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.

ROLE OF CHAPERONES IN HEALTHY BOWEL AND IBD.

The chaperoning system is the wole complement of chaperones, co-chaperones and chaperone cofactors of the body that preserves cell and tissue homeostasis. Its structural and/or functional defects can cause pathologic conditions, nemed chaperonopathies. Large bowel homeostasis includes a healthy status of the mucosal tissues and the microbiota. An alteration of one of them may determine, in turn, modifications of the other. Molecular chaperones of bacteria and human origin have been implicated in inflammatory bowel disease (IBD). In IBD chaperone levels usually increase and their cellular and subcellular loclization change. This is considered a physiological stress-response of mucosal cells …

MESENCHIMAL STEM CELLS IN INFLAMMATORY BOWEL DISEASES: CLINICAL EVIDENCES AND POTENTIAL INSIGHTS FOR THE CLINICIANS

Mesenchimal stem cells (MSCs) have been used experimentally and clinically in the treatment of a wide variety of pathologies MSCs can be safely transplanted in autologous and allogenic ways as they are non-immunogenic, and consequently represent a therapeutic option for refractory connective tissue diseases, fibrosing diseases like scleroderma and fistulizing colitis like in Crohn's disease (CD). The immunomodulatory properties of MSCs have already shown promise when used as therapy for otherwise medically refractory CD. Accumulating evidence suggests that the properties may also be exploited of several other conditions. The currently available experimental and clinical data indicate that, …

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.

Omega-3 PUFAs and gut microbiota: A preventive approach for colorectal cancer

The influence of diet on the composition of the intestinal microbiota and related pathologies has been known for some time. Some classes of nutrients, such as fatty acids belonging to the omega 3 series, have particular effects on the bacteria that make up the intestinal microbiota. ω-3 PUFAs affect the gut microbiota in three different ways: by modulating the type and abundance of intestinal bacteria, by regulate SCFAs levels, and by alter the levels of proinflammatory mediators. Through these modalities, ω-3 PUFAs could be useful for the prevention of intestinal diseases such as Colorectal Cancer (CRC). The ability of ω-3 PUFAs to modulate the intestinal inflammatory response, to preserve…

SUPERIOR MESENTERIC VEIN THROMBOSIS AND CYTOMEGAOLOVIRUS: A DIAGNOSTIC DILEMMA, A CASE REPORT AND REVIEW OF THE LITERATURE

Superior mesenteric vein thrombosis (SMVT) is a rare condition, usually caused by infections, intra-abdominal inflammatory diseases, portal hypertension, hypercoagulable states, or contraceptive therapy. Due to its vague symptomatology, SMVT is often diagnosed only after an abdominal contrast-enhanced computed computed tomography (CT) scan. In this article, we present a case of SMVT in a patient with a history of contraceptive drug use and a recent cytomegalovirus infection. A 36-year-old female was admitted to our department with the clinical symptoms of an acute appendicitis. the patient was a smoker and had been using hormonal contraceptive for over a year. surgery was deemed the best co…

OBSTRUCTED DEFECATION SYNDROME AND CHRONIC CONSTIPATION: CLINICAL AND SURGICAL ANALYSIS AND PSYCHOLOGICAL IMPLICATIONS

Chronic constipation and Obstructed defecation Syndrome (ODS) represent a high-incidence pathological status that severely compromise of Quality of Life (QoL). Our multidisciplinary study is aimed to investigate how the resolution of ODS by surgical technique can improve long-term clinical symptoms and the state of physical and mental health and QoL, focusing on the dual interaction between psyche and intestine Chronic constipation and Obstructed Defectaion Syndrome represent a high-incidence pathological status that severely compromise of Quality of Life. Our multidisciplinary study is aimed to investigate how the resolution of ODS by surgical technique can improve long-term clinical sympt…

Adipokines in obesity and metabolic diseases

Adipose tissue secretes many adipokines that regulate important physiological functions. Growing studies have highlighted that these bioactive molecules may contribute to the development of metabolic and cardiovascular diseases. Adipokines exert systemic metabolic effects and independent activity on numerous cells of the cardiovascular system, including cardiomyocytes and vascular cell walls. Adiponectin shows anti-inflammatory and anti-atherosclerotic activity on blood vessels. Conversely, resistin is endowed with pro-inflammatory effects and stimulates the proliferation of smooth muscle cells, thus promoting the development of atherosclerotic plaque. Leptin plays an important role in card…

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.

EXTRACELLULAR VESCICLES DERIVED FROM GUT MICROBIOTA IN INFLAMMATORY BOWEL DISEASE AND COLORECTAL CANCER

The human gut microbiome encompasses inter alia, the myriad bacterial species that create the optimal host-micro-organism balance essential for normal metabolic and immune function. Various lines of evidence suggest that dys-regulation of the microbiota-host interaction is linked to pathologies such as inflammatory bowel disease (IBD) and colorectal cancer (CRC). Extracellular vesicles (EVs), found in virtually all body fluids and produced by both eukaryotic cells and bacteria are involved in cell-cell communication and crosstalk mechanisms, such as the immune response, barrier function and intestinal flora. This review highlights advancements in knowledge of the functional role that EVs ma…

CLINICAL OUTCOMES OF SELF-EXPAMDABLE METALLIC STENTS IN PALLIATION OF MALIGNANT ANASTOMOTIC STRICTURES: A SINGLE CENTER EXPERIENCE

Background: self-expandable metallic stents (SEMS) are employed as the preferred non surgical palliative treatment for gastric outlet obstruction due to malignancies. Metallic stents are often employed to treat malignant anastomotic obstructions after surgicsl interventions as esophagojejunostomy, gastrojejunostomy and esophagogastrojejunostomy. Methods: this case series reports prospectively the clinical outcomes of SEMS in the palliative care of malignant anastomotic strictures caused by the recurrence gastric cancer follwing gastric surgery as oncological curative treatment, in a series of nine consecutive patients, treated between January 2009 and december 2012 in our center. Results: N…

Colour Doppler-guided haemorrhoidal artery ligation: an adjunct in identification of haemorrhoidal vessels.

Not available (case report)

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.

HSP10,HSP70 AND HSP90 IMMUNOHISTOCHEMICAL LEVELS CHANGE IN ULCERATIVE COLITIS AFTER THERAPY

Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) characterized by damage of large bowel mucosa and frequent extra-intestinal autoimmune comorbidities. The role played in IBD pathogenesis by molecular chaperones known to interact with components of the immune system involved in inflammation is unclear. We previously demonstrated that mucosal Hsp60 decreases in UC patients treated with conventional therapies (mesalazine, probiotics), suggesting that this chaperonin could be a reliable biomarker useful for monitoring response to treatment, and that it might play a role in pathogenesis. In the present work we investigated three other heat shock protein/molecular chaperones:…

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.

HUMAN FIBRIN GLUE SEALING VERSUS SUTURE POLYPROPYLENE FIXATION IN LICHTENSTEIN INGUINAL HERNIORRAPHY: A PROSPECTIVE OBSERVATIONAL STUDY.

Background: Patients who underwent primary inguinal hernia repair still report a high rate of postoperative pain after operation due to effect of mesh fixation by suture. An alternative is the use of human fibrin glue. We compared the two techniques. Methods: 468 patients randomly underwent primary inguinal hernia Lichtenstein repair fixing the mesh by suture or by human fibrin glue (HFG); in both cases themesh was fixed to the posterior wall of the inguinal canal and to the inguinal legament. results: No significant differences were recorded between the two groups in terms of complications, while the sutureless technique reduces the operative time and the postoperative pain. Conclusions: A…

COLON MICROBIAL COMPOSITION IS CORRELATED WITH THE SEVERITY OF COLITIS INDUCED BY 2,4,6-TRINITROBENZESULFONIC ACID IN MICE.

The objective of this study was to evaluate the changes in some bacterial species of colonic microbiota, the clinical signs and the intestinal changes in mice with 2,4,6-trinitrobenzenesulfonic acid (TNBS) induced colitis. CD-1 male mice were randomly divided into three groups and inoculated intrarectally with saline ethanol or TNBS solutions. ethanol and TNBS treatments induced weight loss accompained by mild and severe inflammation of the colon mucosa, respectively. however, TNBS-treated mice displayed significant differences compared to the saline group in terms of disease activity index and histological scoring. Both ethanol and TNBS groups showed an increased prevalence of escherichia …

ITTERO OSTRUTTIVO COME SINTOMO DI ESORDIO IN SOGGETTO CON LEUCEMIA MONOCITICA ACUTA. CASO CLINICO

Un paziente di 24 anni si è presentato alla nostra osservazione con una sintomatologia caratterizzata da dolore addominale, febbre e ittero. L'esame ecografico dell'addome mostrava una colecisti litiasica con dilatazione della via biliare principale senza immagini da riferire a calcoli nel suo interno. La colangio-RM mostrava una stenosi del terzo distale del coledoco con dilatazione del tratto a monte. Lo stesso quadro veniva mostrato da una colangiopancreatografia endoscopica retrograda. Il paziente veniva, quindi, sottoposto a laparotomia esplorativa. La colecisti non conteneva calcoli, ma nella zona infundibolare era palpabile un nodulo duro, rotondeggiante, apparentemente indovato nell…

Thyroid maltoma: report of a case without coexistent Hashimoto's thyroiditis

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…

BENIGN GASTRIC POLYPS AND HELICOBACTER PYLORI INFECTION.

STRESS, CHAPERONI MOLECOLARI E MALATTIE INFIAMMATORIE CRONICHE DELL'INTESTINO

This brief article is focused on HSP60, a very important molecular chaperon for cell surviving, involved in the pathogenesis of several degenerative, autoimmune, and neoplastic disorders. Recent reports confer unravelling role in IBD pathogenesis. involvement of HSP60 in CD and UC development has been recently confirmed. in fact HSP60 levels increase in mucosal epithelium and also in lamina propria of affected subjects.

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.

