76 research outputs found
Correction: Di Febo (2025). Transition Risk in Climate Change: A Literature Review. Risks 13: 66
No full textAs requested by the Editorial Office, the authors have removed Eliana Angelini from the author list due to insufficient contribution to the published paper (Di Febo 2025) [...
Long-term management of GERD in the elderly with pantoprazole
No full textCarlo Calabrese, Anna Fabbri, Giulio Di FeboDepartment of Internal Medicine and Gastroenterology, University of Bologna, ItalyAbstract: The prevalence of gastroesophageal reflux disease (GERD) increases with age and elderly are more likely to develop severe disease. Older patients often complain of less severe or frequent heartburn than younger patients and they may present with atypical symptoms such as dysphagia, weight loss, or extraesophageal symptoms. Proton pump inhibitors (PPIs) are central in the management of GERD and are unchallenged with regards to their efficacy. They are considered safe and more effective than histamine receptor antagonists for healing esophagitis and for preventing its recurrence using a long term maintenance treatment. PPI have minimal side effects and few slight drug interactions and are considered safe for long term treatment. Pantoprazole is significantly effective both for acute and long-term treatment with excellent control of relapse and symptoms. It is well tolerated even for long-term therapy and its tolerability is optimal. Pantoprazole shows to have minimal interactions with other drugs because of a lower affinity for cytocrome P450 than older PPIs. Although the majority of elderly has concomitant illnesses and receive other drugs, this does not adversely effect the efficacy of pantoprazole because of its pharmacokinetics, which are independent of patient age. Clinical practice suggests that a low dose maintenance of PPIs should be used in older patients with GERD.Keywords: GERD, long-term management, pantoprazole, safety, efficacy, tolerabilit
Capsule endoscopy revealing small-intestinal lymphangiectasia and GI stromal tumor polyps in neurofibromatosis type 1.
No full textA 26-year-old woman, without a family history of neurofibromatosis type 1, was admitted with abdominal pain, unexplained anaemia, diarrhea, and malabsorption. Skin examination revealed multiple cutaneous neurofibromas and cafè-au-lait spots on the upper extremities and trunk; 5 neurofibromas were excised. EGD and colonoscopy were unremarkable, but a radiologic small-bowel series showed multiple intraluminal protruding masses in the jejunum and the ileum. Capsule endoscopy found some polypoid lesions and a white-tipped villous pattern of the mucosa consistent with intestinal lymphangiectasia in the proximal jejunum (A); in the distal jejunum and the mid ileum, capsule endoscopy demonstrated the presence of 10 sessile (B) and pedunculated polypoid lesions (range, 2-5 cm) (C), surrounded by hypertrophied plicae with a digit-like, sea-anemone–like appearance (D).
At laparotomy, several nodules were seen on the surface of the small bowel, of which, 4 yellowish serosal nodules from the jejunum and 4 polyps were excised. On microscopic examination, the lesions were composed of bland spindle cells set within the muscle wall without necrosis, mitotic figures, or pleomorphism; these features were of benign GI stromal tumor (E, Immunohistochemistry stain, orig. mag. ×100). There were no postoperative complications, and the patient was discharged 8 days later. She was well and without recurrence 6 months after the operation
[Rivarolo Mantovano]. Il giardino di Corte Palazzo o Grande [60]
No full textIn Cividale, piccola frazione rurale del Comune di Rivarolo Mantovano (Mn), le fonti e le sopravvivenze architettoniche testimoniano l'antica esistenza di un "viridarium", ossia di un giardino e di un "barco", entrambi sostanzialmente perduti: il primo legato alla gonzaghesca Corte Grande (o Palazzo) e il secondo connesso alla demolita e un tempo poco distante Torre Stella, architettura anch'essa da assegnare ad un rappresentante della famiglia Gonzaga, appartenente ai rami cadetti di Bozzolo, Sabbioneta e Rivarolo. La Corte sorse all'incrocio di importanti vie di comunicazione, l'antica Vicinale per Cremona e la via Vitelliana per Bozzolo, costituendo, insieme a Torre Stella, un punto nodale del corto asse stradale alberato detto "delle Pioppe", al confine fra i territori gonzagheschi di Rivarolo, Spineda, Sabbioneta, Bozzolo e quelli del vicino Ducato di Milano, le cui terre iniziavano oltre il corso del canale Navarolo. La Corte appartenne a Febo sr. Gonzaga, figlio adulterino di Gianfrancesco (1446-96), e ai suoi discendenti. Alla luce di inediti documenti d'archivio (soprattutto notarili) il saggio ripercorre gli anni di impianto della Corte (plausibilmente edificata, almeno in parte, entro il 1497 e, dopo la morte di Febo sr., abitata dalla consorte Margherita d'Este) e quelli di ingrandimento, con la costruzione, accanto alla "domus vetus" e al suo "viridarium", di una "domus nova" voluta forse dai nipoti di Febo sr., i fratelli Febo jr. e Federico, o dallo zio di quest'ultimo, Ippolito Gonzaga. La Corte Grande (o Palazzo) corrisponderebbe dunque, insieme alla contigua Corte Ercole (appartenuta forse a Gianfrancesco 'Ercole' Gonzaga, padre di Federico e fratello di Ippolito), al maggiore e più monumentale insediamento gonzaghesco dell'area. Essa, nonostante