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P Dotto

Publications and source records attributed to P Dotto.

25 records · Page 2Linked to original sources

[Ulcer and hepatic cirrhosis. Epidemiologic and clinical correlations].

Peptic ulcer has been reported with increased frequency in patients with liver cirrhosis, its prevalence ranging form 5% to 20%. The aim of the present study is twofold: 1) to define the frequency of peptic ulcer in chronic liver disease in a large sample of cirrhotic patients, 2) to investigate the epidemiological and clinical features of a group of subjects affected by both peptic ulcer and liver cirrhosis. Two years of admission have been retrospectively investigated to define the frequency of peptic ulcer in chronic liver disease. In 237 subjects affected by both cirrhosis and peptic ulcer, epidemiological and clinical data were collected. Peptic ulcer was present in 16% of cirrhotic patients. There were no differences between ulcer subjects who drank and those did not. A linear positive correlation between smoking habit and frequency of ulcer disease has been found in the words. A positive history for peptic ulcer was described in a little subgroup of the studied sample, suggesting a low importance of the genetic factor in the pathophysiological pattern of ulcer disease in chronic hepatitis.

Adult↗

Intermittent negative pressure ventilation may increase urine flow in normal subjects.

In order to analyze the effect of intermittent negative pressure ventilation (NPV) on renal function, we studied 20 healthy male volunteers (mean age 29 +/- 4.1 years). NPV was performed with an "Emerson Chest Respirator Pump", adjusted to a breathing frequency of 10 respirations per minute, with inspiratory time/total respiratory time ratio of 0.4 and negative pressure of 25 cmH2O. The experimental protocol was carried out in two phases of two hours each--spontaneous breathing and NPV breathing. At the end of each phase, urine volume of the whole period was collected as well as venous blood sample for biochemical determinations. During NPV there was significant increase (P < 0.05) in urine flow rate (1.43 +/- 0.81 to 2.76 +/- 1.95 ml/min) as well as in natriuresis (258 +/- 201 to 389 +/- 175 mcEq/min), kaliuresis (61 +/- 45 to 98 +/- 49 mcEq/min), fractional sodium excretion (1.38 +/- 0.88 to (1.96 +/- 0.98%), osmolar clearance (3.13 +/- 1.82 to 4.32 +/- 1.24 ml/min) and pH (7.37 +/- 0.04 to 7.41 +/- 0.07) with unchanged creatinine and free water clearances. We concluded that NPV increases urine flow rate, kaliuresis and natriuresis but the data we have do not allow us to explain the mechanisms underlying such a phenomenon.

Adult↗

Peptic ulcer in cirrhotic patients: a short- and long-term study with antisecretory drugs.

The clinical course of gastric and duodenal ulcer and the efficacy of H2 blockers in ulcer healing and the prevention of relapse in cirrhotic liver patients were studied. Seventy-four cirrhotic patients with endoscopically proven acute gastric ulcer (30), duodenal ulcer (34) or a combination of both gastric and duodenal ulcers (10) were treated for six weeks with either Cimetidine 800 mg/daily (27) or Ranitidine 300 mg/daily (47). Of the 77 patients 49 (66.2%) were healed after therapy, 11 cases (14.8%) remained unhealed even after two additional cycles of the same treatment and four were lost to follow-up. After an endoscopically proven healing of the active ulcer, 51 patients took part in the long-term study over a mean period of 24 months: 21.5% of the 27 patients were treated with a maintenance dosage of H2 blockers and 29.1% of the 24 patients left without therapy relapsed during the first year. We conclude that the ulcer healing rate with H2 blockers is lower and the relapse rate higher in cirrhotic patients than in the general ulcer population.

Adult↗

[Cigarette smoking and group I pepsinogen levels. Study in a normal population].

Several studies have shown an influence of cigarette smoking on serum pepsinogen group I (PGI) levels in duodenal ulcer patients and in control subjects. The elevation of PGI in smokers has just been interpreted as reflecting some degree of smoking-induced inflammation of the gastric mucosa. We have determined fasting serum PGI by radioimmunoassay in 163 healthy subjects investigated by a survey conducted on a sample population of an urban area in the North-East of Italy by means of a random selection based on the public registers of home addresses. The data reported confirmed that PGI levels are increased by smoking in a healthy population. The main contribution of this study consists in demonstrating in a non-selected population an increase of the only parameter up to date claimed to be a possible serological predictive index for ulcer disease.

Adult↗

Risk factors of duodenal ulcer bleeding: the role of smoking and nicotine.

Several studies have shown that cigarette smoking affects duodenal ulcer (DU) recurrence. To verify any correlation between smoking and complications of ulcer disease, we studied 33 DU smokers, 16 DU ex-smokers and 87 DU non-smokers for up to 48 months, recording age, sex, family history of ulcer, ulcer symptoms, non-steroidal anti-inflammatory drug use, length of DU history, alcohol consumption, smoking habit, relapses and bleeding episodes. Nicotine contents were also obtained for the type of cigarettes smoked. Statistics used were: Analysis of variance with Bonferroni's test. Pearson's chi-squared test and stepwise logistic regression analysis. Smokers were found to have significantly more relapses but fewer bleeding episodes than ex-smokers and non-smokers (63.3%, 31.2% and 34.5%, p = 0.029; 12.1%, 43.7% and 34.5%, p = 0.017). Bleeders were significantly more often males than non-bleeders (82.9% vs. 61.0%, p = 0.01) and had ulcer symptoms less frequently (9.7% vs. 26.3%, p = 0.02). Multivariate analysis confirmed sex as a risk factor (OR = 3.0) and smoking as a "protective" factor (OR = 0.4) for bleeding, while nicotine intake was found to be unrelated to this complication. We concluded that smoking (but not nicotine intake) and male sex are factors to take into account in evaluating the risk of DU bleeding.

Adult↗

Effects of H2 blockers and omeprazole on peptic secretion: a prospective, randomized study in duodenal ulcer subjects.

UNLABELLED: Aim of the present study has been to investigate the possible modifications of peptic secretion after a period with H2 blockers and omeprazole, evaluating in the same patient pepsinogen group A levels in gastric mucosa and pepsin in gastric juice. 54 active duodenal ulcer were studied: during an upper gastrointestinal endoscopy a sample of gastric juice and one fundus biopsy were taken before and after four weeks 300 mg/daily ranitidine (23 patients), 40 mg/daily famotidine (7 patients), 300 mg/daily nizatidine (12 patients) therapy and 40 mg/daily omeprazole (12 patients) therapy. RESULTS: H2-blockers and omeprazole treatment determines a non statistically significant decrease of pepsin in gastric juice and in pepsinogen group A in gastric mucosa.

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