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The impact of anxiety on lactose intolerance symptoms

Open Journal of Gastroenterology 2013年第2期3卷 89-92页

作者： Veronica Ojetti Tortora Annalisa Ianiro Gianluca Bertucci Flavio Ferrarese Daniele Buccelletti Francesco Zuccala’ giuseppe Gasbarrini antonio Department of Emergency Medicine Catholic University Rome Italy Department of Internal Medicine and Gastroenterology Catholic University Rome Italy

BACKGROUND Lactose malabsorption is variably associated with lactose intolerance (LI). The determinants of symptom onset have not yet been completely identified. Visceral sensitivity may play a role in the pathogenesis of functional symptoms;an increasing bulk of clinical and research data suggests the importance of the brain-gut interaction in intestinal bowel syndrome. AIM: To assess the impact of anxiety on LI symptoms, and the correlation between gas production during Lactose Breath test (LBT) and the intensity of gastrointestinal symptoms (GI) in anxious (A) and non-anxious (NA) patients. METHODS: LBT was carried out in 104 consecutive participants referred to our Gastroenterology Unit. GI symptoms were evaluated using the visual analogue scale (VAS: 0-10) throughout the LBT. All patients completed the HADS to determine anxiety. RESULTS LBT was positive in 70/104 (67%) participants;49/ 104 (47%) showed significant anxiety symptoms (>10 items). In A subjects we did not find any significant correlation between gas levels and abdominal LI symptoms scores throughout the LBT. A subject showed higher scores for all LI symptoms as compared with other participants, independently of LBT results. NA pts with positive LBT showed higher scores for all LI symptoms, as compared to negative subjects. LIMITATIONS: The predominant gender is female but it is in agreement with literature data that show a preponderance of IBS in women. CONCLUSIONS: A status significantly influences the severity of all LI symptoms and does not strictly correlate with lactase deficiency. Conversely, among NA subjects LI symptoms increase along with H2 production. Anxiety seems to be a confounding factor in IBS pts.

关键词： Lactose Intolerance Anxiety H2 Breath Test

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Gastroesophageal reflux and congenital gastrointestinal malformations

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World Journal of Gastroenterology 2015年第28期21卷 8508-8515页

作者： Lucia Marseglia Sara Manti Gabriella D'Angelo Eloisa Gitto Carmelo Salpietro antonio Centorrino Gianfranco Scalfari giuseppe Santoro Pietro Impellizzeri Carmelo Romeo Neonatal Intensive Care Unit Department of Pediatrics University of Messina Unit of Paediatric Genetics and Immunology Department of Paediatrics University of Messina Unit of Pediatric Surgery Department of Pediatrics University of Messina Department of Biomedical Sciences and Morpho-Functional Images University of Messina

Although the outcome of newborns with surgical congenital diseases(e.g.,diaphragmatic hernia;esophageal atresia;omphalocele;gastroschisis) has improved rapidly with recent advances in perinatal intensive care and surgery,infant survivors often require intensive treatment after birth,have prolonged hospitalizations,and,after discharge,may have longterm sequelae including gastro-intestinal comorbidities,above all,gastroesophageal reflux(GER).This condition involves the involuntary retrograde passage of gastric contents into the esophagus,with or without regurgitation or *** is a well-recognized condition,typical of infants,with an incidence of 85%,which usually resolves after physiological maturation of the lower esophageal sphincter and lengthening of the intra-abdominal esophagus,in the first few months after *** the exact cause of abnormal esophageal function in congenital defects is not clearly understood,it has been hypothesized that common(increased intra-abdominal pressure after closure of the abdominal defect) and/or specific(e.g.,motility disturbance of the upper gastrointestinal tract,damage of esophageal peristaltic pump) pathological mechanisms may play a role in the etiology of GER in patients with birth *** of knowledge could positively impact the long-term prognosis of patients with surgical congenital *** present manuscript provides a literature review focused on pathological and clinical characteristics of GER in patients who have undergone surgical treatment for congenital abdominal malformations.

