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1. Training with a computer-based simulator achieves basic manual skills required for upper endoscopy: a randomized controlled trial.

Author

Di Giulio E, Fregonese D, Casetti T, Cestari R, Chilovi F, D'Ambra G, Di Matteo G, Ficano L, and Delle Fave G

Subjects
Adult, Esophagus, Female, Humans, Intubation, Male, Middle Aged, Clinical Competence, Computer Simulation, Endoscopy, Gastrointestinal, Gastroenterology education
Abstract

Background: Changes in medical practice have constrained the time available for education and the availability of patients for training. Computer-based simulators have been devised that can be used to achieve manual skills without patient contact. This study prospectively compared, in a clinical setting, the efficacy of a computer-based simulator for training in upper endoscopy., Methods: Twenty-two fellows with no experience in endoscopy were randomly assigned to two groups: one group underwent 10 hours of preclinical training with a computer-based simulator, and the other did not. Each trainee performed upper endoscopy in 19 or 20 patients. Performance parameters evaluated included the following: esophageal intubation, procedure duration and completeness, and request for assistance. The performance of the trainees also was evaluated by the endoscopy instructor., Results: A total of 420 upper endoscopies were performed; the computer pretrained group performed 212 and the non-pretrained group, 208. The pretrained group performed more complete procedures (87.8% vs. 70.0%; p < 0.0001), required less assistance (41.3% vs. 97.9%; p < 0.0001), and the instructor assessed performance as "positive" more often for this group (86.8% vs. 56.7%; p < 0.0001). The length of procedures was comparable for the two groups., Conclusions: The computer-based simulator is effective in providing novice trainees with the skills needed for identification of anatomical landmarks and basic endoscopic maneuvers, and in reducing the need for assistance by instructors.

Published
2004
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2. Italian consensus guidelines for chronic pancreatitis

Author

Frulloni, L, Falconi, M, Gabbrielli, A, Gaia, E, Graziani, R, Pezzilli, R, Uomo, G, Andriulli, A, Balzano, G, Benini, L, Calculli, L, Campra, D, Capurso, G, Cavestro, Gm, De Angelis, C, Ghezzo, L, Manfredi, R, Malesci, A, Mariani, A, Mutignani, M, Ventrucci, M, Zamboni, G, Amodio, A, Vantini, I, Bassi, C, Delle Fave, G, Capurso, Iv, Magarini, F, Albarello, L, Alfieri, S, Anti, M, Arcidiacono, P, Baiocchi, L, Berretti, D, Boraschi, P, Buscarini, E, Carroccio, A, Celebrano, Mr, Casadei, R, Chilovi, F, Conigliaro, R, Dall'Oglio, L, De Boni, M, De Pretis, G, Di Priolo, S, Di Sebastiano PL, Doglietto, Gb, Filauro, M, Frieri, G, Fuini, A, Loriga, P, Macarri, G, Manes, G, Massucco, P, Milani, S, Pasquali, Claudio, Pederzoli, P, Pietrangeli, M, Rocca, R, Russello, D, Siquini, W, Traina, M, Veneroni, L, Zilli, M, Italian Association for the Study of the Pancreas, Frulloni L, Falconi M, Gabbrielli A, Gaia E, Graziani R, Pezzilli R, Uomo G, Andriulli A, Balzano G, Benini L, Calculli L, Campra D, Capurso G, Cavestro GM, De Angelis C, Ghezzo L, Manfredi R, Malesci A, Mariani A, Mutignani M, Ventrucci M, Zamboni G, Amodio A, Vantini I, Italian Association for the Study of the Pancreas (AISP), Bassi C, Delle Fave G, Capurso IV, Magarini F, Albarello L, Alfieri S, Anti M, Arcidiacono P, Baiocchi L, Berretti D, Boraschi P, Buscarini E, Carroccio A, Celebrano MR, Casadei R, Chilovi F, Conigliaro R, Dall'Oglio L, De Boni M, De Pretis G, Di Priolo S, Di Sebastiano PL, Doglietto GB, Filauro M, Frieri G, Fuini A, Loriga P, Macarri G, Manes G, Massucco P, Milani S, Pasquali C, Pederzoli P, Pietrangeli M, Rocca R, Russello D, Siquini W, Traina M, Veneroni L, Zilli M, Zamboni G., Frulloni, L, Falconi, M, Gabbrielli, A, Gaia, E, Graziani, R, Pezzilli, R, Uomo, G, Andriulli, A, Balzano, G, Benini, L, Calculli, L, Campra, D, Capurso, G, Cavestro, Gm, De Angelis, C, Ghezzo, L, Manfredi, R, Malesci, A, Mariani, A, Mutignani, M, Ventrucci, M, Zamboni, G, Amodio, A, Vantini, I, Italian Association for the Study of the Pancreas, (AISP), Bassi, C, Delle Fave, G, Capurso, Iv, Magarini, F, Albarello, L, Alfieri, S, Anti, M, Arcidiacono, P, Baiocchi, L, Berretti, D, Boraschi, P, Carroccio, A, Celebrano, Mr, Casadei, R, Chilovi, F, Conigliaro, R, Dall'Oglio, L, De Boni, M, De Pretis, G, Di Priolo, S, Di Sebastiano, Pl, Doglietto, Gb, Filauro, M, Frieri, G, Fuini, A, Macarri, G, Manes, G, Massucco, P, Milani, S, Pasquali, C, Pederzoli, P, Pietrangeli, M, Rocca, R, Russello, D, Siquini, W, Traina, M, Veneroni, L, Zilli, M, and Zamboni, G.

