[Primary infections of the thoraco-abdominal wall. Diagnostic imaging and interventional ultrasonography].
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Biomedical subjects
Publications and source records attributed to A Blasi.
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We investigated the effect of octylonium bromide on a number of symptoms and functional aspects of the irritable bowel syndrome. Seventy-two patients complaining mainly of abdominal pain were studied in a double-blind trial (octylonium bromide 40 mg tid for 4 weeks or placebo). Clinical parameters were: abdominal pain, bloating and bowel frequency. Sigmoid manometry with simultaneous recording of the thresholds for distension and/or pain upon graded inflation of an endoluminal balloon was performed before and at the end of treatment. In contrast to placebo, octylonium bromide significantly reduced pain and bloating, and significantly increased (p < 0.02) the pain threshold throughout the treatment period. However, comparison with the placebo group failed to show any relevant differences. Neither treatment influenced the frequency of bowel movement. Sigmoid motility during distension was significantly reduced after octylonium bromide (p < 0.05), but it did not change after placebo. In conclusion, octylonium bromide is capable of reducing symptoms and motor reactivity of the sigmoid in patients with irritable bowel syndrome.
A 24-week, double-blind, randomized study at 13 centres compared the efficacy and safety of 20 mg famotidine nocte and 150 mg ranitidine h.s. for the prevention of duodenal ulcer recurrence. All participants had been successfully treated for an acute duodenal ulcer with 40 mg famotidine nocte. Patients were endoscoped at baseline and at 24 weeks, unless symptoms warranted earlier examination: of the 208 patients enrolled, 86 who received famotidine and 84 who received ranitidine met all protocol criteria and were considered evaluable. Intention to treat and per protocol analyses showed non-significant trends in favour of famotidine (P = 0.44 and 0.16, respectively). During the 24-week observation period, 16.3% of the famotidine group and 25% of the ranitidine group had an ulcer recurrence (95% CI of percentage difference -0.22 + 0.04). At 24 weeks, relief of day and night pain was reported by 81.2% and 91.8% of the famotidine-treated patients, respectively. The corresponding figures in the ranitidine group were 73.5% and 85.5%. No laboratory abnormalities related to the study-drugs were noted and only two drug related (possibly or probably) adverse experiences were reported, both in the famotidine group. The data from this study therefore, supports the conclusion that the efficacy of 20 mg famotidine nocte is comparable to that of ranitidine in preventing duodenal ulcer recurrence, with comparable tolerability for long-term therapy.
This study attempts to clarify the sense of self that may underlie the adolescent's subjective experience of identity. The initial orientation was provided by descriptions of three different modes of experiencing identity derived from a reanalysis of Loevinger, Wessler, and Redmore's (1970) ego development categories. Our goal was to replicate by a more direct method the Loevinger-derived descriptions. Specifically, we looked at whether the various aspects of the pre-identity mode ("Social Role Identity") and of the early identity mode ("Identity Observed") would in fact form different clusters and whether these clusters would differentiate early and middle adolescent groups. Participants were 24 sixth graders and 24 high-school seniors, equally divided by sex. In individual interviews they were asked questions concerning the main characteristics of the Identity Observed Mode. Six self scales were constructed from subjects' responses. Our two major hypotheses were strongly supported: (a) The two age groups differed dramatically on each of the self scales; and (b) the six self scales highly correlated with each other. Moreover, clusters of responses could be constructed that model the a priori descriptions of identity modes and that sharply separate the two grades.
Forty-three patients with active duodenal ulcer and Helicobacter pylori positivity in gastric antrum were randomly assigned to either omeprazole treatment (20 mg once a day) or ranitidine treatment (300 mg once a day) for 28 days. Re-evaluation of the patients (clinical and endoscopic examination and assessments for H pylori detection) was repeated after 2 weeks and at the end of the treatment. Healing rates in the omeprazole group were 40% after 2 weeks and 90% after 4 weeks, in the ranitidine group ulcer healing was recorded in 20% of patients after 2 weeks and in 80% after 4 weeks. Differences between treatments at 2 and 4 weeks were not statistically significant. Clinical response (disappearance of ulcer-related symptoms) was better in the omeprazole group at 2 weeks (p less than 0.05) but not at 4 weeks. At the end of the trial H pylori positivity in gastric antrum disappeared in 95% of the patients treated with omeprazole and in 5% of the patients who received ranitidine (p less than 0.001). The results confirm the effectiveness of omeprazole in short-term treatment of duodenal ulcer and re-emphasize the powerful activity of the drug on H pylori infection.
A double-blind, randomized, active drug-controlled study was conducted in order to evaluate the efficacy and safety of famotidine vs ranitidine h.s. in promoting the healing of acute duodenal ulcers. Two hundred and eighty patients participated in the trial and received either famotidine 40mg h.s. or ranitidine, 300mg h.s. The two groups were not significantly different with regard to sex and risk factors such as alcohol consumption and family history of peptic ulcer disease, while in the famotidine group, there was a slightly higher number of patients who smoked. Endoscopy was performed at the end of 4 and 6 weeks in 248 patients (128 in the famotidine group and 120 in the ranitidine group). The healing rate in those receiving famotidine was 73.4% at the end of 4 weeks and increased to 93% at the end of 6 weeks, while in the ranitidine group, the rate was 75.8% and 92.5% respectively. Day and night pain markedly reduced in both groups and therapy was generally well tolerated.