关键词： Gastroesophageal reflux Congenital diaphragmatichernia Esophageal atresia Omphalocele Gastroschisis

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Laser ablation for small hepatocellular carcinoma: State of the art and future perspectives

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World Journal of Hepatology 2014年第10期6卷 704-715页

作者： Giovan giuseppe Di Costanzo Giampiero Francica Claudio Maurizio Pacella Liver Unit Antonio Cardarelli Hospital Interventional Ultrasound Unit Pineta Grande Hospital Department of Diagnostic Imaging and Interventional Radiology Regina Apostolorum Hospital

During the last two decades, various local thermal ablative techniques for the treatment of unresectable hepatocellular carcinoma(HCC) have been developed. According to internationally endorsed guidelines, percutaneous thermal ablation is the mainstay of treatment in patients with small HCC who are not candidates for surgical resection or transplantation. Laser ablation(LA) represents one of currently available loco-ablative techniques. In this article, the general principles, technique, image guidance, and patient selection are reported. Primary effectiveness, long-term outcome, and complications are also discussed. A review of published data suggests that LA is equivalent to the more popular and widespread radiofrequency ablation in both local tumor control and long-term outcome in the percutaneous treatment of early HCC. In addition, the LA technique using multiple thin laser fibres allows improved ablative effectiveness in HCCs greater than 3 cm. Reference centres should be equipped with all the available techniques so as to be able to use the best and the most suitable procedure for each type of lesion for each patient.

关键词： Liver Hepatocellular carcinoma Minimally invasive procedures Laser Laser ablation

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Propionyl-L-carnitine hydrochloride for treatment of mild to moderate colonic inflammatory bowel diseases

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World Journal of Gastroenterology 2012年第36期18卷 5065-5071页

作者： giuseppe Merra Giovanni Gasbarrini Lucrezia Laterza Marco Pizzoferrato Andrea Poscia Franco Scaldaferri Vincenzo Arena Francesca Fiore Achille Cittadini Alessandro Sgambato Francesco Franceschi antonio Gasbarrini Emergency Department Catholic University of Sacred Heart00168 RomeItaly Medical Research Foundation and nonprofit organization 40123 BolognaItaly Department of Internal Medicine and Gastroenterology Catholic University of Sacred Heart00168 RomeItaly Institute of Hygiene Catholic University of Sacred Heart00168 RomeItaly Institute of Pathology Catholic University of Sacred Heart00168 RomeItaly Department of Internal Medicine and Geriatry Catholic University of Sacred Heart00168 RomeItaly Institute of General Pathology Catholic University of Sacred Heart00168 RomeItaly

AIM:To assess clinical and endoscopic response to propionyl-L-carnitine hydrochloride(PLC) in colonic inflammatory bowel ***:Patients suffering from mild to moderate ulcerative colitis(UC) or Crohn's disease(CD) colitis,with disease activity index(DAI) between 3 and 10 and under stable therapy with oral aminosalicylates,mercaptopurine or azathioprine,for at least 8 wk prior to baseline assessments,were considered suitable for *** patients were enrolled to assume PLC 2 g/d(two active tablets twice daily) ***-endoscopic and histological activity were assessed by DAI and histological index(HI),respectively,following a colonoscopy performed immediately before and after 4 wk *** response was defined as a lowering of at least 3 points in DAI and clinical remission as a DAI score ≤ *** response was defined as an improvement of HI of at least 1 *** used median values for the *** pre-and post-treatment were analyzed by Wilcoxon signed rank ***:All patients enrolled completed the *** patient,despite medical advice,took deflazacort 5 d before follow-up colonoscopy *** side effects were reported by patients during the *** treatment,71%(SE 12%) of patients achieved clinical response,while 64%(SE 13%) obtained *** UC from CD patients,we observed a clinical response in 60%(SE 16%) and 100%,*** 60%(SE 16%) of UC patients and 75%(SE 25%) of CD patients were in clinical remission after *** median DAI was 7 [interquartile range(IQR):4-8] before treatment and decreased to 2(IQR:1-3)(P < 0.01) after *** patients with UC showed a significant reduction of DAI,from a median 6.5(IQR:4-9) before treatment to 2(IQR:1-3) after treatment(P < 0.01).Conversely,in CD patients,although displaying a clear reduction of DAI from 7(IQR:5.5-7.5) before therapy to 1.5(IQR:0.5-2.5) after therapy,differences observed were not sign

关键词： PropionyI-L-carnitine Ulcerative colitis Crohn's disease Inflammatory bowel disease therapy PropionyI-L-carnitine hydrochloride

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Hepatitis C virus recurrence after liver transplantation:A 10-year evaluation

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World Journal of Gastroenterology 2015年第13期21卷 3912-3920页