Subjects
medicine.medical_specialty, complications, pancreatic supplements, diagnostic imaging, pancreatitis, MEDLINE, cholangiopancreatography, chronic, endoscopic retrograde, pain, quality of life, radiography, sphincterotomy, steatorrhea, surgery, therapy, ultrasonography, Appropriate use, guidelines, chronica pancreatitis, Pancreatitis, Chronic, Pancreatitis, chronic, Complications, Surgery, Medical imaging, Medicine, Humans, Pancreatic stones, Intensive care medicine, Surgical treatment, Hepatology, medicine.diagnostic_test, business.industry, Pancreatitis, Radiography, Therapy, Ultrasonography, Cholangiopancreatography, Sphincterotomy, Diagnostic imaging, Pain, Quality of life, Steatorrhea, Pancreatic supplements, Gastroenterology, medicine.disease, Endoscopy, Pancreatic pain, Italy, CHRONIC PANCREATITIS, Radiology, business
Abstract

This paper gives practical guidelines for diagnosis and treatment of chronic pancreatitis. Statements have been elaborated by working teams of experts, by searching for and analysing the literature, and submitted to a consensus process by using a Delphi modified procedure. The statements report recommendations on clinical and nutritional approach, assessment of pancreatic function, treatment of exocrine pancreatic failure and of secondary diabetes, treatment of pain and prevention of painful relapses. Moreover, the role of endoscopy in approaching pancreatic pain, pancreatic stones, duct narrowing and dilation, and complications was considered. Recommendations for most appropriate use of various imaging techniques and of ultrasound endoscopy are reported. Finally, a group of recommendations are addressed to the surgical treatment, with definition of right indications, timing, most appropriate procedures and techniques in different clinical conditions and targets, and clinical and functional outcomes following surgery. © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. Keywords: Pancreatitis, chronic; Complications; Surgery; Radiography; Therapy; Ultrasonography; Cholangiopancreatography

