140 results on '"Giovanni Gasbarrini"'
Search Results
2. Celiac Disease and Myointimal Proliferation: A Possible Correlation?
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Giuseppe Merra, Antonio Dal Lago, Davide Roccarina, Giovanni Gasbarrini, Antonio Gasbarrini, and Giovanni Ghirlanda
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Autoimmune ,Atheromasia ,Thrombosis ,Gliadin ,Absorption ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Celiac disease (CD) is an autoimmune disorder of the small bowel that occurs in genetically predisposed people of all ages, from middle infancy, and is caused by a reaction to gliadin, a gluten protein. Some patients are diagnosed with symptoms related to the decreased absorption of nutrients or with various symptoms which, although statistically linked, have no clear relationship with the malfunctioning bowel. Classic symptoms of CD include diarrhea, weight loss, and fatigue; bowel symptoms may be limited or even absent. In this article we describe the case of a young woman with CD who presents with myointimal proliferation. However multiple cases of vessel thrombosis have been reported in patients with CD. Despite the fact that no definitive relationship between these diseases could be explained, we think this association must be remembered especially in cases of young and tenuous women with these vascular abnormalities.
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- 2008
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3. Splenomegaly as a Primary Manifestation of Gaucher Disease in a Young Adult Woman
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Giuseppe Merra, Antonio Dal Lago, Roberta Ricci, Daniela Antuzzi, Giovanni Gasbarrini, Antonio Gasbarrini, and Giovanni Ghirlanda
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Gaucher disease ,Lysosomal storage disease ,Splenomegaly ,Accumulation ,Macrophages ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Gaucher disease is the most common lysosomal storage disease. It is caused by the defective activity of acid β-glucosidase, which results in the accumulation of lipid glucocerebroside in macrophages throughout the body. In this case report we describe the case of a young adult woman with splenomegaly as the primary manifestation of this pathology. This is a case of type 1 Gaucher disease because there is a lack of primary neurological involvement but we have, instead, an age-independent involvement of the visceral organs. It is very important to classify or characterize these patients in a precise manner and to make a complete diagnosis with the help of the many diagnostic resources now at our disposal, especially with genetics, radiology and new techniques of advanced microscopy, also because Gaucher disease requires a long and complex management from early life to adulthood.
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- 2008
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4. A case of inflammatory ascites
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Marco Biolato, Maria Letizia Gabrieli, Antonella Gallo, Luca Miele, Laura Riccardi, Massimo Montalto, Giovanni Gasbarrini, and Antonio Grieco
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Ascites ,Serum-ascites albumin gradient ,CA-125 ,Peritoneal tuberculosis ,Cardiac ascites ,Medicine (General) ,R5-920 - Abstract
Even ascites appears mainly as sign of portal hypertension in patiens with liver cirrhosis, in some case depends on a different lying condition such as right congestive heart failure, peritoneal carcinomatosis or tuberculosis. In these cases, paracentesis represents the key tool for diagnosis. We report a case of cardiac ascites in a 71-years-old woman who developed in four-month an abdominal distension. Preliminary exams showed exudative ascites related to portal hypertension, a pelvic mass with caseous apparence, and inflammatory status ad an elevation of CA-125. Successive evaluation exluded peritoneal carcinomatosis or tuberculosis, underlyng a tricuspidal regurgitation. The literature on ascites has also been reviewed.
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- 2008
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5. Psychosocial findings in alcohol-dependent patients before and after three months of total alcohol abstinence
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Anna Ferrulli, Lorenzo Leggio, Silvia Cardone, Cristina D'Angelo, Antonio Mirijello, Luisa Vonghia, Antonio Miceli, Giovanni Gasbarrini, and Giovanni Addolorato
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Social Behavior ,alcohol dependence ,aggressiveness ,alcohol addiction severity ,Disability ,Psychiatry ,RC435-571 - Abstract
Alcohol use disorders (AUDs) may be associated with several psychological and affective disorders. It is controversial, however, if these symptoms are a cause or rather a consequence of alcohol dependence. There are few data testing simultaneously psychosocial and affective disorders before and after a period of alcohol abstinence. The aim of this study was to perform multiple psychometric evaluations in alcohol-dependent patients before and after 12 weeks of abstinence. Twenty-five alcohol-dependent patients were included in the study. The following psychometric tests were administered at baseline (T0) and after 12 weeks (T1): Addiction Severity Index (ASI), Brief Psychiatric Rating Scale (BPRS), Social Behaviour Scale (SBS), Sheehan Disability Scale (DISS), Aggression Questionnaire (AQ). At T1, 16 (64%) patients were abstinent, 5 (20%) patients dropped out and 4 (16%) patients relapsed. Compared to T0, patients totally abstinent at T1 showed a significant reduction of the scores related to BPRS, BPRS-E and its subscales (except BPRS 5), ASI 1, ASI 2, ASI 3, ASI 6, ASI 7, BSM, AQ, DISS 1, DISS 2, DISS 3 (p
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- 2010
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6. Stem Cell-Based Therapies for Liver Diseases: State of the Art and New Perspectives
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Anna Chiara Piscaglia, Mariachiara Campanale, Antonio Gasbarrini, and Giovanni Gasbarrini
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Internal medicine ,RC31-1245 - Abstract
Millions of patients worldwide suffer from end-stage liver pathologies, whose only curative therapy is liver transplantation (OLT). Given the donor organ shortage, alternatives to OLT have been evaluated, including cell therapies. Hepatocyte transplantation has been attempted to cure metabolic liver disorders and end-stage liver diseases. The evaluation of its efficacy is complicated by the shortage of human hepatocytes and their difficult expansion and cryopreservation. Recent advances in cell biology have led to the concept of “regenerative medicine”, based on the therapeutic potential of stem cells (SCs). Different types of SCs are theoretically eligible for liver cell replacement. These include embryonic and fetal SCs, induced pluripotent cells, annex SCs, endogenous liver SCs, and extrahepatic adult SCs. Aim of this paper is to critically analyze the possible sources of SCs suitable for liver repopulation and the results of the clinical trials that have been published until now.
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- 2010
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7. Egophony: is this classic semeiological sign still helpful?
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Domenico Viviani and Giovanni Gasbarrini
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Egophony ,Physical diagnosis ,Lung ,Pleural effusion ,Laënnec. ,Medicine - Abstract
BACKGROUND Egophony, also known as “E to A change”, is a classical, clinical sign detected by chest auscultation, consisting into a change in timbre, but not pitch or volume, produced by solid interposed between the resonator and the stethoscope head. Egophony was first described in 1916 by R.T.H. Laënnec, but today it is almost unknown. Yet it is a powerful tool to detect pleural effusion as well as other pathological conditions associated with lung compression or consolidation, such as hemothorax or atelectasis of the lung. AIM OF THE STUDY The aim of this paper is to remember the value of this frequently neglected clinical sign and to stress the importance of physical examination, that should always precede – and could often replace – instrumental tests, which are quite expensive and sometimes unnecessary.
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- 2013
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8. 'Tear-drop shaped' HCC
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Antonio Grieco, MD, Giuseppe Caminiti, MD, Giovanni B. Doglietto, MD, Luca Miele, MD, and Giovanni Gasbarrini, MD
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Specialties of internal medicine ,RC581-951 - Published
- 2003
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9. The healthy gluten-free diet: Practical tips to prevent metabolic disorders and nutritional deficiencies in celiac patients
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Tommaso Dionisi, Emanuele Rinninella, Marco Cintoni, Silvia Triarico, Maria Cristina Mele, Pauline Raoul, Giovanni Gasbarrini, and Antonio Gasbarrini
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0301 basic medicine ,medicine.medical_specialty ,Millet ,Settore MED/12 - GASTROENTEROLOGIA ,RC799-869 ,Settore MED/49 - SCIENZE TECNICHE DIETETICHE APPLICATE ,Coeliac disease ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Intensive care medicine ,Buckwheat ,Sorghum ,030109 nutrition & dietetics ,Hepatology ,business.industry ,Gastroenterology ,nutritional and metabolic diseases ,Nutritional status ,Metabolic diseases ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,Micronutrient ,digestive system diseases ,Maize ,Malnutrition ,Nutritional deficiencies ,Quinoa ,Gluten-free diet ,Amaranth ,030211 gastroenterology & hepatology ,Gluten free ,Rice ,business - Abstract
The gluten-free diet (GFD) is the cornerstone treatment for coeliac disease (CD). However, a healthy GFD is more complex than the only exclusion of gluten-containing foods. Most celiac patients do not receive nutritional advice and tend to consume industrial gluten-free products (GFPs), which often lack fiber, vitamins, and other micronutrients while being rich in saturated fats and refined sugars. This review focuses on the main potential metabolic disorders and nutritional deficiencies in CD patients at diagnosis and dissects the main nutritional and metabolic issues due to a non-balanced GFD. Nutritional tips to achieve an adequate dietary approach in CD are provided. We also compared the main nutritional components of naturally gluten-free cereals (including pseudocereals) to give an exhaustive overview of the possible healthy alternatives to processed GFPs. Clinicians and dietitians should be systematically involved in the diagnosis of CD to monitor the appropriateness of GFD and the patient’s nutritional status over time.
