Incidence of Crohn's disease and CARD15 mutation in a small township in Sicily.

Background: The incidence of Crohn's disease (CD) has been shown to be lower in Southern than in Northern Europe. Data on the frequency of the NOD2/CARD15 mutations for Mediterranean area are very scant.

Aim: To determine the incidence of CD from 1979 to 2002 in a township in Sicily together with the allele frequency of NOD2/CARD15 mutations in patients, family members and controls, and to determine the allele frequency of these mutations in sporadic CD from other areas of Sicily in comparison with a control population.

Chemokine-mediated migration of melanoma cells towards lymphatics--a mechanism contributing to metastasis.

The mechanisms that cause tumors such as melanomas to metastasize into peripheral lymphatic capillaries are poorly defined. Non-mutually-exclusive mechanisms are lymphatic endothelial cell (LEC) chemotaxis and proliferation in response to tumor cells (chemotaxis-lymphangiogenesis hypothesis) or LECs may secrete chemotactic agents that attract cancer cells (chemotactic metastasis hypothesis). Using migration assays, we found evidence supporting both hypotheses.

Fatal necrotising fasciitis associated with intramuscular injection of nonsteroidal anti-inflammatory drugs after uncomplicated endoscopic polypectomy.

Necrotising fasciitis is a life-threatening infection of the superficial muscle fascia and the adjacent deep layer of subcutaneous tissue that is often fatal. A 46-year-old woman was admitted to the intensive care unit (ICU) three days after an uncomplicated endoscopic polypectomy because of necrotising fasciitis of left tight, buttock and retroperitoneal space and septic shock. Six hours after the polypectomy she was given an intramuscular injection of ketorolac in the left tight because of moderate low abdominal pain.

Postoperative maintenance therapy for inflammatory bowel disease.

Purpose Of Review: This review will highlight the knowledge gained from studies published in the year 2005 on maintenance treatment after surgery for inflammatory bowel diseases.

Recent Findings: In Crohn's disease the role of smoking in increasing the risk of relapse and recurrence after surgery is confirmed. Ornidazole seems effective in reducing endoscopic recurrence and clinical relapse after surgery.

[Prevention of oral cancer: practice patterns in a dentists' group].

Annually, 3000 people in our country die for oral cancer. Contrarily to other forms of cancer that require the use of instrumental diagnostic tools, the oral cavity is easy to examine and the cancer is usually preceded by precancerous conditions. The problem of the diagnostic delay can be explained through a underestimation of the lesions of the oral cavity by patients and a lack of sensibilization to prevention topics from dentists.

The role of calprotectin in predicting endoscopic post-surgical recurrence in asymptomatic Crohn's disease: a comparison with ultrasound.

Background And Objectives: Faecal calprotectin is predictive of clinical relapse in inflammatory bowel disease and ultrasound is sensitive in detecting its post-surgical recurrence. However, no data regarding the role of calprotectin in predicting post-surgical recurrence in asymptomatic Crohn's disease are available. The aim of this study was to prospectively evaluate the role of calprotectin as a predictive marker for one year post-surgical endoscopic recurrence in comparison with ultrasound in patients with asymptomatic Crohn's disease.

Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study.

Objective: To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause.

Subjects: Women attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms.

Methods: Cross-sectional study with no exclusion criteria.

Intestinal permeability and genetic determinants in patients, first-degree relatives, and controls in a high-incidence area of Crohn's disease in Southern Italy.

Objective: A defect of gastrointestinal barrier function is considered to represent an important step in the pathogenesis of Crohn's disease (CD) but the mechanisms leading to an increased intestinal permeability (IP) are poorly understood. Since IP is influenced by pro-inflammatory mediators, it seems likely that a genetically determined abnormal immune response may lead to a loss of barrier function.

Methods: In a geographic area in Southern Italy with high incidence of CD we investigated IP (lactulose/mannitol testing) together with the three main mutations of the NOD2/CARD15 and the D299G polymorphism of the toll-like receptor (TLR)-4 gene in 23 families of CD patients (patients and first-degree relatives).

Modification of the gold-weight implant for insertion into the upper eyelid in facial palsy.

Gold weight has been used as a lid-loading device in facial palsy for more than 50 years. This technique is frequently associated with certain complications like ulceration, migration, extrusion, etc. We have devised a new-shaped gold weight to reduce the rate of occurrence of these complications.

Factors associated with climacteric symptoms in women around menopause attending menopause clinics in Italy.

Objective: To obtain data on correlates of climacteric symptoms in women around menopause attending menopause clinics in Italy.

Methods: Since 1997 a large cross sectional study has been conducted on the characteristics of women around menopause attending a network of first level menopause outpatient's clinics in Italy. A total of 66,501 (mean age 54.

Verrucous carcinoma of the temporal bone: a wolf clothed in wool.

Verrucous carcinomas are rare tumors that predominantly affect the head and neck region. A paradox of slow, aggressive invasion, apparent lymphadenopathy, yet seemingly bland histopathology, they can beguile unwary clinicians into multiple diagnostic biopsies and regional lymphadenectomy. We report a rare verrucous carcinoma of the temporal bone associated with extensive destruction around the skull base.

Infliximab and newly diagnosed neoplasia in Crohn's disease: a multicentre matched pair study.

Background And Aims: The widespread use of anti-tumour necrosis factor alpha antibody (Infliximab) in Crohn's disease (CD) raises concerns about a possible cancer risk in the long term. In a matched pair study, we assessed whether Infliximab is associated with an increased risk of neoplasia.

