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Biomedical subjects

G Pippa

Publications and source records attributed to G Pippa.

10 recordsLinked to original sources
PubMed2000

[Gastric MALT lymphoma and Helicobacter pylori].

Aim of this paper is to evaluate the effects of eradicating Helicobacter pylori (Hp) on the course of low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma. A total of 13 consecutive patients, 7 males and 6 females (median age 54 years) Hp-positive were included, all affected by low-grade B-cell gastric MALT lymphoma, stage I using established criteria; histologic assessment by gastric biopsies was performed. Each patient received anti-Hp therapy with standard protocol for 7 days and underwent endoscopy and histology every 3-6 months. Complete eradication was obtained in all patients (100%); on histology 9 patients showed complete regression, but in one of these lymphoma relapsing after 12 months was observed. Our findings confirm recent cooperative reports of Hp eradication rate and regression of gastric tumour (about 70%). In conclusion, the indolent clinical course of the disease justifies a first-line conservative approach with Hp eradication therapy.

Adult↗
PubMed1998

Association between insulin dependent diabetes mellitus and coeliac disease. A study on 175 diabetes patients.

BACKGROUND: The association between diabetes mellitus and coeliac disease has been known for many years. In a random group of 175 insulin dependent diabetes mellitus patients of varying ages the following tests have been carried out: serum antigliadin antibodies (AGA) of IgA and IgG class, antireticulin antibodies (ARA) and antiendomisyum antibodies (AEA), both of IgA class. MATERIALS AND METHODS: The patients, 85 males and 90 females, had ages ranging from 1 yr to 30 yrs (102 in paediatric age--mainly between 6 and 14 years--and 73 adults). Patients with pathological values for AEA and/or ARA underwent an intestinal biopsy. RESULTS: Out of 175 patients studied, 21 had pathological values for AEA with or without pathological values for ARA and AGA, and 2 patients had only pathological values for ARA. 23 patients (21 with pathological values for AEA with or without ARA and AGA, 2 only for ARA ) underwent intestinal biopsy, all patients with pathological values for AEA had villous atrophy. The prevalence of coeliac disease among IDDM patients was 8.8% (95% CI 3.3 to 14.3) for the children and 16.4% (95% CI 7.9 to 24.9) for the adults. In patients with mucous atrophy, ARA, AGA IgA and IgG were pathological in 85%, 71% and 61% respectively. Symptoms and insulin requirements in all patients affected by coeliac disease before and after one year on a gluten free diet were also evaluated. The patients had clinical features with prevalently one or only few atypical symptoms which disappeared on a gluten free diet. Insulin requirements after one year on a gluten free diet appeared unchanged in coeliac patients. CONCLUSIONS: The need to screen all diabetic patients for coeliac disease is underlined.

Journal Article↗
PubMed1998

[Dyspepsia: a reappraisal problem].

Dyspepsia is a major public problem. It occurs in 25-40% of the general population negatively affecting the quality of life. 2-3% of the patients visited by the GP and up to 30% of those visited by the gastroenterologist have dyspepsia. Both diagnostic procedure and therapy are expensive. Definition, aetiology and pathogenesis of the disorder are not clear cut. The aim of this review is to outline the main trends in the relevant area of the clinical practice. The authors choose the most comprehensive definition among the thirty of the medical literature. To rule out, the most commonly and frequently wrong opinions risk factors have been examined. The authors distinguished between symptoms of function and organic dyspepsia and those of Irritable Bowel Syndrome and Gastro-Esophageal Reflux Disease, which often overlap and make difficult the management of the patient. The aetiology and pathogenesis have also been discussed, with particular emphasis on Hp. Advantages and drawbacks of different diagnostic approaches have been investigated. An age and symptoms related approach of the cases with dyspepsia is proposed, which allows to manage the patient without the necessity of invasive procedures. It is finally suggested that are cases which can be managed by the GP and others for whom the gastroenterologist intervention is mandatory.

Adult↗
PubMed1990

[The duodenum and non-steroidal anti-inflammatory agents].

We have carried out a longitudinal study in order to confirm our preliminary data on the heavier involvement of the duodenum compared to the stomach after non aspirin non-steroidal anti-inflammatory drugs (NSAIDs). 53 patients with upper digestive haemorrhage due to recent intake of NSAIDs without preexisting known peptic pathology -28 p. from aspirin and 25 p. from NSAIDs other than aspirin--were selected. Aspirin and its derivatives mainly affected gastric mucosa whereas non aspirin NSAIDs the duodenum. 42 of these patients have been observed for two more years; independently of the treatment, ranitidine 150 mg daily vs antacids if needed, the annual rate of recurrence has been very low. These findings have further confirmed the accurate selection of our patients without previous peptic pathology (in this case the rate of recurrence would have been much higher) and also suggest a more rational diagnostic and therapeutic approach to these patients. We then observed a consecutive series of 107 patients affected with duodenal ulcer bleeding: 51 by NSAIDs and 56 not by NSAIDs; both groups were given H2-antagonists and blood transfusions if needed. The short term prognosis has been rather positive mainly for the NSAIDs group, in which no mortality has been observed, independently of the number of blood transfusions and length of hospitalization. In our experience the high percentage of NSAIDs duodenal ulcers (about 50%), shows an increase of this pathology, less severe than peptic one, even if expressed by a serious event as digestive bleeding. It is our opinion that these percentages and prognostic evaluations should be considered in therapeutic decision, limiting thus surgical and aggressive endoscopic procedures.

