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Biomedical subjects

C Ricci

Publications and source records attributed to C Ricci.

At least 127 records · Page 7Linked to original sources
PubMed1996

Serological response to Helicobacter pylori in gastric and non-gastric cancer.

1. We aimed to evaluate the seroprevalence of Helicobacter pylori (H. pylori) in gastric cancer, non-gastric cancer and outpatients by ELISA and iso-electric focusing, and to compare histology and serology for H. pylori in gastric cancer and outpatients. 2. In 124 patients with gastric cancer, 78 patients with non-gastric cancer and 110 outpatients, H. pylori seroprevalence was assessed by ELISA and isoelectric focusing. Gastric cancer and outpatients underwent endoscopy with biopsies. 3. Seroprevalence by ELISA was significantly higher in gastric cancer compared with non-gastric cancer (84% versus 56%, P < 0.001) but not with outpatients (84% versus 74%). Iso-electric focusing detection of H. pylori was comparable to ELISA: 85, 51 and 75% in gastric cancer, non-gastric cancer and outpatients respectively. Oligoclonal iso-electric focusing was significantly more frequent in gastric cancer compared with non-gastric cancer and outpatients: 69% versus 45 and 46% respectively, P < 0.01. The reliability of H. pylori detection by antral biopsy was significantly lower in gastric cancer compared with outpatients: 36% versus 74% (P < 0.001). In gastric cancer, ELISA and iso-electric focusing were significantly more reliable than histology in H. pylori detection (84 and 85% versus 36% respectively) (P < 0.001). 4. Serological immune response to H. pylori in gastric cancer, non-gastric cancer and outpatients seems different both quantitatively and qualitatively; serology was more reliable than histology in detection of H. pylori in gastric cancer.

Adult↗
PubMed1996

Is there a postinfection fatigue syndrome?

Prolonged fatigue syndromes are common in general practice. Most of these syndromes are secondary to other common medical or psychological disorders. It appears, however, that some specific infectious illnesses are associated with prolonged recovery. Theories as to the mechanisms for such post infection fatigue syndromes include a range of immunological, psychological and neurobiological processes. Current evidence suggests disruption of fundamental central nervous system mechanisms, such as the sleep-wake cycle and the hypothalamic-pituitary-adrenal axis, may underpin the clinical features of this disorder. Treatment should focus on the provision of continuous medical care, physical rehabilitation and adjunctive psychological therapies.

Fatigue↗
PubMed1995

Helicobacter pylori status, endoscopic findings, and serology in HIV-1-positive patients.

We have carried out a large prospective study of the frequency of H. pylori infection and HIV-1 status in a community of ex-drug abusers including subjects with (N = 210) and without (N = 259) upper gastrointestinal symptoms, endoscopy and serology. Control groups were patients with upper gastrointestinal symptoms not at high risk of HIV-1 infection (N = 219) and asymptomatic blood donors (n = 322). H. pylori was present in 52% of symptomatic community residents having endoscopy and 55% of the control patients with symptoms but not at high risk of HIV-1 infection. H. pylori was less common in HIV-1-positive patients (40%) than those who were negative (66%; P < 0.001). In patients with AIDS (33%), the frequency of H. pylori infection was reduced compared to HIV-1-positive patients without AIDS (53%; P = 0.05). All the residents with AIDS had upper gastrointestinal symptoms. In community residents, peptic ulcer was always associated with H. pylori infection. By H. pylori serology, there was no difference in the frequency of infection in asymptomatic residents (56%) whether HIV-1 positive (55%) or HIV-1 negative (58%) compared with those residents with symptoms. Overall, H. pylori was less common in HIV-1-positive residents (49%) than those who were HIV-1 negative (61%; p < 0.05). This difference was due mainly to the low frequency of infection in residents with AIDS (33%). H. pylori infection is common in HIV-1 positive patients, and only slightly reduced when compared with at-risk HIV-1-negative subjects. Peptic ulcer is associated with H. pylori in HIV-1 infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1995

Hepatitis B virus, hepatitis C virus and human immunodeficiency virus infection in health care workers: a multiple regression analysis of risk factors.

A seroprevalence survey of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV), was conducted using serum samples obtained from 5813 health care workers (HCWs) in five public hospitals in the Latium region of Italy, during the 1985 vaccination campaign against HBV. The seroprevalences of HBV, HCV and HIV were 23.3% [95% confidence interval (CI) = 22.3-24.4%], 2% (95% CI = 1.6-2.4%) and 0.07% (95% CI = 0.001-0.13%), respectively. In a logistic regression model, sex, increasing age, all job categories vs. physicians, dental treatment in the previous six months, and needlestick injury during the previous year were significantly associated with HBV. Conversely, no occupational and community risk factors, but only history of blood transfusion were significantly associated with HCV. Nevertheless, the documented risk of HCV as well as of HIV transmission through percutaneous and mucocutaneous exposure to blood and body fluids should lead to continued efforts to minimize risks of infection by enhancing the compliance of HCWs with vaccination against HBV and adherence to infection control measures, and by introducing safer devices and techniques.

