The significance of duodenal mucosal atrophy in patients with common variable immunodeficiency: a clinical and histopathological study

Gastrointestinal manifestations and villous atrophy can be seen in patients with common variable immunodeficiency (CVID). In some patients, infectious agents may be responsible, whereas in Others, celiac diseases (CD) may be the cause. In this study, we investigate the causes and th ehistopathologic festures seen in patients with CVID. Eleven patients with CVID and villous atrophy underwent duodenal biopsies, human leukocyte antien (HLA) typing, and testing for all celiac antibodies. Fifteen patients with CVID and normal villi and 6 patients with CD but without CVID served as controls. Histologic response to a gluten-free diet (GFD) allowed a diagnosis of CD in 3 of 11 patients. In the remaining 8, the lack of a histologic response to a GFD or HLA typing excluded CD. Celiac antibodies gave conflicting results and were of no help. Polymorphonuclear infiltrates and lesions like graft-versus-host disease are seen more ofter in flat mucos aunresponsive to a GFD. However, the specificity of these findings remains to be determined and response to a GFD remains the only diagnostic criteria for CD in these patients. Villous atrophy was gluten-sensitive in 3 of 11 patients with CVID. It was not related to gluten-responsive CD in most patients

Prevalence and natural history of potential coeliac disease in adult patients.

OBJECTIVE: Potential celiac disease (PCD) is a form of CD characterized by positive endomysial/tissue transglutaminase antibodies and a preserved duodenal mucosa despite a gluten-containing diet (GCD); it can evolve into flat, active CD. This evolution is, however, not certain. Our aim was to retrospectively study the prevalence and the natural history of adult patients with PCD. METHODS: The clinical notes of all 47 patients with PCD attending our clinic between September 1999 and October 2011 were retrospectively reevaluated. To study their clinical features, patients with active CD, randomly selected and matched for sex and date of birth, served as controls. Symptoms, associated diseases, familiarity, and laboratory data at diagnosis were compared. RESULTS: Prevalence of PCD among all celiac patients directly diagnosed in our center was 42/187, (1/4.4, 18.3%, 95% confidence interval (CI) 13.3-23.4%). Age at diagnosis, laboratory data, prevalence of symptoms, associated diseases, and familiarity for CD did not differ between patients with PCD and those with active CD. Some patients with PCD maintained a normal duodenal mucosa for many years and their symptoms spontaneously improved despite maintaining a GCD. CONCLUSIONS: PCD is not a rare form of CD. Having found no difference at all in age at diagnosis and clinical features between PCD and active CD could suggest that PCD is not a prodrome of CD but is a separate entity that can only subsequently evolve into active CD

Carcinomas in inflammatory bowel disease: a narrative review on diagnostic imaging techniques

We aimed, therefore, to review the current evidence on imaging modalities and carcinomas overlapping IBD.Patients affected by inflammatory bowel diseases (IBD) are at increased risk for developing both gastrointestinal and extra-intestinal cancers. The subtype of IBD, namely Crohn's disease or ulcerative colitis, the location, the activity, the extent, and the duration of the disease determine this risk. Standardized surveillance programs based on imaging techniques exist only for colorectal cancer, where colonoscopy is the milestone of early detection. Clarification is needed on whether different imaging modalities might be adopted in the algorithms for screening and diagnosis of cancers in IBD patients.PubMed was searched up to July 2021 to identify relevant studies investigating the accuracy of imaging techniques in identifying carcinomas in IBD patients. The following text words and corresponding Medical Subject Heading/Entree terms were used: "imaging", "computed tomography", "magnetic resonance imaging", "inflammatory bowel disease", "adenocarcinoma" and "cancer".Currently dye-chromoendoscopy (DCE) is established as the gold standard diagnostic modality for the detection of dysplasia in IBD, with a demonstrated superiority compared to white-light endoscopy. Two main radiological patterns have been described at cross-sectional imaging for both colorectal cancer and small bowel adenocarcinoma. The first subtype is characterized by a tissue mass, while the second subtype recognizes a circumferential thickening with or without the stricturing of the lumen. The diagnostic sensitivity, specificity, and accuracy of cross-sectional imaging techniques for the detection of carcinomas in the context of IBD are largely unknown and scarcely investigated. The definition of surveillance programs based on different imaging methods is warranted

Indagine preliminare sulla resistenza ai fluorochinoloni in ceppi di Escherichia coli resistenti all’acido nalidixico isolati da feci animali

E’ stata valutata la possibile resistenza ai fluorochinoloni in 17 ceppi di Escherichia coli resistenti all'acido nalidixico, isolati da feci animali. Sono state impiegate tecniche di PCR, RFLP, ibridazione, e sequenziamento allo scopo di evidenziare la presenza di mutazioni puntiformi nelle subunità A e B della DNA girasi e possibile la presenza del gene qnr a testimonianza di eventuale resistenza plasmidica. In 10 dei 17 ceppi di E. coli esaminati è stata evidenziata una resistenza di tipo cromosomico con la presenza di integroni di classe I e in nessuno di essi è stata evidenziata la presenza del gene qnr. In 6 ceppi è stata osservata la mutazione Ser83-Leu e in un ceppo la mutazione Ser83-Ala. Non sono state evidenziate le mutazioni note ai codoni Asp87 di gyrA e Asp426 e Asp477 di gyrB. Dal sequenziamento del ceppo di E. coli ATCC 25922 sottoposto ad induzione di resistenza è stata rilevata una mutazione in gyrB al residuo Lys 447 che è stato sostituito da una Arginina

