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van Zwieten A, Wong G, Ruospo M, Palmer SC, Teixeira-Pinto A, Barulli MR, Iurillo A, Saglimbene V, Natale P, Gargano L, Murgo M, Loy CT, Tortelli R, Craig JC, Johnson DW, Tonelli M, Hegbrant J, Wollheim C, Logroscino G, Strippoli GF, Cagnazzo A, Antinoro R, Sambati M, Donatelli C, Dambrosio N, Saturno C, Marangelli A, Pedone F, Matera G, Benevento M, Papagni S, Alicino F, Latassa G, Molino A, Grippaldi F, Bertino D, Montalto G, Messina S, Campo S, Nasisi P, Failla A, Bua A, Pagano S, Marino G, Sanfilippo N, Rallo D, Maniscalco A, Capostagno C, Randazzo G, Fici M, Lupo A, Fichera R, D'angelo A, Di Toro Mammarella R, Meconizzi M, Boccia E, Mantuano M, Flammini A, Moscardelli L. Associations of Cognitive Function and Education Level With All-Cause Mortality in Adults on Hemodialysis: Findings From the COGNITIVE-HD Study. Am J Kidney Dis 2019; 74:452-462. [DOI: 10.1053/j.ajkd.2019.03.424] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/08/2019] [Indexed: 12/24/2022]
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Abstract
In spite of our present improved knowledge of the epidemiology and pathways of contamination of the hepatitis C virus (HCV), infection still remains a public health problem. One category of patients who have suffered greatly from the consequences of HCV infection is certainly that of hemodialysis patients. In the past, in fact, their need for transfusions exposed these patients to infection and, as a result, subjects on dialysis for over 15 years are today paying the price for those inevitable transfusions, as the virus and its pathways of contagion were unknown then. However, still today, albeit at a much lower prevalence, even subjects with a shorter dialysis age present a higher prevalence of anti-HCV than the general population, suggesting that other factors of contamination than the classical ones contribute to keeping this prevalence high. Its clinical course is generally asymptomatic and the biological and virological progression of the disease is quite particular and apparently benign. The mortality rate of infected patients is higher than in non-infected subjects and this is not only due to the liver disease itself but also to cardiovascular disorders. Even anti-viral therapy, after its first timid steps, is now routinely used in patients with a certain degree of liver damage and kidney transplant candidates. The appropriate use of pegylated interferons is expected to improve the percentage of eradication and limit side effects, in parallel with what has been observed in non-dialysis patients. Ribavirin, however, is at present contraindicated due to its toxic effects on red blood cells as hemoglobin content could be dangerously reduced in these patients.
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Affiliation(s)
- M Li Vecchi
- Department of Nephrology, University of Palermo, Palermo, Italy
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3
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Di Bona D, Aiello A, Colomba C, Bilancia M, Accardi G, Rubino R, Giannitrapani L, Tuttolomondo A, Cascio A, Caiaffa MF, Rizzo S, Di Lorenzo G, Candore G, Duro G, Macchia L, Montalto G, Caruso C. KIR2DL3 and the KIR ligand groups HLA-A-Bw4 and HLA-C2 predict the outcome of hepatitis B virus infection. J Viral Hepat 2017; 24:768-775. [PMID: 28211154 DOI: 10.1111/jvh.12698] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 02/04/2017] [Indexed: 12/12/2022]
Abstract
Killer immunoglobulin-like receptors (KIRs) regulate the activation of natural killer cells through their interaction with human leucocyte antigens (HLA). KIR and HLA loci are highly polymorphic, and certain HLA-KIR combinations have been found to protect against viral infections. In this study, we analysed whether the KIR/HLA repertoire may influence the course of hepatitis B virus (HBV) infection. Fifty-seven subjects with chronic hepatitis B (CHB), 44 subjects with resolved HBV infection and 60 healthy uninfected controls (HC) were genotyped for KIR and their HLA ligands. The frequency of the HLA-A-Bw4 ligand group was higher in CHB (58%) than subjects with resolved infection (23%) (crude OR, 4.67; P<.001) and HC (10%) (crude OR, 12.38; P<.001). Similar results were obtained for the HLA-C2 ligand group, more frequent in CHB (84%), than subjects with resolved infection (70%) (crude OR, 2.24; P<.10) and HC (60%) (crude OR, 3.56; P<.01). Conversely, the frequency of KIR2DL3 was lower in CHB (81%) than in subjects with resolved infection (98%) (crude OR, 0.10; P<.05). These results suggest a detrimental role of HLA-A-Bw4 and HLA-C2 groups, which are associated with the development of CHB, and a protective role of KIR2DL3. A stepwise variable selection procedure, based on multiple logistic regression analysis, identified these three predictive variables as the most relevant, featuring high specificity (90.9%) and positive predictive value (87.5%) for the development of CHB. Our results suggest that a combination of KIR/HLA gene/alleles is able to predict the outcome of HBV infection.
