[Crohn disease of the colon with acute onset at the 17th week of pregnancy. Description of a clinical case]. / Morbo di Crohn del colon esordito acutamente alla 17a settimana di gestazione. Descrizione di un caso clinico.

A case of Crohn's disease of the colon onsetting at 17 weeks gestation and observed at the 22 weeks when the disease presented severely and concomitant to serious maternal malnutrition, is reported. The patient was treated with NPT for 4 weeks in association with corticosteroids and sulphasalazine therapy continued to term (36 weeks). The newborn (weight 2480 g, Apgar of 9 at 5') developed moderately serious postnatal icterus resolved with phototherapy; at twelve months he presented normal growth and neurological development conditions. Stress is laid on the fortunate outcome of this gestation and the role of NPT in the correction of maternal malnutrition and the maintenance of foetal growth.

["Resistent" obesity. Clinical and metabolic aspects, cellularity of the adipose tissue and personality factors]. / L'obesità "resistente". Considerazioni cliniche, metaboliche, di cellularità del tessuto adiposo e di personalità.

A study was made of 20 patients with "resistant" obesity selected from a series of about 4000 observed between 1970 and 1976 in an assessment of the possible existence of features distinguishing such patients from those who respond to treatment and display a satisfactory decrease in weight. The group was marked by a higher incidence of familial obesity, earlier onset of overweight, and certain personality features (evaluated by psychometric tests). Their blood sugar and insulin curves, blood cholesterol and uric acid, adipose tissue cellularity, and blood pressure (LHAP) were similar to those in the general series. Whereas their blood triglyceride values were normal, however, those in the general series were up by 21%. It is therefore felt that the clinical tests used at present do not enable the "resistant" obese subject to be distinguished. "Resistant" obesity may well constitute a distinct nosological entity, but one that is only identifiable via the patient's response to treatment.

[Preoperative renutrition in patients with esophageal stenosis]. / La renutrizione preoperatoria nei pazienti affetti da stenosi dell'esofago.

UNLABELLED: 50 patients suffering from dysphagia and oesophageal stenosis were treated in the period 1975-77. Of these 31 had renutrition of longer than two weeks and are the subject of the present study. Three nutrition systems were employed: 1) total parenteral feeding (7 patients), 2) feeding by naso-gastric tube or gastric fistula (15 patients), 3) feeding per os with semiliquid foods (9 patients). The patients were suffering from benign cicatricial stenosis (5), tumours of the cardia (7), tumours of the oesophagus (19). Short-term survival, weight behaviour and the course of certain blood parameters (Hb, GR, cholesterol, albumin, total proteins) are reported. CONCLUSIONS: --in benign cicatricial stenosis and tumours of the cardia, a normal protein-caloric amount (2000-3500 KCal., 80-120 g/24 h of proteins) is sufficient to obtain weight increase and stabilization of blood examinations. The administration route is unimportant; --in malignant stenosis, 4000-6000 KCal. and 100-130 g of protein/24 h must be provided to obtain the same result. In patients treated with total parenteral nutrition the weight loss persists. The reason for this behaviour is not known; it is likely that enzymatic blocks exist in substrate utilization; --further study is needed to improve results obtained and to clarify the reasons for such behaviour.