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Endoscopic findings in patients with upper gastrointestinal bleeding clinically classified into three risk groups prior to endoscopy

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World Journal of Gastroenterology 2008年第32期14卷 5046-5050页

作者： Leonardo Tammaro Maria Carla Di Paolo Angelo Zullo Cesare Hassan Sergio Morini SebastianoCaliendo lorella pallotta Gastroenterology and DigestiveEndoscopy Ⅱ "San Giovanni Addolorata" Hospital Gastroentero-logy and Digestive Endoscopy "Nuovo Regina Margherita"Hospital

AIM: To investigate in a prospective study whether a simplifi ed clinical score prior to endoscopy in upper gastrointestinal bleeding (UGIB) patients was able to predict endoscopic findings at urgent endoscopy. METHODS: All consecutive UGIB patients referred to a single endoscopic center during a 16 mo period were enrolled. Before endoscopy patients were strati- fied according to a simple clinical score (T-score), including T1 (high-risk), T2 (intermediate-risk) and T3 (low-risk). Endoscopy was performed in all cases within 2 h, and high-risk stigmata were considered for further analysis. RESULTS: Out of the 436 patients included into the study, 126 (29%) resulted to be T1, 135 (31%) T2, and 175 (40%) T3. Overall, stigmata of recent haem-orrhage (SRH) were detected in 118 cases (27%). SRH occurred more frequently in T1 patients than in T2/T3 cases (85% vs 3.2%; χ2 = 304.5309, P < 0.001). Older age (t=3.311; P < 0.01) and presence of comor-bidities (χ2 = 14.7458; P < 0.01) were more frequently detected in T1 than in T2/T3 patients. CONCLUSION: Our simplifi ed clinical score appeared to be associated with the detection of endoscopic findings which may deserve urgent endoscopy. A further,randomised study is needed to assess its accuracy in safely scheduling endoscopy in UGIB patients.

关键词： Upper gastrointestinal bleeding Urgentendoscopy Timing score Endoscopic treatment Oesophageal varices Peptic ulcer

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High-fibre diet and Lactobacillus paracasei B21060 in symptomatic uncomplicated diverticular disease

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World Journal of Gastroenterology 2012年第41期18卷 5918-5924页

作者： Edith Lahner Gianluca Esposito Angelo Zullo Cesare Hassan Claudio Cannaviello Maria Carla Di Paolo lorella pallotta Nicoletta Garbagna Enzo Grossi Bruno Annibale Department of Digestive and Liver Disease University SapienzaRome 2nd Medical SchoolSant'Andrea Hospital00189 RomeItaly Ospedale Nuovo Regina Margherita 00189 RomeItaly Gastroenterology Unit Ospedale Israelitico00148 RomeItaly Gastroenterology Unit Ospedale San Giovanni00184 RomeItaly Medical Department Bracco Spa 20134 MilanItaly

AIM： To investigate in symptomatic uncomplicated di- verticular disease the efficacy of symbiotics associated with a high-fibre diet on abdominal symptoms. METHODS： This study was a multicentre, 6-too ran- domized, controlled, parallel-group intervention with a preceding 4-wk washout period. Consecutive out- patients with symptomatic uncomplicated diverticular disease, aged 40-80 years, evaluated in 4 Gastroenterology Units, were enrolled. Symptomatic uncomplicated diverticular disease patients were randomized to two treatment arms A or B. Treatment A （n = 24 patients） received 1 symbiotic sachet Flortec~ （Lactobacillus paracasei B21060） once daily plus high-fibre diet for 6 mo. Treatment B （n = 21 patients） received high-fibre diet alone for 6 rno. The primary endpoint was regres- sion of abdominal symptoms and change of symptom severity after 3 and 6 mo of treatment. RESULTS： In group A, the proportion of patients with abdominal pain 〈 24 h decreased from 100% at base- line to 35% and 25% after 3 and 6 mo, respectively （P 〈 0.001）. In group B the proportion of patients with this symptom decreased from 90.5% at baseline to 61.9% and 38.1% after 3 and 6 mo, respectively （P = 0.001）. Symptom improvement became statistically sig- nificant at 3 and 6 mo in group A and B, respectively. The proportion of patients with abdominal pain 〉24 h decreased from 60% to 20% then 5% after 3 and 6 too, respectively in group A （P 〈 0.001） and from 33.3% to 9.5% at both 3 and 6 mo in group B （P = 0.03）. In group A the proportion of patients with ab- dominal bloating significantly decreased from 95% to 60% after 3 mo, and remained stable （65%） at 6-mo follow-up （P = 0.005） while in group B, no significant changes in abdominal bloating was observed （P = 0.11）. After 6 mo of treatment, the mean visual analogic scale （VAS） values of both short-lasting abdominal pain （VAS, mean ± SD, group A： 4.6 ± 2.1 vs 2.2 ± 0.8, P = 0.02; group B： 4.6 ± 2.9 vs 2.0 ± 1.9, P = 0.03） and abdom- inal bloat

关键词： Symptomatic uncomplicated diverticulardisease Lactobacillus paracasei B21060 Probiotics Symbiotics Diverticular disease High-fibre diet

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