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Affiliation(s)
- D Di Bona
- Dipartimento dell'Emergenza e dei Trapianti d'Organo, Università di Bari Aldo Moro, Bari, Italy
| | - A Aiello
- Dipartimento di Biopatologia e Biotecnologie Mediche, Università di Palermo, Palermo, Italy
| | - C Colomba
- Dipartimento di Scienze per la Promozione della Salute e Materno-Infantile "G. D'Alessandro", Università di Palermo, Palermo, Italy
| | - M Bilancia
- Dipartmento Jonico in Sistemi Giuridici ed Economici del Mediterraneo: Società, Ambiente, Culture, Università di Bari Aldo Moro, Bari, Italy
| | - G Accardi
- Dipartimento di Biopatologia e Biotecnologie Mediche, Università di Palermo, Palermo, Italy
| | - R Rubino
- Dipartimento di Scienze per la Promozione della Salute e Materno-Infantile "G. D'Alessandro", Università di Palermo, Palermo, Italy
| | - L Giannitrapani
- Dipartimento BioMedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
| | - A Tuttolomondo
- Dipartimento BioMedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
| | - A Cascio
- Dipartimento di Scienze per la Promozione della Salute e Materno-Infantile "G. D'Alessandro", Università di Palermo, Palermo, Italy
| | - M F Caiaffa
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Foggia, Foggia, Italy
| | - S Rizzo
- Unità Operativa di Medicina Trasfusionale, AOUP, Palermo, Italy
| | - G Di Lorenzo
- Dipartimento BioMedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
| | - G Candore
- Dipartimento di Biopatologia e Biotecnologie Mediche, Università di Palermo, Palermo, Italy.,Unità Operativa di Medicina Trasfusionale, AOUP, Palermo, Italy
| | - G Duro
- Istituto di Biomedicina ed Immunologia Molecolare, Consiglio Nazionale delle Ricerche, Palermo, Italy
| | - L Macchia
- Dipartimento dell'Emergenza e dei Trapianti d'Organo, Università di Bari Aldo Moro, Bari, Italy
| | - G Montalto
- Dipartimento BioMedico di Medicina Interna e Specialistica, Università degli Studi di Palermo, Palermo, Italy
| | - C Caruso
- Dipartimento di Biopatologia e Biotecnologie Mediche, Università di Palermo, Palermo, Italy.,Unità Operativa di Medicina Trasfusionale, AOUP, Palermo, Italy
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- Dipartimento di Biopatologia e Biotecnologie Mediche, Università di Palermo, Palermo, Italy.,Unità Operativa di Medicina Trasfusionale, AOUP, Palermo, Italy
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Emma MR, Iovanna JL, Bachvarov D, Puleio R, Loria GR, Augello G, Candido S, Libra M, Gulino A, Cancila V, McCubrey JA, Montalto G, Cervello M. NUPR1, a new target in liver cancer: implication in controlling cell growth, migration, invasion and sorafenib resistance. Cell Death Dis 2016; 7:e2269. [PMID: 27336713 PMCID: PMC5143401 DOI: 10.1038/cddis.2016.175] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 05/23/2016] [Accepted: 05/25/2016] [Indexed: 01/11/2023]
Abstract
Sorafenib, an oral multikinase inhibitor, is the only approved agent for the treatment of advanced hepatocellular carcinoma (HCC). However, its benefits are modest, and as its mechanisms of action remain elusive, a better understanding of its anticancer effects is needed. Based on our previous study results, we investigated here the implication of the nuclear protein 1 (NUPR1) in HCC and its role in sorafenib treatment. NUPR1 is a stress-inducible protein that is overexpressed in various malignancies, but its role in HCC is not yet fully understood. We found that NUPR1 expression was significantly higher in primary human HCC samples than in the normal liver. Knockdown of NUPR1 significantly increased cell sensitivity to sorafenib and inhibited the cell growth, migration and invasion of HCC cells, both in vitro and in vivo. Moreover, NUPR1 silencing influenced the expression of RELB and IER3 genes. Unsurprisingly, RELB and IER3 knockdown also inhibited HCC cell viability, growth and migration. Using gene expression profiling of HCC cells following stable NUPR1 knockdown, we found that genes functionally involved in cell death and survival, cellular response to therapies, lipid metabolism, cell growth and proliferation, molecular transport and cellular movement were mostly suppressed. Network analysis of dynamic gene expression identified NF-κB and ERK as downregulated gene nodes, and several HCC-related oncogenes were also suppressed. We identified Runt-related transcription factor 2 (RUNX2) gene as a NUPR1-regulated gene and demonstrated that RUNX2 gene silencing inhibits HCC cell viability, growth, migration and increased cell sensitivity to sorafenib. We propose that the NUPR1/RELB/IER3/RUNX2 pathway has a pivotal role in hepatocarcinogenesis. The identification of the NUPR1/RELB/IER3/RUNX2 pathway as a potential therapeutic target may contribute to the development of new treatment strategies for HCC management.
