BONE LOSS I INFLAMMATORI BOWEL DISEASE: OUR MULTICENTRIC STUDY

Patients with inflammatory bowel disease are at increased risk of developing disorder in bone and mineral metabolism. The study was aimed to determine if inflammatory bowel disease (IBD) is a risk factor for osteoporosis in 103 adult patients. We included 103 IBD patients, 67 patients with Crohn's disease (CD) and 36 with ulcerative colitisi (UC). Bone mineral density was measured by dual-energy X-ray absorptiometry. we used T score to express bone loss (osteopenia: -25SD 2 years) and active disease would be risk of bone mineral loss in IBD.

EQUILIBRIO ACIDO-BASE E SQUILIBRI IDROELETTROLITICI NELL’ANZIANO

BONE AND JOINT MANIFESTATIONS IN PATIENTS AFFECTED BY INFLAMMATORY BOWEL DISEASE.

Onset of the symptoms in patients with ulcerative colitis and Crohn's disease is sometimes characterized by osteoarticular manifestations. The usual presentation of peripheral arthritis is asymmetric, polyarticular and migrant, often involving large joints of the upper and lower limbs, unlike rheumatoid arthritis. This study analyses the statistical incidence of arthritic manifestations in elderly patients with inflammatory bowel disease.

Arthritis in patients with Crohn's disease: our experience

Arthritis can occur in association with inflammatory bowel disease (Crohn's disease and Ulcerative Colitis). It usually affects a large lower extremity joint and often occurs when the bowel disease is flaring. Sometimes the arthritis manifestations are the first symtoms that appear and the bring the patient to clinical controls. The authors describe their study effected o 45 patient affections by disease of Crohn that has presented arthritic manifestations.

INFLAMMATORY BOWEL DISEASE AND COLORECTAL CANCER, NUTRACEUTICAL ASPECTS

Nutraceuticals constitute a group of functional foods that provide added health benefits for various disorders including inflammatory bowel disease (IBD) and colorectal cancer (CCR). The main groups of nutraceuticals include probiotics, prebiotics omega 3 and antioxidants. Studies on nutraceutical showed that this type of food possessed similar properties to drugs but with the benefit of not having side effects. This mini review shows that probiotics and prebiotics, when administered simultaneously with traditional therapies, reduce IBD symptoms and reduce synthesis of enzymes probably involved in colorectal carcinogenesis. Moreover, Omega 3 reduces the synthesis of inflammation mediators a…

INTRA-ARTICULAR INJECTION OF HYALURONIC ACID IN PATIENTS AFFECTED BY CROHN-LESNIOSKI DISEASE

The pain and functional limitations caused by osteoarthritis in joints have multiple etiologies and often involve inflammatory mechanism. The first level of medical intervention consists of therapeutic use of NSAIDs or steroids when no complications are present. Such therapies could be ineffective, or cause drug-related complications, prompting the suspension of treatment. in these cases, intra-articular injections of high molecular weight hyaluronic acid can be administered in order to reach therapeutic goals. Patients with Crohn-Lesnioski disease, affected by osteoarthitis of the shoulder or the knee, were included in this study.

INFLAMMATORY BOWEL DISEASE AND PERIPHERAL ATRHITIS: MESALAZINA AND PROBIOTICS

The inflammaotory bowel disease (IBD) are a group of inflammatory pathologies of the digestive line with chronicity and recurrent characteristic. The IBDs mostly recognized are the ulcerative colitis and Crohn's disease; they are more frequent in the industrialized countries and among the caucasian populations that among those africans or oriental. The secondary artropaties to IBD recognize a multifactorial genesis in subjects predisposed as a result genetically or environmental factors; a fundamental role of the intestinal dysbiosis they are hypothesized.