作者： Stefano Gitto Luca Saverio Belli Ranka Vukotic Stefania Lorenzini Aldo Airoldi Arrigo Francesco giuseppe Cicero Marcello Vangeli Lucia Brodosi Arianna Martello Panno Roberto Di Donato Matteo Cescon Gian Luca Grazi Luciano De Carlis antonio Daniele Pinna Mauro Bernardi Pietro Andreone Department of Medical and Surgical Sciences University of Bologna and Azienda Ospedaliero-Universitaria di BolognaPoliclinico Sant’Orsola Malpighi40138 BolognaItaly Department of Gastroenterology Azienda Ospedaliero-Universitaria and University of Modena and Reggio Emilia41124 ModenaItaly Department of Hepatology and Gastroenterology Niguarda Hospital20162 MilanItaly Hepatobiliopancreatic and General Surgery Unit Regina Elena Institute00186 RomeItaly Department of General Surgery and Transplantation Niguarda Hospital20162 MilanItaly

AIM: To evaluate the predictors of 10-year survival of patients with hepatitis C recurrence. METHODS: Data from 358 patients transplanted between 1989 and 2010 in two Italian transplant centers and with evidence of hepatitis C recurrence were analyzed. A χ2, Fisher's exact test and Kruskal Wallis' test were used for categorical and continuous variables, respectively. Survival analysis was performed at 10 years after transplant using the Kaplan-Meier method, and a log-rank test was used to compare groups. A P level less than 0.05 was considered significant for all tests. Multivariate analysis of the predictive role of different variables on 10-year survival was performed by a stepwise Cox logistic ***: The ten-year survival of the entire population was 61.2%. Five groups of patients were identified according to the virological response or lack of a response to antiviral treatment and, among those who were not treated, according to the clinical status(mild hepatitis C recurrence, "too sick to be treated" and patients with comorbidities contraindicating the treatment). While the 10-year survival of treated and untreated patients was not different(59.1% vs 64.7%, P = 0.192), patients with a sustained virological response had a higher 10-year survival rate than both the "non-responders"(84.7% vs 39.8%, P < 0.0001) and too sick to be treated(84.7% vs 0%, P < 0.0001). Sustained virological responders had a survival rate comparable to patients untreated with mild recurrence(84.7% vs 89.3%). A sustained virological response and young donor age were independent predictors of 10-year survival. CONCLUSION: Sustained virological response significantly increased long-term survival. Awaiting the interferon-free regimen global availability, antiviral treatment might be questionable in selected subjects with mild hepatitis C recurrence.

关键词： Hepatitis C Liver transplantation Hepatitis C viru

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Evaluation of the CO<sub>2</sub>Laser Therapy on Vulvo-Vaginal Atrophy (VVA) in Oncological Patients: Preliminary Results

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Journal of Cancer Therapy 2017年第5期8卷 452-463页

作者： Isabella Pagano Stefania Gieri Francesca Nocera giuseppe Scibilia Filippo Fraggetta antonio Galia Mauro Gioè Basilio Pecorino Paolo Scollo Department of Obstetrics and Gynecology Cannizzaro Hospital Catania Italy Institute of Molecular Bioimaging and Physiology National Research Council (IBFM-CNR)-LATO Cefalù (PA) Italy Pathology Unit Cannizzaro Hospital Catania Italy

Objective: To evaluate the impact of fractionated CO2 laser therapy on vaginal atrophy and mild/moderate stress urinary incontinence (SUI) symptoms in patients with physiological or surgically-induced menopause. Materials and Methods: Post-menopausal patients (n = 33) presenting vaginal atrophy and/or SUI, underwent three vaginal CO2 laser treatment sessions, performed at 1-month intervals. Vaginal symptoms were evaluated using the Vaginal Health Index Score (VHI-S), Visual Analogue Scales (VAS) for dyspareunia and global patient satisfaction. The impact of urinary incontinence on patient quality of life was evaluated using the International Consultation on Incontinence Questionnaire (ICIQ). Symptoms were evaluated before treatment and at every subsequent treatment session, as well as 3 months following the last treatment session. RESULTS: The three-session treatment series led to a significant improvement in both subjective symptoms (dryness, burning, dyspareunia) and clinical signs (VHI-S) (P Conclusions: Fractionated CO2 laser therapy is a safe, effective and easy-to-perform treatment modality for menopause-related vaginal atrophy and SUI.

