Giornale di clinica medica最新文献

To obtain a complete study of respiratory patients, it is correct to analyze also the sleeping pattern. In these subjects, to improve respiratory tests and to reduce the bronchoconstriction, we must to use drugs with a constant action. However, during sleep, a decreased respiratory muscle function, a ventilation perfusion imbalance and a decreased response to chemical stimuli are undesirable factors related to transient desaturations. The study of sleep stages is useful to know better the respiratory disorders and the action of the drugs. We report the data of an allergic rhinitis population to evaluate the eventual modifications in sleep pattern brought upon by ketotifen.

The authors report the results of an open study carried out on 23 patients with head-neck neoplasia in order to test whether rational nutritional treatment can improve weight and clinical state. The data obtained would indicate that patients with nutritional intake higher than 26 kcal/kg of body weight underwent increase in body weight. The authors conclude that neoplastic patients, and in particular subjects affected by head-neck or cervico-facial neoplasia, need suitable nutritional intake.

Helicobacter pylori (H.p.), has been shown, experimentally, to exert a proteolytic activity against mucous fractions. Aim of this study was to assess the prevalence of H.p. in peptic ulcer and to analyze its possible influence on gastric mucus components, on peptic activity in gastric juice and the possible action on peptic secretion. 223 patients undergoing upper gastrointestinal endoscopy were analyzed for the presence of H.p. in the mucosa: 99 duodenal ulcer patients (D.U.), 58 gastric ulcer patients (D.U.) and 66 dyspeptic subjects. In each patients, three contiguous gastric biopsies were taken at the antrum: the first was evaluated for gastritis (Whitehead Criteria), the two other analyzed for H.p. with a rapid urease test. In a subgroup of 25 D.U. and 18 G.U. patients, two other biopsies were taken at the fundus corpus of the stomach, to evaluate peptic secretion. To determinate mucous components (acid and neutral glycoproteins, galactose and N-acetylneuraminic acid), gastric juice samples were collected during endoscopy. H.p. was present in 89% of antral biopsies in D.U., in 56% of G.U. and in 51% of D., and was associated to antral gastritis. As regard gastric juice components, we observed an increase and a decrease of acid glycoproteins, respectively, in D.U. and G.U. patients with H.p. infection. An increase of peptic activity has been found in the gastric juice of both gastric and duodenal ulcer patients H.p. positive (G.U. p less than 0.05). On the contrary, no significant differences were observed on peptic activity in the fundus-corpus biopsies between H.p. positive and H.p. negative patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Patients with chronic liver disease (CLD) may show an abnormal glucose tolerance test (GTT). On the other hand, it is debated whether diabetics may undergo abnormalities of liver function. The aim of our study was to see whether galactose tolerance test (GaTT) is a suitable complementary diagnostic tool in defining the glucose metabolism abnormalities characteristic of the two above mentioned clinical entities. Thirty-one patients with CLD, 16 adult diabetics and 12 healthy volunteers were considered. GTT with radioimmunoassay of plasmatic insulin (IRI) and oral GaTT were performed. CLD patients were divided into two groups: with IRI/glycemia greater than 0.4 or less than 0.4. On GaTT, galactosemia was significantly raised in CLD compared to diabetics and control. Further, a statistically significant difference was shown in the glycemic variations during GaTT between diabetics and both CLD groups. A significantly inverse ratio galactosemia/glycemia occurred during GaTT and showed a different pattern between diabetics and CLD patients with impaired insulin secretion. A careful study of galactosemia and glycemia variations during GaTT reliably defines the different patterns of glucose metabolism derangement in CLD with abnormal GTT and in diabetics.