Multiple food hypersensitivity as a cause of refractory chronic constipation in adults

Chronic constipation that is unresponsive to laxative treatment is a severe illness, but children unresponsive to laxatives have been successfully treated with an elimination diet. We report the first cases of refractory chronic constipation caused by food hypersensitivity in adults. Four patients with refractory constipation who were unresponsive to high doses of laxatives were put on an oligo-antigenic diet and underwent successive double-blind, placebo-controlled, food challenges (DBPFC). Routine laboratory tests, immunological assays, colonoscopy, esophago-gastroduodenoscopy and rectal and duodenal histology were performed. While on an elimination diet, bowel habits normalized in all patients and a DBPFC challenge triggered the reappearance of constipation. In comparison with another 13 patients with refractory constipation unresponsive to the elimination diet, observed over the same period, the patients with food-hypersensitivity-related constipation had the following characteristics: longer duration of illness (p < 0.03), lower body mass index (p < 0.03), higher frequency of self-reported food intolerance (p < 0.01), higher frequency of nocturnal abdominal pain and anal itching (p < 0.01). In patients with food hypersensitivity, hemoglobin concentrations and peripheral leukocytes were lower than those in controls (p < 0.03). The duodenal and rectal mucosa histology showed lymphocyte and eosinophil infiltration, and the duodenal villi were flattened in two cases. In adult patients, refractory chronic constipation may be caused by food hypersensitivity and an elimination diet is effective in these subjects

Anti-Transglutaminase Antibody Assay of the Culture Medium of Intestinal Biopsy Specimen Can Improve the Accuracy of Celiac Disease Diagnosis.

BACKGROUND: We measured anti-transglutaminase (anti-tTG) antibody in the culture medium of intestinal biopsy specimens from patients with suspected celiac disease (CD) and evaluated the relationship between antibody production and severity of intestinal mucosal damage. METHODS: We performed diagnostic testing for CD on 273 consecutive patients. In addition to routine histologic evaluation of duodenal biopsy specimens, we assayed anti-tTG antibodies in serum and in the culture medium of duodenal biopsy specimens. RESULTS: CD was diagnosed in 191 of the 273 patients. Sensitivity and specificity of the serum anti-endomysium (EmA) and anti-tTG assays were 83% and 85% and 99% and 95%, respectively, and both had 88% diagnostic accuracy. EmA and anti-tTG assayed in the culture medium had 98% sensitivity, 100% specificity, and 98% diagnostic accuracy (vs serum assays; P <0.0001). Twenty-nine CD patient specimens (16%) were negative for serum anti-tTG and EmA; for 24 of these patients, anti-tTG assay of the culture medium was positive. The CD patients whose biopsy specimens were positive for serum antibodies showed the following intestinal histologies: total villous atrophy, 35%; severe villous atrophy, 25%; mild atrophy, 25%; villi with no atrophy but with increased intraepithelial lymphocytes, 15%. None of the CD patients whose specimens were negative for serum antibodies showed total or severe villous atrophy; 77% had mild villous atrophy, and 23% had no villous atrophy but had increased intraepithelial lymphocyte counts. Mild villous atrophy was also seen in specimens from approximately 15% of patients without CD. CONCLUSION: Anti-tTG assay of the culture medium of biopsy specimens can improve the accuracy of CD diagnosis in patients negative for serum antibodies

Antiendomysium antibodies assay in the culture medium of intestinal mucosa: an accurate method for celiac disease diagnosis

Background Celiac disease (CD) diagnosis is becoming more difficult as patients with no intestinal histology lesions may also be suffering from CD. Aim To evaluate the diagnostic accuracy of antiendomysium (EmA) assay in the culture medium of intestinal biopsies for CD diagnosis. Patients and methods The clinical charts of 418 patients with CD and 705 non-CD controls who had all undergone EmA assay in the culture medium were reviewed. Results EmA assay in the culture medium had a higher sensitivity (98 vs. 80%) and specificity (99 vs. 95%) than serum EmA/antibodies to tissue transglutaminase (anti-tTG) assay. All patients with CD who were tested as false-negatives for serum EmA and/or anti-tTG (32 adults and 39 children) carried the human leukocyte antigen alleles associated to CD. Furthermore, during the follow-up, four patients with negative-serum EmA/anti-tTG, normal villi architecture, and positive-EmAs in the culture medium, developed villous atrophy and underwent gluten-free diet with consequent resolution of the symptoms and complete intestinal histology recovery. Conclusion EmA assay in the culture medium should be included in the diagnostic criteria for CD diagnosis in 'seronegative' patients. Eur J Gastroenterol Hepatol 23:1018-1023 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

Punto e a capo

Tra i lettori della rivista č in atto un dibattito permanente, dove in tempo reale, grazie alla posta elettronica, i partecipanti interloquiscono su tutto quanto č attinente alla clinica e alla formazione (vignette cliniche, commenti, critiche, riflessioni). Lo spazio massimo consentito per ogni intervento č di una "pagina" di 52 righe carattere corpo 12. In questa sezione confluisce numeroso, il materiale accumulatosi nel quadrimestre precedente.</jats:p

Punto e a capo

Tra i lettori della rivista č in atto un dibattito permanente, dove in tempo reale, grazie alla posta elettronica, i partecipanti interloquiscono su tutto quanto č attinente alla clinica e alla formazione (vignette cliniche, commenti, critiche, riflessioni). Lo spazio massimo consentito per ogni intervento č di una "pagina" di 52 righe carattere corpo 12. In questa sezione confluisce numeroso, il materiale accumulatosi nel quadrimestre precedente.</jats:p

