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Biomedical subjects

M Plebani

Publications and source records attributed to M Plebani.

At least 343 records · Page 19Linked to original sources
PubMed1987

A new sustained-release theophylline suspension for asthmatic children: evaluation of serum theophylline concentrations.

Theophylline level variability obtained with standard slow-release theophylline tablets was compared to that obtained with a new sustained-release theophylline suspension in asthmatic children. The sustained-release preparations were administered every 12 hours and serum samples were collected after ten days of treatment during the steady-state period. In this crossover study, the sequence of the two regimens (slow-release tablets versus slow-release suspension) was selected at random. Both preparations of theophylline were administered at a mean dosage (+/- s.d.) of 19.3 +/- 1 mg/kg/day. The results of our study demonstrated that theophylline serum levels remain within the therapeutic range for both preparations, but there was a greater fluctuation with theophylline suspension compared to the tablets. The tolerability of the two drugs was satisfactory.

Adolescent↗
PubMed1986

CA 19-9 and carcinoembryonic antigen in pancreatic cancer diagnosis.

CA 19-9 (Centocor, Malvern, PA) and carcinoembryonic antigen (CEA), two recently developed immunoradiometric assays utilizing monoclonal antibodies, were evaluated in the sera of 139 subjects in order to assay their individual and combined value in pancreatic cancer diagnosis and to assess the influence of jaundice. Sensitivity, specificity, and accuracy in detecting pancreatic cancer were 69%, 85%, and 54% for CA 19-9; and 28%, 78%, and 6% for CEA, respectively. Combined evaluation gave the highest specificity (95%) when both, and the highest sensitivity (79%) when at least one, gave pathologic results. The receiver-operating characteristic curves demonstrated that CA 19-9 is more discriminating than CEA, for any serum value. A correlation between serum bilirubin and CA 19-9 was demonstrated in pancreatic and extrapancreatic disease. CEA determination, performed using monoclonal antibodies, seems to be unsatisfactory as compared to CA 19-9 in pancreatic cancer diagnosis, and combined assessment does not improve the results of CA 19-9 alone. Jaundice may influence serum CA 19-9 in pancreatic and extrapancreatic diseases.

Adult↗
PubMed1986

[The role of CEA, CA 19-9 and TPA in the diagnosis of pancreatic cancer. Evaluation by discriminant analysis].

In order to assess the relative value of CA 19-9, Tissue Polypeptide Antigen (TPA) and Carcinoembryonic Antigen (CEA), evaluated alone and in combination, in diagnosing pancreatic malignancy, serum CA 19-9, TPA and CEA were determined in 25 control subjects (CS), 26 pancreatic cancer (PC), 23 chronic pancreatitis (CP) and 21 benign extra-pancreatic diseases (EPD). The three markers were able to allocate the subjects correctly in 56.8% of the cases (CS 100%, PC 73.1%, CP 17.4%, EPD 28.6%). Sensitivity, specificity and diagnostic accuracy in detecting pancreatic cancer were respectively: 77%, 91% and 68% for CA 19-9; 92%, 75% and 67% for TPA; 50%, 84% and 34% for CEA; 73%, 91% and 64% for the three parameters evaluated simultaneously. CA 19-9 and TPA appear to be useful indices of pancreatic cancer with a satisfactory specificity when related to chronic pancreatitis; their diagnostic value seems to be comparable and better than that of CEA; the combination of these markers does not improve the results obtained by CA 19-9 or TPA alone.

Adult↗
PubMed1986

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↗
PubMed1986

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↗
PubMed1986

New method ("SPAC ET") for free thyroxin in serum evaluated.

We analytically and clinically evaluated a new commercial method ("SPAC ET") for simultaneously determining total and free thyroxin in serum. We found the method to be rapid, simple, and precise. Results significantly correlated with those by "symmetric" dialysis and also agreed with the clinical data for patients with extremely low or high concentrations of thyroxin-binding globulin. On contrast, in those patients the most commonly used thyroid indexes (free thyroxin index or thyroxin:thyroxin-binding globulin ratio) failed to correctly reflect the true functional status of the thyroid.

Adolescent↗
PubMed1986

Carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) in pancreatic cancer. Role of age and liver dysfunction.

