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Addiction and religiosity in facing suicide: A qualitative study on meaning of life and death among homeless people
Adriano Zamperini,Diego De Leo,Ines Testoni,Salvatore Russotto
Mental Illness , 2018, DOI: https://doi.org/10.4081/mi.2018.7420
Abstract: This qualitative research explores the relationship between religiosity, suicide thoughts and drug abuse among 55 homeless people, interviewed with interpretative phenomenological analysis. Analyzing the thematic structure of the participants’ narrations, important main themes appeared in order to avoid suicide, among which family, the certainty of finding a solution and the will to live. However, the suicide ideation inheres in about 30% of participants, almost all believers, addicted and/or alcoholics. Results suggest that religiosity and meaning of death neither prevent from substances abuse and alcoholism, nor is a protective factor against suicide ideation. Meanings of life are the most important reasons for living, and when they are definitively considered unworkable, alcohol and drug help to endure life in the street. A specific model is discussed.
Preventing Post-ERCP Pancreatitis: Where Are We?
Testoni PA
JOP Journal of the Pancreas , 2003,
Abstract: Acute pancreatitis still represents the most common complication after procedures involving Vater's papilla; the reported incidence of this complication varies from less than 1% up to 40%. Attempts at preventing post-ERCP pancreatitis have been carried out using technical measures, pharmacological prophylaxis, or patient selection. Balloon sphincter of Oddi dilatation, difficult papillary cannulation, pancreatic sphincterotomy and multiple pancreatic duct injections have been found to be risk factors for postprocedure pancreatitis. Therefore, technique-related prevention of post-ERCP pancreatitis includes careful pancreatic duct injection, avoiding cannulation trauma, and maintaining adequate pancreatic drainage after the ERCP procedure. Pancreatic stent placement has been shown to be the most effective technique-related prevention of postprocedure pancreatitis. Apart from technique-related risk factors, operator experience also seems to be a potential risk-factor for post-ERCP/ES complications. The experience of the endoscopist rather than other patient- or technique-related conditions could probably constitute the major risk factor for postprocedure pancreatitis. Pharmacological prevention of pancreatitis after ERCP or sphincterotomy has been the topic of several investigations in recent years but still remains a debated question. Pharmacological prevention has been mainly aimed at either reducing the amount of intrapancreatic enzymes, preventing intra-cellular co-localization of enzymes and lysosomal hydrolases or blocking some steps of the enzyme-activated inflammatory cascade. Somatostatin, octreotide, gabexate mesilate and, more recently, recombinant interleukin-10 have been the most investigated drugs. Somatostatin, gabexate mesilate and recombinant interleukin-10, but not octreotide, have been found to be able to prevent post-ERCP pancreatitis in non-selected cases; however, a strategy of routine pharmacological prophylaxis in all patients is not likely to be cost-effective. A strategy of pharmacological prevention only in high-risk cases is cost-effective, but, up to now, only recombinant interleukin-10 has been proven effective. The "on demand" postprocedure treatment should also be of paramount importance, but no data are at present available regarding the potential efficacy of some drugs; on the basis of the mechanism of action, we can argue that recombinant interleukin-10 could be the only drug candidate for such a strategy. Post-ERCP pancreatitis can also be prevented by patient selection. Patient-related risk factors are now well-known, s
Recurrent Acute Pancreatitis. Introduction.
Testoni PA
JOP Journal of the Pancreas , 2001,
Abstract:
Pharmacological Prevention of Post-ERCP Pancreatitis: The Facts and the Fiction
Testoni PA
JOP Journal of the Pancreas , 2004,
Abstract:
Unresolved Issues about Post-ERCP Pancreatitis: An Overview
Testoni PA
JOP Journal of the Pancreas , 2002,
Abstract: Pancreatitis represents the most common and feared complication after endoscopic retrograde cholangio-pancreatography. Since the introduction of ERCP into clinical practice, many attempts have been made to identify the mechanisms and conditions that can place patients at risk of developing post-procedure pancreatitis, with conflicting and in most cases unsatisfactory results. The following questions about post-ERCP pancreatitis still remain unanswered: the knowledge of the mechanisms involved in the onset of pancreatitis, procedural factors that can induce pancreatic damage, patient conditions that can increase the risk of developing pancreatitis in the post-procedure period, criteria for predicting the occurrence of pancreatitis, and possible methods of preventing the complication. Moreover, the criteria used to define post-ERCP pancreatitis differ in various studies and, consequently, there is a wide variation in the literature of the incidence of this complication and it is still not clear what its real incidence is. In the last six years, a significant advance in knowledge has been achieved in most of the above-mentioned fields. Four large prospective multicentre trials seemed to definitely identify patient- and technique-related risk factors that can place patients at risk of developing post-ERCP pancreatitis; clinical conditions, procedure- and patient-related factors, and laboratory tests able to predict the occurrence of post-ERCP pancreatitis in the early phase have been identified. An attempt to identify criteria for defining post-ERCP pancreatitis has also been carried out, although these proposed criteria have not been widely adopted by all Authors.
