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Inflammatory bowel disease: A proposal to facilitate the achievement of an unequivocal diagnosis
Gabriella Canavese,Gabrio Bassotti,Marco Astegiano,Isabella Castellano
World Journal of Gastroenterology , 2013, DOI: 10.3748/wjg.v19.i3.426
Abstract: Following the international guidelines criteria an adequate “diagnostic conclusion” of inflammatory bowel disease (IBD) can be achieved only if clinical, endoscopic and laboratory findings, together with sample technical adequacy and unequivocal histomorphological signs of the disease are available. Thus, a conclusive diagnosis requires a complex combination of clinical, endoscopic and histological data. A considerable number of endoscopic biopsies obtained from IBD patients do not meet the above-mentioned requirements. The aim of the present proposal is to introduce a binary system of evaluation in the “diagnostic conclusion” of the histopathological report that will help to simplify the clinical decisions and consequent patient management. In patients with no history of disease, the pathologist should classify the biopsies in “Diagnostic”, when the criteria established by the international guidelines are satisfied and “not diagnostic” when one or more of the above-mentioned criteria are not met. The term “not diagnostic” should replace “highly suggestive” and “probable”. This new terminology could avoid ambiguous expressions that encourage the clinician to classify the patient as affected by IBD without fulfilling all of the requirements for an accurate diagnostic approach.
Influence of genetics on tumoral pathologies: The example of the adenocarcinoma arising in Barrett's esophagus Influencia de la genética en la patología tumoral: El ejemplo del adenocarcinoma desarrollado sobre el esófago de Barrett
Vincenzo Villanacci,Gabrio Bassotti,Marianna Salemme,Elisa Rossi
Revista Espa?ola de Enfermedades Digestivas , 2012,
Abstract: Barrett's esophagus (BE) refers to an abnormal change (metaplasia) in the cells of the inferior portion of the esophagus. About 10% of patients with symptomatic gastroesophageal reflux disease (GERD) have BE. In some cases, BE develops as an advanced stage of erosive esophagitis. The risk of esophageal cancer appears to be increased in patients with BE. The only way to diagnose BE is by endoscopy and histology. Some studies suggest that intensive treatment of Barrett's esophagus with effective acid suppression can reduce the amount of abnormal lining in the esophagus. It is not clear whether such treatment also prevents esophageal cancer. Generally, the cancer starts out as carcinoma of the esophagus on the surface, and then invades the surrounding tissue. Surgery offers the best chance of long-term survival. There are many events that occur in Barrett's esophagus that lead to the development of cancer and most of them appear to occur early, before high-grade dysplasia or cancer develops. No one knows what the late events are and how cells acquire the ability to leave their normal growth boundaries. It is now widely accepted that the development of most cancers is due to something called genomic or genetic instability. The aim of this review is to show BE pathology in its progression to cancer looking for new biomarkers to distinguish between BE-dysplasia (low grade and high grade)- adenocarcinoma (ADC) and to characterize the ADC, giving more hope for its treatment.
Collagenous sprue with associated features of refractory celiac disease Sprue colágeno con características de enfermedad celiaca refractaria
Lucio Cuoco,Vincenzo Villanacci,Mario Salvagnini,Gabrio Bassotti
Revista Espa?ola de Enfermedades Digestivas , 2012,
Is hyperhomocysteinemia relevant in patients with celiac disease?
Giovanni Casella,Gabrio Bassotti,Vincenzo Villanacci,Camillo Di Bella
World Journal of Gastroenterology , 2011, DOI: 10.3748/wjg.v17.i24.2941
Abstract: AIM: To investigate whether this might be related to the presence of hyperhomocysteinemia. METHODS: From January 1998 to December 2008, we evaluated the presence of hyperhomocysteinemia in a series of 165 adult celiac disease (CD) patients (138 females and 27 males, mean age 43 years). RESULTS: Hyperhomocysteinemia was evident in 32 patients (19.3%), although most of them had moderate levels (mean value 25 mcg/ml; range 15-30). Only one patient had a history of myocardial infarction (heterozygosis for N5-N10-metil tetrahydrofolate reductase mutation). CONCLUSION: The systematic assessment of hyperhomocysteinemia seems, at present, unjustified in CD patients.
