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Biomedical subjects

F Di Mario

Publications and source records attributed to F Di Mario.

At least 163 records · Page 9Linked to original sources
PubMed1990

[Does Helicobacter pylori have a direct proteolytic effect in ulcerative disease?].

Helicobacter pylori (H.p.), has been shown, experimentally, to exert a proteolytic activity against mucous fractions. Aim of this study was to assess the prevalence of H.p. in peptic ulcer and to analyze its possible influence on gastric mucus components, on peptic activity in gastric juice and the possible action on peptic secretion. 223 patients undergoing upper gastrointestinal endoscopy were analyzed for the presence of H.p. in the mucosa: 99 duodenal ulcer patients (D.U.), 58 gastric ulcer patients (D.U.) and 66 dyspeptic subjects. In each patients, three contiguous gastric biopsies were taken at the antrum: the first was evaluated for gastritis (Whitehead Criteria), the two other analyzed for H.p. with a rapid urease test. In a subgroup of 25 D.U. and 18 G.U. patients, two other biopsies were taken at the fundus corpus of the stomach, to evaluate peptic secretion. To determinate mucous components (acid and neutral glycoproteins, galactose and N-acetylneuraminic acid), gastric juice samples were collected during endoscopy. H.p. was present in 89% of antral biopsies in D.U., in 56% of G.U. and in 51% of D., and was associated to antral gastritis. As regard gastric juice components, we observed an increase and a decrease of acid glycoproteins, respectively, in D.U. and G.U. patients with H.p. infection. An increase of peptic activity has been found in the gastric juice of both gastric and duodenal ulcer patients H.p. positive (G.U. p less than 0.05). On the contrary, no significant differences were observed on peptic activity in the fundus-corpus biopsies between H.p. positive and H.p. negative patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[Peptic ulcer and liver cirrhosis. Clinico-epidemiologic considerations].

A significant increase in associated liver disease has been confirmed in duodenal ulcer cases, with various studies showing a 5-14% incidence of the ulcers in patients with cirrhosis. The present study was undertaken to discover the incidence of peptic ulcer in such patients, to investigate a series of epidemiological data in a group cirrhosis patients with ulcers and to establish an adequate protocol for the treatment of the ulcer in both its acute and post-healing stage. The incidence of peptic ulcers in cirrhosis patients was calculated in a retrospective study of 377 hospitalised patients in two consecutive years (1986, 1987). The epidemiological data are based on 99 of them. Acute ulcer treatment was given in 31, while 41 with healed ulcers were put on maintenance therapy. Ulcers were found in 16-17% of the cirrhosis patients; the cirrhosis was caused by alcohol abuse in 61.53% and was post-necrotic in 21.79%. Endoscopy revealed duodenal ulcers in 60.6%, gastric ulcers in 32.3%. In this sample, 39.39% were non-smokers, while 23.23% smoked over 20 cigarettes a day.

Age Factors↗
PubMed1990

[Bleeding of gastric ulcers. Epidemiologic, clinical and functional characteristics].

The frequency of gastrointestinal haemorrhage due to gastric ulcer has been assessed in 254 personally observed patients suffering from this endoscopically verified pathology. 56 patients, namely 22% of the cases, presented haematemesis and/or melena of the ulcerative lesion. This subgroup was compared with 65 patients with endoscopically verified gastric ulcer without previous bleeding episodes from the lesion in their clinical history, in respect of certain epidemiological, clinical and biohumoral features. The purpose of the study was to check the possible existence of clinical and/or physiopathological differences between subjects with bleeding gastric ulcer and the population of non-bleeding ulcer patients. In 80% of patients studied, the gastric ulcerous disease started with digestive haemorrhage and it was not accompanied by dyspeptic-painful symptomatology in 20% of cases. The pain symptomatology does not appear to be influenced by the intake of non-steroid anti-phlogistic drugs. No significant difference emerges between the two groups considered as regards epidemiological features and biohumoral data (PG I, gastrin, B.A.O. and M.A.O.).

