Search PubMed⌕ Search

Biomedical subjects

P Vannini

Publications and source records attributed to P Vannini.

At least 19 recordsLinked to original sources
PubMed1998

The role of serum and gastric juice levels of carcinoembryonic antigen, CA19.9 and CA72.4 in patients with gastric cancer.

PURPOSE: The aim of the present study was to investigate carcinoembryonic antigen (CEA), CA19.9, and CA72.4 in the serum and gastric juice of patients with gastric cancer. METHODS: Serum and gastric juice tumor markers CEA, CA19.9, and CA72.4 were measured in 59 patients who had gastric adenocarcinomas and were undergoing curative gastrectomy. The same markers were measured in 47 patients with benign gastric disorders and in 40 healthy subjects. The correlation between the serum and gastric juice levels of tumor markers and several clinicopathological factors were evaluated by univariate analysis. The significance of the tumor markers as prognostic factors was assessed both by univariate and multivariate analysis. RESULTS: The positivity rates of serum CEA, CA19.9, and CA72.4 were 57.6%, 38.9%, and 18.6% respectively. The positivity rates of gastric juice CEA, CA19.9, and CA72.4 were 62.7%, 30.5%, and 23.7% respectively. The combination of serum and gastric juice markers gave a positivity of 81.3%. There was no correlation between serum and gastric juice level of each tumor marker. Positivity of gastric juice markers did not correlate with prognosis. A significant difference in prognosis was observed between patients positive and negative for serum CEA and CA19.9. Multivariate analysis also revealed that serum CEA and CA19.9 levels were independent prognostic factors. CONCLUSIONS: Levels of both serum and gastric juice tumor markers continue to have only limited diagnostic usefulness in gastric cancer patients. CEA and CA19.9 in the preoperative sera are good prognostic factors, whereas the presence of tumor markers in the gastric juice does not play any prognostic role.

Adenocarcinoma↗
PubMed1997

Urinary excretion of ethylenethiourea in five volunteers on a controlled diet (multicentric study).

Urinary excretion of ethylenethiourea (ETU) was monitored for 8 days in a group of five male non-smoker volunteers on a diet, the items of which were assayed for ETU and carbon sulphide. Urinary excretion of ETU reflected the consumption of wine, fruit and vegetables. Urinary ETU concentrations ranged from 0.6 to 6.7 micrograms/g creatinine. ETU concentrations in the food eaten by the volunteers were generally below the detection limit whereas in wine 8.8 micrograms/l ETU was detected. Evolution of carbon sulphide by food samples ranged from 0.03 to 0.17 mg/kg. Mean (+/- S.D.) daily intake of ETU in wine was 3.5 +/- 0.2% of the acceptable daily intake (ADI): 0.070 +/- 0.004 micrograms/kg body wt. During the 8 days of the study, an average of 48.3% of the ETU ingested in wine was excreted unmodified by the kidneys. Twenty-four hour urinary excretion of ETU was significantly correlated with daily intake of ETU (r = 0.768) and CS2 evolved by the daily food items (r = 0.414).

Adult↗
PubMed1996

Reference values of urinary ethylenethiourea in four regions of Italy (multicentric study).

The results of a study in which urinary ethylenethiourea (ETU) was assayed in the general population (167 subjects) of four Regions of Italy (Veneto, Lombardy, Piedmont and Trentino Alto Adige) are reported. The results are compared with those in a population of 97 subjects from Rovescala, a hillside wine-producing town a few kilometers from Pavia, where ethylenebisdithiocarbamates are sprayed by helicopter. It was found that an average of 24% of the populations of the four regions, taken together, had urinary ETU levels above detection limits (1.0 microgram 1(-1)) as compared to 37% of the population of Rovescala. The ranges of concentration were 0.8-8.3 micrograms 1(-1) for the four regions and 0.9-61.4 micrograms 1(-1) for Rovescala. Statistically significant variables for urinary ETU levels were smoking and wine drinking.

Adolescent↗
PubMed1994

Enhanced pressor responsiveness to norepinephrine in type II diabetes. Effect of ACE inhibition.