ARTHRITIS AND CROHN'S DISEASE: OUR EXPERIENCE

Introduction: Crohn's disease (CD) is a form of inflammatory bowel disease, which may affect any part of the gastrointestinal tract from mouth to anus, causing a wide variety of symptoms. The arthritis is counted as the worst side effect of CD. The orthopaedic manifestations of CD are: peripheral arthritis, spondylitis, sacroiliitis. Material and Method: The authors evaluated the orthopedic clinical manifestation in Sicilian group of forty-five patients with Crohn's disease. Every patients are analyzed with clinical exams, laboratory data, radiographic exams. In addition, all patients were screened for the presence of the antigen HLA B27. Result: Arthritis occurred in 8 patients (17,7 %). P…

CHRONIC INFLAMMATORY BOWEL DISEASES IN PATIENTS WITH ORTHOPEDIC MANIFESTATION. COMPARISON WITH THE DATA REPORTED IN INTERNATIONAL LITERATURE

In Inflammatory Bowel Disease (IBD) the suspected etiological cause is a dysregulation of the intestinal immune system, in which it is possible to determine a cross-like immune reactivity against the resident microbiota; this mechanism explains the exsistence of Lesnioski-Chron's disease, a variant of IBD in which patients manifest osteoarticular problems that may also be the primary manifestation of the disease. The aim of this study was to compare some cases encountered by our research group at the University of Palermo with others reported in international literature on osteoarticular manifestations in IDB.

L’IPOTIROIDISMO NELLE PERSONE ANZIANE: IMPORTANZA DI UNA ADEGUATA TERAPIA SOSTITUTIVA ORMONALE

La prevalenza dei disturbi della ghiandola tiroidea aumenta con l’età, soprattutto nelle donne. L’ipofunzione tiroidea conclamata in età avanzata può manifestarsi clinicamente con sintomi e segni simili alle modificazioni che normalmente accompagnano l’invecchiamento o come disturbi di altri organi. Per tale motivo, un alto indice di sospetto è essenziale per rilevare l’ipotiroidismo in anziani con comorbilità multiple, alterazioni nutrizionali e/o polifarmacoterapia. La decisione di iniziare una terapia sostitutiva ormonale nell’ipotiroidismo conclamato non è discutibile. Viceversa, esiste ancora controversia sulla decisione di trattare o non trattare l’ipotiroidismo subclinico; le raccoma…

PRENATAL DEVELOPMENT OF TEMPORO-MANDIBULAR JOINTS: STATE OF ART

The aim of this work is to analyze the state of the art of temporo-mandibular joint (MJ) to understand the varoius stage of the development of the same during embryogenesis. Various theories have been analyzed, such as the formation of apoptotic or the important role of growth factors, or the Valencia et studies in which are analyzed to numerous articular diseases in various stage of development. By the aforementioned studies show that many factors, of a different nature, are to be involved in the prenatal developlment of this important joint.

THE ROLE OF BUTYRIC ACID AS A OPROTECTIVE AGENT AGAINST INFLAMMATORY BOWEL DISEASE

Inflammatory Bowel disease (IBD), such as Crohn's disease and ulcerative colitis, are pathologies characterized by a chronic inflammation of the gastrointestinal tract. Their etiopathogenesis is not yet fully understood. Immune system and heat shock proteins (HSPs) dysfunctions are considered to be among the most likely causes of these diseases. Butyrate is a short-chain fatty acid produced by intestinal microflora. It has a trophic, benefical and protective role in the colonic mucosa, and it also induces changes in Hsp levels and localization. It may therefore be a valuable complementary therapeutic agent when used alongside trraditional drugs (mesalazine and corticosteroids) to treat the …

NUTRITION IN IBD PATIENTS

Inflammatory Bowel Disease (IBD) is a chronic disorder characterized by a relapsing-remitting course, which alternates between active and quiescent states, ultimately impairing a patients' 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 submucosa of the colon. In physiological conditions the gut is costantly exposed to various antigens, commensal microflora and pathogens and the inflammatory response is finely balanced. Anyhow i some individuals with geneti…

SISTEMIC MANIFESTATIONS IN CROHN DISEASE: OUR EXPERIENCE

Arthritis and Crohm's disease has a close link and are frequently associated with aspecific and specific dermatitis. The arthritis is counted as the worst side effect of Crohn's disease. The greatest part of chronic inflammatory bowel disease induce with dermatologic disease, tha are sometimes the first clinical manifestation. In this article the authors desrcibe their clinical observation about orthopaedic, dermatologic and gastroenteric manifestations.

LA RETTOCOLITE ULCEROSA. Approccio Metodologico alla interpretazione della malattia e prospettive future.

