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R Caprilli

Publications and source records attributed to R Caprilli.

98 records · Page 6Linked to original sources
PubMedDate not supplied

Increased prevalence of Helicobacter pylori in patients with diabetes mellitus.

BACKGROUND: Whilst upper gastrointestinal disturbances are frequently observed in patients with diabetes mellitus, little is known about the prevalence of Helicobacter pylori infection and peptic disease in these patients. AIM: To evaluate prevalence of Helicobacter pylori infection and peptic disease lesions in diabetics with dyspeptic symptoms. PATIENTS AND METHODS: Study population comprises 74 consecutive diabetes mellitus patients with dyspepsia and 117 consecutive non diabetic dyspeptic patients. Upon enrolment, each patient completed an interview screening questionnaire to obtain information concerning presence and severity of dyspepsia. All patients underwent upper gastrointestinal endoscopy with biopsy specimens being collected from gastric antrum and body Helicobacter pylori was evaluated in each patient by rapid urease test and histology (Giemsa). Gastritis was classified according to the Sydney System. Statistical analysis was performed by chi-square, Fisher exact or t test and logistic regression analysis. A p value <0.05 was considered significant. RESULTS: Prevalence of Helicobacter pylori infection was found to be significantly higher in diabetics than in controls. The prevalence rate of endoscopic lesions was comparable in the two groups, but the association between endoscopic lesions and Helicobacter pylori infection was significantly higher in diabetics. Overall, the presence of chronic gastritis, both non atrophic and atrophic, as well as intestinal metaplasia were comparable in the two groups of patients, whilst the association between chronic gastritis and Helicobacter pylori infection or gastritis activity were significantly higher in diabetics. In neither group, was any correlation found between severity of dyspepsia and presence of endoscopic lesions, chronic gastritis or Helicobacter pylori infection. CONCLUSIONS: These data show a higher prevalence of Helicobacter pylori infection in diabetes mellitus patients with dyspepsia. Helicobacter pylori infection was significantly associated both with the presence of endoscopic lesions and chronic gastritis in diabetic patients, but not in the controls.

Adult↗
PubMedDate not supplied

Epidemiology of inflammatory bowel disease in Italy.

The incidence of inflammatory bowel diseases is similar throughout Italy. Two prospective multicentre studies in the same period have shown an incidence very similar to Northern Europe. The incidence of ulcerative colitis ranged from 3.4 to 10.5. The incidence of Crohn's disease ranged from 1.9 to 6.6. The time trends seem to indicate an increase in both diseases. The need to set up General Registries of disease is underlined. The clinical behaviour and the diagnostic approach are homogeneous throughout the country. Compared to Northern Europe, surgery was less common in ulcerative colitis. Among the risk factors, familial occurrence has been shown to have the same prevalence as in Northern Europe suggesting a common genetic background. Studies on other risk factors are warranted considering the lack of data. Data on mortality show that there is a decrease in deaths in ulcerative colitis and a slight increase in mortality for Crohn's disease in the first few years after diagnosis. A retrospective study on costs has shown a greater economic burden from ulcerative colitis, however, new multicentre prospective studies are necessary.

Costs and Cost Analysis↗
PubMedDate not supplied

Acute intestinal obstruction and NOD2/CARD15 mutations among Italian Crohn's disease patients.

UNLABELLED: Three CARD15 mutations (SNP8, SNP12, SNP13) were significantly associated with CD, however ethnic variations and genotype-phenotype relationships are still to be defined. AIMS: To evaluate the prevalence of three CARD15 mutations in 91 in-out consecutive CD, 109 Ulcerative Colitis (UC), 101 healthy controls; to examine the genotype-phenotype relationships among italian pts with CD. MATERIAL AND METHODS: The three mutations were determined by direct sequencing analysis. In CD were evaluated several feature of disease phenotype. Data analysis was performed by using c2 or Fisher Test applying Bonferroni's correction. RESULTS: The allelic and genotype frequencies of CARD15 mutations were significantly associated to CD. None of controls or UC were homozygotes (OM) or compound heterozigotes (CET). In CD the carriers of at least one mutation were 26/91 (28.6%). The frequencies of simple heterozygotes (ET), CET and OM were: 19/26, 4/26, 3/26 respectively. A significant positive association was found between small bowel location and an acute intestinal obstruction at diagnosis and the carriers of at least one mutation (p = 0.036, OR:0.33 [0.12-0.9] and p = 0.0025, OR:0.125 [0.03-0.5], respectively), particularly with OM and CET genotype (p = 0.005, OR:0.07 [0.01-0.6]). A positive trend between the number of surgery and the carriers of at least one mutation was found, but it didn't reach statistical significance (p = 0.0469, OR:0.3 [0.1-0.96]). No relationship between CARD15 mutations and the other phenotype characteristics was found. CONCLUSIONS: Our data confirms that CARD15 mutations are significantly associated with CD also in Italian population and with small bowel location (OM and CET genotype). A new positive association was also found between the carriers of at least one mutation and the acute intestinal obstruction at diagnosis.

Acute Disease↗
PubMedDate not supplied

Management of refractory fistulizing pouchitis with infliximab.

UNLABELLED: This study provides the long-term follow-up data on the efficacy of infliximab in the treatment of chronic refractory pouchitis complicated by fistulae following ileo-pouch anal anastomosis (IPAA) for ulcerative colitis (UC). METHODS: Seven patients (4 F, 3 M) with chronic refractory pouchitis complicated by fistulae were included in an open study. Pouchitis was diagnosed by clinical plus endoscopical and histological criteria. Fistulae were: pouch-bladder in 1, vaginal in 3, perianal in 2, both vaginal and perianal in 1 patient. Extraintestinal manifestations were present in 4 patients. All the patients were refractory to antibiotics (3 patients also to steroids). Crohn's disease was carefully excluded in all patients after re-evaluation of the history, re-examination of the original proctocolectomy specimen, examination of the proximal small bowel. Patients received Infliximab 5 mg/kg at 0, 2 and 6 weeks. Azathioprine (2.5 mg/kg) was also started for all patients as bridge therapy. Clinical response was classified as complete, partial, and no response. Fistulae closure was classified as complete, partial, and no closure. The pouchitis disease activity index (PDAI) and quality of life (QoL) were also used as outcome measures. RESULTS: Clinically, all patients improved. At 10-week follow-up, 6 out of 7 patients had a complete clinical response, and 5 out of 7 patients had complete fistulae closure. At 10- week follow-up, median PDAI dropped from 12 (baseline) (range, 10-15) to 5 (range, 3-8); median QoL decreased from 37 (range, 33-40) to 14 points (range, 9-18), respectively. Extraintestinal manifestations (erythema nodosum and arthralgiae) completely remitted soon after the first infusion of infliximab. Clinical response and fistulae closure were maintained in the long-term follow-up. CONCLUSIONS: These results seem indicate that infliximab plus azathioprine may be recommended for the treatment of refractory pouchitis complicated by fistulae following IPAA for UC.

Adult↗