Minerva dietologica e gastroenterologica最新文献

Steroids and cytostatic drugs have an undoubtedly damaging action on the gastroduodenal mucosa. The action of pirenzepine was compared with that of the placebo in preventing the gastroduodenal lesions brought on by antiblastic therapy. Sixty patients were separated into two random group under double blind conditions and received 100 mg/die/os of pirenzepine or equivalent placebo for a continuous period of 12 weeks. Antiblastic drugs were administered at the same time. Final endoscopic control and symptomatological findings showed a statistically significant different in favour of the pirenzepine-treated group as early as the 6th week of treatment. No side-effects attributable to pirenzepine were reported.

Personal experience with 30 patients treated with Somatostatin for upper gastrointestinal bleeding is reported. The conclusion is drawn that this drug, reducing chloro-peptic secretion and hepatic portal blood flow, can reduce and control bleeding and postpone the surgical operation, which has a high rate of mortality.

The recognition of potentially noxious physiological substances in the intestinal milieu, prompted the use of an "elemental" semi-hydrolysed formula diet in the prophylaxis of experimental acute ischemic enteropathy. An elemental diet protects the intestinal mucosa of rodents from radiation injury and facilitates mucosal healing. Clinical trials have shown the benefits of this form of treatment in the prevention of acute radiation enteritis and therapy of delayed enteropathy and Crohn's disease.

The study has been undertaken to test the usefulness of the freezing-method on foods in the dietary formulations of the Hospital Food Service. Thirty-six recipes of specific diets (blended, liquid diets and diets of normal texture with high and low protein content) have been tested. These recipes were precooked and frozed within 2 hours. They were tested for taste, texture, aspect and colour by the same staff of the Dietetic Service (2 Dietitians and 2 Cooks). Twenty-eight recipes, after being reheated, have shown satisfactory results for all the characteristics tested. The time from freezing (test 15, 30, 45 days after freezing) does not influence the results. The freezing method is then useful for the most part of the specific Hospital Diets. A stock of frozen preparations can be used at any moment even by not qualified personnel and let a better work organization of the Dietetic Service Kitchen.

A whey protein diet has been shown to enhance splenic immune response to sheep red blood cells (SBRC) in mice. This study was designed to investigate the influence of the type of dietary protein on the biliary secretory IgA. A/J mice were fed defined formula diets containing either 20% whey protein, or 20% casein. Another group was fed Purina mouse chow. After 3 weeks of dietary treatment the body weight of each mouse was recorded and the gall-bladder was removed and its whole content analyzed by ELISA to determine S-IgA secretion. Body weight curves were similar in all dietary groups; higher biliary levels of S-IgA appeared in the whey protein fed mice than in the casein (p less than 0.025) or purine (p less than 0.025) fed mice. Dietary protein type may have a direct influence on the immune response in the gastrointestinal tract, without affecting body weight.

This report analyses the results obtained using endoscopic cytodiagnosis in upper gastrointestinal lesions. Cytological and bioptic samples were taken from 435 lesions, in 435 patients. Specificity was 0.99% and sensitivity 0.9%. The accuracy of the endoscopic sampling and in preparing the cytological slides had a decisive influence on the obtaining of these results. The time required for a good cytological sample is the same as required for a biopsy. As employed the cytodiagnosis of esophago-gastric lesions was really useful, and indeed essential in diffuse mucosal lesions.

A simple enzymatic colorimetric procedure for the total serum bile acids determination was evaluated. In 518 normal patients values of statistical analysis ranged from 0.60 to 7.75 mumol/l (mean = 3.38 and S.D. = 2.00).

The paper describes four cases of metastatic colon emphasizing its radiological aspect, represented by irregular and eccentric stenoses with stiffness and angling of the colon segments involved. In three cases, peritoneal carcinomatosis was also present and its radiological aspects (ascites, mesentery and omentum thickening, small intestine infiltration) were investigated by CT.

Six patients, 4 females and 2 males, mean age 58 (range 30-75) underwent an early endoscopic sphincterotomy because of acute pancreatitis. Serum amylases were 8N in 4 patients and greater than 20N in 2 cases. Ranson's criteria average was 2.2 for each patient. Ultrasonography showed gallbladder stones in 4 patients (2 patients underwent previously a cholecystectomy), choledochal stones in 1 patient, dilatation of main bile duct in 2 patients. Meteorism hid bile duct in 3 cases and pancreas in 5 cases. Duodenoscopy showed: papilla obstructed by gallstones in 2 patients, bulging intramural common bile duct in 2 patients; outlet of microstones and pus from papilla in 1 patient and in 1 case outlet of pus from papilla. Papillary obstruction was due to impacted stones in 4 patients, microstones in 1 patient and benign papillary stenosis in 1 patient. We performed standard sphincterotomy 3 times and in 3 patients we had to perform infundibolotomy. After endoscopic sphincterotomy and stones extraction, all the patients improved quickly and biochemical signs become normal in few days. We must not report any complication.

A group of 32 patients with erosive-haemorrhagic duodenitis or EHD (group 5) was followed up for 36 months in order to monitor the natural history of EHD and any connections with peptic ulcers. The control group (group C) was formed of patients with similar clinical symptoms but an endoscopic picture of either a healthy duodenum or only superficial mucosal damage (non-erosive-haemorrhagic duodenitis or NEHD). The follow-up clinical, secretory and endoscopic examinations annually or whenever there were new acute attacks revealed a far higher incidence of peptic ulcer in group S than group C or in the population as a whole. The study also revealed that there is not always a link between the clinical symptoms and the severity of the endoscopic picture. It is therefore concluded that EHD patients constitute a subclass that should be kept under surveillance and given the same management as duodenal ulcer patients.