Background There is substantial evidence linking disturbed gastrointestinal motility to inflammation. Thus, it is not surprising that abnormalities of gastrointestinal motility play a role in inflammatory bowel disease (IBD), affecting patient outcomes. We performed a review of the literature to investigate the relationship between abnormal gut motility and IBD. Methods With an extensive literature search, we retrieved the pertinent articles linking disturbed gut motility to IBD in various anatomical districts. Results The evidence in the literature suggests that abnormal gastrointestinal motility plays a role in the clinical setting of IBD and may confuse the clinical picture. Conclusions Abnormal gut motility may be important in the clinical setting of IBD. However, additional data obtained with modern techniques (e.g., magnetic resonance imaging) are needed to individuate in a more precise manner gastrointestinal motor dysfunctions, to understand the nature of clinical manifestations and properly tailor the treatment of patients.

There are few data on epidemiological and clinical features of adult ulcerative colitis (UC) patients in Sardinia (Italy), mainly derived from administrative sources such as Hospital Discharge Register. The aim of this study was to assess the main clinical and epidemiological features of adult patients diagnosed with ulcerative colitis (UC) in Sardinia, Italy. We evaluated the main clinical features of UC patients followed-up in 7 Gastroenterology/Endoscopy Units in Sardinia, Italy. Data were obtained from medical patients’ records and from a questionnaire administered at inclusion visit. 374 patients with UC were included: 52.9% were female, with a female-to-male ratio of 1.125. Eleven per cent of patients were active smokers and 36.4% were former smokers. Mean age at diagnosis was 39.2 years (SD 15.4). Only 4.3% of patients were < 16 years old at diagnosis; 53.2% were diagnosed at age ranging from 17 to 40 and 42.5% at age >40. About three quarters of patients were diagnosed between 17 and 49 years old (23.7% between 17 and 29, 25.8% between 30 and 39 and 22.8% between 40 and 49). Disease extent at diagnosis was proctitis in 18.2% of patients, left-sided colitis in 38.8% and extensive colitis in 41.2% (missing data in 1.9% of patients). After a median disease duration of 9 years (IQR 13.8), proximal extension of proctitis or left-sided colitis (from E1 to E2/E3 or from E2 to E3) occurred in 12% of patients. 17.9% of patients developed extraintestinal manifestations, the most frequent being articular (11.8%). There were six patients (1.6%) with concomitant primary sclerosing cholangitis. Two patients developed colorectal cancer. This multi-centre study provides important preliminary clinical data on UC in Sardinia.

Journal of the European Academy of Dermatology and VenereologyVolume 32, Issue 8 p. e305-e306 Letter to the Editor Skin manifestations in patients with hepatitis C virus-related chronic liver disease R. Satta, Corresponding Author R. Satta rsatta@uniss.it Dipartimento di Scienze Chirurgiche, Microchirurgiche e Mediche, University of Sassari, Sassari, ItalyCorrespondence: R. Satta. E-mail: rsatta@uniss.itSearch for more papers by this authorG.M. Pes, G.M. Pes Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Sassari, ItalySearch for more papers by this authorB.M. Quarta Colosso, B.M. Quarta Colosso Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Sassari, ItalySearch for more papers by this authorM.P. Dore, M.P. Dore Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Sassari, Italy Baylor College of Medicine, Houston, TX, USASearch for more papers by this author R. Satta, Corresponding Author R. Satta rsatta@uniss.it Dipartimento di Scienze Chirurgiche, Microchirurgiche e Mediche, University of Sassari, Sassari, ItalyCorrespondence: R. Satta. E-mail: rsatta@uniss.itSearch for more papers by this authorG.M. Pes, G.M. Pes Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Sassari, ItalySearch for more papers by this authorB.M. Quarta Colosso, B.M. Quarta Colosso Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Sassari, ItalySearch for more papers by this authorM.P. Dore, M.P. Dore Dipartimento di Medicina Clinica e Sperimentale, University of Sassari, Sassari, Italy Baylor College of Medicine, Houston, TX, USASearch for more papers by this author First published: 08 February 2018 https://doi.org/10.1111/jdv.14848Citations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume32, Issue8August 2018Pages e305-e306 RelatedInformation

OBJECTIVE H. pylori infection is reportedly associated with autoimmune diseases such as chronic thyroiditis and autoimmune diabetes. The aim of this study is to determine the association between H. pylori infection and its virulent strain CagA with antibodies against thyroperoxidase (TPO Ab) and thyrotropin (TSH) in a cohort of latent autoimmune diabetes in adult (LADA) patients. PATIENTS AND METHODS We included 234 LADA patients (53.8% women). Antibodies against H. pylori whole antigens and CagA, TPO Ab and TSH were assessed in all patients. RESULTS Prevalence of IgG against H. pylori and GagA was 52.1% and 20.9% respectively. Antibodies against H. pylori were not associated with TPO Ab and TSH (rho = 0.067, p = 0.620 and rho = 0.156, p = 0.099, respectively). Antibodies against CagA showed a positive association with TSH and TPO Ab (respectively rho = 0.309, p = 0.036 and rho = 0.419, p = 0.037). Subjects with hypothyroidism (TSH ≥ 3.5 μU/ml) had an increased frequency of Ab anti CagA (p = 0.059). CONCLUSIONS The infection by H. pylori strains expressing CagA is associated with increased TPO Ab and TSH levels in LADA patients, suggesting a possible mechanism involved in thyroid autoimmunity and dysfunction of the gland. Further research is needed to test this hypothesis.

