Biomedical subjects

R Farini

Publications and source records attributed to R Farini.

At least 19 recordsLinked to original sources

PubMed1986

Prospective evaluation of the diagnostic efficacy of CA 19-9 assay as a marker for gastrointestinal cancers.

Levels of a new carbohydrate antigen, CA 19-9, which is a monosialoganglioside identified by a monoclonal antibody raised against colorectal carcinoma cells, were compared to conventional CEA assays in 615 sera from healthy controls, patients with benign gastrointestinal disorders, and patients with cancers of gastrointestinal or extragastrointestinal origin. Whereas CEA levels were higher in smokers, CA 19-9 values were independent of the smoking history. CA 19-9 was undetectable in lymphoma and myeloma patients, but some patients with extraintestinal epithelial cancers expressed this antigen in serum. For benign and malignant gastrointestinal diseases, CA 19-9 displayed higher sensitivity, specificity, and predictive values than CEA. CA 19-9 was elevated as frequently as CEA in patients with metastatic pancreatic cancer, but in patients with localized disease, CA 19-9 was elevated more often than was CEA. In colorectal cancer, patients with and without metastases were detected at similar rates by both assays. It is concluded that CA 19-9 is a marker of epithelial cancers, does not vary with the smoking status, and is superior to CEA in detecting gastrointestinal malignancies, especially those arising from the pancreatic gland.

Antibodies, Monoclonal↗

PubMed1985

CA 19-9 in the differential diagnosis between pancreatic cancer and chronic pancreatitis.

CA 19-9 serum concentration was determined by a immunoradiometric technique in 130 subjects to evaluate its role in differentiating pancreatic cancer from chronic pancreatitis. Two threshold values were chosen, 17 and 37 U/ml. With the former, sensitivity, specificity and diagnostic accuracy were 86.7, 62.3 and 49.0 respectively, with the latter 73.3, 87.0 and 60.3%. The receiver-operating characteristic curves demonstrated a satisfactory discriminating capacity of CA 19-9 as regards pancreatic cancer and chronic pancreatitis; in contrast, the discrimination was poor for other gastrointestinal diseases, mainly of a malignant nature.

Adult↗

PubMed1985

Copper, zinc and copper/zinc ratio in chronic pancreatitis and pancreatic cancer.

Serum copper and zinc levels and their ratio were evaluated in 48 control subjects, 29 patients with pancreatic cancer, 46 with chronic pancreatitis and 32 with extra-pancreatic diseases, with the purpose of ascertaining modifications in chronic pancreatic disease. Hepatic involvement and age were also investigated as possible factors influencing results. Cu/Zn ratio was found to be significantly increased in pancreatic cancer (2.66 +/- 0.16, mean +/- SE) as compared to controls (1.39 +/- 0.06, p less than 0.001), chronic pancreatitis (1.82 +/- 0.09. p less than 0.001) and extra-pancreatic diseases (1.81 +/- 0.18, p less than 0.001), but without practical clinical value. Serum zinc levels appear to decrease with age, while copper and Cu/Zn ratio increase. However, covariance analysis demonstrated that age does not play an important role in influencing copper and Cu/Zn ratio. A decreased liver synthetic function, at least in part age-related, seems to be an additional factor in decreasing serum zinc values.

Adult↗

PubMed1985

Is maximal acid output useful in identifying relapsing duodenal ulcer patients?

In a group of 94 duodenal ulcer patients consecutively studied and followed-up for 1 year, subjects with maximal acid output (M.A.O.) above 60 mmol/hour (mostly heavy-smoking men), were found to relapse more frequently than those with lower M.A.O. values (72.2% versus 27.6%; p less than 0.0005). A significantly higher relapse rate was also detected in patients treated with maintenance dosages of effective antisecretory drugs (cimetidine, ranitidine, pirenzepine) and presenting M.A.O. over 60 mmol/hour. It is yet to be established whether an alternative therapeutic regime may prove effective in preventing ulcer recurrence in patients with gastric hypersecretion.

