Is pizza sutable to type 1 diabetes? A real life identification of best compromise between taste and low glycemic index in patients on insulin pump.

Opposed to whole wheat (WWP), traditional pizza (TP) is loved by patients with type 1 diabetes mellitus (T1DM) despite causing hyperglycemia. 50 well-trained T1DM patients had higher glucose levels after TP than after WWP or mixed flour pizza, which however was tasty, digestible and metabolically appropriate to break diet monotony.

A case of silicosis associated with Crohn's disease. Diagnostic and pathogenetic considerations.

A case of silicosis associated with Crohn's disease is reported. Symptoms, radiological and endoscopical findings suggested Crohn's disease in a man, who had worked as ceramist and in whom silicosis was diagnosed four years earlier. The authors, after presenting the clinical and diagnostic features of the patient, discuss the similarity of some pathogenetic features of the two diseases. They hypothesize a common pathogenetic immunological defect in the two diseases, probably caused by inhalation of silica.

Elective cholecystectomy in selected cirrhotic patients.

Of the 53 cirrhotic patients with cholelithiasis observed at our Institution from 1978 to 1991, 31 were operated on. Twenty-eight Child-Pugh class A, two class B and one class C patients underwent elective cholecystectomy with (5 cases) or without (26 cases) common bile duct exploration. Among the symptomatic patients, nine (18.7%) were refused for surgery because the risk was estimated to be too high. Symptoms ranged from mild-moderate abdominal pain to typical biliary colic. Acute biliary inflammatory complications as cholecystitis or cholangitis could be detected in the clinical history of 5 patients (16%). Although a common clinical feature, jaundice was directly related to gallbladder or common bile duct stones only in one half of the cases. A total of 18 postoperative non-lethal complications occurred in ten patients (32.2%), with haemorrhage from the gallbladder bed being the most frequent event. Bleeding was associated with increased prothrombin time more than 1.5 seconds above the control (p < 0.01) but severe haemorrhage occurred only when the platelet count was less than 100.000/ml (p < 0.05). Common bile duct explorations increased the risk of bleeding. Two of the 3 class B or C patients developed ascites (p < 0.05). It is concluded that elective cholecystectomy can be performed without mortality in selected and symptomatic patients with adequate hepatic functional reserve.

Iatrogenic haemobilia: ultrasound appearance of intragallbladder haemorrhage. A report of two cases.

Ultrasound appearance of intragallbladder haemorrhage in two patients with haemobilia is presented. Gallbladder lumina were occupied by non-shadowing, firm masses of mixed echogenicity representing blood clots. In both cases iatrogenic trauma following percutaneous transcholecystic cholangiography and blind hepatic biopsy caused bleeding in the biliary tree.

Gastric lymphoma: diagnosis and follow-up of chemotherapy-induced changes using real-time ultrasonography: a report of three cases.

Three cases of secondary gastric lymphoma are presented in which diagnosis was suggested by ultrasound (US) and confirmed by endoscopy and microscopical examination. Three different US patterns are illustrated and compared with endoscopy. US findings paralleled endoscopy during follow-up under antiblastic treatment: both improvement and lack of change in the gastric lesions were reliably predicted by US.

Influence of dietary intake of energy and carbohydrate on the proportion of saturated and monounsaturated fatty acids in adipose tissue of middle aged men.

The fatty acid composition of subcutaneous tissue has been determined in a population sample of apparently healthy middle aged men from Southern Italy. Dietary appraisal has been carried out by evaluating the usual pattern of food consumption during the year preceding the interview. The whole population sample was subdivided into three tertiles on the basis of the energy intake by the different individuals. The proportion of adipose tissue polyunsaturated fatty acids was relatively low in the high energy tertile III and high in the low energy tertile reflecting parallel differences in the intake of polyunsaturated fatty acids. The percentage of monounsaturated fatty acids (mainly oleic acid) was relatively high (p less than 0.01) and that of saturated fatty acids (mainly palmitic acid) relatively low (p less than 0.05) in the high energy tertile (III) as compared to the low energy tertile (I); these differences were independent of the amount and type of dietary fatty acids. Total energy was positively correlated (r = .87, p less than 0.01) to carbohydrate intake (g/day). Dietary carbohydrates (g/day) were inversely related to adipose tissue saturated fatty acids (r = -.40, p less than 0.001) and directly correlated to adipose tissue monounsaturated fatty acids (p = .40, p less than 0.001). Carbohydrate intake was related to adipose tissue monounsaturated and saturated fatty acids independently of daily energy intake. On the other hand when the influence of dietary carbohydrates was eliminated, no correlation was detectable any longer between energy intake and adipose tissue fatty acids.(ABSTRACT TRUNCATED AT 250 WORDS)

Abnormalities of glucose metabolism induced by liver cirrhosis and glycosylated hemoglobin levels in chronic liver disease.