IBD, malignancy and oral microbiota: Analysis of the literature

The human microbiota, in adults, varies in number and species based on the location in the gastrointestinal tract. The highest concentration is at the intestinal level, where mainly Bacteroidetes, Actinobacteria, Firmicutes and proteobacteria are found. Instead, in the oral cavity, five major phyla exists. Firmicutes, Actinobacteria, Proteobacteria, Bacteroidetes and Fusobacteria. Variations in the microbiota cause bysbiosis, which is responsible to a great extent for the onset of many diseases including inflammatory bowel disease (IBD) and colorectal cancer (CRC). In some cases (8-10%) IBD has shown oral manifestations that may reflect a change in the composition of the oral microbiota. Th…

ENTERAL NUTRITION SUPPORT TO TREAT MALNUTRITION IN INFLAMMATORY BOWEL DISEASE

Malnutrition is a common consequence of inflammatory bowel disease (IBD). Diet has an important role in the management of IBD, as it prevents and corrects malnutrition. It is well known that diet may be implicated in the aethiology of IBD and that it plays a central role in the pathogenesis of gastrointestinal tract disease. Often oral nutrition alone is not sufficient in the pathogenesis of gastrointestinal tract disease. Often oral nutrition alone is not sufficient in the management of IBD patients, especially in children or elederly, and must be combined with oral supplementation or replaced with tube enteral nutrition. In this review, we describe several different approaches to enteral …

NUTRACEUTICALS IMPROVE EXPERIMENTAL COLITIS: PLACE OF CATECHINS IN THE 2,4,6-TRINITROBENZENE SULFONIC ACID MODEL RATS

Background: Nutraceuticals provide added health benefits for inflammatory bowel disese (IBD) and Epigallocatechin-3-galate (EGCG), a green tea catechin, has been shown to possess such anti-inflammatory and anti-oxidant effects. Aim: To evaluate the molecular modulation of Reactive Oxygen Species (ROS), Tumor Necrosis Factor-alpha (TNF_alpha), nuclear factor Kappa Beta (NF-Kbeta), Interleukin 6 (IL-6) by EGCG on experimental colitis. Matherial and Methods: Thirthy five male sprague-dawley rats were randomly divided into 4 groups: Normal control group (n=5), EGCG group (n=9), TNBS group (n=9), and TNBS + EGCG group (n=12). For both TNBS and EGCG treated groups, 1 mg/Kg EGCG was administered d…

NUTRITION, OXIDATIVE STRESS AND INTESTINAL DYSBIOSIS: INFLUENCE OF DIET ON GUT MICROBIOTA IN INFLAMMATORY BOWEL DISEASES.

Background: Microbiota refers to the population of microorganisms (bacteria, viruses and fungi) that inhabit the entire gastrointestinal tract, more particularly the colon whose role is to maintain the integrity of the intestinal mucosa and control the proliferation of pathogenic bacteria. Alteration in the composition of the gut microbiota is called dysbiosis. Dysbiosis redisposes to inflammatory bowel diseases such as ulcerative colitis, Crohn disease and indeterminate colitis. Methods: The purpose of this literature review is to elucidate the influence of diet on the composition of the gastrointestinal microbiota in the healthy gut and the role of diet in the development of dysbiosis. Co…

INTRABDOMINAL DESMOPLASTIC SMALL ROUND CELL TUMOR: CASE REPORT WITH LITERATURE REVIEW

Intra-abdominal desmoplastic small round cell tumor arerrare aggressive neoplasm, with a very poor prognosis, observed in young adults with a male predominance, Their etiology is unknown and the diagnosis is based on histopathology, immunohistochemistry and cytogenetics. Histological analysis shows typically clusters of round cells separated by abundant desmoplastic stroma. These tumors exhibit a multi-marker immunohistochemistry profile expressing the three embryonic lineages: epithelial, neural and mesenchymal. They are positive for desmin and cytokeratin and are characterized by a specific recurring translocation t (11:22) (q12-p13), which involves EWSR! WT1 gene. They are usually fatal …

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.

Carcinosarcoma: inusuale presentazione clinica.

Hsp60 in Inflammatory Disorders

Heat shock proteins (HSP) including HSP60 are immunogenic proteins shared by particular microbial agents and mammals. HSP60 has been implicated in multiple inflammatory disorders and autoimmune diseases mostly through its interactions with the immune system. Such diseases include inflammatory bowel disease, chronic obstructive pulmonary disease, Hashimoto’s thyroiditis, myasthenia gravis, multiple sclerosis and even atherosclerosis plaques among others. It is present in the cytosol, cell membrane, cell surface as well as in the extracellular space and in the circulation. As a super antigen, HSP60 has the dual role as an immunomodulator and as a biomarker, a node molecule in balance between …

GASTRIC METASTASES ORIGINATING FROM OCCULT BREAST LOBULAR CARCINOMA: DIAGNOSTIC AND THERAPEUTIC PROBLEMS

Abstract Background Breast cancer is the most frequent malignant tumour to metastasize into the gastrointestinal tract in female and is second only to malignant melanoma. Nevertheless gastrointestinal metastases arising from breast cancer are quite rare. The upper gastrointestinal tract is more frequently involved and lobular infiltrating carcinoma has a greater predilection compared to the ductal type. Case presentation The authors describe the case of a 70 years old woman with a preoperative diagnosis of gastric undifferentiated medullary – type carcinoma, which was the first manifestation of an occult breast carcinoma. The primary site of carcinoma was identified with the use of a panel …

A mouse model of alcoholic liver disease reveals protection by Lactobacillus fermentum

The knowledge and treatment of alcoholic liver disease is still plagued with gaps mostly due to the inherent limitations of research with patients. We developed an animal model for studying liver histopathology, Hsp-chaperones involvement, and response to treatment. The system was standardized using mice to which ethanol was orally administered alone or in combination with Lactobacillus fermentum for 4, 8 and 12 weeks and applying a battery of techniques (histology, immunohistochemistry, Western blotting, real-time PCR, immunoprecipitation, 3-nitrotyrosine labeling) to assess liver pathology and Hsp60, iNOS gene expression and protein levels, and Hsp60 post-translational modifications. Stea…

Hsp60 in embryonic and adult submandibular salivary gland: quantitative distribution patterns in normal tissue and comparison with benign and malignant tumors

Introduction: Heat Shock Protein 60 (Hsp60) is a member of the chaperoning system that assists protein folding inside mitochondria and plays other roles beyond these organelles. It is implicated in the carcinogenic processes in various types of cancer. In human salivary glands, Hsp60 has not yet been measured or mapped in detail and its role in gland development and functioning is virtually unknown. Consequently, its potential as biomarker for gland diseases, including malignancies cannot be assessed. The S-100 protein, a known marker for schwannomas, has been found also in myoepithelial-cell carcinomas of the salivary glands. Here, we present our initial findings on the anatomic-histologic…

AN EFFECTIVE TREATMENT FOR HEMORRHAGIC RADIATION PROCTITIS

A Misunderstood intestinal perforation believed acute pancreatitis: A case report

Acute pancreatitis represents one, possible but rare, of the several complications of laparoscopic cholecystectomy. In the case reported, a 31-year-old female patient complained of abdominal pain after laparoscopic cholecystectomy. The clinical picture, the high values of serum amylase, lipase and white blood cell count and the subsequent abdominal computed tomography (CT) led to diagnose an acute biliary pancreatitis. This was pharmacologically treated, but the patient worsened in a few days. A contrastenhanced CT showed the presence of free air and effusion into the peritoneal cavity. The patient was submitted to another intervention, which revealed a 1-cm jejunal perforation. The injured…

Synchronous liver metastases from colorectal carcinoma

The mediterranean diet: A history of health

The Mediterranean tradition offers a cousine rich in colors, aromas and memories, which support the taste and the spirit of those who live in harmony with nature. Everyone is talking about the Mediterranean diet, but few are those who do it properly, thus generating a lot of confusion in the reader. And so for some it coincides with the pizza, others identified it with the noodles with meat sauce, in a mixture of pseudo historical traditions and folklore that do not help to solve the question that is at the basis of any diet: combine and balance the food so as to satisfy the qualitative and quantitative needs of an individual and in a sense, preserves his health through the use of substance…

I PROBIOTICI NEL TRATTAMENTO COMPLEMENTARE DELLE PATOLOGIE DELL'INTESTINO CRASSO

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…

POSTOPERATIVE COMPLICATIONS,PAIN AND QUALITY OF LIFE AFTER THORACOSCOPIC OF THOREACOTOMIC LOBECTOMY FOR LUNG CANCER

Aim: Thoracoscopic lobectomy is superior to thoracotomy, but the evidence for this assumption is low. We present a comparison between thoracotomy and thoracoscopy in term of postoperative complications, mortality, postoperative, hospital stay and quaklity of life. Patients and methods: This is a rectrospective analysis of 224 lobectomies in 24-months. 128 patients (57.1%) were operated by thoracotomy; 96 patients (42.9%) by videothoracoscopy. Results: Major complications were observed in 4/128 (3.1%) in thoracotomy group and in 1/96 (16.7%) thoracoscopy. Thoracoscopy patients had a shorter hospital stay. Conclusion: our study shows an advantage of thorascopy over thoracotomy but furher stud…

Maltoma della tiroide: presentazione di un caso clinico non associato a tiroidite di hashimoto

I maltomi della tiroide sono rare neoplasie della ghiandola originati dalle cellule B parafollicolari, frequentemente associati a tiroidite autoimmune di Hashimoto. Gli Autori propongono un caso di linfoma tiroideo primitivo in cui nè l'evoluzione clinica, nè i dati strumentali e citologici preoperatori, nè l'esame istologico eseguito sul resecato chirurgico hanno evidenziato l'associazione con una tiroidite pregressa. Il caso appare interessante per la comparsa a circa 6 mesi dall'intervento di una grave forma di aplasia selettiva della serie rossa (pure red cell aplasia, PRCA) ub assenza di autoanticorpi o di segni di pregressa infezione virale, con remissione completa dopo trattamento co…

COULD THE ENDOSCOPIC RESECTION OF A LARGE RECTAL LEIOMYOMA BE AN EFFETCIVE AND SAFE TECHNIQUE?