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Affiliation(s)
- M R Emma
- Institute of Biomedicine and Molecular Immunology "Alberto Monroy", National Research Council (CNR), Palermo, Italy.,Biomedic Department of Internal Medicine and Specialties (DiBiMIS), University of Palermo, Palermo, Italy
| | - J L Iovanna
- INSERM UMR1068, Center of Research in Cancerology of Marseille (CRCM), Marseille, France
| | - D Bachvarov
- Cancer Research Centre, Hôpital L'Hotel-Dieu de Québec, Centre Hospitalier Universitaire de Québec, Quebec City (Quebec), Canada.,Department of Molecular Medicine, Faculty of Medicine, Laval University, Quebec City (Quebec), Canada
| | - R Puleio
- Istituto Zooprofilattico Sperimentale della Sicilia "A. Mirri", Histopathology and Immunohistochemistry Laboratory, Palermo, Italy
| | - G R Loria
- Istituto Zooprofilattico Sperimentale della Sicilia "A. Mirri", Histopathology and Immunohistochemistry Laboratory, Palermo, Italy
| | - G Augello
- Institute of Biomedicine and Molecular Immunology "Alberto Monroy", National Research Council (CNR), Palermo, Italy.,Biomedic Department of Internal Medicine and Specialties (DiBiMIS), University of Palermo, Palermo, Italy
| | - S Candido
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - M Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - A Gulino
- Tumor Immunology Unit, Department of Health Science, University of Palermo, Palermo, Italy
| | - V Cancila
- Tumor Immunology Unit, Department of Health Science, University of Palermo, Palermo, Italy
| | - J A McCubrey
- Department of Microbiology and Immunology, Brody School of Medicine at East Carolina University, Greenville, NC, USA
| | - G Montalto
- Institute of Biomedicine and Molecular Immunology "Alberto Monroy", National Research Council (CNR), Palermo, Italy.,Biomedic Department of Internal Medicine and Specialties (DiBiMIS), University of Palermo, Palermo, Italy
| | - M Cervello
- Institute of Biomedicine and Molecular Immunology "Alberto Monroy", National Research Council (CNR), Palermo, Italy
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5
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Palmer SC, Ruospo M, Wong G, Craig JC, Petruzzi M, De Benedittis M, Ford P, Johnson DW, Tonelli M, Natale P, Saglimbene V, Pellegrini F, Celia E, Gelfman R, Leal MR, Torok M, Stroumza P, Bednarek-Skublewska A, Dulawa J, Frantzen L, Ferrari JN, del Castillo D, Bernat AG, Hegbrant J, Wollheim C, Gargano L, Bots CP, Strippoli GF, Raña S, Serrano M, Claros S, Arias M, Petracci L, Arana M, De Rosa P, Gutierrez A, Simon M, Vergara V, Tosi M, Cernadas M, Vilamajó I, Gravac D, Paulón M, Penayo L, Carrizo G, Ghiani M, Perez G, Da Cruz O, Galarce D, Gravielle M, Vescovo E, Paparone R, Mato Mira C, Mojico E, Hermida O, Florio D, Yucoswky M, Labonia W, Rubio D, Di Napoli G, Fernandez A, Altman H, Rodriguez J, Serrano S, Valle G, Lobos M, Acosta V, Corpacci G, Jofre M, Gianoni L, Chiesura G, Capdevila M, Montenegro J, Bequi J, Dayer J, Gómez A, Calderón C, Abrego E, Cechín C, García J, Corral J, Natiello M, Coronel A, Muñiz M, Muñiz V, Bonelli A, Sanchez F, Maestre S, Olivera S, Camargo M, Avalos V, Geandet E, Canteli M, Escobar A, Sena E, Tirado S, Peñalba A, Neme G, Cisneros M, Oliszewski R, Nascar V, Daud M, Mansilla S, Paredes Álvarez A, Gamín L, Arijón M, Coombes M, Zapata M, Boriceanu C, Frantzen-Trendel S, Albert K, Csaszar I, Kiss E, Kosa D, Orosz A, Redl J, Kovacs L, Varga E, Szabo M, Magyar K, Kriza G, Zajko E, Bereczki A, Csikos J, Kuti A, Mike A, Steiner K, Nemeth E, Tolnai K, Toth A, Vinczene J, Szummer S, Tanyi E, Toth R, Szilvia M, Dambrosio N, Paparella G, Sambati M, Donatelli C, Pedone F, Cagnazzo V, Antinoro R, Torsello F, Saturno C, Giannoccaro G, Maldera S, Boccia E, Mantuano M, Di Toro Mammarella R, Meconizzi M, Steri P, Riccardi C, Flammini A, Moscardelli L, Murgo M, San Filippo N, Pagano S, Marino G, Montalto