Published
2010

3. Low risk of colon cancer in patients with celiac disease

Author

Volta, Umberto, Vincentini, Olimpia, Quintarelli, Federica, Felli, Cristina, Silano, Marco, Gasbarrini, G, De Vitis, V, Santini, D, Scaggiante, F, Castellano, E, Grosso, S, Campanella, J, Corazza, GR, Sandri, G, Giorgetti, G, Caio, G, Lo Perfido, S, Perri F, Festa V, Pelli MA, Cavalletti ML, Segato S, Curzio M, Pennazio M, Rossini FP, Picarelli A, Pera A, Ercole E, Passaleva MT, Barbato M, Usai P, Dore MF, Chilovi F, Piazzi L, Zancanella L, Boarino V, Ferrari A., GRECO, LUIGI, AURICCHIO, SALVATORE, Volta, Umberto, Vincentini, Olimpia, Quintarelli, Federica, Felli, Cristina, Silano, Marco, Gasbarrini, G, De Vitis, V, Greco, Luigi, Auricchio, Salvatore, Santini, D, Scaggiante, F, Castellano, E, Grosso, S, Campanella, J, Corazza, Gr, Sandri, G, Giorgetti, G, Caio, G, Lo, Perfido, S, Perri, F, Festa, V, Pelli, Ma, Cavalletti, Ml, Segato, S, Curzio, M, Pennazio, M, Rossini, Fp, Picarelli, A, Pera, A, Ercole, E, Passaleva, Mt, Barbato, M, Usai, P, Dore, Mf, Chilovi, F, Piazzi, L, Zancanella, L, Boarino, V, Ferrari, A., Volta U, Vincentini O, Quintarelli F, Felli C, Silano M, and Collaborating Centres of the Italian Registry of the Complications of Celiac Disease

Subjects
Male, Colorectal cancer, COLON CANCER, Disease, Gastroenterology, Colon carcinoma, Retrospective Studie, Medicine, Child, Colonic Neoplasm, education.field_of_study, Medicine (all), Incidence, Celiac disease, Gluten-free diet, Adolescent, Adult, Carcinoma, Celiac Disease, Child, Preschool, Colonic Neoplasms, Diet, Gluten-Free, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Italy, Middle Aged, Patient Compliance, Retrospective Studies, Risk Assessment, Young Adult, Population study, Human, Cohort study, medicine.medical_specialty, Population, Follow-Up Studie, NO, Internal medicine, In patient, Preschool, education, business.industry, Newborn, medicine.disease, digestive system diseases, Diet, Standardized mortality ratio, Gluten-Free, Celiac disease, colon carcinoma, gluten-free diet, business
Abstract

Objective. Celiac disease (CD) has strongly been established as associated with some site-specific gastrointestinal malignancies. On the contrary, according to the few reports available, the risk of colon carcinoma in CD patients has been described similar to that of general population. In this cohort study, we describe the risk of colon carcinoma in a group of Italian celiac patients. Materials and methods. The study population included all CD patients diagnosed at the Collaborating Centers of the Italian Registry of CD between 1st January 1982 and 31st December 2006. Upon diagnosis of CD and upon at every subsequent clinical control, the Collaborating Centers filled in a validated form for each CD patient reporting information about demographic data, possible occurrence of a neoplasm and adherence to a gluten-free diet. Results. Out of 1757 celiac patients enrolled, 6 developed a colon carcinoma during the follow-up period (mean: 18.1 years). The standardized incidence ratio (SIR) resulted 0.29 (95% CI = 0.07–0.45). Stratifying the risk for the dietary gluten intake, the SIR dropped to 0.07 (95% CI = 0.009–0.27) for CD patients with a strict adherence to a gluten-free diet. Conclusion. We confirm the previous finding that there is low risk to develop a colon cancer in celiac patients.

Published
2014

4. Effect of a gluten-free diet on the risk of enteropathy-associated T-cell lymphoma in celiac disease

Author

Silano, Marco, Volta, Umberto, Vincenzi, Alessandro De, Dessì, Mariarita, Vincenzi, Massimo De, Gasbarrini, G., De Vitis, V., Santini, D., F. , Scaggiante M., Vincenzi, M., Federici, Null, Castellano, E., Calvi, A., Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Volta, U., Parisi, C., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., Ferrari, A., GRECO, LUIGI, AURICCHIO, SALVATORE, Silano, Marco, Volta, Umberto, Vincenzi, Alessandro De, Dessì, Mariarita, Vincenzi, Massimo De, Gasbarrini, G., De Vitis, V., Greco, Luigi, Auricchio, Salvatore, Santini, D., F., Scaggiante M., Vincenzi, M., Federici, Null, Castellano, E., Calvi, A., Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Volta, U., Parisi, C., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., and Ferrari, A.