Summary. Rectal leiomyomas are a rare conditions, with low reported incidence in literature and constitute about 0.1% of rectal tumours; in fact rectal leiomyomas occur in approximately 1 out of 2000-3000 rectal tumors. We report on a patient with a 3 cm semi-pedunculated colonic leiomyoma, which was successfully removed by endoscopic polypectomy after normal saline-epinephrine submucosal injection. When we encounter a tumor during a colonoscopic examination, we usually evaluate the tumor carefully and perform an endoscopic resection when we judge it is appropriate. When a symptomatic smooth muscle tumors smaller than 2 cm are incidentally found on colonoscopy, surgical resection is unneces…

IMMUNOLOGICAL ASPECTS OF CROHN'S DISEASE: A REGULATORY FUNCTION OF TIM-3/GALECTIN-9 IN LYTH1.

Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) and its etiology is multifactorial and involves a combination of genetic environmental factors. The interaction of these factors causes an imbalance of the microbiota, leading to the activation of several immunological and inflammatory mechanism. From an immunological point of view, there seems to be an involvement of the TIM-3/GALECTIN-9 pathway and of the autoregulation of lyTh1. These studies show that in patients with CD the autoregulation of lyth1 is lost due to a reduced concentration of galectin-9 and a reduced TIM-3 expression in LyTh1. This could be one of the reason for the state of perpetual activation of lyTh1, r…

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 …

One shoot seldinger central venous catheterization in dialyzed patients

Introduction: Central Venous Catheterization is necessary in uremic patient (before dialysis) and many other conditions. In this study we demonstrated the advantages of ultrasonography to perform the procedure. Materials and methods: 48 uremic patient were submitted to ultrasound-guided central venous catheterization. The procedure was performed following the Seldinger “one shot” technique. Results: The mean operative time was 4 minutes, with a high rate of success (100%) and a low percentage of complications (2%). Conclusion: The ultrasound-guided central venous catheterization is a safe procedure, rapid and easy to perform. The procedure has a low rate of failures and complications and a …

CHIRURGIA IN REGIME DI DAY SURGERY: NOSTRA ESPERIENZA

Con il termine day-surgery s’intende la possibilità clinica, organizzativa ed amministrativa di effettuare interventi chir u rgici o procedure diagnostiche e/o terapeutiche invasive e semiinvasive in regime di ricovero limitato alle sole ore del giorno, in anestesia locale, loco-regionale o generale (1) . Scopo del nostro lavoro è di valutare l’attività di daysurgery integrata nel nostro reparto di chirurgia generale

OBTAINING MESENCHYMAL STEM CELLS FROM ADIPOSE TISSUE OR MURIN ORIGIN: EXPERIMENTAL STUDY.

The aim of this study was to isolate and characterize rat adipose Derived Mesenchymal Stem Cells (AD-MSCs) in order to evaluate their proliferative potential and their ability to different cell types. AD-MSCs and Derived Mesenchymal Stem Cells (BM-MSCs) have the same characteristic in terms of plasticity. The advantage of adipose tissue is that it is an easier accessible source and it offers a large amount of MSCs by less invasive surgical tecniques. MSCs were obtained from subcutaneous adipose tissue of Wistar rats. first of all microbiological controls were made to exclude the presence of bacteria of fungi in then tissue. Adipose tissue was mechanically and enzimatically fragmented and st…

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…

Malignant colorectal obstruction. Palliative endoscopic treatment with self-expanding metallic stents

The Authors report their experience in the palliative management of malignant colorectal obstruction. Between June 2000 and April 2003 sixteen patients (11 men and 5 women, age range 63-82) were found suffering from malignant colorectal obstruction. In these patients it was not possible to perform definitive surgical treatment because of the old age, advanced neoplastic disease and poor health condition, colostomy was the only therapeutic option. Endoscopic self-expanding stents placement was performed as a definitive palliative method to treat colorectal obstructions caused by advanced and unresectable tumours. This procedure was performed under endoscopic and fluoroscopic control and neit…

IMPROVEMENT IN REDOX HOMEOSTASIS AFTER CYTOREDUCTIVE SURGERY IN COLORECTAL ADENOCARCINOMA

Colorectal cancer (CRC) as one the most common cancer type is associated with oxidative stress. Surgery is the only curative modality for early-stage CRC. The aim of this study was to evaluate the oxidative damage biomarkers as well as enzymatic and nonenzymatic antioxidants in patients with CRC before and after tumor resection and in healthy controls. 60 patients with stage I/II colorectal adenocarcinoma and 43 healthy controls were recruited in this study. We measured plasma levels of oxidative damage biomarkers, including advanced oxidation protein products (AOPP), advanced glycation end products (AGEs), malondialdehyde (MDA), and oxidized low-density lipoprotein (ox-LDL) at baseline and…

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…

A MIXTURE OF VEGETABLE EXTRACTS (CHAMOMILLE, PASSIONFLOWER, CARAWAY, FENNEL), AND ENZYMES (BETA-GALACTOSIDASE) FOR IRRITABLE BOWEL SYNDROME (ibs): AN OBSERVATIONAL STUDY ("BIOVES")

Summary. Aims: Irritable bowel syndrome (IBS) is a functional intestinal disorder. This syndrome may creates psychological disorders in patients who are affected and severely limits daily activities and lifestyle. Methods: We investigated the effect of the natural product consisting of chamomile, fennel, caraway, passionflower and melissa (Spasmicol®), on IBS patients. For the study, 187 patients with IBS, enrolled by primary care doctors, were treated with Spasmicol® (Aristeia Farmaceutici s.r.l.), two tablets/daily, for 30 days. At the end of the study, patients were re-evaluated to analyse the effects of therapy. Results: After 30 days, patients showed a marked reduction of symptoms (abd…

ABRIKOSSOFF'S TUMOR:REPORT A RARE CASE IN ANAL AND PERIANAL REGION

Molecular chaperones expression levels and localization in non-tumoral and tumoral thyroid tissues

Papillary thyroid carcinoma (PTC) is the most frequently occurring subtype of thyroid cancer. Exosomes (EXs) secreted from cells to the extracellular environment play an important role in intercellular communication in normality and pathology. Recent data indicates that tumor cells-derived EXs contribute to cancer progression through the modulation of tumor microenvironment(1). Heat Shock Protein (HSPs) are often overexpressed during carcinogenesis and different studies shown that they can be released by tumors cells and that the mechanism of release is mediated by EXs pathway. In this project we performed an immunomorphological study to investigate Hsp60, 90,70,27 levels expression profile…

Obtaining Mesenchymal Stem Cells From Adipose Tissue Of Murin Origin: Experimental Study

MALIGNAT COLORECTAL OBSTRUCTION: PALLIATIVE ENDOSCOPIC TREATMENT WITH SELF-EXSPANDING METALLIC STENTS

USEFULNESS OF CT COLONOGRAPHY IN PATIENTS WITH OCCLUSIVE COLORECTAL CANCER BEFORE METALLIC STENT PLACEMENT: A SINGLE ENTER EXPERIENCE

Up to 15% of patients with colorectal cancer (CRC) present with large bowel obstruction. Currently, computed tomography colonography (CTC) is regarded as a promising technique for complete evaluation of the proximal colon and simultaneous assessment of extraluminal status. Aim of this retrospective, observational study is to evaluate the feasibility of using CTC for preoperative examination of the proximal colon before metallic stgent placement in patients with colon obstruction caused by CRC. Sixteen patients who demonstrated colonic obstruction caused by CRC, underwent CTC immediately after incomplete colonoscopy. Per-patient sensitivity of CTC for lesion 5 mm larger in diameter in the co…

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…

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…

MICROBIOTA INTESTINALE

Il microbiota intestinale è costituito da centinaia di specie batteriche diverse, le cui molteplici attività metaboliche influenzano lo stato di salute. Nel corso dell'evoluzione della specie umana si è instaurato un importante e delicato equilibrio di mutuo vantaggio tra l'uomo e la microflora, che rischia però di essere compromesso da imporovvisi cambiamenti.In condizione di stress psico-fisici, alimentari, ambientali, o in seguito all'assunzione di farmaci, si assiste ad uno sbilanciamento della microflora (disbiosi) che rende l'organismo suscettibile all'attacco di patogeni. La dieta, atraverso opportuni interventi alimentari, costituisce uno dei principali fattori, di natura esogena, i…

A rare cause of acute cholecystitis

COLORECTAL CANCER IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: PRELIMINARY RESULTS FROM AN ONGOING CASE-CONTROL STUDY

Background and Aim:Understanding the risk factors for colorectal cancer (CRC) is crucial to the development of effective strategies for its prevention. meta-analysis and epidemiological studies have already shown that type 2 diabetes mellitus (DM) is associated with an increased risk of CRC and have provided data to support a positive relationship between these diseases. Material and Methods: We retrospectively evaluated 741 consecutive caucasian patients with type 2 DM who underewnt colonoscopic screening cof CRC and followed in our tertiary referrral center in 200-208 for incidence of CRC. Patients were stratified based on gender, age, body mass index (MBI), alchool and NSAIDS assumption,…

MANAGEMENT OF LEIOMYOMA OF THE TRANSVERSE COLON: CASE REPORT

Colonic leiomyoma is a mesenchymal tumor that arises from the muscularis mucosae or muscularis propria and is composed of well-differentiated smooth muscle cells with no atypia. It is often incidentally found since its growth affects the submucosal layer and the lesion is covered with normal epithelium. Endoscopic ultrasonography is recommended to define the grade of infiltration of the tumor and eventually lymph node involvement. Histological examination is critical to establish the nature of the tumor and its behaviour. In the case of a voluminous tumor surgical treatment is needed. we report case of a patient that underwent colonoscopy showing the presence of a neoformation at 70 cm from…

