PubMed Health⌕ Search

Biomedical subjects

F Ferrarini

Publications and source records attributed to F Ferrarini.

At least 19 recordsLinked to original sources
PubMed1995

Non-cardiac chest pain: a real clinical problem.

Non-cardiac chest pain is a frequent clinical problem. Between 10 and 50% of patients with anginal pain who are referred for arteriography are found to have normal coronary arteries. An oesophageal source of non-cardiac chest pain is reported in up to 60% of cases, most of which are attributable to gastro-oesophageal reflux disease. The exclusion of heart disease and the identification of an oesophageal origin of the pain may require an extensive work-up. The outcome in patients with non-cardiac chest pain is influenced by both the underlying diagnosis and the patient's perception of his or her symptom.

Cardiomyopathies↗
PubMed1995

Interictal abnormalities of regional cerebral blood flow in migraine with and without aura.

Some controversial issues exist whether regional cerebral blood flow (rCBF) changes are present both in migraine with and without aura during the interictal period. For this reason we have studied rCBF characteristics in migraine patients when headache-free. rCBF examinations were performed by the 133Xe inhalation method on 39 normal subjects (24 aged 45 or less and 15 older than 45), on 10 migraine patients with (A+) and on 10 without (A-) aura. The values of each patient were compared with the age-matched control population mean by a computer-assisted mapping system that allows statistical analysis in real time. To compare inter-individual variability 10 subjects, out of 39 normals, constituted an age-, sex- and CO2-matched control group (C). 8 A+ patients and 7 A- showed significant alterations of CBF in comparison with the age-matched control population. The analysis between the age-, sex- and CO2 matched groups showed significant differences of the inter-hemispheric (F = 6.669, p = 0.004) and of the frontal (F = 7.480 p = 0.0008) asymmetries. These data show that in the headache-free period a derangement of the cerebral perfusion is present in both migraine with and without aura, suggesting they are due to the same disease process. Furthermore they show the usefulness of a computer-assisted mapping system, suitable for clinical use, in discovering small alterations in cerebral perfusion.

Adult↗
PubMed1992

Influence of erythrocyte aggregability and plasma fibrinogen concentration on CBF with aging.

The influence of the rheological properties of the blood on cerebral perfusion is still unresolved. Data on normal subjects are lacking and difficulties arise regarding the effect of blood viscosity owing to its close relationship with hematocrit. For these reasons we have studied the relationship between two rheological hematocrit-independent parameters and CBF in normal subjects of various ages. 36 normal volunteers, aged 20-74, free from risk factors, have been studied. CBF was measured by the Xenon inhalation method. Erythrocyte aggregability was expressed as Mean Erythrocyte Aggregation Index (MEA). Plasma fibrinogen concentration was evaluated by the coagulative method in 26 subjects. No correlation was found between CBF and MEA or fibrinogen in the subjects under the age of 45. A significant negative correlation was found between CBF and MEA (p = 0.015) and between CBF and fibrinogen (p = 0.011) in the subjects over 45. These data show that cerebral perfusion is influenced by the rheological properties of the microcirulation only with aging. We suggest that a "rheological autoregulation" exists and that it works properly in youth, only to be lost with physiological aging. This finding can be of significance in the pathogenesis of cerebrovascular disease processes in humans.

Adult↗
PubMed1991

[Esophageal and gastric acidity determination: its value and limitations].

Combined esophago-gastric pH measurements has been recently employed to better define gastroesophageal reflux and to simultaneously evaluate esophageal and gastric acidity. We studied 21 patients with esophagitis and 11 controls. Gastric acidity was rather similar in the two groups. A significant difference (p less than 0.05) between controls and patients was found in the postprandial period only. The analysis of the buffering effect of a standardized meal did not show any difference between the two groups. When subdividing the esophagitis patients according to the outcome of medical treatment we could find a more prolonged (p less than 0.05) postcibal recovery phase. Gastric alkalinizations were observed mostly during the night and did not differ in the two groups. As regards gastro-esophageal reflux we evaluated both acid, mixed and alkaline episodes. Acid reflux was the most frequent event, while mixed reflux was less frequently observed and equally distributed in the two groups. As regards alkaline episodes they were absent in controls and occurred very rarely in the patients. In conclusion esophagogastric pH-metry gives us, with a single test, informations about gastric acidity and the characteristics of gastro-esophageal reflux. On the other hand its clinical relevance needs further evaluations.

Esophagitis, Peptic↗
PubMed1991

CBF side-to-side asymmetries in stenosis-occlusion of internal carotid artery. Relevance of CT findings and collateral supply.

