The general practitioner's approach to irritable bowel syndrome: from intention to practice.

Background: Although general practitioners play a critical role in the management of irritable bowel syndrome because they deal with the most patients, guidelines are developed mainly by specialists.

Aims: To evaluate the clinical features of irritable bowel patients and the general practitioners' approach to irritable bowel syndrome in Italy.

Subjects And Methods: A questionnaire focusing on the management of this syndrome was completed by 28 general practitioners.

Time course of changes in retinal thickness and visual acuity after intravitreal triamcinolone acetonide for diffuse diabetic macular edema with and without previous macular laser treatment.

Purpose: To describe the changes in retinal thickness (RT) and visual acuity over time in patients with clinically significant diffuse diabetic macular edema (DME) after intravitreal injection of triamcinolone acetonide (IVTA) and to compare patients with and without previous laser treatment.

Methods: A total of 23 eyes with clinically significant DME received a 4-mg IVTA injection. Twelve eyes were refractory to macular laser treatment (group 1), and 11 eyes received IVTA as primary therapy (group 2).

Haemodynamic effects of eprosartan and valsartan in hypertensive patients during isometric and mental stress.

Objective: To assess the effects of eprosartan and valsartan on the haemodynamics of forearm circulation in hypertensives undergoing isometric and mental stress.

Design And Methods: Thirty-six patients with essential stable hypertension underwent haemodynamic evaluations on the left arm: humeral flux and calibre by means of colour Doppler ultrasound, microcirculatory flux on the third finger of left hand by means of laser Doppler flowmetry, blood pressure and heart rate monitor. District resistance was calculated as the ratio between mean arterial pressure and blood flow, and microcirculatory conductance was calculated as the ratio between flux and the mean pressure.

Beta-lipoprotein- and LDL-associated serum gamma-glutamyltransferase in patients with coronary atherosclerosis.

Elevation of serum gamma-glutamyltransferase (GGT) activity is a risk factor for myocardial infarction and stroke. GGT activity can catalyze the oxidation of low-density lipoprotein (LDL), a process involved in the pathogenesis of atherosclerosis. Serum GGT is partially adsorbed onto circulating LDL, and catalytically active GGT has been found within atherosclerotic plaques, colocalizing with oxidized LDL and foam cells.

Gamma-glutamyltransferase in fine-needle liver biopsies of subjects with chronic hepatitis C.

Serum gamma-glutamyltransferase (GGT) is considered as a sensitive but rather nonspecific marker of hepatobiliary disease, including chronic hepatitis C virus (HCV) infection. Although its increase in HCV infection is associated with poor response to interferon-alpha (IFN-alpha) and poor prognosis, there is little knowledge of the reasons of its increase during disease. Immunohistochemistry and enzyme histochemistry were performed on fine-needle biopsies of subjects with HCV infection.

Calprotectin is a stronger predictive marker of relapse in ulcerative colitis than in Crohn's disease.

Background And Aims: The clinical course of inflammatory bowel disease is characterised by a succession of relapses and remissions. The aim of our study was to assess whether the predictive value of faecal calprotectin-a non-invasive marker of intestinal inflammation-for clinical relapse is different in ulcerative colitis (UC) and Crohn's disease (CD).

Methods: Seventy nine consecutive patients with a diagnosis of clinically quiescent inflammatory bowel disease (38 CD and 41 UC) were followed for 12 months, undergoing regular clinical evaluations and blood tests.

Mathematical skills in Prader-Willi Syndrome.

Objectives: This paper investigates mathematical skills in Prader-Willi Syndrome (PWS), a pathological condition because of congenital alterations of chromosome pair 15. The following questions were addressed: (1) Are mathematical skills in PWS relatively more impaired with respect to other cognitive functions (as has been repeatedly but anecdotally reported)?; and (2) What is the nature of the mathematical impairment?

Methods: The first study employed the Wechsler Adult Intelligence Scale (WAIS) and an extensive battery of cognitive tasks for which norms are known. Both batteries include a mathematical section.

Reciprocal relationship between left ventricular filling pressure and the recruitable human coronary collateral circulation.

