C. Scalici

A.R.N.A.S. Ospedale Civico Palermo, Palermo, Sicily, Italy

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Publications (29)60.66 Total impact

  • G. Iacono · C. Scalici · S. Iacono
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    ABSTRACT: Allergic proctitis can occur in infants and children. It is expressed by feces streaked with blood without other apparent signs. More than 50% of these patients are being breast-fed. Recently, it has been found that a particular symptom of allergic proctitis is constipation, and it is a major cause of consultations in pediatric gastroenterology departments. We carried out a study, which included a series of patients who were seen for chronic constipation that had not responded to the usual therapy. We found that the majority of these patients had a reduction in the layer of mucus coating the rectum, and this sign was associated with intolerance to cow's milk protein and also to other foods. hi patients suffering from chronic constipation associated with proctitis due to food intolerance, reduction in the rectal mucus coating can be considered to be one of the characteristic factors in the pathogenesis of the patient's constipation. (C) 2015 Published by Elsevier Masson SAS.
    No preview · Article · Nov 2015 · Revue Française d'Allergologie
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    ABSTRACT: Celiac disease (CD) is a multifactorial enteropathy induced by the ingestion of gluten in susceptible individuals. It's widely accepted that CD is an immune-mediated enteropathy and clinical manifestations range from typical signs or symptoms of intestinal malabsorption to atypical cases with scarce gastro-intestinal symptoms and extra-intestinal manifestations. Several neurological syndromes have been associated to CD and include epilepsy, myoclonus, ataxia, internuclear ophtalmoplegia, multifocal leukoencephalopathy and peripheral neuropathies of axonal and demyelinating type. In this small case series, electromyography and the study of nerve conduction were performed in 10 young children at first diagnosis of CD without any neurologic sign or symptom. The presence of mild axonal polyneuropathy was revealed in 6 patients, especially involving motor fibers and showing great affinity to peroneal fibers.
    No preview · Article · Jan 2013 · Acta Medica Mediterranea

  • No preview · Article · Oct 2012 · Digestive and Liver Disease

  • No preview · Article · Oct 2012 · Digestive and Liver Disease
  • G. Iacono · M. L. Lospalluti · G. Licastro · C. Scalici