G, Cantarella S, Salamone B, Randazzo G, Rallo D, Maniscalco A, Fici M, Lupo A, Pellegrino P, Fichera R, D’Angelo A, Falsitta N, Bochenska-Nowacka E, Jaroszynski A, Drabik J, Birecka M, Daniewska D, Drobisz M, Doskocz K, Wyrwicz G, Inchaustegui L, Outerelo C, Sousa Mendes D, Mendes A, Lopes J, Barbas J, Madeira C, Fortes A, Vizinho R, Cortesão A, Almeida E, Bernat A, De la Torre B, Lopez A, Martín J, Cuesta G, Rodriguez R, Ros F, Garcia M, Orero E, Ros E, Caetano A, MacGregor K, Santos M, Silva Pinheiro S, Martins L, Leitão D, Izidoro C, Bava G, Bora A, Gorena H, Calderón T, Dupuy R, Alonso N, Siciliano V, Frantzen-Trendel S, Nagy K, Bajusz Ö, Pinke I, Decsi G, Gyergyoi L, Jobba Z, Zalai Z, Zsedenyi Á, Kiss G, Pinter M, Kereszturi M, Petruzzi M, De Benedittis M, Szkutnik J, Sieczkarek J, Capelo A, Garcia Gallart M, Mendieta C. Dental Health and Mortality in People With End-Stage Kidney Disease Treated With Hemodialysis: A Multinational Cohort Study. Am J Kidney Dis 2015; 66:666-76. [DOI: 10.1053/j.ajkd.2015.04.051] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 04/29/2015] [Indexed: 01/28/2023]
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D'Angelo S, Germano D, Zolfino T, Sansonno D, Montalto G, Benedetti A, Montesarchio V, Attili A, Buonadonna A, Barni S, Gasbarrini A, Pirisi M, Cillo U, Marenco S, Villa E, Giovanis P, Pinotti G, Saitta C, Erminero C, de Giorgio M, Lorusso V. Final results of the gideon study according to patient etiology: The italian experience. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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D'Angelo S, Germano D, Zolfino T, Sansonno D, Montalto G, Benedetti A, Montesarchio V, Attili A, Buonadonna A, Barni S, Gasbarrini A, Pirisi M, Cillo U, Marenco S, Villa E, Giovanis P, Pinotti G, Raimondo G, Erminero C, De Giorgio M, Lorusso V. P-111 Final results of the GIDEON (Global Investigational of therapeutic DEcisions in HCC and Of its treatment with sorafeNib) study according to patient etiology: The Italian experience. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv233.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Licata A, Ingrassia D, Serruto A, Soresi M, Giannitrapani L, Montalto G, Craxì A, Almasio PL. Clinical course and management of acute and chronic viral hepatitis during pregnancy. J Viral Hepat 2015; 22:515-23. [PMID: 25288051 DOI: 10.1111/jvh.12335] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Pregnancy is a para-physiologic condition, which usually evolves without any complications in the majority of women, even if in some circumstances moderate or severe clinical problems can also occur. Among complications occurring during the second and the third trimester very important are those considered as concurrent to pregnancy such as hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, HELLP syndrome and acute fatty liver of pregnancy. The liver diseases concurrent to pregnancy typically occur at specific times during the gestation and they may lead to significant maternal and foetal morbidity and mortality. Commonly, delivery of the foetus, even preterm, usually terminates the progression of these disorders. All chronic liver diseases, such as chronic viral hepatitis, autoimmune hepatitis, Wilson's disease, and cirrhosis of different aetiologies may cause liver damage, independently from pregnancy. In this review we will also comment the clinical implications of pregnancies occurring in women who received a orthotopic liver transplantation (OLT) Therefore, the management of immunosuppressive therapy before and after the delivery in women who received liver transplant is becoming a relevant clinical issue. Finally, we will focus on acute and chronic viral hepatitis occurring during pregnancy, on management of advanced liver disease and we will review the literature on the challenging issue regarding pregnancy and OLT.
