Minerva gastroenterologica e dietologica最新文献

{"title":"Endoscopic retrograde cholangiopancreatography related perforations: there is a plenty to discover?","authors":"T. Khoury, A. Mari, W. Sbeit","doi":"10.23736/S1121-421X.20.02736-1","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02736-1","url":null,"abstract":"","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76657326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Irritable Bowel Syndrome and lactose intolerance: the importance of differential diagnosis. A monocentric study.","authors":"R. Catanzaro, Morena Sciuto, Birbal Singh, S. Pathak, F. Marotta","doi":"10.23736/S1121-421X.20.02734-8","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02734-8","url":null,"abstract":"BACKGROUND\u0000Nowadays Irritable Bowel Syndrome (IBS) and Lactose Intolerance (LI) are two very frequent diseases. IBS is a functional disorder, while LI is caused by the inability to digest lactose. LI is often incorrectly diagnosed as IBS. The aim of our study is to identify LI patients among IBS patients, so as to set up a correct therapy.\u0000\u0000\u0000METHODS\u0000We enrolled 259 patients with IBS and we compared them to a control group of 108 patients. All patients underwent H2 Breath-Test (HBT) and two questionnaires regarding the symptoms associated with IBS and LI were administered to the intolerant subjects and one questionnaire to IBS patients with no LI.\u0000\u0000\u0000RESULTS\u0000At the HBT, 79.9% (n = 207) of patients with IBS were positive, while in the control group were positive 25.0% (n = 27) of subjects (p < 0.001). The questionnaires showed, after a month of therapy, a marked improvement in LI symptoms subjects. In addition, there was also a prevalence of more severe symptoms among subjects with IBS and LI than those with IBS and no LI.\u0000\u0000\u0000CONCLUSIONS\u0000We can affirm that most patients with initial diagnosis of IBS are, instead, lactose intolerant. This diagnosis allows us to undertake an adequate therapy so as to improve symptoms and quality of life. Therefore it is important to include LI in the pathologies with which IBS enters into differential diagnosis.","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82128203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rheumatic manifestations in inflammatory bowel disease.","authors":"A. Finucci, M. C. Ditto, S. Parisi, R. Borrelli, M. Priora, C. Realmuto, E. Fusaro","doi":"10.23736/S1121-421X.20.02726-9","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02726-9","url":null,"abstract":"Rheumatic manifestations are the most frequent extra-intestinal manifestations (EIMs) in Inflammatory Bowel Disease (IBD) patients, and they are responsible for a relevant reduction of quality of life. IBD is associated with a variety of musculoskeletal manifestations such as arthritis and non-inflammatory pain as well as with metabolic diseases, such as osteoporosis. Different imaging techniques (primarily ultrasound, magnetic resonance imaging and X-rays) can help the clinician to correctly identify the nature of manifestations and to treat the patient accordingly. Nowadays, in the setting of IBD-related arthritides, different drugs are available and can be effective on both articular and intestinal involvement. Therefore, a multi-disciplinary approach provides an early diagnosis and a better clinical outcome that can only be given from the recognition and consideration of the different EIMs. As for rheumatic manifestations, namely IBDrelated arthritis, an early intervention allows to control disease activity and to prevent structural damage.","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82362718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibromax and inflamatory markers cannot replace liver biopsy in the evaluation of non-alcoholic fatty liver disease.","authors":"Leonardo L Lardi, R. M. Lul, G. Z. Port, G. Coral, A. Peres, G. Dorneles, Fernanda Branco, S. Fernandes, C. Leães, A. Mattos, C. Buss, C. Tovo","doi":"10.23736/S1121-421X.20.02746-4","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02746-4","url":null,"abstract":"BACKGROUND\u0000To evaluate the performance of a non-invasive test (Fibromax™) and inflamatory markers (IL-1 beta, IL-6, IL-8, TNF-alpha, MCP-1) in the diagnosis and staging of patients with non-alcoholic fatty liver disease.\u0000\u0000\u0000METHODS\u0000Patients older than 18 years with steatosis were prospectively evaluated at a tertiary hospital in southern Brazil. Liver biopsy, Fibromax™ test and inflamatory markers (IL 1 beta, IL-6, IL-8, TNF-alpha, MCP-1) were performed. Measures of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy were used, considering liver biopsy as the gold standard.