Adult↗

PubMed1985

A kinetic assay for human urinary kallikrein determination.

A simple kinetic method for human urinary kallikrein determination is proposed. In this assay, the release of p-nitroaniline from the chromogenic substrate S-2266 at 37 degrees C and pH 8.2 is followed spectrophotometrically at 405 nm. The delta A/5 min (0-5 min) interval was chosen. This assay was shown to have good sensitivity since enzyme concentrations as low as 0.00125 KU/ml could be measured. The use of dialyzed urines minimizes the interferences associated with high urinary salt concentration. Because of its precision and reproducibility, this kinetic assay may be proposed in clinical investigation.

Aniline Compounds↗

PubMed1985

CEA and ferritin in chronic pancreatic disease: a comparative evaluation.

CEA and ferritin were determined in 90 subjects with the aim of comparing their value in the diagnosis of pancreatic malignancy. Ferritin was shown to be more sensitive than CEA in detecting pancreatic cancer patients (68.4% and 57.9%, respectively) all of whom were, however, in an inoperable stage. In contrast, CEA showed a higher specificity as compared to ferritin (77.4% and 47.2%, respectively), the latter being frequently increased in inflammatory conditions such as chronic pancreatitis. The simultaneous assessment of CEA and ferritin showed the highest sensitivity when either parameter was found to be pathological and the highest specificity when both were. The receiver-operating characteristic curves demonstrated that CEA is more discriminating than ferritin for all serum values. Neither ferritin nor CEA may be considered a practically suitable marker of pancreatic cancer.

Adult↗

PubMed1984

Study of retinol-binding protein in pancreatic cancer.

Serum RBP, prealbumin, and zinc were evaluated in normal subjects and patients with pancreatic cancer and chronic pancreatitis. A significant decrease of RPB was found in pancreatic cancer patients compared with controls. A concomitant reduction of prealbumin and zinc was also observed. Multiple regression analysis suggested that the modification of RBP serum levels might be accounted for mainly by diminished prealbumin levels, while the direct role of zinc is negligible.

Adult↗

PubMed1984

Combined evaluation of serum ribonuclease and ferritin: any advantages in pancreatic cancer diagnosis?

In 116 subjects, serum ribonuclease (RNase) and ferritin were determined in order to evaluate whether their combined evaluation might improve the diagnostic accuracy of each test. Significantly higher levels were found in pancreatic cancer patients both for RNase and ferritin than in control subjects and chronic pancreatitis. Sensitivity and specificity in diagnosing pancreatic cancer were 86% and 46%, respectively for RNase; 76% and 65% for ferritin. One of the two tests was pathological in 100% of pancreatic cancer, with a specificity of 29.9%; both were pathological in 62.1%, with a specificity of 82.1%. The results emphasize the limits of the combined assessment of pancreatic cancer markers.

Adult↗

PubMed1984

Recurrence of duodenal ulcer under continuous antisecretory treatment: an approach to the detection of predictive markers.

Seventy consecutive duodenal ulcer patients endoscopically followed up and treated after ulcer scarring with maintenance dosages of effective antisecretory drugs for 1 year were studied in order to identify the factors associated with ulcer relapse. Logrank test, discriminant analysis (Rao's method), and chi 2 were used in evaluating the results. Nineteen patients (27.1%) relapsed. Duodenal ulcer was found to relapse more frequently in patients with total serum pepsinogen more than 109 micrograms tyr X ml-1 X 24 h-1 and in patients with maximal acid output more than 60 mmol/h (Logrank test; both p less than 0.025). Discriminant analysis showed that blood group, age at onset of the disease, and sex were together useful in recognizing subjects relapsing within 6 months' maintenance treatment (77.1% cases correctly classified); age at onset of the disease, alcohol intake, and smoking habit were together useful in picking out subjects relapsing throughout the entire observation period (1 year) (61.76% cases correctly classified). Our data suggest that: 1) duodenal ulcer subjects with elevated serum pepsinogen or maximal acid output are significantly more prone to relapse than patients with normal or slightly increased values; 2) genetic and acquired factors (such as blood group A, early onset of the disease, male sex, alcohol intake, and cigarette consumption) may have a role in influencing ulcer relapse.

