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Biomedical subjects

F Di Mario

Publications and source records attributed to F Di Mario.

At least 145 records · Page 8Linked to original sources
PubMed1991

Psychological stress and gastric emptying in normal subjects.

Gastric emptying half-time was measured in 10 healthy volunteers on two different occasions over a one-week interval, with an identical test meal. The first was the control evaluation, and at the second assessment, psychological stress was induced by the technique of dichotomous listening. Psychological and physiological parameters were assessed before and during the test period. No significant or consistent modifications of gastric-emptying time were induced by the stress procedure. Looking at individual subjects instead of mean values, gastric emptying was unchanged in 5 subjects, slower in 3, and faster in the remaining 2. These 3 groups had different mean values on two subscales of the Sixteen Personality Factor Questionnaire.

Adult↗
PubMed1991

A comparison of nizatidine and ranitidine in the maintenance treatment of duodenal ulcer. A randomized, double blind, multicentre, 2-year study.

UNLABELLED: One hundred and eight patients with an endoscopically documented healed duodenal ulcer (DU) participated to a multicentre, randomized, double-blind, long-term study. The study was planned with the aim to compare the efficacy of nizatidine 150 mg with ranitidine 150 mg in preventing relapse during the 2 years following the DU healing. Fifty four patients were assigned to each treatment. Endoscopic examinations were scheduled at 6, 12 and 24 months. Clinical evaluations were performed every two months. Routine laboratory tests were investigated at the beginning of the study and at each of the scheduled endoscopies. STATISTICS: chi-squared test with Yate's correction, Student's t test for unpaired data, Wilcoxon Rank Sum test and Logrank test. Twenty five patients dropped-out: 15 in the nizatidine and 10 in the ranitidine group. The cumulative relapse rate was 18% for nizatidine and 21% for ranitidine treatment (p:ns). Both drugs resulted safe, as only minor side effects were registered. IN CONCLUSION: nizatidine is as effective and safe as ranitidine in the long-term (2 year) treatment of DU.

Adult↗
PubMed1991

Epithelial dysplasia in atrophic gastritis. Bioptical follow-up study.

Fifty-nine cases of gastric dysplasia (46 of which were mild, 11 moderate and 2 severe) were studied in relation to their association with atrophic gastritis and intestinal metaplasia. Atrophic gastritis was found in 39 cases (28 of which were mild, 10 moderate and 1 severe). Dysplasia was considered "persistent" when found of the same degree in at least two consecutive check-ups after initial diagnosis (13 cases); it was considered "progressive" if found more severe or evolving as cancer (5 cases) or "regressive" if detected in a lesser degree or no longer detected (13 cases). Sixteen of the 18 persistent or progressive cases of dysplasia were associated with atrophic gastritis, whereas 10 of the 13 cases with regressive dysplasia revealed no concomitant pattern of gastric mucosa atrophy (p less than 0.005). These findings suggest that dysplasia represents a truly pre-neoplastic change particularly when associated with atrophic gastritis and which must therefore be more carefully monitored.

Adult↗
PubMed1991

Eosinophilic gastroenteritis: report of two atypical cases.

Eosinophilic Gastroenteritis (EG) is a poorly understood disorder defined by eosinophilic infiltration of the bowel wall, eosinophilia and gastrointestinal symptoms. The disease's aetiology, course and treatment are not well known. We report two atypical cases of EG: one involving the mucosal layer and another involving the serosal and muscularis layer. The first shows how EG may present with a long history of episodes of intestinal obstruction and malabsorption and how the disease could take a severe course and may be unresponsive to treatment. The second case shows EG presenting as acute abdomen and which subsequently became asymptomatic without therapy, regardless of the fact that peripheral eosinophilia remained present. This case raises the problem of how to treat an asymptomatic patient, what parameters should be considered in order to assess the progress of the disease and the indications for treatment.

Adult↗
PubMed1991

Pepsinogen A/pepsinogen C or pepsinogen A multiplied by gastrin in the diagnosis of gastric cancer?

Being pepsinogen A (PGA) levels generally reduced and pepsinogen C (PGC) increased in gastric cancer patients, PGA/PGC ratio has been proposed as a useful marker of the tumour. We tested PGA, PGC and Gastrin (G) levels in patients with gastric cancer (39) and, as a control, in patients with epithelial dysplasia (21), chronic atrophic gastritis (57), gastric ulcer (11) or subjects lacking major or minor endoscopic and microscopic changes at gastroscopy (48). PGA and PGA/PGC levels were significantly reduced in gastric cancer patients (p less than 0.005 and p less than 0.0001 respectively with analysis of variance). Gastrin levels were also reduced in the same patients (p less than 0.005). We therefore adopted an index number (PGA x Gastrin) which was also dramatically reduced in gastric cancer (p less than 0.005); using an arbitrarily chosen cut-off, the "marker" showed very high sensitivity (76%), specificity (96%) and overall accuracy (74%, by Youden J test). We therefore suggest the use of the index number PGA x G in the diagnosis of gastric cancer, as the most useful gastrin presently available, to our knowledge.