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- 2021
10. COVID-19: thoughts at sunrise
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Giovanni Gasbarrini
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2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,biology ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,biology.organism_classification ,Virology ,Pandemic ,Emergency Medicine ,Internal Medicine ,Medicine ,Sunrise ,business ,Coronavirus Infections ,Betacoronavirus - Published
- 2020
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11. Machine learning pattern recognition and differential network analysis of gastric microbiome in the presence of proton pump inhibitor treatment or Helicobacter pylori infection
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Giovanni Gasbarrini, Stephan W. Grill, Claudio Durán, Carlo Vittorio Cannistraci, Michael Schroeder, Alessandra Palladini, Gianluca Ianiro, Pirjo Spuul, Luca Masucci, Antonio Gasbarrini, Brunella Posteraro, Giovanni Cammarota, D. Mark Pritchard, Bryony N. Parsons, Maurizio Sanguinetti, Umer Zeeshan Ijaz, Francesco Paroni Sterbini, and Sara Ciucci
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Helicobacter pylori infection ,Multivariate analysis ,biology ,Medical treatment ,medicine.drug_class ,medicine ,Proton-pump inhibitor ,Microbiome ,Computational biology ,Helicobacter pylori ,Early phase ,biology.organism_classification ,Network analysis - Abstract
Although long thought to be a sterile and inhospitable environment, the stomach is inhabited by diverse microbial communities, co-existing in a dynamic balance. Long-term use of orally administered drugs such as Proton Pump Inhibitors (PPIs), or bacterial infection such as Helicobacter pylori, cause significant microbial alterations. Yet, studies revealing how the commensal bacteria re-organize, due to these perturbations of the gastric environment, are in the early phase. They mainly focus on the most prevalent taxa and rely on linear techniques for multivariate analysis.Here we disclose the importance of complementing linear dimensionality reduction techniques such as Principal Component Analysis and Multidimensional Scaling with nonlinear approaches derived from the physics of complex systems. Then, we show the importance to complete multivariate pattern analysis with differential network analysis, to reveal mechanisms of re-organizations which emerge from combinatorial microbial variations induced by a medical treatment (PPIs) or an infectious state (H. pylori).
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- 2020
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12. European consensus conference on faecal microbiota transplantation in clinical practice
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Peter Malfertheiner, Giovanni Gasbarrini, Eero Mattila, Herbert Tilg, Magnus Simren, Cristina Pintus, Patrizia Kump, Alexander Link, Antonio López-Sanromán, Mirjana Rajilić-Stojanović, Max Nieuwdorp, Jonathan Segal, Willem M. de Vos, Ailsa Hart, Harry Sokol, Giovanni Cammarota, Christoph Högenauer, Gianluca Ianiro, Maurizio Sanguinetti, Perttu Arkkila, Antonio Molinaro, Tomica Milosavljevic, Marina Aloi, Reetta Satokari, Luca Masucci, Pieter F. de Groot, Antonio Gasbarrini, Franco Scaldaferri, Research Programs Unit, Reetta Maria Satokari / Principal Investigator, Immunobiology Research Program, Medicum, Department of Bacteriology and Immunology, Department of Medicine, Gastroenterologian yksikkö, Clinicum, Willem Meindert Vos de / Principal Investigator, Infektiosairauksien yksikkö, de Vos & Salonen group, HUS Abdominal Center, HUS Internal Medicine and Rehabilitation, Internal medicine, Amsterdam Gastroenterology Endocrinology Metabolism, and ACS - Diabetes & metabolism
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0301 basic medicine ,IRRITABLE-BOWEL-SYNDROME ,Delphi method ,CLOSTRIDIUM-DIFFICILE INFECTION ,DISEASE ,law.invention ,0302 clinical medicine ,ACTIVE ULCERATIVE-COLITIS ,Randomized controlled trial ,Microbiologie ,law ,Medicine ,RECURRENT ,Enterocolitis, Pseudomembranous ,Evidence-Based Medicine ,Corporate governance ,Gastroenterology ,Consensus conference ,Fecal Microbiota Transplantation ,RANDOMIZED CONTROLLED-TRIAL ,DIARRHOEAL DISEASE ,3. Good health ,Clinical Practice ,Europe ,030211 gastroenterology & hepatology ,Hospital Units ,medicine.medical_specialty ,Microbiology ,FROZEN INOCULUM ,Faecal microbiota transplantation ,ENTERIC BACTERIAL MICROFLORA ,Donor Selection ,Specimen Handling ,03 medical and health sciences ,Nursing ,INTESTINAL MICROBIOTA ,Humans ,Life Science ,TERM-FOLLOW-UP ,VLAG ,Clostridioides difficile ,Donor selection ,business.industry ,Patient Selection ,CLINICAL DECISION MAKING ,Clostridium difficile ,Surgery ,030104 developmental biology ,3121 General medicine, internal medicine and other clinical medicine ,Health Facilities ,Working group ,business ,NASOGASTRIC TUBE - Abstract
Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance. In view of this, an evidence-based recommendation is needed to drive the practical implementation of FMT. In this European Consensus Conference, 28 experts from 10 countries collaborated, in separate working groups and through an evidence-based process, to provide statements on the following key issues: FMT indications; donor selection; preparation of faecal material; clinical management and faecal delivery and basic requirements for implementing an FMT centre. Statements developed by each working group were evaluated and voted by all members, first through an electronic Delphi process, and then in a plenary consensus conference. The recommendations were released according to best available evidence, in order to act as guidance for physicians who plan to implement FMT, aiming at supporting the broad availability of the procedure, discussing other issues relevant to FMT and promoting future clinical research in the area of gut microbiota manipulation. This consensus report strongly recommends the implementation of FMT centres for the treatment of C. difficile infection as well as traces the guidelines of technicality, regulatory, administrative and laboratory requirements.
- Published
- 2017
13. A case of inflammatory ascites
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Antonella Gallo, Marco Biolato, Luca Miele, Laura Riccardi, Giovanni Gasbarrini, M.L. Gabrieli, Massimo Montalto, and Antonio Grieco
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medicine.medical_specialty ,Cirrhosis ,Tuberculosis ,Serum-ascites albumin gradient ,Medicine (miscellaneous) ,Ascites ,CA-125 ,Peritoneal tuberculosis ,Cardiac ascites ,Gastroenterology ,Internal medicine ,medicine ,Paracentesis ,lcsh:R5-920 ,medicine.diagnostic_test ,business.industry ,Abdominal distension ,medicine.disease ,Surgery ,Heart failure ,Business, Management and Accounting (miscellaneous) ,Portal hypertension ,medicine.symptom ,Clinical Medicine ,business ,lcsh:Medicine (General) - Abstract
Even ascites appears mainly as sign of portal hypertension in patiens with liver cirrhosis, in some case depends on a different lying condition such as right congestive heart failure, peritoneal carcinomatosis or tuberculosis. In these cases, paracentesis represents the key tool for diagnosis. We report a case of cardiac ascites in a 71-years-old woman who developed in four-month an abdominal distension. Preliminary exams showed exudative ascites related to portal hypertension, a pelvic mass with caseous apparence, and inflammatory status ad an elevation of CA-125. Successive evaluation exluded peritoneal carcinomatosis or tuberculosis, underlyng a tricuspidal regurgitation. The literature on ascites has also been reviewed.
- Published
- 2008
14. Botulinum toxin B ultrasound-guided injections for sialorrhea in amyotrophic lateral sclerosis and Parkinson's disease
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Gian Ludovico Rapaccini, Paola Tittoto, Maurizio Pompili, Mario Sabatelli, Maria Fiorella Contarino, Giovanni Gasbarrini, Anna Rita Bentivoglio, A Cedrone, Pietro Attilio Tonali, Nicola Vanacore, and Neurology
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Adult ,Male ,medicine.medical_specialty ,Saliva ,Parkinson's disease ,Botulinum Toxins ,Time Factors ,Gastroenterology ,Severity of Illness Index ,Botulinum toxin ,Internal medicine ,medicine ,Humans ,In patient ,Amyotrophic lateral sclerosis ,Botulinum Toxins, Type A ,Aged ,Ultrasonography ,Aged, 80 and over ,Sialorrhea ,Chi-Square Distribution ,business.industry ,Anti-Dyskinesia Agents ,Settore MED/09 - MEDICINA INTERNA ,Amyotrophic Lateral Sclerosis ,Parkinson Disease ,Middle Aged ,medicine.disease ,Ultrasound guided ,Surgery ,Settore MED/26 - NEUROLOGIA ,Neurology ,Tolerability ,malattia di Parkinson ,Female ,Neurology (clinical) ,Geriatrics and Gerontology ,business ,medicine.drug - Abstract
Sialorrhea is frequent and invalidating in patients with amyotrophic lateral sclerosis (ALS) or Parkinson's disease (PD). Botulinum toxin (BTX) emerged as an alternative to traditional treatments. We evaluated efficacy and tolerability of ultrasound-guided BTX-B injections in parotids and submandibular glands in 18 patients with ALS or PD. At 1 week, both objective (cotton rolls weight) and subjective evaluations (dedicated clinical scales) documented sialorrhea reduction (p
- Published
- 2007
15. Utility of Basophil Activation Test for monitoring the acquisition of clinical tolerance after oral desensitization to cow’s milk: Pilot study
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Domenico Schiavino, Eleonora Nucera, Giovanni Gasbarrini, Giampiero Patriarca, Anna Giulia Ricci, Alessia Di Rienzo, Angela Rizzi, Lucilla Pascolini, Manuela Ferraironi, Valentina Pecora, Alessandro Buonomo, Arianna Aruanno, and Simona Mezzacappa
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biology ,CD63 ,business.industry ,medicine.medical_treatment ,Settore MED/09 - MEDICINA INTERNA ,Gastroenterology ,food and beverages ,Milk allergy ,Original Articles ,Basophil ,Immunoglobulin E ,medicine.disease ,Basophil activation ,medicine.anatomical_structure ,Oncology ,Food allergy ,Casein ,Immunology ,biology.protein ,medicine ,Basophil Activation Test ,business ,Desensitization (medicine) - Abstract
Objective: The quantification of basophil activation by flow cytometry is a useful tool for the assessment of immediate-type responses to food allergens and the prediction of clinical tolerance in food allergy patients. The aim of this study is to investigate how the analysis of allergen-induced CD63 up-regulation by flow cytometry can be effective in monitoring the acquisition of clinical tolerance by specific oral desensitization in food allergy. To our knowledge, this is the first study to examine this topic. Materials and methods: Three male patients affected by cow’s milk allergy underwent successful oral desensitization to cow’s milk. In order to monitor the acquired clinical tolerance that occurred after treatment, we performed laboratory tests for total and specific IgE, specific IgG4 and the Basophil Activation Test (BAT) both at baseline and at the end of the desensitization protocol. Results: Using a fluorescent enzyme immunoassay, the comparison of specific cow’s milk antibodies before and after treatment showed a decrease of specific IgE levels, without reaching normal values, and an increase of specific IgG4 levels. A complete suppression of cow’s milk proteins (a-lactoalbumin, b-lactoglobulin and casein) induced CD63 regulation was observed in all three reported cases. Conclusions: Using flow cytometry, food allergen-specific basophil responses could be monitored in order to identify an acquired tolerance induced by desensitization treatment. Although further studies are needed to develop this important new topic, it was interesting to note that the BAT seemed to be more sensitive and characterized by a close correlation with clinical tolerance.
