[Comparative statistical study of the incidence of gastric cancer in the populations of the Republic of San Marino and the Emilia-Romagna region].
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Biomedical subjects
Publications and source records attributed to N D'Imperio.
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The effectiveness and safety of pirenzepine (PRZ) at 150 mg daily in the treatment of active duodenal ulcer was studied in an open pilot clinical trial followed by a double-blind trial against placebo. The open pilot study showed that pirenzepine was well tolerated and promoted ulcer healing in the 45% of patients within 2 weeks of treatment and in 90% within 4 weeks. The double-blind trial against placebo (PL) Confirmed these results: 60% of the patients in PRZ group and 10% of the patients in PL group showed endoscopic ulcer healing after 2 weeks. This difference was significant. Ninety per cent of the PRZ patients and 50% of the PL patients were completely healed after 4 weeks. In the PRZ group, gastric secretory tests showed a significant decrease in B.A.O. (69%), M.A.O. (33%) and P.A.O. (34%) after 2 weeks. In the PL group, the same parameters had only a small decrease, without statistical significance. There were no pathological changes in laboratory findings in either the open or the double-blind studies. Mild and transient side-effects were observed in 7 of 30 patinets receiving pirenzepine (diplopia and dryness of the mouth).
Fifty-five patients with active duodenal ulcer have completed, up to today, a one-month double-blind trial to compare the effects of pirenzepine (150 mg daily), cimetidine (1 g daily) and placebo on the healing of duodenal ulcer. Fifteen (71%) of the 21 patients treated with pirenzepine had healed ulcers compared with 14 (82%) receiving cimetidine (P less than 0.05. In the placebo group there were 7 (41%) healed ulcers. Symptomatic improvement in patients given pirenzepine was as substantial as in cimetidine-treated patients. No adverse effects were noted.
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Recent reports claim that there might be a relationship between sclerotherapy for esophageal varices and cancer of the esophagus. The discovery of a squamous cell cancer of the lower esophagus in a patient treated three years previously with sclerotherapy led us to set up a follow-up protocol. In order to assess this relationship and to monitor the evolution of such lesions, 68 patients treated with sclerotherapy with polidocanol because of esophageal varices were examined endoscopically at six-month intervals, and brushing samples were taken. The ages of the patients ranged between 35 and 81 years, and all had portal hypertension due to cirrhosis; 10 patients with the same disease but without bleeding varices were also examined. The interval between sclerotherapy and the first cytologic follow-up examination averaged 34 months, while the interval to the last follow-up examination averaged 40 months. One patient was examined four times (1.4%), 10 three times (14.7%), 39 twice (57.4%) and 18 only once (26.5%). Two cases were interpreted as nuclear hyperplasia associated with inflammation and were found to have regressed at a subsequent examination; all the other cases were reported as negative although sometimes associated with inflammation. None of the controls showed any abnormalities. While the occurrence of esophageal cancer after sclerotherapy might be associated with other risk factors, such as alcohol intake and smoking, esophageal brushing cytology can successfully monitor these patients and detect early stages of neoplasia.
Personal experience with 30 patients treated with Somatostatin for upper gastrointestinal bleeding is reported. The conclusion is drawn that this drug, reducing chloro-peptic secretion and hepatic portal blood flow, can reduce and control bleeding and postpone the surgical operation, which has a high rate of mortality.
In a double-blind study, 59 patients with chronic erosive gastritis received 50 mg of pirenzepine twice daily and 55 patients received 400 mg of cimetidine twice daily for six weeks. In both groups, days of pain, of heartburn, and of nausea per week were significantly reduced during treatment (P less than 0.01). After six weeks, 64% of the pirenzepine group and 62% of the cimetidine group were free of symptoms and endoscopy revealed healing of lesions in 78% and 80%, respectively. Differences between groups were not significant.
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