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  1. Article ; Online: A modified approach to percutaneous ultrasound-guided left stellate ganglion block for drug-refractory electrical storm: a case report.

    De Giorgi, Francesco / Scaramuzzo, Gaetano / Bertini, Matteo / Malagù, Michele

    European heart journal. Case reports

    2024  Volume 8, Issue 3, Page(s) ytae101

    Abstract: Background: The use of percutaneous stellate ganglion block (SGB) in the management of drug-refractory electrical storm (ES) has been increasingly reported in the last years. Few data are available on the safety, duration, and dosage of local ... ...

    Abstract Background: The use of percutaneous stellate ganglion block (SGB) in the management of drug-refractory electrical storm (ES) has been increasingly reported in the last years. Few data are available on the safety, duration, and dosage of local anaesthetic used.
    Case summary: A 66-year-old male patient with a history of ischaemic cardiomyopathy and an implantable cardioverter-defibrillator (ICD) presented to the emergency room complaining several ventricular arrhythmias and ICD shocks received in the last 24 h. He was treated with many lines of anti-arrhythmic drugs but his condition deteriorated with cardiovascular instability and respiratory distress, so he was intubated. The ES still worsened (82 episodes of ventricular arrhythmias), so we performed an ultrasound-guided left SGB, using a modified technique, with success in suppressing the ventricular arrhythmias. The patient was then treated with electrophysiological study and catheter ablation.
    Discussion: The ultrasound approach to SGB is feasible in emergency setting, and it is safe and effective also using a modified and easier technique in patient with difficult sonographic visualization of the neck structures. Moreover, it is possible and safe to use a combination of short-acting rapid-onset local anaesthetic with a long-lasting one with a good outcome.
    Language English
    Publishing date 2024-02-20
    Publishing country England
    Document type Case Reports
    ISSN 2514-2119
    ISSN (online) 2514-2119
    DOI 10.1093/ehjcr/ytae101
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  2. Article ; Online: Enteroglial-derived S100B protein integrates bacteria-induced Toll-like receptor signalling in human enteric glial cells.

    Turco, Fabio / Sarnelli, Giovanni / Cirillo, Carla / Palumbo, Ilaria / De Giorgi, Francesco / D'Alessandro, Alessandra / Cammarota, Marcella / Giuliano, Mariateresa / Cuomo, Rosario

    Gut

    2014  Volume 63, Issue 1, Page(s) 105–115

    Abstract: Objective: Enteric glial cells (EGC) have been suggested to participate in host-bacteria cross-talk, playing a protective role within the gut. The way EGC interact with microorganisms is still poorly understood. We aimed to evaluate whether: EGC ... ...

    Abstract Objective: Enteric glial cells (EGC) have been suggested to participate in host-bacteria cross-talk, playing a protective role within the gut. The way EGC interact with microorganisms is still poorly understood. We aimed to evaluate whether: EGC participate in host-bacteria interaction; S100B and Toll-like receptor (TLR) signalling converge in a common pathway leading to nitric oxide (NO) production.
    Design: Primary cultures of human EGC were exposed to pathogenic (enteroinvasive Escherichia coli; EIEC) and probiotic (Lactobacillus paracasei F19) bacteria. Cell activation was assessed by evaluating the expression of cFos and major histocompatibility complex (MHC) class II molecules. TLR expression in EGC was evaluated at both baseline and after exposure to bacteria by real-time PCR, fluorescence microscopy and western blot analysis. S100B expression and NO release from EGC, following exposure to bacteria, were measured in the presence or absence of specific TLR and S100B pathway inhibitors.
    Results: EIEC activated EGC by inducing the expression of cFos and MHC II. EGC expressed TLR at baseline. Pathogens and probiotics differentially modulated TLR expression in EGC. Pathogens, but not probiotics, significantly induced S100B protein overexpression and NO release from EGC. Pretreatment with specific inhibitors of TLR and S100B pathways abolished bacterial-induced NO release from EGC.
    Conclusions: Human EGC interact with bacteria and discriminate between pathogens and probiotics via a different TLR expression and NO production. In EGC, NO release is impaired in the presence of specific inhibitors of the TLR and S100B pathways, suggesting the presence of a novel common pathway involving both TLR stimulation and S100B protein upregulation.
    MeSH term(s) Aged ; Biomarkers/metabolism ; Blotting, Western ; Cells, Cultured ; Escherichia coli/metabolism ; Female ; Host-Pathogen Interactions ; Humans ; Intestine, Small/metabolism ; Intestine, Small/microbiology ; Lactobacillus/metabolism ; Male ; Microscopy, Fluorescence ; Middle Aged ; Neuroglia/metabolism ; Neuroglia/microbiology ; Nitric Oxide/metabolism ; Probiotics/metabolism ; Real-Time Polymerase Chain Reaction ; Reverse Transcriptase Polymerase Chain Reaction ; S100 Calcium Binding Protein beta Subunit/metabolism ; Signal Transduction ; Toll-Like Receptors/metabolism
    Chemical Substances Biomarkers ; S100 Calcium Binding Protein beta Subunit ; S100B protein, human ; Toll-Like Receptors ; Nitric Oxide (31C4KY9ESH)
    Language English
    Publishing date 2014-01
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 80128-8
    ISSN 1468-3288 ; 0017-5749
    ISSN (online) 1468-3288
    ISSN 0017-5749
    DOI 10.1136/gutjnl-2012-302090
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    Zs.A 160: Show issues Location:
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  3. Article ; Online: Effects of long-term PPI treatment on producing bowel symptoms and SIBO.