    No preview · Article · Oct 2008 · Digestive and Liver Disease

  • No preview · Article · Oct 2008
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    ABSTRACT: Many coeliac disease patients with atypical symptoms remain undiagnosed. To examine the frequency of oral lesions in coeliac disease patients and to assess their usefulness in making coeliac disease diagnosis. One hundred and ninety-seven coeliac disease patients and 413 controls were recruited and the oral examination was performed. Forty-six out of 197 coeliac disease patients (23%) were found to have enamel defects vs. 9% in controls (P < 0.0001). Clinical delayed eruption was observed in 26% of the pediatric coeliac disease patients vs. 7% of the controls (P < 0.0001). The prevalence of oral soft tissues lesions was 42% in the coeliac disease patients and 2% in controls (P < 0.0001). Recurrent aphthous stomatitis disappeared in 89% of the patients after 1 year of gluten-free diet. Multi-logistic analysis selected the following variables as the most meaningful in coeliac disease patients: dental enamel defects (OR = 2.652 CI = 1.427-4.926) and soft tissue lesions (OR = 41.667, CI = 18.868-90.909). Artificial Neural Networks methodology showed that oral soft tissue lesions have sensitivity = 42%, specificity = 98% and test accuracy = 83% in coeliac disease diagnosis. The overall prevalence of oral soft tissue lesions was higher in coeliac disease patients (42%) than in controls. However, the positive-predictive value of these lesions for coeliac disease diagnosis was low.
    Full-text · Article · Dec 2007 · Alimentary Pharmacology & Therapeutics
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    ABSTRACT: Previous studies have demonstrated that serum anti-actin antibodies are a reliable marker of intestinal damage severity in coeliac disease. To validate in a multicentre study the clinical usefulness of serum IgA anti-actin antibody ELISA and its possible use in monitoring intestinal mucosa lesions during gluten-free diet. Four centres recruited 205 newly diagnosed coeliac disease patients with villous atrophy, 80 healthy controls and 81 "disease" controls. Twelve coeliac disease patients on gluten-free diet but with persistent symptoms underwent serum IgA anti-actin antibody assay and intestinal histology evaluation. IgA anti-actin antibody ELISA was performed with a commercial kit. All coeliac disease patients underwent intestinal histology study. IgA anti-actin antibodies showed a sensitivity of 80% and a specificity of 85% in the diagnosis of coeliac disease patients with villous atrophy. The area under the receiving operator curve for anti-actin antibodies was 0.873 [95% C.I. 0.805-0.899]. Serum anti-actin antibodies values were significantly higher in coeliac disease patients than in healthy or "disease" controls (P<0.0001). Serum anti-actin antibodies were positive in 41 of the 60 coeliac disease patients with mild intestinal histology lesions (69%) and in 123 of the 145 with severe lesions (85.3%) (P<0.05). There was a significant inverse correlation between anti-actin antibody values and the villi/crypts ratio (r=-0.423; P<0.0001). In the 12 coeliac disease patients on gluten-free diet who underwent re-evaluation as they were persistently symptomatic, intestinal histology showed three cases with persistent villous atrophy: all of these were positive for serum anti-actin antibodies ELISA, whereas both serum anti-tTG and EmAs were negative. The other nine patients showed normal intestinal villi and were negative for serum anti-actin antibodies. Anti-actin antibodies are a reliable marker of severe intestinal mucosa damage in coeliac disease patients and a simple ELISA technique offers an accurate method for their determination. These antibodies seem to be a very reliable marker of persistent intestinal damage in coeliac disease patients.
    No preview · Article · Oct 2007 · Digestive and Liver Disease
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    ABSTRACT: The clinical significance of lymphoid nodular hyperplasia (LNH) of the lower gastrointestinal tract is unclear. The aim of this study was to define the frequency and clinical significance of LNH in pediatric patients undergoing colonoscopy. Two hundred forty-five children (101 male, 144 female; median age, 8.5 years) for whom colonoscopy had been indicated were evaluated during a 3-year period. Apart from ileocolonoscopy with biopsy, all patients underwent routine biochemistry, serum total and specific IgE, and/or skin prick tests for food allergens. Patients with LNH underwent elimination diet and subsequent food challenges. LNH was observed in 73 of 245 (30%) consecutive colonoscopies. LNH was the only abnormal finding in 52 of the 73 cases (71%). In 43 of these 52 patients a diagnosis of cow's milk or multiple food hypersensitivity was made. Food allergy was significantly more common than in patients without LNH (83% vs 31%; P < .0001). The patients with LNH and food hypersensitivity presented hematochezia (P < .0001), elevated serum anti-beta-lactoglobulin IgG (P < .0001), anemia (P < .005), and failure to thrive (P < .03) more frequently than those without LNH. In the LNH patients histologic examination showed a higher number of lymphoid follicles throughout the colon and the terminal ileum and an increased number of lamina propria and intraepithelial eosinophils. The presence of LNH in the colon and/or terminal ileum is a frequent finding in symptomatic children undergoing colonoscopy. Unless associated with other specific endoscopic or histologic lesions, LNH is related to a condition of delayed-type food hypersensitivity.