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MESH Headings
- Acute Disease
- Chronic Disease
- Disease Management
- Female
- Hepatitis, Viral, Human/complications
- Hepatitis, Viral, Human/diagnosis
- Hepatitis, Viral, Human/pathology
- Hepatitis, Viral, Human/therapy
- Hepatitis, Viral, Human/virology
- Humans
- Liver Transplantation
- Pregnancy
- Pregnancy Complications, Infectious
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Affiliation(s)
- A Licata
- Sezione di Gastroenterologia & Epatologia, Sezione di Medicina Interna, Di.Bi.M.I.S., Università di Palermo, Palermo, Italy
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Rizzo M, Otvos J, Nikolic D, Montalto G, Toth P, Banach M. Subfractions and Subpopulations of HDL: An Update. Curr Med Chem 2014; 21:2881-91. [DOI: 10.2174/0929867321666140414103455] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 03/14/2014] [Accepted: 04/09/2014] [Indexed: 11/22/2022]
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Onuigbo M, Agbasi N, Wu MJ, Shu KH, Kugler E, Cohen E, Krause I, Goldberg E, Garty M, Krause I, Jansen J, De Napoli IE, Schophuizen CM, Wilmer MJ, Mutsaers HA, Heuvel LP, Grijpma DW, Stamatialis D, Hoenderop JG, Masereeuw R, Van Craenenbroeck AH, Van Craenenbroeck EM, Van Ackeren K, Vrints CJ, Hoymans VY, Couttenye MM, Erkmen Uyar M, Tutal E, Bal Z, Guliyev O, Sezer S, Liu L, Wang C, Tanaka K, Kushiyama A, Sakai K, Hara S, Ubara Y, Ohashi Y, Kunugi Y, Kawazu S, Untersteller K, Seiler S, Rogacev KS, Emrich IE, Lennartz CS, Fliser D, Heine GH, Hoshino T, Ookawara S, Miyazawa H, Ueda Y, Ito K, Kaku Y, Hirai K, Mori H, Yoshida I, Kakuta S, Hayama N, Amemiya M, Okamoto H, Inoue S, Tabei K, Campos P, Dias C, Baptista J, Papoila AL, Ortiz A, Inchaustegui L, Soto K, Moon KH, Yang S, Lee DY, Kim HW, Kim B, Isnard Bagnis C, Guerraoui A, Zenasni F, Idier L, Chauveau P, Cerqueira A, Quelhas-Santos J, Pestana M, Choi JY, Jin DC, Choi YJ, Kim WY, Nam SA, Cha JH, Cernaro V, Loddo S, Lacquaniti A, Romeo A, Costantino G, Montalto G, Santoro D, Trimboli D, Ricciardi CA, Lacava V, Buemi M, Emrich IE, Zawada AM, Rogacev KS, Seiler S, Obeid R, Geisel J, Fliser D, Heine GH, Meneses GC, Silva Junior G, Costa MFB, Goncalves HS, Daher EF, Liborio AB, Martins AMC, Ekart R, Hojs N, Bevc S, Hojs R, Lim CS, Hwang JH, Chin HJ, Kim S, Kim DK, Kim S, Park JH, Shin SJ, Lee SH, Choi BS, Lemoine S, Panaye M, Juillard L, Dubourg L, Hadj-Aissa A, Guebre-Egziabher F, Silva Junior G, Vieira APF, Couto Bem AX, Alves MP, Meneses GC, Martins AMC, Liborio AB, Daher EF, Ito K, Ookawara S, Miyazawa H, Ueda Y, Kaku Y, Hirai K, Hoshino T, Mori H, Yoshida I, Tabei K, Stefan G, Capusa C, Stancu S, Margarit D, Petrescu L, Nedelcu ED, Mircescu G, Szarejko-Paradowska A, Rysz J, Hung CC, Chen HC, Ristovska V, Grcevska L, Podesta MA, Reggiani F, Cucchiari D, Badalamenti S, Buemi M, Ponticelli C, Graziani G, Nouri-Majalan N, Moghadasimousavi S, Eshaghyeh Z, Greenwood S, Koufaki P, Maclaughlin H, Rush R, Hendry BM, Macdougall IC, Mercer T, Cairns H. CKD LAB METHODS, PROGRESSION & RISK FACTORS 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Poesen R, Viaene L, Bammens B, Claes K, Evenepoel P, Meijers B, Bozic M, De Pablo C, Alvarez A, Sanchez-Nino MD, Ortiz A, Fernandez E, Valdivielso JM, Speer T, Zewinger S, Holy EW, Stahli BE, Triem S, Cvija H, Rohrer L, Seiler S, Heine GH, Jankowski V, Jankowski J, Camici G, Akhmedov A, Luscher TF, Tanner FC, Fliser D, Isoyama N, Leurs P, Qureshi AR, Anderstam B, Heimburger O, Barany P, Stenvinkel P, Lindholm B, Bolasco P, Palleschi S, Rossi B, Atti M, Amore A, Coppo R, Loiacono E, Ghezzi PM, Palladino G, Caiazzo M, Di Napoli A, Tazza L, Franco F, Chicca S, Bossola M, Di Lallo D, Michelozzi P, Davoli M, Lucisano S, Arena A, Lupica R, Cernaro V, Trimboli D, Aloisi C, Montalto G, Santoro D, Buemi M, Burtey S, Poitevin S, Darbousset R, Gondouin B, Dubois C, Erkmen Uyar