Search PubMed⌕ Search

Biomedical subjects

G Cavallini

Publications and source records attributed to G Cavallini.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Antibacterial and mezlocillin-enhancing activity of pure human pancreatic fluid.

The majority of deaths in severe pancreatitis are the result of superinfection of necrotic tissue. The pathogen most commonly responsible for such infections is Escherichia coli. Antibiotic prophylaxis would appear a logical precaution. The antibacterial drugs of choice should possess two basic characteristics: they must be active against the flora responsible for the infections and must be capable of penetrating into the pancreas at adequate minimum inhibitory concentrations (MICs). Mezlocillin--which is active against E. coli--has been shown to possess the latter requisite, but achieving therapeutic concentrations requires administration at high doses. In the present study, pure human pancreatic fluid showed properties similar to those observed in the dog against E. coli (bacterial colony growth 100 times lower than in a control culture) and produced a 75% reduction in mezlocillin MICs against this organism. These enhancing characteristics might make the commonly used doses sufficient for prophylactic purposes.

Colony Count, Microbial↗
PubMedDate not supplied

The anti-ageing effects of caloric restriction may involve stimulation of macroautophagy and lysosomal degradation, and can be intensified pharmacologically.

Caloric restriction (CR) and a reduced growth hormone (GH)-insulin-like growth factor (IGF-1) axis are associated with an extension of lifespan across taxa. Evidence is reviewed showing that CR and reduced insulin of GH-IGF-1 axis may exhibit their effects at least partly by their common stimulatory action on autophagy, the cell repair mechanism responsible for the housekeeping of cell membranes and organelles including the free radical generators peroxisomes and mitochondria. It is shown that the life-long weekly administration of an anti-lipolytic drug may decrease glucose and insulin levels and stimulate autophagy and intensify anti-ageing effects of submaximal CR.

Aging↗
PubMedDate not supplied

Early detection of pancreatic cancer following the diagnosis of chronic pancreatitis.

AIM: To assess whether patients with misdiagnoses of chronic pancreatitis (CP), followed at an early stage by a diagnosis of pancreatic cancer (PCr), present different epidemiological characteristics from patients suffering either from CP alone or from CP with late degeneration to PCr. METHODS: We arbitrarily subdivided our patient series into three groups: (1) 12 CP who developed PCr within 4 years after onset of symptoms; (2) 12 CP developing PCr after the 4th year, and (3) 701 CP with no subsequent development of PCr. The variables studied were age, sex, drinking and smoking habits, tumor localization, and presence of intraductal calcifications and diabetes mellitus at the time of diagnosis of CP. RESULTS: There were no significant differences between CP and 'late' PCr in any of the study variables considered. As compared with the CP group, the 'early' PCr cases were older (58.7 vs. 40.7 years; p < 0.0001), with a lower proportion of males (58 vs. 88%; p < 0.01), smaller proportions of both smokers (42 vs. 88%; p < 0.0001) and subjects drinking more than 40 g of alcohol/day (42 vs. 86%; p < 0. 0001), and a greater incidence of non-insulin-dependent diabetics at the time of diagnosis of CP (25 vs. 3.7%; p < 0.012). As compared with the 'late' PCr group, the malignancies in the 'early' PCr cases were more often located in the head of the pancreas (100 vs. 50%; p < 0.01). Multivariate logistic regression analysis selected age over 50 (odds ratio OR 13.5, 95% confidence interval CI 2.79-65.5; p < 0. 001), smoking habits (OR 0.14, 95% CI 0.04-0.49; p < 0.002), and non-insulin-dependent diabetes (OR 5.91, 95% CI 1.20-29.1; p < 0. 028) as variables identifying subjects with 'early' PCr. CONCLUSIONS: A high suspicion of a pancreatic tumor is necessary when CP is diagnosed in a patient with atypical epidemiological characteristics for this condition, possibly female, aged over 50, who is not a smoker or drinker, and suffers from non-insulin-dependent diabetes.

Adult↗
PubMedDate not supplied

Gemcitabine and continuous infusion of 5-fluorouracil in locally advanced and metastatic pancreatic cancer: a phase I-II study.