Adolescent↗

PubMed1984

Personality and psychological factors in chronic duodenal ulcer. Their interaction with biological parameters.

Forty patients with chronic duodenal ulcer were studied to determine whether some particular personality and psychological factors are associated with this disease. To this purpose the Cattell's PF 16 personality Test was utilized. Duodenal ulcer population presented a typical personality profile characterized by: high anxiety, dependence and introversion. Some biological parameters, suggested as predictors of slow healing and/or relapse of ulcer, were studied: patients with maximal acid output greater than 60 mEq/h and /or total serum pepsinogen greater than 109 micrograms tyr/ml/24 hrs and/or serum pepsinogen group I greater than 99 ng/ml showed an anxiety level significantly higher than that of patients with values less than the reported thresholds. These results suggest a contributory role by psychological factors in duodenal ulcer disease. The association of anxiolitic drugs to the traditional antiulcer therapy may be proposed, particularly in hypersecretors.

Adaptation, Psychological↗

PubMed1983

Carcinoembryonic antigen in gastric juice collected during endoscopy. Value in detecting high-risk patients and gastric cancer.

In order to ascertain the role of gastric carcinoembryonic antigen (CEA) determination in detecting patients with a risk for gastric cancer, 69 subjects were studied; 23 were referred for endoscopy because of dyspepsia but without obvious macroscopic lesions, 27 with duodenal ulcer, 11 with benign gastric ulcer, 8 with gastric cancer. The following results were obtained by subdividing the material according to the histologic interpretation of the results of gastric mucosal biopsies: (1) in the presence of minor histologic abnormalities of the gastric mucosa, CEA in gastric juice was under 100 ng/ml in all but five cases; and (2) in moderate or severe chronic atrophic gastritis (associated or otherwise with intestinal metaplasia or dysplasia), and in gastric cancer, gastric CEA ranged between 224 and 3120 ng/ml in all but two cases. Although not diagnostic for gastric cancer, gastric CEA is a promising test in detecting patients at risk, including those with dysplasia of the gastric mucosa.

Adolescent↗

PubMed1983

Gastric epithelial dysplasia and sulphomucin-type intestinal metaplasia.

The HID-AB histologic staining technique, which distinguishes sulphomucin from sialomucin types of intestinal metaplasia, was employed in endoscopic gastric mucosal biopsies to evaluate their frequency of association with epithelial dysplasia. Sulphomucin-type intestinal metaplasia was found in 33% of the cases under observation; moderate or severe dysplasia was only associated with this type of intestinal metaplasia. Its precancerous significance can be ascertained only by means of prospective studies.

Adult↗

PubMed1983

[Immunologic changes in chronic pancreatitis].

In 35 patients with chronic pancreatitis, C3, C4, s-immunoglobulins, circulating immunocomplexes and T-lymphocytes were assessed in order to verify whether an immunological role may be postulated in the pathogenesis and/or in the maintenance of the disease. A significant increase of serum IgM together with normal values of C3 and C4 and without circulating immunocomplexes was found. A significant decrease in the total number of lymphocytes as well as in the number and percentage of T-lymphocytes was also documented. These results suggest a possible involvement of immunological (humoral and cellular) processes in maintaining the chronic pancreatic damage.

Adult↗

PubMed1983

[Benign and malignant gastric ulcers: is their localization relevant in their differential diagnosis?].

A study of potentially benign or malignant ulcer in the stomach was made to assess its role in the differential diagnosis between these two conditions. In the 201 patients observed, no statistically significant differences in frequency in the various sites were noted as regard either benign or malignant lesions. The site of the ulcer cannot be taken as indicative of its nature.

Adolescent↗

PubMed1983

[Chronic pancreatitis and diabetes].