关键词： Laser CO2 Vaginal Atrophy Urinary Incontinence Menopause

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Biochemical Parameters Alterations in Multiple Sclerosis: A Longitudinal Study and Review of the Literature

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Pharmacology & Pharmacy 2012年第2期3卷 248-253页

作者： Nicola Salvatore Orefice Olga Ferraro Francesco Barbato antonio Carotenuto Roberta Lanzillo Vincenzo Brescia Morra Giovanni Coppola giuseppe Orefice Department Neurological Sciences Federico II University of Naples Italy. Department of Experimental Pharmacology Federico II University of Naples Italy

Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) and is characterized by inflammation, demyelination and desctruction of oligodendrocytes and axons. The immunology of MS is complex, involving autoreactive Th1 and Th17 lymphocytes, cells of the innate immune system including dedritic, natural killer (NK) and microglia cells, as well as vascular endothelial cells. Multiple Sclerosis (MS) is based by a series of biochemical changes affecting to different extent neuronal functions;great attention has been focused on: liver enzymes, thyroid function tests, autoantibodies, lipid profile and uric acid levels. Following the introduction of therapy with drugs that modify the course of disease, more attention has been paid to the change of biochemical parameters, in particular to evaluate possible adverse effects. Aim of this study was to perform a review of the literature on biochemical alterations in treated and untreated MS patients and to assess laboratory parameters alterations in a cohort of MS patients, before and during treatment. On a total of 624 patients followed at our center, we selected those who practiced for the first time a therapy with IFN beta 1a at various doses, IFN beta 1b and Glatiramer acetate, that were 595 (95%), with baseline biochemical evaluation available in 488 (82%) (307 females, mean age 36.6 years). We considered the evolution of various biochemical parameters during treatment. The following outcome variables were evaluated: laboratory changes, in particular liver function, thyroid function, lipids and blood cell count. Percentages were compared using the chisquare test. ANOVA was performed to evaluate changes of laboratory tests over time between therapy groups. Our finding confirm the presence of biochemical alterations at baseline, in particular regarding liver enzymes, thyroid hormones and lipids. Treatment effects were more evident on liver enzymes elevation, anti thyroid antibodies production

关键词： Multiple Sclerosis Biochemical Alterations Liver Enzymes Thyroid Lipids

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Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation(Part Ⅱ:Treatment)

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World Journal of Gastroenterology 2012年第14期18卷 4994-5013页

作者： antonio Bove Massimo Bellini Edda Battaglia Renato Bocchini Dario Gambaccini Vincenzo Bove Filippo Pucciani Donato Francesco Altomare giuseppe Dodi Guido Sciaudone Ezio Falletto Vittorio Piloni Gastroenterology and Endoscopy Unit Department of GastroenterologyAORN "A.Cardarelli"80131 NaplesItaly Gastrointestinal Unit Department of GastroenterologyUniversity of Pisa56100 PisaItaly Gastroenterology and Endoscopy Unit Cardinal Massaja Hospital14100 AstiItaly Gastroenterology Unit M.Bufalini Hospital47023 CesenaItaly Department of Medical and Surgical Critical Care University of Florence50141 FlorenceItaly Department of Emergency and Organ Transplantation University of Bari70124 BariItaly Department of Oncological and Surgical Sciences University of Padua35126 PaduaItaly Division of General and Geriatric Surgery Second University of Naples80131 NaplesItaly Sixth Division of University Surgery Department of General SurgerySan Giovanni Battista Hospital10126 TurinItaly Diagnostic Imaging Centre "N.Aliotta" Villa Silvia-SenigalliaI-60100 AnconaItaly

The second part of the Consensus Statement of the Italian Association of Hospital Gastroenterologists and Italian Society of Colo-Rectal Surgery reports on the treatment of chronic constipation and obstructed defecation. There is no evidence that increasing fluid intake and physical activity can relieve the symptoms of chronic constipation. Patients with normal-transit constipation should increase their fibre intake through their diet or with commercial fibre. Osmotic laxatives may be effective in patients who do not respond to fibre supplements. Stimulant laxatives should be re- served for patients who do not respond to osmotic laxatives. Controlled trials have shown that serotonin- ergic enterokinetic agents, such as prucalopride, and prosecretory agents, such as lubiprostone, are effec- tive in the treatment of patients with chronic constipa- tion. Surgery is sometimes necessary. Total colectomy with ileorectostomy may be considered in patients with slow-transit constipation and inertia coil who are resistant to medical therapy and who do not have defecatory disorders, generalised motility disorders or psychological disorders. Randomised controlled trials have established the efficacy of rehabilitative treat- ment in dys-synergic defecation. Many surgical proce- dures may be used to treat obstructed defecation in patients with acquired anatomical defects, but none is considered to be the gold standard. Surgery should be reserved for selected patients with an impaired quality of life. Obstructed defecation is often associated with pelvic organ prolapse. Surgery with the placement of prostheses is replacing fascial surgery in the treatment of pelvic organ prolapse, but the efficacy and safety of such procedures have not yet been established.