Aetiologies of Recurrent Acute Pancreatitis: Acute or Chronic Relapsing Disease?
Testoni PA
JOP Journal of the Pancreas , 2001,
Abstract:
Why the Incidence of Post-ERCP Pancreatitis Varies Considerably? Factors Affecting the Diagnosis and the Incidence of This Complication
Testoni PA
JOP Journal of the Pancreas , 2002,
Abstract: The reported incidence of post-ERCP/sphincterotomy pancreatitis ranges between 1.3 and 24.4% in non-selected series. This varying incidence likely reflects on the one hand difference in patient populations, indications and endoscopic expertise and, on the other hand, different definitions of pancreatitis and methods of data collection. Among a number of patient-related factors recognized at risk for post-ERCP pancreatitis in four recent large prospective studies, the combination of female gender, normal serum bilirubin levels and recurrent abdominal pain suggesting sphincter of Oddi dysfunction and previous post-ERCP pancreatitis placed patients at an increasingly higher risk of pancreatitis. Among the technique-related risk factors for post-ERCP pancreatitis, biliary sphincter balloon dilation, difficult cannulation, sphincter of Oddi manometry and pancreatic sphincterotomy have also been recognized as significant risk factors. However, since the case mix in non-selected series does not significantly differ in the different studies, it is logical to assume that the different criteria adopted for defining the post-ERCP pancreatitis play a key role in the reported wide variation of incidence reported for this complication. The occurrence and duration of pain and the amplitude of serum amylase after ERCP are critical points in the definition of post-ERCP pancreatitis. Although a consensus conference identified 24-hour persisting pain associated with hyperamylasemia greater than 3 times the upper reference limit as an indicator of pancreatitis, these two parameters are however considered in a different manner in the studies available up to now. In a prospective study where we calculated the incidence of post-ERCP pancreatitis by using the most widely used criteria, for both occurrence and duration of pancreatic pain and serum amylase amplitude, the incidence of post-procedure pancreatitis ranged from 1.9 to 11.7% depending on the criteria adopted.
Water deficit affects wood vessels of Croton floribundus Spreng. in different vegetation types, S？o Paulo State, Brazil
Longui, Eduardo Luiz;Romeiro, Diego;Testoni, Luana Naves;Aguiar, Osny Tadeu de;Cielo Filho, Roque;Lima, Israel Luiz de;Florsheim, Sandra Monteiro Borges;
Hoehnea , 2012, DOI: 10.1590/S2236-89062012000100006
Abstract: in this paper we showed that water deficit affects the wood vessels of croton floribundus in five areas with different vegetation types: rain forest, semi-deciduous forest and woody savanna. we concluded that variations in the vessels are due especially to water deficit and the number of months with water deficit. larger diameter vessels occurred in areas with higher water deficit, which may represent a strategy to optimize the water transport in favorable periods. vessels with smaller diameters occur in areas with lower deficit, which may be related to lower minimum temperatures and frost occurrence, which like drought can cause vessel embolism. in caetetus ecological station, a semi-deciduous forest (area of highest water deficit), we observed investments in efficiency and safety, with the occurrence of larger diameter vessels associated with one of the lowest vulnerability indexes and highest proportions of multiple vessels of four or more elements.
Optical Coherence Tomography
Pier Alberto Testoni
The Scientific World Journal , 2007, DOI: 10.1100/tsw.2007.29
Abstract:
Transoral incisionless fundoplication for gastro-esophageal reflux disease: Techniques and outcomes
Giorgia Mazzoleni,Pier Alberto Testoni,Sabrina Gloria Giulia Testoni
- , 2016, DOI: 10.4292/wjgpt.v7.i2.179
Abstract:
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