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A pediatric non-protein losing Menetrier's disease successfully treated with octreotide long acting release

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World Journal of Gastroenterology 2012年第21期18卷 2727-2729页

作者： giovanni di nardo Salvatore Oliva Marina Aloi Federica Ferrari Simone Frediani Adriana Marcheggiano Salvatore Cucchiara Department of Pediatrics Pediatric Gastroenterology and Liver Unit Sapienza University of Rome00161 Rome Italy Department of Medical Science Sapienza University of Rome00161 Rome Italy

Pediatric Menetrier's disease (MD) is an uncommon, acute, self-limited hypertrophic gastropathy characterized by enlarged gastric folds associated with epithelial hyperplasia and usually accompanied by protein losing gastropathy. Gastric cytomegalovirus infection is found in one third of MD children and its treatment is often associated with remission. diagnosis often requires fullthickness biopsy due to inability to detect typical histological findings with conventional endoscopic biopsy. We report an uncommon case of non self-limited pediatric MD needing endoscopic mucosal resection for diagnosis which was then successfully treated with octreotide long-acting release (LAR). To the best of our knowledge, this is the first pediatric MD case successfully treated with octreotide LAR. Our experience suggests octreotide LAR as treatment for refractory MD before gastrectomy.

关键词： Menetrier’s disease Octreotide Endoscopic mucosal resection Children

Enteroscopy in children and adults with inflammatory bowel disease

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World Journal of Gastroenterology 2020年第39期26卷 5944-5958页

作者： giovanni di nardo Gianluca Esposito Chiara Ziparo Federica Micheli Luigi Masoni Maria Pia Villa PasqualeParisi Maria Beatrice Manca Flavia Baccini Vito Domenico Corleto Chair of Pediatrics Pediatric Gastroenterology and Endoscopy UnitNESMOS DepartmentFaculty of Medicine and PsychologySapienza University of RomeSant’Andrea University HospitalRome 00189LazioItaly Department of Medical-Surgical Sciences and Translational Medicine Sant’Andrea HospitalSapienza University of RomeRome 00189LazioItaly Department of Medical-Surgical Sciences and Translational Medicine Sant’Andrea University HospitalSapienza University of RomeRome 00189LazioItaly Department of Surgery Sapienza University of RomeSant’Andrea University HospitalRome 00189LazioItaly Department of Clinical and Surgical Translational Medicine Anesthesia and Intensive Care MedicineSant'Andrea University HospitalSapienza University of Rome 00189LazioItaly

Inflammatory bowel disease(IBD)includes Crohn’s disease(CD),ulcerative colitis and unclassified *** commonly involves the terminal ileum and colon but at the time of diagnosis it can be confined to the small bowel(SB)in about 30%of the patients,especially in the young *** of isolated SB-CD can be challenging and objective evaluation of the SB mucosa is essential in differentiating CD from other enteropathies to achieve therapeutic decisions and to plan the *** introduction of cross-sectional imaging techniques and capsule endoscopy(CE)have significantly expanded the ability to diagnose SB diseases providing a non-invasive test for the visualization of the entire SB *** main CE limitations are the low specificity,the lack of therapeutic capabilities and the impossibility to take *** assisted enteroscopy(DAE)enables histological confirmation when traditional endoscopy,capsule endoscopy and cross-sectional imaging are inconclusive and also allows therapeutic interventions such as balloon stricture dilation,intralesional steroid injection,capsule retrieval and more recently stent *** the current review we will discuss technical aspect,indications and safety profile of DAE in children and adults with IBD.

关键词： Enteroscopy Device assisted enteroscopy Inflammatory bowel disease Crohn’s disease Small bowel disease Endoscopic balloon dilation

Enteric neuropathology of congenital intestinal obstruction:A case report

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World Journal of Gastroenterology 2006年第32期12卷 5229-5233页

