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Biomedical subjects

R Pezzilli

Publications and source records attributed to R Pezzilli.

At least 109 records · Page 6Linked to original sources
PubMed1986

A rapid assay for serum immunoreactive lipase as a screening test for acute pancreatitis.

In 134 consecutive patients with acute abdominal pain, we evaluated the clinical role of a new rapid test for serum lipase based on latex agglutination. The results were compared with those obtained with a widely used lipase immunoassay as well as with serum amylase and pancreatic isoamylase measurements. Fifty-five healthy subjects were studied as controls. In 174 cases (121 patients and 53 controls) the results of the two lipase assays were in agreement. A positive lipase latex test was found in 10 of 12 patients with acute pancreatitis, in eight of 24 patients with other pancreatic diseases, and in 14 of 98 with nonpancreatic diseases. The sensitivity and specificity of this test were similar to those of the other pancreatic enzyme assays performed. The results indicate that the lipase latex agglutination test is useful for emergency screening for acute pancreatitis in patients with acute abdominal pain.

Acute Disease↗
PubMed1986

Aging and exocrine pancreatic function.

In view of the limited information concerning the influence of aging on exocrine pancreatic function, the authors undertook the present study. To examine a large number of elderly persons, including people of very advanced age (80 years and over), pancreatic function was studied by using the fluorescein dilaurate test (pancreolauryl test), one of the most recent tubeless, noninvasive pancreatic function tests. Sixty healthy noninstitutionalized elderly individuals (35 women and 25 men, aged 66 to 88 years, mean 78) participated in the study. Thirty-six healthy younger subjects (16 women and 20 men, aged 21 to 57 years, mean 36) were also studied as controls. All elderly subjects showed a strictly normal fluorescein dilaurate test. No significant differences in the pancreatic function test results were observed between the elderly under 80 years old and those over 80 years old. The authors conclude that the aging process per se does not significantly affect exocrine pancreatic function and, more particularly, does not impair the digestive capacity of the elderly person.

Adult↗
PubMed1985

Inhibition of pancreatic exocrine secretion and bile entry into the duodenum by isometheptene, a sympathomimetic agent.

We have studied the effect of isometheptene, an indirectly acting sympathomimetic with analgesic and antispastic properties, on secretin-cholecystokinin-stimulated pancreatic and biliary outputs. Isometheptene, infused intravenously at a dose of 100 mg in 30 min, significantly inhibited bicarbonate, enzyme, and bilirubin output in eight healthy subjects (compared to control values, the maximum percent inhibition was 34% for bicarbonate, 57% for lipase, 61% for chymotrypsin, and 86% for bilirubin). In four cholecystectomized subjects, the drug inhibited only pancreatic outputs. The inhibitory effect on pancreatic secretion, coupled with the analgesic action, suggest a potential benefit of this drug in acute pancreatic pathology.

Adult↗
PubMedDate not supplied

Multicentre comparative study of two schedules of gabexate mesilate in the treatment of acute pancreatitis. Italian Acute Pancreatitis Study Group.

AIM: To compare the efficacy of two different schedules of gabexate mesilate (900 mg/day, or 1,500 mg/day) in the treatment of severe acute pancreatitis. SETTING: Forty-two Italian medical and surgical centres took part in the study. STUDY DESIGN: A multicentre, prospective, open label, comparative, parallel-group, randomized study. METHODS: The patients enrolled in the study had acute pancreatitis as demonstrated by typical abdominal pain and baseline serum amylase concentrations more than twice the upper normal limit, findings compatible with acute pancreatitis at imaging techniques, and a Glasgow criteria score of > or =3. Patients were randomly assigned to one of the two schedules of treatment with gabexate mesilate being administered intravenously for at least 7 days. The minimum clinically relevant difference (delta), between groups, in incidence of complications due to acute pancreatitis, during the first month of the study treatment, was predefined as equal to 10%. RESULTS: A total of 199 patients were assigned to gabexate mesilate 900 treatment and 189 to gabexate mesilate 1,500. Complications developed in 88 patients within one month of beginning treatment 44/199: patients (22.1%) in the gabexate mesilate 900 group and 44/189 patients (23.3%) in the gabexate mesilate 1,500 group (difference 1.2%; 95% confidence interval: -7.2; 9.5%). CONCLUSIONS: Gabexate mesilate 900 mg per day is as effective as gabexate mesilate 1,500 mg per day in reducing the complications due to acute pancreatitis.