In order to ascertain the clinical usefulness of CA 19-9 in detecting pancreatic cancer in comparison with CEA, and to verify the influence of age and liver dysfunction on serum levels of these two antigens, serum CA 19-9 and CEA were assessed in 32 control subjects, 32 patients with pancreatic cancer, 26 with chronic pancreatitis and 43 with gastrointestinal extra-pancreatic diseases. Sensitivity, specificity and diagnostic accuracy of CA 19-9 and CEA in detecting pancreatic cancer were: 69% and 44%, 91% and 75%, 60% and 19% respectively. Linear correlations were observed between the age of the subjects on the one hand and CA 19-9 or CEA on the other. Significant relationships were also noticed between alanine-amino-transferase or bilirubin serum levels and CA 19-9 values. Serum CA 19-9 seems to be a better diagnostic tool than CEA in the assessment of pancreatic cancer; nevertheless the influence of liver dysfunction and age to some extent limits the diagnostic value of CA 19-9.

Adult↗
PubMed1985

Serum elastase 1 in chronic pancreatic disease.

Elastase 1 and immunoreactive trypsin were assessed by a RIA technique in the sera of 29 control subjects, 24 pancreatic cancer patients, 22 patients with chronic pancreatitis and 31 with extra-pancreatic diseases to ascertain and compare their usefulness in chronic pancreatic disease diagnosis. Increased levels of elastase 1 were detected in 60.9% of pancreatic cancer and in 61.1% of chronic pancreatitis patients; low values were found in only two subjects with pancreatic disease. A close correlation between the two enzymes was found in patients suffering from pancreatic cancer and chronic pancreatitis. These data suggest that serum elastase 1, as well as immunoreactive trypsin, is of limited value in chronic pancreatic disease diagnosis; increased levels of the two enzymes always occur simultaneously; low immunoreactive trypsin values together with normal elastase 1 serum levels are detectable in a number of patients with chronic pancreatitis and severe exocrine insufficiency.

Adult↗
PubMed1985

Enzyme immunoassay for pancreatic lipase: comparison with turbidimetric method in pancreatic diseases.

We report the results of the analytical and clinical evaluation of a specific enzyme immunoassay for determination of human pancreatic lipase, in comparison with a turbidimetric method, in pancreatic pathology. Under standardized conditions of incubation time and temperature we found intraassay coefficient of variation (CV) of 1.3, 3.2, 2.1% at means = 18.7, 43.7, 224 micrograms/L and interassay CV of 2.8, 4.6, 3.0% at means = 19, 42.6, 230 micrograms/L, respectively. In general, a good correlation (r = 0.97) was found between lipase determined as a protein or through its catalytic activity. No significant correlation (r = 0.38) was observed with samples containing low concentration of lipase (up to 18 micrograms/L). We conclude that the turbidimetric method is reliable for routine determinations in the diagnosis of acute pancreatic pathology. However, the better sensitivity of the immunochemical assay should provide additional information for monitoring pancreatic insufficiency.

Acute Disease↗
PubMed1985

Macro creatine kinase type 2: a marker of myocardial damage in infants?

The case histories of two children (aged two months) affected by myocarditis showing an atypical band of serum creatine kinase (EC 2.7.3.2; CK) in the CK isoenzyme electrophoretic pattern are reported. The electrophoretic mobility on cellulose acetate of the atypical iso-CK band and its greater relative molecular mass, the lack of binding with immunoglobulins and the result of CK-BB determination by RIA, allowed us to identify the band with an oligomeric form of the mitochondrial isoenzyme. One child died 2 days after admission, while in the other it was possible to demonstrate reduction and disappearance of the atypical band in concomitance with a marked clinical improvement. Our findings suggest that the oligomeric form of mitochondrial-CK is released in conditions of serious heart muscle damage, and that it may be an indicator of myocardial cellular necrosis in pediatric patients.

Clinical Enzyme Tests↗
PubMed1985

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↗
PubMed1985

Determination of serum theophylline by apoenzyme reactivation immunoassay system.

A reagent strip for the quantitative analysis of theophylline in serum or plasma was evaluated. The strip is based on the apoenzyme reactivation immunoassay system (ARIS) technique and is intended for use with the Ames Seralyzer reflectance photometer. The method gave CVs at three theophylline levels ranging from 3.8 to 6.3% (within run) and from 2.8 to 6.9% (day to day). The regression lines obtained from the correlation studies were y = 0.959x + 0.51 (n = 105, r = 0.9906, Sy/x = 0.56) for the comparison ARIS (y) versus Syva enzyme multiplied immunoassay (x) methods, and y = 0.986x + 0.32 (n = 105, r = 0.9832, Sy/x = 0.62) for the comparison ARIS (y) versus Abbott TDx fluorescence polarization immunoassay (x) methods. The interference from triglycerides, hemoglobin, bilirubin, and ascorbic acid, and the cross-reactivity of 8-chlorotheophylline, caffeine, 1,3-dimethyluric acid, theobromine, and 1,7-dimethylxanthine, were also investigated and discussed. The method was found to be reliable, simple, and rapid. It provides a practicable solution for immediate determinations of theophylline.