作者： giovanni di nardo Vincenzo Stanghellini Salvatore Cucchiara giovanni Barbara Gianandrea Pasquinelli Donatella Santini Cristina Felicani Gianluca Grazi Antonio D Pinna Rosanna Cogliandro Cesare Cremon Alessandra Gori Roberto Corinaldesi Kenton M Sanders Roberto De Giorgio Department of Pediatrics Pediatric Gastroenterology Unit University of Rome 'La Sapienza' Rome Italy Department of Internal Medicine and Gastroenterology and Centro di Ricerca Biomedica Applicata (CRBA) Rome Italy 不详 Department of Pathology and Department of Surgery and Transplantation University of Bologna Bologna Italy Department of Physiology and Cell Biology University of Nevada School of Medicine Reno Nevada United States

Experimental evidence indicates that chronic mechanical sub-occlusion of the intestine may damage the enteric nervous system （ENS）, although data in humans are lacking. We here describe the first case of enteric degenerative neuropathy related to a congenital obstruction of the gut. A 3-year and 9-mo old girl began to complain of vomiting, abdominal distension, constipation with air-fluid levels at plane abdominal radiology. Her subsequent medical history was characterized by 3 operations： the first showed dilated duodeno-jejunal loops in the absence of occlusive lesions; the second （2 years later） was performed to obtain full-thickness biopsies of the dilated intestinal loops and revealed hyperganglionosis at histopathology; the third （9 years after the hyperganglionosis was identified） disclosed a Ladd＇s band which was removed and the associated gut malrotation was corrected. Repeated intraoperative full-thickness biopsies showed enteric degenerative neuropathy along with reduced interstitial cells of Cajal network in dilated loops above the obstruction and a normal neuromuscular layer below the Ladd＇s band. One year after the latest surgery the patient tolerated oral feeding and did well, suggesting that congenital （partial） mechanical obstruction of the small bowel in humans can evoke progressive adaptive changes of the ENS which are similar to those found in animal models of intestinal mechanical occlusion. Such ENS changes mimic neuronal abnormalities observed in intestinal pseudoobstruction.

关键词： Enteric neuropathy Chronic intestinal pseudo-obstruction Congenital intestinal obstruction Ladd's band Enteric nervous system

Italian survey on non-steroidal anti-inflammatory drugsand gastrointestinal bleeding in children

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World Journal of Gastroenterology 2016年第5期22卷 1877-1883页

作者： Sabrina Cardile Massimo Martinelli Arrigo Barabino Paolo Gandullia Salvatore Oliva giovanni di nardo Luigi Dall'Oglio Francesca Rea Gian Luigi de'Angelis Barbara Bizzarri Graziella Guariso Enzo Masci Annamaria Staiano Erasmo Miele Claudio Romano Gastroenterology and Endoscopic Unit Department of PediatricsUniversity of Messina98100 MessinaItaly Department of Translational Medical Science Section of PediatricsUniversity of Naples“Federico II”80131 NaplesItaly Department of Pediatric Gastroenterology Gaslini Institute16148 GenoaItaly Department of Pediatrics and Infantile Neuropsychiatry Pediatric Gastroenterology and Liver UnitSapienza University of Rome00185 RomeItaly digestive Surgery and Endoscopy Unit Bambino GesùChildren’s Hospital00165 RomeItaly Gastroenterology and Endoscopy Service University of Parma43126 ParmaItaly Unit of Paediatric Gastroenterology Digestive EndoscopyHepatologyand Care of Children with Liver TransplantationDepartment of Women’s and Children’s HealthUniversity Hospital of Padova35128 PadovaItaly Gastrointestinal Endoscopy Azienda Ospedaliera San Paolo University HospitalUniversity of Milan20142 MilanItaly

