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R Pellicano

Publications and source records attributed to R Pellicano.

89 records · Page 5Linked to original sources

[Chronic diarrhea: a difficult diagnosis. A rare cause: lymphocytic colitis].

Lymphocytic colitis is a clinicopathological entity, characterized by chronic watery diarrhea, not bloody. Previously termed microscopic, it is now named lymphocytic for histological features, the most important seems to be the diffuse infiltration of intraepithelial lymphocytes, that must be investigated in multiple biopsies during colonoscopy. This review evidences that during endoscopy the mucosa is normal, but this does not exclude a biopsy, only way for take a diagnosis. Ethiologies are unknown too although a correlation with autoimmune diseases as possible. Lymphocytic colitis is a definition histological entity, while the term ''microscopic'' includes different histological entities under the same ''umbrella'', in relation to the concept of no macroscopic changes and multiple different histological specimens. The treatment is based for the first time on mesalazine or sulphasalazine and then in case of non responders, on corticosteroids.

Editorial↗

[Recurring duodenal ulcer. Evaluation of previous complications as a predictive factor of ulcer recurrence after eradication of Helicobacter pylori].

Duodenal ulcer is a chronic disease, punctuated by acute relapses. The pathogenic mechanism in 90-100% of cases is infection by Helicobacter pylori. Two major strains exist of this bacterium: I strain, which secretes a vacuolating cytotoxin (Vac-A), and another protein named cytotoxin-associated (Cag-A) and type II strain, unable to produce both proteins and unable to produce duodenal pathology. We sought to identify the natural history of relapsing duodenal ulcer after cure of the bacterial infection. In particular, we followed the outcome of patients who repeatedly had bled from their recurrent ulcer disease, after success in eliminating the microorganism from the stomach. None of 12 repeated bleeders had an ulcer recurrence after the cure of Helicobacter pylori infection. Only 3 (5%) of 60 frequent relapser had a new episode of duodenal ulcer during a follow-up reinfection by Helicobacter pylori. We demonstrated that the cure of bacterial infection is also the cure of duodenal ulcer recurrence, but for a few cases, in the latter, event one could hypothesize a defect in the production of growth factors (Epidermal Growth Factor, Fibroblast Growth Factor) or of cellular polyamines synthesis. It is important to improve the diagnosis of reinfection by implementing the urea breath test.

English Abstract↗

Genetic susceptibility to fixed drug eruption: evidence for a link with HLA-B22.

BACKGROUND: Our observation of familial cases of fixed drug eruption (FDE) prompted us to consider a genetic predisposition to this disease. OBJECTIVE: Our purpose was to determine whether there is any association between FDE and any of the major histocompatibility complex class I or II alleles. METHODS: HLA class I and II typing was performed by lymphocytotoxicity assay in 36 unrelated patients with FDE. RESULTS: Significantly higher (p < 0.0001) frequencies of the B22 and Cw1 antigens were found in the 36 patients with FDE. CONCLUSION: Our data are the first to suggest a genetic predisposition to FDE.

Adolescent↗

[Combined treatment of colorectal polyps with diathermy and the Nd-YAG laser. Our experience].

Among colorectal polyps, those of the sessile and villous type are said to bear a high frequency cancer degeneration. While surgery is considered the cure, alternative choices are to be offered in the presence of contraindications or lack of an informed consent. We analyzed the results of the "combined therapy" that requires the use of the ND-YAG laser following the ablation of the lesion with diathermic snare. We used an EV laser 132 with double wavelength to allow the ablation of flat lesions and minimize the risk of perforation. We included 12 patients with sessile colorectal polyps. In 9/12 complete eradication was obtained over a follow-up 11 months; of the remaining 3, 2 dropped out, 1 did not respond. Owing to the small series, the relationship between the successful eradication and the size of the polyp cannot be evaluated. We conclude that the treatment of sessile colorectal polyps with this combined approach may be a promising one.

Aged↗

Familial occurrence of fixed drug eruptions.

Fixed drug eruptions following the use of pyrazolone derivatives occurred in 4 members of the same family: a 12-year-old girl, her grandmother, and two of her great aunts. Although the pathophysiologic events leading to this type of reaction are unknown, these cases of familial occurrence suggest that genetic predisposition might be an important causal factor.

Child↗

The chromatographic separation of glycosylated haemoglobins: a comparison between macro- and micromethods.

The microchromatographic determination of "fast haemoglobins" is currently used in long-term control of diabetes: its use is made easier by commercially available kits, that are impaired by some analytical variables. For a good standardization of these kits a comparison with an accurate method of analysis is necessary. The macrochromatographic column allows the determination of each fast component with a good precision, and reveals the great complexity of human haemoglobin. Comparison of the two methods shows that the most appropriate temperature of elution for the kit is 20 degrees C and that the increase in the fraction of "fast haemoglobins" in diabetic samples is only related to the HbA1c component.

Chromatography↗

Chronic Helicobacter pylori infection and migraine: a case-control study.