Subjects
Male, Time Factors, Lymphoma, Physiology, Gastroenterology, Coeliac disease, Celiac disease, Enteropathy-associated T-cell lymphoma, Gluten-free diet, Child, chemistry.chemical_classification, Settore BIO/12, Middle Aged, Child, Preschool, Gluten-free diet, Enteropathy-associated T-cell lymphoma, Female, Human, Adult, medicine.medical_specialty, Intestinal Neoplasm, Glutens, Adolescent, Time Factor, Diet therapy, Malignancy, Lymphoma, T-Cell, Follow-Up Studie, Celiac disease, Celiac Disease, Follow-Up Studies, Humans, Infant, Intestinal Neoplasms, Patient Compliance, Stomach Neoplasms, Stomach Neoplasm, Internal medicine, medicine, Risk factor, Preschool, business.industry, nutritional and metabolic diseases, medicine.disease, T-Cell, Gluten, digestive system diseases, chemistry, Gluten free, business
Abstract

Patients with celiac disease have an increased rate of enteropathy-associated T-cell lymphoma, but conflicting data are available about the protective role of a gluten-free diet with regard to the development of this malignancy. We followed 1,757 celiac patients for a total period of 31,801 person-years, collecting data about the frequency of gluten intake and the incidence of the enteropathy-associated T-cell lymphoma. Out of the nine celiac patients who developed an intestinal lymphoma [standard morbidity ratio of 6.42 (95% CI = 2.9-12.2; P < 0.001)], only two kept a strict gluten-free diet after the diagnosis of celiac disease and developed the malignancy after the peridiagnosis period of 3 years, dropping therefore the standard morbidity ratio to 0.22 (95%CI = 0.02-0.88; P < 0.001). The risk of developing an intestinal lymphoma for the celiac patients that used to have dietary gluten was significant (X(2 )= 4.8 P = 0.01). These results show that a strict gluten-free diet is protective towards the development of enteropathy-associated T-cell lymphoma.

Published
2008

5. Delayed diagnosis of coeliac disease increases cancer risk

Author

Silano, Marco, Volta, Umberto, Mecchia, Anna, Dessì, Mariarita, Di Benedetto, Rita, De Vincenzi, Massimo, Gasbarrini, G., De Vitis, D., Greco, L., Auricchio, S., Santini, D., Scaggiante, F., Federici, M. D., Castellano, E., Sategna-Guidetti, Null, Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Amici, Monica, De Franceschi, L., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., Ferrari, A., Silano, Marco, Volta, Umberto, Mecchia, Anna, Dessì, Mariarita, Di Benedetto, Rita, De Vincenzi, Massimo, Gasbarrini, G., De Vitis, D., Greco, Luigi, Auricchio, Salvatore, Santini, D., Scaggiante, F., Federici, M. D., Castellano, E., Sategna Guidetti, Null, Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Amici, Monica, De Franceschi, L., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., and Ferrari, A.

Subjects
Registrie, tumors, Adult, Male, Risk, medicine.medical_specialty, Time Factors, Time Factor, Delayed diagnosis, Gastroenterology, Coeliac disease, Internal medicine, Neoplasms, medicine, Neoplasm, Humans, Age Factor, In patient, Registries, lcsh:RC799-869, Coeliac disease, neoplasm, tumors, Age Factors, Celiac Disease, Female, Middle Aged, business.industry, Medicine (all), Settore BIO/12, Cancer, General Medicine, Hepatology, medicine.disease, Population study, lcsh:Diseases of the digestive system. Gastroenterology, Cancer risk, business, neoplasm, Human, Research Article
Abstract

