5,542 research outputs found
Assessing the severity of atrophic gastritis
No full textAtrophic gastritis, mainly the consequence of long-standing Helicobacter pylori infection, is linked to the development of gastric cancer. In the case of atrophic gastritis, severity may be mainly related to the lifetime risk of the single patient to develop gastric cancer, mostly in relation to the degree and extension of mucosal damage. As atrophic gastritis is the result of complex multifactorial interactions, the application of artificial neural networks is promising and may be useful for the identification of those patients with atrophic gastritis at higher risk for gastric malignancies. The experience of application of artificial neural networks in atrophic gastritis is still scarce. The available data suggest that these systems may contribute to identify patients with corporal metaplastic atrophic gastritis and to optimize bioptic sampling during gastroscopy. © 2007 Lippincott Williams & Wilkins, Inc
Mesalamine (5-ASA) for the Prevention of Recurrent Diverticulitis (Review)
No full textBackground Mesalamine, or 5-aminosalicylic acid (5-ASA) has been studied for the prevention of recurrent diverticulitis. Objectives To evaluate the efficacy of mesalamine (5-ASA) for the prevention of recurrent diverticulitis. Search methods We searched databases from 2010 to September 2017. In addition, we scanned reference lists from eligible publications, and we contacted corresponding authors to ask about additional trials. Selection criteria We included randomized controlled clinical trials comparing the efficacy of 5-ASA versus placebo or another active drug for the prevention of recurrent diverticulitis. Main results We included in this review seven studies with a total of 1805 participants. We judged all seven studies to have unclear or high risk of bias. Investigators found no evidence of an effect when comparing 5-ASA versus control for the prevention of recurrent diverticulitis (31.3% vs 29.8%; RR 0.69, 95% confidence interval (CI) 0.43–1.09); very low quality of evidence). Five of the seven studies provided data on adverse events of 5-ASA therapy. The most commonly reported side effects were gastrointestinal symptoms (epigastric pain, nausea, and diarrhea). No significant difference was seen between 5-ASA and control (67.8% vs 64.6%; RR 0.98, 95% CI 0.91–1.06; P = 0.63; moderate quality of evidence), nor was significant heterogeneity observed (I2 = 0%; P = 0.50). Authors’ conclusion The effects of 5-ASA on recurrence of diverticulitis are uncertain owing to the small number of heterogenous trials included in this review. Rates of recurrent diverticulitis were similar among participants using
5-ASA and control participants. Effective medical strategies for the prevention of recurrent diverticulitis are needed, and further randomized, double-blinded, placebo-controlled trials of rigorous design are warranted to specify the effects of 5-ASA (mesalamine) in the management of diverticulitis
[Chemotherapy and NSAIDs in neoplastic disease. Role of anti-secretory preventive therapy].
No full textThe patients treated by chemotherapy should be considered at high-risk for developing serious lesions of upper gastrointestinal tract. Several factors should be considered during the initial management of these patients, such as the presence and the staging of the malignancy, the cytotoxic effects of the antiblastic drugs, the co-administration of NSAIDs and corticosteroids, and the possible co-existence of Helicobacter pylori infection, hiatal hernia, and gastro-esophageal reflux. In order to prevent gastro-duodenal damage, the optimal approach first has to include an accurate clinical and pharmacological evaluation. The upper gastrointestinal endoscopy should also be performed in neoplastic patients undergoing chemotherapy before starting treatment. Proton pump inhibitors can play a major role in these patients to prevent gastro-duodenal damages, and to relieve dyspeptic symptoms
Letter: gastric cancer and pernicious anaemia--often Helicobacter pylori in disguise--authors' reply.
No full textProbiotics and Diverticular Disease. Evidence-based?
No full textDiverticular disease (DD) is a common gastrointestinal condition. Clinical spectrum ranges from asymptomatic diverticulosis to symptomatic uncomplicated or complicated DD. Symptoms related to uncomplicated DD are not specific and may be indistinguishable from those of irritable bowel syndrome. Low-grade inflammation, altered intestinal microbiota, visceral hypersensitivity, and abnormal colonic motility have been identified as factors potentially contributing to symptoms. Probiotics may modify the gut microbial balance leading to health benefits. Probiotics, due to their anti-inflammatory effects and ability to maintain an adequate bacterial colonization in the colon, are promising treatment options for DD. This review focuses on the available evidence on the efficacy of prebiotics in uncomplicated DD
Pernicious anemia: New insights from a gastroenterological point of view
No full textPernicious anemia (PA) is a macrocytic anemia that is caused by vitamin B12 deficiency, as a result of intrinsic factor deficiency. PA is associated with atrophic body gastritis (ABG), whose diagnosis is based on histological confirmation of gastric body atrophy. Serological markers that suggest oxyntic mucosa damage are increased fasting gastrin and decreased pepsinogen I. Without performing Schilling's test, intrinsic factor deficiency may not be proven, and intrinsic factor and parietal cell antibodies are useful surrogate markers of PA, with 73% sensitivity and 100% specificity. PA is mainly considered a disease of the elderly, but younger patients represent about 15% of patients. PA patients may seek medical advice due to symptoms related to anemia, such as weakness and asthenia. Less commonly, the disease is suspected to be caused by dyspepsia. PA is frequently associated with autoimmune thyroid disease (40%) and other autoimmune disorders, such as diabetes mellitus (10%), as part of the autoimmune polyendocrine syndrome. PA is the end-stage of ABG. Longstanding Helicobacter pylori infection probably plays a role in many patients with PA, in whom the active infectious process has been gradually replaced by an autoimmune disease that terminates in a burned-out infection and the irreversible destruction of the gastric body mucosa. Human leucocyte antigen-DR genotypes suggest a role for genetic susceptibility in PA. PA patients should be managed by cobalamin replacement treatment and monitoring for onset of iron deficiency. Moreover, they should be advised about possible gastrointestinal long-term consequences, such as gastric cancer and carcinoids. © 2009 The WJG Press and Baishideng. All rights reserved
CATALOGA: a Software for Semantic-Based Terminological Data Mining
No full textThis paper is focused on Cataloga, a software package based on Lexicon-Grammar theoretical and practical analytical framework and embedding a lingware module built on compressed terminological electronic dictionaries. We will here show how Cataloga can be used to achieve efficient data mining and information retrieval by means of lexical ontology associated to terminology-based automatic textual analysis. Also, we will show how accurate data compression is necessary to build efficient textual analysis software. Therefore, we will here discuss the creation and functioning of a software for semantic-based terminological data mining, in which a crucial role is played by Italian simple and compound-word electronic dictionaries.
