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Biomedical subjects

R Cheli

Publications and source records attributed to R Cheli.

At least 19 recordsLinked to original sources
PubMed1995

[Influence of Helicobacter pylori on gastric secretion. Study on variously associated gastric body, fundus and antrum chronic gastritis].

Among the various themes related to Helicobacter pylori (HP) which is still a subject of discussion, there is the possible influence of this bacterium on gastric secretory physiology. In the present study, an evaluation has been carried out of stimulated gastrinemia, stimulated acid secretion and total peptic activity in gastric juice in the course of a paradigmatic condition, as autonomous chronic gastritis, in order to reveal possible modifications induced by the HP infection. In cases of HP positive chronic superficial antral gastritis associated either with normal body-fundic mucosa or with superficial gastritis, there is a significant increase of stimulated gastrinemia in comparison to HP negative groups and controls. In the course of body-fundic atrophic and preatrophic chronic gastritis associated either with antral superficial chronic gastritis or with antral atrophic gastritis, there are no statistically significant differences between HP positive and HP negative subjects. As regards acid and pepsin secretion no significant differences emerge in any group between HP positive and HP negative subjects. In the HP positive subjects with antral superficial gastritis and higher gastrin values the study of acid and pepsin secretion has yielded no significant variations. From the results of this study it emerges how gastric secretory parameters vary exclusively according to the histologic state of gastric mucosa. Therefore, the lesion action of HP may mainly be attributed to a direct action, rather than to substantial gastric secretory changes.

Adult↗
PubMed1994

Epidemiology and etiology of "autonomous" nonspecific duodenitis.

In this prospective study we looked for possible epidemiological and etiological factors in "autonomous" nonspecific duodenitis. Of 136 dyspeptic patients who entered the study, duodenitis was found in 25.6% (94.4% chronic duodenitis and 5.6% isolated active duodenitis). Men predominated with a significant prevalence of 74%; 49% of them had white-collar jobs, but age, psychological factors, and the season of the year played no role. We found that smoking and alcohol and coffee intake bore no relation to duodenitis. Helicobacter pylori (HP) was present in only 17.1% of patients with duodenitis, little different from the 10% prevalence in dyspeptic patients without duodenitis. HP was always associated with gastric metaplasia and inflammatory activity.

Adult↗
PubMed1991

[Esophageal angina].

Angina-like chest pain, caused by alterations of esophageal function, is an increasingly common occurrence confronting cardiologists: advances in pathogenetic knowledge and in diagnostic possibilities in this field have in fact shed light on the prevalence of esophageal angina, which is present in approximately 60% of patients with angiographically intact coronaries (11% of anginal patients overall). Classically, esophageal chest pain is attributed to alterations of motility or to mucosal disease (pathologic gastro-esophageal reflux of the acid, mixed or alkaline type): this last cause prevails quantitatively. Little is known of the nociceptive mechanisms triggered by these alterations: as far as mucous disease is concerned, activation of the chemosensitive receptors has been postulated, while esophageal mechanoreceptors may be activated, in the course of a motor disorder, by distension of the wall. A recently proposed additional mechanism consists in the induction of parietal esophageal ischemia by chemical or mechanical injury: it is a fascinating and potentially resolvable mechanism, which however requires further investigation. Moreover, elements of psychological nature are also involved in the genesis of esophageal pain. A diagnosis of esophageal angina, heavily conditioned by obvious considerations of prognostic order, must necessarily aim for "certainty". Prolonged monitoring of the endoluminal pH and the adoption of provocative tests, in the course of pH monitoring and manometry, play an important role in achieving this aim (ergometric test, distension induced with a balloon, edrophonium, electrostimulation, seem most effective). A promising outlook is supported by the recent introduction of prolonged manometry. Finally, diagnostic attitude must necessarily abandon its limited specialistic horizon to consider the patient's profile in its entirety.

Angina Pectoris↗
PubMed1991

A controlled study of 20 mg famotidine nocte vs. 150 mg ranitidine nocte for the prevention of duodenal ulcer relapse.