Biomarkers, Tumor↗
PubMed1991

[Is there a role for double-contrast radiology in the characterization of patients with non-ulcer dyspepsia?].

Nun-ulcer dyspepsia (NUD) is a very common disorder: about 30% of subjects may suffer from this syndrome, with a subsequent increase in sanitary cost. NUD is diagnosed by means of both an accurate anamnesis and instrumental investigations like double-contrast upper gastrointestinal X-rays, endoscopy, and US of the biliary tract. Our study was aimed at evaluating the actual capabilities of double-contrast radiology in the characterization of NUD patients. One-hundred consecutive outpatients (53 males and 47 females, age range 15-84 years) with clinical symptoms of NUD were submitted to double-contrast gastric radiological examination. X-rays were performed without pharmacological hypotonicity to better depict functional disorders (i.e., impaired esophageal motility, gastroesophageal and duodenogastric reflux, gastric hypotonicity, and delayed gastric emptying) even though this prevented the though evaluation of morphological features, which are better identified by gastrointestinal endoscopy. 42% of patients, especially middle-aged ones, exhibited only functional disorders. Double-contrast X-rays might therefore be suggested as a useful investigation technique in young patients with clinical symptoms of NUD: it is capable of showing functional disorders and therefore can support upper gastrointestinal tract endoscopy in the pathophysiological characterization of NUD patients.

Adolescent↗
PubMed1991

[Ulcer and hepatic cirrhosis. Epidemiologic and clinical correlations].

Peptic ulcer has been reported with increased frequency in patients with liver cirrhosis, its prevalence ranging form 5% to 20%. The aim of the present study is twofold: 1) to define the frequency of peptic ulcer in chronic liver disease in a large sample of cirrhotic patients, 2) to investigate the epidemiological and clinical features of a group of subjects affected by both peptic ulcer and liver cirrhosis. Two years of admission have been retrospectively investigated to define the frequency of peptic ulcer in chronic liver disease. In 237 subjects affected by both cirrhosis and peptic ulcer, epidemiological and clinical data were collected. Peptic ulcer was present in 16% of cirrhotic patients. There were no differences between ulcer subjects who drank and those did not. A linear positive correlation between smoking habit and frequency of ulcer disease has been found in the words. A positive history for peptic ulcer was described in a little subgroup of the studied sample, suggesting a low importance of the genetic factor in the pathophysiological pattern of ulcer disease in chronic hepatitis.

Adult↗
PubMed1991

[Basal and postprandial blood gastrin in peptic ulcer. The physiopathological aspects in relation to different sites of the lesion].

A different pathophysiological mechanism is widely accepted for gastric and duodenal ulcer. In particular, the exact role of gastrin in the determinism of non hormono-dependent peptic ulcer disease is not completely clarified. Therefore, the aim of present study was to analyse fasting and post-prandial serum gastrin levels in 99 duodenal ulcer patients, 17 gastric ulcer patients and 11 subjects presenting an association of gastric and duodenal ulcer. The possible correlation between post-prandial gastrin concentrations and basal and maximal acid output in the 3 fasting serum gastrin levels appear not different among the 3 classes of patients, while post-prandial gastrin concentrations are statistically higher at 15 minutes in duodenal ulcer patients and in subjects with the association of gastric and duodenal ulcer as compared to gastric ulcer patients. Mean fasting and stimulated gastrin levels are higher in gastric ulcer females than in males during the entire test and with statistically difference at 30 minutes. The concentrations of the hormone are not different in males of the 3 groups of patients at basal time, while are statistically lower at 15 and 30 minutes in gastric ulcer males compared to the males with duodenal ulcer and the association of the localization. Finally, positive correlation has been observed between BAO and MAO and post-prandial gastric concentrations in the 3 groups of patients, while there is an inverse correlation between the previous parameters as regards sex, both in gastric and duodenal ulcer.

Adult↗
PubMed1990

Pain and personality in duodenal ulcer: a preliminary report.

Personality factors measured by the Cattell's 16 Personality Factor Questionnaire were assessed for 78 duodenal ulcer patients with moderate to severe pain and in 30 duodenal ulcer patients with mild or no pain. The two groups were comparable for relevant sociodemographic variables. Patients with moderate to severe pain were significantly more tender-minded, kindly, and tended to be more introspective and glum than those reporting mild or no pain. However, the reported differences are small; adjustment of the p values to avoid Type I errors makes these differences no longer statistically significant. These results must be considered preliminary; further studies are necessary to understand the topic better.

