late maximal exercise test after a myocardial infarction. Probably that depends on evolution of coronary disease, which does not provide long-term prognostic informations.

Adult↗
PubMed1988

Renal factors in serum trypsinogen 1 metabolism and excretion in chronic pancreatic disease.

In order to investigate the role of renal factors in affecting trypsinogen 1 metabolism and excretion in chronic pancreatic disease, serum immunoreactive trypsin (IRT), urinary IRT, gamma-glutamyltransferase (GGT), alpha-glucosidase (AGL) and RNase outputs and the molecular size distribution of serum and urine IRT were studied in 8 control subjects, 18 cases with pancreatic cancer, and 23 cases with chronic pancreatitis. Serum chromatography demonstrated that most immunoreactivity eluted as trypsinogen 1. Smaller amounts of immunoreactivity at higher molecular weights were also observed. Urine chromatography displayed both trypsinogen 1 and heavier molecular forms. An inverse linear correlation was noticed between creatinine clearance and serum trypsinogen 1 levels. Multiple regression analysis (urinary IRT output dependent and GGT, AGL, and RNase predictor variables) showed a significant linear correlation. RNase was found to be the most important parameter in explaining urinary IRT output. Mild variations in the glomerular function seem to be able to influence serum trypsinogen 1 levels. Urinary IRT excretion is principally explained by a disturbance in the tubular reabsorption of low molecular weight proteins, such as RNase.

Adult↗
PubMed1988

Prolonged QT period in diabetic autonomic neuropathy: a possible role in sudden cardiac death?

Twenty four men with insulin dependent diabetes and different degrees of autonomic neuropathy were studied to establish the response of the QT interval to various heart rates. Nine men with autonomic neuropathy had a longer QT interval than 13 healthy individuals and 15 patients who had diabetes without, or with only mild, autonomic neuropathy. Those with autonomic neuropathy also had a proportionally greater lengthening of the QT interval for a given increase in RR interval. The results of this study suggest a basis for the finding that sudden death is more common in patients with diabetic autonomic neuropathy.

Adult↗
PubMed1988

Renal involvement in chronic pancreatic disease: effects on trypsin and amylase plasma-urine transfer.

This study was undertaken in order to ascertain the behaviour of amylase and trypsin fractional clearances in chronic pancreatic disease and to speculate on the factors involved. Renal tubular function was also assessed in these patients. An increase of both clearances was found in a number of patients with pancreatic cancer and chronic pancreatitis. Amylase urinary output seems to be mainly related to the circulating enzyme levels; urinary IRT is principally accounted for by a functional tubular impairment. Tubular damage was observed in a number of patients with chronic pancreatic disease. This was related to pancreatic inflammation in chronic pancreatitis and to several factors, among which jaundice and pancreatic damage, in pancreatic cancer.

Amylases↗
PubMed1988

Serum markers and clinical data in diagnosing pancreatic cancer: a contrastive approach.

In order to assess the value of serum markers and simple clinical data in the differential diagnosis of pancreatic cancer, we studied 32 control subjects and 28 patients with pancreatic cancer, 26 with chronic pancreatitis, and 37 with extra-pancreatic diseases. CA 19-9 was found to be the best marker in detecting pancreatic cancer. Among the clinical data, presence and onset of pain attacks, age, and weight loss were selected as the most informative in assessing chronic pancreatic disease. Clinical data correctly classified 88.5% of chronic pancreatitis and 75.0% of pancreatic cancer; serum markers identified pancreatic tumor in 67.9% of the patients. The adjunct of serum markers to clinical data did not improve accuracy in diagnosing chronic pancreatic disease. Since clinical data and serum markers generally become positive at an advanced stage of the disease, early diagnosis of pancreatic cancer is a goal still to be attained.

Adult↗
PubMed1987

Forecast of surgical risk in pancreatic cancer.

