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Biomedical subjects

F Di Mario

Publications and source records attributed to F Di Mario.

At least 199 records · Page 11Linked to original sources

Pancreolauryl test in chronic pancreatitis.

The pancreolauryl test was performed in 30 subjects with chronic pancreatitis, in order to evaluate its behavior in relation to the duration of the clinical history and the presence of pancreatic calcifications, diabetes mellitus, jaundice, and pancreatic pseudocysts. A significant inverse linear correlation was found between the onset of symptoms and FDL test values. While calcifications and diabetes were present in patients with both normal and abnormal test results, those with pseudocysts or jaundice always had pathological results.

Adult↗

Is tissue polypeptide antigen more accurate than serum CEA for diagnosing pancreatic cancer?

Tissue polypeptide antigen (TPA) and carcinoembryonic antigen (CEA) were determined in the sera of 36 control subjects, 30 patients with pancreatic cancer, 35 with chronic pancreatitis and 25 with non-pancreatic digestive disease to evaluate their role in detecting pancreatic malignancy. Abnormal values of TPA and CEA were found in 28 and 19 of 30 patients with pancreatic cancer, and in four and seven of 35 patients with chronic pancreatitis, respectively. Raised titres of TPA were observed more often than equivalent serum CEA in simulated pancreatic diseases. The receiver-operating (ROC) characteristic curves showed that TPA was more discriminating than CEA in detecting pancreatic cancer. Specificity was enhanced when both titres were abnormally high and sensitivity when one titre was raised, but the diagnostic accuracy of TPA alone has not improved, which satisfactorily discriminates pancreatic cancer from chronic pancreatitis.

Adult↗

Personality pattern of patients with chronic gastric ulcer: a case control study.

Personality factors are thought to play a role in peptic ulcer disease. In this study the psychological profiles of chronic gastric ulcer (GU) patients (n = 28) were compared to matched controls (n = 28) using the Cattell Sixteen Personality Factor Questionnaire Form C. GU patients were characterized by traits of anxiety, dependence, introspection, trustfulness and adaptability. These findings are discussed in the light of the literature on personality and peptic ulcer disease.

Adult↗

Serum elastase 1 and immunoreactive trypsin in chronic pancreatic disease: is there any relationship with trypsin inhibitors?

In order to investigate modifications of serum levels of elastase 1, immunoreactive trypsin, alpha 1-antitrypsin and alpha 2-macroglobulin in chronic pancreatic disease, and to speculate on the possible relationships among these parameters, the enzymes and inhibitors were assayed in the sera of 33 control subjects, 34 pancreatic cancer, 28 chronic pancreatitis and 36 extra-pancreatic diseases. An increase of elastase 1, alpha 1-antitrypsin and alpha 2-macroglobulin was detected in pancreatic cancer, chronic pancreatitis and extra-pancreatic diseases; no changes were found for serum immunoreactive trypsin. Multiple regression analyses showed that only 7% of elastase 1 was explained by inhibitors with alpha 1-antitrypsin playing a major role. Inhibitors did not influence immunoreactive trypsin. Our data indicate that the variations of the serum levels of proteases and antiproteases in chronic pancreatic disease are probably independent of each other.

Adult↗

Personality profiles of patients with duodenal ulcer.

Cluster analysis of personality profiles determined by the Sixteen Personality Factor Questionnaire separated 79 patients with duodenal ulcer into three homogeneous subgroups: 32 dependent and anxious patients, 31 neurotic and anxious patients, and 16 patients with a balanced personality. No significant differences among these three groups emerged for the variables of age, sex, duration of illness, fasting total serum pepsinogen, fasting serum pepsinogen group I, and number of cigarettes smoked per day, although there was a nonsignificant trend for both pepsinogen values to be higher in the patients with a balanced personality than in the other two groups. These results support the concept of heterogeneity of peptic ulcer disease.

Adult↗

Discriminant analysis in the clinical and biochemical diagnosis of primary liver cancer.

Discriminant analysis was used in evaluating the importance of clinical aspects and the value of routine and experimental biochemical markers in the differential diagnosis of primary liver cancer (PLC) and chronic, non-neoplastic, liver diseases. Our results show that: 1) Clinical signs, such as the presence of pain, weight loss or mass, correctly indicate the diagnosis in 76% of the cases; 2) The determination of alkaline phosphatase isoenzymes is shown by the computer to be the most useful marker and provides an overall diagnostic accuracy which is higher than that of alpha-fetoprotein. We also found that, by using these two markers together, "by intersection," the best overall accuracy (85%) is obtained. We, therefore, suggest determination of alkaline phosphatase isoenzymes and alpha-fetoprotein in screening the populations at risk for liver cancer.

Adult↗

Psychosomatic factors and peptic ulcer disease.

The authors present a review of the role of psychological factors in peptic ulcer disease (PU). Three lines of research have been identified: personality, psychological factors and PU; stressful life events and their relationship to PU; possible interactions between biological parameters, the CNS and psychosocial aspects. The analysis of the studies presented shows that there is a certain level of agreement with regard to personality and psychological aspects; PU patients present a personality with dependence/independence problems and high level of anxiety. Data concerning the role of stress appear to be far from uniform and often even contradictory. Much remains to be done with respect to the possible links between psychological and biological parameters; there have been only few studies in man--which have not been duplicated and were performed on a limited number of patients--but a fair number in animals. However, the results concerning the relationship between psyche and secretory patterns are very interesting, and represent one of the most important lines of future research.

Animals↗

Is maximal acid output useful in identifying relapsing duodenal ulcer patients?

