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Biomedical subjects

P L Costa

Publications and source records attributed to P L Costa.

18 recordsLinked to original sources
PubMed1992

Hepatocellular carcinoma. Prognostic factors and survival analysis in 135 Italian patients.

This is a retrospective study to evaluate the history of hepatocellular carcinoma and find the relationship between clinical, biochemical and ultrasonographic features and survival in Italian patients. In 135 consecutive patients median follow-up was 16 months (range 1-66 months) and median survival from the time of diagnosis was 12 months. Univariate analysis showed that individual variables associated with significantly decreased survival included: absence of therapy, Okuda's Stage III, Child-Pugh's Class C, alpha-fetoprotein greater than 400 ng/ml, presence of symptoms, moderate or severe ascites, tumor involving both lobes, mixed internal echo pattern, and multinodular or massive type. Multiple regression analysis (Cox model) revealed that the mixed internal echo pattern of hepatocellular carcinoma, the presence of moderate or severe ascites and Okuda's Stage III were independent predictors of high risk of death. These data can help in selecting patients whose probability of survival is considered high enough to undergo treatment and may be useful for stratifying patients in randomized controlled trials.

Adult↗
PubMed1991

Air in the main pancreatic duct: demonstration with US.

Air in the pancreas--nearly always related to an abscess or a pancreatic fistula--is rarely demonstrated. Over a 3-year period, the authors detected air in the main pancreatic duct with ultrasonography (US) in 11 patients. The ductal caliber was normal in five patients and dilated in six. At US, air in the main pancreatic duct is characterized by strongly echogenic foci or echogenic lines in the duct, casting acoustic shadows or producing reverberation artifacts. It is likely that in patients who have biliary-enteric anastomoses or have undergone sphincterotomy, air in the duct of Wirsung is the result of biliary-pancreatic reflux. In patients who have not undergone such operations, the likely cause of pancreatic gas is duodenal-pancreatic duct reflux. Pancreatic gas may be related to causes other than a pancreatic abscess or fistula; it is therefore important for clinicians to realize that pancreatic ductal gas seen on US images may be secondary to prior surgery or due to sphincter of Oddi dysfunction.

Adult↗
PubMed1979

Exocrine pancreatic function after total gastrectomy.

The secretion of bicarbonate, lipase, and chymotrypsin into the duodenum in response to exogenous stimulation with secretin, 1 CU/kg-h, plus caerulein, 100 ng/kg-h, was investigated in 12 patients, on an average, 20.7 months after total gastrectomy and in 14 control subjects. The secretion of bicarbonate and lipase was significantly lower in patients than in controls. The reduction in outputs compared with the control values was 47.9%, 38.7%, and 24.2% respectively for bicarbonate, lipase, and chymotrypsin. Eight of the 12 patients (67%) had steatorrhoea. No significant correlation was found between this parameter and lipase output. It is concluded that the exocrine pancreatic function is impaired in the majority of patients subjected to total gastrectomy. The impairment, which particularly affects bicarbonate and lipase, is generally mild to moderate.

Adult↗
PubMed1978

A comparison between injection and infusion of pancreatic stimulants in the diagnosis of exocrine pancreatic insufficiency.

Exocrine pancreatic function was studied by rapid intravenous injection and by prolonged intravenous infusion of a combination of secretin and caerulein in a group of patients with proven pancreatic disease and in controls. The aim was to compare the value of the two procedures of stimulation in the diagnosis of exocrine pancreatic insufficiency. Results showed that the pancreatic response to infusion of the stimulants discriminates normal from abnormal pancreatic function better than responses to rapid injection.

Adolescent↗
PubMed1977

[Ascites in chronic pancreatitides. Report of 2 cases].

2 cases of alcoholic chronic pancreatitis complicated by ascites are described. Both presented a cystic formation in the pancreas. In the first, a direct communication existed between the cystic and peritoneal cavities with passage of pancreatic secretion and serous membrane inflammatory reaction. The literature shows that this mechanism is the one most frequently responsible for ascites in chronic pancreatitis. For diagnosis, demonstration of high amylase and proteins in the ascitic fluid was decisive. Internal drainage of the cyst carried out in one of the two cases resolved the picture.

Adult↗
PubMed1977

Effect of adrenocorticotropic hormone on pure exocrine pancreatic secretion in man.

The effect of adrenocorticotropic hormone (ACTH) on pure exocrine pancreatic secretion was studied in 7 subjects with external transduodenal drainage of the main pancreatic duct performed after biliary tract surgery. Intravenous injection of 0.25 mg of ACTH during a prolonged intravenous infusion of secretin (0.5 clinical units per kg-hr) plus cholecystokinin (0.5 Ivy dog units per kg-hr) significantly reduced protein and lipase (both concentration and output) without affecting volume and bicarbonate secretion. The reduction appeared soon after ACTH injection (peak inhibition in the first 15-min period) and lasted about 75 min. The adrenocortical response to ACTH reached its peak at the 60th min. The mechanism by which the pituitary hormone selectively inhibits pancreatic enzyme secretion without affecting volume and bicarbonate remains to be clarified.

Adrenocorticotropic Hormone↗
PubMed1976

Investigation of exocrine pancreatic function by continuous infusion of caerulein and secretin in normal subjects and in chronic pancreatitis.

Exocrine pancreatic function has been evaluated in 24 controls and 29 patients with confirmed chronic pancreatitis by continuous infusion (90 min) of synthetic caerulein, 100 ng/kg/h, plus GIH secretin, 1 CU/kg/h. Mean secretory values of the controls were comparable to those obtained by others using maximal doses of secretin and CCK. Unlike the controls, patients suffering from chronic pancreatitis demonstrated a progressive reduction in secretion during infusion. Thus, the comparison of responses for the final 30-min period gave much clearer and more complete discrimination between normal and abnormal pancreatic function than the preceding 30-min period.

Adolescent↗
PubMed1975

[Eosinophilic gastroenteritis. Report of a clinical case].

An unusual case of eosinophilic gastroenteritis is described, together with its differential diagnosis from allergic enteropathy. Numerous biopsies and other instrumental examinations pointed to small intestine as the only site and eosinophilic enteritis as a suitable classification. Disappearance of the clinical symptoms was obtained with corticosteroid management in the space of 6 months.

Adrenal Cortex Hormones↗
PubMed1975

Effect of glucagon on pure human exocrine pancretic secretion.

In this study the inhibitory effect of glucagon on pure exocrine pancreatic secretion obtained by direct drainage of the duct of Wirsung in man is demonstrated. In two experiments carried out during stimulation with secretin and CCK-PZ and in one experiment during secretin stimulation an inhibitory effect on pancreatic secretion was found. This effect was global, affecting both the total volume and the concentration and output of protein and the output of bicarbonate. The greater inhibition, however, occurred in the case of protein.

Adult↗