Effectiveness of double-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (DBE-ERCP): A multicenter real-world study.

Background And Aims: To investigate the effectiveness of double-balloon enteroscope-assisted retrograde cholangiopancreatography (DBE-ERCP) in patients with gastrointestinal surgically altered anatomy (SAA).

Methods: From May 2013 to October 2021, all consecutive patients undergoing DBE-ERCP in three gastroenterological referral centers in Northern Italy were enrolled in the study. Patients were assessed regarding their medical history, previous surgery, time from previous surgery to the DBE-ERCP procedure, and the success or failure of DBE-ERCP.

Supplementation with alpha-linolenic acid and inflammation: a feasibility trial.

Consumption of omega-3 fatty acids, including the precursor α-linolenic acid (ALA) is often sub-optimal and not in line with international guidelines. Supplementation is debatable, but some individuals, e.g.

Endoscopic Papillectomy for Ampullary Adenomas: Different Outcomes in Sporadic Tumors and Those Associated with Familial Adenomatous Polyposis.

Background: Ampullary adenomas are rare and potentially malignant. Surgery was the standard treatment but endoscopic papillectomy (EP) is a possible alternative.

Aim: We retrospectively evaluated the principal clinical outcomes of EP in all patients referred to our unit also dividing sporadic ampullary adenoma (SAA) from familial adenomatous polyposis (FAP)-associated adenomas.

Endoscopic ultrasound-guided biliary drainage for malignant biliary obstruction after failed ERCP in low performance status patients.

Background: Endoscopic retrograde cholangiopancreatography (ERCP) with the placement of a biliary stent is the treatment of choice for palliation of malignant obstructive jaundice. In 5-10% of cases ERCP fails. In these cases an effective alternative is endoscopic ultrasonography-guided biliary drainage (EUS-BD).

Full-spectrum (FUSE) versus standard forward-viewing colonoscopy in an organised colorectal cancer screening programme.

Objective: Miss rate of polyps has been shown to be substantially lower with full-spectrum endoscopy (FUSE) compared with standard forward-viewing (SFV) colonoscopy in a tandem study at per polyp analysis. However, there is uncertainty on whether FUSE is also associated with a higher detection rate of colorectal neoplasia, especially advanced lesions, in per patient analysis.

Methods: Consecutive subjects undergoing colonoscopy following a positive faecal immunochemical test (FIT) by experienced endoscopists and performed in the context of a regional colorectal cancer population-screening programme were randomised between colonoscopy with either FUSE or SFV colonoscopy in seven Italian centres.

Ki-67 cytological index can distinguish well-differentiated from poorly differentiated pancreatic neuroendocrine tumors: a comparative cytohistological study of 53 cases.

The Ki-67 labeling index has been found to bear prognostic significance in gastrointestinal neuroendocrine tumors (NETs), and it was recently incorporated in NET histological grading. Nevertheless, a reliable preoperative determination of NET grading could be useful in clinical practice. The aim of this study is to compare the results of Ki-67 labeling index, as measured on cytological samples and on surgical specimens of patients with pancreatic NETs (P-NETs).

Endoscopic submucosal dissection of scar-embedded rectal polyps: a prospective study (Esd in scar-embedded rectal polyps).

Background & Aims: Endoscopic submucosal dissection (ESD) was developed for en bloc resection of superficial neoplasm of the digestive tract. We evaluated feasibility and safety of ESD, as a salvage therapy of large refractory rectal polyps, in a tertiary care setting.

Methods: We prospectively enrolled in the present study and treated by ESD 11 consecutive patients with rectal polyps (median diameter 3.

A randomized clinical trial comparing 22G and 25G needles in endoscopic ultrasound-guided fine-needle aspiration of solid lesions.

Background And Study Aims: The study aimed to investigate whether the 25G needle is superior to the 22G needle when used in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of solid lesions.

Patients And Methods: The study was a single-center randomized clinical trial. The setting was a tertiary referral hospital, where EUS-FNA of solid lesions was assisted by an on-site cytopathologist, who was blinded to the needle size.

Gastric cancer in a pregnant woman presenting with low back pain and bilateral erythematous breast hypertrophy mimicking primary inflammatory breast carcinoma.

This report describes the first case of a pregnant woman presenting low-back pain and breast pain associated with bilateral erythematous breast hypertrophy, proving to be the result of metastatic disease from a gastric carcinoma. A 30-year-old pregnant woman was admitted complaining of persistent severe low back pain, breast pain and concomitant bilateral erythematous breast hypertrophy, mimicking primary inflammatory breast carcinoma. During the caesarean section, widespread disease was found and finally metastatic gastric cancer was detected.

Massive GI bleeding due to accidental ASA inhalation.

This report describes a 38-year-old man admitted to hospital for a massive rectal bleeding and syncope. He was known to have idiopathic thrombocytopenia but he had never complained of bleeding until he was admitted to hospital with uncontrolled hemorrhage. Upper and lower endoscopic examination, performed 6 hours after occurrence of bleeding, were negative for ulcers or other bleeding lesions.

Diagnostic accuracy of a new rapid urease test (Pronto Dry), before and after treatment of Helicobacter pylori infection.

Aim: The diagnosis of Helicobacter pylori infection can be made easily by the rapid urease test during endoscopy. The mainly commercial rapid urease test available in routine practice, is in liquid phase, need to be stored at 4 degrees C and generally they are not ready to use. Recently a new rapid urease test, the Pronto Dry, has been reported to be faster in the final reading, ready to use, and it can be stored at room temperature.

Peptic ulcer and Helicobacter pylori: update on testing and treatment.