Chronic pancreatitis appears to be increasing likely because increase in alcohol consumption and improved diagnostic tools. So the diabetes due to chronic pancreatitis is gaining importance. In order to obtain a better understanding of that particular secondary diabetes, 179 patients with chronic pancreatitis were studied from 1970 to 1981. 154 patients were male and 25 female. Average admission age was 45, ranging from 25 to 86. All the patients underwent medical therapy, based on diet, pancreatic enzymes, pain control. 99 of them underwent even to surgery. The follow-up is ranging from 6 months to 10 years: during this period 18 patients died, 41 went lost. 120 patients are still under observation. Diabetes was found in the family history of 27 patients (15%). At hospital admission 41 patients (23%) had high fasting glycemia, 23 of them even glycosuria. Other 74 showed diabetic oral glucose tolerance test. During the follow-up time 27 became clinically diabetic, 3 died because hyperosmolar coma and 8 had to be readmitted more than once because diabetic metabolic decompensation. Among the 120 patients at the moment under control, 66 (55%) show abnormal fasting glycemia, 10 developed high blood pressure, 12 inferior limbs vasculopathy with paresthesias and intermittent claudication, 2 myocardiosclerosis and atrial fibrillation, 1 myocardial infarction, 2 chronic nephropathy, 1 diabetic retinopathy. Whereas surgery or medic therapy may relieve chronic pancreatitis typical symptoms, they appear to be useless remedy against the under lying diabetes. As the time goes on more and more patients develop glucose intolerance, quite early became insulin-dependent, are disposed to severe diabetic metabolic decompensation and can show vascular, cardiac or renal complication.

Adult↗

PubMed1983

Actual role of pepsinogen group I in the study of upper gastrointestinal diseases.

The role of serum PG I in screening patients with chronic atrophic gastritis and gastric cancer, and in detecting peptic ulcer patients with high relapse risk, was ascertained in 276 subjects. Although not diagnostic per se, PG I was found to be under 20 micrograms/L in patients with chronic atrophic gastritis and in some gastric cancer or partially gastrectomized patients. In patients presenting with relapsing duodenal ulcer, PG I values were significantly higher than in the non-relapsing ones, but a satisfactory identification of all the duodenal ulcer patients with high relapse risk was not possible on this basis. Even the correlation between PG I and MAO was not accurate in every subject considered. These results suggest that the value of PG I is limited to assessing patients with upper gastrointestinal diseases in which a reduction of peptic secretion, and therefore of PG I in serum, is present.

Duodenal Ulcer↗

PubMed1983

Pepsinogen Group I radioimmunoassay and total serum pepsinogen colorimetric determination: a comparative study in normal subjects and in peptic ulcer patients.

Pepsinogens, proteolytic enzymes produced by peptic cells of the stomach and discharged into the gastric lumen as well as into the blood have been divided into two groups: PG-I, originating from chief cells, and PG-II, mainly from antrum peptic cells. Both total serum pepsinogen (s-Pg) and PG-I have been separately reported as being significantly increased in gastric (GU) and duodenal ulcer (DU) patients and related to maximal acid output. In order to ascertain the relationship between s-Pg measured by means of the colorimetric Uete method, and PG-I determined by RIA method, these were assayed in 72 control subjects, 35 GU and 95 DU patients. s-Pg was found to be significantly increased both in GU and DU patients in comparison with control subjects. Likewise PG-I was significantly enhanced in GU and DU patients as compared with controls. A significant direct correlation between s-Pg and PG-I was found in all the subjects studied (r = 0.732).

Adult↗

PubMed1983

Are biopsy forceps helpful in the endoscopic evaluation of ulcer diameter?

A hand-made papier-mâché stomach model with hollowed-out ulcers was employed for evaluating the accuracy in estimating ulcer diameters by means of endoscopy. The opened biopsy forceps were also used as a reference marker. Ten endoscopists with various degrees of experience were involved in the study. All the endoscopists underestimated the ulcer diameters; the use of the forceps, resulted in an improvement, in particular in the case of the comparatively inexperienced endoscopists. A stomach model may be helpful in the subjective assessment of the endoscopists' ability to estimate ulcer size.

Biopsy↗