Biomedical subjects

Antonio Gasbarrini

Publications and source records attributed to Antonio Gasbarrini.

76 records · Page 5Linked to original sources

PubMedDate not supplied

Salmonella aortic aneurysm: suggestions for diagnosis and therapy based on personal experience--a case report.

Infectious aneurysm is a rare event, especially after the introduction of antibiotic therapy. However, its early detection is very important for timely treatment with antibiotics and surgical intervention. This pathology may generally be due to mycotic endocarditis or septic embolization, prevailing in the preantibiotic era, and to aortitis, whose incidence is actually increasing, mainly in subjects with preexisting large-vessel atherosclerosis and intimal defects. This clinical entity is usually defined as microbial arteritis and recognizes Salmonella spp as the microorganism most frequently isolated from blood or vascular tissue cultures. The authors present the case of a 56-year-old man with a history of hypertension that some weeks before admission manifested as hyperpyrexia and episodic lumbar pain, associated with hepatosplenomegaly and with a pulsing mass in the periumbilical region. Abdominal computed tomography (CT) scan documented a voluminous infrarenal aortic aneurysm with a markedly reduced and irregular vessel wall. The patient underwent surgical excision of the aneurysm, during which marked periaortic inflammation phenomena, complete absence of the posterior aortic wall for a length of 5-6 cm, and the exposure of the correspondent vertebral bodies were observed. Histopathologic examination of the aneurysmal tissue showed atheromatous and thrombotic aspects and confirmed strong signs of inflammation. This case may suggest that the occurrence of microbial aortitis, especially from Salmonella spp, should be taken into account in the presence of a septic status associated with back, abdominal, or thoracic pain.

Aneurysm, Infected↗

PubMedDate not supplied

Thrombopoietin serum levels in patients with inflammatory bowel disease with and without previous thromboembolic events.

BACKGROUND/AIMS: Patients affected by inflammatory bowel disease frequently suffer from thromboembolic complications and mesenteric microvascular occlusion could be involved in the pathogenesis of inflammatory bowel disease. Increased platelet counts and abnormal platelet function seem to play a crucial role in determining the hypercoagulable state observed in inflammatory bowel disease. Thrombopoietin is considered the primary regulator of thrombopoiesis and recent studies have investigated the role of thrombopoietin in inflammatory bowel disease. However, the available data are not conclusive. The aim of this study was to assess thrombopoietin serum levels in inflammatory bowel disease patients according to platelet counts, disease activity and previous thrombotic events. METHODOLOGY: Seventy-one patients with inflammatory bowel disease [41 with ulcerative colitis and 30 with Crohn's disease] and 30 healthy controls were investigated. Eight (11%) inflammatory bowel disease patients had suffered previous thromboembolic complications, none had active thrombosis. Thrombopoietin serum levels were measured by ELISA. RESULTS: Mean thrombopoietin levels were significantly increased in inflammatory bowel disease patients with active disease compared to both healthy controls and patients with inactive disease. Platelet counts were significantly higher only in patients with active disease with respect to healthy subjects. No correlation was found between thrombopoietin levels and platelet counts in either controls or inflammatory bowel disease patients. No differences were found either in thrombopoietin levels or in platelet counts comparing inflammatory bowel disease patients with and without thromboembolic complications. CONCLUSIONS: Our data show elevated thrombopoietin levels in active inflammatory bowel disease. However, no correlation was found between platelet counts and thrombopoietin levels, supporting the hypothesis that other circulating factors than thrombopoietin interact in determining reactive thrombocytosis. Furthermore, thrombopoietin levels did not differ in inflammatory bowel disease patients with or without previous thromboembolic events. This finding could be probably explained by the lack of patients with active thrombosis at the moment of inclusion in the study.

Adult↗

PubMedDate not supplied

Effects of mineral-water supplementation on gastric emptying of solids in patients with functional dyspepsia assessed with the 13C-octanoic-acid breath test.

BACKGROUND/AIMS: Functional dyspepsia is a major problem in terms of prevalence and drug-therapy expenditures. In dyspeptic patients the symptoms are frequently caused by delayed gastric emptying. Conventional treatment is often inefficient. Mineral-water supplementation is prescribed for the treatment of this condition, but there is no concrete proof of its actual efficacy. The aim of this study was to evaluate the effect of supplementation with mineral waters with high mineral salt contents (Acqua Tettuccio, Acqua Regina, Montecatini Terme) on gastric emptying of solids and symptoms in patients with functional dyspepsia. METHODOLOGY: Eight patients with functional dyspepsia and two healthy (non-dyspeptic) controls were placed on high-mineral-content water supplementation (500 cc/day) for eight days. Before and after completion of the supplementation treatment, patient symptoms were scored and the 13C-octanoic-acid breath test was administered to assess gastric emptying. RESULTS: After the treatment, the dyspeptic subjects presented clear decreases in parameters of gastric emptying (half time and lag time) as well as an improvement in symptom scores. CONCLUSIONS: Health spa treatments based on consumption of waters with a high content of mineral salts seem to be capable of improving gastric emptying of solids in dyspeptics. Longer and longitudinal studies are needed to verify the persistence of this effect.

Adult↗

PubMedDate not supplied

Can 13C urea breath test predict resistance to therapy in Helicobacter pylori infection?

BACKGROUND/AIMS: Results of 13C urea breath test (UBT), a noninvasive test for detecting active H. pylori infection, have been regarded also numerically for a possible predictive value on bacterial load and entity of mucosal inflammation. In the present study we wished to determine whether there is a particular value of Delta Over Baseline (DOB) result which could predict resistance to anti-H. pylori therapy. METHODOLOGY: 570 subjects from 1376 tested received a standard triple anti-H. pylori regimen. After a minimum of 6 weeks subjects underwent control UBT testing. Correlation of DOB values at diagnostic and control UBT and sensitivity of different DOB levels to predict resistance to therapy were calculated using simple linear correlation and Bayes' theorem, respectively. RESULTS: Modest linear correlation was observed between DOB values (r2=0.28). The value of 13.0 at diagnostic UBT showed a sensitivity of 65.5% to predict and further positivity at control testing. CONCLUSIONS: In our large series, UBT numerical DOB value weakly predicted resistance to first-line anti-H. pylori therapy.

Adult↗