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Biomedical subjects

G Testino

Publications and source records attributed to G Testino.

At least 19 recordsLinked to original sources
PubMed2006

Combination hepatitis C virus antigen and antibody immunoassay as a new tool for early diagnosis of infection.

Reduction of the window period of hepatitis C virus (HCV) infection represents an important goal in the transfusional and diagnostic setting. A prototype assay designed to simultaneously detect circulating HCV antigen and anti-HCV, has been developed. Aim of this study was to evaluate the performance of this new assay in terms of specificity and sensitivity and to compare its efficacy with commercial assays. To evaluate the specificity of the assay, 400 samples from the general population and 100 'difficult' sera, negative for anti-HCV, were tested. To assess sensitivity, the new test was used on 76 PCR-positive and anti-HCV negative sera, seven natural or commercial seroconversion panels that included 17 RNA-positive and anti-HCV negative sera and 31 anti-HCV positive sera, 20 weak anti-HCV positive sera, 80 viraemic and anti-HCV-positive sera from patients infected with different subtypes and 10 sera from patients with HBV-HCV or HIV-HCV co-infections. Of 500 anti-HCV negative samples, 499 (99.8%) were negative with a cut-off index <0.5, while one sample was within the grey zone. Of the 93 HCV-RNA positive and anti-HCV negative sera from patients and panels, 85 (91.4%) resulted positive, and one had the cut-off index in the grey zone. The reduction in the diagnostic window period observed with the new test and HCV-RNA assays were equal, on average, to 24 and 34.4 days respectively. All anti-HCV positive sera were positive. The new assay shows high sensitivity and specificity and could be a useful tool not only in the diagnostic setting, where procedures to reduce the window period, such as antigen or HCV-RNA detection, are not currently recommended, but also in the screening of blood donations, when nucleic acid technologies is not feasible because of costs, organization, emergency and/or logistic difficulties.

Enzyme-Linked Immunosorbent Assay↗
PubMed2006

Gastric precancerous changes: carcinogenesis, clinical behaviour immunophenotype study and surveillance.

Gastric cancer (GC) is the second most common cause of cancer-related death worldwide. Two-thirds of the GC patients are diagnosed in advanced stages, when surgery can only be a palliative. When the diagnosis is made at an early stage, the surgical treatment results in 10 years survival rates are higher than 85%. From the critical evaluation of the literature data we can affirm that there are some obstacles to an exclusive acceptance of the idea that the relation of Helicobacter pylori (H. pylori) infection with noninvasive (formerly dysplasia) or invasive neoplastic modifications solely develop by means of chronic gastritis with its atrophic evolution and achlorhydria. Intestinal metaplasia as a precursor of GC has been overemphasized and doubts persist about the real necessity to operate histologically a subdivision into subtypes. The extent of the metaplastic process is probably more important that the metaplastic subtype. The evaluation of the clinical behaviour shows how low grade noninvasive neoplasia is associated with or progressed to GC in about 9% of cases, while high grade noninvasive neoplasia is associated with or progressed to GC in about 75% of cases, thus proving to be a real histological marker of GC. The subdivision of the cases according to the TNM classification demonstrates that, in most of the cases, early GC is present (43/45: 95.5%). An appropriate endoscopy follow-up with biopsies according to well defined criteria increases the likelihood of invasive neoplasia being detected in its early stage with a better postsurgical prognosis. Noninvasive neoplasia is characterized by severe alterations of the immunophenotype profile in association with a high proliferation index and frequent p53 mutations. The choice to address the patients to surgical intervention could be made not only on the basis of histochemical techniques, but also with the help of immunohistochemical evaluations.

Cell Proliferation↗
PubMed2002

Helicobacter pylori influence on gastric acid secretion in duodenal ulcer patients diagnosed for the first time.

BACKGROUND: Many experiences have hypothesised that Helicobacter pylori induced hypergastrinemia could lead to an increase of the parietal cell mass and, consequently, of acid secretion. METHODS: The parietal cell mass and maximal acid output have been studied in patients with duodenal ulcer diagnosed for the first time, not due to drugs assumption. In particular, it has been evaluated the parietal cell mass and the acid secretion subdividing duodenal ulcer patients in relation to gastrinemia values (hypergastrinemia and normogastrinemia). RESULTS: The parietal cell mass and the maximal acid output remain high independently of Helicobacter pylori presence. About 60% of the subjects in the Helicobacter pylori positive group show gastrinemia values higher than the average: neither did the study reveal in this group any variations in the parietal cell mass and acid secretion. CONCLUSIONS: It emerges from the results that the mild chronic hypergastrinemia in Helicobacter pylori positive duodenal ulcer is not important enough to induce an increase in parietal cell mass and acid secretion. Therefore, Helicobacter pylori eradication is important in relapse prevention of duodenal ulcer, but not for its repercussions on the gastric secretion.

Adult↗
PubMed2002

p53 and Ki-67 expression in epithelial gastric dysplasia and in gastric cancer.