    Compare, Debora / Pica, Loredana / Rocco, Alba / De Giorgi, Francesco / Cuomo, Rosario / Sarnelli, Giovanni / Romano, Marco / Nardone, Gerardo

    European journal of clinical investigation

    2011  Volume 41, Issue 4, Page(s) 380–386

    Abstract: Background: Gastroesophageal reflux disease (GERD), including erosive reflux disease and non-erosive reflux disease (NERD), is a chronic disease with a significant negative effect on quality of life. State-of-the-art treatment involves proton pump ... ...

    Abstract Background: Gastroesophageal reflux disease (GERD), including erosive reflux disease and non-erosive reflux disease (NERD), is a chronic disease with a significant negative effect on quality of life. State-of-the-art treatment involves proton pump inhibitors (PPIs). However, relapse of symptoms occurs in the majority of the patients who require recurrent or continuous therapy. Although PPIs are well tolerated, little information is available about gastrointestinal side effects.
    Aim: To evaluate the effects of long-term PPI treatment on development of bowel symptoms and/or small intestinal bacterial overgrowth (SIBO).
    Methods: Patients with NERD not complaining of bowel symptoms were selected by upper endoscopy, 24-h pH-metry and a structured questionnaire concerning severity and frequency of bloating, flatulence, abdominal pain, diarrhoea and constipation. Patients were treated with esomeprazole 20 mg bid for 6 months. Prior to and after 8 weeks and 6 months of therapy, patients received the structured questionnaire and underwent evaluation of SIBO by glucose hydrogen breath test (GHBT).
    Results: Forty-two patients with NERD were selected out of 554 eligible patients. After 8 weeks of PPI treatment, patients complained of bloating, flatulence, abdominal pain and diarrhoea in 43%, 17%, 7% and 2%, respectively. After 6 months, the incidence of bowel symptoms further increased and GHBT was found positive in 11/42 (26%) patients. By a post hoc analysis, a significant (P < 0·05) percentage of patients (8/42) met Rome III criteria for irritable bowel syndrome.
    Conclusions: Prolonged PPI treatment may produce bowel symptoms and SIBO; therefore, the strategy of step-down or on-demand PPI therapy should be encouraged in GERD.
    MeSH term(s) Adult ; Esomeprazole/adverse effects ; Female ; Gastroesophageal Reflux/drug therapy ; Gastroesophageal Reflux/physiopathology ; Humans ; Intestines/drug effects ; Intestines/microbiology ; Irritable Bowel Syndrome/chemically induced ; Irritable Bowel Syndrome/physiopathology ; Italy ; Male ; Middle Aged ; Proton Pump Inhibitors/adverse effects ; Time Factors
    Chemical Substances Proton Pump Inhibitors ; Esomeprazole (N3PA6559FT)
    Language English
    Publishing date 2011-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 186196-7
    ISSN 1365-2362 ; 0014-2972 ; 0960-135X
    ISSN (online) 1365-2362
    ISSN 0014-2972 ; 0960-135X
    DOI 10.1111/j.1365-2362.2010.02419.x
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    Zs.A 677: Show issues Location:
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  4. Article: Correlation between oesophageal acid exposure and dyspeptic symptoms in patients with nonerosive reflux disease.