OBJECTIVE: To evaluate the effect of angiotensin-converting enzyme (ACE) inhibition on the pressor responsiveness to norepinephrine in type II diabetes. RESEARCH DESIGN AND METHODS: Eight normotensive subjects, eight mild-to-moderate hypertensive type II diabetic patients, and eight nondiabetic patients with essential hypertension were studied before and after 4 weeks of being administered enalapril. The pressor response to norepinephrine was assessed by infusing the hormone in an antecubital vein at incremental doses of 30 ng.kg-1.min-1 for periods of 5 min until reaching an increase of 20 +/- 2 mmHg in mean arterial pressure (MAP) measured by an automatic device at 1-min intervals. An effective dosage of norepinephrine that increased MAP by 20 mmHg (EDNE 20) was thereafter calculated. Before and during the last minute of norepinephrine infusion at maximum dosage, a venous blood sample was drawn to determine plasma renin activity (PRA), aldosterone, and norepinephrine levels. RESULTS: In the three groups of patients, blood pressure and aldosterone were reduced while PRA was raised following ACE inhibition. Basal and maximum postinfusion levels of norepinephrine were not modified by enalapril. The EDNE 20 was basally lower in diabetic patients and remained unchanged after ACE inhibition, contrary to that observed in nondiabetic patients with essential hypertension. CONCLUSIONS: Both normotensive and hypertensive type II diabetic patients have an increased pressor responsiveness to norepinephrine that is not modified by therapeutic doses of enalapril, contrary to what is observed in nondiabetic patients with essential hypertension.

Adult↗
PubMed1994

[Pregnancy and diabetes: physiopathological aspects].

UNLABELLED: During a pregnancy metabolic and hormonal modifications aimed at survival and fetal growth were observed, many of which regard glucose metabolism and insulin secretion. During pregnancy insulinemia progressively rises while insulin action at hepatic level falls with a consequent development of insulin resistance. This condition, connected mainly to contra-insular activity of pregnancy hormones, may cause, in susceptible pregnant women, an impaired glucose tolerance or gestational diabetes or may cause, in diabetic women, a worsening of metabolic control. At same time diabetes may negatively influence the embryo , fetus and perinatal events. The nutrients, used by the fetus mainly as a source of energy, through the placenta or directly by means of a mechanism of "facilitated transport" (glucose), or by means of a system of "active transport" requiring energy (amino acids). In particular, maternal hyperglycemia constantly determines a fetal hyperglycemia which is corrected by increasing insulin secretion with a consequent fetal hyperinsulinism. Modified concentration of fetal nutrients and hyperglycemia in particular, are through responsible, in diabetes, for the embryo-fetal pathology of which the man features are malformation, hypertropic cardiomyopathy, placental insufficiency, pre-eclampsia, macrosomia, fetal intrauterine death, delay in fetal lung maturity, hypoglycemia, and neonatal hypocalcemia. IN CONCLUSION: strict metabolic control of pre-pregnancy diabetes already at conception and the treatment of gestational diabetes are the best way to protect fetal-maternal health in diabetic pregnancy.

Blood Glucose↗
PubMed1993

Epidemiology of the dermatophytoses in the Florence area of Italy: 1985-1990. Trichophyton mentagrophytes, Epidermophyton floccosum and Microsporum gypseum infections.

Between 1985 and 1990 we observed 2085 cases of dermatophytoses in the Florence area of Italy. Trichophyton rubrum and Microsporum canis were the major etiological agents. 126 cases of dermatophytoses observed during this period were caused by Trichophyton mentagrophytes. Most of the patients came from rural areas or they kept pets. Epidermophyton floccosum ranked fourth in frequency (95 cases). The patients were adults and mainly males, most of whom engaged in sports or lived in group environments. Microsporum gypseum was isolated in 31 cases. Infections occurred directly from contact with soil or domestic animals. We report the principal clinical data concerning these last three dermatophyte infections.

Adult↗
PubMed1993

[Yellow, but healthy. Report of 4 cases of diet-induced carotenosis].

Four women who had been following a "healthy" diet based on carrots and citrus fruits for some time presented with yellow-tinged skin. All four patients had high carotene levels in the blood, and three were also found to have slightly increased vitamin A levels. The other laboratory test results were normal. They were prescribed diets that did not contain carotene-rich foods, and both skin colour and laboratory tests returned to normal.

Adult↗
PubMed1992

Low-dose angiotensin converting enzyme inhibitors: effect on renal function in normo- and hypertensive type 1 diabetic patients.

