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Biomedical subjects

F Parente

Publications and source records attributed to F Parente.

At least 109 records · Page 6Linked to original sources
PubMed1989

The diagnosis of esophageal candidiasis in patients with acquired immune deficiency syndrome: is endoscopy always necessary?

Oral and esophageal candidiasis represents a common infection in patients with acquired immune deficiency syndrome (AIDS). Because the relationship between the infection in both sites is not well known, we submitted to routine upper digestive endoscopy 57 patients with AIDS. Furthermore, we evaluated the diagnostic accuracy of oral candidiasis and esophageal symptoms as markers of Candida esophagitis. Oral and esophageal candidiasis were found in 52% and 48% of patients, respectively, whereas symptoms of esophageal origin were referred to by 60% of patients successively documented to have an esophageal infection. The sensitivity of esophageal symptoms and oral candidiasis alone, as indexes of an esophageal infection, was 60% and 88%, and their specificity was 100% and 81%, respectively. The combination of these two parameters improved their degree of diagnostic accuracy (sensitivity 93%, and specificity 100%), whereas the predictive value of their simultaneous presence or absence was 100% and 96%, respectively. These results document that routine endoscopy to verify the presence of esophageal candidiasis in all of the patients with AIDS is unnecessary; it could be reserved for selected subgroups such as those with esophageal symptoms despite systemic antifungal treatment, and for patients with AIDS-related complex presenting oral candidiasis without symptoms of esophageal origin.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Recent developments in peptic ulcer treatment.

Since peptic ulcer disease is a multifactorial disease, the ideal therapeutic approach would be to use different drugs for different ulcers. In the past few years some studies have been published suggesting that subgroups of patients with peptic ulcer might particularly benefit from specific forms of therapy. In the present report the available evidence has been critically reviewed.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1987

Tripotassium dicitrato bismuthate (TDB) versus two different dosages of cimetidine in the treatment of resistant duodenal ulcers.

The use of tripotassium dicitrato bismuthate (TDB) has been suggested recently for cimetidine resistant duodenal ulcers. This study compares the efficacy of TDB with two different cimetidine dosages in the treatment of duodenal ulcer patients who failed to respond to an eight week therapy with H2-blockers. Fifty two patients (40 men, 12 women) were randomly allocated to one of the following three oral regimens: (1) TDB 120 mg quid, (2) cimetidine 400 mg tid, (3) cimetidine 400 mg with meals plus 800 mg at bedtime. Endoscopy was carried out after four weeks; if the ulcer had not healed patients continued with the same treatment for a further four week period when they were endoscopically reassessed. After four weeks similar percentages of ulcer healing were registered in the two cimetidine schedules (39% with 1.2 g and 44% with 2 g), whereas TDB resulted in a significantly higher healing rate (82%) compared with cimetidine 1.2 g (p = 0.01) and with cimetidine 2 g (p = 0.025). After eight weeks the cumulative percentages of healing were 65% on cimetidine 1.2 g, 75% on cimetidine 2 g, and 94% on TDB (TDB v cimetidine 1.2 p = 0.042). These results confirm previous data that resistant duodenal ulcers are more responsive to an agent which strengthens the mucosal defences than to antisecretory compounds.

Adult↗
PubMed1987

Role of PMN's candidicidal activity in the pathogenesis of AIDS-related systemic candidiases.

Phagocytic and fungicidal activity towards C. albicans spores were tested in 9 patients with AIDS-Related Complex (ARC), but without Candida infections, and in 13 patients with AIDS and deep candidiasis. No significant differences were observed between the two mentioned groups as far as PMN's phagocytosis and killing were concerned. PMN's migration in response to a "non-mycotic" chemoattractant was defective in both groups; although, from this point of view, patients with candidiasis were more severely affected. A significant difference was noted, instead, as far as mean T helper values were concerned; in fact, their number was significantly lower in patients with systemic candidiasis than in those with ARC or even AIDS, but oesophageal candidiasis only. In conclusion, defective PMN's activity towards C. albicans spores, as observed in vitro, does not seem in itself to predispose AIDS patients to candidiasis in vivo; mycoses may be rather due to defects of cell-mediated immunity as a whole.

AIDS-Related Complex↗
PubMed1986

Medium-dose antacids versus cimetidine in the short-term treatment of duodenal ulcer.

Seventy-eight patients with endoscopically proven duodenal ulcer were randomly allocated to be treated with a medium dose of liquid aluminum-magnesium antacid (75 ml in five daily doses) or cimetidine (400 mg twice daily) for 4 weeks in a prospective double-blind, double-dummy study. Healing rates at completion of trial were 66.7% in the cimetidine-treated group and 71.8% in the antacid group (p, ns). Both treatments were equally effective in relieving ulcer symptoms. Among the patient variables considered, only cigarette smoking was found to have a significant negative effect on ulcer healing. These results indicate that medium doses of antacids are as effective as cimetidine in the short-term treatment of duodenal ulcer.

