[Efficacy of low dose mesalazine (5-ASA) in the treatment of acute inflammation and prevention of complications in patients with symptomatic diverticular disease. Preliminary results]. / Efficacia della mesalazina (5-ASA) a basse dosi nel trattamento della flogosi acuta e nella prevenzione delle complicanze in pazienti con malattia diverticolare sintomatica. Risultati preliminari.

MATERIALS AND METHODS: To assess the efficacy of mesalazine in treating acute diverticulitis and preventing diverticular disease (DD) complication. 166 patients with symptomatic DD were randomly assigned to receive mesalazine Pentacol (400 mg b.i.d., orally; M group) or no additional treatment (controls; C group). RESULTS: After a 12 months follow-up, 26 patients experienced a symptomatic relapse (8%M vs 27% C, p=0.003), with a higher rate in C group for the patients with a history of previous diverticulitis (p=0.006) and independently of the diverticular site (sigmoid p=0.041; colon and sigmoid p=0.044). Minor diverticular haemorrhages were less frequent in M group (p=0.016), with a significant difference only for the patients with sigmoid diverticula (p=0.023); abdominal pain persisted for a shorter time in the treated group (p=0.0015). CONCLUSIONS: No significant difference was found between the two groups for the incidence of DD major complications.

[Therapeutic and prophylactic role of mesalazine (5-ASA) in symptomatic diverticular disease of the large intestine. 4 year follow-up results]. / Ruolo terapeutico e profilattico della mesalazina (5-ASA) nella malattia diverticolare sintomatica del crasso. Risultati a 4 anni di follow-up.

In order to evaluate the efficacy and tolerability of mesalazine (5-ASA) in the prophylaxis of symptomatic relapses, of major complications and of microhemorrhagic phenomena in diverticular disease of the large intestine (MDC), prospective clinical study was conducted on patients with light-moderate symptomatic MDC under treatment with sulbactam-ampicillin 1.5 g/12 h i.m. and rifaximine 400 mg/12 h per os for 7 days. Follow-up period of 5 years with seriated checkups and laboratory and instrumentation controls. End points are represented by the relapse on inflammation and/or by the occurrence of major complications. On enrollment, 166 patients were randomized to receive mesalazine (Pentacol tablets--SOFAR S.p.A.) 400 mg b.i.d. per os for 8 weeks (81 patients; group M) or no supplementary treatment (85 patients; group C). After 4 years of follow-up, 44 patients dropped out of the study (9 because of major complications, 3 for massive hemorrhage, and 32 drop outs). Symptomatic relapses occurred in 51 patients (12 M; 39 C), while minor diverticular hemorrhages occurred in 43 patients (12 M; 31 C), with an estimated probability of remaining free respectively from symptomatic relapse (p=0.00005) and from microhemorrhagic phenomena (p=0.001) decisively in favor of the group treated with mesalazine. The duration of abdominal pain due to diverticolitis was also shorter in patients of group M (p=0.0002), while the incidence of major complications and side effects was comparable in the two groups. In conclusion, supplementary treatment with mesalazine in patients affected with MDC--at a follow-up limited to 48 months--proved to be well tolerated and effective in reducing the frequency of symptomatic relapses and microhemorrhagic phenomena and in reducing the duration of abdominal pain.

[Behavior of Helicobacter pylori in 3d and 4th age-bracket patients]. / Comportamento di Helicobacter pylori in pazienti della III e IV età.

AIMS AND BACKGROUND: Helicobacter pylori is known to be the pathogenic agent of atrophic gastritis and above all ulcer disease. It is also thought to play a role, together with other factors, in the development of stomach cancer and is currently the focus of numerous studies. In industrialised countries, infection is relatively commonplace in children, whereas its incidence rises more steeply in patients aged over 35, reaching a mean prevalence of 50% in over 60 year olds. METHODS: During 1997 the authors carried out an epidemiological study to assay levels of anti-Helicobacter pylori (IgG anti-Hp) in a sample of 91 aged patients hospitalised in the S. Margherita Geriatric Hospital in Pavia. The patients had been admitted to hospital for various pathologies and the study also took into account gastric pathologies which usually, particularly in neoplastic forms, prefers the third and fourth ages. The assay for antibodies was performed using mouse monoclonal antibody, specific for Helicobacter pylori, absorbed on a polyester pad. A total of 5 ml of blood were collected from each patient. The blood samples were all centrifuged and the serum frozen at -20 degrees C until the tests were performed. RESULTS: In this study, 46 of the 91 patients tested were positive for anti-Helicobacter pylori antibodies, 35 were negative and 10 borderline. CONCLUSIONS: The high level of positive results found in these patients is in line with the findings reported by other authors.

Rapid control of two outbreaks of Serratia marcescens in a Northern Italian neonatal intensive care unit.

Serratia marcescens is a recognized cause of outbreaks in neonatal intensive care units (NICUs). The aim of the present study was to investigate two nosocomial outbreaks of S. marcescens that occurred in an NICU in Northern Italy. In order to determine the origin of the outbreaks and the associated morbidity and mortality of S. marcescens infections and epidemiological investigation was established including molecular typing of the isolates. Containment of the outbreaks was achieved by means of strict hygienic measure and cohort nursing of the infected and/or colonized infants. We experimented with the use of probiotics as an infection control measure.

Blood hypercoagulability secondary to experimental cerebral ischemia in the rabbit: influence of a hyperdyslipemia induced by an atherogenic diet.

Within the framework of a research carried out at the Neurological Institute of Pavia on experimental cerebral ischemia some biohumoral determinations were done on two groups of rabbits: one kept on a standard diet and the other on an atherogenic diet to induce dyslipemia. The aim was to find out whether induced ischemia produces an activation of the hemocoagulation processes and whether hyperdyslipemia constitutes an aggravating factor. In the animals on a standard diet there was a statistically significant increase in factor X A and a nonsignificant increase in parameter (r + k) on TEG (thromboelastogram) and of factor VIII C after embolization. In the hyperdyslipemic group the changes were definitely more marked and, in the case of factor VIII C and parameter (r + k), statistically significant, accompanied by slight variations in APTT and factor IX pointing in the same direction. We discuss the meaning of our findings.