OBJECTIVES: To investigate the effect of low doses of the angiotensin converting enzyme inhibitor enalapril on renal haemodynamics and albuminuria in normotensive and hypertensive type 1 (insulin-dependent) diabetic patients with incipient or overt nephropathy. METHODS: Twenty-two type 1 (insulin-dependent) diabetic patients with persistent microalbuminuria or macroalbuminuria and normal serum creatinine were studied. Of all patients, 16 males and 6 females, age 45 +/- 13 years, diabetes duration 19 +/- 11 years, insulin dose 38 +/- 11 U/day, 10 were normotensive and 12 were hypertensive. After 3 months of run-in period the patients were assigned to treatment with 5 mg or 10 mg enalapril based on the presence of normotension or hypertension respectively. Before and after 6 months of treatment, renal function was assessed by evaluation of glomerular filtration rate (99m Tc-DTPA), renal plasma flow (131-I iodohippurate), filtration fraction and renal vascular resistance. Mean arterial pressure, albumin excretion rate, urinary urea excretion and glycated haemoglobin were also determined. RESULTS: Administration of enalapril resulted in both groups of patients in a significant fall in mean arterial pressure, albumin excretion rate, glomerular filtration rate, filtration fraction, and renal vascular resistance. Decreasing albumin excretion did not correlate with a drop in systemic blood pressure or filtration fraction. No significant variations were observed in renal plasma flow, in urinary urea excretion or in glycated haemoglobin. CONCLUSIONS: Our results suggest that low doses of enalapril are effective in influencing renal haemodynamics and reducing urinary albumin excretion in both normotensive and hypertensive type 1 (insulin-dependent) diabetic patients with incipient or overt nephropathy. The lowering effect of the angiotensin converting enzyme inhibitor on albuminuria seems to be independent of the action on systemic blood pressure and renal haemodynamic changes.

Adult↗
PubMed1992

ACE inhibition in diabetic patients: effect on pressor responsiveness to noradrenaline.

The pressor responsiveness to noradrenaline was assessed before and after four weeks of treatment with enalapril (20 mg/day) in eight mild-to-moderate essential hypertensives, in eight normotensive type II diabetics and in eight mild-to-moderate hypertensive type II diabetic patients. The ACE inhibitor interfered to the same extent with the renin-angiotensin system and did not alter noradrenaline kinetics in the three groups of patients, but significantly reduced the arterial responsiveness only in non-diabetic subjects. It is suggested that factors, such as an exaggerated sodium retention, might determine the lack of effect of enalapril in diabetic patients.

Adult↗
PubMed1991

The effect of ace inhibition on peripheral hemodynamics in normotensive and hypertensive patients with type II diabetes.

The effect of treatment with enalapril (10 days at 10 mg/d followed by 4 weeks at 20 mg/d) on forearm hemodynamics was assessed in eight normotensive patients and eight patients with hypertension affected by Type II diabetes as well as in eight patients with essential hypertension and normal glucose tolerance. The ACE inhibitor decreased regional vascular resistances and increased the maximum arteriolar-vasodilating capacity and venous distensibility in the three groups of patients. Thus, this study shows that ACE inhibition by enalapril improves regional hemodynamics in patients with Type II diabetes.

Adult↗
PubMed1991

Intra-arterial urokinase infusion in diabetic patients with rapidly progressive ischemic foot lesions.

OBJECTIVE: The effectiveness of local intra-arterial thrombolysis by urokinase was evaluated in eight non-insulin-dependent diabetic patients with angiographic evidence of infrapopliteal occlusive disease and rapidly progressive foot lesions. RESEARCH DESIGN AND METHODS: With an electric peristaltic pump, urokinase was infused for 96 h by a 5-6 F catheter introduced into the femoral artery and placed immediately above the occluded infrapopliteal arteries. After baseline, angiography was repeated at 24- to 48-h intervals and at conclusion of the treatment. RESULTS: Six patients showed immediate improvement of clinical symptoms. Angiography revealed the reestablishment of blood flow in collateral vessels of the leg and foot in the dorsal pedal artery in three patients and in the plantar arch in two. Recanalization of the major arteries of the trifurcation was not achieved. After 12 mo of follow-up, all limbs were salvaged, although four patients required vascular reconstruction to further improve foot perfusion and complete healing. CONCLUSIONS: Intra-arterial urokinase, which opens collateral and smaller vessels of the leg and foot in patients with diabetes, may be effective in improving blood flow in lower extremities and in making the patient a better candidate for vascular surgery.

Aged↗
PubMed1989

A screening test for microalbuminuria in type 1 (insulin-dependent) diabetes.

In this study we evaluated the acceptability of using the first morning urine albumin concentration (FMAC) and the first morning urine albumin/creatinine (FMA/C) ratio as an indirect estimation of timed albumin excretion in order to screen for microalbuminuria in a large diabetic population. Urinary albumin excretion rate (AER) was determined in samples from 4-h urine collection in 99 type 1 diabetic patients aged 30 +/- 10 years with a mean duration of diabetes of 15 +/- 8 years. The results of timed albumin excretion were successively compared with single-void first morning samples. On the basis of AER, 46 patients were normoalbuminuric (AER less than 20 micrograms/min), 28 microalbuminuric (AER 20-200 micrograms/min), and 25 proteinuric (AER greater than 200 micrograms/min). The relationship of 4-h AER to FMAC and FMA/C ratio was highly significant (r = 0.96 and r = 0.98 respectively). High sensitivity and specificity were found when cut-offs of 20 micrograms/ml and 2.5 mg/mmol were selected for albumin concentration and albumin/creatinine ratio respectively to discriminate between normal and elevated albuminuria. It is concluded that the measurements of albumin concentration and albumin/creatinine ratio in first morning urine samples are highly representative of 4-h timed albumin excretion. Because of their sensitivity, specificity and simplicity to perform, the tests proposed might be used in routine diabetic care and as a screening test for microalbuminuria in type 1 (insulin-dependent) diabetic patients. The not negligible day-to-day variability in albumin excretion confirms the need of several measurements to establish the presence of abnormal levels of albuminuria above all in patients with borderline values and/or clinically unstable metabolic control.