As evidence about the relationship between Helicobacter pylori infection and peptic ulcers accumulates, accurate testing and treatment are becoming increasingly important. However, big questions remain about the best strategies for detecting and managing this infection. In this article, the authors discuss the association between H pylori and peptic ulcer disease, the available tests for detecting the infection, and the latest treatment strategies for effective eradication.

A 10-day levofloxacin-based triple therapy in patients who have failed two eradication courses.

Background: A standard third-line treatment is lacking, and European guidelines recommend performing culture in these patients. However, the use of this procedure as 'routine practice' is definitively not feasible.

Aim: To evaluate the eradication rate of a 10-day levofloxacin-based triple therapy in patients who have failed two eradication courses for Helicobacter pylori.

High rate of Helicobacter pylori eradication with sequential therapy in elderly patients with peptic ulcer: a prospective controlled study.

Background: Helicobacter pylori eradication rates with triple therapies are decreasing, and few data in elderly patients are available. A 10-day sequential regimen succeeded in curing such H. pylori infection in unselected patients.

[Non-invasive analyses for the diagnosis of Helicobacter pylori infection. A critical review of the literature].

Helicobacter pylori (H. pylori) infection may be diagnosed by means of invasive techniques requiring endoscopy and biopsy (histological examination, rapid urease test, culture, polymerase chain reaction) and by non-invasive techniques (urea breath test, detection of specific antibodies in the serum or urine, detection of the H. pylori antigen in a stool specimen).

Spiral CT evaluation of pulmonary emphysema using a low-dose technique.

Purpose: To evaluate the diagnostic accuracy and clinical acceptability of low-dose spiral CT for determining pulmonary volumes and emphysema extension in patients with pulmonary emphysema, in comparison with studies based on spiral CT at conventional dose.

Materials And Methods: We prospectively evaluated eighteen patients, current or former smokers, with a clinical diagnosis of chronic obstructive pulmonary disease. All the patients underwent: HRCT with three scans at predetermined levels; quantitative spiral CT, with two inspiratory scans, one conventional scan at 240 mA, and the second one a low-dose scan at 80 mA.

[Automatic evaluation of total lung capacity and of emphysema involvement with spiral computerized tomography (CT) in obstructive pneumonia].

Objective: To evaluate, in patients with chronic obstructive lung disease or chronic bronchitis, inspiratory helical CT with 3D postprocessing, to measure lung volumes and the amount of emphysema and to compare these measurements with lung function tests.

Material And Methods: Seventeen patients with chronic obstructive lung disease disease or chronic bronchitis underwent pulmonary function tests and helical CT after a full inspiration with 3D postprocessing (lower threshold -1024 HU, upper thresholds -200, -300 and -400 HU). Lung inspiratory volumes (TLC-CT) were determined for each model; the amount of emphysema was evaluated by means of an automatic score and a visual score with HRCT.

[Role of emphysema in the etiology of functional impairment in patients with severe chronic obstructive pulmonary disease. Study with high resolution computerized tomography].

Purpose: To investigate whether high-resolution CT (HRCT) can detect the subjects with massive emphysematous destruction in a group of patients with severe chronic obstructive pulmonary disease (COPD) and therefore be of help in selecting the candidates to surgical lung volume reduction.

Material And Methods: We examined 40 former smokers with severe COPD (FEV1, < or = 40% of the predicted value, with no major improvement after inhalation of bronchodilators). Clinico-functional assessment included: a flow/volume loop (mean FEV1 = 28.

[Role of spiral computerized tomography in the staging of pancreatic carcinoma].

Introduction: Few pancreatic carcinomas (5-22%) are resectable at the time of diagnosis because this lesion is seldom diagnosed in an early stage. Unresectability is mainly due to the presence of metastases to the liver, peritoneum and lymph nodes and to tumor spread especially to the portal mesenteric trunk where it can invade, compress, reduce, or occlude the vessels. We investigated the diagnostic yield of multiplanar and 3D spiral CT in the assessment of pancreatic carcinoma resectability.

[Clinical role of CT-guided transthoracic needle biopsy in the diagnosis of solitary pulmonary nodules].

Purpose: The aim of this prospective study was to assess the overall diagnostic accuracy of CT-guided transthoracic biopsy of solitary pulmonary nodules, to compare the reliability of the diagnosis of malignancy made at prebiopsy CT and to investigate the final clinical impact of cyto-histologic results.

Materials And Methods: A prospective study was carried out on 128 CT-guided transthoracic biopsies performed in 119 subjects with a solitary pulmonary nodule to assess the diagnostic accuracy of the method. The cyto-histologic diagnosis was then compared to the previous radiologic and CT diagnosis and to clinical outcome, to define the reliability of the previous CT diagnosis and the clinical impact of lung biopsy in relation to its risk.

[High-resolution volumetric computerized tomography of the lung: optimization of technique and image quality as a function of its clinical-diagnostic use and dose to the patient].

Purpose: The aim of this project was to analyze and validate the diagnostic applications of Volumetric High Resolution CT in the study of focal or diffuse infiltrative lung disease compared with High Resolution CT. To date HRCT is the gold standard in the assessment of infiltrative lung diseases, but it shows some limitations such as artifacts due to both respiratory and cardiac motions, as well as the need for multiple breath-holds.

Material And Methods: September, 1996, to September, 1997, anthropomorphic test phantoms and a group of 34 subjects (8 without lung disease and 26 with aspecific lung disease: TBC, BPCO, micronodular conditions, cardiogenic interstitial pulmonary edema) were submitted to both HRCT and VHRCT.