OSAS and metabolic diseases: Round Table, 99(th) SIO National Congress, Bari 2012.

This draft of the Official Round Table held during the 99th SIO National Congress is an updated review on the diagnostic tools, the importance of polysomnographic recording and a critical analysis of the surgical techniques in obstructive sleep apnoea syndrome (OSAS). The review and analysis of available publications is the premise along with a specific analysis of the relationship between OSAS and metabolic and vascular disorders. In addition, the most recent investigations on sleep disorders and altered glucose metabolism are summarised and discussed together with the results of a study by the authors involving a fairly large number of patients with OSAS and diabetes.

Laparoscopic liver resections in normal and cirrhotic livers: a retrospective analysis in a tertiary hepato-biliary unit.

Background: Liver surgery in patients with underlying liver disease results in higher mortality and morbidity rates compared to patients without underlying liver disease. Laparoscopy seems to have good results in patients with normal liver in terms of postoperative outcomes, but is more challenging in cirrhotic patients. Aim of this study was to evaluate the feasibility of laparoscopic liver resection both in normal and cirrhotic livers, and secondary endpoint was to compare the surgical results.

How to manage HBeAg-negative chronic HBV infection with normal alanine aminotransferase levels in clinical practice?

Many HBsAg-positive/HBeAg-negative patients show normal alanine aminotransferase levels. However, in this group of patients two different virological and clinical subsets do exist: inactive HBV carriers and patients with chronic hepatitis B with transient virological and biochemical remission. Natural history and outcome, severity of liver damage and need for liver biopsy and antiviral treatment differ significantly between these groups of patients.

Quantitation of tissue polypeptide antigen (TPA) in hepatic and systemic circulation in patients with chronic liver diseases.

Background And Aim: Abnormal serum tissue polypeptide antigen (TPA) values are commonly found in patients with chronic liver damage and liver cirrhosis even in the absence of malignancies. The aim of this study was to compare serum TPA levels in patients with cirrhosis, to examine correlations between TPA levels and the degree of portal hypertension, and to evaluate TPA concentrations in paired hepatic and peripheral blood samples.

Methods: A total of 128 patients with chronic liver disease of various severity were studied prospectively.

Hepatic venous pressure gradient does not correlate with the presence and the severity of portal hypertensive gastropathy in patients with liver cirrhosis.

Background And Aims: To evaluate whether the hepatic venous pressure gradient (HVPG) differs between cirrhotic patients with severe portal hypertensive gastropathy (PHG) and those with mild or absent PHG.

Methods: 59 cirrhotic patients with portal hypertension underwent hepatic vein catheterisation. 44 patients (76%) had PHG (16 mild and 28 severe).

Extrahepatic manifestations of chronic HCV infection.

Several extrahepatic manifestations have been reported in the natural history of hepatitis C virus infection (HCV). Up to 40-74% of patients infected with HCV might develop at least one extrahepatic manifestation during the course of their disease. Mixed Cryoglobulinemia (MC) is the most known and studied syndrome associated with HCV infection.

Hospital prevalence of asymptomatic primary biliary cirrhosis: 4-year study based on analysis of 4468 consecutive in-patients.

To assess the hospital prevalence of asymptomatic primary biliary cirrhosis (PBC), routine determination of serum alkaline phosphatase (AP), liver function tests (albumin, bilirubin, prothrombin time) and serum liver biochemistry (aminotransferases, gamma-glutamyltranspeptidase) were performed in 4468 consecutive in-patients (2332 men, 2136 women; mean age 57 years, range 16-94 years) admitted to our medical department from April 1991 to May 1995. In patients with an increase of serum AP levels, antimitochondrial antibody (AMA) testing, ultrasonography or CT scan, HIDA biliary scintiscan, bone scintiscan and endoscopic retrograde cholangio-pancreatography (ERCP) were performed to exclude any disorders other than PBC. Fourteen out of the 4468 patients (0.

Effects of ursodeoxycholic acid on serum liver enzymes in patients with hepatitis C virus-related chronic liver disease.

Objective: To study the effect of ursodeoxycholic acid (UDCA) on serum liver enzyme levels [alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT)] in 101 patients with hepatitis C virus-related chronic liver disease.

Methods: Forty-nine patients were assigned to receive UDCA (450 mg/day) over a period of 6 months and 52 to receive no treatment.

Results: In the UDCA group, serum ALT and GGT levels significantly improved.