Avoiding biopsy in iron deficiency anemia is not a cost-effective approach Evitar la biopsia en la anemia sideropénica no es coste-efectivo
Sauid Ishaq,Rizwan Mahmood,Vicenzo Vilannacci,Gabrio Bassotti
Revista Espa?ola de Enfermedades Digestivas , 2012,
Performance of a greedy algorithm for edge covering by cliques in interval graphs
Gabrio Caimi,Holger Flier,Martin Fuchsberger,Marc Nunkesser
Computer Science , 2008,
Abstract: In this paper a greedy algorithm to detect conflict cliques in interval graphs and circular-arc graphs is analyzed. In a graph, a stable set requires that at most one vertex is chosen for each edge. It is equivalent to requiring that at most one vertex for each maximal clique is chosen. We show that this algorithm finds all maximal cliques for interval graphs, i.e. it can compute the convex hull of the stable set polytope. In case of circular-arc graphs, the algorithm is not able to detect all maximal cliques, yet remaining correct. This problem occurs in the context of railway scheduling. A train requests the allocation of a railway infrastructure resource for a specific time interval. As one is looking for conflict-free train schedules, the used resource allocation intervals in a schedule must not overlap. The conflict-free choices of used intervals for each resource correspond to stable sets in the interval graph associated to the allocation time intervals.
Self-Expandable Metal Stenting of Refractory Upper Gut Corrosive Strictures: A New Role for Endoscopy?
Raffaele Manta,Rita Conigliaro,Helga Bertani,Mauro Manno,Ahmed Soliman,Paolo Fedeli,Gabrio Bassotti
Case Reports in Gastrointestinal Medicine , 2011, DOI: 10.1155/2011/346413
Abstract: Caustic strictures of the gastrointestinal tract are often difficult to treat, since relapses are frequent after medical or endoscopic treatment. Thus, novel approaches are needed. We report here our experience with self-expandable metallic stents (SEMS) as a new endoscopic approach in three patients with corrosive strictures of the upper gastrointestinal tract.
Efficacy of an enterovaccine in recurrent episodes of diarrhea in the dog: a pilot study
Cerquetella,Matteo; Laus,Fulvio; Speranzini,Fabiana; Carnevali,Cristina; Spaterna,Andrea; Battaglia,Edda; Bassotti,Gabrio;
Revista Espa?ola de Enfermedades Digestivas , 2012, DOI: 10.4321/S1130-01082012000200004
Abstract: recurrent episodes of self-limiting diarrhea in the dog, due to sudden dietary changes and to stressful or exciting situations, are conditions sometimes difficult to treat. colifagina?, a commercially available bacterial enterovaccine, showed, in previous studies performed on experimentally induced colitis in mice, to be able to improve both disease activity index and histological appearance, increase colonic secretion of iga, and reduce inflammatory chemokine secretion. in the present study colifagina? was administered to five dogs presenting recurrent episodes of self-limiting diarrhea and to one dog presenting chronic diarrhea. during the follow-up period, almost all patients decreased the number of episodes of abnormal defecation and the fecal score of such episodes improved in five out of six dogs. even if further studies are needed to understand the exact potential of the compound, in dogs presenting recurrent episodes of self-limiting diarrhea due to sudden dietary changes and/or stressing or exciting situations, colifagina? seems to be helpful in managing most of these patients.
Chronic hepatitis in man and in dog: a comparative update
Cerquetella,Matteo; Giuliano,Vittorio; Rossi,Giacomo; Corsi,Simona; Laus,Fulvio; Spaterna,Andrea; Villanacci,Vincenzo; Bassotti,Gabrio;
Revista Espa?ola de Enfermedades Digestivas , 2012, DOI: 10.4321/S1130-01082012000400006
Abstract: chronic hepatitis is a frequent pathologic condition encountered in both dogs and humans; however, in the latter etiologic factors are usually searched and found that allow targeted therapeutic approaches, whereas in dogs this is less frequent. this review will take into consideration chronic hepatitis in dogs, and discuss differences and similarities between the two species with respect to this disease.
Non-IBD colitides: clinically useful histopathological clues
Villanacci,Vincenzo; Manenti,Stefania; Antonelli,Elisabetta; Chiudinelli,Mariella; Giuliano,Vittorio; Bassotti,Gabrio;
Revista Espa?ola de Enfermedades Digestivas , 2011, DOI: 10.4321/S1130-01082011000700006
Abstract: apart from inflammatory bowel diseases (ibd), there are several other form of colitis that may resemble macroscopically ibd, entering the differential diagnosis. these forms are represented by infectious colitis, ischemic colitis, pseudomembranous colitis, colitis related to diverticular disease, colitis related to mucosal prolapse, drug colitis, allergic colitis, and microscopic colitis. however, to distinguish between these forms is not always easy, and it frequently requires a strict interrelationship between the pathologist and the gastroenterologist. here we discuss the more frequent forms of non- inflammatory bowel diseases colitides, trying to give useful hints for helping the clinician to better understand the extent to which the pathologist is called to give a definitive response in the differential diagnosis of these entities.
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