Adult↗
PubMed1986

The influence of colloidal bismuth subcitrate on duodenal ulcer relapse.

Antisecretory drugs, although able to promote ulcer healing, have been shown to be unable to modify the course of ulcer disease. Relapse rates after short-term cures and after prophylactic long-term therapy are equivalent to those observed during placebo treatment. Conversely, evidence shows that colloidal bismuth subcitrate (CBS)--by means of a mechanism as yet unclear--reduces the risk of ulcer relapse after a short cure for acute disease. This has been shown in several controlled trials and in two studies on duodenal ulcer patients undertaken by our group. Our experience has shown that 12 months after treatment the relapse rate in patients treated with CBS only during the acute phase was: a) equivalent to that observed in patients whose acute ulcers had healed with cimetidine and had thereafter been treated prophylactically with cimetidine 400 mg at night (69% versus 68%), and b) significantly lower than that of patients whose ulcers had healed with ranitidine and who were subsequently placed under medical observation (67% versus 84%; P less than 0.05). It is concluded that CBS is a valid alternative in the prophylactic treatment of duodenal ulcer.

Bismuth↗
PubMed1986

Colloidal bismuth subcitrate and two different dosages of cimetidine in the treatment of resistant duodenal ulcer. Preliminary results.

The use of colloidal bismuth subcitrate (CBS) has been recently suggested for cimetidine-resistant duodenal ulcers. We have therefore compared the activity of CBS with that of two different doses of cimetidine in patients whose duodenal ulcers had not healed after 8 weeks of therapy with cimetidine, 1.2 g, or ranitidine, 300 mg/day. Forty-three patients (35 men and 8 women) were randomly allocated to one of the following oral regimens: CBS, 120 mg 4 times a day, or cimetidine (C), 400 mg 3 times a day, or cimetidine, 400 mg at meals plus 800 mg at bedtime, for 4-8 weeks. The interim analysis after 4 weeks of treatment showed similar percentages of healing in the two cimetidine schedules (46.7% with C, 1.2 g, and 42.9% with C, 2 g, respectively); conversely, CBS treatment resulted in a significantly higher healing rate as compared with both C, 1.2 g, and C, 2 g (P less than 0.05). These findings suggest that resistant duodenal ulcers are more responsive to cytoprotective agents than to antisecretory compounds.

Adult↗
PubMed1986

Colloidal bismuth subcitrate and ranitidine in the short-term treatment of benign gastric ulcer. An endoscopically controlled trial.

Colloidal bismuth subcitrate (CBS) in the form of a chewable tablet has been compared with ranitidine in the short-term treatment of benign gastric ulcers. Eighty patients were admitted to this randomised single blind study. Endoscopic control was carried out after 4 weeks, and after 8 weeks when healing was incomplete or had not occurred at the 4-week examination. After 1 month of therapy the healing rates were 70% with CBS and 62.5% with ranitidine (P = not significant). At two months the corresponding cure rates were 87.5% and 79%, respectively (P = not significant). Antacid consumption was higher in the group treated with ranitidine, but the difference was not statistically significant. Patient cooperation was good and similar in the two groups. These findings confirm that CBS, in tablet form, is at least as effective as ranitidine in the acute treatment of benign gastric ulcers.

Adult↗
PubMed1986

Colloidal bismuth subcitrate as coated tablets: four times versus twice daily dosage in duodenal ulcer.

Forty patients with endoscopically proven duodenal ulceration have cooperated in a clinical trial to compare the ulcer healing effect of colloidal bismuth subcitrate (CBS) at standard dosage administered either twice or four times a day. No statistically significant difference was found to exist between ulcer healing in the two groups after 4 weeks (70% and 95%, respectively), and it is concluded that twice daily CBS is an effective treatment for duodenal ulcer with clear advantages as regards patient cooperation.

Adult↗
PubMed1986

Inhibition of food stimulated acid secretion by association of pirenzepine and ranitidine in duodenal ulcer patients.