OBJECTIVE: To determine whether chronic Helicobacter pylori infection is a risk factor for migraine. BACKGROUND: Preliminary studies have shown a high prevalence of Helicobacter pylori infection in patients with primary headaches. METHODS: One hundred three consecutive patients with migraine were enrolled in the study and compared with a group of 103 matched controls. Helicobacter pylori infection was diagnosed by means of both (13)C-urea breath test and serology. RESULTS: Of patients with migraine, 30.1% were positive for Helicobacter pylori, compared with 31.1% of controls (P = NS). The odds ratio for migraine associated with chronic Helicobacter pylori infection was 0.96 (95% confidence interval, 0.51 to 1.80). Demographic, clinical, and psychological characteristics of Helicobacter pylori-positive migraineurs were compared with those of migrainous patients without infection. Helicobacter pylori-positive patients had a significantly (P<.05) lower incidence of food sensitivity than Helicobacter pylori-negative patients. No significant difference was found in any other feature examined. CONCLUSIONS: Our study suggests that chronic Helicobacter pylori infection is not more frequent in patients with migraine than in controls and that infection does not modify clinical features of the disease.

Adult↗

[Chronic HCV hepatopathy and cryoglobulinemia. The associated clinical spectrum].

BACKGROUND AND AIM: The hepatitis C infection (HCV) has numerous extrahepatic manifestations owing to the systemic nature of the infection itself. HCV infects the cells that carry a CD 81 receptor and show a marked tropism for hepatocytes, bone marrow staminal cells and circulating lymphomonocytes. One consequence of this tropism is the activation of B lymphocyte clones with the consequent production of autoantibodies and cryoglobulins. The secondary event is the formation of circulating immune complexes which, having precipitated at an intravascular level, may cause part of the extrahepatic manifestations associated with these infections. METHODS: This retrospective study evaluated the manifestations correlated and/or associated with HCV hepatitis and mixed cryoglobulinaemia. RESULTS: This analysis showed that 75% of consecutively studied patients reveal clinically important extrahepatic manifestations. CONCLUSIONS: This underlines the "broad spectrum" action played by the hepatitis C virus in the host organism.

Adult↗

[Helicobacter pylori infection in pediatrics. Present knowledge and practical problems].

Helicobacter pylori (H. pylori) infection is acquired in childhood, earlier in developing countries, as a consequence the prevalence of infection is higher in developing countries (70%) than in developed countries (5-15%). H. pylori infection spreads from person-to-person, however the precise mode of transmission (oral-oral, fecal-oral or gastro-oral routes) is as yet, not known. Diagnosis of H. pylori infection can be performed with both invasive endoscopic-based tests, or non-invasive tests, mainly by measurement of IgG antibodies against the bacterium in serum samples or by measurement of 13CO2 in expired air (13C-urea breath test). In clinical practice endoscopy and biopsy is recommended before treatment to determine the presence and the degree of gastritis or ulcer. However, endoscopy is a complicated procedure in children and diagnosis of infection can be based on a non-invasive test. The association of H. pylori infection with recurrent abdominal pain seems evident in a subgroup of children with endoscopic features of gastritis, ulcer or hemorrhage. There is an increasing interest in the extraintestinal manifestations of H. pylori infection in children, i.e. iron-deficiency anemia, growth retardation and migraine, but this domain remains controversial. Since infection at a young age is believed to result in chronic atrophic gastritis and gastric cancer in adult life, it is logical to consider a future massive programme of eradication and immunization. Regimens suggested for H. pylori eradication are a combination of inhibitors of gastric acid secretion plus two antibiotics for 7-10 days.

Adolescent↗

[Infections and cardiovascular diseases on an ischemic basis. The case of Helicobacter pylori].

Cardiac and cerebrovascular diseases are an important cause of mortality in industrialized countries. "Classical" risk factors cannot fully explain epidemiological variations of these diseases. From several years infections have been linked to ischemic vascular events and recent publications pointed to the role of Helicobacter pylori, a Gram negative bacterium, involved in the pathogenesis of gastritis and peptic ulcer. Results on the association between this bacterium and acute myocardial infarction or stroke are controversial, due to the degree of studies heterogeneity. There is the need for extensive prospectic studies to evaluate the incidence of these diseases in relation to the presence of Helicobacter pylori infection. Interventional randomized studies employing an antibiotic treatment for patients affected by ischemic vascular diseases will rapidly answer the question of wheather Helicobacter pylori has a causal role in the pathogenesis of acute myocardial infarction and ischemic stroke.

Cardiovascular Diseases↗

Linear IgA disease and ulcerative colitis.

Linear IgA disease is an acquired bullous disease of the skin characterized by linear IgA deposits along the dermal-epidermal junction. Inflammatory bowel diseases have been rarely reported in association with linear IgA disease. We have recently observed a patient suffering from ulcerative colitis who developed a cutaneous bullous eruption that was diagnosed as a linear IgA disease. Foreign antigens penetrating the inflamed bowel mucosa might give rise to the production of autoantibodies cross-reacting with the cutaneous antigens involved in the pathogenesis of linear IgA disease.

Adult↗