[The possible uses of balneotherapy in treating chronic venous insufficiency of lower limbs]. / Possibilità della balneoterapia termale nell'insufficienza venosa cronica degli arti inferiori.

The Chronic Venous Insufficiency (CVI) of inferior limbs is a widespread disease, with an increasing incidence as a consequence of longer life expectance, life-style, obesity, smoking, use of drugs as oestrogens and progestins and working conditions. Medical therapy is still lacking for evidence of efficacy, and compression therapy is useful only in preventing a worsening of this condition. Surgical treatment is the only radical therapy effective for the advanced phases of the disease. In this context spa balneotherapy can be considered as a possible chance to improve some subjective and objective symptoms of CVI of inferior limbs, and to prevent worsening of this condition. The authors performed a review of the relevant scientific literature concerning the treatment of CVI of inferior limbs with mineral water balneotherapy, in order to evaluate its effects on objective and subjective symptoms and its effectiveness to prevent further worsening. We searched the PubMed/Medline, Cochrane Library, Embase, Web of Science databases for articles published between 1990 and 2011 on this topic. To this end, the authors selected few clinical-controlled and case-controlled studies; patients affected from CVI of inferior limbs were treated with balneotherapy at health spas with sulphureous, sulphate, salsojodic or salsobromojodic mineral waters. Baths in mineral waters were often associated with idromassotherapy and vascular pathway. Effects of spa balneotherapy are related to some aspecific properties, like hydrostatic pressure, osmotic pressure and water temperature, partly related with specific chemico-physical properties of the adopted mineral water. The controlled clinical studies on spa therapy showed significant improvement of subjective (such as itch, paresthesias, pain, heaviness) and objective symptoms (namely edema and skin discromias). These studies suggest that spa balneotherapy may give a good chance of secondary prevention and effective therapy of CVI of inferior limbs, but also that it needs of other clinical controlled trials.

[Helicobacter pylori and hepatobiliary diseases]. / Helicobacter pylori e malattie epatobiliari.

The aim of this short review is to understand if the Helicobacter pylori could have some sort of importance in the pathogenesis and in the development of not only gastroduodenal diseases, but in particular of those of the liver: a summary of the last researches has been done on the relations between this bacterium and some liver diseases; our intention is to continue this researches.

[Hepatic steatosis: clinical-statistical study of patients diagnosed by histological or ultrasonographic methods]. / Steatosi epatica: indagine clinico-statistica in pazienti con diagnosi istologica o esclusivamente ultrasonografica.

PURPOSE: This study wants to document eziopathogenetic factors and clinical, instrumental and hystological characters that associate to the various types of hepatic steatosis. PATIENTS AND METHODS: In this retrospective study have been examined two different groups of randomized patients. The "Group 1" comprehended 70 patients with hystologic diagnosis of hepatic steatosis (steatohepatitis--SH--60%; steatosis--SE--40%). The "Group 2" comprehended 70 patients with ultrasonographic pattern of fatty liver (slight degree: 70%; severe degree: 30%). RESULTS: Analysis of results relative to the "Group 1" showed the role of HCV-infection in etiopathogenesis of the SH, significantly greater than in SE (76.2% vs 25%; p < 0.0001). SE is often associated with exogenous noxae (alcoholism: 28.6%; use of long-term medications: 14.3%) or metabolic disorders (hyperglycemia 28.6%, hyperlipidemia 42.8%, obesity 25%). Haven't seen differences of clinical data or serum liver tests between SE and SH. Histological features that predicted the development of cirrhosis and/or fibrosis are more frequent in SH (SH: 40.4% vs SE: 10.7%; p < 0.01). The analysis of "Group 2" hasn't shown differences of clinical data or serum liver tests between slight and severe degree. CONCLUSIONS: Analysis of results relative to the two groups of patients ones has shown that SE and SH are thick asymptomatics and associated at hepatomegaly and at increase of ALT, AST, gamma GT. The increase of ALT and/or AST leads to search for the markers of HBV and HCV; when they are positive, hepatobiopsy is necessary for the diagnosis of possible SH or evolutive state to liver cirrhosis.