Lexicon-Grammar is one of the most profitable and consistent methods for natural language formalisation and automatic textual analysis; it was set up by French linguist Maurice Gross during the ‘60s, and subsequently developed for and applied to Italian by Annibale Elia, Emilio D’Agostino and Maurizio Martinelli. Basically, Lexicon-Grammar establishes morphosyntactic and statistical sets of analytic rules to read and parse large textual corpora.
The analytical procedure here described will prove itself appropriate for any type of digitalised text, and will represent a relevant support for the building and implementing of Semantic Web (SW) interactive platforms.
http://www.computer.org/portal/web/csdl/abs/proceedings/ccp/2011/4528/00/pccp201100toc.htm
http://www.computer.org/csdl/proceedings/ccp/2011/4528/00/4528a153-abs.htm
Symbiotics, Probiotics, and Fiber Diet in Diverticular Disease
No full textDiverticular disease is a common gastrointestinal condition in the Western world with the highest rates in the United States
and Europe. The clinical spectrum ranges from diverticulosis without symptoms to symptomatic uncomplicated, or complicated diverticular disease. Symptoms related to uncomplicated diverticular disease are not specific and may be indistinguishable from those of irritable bowel syndrome as vague abdominal pain or discomfort, abdominal bloating, or changes in bowel habit. In symptomatic uncomplicated diverticular disease, low-grade inflammation, altered intestinal microbiota, visceral hypersensitivity, and abnormal colonic motility have been identified as potential contributing factors to symptoms. Even though the pathogenesis and management of diverticulosis and diverticular disease still remain uncertain for several aspects, new hypotheses and observations are changing how to treat diverticular disease to improve symptoms and prevent potentially serious complications.
Probiotics, prebiotics, and synbiotics may modify the gut microbial balance leading to health benefits. Changes in peridiverticular bacterial flora have been suggested as playing a role in generating abdominal symptoms in diverticular disease. Thus, probiotics and synbiotics are promising treatment options for this condition. The rationale for the use of probiotics or synbiotics in diverticular disease is given by their anti-inflammatory effects and by maintaining an adequate bacterial colonization in the gastrointestinal tract. High-fiber diet is largely suggested for patients with symptomatic uncomplicated diverticular disease patients. Dietary fiber intake provides many health benefits. In the colon, fermentable dietary fiber may act as prebiotic to promote healthpromoting species of the intestinal microbiota. Insoluble fibers are especially effective in increasing fecal mass and promoting regularity of bowel movements. Although the widely believed idea that colonic diverticula are the result of a low-fiber diet has been challenged, there is some evidence that a high-fiber diet may protect against diverticular disease.
This chapter focuses on the use of prebiotics, synbiotics, and dietary fiber in uncomplicated diverticular disease, because
complicated diverticular disease as acute diverticulitis requires other treatment options such as oral or parenteral antibiotics
and in some cases, surgery and is beyond the purpose of this work
Rifaximin and diverticular disease. Position paper of the Italian Society of Gastroenterology (SIGE)
No full textManagement of diverticular disease has significantly improved in the last decade. Antibiotic treatment is used for symptom relief and prevention of complications. In Italy, the non-absorbable antibiotic rifaximin is one of the most frequently used drugs, and it is perceived as the reference drug to treat symptomatic diverticular disease. Its non-systemic absorption and high faecal concentrations have oriented rifaximin use to the gastrointestinal tract, where rifaximin exerts eubiotic effects representing an additional value to its antibiotic activity. This position paper was commissioned by the Italian Society of Gastroenterology governing board for a panel of experts (RC, GB, BA) to highlight the indications for treatment of diverticular disease. There is a lack of rationale for drug use for the primary prevention of diverticulitis in patients with diverticulosis; thus, rifaximin use should be avoided. The cyclic use of rifaximin, in association with high-fibre intake, is safe and useful for the treatment of symptomatic uncomplicated diverticular disease, even if the cost-efficacy of long-term treatment remains to be determined. The use of rifaximin in the prevention of diverticulitis recurrence is promising, but the low therapeutic advantage needs to be verified. No evidence is available on the efficacy of rifaximin treatment on acute uncomplicated diverticulitis
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