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Gastroesophageal reflux disease management according to contemporary international guidelines:A translational study

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World Journal of Gastroenterology 2011年第9期17卷 1160-1166页

作者： fabio pace Gabriele Riegler Annalisa de Leone Patrizia Dominici Enzo Grossi the EMERGE Study Group Division of Gastroenterology Department of Clinical Sciences 'L. Sacco' UniversityHospital 74-20157 Milano Italy 'Magrassi-Lanzara' Department of Clinicaland Experimental Medicine 2nd University of Naples 80100Naples Italy Medical Department BraccoImaging SpA 24100 Milano Italy

AIM:To test the Genval recommendations and the usefulness of a short trial of proton pump inhibitor(PPI) in the initial management and maintenance treatment of gastroesophageal reflux disease(GERD)patients. METHODS:Five hundred and seventy seven patients with heartburn were *** completing a psychometric tool to assess quality of life(PGWBI)and a previously validated GERD symptom questionnaire (QUID),patients were grouped into those with esophagitis(EE,n=306)or without mucosal damage (NERD,n=271)according to endoscopy results. The study started with a 2-wk period of high dose omeprazole(omeprazole test);patients responding to this PPI test entered an acute phase(3 mo)of treatment with any PPI at the standard ***,those patients with a favorable response to the standard PPI dose were maintained on a half PPI dose for a further 3-mo period. RESULTS:The test was positive in 519(89.9%)patients,with a greater response in EE patients(96.4%) compared with NERD patients(82.6%)(P=0.011). Both the percentage of completely asymptomatic patients,at 3 and 6 mo,and the reduction in heartburn intensity were significantly higher in the EE compared with NERD patients(P<0.01).Finally,the mean PGWBI score was significantly decreased before and increased after therapy in both subgroups when compared with the mean value in a reference Italian population. CONCLUSION:Our study confirms the validity of the Genval guidelines in the management of GERD patients. In addition,we observed that the overall response to PPI therapy is lower in NERD compared to EE patients.

关键词： Gastroesophageal reflux disease Proton pump inhibitors Nonerosive gastroesophageal reflux Questionnaire Quality of life

An uncommon cause of corrosive esophageal injury

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World Journal of Gastroenterology 2008年第4期14卷 636-637页

作者： fabio pace Salvatore Greco Stefano Pallotta Daniela Bossi Emilio Trabucchi Gabrielle Bianchi Porro Clinical Science Department Gastroenterology Unit"L. Sacco" University HospitalMilan 20157Italy Clinical Science Department Unit of Surgery"L. Sacco" University HospitalMilan 20157Italy Clinical Science Department Gastro-enterology Unit"L. Sacco" University HospitalMilan 20157Italy

We present an unusual case of corrosive esophageal injury following liquid glue ingestion. The endoscopic f indings were tissue sloughing and blackened appearance of the esophagogastric junction,due to caustic esophag... 详细信息

关键词： Ingested foreign bodies Corrosive esophagitis

Microbiota-gut-brain axis and its affect inflammatory bowel disease:Pathophysiological concepts and insights for clinicians

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World Journal of Clinical Cases 2020年第6期8卷 1013-1025页

作者： Emanuele Sinagra Erika Utzeri Gaetano Cristian Morreale Carlo Fabbri fabio pace Andrea Anderloni Gastroenterology and Endoscopy Unit Fondazione Istituto Giuseppe GiglioContrada Pietra Pollastra PisciottoCefalù90015Italy Euro-Mediterranean Institute of Science and Technology Palermo 90100Italy Nuova Casa di Cura di Decimomannu Cagliari 09100Italy Section of Gastroenterology S.Elia-Raimondi HospitalCaltanissetta 93100Italy Gastroenterology and Digestive Endoscopy Unit Forlì-CesenaAzienda USL RomagnaForlì47121Italy Unit of Gastroenterology Bolognini HospitalBergamo 24100Italy Digestive Endoscopy Unit Division of GastroenterologyHumanitas Research HospitalRozzano 20089Italy

Despite the bi-directional interaction between gut microbiota and the brain not being fully understood,there is increasing evidence arising from animal and human studies that show how this intricate relationship may facilitate inflammatory bowel disease(IBD)pathogenesis,with consequent important implications on the possibility to improve the clinical outcomes of the diseases themselves,by acting on the different components of this system,mainly by modifying the *** the emergence of precision medicine,strategies in which patients with IBD might be categorized other than for standard gut symptom complexes could offer the opportunity to tailor therapies to individual *** aim of this narrative review is to elaborate on the concept of the gutbrain-microbiota axis and its clinical significance regarding IBD on the basis of recent scientific literature,and finally to focus on pharmacological therapies that could allow us to favorably modify the function of this complex system.