A 24-week, double-blind, randomized study at 13 centres compared the efficacy and safety of 20 mg famotidine nocte and 150 mg ranitidine h.s. for the prevention of duodenal ulcer recurrence. All participants had been successfully treated for an acute duodenal ulcer with 40 mg famotidine nocte. Patients were endoscoped at baseline and at 24 weeks, unless symptoms warranted earlier examination: of the 208 patients enrolled, 86 who received famotidine and 84 who received ranitidine met all protocol criteria and were considered evaluable. Intention to treat and per protocol analyses showed non-significant trends in favour of famotidine (P = 0.44 and 0.16, respectively). During the 24-week observation period, 16.3% of the famotidine group and 25% of the ranitidine group had an ulcer recurrence (95% CI of percentage difference -0.22 + 0.04). At 24 weeks, relief of day and night pain was reported by 81.2% and 91.8% of the famotidine-treated patients, respectively. The corresponding figures in the ranitidine group were 73.5% and 85.5%. No laboratory abnormalities related to the study-drugs were noted and only two drug related (possibly or probably) adverse experiences were reported, both in the famotidine group. The data from this study therefore, supports the conclusion that the efficacy of 20 mg famotidine nocte is comparable to that of ranitidine in preventing duodenal ulcer recurrence, with comparable tolerability for long-term therapy.

Adult↗
PubMed1991

Famotidine vs ranitidine h.s. in acute duodenal ulcer. A multicentre endoscopic trial.

A double-blind, randomized, active drug-controlled study was conducted in order to evaluate the efficacy and safety of famotidine vs ranitidine h.s. in promoting the healing of acute duodenal ulcers. Two hundred and eighty patients participated in the trial and received either famotidine 40mg h.s. or ranitidine, 300mg h.s. The two groups were not significantly different with regard to sex and risk factors such as alcohol consumption and family history of peptic ulcer disease, while in the famotidine group, there was a slightly higher number of patients who smoked. Endoscopy was performed at the end of 4 and 6 weeks in 248 patients (128 in the famotidine group and 120 in the ranitidine group). The healing rate in those receiving famotidine was 73.4% at the end of 4 weeks and increased to 93% at the end of 6 weeks, while in the ranitidine group, the rate was 75.8% and 92.5% respectively. Day and night pain markedly reduced in both groups and therapy was generally well tolerated.

Acute Disease↗
PubMed1990

Famotidine in the management of acid-reflux oesophagitis: a multicentre study.

The management of gastro-oesophageal reflux still presents a considerable problem mostly because of its multifactorial pathogenesis. In this study, we tested the response to treatment with famotidine for 8 weeks in patients with reflux oesophagitis, taking into consideration, however, only cases with pathological gastro-oesophageal reflux of the acidic type. All the patients participating in the multicentre study underwent gastro-oesophageal 24-hr pH-metry. The results show a good response to the H2 antagonist treatment with regards to both symptomatology (improvement/healing in 98% of cases, asymptomatic in 68%) and the endoscopic and histological picture. In fact, endoscopy showed complete remission of the lesions in 60% of cases and an improvement in 21%. The histological picture of oesophagitis improved in 64% of cases, 36% of which were completely healed, with no modifications in the remaining 36%. These data, which are globally better than those reported in the literature, can probably be attributed to the original selection of patients treated by means of prolonged gastro-oesophageal pH-metry, who had exclusively pathological gastro-oesophageal reflux of the acidic type. For these patients the use of the H2 antagonist drug is more appropriate even as monotherapy, than it is for those patients who have combined or isolated alkaline gastrooesophageal reflux.

Adult↗
PubMed1989

Epidemiology of duodenal erosions.

The epidemiological characters of 142 patients, 121 males and 21 females, with duodenal erosions were evaluated. They were predominantly between 30 and 60 years old. During the observation time, 125 of them were complaining of dyspeptic symptoms while the remaining 17 had haematemesis and/or melena. Duodenal erosions were single in 9 cases, zonally distributed in 51 and disseminated in 82. Erosions were associated with duodenal ulcer in 25% of cases, with ulcer scar in 4%, and with gastric ulcer in 2%. The intake of alcohol, coffee, anti-inflammatory drugs and the smoking habit were similar in patients with duodenal erosions and the general population subjected to endoscopy. These results suggest a relationship between duodenal erosions and peptic ulcer.

Adult↗
PubMed1989

Anatomic-functional profiles in duodenal ulcer.

