Minerva dietologica e gastroenterologica最新文献

The aim of the study was to compare the efficacy and side-effects of 5-ASA and SASP in the treatment of active ulcerative colitis. An improvement was seen in 71.4% (5-ASA) and 70.3% (SASP) but there were no complete remissions. The incidence of improvements was only 36.3% (5-ASA) and 37.5% (SASP) in pancolitis. The side-effects appeared in 14.2% (5-ASA) and 21% (SASP).

Following a brief review of the various names in routine use to indicate solitary ulcer of the rectum syndrome, stress is laid on its variable anatomoclinical expressions, presenting personally observed cases and discussing the pathogenetic mechanisms and the diagnostic and therapeutic implications.

Oesophagus scintigraphy with 99mTc was used to evaluate oesophageal motility in a group of 23 diabetics without symptoms of autonomic neuropathy (AN). 11 patients were found to have a pathological response to the cardiovascular AN nerve tests. This group of diabetic patients with asymptomatic AN had a high frequency of esophageal dysfunction and a pattern of motor change characterized by uncoordinated movements compared with the group of diabetics without AN and with controls. No correlation between duration of diabetes, insulin dependence, presence of peripheral neuropathy (PN) and motor changes was found. The authors conclude asserting that oesophagus scintigraphy, owing to its sensibility, can lead to an early diagnosis of oesophageal dysfunction in diabetics when symptoms of NA are not yet observed.

A lethal case of E. coli induced meningitis and sepsis in patient with Le Veen peritoneo-venous shunt (PVS) for refractory ascites during alcohol induced cirrhosis of the liver is reported in confirmation of the high number of infectious complications that affects the cirrhotic, especially if he has been subjected to PVS. This report owes its interest to the unusual site of the infection which is however fairly frequent in these particular patients.

Gastric leiomyoblastoma is a rare stomach tumour arising in the muscular tunica. Its prevalently oesophytic development makes diagnostic techniques that mainly concentrate on the intestinal lumen (digestive X-ray and endoscopy) of little use. A case is reported in which echography pointed diagnosis in the right direction by analysing a number of typical symptomatological signs.

We have observed an adenocarcinoma of the stomach which developed on the site where an apparently benign active gastric ulcer had been diagnosed radiologically 10 and 7 years previously. The patient had complained of recurrent episodes of epigastric pain over ten years, which were well controlled by the medical treatment. The length of clinical history in this patient makes it unlikely that his ulcer was neoplastic at the time of onset. This appears to be, therefore, one of the rare instances of development of a gastric carcinoma on the site of a previously benign peptic ulcer.

The use of inflatable intragastric balloons is a new non-intensive approach in the treatment of obesity when poor results are obtained by more conservative treatment. The intragastric balloons are certainly less hazardous than bariatric surgery but their long term effect on body-weight reduction it is not still proved. Several types of balloons are currently in use. The two used most widely are the Garren-Edwards Gastric Bubble and the Ballobes Balloon. The Authors report their experience with these two types of anti-obesity gastric-balloon in 60 grossly obese patients.

Levels of alkaline phosphatase isoenzymes in patients with hepatic diseases, liver tumours and in normal control groups were analysed. Attention was focused on the ALP 1 isoenzyme and its validity in the diagnosis of hepatic metastases was confirmed.

Lipoma of the large bowel is an infrequent pathology. The Authors, on the basis of a review of the literature and of their own experience of two cases reported analyze the clinical features, macroscopic appearance, endoscopic signs which may serve as a guide to diagnose the disease. They stress the importance of colonoscopy for a correct diagnostic and therapeutic approach.

It is well known that prolonged use of Non Steroidal Anti-inflammatory Drugs (NSAIDs) can trigger gastroduodenal lesions and/or their complications, even in the absence of any dramatic painful and dyspeptic symptomatology. The paper reports the results of a double-blind study carried out with Colloidal Bismuth Subcitrate (CBS, DE-NOL), an antiulcer drug with cytoprotective activity, versus ranitidine (RN) with the aim of assessing its therapeutic efficacy in promoting healing of either gastric or duodenal ulcers induced by NSAIDs. It is concluded that the efficacy of DE-NOL is comparable to that of RN, although some minor differences in healing rates were observed: these being in favour of DE-NOL in the gastric ulcer patients and in favour of RN in the duodenal ulcer patients, respectively. In addition, it is stated that in patients undergoing chronic treatment with NSAIDs the use of cytoprotective drugs as a preventive treatment as well as periodic endoscopic surveillance are more useful and rational in order to combat the onset of NSAIDs-induced side-effects, given the frequent paucity of symptomatology following the occurrence of gastroduodenal lesions.