    No preview · Article · Apr 2007 · Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association
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    ABSTRACT: The authors, after a concise description of cow's milk protein allergy, report their own experience about a patient whose diagnosis has been formulated after two month from the introduction of bovine milk in her diet, followed by a sensitiveness to the soy milk.
    No preview · Article · Jan 2007 · Acta Medica Mediterranea
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    ABSTRACT: The Authors, after to have described shortly on the abdominal pains in age to drain, bring back the case of a patient, to which it has been made diagnosis of psychical violence, as a result of shelter for vomito, chetosi, abdominal pains, ains.
    No preview · Article · Jan 2007
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    ABSTRACT: The authors, after a concise description of gastroesophageal reflux, report their own experience about a patient whose the patology has been with airway disorders.
    No preview · Article · Jan 2007 · Acta Medica Mediterranea
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    ABSTRACT: We measured anti-transglutaminase (anti-tTG) antibody in the culture medium of intestinal biopsy specimens from patients with suspected celiac disease (CD) and evaluated the relationship between antibody production and severity of intestinal mucosal damage. We performed diagnostic testing for CD on 273 consecutive patients. In addition to routine histologic evaluation of duodenal biopsy specimens, we assayed anti-tTG antibodies in serum and in the culture medium of duodenal biopsy specimens. CD was diagnosed in 191 of the 273 patients. Sensitivity and specificity of the serum anti-endomysium (EmA) and anti-tTG assays were 83% and 85% and 99% and 95%, respectively, and both had 88% diagnostic accuracy. EmA and anti-tTG assayed in the culture medium had 98% sensitivity, 100% specificity, and 98% diagnostic accuracy (vs serum assays; P <0.0001). Twenty-nine CD patient specimens (16%) were negative for serum anti-tTG and EmA; for 24 of these patients, anti-tTG assay of the culture medium was positive. The CD patients whose biopsy specimens were positive for serum antibodies showed the following intestinal histologies: total villous atrophy, 35%; severe villous atrophy, 25%; mild atrophy, 25%; villi with no atrophy but with increased intraepithelial lymphocytes, 15%. None of the CD patients whose specimens were negative for serum antibodies showed total or severe villous atrophy; 77% had mild villous atrophy, and 23% had no villous atrophy but had increased intraepithelial lymphocyte counts. Mild villous atrophy was also seen in specimens from approximately 15% of patients without CD. Anti-tTG assay of the culture medium of biopsy specimens can improve the accuracy of CD diagnosis in patients negative for serum antibodies.
    Preview · Article · Jul 2006 · Clinical Chemistry
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    ABSTRACT: Red umbilicus is considered to be an infectious disease typical of neonates. In our experience, umbilical erythema could be due to cow's milk protein intolerance (CMPI). To evaluate the frequency and clinical significance of umbilical erythema in a series of consecutive children referred for suspected CMPI. Seven hundred ninety-six consecutive patients (median age, 18 months) referred for suspected CMPI diagnosis were studied. CMPI diagnosis was based on the disappearance of symptoms on elimination diet and their subsequent reappearance on double-blind placebo-controlled cow's milk challenge. CMPI was diagnosed in 384 patients: 120 with respiratory, 75 dermatologic and 198 gastroenterological symptoms. Although some patients showed more than 1 type of symptom, whether gastroenterological, dermatologic or respiratory, they were classified in 1 category only according to the main reason for referral to the outpatients clinic. Umbilical erythema was observed in 36 patients (median age, 10 months): 16 (8%) with gastroenterological symptoms, 9 (7.5%) with recurrent asthma and 11 (15%) with atopic dermatitis. None of the symptomatic controls without CMPI had umbilical erythema. On elimination diet, the erythema disappeared within the second week. On CMPI challenge, it reappeared within 24 hours. Umbilical erythema can be a sign of food intolerance and can be a useful diagnostic tool for CMPI.
    Full-text · Article · Jun 2006 · Journal of pediatric gastroenterology and nutrition