Adult↗
PubMed1990

Measurement of pepsinogen group I in endoscopic gastroduodenal biopsies.

A technique for determining pepsinogen group I (PGI) concentrations in endoscopic gastroduodenal biopsies is described and validated. This method has a good precision (intra-assay CVs 4.1% to 8.4%; between-assay CVs 4.6% to 9.3%), and analytical recovery is satisfactory (94% to 102%). Results were uninfluenced by the storage interval of the samples. At PGI-producing sites (i.e., fundus, corpus) peptic activity was greater than in the antrum and duodenum. PGI concentrations in serum and in gastroduodenal biopsies were not correlated. This simple, reliable method can quantify better than other assays peptic activity in humans, without being influenced by gastric secretory volumes. It will also facilitate prospective studies on the effect of various secretagogues in vivo and evaluations of the influence of anti-ulcer drugs on peptic secretion.

Adult↗
PubMed1990

[X-ray diffraction study of biliary calculi. Morphological and composition correlations of calculi].

In this study, we examined the composition of crystallographic structure of biliary stones in 106 patients (27 male, 79 female). The material has been obtained following cholecystectomy. In 70 cases (66%), the monohydrate cholesterol was the main constituent, alone (33%) or in combination with calcium salts (32%). In 52% of the cases, we found presence of vaterite, aragonite and calcite. The anhydrous cholesterol was determined in 28 subjects (26%), alone (9.4%) or associated with calcium salts (16%). Cholesterol was completely absent in 8 cases: of them, 4 presented an aspecific diffrattografic picture and 4 revealed presence of calcium carbonate. Finally, no correlation was found between epidemiological data (sex or age) and macroscopic feature of biliary stones (chemical and morphological structure).

Calcium↗
PubMed1989

Alpha-fetoprotein, tissue polypeptide antigen and ferritin in diagnosing primary hepatocellular carcinoma in patients with liver cirrhosis.

This study was undertaken in order to compare the usefulness of three indices of tumour proliferation in detecting primary hepatocellular carcinoma (HCC) and in differentiating this neoplasm from liver cirrhosis. In 10 patients with HCC and in 63 with liver cirrhosis serum alpha-fetoprotein (AFP), tissue polypeptide antigen (TPA) and ferritin were assayed. Increased levels of AFP but not of TPA and ferritin were observed in HCC as compared to liver/cirrhosis. The receiver-operating characteristic curves demonstrated that AFP is more discriminating between HCC and liver cirrhosis than the other two markers. Correlations between liver function tests and serum markers were observed in liver cirrhosis but no in HCC. We can conclude that AFP is more useful than TPA and ferritin in detecting HCC in patients with liver cirrhosis, owing to the high frequency of false positive results of the latter two indices in liver cirrhosis. Liver dysfunction is probably involved in increasing all these markers of malignancy, thus reducing the specificity of these tests.

Adult↗
PubMed1989

Renal tubular dysfunction in pancreatic cancer and chronic pancreatitis.

Urinary excretion of alpha-glucosidase (AGL), gamma-glutamyltransferase (GGT) and ribonuclease (RNase), and serum amylase and immunoreactive trypsin (IRT) were determined in 38 control subjects, 48 patients with pancreatic cancer, 77 with chronic pancreatitis and 47 with extrapancreatic diseases in order to ascertain the presence of a renal tubular damage and to investigate its etiology. A significantly increased frequency of pathological results for all urinary enzymes was documented in the various groups of patients as compared to controls. Significant correlations were detected among AGL, GGT and RNase. Considering the subjects as a whole, GGT and RNase excretions correlated with serum IRT and amylase; the two urinary enzymes were found to be higher when jaundice was present. In chronic pancreatic disease enzymuria was related to increased serum pancreatic enzymes; in extrapancreatic diseases it was associated to hyperbilirubinemia. The vast majority of patients with pancreatic cancer and elevated urinary enzymes presented hepatic metastases and/or jaundice. We can conclude that an anatomical and functional tubular impairment is detectable in some patients with chronic pancreatic and extrapancreatic diseases. Tubular damage seems to least in part to be related to pancreatic inflammation and necrosis in chronic pancreatic disease, while jaundice may be found to play an important role in diseases of the hepatobiliary tract. In pancreatic cancer, liver dysfunction (presence of liver metastases and/or extrahepatic cholestasis) also appears to be involved in altering tubular cells.

