The use of inflatable intragastric balloons is a new non-intensive approach in the treatment of obesity when poor results are obtained by more conservative treatment. The intragastric balloons are certainly less hazardous than bariatric surgery but their long term effect on body-weight reduction it is not still proved. Several types of balloons are currently in use. The two used most widely are the Garren-Edwards Gastric Bubble and the Ballobes Balloon. The Authors report their experience with these two types of anti-obesity gastric-balloon in 60 grossly obese patients.

Evaluation Studies as Topic↗

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Update on hemorrhoids.

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Combined Modality Therapy↗

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Pouch ileitis in excluded reservoir: an unusual complication of restorative proctocolectomy for ulcerative colitis.

One case of pouch ileitis after restorative proctocolectomy for ulcerative colitis is described. Diagnosis was made by endoscopy, histology and electron microscopy. The most prominent feature was intense inflammation of the mucosa and submucosa, with atrophy of the villi, and colonic metaplasia, occurring before closure of the loop ileostomy. The patient improved after a course of metronidazole therapy, but ileostomy closure was postponed. It appears that the ileum mucosa of patients with ulcerative colitis is highly prone to the development of inflammation and careful, regular follow-up is recommended.

Adult↗

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[Microvalves in microvenules].

A long-lasting histological study on muscle and cutaneous-subcutaneous biopsies allowed certain observations of microvalves in venules with a diameter ranging from 80 to 200 micron. Venular leaflets originate from the vein as extroflection of the intima, made by a single layer of endothelial cells. In the patient affected by severe chronic venous insufficiency the valvular leaflets appear thickened while the wall of the venule presents sclero-hyalinotic alterations. The presence of microvalves in venules suggests a role of their incontinence in the venous insufficiency. Considering that the venular leaflets are made just by endothelial cells, a primary pathogenetic role has to be achieved to the endotheliopathy in the genesis of venous insufficiency.

Chronic Disease↗

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Surgical therapy for morbid obesity.

The results of jejunoileal bypass for morbid obesity were studied in 192 operated patients. Mean weight loss was 39.3% of initial weight and 80.5% of overweight. Medical benefits (such as improved glucose tolerance, lowered blood pressure, healed Pickwick syndrome, etc.) were maintained during the follow-up (average five years). The most feared complication of the jejunoileal bypass is severe hepatic failure, which appeared in 2.3% of the cases, only after the end-to-end jejunoileal bypass, and never more than 12 months after surgery. Most patients had satisfactory and lasting results due to a careful and assiduous postoperative follow-up, and to the strict co-operation between the medical staff and the patient. Medical therapy in the preoperative period was useful to control the weight gain by administration of a hypocaloric definite diet. In the postoperative period, we usually got benefits for the bypass induced intestinal malabsorption by administration of supportive vitamins and electrolytes. To prevent liver diseases we often found intestinal-specific antibiotics, aminoacidic solutions, hyperproteical diet and anti-steatosis agents helpful.

Adult↗

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