Gastric acid secretion, gastrinemia, the type of gastritis of the fundic mucosa and the parietal cell mass, expressed by means of a 'parietal index', were considered in 70 patients with active duodenal ulcer. Hypersecretion was found in 60% of cases, normosecretion in 35.7% and hyposecretion in 4.3%, while achlorhydria was absent. Chronic fundic gastritis of the superficial or follicular type occurred at a similar rate in normosecretors (22%) and in hypersecretors (26%), being constantly of the preatrophic type in the 3 cases of hyposecretion. The parietal index was strictly correlated with maximal acid output but there was no correlation between gastrinemia and the secretory state or with the histological picture of the fundic mucosa. The results outline the prevalence of hypersecretion-hyperparietalism in duodenal ulcer but indicate also the frequent occurrence of normosecretion and normoparietalism and the rare finding of hypersecretion and hypoparietalism.

Adult↗
PubMed1989

The distribution of duodenal G cells in duodenal ulcer patients.

The number of G cells is evaluated in biopsy specimens of fundic, antral and duodenal mucosa from the bulb, second and third parts in 10 patients with duodenal ulcer, and compared with that observed in 6 normal controls. G cells are absent in fundic mucosa but in the antrum their number in duodenal ulcer patients does not differ from that of controls and is strictly related to the histological pattern of the mucosa. In the second and third duodenum of duodenal ulcer patients the number of G cells is significantly higher in comparison with controls, while in the bulb the two groups do not differ significantly. Moreover, when different duodenal portions are compared no differences in the number of G cells are observed in the duodenal ulcer group; while in controls the bulbar number of G cells is higher in comparison with second and third duodenum.

Adult↗
PubMed1988

Tripotassium dicitrate bismuthate and ranitidine in duodenal ulcer. Healing and influence on recurrence.

One hundred patients were entered into a double-blind, double-dummy comparison of tripotassium dicitrate bismuthate (TDB) versus ranitidine, to evaluate short-term healing rates, and successfully healed patients were then entered into a follow-up phase to observe relapse rates. At 4 weeks 84% of patients treated with TDB and 68% of those treated with ranitidine had healed. At 8 weeks these figures had risen to 96% and 90%, respectively (p = NS). After a year's follow-up study 84% of patients healed initially with ranitidine had relapsed, whereas in the case of patients healed initially with TDB the relapse rate was 67% (p less than 0.05). The results confirm that in the short term, TDB is as effective as ranitidine, whereas the significantly better protection against relapse offered by TDB compared with ranitidine underlines the importance of restoring mucosal defence, an approach that to date has been somewhat overlooked.

Adult↗
PubMed1988

Cytoprotective drugs: a new perspective in the treatment of adverse reactions to foods.

Food allergy (FA) and food intolerance (FI) are complex syndromes caused by adverse reactions to foods. Since mucosal permeability of the digestive tract is often increased during this pathology, we evaluated the clinical efficacy of two different cytoprotective drugs in patients with urticaria-angioedema due to FA and FI. These drugs were pirenzepine, an anti-muscarinic (anti-MI) receptor antagonist, and rosaprostol, a synthetic prostaglandin. Further, the results obtained by these schedules of treatment were compared with those achieved by the previously described polyantihistaminic treatment (ie, the association of anti-H1 plus anti-H2 receptor blockers). The present investigation suggests that the cytoprotective drugs are more effective than the antisecretive ones (ie, the anti-H2). Recently, anti-H2 drugs and ketotifen were shown to be in vitro inhibitors of the immune response and cromolyn was demonstrated capable of exerting an enhancing effect on T cell proliferation. In the present study we tested the effect of pirenzepine on several immunologic parameters, such as lymphocyte proliferation (through different activation pathways) and lymphokine (interleukin-2 and interferon-gamma) production. Since we found that pirenzepine does not affect the immune response and in consideration of its clinical efficacy, we consider this cytoprotective drug a valuable tool in the treatment of adverse reactions to foods.

Adult↗
PubMed1987

Photodynamic therapy of spontaneous animal tumors using the active component of hematoporphyrin derivative (DHE) as photosensitizing drug: clinical results.

Photodynamic therapy was performed on 25 primary spontaneous tumors in dogs and cats. The animals were injected with 2.5 mg/kg body wt. of tumor localizing fraction of hematoporphyrin derivative and treated 48 h later with laser light at 631 nm. In 5 cases the treatment was performed on the tumor bed after surgical excision of the tumor mass. An evaluation of clinical results is presented and discussed. Complete remission was obtained in 19 cases and partial remission in 6 cases.

Animals↗