Biliary sludge is a mixture of particulate matter which has precipitated from bile. It generally ... more Biliary sludge is a mixture of particulate matter which has precipitated from bile. It generally consists of cholesterol monohydrate crystals, calcium bilirubinate or other calcium salts. In a clinical setting, biliary sludge is almost always an ultrasonographic diagnosis. Although it is less clinically applicable, direct microscopic examination of gallbladder bile is far more sensitive than ultrasonography into sludge detection, and has to be regarded as the diagnostic gold standard. The overall prevalence of sludge in the general population is relatively low. However, several clinical conditions are associated with a particularly high prevalence of biliary sludge, including pregnancy, rapid weight loss, total parenteral nutrition, octreotide therapy, bone marrow or solid organ transplantation. The clinical course of biliary sludge varies, and complete resolution, a waxing and waning course, and progression to gallstones are all possible outcomes. It may cause complications usually...
Helicobacter pylori and Gastroduodenal Pathology, 1993
Notwithstanding the many specific treatments against Helicobacter pylori (HP)-positive antral gas... more Notwithstanding the many specific treatments against Helicobacter pylori (HP)-positive antral gastritis [1–13], HP detection on the gastric mucosa of patients with gastroduodenal peptic disease is still an open question. The purpose of this open noncontrolled study was to compare, the efficacy of two established treatments, i.e., colloidal bismuth subcitrate (CBS; De-Nol) and amoxicillin in HP-positive patients with histologically confirmed type B gastritis.
Il n'est pas totalement irréaliste de penser que, dans quelques années, le bois de Hêtre à coeur ... more Il n'est pas totalement irréaliste de penser que, dans quelques années, le bois de Hêtre à coeur rouge ait supplanté, sur le marché des bois, le bois de Hêtre sans coeur. Pourquoi ?
AIM: The fears and concerns are associated with gastroscopy (EGD) decrease patient compliance. Co... more AIM: The fears and concerns are associated with gastroscopy (EGD) decrease patient compliance. Conscious sedation (CS) and non-pharmacological interventions have been proposed to reduce anxiety and allow better execution of EGD. The aim of this study was to assess whether CS, supplementary information with a videotape, or presence of a relative during the examination could improve the tolerance to EGD. METHODS: Two hundred and twenty-six outpatients (pts), scheduled for a first-time non-emergency EGD were randomly assigned to 4 groups: Co-group (62 pts): throat anaesthesia only; Mi-group (52 pts): CS with i.v. midazolam; Re-group (58 pts): presence of a relative throughout the procedure; Vi-group (54 pts): additional information with a videotape.
Colorectal cancer represents the second leading cause of cancer deaths in western countries with ... more Colorectal cancer represents the second leading cause of cancer deaths in western countries with elevated costs for health service. It's very important to develop screening and surveillance programs for cancer prevention with "cost-effective" means. We present a surveillance program with colonoscopy focused on first degree relatives of CRC patients. Colonoscopy is a "cost-effective" mean of screening for high risk subjects.
Conflicting results on the relationship between gallstone disease and the use of nonsteroidal ant... more Conflicting results on the relationship between gallstone disease and the use of nonsteroidal antiinflammatory drugs (NSAIDs) have been reported, but studies on the effect of NSAID use in populations not selected on the basis of a high risk for gallstone development are still lacking. Methods: We conducted a casecontrol study involving 216 patients, regular NSAID users (43 men and 173 women) consecutively admitted to a rheumatology department, suffering from rheumatoid arthritis (n ؍ 147), osteoarthritis (n ؍ 49), and ankylosing spondylitis (n ؍ 20). Two-hundred sixteen patients who were not NSAID users, matched for gender, age, and body mass index, consecutively admitted to a medical department for various medical pathologies, acted as a control group. All patients underwent upper abdomen ultrasonography. Results: The overall prevalence of gallstones was similar in the two groups: 24.0% in NSAID users (15.7% actual stones and 8.3% previous cholecystectomy) and 21.3% in controls (13.9% gallstones and 7.4% cholecystectomy). The prevalence of gallstone disease was significantly higher in women than in men, and the mean age was higher in gallstone patients than in gallstone-free patients, in both groups. No significant differences in type and duration of arthritis condition, type and dose of NSAID taken, and duration of treatment between gallstone patients and gallstonefree patients were found. On logistic regression analysis only female gender, aging, and family history of gallstone disease were significantly associated with the presence of gallstones, whereas no relationship between NSAID use and gallstone disease was found. Conclusions: Chronic NSAID ingestion does not seem to prevent gallstones in arthritis patients; in these patients gallstone disease is associated with classic risk factors (female gender and age).
The aim of the study was an evaluation of the effect of onesided lumbar sympathectomy in patients... more The aim of the study was an evaluation of the effect of onesided lumbar sympathectomy in patients with peripheral vascular disease of lower extremity(ies), using perfusion scintigraphy with (99)mTc-MIBI and ultrasound Doppler blood flow-rate measurements. A secondary aim was a comparison of the diagnostic efficacy of the two techniques applied. The study was performed on 30 patients, studied prior to and early after one-sided lumbar sympathectomy. The scintigraphy yielded results indicating a statistically significant increase in perfusion of femoral and calf muscles (p < 0.001). Ultrasound investigation demonstrated significant (p < 0.001) increase of the maximal blood flow rate in the popliteal artery. Scintigraphic perfusion study yielded better agreement with the clinical evaluation than the ultrasound Doppler technique (83 v. 47 per cent, p < 0.01) and higher sensitivity in demonstration of improved blood supply (88 v. 36 per cent, p < 0.001).