Background The association between coeliac disease (CD) and neoplasms has been long established, but few data are available about the risk factors. The aim of this paper is to estimate the risk of developing a neoplasm among non diagnosed coeliac patients and to evaluate if this risk correlates with the age of patients at diagnosis of coeliac disease. Methods The study population consists of patients (n = 1968) diagnosed with CD at 20 Italian gastroenterology referral Centers between 1st January 1982 and 31st March 2005. Results The SIR for all cancers resulted to be 1.3; 95% CI = 1.0–1.7 p < 0.001. The specific SIRs for non Hodgkin lymphoma was 4.7; 95% CI = 2.9–7.3 p < 0.001, for the small bowel carcinoma 25; 95% CI = 8.5–51.4 p < 0.001, for non Hodgkin lymphoma 10; 95% CI = 2.7–25 p = 0.01, finally for the stomach carcinoma 3; 95% CI = 1.3–4.9 p < 0.08. The mean age at diagnosis of CD of patients that developed sooner or later a neoplasm was 47,6 ± 10.2 years versus 28.6 ± 18.2 years of patients who did not. Conclusion Coeliac patients have an increased risk of developing cancer in relation to the age of diagnosis of CD. This risk results higher for malignancies of the gastro-intestinal sites. An accurate screening for tumors should be performed in patients diagnosed with CD in adulthood and in advancing age.

Published
2007

6. Bovine lactoferrin for Helicobacter pylori eradication: an open, randomized, multicentre study

Author

DI MARIO, Francesco, Aragona, G, DAL BO, N, Cavallaro, L, Marcon, V, Olivieri, P, Benedetti, E, Orzes, N, Marin, R, Tafner, G, Chilovi, F, DE BASTIANI, R, Fedrizzi, F, Franceschi, M, Salvat, Mh, Monica, F, Piazzi, L, Valiante, F, Vecchiati, U, Cavestro, Gm, Comparato, G, Iori, V, Maino, M, Leandro, G, Pilotto, A, Rugge, Massimo, Franze, A, GASTROINTESTINAL STUDY UNIT GISU, Di Mario, F, Aragona, G, Dal Bó, N, Cavallaro, L, Marcon, V, Olivieri, P, Benedetti, E, Orzès, N, Marin, R, Tafner, G, Chilovi, F, De Bastiani, R, Fedrizzi, F, Franceschi, M, Salvat, Mh, Monica, F, Piazzi, L, Valiante, F, Vecchiati, U, Cavestro, GIULIA MARTINA, Comparato, G, Iori, V, Maino, M, Leandro, G, Pilotto, A, Rugge, M, Franzè, A, and Gastrointestinal Study, Unit

Subjects
Adult, Male, medicine.medical_specialty, Group A, Gastroenterology, Group B, Drug Administration Schedule, Tinidazole, Esomeprazole, Helicobacter Infections, Clarithromycin, Internal medicine, medicine, Animals, Humans, Pharmacology (medical), Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, Chi-Square Distribution, Hepatology, biology, Helicobacter pylori, business.industry, Lactoferrin, Middle Aged, biology.organism_classification, Surgery, Anti-Bacterial Agents, Treatment Outcome, biology.protein, Cattle, Drug Therapy, Combination, Female, business, medicine.drug
Abstract

Summary Background Cure rates for eradication of Helicobacter pylori appear to be decreasing, thus more effective therapies must be identified. Aim To evaluate the efficacy of bovine lactoferrin in the treatment of H. pylori infection. Methods In a multicentred prospective study, 402 (mean age 52.4, range 19–84 years) H. pylori-positive patients were assigned to one of three regimens: group A – esomeprazole 20 mg b.d., clarithromycin 500 mg b.d. and tinidazole 500 mg b.d. for 7 days; group B – lactoferrin 200 mg b.d. for 7 days followed by the same schedule of group A; group C – esomeprazole 20 mg b.d., clarithromycin 500 mg b.d. and tinidazole 500 mg b.d. plus lactoferrin 200 mg b.d. for 7 days. Results Of the 402 patients, 389 completed the study. Six patients were discontinued due to side effects, one patient in group B died and six patients were lost to follow up. The eradication rate (intention-to-treat analysis) was 77% in group A (105/136), 73% in group B (97/132) and 90% in group C (120/134) (χ2-test P

Published
2006

7. Clinical features of chronic C virus hepatitis in patients with celiac disease

Author

Silano, M., Volta, U., Vincentini, O., De Vincenzi, M., Gasbarrini Italian Registry Of The Complications Of Celiac Disease, (., De Vitis, V., Greco, L., Auricchio, S., Santini, D., Scaggiante, F., Vincenzi, M., Federici, Castellano, E., Calvi, A., Sategna, Guidetti, Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Amici, M., Parisi, C., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, Antonio, Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., and Ferrari, A.