\u0000\u0000\u0000RESULTS\u0000Seventy three Fibromax™ tests were analyzed. Steatotest presented a sensitivity of 95.5% and PPV of 97.0% for the diagnosis of steatosis. Nashtest obtained a sensitivity of 83.3%, specificity of 37.5%, PPV of 90.9% and NPV of 23.1% for the diagnosis of non-alcoholic steatohepatitis (NASH). Fibrotest presented a sensitivity of 38.9%, specificity of 92.7%, PPV of 63.6% and NPV of 82.3% to evaluate advanced fibrosis. In the evaluation of patients with grade 2 and 3 steatosis, ROC analyses showed an area under the curve (AUROC) for Steatotest of 0.68 (p=0.015). Nashtest AUROC was 0.59 (p=0.417) for the evaluation of NASH. Fibrotest AUROC was 0.79 (p<0.001) for advanced fibrosis. Kappa coefficient values for Steatotest, Nashtest and Fibrotest were not statistically significant. Thirty seven patients performed also analysis of the inflamatory markers, showing that patients with inflammatory activity grade 2-3 on liver biopsy had significantly higher levels of IL6 (p=0.016) and lower TNF-alpha (p=0,034), but there was no other difference when analysed fibrosis or steatosis.\u0000\u0000\u0000CONCLUSIONS\u0000The Fibromax™ test and the inflamatory markers (IL 1 beta, IL-6, IL-8, TNF-alpha, MCP-1) did not present a satisfactory performance to be considered a good alternative to replace liver biopsy in the evaluation of NAFLD.","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76353805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Groove pancreatitis: a case report with a brief review of this diagnostic challenge.","authors":"G. Valentini, M. Surace, S. Grosso, A. Vernetto, A. Serra, I. Andria, D. Mazzucco","doi":"10.23736/S1121-421X.20.02721-X","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02721-X","url":null,"abstract":"Groove Pancreatitis is an uncommon and still under-recognized form of recurrent or chronic pancreatitis that involves the space between the pancreatic head, the duodenum and the common bile duct, the so called groove area. Its importance is that it can mimic pancreatic carcinoma, it may coexist with it or even masks it and should be considered in the differential diagnosis of pancreatic masses or duodenal stenosis. Groove Pancreatitis represents a diagnostic challenge because, from a clinical point of view, its manifestations and complications can be numerous and different from each other. Despite modern imaging techniques, even in the most specialized centers, many untrained radiologists and gastroenterologists may encounter difficulty to make the proper diagnosis. In this work, we have described a case Groove Pancreatitis manifesting as flare up of previously diagnosed chronic pancreatitis and we have tried to make a brief revision of literature concerning diagnosis and treatment of the disease.","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"429 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83054948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatients bowel preparation: with team work we can win.","authors":"G. Iabichino, L. Eusebi, M. Palamara, C. Luigiano","doi":"10.23736/S1121-421X.20.02725-7","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02725-7","url":null,"abstract":"","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"210 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78387512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intestinal perforations after endoscopic retrograde cholangiopancreatography in the United States: a 16-year study using the national inpatient sample.","authors":"B. Olaiya, D. Adler","doi":"10.23736/S1121-421X.20.02718-X","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02718-X","url":null,"abstract":"BACKGROUND\u0000Intestinal perforation is a rare but feared complication of ERCP. In this study, we identify patient and hospital factors for ERCP related intestinal perforation using a large national database. We also examine the effects of intestinal perforations on hospital outcomes.\u0000\u0000\u0000METHODS\u0000Data were obtained from the National Inpatient Sample, the largest publicly available inpatient care database in the United States. ICD-9-CM procedure codes for all ERCP procedures conducted between 1998 and 2013. Our primary outcome of interest was the incidence of intestinal perforations after ERCP. Secondary outcomes of interest included hospital length of stay and inpatient mortality.\u0000\u0000\u0000RESULTS\u0000A total of 392,336 ERCP procedures were performed over the study period, met our inclusion criteria, and were analyzed. Mean age of sample was 59 years and just over 60% were females. Low volume hospitals accounted for over 85% of ERCPs. Intestinal perforations occurred at a rate of 1.2 per 1000 ERCP procedures. Patient's age was the only patient-related factor significantly associated with perforation. (OR: 1.016; 95% CI 1.009 - 1.025). For hospitals, teaching status was the only hospital related factor associated with intestinal perforation after ERCP (OR: 1.56; 95% CI 1.28 -1.91). Length of stay was much longer in patients with ERCP related perforations and mortality risk was ten times higher in the same cohort.