In a group of 94 duodenal ulcer patients consecutively studied and followed-up for 1 year, subjects with maximal acid output (M.A.O.) above 60 mmol/hour (mostly heavy-smoking men), were found to relapse more frequently than those with lower M.A.O. values (72.2% versus 27.6%; p less than 0.0005). A significantly higher relapse rate was also detected in patients treated with maintenance dosages of effective antisecretory drugs (cimetidine, ranitidine, pirenzepine) and presenting M.A.O. over 60 mmol/hour. It is yet to be established whether an alternative therapeutic regime may prove effective in preventing ulcer recurrence in patients with gastric hypersecretion.

Adult↗

The risk of gastric dysplasia in medical long-term treatment of peptic ulcer disease.

There have been recent findings of gastric cancer in patients treated with cimetidine but too soon after treatment for that drug to have had a pathogenetic role. Ranitidine has been shown to induce slight changes in the gastric mucosa. In 117 patients with gastric ulcer followed-up in some cases for 24 months, five cases of cancer were detected, one after more than a year of follow-up. The numbers were too small to allow any conclusion to be drawn regarding relationships with medication. No significant differences in incidence of gastric epithelial dysplasia between control patients and patients treated with cimetidine or ranitidine were found. No dysplastic lesions were seen during a brief follow-up of 19 duodenal ulcer patients and a few gastric ulcer patients treated with pirenzepine but the data is too limited to allow conclusions to be drawn.

Adult↗

[Efficacy of oral nitroglycerin in the therapy of exertion angina].

A sample of 14 patients suffering from stable effort angina has been examined by means of exercise ECG test, in order to evaluate the efficacy, the onset of action and duration of effect of buccal nitroglycerin in the treatment of effort angina. The optimal dose of buccal NTG was predetermined for each patient through the analysis of heart rate changes (increase of at least 10 beats/min) and/or of blood pressure modifications (decrease of at least 10 mmHg). By applying a randomized double-blind design, the variations observed during exercise ECG tests after 20 minutes and 4 hours from the administration of buccal NTG (at the given dosage) or of placebo, have been evaluated. The following variables have been analyzed: heart rate, blood pressure, double product, time of onset of angina and/or of ST depression, amount of ST depression, duration of exercise test and maximum work-load. No significant changes have been observed for heart rate, blood pressure and double product both at the maximum effort and at the same level of effort as in the basal test. For each of the remaining variables a significant difference has been shown in favour of buccal NTG as compared to placebo, both after 20 min. and 4 hs. More in detail, the duration of the exercise test has been 6.14 +/- 2.77 mins on buccal NTG and 4.42 +/- 2.08 mins on placebo (+ 38%; p less than 0.05) after 20 mins and 6.40 +/- 3.19 on buccal NTG and 5.15 +/- 2.73 on placebo, after 4hs (+ 24%; p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

Gastric emptying and anxiety in chronic duodenal ulcer.

The authors have evaluated in a group of patients afflicted with duodenal ulcer whether anxiety might be in some way linked to gastric emptying. The 23 patients studied were subdivided into two groups: "fast" emptiers (n = 12; t 1/2 less than 90 min) and "normal" emptiers (n = 11; t 1/2 greater than 90 min). There were no significant differences between the two groups for the following parameters: sex, age, marital status, educational level, social class, number of cigarettes smoked per day, type of treatment undergone for the duodenal ulcer and maximal acid output. Anxiety levels measured with the Q4 and QII factors of the Cattell's PF 16 were found to be the same in the two groups. The authors conclude that anxiety does not seem to be linked to gastric emptying in chronic duodenal ulcer.

Adult↗

Recurrence of duodenal ulcer under continuous antisecretory treatment: an approach to the detection of predictive markers.

Seventy consecutive duodenal ulcer patients endoscopically followed up and treated after ulcer scarring with maintenance dosages of effective antisecretory drugs for 1 year were studied in order to identify the factors associated with ulcer relapse. Logrank test, discriminant analysis (Rao's method), and chi 2 were used in evaluating the results. Nineteen patients (27.1%) relapsed. Duodenal ulcer was found to relapse more frequently in patients with total serum pepsinogen more than 109 micrograms tyr X ml-1 X 24 h-1 and in patients with maximal acid output more than 60 mmol/h (Logrank test; both p less than 0.025). Discriminant analysis showed that blood group, age at onset of the disease, and sex were together useful in recognizing subjects relapsing within 6 months' maintenance treatment (77.1% cases correctly classified); age at onset of the disease, alcohol intake, and smoking habit were together useful in picking out subjects relapsing throughout the entire observation period (1 year) (61.76% cases correctly classified). Our data suggest that: 1) duodenal ulcer subjects with elevated serum pepsinogen or maximal acid output are significantly more prone to relapse than patients with normal or slightly increased values; 2) genetic and acquired factors (such as blood group A, early onset of the disease, male sex, alcohol intake, and cigarette consumption) may have a role in influencing ulcer relapse.

Adolescent↗

Personality and psychological factors in chronic duodenal ulcer. Their interaction with biological parameters.

Forty patients with chronic duodenal ulcer were studied to determine whether some particular personality and psychological factors are associated with this disease. To this purpose the Cattell's PF 16 personality Test was utilized. Duodenal ulcer population presented a typical personality profile characterized by: high anxiety, dependence and introversion. Some biological parameters, suggested as predictors of slow healing and/or relapse of ulcer, were studied: patients with maximal acid output greater than 60 mEq/h and /or total serum pepsinogen greater than 109 micrograms tyr/ml/24 hrs and/or serum pepsinogen group I greater than 99 ng/ml showed an anxiety level significantly higher than that of patients with values less than the reported thresholds. These results suggest a contributory role by psychological factors in duodenal ulcer disease. The association of anxiolitic drugs to the traditional antiulcer therapy may be proposed, particularly in hypersecretors.

Adaptation, Psychological↗