Adolescent↗
PubMed1989

Epidemiological study of duodenal erosive disease; its prevalence and nosological position in relation to ulcerative peptic disease.

The prevalence of erosive lesions was found to be 27.5% in 11838 cases examined during the last 10 years. In almost 66% of the cases, erosive lesions were localized in the duodenal bulb but mainly isolated and less often in the antro-pyloric area. In 55% of the cases, duodenal erosions coexist with ulcerative peptic disease, 20% in "active" phase and 35% in "inactive" phase. Erosive lesions, appeared autonomously in 45% of the cases. Morphologically, they can be divided in: a) periulcerative marginal erosions closely connected with activity of the ulcers; b) clustered, complete or incomplete erosions, which may or may not be associated with the ulcerative disease and often have a prolonged acyclic behaviour; c) scattered flat erosions which can at times be associated with the ulcerative peptic disease but are always related to a chronic widespread duodenitis. An epidemiological study was performed on 564 cases which were divided into 3 groups: a) cases with autonomous erosive disease; b) those with erosions associated with post-ulcerative scars; and c) those with erosions associated with active ulcers. The control group of 111 cases was characterised by duodenal active ulcers with no erosions. Statistical evaluation of the percentage differences between the 4 groups revealed that in duodenal erosive disease predisposing factors such as psychic temper, environmental and work conditions and eating habits are evident. In autonomous disease drug intake and spices and, to a less extent, alcohol and/or stress situations play a more important role. In erosions associated with an active ulcer, a dominant obsessive temper facilitated by a difficult family situation, bad eating habits and a great amount of smoking are prominent factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Duodenal Diseases↗
PubMed1989

Healing rate of duodenal ulcer with hyper-aggressive peptic activity under H2-receptor antagonists.

In 60 cases of hyper-aggressive duodenal ulcer an endoscopic examination was made, at short intervals (4,7,11,13,21,28 days) after the treatment with H2-receptor antagonists. The open trial was based on random cases under ranitidine 150 mg b.i.d. (31 cases) or cimetidine 400 mg b.i.d. (29 cases). The healing rate has been calculated from the regression slope of the ulcerative area in mm2. Regression does not have a linear slope; it is slow in the first week, increases in the second week, in which it reaches the maximum value, and then decreases gradually in the following weeks. H2-receptor antagonists have no doubt an accelerating effect on healing; cimetidine, in comparison with ranitidine, has a faster and more evident action in the first week. But then, it reduces its action more rapidly in the following weeks so that, on the whole, it turns out to be slightly less valuable. These results can be practically useful for the treatment of hyper-aggressive D.U. as far as early risks are concerned.

Cimetidine↗
PubMed1989

Right colonic hemangioma diagnosed by scintigraphy with 99-mTc sucralfate. A case report.

99-mTc-SF gastrointestinal scintigraphy used in recent years in the assessment of site and activity for ulcerative lesions, was shown to be very important for the diagnosis of a rare case of right colonic hemangioma. A young female patient suffering for some time from functional intestinal disorders, following negative radiologic and endoscopic findings, underwent 99-mTc-SF scintigraphy, which showed massive uptake of radioactivity in the ascending and right flexure of colon. A repeated colonoscopy with biopsy allowed the histologic diagnosis of capillary hemangioma.

Adult↗
PubMed1979

Role of ulcer morphology in evaluating prognosis and therapeutic outcome in duodenal ulcer.

Endoscopic morphology of duodenal ulcer (DU) have been studied in 188 patients repeatedly observed in the course of medical therapy (120 with conventional therapy and 68 with Cimetidine alone). The evolutive behaviour under treatment reveals a clear speeding up effect of Cimetidine on the healing time with a smaller number of failed and delayed recoveries and a lower frequency of relapses than after conventional therapy. Endoscopic morphology allows a limited but significant forecast of therapeutic outcome of DU. The shape, the number and partly the location of ulcer in the bulb appear to be the most significant parameters with prognostic influence both on the healing time and on the frequency and early development of relapses.

Cimetidine↗