Cerebral blood flow (CBF) was studied at rest by 133-Xenon inhalation method in 15 normal subjects, in 10 patients with cerebral infarction and normal angiograms of major cerebral arteries and in 28 patients with unilateral stenosis-occlusion of the internal carotid artery (ICA), with or without cerebral infarction. All the normals and 20 patients with ICA stenosis-occlusion were tested again after cerebral vasodilatation induced by an intravenous bolus of acetazolamide. At rest the patients with cerebral infarction, irrespective of whether ICa stenosis-occlusion was present or not, showed abnormal side-to-side CBF asymmetry. After cerebral vasodilation variations in side-to-side asymmetry were shown to depend on the inefficiency of the collaterals and not on the degree of ICA obstruction or on the presence of cerebral infarction. These data indicate that at rest side-to-side CBF distribution is influenced more by the presence of an ischemic zone than by a ICA stenosis-occlusion and that under these circumstances the hemodynamic effect of the vascular stenosis cannot be assessed. After cerebral vasodilatation a subset of patients--irrespective of the degree of ICA obstruction and of whether or not cerebral infarction is present--with true cerebrovascular insufficiency can be isolated.

Acetazolamide↗
PubMed1991

Ambulatory 24-hour oesophageal pH monitoring in normal subjects: a multicentre study in Italy. G.I.S.M.A.D. GOR Study Group.

A multicentre study was performed in Italy in order to establish normal values for acid gastro-oesophageal reflux. In 73 healthy subjects 24-hour oesophageal pH measurements were carried out under standardized conditions. The hourly number of reflux episodes and oesophageal acid exposure was assessed and analyzed by means of a computerized system. The distribution frequency of both parameters was skewed to the left, thus exhibiting a non-normal pattern. Acid reflux was lowest during the night and highest after meals. The oesophageal acid exposure and the number of reflux episodes were correlated both over 24 hours and in the subsets studied. A good agreement was found with data from previous reports. Our findings should be helpful in establishing a data base for physiological gastro-oesophageal reflux.

Adult↗
PubMed1990

Long-term treatment of reflux oesophagitis.

Reflux oesophagitis is a chronic recurrent disease with high tendency towards relapse after medical healing. It has been calculated that after 6 months a symptomatic relapse may occur in about 45% of patients, while a recurrence of mucosal lesions ranges between 20 to 70%. The most important adverse factors affecting the likelihood of recurrence are: a) the daytime symptoms at time of healing and b) an impairment of both oesophageal body motility and LOS tonic and phasic activity. The available data show that the maintenance treatment with anti-H2 at standard doses does not affect the spontaneous recurrence of the disease. Better results could be achieved with higher dosage, possibly tailored to the physiopathological characteristics of the patients.

Esophagitis, Peptic↗
PubMed1989

Acid gastroesophageal reflux and symptom occurrence. Analysis of some factors influencing their association.

In 17 patients with esophagitis (degree I = erythema, N = 10; degree II = erosions, N = 7) esophageal pH was measured at 5 and 10 cm above the esophagogastric junction to assess whether the extension of acid reflux and the severity of the mucosal lesions could influence the association between reflux and symptoms. A minority of the refluxes were related with symptoms (4.0% and 7.7% in degree I, 14.1% and 12.0% in degree II at 5 and 10 cm respectively), whereas 65.4% and 100% of the symptoms were related with reflux in degrees I and II, respectively, with 76.5% and 35.7% occurring during refluxes reaching the proximal recording site. A relationship of symptoms with reflux is shown, particularly in erosive disease. Some reflux characteristics (extension, duration, acidity) seem to influence symptom occurrence mainly in mild esophagitis; however, more than 85% of the acid reflux episodes are symptom-free, regardless of the severity of the mucosal injury.

Adult↗
PubMed1988

Oesophageal function before, during, and after healing of erosive oesophagitis.

In order to investigate the relationship between oesophageal motor abnormalities and oesophagitis, we carried out four hour studies of oesophageal motility and 24 hour pH measurements in fasting and fed conditions in eight patients before, during (pH only), and after medical healing of erosive oesophagitis. Gastrooesophageal acid reflux decreased (ns) during the treatment, but tended to return to basal values at the end. Oesophageal body motility was unchanged after healing, while the lower oesophageal sphincter basal tone was significantly increased at the end of the study in the postcibal period. The results suggest that the impairment of the sphincter tone in reflux oesophagitis is secondary to the presence of the oesophageal lesions. Macroscopic healing is not paralleled by improved major pathogenic factors of the disease, however--that is, acid reflux and oesophageal body motility.

Adult↗
PubMed1985

Oesophageal motor events at the occurrence of acid reflux and during endogenous acid exposure in healthy subjects and in patients with oesophagitis.

In order to assess the oesophageal motor events associated with the occurrence of gastro-oesophageal acid reflux and those during endogenous acid exposure, we studied six healthy subjects and nine patients with symptoms and lesions of reflux oesophagitis. In the case of each subject simultaneous pressure and pH measurements of the distal oesophagus were taken both in fasting conditions and after a standardised balanced meal. Reflux episodes occurred in the absence of a lower oesophageal sphincter relaxation (34.3%, 17.7%) or in the presence of a relaxation associated (34.2%, 30.8%) or unassociated (31.5%, 51.5%) with a peristaltic sequence, in the controls and patients respectively. No significant differences were found between the two groups. During endogenous acid perfusion the distal oesophagus showed mainly a peristaltic motor activity, but the mean hourly number of peristaltic sequences was significantly lower in the patients than in the controls (33.5 +/- 27.2 vs 81.5 +/- 3.2, p less than 0.01). Our results show that the mechanisms of reflux are similar in controls and in patients, while the peristaltic frequency is reduced in the latter. This motor failure may be responsible for the increased reflux duration observed in patients with oesophagitis.

