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Biomedical subjects

G Ideo

Publications and source records attributed to G Ideo.

At least 55 records · Page 3Linked to original sources
PubMed1993

Problems in diagnosing viral hepatitis.

The most reliable method of making a specific aetiological diagnosis of chronic viral hepatitis would be to identify virus specific cytotoxic T lymphocytes responsible for the killing of virus infected hepatocytes in each patient's liver. Unfortunately, this can not be proposed for routine diagnosis and surrogate tests are required. The detection of virus markers, and even of the virus itself, does not imply that liver damage is caused by virus infection. Indirect markers of the host's antiviral immunoresponse have to be used to confirm more specifically the diagnosis of viral hepatitis. IgM antibodies against viral antigens implicated in the elimination of the virus seem to be suitable alternative candidates. Significant changes in the serum values of viraemia and aminotransferases occur within a few days, while a significant variation in liver histology takes much longer. Only the kinetics of the highly variable parameters can be used for an appropriate study of the relationship between viraemia, antiviral immunoresponse, and liver cell necrosis. Quantitative and dynamic analyses of hepatitis virus markers seem the most suitable and reliable methods of monitoring the patients eligible for antiviral treatment and identifying the most appropriate time to start this.

Antibodies, Viral↗
PubMed1993

Duodenal bicarbonate secretion induced by human epidermal growth factor in rats is partially mediated by prostaglandins.

In the present study, the effect of graded intravenous infusions of human epidermal growth factor (hEGF) 0.005, 0.05 and 0.25 micrograms/ml, with or without 4 mg/kg i.p. indomethacin pretreatment, on rat duodenal bicarbonate secretion was investigated. Perfused duodenal loops were prepared in rats which were given intravenous infusions of hEGF with or without indomethacin. Duodenal pH and pCO2 were measured at 5-min intervals for 45 min, and bicarbonate secretion was calculated. Compared to control, each dose of hEGF caused a significant dose/response rise of duodenal bicarbonate secretion. Prostaglandin release was abolished by indomethacin pretreatment. Indomethacin-pretreated rats had a significant reduction of bicarbonate secretion which was still higher than in controls. These results provide evidence that duodenal bicarbonate secretion induced by hEGF is only partly accounted for by a prostaglandin-dependent mechanism.

Animals↗
PubMed1992

[A new therapeutic approach in hepatic hydrothorax].

Hepatic hydrothorax is a complication of hepatic cirrhosis which frequently conditions respiratory insufficiency. Traditional therapy is almost always inefficacious. The paper reports four cases which were successfully treated using pleurodesis with sterile talc. Treatment was simple with no major complications. At the 6-month check-up no cases of recurrent pleural effusion were observed.

Adult↗
PubMed1991

Beta-adrenergic-antagonist drugs in the prevention of gastrointestinal bleeding in patients with cirrhosis and esophageal varices. An analysis of data and prognostic factors in 589 patients from four randomized clinical trials. Franco-Italian Multicenter Study Group.

BACKGROUND: The value of beta-adrenergic-antagonist drug therapy for the prevention of initial episodes of gastrointestinal bleeding in patients with cirrhosis and esophageal varices is uncertain, both positive and negative study results having been reported. METHODS: In this study, we analyzed data on individual patients from four randomized, controlled trials to assess the efficacy of this treatment. Of the 589 patients studied, 286 received a beta-adrenergic-antagonist drug (propranolol in 203 and nadolol in 83) and 303 received placebo. RESULTS: After two years, the mean (+/- SE) percentage of patients who had had no upper gastrointestinal bleeding was 78 +/- 3 percent in the beta-adrenergic-antagonist treatment group and 65 +/- 3 percent in the control group (P = 0.002). The percentage of patients without fatal bleeding was 90 +/- 2 percent in the treatment group and 82 +/- 3 percent in the control group (P = 0.01). The percentage of patients surviving after two years was 71 +/- 3 percent in the treatment group and 68 +/- 3 percent in the control group (P = 0.34). After age and severity of cirrhosis were taken into account, the survival rate was better in the treatment group (P = 0.09). The percentage of surviving patients who had had no bleeding after two years was 62 +/- 3 percent in the treatment group and 53 +/- 3 percent in the control group (P = 0.04). Both propranolol and nadolol prevented a first episode of bleeding. Severe cirrhosis and especially the presence of ascites were associated with bleeding (P less than 0.001) and death (P less than 0.001) in both groups. The efficacy of beta-adrenergic-antagonist therapy in the prevention of bleeding (P less than 0.001) and of fatal bleeding (P = 0.004) and in the prevention of bleeding or death (P = 0.005) was the same after adjustment for cause and severity of cirrhosis, ascites, and size of varices. CONCLUSIONS: Propranolol and nadolol are effective in preventing first bleeding and reducing the mortality rate associated with gastrointestinal bleeding in patients with cirrhosis, regardless of severity.

