Maurizio Koch - Academia.edu (original) (raw)
Papers by Maurizio Koch
The Italian journal of gastroenterology
L'evidence-based medicine (EBM) ha origine nell'università canadese McMaster: il nucleo della Mc-... more L'evidence-based medicine (EBM) ha origine nell'università canadese McMaster: il nucleo della Mc-Master aveva in precedenza pubblicato due serie di articoli su come usare la letteratura scientifica per la pratica medica -la prima sul Canadian Medical Association Journal (CMAJ) dal 1981 al 1984, la seconda su Annals of Internal Medicine nel 1986. Il termine EBM fu coniato da Guyatt nel 1990 per definire un programma interno della McMaster; fu "esportato" con un articolo sul JAMA nel 1992 da un Working Group della stessa università che definì l'EBM: "un nuovo paradigma emergente per la pratica medica". In coerenza con questa definizione, l'esperienza e le discipline di base erano sommariamente citate come "necessarie ma non sufficienti"
All'inizio del XX secolo Elia Metchinkoff, ipotizzava che la presenza dei batteri nell'intestino ... more All'inizio del XX secolo Elia Metchinkoff, ipotizzava che la presenza dei batteri nell'intestino dell'uomo potesse influenzarne positivamente la salute e la longevità. Egli era anche convinto che la flora batterica fosse responsabile sia della produzione di tossine che del controllo dell'autointossicazione. La prova empirica della correttezza delle sue ipotesi gli proveniva dall'osservazione epidemiologica della longevità delle popolazioni balcaniche che consumavano yogurt in grandi quantità. Nel suo libro "The prolongation of life" del 1907, Metchinkoff scriveva: "
Recenti progressi in medicina
The suggestion that dietary fibre is of particular importance in our diet is a relatively recent ... more The suggestion that dietary fibre is of particular importance in our diet is a relatively recent concept. Much of the initial emphasis for increased dietary fibre began with the pioneering work of Burkitt and Trowell in the 1960s who observed that traditional African populations consumed diets high in plant fibre and that these populations experienced very low incidences of non-communicable diseases including cardio-vascular disease, diabetes mellitus and non-infectious bowel diseases, including cancer. Although it is difficult to predict from the chemical structure how dietary fibres will behave physiologically, generally dietary fibre sources can be grouped into two major types: (a) soluble, viscous, fermentable and (b) insoluble, non-viscous, slowly fermentable. As detailed below, these sources of fibres appear to have quite different physiological effects.
The Italian journal of gastroenterology
European journal of gastroenterology & hepatology
The Italian journal of gastroenterology
Studi di medicina e chirurgia dello sport
The Italian journal of gastroenterology
The Italian journal of gastroenterology
ABSTRACT
Rivista europea per le scienze mediche e farmacologiche = European review for medical and pharmacological sciences = Revue européenne pour les sciences médicales et pharmacologiques
Medical and surgical treatment of diverticular disease has to be set against a background of inco... more Medical and surgical treatment of diverticular disease has to be set against a background of incomplete knowledge of the natural history and geographical differences of the disease, and difficulties in its definition and classification. This clinical retrospective study was performed to answer the following questions: 1) what was the clinical course after an episode of acute diverticulitis, obliging to an hospital admission? 2) what was the role of cyclic course of antibiotics, if any, in reducing the risk of complications? We examined all admissions to the surgical ward from 1967 to 1991 for a complication of diverticular disease: we looked for occlusion, perforation, fistula, or bleeding. Patients not operated with diverticular disease have been divided in 2 groups, that is patients with a medical prescription at the end of hospital period, and patients admitted without a drug prescription. All patients have been prescribed bulk agents. The medical prescription included monthly cycles of 1 week of oral antibiotics (Neomycin associated with Bacitracin, Paromomycin, or 1989 Rifaximin). We looked for the natural history of the disease in the 2 groups (the "drug" group and the "no drug" group) after the first admission, that is the development of new complications of the diverticular disease and the reason for readmissions, calculating the Absolute Risk Reduction (the difference in event rates between the treatment and control groups) and the Relative Risk Reduction (the difference in event rates between the treated and control groups, divided by the event rate in the control groups). The total number of admitted patients in the period 1967-1991 was 505. A statistically significant trend in favour of a risk reduction of new admissions in the group given antibiotics seems evident.(ABSTRACT TRUNCATED AT 250 WORDS)
