Stefano Tinozzi

Oral butyrate for mildly to moderately active Crohn's disease

Background : Butyrate exerts anti‐inflammatory effects in experimental colitis and on Crohns disease lamina propria mononuclear cells in vitro.

Doppler enhancement after intravenous levovist injection in Crohn's disease

Although transabdominal bowel sonography (TABS) has been proposed as a reliable tool to assess increased bowel wall thickness (BWT), the most common sonographic pattern in patients with Crohns disease (CD), its accuracy is limited in the diagnosis of CD. We therefore tried to assess whether color Doppler enhancement with Levovist, a galactose-based intravenous sonographic contrast agent able to enhance the arterial Doppler signal, increases TABS accuracy. Thirty-one patients with ileal CD, diagnosed by endoscopy and enteroclysis, and 20 healthy volunteers were examined with conventional TABS. Color Doppler of the intramural enteric vessels was then performed before and after intravenous injection of Levovist. Twenty-two CD patients had a BWT >4 mm, and 16 of them presented with active disease. Two of the remaining nine CD patients, all with BWT <4 mm, presented with active disease. By means of color Doppler we identified six patients with inactive disease, normal BWT, and normal basal Doppler signal intensity, who showed an enhanced Doppler signal in intramural vessels after contrast agent bolus. Four of these patients, identified only by color Doppler after Levovist injection, relapsed within 6 months. In our experience, sensitivity and specificity of TABS, integrated with additional stimulated acoustic emission mode, were 96.7% and 100%, respectively. The use of Levovist in color Doppler increases the accuracy of TABS in CD diagnosis and follow-up.

Efficacy of butyrate in the treatment of mild to moderate Crohn's disease

Abstract Background Butyrate exerts anti-inflammatory effects in experimental colitis and in lamina propria mononuclear cells of patients with Crohns disease. Aims To assess the safety and efficacy of butyrate in Crohns disease. Patients Thirteen patients with mild to moderate Crohns disease were treated with enteric-release sodium butyrate tablets at a dosage of 4 g/day for eight weeks. Methods Before and after treatment, patients underwent coloscopy with evaluation of the clinical activity of their disease, systemic inflammation index and mucosal expression of interleukin (IL)-1β, IL-6, IL-12, interferon (IFN)-γ, tumour necrosis factor (TNF)-α and nuclear factor (NF)-κB. Results Of the nine patients (69%) responding to treatment, 7 (53%) exhibited complete response and 2 exhibited partial response. Endoscopic and histological evaluation scores were significantly improved ( p p Conclusions Oral administration of butyrate may be effective in inducing clinical improvement or remission in patients with Crohns disease.

A case of bilateral breast cancer and Graves' disease.

We report a case of bilateral breast cancer associated with Graves’ disease characterized by a large goiter and complicated by a severe ophthalmopathy. The hyperthyroidism was treated initially with methimazole and then with thyroidectomy, the ophthalmopathy with intravenous steroids combined with orbital radiotherapy. The breast tumors underwent surgical resection followed by chemotherapy. We describe this case because of the well-known association between breast cancer and thyroid disease, particularly of the autoimmune type, the causes of this being still unclear. Recent literature on this topic is reviewed, discussing the possible role of the Na+-I− symporter and anti-TPO antibodies.