Adult↗
PubMed1995

Ovarian influence on adrenal androgen secretion in polycystic ovary syndrome.

OBJECTIVE: To determine whether the ovary influences adrenal androgen secretion in polycystic ovary syndrome (PCOS). DESIGN: The adrenal androgen secretion was evaluated before and during ovarian suppression with a long-acting GnRH agonist. SETTING: Department of Obstetrics and Gynecology, Pisa, Italy. PARTICIPANTS: Women with PCOS and high (10 subjects) and normal (12 subjects) DHEAS levels and 6 normal women. INTERVENTIONS: After 1 mg dexamethasone, an ACTH-(1-24) stimulation test was performed in the early follicular phase of the menstrual cycle. The test was repeated after two injections of a long-acting GnRH analogue (GnRH-a). MAIN OUTCOME MEASURES: Basal plasma levels of gonadotropins, E2, T, androstenedione (A), 17 alpha-hydroxyprogesterone (17-OHP), DHEAS, and cortisol (F) were evaluated before the evening administration of dexamethasone. Serum A, T, 17-OHP, DHEAS, and F were measured 9 hours after dexamethasone and in samples collected 60 and 120 minutes after ACTH IV injection. RESULTS: In the high DHEAS group the maximum increases in T, A, 17-OHP, and DHEAS in response to ACTH were significantly higher than in normal DHEAS PCOS women and in normal women. The GnRH-a modified the A and T responses to ACTH in the high DHEAS group. CONCLUSIONS: Ovarian steroids, or other extra-ovarian factors, seem to be responsible for the increased A and T responses to the corticotropin stimulation demonstrated in some PCOS women.

Adolescent↗
PubMed1995

Preoperative chemotherapy and immunochemotherapy for locally advanced stage IIIA and IIIB non small cell lung cancer. Preliminary results.

From January 1991 to November 1993, 110 patients with histologically confirmed stage IIIA and IIIB non-small cell lung cancer (NSCLC), were seen at our Institution. Our study was designed to evaluate whether redirection to surgery of otherwise unresectable patients may be obtained by preoperative therapy. Forty-nine patients were considered eligible for neoadjuvant treatment. Thirty-two (Group I) were treated with two or three cycles of cisplatin, vinblastine and mitomycin C and 17 (Group II) received two cycles of cisplatin, VP16, alpha 1 timosine and interferon. The overall response rate was 81.2% for Group I and 88.7% for Group II. Downstaging was predictive of resectability (P < 0.05). Forty-one patients (83.6%) underwent thoracotomy with 37 (75.5%) radical resections. Conservative techniques (bronchovascular reconstruction) (22 cases) were preferred over pneumonectomy (2 cases). The resectability rate was 84% for Group I and 87% for Group II (P = NS). Treatment-related complications were minor, with no deaths. Postoperative complications occurred in two cases in each group (7.4% and 14.3%). There was no histologic evidence of tumor in three patients. Two-year survival was 75% for Group I and 55% for Group II (P = NS). To date 35 patients who had complete resection are alive, and free of disease. We conclude that preoperative chemotherapy produces high response and resectability rates in both stage IIIA and IIIB unresectable NSCLC; radical resection using a conservative technique is possible in patients who are otherwise unresectable; no local recurrence occurred after radical resection; no significant differences were demonstrated between the two protocols.

Aged↗
PubMed1995

Recurrent thymoma: evidence for histological progression.

The clinicopathological features of nine cases of recurrent thymomas have been studied. At presentation, all cases were histologically classified as thymomas with cortical differentiation, including predominantly cortical thymoma, cortical thymoma and well-differentiated thymic carcinoma. In five cases the morphological features of the recurrence(s) were suggestive of a histological progression of the tumour from predominantly cortical thymoma to cortical thymoma and/or well-differentiated thymic carcinoma, usually associated with a more advanced clinical stage, the latter indicating a clinical progression. These findings suggest that all types of thymoma with cortical differentiation are histologically and histogenetically related neoplasms, associated with a more aggressive clinical behaviour and a significant risk of recurrence. The overall outcome of patients with recurrent thymoma in this series was poor, since six patients (66.6%) died due to the disease, 2-14 years after the first diagnosis. The clinical implication of our findings is that thymomas with cortical differentiation always need careful follow-up, even in those cases which are not obviously invasive at onset.

Adult↗
PubMed1995

Video-assisted thoracoscopy in the management of recurrent spontaneous pneumothorax.