La presente monografia affronta la "Rettocolite Ulcerosa" (RCU). Questa patologia ha una vasta diffusione epidemiologica e risulta inserita nell'ambito delle malattie infiammatorie croniche intestinali (IBD). La Rettocolite Ulcerosa, in questo volume, è affrontata sotto il profilo ermeneutico: interpretando ed elaborando i dati raccolti, alla luce dell'esperienza maturata in quasi 20 anni di attività clinica, ed in particolare endoscopica. La circoscrizione del quadro morboso, unitamente alla interpretazione dinamica della malattia, sono gli obiettivi che si è inteso perseguire. L'imperativo è quello di far precedere sempre, le informazioni alla operatività diagnostico-terapeutica. La prepa…

Changes in immunohistochemical levels and subcellular localization after therapy and correlation and colocalization with CD68 suggest a pathogenetic role of Hsp60 in ulcerative colitis.

In an earlier work, the role of heat shock protein (Hsp60) in the pathogenesis of ulcerative colitis (UC) was suggested by its significant increase in the pathological mucosa parallel with an increase in inflammatory cells. More data in this direction are reported in this work. We analyzed by immunohistochemistry biopsies of colon tissue from 2 groups of patients with UC and treated with either 5-aminosalicylic acid (5-ASA) alone or in combination with a probiotic. We looked for inflammatory markers and Hsp60. Both the treatments were effective in reducing symptoms but the group treated with both 5-ASA and probiotics showed better clinical results. Amelioration of symptoms was associated wi…

Malignant tumor-like gastric lesion by Candida albicans.

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…

USO DI IPOGLICEMIZZANTI ORALI SECRETAGOGHI E CADUTE IN PAZIENTI DIABETICI ANZIANI RICOVERATI IN UN REPARTO PER ACUTI

GASTROINTESTINAL COMPLICATIONS DURING USE OF ANTI-INFLAMMATORY DRUGS FOR ORTHOPEDIC DISEASES

Non-Steroidal Anti-inflammatory Drugs (NSAIDs) are molecules that inhibit the functionality of cyclooxygenase, resulting in suppression of prostaglandin production. Primary physicians and specialist clinics frequently prescribe NSAIDs for the treatment of osteoarticular diaseases such as tendinitis, bursitis, synovitis, spondylitis and osteoarthritis. This analysis aims to study gastrointestinal complications in orthopedic patients, caused by the use of NSAIDs, employng esophagogastroduodenoscopy and colonoscopy.

From gut microflora imbalance to mycobacteria infection: is there a relationship with chronic intestinal inflammatory diseases?

The gut of a healthy adult harbours a myriad of different microbial species. It is estimated that approximately 10 14 are present in total bacterial colony forming units (CFU). Each colony colonizes a specific intestinal tract. In healthy adult, the main control of intestinal bacterial colonization occurs through gastric acidity but also other factors can influence the intestinal microenvironment such as pH, temperature, competition among different bacterial strains, peristalsis, drugs, radiotherapy and much more. Impaired microbial homeostasis leads to an alteration of the permeability of tissue, together with the activation of the intestinal immune system MALT (mucosal associated lymphoid…

THE IMPORTANCE OF INTESTINAL MICROBIAL FLORA (MICROBIOTA) AND ROLE OF DIET

In this article we want to analyze the function of the intestinal microbial flora. In the intestinal environment microorganism "good" microrganisms coexist with "bad". The coexistence between good and bad bacteria is balanced by a mutual action of contrast that has the purpose of maintaining the intestinal microbiota flora in a state of equilibrium. This condition is referred eubiosis. This article will attempt to analyze the beneficial role carried out by eubiotic microbial flora showing the negative effects of dysbiosis.

AMYLOIDOSIS AND INFLAMMATORY BOWEL DISEASE: FACT OR MITH?

Inflammatory Bowel Disease (IBD), which includes both Crohn's Disease (CD) and Ulcerative Colitis (UC), is a chronic idiopathic inflammatory disorder affecting the gastrointestinal tract. Extraintestinal manifestations (EIM) are common in patients with IBD, and occur in 6-47% of patients with CD or UC. EIM can involve organs other than the gastrointestinal tract such as skin, eyes, joints, biliary tract and kidneis. Renal and urinary involvement particularly occurs in 4-23% of patients with IBD. Among the renal complications of IBD, seconfary amyloidosis (AA-type, AAA) is a rare but serious complication. renal amyloidosis has been proven to be the most common lethal manifestation of IBD-ass…

LONG-TERM RESULTS AFTER ENDOSCOPIC DILATION OF POST-OPERATIVE COLO-COLONIC ANASTOMOTIC STENOSES. OUR EXPERIENCE IN 42 PATIENTS.