- Published
- 2015
16. Looking for Celiac Disease in Italian Women with Endometriosis: A Case Control Study
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Massimo Montalto, Luca Santoro, Marcello Covino, Ferruccio D'Onofrio, Guglielmo Palombini, Angelo Santoliquido, Giovanni Gasbarrini, Antonella Gallo, Sebastiano Campo, and Vincenzo Campo
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Adult ,Infertility ,medicine.medical_specialty ,Article Subject ,Population ,Endometriosis ,lcsh:Medicine ,Disease ,Gastroenterology ,General Biochemistry, Genetics and Molecular Biology ,Miscarriage ,Internal medicine ,medicine ,Humans ,Family history ,education ,Retrospective Studies ,Gynecology ,education.field_of_study ,General Immunology and Microbiology ,business.industry ,lcsh:R ,Case-control study ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Abortion, Spontaneous ,Celiac Disease ,Settore MED/40 - GINECOLOGIA E OSTETRICIA ,Italy ,Female ,business ,Research Article - Abstract
In the last years, a potential link between endometriosis and celiac disease has been hypothesized since these disorders share some similarities, specifically concerning a potential role of oxidative stress, inflammation, and immunological dysfunctions. We investigated the prevalence of celiac disease among Italian women with endometriosis with respect to general population. Consecutive women with a laparoscopic and histological confirmed diagnosis of endometriosis were enrolled; female nurses of our institution, without a known history of endometriosis, were enrolled as controls. IgA endomysial and tissue transglutaminase antibodies measurement and serum total IgA dosage were performed in both groups. An upper digestive endoscopy with an intestinal biopsy was performed in case of antibodies positivity. Presence of infertility, miscarriage, coexistence of other autoimmune diseases, and family history of autoimmune diseases was also investigated in all subjects. Celiac disease was diagnosed in 5 of 223 women with endometriosis and in 2 of 246 controls (2.2% versus 0.8%;P=0.265). Patients with endometriosis showed a largely higher rate of infertility compared to control group (27.4% versus 2.4%;P<0.001). Our results confirm that also in Italian population an increased prevalence of celiac disease among patients with endometriosis is found, although this trend does not reach the statistical significance.
- Published
- 2014
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17. Palaeodiet reconstruction in a woman with probable celiac disease: a stable isotope analysis of bone remains from the archaeological site of Cosa (Italy)
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Gabriele, Scorrano, Mauro, Brilli, Cristina, Martínez-Labarga, Francesca, Giustini, Elsa, Pacciani, Filberto, Chilleri, Franco, Scaldaferri, Antonio, Gasbarrini, Giovanni, Gasbarrini, and Olga, Rickards
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Adult ,Male ,Carbon Isotopes ,Sheep ,Imperial Roman period ,Nitrogen Isotopes ,malabsorption ,Deer ,Settore MED/12 - GASTROENTEROLOGIA ,chronic malnutrition ,Roman World ,Bone and Bones ,Diet ,Celiac Disease ,Archaeology ,Italy ,Tuscany ,Animals ,Humans ,Cattle ,Female ,Collagen ,Child ,History, Ancient - Abstract
Stable isotope analysis in the reconstruction of human palaeodiets can yield clues to early human subsistence strategies, origins and history of farming and pastoralist societies, and intra- and intergroup social differentiation. In the last 10 years, the method has been extended to the pathological investigation. Stable isotope analysis to better understand a diet-related disease: celiac disease in ancient human bones was carried out. To do this, we analyzed the nitrogen and carbon isotopic composition of human (n = 37) and faunal (n = 8) bone remains from the archaeological site of Cosa at Ansedonia, on the Tyrrhenian coast near Orbetello (Tuscany), including the skeletal remains of a young woman (late 1st century-early 2nd century Common Era [CE]) with morphological and genetic features suggestive of celiac disease. We compared the young woman's isotopic data with those of other individuals recovered at the same site but from two later time periods (6th century CE; 11-12th century CE) and with literature data from other Italian archaeological sites dating to the same period. Her collagen δ(13) C and δ(15) N values differed from those of the samples at the same site, and from most but not all of the contemporary sites. Although the woman's diet appears distinct, chronic malnutrition resulting from severe malabsorption of essential nutrients due to celiac disease may have affected the isotopic composition of her bone collagen.
- Published
- 2014
18. Basic and Clinical Aspects of Helicobacter Pylori Infection
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Giovanni Gasbarrini, Stefano Pretolani, Giovanni Gasbarrini, and Stefano Pretolani
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- Helicobacter pylori infections--Congresses, Helicobacter Infections--pathology--congresses, Helicobacter Infections--drug therapy--congres, Helicobacter pylori--pathogenicity--congresses, Peptic Ulcer--parasitology--congresses, Gastritis--parasitology--congresses
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A century ago the Italian pathologist Bizzozero described the relationships between spiral bacteria and the mammalian gastro intestinal tract. Since 1982, when Helicobacter pylori was discovered, gastroduodenal disease have been completely revised as a con sequence of the results of basic and clinical research in this field. Progress in understanding the pathogenesis of this bacterium has been made by studying H. pylori infection in animal models. More specific diagnostic tools have been developed using new molecular biology techniques. Future trends are directed towards preparing a specific H. pylori vaccine. A new classification for gastritis, the Sydney System, including H. pylori gastritis, was proposed in 1990. As concerns the clinical approach to peptic ulcer disease in the 1990's, the majority of authors agree on the importance of H. pylori eradication. Moreover, recent clinical studies suggest that H. pylori infection can be associated with other gastroduodenal diseases, such as non ulcer dyspepsia and gastric cancer. Multicenter trials to standardize serological methods and evaluate the efficacy of new antimicrobial therapy schedules are planned throughout different European countries. The fourth Workshop of the European Helicobacter Pylori Study Group was held in Bologna, Italy, in November 1991. Two years before Bologna University celebrated its ninth centennial, giving evidence of being the oldest University in the modern world. Thus the H. pylori story that has continued for more than a century has been discussed once again at the University with the oldest tradition in the world.
- Published
- 2012
19. Update on small intestinal stem cells
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Valentina Tesori, Antonio Gasbarrini, Wanda Lattanzi, Giovanni Gasbarrini, and Maria Ausiliatrice Puglisi
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Cellular differentiation ,Settore MED/12 - GASTROENTEROLOGIA ,Cell ,Crypt ,Review ,Biology ,Lgr5 ,Niche ,medicine ,Animals ,Humans ,Regeneration ,Cell Lineage ,Intestinal Mucosa ,Stem Cell Niche ,Cell Proliferation ,Regeneration (biology) ,Stem Cells ,Intestinal stem cells ,Gastroenterology ,LGR5 ,Cell Differentiation ,General Medicine ,Small intestine ,Cell biology ,Organoids ,Intestines ,Intestinal regeneration ,Intestinal Diseases ,medicine.anatomical_structure ,Biological Markers ,Stem cell ,Biomarkers ,Adult stem cell ,Signal Transduction - Abstract
Among somatic stem cells, those residing in the intestine represent a fascinating and poorly explored research field. Particularly, somatic stem cells reside in the small intestine at the level of the crypt base, in a constant balance between self-renewal and differentiation. Aim of the present review is to delve into the mechanisms that regulate the delicate equilibrium through which intestinal stem cells orchestrate intestinal architecture. To this aim, special focus will be addressed to identify the integrating signals from the surrounding niche, supporting a model whereby distinct cell populations facilitate homeostatic vs injury-induced regeneration.