Acute Disease↗
PubMedDate not supplied

Stimulation of gallbladder emptying by intravenous lipids.

BACKGROUND: Few studies have dealt with the effect of i.v. administration of lipids on gallbladder emptying, and the results have been conflicting. METHODS: Five healthy volunteers, three women and two men, aged 26 to 54 years, (mean, 29 years) were studied. Gallbladder emptying was assessed by means of real-time ultrasonography. RESULTS: In all subjects, the infusion of a 10% fat emulsion (Intralipid; Kabivitrum, Stockholm) over 3 hours caused a reduction in gallbladder volume. This effect was statistically significant at about 80 minutes of lipid infusion and became progressively more marked as the infusion progressed, reaching a reduction of approximately 30% during the third hour of infusion. A significant relationship (p < .001) was found between the concentration of serum triglycerides and the degree of gallbladder volume decrease. In control studies, infusion of physiologic saline containing glycerol, the excipient of intralipid, caused no significant changes in gallbladder volume. CONCLUSIONS: The results indicate that i.v. infusion of lipids is able to stimulate significantly contraction of human gallbladder.

Adult↗
PubMedDate not supplied

Treatment of small intestine bacterial overgrowth with rifaximin, a non-absorbable rifamycin.

In twelve patients affected by small bowel bacterial overgrowth, diagnosed by means of the lactulose hydrogen breath test, the therapeutic efficacy of a non-absorbable derivative of rifamycin, rifaximin, was evaluated. This study showed that this drug has a satisfactory therapeutic efficacy in contaminated small bowel syndrome and, at the doses tested, is free of side-effects.

Adult↗
PubMedDate not supplied

Serum pancreatic enzyme assays in acute abdomen: a comparative prospective study.

Serum amylase, pancreatic isoamylase, lipase, trypsinogen and elastase-1 were measured in 100 consecutive patients who were emergency admissions to a surgical department, and in 27 selected patients with proven acute pancreatitis who served as controls. The final diagnoses in the 100 patients of the study group were: acute pancreatitis in eight patients, other digestive diseases in 87, and urogenital tract diseases in five. In the control group, pancreas-specific enzymes were abnormally high in all patients and amylase in 26 out of 27. In the study group, all enzymes were markedly high in all eight patients with acute pancreatitis. In the remaining 92 patients, serum amylase was abnormally high in seven, and at least one pancreatic enzyme was elevated in 16. These elevations were generally mild. The diagnostic efficiency, i.e., the percentage of patients correctly classified, was 96% for pancreatic isoamylase and lipase, 93% for amylase, 91% for elastase-1, and 84% for trypsinogen. We conclude that serum lipase turbidimetric assay is the most suitable test for emergency diagnosis of acute pancreatitis, because it is highly sensitive and specific and simply and quickly performed.

Abdomen, Acute↗
PubMedDate not supplied

Serum lipase assay. A test of choice in acute pancreatitis.