Adrenergic beta-Antagonists↗
PubMed1991

Fibronectin, cholesterol and triglycerides ascitic fluid concentration in the prediction of malignancy.

There have been few trials comparing the efficacy of determinations of cholesterol, fibronectin and triglycerides for diagnosis of malignant ascites. In this study we measured these in 200 ascitic fluids from 93 cirrhotic patients (Group A), 47 hepatocellular-carcinoma patients (Group B), 60 extra-hepatic tumour patients (Group C), 44 of them with malignant cells (Group Cpos) and 16 without (Group Cneg). Anova one-way and the Bonferroni test for multiple comparisons showed that fibronectin and cholesterol were significantly higher in the ascitic fluids of patients of group C than of groups A and B (mean +/- ESM) (Cholesterol in A: 27.2 +/- 2.8; in B 23.5 +/- 1.5; in C: 68.6 +/- 5.3 mg/dl. Fibronectin in A: 32.7 +/- 2.8; in B 31.3 +/- 2.6; in C 127.7 +/- 11.1 mg/l). Both were significantly higher in Group Cpos than in Group Cneg (Cholesterol in Cneg: 41.2 +/- 6.7; in Cpos: 78.6 +/- 6.2 mg/dl. Fibronectin in Cneg: 55.0 +/- 11.2; in Cpos 154 +/- 12.3 mg/dl). We found no differences between cirrhotic ascites and malignant ascites due to primary liver hepatocellular-carcinoma. No difference at all in triglycerides were detected. With the Receiver-Operating Characteristic (ROC) curve, cholesterol had the best Youden Index (57%) at a cut-off of 32 mg/dl (sensitivity 78.3%, specificity 79.3% at this level); the best Youden Index (64%) for fibronectin had a cut-off of 60 mg/dl (sensitivity 65%, specificity 89.3%). Triglycerides appeared to be a great deal less effective as a diagnostic marker, with their best Youden Index (23%) at a cut-off 32 mg/dl (sensitivity 66.7%, specificity 56.4%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Prognostic factors after percutaneous transhepatic biliary drainage].

The authors reviewed the clinical charts and the radiographic files of 93 patients with obstructive jaundice--in 86 cases due to neoplasm--treated with PTBD. The test of differences from survival curves was used to identify the clinical parameters predictive of short survival after PTBD. The difference in survival curves was significant relative to serum indirect bilirubin (cut point: 7.6 mg%), to serum cholinesterase (cut point: 1290 mU/ml), to white blood cell counts (cut point: 8600/mm3), to blood urea nitrogen (BUN) levels (cut point: 60 mg%). Because of the marked negative prognostic value of high BUN levels, our data seem to indicate that PTBD should not be performed when severe renal insufficiency is present. Other parameters correlated with a short survival after PTBD were the histotype of metastasis (in comparison with the other ones), and large neoplastic volume (in comparison with a small and a medium ones). Through pre-PTBD radiological and laboratory data analysis, a group of patients can be selected in whom the procedure will increase neither well-being nor survival, as plotted against those patients who are likely to benefit from biliary drainage.

Bile Duct Neoplasms↗
PubMed1987

Comparison of once-daily bedtime administration of famotidine and ranitidine in the short-term treatment of duodenal ulcer. A multicenter, double-blind, controlled study.

A multicenter, double-blind, randomized, controlled study was conducted in 234 duodenal ulcer patients to compare the efficacy and safety of the H2-receptor antagonists famotidine and ranitidine in the treatment of duodenal ulcer. Patients received 40 mg famotidine (119 patients) or 300 mg ranitidine (115 patients) once daily at bedtime for 4 weeks. If ulcer lesions persisted, treatment was extended to 6 weeks. Efficacy was assessed by relief of symptoms and endoscopic findings of ulcer healing. Safety was determined on the basis of reports of side effects, results of laboratory tests, and, in selected patients, changes in plasma levels of hormones. The 4- and 6-week healing rates achieved with famotidine were 76% and 91%, respectively, and with ranitidine they were 76% and 87%, respectively; the differences in healing rates for the two drugs were not statistically significant. Similarly, both drugs provided satisfactory relief of pain and dyspeptic symptoms. However, famotidine produced significantly (P less than 0.05) greater relief of postprandial fullness and heartburn. The incidence of untoward effects was low in both treatment groups, and abnormal results in laboratory tests were observed in only one patient, a chronic alcoholic receiving famotidine, who withdrew from the study because of a slight elevation in serum transaminase levels. One patient in the ranitidine treatment group dropped out of the study because of a generalized urticarial rash; however, a causal relationship between drug and effect could not be established. The authors conclude that famotidine may be regarded as the best alternative to ranitidine in the treatment of duodenal ulcer.

