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P Porcelli

Publications and source records attributed to P Porcelli.

At least 19 recordsLinked to original sources
PubMed2003

Persistent dyspepsia after laparoscopic cholecystectomy. The influence of psychological factors.

BACKGROUND: Many patients with gallstone disease continue to report gastrointestinal symptoms after cholecystectomy, but the predictive value of preoperative factors is not well understood. We aimed to investigate whether psychological symptoms can be associated with poor outcome after cholecystectomy in patients with gallstones and dyspepsia. METHODS: A sample of 52 consecutive patients with uncomplicated gallstone disease and dyspepsia (conceived in a broader sense to include symptoms of the whole digestive tract) were assessed for psychological (revised 90-item Hopkins Symptom Checklist) and gastrointestinal symptoms (Gastrointestinal Symptom Rating Scale). One year after laparoscopic cholecystectomy, patients rated their gastrointestinal symptoms and were divided into improved and unimproved on the basis of the change in symptoms. RESULTS: Twenty-one (40.4%) patients did not improve after surgery. Improved and unimproved patients did not differ in terms of sex, age, education or illness duration. Unimproved patients showed significantly higher psychological and dyspeptic symptoms than improved patients before surgery. Logistic regression showed that psychological factors were significantly associated with unimprovement after surgery. CONCLUSIONS: Patients with gallstone disease and dyspeptic symptoms are unlikely to improve 1 year after surgery if they show psychological distress before surgery. Psychological symptoms were strongly associated with poor post-cholecystectomy outcome, thus highlighting the clinical relevance of joint assessment of psychological and gastrointestinal symptoms before surgery.

Adult↗
PubMed2000

Growth in human milk-Fed very low birth weight infants receiving a new human milk fortifier.

BACKGROUND/AIMS: Human milk fortification has been advocated to enhance premature infants' growth. We, therefore, undertook this study of a new human milk fortifier containing more protein than a reference one. METHODS: Open, randomized, controlled, multiclinic trial, with weekly growth parameters and safety evaluations in premature infants <1,500 g. RESULTS: The 2 groups did not differ in demographic and baseline characteristics. The adjusted daily milk intake was significantly higher in the infants fed reference human milk fortifier (n = 29; 154.2 +/- 2.1 vs. 144.4 +/- 2.5 ml/kg/day, mean +/- SE; p < 0.05). Both human milk fortifiers produced increases over baseline in weight, length, and head circumference, with greater gains observed in the new human milk fortifier-fed infants for the former two parameters (weight gain 26.8 +/- 1.3 and 20.4 +/- 1.2 g/day, p < 0.05; head circumference 1.0 +/- 0.1 and 0.8 +/- 0.1 cm/week; length 0.9 +/- 0.1 and 0.8 +/- 0.1 cm/week, respectively). Serum chemistries were normal and acceptable for age. Study events were typical for premature infants and similar in both groups. CONCLUSIONS: This new human milk fortifier had comparable safety to the reference human milk fortifier and promoted faster weight gain and head circumference growth.

Body Height↗
PubMed1999

Evaluation of a long-chain polyunsaturated fatty acid supplemented formula on growth, tolerance, and plasma lipids in preterm infants up to 48 weeks postconceptional age.

BACKGROUND: The last trimester of pregnancy is a period of rapid accretion of long-chain polyunsaturated fatty acids, both in the central nervous system and the body as a whole. Human milk contains these fatty acids, whereas some preterm infant formulas do not. Infants fed formulas without these fatty acids have lower plasma and erythrocyte concentrations than infants fed human milk. Preclinical and clinical studies have demonstrated that single-cell sources (algal and fungal) of long-chain polyunsaturated fatty acids are bioavailable. A balanced addition of fatty acids from these oils to preterm formula results in blood fatty acid concentrations in low birth weight infants comparable to those of infants fed human milk. METHODS: In the present study the growth, acceptance (overall incidence of discontinuation, reasons for discontinuation, overall incidence and type of individual adverse events), and plasma fatty acid concentrations were compared in three groups of infants fed a long-chain polyunsaturated fatty acid-supplemented preterm infant formula, an unsupplemented control formula, or human milk. The study was prospective, double-blind (formula groups only), and randomized (formula groups only). Two hundred eighty-eight infants were enrolled (supplemented formula group, n = 77; control formula group, n = 78; human milk group, n = 133). RESULTS: Anthropometric measurements at enrollment, at first day of full oral feeding, and at both 40 and 48 weeks postconceptional age did not differ between the formula groups, whereas the human milk-fed group initially grew at a lower rate. The incidence of severe adverse events was rare and not significantly different between formula groups. The groups fed either human milk or supplemented formula had long-chain polyunsaturated fatty acid concentrations higher than those in the control formula group. CONCLUSIONS: The results of this study demonstrate the safety and efficacy of a preterm formula supplemented with long-chain polyunsaturated fatty acids from single-cell oils.