关键词： Irritable bowel syndrome Inflammatory bowel disease Gut-brain axis Therapy

Family history of irritable bowel syndrome is the major determinant of persistent abdominal complaints in young adults with a history of pediatric recurrent abdominal pain

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World Journal of Gastroenterology 2006年第24期12卷 3874-3877页

作者： fabio pace Giovanna Zuin Stefania Di Giacomo Paola Molteni Valentina Casini Massimo Fontana Gabriele Bianchi Porro Gastroenterology Department University Hospital "L.Sacco"-Milan Italy Pediatric Department University Hospital "L.Sacco"-Milan Italy

AIM： To assess the late outcome of teen-agers with a previous history of recurrent abdominal pain （RAP） or irritable bowel syndrome （IBS）. METHODS： A group of 67 children with RAP referred to the department from January 1986 to December 1995 was followed up between 5 and 13 years after the initial diagnosis by means of a structured telephone interview. We hypothesized that those patients with persistent adult IBS-like symptoms would be significantly more likely to report a family history oflBS in comparison with adults with no persistent abdominal complaint. RESULTS： Out of the 52 trackable subjects, 15 were found to present IBS-like symptoms at follow-up （29%） whereas the majority （37 subjects） did not. Subjects with IBS-like symptoms were almost three times more likely to present at least one sibling with similar symptoms compared to subjects not complaining （40.0% vs 16.0%）, respectively （P 〈 0.05 at Student t test）. Subjects with IBS-like symptoms also reported a higher prevalence of extra-intestinal symptoms, such as back pain, fibromyalgia, headache, fatigue and sleep disturbances. CONCLUSION： The study confirms previous observations indicating that pediatric RAP can predict later development of IBS. The latter appears to be greatly influenced by intrafamilial aggregation of symptoms, possibly through the learning of a specific illness behavior.

关键词： Irritable bowel syndrome Recurrent abdominal pain Family history Teenager

Influence of capsaicin infusion on secondary peristalsis in patients with gastroesophageal reflux disease

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World Journal of Gastroenterology 2016年第45期22卷 10045-10052页

作者： Chih-Hsun Yi Wei-Yi Lei Jui-Sheng Hung Tso-Tsai Liu Chien-Lin Chen fabio pace Department of Medicine Hualien Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation and Tzu Chi University Division of Gastroenterology Department of Clinical Sciences L. Sacco University Hospital

AIM To determine whether capsaicin infusion could influence heartburn perception and secondary peristalsis in patients with gastroesophageal reflux disease(GERD). METHODS Secondary peristalsis was performed with slow and rapid mid-esophageal injections of air in 10 patients with GERD. In a first protocol, saline and capsaicincontaining red pepper sauce infusions were randomly performed, whereas 2 consecutive sessions of capsaicin-containing red pepper sauce infusions were performed in a second protocol. Tested solutions including 5 m L of red pepper sauce diluted with 15 m L of saline and 20 m L of 0.9% saline were infused into the mid-esophagus via the manometric catheter at a rate of 10 mL /min with a randomized and doubleblind fashion. During each study protocol, perception of heartburn, threshold volumes and peristaltic parameters for secondary peristalsis were analyzed and compared between different *** Infusion of capsaicin significantly increased heartburn perception in patients with GERD(P < 0.001), whereas repeated capsaicin infusion significantly reduced heartburn perception(P = 0.003). Acute capsaicin infusion decreased threshold volume of secondary peristalsis(P = 0.001) and increased its frequency(P = 0.01) during rapid air injection. The prevalence of GERD patients with successive secondary peristalsis during slow air injection significantly increased after capsaicin infusion(P = 0.001). Repeated capsaicin infusion increased threshold volume of secondary peristalsis(P = 0.002) and reduced the frequency of secondary peristalsis(P = 0.02) during rapid air injection. CONCLUSION Acute esophageal exposure to capsaicin enhances heartburn sensation and promotes secondary peristalsis in gastroesophageal reflux disease, but repetitive capsaicin infusion reverses these effects.

关键词： Capsaicin Esophageal motility Secondary peristalsis Esophageal manometry Gastroesophageal reflux disease

Outcome of nonerosive gastro-esophageal reflux disease patients with pathological acid exposure

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World Journal of Gastroenterology 2009年第45期15卷 5700-5705页

作者： fabio pace Stefano Pallotta Gianpiero Manes Annalisa de Leone Patrizia Zentilin Luigi Russo Vincenzo Savarino Matteo Neri Enzo Grossi Rosario Cuomo Division of Gastroenterology Department of Clinical Sciences "L. Sacco" University HospitalVia G. B. Grassi 74-20157 MilanoItaly Gastroenterology Unit D.I.M.I University of GenovaViale Benedetto XV 6 16132 Genova Italy Gastroenterology Unit Dip. Med. Clin e Sper. AOU Federico ⅡVia S. Pansini 5 80131 Napoli Italy Department of Medicine and Aging Sciences and Ce.S.I "G. D'Annunzio" University & FoundationVia dei Vestini 31 66013 Chieti Italy Department of Medical Bracco Imaging SpAVia XXV Aprile 4 20097 San Donato Milanese Milano Italy