We evaluated the clinical accuracy of an automated turbidimetric assay for serum lipase determination in order to screen for acute pancreatic damage. Seventy patients with pancreatic and thirty with nonpancreatic digestive diseases were studied. Fifty-two healthy subjects were also studied as controls. Serum lipase concentrations were abnormally high in all patients with acute pancreatitis and in 3 (10%) in the group of 30 patients with nonpancreatic acute abdomen. In the 35 patients with chronic pancreatitis studied during clinical remission, serum lipase levels were abnormally high in 8 (23%), and abnormally low in 3 (9%). In the 9 patients with pancreatic cancer, 4 (44%) had abnormally elevated serum lipase values and 1 (11%) abnormally low. The results indicate that serum lipase determination is useful in the emergency diagnosis of acute pancreatic damage because of its high sensitivity and specificity. In patients with chronic pancreatitis and in patients with pancreatic carcinoma serum lipase determination is of limited value.

Acute Disease↗
PubMedDate not supplied

[Serum pancreatic enzymes in the diagnosis of carcinoma of the pancreas].

Serum levels of amylase, pancreatic isoamylase, lipase, trypsinogen, and elastase 1 were determined in 41 patients with pancreatic carcinoma and compared with those 71 patients with chronic pancreatitis and 17 patients with digestive non-pancreatic carcinoma, in an attempt to evaluate their relative values in the diagnosis of pancreatic cancer. Trypsinogen and elastase 1 levels were the most frequently abnormal (56%), followed by pancreatic isoamylase (39%), lipase (34%), and amylase (27%). In 4 patients with resectable cancer levels of all serum enzymes were within normal limits, with the single exception of a low trypsinogen level in one patient. No significant differences in the behavior of serum enzymes were found between patients with pancreatic cancer and those with chronic pancreatitis or digestive non-pancreatic cancer. The results of our study indicate that measurement of serum pancreatic enzymes is of limited usefulness in the diagnosis of pancreatic cancer.

Adult↗
PubMedDate not supplied

Glucose tolerance and insulin secretion in pancreatic cancer.

While the association between pancreatic cancer and diabetes is well recognized, little is known about glucose tolerance and insulin secretion in patients with this tumour. Thirty patients with pancreatic cancer not complicated by diabetes, 10 with nonpancreatic cancer, and 10 healthy subjects were studied for glucose tolerance and insulin secretion in response to an oral glucose load. Twenty of the 30 patients with pancreatic cancer (70%) had impaired glucose tolerance compared with none of the patients in the other two groups. In most of these 20 patients' insulin responses were higher than those of patients with non-pancreatic cancer or healthy subjects. The results indicate that about two-thirds of patients with pancreatic cancer have abnormal glucose tolerance; this intolerance is associated with elevated insulin secretion, suggesting that it may be due to a peripheral resistance to insulin.

Aged↗
PubMedDate not supplied

Serum CA 242 in pancreatic cancer. Comparison with CA 19-9 and CEA.

Serum CA 242, CA 19-9 and CEA concentrations were determined in 94 subjects divided into 5 groups: Group 1 consisted of 22 healthy subjects; Group 2 consisted of 40 patients with pancreatic adenocarcinoma; according to Cubilla and Fitzgerald's classification, 11 tumours were Stage I, 4 were Stage II, and 25 were Stage III. Group 3 consisted of 10 chronic pancreatitis patients, group 4 of 10 acute pancreatitis patients, group 5 of 12 patients with nonpancreatic digestive carcinomas. Ten of these 12 patients had distant metastases. The sensitivity of CA 19-9 in the diagnosis of pancreatic cancer was higher than that of CEA and CA 242 (p < 0.05 and p < 0.005, respectively). In Stage I cancer patients the sensitivity of the markers studied was less than 50% (45% for CA 19-9, 18% for CEA, and 9% for CA 242) whereas most of the 25 patients with metastatic tumours of the pancreas had elevated serum levels of all 3 markers. The various combinations of the three markers did not significantly improve the sensitivity in diagnosing pancreatic cancer. No relationship was found between the localization of the tumour and the serum levels of the 3 markers studied. Similarly, no differences were found between patients with cholestasis and those without. The specificity of the 3 markers, evaluated in patients with benign pancreatic diseases, was 100% for CA 242, 90% for CA 199 and 70% for CEA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