EFFICACY OF ARGENTUM-QUARTZ SOLUTION IN THE TREATMENT OF PERIANAL FISTULAS: A PRELIMINARY STUDY

Objective: Nowadays, an optional and effective medical surgery remains the gold standard for perianal fistulas. Hereby we reported preliminary rsults in favor of using Argentum-Quartz solution for both primary and recurrent perianal fisrtulas. Methods: Three patients with intersphimncter and extrasphinteric fistulas were enrolled. Argentum-Quartz solution was administrated twice a week for sa period of 4 weeks, followed by a pause of 8 days and then another 4 weeks of treatment, totally 16 administrations. After treatment, all patients were monitored for 4-months follow-up. Results: Complete closures of 2 extrasphinteric fistulas and a partial closure with absence of inflammation and supera…

Un raro caso di Occlusione Intestinale:Fitobezoar

Gli Autori riportano il caso di una paziente di 62 anni affetta da fitobezoar gastrico, sottoposto a frammentazione e asportazione per via endoscopica. A distanza di 36 ore circa dall'esecuzione di tale metodica, la paziente ha manifestato l'insorgenza di una sindrome occlusiva. L'esame TC addome evidenziava il digiuno e le prime anse ileali sovradistese dopo somministrazione di mdc per os. Nel lume di un'ansa ileale, a valle, si evidenziava la presenza di una formazione disomogenea, del diametro 2,5x4 cm nel cui contesto si rilevano piccole bolle di gas, da riferire in 1° ipotesi a bezoar. La paziente veniva quindi sottoposta a intervento chirurgico di enterotomia e asportazione del materi…

Intestinal microbiota mutualism and gastrointestinal diseases

The purpose of this work is to investigate the link between an altered intestinal mcro-biota or dysbiosis and chronic inflammatory disorders, in particular inflammatory bowel disease (IBD). Along with probiotics, faecal microbiota transplantation (FMT) opts to be a promising therapeutic treatment for restoring the bacterial homeostasis of the hu-man intestine and reducing the risk of colorectal carcinogenesis. Microbiota is the com-plex microbial flora that resides in the gut establishing a mutually beneficial relation-ship. Alteration of the microbiota’s composition, termed as dysbiosis, may lead to pathological conditions. Treatment with probiotics can restore the normal commensal flora i…

Malignant tumor-like gastric lesion by Candida albicans.

Superior Mesenteric Artery Syndrome: Clinical, Endoscopic, and Radiological Findings.

Background. The superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required. Aims and Methods. This study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome. Ten cases of SMA syndrome out of 2074 esophagogastroduodenoscopies were suspected. A contrast-enhanced computed tomography (CECT) scan was performed to confirm the diagnosis. After, a gastroenterologist and a nutritionist personalized the therapy. Furthermore, we compared the demographical, clinical, endoscopic, and radiological parameters of these …

Synchronous adenomatous polyps and colorectal carcinoma

PERFORATED DIVERTICULITIS OF SIGMOID: AN UNCOMMON PRESENTATION

POSTURE AND POSTUROLOGY, ANATOMICAL AND PHYSIOLOGICAL PROFILES: OVERVIEW AND CURRENT STATE OF ART

Background and aim of work: posture is the position of the body in the space, and is controlled by a set of anatomical structures. The maintenance and the control of posture are a set of interactions between muscle-skeletal, visual, vestibular, and skin system. Lately there are numerous studies that correlate the muscle-skeletal and the maintenance of posture. In particular, the correction of defects and obstruction of temporomandibular disorders, seem to have an impoact on posture. The aim of this work is to collect information in literature on posture and the influence of the stomatognatich system on postural system. Methods: Comparison of the literature on posture and posturology by cons…

3,5-DIIODO-L-THYRONINE-INDUCED MODIFICATION IN PITUITARY-THYROID AXIS IN RATS FED HIGH-FAT DIET. A PRELIMINARY REPORT

Experimental observations highlight that the administration of 3,5-diiodo-L-thyronine (T2) may decrease the body weight and the plasma levels of cholesterol and triglycerides and may prevent the onset of hepatic steatosis in rats fed diets rich in lipids (HFD). On the basis of these findings we have carried out some in vivo studies to evaluate the effects of increased levels of T2 on pituitary thyroid axis function in HFD rats. Fifteeen Wistar male rats were divided in 3 groups. The first group (N) was fed with a standard diet. The second group (G) was fed with a diet high in fat (HDF), while the third group (GT2) was additionally administered intraperitoneally with T2 (70 ug/100g body weig…

I PROBIOTICI NEL TRATTAMENTO COMPLEMENTARE DELLE PATOLOGIE GASTRICHE

SELF-EXPANDABLE METAL STENT PLACEMENT FOR CLOSURE OF A LEAK AFTER TOTAL GASTRECTOMY FOR GASTRIC CANCER: REPORT ON THREE CASES AND REVIEW OF THE LITERATURE

In the setting of the curative oncological surgery, the gastric surgery is exposed to complicated upper gastrointestinal leaks, and consequently the management of this problem has become more critically focused than was previously possible. We report here three cases of placement of a partially silicone-coated SEMS (Evolution Controlled Release Esophageal Stent System, Cook Medical, Winston-Salem, NC, USA) in patients who underwent total gastrectomy with Roux-en-Y end-to-side esophagojejunostomy for a gastric adenocarcinoma. The promising results of our report, despite the small number of patients, suggest that early stenting (through a partially silicone-coated SEMS) is a feasible alternat…

ANATOMICAL DISSECTION AND ANALYSIS OF THE STRUCTURES OF THE UPPER LIMB

In 2015, a whole body dissection course was proposed by the University of Palermo, Palermo, Italy, thanks to the cooperation with the University of Malta, Msida, Malta. The purpose of this study was to show the the difference between the studyof anatomy on books and on corpses. The article focuses its attention on the dissection method of the upper limb. The astudy was performed on two corpses, a male and a female, by using a basic surgeon kit. Blunt dissection method was used for fasciae, innards and to isolate vascular-nervous structures from the fat; we used scalped for cutis, sub cutis, muscles, fasciae, veins, arteries and nerves of the upper limb from the shoulder to the hand. The upp…

ADVANCED ENDOSCOPIC IMAGING FOR SURVEILLANCE FOR DYSPLASIA AND COLORECTAL CANCER IN INFLAMMATORY BOWEL DISEASE: COULD THE PATHOLOGIST BE FURTHER HELPED?

Patients with inflammatory bowel disease (IBD) have an increased risk of developing intestinal cancer. The magnitude of that increased risk as well as how best to mitigate it remain a topic of ongoing investigation in the field. It is important to quantify the risk of colorectal cancer in association with IBD. The reported risk varies widely between studies. This is partly due to the different methodologies used in the studies. Because of the limitations of surveillance strategies based on the detection of dysplasia, advanced endoscopic imaging and techniques involving the detection of alterations in mucosal antigens and genetic abnormalities are being investigated. Development of new bioma…

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…

BENIGN GASTRIC POLYPS AND HELICOBACTER PYLORI

Antitumoral activity of curcumin: an adjuvant therapeutic strategy

Curcumin, an active substance contained in an Indian spice called turmeric or curcuma, is well known for its anti-inflammatory and antioxidant properties. In recent times, it was taken into account and studied as an antitumoral molecule, by relying on its interference on several biological mechanisms, such as the inhibition of inflammatory mediators, the enhancement of detoxifying enzymes’ action and processes of cell growth and proliferation. Studies show how the high dosage of curcumin in vitro inhibits colorectal tumor cells, pancreatic tumor cells, lung cancer cells and glioblastoma’s cells, interfering in signaling pathways as Wnt/β-catenin, NF-kB and PI3K/Akt and leading to cell cycle…

Hsp60 and Hsp10 increase in colon mucosa of Crohn's disease and ulcerative colitis.

The purpose of this work was to determine in colon mucosa of Crohn’s disease (CD) and ulcerative colitis (UC) in relapse: a) the levels of the chaperonins Hsp60 and Hsp10; b) the quantity of inflammatory cells; and c) if the levels of chaperonins parallel those of inflammation cells. Twenty cases of CD and UC and twenty normal controls (NC) were studied using immunohistochemistry, Western blotting and immunofluorescence. Immunohistochemically, Hsp60 and Hsp10 were increased in both inflammatory bowel diseases (IBD) compared to NC. These results were confirmed by Western blotting. Hsp60 and Hsp10 occurred in the cytoplasm of epithelial cells in CD and UC but not in NC. Hsp60 and Hsp10 co-loc…

TERAPIA INFILTRATIVA INTRA-ARTICOLARE ASSOCIATA A MESALAZINA E PROBIOTICI NEL TRATTAMENTO DELL'ARTRITE NEL PAZIENTE CON MALATTIA INFIAMMATORIA CRONICA INTESTINALE (IBD)

L'artrite secondaria a malattia infiammatoria cronica intestinale può essere presente parecchi anni prima della diagnosi oppure manifestarsi come una vera complicanza.

ENDOSCOPIC FINDINGS IN CHRONIC RENAL FAILURE: REVIEW OF LITERATURE

Chronic kidney Disease (CKD) is associated with several gastrointestinal diseases, documented with endoscopy. we revisited internation experience about endoscopic pictures in these patients, analyzing only the pre-transplantation period. Gastritis, esophagitis, duodenitis, gastrointestinal bleeding, intestinal ischaemia, angiodysplasia and diverticula are the most common findings, but others are reported too. Every author has different data and percentages, and further studies are necessary to assess the relation between CKD and gastrointestinal diseases. CKD is often part of a multisystem damage, that makes the management of the patinet critical. The aim of this review is to consider patie…

The complex interplay between vitamin D deficiency and diabetes

It has been recently highlighted the link between vitamin D and metabolic and immunological pro- cesses, which established its role as an essential component of human health preservation. Vitamin D has been defined as natural immune modulators, and through the activation of its receptors (VDRs), it regulates calcium metabolism, cellular growth, proliferation and apoptosis, and other immunological functions. In this setting, vita- min D has also been reported to influence glucose regulation via effects on insulin secretion and action. Vitamin D deficiency is strongly associated with obesity mostly due to the storage of vitamin D in adipose tissue because of its lipophilic properties. The dec…

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.