- Published
- 2013
20. Colon cancer stem cells: controversies and perspectives
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Valentina Tesori, Giovanni Gasbarrini, Antonio Gasbarrini, Wanda Lattanzi, and Maria Ausiliatrice Puglisi
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Oncology ,medicine.medical_specialty ,Colorectal cancer ,Cellular differentiation ,Settore MED/12 - GASTROENTEROLOGIA ,Population ,Antineoplastic Agents ,Disease ,Review ,Cell Transformation ,Colon cancer stem cells ,Basic research ,Internal medicine ,medicine ,Biomarkers, Tumor ,Animals ,Humans ,Cell Lineage ,CD133 ,Molecular Targeted Therapy ,education ,Tumor Markers ,Cell Proliferation ,education.field_of_study ,Neoplastic ,business.industry ,Cell growth ,Gastroenterology ,Cancer ,Cell Differentiation ,General Medicine ,medicine.disease ,Biological ,Cell Transformation, Neoplastic ,Tumor Markers, Biological ,Colonic Neoplasms ,Neoplastic Stem Cells ,Therapy ,Stem cell ,business ,Chemoresistance ,Signal Transduction - Abstract
Tumors have long been viewed as a population in which all cells have the equal propensity to form new tumors, the so called conventional stochastic model. The cutting-edge theory on tumor origin and progression, tends to consider cancer as a stem cell disease. Stem cells are actively involved in the onset and maintenance of colon cancer. This review is intended to examine the state of the art on colon cancer stem cells (CSCs), with regard to the recent achievements of basic research and to the corresponding translational consequences. Specific prominence is given to the hypothesized origin of CSCs and to the methods for their identification. The growing understanding of CSC biology is driving the optimization of novel anti-cancer targeted drugs.
- Published
- 2013
21. Use and indications of cholestyramine and bile acid sequestrants
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Francesca Romana Ponziani, Antonio Gasbarrini, Franco Scaldaferri, M. Pizzoferrato, and Giovanni Gasbarrini
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medicine.medical_specialty ,medicine.drug_class ,Settore MED/12 - GASTROENTEROLOGIA ,Cholestyramine Resin ,Hypercholesterolemia ,Gastroenterology ,Bile acid sequestrant ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,Medicine ,Bile ,Humans ,Sequestering Agents ,Cholestyramine ,bile acid sequestrans ,Cholestasis ,Bile acid ,business.industry ,Colesevelam ,Anticholesteremic Agents ,Colestipol ,Settore MED/09 - MEDICINA INTERNA ,Bile acid malabsorption ,medicine.disease ,Diarrhea ,Endocrinology ,Emergency Medicine ,medicine.symptom ,business ,medicine.drug - Abstract
Cholestyramine is a bile acid sequestrant, like colestipol and colesevelam. These molecules are positively charged non-digestible resins that bind to bile acids in the intestine to form an insoluble complex, which is excreted in the feces. They are used mainly for the treatment of primary hypercholesterolemia and hypercholesterolemia associated with mild hypertriglyceridemia, in patients not responding to dietary treatment as well as a second line-treatment for pruritus associated with cholestatic disease, in patients with incomplete biliary obstruction. Several data indicate that modulation of bile acid homeostasis has a good clinical effect in managing diabetes mellitus and the diarrhea from bile acid malabsorption. In this review, we present the “in label” use and indication for these compounds, revisiting the other clinical applications that may benefit from the use of bile acid sequestrants in the near future.
- Published
- 2013
22. Origin of celiac disease: How old are predisposing haplotypes?
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Giovanni, Gasbarrini, Olga, Rickards, Cristina, Martínez-Labarga, Elsa, Pacciani, Filiberto, Chilleri, Lucrezia, Laterza, Giuseppe, Marangi, Franco, Scaldaferri, and Antonio, Gasbarrini
- Subjects
Risk ,Polymorphism, Genetic ,Genotype ,malabsorption ,Case Report ,celiac disease ,human leukocyte antigen haplotype ,ancient DNA ,single nucleotide polymorphisms ,Settore BIO/08 ,DNA, Mitochondrial ,Settore MED/02 - STORIA DELLA MEDICINA ,Archaeology ,Haplotypes ,Italy ,Malabsorption Syndromes ,HLA Antigens ,HLA-DQ Antigens ,Humans ,Female ,Genetic Predisposition to Disease ,DNA Primers - Abstract
We recently presented the case of a first century AD young woman, found in the archaeological site of Cosa, showing clinical signs of malnutrition, such as short height, osteoporosis, dental enamel hypoplasia and cribra orbitalia, indirect sign of anemia, all strongly suggestive for celiac disease (CD). However, whether these findings were actually associated to CD was not shown based on genetic parameters. To investigate her human leukocyte antigen (HLA) class II polymorphism, we extracted DNA from a bone sample and a tooth and genotyped HLA using three HLA-tagging single nucleotide polymorphisms for DQ8, DQ2.2 and DQ2.5, specifically associated to CD. She displayed HLA DQ 2.5, the haplotype associated to the highest risk of CD. This is the first report showing the presence of a HLA haplotype compatible for CD in archaeological specimens.
- Published
- 2012
23. Anticoagulants in cirrhotic patients: controversies and certainties in PVT management
- Author
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Antonio Gasbarrini, Giovanni Gasbarrini, Francesca Romana Ponziani, Maria Assunta Zocco, and Annalisa Tortora
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Liver Cirrhosis ,medicine.medical_specialty ,Variceal bleeding ,Cirrhosis ,Mesenteric infarction ,Disease ,Clinical manifestation ,medicine ,Humans ,In patient ,Intensive care medicine ,Pharmacology ,Venous Thrombosis ,business.industry ,Portal Vein ,Gold standard ,Settore MED/09 - MEDICINA INTERNA ,Disease Management ,Anticoagulants ,Hematology ,medicine.disease ,Surgery ,Portal vein thrombosis ,Drug Evaluation ,Cardiology and Cardiovascular Medicine ,business - Abstract
Portal vein thrombosis (PVT) is a relatively common event in patients with advanced-stage liver cirrhosis, even in patients with a compensated disease. Because of the protean clinical manifestation of PVT, ranging from massive variceal bleeding and mesenteric infarction to the complete absence of any symptom, it is mandatory to provide an early diagnosis and a prompt management. However, even if various treatments have been tested in clinical studies, most of them can be suitable only for a limited number of patients and anticoagulants are recognized as the gold standard, even if the debate about their use in PVT management in cirrhotic patients is still opened. In particular, "old" and "new" generations of anticoagulants have always been used carefully and, sometimes, with skepticism or diffidence in cirrhotic patients. In this review, we report the rationale of anticoagulants use in PVT cirrhotic patients management, analyzing the most accepted controversies and certainties, with a particular attention to their possible role as preemptive therapy.
- Published
- 2011
24. Fecal calprotectin concentrations in alcoholic patients: a longitudinal study
- Author
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Marcello Covino, Giovanni Gasbarrini, Massimo Montalto, Giovanni Addolorato, Silvia Cardone, Anna Ferrulli, Lorenzo Leggio, Ferruccio D'Onofrio, Elena Campobasso, Luca Santoro, Antonio Mirijello, Antonella Gallo, and Dina Visca
- Subjects
Adult ,Male ,Longitudinal study ,Pathology ,medicine.medical_specialty ,Adolescent ,Alcohol Drinking ,Alcohol abuse ,calprotectin ,Gastroenterology ,Feces ,Young Adult ,Internal medicine ,medicine ,Humans ,Longitudinal Studies ,Young adult ,Alcoholics ,Child ,Subclinical infection ,Hepatology ,alcohol ,business.industry ,Settore MED/09 - MEDICINA INTERNA ,Middle Aged ,medicine.disease ,Substance abuse ,Alcoholism ,Intestinal Diseases ,Drinking Status ,Child, Preschool ,Biological Markers ,Female ,Calprotectin ,business ,Leukocyte L1 Antigen Complex ,Biomarkers - Abstract
OBJECTIVES: Excessive alcohol consumption often results in intestinal damage, mediated by inflammatory processes, mainly characterized by an increased influx of leukocytes. Fecal calprotectin is a granulocyte cytosolic protein, representing as a promising marker of subclinical intestinal inflammation. In this study, we assessed fecal calprotectin concentrations (FCCs) in current drinking alcoholics, both at the baseline, and then during a subsequent 84-day period. Moreover, FCCs in the alcoholics were compared with the FCCs in healthy controls. METHODS: Twenty-eight, active-drinking alcoholics were enrolled in this study and compared with 40 healthy volunteers as the control group. In alcoholics, FCCs were determined at the beginning of the study (baseline; T0) and then every 2 weeks (T1-T6) during the following 84-day period. Potential differences in FCCs were analyzed between alcoholics and healthy controls, and during the 84-day period within the group of alcoholics. In addition, an analysis of FCCs was conducted in three subgroups of alcoholics, considering their drinking status during the 84-day period (abstinent, relapsed, and active). RESULTS: At baseline, no significant differences in median FCCs were found between alcoholics and controls. No significant changes of median FCCs were found, comparing baseline FCCs and FCCs during the 84-day period (T1-T6) in the whole group of alcoholics, nor in the three subgroups of alcoholics. CONCLUSION: FCCs in active-drinking alcoholics are not significantly different, compared with the healthy controls. Moreover, FCCs do not significantly differ according to the alcohol drinking status. These results may suggest the absence of a subclinal intestinal inflammation involving neutrophils in the alcoholics.