Aims: The aim of our study in patients with coronary artery disease (CAD) and present, or absent, myocardial ischaemia during coronary occlusion was to test whether (i) left ventricular (LV) filling pressure is influenced by the collateral circulation and, on the other hand, that (ii) its resistance to flow is directly associated with LV filling pressure.

Methods And Results: In 50 patients with CAD, the following parameters were obtained before and during a 60 s balloon occlusion: LV, aortic (Pao) and coronary pressure (Poccl), flow velocity (Voccl), central venous pressure (CVP), and coronary flow velocity after coronary angioplasty (V(Ø-occl)). The following variables were determined and analysed at 10 s intervals during occlusion, and at 60 s of occlusion: LV end-diastolic pressure (LVEDP), velocity-derived (CFIv) and pressure-derived collateral flow index (CFIp), coronary collateral (Rcoll), and peripheral resistance index to flow (Rperiph).

Blood levels of TT virus following immune stimulation with influenza or hepatitis B vaccine.

Torque Teno virus (TTV) has been demonstrated to be present persistently in the blood of healthy individuals without evidence that it causes any disease process. The levels of TTV vary in patients co-infected with other viruses and there has been considerable speculation as to whether TTV contributes to pathogenesis by other viruses or if the varying levels might be related to immune activation in the host. In the present study, the load of TTV was examined in plasma and peripheral blood mononuclear cells (PBMCs) following immunization of subjects with either influenza (a recall antigen) or hepatitis B virus (HBV) (a new antigenic exposure).

Optical coherence tomography evaluation of macular edema after radial optic neurotomy in patients affected by central retinal vein occlusion.

Purpose: To evaluate the characteristics of macular edema (ME) before and after radial optic neurotomy (RON) detected by optical coherence tomography (OCT), in patients with central retinal vein occlusion (CRVO).

Design: Interventional case series.

Methods: Five eyes of 5 patients affected by CRVO underwent RON.

Thyroid disorders in chronic hepatitis C.

Purpose: To explore the association of hepatitis C virus (HCV) infection with thyroid disorders.

Methods: We investigated the prevalence of thyroid disorders in 630 consecutive patients with chronic hepatitis due to HCV infection; all patients were free of cirrhosis and hepatocarcinoma, and were not on interferon treatment. Also included were a control group of 389 subjects from an iodine-deficient area, another control group of 268 persons living in an area of iodine sufficiency, and 86 patients >40 years of age with chronic hepatitis B.

Radionuclide gastroesophageal motor studies.

Disorders of the upper digestive tract have a high impact on modern society, in terms of both direct and indirect health care costs and of social burden. The most common presenting symptom is either dysphagia or dyspepsia. Discriminating specific diagnoses within this wide group of diseases requires sound clinical judgment and application of procedures to distinguish organic from nonorganic disease and to further characterize the functional or motility disturbance of nonorganic diseases.

Physiological and morphological responses of grassland species to elevated atmospheric CO2 concentrations in FACE-systems and natural CO2 springs.

Stomatal density, leaf conductance and water relations can be affected by an increase in the concentration of atmospheric CO, and thus affect plant productivity. However, there is uncertainty about the effects of elevated CO on stomatal behaviour, water relations and plant productivity, owing to the lack of long-term experiments in representative natural ecosystems. In this work, variations in stomatal density and index, leaf water relations and plant biomass of semi-natural grassland communities were analysed under field conditions by comparing plants in three different experimental set-ups (natural CO springs, plastic tunnels and mini-FACE systems).

Platelet serotonin transporter in patients with diarrhea-predominant irritable bowel syndrome both before and after treatment with alosetron.

Objectives: Serotonin reuptake is mediated by a transporter protein (SERT), and its dysfunctions can alter serotonergic transmission. The present study examines the binding profile of platelet SERT in healthy volunteers as well as in patients with diarrhea-predominant irritable bowel syndrome (D-IBS), both before and after treatment with the 5-HT(3) receptor antagonist alosetron.

Methods: Binding of [(3)H]paroxetine to SERT was assayed in platelet membranes collected from D-IBS patients (12 women, age 21-73 yr) and healthy volunteers (12 women, age 24-68 yr).

