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We sought (i) to validate a new prediction rule of mortality (Progetto Nazionale Emorragia Digestiva (PNED) score) on an independent population with non-variceal upper gastrointestinal bleeding (UGIB) and (ii) to compare the accuracy of the Italian PNED score vs. the Rockall score in predicting the risk of death.We conducted prospective validation of analysis of consecutive patients with UGIB at 21 hospitals from 2007 to 2008. Outcome measure was 30-day mortality. All the variables used to calculate the Rockall score as well as those identified in the Italian predictive model were considered. Calibration of the model was tested using the chi2 goodness-of-fit and performance characteristics with receiver operating characteristic (ROC) analysis. The area under the ROC curve (AUC) was used to quantify the diagnostic accuracy of the two predictive models.Over a 16-month period, data on 1,360 patients were entered in a national database and analyzed. Peptic ulcer bleeding was recorded in 60.7% of cases. One or more comorbidities were present in 66% of patients. Endoscopic treatment was delivered in all high-risk patients followed by high-dose intravenous proton pump inhibitor in 95% of them. Sixty-six patients died (mortality 4.85%; 3.54-5.75). The PNED score showed a high discriminant capability and was significantly superior to the Rockall score in predicting the risk of death (AUC 0.81 (0.72-0.90) vs. 0.66 (0.60-0.72), P0.000). Positive likelihood ratio for mortality in patients with a PNED risk score8 was 16.05.The Italian 10-point score for the prediction of death was successfully validated in this independent population of patients with non-variceal gastrointestinal bleeding. The PNED score is accurate and superior to the Rockall score. Further external validation at the international level is needed.

Previous studies have shown similar effects of rabeprazole and omeprazole, when used at the same dose in the treatment of reflux oesophagitis. However, such studies have been conducted as superiority studies but interpreted as equivalence ones.To properly assess the comparative efficacy of rabeprazole and omeprazole in inducing complete endoscopic healing and symptom relief in patients with reflux oesophagitis.Patients (n=560) with Savary-Miller grade I-III reflux oesophagitis were randomised in a double-blind, double-dummy fashion to rabeprazole or omeprazole 20 mg once daily for 4-8 weeks. Then, patients endoscopically healed and symptomatically relieved were openly maintained with rabeprazole 10 mg or 2x10 mg once daily (in the event of clinical and/or endoscopic relapse) for a maximum of 48 weeks.After 4-8 weeks of treatment, healing (primary end-point) was observed in 228/233 (97.9%) patients in the rabeprazole group and in 231/237 (97.5%) in the omeprazole one (equivalence effect demonstrated by p0.0001 at Blackwelder test and an upper confidence limit at 97.5% of 0.023). However, rabeprazole was faster in inducing heartburn relief than omeprazole (2.8+/-0.2 versus 4.7+/-0.5 days of therapy to reach the first day with satisfactory heartburn relief, p=0.0045 at log-rank test). In the maintenance phase, 15.2% of patients had an endoscopic and/or clinical relapse.Rabeprazole is equivalent to omeprazole in healing reflux oesophagitis, but shows a faster activity on reflux symptoms in the early treatment phase.

I volumi sono il risultato di uno dei due filoni dell’impresa avviata nel 1992 dall’École française de Rome e dalla Fondazione Ezio Franceschini, al fine di produrre strumenti di base sulla tradizione agiografica e sulla tradizione biblica nei volgari italiani. La Biblioteca Agiografica Italiana (BAI), ispirata al modello bollandista della Bibliotheca Hagiographica Latina (BHL), censisce per la prima volta un immenso patrimonio testuale, relativo a più di 500 santi: sono repertoriati in totale più di 1700 testi, in prosa e in poesia, tra volgarizzamenti e agiografie composte direttamente in volgare, dalle origini fino a tutto il Quattrocento; accanto alle edizioni a stampa e alla bibliografia sono schedati circa un migliaio di manoscritti, tra i quali moltissimi inediti. Un filone sommerso della cultura medievale e rinascimentale esce così alla luce, mostrando l’importanza di questa tradizione per lo studio della religiosità popolare, ma anche della letteratura e della lingua dei primi secoli. Il repertorio è presentato anche in formato elettronico, con un cd-rom che consente ricerche articolate su ogni aspetto della tradizione, incrociando i criteri di ricerca in base ai tutti i dati contenuti negli archivi informatici e nei due volumi a stampa: autori dei testi italiani e latini, incipit ed explicit, fonti latine e romanze, aree cronologiche e dialettali, tipologie dei santi e dei testi agiografici, copisti e possessori dei codici. Ricerche particolari si potranno eseguire sulle schede relative ai manoscritti, ricostruendo tra l’altro la fisionomia delle diverse raccolte agiografiche. Nell’insieme, un tesoro di informazioni, che certo non può ambire alla completezza assoluta, ma che si pone come punto di riferimento imprescindibile, e insieme e apre la strada ad un rinnovamento della ricerca.