Aging↗
PubMed1998

Functional gastrointestinal disorders and eating disorders. Relevance of the association in clinical management.

BACKGROUND: As functional gastrointestinal disorders (FGID) are common in eating disorder patients, we aimed to assess past eating disorders in patients referred for current FGID. METHODS: One hundred and twenty-seven consecutive FGID outpatients and 163 patients with gallstone disease (GD) were enrolled. All patients were interviewed to detect GI symptoms (by means of the GI Symptom Rating Scale), lifetime eating disorders (on the basis of DSM-IV criteria), and current psychologic distress (on the Hospital Anxiety and Depression Scale). RESULTS: Past eating disorders were significantly more prevalent in FGID (15.7%) than in GD patients (3.1%) (chi-square = 14.6, P < 0.001). FGID patients with past eating disorders were significantly younger, more educated, more psychologically distressed, more dyspeptic, and more were women than FGID patients without past eating disorders. CONCLUSIONS: This study confirms the previously found association between functional GI symptoms and eating disorders and shows that functional GI symptoms may still persist even after the recovery from eating disorders, particularly in psychologically distressed patients.

Abdominal Pain↗
PubMed1996

A longitudinal study of alexithymia and psychological distress in inflammatory bowel disease.

A group of 104 patients with inflammatory bowel disease (IBD) was followed longitudinally for 6 months. While anxiety and depression scores were influenced over time by changes in the level of disease activity, there was no significant change in alexithymia scores. The findings support the contention that alexithymia is a stable personality characteristic in some IBD patients, in contrast to anxiety and depression which are state phenomena influenced by the level of disease activity.

Adult↗
PubMed1996

Effects of different psychophysiological stressors on the cutaneous electrogastrogram in healthy subjects.

To evaluate the effect of psychophysiological stress on the gastric electrical activity, the cutaneous electrogastrography (EGG), a non-invasive technique, was performed in ten healthy subjects. Three different stressful (cold pressor test, arithmetic task, and Stroop color-word test) tests and a non-stressful (reading a booklet) task were administered, and EGG parameters (dominant frequency, coefficient of variation of dominant frequency, and gastric power) were recorded during baseline, task and rest periods. Neutral task did not affect EGG parameters. During stressful stimulations, a slight decrease in the dominant frequency and an increase in the coefficient of variation of the dominant frequency were found. During arithmetic task, the gastric power significantly increased (baseline vs stimulus P = 0.008; stimulus vs rest P = 0.015; baseline vs rest P = 0.011), and a statistically significant difference between gastric power during arithmetic and neutral task was observed (P = 0.007). During Stroop test, the gastric power showed only a trend toward significance (baseline vs stimulus P = 0.018; stimulus vs rest P = 0.018). A wide interindividual variability was recorded during the stress period. Therefore, the individual susceptibility to psychological stress may influence the EGG response and gastric electrical activity. In conclusion, cutaneous electrogastrography may be used as a non-invasive technique to study the effects of acute stressors on the gastric electrical activity.

Adult↗
PubMed1996

A prospective study of the relationship between disease activity and psychologic distress in patients with inflammatory bowel disease.