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    ABSTRACT: The frequency of elevated serum pancreatic enzymes in patients with celiac disease (CD) is unknown. The aim of this study was to evaluate the serum levels of pancreatic enzymes in CD patients. Serum pancreatic isoamylase and lipase levels were assayed in 90 adult and 112 pediatric consecutive CD patients at diagnosis and after 12 months of gluten-free diet (GFD). Serum elastase and trypsin levels were assayed in a subgroup of adult CD patients. Pancreatic ultrasonography was also performed. Twenty-six adult (29%) and 29 pediatric (26%) CD patients exhibited elevated values of serum pancreatic amylase and/or lipase; trypsin was elevated in 69% and elastase in 19%. The frequency of elevated serum pancreatic enzymes observed was identical in the patients with "typical" and "atypical" CD symptoms and in the asymptomatic patients. Most of the elevated values were lower than 2-fold the threshold limits. Elevated pancreatic enzymes were not associated with alcohol consumption, drug use, presence of abdominal pain, or diabetes mellitus. Abdominal ultrasound scan showed no abnormal findings in the pancreatic region in any of the CD patients. After 12 months of GFD, pancreatic amylase was elevated in 3 cases and lipase in 2 cases; these patients had not strictly adhered to the GFD. We demonstrated a frequency of about 25% of elevated pancreatic enzymes values in CD patients, including subjects without gastrointestinal manifestations and apparently asymptomatic subjects. The finding of elevated serum amylase or lipase level, in the absence of signs of pancreatic disease, would appear to suggest a need to screen for celiac disease.
    No preview · Article · May 2006 · Clinical Gastroenterology and Hepatology
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    ABSTRACT: Chronic constipation in children can be caused by cows' milk intolerance (CMI), but its pathogenesis is unknown. To evaluate the histology and manometry pattern in patients with food intolerance-related constipation. Thirty-six consecutive children with chronic constipation were enrolled. All underwent an elimination diet and successive double-blind food challenge. All underwent rectal biopsy and anorectal manometry. A total of 14 patients were found to be suffering from CMI and three from multiple food intolerance. They had a normal stool frequency on elimination diet, whereas constipation recurred on food challenge. The patients with food intolerance showed a significantly higher frequency of erosions of the mucosa, and the number of intra-epithelial lymphocytes and eosinophils. The rectal mucous gel layer showed that the food-intolerant patients had a significantly lower thickness of mucus than the other subjects studied. Manometry showed a higher anal sphincter resting pressure and a lower critical volume in food intolerance patients than in the others suffering from constipation unrelated to food intolerance. Both histology and manometry abnormalities disappeared on the elimination diet. Food intolerance-related constipation is characterized by proctitis. Increased anal resting pressure and a reduced mucous gel layer can be considered to be contributory factors in the pathogenesis of constipation.
    Full-text · Article · Mar 2006 · European Journal of Gastroenterology & Hepatology
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    ABSTRACT: During the first months of life, infants can suffer from many 'minor' gastroenterological disturbances. However, little is known about the frequency of these problems and the factors which predispose or facilitate their onset. (a) To ascertain the frequency of the most common gastrointestinal symptoms in infants during the first 6 months after birth; (b) to evaluate the influence of some variables on the onset of the symptoms. Each of the 150 paediatricians distributed throughout Italy followed 20 consecutive infants from birth to 6 months. 2879 infants (1422 f, 1457 m) concluded the study. The presence of the following symptoms was evaluated: constipation, diarrhoea, vomiting, regurgitation, failure to thrive and prolonged crying fits (colic). Symptoms were recorded whenever the parents requested a clinical check-up or during a set monthly examination. 1582/2879 (54.9%) infants suffered from one of the gastrointestinal symptoms. Regurgitation was the most common disturbance (present in 23.1% of infants), followed by colic (20.5%), constipation (17.6%), failure to thrive (15.2%), vomiting (6%) and diarrhoea (4.1%). Low birth weight was the factor most frequently associated with the onset of gastrointestinal symptoms, followed by low gestational age. Feeding habits did not influence the onset of symptoms, with the exception of constipation, which was linked to a low frequency of breast-feeding. Ninety-three infants (3.2%) were hospitalised for one or more of the gastrointestinal symptoms which were considered. During the whole study period the type of formula-milk was changed in 60% of the infants with one or more gastrointestinal symptoms, and in 15.5% of the infants who did not suffer from any gastrointestinal troubles. Gastrointestinal symptoms are very common in infants during the first 6 months after birth. These symptoms required hospitalisation only in a small percentage of cases, but led to the prescription of a 'dietary' milk formula in approximately 60% of the cases. Low birth weight and low gestational age were the main factors influencing the onset of the symptoms.