The aim of this study is to evaluate long-term complications and patient's quality of life after the endoscopic treatment of benign anastomotic colo-colonic strictures. From January 2000 to November 2008,, 42 patients who had undergone surgery for colorectal cancer were endoscopically treated for a postoperative symptomatic stricture. The dilation were performed using a 20-30 mm pneumatic dilator. The clinical results were classified in relation to the abdominal symptomatology reported by the patients, and were evaluated in the short-term (one-week) and long-term (mean follow-up.36 months)period. Results: 15 patients underwent a total of 22 dilating sessions; 9 patients had a single dilatin…

GASTRO-ESOPHAGEAL REFLUX MANIFESTATIONS IN THE TREATMENT OF OSTEOARTHRITIS WITH NON STEROIDAL ANTI-INFLAMMATORY DRUGS

PROBIOTICI E TERAPIA CONVENZIONALE: NUOVE FRONTIERE NELLA GESTIONE DELLE MANIFESTAZIONI ARTICOLARI DELLE MALATTIE INFIAMMATORIE INTESTINALI (IBD)

Summary: This work reports a clinical trial performed at palermo University Hospital "paolo Giaccone". From January 2004 to December 2011, 79 patients were enrolled (40 men and 39 women). All patients suffered from Inflammatory Bowel Disease (IBD) and were subjected to orthopedic consultation at the institute of Orthopaedics, University Hospital of palermo, for arthropathy to IBD. The patients were divided into two groups (A and B) and dealt with different therapies for the resolution of the inflammatory picture of the colonic mucosa and the treatment of the extraintestinal articular manifestations. Group A was treated with drug therapy: Diclofenac (75 mg im/ day for 10 days9 and Mesalazine…

DIAGNOSIS-RELATED GROUP ANALYSIS AND STRATEGIC HEALTHCARE BUDGETING

The term Diagnosis-Related Group DRG) refers to a classification system used to assess hospital services with the aim of streamling 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 examines the variables used to correctly evaluate hospital performance based on the DRG system. These include: Average length of Stay, Average Daily Patients Load, Comparative Performance Index and Case Mix Index.

ASSOCIATION BETWEEN HELYCOBACTER PYOLRI INFECTION AND PATHOLOGICAL ORAL MANIFESTATIONS

DATA FROM LITERATURE ARE CONTROVERSAL REGARDING THE PRESENCE OF bELICOBACTER PYLORI (HP) IN DENTAL PLAQUE AND ITS ASSOCIATION WITH GASTRIC INFECTION. oNE OF THE POSSIBLE MECHANISMS SUGGETSED FOR RE-INFECTION IS THE RECOLONIZATION WITH HP DENTAL PLAQUE. THE PURPOSE OF THIS REVIEW WAS TO DETERMINE WHETHER DENTAL PLAQUE, POOR ORAL HYGIENE, AND PERIODONTAL DISEASE WERE RISK FACTORS FOR HP INFECTION.

Organismi geneticamente modificati: definizioni e finalità.

Article 2 of the European Directive 2011/18/EC defines a genetically modified organism (GMO) a san organism in which the genetic material has been altered in a way that does not occuirr naturally by inserting DNA fragments from one organism's gene into the chromosomes of another, changing its genetic expression. In the field of animal and plants biotechnology there are different application areas of genetic engineering such as improving the quantity and quality of argicultural production, pharmaceutical production in more sustainable ways or applications in environmental field.

Simple and fast orotracheal intubation procedure in rat

Introduction: Endotracheal intubation in the rat is difficult because of extremely small size of anatomical structures (oral cavity, epiglottis and vocal cords), small inlet for an endotracheal tube and the lack of proper techniacal instruments. Matherial and Methods: In this study we used seventy rats weighthing 400-500 g. The equipment needed for intubation was an operating table, a longish of cotton, a cotton tip, orotracheal tube, neonatal laryngoscope KTR4, small animal ventilator, and isoflurane for inhalation anaesthesia. Premedication was carried out by medetomidine hydrochloride 1 mg/mL; then, thanks to a closed glass chamber, a mixture of oxygen and isoflurane was administered. By…

