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Biomedical subjects

R Naccarato

Publications and source records attributed to R Naccarato.

At least 217 records · Page 12Linked to original sources

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↗

Detection of two forms of HBeAg (free-and IgG-bound HBeAg) in patients with HBe antigenemia using staphylococcus bearing protein A.

Protein A-bearing Staphylococcus aureus organisms (STA) were used to separate free HBeAg from IgG-bound HBeAg. Free HBeAg was detected in the supernate while IgG-bound HBeAg could be liberated from the pellets using MgCl2 or a glycine buffer. HBeAg was determined by radioimmunoassay and the results expressed as patient's cpm/normal control's cpm ratio (S/N ratio). This ratio was demonstrated to be proportionate to the antigen concentration and used as a titer of HBeAg. Sera of 40 HBsAg-negative healthy volunteers and 82 HBeAg-positive patients who were either asymptomatic HBsAg carriers or had various diseases including chronic persistent hepatitis (CPH), chronic active hepatitis (CAH), and renal disease undergoing hemodialysis, were tested for free HBeAg and IgG-bound HBeAg. Patients with CAH from two different countries were compared. Free HBeAg was detected in all patients but one, IgG-bound HBeAg was detected with similar prevalences (from 56% to 67%) in HBsAg asymptomatic carriers, hemodialysis patients, CPH and Italian CAH patients. In contrast, all CAH patients from New York, who had frequently been exposed to HBV infection, had detectable levels of IgG-bound HBeAg, with the highest S/N ratios observed in the study, and frequently showed an unfavorable outcome. In AVH due to HBV and delta agent co-infection, IgG-bound HBeAg was detected in two of four patients only in the initial stage of the disease. The data reported indicate that a separate determination of free- and IgG-bound HBeAg may have clinical value.

Adolescent↗

Monitoring liver regeneration after right hepatectomy.

Factor VII coagulant, prothrombine time, fibrinogen, prealbumin and a fetoprotein have been evaluated in a patient operated on for right hepatectomy, in order to identify the best markers in prognosing liver regeneration. Factor VII and prothrombine time progressively increased, starting from the 5th-7th day, entering normal range by the 10th and demonstrated a good correlation with both liver scintiscan and ultrasonography. Prealbumin and fibrinogen did not provide any useful information and a fetoprotein levels progressively decreased, demonstrating the complete removal of the neoplastic tissue. Factor VII and prothrombine time seem therefore to be the most reliable markers, among those investigated in this study, of liver regeneration after partial hepatectomy.

Carcinoma, Hepatocellular↗

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↗

Study of retinol-binding protein in pancreatic cancer.

Serum RBP, prealbumin, and zinc were evaluated in normal subjects and patients with pancreatic cancer and chronic pancreatitis. A significant decrease of RPB was found in pancreatic cancer patients compared with controls. A concomitant reduction of prealbumin and zinc was also observed. Multiple regression analysis suggested that the modification of RBP serum levels might be accounted for mainly by diminished prealbumin levels, while the direct role of zinc is negligible.

Adult↗

Gastric emptying and anxiety in chronic duodenal ulcer.

The authors have evaluated in a group of patients afflicted with duodenal ulcer whether anxiety might be in some way linked to gastric emptying. The 23 patients studied were subdivided into two groups: "fast" emptiers (n = 12; t 1/2 less than 90 min) and "normal" emptiers (n = 11; t 1/2 greater than 90 min). There were no significant differences between the two groups for the following parameters: sex, age, marital status, educational level, social class, number of cigarettes smoked per day, type of treatment undergone for the duodenal ulcer and maximal acid output. Anxiety levels measured with the Q4 and QII factors of the Cattell's PF 16 were found to be the same in the two groups. The authors conclude that anxiety does not seem to be linked to gastric emptying in chronic duodenal ulcer.

Adult↗

Combined evaluation of serum ribonuclease and ferritin: any advantages in pancreatic cancer diagnosis?

In 116 subjects, serum ribonuclease (RNase) and ferritin were determined in order to evaluate whether their combined evaluation might improve the diagnostic accuracy of each test. Significantly higher levels were found in pancreatic cancer patients both for RNase and ferritin than in control subjects and chronic pancreatitis. Sensitivity and specificity in diagnosing pancreatic cancer were 86% and 46%, respectively for RNase; 76% and 65% for ferritin. One of the two tests was pathological in 100% of pancreatic cancer, with a specificity of 29.9%; both were pathological in 62.1%, with a specificity of 82.1%. The results emphasize the limits of the combined assessment of pancreatic cancer markers.

Adult↗

Recurrence of duodenal ulcer under continuous antisecretory treatment: an approach to the detection of predictive markers.

Seventy consecutive duodenal ulcer patients endoscopically followed up and treated after ulcer scarring with maintenance dosages of effective antisecretory drugs for 1 year were studied in order to identify the factors associated with ulcer relapse. Logrank test, discriminant analysis (Rao's method), and chi 2 were used in evaluating the results. Nineteen patients (27.1%) relapsed. Duodenal ulcer was found to relapse more frequently in patients with total serum pepsinogen more than 109 micrograms tyr X ml-1 X 24 h-1 and in patients with maximal acid output more than 60 mmol/h (Logrank test; both p less than 0.025). Discriminant analysis showed that blood group, age at onset of the disease, and sex were together useful in recognizing subjects relapsing within 6 months' maintenance treatment (77.1% cases correctly classified); age at onset of the disease, alcohol intake, and smoking habit were together useful in picking out subjects relapsing throughout the entire observation period (1 year) (61.76% cases correctly classified). Our data suggest that: 1) duodenal ulcer subjects with elevated serum pepsinogen or maximal acid output are significantly more prone to relapse than patients with normal or slightly increased values; 2) genetic and acquired factors (such as blood group A, early onset of the disease, male sex, alcohol intake, and cigarette consumption) may have a role in influencing ulcer relapse.