Preliminary investigations into fluoroquinolone resistance in Escherichia coli strains resistant to nalidixic acid isolated from animal faeces

Resistance to fluoroquinolones was evaluated in 17 nalidixic acid-resistant Escherichia coli strains isolated from animal faeces. Polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP), hybridisation and sequencing were used to reveal point mutations in DNA gyrase subunits A and B and the presence of the qnr gene as evidence of plasmid resistance. Chromosomal resistance and class 1 integrons were found in 10 of the 17 E. coli strains examined, while the qnr gene was not found in any of these. Mutation Ser83-Leu was found in six strains and in one strain mutation Ser83-Ala was found in gyrA. Mutations in gyrA Asp87 codons and in gyrB Asp426 or Lys 447 codons were not identified. Sequencing of the E. coli strain ATCC 25922 subjected to resistance induction revealed a gyrB mutation of the Lys 447 residue which had been replaced by arginine

Polymerase chain reaction and bacteriological comparative analysis of raw milk samples and buffalo mozzarella produced and marketed in Caserta in the Campania region of Italy

To help identify an epidemiological link between the consumption of buffalo mozzarella prepared with raw milk (not heat-treated) and cases of human brucellosis, 80 samples of raw buffalo milk and 315 samples of mozzarella were tested for the presence of Brucella spp. Samples originated from Caserta, the province with the highest number of Brucella-positive buffalo herds in Campania, the region in which 96.02% of all cases of human brucellosis reported in 2000-2005 were recorded. To take into account possible seasonal variations, between February 2006 and March 2007, samples were purchased directly from 72 dairy outlets that were representative of the province. Samples were tested for Brucella spp. using the polymerase chain reaction (PCR) and bacterial isolation. Samples tested negative for Brucella using both methods. Spiked samples were then prepared and tested by PCR and bacterial isolation and the sensitivity, specificity, repeatability, reproducibility and limit of detection were determined. The PCR limit of detection was below 1 colony-forming unit (cfu)/g. The repeatability and reproducibility of the method were 100% (p = 0.95), the sensitivity was 96.7% (p = 0.95) and the specificity was 100% (p = 0.95)

Comparazione fra polymerase chain reaction e isolamento batteriologico in campioni di latte crudo e mozzarella di bufala prodotta in provincia di Caserta, regione Campania (Italia)

Per contribuire all’individuazione di un possibile nesso epidemiologico tra consumo di mozzarella di bufala preparata con latte crudo (non trattato al calore) e casi di brucellosi umana, sono stati analizzati, per ricerca di Brucella spp., 80 campioni di latte bufalino crudo e 315 campioni di mozzarella. Gli alimenti esaminati sono stati prelevati in caseifici della provincia di Caserta dove è presente la più alta concentrazione di allevamenti bufalini sierologicamente positivi alla brucellosi in Campania, regione che, nel periodo 2000-2005, ha registrato il 96,02% dei casi di brucellosi umana notificati in Italia. Al fine de valutare possibili variazioni stagionali, i campioni sono stati acquistati in 72 rivendite associate a caseifici nel periodo febbraio 2006-marzo 2007. La ricerca di Brucella spp. è stata effettuata utilizzando polymerase chain reaction (PCR) ed eseguendo contemporaneamente l’isolamento microbiologico. I campioni esaminati sono risultati negativi alla ricerca di Brucella con entrambi i metodi utilizzati. Sono stati, inoltre, definiti i parametri di sensibilità, specificità, ripetibilità, riproducibilità e il limite di rilevazione del metodo molecolare, esaminando campioni artificialmente contaminati, sia con metodo PCR sia con isolamento microbiologico classico. Il limite di rilevazione è risultato inferiore a 1 UFC/g, ripetibiltà e riproducibilità sono stati pari a 100% (p=0,95), sensibilità a 96,7% (p=0,95) e specificità a 100% (p=0,95)

A Comprehensive Multidisciplinary Approach to Diagnosing Chronic Inflammatory Bowel Diseases: Integration of Clinical, Endoscopic, and Imaging Modalities

Chronic inflammatory bowel diseases, such as Crohn’s disease and ulcerative colitis, present diagnostic challenges due to their complex and heterogeneous nature. While histology remains fundamental for accurate diagnosis, a multidisciplinary approach incorporating clinical, endoscopic, and imaging modalities is increasingly recognized as essential for comprehensive evaluation. This article delves into the importance of integrating various diagnostic techniques in the assessment of IBD. Colonoscopy and histology, with its ability to directly visualize the intestinal mucosa, play a central role in the diagnostic process. However, histological analysis alone may not suffice, necessitating the inclusion of advanced imaging techniques, such as magnetic resonance enterography (MRE), computed tomography enterography (CTE), and intestinal ultrasound (IUS). These techniques provide valuable insights into the disease’s extent, severity, and complications, and should be used in conjunction with biochemical parameters. These modalities complement traditional endoscopic and histological findings, offering a more holistic understanding of the disease process. A multidisciplinary approach that incorporates clinical, endoscopic, histological, serological, and imaging assessments enables clinicians to achieve a more accurate and timely diagnosis of IBD. Moreover, this integrated approach facilitates personalized treatment strategies tailored to individual patient needs, ultimately improving clinical outcomes and quality of life for those affected by chronic inflammatory bowel diseases