The Italian journal of gastroenterology
The Italian journal of gastroenterology
Italian journal of gastroenterology and hepatology
The Italian journal of gastroenterology
Functional dyspepsia (FD) includes a heterogeneous group of patients suffering from a variety of ... more Functional dyspepsia (FD) includes a heterogeneous group of patients suffering from a variety of different conditions. The Dyspepsia Project has been implemented in 14 GI Units since 1984, in order to epidemiologically test the discriminating power of the Working Teams definitions and of standardized questionnaires. Five per cent of admitted subjects were subclassified as sphincter of Oddi dysfunction or biliary dyspepsia (BD), defined as biliary pain associated or not to bilirubin or alkaline phosphatase elevation, in the abscence of ultrasonographic evidence of gallstone disease or bile duct dilatation. The more useful symptoms in favour of the diagnosis of biliary dyspepsia were found to be pain in the right hypochondrium, radiating to the shoulder, or to the back, initiated by food, and eventually associated with constipation, or epigastric postprandial discomfort. Interestingly, symptoms suggesting biliary dyspepsia are partially shared by dysmotility-like dyspepsia. The placebo response in functional dyspepsia is variable, between 6 and 80% of patients, reflecting variations in the kind and severity of the diseases in different studies. That represents a considerable difficulty in evaluating drug efficacy, even in the case of biliary dyspepsia. A therapeutic double-blind trial in functional dyspepsia using tauro-ursodeoxycholic acid is discussed.
The Italian journal of gastroenterology
The Italian journal of gastroenterology
L'evidence-based medicine (EBM) ha origine nell'università canadese McMaster: il nucleo della Mc-... more L'evidence-based medicine (EBM) ha origine nell'università canadese McMaster: il nucleo della Mc-Master aveva in precedenza pubblicato due serie di articoli su come usare la letteratura scientifica per la pratica medica -la prima sul Canadian Medical Association Journal (CMAJ) dal 1981 al 1984, la seconda su Annals of Internal Medicine nel 1986. Il termine EBM fu coniato da Guyatt nel 1990 per definire un programma interno della McMaster; fu "esportato" con un articolo sul JAMA nel 1992 da un Working Group della stessa università che definì l'EBM: "un nuovo paradigma emergente per la pratica medica". In coerenza con questa definizione, l'esperienza e le discipline di base erano sommariamente citate come "necessarie ma non sufficienti"
All'inizio del XX secolo Elia Metchinkoff, ipotizzava che la presenza dei batteri nell'intestino ... more All'inizio del XX secolo Elia Metchinkoff, ipotizzava che la presenza dei batteri nell'intestino dell'uomo potesse influenzarne positivamente la salute e la longevità. Egli era anche convinto che la flora batterica fosse responsabile sia della produzione di tossine che del controllo dell'autointossicazione. La prova empirica della correttezza delle sue ipotesi gli proveniva dall'osservazione epidemiologica della longevità delle popolazioni balcaniche che consumavano yogurt in grandi quantità. Nel suo libro "The prolongation of life" del 1907, Metchinkoff scriveva: "
Recenti progressi in medicina
The suggestion that dietary fibre is of particular importance in our diet is a relatively recent ... more The suggestion that dietary fibre is of particular importance in our diet is a relatively recent concept. Much of the initial emphasis for increased dietary fibre began with the pioneering work of Burkitt and Trowell in the 1960s who observed that traditional African populations consumed diets high in plant fibre and that these populations experienced very low incidences of non-communicable diseases including cardio-vascular disease, diabetes mellitus and non-infectious bowel diseases, including cancer. Although it is difficult to predict from the chemical structure how dietary fibres will behave physiologically, generally dietary fibre sources can be grouped into two major types: (a) soluble, viscous, fermentable and (b) insoluble, non-viscous, slowly fermentable. As detailed below, these sources of fibres appear to have quite different physiological effects.