Adult↗
PubMed1989

Hyperglycemic effect of sucrose ingestion in IDDM patients controlled by artificial pancreas.

The hyperglycemic effect of 28 g sucrose, taken during a mixed meal, was studied in six insulin-dependent diabetes mellitus (IDDM) patients controlled by artificial pancreas. On 2 consecutive days the patients were given, in random order, two Italian meals containing macaroni, bread, meat, vegetables, fruit, olive oil, and an eggnog made with sucrose (meal A) or saccharin (meal B). The two meals were isocaloric and contained equal amounts of carbohydrates. The feedback control on blood glucose continued for 180 min after the meals. Plasma glucose levels and insulin infusion rates delivered by the artificial pancreas after the two test meals did not show any significant differences regarding basal and peak values, peak times, and areas under the curves. A modest amount of sucrose, taken during a mixed meal, does not produce a hyperglycemic effect higher than an equal amount of complex carbohydrates in IDDM patients controlled by artificial pancreas. The same may be expected in well-controlled IDDM patients in conventional therapy because a correlation exists between insulin requirement for conventional therapy and insulin delivered during glucose-controlled insulin infusion.

Adult↗
PubMed1989

Oesophageal transit time and cardiovascular autonomic neuropathy in type 1 (insulin-dependent) diabetes mellitus.

Oesophageal computerized dynamic scintigraphy with 99 mTc was used to evaluate oesophageal motility in type 1 (insulin-dependent) diabetic patients without upper gastrointestinal symptoms. Twenty-nine patients, 10 women and 19 men, mean age 38 +/- 12 yr (range 17-55), mean duration of diabetes 15 +/- 8 yr (range 3-30) and 15 controls were studied. Background or proliferative retinopathy was found in 72.4% of patients, incipient or clinical nephropathy in 48.3% and peripheral neuropathy in 62% of them. In all, oesophagitis and/or other disorders of the upper gastrointestinal tract were excluded by barium studies and endoscopy. Oesophagus scintigraphy with 99 mTc sulphur colloid was performed in each subject after fasting for at least 3 hr in the supine position and repeated after few minutes to assess its reproductivity. The rate of passage of the fluid bolus through oesophagus was analyzed by computer and oesophageal transit time (OTT) for the whole oesophagus was measured by time-activity curves. All diabetic patients were screened for autonomic cardiovascular function by standard tests and, on the base of results, assigned to cardiovascular autonomic neuropathy positive (CVAN-positive) or to cardiovascular autonomic neuropathy negative (CVAN-negative) group. Abnormal oesophageal motility (OTT less than 14 sec as mean +/- 2 SD of controls) was found in 68.7% of CVAN-positive and in 15.4% of CVAN-negative patients (p less than 0.05). CVAN-positive patients resulted older and had significantly longer duration of diabetes than other patients. Furthermore, they showed higher frequency of severe retinopathy, nephropathy, peripheral neuropathy and prolonged OTT compared with CVAN-negative patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Insulin resistance is the main determinant of impaired glucose tolerance in patients with liver cirrhosis.

To clarify the pathogenesis of impaired glucose tolerance in patients with cirrhosis, several factors possibly affecting carbohydrate metabolism were studied in 12 cirrhotic patients with different blood glucose responses to an oral glucose tolerance test. Glucose levels, 120 min after the load, were inversely and significantly related to insulin sensitivity, measured by means of the euglycemic "glucose clamp" technique (r = -0.746). Basal and glucose-induced insulin secretion (insulin and C-peptide levels) only slightly correlated with glucose tolerance, which was not related to functional liver cell mass (galactose elimination), portal-systemic shunting (degree of varices at endoscopy), or maximal glucose-independent insulin secretion (peak C-peptide levels after a glucagon test). Multiple regression analysis identified insulin sensitivity and liver cell mass as the independent variables able to explain most of the variance of 120-min blood glucose (about 84%), and both of them contributed considerably to the regression. While reduced insulin sensitivity is probably the main cause of impaired glucose tolerance, the reduced hepatocellular mass only appears to modulate the degree, and therefore the clinical relevance, of this defect.

Adult↗