M, Bal Z, Bayraktar N, Gurlek Demirci B, Sayin B, Sezer S, Rogacev K, Zawada A, Emrich I, Seiler S, Bohm M, Fliser D, Woollard K, Heine G, Gbandjaba NY, Ghalim N, Saile R, Khalil A, Fujii H, Yamashita Y, Yonekura Y, Nakai K, Kono K, Goto S, Sugano M, Goto S, Ito Y, Nishi S, Leurs P, Meuwese C, Carrero JJ, Qureshi AR, Anderstam B, Barany P, Heimburger O, Stenvinkel P, Lindholm B, Riccio E, Sabbatini M, Bellizzi V, Pisani A, Svedberg O, Stenvinkel P, Qureshi AR, Barany P, Heimburger O, Leurs P, Isoyama N, Lindholm B, Anderstam B, Barreto-Silva MI, Lemos C, Costa-Silva F, Mendes R, Bregman R, Barreto - Silva MI, Lemos C, Vargas S, Barja-Fidalgo TC, Bregman R, Sidoti A, Lusini ML, Biagioli M, Sereni L, Ghezzi PM, Caiazzo M, Palladino G, Kara E, Ahbap E, Basturk T, Koc Y, Sakaci T, Sahutoglu T, Sevinc M, Akgol C, Unsal A, Snaedal S, Qureshi AR, Carrero JJ, Heimburger O, Stenvinkel P, Barany P, Paliouras C, Haviatsos T, Lamprianou F, Papagiannis N, Ntetskas G, Roufas K, Karvouniaris N, Anastasakis E, Moschos N, Alivanis P, Santoro D, Ingegneri MT, Vita G, Pisacane A, Bellinghieri G, Savica V, Buemi M, Lucisano S, Kim HK, Kim SC, Kim MG, Jo SK, Cho WY, Altunoglu A, Yavuz D, Canoz MB, Yavuz R, Karakas LA, Bayraktar N, Colak T, Sezer S, Ozdemir FN, Haberal M, Akbasli AC, Keven K, Erbay B, Nebio lu S, Loboda O, Dudar I, Krot V, Alekseeva V, Grabulosa CC, De Carvalho JTG, Manfredi SR, Canziani ME, Quinto BMR, Peres AT, Batista MC, Cendoroglo M, Dalboni MA, Zingerman B, Azoulay O, Gamzo Z, Rozen-Zvi B, Stefan G, Capusa C, Stancu S, Ilyes A, Viasu L, Mircescu G, Yilmaz MI, Solak Y, Saglam M, Cayci T, Acikel C, Unal HU, Eyileten T, Oguz Y, Sari S, Carrero JJ, Stenvinkel P, Covic A, Kanbay M, Kim YN, Park K, Gwoo S, Shin HS, Jung YS, Rim H, Rhew HY, Gok M, Kurt Y, Unal HU, CetInkaya H, Karaman M, EyIeten T, Vural A, Yilmaz MI, Oguz Y, Flisi Ski M, Brymora A, StrozEcki P, Stefa Ska A, Manitius J, Donderski R, Mi Kowiec-Wi Niewska I, Kretowicz M, Johnson R, Kami Ska A, Junik R, Siodmiak J, Stefa Ska A, Odrowaz-Sypniewska G, Manitius J, Tasic D, Radenkovic S, Kocic G, Wyskida K, Spiechowicz-Zato U, Rotkegel S, Ciepal J, Klein D, Bozentowicz-Wikarek M, Brzozowska A, Olszanecka-Glinianowicz M, Chudek J, Dimitrijevic Z, Cvetkovic T, Mitic B, Paunovic K, Paunovic G, Stojanovic M, Velickovic-Radovanovic R, Gliga ML, Gliga PM, Stoica C, Tarta D, Dogaru G. CKD NUTRITION, INFLAMMATION AND OXIDATIVE STRESS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kanlaya R, Sintiprungrat K, Thongboonkerd V, Torremade N, Bindels R, Hoenderop J, Fernandez E, Dusso A, Valdivielso JM, Krueger T, Boor P, Schafer C, Westenfeld R, Brandenburg V, Schlieper G, Jahnen-Dechent W, Ketteler M, Jee W, Li X, Richards B, Floege J, Goncalves JG, Canale D, de Braganca AC, Shimizu MHM, Moyses RMA, Andrade L, Seguro AC, Volpini RA, Romoli S, Migliorini A, Anders HJ, Eskova O, Neprintseva N, Tchebotareva N, Bobkova I, Kozlovskaya L, Simic I, Tabatabaeifar M, Wlodkowski T, Denc H, Mollet G, Antignac C, Schaefer F, Ekaterina IA, Giardino L, Rastaldi MP, Van den Heuvel L, Levtchenko E, Okina C, Okamoto T, Kamata M, Murano J, Kobayashi K, Takeuchi K, Kamata F, Sakai T, Naito S, Aoyama T, Sano T, Takeuchi Y, Kamata K, Thomasova D, Bruns HA, Liapis H, Anders HJ, Iwashita T, Hasegawa H, Takayanagi K, Shimizu T, Asakura J, Okazaki S, Kogure Y, Hatano M, Hara H, Inamura M, Iwanaga M, Mitani T, Mitarai T, Savin VJ, Sharma M, Wei C, Reiser J, McCarthy ET, Sharma R, Gauchat JF, Eneman B, Freson K, Van den Heuvel L, Van Geet C, Levtchenko E, Choi DE, Jeong JY, Chang YK, Na KR, Lee KW, Shin YT, Ni HF, Chen JF, Zhang MH, Pan MM, Liu BC, Lee KW, Jeong JY, Choi DE, Chang YK, Kim SS, Na KR, Shin YT, Suzuki T, Iyoda M, Matsumoto K, Shindo-Hirai Y, Kuno Y, Wada Y, Yamamoto Y, Shibata T, Akizawa T, Munoz-Felix JM, Lopez-Novoa JM, Martinez-Salgado C, Ehling J, Babickova J, Gremse F, Kiessling F, Floege J, Lammers