Nutrition in inflammatory bowel disease patients

Inflammatory Bowel Diseases (IBD) is a chronic disorder characterized bya relapsing-remitting course, which alternates between active and quiescent states, ultimately impairing a patient's quality of life. The two main types of IBD are Crohn's disease (CD) and ulcerative colitis (UC). CD shows a transmural granulomatous inflammation that can involve any segment of the intestine affecting all layers of the intestinal wall while UC is limited to the mucosa and superficial sub-mucosa of the colon. In physiologial conditions the gut is costantly exposed to various antigens, commensal microflora and pathogens and the inflammatory response is finely balanced. Anyhow in some individuals with genet…

Comparative analysis of Hsp10 and Hsp90 in large bowel healthy mucosa and adenocarcinomas

Heat shock proteins (Hsps) are an important class of molecules with various functions. Their classic role is to assist other proteins in folding and re-folding and, when proteins are defective or irreversibly misfolded, to drive their degradation. For this reason, some Hsps are also named molecular chaperones. During evolution, this class of proteins has also acquired extrachaperoning roles such as participation in immune system regulation, cell differentiation, programmed cell death and carcinogenesis. Hsp10 is a partner of Hsp60 in the Hsp60/10 folding machine, but numerous scientific studies have shown that Hsp10 may also play other roles. In fact, Hsp10 seems to have an immunomodulatory…

Probiotics, prebiotics and symbiotics in inflammatory bowel diseases: state-of-the-art and new insights

Inflammatory bowel disease (IBD) consists of two distinct clinical forms, ulcerative colitis (UC) and Crohn's disease (CD), with unknown aetiology, which nevertheless are considered to share almost identical pathophysiological backgrounds. Up to date, a full coherent mechanistic explanation for IBD is still lacking, but people start to realize that the pathogenesis of IBD involves four fundamental components: the environment, gut microbiota, the immune system and the genome. As a consequence, IBD development might be due to an altered immune response and a disrupted mechanism of host tolerance to the non-pathogenic resident microbiota, leading to an elevated inflammatory response. Consideri…

ASPETTI CLINICI DELLA MALATTIA DIVERTICOLARE

La malattia diverticolare è una patologia piuttosto frequente nella popolazione occidentale. E' stimato che il 30-40% dei pazienti sottoposti ad indagini strumentali sull'apparato digerente presentino diverticoli al colon. Questi, nel 75% dei casi sono del tutto asintomatici. la diverticolosi appare strettamente connessa allo stile di vita ed alle abitudini alimentari tipiche dei paesi occidentali. a seguito di questa preferenza geografica, gli autori anglosassoni definiscono questa condizione patologica "a disease of western civilization". La diverticolosi insorge solitamente nei soggetti adulti, il trend della malattia aumenta proporzionalmente con l'età; pur tuttavia, negli ultimi anni a…

Toward a new prognostic-therapeutic index in geriatric oncology

Towards an improvement of hospital services and streamlining of health care costs: The DRG analysis in Italy

The term Diagnosis-related Group (DRG) refers to a classification system used to assess hospital services with the aim of a better management of health care costs and improving performance. The DRG system focuses on the utilization of resources, and is not concerned with the specific type of care provided to the patient. This system highlights any diseconomies and eventual critical aspects of the hospital system. This article, starting from the history of heath care financing in Italy and pointing out the difficulty to define the "quality" of health care services, describes the variables used to evaluate correctly hospital performance based on the DRG system. These include Average Length of…

Dissecting the different biological effects of oncogenic Ras isoforms in cancer cell lines: could stimulation of oxidative stress be the one more weapon of H-Ras? Regulation of oxidative stress and Ras biological effects

Ras proteins are small GTPase functioning as molecular switches that, in response to particular extracellular signalling, as growth factors, activate a diverse array of intracellular effector cascades regulating cell proliferation, differentiation and apoptosis. Human tumours frequently express Ras proteins (Ha-, Ki-, N-Ras) activated by point mutations which contribute to malignant phenotype, including invasiveness and angiogenesis. Despite the common signalling pathways leading to similar cellular responses, studies clearly demonstrate unique roles of the Ras family members in normal and pathological conditions and the lack of functional redundancy seems to be explainable, at least in par…

Argon plasma coagulation in the treatment of post-radiotherapy rectal bleeding

Introduction: Chronic radiation proctitis is often associated to radiotherapy for treatment of pelvic cancer. The most common side effect of this pathological condition is rectal bleeding but despite the great number of clinical approaches and techniques that have been employed no consensus for the management of it is available. Although prospective randomized trials about hemorrhagic radiation proctitis are still lacking, endoscopic approach delivering an Argon Plasma Coagulation (APC) seems to be a successful and available option. Patients and Methods: Sixteen patients suffering from post-radiotherapy rectal bleeding were followed. In the nine cases presenting a rectum ulcerative colitis …

Lactobacillus casei and Bifidobacterium lactis supplementation reduces tissue damage of intestinal mucosa and liver after 2,4,6-trinitrobenzenesulfonic acid treatment in mice

Probiotics (PB) are living microorganisms that act as a commensal population in normal intestines and confer numerous beneficial effects on the host. The introduction of probiotics in the treatment of inflammatory bowel disease (IBD) prolongs remission. The aim of this study was to investigate the intestinal and hepatic effects of PB supplementation in an experimental IBD model in mice induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS). In the first step of the experimental procedure, CD-1 male mice, 5 to 6 weeks old, were randomly divided into 3 groups and inoculated intrarectally with, respectively, saline, alcohol, or TNBS to assess the experimental IBD model. In the second step, mice…

Enteral nutrition: Our experience with percutaneous endoscopic gastrostomy (PEG) and revision of literature

Enteral nutrition (EN), as parenteral nutrition (PN), can be used in cases of patients whose medical conditions prevent the intake of food by mouth; unlike PN, EN keeps the functionality of the digestive tract and it makes home management of patients easier. However, the experience and literature have documented a number of serious complications, fortunately rare, which depend on the methods used in EN realization. We report in this paper our experience in 44 cases of percutaneous endoscopic gastrostomy (PEG), concluding that it is a safe and complications-free procedure. We believe that a nutritional intervention is indicated when, improving nutritional status, patients can obtain a better…

Biocompatibility and biodegradability of electrospun phea-pla scaffolds: Our preliminary experience in a murine animal model

We obtained a nano-fibrillar scaffold starting from a polymeric solution which, through electrospinning, gave a biodegradable material with optimal mechanical features and the capacity to allow cell adhesion. In this paper we report the in-vivo application on a murine animal model of two electrospun biodegradable materials, specifically designed to create tubular structures. In one case PHEA-PLA was co-spun with silk fibroin (Fibro-PHEAPLA) by a parallel electrospinning process to obtain a scaffold with two different polymeric fibers. In the other case, PHEA-PLA was mixed with polycaprolactone (PCLPHEA-PLA) to obtain a hybrid fibers scaffold. The in-vitro assay showed fibroblast colonizatio…

Fentanyl and sufentanyl in fast track anaesthesia for major intra-abdominal surgery

Background and aim: Major intra-abdominal surgery is estimated to have high costs annually in Italy. In an attempt to decrease surgery costs and improve outcome for patients, fast-track programs have become popular. This is especially due both to the improvement of surgery and to the new anesthetic agents (regarding pharmacokinetic and pharmacodynamic) resulting in better care for patients. The aim of this study was to evaluate two different anesthetic protocols in patients undergoing scheduled anesthesia including the combination of two different opioids (fentanyl or sufentanil) with the same hypnotic and muscle relaxant. Material and Methods: 40 patients, with an American Society of Anest…