AIM: To investigate prevalence, type and time of onset of extraintestinal manifestations (EIMs) in a series of Italian inflammatory bowel disease (IBD) patients.
AIM: To evaluate the prevalence of lactose intolerance (LI) following a load of 12.5 g in patients diagnosed as high-grade malabsorbers using the hydrogen breath test (HBT)-25.METHODS: Ninety patients showing high-gra...AIM: To evaluate the prevalence of lactose intolerance (LI) following a load of 12.5 g in patients diagnosed as high-grade malabsorbers using the hydrogen breath test (HBT)-25.METHODS: Ninety patients showing high-grade malabsorption at HBT-25 were submitted to a second HBT with a lactose load of 12.5 g.Peak hydrogen production,area under the curve of hydrogen excretion and occurrence of symptoms were recorded.RESULTS: Only 16 patients (17.77%) with positive HBT-25 proved positive at HBT-12.5.Hydrogen production was lower as compared to HBT-25 (peak value 21.55 parts per million (ppm) ± 29.54 SD vs 99.43 ppm ± 40.01 SD; P < 0.001).Symptoms were present in only 13 patients.The absence of symptoms during the high-dose test has a high negative predictive value (0.84) for a negative low-dose test.The presence of symptoms during the first test was not useful for predicting a positive low-dose test (positive predictive value 0.06-0.31).CONCLUSION: Most patients with a positive HBT-25 normally absorb a lower dose of lactose and a strict lactose restriction on the basis of a "standard" HBT is,in most instances,unnecessary.Thus,the 25 g lactose tolerance test should probably be substituted by the 12.5 g test in the diagnosis of LI,and in providing dietary guidelines to patients with suspected lactose malabsorption/intolerance.展开更多
AIM:To identify factors predicting the clinical response of ulcerative colitis patients to granulocyte-monocyte apheresis (GMA). METHODS:Sixty-nine ulcerative colitis patients (39 F,30 M) dependent upon/refractory to ...AIM:To identify factors predicting the clinical response of ulcerative colitis patients to granulocyte-monocyte apheresis (GMA). METHODS:Sixty-nine ulcerative colitis patients (39 F,30 M) dependent upon/refractory to steroids were treated with GMA. Steroid dependency,clinical activity index (CAI),C reactive protein (CRP) level,erythrocyte sedimentation rate (ESR),values at baseline,use of immunosuppressant,duration of disease,and age and extent of disease were considered for statistical analysis as predictive factors of clinical response. Univariate and multivariate logistic regression models were used. RESULTS:In the univariate analysis,CAI (P = 0.039) and ESR (P = 0.017) levels at baseline were singled out as predictive of clinical remission. In the multivariate analysis steroid dependency [Odds ratio (OR) = 0.390,95% Confidence interval (CI):0.176-0.865,Wald 5.361,P = 0.0160] and low CAI levels at baseline (4 < CAI <7) (OR = 0.770,95% CI:0.425-1.394,Wald 3.747,P = 0.028) proved to be effective as factors predicting clinical response. CONCLUSION:GMA may be a valid therapeutic option for steroid-dependent ulcerative colitis patients with mild-moderate disease and its clinical efficacy seems to persist for 12 mo.展开更多
文摘AIM: To investigate prevalence, type and time of onset of extraintestinal manifestations (EIMs) in a series of Italian inflammatory bowel disease (IBD) patients.
文摘AIM: To evaluate the prevalence of lactose intolerance (LI) following a load of 12.5 g in patients diagnosed as high-grade malabsorbers using the hydrogen breath test (HBT)-25.METHODS: Ninety patients showing high-grade malabsorption at HBT-25 were submitted to a second HBT with a lactose load of 12.5 g.Peak hydrogen production,area under the curve of hydrogen excretion and occurrence of symptoms were recorded.RESULTS: Only 16 patients (17.77%) with positive HBT-25 proved positive at HBT-12.5.Hydrogen production was lower as compared to HBT-25 (peak value 21.55 parts per million (ppm) ± 29.54 SD vs 99.43 ppm ± 40.01 SD; P < 0.001).Symptoms were present in only 13 patients.The absence of symptoms during the high-dose test has a high negative predictive value (0.84) for a negative low-dose test.The presence of symptoms during the first test was not useful for predicting a positive low-dose test (positive predictive value 0.06-0.31).CONCLUSION: Most patients with a positive HBT-25 normally absorb a lower dose of lactose and a strict lactose restriction on the basis of a "standard" HBT is,in most instances,unnecessary.Thus,the 25 g lactose tolerance test should probably be substituted by the 12.5 g test in the diagnosis of LI,and in providing dietary guidelines to patients with suspected lactose malabsorption/intolerance.
文摘AIM:To identify factors predicting the clinical response of ulcerative colitis patients to granulocyte-monocyte apheresis (GMA). METHODS:Sixty-nine ulcerative colitis patients (39 F,30 M) dependent upon/refractory to steroids were treated with GMA. Steroid dependency,clinical activity index (CAI),C reactive protein (CRP) level,erythrocyte sedimentation rate (ESR),values at baseline,use of immunosuppressant,duration of disease,and age and extent of disease were considered for statistical analysis as predictive factors of clinical response. Univariate and multivariate logistic regression models were used. RESULTS:In the univariate analysis,CAI (P = 0.039) and ESR (P = 0.017) levels at baseline were singled out as predictive of clinical remission. In the multivariate analysis steroid dependency [Odds ratio (OR) = 0.390,95% Confidence interval (CI):0.176-0.865,Wald 5.361,P = 0.0160] and low CAI levels at baseline (4 < CAI <7) (OR = 0.770,95% CI:0.425-1.394,Wald 3.747,P = 0.028) proved to be effective as factors predicting clinical response. CONCLUSION:GMA may be a valid therapeutic option for steroid-dependent ulcerative colitis patients with mild-moderate disease and its clinical efficacy seems to persist for 12 mo.