Subjects
Microbiology (medical), Adult, Male, medicine.medical_specialty, Hepatitis C virus, Population, Autoimmune hepatitis, medicine.disease_cause, Gastroenterology, Antiviral Agents, Coeliac disease, Primary sclerosing cholangitis, Primary biliary cirrhosis, Internal medicine, medicine, Prevalence, Humans, education, Hepatitis, education.field_of_study, Anemia, Iron-Deficiency, business.industry, Depression, General Medicine, Hepatitis C, Hepatitis C, Chronic, medicine.disease, Arthralgia, digestive system diseases, Celiac Disease, Infectious Diseases, Diabetes Mellitus, Type 2, Immunology, Female, business
Abstract

The association between celiac disease (CD) and several liver disorders has long been documented. About 40% of adult celiac patients have been reported to have mild to moderate hypertransaminasemia (up to five times the upper limit of normal) at the time of diagnosis of CD [1, 2]. In addition, CD has been found in roughly 10% of patients with unexplained hypertransaminasemia, and the majority of them have had their liver enzyme levels normalized after one year of following a strict gluten-free diet [3, 4]. In addition, an increased prevalence of primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis among CD patients has been reported [5, 6]. CD might also be linked to very severe liver conditions such as end-stage liver failure and hepatocellular carcinoma [7]. There is also evidence, even contrasting reports, about the association of CD with nonalcoholic steatohepatitis and fatty liver disease [8]. In contrast, no definitive evidence is available about the association between chronic hepatitis C (hepatitis C virus [HCV]) and CD. Fine et al. described a three-fold increase of CD prevalence among HCV patients compared to noninfected celiac individuals [9]. It has also been reported the activation of silent CD during the antiviral treatment for HCV with interferon-α and ribavirin, both alone and in combination [10]. Consequently, a routine serological screening for CD has been proposed in HCV patients before starting antiviral therapy. In case of HCV positivity, the achievement of the histological normalization of the intestinal mucosa after following a gluten-free diet has been advised before starting the therapy [10]. On the contrary, some recent prospective studies have not shown increased prevalence of CD among HCV patients and reported that the link between these two conditions is biased by the route of transmission [11, 12]. Among the 3,725 celiac patients included in the Italian Registry of the Complication of Celiac Disease, we identified 34 individuals (0.91%) that had an HCV chronic hepatitis at the time of diagnosis of CD. For the diagnosis of HCV, we considered the serological positivity of antiHCV antibodies. Some of the patients had the diagnosis made in the early 1980s, when the molecular tests for the detection of the viral antigens were not yet available. The demographic and clinical features of the patients with both CD and HCV with respect to those of patients with CD only are listed in Table 1. The prevalence of HCV among our celiac series is lower than the overall prevalence of HCV among the general population in Italy, matched for age and gender, which is estimated to be around 2% [13]. This finding does not support the hypothesis of a potential correlation between these two disorders. It has been assumed that antiviral therapy with INF-α and ribavirin may precipitate the onset of CD in susceptible individuals, promoting a Th1-specific response in the small intestine [14]. However, in our series, only 12 of the 34 celiac patients with HCV had antiviral therapy before CD diagnosis. Looking at our series, it seems more likely that an overall increased risk of CD in HCV patients exists, due to the predisposition for autoimmune diseases related to Eur J Clin Microbiol Infect Dis (2009) 28:1267–1269 DOI 10.1007/s10096-009-0769-6