UNLABELLED: The prevalence of impaired glucose tolerance (IGT) and diabetes mellitus (DM) such as defined by National Diabetes Data Group criteria, and glycosylated hemoglobin levels were assessed in a series of consecutive patients who had chronic active hepatitis (CAH) or cirrhosis in the absence of any known diabetogenic risk factors and who had normal fasting glycemic levels. Based on oral glucose tolerance test, the prevalence of IGT (15%) and DM (27%) in cirrhosis was significantly higher (p less than 0.005) than that observed in CAH (0%) and controls (0%). In contrast, HbA1 levels were not statistically different in cirrhotic patients (with normal or altered glucose tolerance) as compared with CAH and control subjects. IN CONCLUSION: (a) HbA1 is an unsatisfactory test in the diagnosis of altered glucose tolerance in patients with cirrhosis, and (b) Cirrhosis (but not CAH) represents itself a risk factor for the development of glucose metabolism alterations. Therefore, routine oral glucose tolerance testing is warranted in these patients.

[Variability of the clinical and laboratory aspects in the presentation of chronic liver diseases in relation to their etiology. Analysis of a case study and review of the literature]. / Variabilità del quadro clinico e laboratoristico di presentazione delle epatopatie croniche in rapporto all'eziologia. Analisi di uno studio casistico e rassegna della letteratura.

247 cases of patients suffering from chronic liver diseases were reviewed. These cases were divided according to "risk areas" (viral, alcoholic, viral and alcoholic, cryptogenic) and diagnosis (CAH, compensated cirrhosis, decompensated cirrhosis). Differences found in clinical and laboratory aspects of liver diseases from different risk areas are described but it is concluded that no single aetiology affects the liver functional reserve more than the others. Laboratory tests give more information in the early stages of chronic liver diseases while clinical analysis is more varied in the terminal ones. Literature on the subject is reviewed. Our data neither confirm nor disprove that HBsAg+ Alcohol+ patients display a characteristic clinical picture and this hypothesis should be further investigated.

[Juvenile arterial hypertension and body surface area. Initial results of a longitudinal epidemiologic study]. / Ipertensione arteriosa giovanile e superficie corporea. Primi risultati di uno studio epidemiologico longitudinale.

An epidemiological study has been carried out on a group of 622 students (10 to 13 years old) from a secondary school in Naples. Aims of the present work were: the evaluation of the prevalence of hypertension in an adolescent population; the association with familial hypertension and obesity; the persistence of high blood pressure values at follow-up. Blood pressure data obtained in these subjects by the use of a standard evaluation scale based on body surface percentiles were compared with those obtained by two major current methods used for the definition of "normal" blood pressure values in pediatric age. The method based on body surface percentiles has shown the highest specificity. The prevalence of hypertension, as detected by this method, has been of 3,5% as compared to 12,9% and to 9,5% of the other two methods. In a follow-up at one year, while the percentage of hypertensive students remained unchanged in the group detected by the method of body surface percentiles, it decreased from 12,9% to 9,3% and from 9,5% to 7,8% in the other two groups. The high prevalence of obesity and familial hypertension observed in these young hypertensive subjects suggest the possibility of selecting, by body surface percentiles, well defined group of subjects at risk, characterized by borderline hypertension, high grade of familial aggregation, high prevalence of obesity and by the persistence of hypertension at the follow-up.

Lack of correlation between the laboratory findings and a series of steps in the clinical severity of chronic liver disease.

A series of clinical steps in the severity of chronic liver disease (CLD) has been arranged to represent the case history of chronic active hepatitis and cirrhosis retrospectively. The 'steps' in such series of clinical stages have been chosen on the basis of physiopathological considerations, the state of health of the patients, and their ability to work. For every 'step' the laboratory findings were studied in order to verify the hypothesis that a laboratory case history exists, which is parallel to the clinical history of CLD. With the exception of serum albumin and, to a lesser extent, sulfobromophthalein-ki, which seem to reflect the progressive deterioration in hepatocellular function, the results suggest that most conventional tests do not seem to be of any value in monitoring a CLD patient in cases where the diagnosis is already known, whereas a physical examination provides a physician with more, and cheaper, information than laboratory tests.

Differential diagnosis between hepatic cirrhosis and chronic active hepatitis: specificity and sensitivity of physical and laboratory findings in a series from the Mediterranean area.

Sensitivity and specificity of physical and laboratory findings have been evaluated for the purpose of establishing a differential diagnosis between cirrhosis and chronic active hepatitis on clinicolaboratory grounds. Data from 213 patients from southern Italy with biopsy-proven chronic active hepatitis or cirrhosis have been studied retrospectively. Splenomegaly, hypocholesterolemia, and decreased sulfobromophthalein-Ki were among the most sensitive individual findings in cirrhosis, whereas decreased platelet count, jaundice, and hypoprothrombinemia were the most specific ones. The presence in the same patient of both one of the former and one of the latter findings yields a correct diagnosis of cirrhosis with at least 90% likelihood. Advantages of the proposed diagnostic technique and comparison with data from an American series are discussed.