AIM: To investigate gastrointestinal complications associated with non-steroidal anti-inflammatory drug(NSAIDs) use in ***: A retrospective, multicenter study was conducted between January 2005 and January 2013, with the participation of 8 Italian pediatric gastroenterology centers. We collected all the cases of patients who refer to emergency room for suspected gastrointestinal bleeding following NSAIDs consumption, and underwent endoscopic evaluation. Previous medical history, associated risk factors, symptoms and signs at presentation, diagnostic procedures, severity of bleeding and management of gastrointestinal bleeding were collected. In addition, data regarding type of drug used, indication, dose, duration of treatment and prescriber(physician or selfmedication) were examined. RESULTS: Fifty-one patients, including 34 males, were enrolled(median age: 7.8 years). Ibuprofen was the most used NSAID [35/51 patients(68.6%)]. Pain was the most frequent indication for NSAIDs use [29/51 patients(56.9%)]. Seven patients had positive family history of Helicobacter pylori(H. pylori) infection or peptic ulcer, and 12 had associated comorbidities. Twenty-four(47%) out of 51 patients used medication inappropriately. Hematemesis was the most frequent symptom(33.3%). Upper gastrointestinal endoscopy revealed gastric lesions in 32/51(62%) patients, duodenal lesions in 17(33%) and esophageal lesions in 8(15%). In 10/51(19.6%) patients, a diagnosis of H. pylori gastritis was made. Forty-eight(94%) patients underwent medical therapy, with spontaneous bleeding resolution, while in 3/51(6%) patients, an endoscopic hemostasis was ***: The data collected in this study confirms that adverse events with the involvement of the gastrointestinal tract secondary to NSAID use are also common in

关键词： Hematemesis Gastrointestinal bleeding non-steroidal anti-inflammatory drug Melena Pediatrics

Imaging of the small bowel:Crohn's disease in paediatric patients

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World Journal of Radiology 2014年第6期6卷 313-328页

作者： Emanuele Casciani Chiara De Vincentiis Elisabetta Polettini Gabriele Masselli giovanni di nardo Fortunata Civitelli Salvatore Cucchiara Gian Franco Gualdi Department of Emergency Radiology "La Sapienza" University-Hospital Umberto I 00166 Rome Italy Department of Radiology "La Sapienza" University-Sant’Andrea’s Hospital 00189 Rome Italy Department of Pediatrics Gastroenterology and Liver Unit "La Sapienza" University-Hospital Umberto I 00166 Rome Italy

In more than 20% of all patients, the Crohn's diseasepresents before the age of 18 years. The diagnosisand management of Crohn's disease in children haschanged dramatically over the last decade, mainly dueto increased awareness, availability of newer diagnosticmodalities such as magnetic resonance imaging(MRI)and newer, more powerful treatments such as biolog-ics. Imaging of the small bowel is needed for diagno-sis, management, follow-up and also evaluation of thedisease in terms of location, extent, activity and com-plications. We review all the methods(barium exami-nations, ultrasonography, computed tomography, MR,and computed tomography- positron emission tomog-raphy) commonly used for imaging the small bowel inpaediatric patients with Crohn's disease analyzing theadvantages and disadvantages of each modality, withparticular emphasis on MR imaging.

关键词： Barium studies Ultrasonography Computed tomography Magnetic resonance Positron emission tomography-computed tomography

Adaptive Match-Filtering: A Biomedical Application to Identify T-Wave Alternans

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Natural Science 2014年第10期6卷 709-718页

作者： Laura Burattini giovanni Ottaviano Francesco di nardo Sandro Fioretti B.M.E.D. Bio-Medical Engineering Development SRL Università Politecnica delle Marche Ancona Italy Department of Information Engineering Università Politecnica delle Marche Ancona Italy

T-wave alternans (TWA), consisting in an alternation of the electrocardiographic (ECG) repolarization segment (T-wave), is a promising index of the risk of sudden cardiac death. By definition, it is characterized by a frequency component, termed fTWA, that matches half heart rate. The heart-rate adaptive match filter (AMF) based method is a technique for automatic TWA identification from the digital ECG. Aim of the present study was to provide a complete technical description of the filter able to explain its methodological principles. The AMF is usually realized as a 6th order Butterworth filter with a narrow (0.12 Hz) passing band centered in fTWA. It is applied in a bidirectional fashion, so that final filtering order is 12. While extracting the TWA component, the AMF simultaneously filters out every ECG component including noise and artefacts, and thus results are very robust. Goodness of the technique was tested using 8 synthetic ECG tracings corrupted by typical noisy factors, such as white random noise, baseline wanderings, heart-rate variability, and others. Six ECG tracings were affected by 100 μV TWA, whereas two were not. Results indicate that the AMF-based method is able to prevent false-positive and false-negative detections and, thus, represents a useful tool for a reliable TWA identification.

关键词： Adaptive Filtering digital ECG T-Wave Alternans Sudden Cardiac Death