Role of faecal calprotectin as non-invasive marker of intestinal inflammation.

Background/aim: Faecal calprotectin, a neutrophil granulocyte cytosol protein, is considered a promising marker of intestinal inflammation. We assessed and compared the faecal calprotectin concentration in patients with organic and functional chronic intestinal disorders.

Patients And Methods: The study was carried out, using a commercially available ELISA test, measuring calprotectin in stool samples collected from 131 patients with inflammatory bowel diseases, 26 with intestinal neoplasms, 48 with irritable bowel syndrome and 34 healthy subjects.

Relationships between TT virus infection and hepatitis C virus response to interferon therapy in doubly infected patients.

A group of 24 well-characterized patients doubly infected with hepatitis C virus (HCV) and TT virus (TTV) were studied to evaluate whether the loads and number or identity of the genogroups of TTV they carried could affect the response of HCV infection to interferon-alpha (IFN) treatment. The features of HCV infection in the study patients provided a fair representation of the variables that are usually found in considering patients for IFN treatment. The same was true for the features of TTV infection.

Long-term endoscopic surveillance of patients with Barrett's esophagus. Incidence of dysplasia and adenocarcinoma: a prospective study.

Objective: Barrett's esophagus (BE) is a premalignant condition for which regular endoscopic follow-up is usually advised. We evaluated the incidence of esophageal adenocarcinoma (AC) in patients with BE and the impact of endoscopic surveillance on mortality from AC.

Methods: A cohort of newly diagnosed BE patients was studied prospectively.

Relationship of TT virus and Helicobacter pylori infections in gastric tissues of patients with gastritis.

Blood and gastric tissue biopsies of 34 patients with gastritis were tested for the presence of TT virus (TTV), a ubiquitous virus found in the blood of most humans. Thirty-one of these patients were TTV positive, and 27 patients had virus in both tissues. In addition, 13 of the patients who had TTV in gastric tissue were Helicobacter pylori positive.

An inter- and intra-laboratory comparison of breath ¹³CO₂analysis.

Background: ¹³C breath test analysis requires accurate ¹³CO₂measurements.

Aim: To perform a multicentre study to evaluate the repeatability and reproducibility of breath ¹³CO₂analysis.

Methods: Two series of 25 paired randomly coded tubes (each consisting of 23 ¹³CO₂-enriched breath samples and two samples of standard reference pure CO₂with certified δ ¹³C(PDB)) were sent to participating centres for ¹³CO₂measurement.

Serum lipoprotein(a) concentrations and alcohol consumption in hypertension: possible relevance for cardiovascular damage.

Objectives: To evaluate the relationships between alcohol intake and serum lipoprotein(a) [Lp(a)], a powerful predictor of organ damage, in patients with essential hypertension with a wide range of alcohol intake, and to investigate whether the association between alcohol intake and serum Lp(a) concentrations occurs over the entire spectrum of apo(a) phenotypes.

Design: Cross-sectional study of a case series.

Setting: University medical centre.

TT virus in the nasal secretions of children with acute respiratory diseases: relations to viremia and disease severity.

The natural history and pathogenic potential of the recently identified TT virus (TTV) are currently a matter of intensive investigation. In an attempt to shed some light on these issues, nasal and blood specimens of 1- to 24-month-old children hospitalized with a clinical diagnosis of acute respiratory disease (ARD) were examined for the presence, load, and genetic characteristics of TTV. The results have indicated that at least in young children, the respiratory tract not only represents a route by which abundant TTV can be shed into the environment but also may be a site of primary infection and continual replication.

The emerging risk factors for cardiovascular disease: a review of the epidemiologic evidence for lipoprotein(a), homocysteine, and fibrinogen.

Appropriate correction of cardiovascular risk factors is a mainstay of the treatment of patients that have developed or might develop cardiovascular disease. In addition to classical risk factors, such as hypertension, smoking, dyslipidemia, diabetes, obesity, and sedentary life, epidemiological research has identified a number of additional conditions that are associated with a greater risk of cardiovascular disease. In fact, a substantial percentage of patients who develop cardiovascular events do not have any of the classical risk factors.