Adult↗
PubMed1989

Do CA 19-9 and TPA play a minor role as compared to AFP in diagnosing primary hepatocellular carcinoma?

This study was undertaken in order to compare the ability of 4 tumour markers to discriminate between liver cirrhosis patients with or without hepatocellular carcinoma (HCC). Serum alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), CA 19-9 and tissue polypeptide antigen (TPA) were determined in 63 patients with liver cirrhosis and in 25 patients with HCC in liver cirrhosis. All 4 serum markers were found to be increased in a number of liver cirrhosis patients, regardless of the presence of HCC. AFP was found to be more elevated in HCC patients as compared to the other group; no difference was observed for CA 19-9, CEA and TPA. A significant correlation was detected in HCC patients between AFP and TPA. Significant correlation were detected in all except HCC patients between liver function tests and TPA. We can conclude that AFP determination remains as yet the only suitable marker able to detect HCC in liver cirrhosis. The newly introduced serum marker CA 19-9 is, as previously reported, unhelpful for CEA. TPA can in some instances (i.e. in the absence of an important hepatic cell necrosis or cholestasis) provide a clue to neoplastic growth.

Adult↗
PubMed1989

[Basal and postprandial blood gastrin in peptic ulcer. The physiopathological considerations in relation to different locations 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 nonhormone-dependent peptic ulcer disease has been completely clarified. The aim of the present study was to analyse fasting and postprandial 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 postprandial gastrin concentrations and basal and maximal acid output in the 3 groups of patients has also been investigated. Fasting serum gastrin levels do not appear different among the 3 classes of patients, while postprandial 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 a statistically significant difference at 30 minutes. The concentrations of the hormone are not different in males of the 3 groups of patients at basal time, while they are statistically lower at 15 and 30 minutes in gastric ulcer males compared to those with duodenal ulcer and the association of the localization. Finally, positive correlation has been observed between B.A.O. and M.A.O. and postprandial gastrin concentration 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↗
PubMed1989

[Ca 19-9 in the diagnosis of pancreatic carcinoma].

This study was undertaken in order to ascertain the role of CA 19-9 in pancreatic cancer diagnosis. Therefore CA 19-9 was determined in the sera of 83 control subjects, 108 patients with pancreatic cancer, 112 with chronic pancreatitis and 126 with extrapancreatic diseases. Sensitivity, specificity and accuracy in detecting pancreatic cancer were: 75%, 86% and 61% respectively. The receiver-operating characteristic curves showed that CA 19-9 is able to well discriminate pancreatic cancer from controls; satisfactorily it differentiated pancreatic malignancy from chronic pancreatitis and other benign extrapancreatic diseases. Extrapancreatic neoplasms were not accurately separated. No difference was detected in CA 19-9 levels between pancreatic cancer patients with or without hepatic metastases. We can conclude that CA 19-9 is a test for pancreatic malignancy with a satisfactory sensitivity and specificity in respect of other pancreatic and extrapancreatic benign pathologies; the presence of hepatic metastases is only one of the factors which may increase its serum levels.

Adult↗
PubMed1989

[Clinical usefulness of the blood gastrin curve after protein meal in duodenal ulcer].