关键词： Laxatives Prokinetics Biofeedback Pelvicfloor rehabilitation Outlet obstruction Stapled trans-anal rectal resection Delorme operation Colectomy Pelvic organ prolapse Mesh

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Megadoses of Sodium Ascorbate Efficiently Kill HL60 Cells <i>in Vitro</i>: Comparison with Arsenic Trioxide

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Journal of Cancer Therapy 2013年第8期4卷 1366-1372页

作者： Domenico Mastrangelo Lauretta Massai giuseppe Fioritoni antonio Iacone Paolo Di Bartolomeo Patrizia Accorsi Tiziana Bonfini Michela Muscettola Giovanni Grasso Department of Hematology Pescara Main Hospital Pescara Italy Department of Medical Surgical and Neurological Sciences University of Siena Siena Italy Pescara Cell Factory Foundation Pescara Main Hospital Pescara Italy

Arsenic Trioxide (ATO) is widely acknowledged as the treatment of choice for Acute Promyelocytic Leukemia (APL). It is a “two-sided” drug since it can induce differentiation or kill APL and other tumor cells according to the dosage. Part of the cytotoxic effects of ATO on APL cells is due to its pro-oxidant activity, a characteristic which ATO shares with a number of other compounds, including high doses of ascorbate (ASC). In a comparative investigation on the cytotoxic effects of both ATO and ASC on HL60 (APL) cell lines, in Vitro, we have been able to confirm the known cytotoxic effects of ATO, but, more importantly, we have demonstrated that ASC is significantly more effective than ATO, in killing these cancer cells in Vitro, when the concentrations are maintained within the millimolar (mM) range, i.e. the range of plasma concentrations at which ASC induces oxidative damage to tumor cells. Since these plasma levels can be reached only by the intravenous administration of high doses of ASC, we propose that intravenous high doses of ASC may represent a potentially revolutionary new approach in the management of APL.

关键词： HL60 Acute Promyelocytic Leukemia High Doses of Ascorbate Cell Count and Viability Assays

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Hyperferritinemia is a risk factor for steatosis in chronic liver disease

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World Journal of Gastroenterology 2009年第17期15卷 2132-2138页

作者： Anna Licata Maria Elena Nebbia giuseppe Cabibbo Giovanna Lo Iacono Francesco Barbaria Virna Brucato Nicola Alessi Salvatore Porrovecchio Vito Di Marco antonio Craxì Calogero Cammà Gastroenterology and Hepatology Unit Department of Internal Medicine University of Palermo 90127 Palermo Italy

AIM: To investigate the relationship between ferritin and steatosis in patients with chronically abnormal liver function tests (LFTs) and high ferritin level. METHODS: One hundred and twenty-four consecutive patients with hyperferritinemia (male > 300 ng/mL, female > 200 ng/mL) were evaluated; clinical, biochemical and serological data, iron status parameters, HFE gene mutations and homeostasis model assessment score were obtained. Steatosis was graded by ultrasound as absent or present. Histology was available in 53 patients only. RESULTS: Mean level of ferritin was 881 ± 77 ng/mL in men and 549 ± 82 ng/mL in women. The diagnosis was chronic hepatitis C in 53 (42.7%), non-alcoholic fatty liver disease/non-alcoholic steatohepatitis in 57 (45.9%), and cryptogenic liver damage in 14 (11.3%). None was diagnosed as hereditary hemochromatosis (HH). Hepatic siderosis on liver biopsy was present in 17 of 54 (32%) patients; grade 1 in eight and grade 2 in nine. Overall, 92 patients (74.2%) had steatosis. By logistic regression, ferritin and γ-glutamyltransferase were independent predictors of steatosis. Ferritin levels were signifi cantly related to low platelet count, steatosis and hepatitis C virus infection. CONCLUSION: In a non-obese cohort of non-alcoholic patients with chronically abnormal LFTs without HH, high serum ferritin level is a risk factor for steatosis.

关键词： Steatosis Serum ferritin Chronic liverdisease Hepatitis C γ-glutamyltransferase

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