BACKGROUND: Gemcitabine has been recently recognized as standard treatment in advanced pancreatic cancer. To potentiate its single-agent activity we conducted a phase I-II study with the primary objective of establishing the maximum tolererated dose (MTD) of gemcitabine and continuous infusion 5-FU in patients with locally advanced or metastatic pancreatic cancer. PATIENTS AND METHODS: Fifteen patients received a fired dose of 5-FU 200 mg/mq protracted infusion for six months. Gemcitabine was administered weekly for three out of four weeks for six cycles at escalating doses of 800 mg/mq to 1100 mg/mq. RESULTS: MTD was established at 1000 mg/mq of gem citabine. Of the 11 evaluable patients, 7 patients had stable disease, 1 had partial response and 3 had progressive disease. Of the 14 patients evaluable at follow-up, median time to progression was 5 months. Median survival was 10 months. CONCLUSION: This study confirms the good tolerability of the combination, of gemcitabine with 5-FU.

Adenocarcinoma↗
PubMedDate not supplied

Acute and chronic pancreatitis: an up-date.

According to the 1988 Marseilles-Rome classification inflammatory pancreatic diseases are represented by acute (AP) and chronic pancreatitis (CP), pancreatic fibrosis and abscesses (due to infection of cystic cavities). Each form is defined by specific etiological, pathomorphological, functional and evolutive aspects. In our experience with 348 AP cases, gallstones and chronic alcohol abuse, alone or together, represent the major causative factors (over 70% of cases). Mortality observed in necrotizing AP only, varies from 26% of idiopathic to 8% of biliary cases. Ductal scars, exocrine and endocrine impairment were observed in about 45% and 20% respectively as sequelae of necrotizing AP, whatever the etiology. As far as CP is concerned, the main etiological factor is chronic alcohol consumption (82% of cases). The clinical evolution of CP may be roughly divided in two phases, the earlier (within 5 years from onset) characterized by frequently recurrent pain, calcifications and cystic cavities and the later when pain spontaneously regresses and steatorrhea and diabetes tend to appear. Heavy alcohol intake, smoking and frequent relapses are related to a less favourable course. About 60% of the patients underwent surgery within 5 years from onset. Pain relief was achieved in the large majority. Reduction in alcohol intake and the natural tendency of the disease to burn out, probably aid pain relief. Mortality in CP is due to diseases secondary to alcohol and smoking abuse (cardiovascular and neoplastic) more than to CP alone. We believe that multiple parameters are required for a complete definition of each pancreatic patient.

Adult↗
PubMedDate not supplied

Biomaterials and immune system: cellular reactivity towards PTFE and Dacron vascular substitutes pointed out by the leukocyte adherence inhibition (LAI) test.

Thirty-eight patients affected by peripheral vascular insufficiency, and twelve healthy volunteers, were submitted to a cellular immunity test: LAI test, in which leukocytes fail to adhere to glass in contact with a sensitizing antigen. Patients were divided as follows: Class 1: Dacron+PTFE grafted patients, Class 2: Dacron, Class 3: PTFE, Class 4: controls. Total leukocytes, mononuclear cells, T and B lymphocytes were used as cellular populations. Finely minced Dacron and PTFE fabric vascular prostheses were employed as targets. This research showed that a T cellular immune-reactivity towards Dacron and PTFE respectively occurs in Dacron and PTFE grafted patients, and that reactivity is greater in case of Dacron. Wider researches are required to state the immune system role in fabric prostheses patency; at this regard, must be kept in mind that T lymphocytes release thrombogenic factors in course of cellular immune response.

B-Lymphocytes↗
PubMedDate not supplied

Gabexate mesilate in the treatment of acute pancreatitis.