- Published
- 2011
25. Food Fried in Extra-Virgin Olive Oil Improves Postprandial Insulin Response in Obese, Insulin-Resistant Women
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Esmeralda Capristo, Sara Farnetti, Giovanni Gasbarrini, Davide Luciani, and Noemi Malandrino
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Adult ,Blood Glucose ,obesity ,Flour ,Medicine (miscellaneous) ,Statistics, Nonparametric ,Insulin resistance ,fried oil ,Olea ,Glycemic load ,Dietary Carbohydrates ,Humans ,Insulin ,Plant Oils ,Medicine ,Cooking ,Food science ,Olive Oil ,Meal ,Nutrition and Dietetics ,business.industry ,digestive, oral, and skin physiology ,food and beverages ,Settore MED/13 - ENDOCRINOLOGIA ,Fasting ,Middle Aged ,Postprandial Period ,medicine.disease ,Obesity ,Bioavailability ,C-Reactive Protein ,Glycemic index ,Postprandial ,Glycemic Index ,Area Under Curve ,Female ,business ,Body mass index ,Phytotherapy - Abstract
The benefits of low glycemic load (GL) diets on clinical outcome in several metabolic and cardiovascular diseases have extensively been demonstrated. The GL of a meal can be affected by modulating the bioavailability of carbohydrates or by changing food preparation. We investigated the effect on plasma glucose and insulin response in lean and obese women of adding raw or fried extra-virgin olive oil to a carbohydrate-containing meal. After an overnight fast, 12 obese insulin-resistant women (body mass index [BMI], 32.8 ± 2.2 kg/m(2)) and five lean subjects (BMI, 22.2 ± 1.2 kg/m(2)) were randomly assigned to receive two different meals (designated A and B). Meal A was composed of 60 g of pasta made from wheat flour and 150 g of grilled courgettes with 25 g of uncooked oil. Meal B included 15 g of oil in the 150 g of deep-fried courgettes and 10 g of oil in the 60 g of stir-fried pasta. Both meals included 150 g of apple. Blood samples were collected at baseline and every 30 minutes over a 3-hour post-meal period and were tested for levels of glucose, insulin, C-peptide, and triglycerides. The area under the curve (AUC) values were calculated. In obese women the AUCs for C-peptide were significantly higher after meal A than after meal B at 120 minutes (W [Wilcoxon sign rank test] = 27.5, P = .0020), 150 minutes (W = 26.5, P = .0039), and 180 minutes (W = 26.5, P = .0039). No differences were found in lean subjects. This study demonstrated that in obese, insulin-resistant women, food fried in extra-virgin olive oil significantly reduced both insulin and C-peptide responses after a meal.
- Published
- 2011
26. Percutaneous laser ablation of hepatocellular carcinoma in patients with liver cirrhosis awaiting liver transplantation
- Author
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Giovanni Gasbarrini, Claudio Maurizio Pacella, Giampiero Francica, Giuseppe Tisone, Paolo Craboledda, Maurizio Pompili, Erica Nicolardi, Gian Ludovico Rapaccini, and Mario Angelico
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Liver Cirrhosis ,Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Percutaneous ,Cirrhosis ,medicine.medical_treatment ,Liver transplantation ,Biopsy ,medicine ,Carcinoma ,Humans ,Radiology, Nuclear Medicine and imaging ,Laser ablation ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,General Medicine ,Middle Aged ,medicine.disease ,Ablation ,Surgery ,Settore MED/18 - Chirurgia Generale ,Treatment Outcome ,Hepatocellular carcinoma ,Laser Therapy ,business - Abstract
Objective The aim of this study was to determine the effectiveness and safety of percutaneous laser ablation for the treatment of cirrhotic patients with hepatocellular carcinoma awaiting liver transplantation. Materials and methods The data of 9 male cirrhotic patients (mean age 50 years, range 45–60 years) with 12 biopsy proven nodules of hepatocellular carcinoma (mean diameter 2.0 cm, range 1.0–3.0 cm) treated by laser ablation before liver transplantation between June 2000 and January 2006 were retrospectively reviewed. Laser ablation was carried out by inserting 300 nm optical fibers through 21-Gauge needles (from two to four) positioned under ultrasound guidance into the target lesions. A continuous wave Neodymium:Yttrium Aluminium Garnet laser was used. Transarterial chemoembolization prior to liver transplantation was performed in two incompletely ablated tumors. Results No procedure-related major complications were recorded. During the waiting time to liver transplantation local tumor progression after ablation occurred in 3 nodules (25%). At histological examination of the explanted livers complete necrosis was found in 8 nodules (66.7%, all treated exclusively with laser ablation), partial necrosis >50% in 3 nodules (25%), and partial necrosis Conclusion In patients with cirrhotic livers awaiting liver transplantation, percutaneous laser ablation is safe and effective for the management of small hepatocellular carcinoma.
- Published
- 2010
27. Familial Mediterranean Fever: a review for clinical management
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Valentina Curigliano, C. Cerquaglia, Giovanni Gasbarrini, M Giovinale, Micaela La Regina, Elena Verrecchia, C. Fonnesu, Raffaele Manna, and Giuliana de Socio
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Familial Mediterranean fever ,Pyrin domain ,Gout Suppressants ,Pathogenesis ,chemistry.chemical_compound ,Rheumatology ,AA amyloidosis ,autoinflammatory disease ,inflammasome ,medicine ,Colchicine ,Humans ,therapy ,business.industry ,Settore MED/09 - MEDICINA INTERNA ,Amyloidosis ,geno-phenotypical correlations ,Pyrin ,medicine.disease ,MEFV ,trigger factors ,Familial Mediterranean Fever ,Cytoskeletal Proteins ,chemistry ,Immunology ,Kidney Failure, Chronic ,Complication ,business ,Serositis - Abstract
Familial Mediterranean Fever (FMF) is a hereditary autosomal recessive, autoinflammatory disorder characterized by recurrent, self-limiting episodes of short duration (mean 24-72 h) of fever and serositis. FMF is the most frequent periodic febrile syndrome among the autoinflammatory syndromes (AS), a heterogeneous group of recently identified diseases clinically characterized by recurrent febrile attacks, in the absence of autoantibodies and antigen-specific T lymphocytes. In FMF, periodic attacks show inter- and intra-individual variability in terms of frequency and severity. Usually, they are triggered by apparently innocuous stimuli and may be preceded by a prodromal period. The Mediterranean FeVer gene (MEFV) responsible gene maps on chromosome 16 (16p13) encoding the pyrin-marenostrin protein. The precise pathologic mechanism is still to be definitively elucidated; however a new macromolecular complex, called inflammasome, seems to play a major role in the control of inflammation and it might be involved in the pathogenesis of FMF. The most severe long-term complication is type AA amyloidosis, principally affecting the kidney and the cause of chronic renal failure. Two types of risk factors, genetic and non-genetic, have been identified for this complication. Currently, the only effective treatment of Familial Mediterranean Fever is the colchicine. New drugs in a few colchicine resistant patients have been tried, but additional studies on larger series are necessary to draw definitive conclusions.
- Published
- 2009
28. Prevalence, characteristics and severity of non-alcoholic fatty liver disease in patients with chronic plaque psoriasis
- Author
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Giovanni Gasbarrini, Gioacchino Francesco La Torre, Luca Miele, Clara De Simone, Magda D'Agostino, Consuelo Cefalo, Selenia Vallone, Gian Lodovico Rapaccini, V. Vero, Maurizio Pompili, Pierluigi Amerio, Alessandro Grieco, Carmine Di Stasi, Fabio Maria Vecchio, Marco Biolato, and M.L. Gabrieli
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Adult ,Male ,medicine.medical_specialty ,Pathology ,Adolescent ,Settore MED/12 - GASTROENTEROLOGIA ,Psoriatic ,digestive system ,Gastroenterology ,Cohort Studies ,Liver disease ,Psoriatic arthritis ,Young Adult ,Psoriasis Area and Severity Index ,Internal medicine ,Psoriasis ,medicine ,80 and over ,Humans ,Obesity ,Aged ,Metabolic Syndrome ,Aged, 80 and over ,Hepatology ,medicine.diagnostic_test ,business.industry ,Metabolic Syndrome X ,Arthritis ,Arthritis, Psoriatic ,Settore MED/09 - MEDICINA INTERNA ,nutritional and metabolic diseases ,Retrospective cohort study ,Middle Aged ,medicine.disease ,digestive system diseases ,Fatty Liver ,Cross-Sectional Studies ,Italy ,fatty liver/epidemiology ,fibrosis ,liver function test ,metabolic syndrome x/complications ,methotrexate ,nafld ,obesity/complications ,psoriatic arthritis ,steatosis ,Case-Control Studies ,Chronic Disease ,Female ,Liver function ,Metabolic syndrome ,Liver function tests ,business ,Settore MED/35 - MALATTIE CUTANEE E VENEREE - Abstract
Background / Aims The association between NAFLD and psoriasis has never been explored in prospective epidemiological studies. The aim of this 2-phase study was to study the clinical features of NAFLD in patients with psoriasis. Methods Phase 1: Investigation of prevalence and characteristics of NAFLD in an unselected cohort of 142 adult Italian outpatients with psoriasis vulgaris. Phase 2: Comparison of the psoriasis cohort subgroup with NAFLD and an age- and body mass index-matched retrospective cohort of 125 non-psoriasis patients with biopsy proven NAFLD. Results Based on histories, laboratory tests, and ultrasound studies, 84 (59.2%) received clinical diagnosis of NAFLD; 30 had factors potentially associated with liver disease other than NAFLD (e.g., viral hepatitis, significant ethanol, methotrexate use); and 28 (19.7%) had normal livers. Comparison of the normal-liver and NAFLD subgroups revealed that NAFLD in psoriasis patients (Ps-NAFLD) was significantly correlated with metabolic syndrome ( p p =0.043); hypercholesterolemia ( p =0.029); hypertriglyceridemia ( p 1 ( p =0.019), and psoriatic arthritis (PsA) ( p =0.036). The association with PsA remained significant after logistic regression analysis (OR=3.94 [CI, 1.07–14.46]). Compared with the retrospective non-psoriatic NAFLD cohort (controls), Ps-NAFLD patients (cases) were likely to have severe NAFLD reflected by non-invasive NAFLD Fibrosis Scores and AST/ALT >1. Conclusions NAFLD is highly prevalent among psoriasis patients, where it is closely associated with obesity (overall and abdominal), metabolic syndrome, and PsA, and more likely to cause severe liver fibrosis (compared with nonPs-NAFLD). Routine work-up for NAFLD may be warranted in patients with psoriasis, especially when potentially hepatotoxic drug therapy is being considered.