Over a 22 year period, 305 patients underwent operations for pancreatic cancer. Seventy-one patients who only underwent a laparotomy and 60 patients with defective data were excluded from our study. The remaining 174 patients were analyzed to find a clinically applicable algorithm to allow the preoperative surgical risk to be evaluated in a single patient. One hundred twenty-six had undergone a bypass operation (Group I) and 48, a potentially curative resection (Group II). The two groups were divided into the following three risk groups according to the postoperative course: D, patients who died during the first postoperative month; C, patients with postoperative complications; and U, patients with an uneventful course. Preoperative weight loss, duration of jaundice, serum bilirubin level, total protein level, and age of every patient were collected and transformed into a three-score ordinal scale. Stepwise discriminant analysis of these data enabled us to correctly classify 88 percent of the patients who underwent palliative operations and 83 percent of those who had pancreatic resection. This method is useful in identifying the risk group for a single patient using individual preoperative variables. It may, moreover, suggest the most suitable treatment for each patient with pancreatic cancer.

Adult↗
PubMed1987

Perendoscopic gastric pH determination. Simple method for increasing accuracy in diagnosing chronic atrophic gastritis.

The endoscopic diagnosis of chronic atrophic gastritis is often underestimated, and most of the procedures adopted to increase diagnostic accuracy are time consuming and complex. In this study, we evaluated the usefulness of the determination of gastric juice pH by means of litmus paper. Values obtained by this method correlate well with gastric acid secretory capacity as measured by gastric acid analysis (r = -0.64, p less than 0.001) and are not affected by the presence of bile. Gastric juice pH determination increases sensitivity and other diagnostic parameters such as performance index (Youden J test), positive predictive value, and post-test probability difference by 50%. Furthermore, the negative predictive value is very high, the probability of missing a patient with chronic atrophic gastritis with this simple method being 2% for fundic and 15% for antral atrophic change. We conclude that gastric juice pH determination, which substantially increases diagnostic accuracy and is very simple to perform, should be routinely adopted.

Female↗
PubMed1987

Resting and stimulated cytosolic free calcium levels in neutrophils from patients with Bartter's syndrome.

Cytosolic free calcium concentrations ([Ca2+]i) were measured in resting and chemotactic peptide-activated neutrophils from eight patients with Bartter's syndrome and compared with levels determined in neutrophils isolated from healthy controls. [Ca2+]i was measured with the intracellular trappable fluorescent indicator Quin2. The synthetic tripeptide formylmethionyl-leucyl-phenylalanine (fMet-Leu-Phe) was used as a stimulant. No difference was found in resting [Ca2+]i between neutrophils from normal controls and those from patients with Bartter's syndrome. On the contrary increases in [Ca2+]i stimulated by fMet-Leu-Phe concentrations higher than 10(-8) mol/l were significantly less in neutrophils from patients with Bartter's syndrome. It is suggested that neutrophils from patients affected by Bartter's syndrome exhibit an intrinsic anomaly in the mechanism responsible for intracellular Ca2+ mobilization.

Adolescent↗
PubMed1987

Clinical markers of slow healing and relapsing gastric ulcer.

The aim of the study was to identify the clinical markers useful in characterising slow healing and relapsing gastric ulcer patients. Ninety nine subjects entered the short term and 79 the long term study (12 months). The following parameters were taken into account: therapy, sex, age, smoking habit, alcohol consumption, analgesic intake, peptic ulcer family history and onset of the disease. Results of the studies were analysed by means of chi 2 test and logistic regression, both in stepwise and in specifying models. Cigarette smoking was found to be the most important risk factor of non-healing (p = 0.04). In women with late onset of the disease, cigarette smoking identified the gastric ulcer subjects at higher risk of non-healing with a predictive probability of 0.4679. Age under 50 years was found to be the most important risk factor of relapsing throughout the entire 12 month follow up period (p = 0.025). In those under 50 years, cigarette smoking and negative peptic ulcer family history in combination, identified the gastric ulcer subjects at higher risk of relapsing, the predicted probability being 0.6027. It is concluded that cigarette smoking is the most important risk factor for non-healing and those who relapse under the age of 50. The possibility of singling out categories of patients more prone not to heal and to relapse suggests new strategies in the management of gastric ulcer disease.

Adult↗
PubMed1987

Long-term monitoring of renal transplant patients by a CUSUM test on serum creatinine.