The Italian journal of gastroenterology
European journal of gastroenterology & hepatology
The Italian journal of gastroenterology
Studi di medicina e chirurgia dello sport
The Italian journal of gastroenterology
The Italian journal of gastroenterology
ABSTRACT
Rivista europea per le scienze mediche e farmacologiche = European review for medical and pharmacological sciences = Revue européenne pour les sciences médicales et pharmacologiques
Medical and surgical treatment of diverticular disease has to be set against a background of inco... more Medical and surgical treatment of diverticular disease has to be set against a background of incomplete knowledge of the natural history and geographical differences of the disease, and difficulties in its definition and classification. This clinical retrospective study was performed to answer the following questions: 1) what was the clinical course after an episode of acute diverticulitis, obliging to an hospital admission? 2) what was the role of cyclic course of antibiotics, if any, in reducing the risk of complications? We examined all admissions to the surgical ward from 1967 to 1991 for a complication of diverticular disease: we looked for occlusion, perforation, fistula, or bleeding. Patients not operated with diverticular disease have been divided in 2 groups, that is patients with a medical prescription at the end of hospital period, and patients admitted without a drug prescription. All patients have been prescribed bulk agents. The medical prescription included monthly cycles of 1 week of oral antibiotics (Neomycin associated with Bacitracin, Paromomycin, or 1989 Rifaximin). We looked for the natural history of the disease in the 2 groups (the "drug" group and the "no drug" group) after the first admission, that is the development of new complications of the diverticular disease and the reason for readmissions, calculating the Absolute Risk Reduction (the difference in event rates between the treatment and control groups) and the Relative Risk Reduction (the difference in event rates between the treated and control groups, divided by the event rate in the control groups). The total number of admitted patients in the period 1967-1991 was 505. A statistically significant trend in favour of a risk reduction of new admissions in the group given antibiotics seems evident.(ABSTRACT TRUNCATED AT 250 WORDS)
The Italian journal of gastroenterology
The Italian journal of gastroenterology
Italian journal of gastroenterology and hepatology
The Italian journal of gastroenterology
Functional dyspepsia (FD) includes a heterogeneous group of patients suffering from a variety of ... more Functional dyspepsia (FD) includes a heterogeneous group of patients suffering from a variety of different conditions. The Dyspepsia Project has been implemented in 14 GI Units since 1984, in order to epidemiologically test the discriminating power of the Working Teams definitions and of standardized questionnaires. Five per cent of admitted subjects were subclassified as sphincter of Oddi dysfunction or biliary dyspepsia (BD), defined as biliary pain associated or not to bilirubin or alkaline phosphatase elevation, in the abscence of ultrasonographic evidence of gallstone disease or bile duct dilatation. The more useful symptoms in favour of the diagnosis of biliary dyspepsia were found to be pain in the right hypochondrium, radiating to the shoulder, or to the back, initiated by food, and eventually associated with constipation, or epigastric postprandial discomfort. Interestingly, symptoms suggesting biliary dyspepsia are partially shared by dysmotility-like dyspepsia. The placebo response in functional dyspepsia is variable, between 6 and 80% of patients, reflecting variations in the kind and severity of the diseases in different studies. That represents a considerable difficulty in evaluating drug efficacy, even in the case of biliary dyspepsia. A therapeutic double-blind trial in functional dyspepsia using tauro-ursodeoxycholic acid is discussed.
The Italian journal of gastroenterology