ABSTRACT Background: In patients with celiac disease, the occurrence of exocrine pancreatic insufficiency has been related to an impairment of the gut‐mediated stimulatory effect of the meal on the pancreas. The purpose of this study was to assess the intraduodenal lipase activity in patients with celiac disease by means of the 13 C mixed‐triglyceride breath test and to monitor pancreatic function after the institution of a gluten‐free diet. Methods: Seventeen untreated patients with celiac disease (mean age, 17.4 ± 10.5 years) were studied. After an overnight fast, patients were given a standard test meal consisting of 100 g of white bread and 0.25 g of butter per kilogram of body weight, to which 16 mg di‐stearyl‐ 13 C‐octanoyl‐glyceride (mixed triglyceride) had been added. Breath samples were taken twice at baseline and at 30‐minute intervals for 6 hours after the meal. 13 C enrichment in breath was determined by means of Isotope Ratio Mass Spectrometer (IRMS) (ANCANT; Europa Scientific, Crewe, UK). Results were expressed as the maximum percentage of 13 C recovery per hour at any time, the time to reach peak excretion of 13 C, and the percentage of 13 C cumulative dose over 6 hours. Results: Mixed‐triglyceride breath test results were pathologic in three patients and at the lower limit of the normal range in another patient. In the remaining 13 patients, the results were within normal values. At the 6‐ and 12‐month follow‐ups, all patients showed normal intraduodenal lipase activity. Conclusions: In approximately 24% of patients with celiac disease, the intraduodenal pancreatic lipolytic activity is impaired. The mixed‐triglyceride breath test could be used to assess fat maldigestion and to monitor the need for enzyme replacement therapy in such patients.
The purpose of this study is to report personal experience in laparoscopic antireflux surgery and to analyze the clinical and functional outcomes of this procedure, also in relation to the different techniques used.From 1996 to 2000, 20 patients with gastroesophageal reflux disease associated with hiatal hernia underwent laparoscopic surgery. The indication for surgery was failure of long-term medical therapy. All patients had severe acid reflux on 24 hrs-pH monitoring, endoscopic evidence of esophagitis and hiatal hernia, and defective lower esophageal sphincter. A Nissen fundoplication was performed in 13 patients with normal esophageal body motility, and a 270 degrees posterior fundoplication in seven patients with low esophageal motility.Mortality and conversion rate were 0. Mean operative time was 135 min and mean postoperative hospital stay 5 days. Operative morbidity was 15%. All the patients were completely cured of reflux symptoms; transient mild postoperative dysphagia occurred in two patients (10%). There was a significantly improvement of the results in postoperative esophageal manometry and 24 hrs-pH monitoring.This preliminary experience suggests that laparoscopic surgery represents a safe and effective procedure for the treatment of gastroesophageal reflux disease. Precise selection of patients and adequate surgical technique are essential.
development of complications was reported. CONCLUSION:The therapeutic strategies were extremely heterogeneous.Ursodeoxycholic acid was ineffective in dissolution of gallstones but it had a positive effect on the symptoms.Laparoscopic cholecystectomy was confirmed to be an efficacy and safe treatment for pediatric gallstones.
From September 2020, a second wave of COVID-19 pandemic started. We aimed at exploring the impact of SARS-CoV-2 infection in IBD patients during the two waves.All IBD patients with a confirmed diagnosis of SARS-CoV-2 infection were enrolled. They were sorted into two groups (those infected before September 2020, and those from September 2020 to January 2021) and compared by demographic and clinical data.Twenty-five patients (out of about 600 with a follow-up visit) were infected with SARS-CoV-2 (4.1%). Sixteen were male and the mean age was 46.5 ± 14.3 years (range 24-74). Six were smokers and 11 had comorbidities; 2 were on steroids and 17 on immunosuppressants or biologics. Three patients (12%) needed hospitalization and other three patients were treated with azithromycin, steroids and LMWH, all of them during the second wave. No patient died or developed any sequelae. Two subjects were infected during the first wave (0.3 vs. 3.83, p<0.0001). Non-significant differences were found between the two groups.A higher number of IBD patients were infected during the second wave. No patient developed a severe form of pneumonia, even those treated with immunosuppressants or biologics. No risk factor for hospitalization was found.
ISHS XXVII International Horticultural Congress - IHC2006: International Symposium on Enhancing Economic and Environmental Sustainability of Fruit Production in a Global Economy MOLECULAR DETECTION OF 'CANDIDATUS PHYTOPLASMA ZIZIPHAE' IN DIFFERENT JUJUBE CULTIVARS