Efficacy of pneumatic dilatation for the treatment of idiopatic achalasia: a single-center experience

Pneumatic dilatation (PD) and Surgical Miotomy (SM) are presently the best treatments for untreated achalasia, with similar efficacy. There is no information on the relative efficacy of PD in younger compared to older patients. Aim of our study was to compare success rate and safety of PD in patients under fifty years old and in those over fifty years old affected by achalasia. Twenty consecutive symptomatic patients were treated in our Unit with graded PD under fluoroscopic view. Five male and 15 female with a median age of 47 years were treated. Twelve patients were less than fifty years old (group I) while 8 were older (group II). Median dysphagia questionnaire score was 14 and13 ingroup…

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.

CISTOADENOMA GIGANTE DELL'OVAIO: CONSIDERAZIONI CLINICHE E STRATEGIA DIAGNOSTICA

gli autori riortano il caso di una donna obesa affetta da cistoadenoma mucinoso gigante dell'ovaio. nonostante la presenza di una massa addominale voluminosa, la paziente non accusava sintomatologia degna di rilievo.

From Dysbiosis to Neurodegenerative Diseases through Different Communication Pathways: An Overview

The microbiome research field has rapidly evolved over the last few decades, becoming a major topic of scientific and public interest. The gut microbiota (GM) is the microbial population living in the gut. The GM has many functions, such as maintaining gut homeostasis and host health, providing defense against enteric pathogens, and involvement in immune system development. Several studies have shown that GM is implicated in dysbiosis and is presumed to contribute to neurodegeneration. This review focuses mainly on describing the connection between the intestinal microbiome alterations (dysbiosis) and the onset of neurodegenerative diseases to explore the mechanisms that link the GM to nerv…

Intestinal dysbiosis and hormonal neuroendocrine secretion in the fibromyalgic patient

Fibromyalgia is a rheumatic syndrome and its pathogenesis is controversial. The recent literature has placed considerable attention on the link between alteration of the intestinal microbiota and fibromyalgia, emphasizing the close connection between the neuroenteric system and the CNS. This study aims to evaluate the probable relationship between intestinal dysbiosis and altered secretion of hormones and vitamins such as cortisol, serotonin, Vitamin D and thyroid hormones in a patient with fibromyalgia.

A RARE CAUSE OF SIGMOID DIVERTICULUM PERFORATION

Gemcitabine and oxaliplatin combination chemotherapy in advanced biliary tract cancers

Background Biliary tract cancers are uncommon tumors with a poor prognosis and most patients present with invasive and inoperable disease at diagnosis. Chemotherapy represents a palliative treatment, with poor response rates and a median survival of less than 6 months. Oxaliplatin and gemcitabine have shown an interesting activity as single agents in this group of patients. Patients and methods We carried out a multicenter phase II study to evaluate the efficacy and safety of combined oxaliplatin and gemcitabine in locally advanced and metastatic biliary tract carcinoma. The schedule of chemotherapy included oxaliplatin 100 mg/m2 on day 1 and gemcitabine 1000 mg/m2 on days 1 and 8, every 21…

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…

Using Polymeric Scaffolds for Vascular Tissue Engineering

With the high occurrence of cardiovascular disease and increasing numbers of patients requiring vascular access, there is a significant need for small-diameter (<6 mm inner diameter) vascular graft that can provide long-term patency. Despite the technological improvements, restenosis and graft thrombosis continue to hamper the success of the implants. Vascular tissue engineering is a new field that has undergone enormous growth over the last decade and has proposed valid solutions for blood vessels repair. The goal of vascular tissue engineering is to produce neovessels and neoorgan tissue from autologous cells using a biodegradable polymer as a scaffold. The most important advantage of …

IL TRATTAMENTO DELL'ERNIA INGUINALE CON TECNIVA TENSION FREE. ESPERIENZA PERSONALE

POSSIBLE RELATION BETWEEN GUT MICROFLORA COMPOSITION AND ONCOGENIC RISK: IS STIMULATION OF INFLAMMATION THE ONE RING OF CONNECTION?

Human intestinalmicrobiotais characterizedby highpopulationdensity, wide diversity and complexity of interactions. Dysbiosis, both qualitative and quantitative, might have serious health consequences including an increase in the number and/or alteration of bacteria colonizing the gastrointestinal tract, which could be referred as gut microflora imbalance (GMI). GMI is frequently found in patients suffering from irritable bowel syndrome; this is the reason why some authors believe that IBS is secondary to GMI. Interestingly, GMI is also found in about 25% of Crohn’s disease patients. Stimulation of inflammation by the ‘dangerous bacteria’, through specific activation of the intestinal immune…

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…

Salivary gland proteins alterations in the diabetic milieu

AbstractSalivary glands are considered the chief exocrine glands of the mouth and physiologically contribute to the maintenance of the homeostasis of the oral cavity. They consist of the parotid, submandibular and sublingual glands, which come in pairs and are collectively called the major glands, and the minor glands, which are much smaller and are dispersed throughout the buccal cavity. Salivary glands are distinguished by their size, amount of saliva secretion and their location in the oral cavity. Salivary glands pathophysiology has been a subject of interest in various worldwide metabolic disorders, including diabetes mellitus. Diabetes mellitus (DM), a global health concern, with a pa…

Heat shock proteins and ulcerative colitis: The start of a new era?

Probiotics Can Cure Oral Aphthous-Like Ulcers in Inflammatory Bowel Disease Patients: A Review of the Literature and a Working Hypothesis

Dysbiosis has been associated with the onset of several chronic autoimmune or inflammatory pathologies (e.g., inflammatory bowel diseases—IBD), because of its primary role in the establishment of a chronic inflammatory process leading to tissue damage. Inflammatory bowel diseases can even involve areas far away from the gut, such as the extraintestinal manifestations involving the oral cavity with the onset of aphthous-like ulcers (ALU). Studies carried out on animal models have shown that intestinal dysbiosis may be related to the development of autoimmune diseases, even if the mechanisms involved are not yet well known. The aim of this paper is to verify the hypothesis that in inflammator…

Circulating exosomal Hsp60 as a new marker of colon cancer.

Potential benefits of colostrum in gastrointestinal diseases

This paper reviews the composition of colostrum and the potential preventive and therapeutic use of this "first milk" for treating various gastrointestinal disorders in humans. Colostrum is a complex biological liquid that is richer in antimicrobial peptides, immune-regulating compounds and growth factors than the subsequent mature milk. The main functions of colostrum are to provide essential nutritional components, strengthen the natural defense system, modulate immune response, balance intestinal microbiota and enhance the growth and repair of several tissues. Several studies and clinical trials carried out both in vitro and in vivo on humans and animals suggest the clinical benefits of …

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…

Self-Expandable Metal Stent Placement for Closure of a Leak after Total Gastrectomy for Gastric Cancer: Report on Three Cases and Review of the Literature

In the setting of the curative oncological surgery, the gastric surgery is exposed to complicated upper gastrointestinal leaks, and consequently the management of this problem has become more critically focused than was previously possible. We report here three cases of placement of a partially silicone-coated SEMS (Evolution Controlled Release Esophageal Stent System, Cook Medical, Winston-Salem, NC, USA) in patients who underwent total gastrectomy with Roux-en-Y end-to-side esophagojejunostomy for a gastric adenocarcinoma. The promising results of our report, despite the small number of patients, suggest that early stenting (through a partially silicone-coated SEMS) is a feasible alternat…

SUPERIOR MESENTERIC ARTERY SYNDROME: CLINICAL, ENDOSCOPICAL AND RADIOLOGICAL CORRELATIONS ACCORDING TO A SINGLE-CENTER EXPERIENCE

Background and aim: The superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss, due to the compression of the third part of duodenum between the aorta and the SMA. Studies to determine the optimal methods of diagnosis and treatment are essential. This study aims to analyze the clinical presentation, the doagnosis and the management of this syndrome. Material and medthods: Over a 2-year (2013-2014), 8 cases of SMA syndrome (out of 2074 esophago-gastro-duodenoscopies, EGDS) were initially suspected through EGDS. Therefore, these patients performed computed tomography (CT) scan to confirm the diagnosis. Once the diagn…

INFLAMMATION IN IRRITABLE BOWEL SYNDROME: MYTH OR NEW TREATMENT TARGET?

Low-grade intestinal inflammation plays a key role in the pathophysiology of irritable bowel syndrome (IBS), and this role is likely to be multifactorial. The aim of this review was to summarize the evidence on the spectrum of mucosal inflammation in IBS, highlighting the relationship of this inflammation to the pathophysiology of IBS and its connection to clinical practice. We carried out a bibliographic search in Medline and the Cochrane Library for the period of January 1966 to December 2014, focusing on publications describing an interaction between inflammation and IBS. Several evidences demonstrate microscopic and molecular abnormalities in IBS patients. Understanding the mechanisms u…

ALCOHOLIC LIVER DISEASE: A MOUSE MODEL REVEALS PROTECTION BY LACTOBACILLUS FERMENTUM

Objectives Alcoholism is one of the most devastating diseases with high incidence, but knowledge of its pathology and treatment is still plagued with gaps mostly because of the inherent limitations of research with patients. We developed an animal model for studying liver histopathology, Hsp (heat-shock protein)-chaperones involvement, and response to treatment. Methods The system was standardized using mice to which ethanol was orally administered alone or in combination with Lactobacillus fermentum following a precise schedule over time and applying, at predetermined intervals, a battery of techniques (histology, immunohistochemistry, western blotting, real-time PCR, immunoprecipitation, …

MULTIDISCIPLINARY APPROACH TO PALLIATIVE MANAGEMENT OF PANCREATOBILIARY TRACT CARCINOMAS

Colorectal cancer: An update on the effects of lycopene on tumor progression and cell proliferation

Colorectal cancer (CRC) is one of the most common cancers worldwide. Various factors, including oxidative stress, where excessive productions of reactive oxygen species (ROS) and reactive nitrogen species (RNS) occur, contribute to its pathogenesis. Numerous studies have investigated the effect of antioxidant substances derived from food such as fruits and vegetables; however, data on Lycopene are still rare. Studies on HT-29 colorectal cancer cells and on animal models have shown that lycopene has effects on cell proliferation and on the progression of the CRC by interacting with various cellular signaling pathways. This analysis of the literature focused on the antioxidant effect of lycop…

Resection of a giant mediastinal leiomyosarcoma

ABSTRACT Primary leiomyosarcomas of the lung are rare tumors. We report a case of 49-year-old female with history of cough, breathless at rest, right sided chest pain. Chest CT showed a huge (16 cm) mediastinal mass located on the right mediastinum encasing the right main pulmonary artery and infiltrating the main right bronchus and pericardium. The tumor was resected with combined pericardiectomy and pnemonectomy via hemiclamshell incision. This surgical access provided an adequate exposure of the chest “blind zones” and it allowed a radical and safe surgical resection of lung, pleura, pericardium and diaphragm. The final diagnosis showed a low grade differentiation leiomyosarcoma.