The pancreatic duct or at least parts of this structure can be demonstrated today by sonography in 50-82% according to various authors. We have measured the caliber of the sonographically visualized pancreatic duct in 20 normal subjects after physiological stimulation with meal. The mean caliber of the duct markedly increased after meal. During dilatation a longer segment of duct is more clearly visualized. It is possible to document an increase of caliber of Wirsung duct "in vivo" as an evident sign of pancreatic secretion.
Seventy-two patients complaining of abdominal pain were studied in a double blind trial with otilonium bromide (OB) (40 mg tid or placebo). In our patients we performed, before and after the treatment, a clinical evaluation (symptom variations) and functional studies (sigmoid manometry during bowel distension). As regards clinical parameters, otilonium bromide significantly reduced abdominal pain and bloating and significantly increased (p less than 0.02) the pain threshold. However the comparison with the placebo group did not show any difference between the two groups. Sigmoid motility during distension was significantly reduced (p less than 0.05) in OB group, whereas it did not change in the placebo group. We can conclude that, in irritable bowel syndrome (IBS) patients, OB is able to improve symptoms and to reduce stimulated motor activity of the sigmoid.
The efficacy and safety of the new prostaglandin E1 (PGE1) synthetic analogue, rioprostil, 300 micrograms b.d. and cimetidine, 400 mg b.d., on duodenal ulcer healing are compared in an international, multicentre, double-blind study. A total of 257 patients have entered the study; 243 are considered eligible for efficacy analysis and 207 for safety analysis. After 4 and 6 weeks of treatment, the endoscopic healing rates do not significantly differ between the two groups, being 55% and 83% respectively with rioprostil vs. 60% and 78% respectively with cimetidine. The major adverse effect attributable to rioprostil is diarrhoea, which was documented in 11% of patients compared with 1% of patients taking cimetidine. However, central nervous system complaints are twice as frequent in the cimetidine group. Monitoring of clinical laboratory tests show no significant abnormalities when compared with the baseline values during the administration of either drug. This study documents that rioprostil, at the dosage of 300 micrograms b.d., is as effective and safe as cimetidine in the short-term therapy of duodenal ulcer.
Tuberculosis of the breast is an uncommon disease and the correct diagnosis may be established only by histologic demonstration of granulomatous inflammatory infiltrates with central caseation. In fact, preoperative examination and mammography suggest carcinoma or sometimes bacterial abscess in most instances. Tuberculous mastitis was diagnosed in a 74-year-old woman. The case history and a review of the literature are presented. The Authors emphasize the role of excision of necrotic tissue and drainage, in combination with antimicrobial therapy, in the treatment of this pathology.
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Gastric acid responses to intragastric administration of graded doses (14-30-45 mg/Kg) of copper (II) complexes with aminoacids (two simple complexes, Cu-Trp2 and Cu-Phe2, and on mixed complex, Cu-Trp-Phe) were investigated in Shay rats. The results (% inhibition of H+ mEq/4h) shown that graded doses of copper complexes caused a progressive inhibition on gastric acid secretion, and that percentage inhibition values were, for all complexes, in linear correlation with employed doses. A possible mechanism by which copper complexes affect gastric acid secretion is discussed.
Eighty-four patients with endoscopically-proved active duodenal ulcer were admitted to a multicentre double-blind trial with either pirenzepine tablets (25 mg three times per day for 1 week followed by 25 mg two times per day for 3 weeks) or placebo. Seventy-nine patients completed the trial, 44 treated with pirenzepine and 35 with placebo. After 4 weeks, complete healing had been achieved in 52% of the pirenzepine-treated patients and in 34% of the placebo-treated ones. Symptomatic responses were signigicantly better in those receiving pirenzepine than in those receiving placebo. In addition, the supplementary antacid consumption was significantly lesser in the pirenzepine group than in the placebo group. No important side-effects were observed in the two groups.
Ninety-six patients with endoscopically proved active duodenal ulcers were admitted to a multicentre double-blind trial with either pirenzepine (100 mg/day, 25 mg in the morning and midday and 50 mg at bed time) or placebo for 4 weeks. Ninety-two patients (46 in each group) completed the trial. After 4 weeks, complete healing had been achieved in 70% of the pirenzepine-treated patients and in 32% of the placebo-treated ones (P less than 0.01). No important side-effects and no abnormal changes in blood values or urinalysis were observed during treatment. The difference in the ulcer healing rates observed in the two parts of this multicentre trial is briefly discussed.
Pirenzepine (PRZ) 75 mg/day for 1 week followed by 50 mg/day for 3 weeks did not show a good activity in gastric ulcer healing in comparison to carbenoxolone (CB) (300 mg/day for 1 week followed by 200 mg/day for 3 weeks). The tolerability of PRZ seemed to be better than that of CB. The increase in the daily dose of PRZ to 100 mg/day for 4 weeks led to better results in the patients who have completed satisfactorily the treatment up to now. PRZ's tolerability was greater than CB's. The results of this study are preliminary to further trial.
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The data on the epidemiologic situation of sarcoidosis from 24 countries of Europe have been reviewed. The new facts seem to demonstrate that the differences between the frequency of this disease in the north and south are not real. The actual situation is dependent on the general knowledge of this disease and on the extent and intensity of the active detection of its asymptomatic stage. A new prospective cooperative study of the yearly incidence of all forms of sarcoidosis in the total population of at least some European countries would be desirable.
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