Published
2009

8. Rabeprazole is equivalent to omeprazole in the treatment of erosive gastro-oesophageal reflux disease. A randomised, double-blind, comparative study of rabeprazole and omeprazole 20 mg in acute treatment of reflux oesophagitis, followed by a maintenance open-label, low-dose therapy with rabeprazole

Author

Pace, F., Annese, V., Prada, A., Zambelli, A., Casalini, S., Nardini, P., Bianchi Porro, G., Rossi, Z., Fenderico, P., Molinari, F., Molinari, A., Poletti, M., Benedetti, A., Bolognini, L., Cercamondi, P., Piergallini, S., Pieroni, N., Ridolfi, F., Palazzi, A., Agnolucci, A., Ceccatelli, P., Laurenzi, F., Grassini, M., Iaquinto, G., D'Onofrio, V., Giardullo, N., Pasquale, L., Sedici, A., Moschetta, R., Maurogiovanni, G., Costan, F., Germana, B., Lecis, P., Negrini, F., Signorelli, S., Landi, P., Malaguti, P., Roda, E., De, E., Gandolfi, L., Torresan, F., Chilovi, F., Benvenuti, S., Grasso, T., Adamo, S., Azzurro, M., Carrara, M., Rubbiani, C., P. V., Di, Di, M., Belvedere, F., Di, A., Giglio, A., De Medici, A., Rodino, S., Sacca, N., Neri, M., Carbone, F., Laterza, F., Trimboli, V., Accattatis, G. C., Rizzuti, L. F., Sabatino, A., Lupinacci, G., Faleo, D., De Francesco, V., Lombardi, L. P, Minenna, M., Nocchiero, M. C., Tonti, P., Bocchini, R., D'Imperio, N., Giaccari, S., Tronci, S., Dall'Acqua, S., Berrini, E., Garatti, S., Putignano, R., Sferrazzo, A., Giacosa, A., Blanchi, S., Munizzi, F., Morlando, L., Bruno, G., Guardascione, F., Benedetti, E., Orzes, N., Pincione, F., Dell'Amico, I., Vannucci, P., Maurano, A., Calabrese, A., Napoli, G., Quagliariello, G., Sabarese, G., Pracanica, G., Gullotti, G., Princiotta, A., Rando, L., Anderloni, A., Pallotta, S., Fesce, E., Abbiati, D., Crippa, C., Ideo, G. M., Mannucci, P. M., Abbiati, C., De Franchis, R., Fazzini, L., Rossi, A., Bini, M., Chahin, N. J., Testoni, P. A., Fossati, D., Frego, R., Passaretti, S., Catanzano, C., Siciliano, S., Sivero, L., Cattaneo, D., Di Martino, V., Inzirillo, A., Lavelli, M., Del Genio, A., Maffettone, V., Napolitano, V., Del Piano, M., Ballare, M., Garello, E., Orsello, M., Capezzuto, E., Amuso, M., Marino, M., Reina, G., Craxi, A., Arini, A., Di Pisa, M., Peralta, S., Ficano, L., Miceli, D., Tarantello, M., Orlando, A., Perego, M., Alvisi, C., Pozzi, L., Torello Viera, F., Marchi, S., Arpe, P., Bellini, M., Costa, F., Da Massa Carrara, P., Manghetti, M., Meletis, P., Romano, A., Torelli, E., Garcea, M. R., Lombardi, M., Tristaino, B., Farroni, F., Di Cicco, M., Proietti, M., Tanzilli, A., Benedetti, G., Guido, E., Lacchin, T., Sablich, R., Vitalba, A., Casetti, T., Cantoni, F., Salzetta, A., Polimeni, F., Bortoli, A., Buono, M., Gozzini, C., Barberani, F., Boschetto, S., Giovannone, M., Casale, V., Assisi, D., Grassi, A., Lapenta, R., Stigliano, V., Fedeli, G., Pirozzi, G. A., Pippa, G., Bazuro, M. E., Romano, M., Borgheresi, P., Andriulli, A., Fiorella, S., De Rocco, R., Greco, G., Meloni, M., Fina, G., Frosini, G., Macchiarelli, R., Virgilio, C., Borina, E., Lauria, M., Cappelletti, F., Puglisi, F., Ravizza, M., Emanuelli, G., Battaglia, E., Dughera, L., Navino, M., Ferrari, A., Martinoglio, P., Turco, D., Pera, A., Daperno, M., Lombardo, L., Gusmaroli, R., Milesi, F., Zilli, M., Brosolo, P., De, G., Zoratti, L., Curzio, M., Amato, A., Bisso, G., Feliziani, M., Gianfrate, L., Natale, C., Petillo, A., Spadaccini, A., Meddi, P., Sciampa, G., and Ubalducci, G. M.