    No preview · Article · Jul 2005 · Digestive and Liver Disease
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    ABSTRACT: Chronic constipation in children can be linked to cow's milk intolerance (CMI) but the existence of a food intolerance-dependent proctitis is still debated. The aim of this study was to evaluate the histologic data in patients with food intolerance-related constipation. Fifty-two consecutive patients (22 M, median age 4 years) with chronic constipation unresponsive to common treatment were enrolled. All patients were put on a cow's milk-free diet for 4 weeks and those uncured on this diet underwent a subsequent 4-week period of oligoantigenic diet. In the patients cured on elimination diet, a subsequent double-blind food challenge was performed to confirm the diagnosis of food intolerance. At entry to the study, routine hemato-chemical and immunologic assays, rectoscopy, and histologic study of the rectal mucosa were performed. In the patients cured on elimination diet, rectal histology was repeated when they were cured. Twenty-four patients were found to be suffering from CMI and 6 from multiple food intolerance. These patients had a normal stool frequency on elimination diet, while constipation reappeared on food challenge. The condition of the remaining 22 patients did not improve on elimination diet. The patients with food intolerance showed a significantly higher frequency of erosions of the mucosa, number of intraepithelial lymphocytes and eosinophils, and number of eosinophils in the lamina propria. Study of the rectal mucus gel layer showed that the food-intolerant patients had a significantly lower thickness than the other subjects studied. In the food intolerant patients, histologic abnormalities disappeared on elimination diet, when the patients were well. Food intolerance-related constipation is characterized by proctitis with eosinophil infiltrate of the rectal mucosa. A reduced mucus gel layer can be considered a contributory factor in the pathogenesis of the constipation.
    Full-text · Article · Feb 2005 · Scandinavian Journal of Gastroenterology
  • C. Scalici · G. Licastro · D. Manzoni · C. Sferlazza
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    ABSTRACT: Celiac disease a permanent gluten intolerance, has recently been shown to be frequent even in the developing countries, which were thought to be free from this pathology. This phenomenon seems to be due to the progressive Westernization of the diet, often as a consequence of humanitarian aid from international organizations. A model in this sense is the Saharawi people in the north-west Africa: the incidence of celiac disease of a group of Saharawi children, who were staying in Italy for 45 days as part of humanitarian project, showed that a correct diet without gluten can lead to an impressive growth recovery but the potential benefits were decidedly reversed on the children's return to the diet followed in their native country.
    No preview · Article · Jan 2005 · Acta Medica Mediterranea
  • C. Scalici · G. Licastro · D. Manzoni · C. Sferlazza
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    ABSTRACT: Background: Chronic constipation in children can be due to cow's milk intolerance (CMI) but its pathogenesis is unknown. Aims: To evaluate the histology in patients with food intolerance-related constipation. Patients and Methods: Tirthy-nine consecutive children with chronic constipation were enrolled. All underwent an elimination diet and successive double-blind food challenge. All underwent rectal biopsy. Results: 17 patients were found to be suffering from CMI and 3 from multiple food intolerance. They had a normal stool frequency on elimination diet, while constipation recurred on food challenge. The patients with food intolerance showed a significantly higher frequency of erosions of the mucosa, number of intra-epithelial lymphocytes and eosinophils. The rectal mucus gel layer showed that the food-intolerant patients had a significantly lower thickness of the mucus than the other subjects studied. The histology abnormalities disappeared on elimination diet. Conclusions: Food intolerance-related constipation is characterized by proctitis. The reduction of mucus gel layer can be considered contributory factor in the pathogenesis of constipation.
    No preview · Article · Jan 2005 · Acta Medica Mediterranea

Publication Stats

380 Citations
60.66 Total Impact Points

Institutions

  • 2008
    • A.R.N.A.S. Ospedale Civico Palermo
      Palermo, Sicily, Italy
  • 2006
    • Università degli Studi di Palermo
      • Department of internal medicine and medical specialties (DIMIS)
      Palermo, Sicily, Italy