AIM： To assess the management and outcome of nonerosive gastro-esophageal reflux disease （NERD） patients who were identified retrospectively, after a 5-year follow-up. METHODS： We included patients with gastro-esophageal reflux disease （GERD） symptoms who had a negative endoscopy result and pathological 24-h esophageal pH-monitoring while off therapy. We interviewed them after an average period of 5 years （range 3.5-7 years） by means of a structured questionnaire to assess presence of GERD symptoms, related therapy, updated endoscopic data and other features. We assessed predictors of esophagitis development by means of univariate and multivariate statistical analysis. RESULTS： 260 patients （137 women） were included. Predominant GERD symptoms were heartburn and regurgitation in 103/260 （40%）. 70% received a maintenance treatment, which was proton pump inhibitor （PPI） in 55% of cases. An average number of 1.5 symptomatic relapses per patient/year of follow-up were observed. A progression to erosive gastro-esophageal reflux disease （ERD） was found in 58/193 （30.0%） of patients undergoing repeat endoscopy; 72% of these were Los Angeles grade A-B. CONCLUSION： This study to ERD occurs in about 5% shows that progression of NERD cases per year, despite therapy. Only two factors consistently and independently influence progression： smoking and absence of PPI therapy.

关键词： Esophagus Nonerosive gastro-esophageal reflux disease Gastro-esophageal reflux disease Epidemiology Acidity

New beverage based on grapes and purple-fleshed sweet potatoes:Use of non-standard tubers

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Food Bioscience 2022年第3期47卷 279-288页

作者： Letícia Silva Pereira Basílio Cristine Vanz Borges Igor Otavio Minatel Pablo Forlan Vargas Marco Antonio Tecchio fabio Vianello Giuseppina pace Pereira Lima Department of Chemical and Biological Sciences Institute of BiosciencesSão Paulo State University18.618-000 BotucatuSão PauloBrazil Tropical Root and Starches Center São Paulo State University18610-034 BotucatuSão PauloBrazil Department of Crop Production School of AgricultureSão Paulo State University18.610-034 BotucatuSão PauloBrazil Department of Comparative Biomedicine and Food Science University of Padova35020LegnaroItaly

Grapes and sweet potatoes are two different plant species that have distinct bioactive composition and the use of both in a non-alcoholic mixed beverage may be an interesting source of *** and sensory characteristics,profile of phenolic compounds and biogenic amines of mixed juices of grapes (‘BRS Violeta’,‘BRS Cora’ and ‘Bordô’) and purple-fleshed sweet potato (‘JNRX12’) (0,10 and 30%) were *** beverage with sweet potato had high antioxidant activity attributed to the phytochemical compounds (***,gallic acid,catechin,tryptophan,melatonin,serotonin and dopamine).Low levels of unwanted amines (histamine,tyramine,putrescine and cadaverine) were detected,showing that their consumption is ***-fleshed sweet potato had high levels of desirable amines,mainly melatonin,making the addition of sweet potato attractive for enriching *** color,texture and sensory aspects were similar in whole grape juice and in mixed *** from ‘BRS Violeta’,with or without sweet potato showed high levels of bioactive compounds but were the least *** overall appearance and aroma of juices elaborated from ‘BRS Cora’ or ‘Bordô' grapes had similar acceptance,regardless of the addition of sweet *** from ‘BRS Cora’ and 30% purple-fleshed sweet potato are the most interesting mixture due to tryptophan and melatonin *** juices of grapes and sweet potatoes (10% and 30%) are viable options for the use of tubers outside the commercial standard,as they add interesting bioactive compounds to beverages and please the consumer.

关键词： Functional beverages Phenolic compounds Biogenic amines Quality index

Polyphenols in Fruits and Vegetables and Its Effect on Human Health

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Food and Nutrition Sciences 2014年第11期5卷 1065-1082页

作者： Giuseppina pace Pereira Lima fabio Vianello Camila Renata Corrêa Renê Arnoux da Silva Campos Milena Galhardo Borguini Department of Chemistry and Biochemistry Sao Paulo State UniversityUNESPBotucatuSao PauloBrazil Department of Comparative Biomedicine and Food Science University of PadovaPadovaItalia Department of Internal Medicine Botucatu Medical SchoolSao Paulo State UniversityUNESPBotucatuSao PauloBrazil

Polyphenols represent a group of chemical substances common in plants, structurally characterized by the presence of one or more phenol units. Polyphenols are the most abundant antioxidants in human diets and the largest and best studied class of polyphenols is flavonoids, which include several thousand compounds. Numerous studies confirm that they exert a protective action on human health and are key components of a healthy and balanced diet. Epidemiological studies correlate flavonoid intake with a reduced incidence of chronic diseases, such as cardiovascular disease, diabetes and cancer. The involvement of reactive oxygen species (ROS) in the etiology of these degenerative conditions has suggested that phytochemicals showing antioxidant activity may contribute to the prevention of these pathologies. The present review deals with phenolic compounds in plants and reports on recent studies. Moreover, the present work includes information on the relationships between the consumption of these compounds, via feeding, and risk of disease occurrence, i.e. the effect on human health. Results obtained on herbs, essential oils, from plants grown in tropical, subtropical and temperate regions, were also reported.

关键词： Fruits Vegetables Consume Effect on Human Phenolic Content Thermal Processing Absorption