Methods: In a multicentre matched pair study, 404 CD patients treated with Infliximab (CD-IFX) were matched with 404 CD patients who had never received Infliximab (CD-C).

Infliximab in the treatment of Crohn's disease: predictors of response in an Italian multicentric open study.

Background: Almost 20% of patients with active Crohn's disease are refractory to conventional therapy. Infliximab is a treatment of proven efficacy in this group of patients and it is not clear which variables predict a good response. AIMS.

Treatment of hepatocellular carcinoma in compensated cirrhosis with radio-frequency thermal ablation (RFTA): a prospective study.

Background/aims: To assess the effectiveness and the safety of radio-frequency thermal ablation (RFTA) in patients with hepatocellular carcinoma (HCC) < or = 5 cm in compensated cirrhosis.

Methods: A cohort of 202 consecutive patients (165 Child-Pugh class A and 37 class B) was prospectively assessed. A single lesion was observed in 160/202 (79.

Severe acute colitis associated with CMV: a prevalence study.

Background: Cytomegalovirus has been identified as a pathogen that contributes to flares of colitis when detected in colonic specimens of patients with inflammatory bowel disease.

Aim: To determine the overall prevalence and the role of cytomegalovirus infection in a consecutive series of patients with acute severe colitis admitted to our department from 2000 to 2003.

Methods: Among 42 patients (38 with ulcerative colitis and 4 with Crohn's disease) admitted to our hospital for acute severe colitis, we performed proctoscopy and biopsy together with blood sample for cytomegalovirus determination at the time of admission, regardless of their steroid resistance.

Sewing hot and cold: successful replant of a hand in a patient who developed malignant hyperthermia intraoperatively.

We report a case in which a patient developed malignant hyperthermia (MH) during surgery to replant his hand. His condition was stabilised without the need to cease the procedure which continued for a further 6 h. MH and traumatic amputation of a hand are both rare emergencies.

Randomized phase III trial of neoadjuvant chemotherapy in head and neck cancer: 10-year follow-up.

In 1986, we initiated a multicenter, randomized trial to compare induction chemotherapy with cisplatin and 5-fluorouracil followed by locoregional treatment (surgery and radiotherapy or radiotherapy alone) with locoregional treatment alone in patients with head and neck squamous cell carcinoma. Here we report the long-term results of the trial. A total of 237 patients with nonmetastatic stage III or IV head and neck carcinoma were randomly assigned to receive four cycles of neoadjuvant chemotherapy followed by locoregional treatment (group A) or locoregional treatment alone (group B).

Relationship of demographic variables on perception of fatigue and discomfort following prolonged standing under various flooring conditions.

It has been suggested that prolonged standing is associated with pain and discomfort experienced by assembly line workers and other occupations. In an attempt to alleviate these problems, companies have implemented ergonomic interventions which include alterations to the flooring conditions upon which workers stand. The purpose of this study was to investigate assembly line workers' perceptions of fatigue and discomfort associated with various body regions after standing for an 8-h shift on three different flooring conditions: (1) standing on a wood-block floor, (2) standing on a floor mat, and (3) wearing insoles.

Lymphatic density and metastatic spread in human malignant melanoma.

Malignant melanoma (MM), the most common cause of skin cancer deaths, metastasises to regional lymph nodes. In animal models of other cancers, lymphatic growth is associated with metastasis. To assess if lymphatic density (LD) was increased in human MM, and its association with metastasis, we measured LD inside and around archival MM samples (MM, n=21), and compared them with normal dermis (n=11), basal cell carcinoma (BCC, n=6) and Merkel cell carcinoma (MCC), a skin tumour thought to metastasise through a vascular route (MCC, n=6).

Familial occurrence of inflammatory bowel disease in celiac disease.

Background: The authors have previously reported a possible increased risk of the familial occurrence of Crohn's disease in patients with celiac disease.

Aim: The aim of the current study was to evaluate in a case-control study the familial occurrence of inflammatory bowel disease (IBD) in first-degree relatives of patients with celiac disease.

Methods: One hundred eleven consecutive patients with biopsy-proven celiac disease were interviewed to ascertain whether IBD was present in first-degree relatives.

Massive plexiform neurofibroma with associated meningo-encephalocoele and occipital bone defect presenting as a cervical mass.

The commonest skull manifestations in neurofibromatosis involve the orbit, with very few reports about occipital defects. We report a rare case of a 54-year-old lady with a massive plexiform neurofibroma extending from the auricular region down her left neck and into her shoulder, with an associated large left occipital and left petrous bone defect and extensive cerebellar meningo-encephalocoele, which presented with a relatively asymptomatic cervical mass and was treated with resection of the neurofibroma and advancement and rotational skin flaps.

[Oral cancers and the need for secondary prevention programs].

Each year, 250,000 people all over the world develop oral cancer, while 130,000 die for this condition. In Italy, these figures are 6000 and 3000, respectively. The 53% average survival rate in five years is one of the lowest, although it increases to 72-86% if oral cancer is diagnosed at the TNM stage I.

Nodal metastatic melanoma in the neck of a 4-year-old girl after diagnosis of Spitz nevus of the cheek.

A 4-year-old girl was referred to the plastic surgery unit with metastatic malignant melanoma diagnosed in a cervical lymph node. She had previously undergone excision of a Spitz nevus of the cheek at age 18 months. The management of this patient is discussed along with a review of the literature relating to Spitz nevi and malignant melanoma in childhood.