Despite controversial experimental and clinical findings, the use of Aprotinin (A) in the treatment of acute pancreatitis (AP) is still widespread in our country. Compared to A, Gabexate Mesilate (FOY) should have the following advantages: lack of antigenicity, low molecular weight with better cellular penetrance, wide inhibitory spectrum (against phospholipase A2 too) and good tolerability. In order to verify the efficacy of FOY versus, we decided to carry out a prospective multicenter (34 centers) randomized double blind trial in moderate-severe AP with FOY 3g/day versus A 1,500,000 U.I.K./day infused for 7 days with central venous line. Based on standard clinical, biochemical and radiological data, 199 patients suffering from AP were enrolled to the study from January 1989 to December 1990. The main admission criteria were: onset of the disease from no more than 72 hours, at least 2 Ranson positive criteria and C.T. evidence of acute pancreatic damage. Seventeen no protocol patients were excluded. The Etiology in the 182 analyzed patients (106 male, 76 female; mean age 57.6 years, range 21-91) were: biliary 102 (56%), alcohol 47 (25.8%), post-operative 13 (7.1%), unknown causes 13 (7.1%) and others 7 (3.8%). Median Ranson's Score was 3. CT examination showed 66 AP with edema, while 116 cases (63.7%) were recognized as severe forms with pancreatic necrotic involvement of 30% of the gland in 71 (61.2%), 50% in 31 (26.7%), and more than 50% in 14 (12.1%). Out of 182 patients, 91 were treated with A and 91 with FOY. The two groups were comparable regarding the main prognostic factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMedDate not supplied

[Medical therapy of chronic idiopathic constipation].

The medical care of the idiopathic constipation requires the correct patient identification based on precise classification items and on physiopathological considerations. The laxative abuse is often the most difficult problem to be solved and it has to be dealt with the consideration of different clinical aspects (wrong diet, psychological profile, concomitant diseases, drug therapy, etc.). The first step exactly consists in the identification and correction of the wrong convictions, of the behavioural attitudes and of the unbalanced dietary habits. Adding bran is the second widely accepted therapeutic step based on both physiopathological and epidemiological considerations. Even if the mechanism of action is still not completely understood, the fibre addition per se leads to an improvement of the constipation in quite a relevant percentage of patients, although it is often poorly tolerated. Nevertheless there are peculiar conditions not responsive to the bran addition such as the so-called "anismus". For these situations different therapeutic approaches have been proposed with variable results. Among these we can mention the re-educational programmes of the modalities of the defecation using biofeedback techniques. The chronic idiopathic constipation not respondent to the conventional medical therapy appears anyway a problematic and very difficult condition both from the investigational viewpoint and the therapeutic options. Finally it can be stated that the laxatives have a certain role in those clinical conditions most probably leading to the constipation. For each therapeutic drug class it is, of course, of great importance to know its mode of action as well as its adverse event profile.

Cathartics↗
PubMedDate not supplied

Rapid diagnosis of pancreatic cancer by combination of ultrasonography and serum tumour markers CA 19-9 and CA 50.

Non-invasive tests such as ultrasonography (US) and serum CA 19-9 or CA 50 present substantial sensitivity, but are not devoid of false-negative results in the diagnosis of pancreatic cancer. The patient sample in this study comprised 58 patients, 51 with adenocarcinoma, 4 with cystadenocarcinoma, 2 with islet-cell carcinoma and 1 with anaplastic carcinoma. All the patients underwent US examination with evaluation of visible tumour volume by means of the sphere or ellipsoid rotation formula. Serum CA 19-9 was measured in all cases, and CA 50 in 50. Pancreatic tumours were diagnosed by US in 47/58 patients [sensitivity (S) = 81.03%] and ductal carcinomas in 46/55 (S = 83.6%). Abnormal CA 19-9 values were found in 48/58 subjects (S = 82.7%) and in 47/55 ductal carcinomas (S = 85.4%). CA 50 showed abnormal values in 39 of the 50 tumours assessed (S = 78%) and in 38/47 ductal carcinomas (S = 80.8%). Combined use of the tests considerably improves these sensitivities. It is concluded that US results can be improved when combined with the two antigen assays. The poor correlation between tumour mass and serum antigen levels is compensated for by the US performance. The combination of US plus CA 19-9 and CA 50 provides a very good tool for the rapid non-invasive diagnosis of pancreatic cancer.

Adenocarcinoma↗