Bone loss in inflammatory 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 colitis (UC). Bone mineral density was measured by dual-energy X-ray absorptiometry. We used T score to express bone loss (osteopenia: -2.5 SD 2 years) and active disease would be risk factors of bone mineral loss in IBD.

Gallbladder carcinoma late metastases and incisional hernia at umbilical port site after laparoscopic cholecystectomy.

A potentially serious complication of laparoscopic cholecystectomy is the inadvertent dissemination of unsuspected gallbladder carcinoma. There are increasing reports of seeding of tumor at the trocar sites following laparoscopic cholecystectomy in patients with unexpected or inapparent gallbladder carcinoma. Although the mechanism of the abdominal wall recurrence is still unclear, laparoscopic handling of the tumor, perforation of the gallbladder, and extraction of the specimen without an endobag may be risk factors for the spreading of malignant cells. The Authors report the case of late development of umbilical metastasis after laparoscopic cholecystectomy; the presence of an incisional …

Anterior cervical discectomy and fusion with ROI-C peek cage: cervical alignment and patient outcomes

OBJECTIVE: The intersomatic cage ROI-C one is a new promising system in anterior cervical discectomy with subsequent fusion. METHODS: Patients were studied prospectively. ROI-C cages were used in consecutive 32 patients. Intraoperative parameters, clinical features and dysphagia scores were recorded. Radiographs evaluated the height of intervertebral space, the cervical Cobb angle and implant positioning. Data were collected on the last day of hospital stay, at 6 weeks, at 3, 6, 12 and 24 months. RESULTS: A total of 32 cages were implanted. One patient had transient dysphagia. The intervertebral height and the cervical Cobb angle were significantly improved at 24 months follow-up (P < 0.05)…

Studio di Fase II con Gemcitabina + oxaliplatino in combinazione nel trattamento delle neoplasie delle vie biliari, pancreas e colecisti in fase metastatica.

Studio di Fase II con Gemcitabina + oxaliplatino in combinazione nel trattamento delle neoplasie delle vie biliari, pancreas e colecisti in fase metastatica.

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…

ERYTHROPOIETIN FOR THE TREATMENT OF SUBARACHNOID HEMORRAGE: A FEASIBLE INGREDIENT FOR A SUCCESS MEDICAL RECIPE

Subarachnoid hemorrhage (SAH) following aneurysm bleeding accounts for 6% to 8% of all cerebrovascular accidents. Although an aneurysm can be effectively managed by surgery or endovascular therapy, delayed cerebral ischemia is diagnosed in a high percentage of patients resulting in significant morbidity and mortality. Cerebral vasospasm occurs in more than half of all patients after aneurysm rupture and is recognized as the leading cause of delayed cerebral ischemia after SAH. Hemodynamic strategies and endovascular procedures may be considered for the treatment of cerebral vasospasm. In recent years, the mechanisms contributing to the development of vasospasm, abnormal reactivity of cerebr…

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…

Could JC virus provoke metastasis in colon cancer?

AIM: To evaluate the prevalence of John Cunningham virus (JC virus) in a small cohort of patients with colon cancer and to assess its presence in hepatic metastasis. METHODS: Nineteen consecutive patients with histologically diagnosed colon cancer were included in our study, together with ten subjects affected by histologically and serologically diagnosed hepatitis C virus infection. In the patients included in the colon cancer group, JC virus was searched for in the surgical specimen; in the control group, JC virus was searched for in the hepatic biopsy. The difference in the prevalence of JC virus in the hepatic biopsy between the two groups was assessed through the χ2 test. RESULTS: Four…

Modulation of mucin 2 and mucin 3 in colitis induced by iodoacetamide and enteropathogenic bacteria in rats

The iinate and acquired immune systems are both implicarted in the etiology of Inflammatory Bowel Disease (IBD) in addition to the genetic predisposition, the environmental factors and the intestinal flora covering the mucosa. A defect in the mucous covering will lead to an invasion of pathogens and stimulation of the immuune response with aberrations of mucin 2, the major mucin of the mucous layer. Aim: this study aims to assess the modulation of colonic MUC 2 and MUC 3 in a arat model of IBD induced by a combination of iodoacetamide and enteropatogenic E. Coli. Methods: 78 sprague-Dawley female rats were divided into 4 groups. Each group was subjeceted, on a basis, to a rectal injection o…

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.

Permanence of Modifications in Oral Microcirculation in Ex-Smokers.

Background: The aim of this study was to assess the long-term effects of smoking and to investigate the permanence of this damage to the oral microcirculation. Material/Methods: We recruited 75 patients and divided them into 3 groups: group 1 was composed of 25 healthy non-smokers, group 2 was composed of 25 healthy current smokers, and group 3 was composed of 25 healthy ex-smokers. Video-capillaroscopic examination was performed on all patients. The video-capillaroscopic investigation was performed on patients in sitting position, always with the same light source, at the same room temperature (23°C), in the morning, with the same operator (GAS), and was repeated many times for every area …

JC Virus and Lung Adenocarcinoma: Fact or Myth?

Background/aim An association has been reported between lung cancer and John Cunningham (JC) virus infection. The aim of this study was to evaluate the prevalence of JC virus in a small cohort of patients with lung adenocarcinoma and assess its presence in nodal metastasis. Materials and methods Consecutive samples of 13 surgically-removed lung tumors and 13 surrounding normal cancer-free tissues were selected. Five cases included metastatic lymph nodes. JC virus infection was assessed through nested PCR. Results Seven out of thirteen patients with lung adenocarcinoma had a positive PCR test for JC virus. One of the five patients with nodal metastasis had a positive PCR test for JC virus. N…

Gut microbiota imbalance and chaperoning system malfunction are central to ulcerative colitis pathogenesis and can be counteracted with specifically designed probiotics: a working hypothesis

In this work, we propose that for further studies of the physiopathology and treatment for inflammatory bowel diseases, an integral view of the conditions, including the triad of microbiota-heat shock proteins (HSPs)-probiotics, ought to be considered. Microbiota is the complex microbial flora that resides in the gut, affecting not only gut functions but also the health status of the whole body. Alteration in the microbiota's composition has been implicated in a variety of pathological conditions (e.g., ulcerative colitis, UC), involving both gut and extra-intestinal tissues and organs. Some of these pathologies are also associated with an altered expression of HSPs (chaperones) and this is…

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.

THE PATIENT IN THE OPERATING ROOM: CONSIDERATION AT SEVEN YEARS FROM WORLD HEALTH ORGANIZATION GUIDELINES PUBLICATION.

Modern surgery is burdened by a huge amount of patient to be treated and an increasingly complex number of procedures which request planned action and shared behaviours, aimed to prevent perioperative accidents and favour good surgical outcomes. Surgical and anaesthetic safety has improved significantly in last few decades. However, the operating room environment continues to have significant safety risks for patients as well as the health care providers who work there. Adverse events may result from problems in practice, products, procedures or systems. The worldwide incidence of surgical site infection, one of the most important and frequent post-operative complication, ranges from 3% to …

Hsp10: Anatomic distribution, functions, and involvement in human disease

There is growing evidence that molecular chaperones/heat shock proteins are involved in the pathogenesis of a number of human diseases, known as chaperonopathies. A better molecular understanding of the pathogenetic mechanisms is essential for addressing new strategies in diagnostics, therapeutics and clinical management of chaperonopathies, including those in which Hsp10 is involved. This chaperonin has been studied for a long time as a member of the mitochondrial protein-folding machine. However, although in normal cells Hsp10 is mainly localized in the mitochondrial matrix, it has also been found during and after stress in other subcellular compartments, such as cytosol, vesicles and sec…

NEW THERAPEUTIC PERSPECTIVES IN IRRITABLE BOWEL SYNDROME: TARGETING LOW-GRADE INFLAMMATION, IMMUNO-NEUROENDOCRINE AXIS, MOTILITY, SDECRETION AND BEYOND.

Irritable bowel syndrome (IBS) is a chronic, recurring, and remitting functional disorder of the gastrointestinal tract characterized by abdominal pain, distention, and changes in bowel habits. Although there are several drugs for IBS, effective and approved treatments for one or more of the symptoms for various IBS subtypes are needed. Improved understanding of pathophysiological mechanisms such as the role of impaired bile acid metabolism, neurohormonal regulation, immune, dysfunction, the epithelial barrier and the secretory properties of the gut has led to advancements in the treatment of IBS. With regards to therapies for restoring intestinal permeability, multiple studies with prebiot…

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.