Background Only a few data regarding colonic diverticulosis are available in Italy. We examined the frequency of colonic diverticulosis and its associations with risk factors in a homogeneous Northern Sardinian population undergoing colonoscopy for any reason in the last decades.Methods This was a retrospective single-center study. Medical records of patients undergoing colonoscopy for any indication between 1995 and 2013 were reviewed. Demographic information including age, gender, geographic area (urban, rural), marital status, smoking habit, occupation, body mass index, and comorbidities were collected. Presence, number, and extension of diverticula were assessed by colonoscopy. The diagnosis of diverticulosis was defined by the presence of more than five diverticula.Results A total of 4458 records were collected (39.8 % males). Analysis by birth cohorts showed a significant progressive age-related increase in the prevalence of diverticulosis. The average prevalence was 18.9 % without significant variation across the 19-year observation period. In 101 (12.1 %) subjects diverticula were single or few. Seventy-one percent of diverticula were located predominantly in the left side, 2 % in the right side, and 14.3 % were spread throughout the colon. There was a significant association with obesity but not with smoking habits, marital status, or urban versus rural environment. A strong association was observed between the presence of diverticulosis and cardiovascular and other gastrointestinal and lung disease (p < 0.0001). These associations were also confirmed by the logistic regression analysis.Conclusions In this endoscopic study, colonic diverticulosis in Northern Sardinia showed prevalence similar to other series in Western countries, and it was predominantly left sided and age related.

The psycho-neuroendocrine-immune approach relies on the concept of considering diseases from a holistic point of view: the various components (psyche, nervous system, endocrine system, and immune system) control the diseased organ/apparatus and in turn are influenced by a feedback mechanism. In this article, we will consider the psycho-neuroendocrine-immune approach to coloproctological disorders, by providing clinical cases and discussing them in light of this approach.

The identification of a hot spot of exceptional longevity, the Longevity Blue Zone (LBZ), in the mountain population of Sardinia has aroused considerable interest toward its traditional food as one of the potential causal factors. This preliminary study on the traditional Sardinian diet has been supported by the literature available, which has been carefully reviewed and compared. Up to a short time ago, the LBZ population depended mostly upon livestock rearing, and consumption of animal-derived foods was relatively higher than in the rest of the island. The nutrition transition (NT) in urbanized and lowland areas began in the mid-1950s, fueled by economic development, whereas in the LBZ it started later owing to prolonged resistance to change by a society organized around a rather efficient pastoral economy. Even nowadays a large proportion of the population in this area still follows the traditional diet based on cereal-derived foods and dairy products. The LBZ cohorts comprising individuals who were of a mature age when NT began may have benefited both from the high-quality, albeit rather monotonous, traditional diet to which they had been exposed most of their life and from the transitional diet, which introduced positive changes such as more variety, increased consumption of fruits and vegetables and moderate meat intake. It could be speculated that these changes may have brought substantial health benefits to this particular aging group, which was in need of nutrient-rich food at this specific time in life, thereby resulting in a decreased mortality risk and, in turn, life-span extension.

Lipid pathway impairment, decrease in the antioxidant pool and downregulation in amino-acid metabolism are just some of the metabolic variations attributed to chronic HCV infection. All of them have been studied separately, mainly in animal models. Thanks to proteomic analysis we managed to describe (for the fist time to the best of our knowledge), in vivo and in humans, the metabolic alterations caused by HCV, and the recovery of the same alterations during HCV treatment. We performed proteomic analysis on liver specimens of a 28-year-old woman affected by hepatitis C genotype 1a, alcoholism and diabetes mellitus type 1, before and after antiviral treatment with pegylated interferon alpha 2b and ribavirin. The subject, thanks to a patient-tailored therapy, reached Sustained Virological Response. Throughout the treatment period the patient was monitored with subsequent biochemical, clinical and psychological examinations. The data obtained by the patient's close monitoring suggest a direct interaction between insulin resistance and an active HCV genotype 1 infection, with a leading role played by the infection, and not by insulin resistance, as demonstrated by the sharp fall of the insulin units needed per day during treatment. The proteomic analysis showed that after therapy, a downregulation of enzymes involved in amino acid metabolism, glycolysis/gluconeogenesis and alcohol catabolism takes place, the latter probably due to cessation of alcohol abuse. On the contrary, the metabolic pathways linked to metabolism of the reactive oxygen species were upregulated after therapy. Finally, a significant alteration in the pathway regulated by peroxisome proliferator-activated receptor alpha (PPARA), a major regulator of lipid metabolism in the liver, was reported. These “real time” data confirm in vivo, in humans, that during HCV infection, the pathways related to fatty acids, glucose metabolism and free radical scavenging are inhibited. The same enzyme deficit is completely recovered after HCV eradication.