BACKGROUND: The evaluation of psychologic states is very useful in the management of inflammatory bowel disease (IBD) patients, particularly when related to disease activity (DA). Our aim was to prospectively evaluate the relationship between psychologic distress and DA. METHODS: DA and psychologic distress were evaluated in 104 IBD outpatients by means of clinical criteria and the Hospital Anxiety and Depression Scale (HADS) at base line and after 6 months. Patients were grouped in unchanged, improved, and worsened DA from base line to follow-up. RESULTS: Repeated-measures ANOVA showed a significant group-by-time interaction for HADS anxiety (F = 89.6, P = 0.0001) and depression (F = 3.67, P = 0.03) subscales. CONCLUSIONS: Over time changes in DA significantly affect psychologic distress and are closely related to corresponding increases and decreases in anxiety and depression in IBD patients. Our findings therefore suggest that the assessment of psychologic distress, particularly anxiety, should be included in the clinical management of IBD patients.

Adult↗
PubMed1996

[Selective subarachnoid anesthesia for intervention for hip fracture].

METHODS: 50 ASA I-IV patients (62-90 aged, mean 78.54 +/- 6.48) were submitted to subarachnoidal selective anaesthesia with hyperbaric 1% bupivacaine and morphine for hip surgery. The aim of the study was to evaluate the clinical effectiveness of this anaesthetic technique. Ketamine 0.25 mg/kg and propofol 0.5 mg/kg were administered intravenously before positioning the patients homolaterally to the sick hip. The subarachnoidal puncture was effected at L2-L3 or L3-L4 level with a 22 gauge Quinke or Whitacre needle. The mean dose of bupivacaine was 7.72 +/- 0.81 mg and the mean dose of morphine was 0.23 +/- 0.03 mg. No patient needed general anaesthesia; 3 patients needed small boluses of ketamine and propofol or fentanyl (50 gamma) before the end of surgery. Ephedrine (5 mg) was administered to 5 patients to counteract hypotension by sympathetic block. Only one patient needed extra analgesia up to 8 hours after surgery (Ketorolac 60 mg). RESULTS: The morphine side effects were 3 cases of itch (6%), 4 cases of drowsiness (8%), 5 cases of nausea and vomiting (10%), 1 case of herpes labialis (2%); the subarachnoidal puncture caused one case of headache. CONCLUSIONS: The authors believe that such an easily executable anaesthetic technique is safe enough even in elderly patients.

Aged↗
PubMed1995

Alexithymia in inflammatory bowel disease. A case-control study.

The purported association between alexithymia and inflammatory bowel disease (IBD) was investigated in a group of 112 IBD patients (89 with ulcerative colitis and 23 with Crohn's disease) using the well-validated 20-Item Toronto Alexithymia Scale. Alexithymia was assessed also in a group of 112 normal subjects matched for gender, age, and education. The IBD group was significantly more alexithymic than the control group, and no significant difference was found between the ulcerative colitis and Crohn's disease patients. Alexithymia was unrelated to the duration of illness and the level of disease activity. Although the rate of alexithymia in the IBD group (35.7%) was significantly higher than the rate in the control group (4.5%), it is lower than rates of alexithymia that have been found among psychiatric patients with disorders that also have been linked theoretically and clinically with alexithymia.

Adult↗
PubMed1994

Psychological distress and levels of disease activity in inflammatory bowel disease.

The aim of this study was to evaluate the association between anxiety and depression, and levels of disease activity (LDA) in IBD patients. One hundred and fifty IBD patients (91 males and 59 females) were assessed by means of the Hospital Anxiety and Depression scale, and divided into three LDA groups according to standard clinical criteria: LDA1 = absence, LDA2 = mild, LDA3 = moderate and severe. Using the analysis of variance and the Scheffé test, a significant difference was found in the anxiety score, but not in the depression score, between LDA1 and LDA3 (p < 0.005). The risk of developing anxiety and depression in relation to LDA was estimated by multiple logistic regression. A significant linear trend (p < 0.01) to develop anxiety was found in the highest LDA. Our study showed that anxiety was significantly associated with a higher disease activity and suggested that anxiety should be appropriately evaluated and treated with the exacerbated symptoms in IBD patients.

Adult↗
PubMed1993

[Body Image Index in the Rorschach test in ulcerative proctocolitis].

