Modena, Italy
Modena, Italy

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Fiorelli A.,The Second University of Naples | Caterino U.,Endoscopic Unit | Raucci A.,The Second University of Naples | Santini M.,The Second University of Naples
Interactive Cardiovascular and Thoracic Surgery | Year: 2017

Tracheobronchial malignant stenosis is a life-threatening and challenging condition. In inoperable patients, a stent is the mainstay treatment to ensure ventilation. Here, we report the use of a fully covered standard conical self-expandable metallic stent as an emergency treatment for complex tracheobronchial malignant stenosis. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.


de Francesco V.,University of Foggia | Giorgio F.,University of Foggia | Ierardi E.,University of Foggia | Zotti M.,University of Foggia | And 22 more authors.
Journal of Gastrointestinal and Liver Diseases | Year: 2011

Background. Primary clarithromycin resistance markedly reduces Helicobacter pylori eradication rate following standard therapies. Prevalence of primary clarithromycin resistance in H. pylori is increasing, and three point mutations are mainly involved. Aim. To assess both the prevalence of primary clarithromycin resistance in Italy, and the distribution of the involved point mutations. methods. Primary clarithromycin resistance was assessed by TaqMan real-time polymerase chain reaction on antral biopsies of 253 consecutive, H. pylori infected patients enrolled in 13 Italian centres between January and September 2010. Results. Primary clarithromycin resistance was detected in 25 (9.9%) patients, with prevalence values widely ranging from 0 to 25%. Clarithromycin resistance rate was higher in female as compared to male patients (13.4% vs. 5.3%, p=0.03), and it tended to be higher in non-ulcer dyspepsia than in peptic ulcer patients (10.6% vs. 6.9%, p=0.5), female patients with non-ulcer dyspepsia showing the highest value (15.4%). The A2143G point mutation was detected in 13 (52.0%) patients, the A2142G in 9 (34.6%), whilst a double point mutation (A2143G plus A2142G) in 3 (11.6%) cases. Conclusions. Primary clarithromycin resistance is highly variable in different Italian geographic areas. High resistance rates were observed in female and in dyspeptic patients. Among the three point mutations of clarithromycin resistance, the A2143G remains the most frequently observed.


Pilotto A.,St Antonio Hospital | Franceschi M.,Endoscopic Unit
World Journal of Gastroenterology | Year: 2014

Since the discovery of Helicobacter pylori (H. pylori) infection as the major cause of gastroduodenal disorders three decades ago, H. pylori has been the focus of active research and debate in the scientific community. Its linkage to several diseases, such as peptic ulcer disease, gastritis and gastric malignancy is incontestable. In particular, it has been noticed that, as the aged population is increasing worldwide, older people are at increased risk of developing several gastroduodenal diseases and related complications. At the same time, gastric cancer is definitely more frequent in elderly than in adult and young people. In addition, it has been showed that peptic ulcer and related complications occur much more commonly in aged individuals than in young people, resulting in a significantly higher mortality. Although this infection plays a crucial role in gastrointestinal disorders affecting all age groups and in particular older people, only a few studies have been published regarding the latter. This article presents an overview of the epidemiology, diagnosis, clinical manifestations and therapy of H. pylori infection in elderly people. © 2014 Baishideng Publishing Group Inc. All rights reserved.


Jaka H.,Catholic University of Health and Allied Sciences | Jaka H.,Endoscopic Unit | McHembe M.D.,Muhimbili University of Health and Allied Sciences | Rambau P.F.,Catholic University of Health and Allied Sciences | Chalya P.L.,Catholic University of Health and Allied Sciences
BMC Surgery | Year: 2013

Background: Gastric outlet obstruction poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. There is a paucity of published data on this subject in our setting. This study was undertaken to highlight the etiological spectrum and treatment outcome of gastric outlet obstruction in our setting and to identify prognostic factors for morbidity and mortality. Methods. This was a descriptive prospective study which was conducted at Bugando Medical Centre between March 2009 and February 2013. All patients with a clinical diagnosis of gastric outlet obstruction were, after informed consent for the study, consecutively enrolled into the study. Statistical data analysis was done using SPSS computer software version 17.0. Results: A total of 184 patients were studied. More than two-third of patients were males. Patients with malignant gastric outlet obstruction were older than those of benign type. This difference was statistically significant (p < 0.001). Gastric cancer was the commonest malignant cause of gastric outlet obstruction where as peptic ulcer disease was the commonest benign cause. In children, the commonest cause of gastric outlet obstruction was congenital pyloric stenosis (13.0%). Non-bilious vomiting (100%) and weight loss (93.5%) were the most frequent symptoms. Eighteen (9.8%) patients were HIV positive with the median CD 4+ count of 282 cells/μl. A total of 168 (91.3%) patients underwent surgery. Of these, gastro-jejunostomy (61.9%) was the most common surgical procedure performed. The complication rate was 32.1 % mainly surgical site infections (38.2%). The median hospital stay and mortality rate were 14 days and 18.5% respectively. The presence of postoperative complication was the main predictor of hospital stay (p = 0.002), whereas the age > 60 years, co-existing medical illness, malignant cause, HIV positivity, low CD 4 count (<200 cells/μl), high ASA class and presence of surgical site infection significantly predicted mortality (p< 0.001). The follow up of patients was generally poor as more than 60% of patients were lost to follow up. Conclusion: Gastric outlet obstruction in our setting is more prevalent in males and the cause is mostly malignant. The majority of patients present late with poor general condition. Early recognition of the diagnosis, aggressive resuscitation and early institution of surgical management is of paramount importance if morbidity and mortality associated with gastric outlet obstruction are to be avoided. © 2013 Jaka et al.; licensee BioMed Central Ltd.


PubMed | Endoscopic Unit and The Second University of Naples
Type: | Journal: Interactive cardiovascular and thoracic surgery | Year: 2016

Tracheobronchial malignant stenosis is a life-threatening and challenging condition. In inoperable patients, a stent is the mainstay treatment to ensure ventilation. Here, we report the use of a fully covered standard conical self-expandable metallic stent as an emergency treatment for complex tracheobronchial malignant stenosis.

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