Digestive and Liver Disease - Volume 48 - Supplement 2 - February 2016

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e146 Abstracts of the 22nd National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
with sequential therapy, whereas individuals from countries with
a low percentage (<20%) of antibiotic resistance to clarithromycin
(Africa, America) were treated with standard triple therapy with
clarithromycin.
Results: Among the 311 patients submitted to UBT, 188 (67.6%) were
HP positive, and among these 163 began a treatment cycle.
Among the 101 patients that were examined post-therapy, the
overall response rate was 75.2%, of which 80.6% concerned sequential
therapy and 78.3% standard triple therapy.
Conclusions: The prevalence of HP infection in the cohort studied is
high (67.6%); this confirms that HP infection represents one of the
main causes of chronic dyspepsia.
P.04.9
DIAGNOSIS OF CHRONIC ATROPHIC GASTRITIS IN PRIMARY CARE
SETTING BY MEANS OF GASTROPANEL®: A POPULATION STUDY
ON 10,000 CONSECUTIVE PATIENTS
Di Mario F.*1, Franceschi M.2, Cannizzaro R. 3, Dal Bo’ N.4, Ricco’ M.5,
Corrente V.6, Bertele’ A.1, Scarpignato C.1, Rugge M.7
1Department of Clinical and Experimental Medicine, University of
Parma, Parma, Italy, 2Endoscopic Unit - Department of Surgery, ULSS 4
AltoVicentino, Santorso, Vicenza, Italy, 3Gastroenterology Unit, Centro
di Riferimento Oncologico (CRO), Aviano National Cancer Institute,,
Aviano, Italy, 4 Gastroenterology and Gastrointestinal Endoscopy Unit,
Treviso Hospital, Treviso, Italy, 5Dipartimento di Prevenzione, Unità
Operativa di Prevenzione e Sicurezza degli Ambienti di Lavoro, Azienda
Provinciale per i Servizi Sanitari della Provincia Autonoma di Trento,
Trento, Italy, 6Internal Medicine and Critical Subacute Care Unit,
University-Hospital of Parma, Parma, Italy, 7Department of Pathology,
University of Padua, Padua, Italy
Background and aim: Chronic atrophic gastritis (CAG) is a stomach
precancerous condition, often related to Helicobacter pylori (H.p.)
infection. This condition is characterized by hypo- or achloridria due
to loss of appropriate gastric glands. Gastropanel® is a non-invasive
test able to detect both CAG and H.p. infection. This test, which
provides information on
both morphological and functional status of the gastric mucosa,
is often referred to as “serological biopsy”. The aim of the present
study is to investigate, by means of Gastropanel®, the prevalence of
CAG in a large primary care population.
Material and methods: Ten thousand dyspeptic patients, from two
different areas of North-East of Italy, were enrolled. The first one
(Group A) included 7,400 patients (M:F=1.2:2.0 mean age 53 years)
from 2003 to 2014 while the second one (Group B) involved 2,600
patients (M:F=1.5:2.3, mean age 56 years) from 2011 to 2013. Upper
GI endoscopy with biopsies sampling, evaluated histologically
according to the Sydney classification and the O.L.G.A. staging
system, as well as Gastropanel® (Biohit Oyj, Helsinki, Finland) were
performed in every patient.
Serological diagnosis of CAG was made when PGI serum levels were
< 25 microg/L and G-17 concentrations > 14 pmol/L. Histological
diagnosis of CAG followed the criteria of both Sydney system and
O.L.G.A. staging.
Results: Overall, CAG was diagnosed by serology in 716 out of
10,000 patients. In Group A population, 608 patients (mean age 57
years old) has a CAG, 2,492 (mean age 54) a non-atrophic gastritis
related with H.p. infection was performed while 879 patients (mean
age 44 years) presented with a normal gastric morpho-functional
assessment. In Group B population, CAG was found in 108 patients
(mean age 58 years) and H.p.-related gastritis in 643 (mean age 59)
while a normal pattern was detected in 721 patients (mean age 47).
Conclusions: Overall, in a primary care setting, a picture of CAG was
found in 7.2% of patients. The prevalence was higher in Group A than
in Group B (8.2% and 4.2%, respectively) for unknown reasons. The
mean age of subjects with CAG was higher than that of patients with
NAG H.pylori-related and normal population in both areas.
P.04.10
GASTRIC CANCER AND SIMULTANEOUS CARE: PRELIMINARY
REPORT ABOUT THE TAKE CHARGE APPROACH
Vannelli A.*1, Putortì A.1, Rossi F.1, Sabatino G.2, Amato A.1
1 Ospedale Valduce, Como, Italy, 2ASL COMO, Como, Italy
Background and aim: In multimodal therapy era, surgery is
considered the main treatment for gastric cancer (GC). Yet, the main
topic of National Health Service is GC treatments’ costs. In Italy,
the cost due to GC’s care, results in loss of productivity (LP), and is
134% higher than average cancer costs. Among its proposed actions,
“National Cancer Plan” intends to reduce migration of the health
care and better utilize the available resources so to reduce LP‘s. We
present our preliminary results of the first italian simultaneous care
model with the intent to increase relationship between oncology
and territory, and reduce treatment costs.
Material and methods: Como has 600.000 people. Incidence of GC,
standardized for age, is the highest in North Italy: 18,7 vs 17,1. An
average of 110 patients/year undergo a GC surgery, with a migration
value of 30%-35%. Erone onlus (oncological volunteer association)
has organized a plan of simultaneous care model. In February 2014,
in collaboration with Valduce (religious hospital), organized a two-
days conference on “Oncology and territory”. The first day dedicated
for everybody while the second day for general practitioners (GP).
After a year, we examined and compared the results with the historic
database of Como Local Health Authority
Results: Como has a “Dipartimento Interaziendale Provinciale
Oncologico”, that treats all oncological patients, nonetheless in
2013 the migration index was of 30,5%. Following our event in 2014,
that had an attendance of over 600 people, the migration index
decreased to 24,5%. A cutback of migration of health care means a
better use of the available resources. Compared to 2013, gastroscopy
increased of 4% (up 27% in surgery endoscopy); a sign that GPs
paid more importance to upper gastrointestinal symptoms of their
patients. Moreover in 2015, first time in Italy, Valduce described an
integrated multidisciplinary clinical protocol, on treatment of GC.
Conclusions: As the fifth most commonly diagnosed cancer and the
fourth leading cause of cancer-related death, GC is a major clinical
and financial burden with significant differences in territorial
distribution. Multimodal progress is extremely costly and the
results often end in marginal survival benefit, therefore, excellence
in surgery should be achieved. A new program for a simultaneous
care model is one of several changes required to improve the
intended actions of GC surgical treatment. Our preliminary results
on this model, demonstrate an advantage in territory, reducing the
migration index
P.05 Clinical Cases
P.05.1
ENDOSCOPIC REMOVAL OF A LARGE SYMPTOMATIC IMPACTED
BONE IN THE COLON
Limido E.*, Bassino C., Tettamanzi D., Sala D., Golia M.,
Azzola Guicciardi M., Gerosa P.
A.O. Sant’Anna, Como, Italy
Background and aim: Most foreign bodies pass through the
gastrointestinal tract without any consequence. A very small