Minerva dietologica e gastroenterologica最新文献

After a short introductory note on the incidence, classification and malignant potentiality of gastric polyps, according to the literature, the paper presents data on a six-year experience in gastric polypectomy involving 5942 endoscopies. The incidence of gastric polyps was 2.1%. Gastric polypectomy was performed on 84 patients with extirpation of 113 polyps. Assessments and comments are presented on the site, size, morphology, histological type, degree of dysplasia and degenerative potentiality of several types of gastric polyps. Gastric endoscopic polypectomy is a safe, economical, well-tolerated and valid methodology with considerable therapeutic possibilities and potential prophylactic actions against cancer.

41 consecutively observed patients with chronic HB virus infection in replication phase (HBeAG positive) were followed up for an average period of 60 months with a view to evaluating the frequency of spontaneous HBeAg/anti-HBe seroconversion and the influence of the event on the clinical course of the liver disease. The 41 patients, of mean age 22 years, suffered from: 26 ECP, 7 ECA, 8 CIRR. 18 patients (41%) presented HBeAg/anti-HBe seroconversion with an annual percentage of 12%, all with stable normalisation of hepatic cytolysis tests. Factors related to HBeAg/anti-HBe seroconversion were: female sex, higher mean starting values of transaminase, positive history for EVA, absence of Virus Delta superinfection. The effectiveness of antiviral treatments will only be demonstrated when seroconversion (inhibition of viral replication) is produced much more frequently than that which occurs spontaneously. Candidates for current antiviral treatment are indicated.

Gastroenteric changes in patients suffering from connectivitis observed consecutively between 1977 and 1986 have been examined: of the 24 patients (20 f, 4 m) aged between 13 and 76 yrs observed, 12 suffered from rheumatoid arthritis, 8 systemic lupus erythematosus, 2 sclerodermia, 2 mixed connectivitis. 14 reported gastroenteric disturbances, particularly dyspepsia, rarely dysphagia, diarrhoea, melena. Gastroenteric lesions, gastroesophageal reflux, erosive oesophagitis, oesophageal diverticulum, congestive gastritis, duodenitis, duodenal ulcer, diverticular colonopathy were observed, confirming the frequency of gastroenteric changes in connectivitis.

A case of Crohn's disease of the colon onsetting at 17 weeks gestation and observed at the 22 weeks when the disease presented severely and concomitant to serious maternal malnutrition, is reported. The patient was treated with NPT for 4 weeks in association with corticosteroids and sulphasalazine therapy continued to term (36 weeks). The newborn (weight 2480 g, Apgar of 9 at 5') developed moderately serious postnatal icterus resolved with phototherapy; at twelve months he presented normal growth and neurological development conditions. Stress is laid on the fortunate outcome of this gestation and the role of NPT in the correction of maternal malnutrition and the maintenance of foetal growth.

Gallstone ileus is a rare condition whose diagnosis may be puzzling. A series of 4 cases of gallstone ileus is presented. The last twenty years' literature was reviewed and compared with our results. Enterolithotomy was performed in all patients and no surgery was performed on the gallbladder and/or the fistula. The outcome was favourable in all cases, thus supporting our procedure.

The results obtained in the last 4 years in the treatment of superior digestive haemorrhage are reported. Of 71 patients examined, haemorrhage control with i.v. somatostatin was obtained in 95% of cases (68 patients). Arrest of haemorrhage was temporary in 2 patients, permitting surgery of choice. Three patients failed to respond to medical therapy and were operated in emergency. One of these patients died. No unwanted side-effects were observed.

The aim of the present study was to evaluate the gastro-duodenal motility coordination, both during the interdigestive phase and after antroduodenal volumetric stimulus. It has been proved that it is possible to evoke the peristaltic gastric activity by stretching the gastric walls. Thus, the Authors simulated the mechanical conditions of the meal by inflating air into the antrum. They studied 5 healthy volunteers, whose age averaged 43 +/- 22.85 years. A 120 cm probe provided with two balloons at 7 and 21 cm from the distal end, and with 7 open-tips for manometric recording, was positioned by endoscopic way. The Authors were able to evaluate the Motor Antral Threshold (i.e. minimum air volume able to evoke an antral motor reflex), obtained by means of the antral inflatable balloon. The average values of this threshold showed to be 35 +/- 5 ml of air. While keeping the duodenal balloon inflated, the repetition of volumetric antral stimulus did not show any Motor Antral Threshold. This threshold showed up again with similar volumes in every patient after deflating the duodenal balloon. The results obtained suggest the existence of a negative duodenal-antral feed-back control on gastric emptying.

The appearance and the progression of the specific immunoreactions at biliary levels (agglutinant titre, immunoenzimatic titration of IgAGM, IgA, IgG) in rabbits treated per os from 1 to 10 times, daily or bi-weekly, with 20 and 40 milliard of inactivated bacterial antigens (E. coli, Proteus vulgaris, Staph. aureus, Str. faecalis) have been studied. The appearance of the specific biliary antibodies has been very precocious (only one day after the first administration) and the values increased progressively with the number of administrations. The posology of 40 milliard and the bi-weekly sequence of the treatments presented the highest immunoreactions. In the bile the IgA and IgG increased considerably, but the IgA have been preponderant; in the serum only the IgG presented a remarkable increase, not the IgA, that are present in very small quantity.

Liquid alginate (Gaviscon) binds small amount of bile acids. At pH 7 its viscosity (at low shear rate) is higher than that of other antiacids. High viscosity reduces the diffusion rate of bile salts and glucose and this property can play a role in the treatment of gastro-esophageal and duodeno-gastric refluxes.

The essential nutritional value of the polyunsaturated fatty acids can, in the light of present-day knowledge, be considered valid in all respects as regards the n-6 family which derives from linoleic acid. On the other hand, the polyunsaturated fatty acids of the n-3 family deriving from linolenic acid to not possess essential requisites as, for instance, they are ineffective for healing skin lesions caused by deficiency of polyunsaturated fatty acids. Unsaturated fatty acids taken in with the diet have a two-fold function: 1) plastic, insofar as they are necessary for the biosynthesis of the phospholipids; 2) regulatory, as precursors of prostanoids or eicosanoids (prostaglandins, thromboxanes, prostacyclins). The process of desaturation-lengthening that leads to the formation of these compounds is, however, limited by the activity of desaturase, which is in poor enough supply, especially in certain tissues, under physiological conditions and is almost non-existent in certain pathologies such as diabetes, alcoholism, anaemia and hypercholesterolaemia. The recent use of vegetable oils such as those obtained from the seeds of Evening Primrose, is of particular interest owing to the presence of gamma-linolenic acid, the product of the activity of desaturase. In the light of this unusual property, the recent nutritional-therapeutic results obtained by using this vegetable oil are described.