- Published
- 2009
29. A CASE REPORT OF BRUGADA SYNDROME
- Author
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Giovita, Piccillo, Aurelio, Pantò, Azzarelli, SALVATORE A., Mondati, Enrico, Riccardo, Polosa, and Giovanni, Gasbarrini
- Published
- 2009
30. Serum levels of hyaluronic acid and tissue metalloproteinase inhibitor-1 combined with age predict the presence of nonalcoholic steatohepatitis in a pilot cohort of subjects with nonalcoholic fatty liver disease
- Author
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Fabio Maria Vecchio, Manuela G. Neuman, Alessandra Forgione, Antonio Grieco, Consuelo Cefalo, V. Vero, Valerio Gaetano Vellone, Giuseppe La Torre, Gian Lodovico Rapaccini, Luca Miele, Giovanni Gasbarrini, and S. Racco
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Adolescent ,Settore MED/12 - GASTROENTEROLOGIA ,Pilot Projects ,Gastroenterology ,Sensitivity and Specificity ,Cohort Studies ,Young Adult ,Liver Function Tests ,Fibrosis ,Physiology (medical) ,Internal medicine ,NAFLD ,Nonalcoholic fatty liver disease ,Medicine ,Humans ,Hyaluronic Acid ,Prospective cohort study ,Tissue Inhibitor of Metalloproteinase-1 ,medicine.diagnostic_test ,business.industry ,Biochemistry (medical) ,Acido ialuronico ,Settore MED/09 - MEDICINA INTERNA ,Public Health, Environmental and Occupational Health ,NASH ,Age Factors ,General Medicine ,Middle Aged ,medicine.disease ,Fatty Liver ,Liver biopsy ,Cohort ,Matrix Metalloproteinase 2 ,Regression Analysis ,Female ,Metabolic syndrome ,Matrix Metalloproteinase 1 ,business ,Liver function tests ,metalloproteinasi ,Cohort study - Abstract
Hyaluronic acid (HA) and tissue inhibitor of metalloproteinase 1 (TIMP-1) are reliable markers of liver fibrosis and are closely linked to the proinflammatory status. In this pilot cohort study, we attempted to identify a clinical score that would predict the severity of nonalcoholic fatty liver disease (NAFLD) based on clinical variables and serum markers of fibrosis and inflammation. The cohort included 46 patients with histologically confirmed NAFLD (76.1% male; mean age, 43+/-13 years; mean body mass index [BMI], 27.8+/-3.5). Serum transforming growth factor beta (TGF-beta), HA, TIMP, and matrix metalloproteinase (MMP) levels were measured with commercial enzyme-linked immunoassay (ELISA) kits. Demographic features and clinical and laboratory findings were subjected to univariate and multivariate binary logistic regression analysis to construct the mathematical model. Receiver operating characteristic curve (ROC) analysis was used to identify a threshold value for diagnosis of NASH and to assess its sensitivity and specificity. Serum levels of HA and TIMP-1 were statistically different in patients with nonalcoholic steatohepatitis (NASH) (P0.05). Logistic regression analysis of several clinical variables indicated patient age as the only independent predictor of NASH (odds ratio [OR], 1.129, 95% confidence interval [CI], 1.019-1.251, P=0.020). The mathematical model constructed on the basis of these results included age, TIMP-1, and HA levels. A value of 148.27 or more identified patients with NASH with 85.7% sensitivity, 87.1% specificity, and negative and positive predictive values of 96.4% and 60%, respectively. This model seems to represent a reliable noninvasive tool for excluding the presence of NASH. If validated in larger prospective cohort studies, it might be useful for determining when a liver biopsy is actually warranted in patients with NAFLD.
- Published
- 2009
31. Abdominal angina due to recurrence of cancer of the papilla of vater: a case report
- Author
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Marco Biolato, M.L. Gabrieli, Antonio Parente, Lorenzo Bonomo, Giovanni Gasbarrini, S. Racco, Antonio Grieco, Melania Costantini, and Gian Ludovico Rapaccini
- Subjects
Medicine(all) ,Abdominal pain ,Duplex ultrasonography ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Analgesic ,lcsh:R ,lcsh:Medicine ,General Medicine ,Pancreaticoduodenectomy ,Surgery ,Major duodenal papilla ,medicine.artery ,Case report ,medicine ,Superior mesenteric artery ,medicine.symptom ,business ,Abdominal angina ,Vascular Stenosis ,abdominal angina ,Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA - Abstract
Introduction Abdominal angina is usually caused by atherosclerotic disease, and other causes are considered uncommon. This is the first report of a case of abdominal angina secondary to neoplastic vascular stenosis caused by local recurrence of an adenocarcinoma of the papilla of Vater. Case presentation An 80-year-old woman of Caucasian origin presented with abdominal pain and diarrhea. She had undergone a pancreaticoduodenectomy for adenocarcinoma of the papilla of Vater four years earlier. Computed tomography revealed a mass surrounding her celiac trunk and superior mesenteric artery. Her abdominal pain responded poorly to analgesic drugs, but disappeared when oral feedings were withheld. A duplex ultrasonography of the patient's splanchnic vessels was consistent with vascular stenosis. Parenteral nutrition was started and the patient remained pain free until her death. Conclusion Pain relief is an important therapeutic target in patients with cancer. In this case, abdominal pain was successfully managed only after the ischemic cause had been identified. The conventional analgesic therapy algorithm based on nonsteroidal anti-inflammatory drugs and opioids had been costly and pointless, whereas the simple withdrawal of oral feeding spared the patient of the discomfort of additional invasive procedures and allowed her to spend her remaining days in a completely pain-free state.
- Published
- 2009
32. A CATASTROPHIC CASE OF FELTY’S DISEASE
- Author
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Giovita, Piccillo, Aurelio, Pantò, Carla, Giansiragusa, Mauro, Gennaro, Mondati, Enrico, Riccardo, Polosa, and Giovanni, Gasbarrini
- Published
- 2009
33. food allergy and food intolerance: diagnosis and treatment
- Author
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Valentina Pecora, Giovanni Gasbarrini, Eleonora Nucera, Chiara Roncallo, Arianna Aruanno, Vito Sabato, Carla Lombardo, Angela Rizzi, Emanuela Pollastrini, Marzia Decinti, Alessandro Buonomo, Sonia Nunzialfina Musumeci, Giampiero Patriarca, Domenico Schiavino, Amira Colagiovanni, and Tiziana Maria De Pasquale
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Controlled studies ,Immunoglobulin E ,double-blind placebo-controlled food challenge ,Food allergy ,Internal Medicine ,medicine ,Humans ,food intolerance ,Intensive care medicine ,Diagnostic Techniques and Procedures ,Desensitization (medicine) ,food allergy ,biology ,oral specific desensitizazion ,business.industry ,digestive, oral, and skin physiology ,Settore MED/09 - MEDICINA INTERNA ,medicine.disease ,Surgery ,Food intolerance ,skin prick test ,Epinephrine ,Emergency Medicine ,biology.protein ,business ,Anaphylaxis ,Food Hypersensitivity ,Paediatric population ,medicine.drug - Abstract
Food allergy is a matter of concern because it affects about 0.5–3.8% of the paediatric population and 0.1–1% of adults, and as well may cause life-threatening reactions. Skin prick testing with food extracts and with fresh foods, the measurement of food-specific IgE, elimination diets and a double-blind, placebo-controlled food challenge are the main diagnostic procedures; many non-validated procedures are available, creating confusion among patients and physicians. The treatment of food allergy is still a matter of debate. Antihistamines, corticosteroids and, if necessary (in case of anaphylaxis), epinephrine, are the drugs of choice for the treatment of symptoms of food allergy. Sodium cromolyn may be used prophylactically even though there are no controlled studies certifying its efficacy. The only etiologic treatment of food allergy is specific desensitization. Sublingual-oral-specific desensitization has been used by our group for the treatment of food-allergic patients with a high percentage of success.
- Published
- 2009
34. MULTIPLE CHEMICAL SENSITIVITY A MYSTERIOUS UNIVERSE…A CASE REPORT
- Author
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Giovita, Piccillo, Aurelio, Pantò, Mondati, Enrico, Riccardo, Polosa, and Giovanni, Gasbarrini
- Published
- 2009
35. CARMELINA’S STORY: A PATIENT WITH SLEEP DISORDERED BREATHING AND PRADER-WILLI SYNDROME
- Author
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Giovita, Piccillo, Aurelio, Pantò, Leonardo, Salmeri, Azzarelli, SALVATORE A., Mondati, Enrico, Riccardo, Polosa, and Giovanni, Gasbarrini
- Published
- 2009
36. A CASE REPORT OF WERNER SYNDROME
- Author
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Giovita, Piccillo, Aurelio, Pantò, Mondati, Enrico, Riccardo, Polosa, Luca, Miele, and Giovanni, Gasbarrini
- Published
- 2008
37. Celiac disease: what's new about it?
- Author
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Antonio Gasbarrini, Davide Roccarina, Giuseppe Merra, Noemi Malandrino, Giovanni Gasbarrini, Giovanni Cammarota, Valentina Giorgio, Carlo Fundarò, and Esmeralda Capristo
- Subjects
medicine.medical_specialty ,Pathology ,Malabsorption ,business.industry ,Settore MED/12 - GASTROENTEROLOGIA ,Gastroenterology ,MEDLINE ,General Medicine ,Disease ,medicine.disease ,Autoimmune Diseases ,Settore MED/12 ,Internal medicine ,medicine ,Humans ,Villous atrophy ,business ,celiac disease - Abstract
In the present review we will try to summarize the clinical and diagnostic features of celiac disease (CD) as well as the new findings on extraintestinal manifestation. CD is an immune-mediated enteropathy caused by a permanent gluten intolerance. In the last years, the diagnosis is becoming more and more frequent because of the recognition of ‘new’ symptoms and associated extraintestinal manifestations. Classical CD is dominated by symptoms and sequelae of gastrointestinal malabsorption. In the ‘atypical forms’, the extraintestinal features usually predominate, with few or no gastrointestinal symptoms. Silent CD refers to asymptomatic patients with a positive serologic test and villous atrophy on biopsy. This form is detected by screening of high-risk individuals, or villous atrophy occasionally may be detected by endoscopy and biopsy conducted for another reason. The potential form is diagnosed in groups at risk including relatives of celiac patients, Down syndrome and autoimmune diseases. Latent CD is defined by positive serological tests but not histological changes on biopsy. These individuals are asymptomatic, but later may develop symptoms and/or histological alterations. Recognition of atypical manifestations of CD is very important because many cases can remain undiagnosed with an increased risk of long-term complications.
