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Chronic functional constipation is strongly linked to vitamin D deficiency

World Journal of Gastroenterology 2019年第14期25卷 1729-1740页

作者： Alba Panarese francesco pesce Piero Porcelli Giuseppe Riezzo Palma Aurelia Iacovazzi Carla Maria Leone Massimo De Carne Caterina Mammone Rinaldi Endrit Shahini Department of Gastroenterology and Digestive Endoscopy Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital Nephrology section Department of Emergency and Organ TransplantationUniversity of Bari Department of Psychological Health and Territorial Sciences D'Annunzio University of Chieti-Pescara Department of Clinical Pathology Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital Department of Radiology Scientific Institute for Digestive Disease "Saverio de Bellis" Hospital Department of Emergency and Organ Transplantation University of Bari

BACKGROUND Few studies have examined intestinal motility disorders, which are disabling conditions associated with chronic functional constipation, whose pathogenesis is actually not *** To investigate the relationship between serum 25-hydroxyvitamin D levels and functional chronic constipation associated to intestinal motility *** We performed a prospective case-control study, from May-June to November2017. Glucose/lactulose breath tests, radiopaque markers(multiple capsule techniques) and wireless motility capsule analysis were used to assess colonicand oro-cecal transit time, after excluding small-intestinal bacterial overgrowth condition. Then, we measured 25-hydroxyvitamin D levels in patients with intestinal motility disorders and we further evaluated the influence of intestinal motility disorders on psychological symptoms/quality of life using validated questionnaires, the Irritable Bowel Syndrome Quality of life(IBS-QOL), the Short Form Health Survey 12, and the Hospital Anxiety and Depression Scale 14(HADS-14 A and HADS-14 D).RESULTS We enrolled 86 patients with chronic functional constipation associated to intestinal motility disorders and 86 matched healthy subjects. Patients with intestinal motility disorders had lower 25-hydroxyvitamin D levels(P < 0.001), and they showed a significant impairment of all health-related quality of life and psychological tests(IBS-QOL, Short Form Health Survey 12-Physical Component Summary, Short Form Health Survey 12-Mental Component Summary, HADS-14 A and HADS-14 D), as compared to the control group(P < 0.001), which significantly correlated with low vitamin D levels(r =-0.57, P < 0.001; r = 0.21, P = 0.01; r =-0.48, P < 0.001; r =-0.57, P < 0.001; r =-0.29, P < 0.001, respectively). At multivariate analysis vitamin D low levels remained a significant independent risk factor for the occurrence of intestinal motility disorder(odds ratio = 1.19; 95% confidence interval: 1.14-1.26, P < 0.001).CONC

关键词： Chronic constipation Intestinal motility Vitamin D Quality of life Anxiety Depression

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Helicobacter pylori-induced inflammation masks the underlying presence of low-grade dysplasia on gastric lesions

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World Journal of Gastroenterology 2020年第26期26卷 3834-3850页

作者： Alba Panarese Giovanni Galatola Raffaele Armentano Pedro Pimentel-Nunes Enzo Ierardi Maria Lucia Caruso francesco pesce Marco Vincenzo Lenti Valeria Palmitessa Sergio Coletta Endrit Shahini Department of Gastroenterology and Digestive Endoscopy National Institute of Gastroenterology"S De Bellis"Research HospitalCastellana Grotte 70013Italy Department of Clinical Pathology National Institute of Gastroenterology"S De Bellis"Research HospitalCastellana Grotte 70013Italy Center for Research in Health Technologies and Information Systems Faculty of MedicinePorto 4200072Portugal Surgery and Physiology Department Faculty of Medicine of the University of PortoPorto 4200072Portugal Department of Emergency and Organ Transplantation University of BariBari 70124Italy Nephrology Section Department of Emergency and Organ TransplantationUniversity of BariBari 70124Italy First Department of Internal Medicine San Matteo Hospital FoundationUniversity of PaviaPavia 27100Italy Laboratory of Microbiology and Virology National Institute of Gastroenterology"S De Bellis"Research HospitalCastellana Grotte 70013Italy Gastroenterology Unit Institute for Cancer Research and TreatmentTurin 10121Italy

BACKGROUND Helicobacter pylori(***)infection has been associated with a long-term risk of precancerous gastric conditions(PGC)even after *** *** To investigate the efficacy of High-Resolution White-Light Endoscopy with Narrow-Band Imaging in detecting PGC,before/after *** *** We studied 85 consecutive patients with ***-related gastritis with/without PGC before and 6 mo after proven *** ***-Takemoto modified and endoscopic grading of gastric intestinal metaplasia classifications,were applied to assess the endoscopic extension of atrophy and intestinal *** histological result was considered to be the gold *** Sydney System,the Operative-Link on Gastritis-Assessment,and the Operative-Link on Gastric-Intestinal Metaplasia were used for defining histological gastritis,atrophy and intestinal metaplasia,whereas dysplasia was graded according to World Health Organization *** anti-parietal cell antibody and anti-intrinsic factor were measured when autoimmune atrophic gastritis was *** After *** eradication histological signs of mononuclear/polymorphonuclear cell infiltration and Mucosal Associated Lymphoid Tissue-hyperplasia,disappeared or decreased in 100%and 96.5%of patients respectively,whereas the Operative-Link on Gastritis-Assessment and Operative-Link on Gastric-Intestinal Metaplasia stages did not ***-Grade Dysplasia prevalence was similar on random biopsies before and after *** eradication(17.6%vs 10.6%,P=0.19),but increased in patients with visible lesions(0%vs 22.4%,P<0.0001).At a multivariate analysis,the probability for detecting dysplasia after resolution of ***-related active inflammation was higher in patients with regression or reduction of Mucosal Associated Lymphoid Tissue hyperplasia,greater alcohol consumption,and anti-parietal cell antibody and/or anti-intrinsic factor positivity[odds ratio(OR)=3.88,95%confidence i

关键词： Autoimmune gastritis Dysplasia Diagnosis Malignancy Gastric cancer Symptoms Signs

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