Biliary sludge is a mixture of particulate matter which has precipitated from bile. It generally ... more Biliary sludge is a mixture of particulate matter which has precipitated from bile. It generally consists of cholesterol monohydrate crystals, calcium bilirubinate or other calcium salts. In a clinical setting, biliary sludge is almost always an ultrasonographic diagnosis. Although it is less clinically applicable, direct microscopic examination of gallbladder bile is far more sensitive than ultrasonography into sludge detection, and has to be regarded as the diagnostic gold standard. The overall prevalence of sludge in the general population is relatively low. However, several clinical conditions are associated with a particularly high prevalence of biliary sludge, including pregnancy, rapid weight loss, total parenteral nutrition, octreotide therapy, bone marrow or solid organ transplantation. The clinical course of biliary sludge varies, and complete resolution, a waxing and waning course, and progression to gallstones are all possible outcomes. It may cause complications usually...
Helicobacter pylori and Gastroduodenal Pathology, 1993
Notwithstanding the many specific treatments against Helicobacter pylori (HP)-positive antral gas... more Notwithstanding the many specific treatments against Helicobacter pylori (HP)-positive antral gastritis [1–13], HP detection on the gastric mucosa of patients with gastroduodenal peptic disease is still an open question. The purpose of this open noncontrolled study was to compare, the efficacy of two established treatments, i.e., colloidal bismuth subcitrate (CBS; De-Nol) and amoxicillin in HP-positive patients with histologically confirmed type B gastritis.
Il n'est pas totalement irréaliste de penser que, dans quelques années, le bois de Hêtre à coeur ... more Il n'est pas totalement irréaliste de penser que, dans quelques années, le bois de Hêtre à coeur rouge ait supplanté, sur le marché des bois, le bois de Hêtre sans coeur. Pourquoi ?
AIM: The fears and concerns are associated with gastroscopy (EGD) decrease patient compliance. Co... more AIM: The fears and concerns are associated with gastroscopy (EGD) decrease patient compliance. Conscious sedation (CS) and non-pharmacological interventions have been proposed to reduce anxiety and allow better execution of EGD. The aim of this study was to assess whether CS, supplementary information with a videotape, or presence of a relative during the examination could improve the tolerance to EGD. METHODS: Two hundred and twenty-six outpatients (pts), scheduled for a first-time non-emergency EGD were randomly assigned to 4 groups: Co-group (62 pts): throat anaesthesia only; Mi-group (52 pts): CS with i.v. midazolam; Re-group (58 pts): presence of a relative throughout the procedure; Vi-group (54 pts): additional information with a videotape.
Colorectal cancer represents the second leading cause of cancer deaths in western countries with ... more Colorectal cancer represents the second leading cause of cancer deaths in western countries with elevated costs for health service. It's very important to develop screening and surveillance programs for cancer prevention with "cost-effective" means. We present a surveillance program with colonoscopy focused on first degree relatives of CRC patients. Colonoscopy is a "cost-effective" mean of screening for high risk subjects.
Conflicting results on the relationship between gallstone disease and the use of nonsteroidal ant... more Conflicting results on the relationship between gallstone disease and the use of nonsteroidal antiinflammatory drugs (NSAIDs) have been reported, but studies on the effect of NSAID use in populations not selected on the basis of a high risk for gallstone development are still lacking. Methods: We conducted a casecontrol study involving 216 patients, regular NSAID users (43 men and 173 women) consecutively admitted to a rheumatology department, suffering from rheumatoid arthritis (n ؍ 147), osteoarthritis (n ؍ 49), and ankylosing spondylitis (n ؍ 20). Two-hundred sixteen patients who were not NSAID users, matched for gender, age, and body mass index, consecutively admitted to a medical department for various medical pathologies, acted as a control group. All patients underwent upper abdomen ultrasonography. Results: The overall prevalence of gallstones was similar in the two groups: 24.0% in NSAID users (15.7% actual stones and 8.3% previous cholecystectomy) and 21.3% in controls (13.9% gallstones and 7.4% cholecystectomy). The prevalence of gallstone disease was significantly higher in women than in men, and the mean age was higher in gallstone patients than in gallstone-free patients, in both groups. No significant differences in type and duration of arthritis condition, type and dose of NSAID taken, and duration of treatment between gallstone patients and gallstonefree patients were found. On logistic regression analysis only female gender, aging, and family history of gallstone disease were significantly associated with the presence of gallstones, whereas no relationship between NSAID use and gallstone disease was found. Conclusions: Chronic NSAID ingestion does not seem to prevent gallstones in arthritis patients; in these patients gallstone disease is associated with classic risk factors (female gender and age).
The aim of the study was an evaluation of the effect of onesided lumbar sympathectomy in patients... more The aim of the study was an evaluation of the effect of onesided lumbar sympathectomy in patients with peripheral vascular disease of lower extremity(ies), using perfusion scintigraphy with (99)mTc-MIBI and ultrasound Doppler blood flow-rate measurements. A secondary aim was a comparison of the diagnostic efficacy of the two techniques applied. The study was performed on 30 patients, studied prior to and early after one-sided lumbar sympathectomy. The scintigraphy yielded results indicating a statistically significant increase in perfusion of femoral and calf muscles (p < 0.001). Ultrasound investigation demonstrated significant (p < 0.001) increase of the maximal blood flow rate in the popliteal artery. Scintigraphic perfusion study yielded better agreement with the clinical evaluation than the ultrasound Doppler technique (83 v. 47 per cent, p < 0.01) and higher sensitivity in demonstration of improved blood supply (88 v. 36 per cent, p < 0.001).
Uploads
Papers by Sergio Gullini