- Published
- 2008
38. PANCREATIC INSUFFICIENCY IN A PATIENT WITH VON HIPPEL-LINDAU DISEASE
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Giovita, Piccillo, Aurelio, Pantò, Mondati, Enrico, Polosa, Riccardo, Luca, Miele, and Giovanni, Gasbarrini
- Published
- 2008
39. Intestine: organ or apparatus?
- Author
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Massimo Montalto, Dina Visca, Giovanni Gasbarrini, Luca Santoro, Ferruccio D'Onofrio, Antonella Gallo, Antonio Gasbarrini, and Valentina Curigliano
- Subjects
Human intestine ,Mechanism (biology) ,Settore MED/12 - GASTROENTEROLOGIA ,Gastroenterology ,digestion absorption ,General Medicine ,Biology ,intestine ,microflora ,Intestinal absorption ,Intestine ,Intestines ,Immune system ,Intestinal Absorption ,Biochemistry ,Humans ,Endocrine system ,Digestion - Abstract
It is well known that human intestine is involved in different important functions. First of all, it is responsible for digestion and absorption of nutrients, electrolytes, water, bile salts and drugs, but it also has immunologic, endocrine and motor functions. Moreover, intestinal microflora, composed by a large diversity of bacterial cells, provides several beneficial functions for the host and is, nowadays, defined by many authors as an organ itself. In consideration of intestine complexity, we tried to understand if it can be considered only an organ or if it is an apparatus itself. We have analyzed the different components and their relationships, showing that a continuous collaboration is required among enterocytes, endocrine intestinal cells, gut immune system and microflora to assure an efficient mechanism of defense. In consideration of the complexity of intestinal components, together with the emergent role of microflora, we think that we could start to consider gut as a real apparatus, and not only as an organ.
- Published
- 2008
40. TWO CASES REPORT OF CHYLOTHORAX DUE TO LYMPHANGIOLEIOMYOMATOSIS
- Author
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Giovita, Piccillo, Aurelio, Pantò, Mondati, Enrico, Riccardo, Polosa, Luca, Miele, and Giovanni, Gasbarrini
- Published
- 2008
41. State and trait anxiety and depression in patients with primary brain tumors before and after surgery: 1-year longitudinal study
- Author
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Giovanni Addolorato, Anna Ferrulli, Nadia Icolaro, Vincenzo D'Angelo, Vincenzo Carotenuto, Giovanni Gasbarrini, Antonio Miceli, Lorenzo Leggio, Cristina D'Angelo, and Antonio Mirijello
- Subjects
Adenoma ,Adult ,Male ,medicine.medical_specialty ,Longitudinal study ,Personality Inventory ,Brain tumor ,primary brain tumors ,Pituitary neoplasm ,Central nervous system disease ,Sex Factors ,medicine ,Humans ,Pituitary Neoplasms ,Longitudinal Studies ,Depression (differential diagnoses) ,Aged ,Aged, 80 and over ,business.industry ,Brain Neoplasms ,Mood Disorders ,Settore MED/09 - MEDICINA INTERNA ,General Medicine ,Glioma ,Neuroma, Acoustic ,Middle Aged ,medicine.disease ,anxiety ,Surgery ,Mood disorders ,depression ,Anxiety ,Female ,medicine.symptom ,Personality Assessment Inventory ,business ,Cognition Disorders ,Meningioma ,Mental Status Schedule ,Follow-Up Studies - Abstract
Object The aim in this study was to assess the state and trait types of anxiety as well as current depression before and after surgery in patients affected by brain tumors. The relationships between these affective disorders and the patient's sex, tumor histology, and laterality of the tumor were also evaluated. Methods A total of 72 patients affected by a primary brain tumor were enrolled in the study. Histological grades were assigned according to the World Health Organization classification. State and trait anxiety were assessed using the State and Trait Anxiety Inventory; current depression was assessed using the Zung Self-Rating Depression Scale. Cognitive impairment was assessed using the 10-item Short Portable Mental Status Questionnaire. Psychometric evaluation was assessed before surgery and at 1, 3, 6, and 12 months after surgery. Results Before brain surgery, 62.5% of patients showed state anxiety, 50% of patients showed trait anxiety, and 9.7% of patients showed current depression. During the follow-up period there was no significant variation in the percentage of patients with state anxiety (p = 0.416) and trait anxiety (p = 0.7), whereas a significant increase in the percentage of those with current depression was found (p < 0.0001), in particular at 1 month (p = 0.002) and 3 months (p = 0.039) after surgical treatment. The tumor's laterality and histology showed no correlation with psychometric variables, whereas a relationship between the presence of trait anxiety at the enrollment and current depression after surgery (p < 0.0001) was found. Conclusions Patients affected by brain tumors frequently experience affective disorders. After brain surgery, a depressive state can develop. The psychometric assessment could be useful in these patients for quick recognition of psychological disorders.
- Published
- 2008
42. Social phobia in coeliac disease
- Author
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Anna Ferrulli, Lorenzo Leggio, Giovanni Gasbarrini, Cristina D'Angelo, Giovanni Addolorato, L. Vonghia, Antonio Miceli, Veruscka Leso, Antonio Mirijello, Silvia Cardone, Addolorato, Giovanni, Mirijello, Antonio, D'Angelo, Cristina, Leggio, Lorenzo, Ferrulli, Anna, Vonghia, Luisa, Cardone, Silvia, Leso, Veruscka, Miceli, Antonio, and Gasbarrini, Giovanni
- Subjects
Adult ,Male ,medicine.medical_specialty ,Depression scale ,Liebowitz social anxiety scale ,Coeliac disease ,Affective disorder ,Immunopathology ,Internal medicine ,Medicine ,Humans ,Psychiatry ,Depression (differential diagnoses) ,Depressive Disorder ,business.industry ,Depression ,Gastroenterology ,medicine.disease ,Anxiety Disorders ,humanities ,Celiac Disease ,Phobic Disorders ,Anxiety ,Gluten free ,Female ,medicine.symptom ,business ,Social phobia ,Anxiety disorder - Abstract
OBJECTIVE: A high prevalence of anxiety and depression has been reported in coeliac disease (CD). Although social phobia is included among the anxiety disorders, its presence in CD has never been investigated. The aim of the present study was to evaluate social phobia in CD patients. MATERIAL AND METHODS: A total of 40 CD patients were consecutively enrolled in the study. Fifty healthy subjects were studied as controls. Social phobia was assessed by the Liebowitz Social Anxiety Scale (LSAS) and current depression by the modified version of the Zung Self-rating Depression Scale (M-SDS). RESULTS: The percentage of subjects with social phobia was significantly higher in CD patients than in controls (70% versus 16%; p
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- 2008
43. A CASE REPORT OF BROKEN HEART SYNDROME
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Giovita, Piccillo, Aurelio, Pantò, Mondati, Enrico, Riccardo, Polosa, Luca, Miele, and Giovanni, Gasbarrini
- Published
- 2008
44. Low-dose lactose in drugs neither increases breath hydrogen excretion nor causes gastrointestinal symptoms
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Antonio Grieco, Valentina Curigliano, Giovanni Cammarota, Luca Santoro, Antonio Gasbarrini, Massimo Montalto, Giovanni Gasbarrini, Antonella Gallo, Marcello Covino, and Ferruccio D'Onofrio
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Adult ,Male ,medicine.medical_specialty ,malabsorption ,Gastrointestinal Diseases ,medicine.medical_treatment ,Statistics as Topic ,Placebo ,Gastroenterology ,Severity of Illness Index ,Excretion ,lactose ,chemistry.chemical_compound ,Lactose Intolerance ,Pharmacokinetics ,Double-Blind Method ,Internal medicine ,Medicine ,Ingestion ,Humans ,Pharmacology (medical) ,Lactose ,Aged ,Aged, 80 and over ,Cross-Over Studies ,Hepatology ,Dose-Response Relationship, Drug ,business.industry ,Stomach ,Settore MED/09 - MEDICINA INTERNA ,Lactase ,Middle Aged ,Crossover study ,Abdominal Pain ,medicine.anatomical_structure ,Endocrinology ,chemistry ,Breath Tests ,Female ,business ,Hydrogen - Abstract
Summary Background Despite the reported tolerance to a low dose of lactose, many lactose malabsorbers follow a rigorous lactose-free diet also avoiding lactose-containing drugs. Up to now, only a few case reports have described the onset of gastrointestinal symptoms in lactose malabsorbers following the ingestion of these drugs. It has been suggested that capsules/tablets contain no more than 400 mg of lactose. Aim To evaluate breath H2 excretion and intolerance symptoms after ingestion of a capsule containing 400 mg of lactose or placebo through a randomized, cross-over, double-blind, controlled study. Methods Seventy-seven lactose maldigesters with intolerance underwent two H2 breath tests with both 400 mg of lactose and 400 mg of placebo. Gastrointestinal symptoms occurring in the 8 h following the ingestion of different substrates were evaluated by a visual-analogue scale. Results Ingestion of 400 mg of lactose did not cause a significant difference in breath H2 excretion or in the severity of gastrointestinal symptoms compared to placebo. Conclusion In patients with lactase deficiency, drugs containing 400 mg of lactose or less can be used safely.