    Sarnelli, Giovanni / De Giorgi, Francesco / Efficie, Eleonora / Aprea, Giovanni / Masone, Stefania / Savarese, Maria Flavia / Esposito, Ida / Russo, Luigi / Cuomo, Rosario

    European journal of gastroenterology & hepatology

    2008  Volume 20, Issue 4, Page(s) 264–268

    Abstract: Background & aims: Oesophageal acidification induces dyspeptic symptoms in healthy individuals. This study aimed to evaluate the correlation between oesophageal acid exposure and dyspeptic symptoms in patients with nonerosive reflux disease.: Methods!# ...

    Abstract Background & aims: Oesophageal acidification induces dyspeptic symptoms in healthy individuals. This study aimed to evaluate the correlation between oesophageal acid exposure and dyspeptic symptoms in patients with nonerosive reflux disease.
    Methods: A total of 68 patients with dominant symptoms of heartburn, negative upper gastrointestinal endoscopy and concomitant dyspeptic symptoms participated in the study. The severity of dyspepsia and reflux-related symptoms was evaluated, and 24-h gastro-oesophageal pH-monitoring study was performed in all patients at baseline and after 4 weeks of therapy with esomeprazole 40 mg.
    Results: Oesophageal basal acid exposure was pathological in 43 patients and normal in 25 patients, with a similar prevalence and severity of individual dyspeptic symptoms in the two groups. A significant correlation between reflux and dyspepsia scores was observed in the subgroup of patients with normal, but not in those with abnormal pHmetry (r=0.4, P=0.04 and r=0.2 P=0.07, respectively). After esomeprazole, a reduction in severity of dyspepsia (>or=50% with respect to baseline) was observed, independent of improvement of reflux-associated symptoms. Improvement in dyspepsia was, however, similar in patients with normal and abnormal basal acid exposure (14/25 vs. 33/43, respectively, P=NS).
    Conclusion: Dyspeptic symptoms coexist in a subset of nonerosive reflux disease patients, but prevalence and severity of the symptoms seems to be independent of oesophageal acid exposure.
    MeSH term(s) Anti-Ulcer Agents/therapeutic use ; Dyspepsia/drug therapy ; Dyspepsia/etiology ; Esomeprazole/therapeutic use ; Esophageal pH Monitoring/instrumentation ; Female ; Gastric Acid/physiology ; Gastric Acid/secretion ; Gastroesophageal Reflux/complications ; Gastroesophageal Reflux/drug therapy ; Humans ; Male ; Middle Aged ; Proton Pump Inhibitors/therapeutic use ; Treatment Outcome
    Chemical Substances Anti-Ulcer Agents ; Proton Pump Inhibitors ; Esomeprazole (N3PA6559FT)
    Language English
    Publishing date 2008-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 1034239-4
    ISSN 1473-5687 ; 0954-691X
    ISSN (online) 1473-5687
    ISSN 0954-691X
    DOI 10.1097/MEG.0b013e3282f340b2
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    Zs.A 2932: Show issues Location:
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  5. Article: Symptoms and pathophysiological correlations in patients with constipation and functional dyspepsia.

    Sarnelli, Giovanni / Grasso, Raffaella / Ierardi, Enzo / De Giorgi, Francesco / Savarese, Maria Flavia / Russo, Luigi / Budillon, Gabriele / Cuomo, Rosario

    Digestion

    2005  Volume 71, Issue 4, Page(s) 225–230

    Abstract: Introduction: Patients with constipation often report dyspeptic symptoms, but whether constipation is associated with specific dyspeptic symptoms and altered gastrointestinal (GI) motility, remains to be established. Our aim was to study symptoms ... ...