Immunomorphological Pattern of Molecular Chaperones in Normal and Pathological Thyroid Tissues and Circulating Exosomes: Potential Use in Clinics

The thyroid is a major component of the endocrine system and its pathology can cause serious diseases, e.g., papillary carcinoma (PC). However, the carcinogenic mechanisms are poorly understood and clinical useful biomarkers are scarce. Therefore, we determined if there are quantitative patterns of molecular chaperones in the tumor tissue and circulating exosomes that may be useful in diagnosis and provide clues on their participation in carcinogenesis. Hsp27, Hsp60, Hsp70, and Hsp90 were quantified by immunohistochemistry in PC, benign goiter (BG), and normal peritumoral tissue (PT). The same chaperones were assessed in plasma exosomes from PC and BG patients before and after ablative surg…

A novel therapeutic approach to colorectal cancer in diabetes: role of metformin and rapamycin

International audience; The link between colorectal cancer (CRC), diabetes mellitus (DM) and inflammation is well established, and polytherapy, including rapamycin, has been adopted. This study is a novel approach that aimed at assessing the effect of a combination therapy of metformin and rapamycin on the control or prevention of CRC in diabetic animals, in presence or absence of probiotics. Fifty NOD/SCIDs male mice developed xenograft by inoculating HCT116 cells. They were equally divided into diabetics (induced by Streptozotocin) and non-diabetics. Metformin was given in drinking water, whereas rapamycin was administered via intra-peritoneal injections. Probiotics were added to the doub…

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…

Hsp60 as a Novel Target in IBD Management: A Prospect

Inflammatory bowel disease (IBD) encompasses various pathological conditions similar but distinct that share a multifactorial etiology, including involvement of the intestinal barrier function, the immune system, and intestinal microorganisms. Hsp60 is a chaperonin component of the chaperoning system, present in all cells and tissues, including the intestine. It plays important roles in cell physiology outside and inside mitochondria, its canonical place of residence. However, Hsp60 can also be pathogenic in many conditions, the Hsp60 chaperonopathies, possibly including IBD. The various clinico-pathological types of IBD have a complicated mix of causative factors, among which Hsp60 can be …

Single-Stage Laparoscopic Treatment of the common bile duct lithiasis

Colorectal Carcinogenesis: Role of Oxidative Stress and Antioxidants

One of the contributory causes of colon cancer is the negative effect of reactive oxygen species on DNA repair mechanisms. Currently, there is a growing support for the concept that oxidative stress may be an important etiological factor for carcinogenesis. The purpose of this review is to elucidate the role of oxidative stress in promoting colorectal carcinogenesis and to highlight the potential protective role of antioxidants. Several studies have documented the importance of antioxidants in countering oxidative stress and preventing colorectal carcinogenesis. However, there are conflicting data in the literature concerning its proper use in humans, since these studies did not yield defin…

Ittero ostruttivo come sintomo d'esordio in soggetto con leucemia monocitica acuta

A 24-year-old man presented with abdominal pain, fever and jaundice. Ultrasound examination of the abdomen showed a lithiasis of the gallbladder and a dilatation of the common bile duct without stones inside. A MR cholangiography showed a stenosis in the distal tract of the common bile duct which was dilated. The same picture was demonstrated by an endoscopic retrograde cholangiopancreatography (ERCP). The patient underwent an explorative laparotomy. No stones were found in the gallbladder, but in its infundibular region a hard nodule was present and located in the thickness of the wall. Another hard lesion was palpable in the middle tract of the common bile duct. Some enlarged mesenteric a…

Argentum-quarz solution in the treatment of anorectal fistulas: Is it possible a conservative approach?

Patients suffering from chronic intestinal diseases (Crohn's disease, Ulcerative Colitis, Indeterminate Colitis) are prone to the development of pyogenic complications. These complications are most commonly in the form of perianal or intraabdominal abscesses and/or fistulas. The treatment of these complications are managed differently but, after an initial treatment based on medical or minimally invasive management, the solution of the pathological condition is always achieved by a surgical procedure. In the last few years prospective studies have proposed an alternative conservative therapeutic approach based on application of fibrin glue in the healing of patients with fistulas-in-ano. In…

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.

Syncronous adenomatous polyps and colorectal carcinoma

MALIGNANT TUMOR-LIKE GAASTRIC LESION DUE TO CANDIDA ALBICANS IN A DIABETIC PATIENT TREATED WITH CYCLOSPORIN: A CASE REPORT AND REVIEW OF THE LITERATURE

The gastrointestinal tract of healthy individuals is colonized by hundreds of saprophytes and mycetes, especially the Candida species, are habitual ones. Under certain conditions, the fungal flora may overgrow, resulting in lesions of the digestive mucosa which, rarely, can have a local diffusion and/or spread to the lympho-hematogenous system. Mycotic infections of the stomach can sometimes look like benign gastric ulcers. Here, we present the case report of a woman, aged 64, who presented with type II diabetes mellitus and psoriasis, on chronic treatment with cyclosporin A and with endoscopic evidence of an ulcerated, vegetating gastric lesion secondary to Candida albicans infection. Alth…

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…

Bioengineered vascular scaffolds: the state of the art

To date, there is increasing clinical need for vascular substitutes due to accidents, malformations, and ischemic diseases. Over the years, many approaches have been developed to solve this problem, starting from autologous native vessels to artificial vascular grafts; unfortunately, none of these have provided the perfect vascular substitute. All have been burdened by various complications, including infection, thrombogenicity, calcification, foreign body reaction, lack of growth potential, late stenosis and occlusion from intimal hyperplasia, and pseudoaneurysm formation. In the last few years, vascular tissue engineering has emerged as one of the most promising approaches for producing …

La colangiografia intraoperatoria in corso di colecistectomia videolaparoscopica: quale ruolo?

The routine use of intraoperative cholangiography during laparoscopic cholecystectomy remains controversial. Mirizzi was the first to recommend the use of intraoperative cholangiography in 1931 based on the high incidence of unsuspected common bile duct stones. The use of intraoperative cholangiography before common bile duct exploration reduced the incidence of unnecessary common bile duct explorations from 66% to less than 5%. With the introduction of laparoscopic cholecystectomy, an increase of incidence of bile duct injury two to four times that seen in open cholecystectomy was witnessed. The vast majority of the injuries were a direct result of the surgeon misidentifying the anatomy. T…

CARCINOSARCOMA: INUSUALE PRESENTAZIONE

“Magnifying glass” for difficult radiocephalic arteriovenous fistulas

Background: Some uremic patients suffering from diabetes, atherosclerosis or simple by absent or exhausted peripheral vascular bed require bigger effort in creating arteriovenous fistula. Although it is possible to use prosthetic graft for difficult cases, the use of native vessels falls always in the respect of patient’s quality of life. A help for these cases comes from the use of a microsurgical technique for creating vascular access. Patient and Methods: For this study we evaluated the 72 patients underwent microsurgical radiocephalic fistula comparing them to a homogeneous group of 72 patients underwent traditional surgery. The patients were followed up at 1, 2 months and 1 year. Resul…

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

MULTIDISCIPLIBILIARY TRACT CARCINOMASNARY APPROACH TO PALLIATIVE MANAGEMENT OF PANCREATICO

GRANULOMATOUS MASTITIS DURING CHRONIC ANTIDEPRESSANT THERAPY: IS IT POSSIBLE A CONSERVATIVE THERAPEUTIC APPROACH?

Granulomatous mastitis is a rare benign inflammatory disease of the breast with multiple etiologies such as tuberculosis, sarcoidosis, foreign body reaction, and mycotic and parasitic infections. In contrast, idiopathic granulomatous mastitis (IGM) is characterized by the presence of chronic granulomatous lobulitis in the absence of an obvious etiology. Clinically and radiologically it may mimic breast carcinoma and so awareness of surgeons, pathologists, and radiologists is essential to avoid unnecessary mastectomies. Cases of IGM are reported during antidepressant therapy in patients also showing high levels of prolactinemia. In these cases, we believe that surgical excision must be avoid…

TRATTAMENTO CHIRURGICO DEL VARICOCELE: CASISTICA ED ANALISI DELLA LETTERATURA

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…

RECURRENT RENAL CARCINOMA MIMICKING A GOITRE: A CASE REPORT

Although the thyroid is a high vascularised gland, it is not common terget of metastases from extraglandular cancer. We reported a case of a 70 year-old woman who underwnt total thyroidectomy for multinodular goitre. In the patient's clinical hystory a nephrectomy was carried out 2 years before due to unspecified causes. The histopathological examination of the thyiroid showed a pattern compatible with clear cell renal carcinoma metastasis. The patient's relatives revealed, when questioned again, that the nephrectomy was due to the presence of a clear renal cell carcinoma keep concealed to the patients. Thanks to a timely intervention, the mass was removed and a better survival was guarante…

Quantitative patterns of Hsps in tubular adenoma compared with normal and tumor tissues reveal the value of Hsp10 and Hsp60 in early diagnosis of large bowel cancer

Large bowel carcinogenesis involves accumulation of genetic alterations leading to transformation of normal mucosa into dysplasia and, lastly, adenocarcinoma. It is pertinent to elucidate the molecular changes occurring in the pre-neoplastic lesions to facilitate early diagnosis and treatment. Heat shock proteins (Hsps), many of which are molecular chaperones, are implicated in carcinogenesis, and their variations with tumor progression encourage their study as biomarkers. There are many reports on Hsps and cancer but none to our knowledge on their systematic quantification in pre-neoplastic lesions of the large bowel. We performed immunohistochemical determinations of Hsp10, Hsp60, Hsp70, …

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 …

Antinflammatory effect of Levorag® (THD) emulgel on radiation proctocolitis around a colo-anal anastomosis

L'ESOFAGO DI BARRETT - Valutazioni personali dell'endoscopista ed analisi delle più recenti acquisizioni scientifiche

L’intento di questa monografia è quello di stimolare un momento di riflessione e di confronto, sull'"Esofago di Barrett". L’autore ha messo a confronto, quanto acquisito in quasi 20 anni di attività endoscopica, con le acquisizioni più recenti riportate in letteratura. Questa patologia, è considerata essere una condizione pre-cancerosa in quanto può evolvere, ma fortunatamente, non in tutti, verso il tumore dell’esofago. L’esofago di Barrett, ritengo corretto considerarlo una “patologia di interesse emergente”. L’affinamento delle metodiche diagnostiche, unitamente ai programmi di screening stimolati dalla maggiore consapevolezza, ha fatto si, che questa condizione patologica, sia sempre pi…

