Familial Adenomatous Polyposis (FAP).
Chronic inflammatory intestinal diseases.
IFN therapy in patients with HCV-related cirrhosis and
the role of the natural history markers correlate
HCV.
Treatment of microscopic colitis.
Gastric Infection by Helicobacter pylori infection: the role
of endoscopy and treatment protocols.
Gastroesophageal reflux disease: physiopathogenesis aspects,
diagnosis and therapy.
Biochemical indicators of gastrointestinal mucosa human tumor
and normal.
Capsule Endoscopy.
Familial Adenomatous Polyposis (FAP). From 20 to 90% of
patients with FAP develop a cancer of the duodenum. Since colectomy
prevents the development of colorectal cancer developing cancer
elsewhere is of great importance in these young patients. The
identification of abnormal cell at the duodenal mucosa in patients
at high risk is therefore both diagnostic value both in terms of
chemoprevention therapeutic strategies. Initially, we showed the
presence of a high proliferative capacity of cells duodenal in FAP
patients with a normal macroscopic. Then, we assessed the
proliferative indices and ultrastructural appearance (scanning
electron microscopy and transmission) in patients suffering from
FAP with microscopically normal mucosa and those with polyps. These
studies showed that the duodenal mucosa of patients with FAP
increased cell proliferation and reduced intercellular interaction
are to be considered as potential markers of neoplastic
transformation.
Chronic inflammatory intestinal diseases. It was suggested
that the risk of colorectal cancer in patients with ulcerative
colitis is related to a reduced bioavailability of folate. We then
conducted a study that evaluated the effects of folate
supplementation on the proliferative cells of colorectal in
patients suffering from long-CU. The results suggested that folate
may represent a valuable chemoprevention agent against
colorectal malignancy in these patients. In patients
suffering from RCU was conducted a prospective study that included
surveillance in 65 patients performing colitis annually or every
two years during which multiple biopsies were performed series
searching for histological changes (dysplasia low, medium, high
degree or carcinoma). Despite well in 8 patients were diagnosed
relevance of surgical lesions, the results of the study are
unfortunately not significant given the high number of drop-outs
(29 patients, equal to 44.6% have left the study), even if there
are confirmations previous observations such as the onset of
colorectal cancer appears more related to the duration of the
disease, with an average age of onset similar to that of the
general population; the low-grade dysplasia or grade undefined,
finally not appeared lesions
IFN therapy in patients with HCV-related cirrhosis. The goal
of therapy with IFN in HCV-related chronic hepatitis is to prevent
or delay the emergence of cirrhosis and the. In cirrhotic patients
undergoing initial treatment with IFN should aim to slow the
progression of the disease by improving the survival and quality of
life. In order to assess the efficacy and tolerability of IFN-
alpha in patients with compensated liver cirrhosis HCV positive, we
conducted a prospective clinical study using a non-conventional
treatment involving the use of progressively increasing doses for
12 months . The results at the end of treatment showed that the
IFN-alpha is able to induce a primary response in over 30% of
cases. In patients with HCV related hepatitis response to
therapy with IFN-alpha is closely related to both levels is at
histology Gamma-glutamil transferase liver, in particular,
the higher the levels of GGT and the presence of cirrhosis are
independent predictive values not therapy response to the common
strengths of INF- alpha.
The role of the natural history markers correlate HCV has
long been controversy. We conducted a prospective non-randomized
controlled the maximum duration of 58 months on 144 patients, half
of whom have been treated with IFN. During the follow-up were
assessed the appearance of clinical complications (ascites, varices
from bleeding, jaundice, encephalopathy, and exitus HCC). The study
concluded that treatment with IFN does not seem to improve the
survival of cirrhotic patients while being able to prevent or delay
the development. Patients with clinical response to IFN did not
develop any complication during the follow-up.
Treatment of microscopic colitis. The microscopic colitis is
a syndrome characterized by chronic watery diarrhea with normal
macroscopic and radiological, and some histological abnormality.
There have been some studies conducted on the treatment of this
condition, but not conclusive. We conducted a prospective
randomized study on the treatment of colitis mesalazine with
microscopic and the possible association with cholestyramine. This
study showed that treatment with mesalazine alone is able to
induce healing in more than 85% of patients with lymphocytic
colitis and the association with cholestyramine increases in the
percentage of healing colitis collagenosic up to 91%.