    Abstract Introduction: Patients with constipation often report dyspeptic symptoms, but whether constipation is associated with specific dyspeptic symptoms and altered gastrointestinal (GI) motility, remains to be established. Our aim was to study symptoms association and GI motility parameters in patients with constipation and functional dyspepsia.
    Patients and method: 42 patients with different symptoms and severity of constipation and dyspepsia were enrolled. Scintigraphic gastric emptying, colonic transit time and gallbladder contraction were studied in all subjects.
    Results: No significant association was observed between individual symptoms of constipation and dyspepsia. Patients with more severe constipation did not have higher dyspepsia severity scores. Colonic transit time, gastric half emptying and gallbladder contraction were not significantly correlated. Although patients with severe nausea had faster colonic transit than those with absent/mild symptom (19 +/- 2 vs. 48 +/- 7 h; p < 0.05), the multivariate analysis only revealed a significant association between severe postprandial fullness, delayed t1/2 (OR 1.05, CI 1-1.1) and impaired gallbladder contraction (OR 0.94, CI 0.89-0.99).
    Conclusions: Constipation was not associated with severity, or any particular dyspeptic symptom. Although motor abnormalities of both colon and proximal GI tract regions existed in the subset of constipated dyspeptic patients, they did not seem associated with the genesis of different dyspeptic symptoms.
    MeSH term(s) Adult ; Aged ; Constipation/diagnostic imaging ; Constipation/physiopathology ; Dyspepsia/diagnostic imaging ; Dyspepsia/physiopathology ; Female ; Gallbladder/diagnostic imaging ; Gallbladder/physiopathology ; Gamma Cameras ; Gastric Emptying ; Gastrointestinal Motility ; Gastrointestinal Transit ; Humans ; Logistic Models ; Male ; Middle Aged ; Radionuclide Imaging ; Severity of Illness Index
    Language English
    Publishing date 2005
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 1712-7
    ISSN 1421-9867 ; 0012-2823
    ISSN (online) 1421-9867
    ISSN 0012-2823
    DOI 10.1159/000087047
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    Zs.A 572: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article: Symptoms and Pathophysiological Correlations in Patients with Constipation and Functional Dyspepsia

    Sarnelli, Giovanni / Grasso, Raffaella / Ierardi, Enzo / De Giorgi, Francesco / Savarese, Maria Flavia / Russo, Luigi / Budillon, Gabriele / Cuomo, Rosario

    Digestion

    2005  Volume 71, Issue 4, Page(s) 225–230

    Abstract: Introduction: Patients with constipation often report dyspeptic symptoms, but whether constipation is associated with specific dyspeptic symptoms and altered gastrointestinal (GI) motility, remains to be established. Our aim was to study symptoms ... ...

    Institution Gastroenterologia, Dipartimento di Medicina Clinica e Sperimentale, Università ‘Federico II’, Napoli, and Cattedra di Gastroenterologia, University of Foggia, Foggia, Italy
    Abstract Introduction: Patients with constipation often report dyspeptic symptoms, but whether constipation is associated with specific dyspeptic symptoms and altered gastrointestinal (GI) motility, remains to be established. Our aim was to study symptoms association and GI motility parameters in patients with constipation and functional dyspepsia. Patients and Method: 42 patients with different symptoms and severity of constipation and dyspepsia were enrolled. Scintigraphic gastric emptying, colonic transit time and gallbladder contraction were studied in all subjects. Results: No significant association was observed between individual symptoms of constipation and dyspepsia. Patients with more severe constipation did not have higher dyspepsia severity scores. Colonic transit time, gastric half emptying and gallbladder contraction were not significantly correlated. Although patients with severe nausea had faster colonic transit than those with absent/mild symptom (19 ± 2 vs. 48 ± 7 h; p < 0.05), the multivariate analysis only revealed a significant association between severe postprandial fullness, delayed t1/2 (OR 1.05, CI 1–1.1) and impaired gallbladder contraction (OR 0.94, CI 0.89–0.99). Conclusions: Constipation was not associated with severity, or any particular dyspeptic symptom. Although motor abnormalities of both colon and proximal GI tract regions existed in the subset of constipated dyspeptic patients, they did not seem associated with the genesis of different dyspeptic symptoms.
    Keywords Gallbladder contraction ; Colonic transit time ; Constipation ; Dyspepsia ; Gastric emptying
    Language English
    Publishing date 2005-08-19
    Publisher S. Karger AG
    Publishing place Basel, Switzerland
    Document type Article
    Note Original Paper
    ZDB-ID 1712-7
    ISSN 1421-9867 ; 0012-2823
    ISSN (online) 1421-9867
    ISSN 0012-2823
    DOI 10.1159/000087047
    Database Karger publisher's database

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