[Motility of the gastric antrum and the gallbladder following oral administration of sulfate-bicarbonate]. / Motilità dell'antro gastrico e della colecisti dopo somministrazione orale di un'acqua minerale solfato-bicarbonata.

The authors evaluate the influence of a sulphate-bicarbonate mineral water on gastric emptying and cholecystic motility. Nine healthy volunteers drunk at settled intervals and with same procedures equal doses of mineral water and tap water on alternate days. Ultrasonographic evaluation of the gastric emptying and cholecystic volumes was performed before and after mineral water and top water drinks at settled intervals. The mean values of the gastric and the cholecystic volumes were calculated and compared at the single times. The results showed a significant colecystocinetic effect of the mineral water compared with tap water. No difference was observed in the gastric emptying with the mineral and tap water. Our work contributes to the knowledge of the pharmacodynamic effects of the mineral water employed and confirms its usefulness in the syndromes based on alterations in bile secretion and bile excretion in duodenum.

[Endoscopic and histologic findings of gastric mucosa and Helicobacter pylori prevalence in patients suffering from chronic liver disease]. / Quadro endoscopico ed istologico della mucosa gastrica e prevalenza dell'Helicobacter pylori in pazienti con epatopatia cronica.

In this research we evaluated the prevalence of Hp in the gastric mucosa in patients suffering for chronic liver disease, either chronic hepatitis or liver cirrhosis. Sixty-three patients 27 with chronic hepatitis and 36 with liver cirrhosis, were examined by EGDS; of them we evaluated: endoscopic findings of stomach and duodenum, histology of gastric mucosa (antrum and corpus-fundus), presence of Hp in the histologic samples. We compared the positivity for Hp with the following parameters: presence of esophageal varices, macroscopic aspect of the gastric and duodenal mucosa, presence of hystological findings of gastritis, gastritis's activity, grading of the hepatic damage. In the our research we didn't point out greater prevalence of the Hp in the gastric mucosa with respect to hepatic damage, esophageal varices or macroscopic signs of gastric pathology. The Hp is significantly associated with histologic evidence of gastritis and also with the grade of gastritis's activity. The data of the present work don't suggest any correlation within the pathologic changes of the gastric mucosa caused from the liver cirrhosis and the presence or the growth of Hp.

[Current orientation on medical therapy of Crohn disease]. / Moderni orientamenti di terapia medica del morbo di Crohn.

The Crohn's disease has an increasing incidence and prevalence in the western countries and also in Italy; genetic, familiar and enviromental factors, but, above all, altered immunity have pathogenetic effects for the chronic flogosis and damage of gastroenteric tract. With ulcerative rettocolitis, the Crohn's disease is part of the chronic inflammatory bowel disease. In the present paper the medical therapy of Crohn's disease is especially studied; it is based on the use of corticosteroids and SASP or its active metabolite 5-ASA. Other pharmacs are reviewed as: immunosuppressors, antibiotics, antimetabolites and symptomatic or substitutive therapy. At the end the authors pointed out therapeutic lines in relation to acute or chronic stage and gravity of the disease.

[Chronic obstructive bronchopneumopathy. Epidemiologic aspects and balneotherapy potential]. / Broncopneumopatie croniche ostruttive (BPCO). Aspetti epidemiologici e possibilità crenoterapiche.

The authors remember the epidemiological data of BPCO in Italy and in the world and stress the increasing incidence and prevalence of these disease, interesting above all industrial-urban areas, middle and old aged, males and smokers. The pathogenetic role of atmospheric pollution, caused by industries, heating system and motor vehicles, in exposed. At the end Auctors summarise the results of the inhalatory therapy by mineral waters in BPCO, especially of sulphureas and salso-jodic spas.