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- 2008
45. Celiac disease and myointimal proliferation: a possible correlation?
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Giovanni Ghirlanda, Antonio Gasbarrini, Giuseppe Merra, Giovanni Gasbarrini, Davide Roccarina, and Antonio Dal Lago
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celiac ,Settore MED/12 - GASTROENTEROLOGIA ,Disease ,Settore MED/49 ,Published: November 2008 ,Gliadin ,Absorption ,Weight loss ,medicine ,In patient ,lcsh:RC799-869 ,chemistry.chemical_classification ,biology ,business.industry ,Gastroenterology ,Thrombosis ,medicine.disease ,Gluten ,digestive system diseases ,Atheromasia ,Diarrhea ,chemistry ,Immunology ,biology.protein ,lcsh:Diseases of the digestive system. Gastroenterology ,medicine.symptom ,business ,Autoimmune - Abstract
Celiac disease (CD) is an autoimmune disorder of the small bowel that occurs in genetically predisposed people of all ages, from middle infancy, and is caused by a reaction to gliadin, a gluten protein. Some patients are diagnosed with symptoms related to the decreased absorption of nutrients or with various symptoms which, although statistically linked, have no clear relationship with the malfunctioning bowel. Classic symptoms of CD include diarrhea, weight loss, and fatigue; bowel symptoms may be limited or even absent. In this article we describe the case of a young woman with CD who presents with myointimal proliferation. However multiple cases of vessel thrombosis have been reported in patients with CD. Despite the fact that no definitive relationship between these diseases could be explained, we think this association must be remembered especially in cases of young and tenuous women with these vascular abnormalities.
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- 2008
46. Affective and psychiatric disorders in celiac disease
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Giovanni Addolorato, Lorenzo Leggio, Cristina D'Angelo, Salvatore Piano, Veruscka Leso, Silvia Cardone, Antonio Mirijello, Esmeralda Capristo, L. Vonghia, Anna Ferrulli, Ludovico Abenavoli, Giovanni Gasbarrini, Antonio Nesci, Addolorato, Giovanni, Leggio, Lorenzo, D'Angelo, Cristina, Mirijello, Antonio, Ferrulli, Anna, Cardone, Silvia, Vonghia, Luisa, Abenavoli, Ludovico, Leso, Veruscka, Nesci, Antonio, Piano, Salvatore, Capristo, Esmeralda, and Gasbarrini, Giovanni
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Quality of life ,medicine.medical_specialty ,Disease ,Organic disease ,Affective disorders ,Celiac disease ,Gluten-free diet ,Psychiatric disorders ,Psychological support ,Celiac Disease ,Humans ,Mental Disorders ,Gastroenterology ,Affective disorder ,Epidemiology of child psychiatric disorders ,medicine ,In patient ,Psychiatry ,business.industry ,Psychiatric disorder ,General Medicine ,Mental Disorder ,business ,Human - Abstract
Several extraintestinal clinical manifestations have been reported in celiac disease (CD). Among them, growing evidence suggests the association between CD and affective and psychiatric disorders. In this review the most frequent affective and psychiatric disorders associated with CD and the possible mechanisms involved in these associations were analyzed. The available data suggest that screening for CD in patients with affective and/or psychiatric symptoms may be useful since these disorders could be the expression of an organic disease rather than primary psychiatric illnesses.
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- 2008
47. The role of immune serological parameters and allergological tests in psoriasis
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Eleonora Nucera, Veronica Ojetti, Rodolfo Capizzi, Alessio Migneco, Antonio Gasbarrini, JA Aguilar Sanchez, Domenico Schiavino, C. De Simone, Giampiero Patriarca, and Giovanni Gasbarrini
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Adult ,Male ,business.industry ,Eosinophil Cationic Protein ,Dermatology ,Allergens ,Immunoglobulin E ,Middle Aged ,medicine.disease ,Serology ,Infectious Diseases ,Immune system ,Psoriasis ,Case-Control Studies ,Immunology ,Medicine ,Humans ,Female ,business ,Settore MED/35 - MALATTIE CUTANEE E VENEREE ,Skin Tests - Published
- 2008
48. Amantadine-induced livedo reticularis occurring during treatment of chronic hepatitis C
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Marco Castagneto, E. Minutilli, Gian Ludovico Rapaccini, Giovanni Gasbarrini, Maurizio Pompili, and Giorgio Pelecca
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business.industry ,Settore MED/09 - MEDICINA INTERNA ,Amantadine ,Dermatology ,Hepatitis C ,Hepatitis C, Chronic ,Middle Aged ,Viral Load ,medicine.disease ,Virology ,Antiviral Agents ,Infectious Diseases ,Chronic hepatitis ,medicine ,Humans ,Female ,medicine.symptom ,Chronic ,business ,Viral load ,medicine.drug ,Livedo reticularis ,Livedo Reticularis - Published
- 2008
49. Classification of malabsorption syndromes
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Dina Visca, Giovanni Cammarota, Luca Santoro, Antonio Gasbarrini, Antonella Gallo, Ferruccio D'Onofrio, Massimo Montalto, Giovanni Gasbarrini, and Valentina Curigliano
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medicine.medical_specialty ,Malabsorption ,maldigestion ,malabsorption ,business.industry ,Settore MED/12 - GASTROENTEROLOGIA ,Gastroenterology ,General Medicine ,Disease ,medicine.disease ,celiac disease ,classification ,Intestinal Absorption ,Internal medicine ,malabsorption syndromes ,medicine ,Humans ,Digestion ,Malabsorption syndromes ,business - Abstract
Malabsorption syndrome is usually defined as the complex of symptoms secondary to maldigestion and/or malabsorption, realizing when the extension of the disease exceeds the ability of intestine compensation. Several conditions have been recognized as being responsible for this syndrome. Up to now, different criteria have been used to order them, but a definitive classification is still not available because of the complexity of the absorption process, the involvement of different organs and structures, and the coexistence of different mechanisms in some diseases causing malabsorption. We propose a new classification of diseases causing malabsorption syndrome according to the responsible etiopathogenetic mechanisms: (a) alteration of digestive processes; (b) alteration of uptake and transport caused by damage or reduction of absorption surface, and (c) miscellaneous. A comment about the mechanisms responsible for malabsorption is given for all the cited diseases.
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- 2008
50. Vascular involvement in inflammatory bowel disease: pathogenesis and clinical aspects
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M. Bonizzi, Antonio Gasbarrini, Franco Scaldaferri, Silvio Danese, Caterina Ricci, Gianluca Andrisani, Giovanni Gasbarrini, I. Roberto, Carla Felice, Giuseppe Fedeli, Simona Guglielmo, Giammarco Mocci, Alfredo Papa, Papa, A, Scaldaferri, F, Danese, S, Guglielmo, S, Roberto, I, Bonizzi, M, Mocci, G, Felice, C, Ricci, C, Andrisani, G, Fedeli, G, Gasbarrini, G, and Gasbarrini, A
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medicine.medical_specialty ,Settore MED/12 - GASTROENTEROLOGIA ,Population ,Disease ,Inflammatory bowel diseases ,digestive system ,Inflammatory bowel disease ,Gastroenterology ,Coagulation ,Crohn's disease ,Thrombosis ,Ulcerative colitis ,Pathogenesis ,Internal medicine ,medicine ,Humans ,Risk factor ,education ,education.field_of_study ,business.industry ,Microcirculation ,General Medicine ,medicine.disease ,digestive system diseases ,Intestines ,business - Abstract
Crohn's disease (CD) and ulcerative colitis (UC), the two major forms of inflammatory bowel disease (IBD), are chronic inflammatory conditions, characterized by a microvascular and also macrovascular involvement. Chronically inflamed intestinal microvessels of IBD patients have demonstrated significant alterations in their physiology and function compared with vessels from healthy and uninvolved IBD intestine. Recently, some studies have revealed that the poor mucosal healing, refractory inflammatory ulcerations and damage in the IBD intestine could depend on microvascular dysfunction, resulting in diminished vasodilatory capacity and tissue hypoperfusion in the IBD gut. Furthermore, several data show that the activation of intestinal endothelium plays a critical role in the pathogenesis and/or in perpetuating and amplifying the inflammatory process in IBD and, consequently, it is now emerging as a potential use of anticoagulant or coagulation-related drugs in treating IBD. IBD is also associated with an increased risk of macrovascular venous and arterial thrombosis. Thrombotic events occur prevalently as deep vein thrombosis and pulmonary embolism. They happen at an earlier age than in non-IBD patients. Prothrombotic risk factors in IBD patients could be distinguished as acquired, such as active inflammation, immobility, surgery, steroid therapy, and use of central venous catheters, and inherited. Furthermore, it has been found that IBD, per se, is an independent risk factor for thrombosis. The prevention of thromboembolic events in IBD patients includes the elimination of removable risk factors and, if thrombosis occurs, a pharmacological therapy similar to that used for thromboembolic events occurring in the general population. Copyright (c) 2008 S. Karger AG, Basel.
- Published
- 2008
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