BENEFICIAL EFFECT OF PROBIOTICS ADMINISTRATION IN INFLAMMATORY BOWEL DISEASE AND RELATED SPONDYLOARTHROPATHY: A PROSPECTIVE STUDY

Background: Therapeutic treatment for inflammatory bowel disease (IBD) may follow different approaches, systemic as well as local, especially when the target is the osteoarticular apparatus. Although some clinical trials have suggested benefits from probiotics administration in IBD, there is still a great deal of controversy on their use. The aim of this study was to further investigate the effects of probiotics in patients with IBD and related spondyloarthropathy. Material/Methods: Fifty-nine patients affected by IBD with extra-intestinal involvement where evaluated from 2006 to 2010. Twenty-eight patients received administration of a standard therapy with mesalazine and 31 where treated w…

Laparoscopic treatment of mesenteric cysts report of two cases

SELENIUM AND AUTOIMMUNE THYROIDITIS

Selenium (Se) is an essential trace element of pivotal importance to human health. Se is incorporated into selenoproteins (SePs) which have pleiotropic effects, including antioxidant and anti-inflammatory effects, and in the production of active thyroid hormone. These findings may explain the relationship between Se deficiency and pathogenesis of various human diseases including thyroid disorder. In line with these observations, the therapeutic effectiveness of Se supplementation has already been reported in patients with various thyroid diseases. However, there are still controversial data about the optimal dose of Se to be administered, as well as the duration and efficacy of treatment an…

ADDOME ACUTO DA PERFORAZIONE DI DIVERTICOLO DEL SIGMA CAUSATO DALLA MIGRAZIONE DI UNO STENT BILIARE

Validation of a modified model of TNBS-induced colitis in rats. How to induce a chemical colitis in rats

Background: there are no standard practice in the induction of colitis by 2,4,6-trinitrobenzene sulfonic (TNBS) acid. Usually, the repeated administration of TNBS is preferred, because it will result in a local Th1 response that has the characteristics of Crohn's disease. material and Methods: A total of 30 rats were randomized into two groups, consisting of a saline control group of ten rats and a TNBS groups of 20 rats. After the animals were anesthesized, 0,5 ml of either 0,9 % saline 8controls) or TNBS 50 mg/Kg dissolved in 50% ethanol were instilled into the colon through a rubber catheter. The experiment was repeated weekly for four weeks, then, the rats were killed at day 40, and the…

RECURRENT RETROPERITONEAL ABSCESS AFTER BILIARY TRACT SURGERY IN AN ELEDERLY PATIENT: A MINIMALLY INVASIVE NONSURGICAL APPROIACH AND ITS CONSEQUENCES: A CASE REPORT

Abstract Introduction Hepatic abscess can be defined as an encapsulated collection of suppurative material within the liver parenchyma. Hepatic abscess can be distinguished as pyogenic, amebic, or fungal. Biliary tract disease remains the most common cause of hepatic abscess today, and the most common complications range from pleural effusion, empyema, and bronchohepatic fistula to subphrenic abscess and rupture into the peritoneal cavity, stomach, colon, vena cava, or kidney. A large abscess compressing the inferior vena cava and the hepatic veins may result in Budd-Chiari syndrome. In this report, we present a rare case of hepatic abscess with an unusual evolution that was treated with a …

EFFICACIA NELLA PRATICA CLINICA DI UN SUPPLEMENTO A BASE DI GLUCOSAMINA SOLFATO(GS), CONDROITINA SOLFATO (CS), COLLAGENE IDROLIZZATO DI TIPO B, ACIDO IALURONICO IDROLIZZATO E L-CARNITINA IN SOGGETTI CON OSTEOARTROSI DEL GINOCCHIO

Aim: Osteoarthritis (OA) is a degeneration of articular cartilage. four components of the cartilage structure, glucosamine, chondroitin collagen type II and hyaluronic acid are available in a food supplements. It has been claimed that they reduce the pain of OA and help rebuild cartilage in patients with early OA. Methods: A multicentre, randomized, double-blind ascorbic acid controlled study was carried out in patients with osteoarthritis of the knee. The purpose of the study was to evaluate the effectiveness of a food supplement sachet containing glucosamine sulfate (500 mg), chondroitin sulfate (400 mg), hydrolyzed collagen tipe II and hyaluronic acid mixture (300 mg), L-carnitine fumara…

A brief anatomo-surgical dissection guide to human mediastinal anatomy: results of the collaboration between the University of Palermo and the University of Malta.

In the summer of 2017, thanks to an agreement between the University of Malta and the University of Palermo, a group of students from the University of Palermo, who had already taken the anatomy exams and had a good knowledge of English, went for a 4 week period to the University of Malta to follow a dissection course . The students dissected skin, the sternum, the vessels, the nerves, analyzed the pericardium, the lungs and all the mediastinal organs. This work proves to be a small dissection guide for young medical students who want to learn the basics of dissection and the relevant topographical anatomy. The students were selected by the University of Palermo because of the good quality …

LA MIOTOMIA DEL CRICOFARINGE NELL'ACALASIA DELL'UES

ROUTINARY USE OF FIBRIN SEALANTS TO PREVENT PROLONGED AIR LEAK IN THORACIC SURGERT: OUR EXPERIENCE

Introduction: prolonged air leak (PAL) is one of the most common postoperative complications after lung surgery. It is associatred with increased significant morbidity, lower quality of life, longer hospital stay and higher hospital costs. Since its great clinical and economic burden, it is important to establish the feasibility and the effectiveness of the routinary preventive use of a fibrin sealant in order to reduce the incidence of prolonged air leaks. Patients and methods: this is a randomized study on 189 adult patients - 118 men (62,4%) and 71 women (37,6%) aged from 39 to 87 y.o. (mean age 68,3 y.o.) - who underwent lung surgery (lobectomy or bilobectomy) with intraoperatory detect…

LOCAL EXCISION ANORECTAL MELANOMA SIMULATING HEMORROIDAL MASS BY LIGASURE

AA. report an extremely rare case of anorectal melanoma s imul a t ing an hemor rhoida l ma s s in a s ixty- four ye a r old woman. The first symptom was anal pain attributed to an anal fissure, easily bleeding, unsuccessfully treated with ointments. It was confused with hemorrhoids andthe patient a underwent to operation. Dur ing thi s proc edur e , us ing Liga sur e™ (Va l l e y l a b , California, S.U.A.) the surgeon suspected the presence of malignancy togheter too rmorroidal mass. Extemporaneous istological exam shos the presenceof the melanoma. Instrumental examination to staging disease demonstred bilateral inguinal linfoadenectomy. The linfonodes excised veren’t metastatic.

DIVERTICULAR DISEASE OF RIGHT COLON: clinical variants and personale experience

Intraperitoneal coated polypropylene hernia meshes: the dark side of the moon.

To date, the use of meshes in repairing abdominal wall defects has brought many advantages, especially in terms of recurrence prevention, but it is not exempt from complications, such as chronic pain, entero-cutaneous fistulas and intestinal obstruction. Here we report a case of intestinal obstruction in a patient with a large umbilical hernia treated laparoscopically by means of a composite polypropylene mesh, six year before.A 49-year-old man came to our care with a 3-day history of central and right lower abdominal quadrant pain and a clinical picture of intestinal obstruction. Six years before the patient underwent a laparoscopic intervention to repair his umbilical hernia, with the pos…

A brief anatomo-surgical dissection guide to the human neck: results of a collaboration between the University of Palermo and the University of Malta.

The aim of this work was to offer a guide to young students and medical doctors that want to learn the bases of neck dissection. In the summer of 2017 a group of students from the University of Palermo that had already passed the Human Anatomy exams took a 4 weeks dissection course at the University of Malta Medicine is a science that requires both a practical and theoretical approach, and the last one, unfortunately, often is not valued by our University. Studying Human Anatomy, which is the basis for a doctor's education, exclusively through books and atlases, is indeed partially lacking. For this reason a group of students from the University of Palermo have been selected, based on their…

Effects of 3,5-diiodo-L-thyronine on the liver of high fat diet fed rats

Experimental studies have highlighted that the administration of 3,5-diiodo-L-thyronine (T2) to rats fed diets rich in lipids induces a decrease of cholesterol and triglycerides plasma levels and body weight (BW) without inducing liver steatosis. On the basis of these observations we carried out some experimental &lt;em&gt;in vivo&lt;/em&gt; studies to assess the effects of multiple high doses of T2 on the pituitary thyroid axis of rats fed diet rich in lipids. Fifteen male Wistar rats were divided into three groups of five animals each. The first group (N group) received standard diet, the second group was fed with a high fat diet (HFD group), while the third group (HFDT2 group) was additi…

Benign gastric polyps and Helicobacter pilori infection

The long-term effects of probiotics in the therapy of ulcerative colitis: a clinical study

Aim: Intestinal dysbiosis seems to be the leading cause of inflammatory bowel diseases, and probiotics seems to represent the proper support against their occurrence. Actually, probiotic blends and anti-inflammatory drugs represent a weapon against inflammatory bowel diseases. The present study evaluates the long-term (2 years) effects of combination therapy (mesalazine plus a probiotic blend of Lactobacillus salivarius, Lactobacillus acidophilus and Bifidobacterium bifidus strain BGN4) on ulcerative colitis activity. Method: Sixty patients with moderate-to-severe ulcerative colitis were enrolled: 30 of them were treated with a single daily oral administration of mesalazine 1200 mg; 30 pati…

NUTRITION IN IBD PATIENT'S: WHAT ARE THE PROSPECTS?

Summary: 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). In physiological conditions the gut is costantly exposed to various antigens, commensal microflora and pathogens and the inflammatory response is finely balanced. It is thought that a vast number of environmental risk factors may be implicated in the development of IBD, including smoking factors, dietary factors, psycological stress, use of non-steroidal anti-inflammatory drugs and oral contraceptives,…

Studio di fase II con Gemcitabine + Oxaliplatino in combinazione nel trattamento delle neoplasie delle vie biliari, pancreas e colecisti in fase metastatica.