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Publications (9)2.3 Total impact

  • Italian Journal of Medicine 03/2011; 5(1):96-103.
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    ABSTRACT: Background Despite its uncommon occurrence, eosinophilic gastroenteritis is one of the most important primary eosinophilic gastrointestinal disorders. These are defined as disorders that selectively affect the gastrointestinal tract with eosinophil-rich inflammation in the absence of known causes for eosinophilia. The disorders include eosinophilic esophagitis, eosinophilic gastritis, eosinophilic gastroenteritis, eosinophilic enteritis and eosinophilic colitis. Aim of the study This review focuses on the epidemiology, pathophysiology, clinical features and treatment of primary eosinophilic gastrointestinal disorders with particular attention to primary eosinophilic gastroenteritis. Clinical case We report a case of a 32-years-old woman that was admitted to our Hospital complaining of abdominal pain, ascites and diarrhea. Laboratory investigations showed a white cell count of 15.1 thousands/mm3 with eosinophilia; other laboratory studies were within the normal limits. Abdominal ultrasonography demonstrated peritoneal effusion and cytological analysis revealed a prevalence of eosinophils in the ascites. The multiple endoscopic biopsies were normal. However, the clinical history, and the laboratory, radiological and endoscopic findings gave a firm diagnosis of the serosal form of primary eosinophilic gastroenteritis. Discussion This is a rare, benign condition, pathologically characterized by an important eosinophilic infiltration of the wall of the digestive tract and presents a constellation of symptoms that are related to the degree and area of the gastrointestinal tract affected. Primary eosinophilic gastroenteritis encompasses multiple disease entities subcategorized into three types on the basis of the level of histologic involvement: mucosal, muscolaris and serosal forms. Every layer of the gastrointestinal tract can be involved, so that endoscopic biopsy can be normal in patients with the muscolaris subtype, serosal subtype, or both.
    Italian Journal of Medicine 09/2009; 3(3):166-171.
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    ABSTRACT: Although the number of elderly people is progressively increasing in the world, old and very old patients have been under-represented and understudied in trials evaluating the efficacy of chronic illness management models. The usual hospital indicators and practice guidelines do not consider the effects of complexity - co-morbidity, social support, functional and cognitive status, patient adherence to therapy, risk of adverse drug reactions - in these subjects. The aim of this observational, multi-centric cohort study was to carefully assess factors contributing to the complexity of care for patients admitted to internal medicine wards. This was done by evaluating the severity of disease and degree of stability at admission, co-morbidity, age-related impairments, and the need for discharge planning plus post-discharge support. A total of 386 patients from 11 internal medicine wards in Emilia-Romagna and Marche, Italy, enrolled in a given week were evaluated. At admission, the following variables were recorded: demographic characteristics, medical history, global clinical-social prognostic evaluation, co-morbidity, severity of illness, presence of shock or hemodynamic instability, coma, and frequencies and causes of unscheduled hospital re-admission. Cancer, congestive heart failure, pneumonia, stroke, and chronic obstructive pulmonary disease were the most frequent primary diagnoses. The complexity of our case study was characterized by several concomitant diseases. Over 50% of the patients were considered severe or more than severe, and over 20% extremely severe, with very high co-morbidity indices and illness severity scores. Some 55% of our patients were in need of partial or total care; 10% had some speech impairment, and 63% needed in-home health care after hospital discharge. The increasing numbers of elderly patients admitted to internal medicine departments suggests the need for a chronic illness management model, integrating gerontological and geriatric care to improve outcomes. For effective care, future protocols need to take a multi-dimensional, interdisciplinary approach to these patients and to develop a coordinated, integrated plan for treatment and long-term follow-up.