i secoli di uso 'massarizio', esibisce ancora (soprattutto all'interno) caratteri costruttivi e decorativi compatibili con maestranze e artisti attivi non tanto all'epoca di Febo sr. e dei figli Gianfrancesco 'Ercole' e Ippolito, quanto piuttosto con maestranze operanti negli anni e nell'ambito della committenza di Vespasiano Gonzaga. Proprio al duca di Sabbioneta gli storici, ignorando il ruolo svolto da Febo sr. e dai suo successori, hanno tradizionalmente ascritto la proprietà del complesso, sino alla morte di Vespasiano avvenuta nel 1591, ma in realtà le fonti non rivelano mai la sua permanenza in Cividale. L'impianto del giardino, del palazzo e le sue decorazioni (attribuite al pittore Giulio Rubone, epigono di Giulio Romano, attivo a Sabbioneta e nelle non lontana Corte Castiglioni di Casatico di Marcaria) sarebbero quindi da ascrivere non al duca Vespasiano, bensì ai discendenti di Febo sr. Gonzaga. Per quanto si ignorino i passaggi di proprietà successivi alla metà del XVI secolo, è noto che Corte Grande (o Palazzo) appartenne ai conti Peyri e Castiglioni. Il saggio prosegue dunque con la ricostruzione degli assetti fra XVIII e XX secolo
Risk of duodenal adenomas in familial adenomatous polyposis to progress toward advanced neoplastic disease
No full textTo the Editor:
In the February 1, 2004, issue of the Journal of Clinical Oncology, Saurin et al1 report that 50% of duodenal adenomas in familial adenomatous polyposis (FAP) patients progress toward more advanced disease during a mean follow-up period of 47.9 months. As the same authors observe, this value is higher than other published data. In our experience, only two (6.2%) of 32 FAP patients who are taking part of a study for identification of prognostic factors2 show an increased severity of the duodenal lesions after a mean surveillance period of 72.5 months. Moreover, until now, none of these patients have developed the most severe stage of the disease.
The authors justified their results because the very accurate duodenoscopic methodology adopted in the study. This hypothesis can be shared as far as the detection of progression of the lesions is concerned, but it cannot explain the cumulative high number of high scores. At the end of the study period, the percentage of patients with severe lesions (stage IV) was 35%. High-grade dysplasia has been found in 37.1%. It is difficult to hypothesize that lesions like those described in the article could have been underestimated or missed in the available studies reporting lower percentage. The high-grade lesions are also usually detectable also by routine endoscopic examinations.
To know the profile of the population under study may be crucial in these works. It may make the difference. In the Saurin et al article, we do not have the results of the molecular analysis of the patients who have progressed toward the high grade. Moreover, more information on clinical data should be available. In particular, the number of patients with ileoanal anastomosis may be of interest because they have a defective absorption of bile acids, which are involved in the risk of developing duodenal neoplasia.3
The last part of the article discusses the alternative role of endoscopy surgery in the prevention of duodenal cancer. The authors don't comment on the treatment with pharmacologic agents (ie, COX-2 inhibitors, which is a very promising field of prevention).4 Endoscopy should also be improved to increase evaluation efficiency in chemoprevention policy
Serological and histological aspects of hepatitis C virus infection in alcoholic patients
No full textThe recent cloning of the genome of hepatitis C virus (HCV) has allowed the detection of antibodies to HCV (anti-HCV) in human serum. The presence of serum antibodies to HCV often indicates active infection with HCV. We have assessed the serological and histological features in a group of alcoholic patients with chronic liver disease and have evaluated the possible etiologic rote of HCV infection in the development of liver damage. Serum samples and liver biopsy specimens were obtained from 41 consecutive patients, all having a definite history of alcohol abuse and evidence of chronic hypertransaminasemia. Fifteen patients (37%) were positive for anti-HCV by ELISA, and 13 (86.6%) of them were also positive by RIBA. Eleven of these patients had histologic features of chronic active hepatitis (CAH), a lesion which is not known to be induced by excessive alcohol intake. No other possible causes of CAH were found, and CAH was not present in any of the anti-HCV negative patients. In patients with CAH, mean AST to ALT ratio was less than 1 (0.6), a finding which is characteristic of viral rather than alcoholic chronic liver disease. In conclusion, our study suggests that sporadic hepatitis C virus infection plays an etiologic role in the development of chronic active liver disease in a subgroup of alcoholic patients. © 1991
Measurement of Differential Mode Propagation in Printed Circuit Board for Satellites Applications
No full texthis work deals with a test procedure for EMC/SI measurements on artificial satellites for telecommunication applications. This work proposes a fast method to compare the effects of different test setups for the measurement of conducted emissions and introduces a different test setup for this category of EUT
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