The use of the Rorschach test allows the body image to be examined using the Body-Image Index formulated by Fisher-Cleveland. This index is obtained by calculating the responses to Penetration and Barrier. The hypothesis is that the diseases which affect the inside of the body are more greatly correlated to a high P score and a low B score (high P-low B type personality). The paper examines the Body-Image Index in a sample of 41 patients suffering from ulcerous rectocolitis comprising 24 males and 17 females with a mean age of 32 years. The personality profile obtained is of the "high P-low B" type with a P/R% ratio which is clearly higher than the central mean value (28.7% vs 8%) and a B/R% ratio which is clearly lower than the central mean value (4.2% vs 18%). The personality of the patients in this group was marked by a tendency to anxiety and a tendency to express aggression within their bodies (anger-in) which was field-dependent, difficulty in tolerating stress, a tendency to react somatically to conflicts, a low degree of body image stability and a constant need for an external holding object.

Adult↗
PubMed1991

[Disabling outcomes and psychological disorders in the patient with an enterostomy].

The authors carried out a retrospective study of patients undergoing enterostomy during the past 9 years. From 1981 to present a total of 60 patients (39 males and 21 females) were operated and subsequently followed-up. The aim of the study was to examine the following factors: the diagnosis which led to operation, the type of stoma used, early and late complications, the behaviour of the alvus, psychological disorders and Karnofsky's Performance-Status Index. After having presented the findings, the surgical results obtained are discussed together with the patient's psychological reactions to stoma. All types of early surgical complications were absent in 66.6% of patients, whereas late complications were absent in 41.6%. Even in those cases where surgical techniques and prostheses permitted a satisfactory post-operative outcome, the sociopsychological and sexual problems relating to the wound and the perceived difference between the real and ideal Ego are highlighted.

Adult↗
PubMed1980

Transient aplastic crisis in hereditary spherocytosis.

In this study the case of a child affected with hereditary spherocytosis, who presented with a presumably viral infection induced transient aplastic crisis, is described. The bone marrow aspirate showed phagocytosis of erythrocytes and nucleated cells by reticular cells. The possible pathogenetic role of bone marrow phagocytosis in aplastic crises in patients with haemolytic anaemias is discussed.

Anemia, Aplastic↗
PubMed1977

Correlation between pituitary gonadotropin response to GnRH and testicular histology in subjects suffering from dyspermia.

No significant changes of LH in basal conditions and in response to GnRH stimulation were found in any of the subjects studied; the same applies to basal testosterone and testosterone after HCG stimulation. On the other hand, the pituitary response for FSH gonadotropin showed significant variations in the different groups of subjects examined. These variations were closely correlated to the stages at which spermatogenesis was arrested. The earlier the stage of spermatogenetic arrest, the more strongly enhanced the FSH response to GnRH stimulation. Further, the most significant change, and the one most liable to be suited for purposes of diagnosis, was the one observed when passing from the 1st to the 2nd degree arrest (spermatids-spermatocytes). This FSH pattern is a constant finding; so much so that in the view of some authors testicular biopsy can now be avoided in cases with strongly increased pituitary FSH reserve since in these conditions the seminal line has been shown not to go beyond the stage of the spermatocyte.

Adult↗
PubMedDate not supplied

Alexithymia and functional gastrointestinal disorders. A comparison with inflammatory bowel disease.

BACKGROUND: Although the alexithymia construct was derived from observations of patients with classical psychosomatic diseases, empirical studies have found only a moderate association between alexithymia and inflammatory bowel disease (IBD). Indeed, there is some evidence that alexithymia may be associated more strongly with functional somatic symptoms than with the psychosomatic diseases. The present study examined the relationship between alexithymia and functional gastrointestinal disorders (FGIDs) in a group of 121 FGID patients, and compared the results with findings from a group of 116 IBD patients and a group of 112 healthy subjects. METHOD: The subjects completed the 20-item Toronto Alexithymia Scale and the Hospital Anxiety and Depression Scale. RESULTS: The FGID group was significantly more alexithymic than the IBD group, and the two gastrointestinal groups were more alexithymic than the normal healthy group. These differences remained even after controlling for the influence of education, gender, anxiety, depression and gastrointestinal symptoms. CONCLUSIONS: The finding of a high rate of alexithymia (66%) in the group of FGID patients is consistent with the propensity of these patients to somatization and to high levels of poorly differentiated psychological distress.

Adult↗