    European Journal of Internal Medicine 08/2007; 18(4):283-7. · 2.30 Impact Factor
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    ABSTRACT: We report the case of a patient with alcoholic liver cirrhosis and generalized atherosclerosis who rapidly developed erythrocytosis. Concomitantly we documented a significative and progressive increase of serum Erythropoietin (Epo) and a small focus of hepatocellular carcinoma (HCC) never diagnosed before. Even in absence of immunohistochemical and/or biomolecular evidence of Epo production in the neoplastic tissue we think the hypothesis of the paraneoplastic syndrome may be the most likely both for the strict temporal relationship between the observation of the neoplastic lesion and the appearance of polycythemia and for the absence of all other known causes of erythrocytosis. Objection to this hypothesis: 1) ectopic production of Epo during HCC has been usually described in large neoplastic lesions 2) liver cirrhosis by itself may be accompanied by increased Epo levels 3) an intratumoral hypoxia with compensatory production of Epo may have occurred 4) generalized vasculopathy could have determined renal hypoxia with greater local production of Epo.
    Recenti progressi in medicina 06/1998; 89(5):250-2.
  • M Grandi, S Pederzoli, C Sacchetti
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    ABSTRACT: The authors evaluated the effect of carnitine on glucose insulin metabolism. Twenty-five subjects free from metabolic disorders or serious functional alterations in the liver, kidneys or myocardium were studied. All were infused with a 5% glucose-enriched solution (Group A); 48 h later the same subjects were infused with a 5% glucose solution containing 2g carnitine (Group B). Variations in blood glucose and insulin levels and range were measured at different times during and after infusion. Study results showed that the administration of carnitine lead to an improvement in glucose metabolism, as demonstrated by a saving in insulin secretion accompanied, at least on a temporary basis, by a corresponding decrease in blood glucose which, however, remained within normal parameters.
    International journal of clinical pharmacology research 01/1997; 17(4):143-7.
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    ABSTRACT: In this study we have examined the relationship between obesity and endocrine glands. We have underlined that obesity can be a symptom of some endocrine diseases and that, on the other side, only a few number of cases with excessive weight have a true endocrine pathogenesis. The endocrine implications of essential obesity, only detectable with appropriate dynamic tests, are sometimes expression of an altered peripheral metabolism. The more relevant hormonal data that we will examine in details are: increase of insulin plasma levels, altered hypothalamic neuroregulation with consequence on the gonadotropin secretion and values of prolactin, growth hormone and cortisol.
    Recenti progressi in medicina 03/1991; 82(2):104-9.
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    ABSTRACT: Hepatic diseases and particularly cholestasis are well known to affect bone metabolism and induce osteoporosis. We have studied bone metabolism in normal volunteers and in 20 patients with non alcoholic liver cirrhosis without cholestasis, classified stage "B" according to Child's classification. A reduced bone density as measured by mineralometry was observed in patients as compared to controls. Serum osteocalcin and urinary hydroxyproline levels were consistent with the "low turnover" osteoporosis type of osteopathy. The major determinants of the bony loss seem to be low blood testosterone and the consequent reduced metabolism in cirrhotics.
    Recenti progressi in medicina 01/1991; 82(7-8):363-6.
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    ABSTRACT: The authors report a case of a patient with a refractory ascites due to extrahepatic portal thrombosis in course of idiopathic thrombocythemia. A peritoneovenous shunt was applied and as a late complication a massive thrombosis of the intracardiac portion of the duct developed. Thrombolysis was obtained with tissue plasminogen activator at doses usually administered for acute myocardial infarction. Prophylaxis of recurrence was pursued with pictomide and defibrotide.
    Recenti progressi in medicina 85(7-8):387-90.
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    ABSTRACT: The efficacy and the tolerability of the new crystalline pure lactulose formulation (Laevolac Cristalli) vs lactitol is evaluated in 40 patients suffering from liver cirrhosis and treated for the associated encephalopathy (PSE). Both disaccharides proved to be effective in the maintenance therapy of PSE. With respect to the previous formulation of lactulose, the crystalline one has a significantly lower incidence of side-effects. Pure crystalline lactulose, showing a similar efficacy and rise of side-effects, proved to be better accepted by the subjects of this study.
    Minerva gastroenterologica e dietologica 37(4):225-30.