FocusX temporary land-network (FXland), seismic data and preliminary analysis

In the frame of FocusX2 project INGV (Osservatorio Nazionale Terremoti and Osservatorio Etneo) and UniCal (Laboratorio di Sismologia) are deploying, from the end of 2021 to January 2023 a temporary seismic network for an active/passive seismological experiment to record regional and global seismicity in the Ionian Sea. The goal of this experiment is to improve the detection of seismicity in the Ionian Sea area and the accuracy of the locations; to better define the crustal structure of the region and find patterns related to fault systems. The seismicity in the area is possibly the result of two types of tectonic activity at different depths: a gently NW dipping subduction interface of the Calabrian subduction zone, and the strike-slip fault systems in the Ionian Sea, well expressed in the morpho-bathymetry and observed in previous seismic profiles. The deployment of 13 temporary land stations, FocusX temporary land (network code 1J) https://doi.org/10.13127/SD/O5QWM6WJCD along the coasts of eastern Sicily and SW Calabria, is going to complement the permanent networks (network codes IV, MN and IY); in the same period OBS stations are deployed at sea: FocusX temporary OBS-network (network code XH). The land stations are equipped with two different type of digitizers: Reftek 130 (12), and SaraSL06 (2); and with three different type of velocimeters: Trillium 120C (10), Le 5s (2) and ss08 60s (2). Continuous data are transmitted in real time at the INGV Rome acquisition system, used in the seismic surveillance, archived and distributed in EIDA https://eida.ingv.it/it/. In the deployment period 23rd December 2021 - 9th May 2022 regional seismicity (area between Lat 36.5-38.2 Lon 14.5-16.0) include 390 events located by the INGV seismic surveillance system, two of them with magnitude larger than 4.0 as well as 56 teleseismic earthquakes with magnitude larger than magnitude 6.0, two of them larger than 7.0. The two local events with M>4.0 and some of their aftershocks, were analyzed by the analysts of the Italian Seismic Bulletin including all the stations of the FXland 1J network.PublishedCatania4T. Sismicità dell'Itali

Seismic Surveillance and Earthquake Monitoring in Italy

Abstract The Istituto Nazionale di Geofisica e Vulcanologia (INGV) is an Italian research institution with focus on earth sciences. Moreover, the INGV is the operational center for seismic surveillance and earthquake monitoring in Italy and is a part of the civil protection system as a center of expertise on seismic, volcanic, and tsunami risks.INGV operates the Italian National Seismic Network and other networks at national scale and is a primary node of the European Integrated Data Archive for archiving and distributing strong-motion and weak-motion seismic recordings. In the control room in Rome, INGV staff performs seismic surveillance and tsunami warning services; in Catania and Naples, the control rooms are devoted to volcanic surveillance. Volcano monitoring includes locating earthquakes in the regions around the Sicilian (Etna, Eolian Islands, and Pantelleria) and the Campanian (Vesuvius, Campi Fregrei, and Ischia) active volcanoes. The tsunami warning is based on earthquake location and magnitude (M) evaluation for moderate to large events in the Mediterranean region and also around the world. The technologists of the institute tuned the data acquisition system to accomplish, in near real time, automatic earthquake detection, hypocenter and magnitude determination, and evaluation of several seismological products (e.g., moment tensors and ShakeMaps). Database archiving of all parametric results is closely linked to the existing procedures of the INGV seismic surveillance environment and surveillance procedures. Earthquake information is routinely revised by the analysts of the Italian seismic bulletin. INGV provides earthquake information to the Department of Civil Protection (Dipartimento di Protezione Civile) to the scientific community and to the public through the web and social media. We aim at illustrating different aspects of earthquake monitoring at INGV: (1) network operations; (2) organizational structure and the hardware and software used; and (3) communication, including recent developments and planned improvements.</jats:p

Seismic Surveillance and Earthquake Monitoring in Italy

The Istituto Nazionale di Geofisica e Vulcanologia (INGV) is an Italian research institution with focus on earth sciences. Moreover, the INGV is the operational center for seismic surveillance and earthquake monitoring in Italy and is a part of the civil protection system as a center of expertise on seismic, volcanic, and tsunami risks.INGV operates the Italian National Seismic Network and other networks at national scale and is a primary node of the European Integrated Data Archive for archiving and distributing strong‐motion and weak‐motion seismic recordings. In the control room in Rome, INGV staff performs seismic surveillance and tsunami warning services; in Catania and Naples, the control rooms are devoted to volcanic surveillance. Volcano monitoring includes locating earthquakes in the regions around the Sicilian (Etna, Eolian Islands, and Pantelleria) and the Campanian (Vesuvius, Campi Fregrei, and Ischia) active volcanoes. The tsunami warning is based on earthquake location and magnitude (M) evaluation for moderate to large events in the Mediterranean region and also around the world. The technologists of the institute tuned the data acquisition system to accomplish, in near real time, automatic earthquake detection, hypocenter and magnitude determination, and evaluation of several seismological products (e.g., moment tensors and ShakeMaps). Database archiving of all parametric results is closely linked to the existing procedures of the INGV seismic surveillance environment and surveillance procedures. Earthquake information is routinely revised by the analysts of the Italian seismic bulletin. INGV provides earthquake information to the Department of Civil Protection (Dipartimento di Protezione Civile) to the scientific community and to the public through the web and social media. We aim at illustrating different aspects of earthquake monitoring at INGV: (1) network operations; (2) organizational structure and the hardware and software used; and (3) communication, including recent developments and planned improvements.FISR SOIR DPCPublished1659–16711SR TERREMOTI - Sorveglianza Sismica e Allerta TsunamiJCR Journa