Apoenzymes↗
PubMed1985

Fluorescence energy transfer immunoassay of digoxin in serum.

We have evaluated the reliability of the new fluorescence energy transfer immunoassay (FETI) for determining concentrations of digoxin in serum. The method demonstrated good stability of the standard curve and satisfactory precision in both within-and between-run assay. We have also found a significant correlation between FETI and two RIA methods (r=0.97). Furthermore, the association between results by FETI and by the EMIT method (a conventional enzyme immunoassay) was a linear one. Finally, the assay encountered no significant interference from endogenous substances (hemoglobin, bilirubin , and triglycerides).

Digoxin↗
PubMed1985

[Early diagnosis of myocardial infarct: value of the combined use of creatine kinase and MB isoenzyme determinations].

To define the optimal diagnostic strategy for acute myocardial infarction, 225 patients with suspected myocardial infarction were studied by serial (3 hour intervals) sampling for CK and CK-MB enzyme activity. In 12 patients the diagnosis of myocardial infarction was rejected. In the remaining 213 the myocardial infarction was transmural in 183 (anterior in 79, postero-inferior in 95, anterior and inferior in 9), non transmural in 30. In these patients the mean increase of enzyme activity, the time to pick activity and the infarct size (Sobel method) were measured. The best diagnostic sensitivity in the early phases of myocardial infarction was obtained by the combined use of CK and CK-MB determinations (95.9% of the diagnosis at 9 hours after the acute event). However the percent of positivity of CK & CK-MB values occurred significantly (p less than 0.01) later in non transmural (4.3% at 3, 34.7% at 6 and 86.9% at 9 hours after the onset of the chest pain) than in transmural myocardial infarction (25.2% at 3, 54.4% at 6 and 97.6% at 9 hours) and among these in inferior as compared to anterior (18.7% vs 32.2% at 3 hours, 46.8% vs 62.7% at 6 hours and 96.8% vs 98.3% at 9 hours). The CK/CK-MB ratio was of limited diagnostic value because it was increased (greater than 8) in most of the patients, either with normal or abnormal enzymes activities. Early kinetics differed in the different anatomo-clinical types of infarction. In all locations of myocardial infarction the mean enzyme activity increase was significantly correlated with the calculated enzymatic infarct size.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Enzyme Tests↗
PubMed1985

CEA and ferritin in chronic pancreatic disease: a comparative evaluation.

CEA and ferritin were determined in 90 subjects with the aim of comparing their value in the diagnosis of pancreatic malignancy. Ferritin was shown to be more sensitive than CEA in detecting pancreatic cancer patients (68.4% and 57.9%, respectively) all of whom were, however, in an inoperable stage. In contrast, CEA showed a higher specificity as compared to ferritin (77.4% and 47.2%, respectively), the latter being frequently increased in inflammatory conditions such as chronic pancreatitis. The simultaneous assessment of CEA and ferritin showed the highest sensitivity when either parameter was found to be pathological and the highest specificity when both were. The receiver-operating characteristic curves demonstrated that CEA is more discriminating than ferritin for all serum values. Neither ferritin nor CEA may be considered a practically suitable marker of pancreatic cancer.

Adult↗
PubMed1984

CPK and CPK-MB in the early diagnosis of acute myocardial infarction and prediction of infarcted area.

This study was carried out on patients of a coronary unit to evaluate the diagnostic efficiency of total CPK and CPK-MB by using different analytical techniques: catalytic, immunoassisted, cellulose acetate electrophoresis, radioimmunoassay and immunoradiometric assay. The behaviour of the enzyme was studied in all patients with reference to the localization and extent of the infarct. In all cases a diagnostic algorithm was followed based on the combined use of CPK and its MB isoenzyme; the activity was measured twice, at three-hour intervals after admission. In this way the utilization of total CPK and MB isoenzyme allows almost complete diagnostic efficiency within the first 9 hours from onset of chest pain, together with the possibility of calculating the slope of the curve of MB isoenzyme release useful for calculating infarct size. Maximum diagnostic efficiency is also obtained in cases of small infarcts, with silent ECG, and those difficult to classify clinically.

Creatine Kinase↗