Conflicting data are present in the literature on pathophysiological role of serum gastrin and peptic ulcer disease. The aim of this study was to evaluate, in duodenal ulcer patients, the possible correlation between post-prandial serum gastrin concentrations and some epidemiological (sex, family history, onset of the disease, blood group status, smoking habit, alcohol consumption) and clinical (effectiveness of therapy, bleeding episodes) factors. The gastrin levels were expressed in absolute values and as per cent increase of fasting serum gastrin concentrations. As regards sex, the per cent increase of fasting serum gastrin concentration was significantly higher in females (No. 16) than in males (No. 60) at 30 and 60 minutes (192.25% vs 116.52% and 105.42% vs 40.96% respectively; p less than 0.05 and p less than 0.005). Post-prandial serum gastrin concentrations, expressed as per cent increase, were higher in heavy drinkers (No. 14) and statistically significant at 120 minutes (40.57% vs 9.58%, p less than 0.025); as well as in smoker patients (No. 31), at 15, 30 and 60 minutes (227.59% vs 123.52%, 177.23% vs 101.62%, 0.025 and p less than 0.05). Post-prandial gastrin was unrelated to blood group status, onset of the disease, family history, effectiveness of medical treatment and bleeding episodes.

Adult↗
PubMed1989

[Famotidine in the short and long term treatment of duodenal ulcer: clinical and physiopathologic study].

UNLABELLED: The aim of this study was to evaluate the clinical efficacy of short and long-term treatment with famotidine 40 mg/daily at bed time in duodenal ulcer disease. 45 patients with endoscopically proven active duodenal ulcer undertaken the study. Endoscopic evaluations were performed at 6 weeks, 3 and 6 months from the start of the study. The following parameters were evaluated: pepsinogen group I and gastrin levels in serum, pH, acid and neutral glycoprotein, N-acetylneuraminic acid, pepsin in gastric juice collected during the upper gastrointestinal endoscopy. 6 weeks healing rate was 91.1%. After the third month of follow-up 14.2% of the patients presented an endoscopical proven episode of relapse. No relapses were observed at the end of the study (after 6 months of treatment). Acid glycoprotein, N- acetylneuraminic acid and pepsin concentrations significantly decreased after 6 weeks of treatment (p less than 0.0125, p less than 0.025, p less than 0.005 respectively), while serum levels of pepsinogen group I, gastrin and gastric pH increased (p less than 0.0005, p less than 0.005, p less than 0.025). After 6 months period of therapy, a significant increase of neutral glycoproteins (p less than 0.01) and a decrease of pepsin (p less than 0.005) and acid glycoproteins (p less than 0.01) was observed. On the contrary, gastric N- acetylneuraminic acid, pH, serum gastrin and pepsinogen group I presented the pre-trial values. IN CONCLUSION: 1) famotidine appears to be an effective and safe therapy for duodenal ulcer treatment; 2) it seems to act not only by inhibiting gastric acid secretion but also influencing some parameters related to the gastric mucosal barrier.

Adolescent↗
PubMed1989

[Intragastric pH determination as a screening test in the diagnosis of chronic atrophic gastritis].

A simple routine endoscopic screening test has been sought for the diagnosis of chronic atrophic gastritis. An endoscopic-bioptic study was therefore carried out on 850 subjects presenting consecutively at a Digestive Endoscopy Department with dyspeptic-pain symptomatology. In a first sample of 389 patients, 2 biopsies of the gastric body and 2 of the gastric antrum were carried out, independently of the endoscopically documented macroscopic picture. Atrophic changes were in this way encountered in 65 patients (16.7%). In a second group of 461 patients, intragastric pH was determined extemporaneously during endoscopy. pH was = or greater than the chosen threshold value (3.5) in 117 patients and less than this value in 344. In all subjects with pH greater than 3.5 and, by comparison, in 130 with pH less than 3.5 biopsy was carried out on the gastric mucosa, 2 biopsies of the body and 2 of the antrum. Using this approach it was possible to determine the presence of atrophic changes in the gastric mucosa in 57 of 117 (48%) and in 25 of 130 (20%) respectively. In total, chronic atrophic gastritis was diagnosed in 83 of 461 subjects (18%). This percentage is comparable to that observed in the frequency of chronic atrophic gastritis using the more demanding and less selective test of bioptic sampling indiscriminately for all patient. So, the straight-forward determination of intragastric pH in a sample of gastric juice taken during digestive endoscopy would appear to meet the criteria demanded for a screening test and its wider use is recommended in routine endoscopic practice.

Adolescent↗