\u0000\u0000\u0000CONCLUSIONS\u0000Patients who have ERCP related perforations have longer hospital stays and have a higher mortality risk. Older patients and those who had ERCP in teaching hospitals are at a higher risk of perforation.","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78881014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Irritable bowel syndrome: diagnosis and management.","authors":"Imke Masuy,&nbsp;Jasper Pannemans,&nbsp;Jan Tack","doi":"10.23736/S1121-421X.19.02640-0","DOIUrl":"https://doi.org/10.23736/S1121-421X.19.02640-0","url":null,"abstract":"<p><p>Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders (FGIDs) encountered in clinical practice. In the absence of an accurate biomarker for the disorder, IBS is mainly diagnosed based symptomology using the Rome criteria. Due to the heterogeneity of the disorder, finding the correct treatment option is often challenging. In general, lifestyle and dietary changes, including the low-FODMAP of gluten-free diet, are the first-in-line treatment for all patients. Issues with dietary changes are the strict elimination of multiple food products and hence difficult compliance to the diet. When lifestyle changes do not lead to adequate symptom relief, patients should be treated according to their predominant bowel habits and most prominent symptoms. Laxatives or prokinetics and antidiarrheals are used to treat constipation and diarrhea respectively, but have little effect on abdominal pain. To treat gastro-intestinal (GI) symptoms, antispasmodics can be attributed. Low doses of neuromodulators can help gain control over GI and central symptoms, but are also prone to more severe side effects, restricting their widespread use. Refractory IBS symptoms can be treated with probiotics, antibiotics, histamine-receptor antagonists or alternative therapy, including psychotherapy, hypnotherapy, acupuncture or phytomedicines. However, for many of these options, scientific evidence is sparse and high-quality research is often lacking, leading to inconclusive results. In general, all of the available treatment options only provide symptom relief for a subset of patients. This review provides a full overview of the diagnostic process and currently available treatment options for IBS.</p>","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"66 2","pages":"136-150"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37443359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Another case of spontaneous gastric decompression and resolution of infected walled-off pancreatic necrosis: is it time to change approach?","authors":"Giovanni Valentini,&nbsp;Monica Surace,&nbsp;Dario Mazzucco","doi":"10.23736/S1121-421X.20.02663-X","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02663-X","url":null,"abstract":"","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"66 2","pages":"178-179"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37777668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of risk of fracture in inflammatory bowel diseases: a prospective study using FRAX score.","authors":"Davide G Ribaldone,&nbsp;Massimo Procopio,&nbsp;Rinaldo Pellicano,&nbsp;Marco Barale,&nbsp;Gabriele Giudici,&nbsp;Mario Morino,&nbsp;Giorgio M Saracco,&nbsp;Marco Astegiano","doi":"10.23736/S1121-421X.20.02672-0","DOIUrl":"https://doi.org/10.23736/S1121-421X.20.02672-0","url":null,"abstract":"<p><strong>Background: </strong>Despite the well-known risk of osteoporosis and bone fractures among patients with inflammatory bowel diseases, the WHO FRAX tool has been used in a limited number of studies in this specific population. The purpose of this study was to search for predictors of risk of fractures assessed by FRAX score.</p><p><strong>Methods: </strong>We prospectively calculated FRAX score for hip and major osteoporotic fractures in inflammatory bowel disease patients consecutively recruited.</p><p><strong>Results: </strong>The mean risk of hip fractures at 10 years, for the 80 recruited patients, resulted 1.4%, while the mean risk of major osteoporotic fractures was 7.8%. The risk of hip fractures was 1.3% among the 30 Crohn's disease patients versus 1.4% (P=0.82) among 50 ulcerative colitis patients. A prolonged use of corticosteroids correlated with a tendency to a greater risk of hip fracture (r=0.38, P=0.08). Patients with normal erythrocyte sedimentation rate (ESR) values had a risk of osteoporotic hip fractures of 0.75%, while those with high ESR values had a risk of 1.86% (P=0.04). Regarding the risk of major bone fractures, patients with normal ESR values had a risk of 5.9%, versus a risk of 18% in those with elevated ESR (P=0.03).</p><p><strong>Conclusions: </strong>The correlation between increase of inflammatory markers and increased risk of osteoporotic fractures and the lack of difference between Crohn's disease and ulcerative colitis suggest a central role of inflammation over malabsorption in this population.</p>","PeriodicalId":74201,"journal":{"name":"Minerva gastroenterologica e dietologica","volume":"66 2","pages":"106-112"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37777671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}