Gastric Infection by Helicobacter pylori infection: the role
of endoscopy and treatment protocols. The gastric infection by
Helicobacter pylori induces paintings of histological inflammation
with different expression of mucosal damage. However, the
correlation between a specific framework macroscopic and the
infection itself is widely debated in the literature. To this end,
we conducted a prospective randomized study on a large series of
patients undergoing endoscopy of the upper digestive tract on which
were performed biopsies for histological evaluation and for the
presence of H. Pylori. The panel found endoscopic antral were
assigned to 1 of 5 categories provided by endoscopic classification
of Sydney. The study showed the presence of a statistically
significant correlation between the frame of modularity antral and
infection by H. Pylori. However, the predictive value of disease
was 70%, even for the high presence of paintings histologically
normal despite co-existing infection. This involves the inability
to use the framework as endoscopic predictive of disease and the
need to search through other methods (13C-UBT, Test with rapid,
Histology). During the last decade many have been conducted
research to identify the key therapeutic ideal for eradication.
Helicobacter pylori, which should be simple or short-term,
effective and limited side effects. Therefore, we conducted a
prospective randomized study in 100 patients with infection by H.
Helicobacter pylori, randomly assigned to one of two treatment
schedules that included the use of Azitromicyne and Tinidazole for
3 days with or without pretreatment with Pantoprazole. The
percentage of eradication was excellent (88%) and no differences
were noted between the two treatment groups.
Gastroesophageal reflux disease: physiopathogenesis aspects,
diagnosis and therapy. The GERD is a common disease whose
definition is complex, a wide spectrum of severity, in which the
symptomatic patients with non-erosive disease, representing about
two thirds. Studies physio-pathogenesis and ultrastructural
morphology, conducted on rabbits have shown in the expansion of
spaces a marker of disease. We conducted a clinical study,
functional, and ultrastructural morphometric on 38 patients and 12
healthy volunteers. We showed that the expansion of spaces, in
animals as in humans, is the marker of disease. Later we assessed
the ability of proton pump inhibitors to induce healing
symptomatic, endoscopic and ultrastructural both in acid-peptic
reflux disease or without bile. We also assessed the proliferative
capacity of being esophageal reflux disease and erosive
gastro-esophageal not. Assuming that the development of different
macroscopic pattern with the same underlying event
physiopathological what is gastro-esophageal reflux, are from a
different proliferative capacity expressed from esophageal probably
intrinsic to the same cells and therefore genetically
determined. In addition, they have been assessed and
validated two questionnaires on the quality of life in the course
of gastro-esophageal reflux disease and dyspepsia. Finally, it was
assessed the effect of pantoprazole used a double dose and for six
months in the course of asthma related to reflux disease.
Biochemical indicators of gastrointestinal mucosa human tumor
and normal. The research for possible mediators in carcinogenesis
gastrointestinal showed production of molecules that can be used as
a biochemical marker. These may provide a means of early diagnosis,
before the development of macroscopic lesions. Moreover, contrary
to histological markers, any molecular markers can be sought in
biological fluids, such as blood or stool. Therefore, a better
understanding of the biochemical composition of normal human
tissues and pathological can provide information on the presence of
molecular changes pre-morphologic. This is a necessary condition
for a clinical application of modern methods and innovative
non-invasive such as magnetic resonance spectroscopic achieved in
vivo directly on the patient whose feasibility is based on the
identification of molecular markers. The objectives of the project
were: characterization of biochemical composition of
gastrointestinal tissue; Better understanding of the development of
cancer at the molecular level; Identification of biochemical
indicators of an altered metabolic state in order to develop
diagnostic methods in vivo.
Capsule Endoscopy. The pouchitis is a frequent complication of
IPAA for ulcerative colitis. The refractory pouchitis is a chronic
condition resistant to treatment with a frequency of approximately
15% of patients. The purpose of this study was to evaluate the
possibility of an involvement by the CE. The presence of chronic
refractory pouchitis may suggest the involvement of an inflammatory
disease of unknown.