Biomedical subjects

F Vianello

Publications and source records attributed to F Vianello.

132 records · Page 8Linked to original sources

PubMedDate not supplied

The efficacy of two doses of omeprazole for short- and long-term peptic ulcer treatment in the elderly.

This study evaluated the efficacy, safety, and most suitable dose of omeprazole in short-term acute treatment (4 weeks) and maintenance treatment (6 months) of patients older than 60 years of age with endoscopically diagnosed gastric ulcer (GU) or duodenal ulcer (DU). This randomized, prospective study included 156 patients (67 GU and 89 DU; mean age, 74.8 and 72.3 years, respectively) who were randomized in the acute phase into two treatment groups: omeprazole 20 mg/d or 40 mg/d as a single morning dose for 4 weeks. The 6-month follow-up phase included 101 patients who were randomized to receive omeprazole 20 mg/d or 20 mg every other day. After 4 weeks of treatment, 94.0% of GU patients and 95.5% of DU patients showed complete ulcer scarring with no statistical differences between doses. At the end of the 6-month follow-up, 4.5% of GU patients and 8.8% of DU patients relapsed, with no statistical differences between groups. No clinically significant adverse events were recorded. In conclusion, omeprazole is a highly effective, well-tolerated, and safe drug for the short- and long-term treatment of GU and DU in the elderly. The dose of 20 mg/d for the acute phase and 20 mg on alternate days for maintenance therapy appears most appropriate for elderly patients with ulcers.

Aged↗

PubMedDate not supplied

Risk factors of duodenal ulcer bleeding: the role of smoking and nicotine.

Several studies have shown that cigarette smoking affects duodenal ulcer (DU) recurrence. To verify any correlation between smoking and complications of ulcer disease, we studied 33 DU smokers, 16 DU ex-smokers and 87 DU non-smokers for up to 48 months, recording age, sex, family history of ulcer, ulcer symptoms, non-steroidal anti-inflammatory drug use, length of DU history, alcohol consumption, smoking habit, relapses and bleeding episodes. Nicotine contents were also obtained for the type of cigarettes smoked. Statistics used were: Analysis of variance with Bonferroni's test. Pearson's chi-squared test and stepwise logistic regression analysis. Smokers were found to have significantly more relapses but fewer bleeding episodes than ex-smokers and non-smokers (63.3%, 31.2% and 34.5%, p = 0.029; 12.1%, 43.7% and 34.5%, p = 0.017). Bleeders were significantly more often males than non-bleeders (82.9% vs. 61.0%, p = 0.01) and had ulcer symptoms less frequently (9.7% vs. 26.3%, p = 0.02). Multivariate analysis confirmed sex as a risk factor (OR = 3.0) and smoking as a "protective" factor (OR = 0.4) for bleeding, while nicotine intake was found to be unrelated to this complication. We concluded that smoking (but not nicotine intake) and male sex are factors to take into account in evaluating the risk of DU bleeding.

Adult↗

PubMedDate not supplied

Myelodysplastic syndrome and thrombocytosis: a random association?

We describe a case characterized by the onset of bone marrow hypoplasia. After treatment with steroid and anabolic compounds, it evolved into a myelodysplastic syndrome (MDS) as demonstrated by morphological and karyotypic analysis. Despite the dysplastic nature of the disorder, a unique feature was its association with a high platelet count. The pathogenesis of the thrombocytosis could not be clearly identified. In fact, the course of the disease was complicated by severe infections that, together with therapy, could have played some role in stimulating thrombopoiesis. However, since MDS can precede or follow a chronic myeloproliferative disease, it is also possible that the platelet elevation in our patient could have been sustained by a primitive thrombocyte disorder.

Anabolic Agents↗

PubMedDate not supplied

High IgE serum levels and "peptic" ulcers: clinical and functional approach.

The prevalence of high total IgE serum levels was evaluated in 232 consecutive patients suffering from peptic ulcer. Twenty-one percent of the patients presented total IgE serum levels above 200 KU/L compared with the 5% found in a healthy control population (p < 0.004). Similar prevalence was found in gastric and/or duodenal ulcers. No significant differences in the duration of the disease, smoking habits, familiarity for peptic ulcer, symptomatology and frequency of complications were observed between patients with high and with normal total IgE serum levels. Gastric function studies (gastric acid secretion, serum pepsinogen and gastrin levels) did not show any significant differences between the two groups. The incidence of Helicobacter pylori infection was 65% in patients with normal IgE levels and 75% in those with high IgE levels (p: n.s.). The response to treatment with full dose of H2-receptor antagonists was comparable in both groups (91.25% and 90.7% of ulcer healing after 6-8 weeks of treatment). A relapse of the ulcer after 6 months of maintenance therapy (half dose of H2-receptor antagonists) was observed in 39.5% of the patients with ulcer and high total IgE serum as against the 11.9% observed in patients with normal IgE (p < 0.001). These data lend further support to the hypothesis of an underlying immuno-allergic reaction in some forms of gastric or duodenal ulcer.

Adolescent↗

PubMedDate not supplied

Effects of H2 blockers and omeprazole on peptic secretion: a prospective, randomized study in duodenal ulcer subjects.

UNLABELLED: Aim of the present study has been to investigate the possible modifications of peptic secretion after a period with H2 blockers and omeprazole, evaluating in the same patient pepsinogen group A levels in gastric mucosa and pepsin in gastric juice. 54 active duodenal ulcer were studied: during an upper gastrointestinal endoscopy a sample of gastric juice and one fundus biopsy were taken before and after four weeks 300 mg/daily ranitidine (23 patients), 40 mg/daily famotidine (7 patients), 300 mg/daily nizatidine (12 patients) therapy and 40 mg/daily omeprazole (12 patients) therapy. RESULTS: H2-blockers and omeprazole treatment determines a non statistically significant decrease of pepsin in gastric juice and in pepsinogen group A in gastric mucosa.

Adult↗

PubMedDate not supplied

Primary breast lymphoma.

Breast involvement by non-Hodgkin lymphoma is uncommon. Differences between primary and secondary breast lymphoma have been well-defined. However, histopathological features, therapeutic approach and outcome are still debated. We report the clinical and pathological features of 5 cases of malignant lymphoma primarily involving the breast. The literature is extensively reviewed paying particular attention to pathological features, therapeutic approach and survival analysis. All patients were women; the median age was 63.2 yr. The clinical course was indistinguishable from that of breast carcinoma. High-grade lymphoma was found in 4 cases; T cell lineage antigens were expressed in one case. All patients were in stage I or II. Treatment consisted of chemotherapy and/or radiotherapy. The follow-up period ranged from 20 to 54 months (mean, 33.2). All patients are still in complete clinical remission. Analysis of the literature showed that about 80% of cases are high grade lymphoma. In this group, stage I at presentation statistically gives the best survival rate; surgery does not appear to have a role in high-grade lymphoma treatment.

Adolescent↗