DILATION TREATMENT OF BENIGN STRICTURED OF COLOCOLONIC ANASTOMOSES

SCOPO DI QUESTO ARTICOLO E' DI METTERE IN LUCE LA COMPLIANCE, I BENEFICI ED IL MIGLIORAMENTO DELLA QUALITA' DELLA VITA, NEI SOGGETTI AFFETTI DA STENOSI BENIGNA POST-ANASTOMOTICA COLO-COLICA E COLO-RETTALE E TRATTATI CON DILATAZIONE ENDOSCOPICA DEL TRATTO STENOTICO. LA DILATAZION PER VIA ENDOSCOPICA RISULTA ESSERE SICURA E DI SEMPLICE ESECUZIONE E PERMETTE DI OTTENERE RISULTATI SODDISFACENTI ANCHE PER PERIODI PROLUNGATI. I CRITERI STANDARD PER UNA EFFICACE DILATAZIONE VARIANO TRA 1 10 E 13 MM.

DISMICROBISM IN INFLAMMATORY BOWEL DISESE AND COLORECTAL CANCER: CHANGES IN RESPONSE OF COLOCYTES

Patients with inflammatory bowel disease (IBD) have an increased risk of 10%-15% developing colorectal cancer (CRC) that is a common disease of high economic costs in developed countries. the CRC has been increasing in recent years and its mortality rates are very high. Multiple biological and biochemical factors are responsible for the onset nad progression of this pathology. moreover, it appears absolutely necessary to investigate the environmental factors favoring the onset of CRC and the production of colonic healt. the gut microflora, or microbiota, has an extensive diversity both quantitatively and qualitatively. in utero, the intestine of the mammalian fetus is sterile. Al birth, the…

COMPARSA DI COMPLICANZE GASTRO-INTESTINALI NELL'UTILIZZO DI ANTI-INFIAMMATORI NELLE MALATTIE DEGENERATIVE CRONICHE DELLE ARTICOLAZIONI

Management of anemia: blood loss in orthopaedic surgery

Major ortopaedic surgery and high energy trauma are often responsible of acute bleeding. Long bones and pelvis fractures are correlated with increased blood loss. The final consequence of a major bleeding is hypovolemic shock. The reduced oxygen tension of tissue could be responsible of heart attack, arrythmia, ictus, multi organ deficiency. For these reasons, it is important to immediately recognize and correct all potential bleeding in order to avoid complications. In orthopaedics the elective treatments in the managenment of hypovolemia are different. Blood banks and allogenic blood components have had an important impact on operative treatment and health care worldwide. erythropoietin h…

IL RANK LIGANDO QUALE TARGET TERAPEUTICO NEL TRATTAMENTO DELLE PAZIENTI ANZIANE CON OSTEOPOROSI

Cortical and trabecular bone undergo a continuous and balanced remodeling process, which consists of a phase of resorption, mediated by osteoclasts, and a phase of neoformation mediated by osteoblasts. The activity of both, osteoblasts and osteoclasts, is regulated by the osteocytes, which are the most abundant cells in bone tissue. An imbalance of this process with an excessive resorption activity causes a loss of bone mass and microarchitectural deterioration of the skeleton, with consequent reduction of bone strength and increased risk of fractures. The ligand for the “Receptor Activator of Nuclear Factor Kappa- B” (RANK-L), a protein expressed by osteoblasts, plays a fundamental role in…

TOWARDS AN IMPROVEMENT OF HOSPITAL SERVICES AND STREAMLING 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 menagement of a 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 aspectsof 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 evaluated correctly hospital performance based on the DRG system. These include Average Length …

RHEUMATIC PATHOLOGIES IN SUBJECTS WITH INFLAMMATORY BOWEL DISEASE

Inflammatory Bowel Disease (IBD) are commonly associated with rheumatic diseases of the joints. Sixty-five patients are selected during a 5-year study period. All Patients were analyzed with clinical, laboratory and radiographic exams. 38 patients had ulcerative colitis (mean age 42.1 years range:19-75) and 27 patients had Crohn's disease (CD) (mean age 37.2 years, range: 17-64 years). Arthritis occurred in 11 patients (17%): 7 with UC (18.4%) and 4 CD (14.8%). The mean age of patients with arthritis was 35 and mean disease duration of pain and limitation symptoms was 28 months. In 9 patients, arthritis appeared after the onset of bowel symptoms with mean duration of 20 months in UC and 24 …