A retrospective clinical assessment of kidney function change was performed on 38 kidney transplant patients over a median follow-up period of 128 weeks. Full records of the patients' course were available to the clinician, while only the serum creatinine series of each patient was supplied to the computer on which a bilateral CUSUM test was implemented. The frequency of change assessed by the clinician was 146 out of 2,688 patient-weeks. The computer identified the function changes with 84.9% sensitivity and 94.3% specificity and the function deteriorations attributed to rejection with 88.9% sensitivity and 97.2% specificity. Thus we suggest an efficient long-term monitoring of the graft function with this simple and reliable statistical technique.

Adolescent↗
PubMed1987

Molecular size distribution of immunoreactive trypsin and renal tubular dysfunction: role in trypsin plasma-urine transfer.

In order to investigate the role of circulating free trypsinogen and renal tubular dysfunction in affecting trypsin plasma-urine transfer, serum immunoreactive trypsin (IRT), its urinary output, IRT molecular size distribution, filtrable immunoreactive trypsin, gamma-glutamyltransferase and alpha-glucosidase outputs were studied in 6 control subjects, 9 patients with pancreatic cancer and 15 with chronic pancreatitis. The majority of immunoreactivity was always eluted at a molecular weight of about 24,000 and might therefore be considered as free trypsinogen. Variable amounts of IRT at higher molecular weights, possibly represented by trypsin-inhibitor complexes, were also detected. Increasing IRT levels were generally accounted for by free trypsinogen, regardless of the nature of the disease. Unlike serum free trypsinogen levels, renal tubular damage, evaluated by means of the excretion of two high-molecular weight urinary enzymes, seems to play a prominent role in explaining trypsin plasma-urine transfer.

Adolescent↗
PubMed1986

CA 19-9 and carcinoembryonic antigen in pancreatic cancer diagnosis.

CA 19-9 (Centocor, Malvern, PA) and carcinoembryonic antigen (CEA), two recently developed immunoradiometric assays utilizing monoclonal antibodies, were evaluated in the sera of 139 subjects in order to assay their individual and combined value in pancreatic cancer diagnosis and to assess the influence of jaundice. Sensitivity, specificity, and accuracy in detecting pancreatic cancer were 69%, 85%, and 54% for CA 19-9; and 28%, 78%, and 6% for CEA, respectively. Combined evaluation gave the highest specificity (95%) when both, and the highest sensitivity (79%) when at least one, gave pathologic results. The receiver-operating characteristic curves demonstrated that CA 19-9 is more discriminating than CEA, for any serum value. A correlation between serum bilirubin and CA 19-9 was demonstrated in pancreatic and extrapancreatic disease. CEA determination, performed using monoclonal antibodies, seems to be unsatisfactory as compared to CA 19-9 in pancreatic cancer diagnosis, and combined assessment does not improve the results of CA 19-9 alone. Jaundice may influence serum CA 19-9 in pancreatic and extrapancreatic diseases.

Adult↗
PubMed1986

[The role of CEA, CA 19-9 and TPA in the diagnosis of pancreatic cancer. Evaluation by discriminant analysis].

In order to assess the relative value of CA 19-9, Tissue Polypeptide Antigen (TPA) and Carcinoembryonic Antigen (CEA), evaluated alone and in combination, in diagnosing pancreatic malignancy, serum CA 19-9, TPA and CEA were determined in 25 control subjects (CS), 26 pancreatic cancer (PC), 23 chronic pancreatitis (CP) and 21 benign extra-pancreatic diseases (EPD). The three markers were able to allocate the subjects correctly in 56.8% of the cases (CS 100%, PC 73.1%, CP 17.4%, EPD 28.6%). Sensitivity, specificity and diagnostic accuracy in detecting pancreatic cancer were respectively: 77%, 91% and 68% for CA 19-9; 92%, 75% and 67% for TPA; 50%, 84% and 34% for CEA; 73%, 91% and 64% for the three parameters evaluated simultaneously. CA 19-9 and TPA appear to be useful indices of pancreatic cancer with a satisfactory specificity when related to chronic pancreatitis; their diagnostic value seems to be comparable and better than that of CEA; the combination of these markers does not improve the results obtained by CA 19-9 or TPA alone.

Adult↗