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Biomedical subjects

R Farini

Publications and source records attributed to R Farini.

At least 37 records · Page 2Linked to original sources

Is mild gastric epithelial dysplasia an indication for follow-up?

We evaluated the changes over 1-55 months in mild gastric epithelial dysplasia (a relatively frequent, but not widely studied histological lesion) in 20 patients (11 with benign gastric ulcer, eight with chronic gastritis, and one after Billroth 2 operation), in order to ascertain whether to follow-up such patients in the future. Regression of the lesion was documented in 13 (65%), and no change in six (30%). Progression from mild to moderate dysplasia occurred in only one patient (5%). As mild dysplasia regresses or remains unchanged in most patients, at least over the short-term, specific follow-up is probably unnecessary. Nevertheless, a rational program of monitoring the associated precancerous conditions is in order.

Adult↗

Urinary ribonuclease excretion in pancreatic disease.

Urinary ribonuclease output and indices of renal tubular integrity were evaluated in control subjects and patients with pancreatic cancer, chronic pancreatitis and extrapancreatic diseases. The aim of the study was to ascertain the contribution to such diagnoses of ribonuclease determination in urine, and the possible influence of tubular damage on the extent of ribonuclease excretion. Information from the ribonuclease assay in urine offered no advantage over that obtained by the same determination in serum; tubular damage may contribution in some cases to an elevated ribonuclease excretion.

Adult↗

Risk of hepatitis B virus infection following upper gastrointestinal endoscopy: a prospective study in an endemic area.

A prospective survey, comprising 623 consecutive upper gastrointestinal endoscopies (in 588 patients) was carried out simultaneously at two endoscopy centres of a Mediterranean country, without altering the routine procedures. Each patient was tested for HBsAg, and sera found to be HBsAg-positive were tested for HBeAg/antiHBe: 40/588 (7.1%) subjects were found to be HBsAg-positive and 6 of them were HBeAg-positive. Sera of the first 5 HBsAg-negative patients in whom the same endoscope and/or biopsy forceps were used after a HBsAg-positive subject, were tested for antiHBc to ascertain antecedent HBV immunity: 77/136 (56.6%) were found to be antiHBc-positive. Forty-eight out of the 59 individuals "at risk" lacking evidence of previous HBV infection were contacted 6 months after endoscopy: none reported symptoms of hepatitis; 40 of them had blood tests for HBsAg and antiHBc: none showed serum markers of HBV infection. It is therefore concluded that, in spite of the high number of HBsAg carriers among endoscopy candidates, the risk of HBV spread during upper G.I. endoscopy is very low, even in high prevalence areas.

Adult↗

Serum ferritin in pancreatic disease. An accurate test of malignancy?

Serum ferritin, described as increased in patients with pancreatic cancer, was studied in 109 subjects by an immunoradiometric technique in order to assess its reliability in detecting pancreatic malignancy. A significant increase of serum ferritin was found in pancreatic cancer as compared to controls (p less than 0.01), to calcifying (p less than 0.05), non-calcifying (p less than 0.05), and recurrent (p less than 0.01) chronic pancreatitis. Nevertheless, high levels of serum ferritin were found in 10 out of the 36 chronic pancreatitis patients and in 10 out of the 26 patients with non-pancreatic diseases, whilst values within the normal range were detected in 6 out of the 22 pancreatic cancer patients. These data suggest that serum ferritin, although frequently increased in pancreatic cancer, cannot be considered a marker of pancreatic malignancy.

Adult↗

Gastric epithelial dysplasia in relapsing and nonrelapsing gastric ulcer.

In 50 patients with benign gastric ulcer (eight relapsing, 42 nonrelapsing) the evolution of the edge and scar histological characteristics was studied with special regard to the pressure and modification of epithelial dysplasia. The patients were endoscopically followed-up; for 1 to 74 months. Dysplasia was present in 29% of observations made in active ulcer and in 19% of patients with scarring gastric ulcer. Severe dysplasia was found only in one case. During follow-up, regression of the dysplastic changes was documented in 64% of the cases, progression from mild to moderate dysplasia in 4%, while no change was recorded in 32%. Appearance of dysplasia or progression from mild to moderate was seen in 62% of the relapsing cases, as opposed to 14% of the nonrelapsing cases (p less than 0.005). Dysplastic changes, usually mild, are relatively frequent in the mucosa both at the edge and scar of gastric ulcer, but they tend to disappear with the healing of the ulcer. Appearance or progression in severity of dysplasia during follow-up are rare, but significantly more frequent in relapsing ulcers, which therefore require more careful follow-up.

Adult↗

Epithelial dysplasia in endoscopic gastric mucosal biopsies.

To define the frequency of gastric epithelial dysplasia (precancerous lesion), 1463 biopsies from 842 endoscopically studied patients were reassessed. Mild dysplasia was found in 19.9% of the cases, moderate in 4.1%, severe in 0.95%. Since the clinical and biological significance of the lesion is still an open question, indications for follow-up are discussed in the light of personal views, together with a critical evaluation of the recently proposed classifications.

Biopsy↗

A comparative evaluation of endoscopic retrograde cholangiopancreatography and the secretin-cholecystokinin test in the diagnosis of chronic pancreatitis: a multicentre study in 124 patients.