BACKGROUND: The aim of this study was to examine p53 and Ki-67 expression in relation to high grade dysplasia (HGD) clinical behaviour. METHODS: A retrospective, cross sectional study was conducted on mucosal biopsies from the stomach of 38 consecutive cases of HGD (25 males, average age: 57.5). The studied samples are represented by gastric biopsies obtained in course of gastroscopy for dyspepsia (at least 8 biopsies). HGD diagnosis was done by experienced pathologists (MC, DG) according to Goldstein's criteria. There were 12 non-dysplastic controls (7 males, average age: 49.4). The immunohistochemical study has been led with the utilization of a p53-antibody. For the cell proliferation assay, the sections were incubated with the MM1 monoclonal antibody. The clinical outcome subdivision of HGD was effected using the criteria of Rugge et al. For the classification of gastric cancer (GC): UICC TNM. RESULTS: p53 positivity has been evidenced in 65.5% of cases, while hyperproliferation in 100% of cases. That independently of the clinical behaviour. CONCLUSIONS: p53 positivity has been found only in part of the HGD cases and moreover a number of HGD with low or absent p53 scores has been found associated with high proliferation indices independently of the clinical evolution. This dissociation of cell kinetics and p53 expression suggests that other genetic events contributing to unregulate cell proliferation may occur in these lesions.

Cross-Sectional Studies↗
PubMed2001

[Endoscopic surveillance of precancerous changes in the stomach].

Undoubtedly, one of the most important achievements of gastroenterology is the demonstration that, for many pathological conditions with future neoplastic degeneration risk, a periodical endoscopic surveillance is a determining element for the restraining of possible evolutive complications. Nonetheless, it is to be considered how, during the last years, the prevention and follow-up procedures for the stomach disease have been sometimes emphasized. In fact, various recent evidences originated from precise scientific evaluations have contained same prevention strategic attitudes so as to reach the best cost-benefit ratio. In this survey the various gastric preneoplastic modifications, subdivided in precancerous conditions and lesions are examined and guidelines are proposed in order to offer quick and easily applicable solutions.

Gastroscopy↗
PubMed2001

Collagenous colitis in symptomatic subjects without endoscopic morphologic evidence: case report.

Collagenous colitis (CC) is a rare pathology and, even though various etiopathogenetic hypotheses have been put forward, the etiology and pathology are still not well defined. We report the case of a female patient suffering from chronic watery diarrhoea, positive for guaiac-based fecal occult blood test and morphologically negative to endoscopic investigation, but histologically classifiable as CC. This case report suggests that the clinical history must lead towards the execution of a colonoscopy with bioptic samples done even on apparently normal mucosa. Furthermore, the clinic should always signal a suspect CC to the anatomopathologist in order to have a correct diagnosis.

Colitis↗
PubMed2001

[Helicobacter pylori and gastric carcinogenesis].

Gastric carcinogenesis is a multistep and multifactorial process beginning with chronic gastritis Helicobacter pylori (Hp) induced in most cases. There are some obstacles to an exclusive acceptance of the idea that the relation of Hp with the preneoplastic/neoplastic changes solely develops by means of the chronic gastritis with its atrophic evolution and achlorydria. Hp may be considered a trigger by means of alteration of cellular synetics without any direct influence on genetic alterations. Under the push of an intense proliferation, the expression of typical antigens of the organ is progressively lost, with acquisition of antigens from other organs. Cellular dedifferentiation displayed, with the progressive increase of immature elements that progress to the more or less total disappearance of differentiated gastric cells or differentiating ones, with the formation of metaplastic/dysplastic clones or even neoplastic ones. The bacteria, together with other environmental factors and individual genetic susceptibility, determine the final risk for the development of gastric cancer. Considering that 1-2% of the Hp positive subjects are estimated to develop gastric cancer and that Hp is considered the cause of 75% of gastric cancer, the eradication of the infection, not only in the initial phases but even in those with preneoplastic changes, involves an advantage for the prevention of gastric cancer. For the prevention among the general population testing Hp-positive subjects for serum antibodies against CagA protein might represent an effective way of identifying patients in whom Hp eradication is advisable also in term of gastric cancer prevention.

Helicobacter Infections↗
PubMed2000

[The physiopathological aspects of chronic gastritis, Helicobacter pylori and precancerous gastric changes].

Chronic gastritis represents the paradigmatic histological condition by means of which the various clinical displays develop. Among the several etiologic factors, Helicobacter pylori (Hp) certainly represents a determining element for the promotion of such condition. Several morpho-functional evaluations (parietal cells, peptic cells, acid secretion, peptic secretion, gastrinemia) point out how Hp has on the mucosa a mainly direct action, without any substantial modifications of the gastric milieu. Certainly, the bacteria help the bodyfundic atrophic gastritis, but seldom this condition contributes to the modification of the gastric pH in such a relevant way so as to prime the fall of events which lead to the preneoplastic/neoplastic modifications. Metaplastic, dysplastic and neoplastic clones may arise, in the course of Hp infection, even in conditions of normochloridria. Such bacterium behaves as a cofactor of various other damaging or predisposing agents, contributing to modulate the risk by acting on host genetic susceptibility.

Chronic Disease↗