Agata Zirilli

Optical coherence tomography evaluation of ulcerative colitis: the patterns and the comparison with histology.

HYPOTHESIS:The optical coherence tomography (OCT) is an imaging modality based on infrared light backscattering properties of tissues. OCT studies documented the disappearance of crypts and the alteration in light backscattering as features of ulcerative colitis (UC) in human colon. This technique should be more and more able to identify tissue microstructures with a resolution that is nearly that of histology (optical biopsy).AIM:To evaluate whether there are OCT patterns specific for UC and to compare the overall technique performance with the histology.METHODS:A total of 27 patients (20–76 yr) with UC underwent OCT imaging during a total colonoscopy. The OCT images were collected both from affected and normal sites in active UC or disease in remission. Two biopsies of the same sites were acquired. The OCT images were separately scored. Two pathologists blinded to the endoscopic and OCT patterns scored the samples.RESULTS:Three OCT patterns were identified: the mucosal backscattering alteration (MBA), the delimited dark areas (DDA), and the layered colonic wall (LCW). In colon affected segments of active and UC in remission, these patterns showed a good correspondence with the histology. Moreover, in 14/25 (56%) normal sites above the affected segment, the OCT documented the pathological features, confirmed only in 10/14 by the histology. Thus, the assessed sensitivity and specificity of OCT in normal segments of UC patients have been 100% and 69%, respectively.CONCLUSIONS:The in vivo OCT correctly detected disease features in endoscopically affected colon segments, but even in apparently normal segments of UC patients.

Single session versus separate session endoscopic ultrasonography plus endoscopic retrograde cholangiography in patients with low to moderate risk for choledocholithiasis

Background and Aim:  Endoscopic ultrasonography (EUS) is a minimally invasive diagnostic tool for common bile duct stones (CBDS) and may be used to select patients for therapeutic endoscopic retrograde cholangiography (ERC). The aim of this trial is to compare, in patients with non‐high‐risk for CDBS, the clinical and economic impact of EUS plus ERC performed in a single endoscopic session versus EUS plus ERC in two separate sessions.

Minor Cognitive Deficits and Mood States in HIV-1 Infected Men

The aim of this study is to evaluate cognitive deficits and the psychoemotional state of patients affected by HIV-1. The sample, composed of 30 male HIV-1 positive patients aged on average 35.59, was assessed using a psychodiagnostic protocol based on the Wechsler Adult Intelligence Scale—Revised (WAIS-R) and the Profile of Mood State (POMS) applied at the three phases of observation: baseline (T1), 6 months later (T2), and 18 months later (T3). The outcomes were compared using a non-parametric statistical technique in a multivariate context (NPC test). The results highlight significative differences in responses during the three different phases of observation (T1, T2, T3) showing, in particular, reduced cognitive performance at T3 with increased anxiety, depression, aggressiveness, asthenia, and cerebral confusion. It is thus suggested that in the study sample the condition of disease accelerates the decline of specific brain mechanisms, resulting in psychiatric disorders with reduced quality of social and working life.

Assessment of milk consumer preferences: Identifying the choice factors through the use of a discrete logistic model

Purpose The purpose of this paper is to report a survey in random-selected supermarkets in Italy in order to identify the attitudes and perceptions of consumers toward milk and in particular toward donkey milk. Design/methodology/approach The analysis was conducted through Google Forms platform of docs.google interviews with a sample of 705 consumers who were given a questionnaire to collect information about their economic status and their attitudes toward milk and special milk consumption. Findings The results were analyzed in order to identify the socio-economic and behavioral characteristics of homogeneous groups of consumers. They consume milk mainly because it is not expensive and it is possible to easily buy it in the supermarket. They consume special milk mainly because of food allergies or intolerances. They would like to buy special milk at large-scale retail trade outlets; they underline difficulties in finding and purchasing it. They think that the price of special milk is very high. Originality/value The results showed that those who occasionally consume special milk choose it because it is more nourishing or for health reasons; there is also a significant association between the judgment on prices of special milk and the frequency of purchase. The estimation of a generalized linear model allowed to highlight that only age and the presence of health problems/intolerances are significant predictors of special milk consumption.

A Permutation Solution to Compare Two Hepatocellular Carcinoma Markers

In medical literature Alpha-fetoprotein (AFP) is the most commonly used marker for hepatocellular carcinoma (HCC) diagnosis. Some researches showed that there is over-expression of insulin-like growth factor (IGF)-II in HCC tissue, especially in small HCC. In this background our study investigates the diagnostic utility of IGF-II in HCC. Serum levels of IGF-II and AFP were determined on 96 HCC patients, 102 cirrhotic patients and 30 healthy controls. The application of NPC test, stratified for small and large tumours, allowed us to notice that IGF-II and AFP levels in HCC were significantly higher than cirrhotic patients and controls, the IGF-II levels in cirrhotic patients were significantly lower than controls. The optimal cut-off values for diagnosing HCC were determined with ROC curve. The sensitivity, specificity and diagnostic accuracy values for AFP and IGF-II have been estimated for diagnosis of HCC and, subsequently, for small or large HCC. Determination of jointly used markers significantly increases the diagnostic accuracy and sensitivity, with a high specificity. So IGF-II serum can be considered a useful tumour marker to be jointly used with AFP, especially for diagnosis of small HCC.