The effects of pirenzepine and ranitidine alone and combined, on gastric acid secretion and gastrin release stimulated by liquid peptone meal were evaluated in 12 duodenal ulcer patients. Six patients received placebo and ranitidine 150 mg per os and the other six patients were given placebo, pirenzepine 50 mg and pirenzepine 50 mg plus ranitidine 150 mg per os, according to randomized sequences. In the first experiment ranitidine markedly inhibited (69%) gastric acid secretion for entire two hours period (p less than 0.01). In the second experiment acid secretion after pirenzepine, was reduced by 39% while the combination of pirenzepine plus ranitidine almost completely inhibited the meal stimulated acid secretion (99%). Mean integrated gastrin responses after pirenzepine and ranitidine alone as well as pirenzepine plus ranitidine were not significantly different from placebo. The results of these studies show that in duodenal ulcer patients, the simultaneous block of muscarinic and H2-receptors, suppresses meal stimulated gastric acid secretion, without affecting gastrin release. This therapeutic combination might be used in clinical situations (non-responders, Zollinger-Ellison syndrome) in which complete inhibition of gastric acid secretion is needed.

Adult↗
PubMed1985

Cigarette smoking, gastric acid secretion, and serum pepsinogen I concentrations in duodenal ulcer patients.

Cigarette smoking has been linked with duodenal ulcer disease although the mechanism of this association is unclear. This study assessed basal gastric secretory response to acute smoking of smokers with an active duodenal ulcer; in addition the possible effects of chronic smoking on gastric secretory capacity, as expressed by pentagastrin stimulated gastric acid secretion and fasting serum pepsinogen I (PG I) concentrations, were investigated in patients with active duodenal ulcer, or non-ulcer dyspepsia. In 10 smokers with duodenal ulcer smoking four cigarettes during 40 minutes did not influence basal gastric secretion of acid and pepsin, or serum PG I and gastrin concentrations. In 136 patients with duodenal ulcer and 90 controls with non-ulcer dyspepsia, pentagastrin stimulated acid secretion and fasting serum PG I concentrations were significantly higher among habitual heavy smokers than among non-smokers. These findings suggest that in heavy smokers with duodenal ulcer acid- and pepsin-secreting cell function is not affected by acute cigarette smoking. By contrast, chronic cigarette smoking seems to be associated either with an increase of parietal- and chief-cell mass, or with an enhancement of their secretory capacity.

Adult↗
PubMed1985

The use of cimetropii bromidum as premedication for endoscopy of the upper gastro-intestinal tract: a double-blind controlled clinical trial.

The effectiveness of cimetropii bromidum (10 or 20 mg i.v.) as premedication for upper gastro-intestinal tract endoscopy was examined and compared with that of placebo in a double-blind crossover study involving 160 patients. The drug effects were assessed from the degree of opening of the pyloric sphincter and the endoscopist's rating of drug performance. The study showed that the effects of cimetropii bromidum differed highly significantly (p less than 0.0001) from those of placebo, on either count. No adverse effects were noted.

Adolescent↗
PubMed1983

Lactose intolerance in adults with chronic unspecific abdominal complaints.

77 hospitalized patients with chronic unspecific abdominal complaints, in whom any other organic disease had been previously excluded, were investigated for lactose malabsorption; they were subdivided into two groups: 46 patients complaining primarily of colicky abdominal pain and/or intermittent diarrhoea (group 1) and 31 patients presenting with dyspepsia as the predominant symptom (group 2). To establish the exact prevalence of isolated lactase deficiency in the healthy adult population served by our hospital, 40 Italian adult healthy subjects were also studied. The prevalence of lactose malabsorption was significantly higher (p less than 0.005) in patients of the 1st group than in patients of the 2nd group, and in the healthy adult population seen at our hospital (74% vs 35.5% and 37.5%, respectively). Furthermore a high prevalence of lactose intolerance, determined by means of a three-week diet trial (lactose free-diet versus normal diet), was documented among lactose malabsorbers of the 1st group. We concluded therefore that lactose intolerance is a factor in some Italian adult patients who suffer from long-standing aspecific abdominal discomfort, and it should be always considered in these patients, especially when colicky abdominal pain and diarrhoea are present, before the diagnosis of irritable bowel syndrome is made.

Abdomen↗
PubMed1982

The effect of pirenzepine on meal-stimulated gastric acid secretion, gastrin release and gastric emptying.

Pirenzepine is a new antimuscarinic drug with a peculiar affinity for gastric parietal cells' acetylcholine receptors. Previously it has been shown that the drug effectively inhibits both basal and gastric acid secretion stimulated by several secretagogues. The aim of the present work has been to evaluate, in double-blind, placebo controlled, randomized studies on 6 male patients, the effect of pirenzepine (50 mgs orally) on gastric secretion stimulated by peptone meal, gastric emptying and gastrin release. The results show a significant decrease of gastric secretion (48 per cent in the 1st and 30 per cent in the 2nd hour) without any effect on gastric emptying and gastrin release.

Adult↗