Subjects
Adult, Male, Gastrointestinal, Time Factors, Severity of Illness Index, 2-Pyridinylmethylsulfinylbenzimidazoles, Endoscopy, Gastrointestinal, Helicobacter Infections, Dose-Response Relationship, Gastro-oesophageal reflux disease, Double-Blind Method, Heartburn, Esophagitis, Humans, Esophagitis, Peptic, Curative/maintenance therapy, Peptic, Hepatology, Dose-Response Relationship, Drug, Helicobacter pylori, Rabeprazole, Antacids, Anti-Ulcer Agents, Benzimidazoles, Female, Gastroesophageal Reflux, Middle Aged, Omeprazole, Patient Satisfaction, Treatment Outcome, Gastroenterology, Endoscopy, Drug
Abstract

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.

Published
2005

9. Clinical Trial on the Efficacy of a New Symbiotic Formulation, Flortec, in Patients With Irritable Bowel Syndrome

Author

Nicoletta Garbagna, Angelo Andriulli, Sergio Cavenati, Maria Pia Cardarella, Renata Cerutti, Matteo Neri, Natalia Terreni, Sergio Gullini, Michela De Bona, Gian Luigi Milandri, Alessandro Federico, Antonio Merla, Roberto Abbiati, Carmelina Loguercio, Fausto Chilovi, Enzo Grossi, Andriulli, A, Neri, M, Loguercio, Carmelina, Terreni, N, Merla, A, Cardarella, M. P., Federico, Alessandro, Chilovi, F, Milandri, G. L., DE BONA, M, Cavenati, S, Gullini, S, Abbiati, R, Garbagna, N, Cerutti, R, and Grossi, E.

Subjects
Adult, Male, medicine.medical_specialty, Diet therapy, Glutamine, Population, Oligosaccharides, Placebo, Gastroenterology, law.invention, Irritable Bowel Syndrome, Double-Blind Method, Randomized controlled trial, law, Internal medicine, medicine, Humans, education, Irritable bowel syndrome, education.field_of_study, business.industry, Probiotics, Drug Synergism, Middle Aged, medicine.disease, Clinical trial, Lactobacillus, Diarrhea, Treatment Outcome, Defecation, Female, medicine.symptom, business
Abstract

Objectives: Efficacy of symbiotics in patients with irritable bowel syndrome (IBS) remains unknown. Methods: Patients were randomized to a prebiotic (n = 135), or a symbiotic formulation containing Lactobacillus paracasei B21060 (Flortec, n = 132). Primary efficacy was the responder rate for pain and global relief of symptoms in the overall population and in patients with predominant diarrhea (n = 47). Post hoc time-trend analyses for changes within each treatment were carried out. Results: Patients with absent/mild pain amounted to 54.7% in the symbiotic group and to 57.4% in the prebiotic group at treatment week 4, and to 53.9% and 53.4% at the end of treatment. Patients with amelioration of well-being were, respectively, 60.7% versus 61.7% at treatment week 4, and 63.3% versus 60.9% at the end of treatment. Within each treatment group, patients with absent/mild pain increased in the Flortec and the prebiotic group, but time trend analyses were significant only for Flortec (P = 0.019). In IBS-predominant diarrhea, Flortec significantly reduced bowel movements, pain, and IBS scores. Conclusions: To improve pain and well-being, Flortec is encouraging in patients with diarrhea predominant IBS. To establish its efficacy for the majority of IBS patients, Flortec has to be compared with an inert placebo in future work.

Published
2008

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