Adolescent↗

Personality and psychological factors in chronic duodenal ulcer. Their interaction with biological parameters.

Forty patients with chronic duodenal ulcer were studied to determine whether some particular personality and psychological factors are associated with this disease. To this purpose the Cattell's PF 16 personality Test was utilized. Duodenal ulcer population presented a typical personality profile characterized by: high anxiety, dependence and introversion. Some biological parameters, suggested as predictors of slow healing and/or relapse of ulcer, were studied: patients with maximal acid output greater than 60 mEq/h and /or total serum pepsinogen greater than 109 micrograms tyr/ml/24 hrs and/or serum pepsinogen group I greater than 99 ng/ml showed an anxiety level significantly higher than that of patients with values less than the reported thresholds. These results suggest a contributory role by psychological factors in duodenal ulcer disease. The association of anxiolitic drugs to the traditional antiulcer therapy may be proposed, particularly in hypersecretors.

Adaptation, Psychological↗

The risk of hepatitis A virus infection for hospital staff.

The prevalence of antiHA was assessed in 594 hospital employees and in control groups comprising 932 "healthy" adults not working in the hospital, selected from different socioeconomic classes. Age specific antiHA prevalence which was lower in doctors than in nurses and ancillary staff, was also found to be lower in each group than in the respective controls, matched according to socioeconomic criteria. It is concluded that in our population (i.e. high risk area) the hospital environment does not involve an increased risk of HAV infection for personnel. However, precautions should be taken when working in high risk department, as this study demonstrated that a considerable proportion of health care workers (above all doctors) are still susceptible to Hepatitis A virus infection.

Hepatitis A↗

Gastric epithelial dysplasia and sulphomucin-type intestinal metaplasia.

The HID-AB histologic staining technique, which distinguishes sulphomucin from sialomucin types of intestinal metaplasia, was employed in endoscopic gastric mucosal biopsies to evaluate their frequency of association with epithelial dysplasia. Sulphomucin-type intestinal metaplasia was found in 33% of the cases under observation; moderate or severe dysplasia was only associated with this type of intestinal metaplasia. Its precancerous significance can be ascertained only by means of prospective studies.

Adult↗

[Immunologic changes in chronic pancreatitis].

In 35 patients with chronic pancreatitis, C3, C4, s-immunoglobulins, circulating immunocomplexes and T-lymphocytes were assessed in order to verify whether an immunological role may be postulated in the pathogenesis and/or in the maintenance of the disease. A significant increase of serum IgM together with normal values of C3 and C4 and without circulating immunocomplexes was found. A significant decrease in the total number of lymphocytes as well as in the number and percentage of T-lymphocytes was also documented. These results suggest a possible involvement of immunological (humoral and cellular) processes in maintaining the chronic pancreatic damage.

Adult↗

[Benign and malignant gastric ulcers: is their localization relevant in their differential diagnosis?].

A study of potentially benign or malignant ulcer in the stomach was made to assess its role in the differential diagnosis between these two conditions. In the 201 patients observed, no statistically significant differences in frequency in the various sites were noted as regard either benign or malignant lesions. The site of the ulcer cannot be taken as indicative of its nature.

Adolescent↗

Hepatitis A and hepatitis B virus infection in children and adolescents in north-east Italy.

The sera of 722 children and adolescents without overt liver disease were tested for hepatitis B surface antigen (HBsAg), antiHBs and anti-hepatitis B core anti-HBc; 658 of the sera were also tested for anti-hepatitis A virus anti-HAV. Except for the "passive" antibody peak observed in babies, the anti-HAV age-specific prevalence was negligible until the age of 3; it then increased, reaching 35% by the age of 15. Serological evidence of HBV was present in 16% of the subjects: this prevalence was almost constant at all ages. The HBsAg carrier rate was highest in children under 5 years of age (7.6%) and decreased with age. However, only one HBsAg carrier was under 1 year of age. Anti-HBs age-specific prevalence increased progressively from 2.7% to 11.4%. Anti-HBc alone was present in 4.1% of the subjects. No significant sex differences were found in the prevalence of HBV serum markers or in the HBsAg carrier rate. Neither HAV nor HBV infection was significantly influenced by place of residence or socioeconomic status. It is concluded that in this area both HAV and HBV are endemic, but while HAV is mainly acquired at school, most of the HBV infections occur within the household. The results suggest that not only perinatal transmission, but also intrafamilial horizontal infection, plays a role in HBV spread among infants.

Adolescent↗

Evaluation of a structured alcohol education course in a secondary school system in north Italy.

The authors describe the results of an alcohol education course given to 2166 high school students in the area of Padua, Italy. An evaluation was performed, utilizing a before and after technique: it was shown that baseline knowledge of relevant information on alcohology was similar among younger and older teenagers; also, baseline information and course gain varied according to question content.

Adolescent↗

Occurrence of an atypical alkaline phosphatase fraction ("biliary") in primary liver cancer.

The appearance and clinical significance of an atypical fraction of serum alkaline phosphatase called "biliary" have been evaluated in patients with primary liver cancer (PLC) and control subjects. The "biliary" fraction was present in all 42 PLC patients and proved to be the most sensitive of the biochemical parameters utilized. The association with alpha-fetoprotein determination allowed us to identify patients affected by hepatic pathology of neoplastic type, with a diagnostic efficiency of 92%.

Aged↗