A comparative evaluation of ERCP and the bicarbonate output 30 min after stimulation of the pancreas with secretin and cholecystokinin-pancreozymin, was carried out in 124 patients, of whom 65 were affected by proven chronic pancreatitis (PCP), and 59 by only suspected chronic pancreatitis (SCP). In PCP patients the false negative results were 14.7% and 21.5%, respectively. In 5 of the PCP patients with false negatives on ERCP and functional test a normal result of both the procedures was found. ERCP and bicarbonate output were found to be abnormal in 12% and 40%, respectively of 59 patients with SCP. In 30 SCP subjects both procedures gave a normal result, and only in two cases were results abnormal. A correct classification of the SCP patients with pathological bicarbonate secretion and normal ERCP seems quite impossible. The diagnostic usefulness of ERCP results is preeminent but the of carrying out both types of investigation together may give complementary information in the evaluation of pancreatic disorders.

Cholangiopancreatography, Endoscopic Retrograde↗

Role of trypsin/creatinine clearance ratio in the differential diagnosis of chronic pancreatic disease.

Trypsin/creatinine clearance ratio--a recently proposed screening test for pancreatic cancer--was assessed in 45 subjects (17 control subjects, 15 patients with pancreatic cancer, and 13 with chronic pancreatitis). A statistically significant increase of the ratio was detected not only in pancreatic cancer, but also in chronic calcifying pancreatitis. Thus, the previously reported clinical usefulness of the test in pancreatic cancer diagnosis was not substantiated by the present data. Although not fully investigated as yet, reasons for an abnormal ratio are probably independent of the neoplastic or inflammatory nature of the pancreatic disease. Science renal enzyme excretion (alpha-glucosidase, gamma-glutamyltranspeptidase, leucine aminopeptidase) was not found to be invariably elevated when trypsin/creatinine clearance ratio was increased, tubular damage cannot be assumed as constituting the only reason for an altered clearance ratio.

Adult↗

"Plasma"-type ribonuclease in pancreatic cancer diagnosis: a critical appraisal.

The so-called "plasma" ribonuclease (RNase), described as increased in most patients with pancreatic cancer, was studied in the blood of 92 subjects utilizing the method of Reddi and Holland, to evaluate its reliability in detecting pancreatic tumors. A significant increase of "plasma" RNase was found in pancreatic cancer (p less than 0.01) as compared with controls, non-calcifying chronic pancreatitis (p less than 0.01), calcifying chronic pancreatitis (p less than 0.01), and chronic recurrent pancreatitis (p less than 0.01). Nevertheless increased "plasma" RNase activity was also found in 18/43 patients with chronic pancreatitis, as well as in the majority of the non-pancreatic malignant tumors studied. Furthermore, in 2 out of 22 subjects with pancreatic cancer the enzyme activity was found to be normal. These data suggest that increased "plasma" RNase, although very frequent in pancreatic cancer, is not a marker of pancreatic malignancy.

Adult↗

CEA concentration and cytology in duodenal fluid collected during the Secretin-Pancreozymin test. Attempt at an early diagnosis of pancreatic carcinoma by means of simple procedure.

CEA concentration in juice collected during the Secretin-Pancreozymin test, and cytology were evaluated in order to establish whether they may be used as an aid in the diagnosis of pancreatic carcinoma before resorting to x-ray examinations. Thirty-three subjects were studied: 6 normal subjects, 12 with chronic pancreatitis, 3 after recovery from acute pancreatitis, 8 with gall-stones, 3 with carcinoma of the pancreas and 1 with cancer of the biliary tract. Three duodenal juice samples (at 30, 60 and 90 mins of hormonal infusion) were taken in each subject for CEA, cytology, bicarbonate and trypsin determinations. Although a significant statistical difference was noted between normal subjects and patients with carcinoma of the pancreas in the 30-min-juice sample, CEA concentration in the duodenal juice did not seem a reliable index in the diagnosis of pancreatic carcinoma. The information provided by cytology was also very scanty and sometimes misleading. The clinical picture and radiological investigation still remain the surest basis for the diagnosis of pancreatic cancer.

Adult↗

[Incidence of skin changes during active chronic hepatitis and liver cirrhosis. Comparison with normal controls].

The frequency of the principal skin changes held to be typical of chronic diseases of the liver has been evaluated together with the frequency of diseases of primarily dermatological interest in a group of 116 chronic liver patients (73 with cirrhosis, 43 with active chronic hepatitis) and in a group of 90 controls comparable by sex and age. The frequency of skin changes secondary to liver disease was statistically higher in the patients with respect to the control group. The incidence of primarily skin diseases associated with liver disease was, by contrast, extremely rare. The simultaneous presence of spiders, hepatic palms and white nails was observed in 21% of the chronic liver patients, while it was never encountered in the controls. Clinical observation of these changes (particularly the triad mentioned) is therefore highly indicative of chronic liver disease, even without a significant clinical history.

Adult↗

[Value and limitations of exfoliative cytological study of the pancreatico-duodenal juice collected during the secretin and pancreozymin test in the diagnosis of pancreatic carcinoma].

Studies on exfoliative cytology of the pancreatic-duodenal juice in the diagnosis of pancreas neoplasia are not numerous and the data reported are not uniform. The present study examines 176 patients, 18 of them suffering from carcinoma of the pancreas. In these latter patients there were no advanced signs of the disease. Cytology gave a correctly negative result in 46.8% of the normal subjects and in those with non-neoplastic pancreatic or digestive conditions, correctly positive in 66.6% of the pancreas neoplasias, falsely negative in 2,2% of the total series and in 33.3% of the pancreatic cancers, and falsely positive in 1,1% of the series. In 47.7% of cases, the study proved useless owing to the absence of material in the collected juice.

Cholecystokinin↗