Adult↗
PubMed1985

M-mode subxiphoid echocardiography in assessing pulmonary hypertension. Its usefulness in chronic obstructive pulmonary disease.

12 patients (9 males, 3 females; aged 35-63 years, mean 55) with chronic obstructive pulmonary disease (COPD) were studied in order to determine the correlation between the values of pulmonary arterial pressure and the M-mode echographic size of the right pulmonary artery (RPA) from the subxiphoid approach. Both the largest (systolic) and smallest (diastolic) size of the vessel were considered, and both were corrected for body surface area ('index size' - PA/BSA). The reliability of this echographic size is supported by the evidence that the tract of the pulmonary artery considered in this study is perpendicular to the ultrasonic beam. Both the systolic and diastolic size of RPA correlated with the systolic, diastolic, and mean pulmonary arterial pressure, detected by catheterization. Measurements of RPA size were made from the suprasternal approach in 8 patients out of 12. The size of RPA from the subxiphoid approach was also estimated in 21 normal subjects, serving as controls. Measurements of RPA size from the suprasternal approach were made in 12 of these subjects. Both the systolic and diastolic size of RPA from the subxiphoid approach correlated with the systolic and diastolic size of the suprasternal view in patients and in normal subjects. Subxiphoid M-mode echocardiography seems to be a valuable noninvasive technique in assessment of pulmonary hypertension, particularly in patients affected by COPD.

Adult↗
PubMed1984

Oesophageal function after oral ranitidine: an acute double blind study in normal subjects.

The effect of oral ranitidine on oesophageal peristalsis, LOS basal pressure and gastro-oesophageal acid reflux, was investigated in 6 healthy men in a double-blind randomized study. Simultaneous manometry and pH measurements were performed twice in each volunteer during a five hour study period which included the administration of a standard meal. Ranitidine did not affect the motor parameters studied (amplitude, duration and velocity of the peristaltic waves and LOS basal tone), whereas it almost abolished acid gastroesophageal reflux. Our results show that ranitidine, like cimetidine, does not alter the motor function of the oesophagus, while it virtually abolishes acid gastro-oesophageal reflux in normal man.

Administration, Oral↗
PubMed1982

Function of the internal anal sphincter and rectal sensitivity in idiopathic constipation.

Anal manometry was performed in 8 control individuals (group A) and in 13 patients with idiopathic constipation (group B), 6 of whom were grouped apart (group C) because of an elective delay of the intestinal transit in the rectum. The basal pressure of the internal anal sphincter, the rectal inflation volume necessary to elicit the rectoanal inhibitory reflex, and the duration of the reflex were not significantly different in the three groups, while the maximal amplitude of the reflex was significantly lower in group C at 10 and 100 cm3 of rectal distension. However, the amplitude of the sphincteric relaxation and the rectal inflation volumes were significantly correlated (p less than 0.001) in the three groups. The rectal sensitivity was lower in the patient groups and particularly in group C (p less than 0.05 vs. controls up to 50 cm3 of rectal distension). The results obtained do not support the 'outlet obstruction' hypothesis as a mechanism of idiopathic constipation and point out that rectal hyposensitivity seems to be the only abnormality in these patients, particularly in those with an elective delay of the transit in the rectum.

Adolescent↗
PubMed1981

Gastric secretion and emptying of liquids in reflex esophagitis.

We have investigated the gastric secretory activity and the emptying half-time of a liquid meal in 17 selected patients with reflex esophagitis compared to 10 controls. The basal acid output and the basal and maximal secretory volume were higher in the patient group (P less than 0.05, P = 0.05, and P less than 0.01, respectively), while the maximal acid output and the basal and maximal acid concentration were not different in the two groups. The gastric emptying half-time of a liquid meal was higher in the patient group (P less than 0.001). Our results show that gastric function may be altered in reflux esophagitis patients and suggest particularly that a delayed emptying of liquids may play a role in the pathogenesis of the disease in some patients.

Adult↗
PubMed1980

Effect of various stimulants and inhibitors of gastric acid secretion on mucosal potential difference in man.

Pentagastrin and histamine in doses effective in stimulating gastric acid secretion (5 microgram/kg/h intravenously and 25 microgram/kg intramuscularly, respectively) produce a significant decrease in the gastric mucosal potential difference (PD) in man. In contrast, atropine and cimetidine (2 mg/30 min intravenously and 4.5 mg/kg/h intravenously respectively) cause a significant increase in gastric PD. The subsequent or simultaneous administration of cimetidine reverses the effect of the stimulating agents on gastric PD and pH. Similarly, the subsequent administration of pentagastrin reverses the effect of atropine. The intragastric instillation of 100 c HCl 0.1 N increases significantly the gastric PD valuesp in this case the patterns of PD and pH changes are dissimilar. This study indicates that substances that modify gastric acid secretion also induce changes in gastric PD; this last effect does not seem to depend on variations of the intragastric pH. Therefore, in the clinical evaluation of the gastric PD in man, its multifactorial origin must alway be considered.

Adult↗