OBJECTIVE: To present our experience of video-assisted thoracoscopy in the treatment of recurrent spontaneous pneumothorax, and to compare the results with those of a historical control group treated by lateral thoracotomy. DESIGN: Prospective evaluation with historical controls. SETTING: Teaching hospital, Italy. SUBJECTS: 41 Patients with recurrent spontaneous pneumothorax, 20 of whom were treated by video-assisted thoracoscopy and 21 of whom underwent lateral thoracotomy (historical control group). MAIN OUTCOME MEASURES: Duration of chest drainage, length of hospital stay, amount of narcotic analgesia required, postoperative complications, and recurrence during follow up. RESULTS: The mean (range) duration of chest drainage in the group who underwent video-assisted thoracoscopy was 5 days (4-7) compared with 7 days (4-13) in the control group; the corresponding figures for length of hospital stay were 6 days (4-8) compared with 10 days (5-16). 3 Patients (15%) in the thoracoscopy group required parenteral narcotic analgesia compared with 14 (66%) in the control group, and 2 (10%) developed minor complications compared with 5 (24%). The mean length of follow up was 9 months (range 1-18) compared with 26 months (19-34), and no patient in either group developed a recurrence. CONCLUSION: Our early results of treating recurrent spontaneous pneumothorax with video-assisted thoracoscopy have been encouraging, and we have adopted it in preference to lateral thoracotomy.

Adult↗
PubMed1995

Helicobacter pylori in patients with gastric and nongastric cancer.

OBJECTIVES: To compare the seroprevalence of Helicobacter pylori in gastric and nongastric carcinoma patients and to investigate the relationship between H. pylori, gastric cancer site, and histological type. METHODS: In a 24-month period, 307 gastric cancer patients (male/female: 185/122; age range 19-94 yr, mean 69 yr) were investigated by serology (IgG to H. pylori), histology, and urease test for H. pylori. One hundred and seventy-seven gastric cancers were in the antrum, 98 were in the corpus, and 32 were in the fundus; 227 were intestinal and 80 were diffuse type. In the same study period, we assessed the H. pylori seroprevalence in 162 patients with nongastric carcinoma (lung n = 41, breast n = 42, genitourinary n = 41, GI tract n = 22, others n = 16) (male/female: 84/78; age range 31-81 yr, mean 56 yr). RESULTS: The overall seroprevalence of H. pylori in gastric cancer and in nongastric cancer was 82 and 56%, respectively (p < 0.001). In asymptomatic blood donors (age range 55-65 yr) and in dyspeptic patients older than 60 yr, a seroprevalence of 55 and 58% was found, respectively, which is significantly lower (p > 0.001) than the gastric cancer patients but similar to the nongastric cancer population. No difference was found in the H. pylori status according to the gastric cancer site (83, 82, and 81% in the antrum, corpus, and fundus, respectively). Two hundred and twenty-seven gastric cancers [185 (81%) H. pylori-positive] were found to be of an intestinal type and 80 [66 (82%) H. pylori-positive] of a diffuse type (not significant). No age-related difference (below and above 60 yr) in H. pylori prevalence was observed within each cancer population, and, in both age groups, the seroprevalence of infection was higher in gastric cancer patients (86 and 81%) than in nongastric cancer patients (56 and 56%) (below and above 60 yr, respectively). CONCLUSION: H. pylori seroprevalence is significantly higher in gastric cancer compared with nongastric cancer patients. No differences were observed in H. pylori seroprevalence according to gastric cancer site or histological type. The higher H. pylori seroprevalence in gastric cancer patients is not age related.

Age Factors↗
PubMed1995

[Video-assisted thoracoscopy in the treatment of recurrent pneumothorax].

Between April 1992 and May 1994, 45 patients with recurrent spontaneous pneumothorax underwent videoassisted thoracoscopy (group I). The mean chest tube duration, the length of hospital stay, the use of parenteral narcotics, the complications and the follow-up were analyzed and compared to the same data of a group of 21 patients previously treated by open approach between January 1991 and March 1993 (group II). Average age, sex and surgical indications distribution were comparable (group I: 36 males, 9 females, mean age 31.7 years; group II: 17 males, 4 females, mean age 31.5 years). Mean chest tube duration was lower in group I (group I 4.3 days vs group II 7.2 days), as was mean hospital stay (group I 4.6 days vs group II 10.3 days) and the necessity of parenteral narcotics for pain relief (group I 11% vs group II 66% of patients). No episodes of relapsing pneumothorax occurred in either group of patients after a mean follow-up of 12.4 months (range from 1-24 months) for group I and 30 months (range from 24-36 months) for group II. The incidence of minor complications was less in group I (4.4%) than group II (23.8%). Our early results in the treatment of recurrent spontaneous pneumothorax by videoassisted thoracoscopy have been encouraging and the merits of this approach make it preferable to thoracotomy.

Adult↗