Cronkhite Canada syndrome: case report with some features not previously described.
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Achlorhydria↗
Biomedical subjects
G Nardone
Publications and source records attributed to G Nardone.
Treatment of duodenal varices by endoscopic sclerotherapy.
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Aged↗
Clinical nutrition practice in Italian Gastroenterology Units.
BACKGROUND: Nutritional status affects the course, ensuing complications and prognosis of virtually all diseases. AIMS: To define the role of nutrition in Gastroenterology Units by means of two investigations that analyse: a) availability of devices for assessing nutritional status; b) nutritional treatment in clinical practice: incidence and frequency of indications for its use, together with type of treatment adopted. PATIENTS AND METHODS: Two questionnaires were sent to Italian Academic and Hospital Gastroenterology Units, all with clinical wards. RESULTS: Results refer to 27 Units, 22 of which took part in both parts of the analysis, enrolling 547 patients during the two-week study The first analysis shows that scales and the altimeter are not available everywhere, while more specific tools, such as skinfold calipers are available in 54% of the Units, and caloric intake can be assessed in 22-41%. The second analysis reveals that nutritional treatment was necessary in 50% of patients in the series examined, and that this was taken into account and prescribed in almost all cases (91%). Of the patients treated, 69% received dietetic supplementation and 31% artificial nutrition [12% enteral, 88% parenteral), although supportive parenteral nutrition is often contraindicated in conditions where good bowel function provides the conditions for enteral nutrition. CONCLUSION: Data emerging from the investigation showed that i) artificial nutrition is commonly used in gastroenterology Units in Italy although 23% of them never consider either enteral or parenteral nutrition as medical treatment of gastrointestinal disease; ii) malnutrition is a very frequent complication (mean 27%; range 4-55%0) in Gastroenterology Unit patients albeit only 42% of malnourished patients received artificial nutrition; iii) indications for enteral and parenteral nutrition are not always respected, as there is an excessive use of parenteral nutrition and an unjustified resistance to the use of enteral nutrition; iv] nutritional treatment is often administered without adequate nutritional assessment and without a complete adherence to the standards recommended for preparation of parenteral bags, supported by suitable technology; v) only two Gastroenterology Units report admitting and following patients in a home parenteral nutrition programme; vi) this investigation probably reflects the response of those Gastroenterology Units most aware of the importance of nutritional problems. Better awareness of correct practices for nutritional support should be promoted, encouraging greater use of diagnostic and monitoring techniques and a more discerning choice of the most suitable type of artificial nutrition to be administered in gastroenterology
Delivery of Health Care↗
Apoptosis and cytologic differentiation in hepatocellular carcinoma on fine needle aspiration samples.
OBJECTIVE: To evaluate possible alterations of the mechanisms leading to apoptosis in hepatocellular carcinoma by studying bcl-2 expression on fine needle aspiration biopsy (FNAB) samples using immunocytochemistry. STUDY DESIGN: The study was performed on a series of 84 hepatocarcinomas aspirated under ultrasound guidance. A Papanicolaou-stained smear for each case was destained and restained for bcl-2 by using the immunoperoxidase technique. bcl-2 Expression was then correlated with cytologic grading and the size of the tumor. RESULTS: In 16 cases (19%), bcl-2 immunostaining gave a specific cytoplasmic signal. Fourteen of these positive cases were well differentiated, and two were pleomorphic tumors. Six positive cases were smaller than 5 cm, 3 were larger than 5 cm, and 7 were diffuse. CONCLUSION: A significant percentage of hepatocellular carcinomas produce and accumulate bcl-2 protein in cell cytoplasm. bcl-2 Expression can be detected on destained cytologic smears. bcl-2 Expression seems to correlate with the cytologic degree of differentiation but not with the size of the tumor.
Apoptosis↗
Treatment of chronic hepatitis C with recombinant interferon alfa.
We studied the clinical course and the effect of alfa interferon treatment in sixty-six patients of Southern Italy suffering from chronic hepatitis C virus. The patients were randomly assigned to the control group (33 patients without treatment) or to the group treated with 3MU of interferon three times a week for six months. Alanine transaminase (ALT) levels normalized in 17 of the 33 treated subjects (52%) within two months of treatment. Seven of these "responders" relapsed at the end of the six-month treatment period, but ALT normalized in these patients after resumption of interferon at the same dosage. None of the non responders on 3MU for four months showed improvement even when the dose was increased to 6MU. Our results coincide with other reports on interferon treatment in hepatitis C virus. Further studies are required to clarify whether or not higher doses at the onset of treatment increase the number of responders and decrease the frequency of relapses.
Alanine Transaminase↗
[Neuronal ceroid lipofuscinosis. Description of a case].
The Authors describe a case of Batten-Bielschowsky disease and how they made the diagnosis. It's stressed the importance of the pathological examination, in the absence of any laboratory tests for the diagnosis of this disease.
Cerebellum↗
[Recurrent right pleural effusion].
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Chronic Disease↗
Cirrhosis negatively affects the efficiency of serologic diagnosis of Helicobacter pylori infection.
In cirrhosis, Helicobacter pylori infection may be implicated, together with portal hypertension, bile reflux and alcohol abuse, in damage to gastric mucosa. Aim of this study was to define the influence of non-alcoholic liver disease on the incidence of Helicobacter pylori infection and on the diagnostic accuracy of specific serology. Enrolled in the study were 232 individuals, 105 also had cirrhosis. Infection by Helicobacter pylori, diagnosed by a positive concordance of quick urease test and histology, was detected in 97 (48 with cirrhosis) out of 184 patients. Severe gastritis was more frequent in patients with Helicobacter pylori infection than in patients without. Cirrhosis did not significantly affect the prevalence of Helicobacter pylori infection or the histological features of gastritis. Specific anti-Helicobacter pylori IgG and IgA assay (Bio-Rad GAP test) was used for serological diagnosis. Anti-Helicobacter pylori IgG showed a high sensitivity (85% in cirrhotics, 89% in non-cirrhotics) and low specificity being more evident in cirrhotics (38% vs 56% non-cirrhotics). Serum specific IgA showed low sensitivity (approximately 25% in both groups) and specificity of 79% in cirrhotics vs 84% in non-cirrhotics. In conclusion, non-alcoholic cirrhosis does not affect the incidence of Helicobacter pylori infection and the histological features of chronic gastritis but does decrease diagnostic efficiency of serological tests for Helicobacter pylori.
Antibodies, Bacterial↗