1,166 research outputs found
La sindrome dell'intestino irritabile.
No full textLa sindrome dell’intestino irritabile (dall'inglese "irritable bowel syndrome" o IBS) è un disordine funzionale intestinale in cui il dolore (o il “fastidio”) addominale si associa all’evacuazione o ad alterazioni dell’alvo. La prevalenza dell’IBS in Europa e negli USA risulta, in media attorno al 10% (in Italia 12%) , sebbene sia molto variabile (dal 2% al 22%), anche in rapporto ai criteri diagnostici utilizzati. La frequenza dell’IBS risulta più elevata fra la seconda e la quarta decade di vita, con una predominanza per il sesso femminile (rapporto F:M pari a circa 2:1). L’incidenza è stimata attorno a 2-70/1000 pazienti all’anno. Sebbene una consistente proporzione dei pazienti affetti da IBS (fra il 33% e il 90%) non consulti il medico per i propri disturbi, l’IBS rappresenta la patologia di più frequente riscontro nella pratica clinica gastroenterologia e fino al 10% dell’attività dei medici di medicina generale
Helicobacter pylori and other Helicobacter spp chronic infections and extragastric diseases
No full textRole of the tumor necrosis factor antagonists in the treatment of inflammatory bowel disease: an update
No full textCrohn's disease and ulcerative colitis represent the two major forms of inflammatory bowel disease (IBD). Recent research points out the role of uncontrolled intestinal inflammation in the pathogenesis of IBD. Therefore, there is a growing interest in developing novel biologic therapies targeting specific molecules of the inflammatory cascade. Among them, anti-tumor necrosis factor (anti-TNF) agents (i.e. infliximab, adalimumab, certolizumab pegol) have proved to be effective, particularly for patients with refractory IBD. These biological therapies have changed, at least partially, the clinical course and medical management of IBD. However, the administration of anti-TNF drugs has also been associated with serious side-effects, which have raised concerns on the application of these drugs in clinical practice. The goal of this review is to provide an update and analyze the pros and cons of using anti-TNF therapies in the treatment of IBD
Eradication of Helicobacter pylori: are rifaximin-based regimens effective?
No full textAbstract
Rifaximin is a non-absorbed semisynthetic rifamycin derivative with a broad spectrum of antibacterial activity including Gram-positive and Gram-negative bacteria, both aerobes and anaerobes. Although originally developed for the treatment of infectious diarrhea, the appreciation of the pathogenic role of gut bacteria in several organic and functional gastrointestinal diseases has increasingly broadened its clinical use. Being the antibiotic active against Helicobacter pylori, even towards clarithromycin-resistant strain, and being the primary resistance very rare, several investigations explored its potential use for eradication of the microorganism. Rifaximin alone proved to be effective, but even the highest dose (1,200 mg daily) gave a cure rate of only 30%. Dual and triple therapies were also studied, with the better results obtained with rifaximin-clarithromycin and rifaximin-clarithromycin-esomeprazole combinations. However, the eradication rates (60-70%) obtained with these regimens were still below the standard set by the Maastricht Consensus guidelines. Although rifaximin-based eradication therapies are promising, new antimicrobial combinations (with and without proton pump inhibitors) need to be explored in well-designed clinical trials including a large cohort of H. pylori-infected patients. The remarkable safety of rifaximin will allow high-dose regimens of longer duration (e.g. 10 or 14 days) to be tested with confidence in the hope of achieving better eradication rates. A drawback of rifaximin could be its inability to reach sufficiently high concentrations in the gastric mucus layer under and within which H. pylori is commonly located and this would likely affect eradication rate. Taking these considerations into account, bioadhesive rifaximin formulations able to better and persistently cover gastric mucosa, or combination with mucolytic agents, such as pronase or acetylcysteine, need to be evaluated in order to better define the place of this antibiotic in our therapeutic armamentariu
Palaeodiet reconstruction in a woman with probable celiac disease: a stable isotope analysis of bone remains from the archaeological site of Cosa (Italy)
No full textStable 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
A) Helicobacter pylori and extragastric diseases--other Helicobacters.
No full textReports on Helicobacter pylori and extragastric diseases have almost doubled this year compared with last year, bearing witness to the persistent scientific interest in this branch of Helicobacter-related pathology. Data belong increasingly to the area of vascular medicine, as well as hematology, dermatology, pediatrics and other fields. Unfortunately, these studies show overall controversial results, due to the impact of several confounding factors, and to the difficulty of recruiting homogeneous patient populations. Furthermore, many studies continue to be conducted on Helicobacter species other than H. pylori, focusing on animal models of gastroenterological illnesses which may retain strong similarities with human diseases. In this paper, taxonomy, detection and characterisation of Helicobacter spp. will be reviewed, together with the most important data issued this year on other Helicobacters and animal models
Helicobacter pylori and extragastric diseases -- other helicobacters
No full textThe role of Helicobacter pylori infection is explored in more and more extragastric diseases without definite proof in most of the studies, except possibly some hematologic diseases. In cardiovascular diseases, including stroke, the presence of CagA positive strains may be involved. The possible role of helicobacters in hepatobiliary diseases goes beyond that of H. pylori to involve enterohepatic helicobacters. New Helicobacter species are regularly described and molecular methods are developed to improve their detection. Helicobacter felis remains the major species to be used in animal models of Helicobacter infection
The combined application of advanced endoscopic imaging techniques may increase the duodenal villous morphology definition in suspected celiac disease.
No full text[Gastrointestinal angiodysplasias: Is Rendu-Osler-Weber disease or hereditary hemorrhagic telangiectasis the tip of an iceberg?]. FT Angiodisplasie gastrointestinali: la malattia di Rendu-Osler-Weber o teleangiectasia emorragica ereditaria e la punta di un iceberg?
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