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Biomedical subjects

R Naccarato

Publications and source records attributed to R Naccarato.

386 records · Page 22Linked to original sources
PubMedDate not supplied

Incidence of hepatic and extra-hepatic malignancies in primary biliary cirrhosis (PBC).

The aim of this study was to analyze the incidence of malignancies in a large series of PBC patients from Italy. The overall sample included 178 patients (10 M, 168 F). The mean age at presentation was 52 yrs (range 29-74); 17 patients had histological stage I, 52 stage II, 66 stage III, 44 stage IV. The follow-up period ranged from 1 to 16 years (mean 5 years). During the follow-up, extra-hepatic malignancies developed in 6 cases (3.3%), and hepatocellular carcinoma (HCC) in a further 4 patients, all associated with cirrhosis (2.2%). Breast cancer developed only in one patient, resulting in a crude incidence rate of 130/100.000 person years among females. The calculated crude incidence of HCC was 492.4/100.000 person years. Three of the four patients with HCC had a superinfection with HCV. In conclusion, the incidence of breast cancer is not significantly increased. HCC has a relatively high prevalence in PBC and HCV superinfection may play an important role in favouring HCC.

Adult↗
PubMedDate not supplied

Biochemical and histopathological aspects in duodenogastric reflux gastritis patients with or without prior cholecystectomy.

The aim of this study was to evaluate some biochemical and histopathological aspects in a group of patients with a view to identifying any differences depending on whether the pathology was associated with previous cholecystectomy or idiopathic. The study involved 23 patients (8 post-cholecystectomy cases and 15 ulcer-free dyspeptic patients) with the diagnosis of duodenogastric reflux gastritis confirmed by endoscopic histopathological evaluation. The following parameters were considered: 1. pH and bile salt concentration in gastric juice; 2. histological classification of antral biopsies (Niemela's criteria); 3. dyspeptic symptoms (dyspepsia, pyrosis and epigastric pain, sense of repletion, foul-tasting mouth) graded on a scale from 0 to 4. All parameters were considered in relation to whether or not Helicobacter Pylori was found in the histological specimens. No significant differences were found between the two groups for pH and bile salt values or for Helicobacter Pylori positivity. No relationship was observed between the Helicobacter Pylori and either the severity of the histological picture, the features of the biochemical parameters or the severity of the clinical symptoms. Such findings confirm the common pathophysiological pattern of reflux gastritis regardless of any permanent biliary tract alterations and the low importance of Helicobacter Pylori infection in determining this syndrome.

Adult↗
PubMedDate not supplied

Gastric involvement in primary Sjögren's syndrome.

Gastric involvement was investigated in twenty Italian patients with primary Sjögren's syndrome (pSS). Gastric complaints were present in 11 cases (55%) and endoscopic abnormalities in 10 (50%) including 2 cases with active duodenal ulcer. Only two patients (10%) showed moderate chronic atrophic gastritis (AG), while most (85%) had superficial gastritis (SG). No correlations were found among endoscopy, histology and gastric symptoms. Mean serum group I pepsinogen (PG I) levels were significantly higher (p < 0.01) and PG I concentrations in the fundus of the stomach were significantly lower (p < 0.05) in pSS patients than in a matched control group of dyspeptic subjects. Serum and antral gastrin levels were elevated in 3 cases with pSS (15%) including the two with AG, although the mean levels were not different from the controls. Antibodies to gastric parietal cells (PCA) were detected in two cases (10%) including 1 with AG. The present study contradicts previous reports claiming that AG with hypopepsinogenemia is a prominent feature in Sjögren's syndrome. We suggest that, at least in Italian patients, pSS is often associated with SG and high PG I levels.

Adult↗
PubMedDate not supplied

Quality of life in inflammatory bowel disease.

The usual indices of activity of Inflammatory Bowel Disease fail to evaluate an important aspect of patients' status, their Quality of Life (QOL). A questionnaire dealing with four important aspects of QOL (intestinal and systemic symptoms, emotional and social function) was developed and validated. The questionnaire was administered to 72 healthy controls, 57 patients with Ulcerative Colitis and 55 with Crohn's Disease with different disease severity. Compared to controls, QOL was impaired not only in the more severe forms of disease, but also in patients in remission. In Crohn's Disease, QOL was not closely correlated with the clinical features, thus indicating that the impairment of QOL cannot be inferred from the clinical status and that patients do not "adapt" with the passing of time. The questionnaire allows a more comprehensive definition of the patients' state of health, identifying features which might be underestimated as they fail to emerge from the routine clinical evaluation. A tool of this kind could be used alongside the activity index of disease, both in clinical studies and during routine follow-up.

Adaptation, Psychological↗
PubMedDate not supplied

Levosulpiride in functional dyspepsia: a multicentric, double-blind, controlled trial.

Abnormalities in gastrointestinal motility have been reported in a substantial proportion of patients with functional dyspepsia, supporting the use of prokinetic drugs for treatment of dyspeptic symptoms. To evaluate efficacy and safety of levosulpiride in short-term treatment, 1298 patients were enrolled in a double-blind multicentric study carried out in 45 Italian Gastroenterology Departments. Patients were randomly assigned to either levosulpiride (25 mg tid), domperidone (10 mg tid), metoclopramide (10 mg tid) or placebo (1 tablet tid) for 4 weeks. Patients were selected on the basis of: a) occurrence in the last 4 weeks of at least 5/10 selected symptoms (anorexia, nausea, vomiting, upper abdominal pain, postprandial bloating, abdominal fullness, early satiety, belching, heartburn, regurgitation), severity of which should reach/exceed a total score of 8, as assessed by a specific scale ranging from 0 (absent) to 3 (severe); b) normal results of routine biochemical, ultrasound and endoscopic examinations. In addition, each patient subjectively evaluated efficacy of treatment by a visual analogue scale. Significant improvement was recorded for all symptoms at days 10 and 28 in all groups (p < 0.001), but levosulpiride was significantly (p < 0.01) superior to domperidone, metoclopramide and placebo both in the overall clinical improvement scale as well as in a subgroup of symptoms (postprandial bloating, epigastric pain, heartburn). Active treatments and placebo were comparable as far as concerns occurrence of side-effects (12-20%) including galactorrhoea, breast tenderness and menstrual changes.

Adolescent↗
PubMedDate not supplied

Liver transplantation in Italy: preliminary 10-year report. The Monotematica Aisf-Olt Study Group.

Experience in liver transplantation (OLT) in Italy over a ten-year period is reported. Data were obtained using a multiple-items form collected from Italian liver transplant centres (reference centres) and other Italian institutions actively involved both in the processes of evaluation of the candidates and the follow-up of liver transplant recipients (afference centres). During this period, a total of 1046 liver transplants were performed on 954 patients, with a cumulative proportional survival of 71%. The most common indication for liver transplantation was post-hepatitic cirrhosis due to either hepatitis B virus (+/-hepatitis Delta virus) or hepatitis C virus infection. Good survival rates were observed, particularly in controversial indications, such as alcoholic cirrhosis, post-hepatitic hepatitis B virus-related cirrhosis and hepatocellular carcinoma, most likely due to proper and careful selection of the patients. Cirrhosis, secondary to an autoimmunity-based liver disease, showed the highest rate of rejection episodes. Infections, in our study population, were the most common cause of death after transplantation.

Adolescent↗