Abdominal Pain↗
PubMed1990

Cholestatic jaundice as the presenting symptom of small cell lung cancer.

Small-cell lung cancer is an infrequent (10%) form of lung cancer which may rarely become apparent with signs of distant metastases. A case is presented where a cholestatic syndrome was the presenting feature of a small-cell lung cancer which was not suspected clinically. The misleading clinical picture, the inaccurate results of ultrasound, ERCP and chest x-ray did not allow the correct diagnosis to be made until post mortem examination. Even according to the published experience, which is reviewed here, this presentation and clinical course appear exceedingly rare.

Bile Duct Neoplasms↗
PubMed1990

[A clinico-endoscopic study on cicatrization of lesions and prevention of recurrences in patients with liver cirrhosis and peptic ulcer].

Seventy-four and five cirrhotic patients with acute peptic ulcer were respectively treated with H2-blockers and cytoprotective drugs for 4-6 weeks; after this period 49 (62.2%) healed and 14 (17.7%) did not heal after further 2 months with the same therapy. In order to observe the effectiveness of H2-blockers in preventing peptic ulcer recurrences, 77 cirrhotic patients were followed-up for a mean period of 12 months (range 3-48 months) after ulcer scarring; 51.2% under H2-blockers maintenance treatment and 54.8% who took antiacid in case of need, relapsed. The therapeutical response, as regards short-term treatment in cirrhotic patients, seems not to differ from the usual outcome of the general ulcer population; on the contrary, the relapses, also during a maintenance therapy, appears increased.

Adult↗
PubMed1990

Comparison of 150 mg nizatidine BID or 300 mg at bedtime, and 150 mg ranitidine BID in the treatment of gastric ulcer--an 8-week randomized, double-blind multicentre study.

One hundred and one active gastric ulcer patients concluded an 8-week, randomized, double-blind multicentre study, planned with the aim to compare the effectiveness of a new H2 blocker, nizatidine, with ranitidine. Thirty-three patients received 300 mg nizatidine at bedtime, 34,150 mg nizatidine b.i.d. and 34,150 mg ranitidine b.i.d. The three groups were well matched for the common clinical parameters. After 4 weeks, healing rates were 51.5% (confidence intervals 95%: 34.1-68.9%), 61.8% (41.2-82.4%), 76.5% (51-102%), respectively. At this check point ranitidine showed a significantly better outcome than did 300 mg nizatidine at bedtime (p less than 0.05). After 8 weeks, healing rates were 81.8% (54.1-109.5%), 88.2% (58.7-117.7%) and 88.2% (58.7-117.7%); these differences were not statistically significant. Age, sex, ulcer symptoms, alcohol and cigarette consumption, concomitant treatments, ulcer size and site and length of ulcer history were all found not to influence ulcer healing. Pain relief and antacid consumption were comparable in the three treatment groups. No clinically significant unwanted effects were recorded throughout the study. Nizatidine can, in our opinion, be successfully used in the treatment of active gastric ulcer.

Adult↗
PubMed1990

Long-term treatment for gastric and duodenal ulcer.

The histamine H2-receptor antagonists, cimetidine, ranitidine, famotidine and nizatidine are effective in promoting the healing of both gastric and duodenal ulcer. Unfortunately the recurrence rate after withdrawal of the therapy does not appear modified and many studies indicate an increased rate of relapse after antisecretory treatment. The difference between various H2-blockers in terms of duration of acid inhibition and then increasing in gastrin levels may play a role in explaining the phenomenon, the exception represented by the last H2-blocker, nizatidine. It is reasonable, therefore, to analyze the different therapeutical approaches proposed for ulcer relapse prevention, such as continuous maintenance therapy, seasonal on demand, intermittent, week-end therapy, association of drugs with different mechanisms of action, etc. Four categories of patients can be characterized both for gastric and duodenal localization: 1. Subjects with low rate of relapses, i.e. less than one each fifteen months; 2. Subjects with episodic relapses, i.e.; one or two per year; 3. Subjects with frequent relapses, i.e. more than three per year; 4. Subjects with complications (bleeding, perforation).

Duodenal Ulcer↗
PubMed1990

Is computed tomography a reliable indicator of stone solubility?

This study was undertaken to ascertain whether CT evaluated stone densiometry, prior to treatment, is able to identify patients with high likelihood of success with litholisis. Eight patients with single radiolucent stone (less than 15 mm diameter) in a functioning gallbladder that showed no reduction in size after 12 months treatment with UDCA (10 mg/Kg/day) were submitted to CT scan to determine stone densitometry. Seven patients still had a radiolucent stone after therapy; six out of seven stones showed densitometric values over 50 Hounsfield units, which we considered the upper normal limit for stones consisting of cholesterol. CT can be a useful tool to identify patients at high risk for oral dissolution therapy failure.

Cholelithiasis↗