Adolescent↗
PubMed1985

[Effect of tiropramide chlorhydrate on intestinal transit time in patients with irritable colon syndrome].

The effect of tiropramide hydrochloride--a new spasmolytic drug with calmodulin-independent activity--in correcting alterations of intestinal transit, has been investigated in 40 IBS patients (20 with accelerated and 20 with delayed transit time). Intestinal transit has been evaluated by means of radioopaque markers. Tiropramide hydrochloride, at a dose of 100 mg t.i.d. for 4 weeks, was found significantly more effective than placebo both in normalizing intestinal transit time and in inducing symptomatic relief.

Adult↗
PubMed1982

Increased urinary D-glucaric acid excretion by children living in an area polluted with tetrachlorodibenzoparadioxin (TCDD).

Extremely small doses of TCDD have been shown to induce hepatic microsomal enzymes in animals. Whether levels of environmental exposure to TCDD were sufficient to produce enzyme induction in man, has been investigated in Seveso, where in July 1976 explosion in a factory spread toxic substances, one of which was TCDD, to the surrounding area. The hepatic microsomal enzyme activity was assessed by estimating urinary d-glucaric acid (UGA) excretion in children 6-8 years old. In 31 children, urine samples were collected between August and December 1976; in 67 other children in February 1979. As a control group 60 children living in Busto Arsizio (a small industrial town near Milan) and 26 living Cannero (a non-industrialized village on Lake Maggiore) were chosen. In the first period of collection, children with chloracne (which is considered to be a characteristic manifestation of intoxication with chlorinated products), showed significantly increased levels of UGA compared with children without chloracne. In 1979, children living in the Seveso area showed a statistically significant enhancement of d-glucaric acid excretion compared to the control groups. In conclusion, this study demonstrates that many children living in the Seveso area have an increased activity of hepatic microsomal enzymes, since, although the urinary excretion of d-glucaric acid is only an indirect measure of enzyme activity, studies in man have indicated that it is both sensitive and quantitative. As far as the cause of this increase is concerned, since it is possible to exclude the influence of alcohol, contraceptives, phenobarbitone or other drugs, it is reasonable to conclude that TCDD, a potent inducer agent, could be responsible for this phenomenon.

Child↗
PubMed1980

[Effect of acute administration of high doses of ethanol on the canalicular Na+K+ dependent ATPASE in the isolated and perfused rat liver].

Na+-K+-ATPase in canaliculi-enriched liver plasma membranes was found to be inhibited by high concentration of ethanol (12 mmoles %ml) both in vitro and in vivo; the decrease of Na+-K+-ATPase, which is considered a major factor in the production of bile-salt independent fraction of canalicular bile flow, may be the cause of the previously observed reduction of bile flow after ethanol administration.

Animals↗
PubMed1978

Prednisone or prednisolone for the treatment of chronic active hepatitis? A comparison of plasma availability.

1 The plasma availability of prednisolone after oral doses of prednisolone and its precursor, prednisone, were compared in ten normal controls and twenty-five patients with chronic active hepatitis by estimation of the area under the plasma concentration--time curve for the drug (AUC). 2 In controls, values for AUC were significantly more variable after prednisone than prednisolone, and two subjects showed markedly inefficient conversion of prednisone to prednisolone. In patients, variability was similarly wide after both preparations, but overall bioavailability after both prednisone and prednisolone was similar to that found in controls, although three patients showed subnormal values after both preparations, possibly as a result of impaired intestinal absorption. 3 Patients with biochemical and histological evidence of active hepatocellular necrosis showed evidence of impaired activation of prednisone, but this was compensated for by a decreased rate of elimination of prednisolone from the plasma. 4 It is concluded that plasma prednisolone levels will be more predictable after prednisolone than after prednisone in subjects without hepatic dysfunction. In the presence of liver disease, because of the marked variability in plasma prednisolone levels after either drug, estimation of these could be of value in those patients whose disease cannot be controlled by normal maintenance doses.

Adult↗