T, Boor P, Lech M, Gunthner R, Lorenz G, Ryu M, Grobmayr R, Susanti H, Kobayashi KS, Flavell RA, Anders HJ, Rayego-Mateos S, Morgado J, Sanz AB, Eguchi S, Pato J, Keri G, Egido J, Ortiz A, Ruiz-Ortega M, Leduc M, Geerts L, Grouix B, Sarra-Bournet F, Felton A, Gervais L, Abbott S, Duceppe JS, Zacharie B, Penney C, Laurin P, Gagnon L, Detsika MG, Duann P, Lianos EA, Leong KI, Chiang CK, Yang CC, Wu CT, Chen LP, Hung KY, Liu SH, Carvalho FF, Teixeira VP, Almeida WS, Schor N, Small DM, Bennett NC, Coombes J, Johnson DW, Gobe GC, Montero N, Prada A, Riera M, Orfila M, Pascual J, Rodriguez E, Barrios C, Kokeny G, Fazekas K, Rosivall L, Mozes MM, Munoz-Felix JM, Lopez-Novoa JM, Martinez-Salgado C, Hornigold N, Hughes J, Mooney A, Benardeau A, Riboulet W, Vandjour A, Jacobsen B, Apfel C, Conde-Knape K, Grouix B, Felton A, Sarra-Bournet F, Leduc M, Geerts L, Gervais L, Abbott S, Bienvenu JF, Duceppe JS, Zacharie B, Penney C, Laurin P, Gagnon L, Tanaka T, Yamaguchi J, Nangaku M, Niwa T, Bolati D, Shimizu H, Yisireyili M, Nishijima F, Brocca A, Virzi G, de Cal M, Ronco C, Priante G, Musacchio E, Valvason C, Sartori L, Piccoli A, Baggio B, Boor P, Perkuhn M, Weibrecht M, Zok S, Martin IV, Schoth F, Ostendorf T, Kuhl C, Floege J, Karabaeva A, Essaian A, Beresneva O, Parastaeva M, Kayukov I, Smirnov A, Audzeyenka I, Kasztan M, Piwkowska A, Rogacka D, Angielski S, Jankowski M, Bockmeyer CL, Kokowicz K, Agustian PA, Zell S, Wittig J, Becker JU, Nishizono R, Venkatareddy MP, Chowdhury MA, Wang SQ, Fukuda A, Wickman LT, Yang Y, Wiggins RC, Fazio MR, Donato V, Lucisano S, Cernaro V, Lupica R, Trimboli D, Montalto G, Aloisi C, Mazzeo AT, Buemi M, Gawrys O, Olszynski KH, Kuczeriszka M, Gawarecka K, Swiezewska E, Chmielewski M, Masnyk M, Rafalowska J, Kompanowska-Jezierska E, Lee WC, Chau YY, Lee LC, Chiu CH, Lee CT, Chen JB, Kim WK, Shin SJ. Experimental models of CKD. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Wong MMY, Thijssen S, Usvyat LA, Kotanko P, Maddux FW, Speer T, Rohrer L, Blyzszuk P, Krankel N, Zewinger S, Martin T, von Eckardstein A, Luscher T, Landmesser U, Fliser D, Prats M, Font R, Garcia C, Cabre C, Jariod M, Martinez Vea A, Costa E, Ribeiro S, do Sameiro-Faria M, Rocha-Pereira P, Kohlova M, Fernandes J, Reis F, Miranda V, Quintanilha A, Bronze-da-Rocha E, Belo L, Santos-Silva A, do Sameiro-Faria M, Kohlova M, Ribeiro S, Rocha-Pereira P, Fernandes J, Nascimento H, Reis F, Miranda V, Bronze-da-Rocha E, Quintanilha A, Belo L, Costa E, Santos-Silva A, Schepers E, Glorieux G, Van den Abeele T, Neirynck N, Vanholder R, Neirynck N, Glorieux G, Boelaert J, Liabeuf S, Massy Z, Vanholder R, Kaynar K, Kural BV, Ulusoy S, Cansiz M, Akcan B, Misir N, Yaman S, Kaya N, Dimas GG, Iliadis FS, Tegos TJ, Spiroglou SG, Pitsalidis CG, Karamouzis IM, Didaggelos TP, Adamidou AP, Savopoulos CG, Karamouzis MI, Orologas AG, Hatzitolios AI, Grekas DM, Flisinski M, Brymora A, Stefanska A, Strozecki P, Manitius J, Khalfina TN, Maksudova AN, Valeeva IK, Bantis C, Kouri NM, Bamichas G, Stangou M, Tsantekidou E, Natse T, Fazio MR, Basile G, Lucisano S, Montalto G, Valeria C, Donato V, Lupica R, Trimboli D, Aloisi C, Buemi M, Henze A, Raila J, Scholze A, Schweigert F, Tepel M, Nakamichi R, Prates E, Redublo Quinto BM, Zanella MT, Batista MC, Masajtis-Zagajewska A, Kurnatowska I, Wajdlich M, Nowicki M, Mennini F, Russo S, Marcellusi A, Quintaliani G, Andrulli S, Chiavenna C, Bigi MC, Tentori F, Crepaldi M, Corti MM, Dell'Oro C, Bacchini G, Limardo M, Pontoriero G, Williams C, Abbas SR, Zhu F, Flores-Gama C, Moskowitz J, Cartagena C, Carter M, Levin N, Kotanko P, de Oliveira RB, Liabeuf S, Okazaki H, Lenglet A, Desjardins L, Lemke HD, Valholder R, Choukroun G, Massy ZA. Nutrition / inflammation. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Castellano G, Cafiero C, Divella C, Sallustio F, Gigante M, Gesualdo L, Kirsch AH, Smaczny N, Riegelbauer V, Sedej S, Hofmeister A, Stojakovic T, Brodmann M, Pilger E, Rosenkranz A, Eller K, Eller P, Meier P, Lucisano S, Arena A, Donato V, Fazio MR, Santoro D, Buemi M, Wornle M, Ribeiro A, Koppel S, Pircher J, Czermak T, Merkle M, Rupanagudi K, Kulkarni OP, Lichtnekert J, Darisipudi MN, Mulay SR, Schott B, Hartmann G, Anders HJ, Pletinck A, Glorieux G, Schepers E, Van Landschoot M, Eloot S, Van Biesen W, Vanholder R, Castoldi A, Oliveira V, Amano M, Aguiar C, Caricilli A, Vieira P, Burgos M, Hiyane M, Festuccia W, Camara N, Djudjaj S, Rong S, Lue H, Bajpai A, Klinkhammer B, Moeller M, Floege J, Bernhagen J, Ostendorf T, Boor P, Wornle M, Ribeiro A, Koppel S, Merkle M, Ito S, Aoki R, Hamada K, Edamatsu T, Itoh Y, Osaka M, Yoshida M, Oliva E, Maritati F, Palmisano A, Alberici F, Buzio C, Vaglio A, Grabulosa C, Cruz E, Carvalho J, Manfredi S, Canziani M, Cuppari L, Quinto B, Batista M, Cendoroglo M, Dalboni M, Wornle M, Ribeiro A, Merkle M, Niemir Z, Swierzko A, Polcyn-Adamczak M, Cedzynski M, Sokolowska A, Szala A, Baudoux T, Hougardy JM, Pozdzik A, Antoine MH, Husson C, De Prez E, Nortier J, Ni HF, Chen JF, Zhang MH, Pan MM, Liu BC, Machcinska M, Bocian K, Korczak-Kowalska G, Tami Amano M, Castoldi A, Andrade-Oliveira V, da Silva M, Miyagi MYS, Olsen Camara N, Xu L, Jin Y, Zhong F, Liu J, Dai Q, Wang W, Chen N, Grosjean F, Tribioli C, Esposito V, Catucci D, Azar G, Torreggiani M, Merlini G, Esposito C, Fell LH, Zawada AM, Rogacev KS, Seiler S, Fliser D, Heine GH, Neprintseva N, Tchebotareva N, Bobkova I, Kozlovskaya L, Virzi GM, Brocca A, de Cal M, Bolin C, Vescovo G, Ronco C, Fuchs A, Eidenschink K, Steege A, Fellner C, Bollheimer C, Gronwald W, Schroeder J, Banas B, Banas MC, Zawada AM, Luthe A, Seiler SS, Rogacev K, Fliser D, Heine GH, Trimboli D, Graziani G, Haroche J, Lupica R, Fazio MR, Lucisano S, Donato V, Cernaro V, Montalto G, Pettinato G, Buemi M, Cho E, Lee JW, Kim MG, Jo SK, Cho WY, kim HK. Immune and inflammatory mechanisms. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lai CF, Lin SL, Chiang WC, Chen YM, Kuo ML, Tsai TJ, Hwang HS, Choi YA, Park KC, Yang KJ, Choi HS, Kim SH, Lee SJ, Chang YK, Kim SY, Yang CW, Xiujuan Z, Yoshimura R, Matsuyama M, Chargui J, Touraine JL, Yoshimura N, Zulkarnaev AB, Vasilenko IA, Artemov DV, Vatazin AV, Park SK, Kang KP, Lee S, Kim W, Schneider R, Betz B, Moller-Ehrlich K, Wanner C, Sauvant C, Yang KJ, Park KC, Choi HS, Kim SH, Choi YA, Chang YK, Park CW, Kim SY, Lee SJ, Yang CW, Hwang HS, Sohotnik R, Nativ O, Abbasi A, Awad H, Frajewicki V, Armaly Z, Heyman SN, Nativ O, Abassi Z, Chen PY, Chen BL, Yang CC, Chiang CK, Liu SH, Abozahra AE, Abd-Elkhabir AA, Shokeir A, Hussein A, Awadalla A, Barakat N, Abdelaziz A, Yamaguchi J, Tanaka T, Eto N, Nangaku M, Quiros Y, Lopez-Hernandez FJ, Perez de Obanos MP, Ruiz J, Lopez-Novoa JM, Shin HS, Kim MJ, Choi YJ, Ryu ES, Choi HS, Kang DH, Jankauskas SS, Pevzner IB, Zorova LD, Babenko VA, Morosanova MA, Plotnikov EY, Zorov DB, Huang CY, Huang TM, Wu VC, Young GH, Plotnikov EY, Pevzner IB, Zorova LD, Chupyrkina AA, Zorov SD, Zorov DB, Grande JP, Hartono SP, Knudsen BE, Mederle K, Castrop H, Hocherl K, Iwakura T, Fujikura T, Ohashi N, Yasuda H, Fujigaki Y, Matsui I, Hamano T, Inoue K, Obi Y, Nakano C, Kusunoki Y, Tsubakihara Y, Rakugi H, Isaka Y, Shimomura A, Wallentin Guron C, Nguy L, Lundgren J, Grimberg E, Kashioulis P, Guron G, Guron G, DiBona GF, Nguy L, Grimberg E, Lundgren J, Nedergaard Mikkelsen M, Marcussen N, Saeed A, Edvardsson K, Lindberg K, Larsson T, Ito K, Nakashima H, Watanabe M, Abe Y, Ogahara S, Saito T, Albertoni G, Borges F, Schor N, Beresneva ON, Parastayeva MM, Kucher AG, Ivanova GT, Shved N, Rybakova MG, Kayukov IG, Smirnov AV, Chen JF, Ni HF, Pan MM, Liu H, Xu M, Zhang MH, Liu BC, Kim Y, Choi BS, Kim YS, Han JS, Reis LA, Christo JS, Simoes MDJ, Schor N, Mulay SR, Santhosh Kumar VR, Kulkarni OP, Darisipudi M, Lech M, Anders HJ, Zorov DB, Plotnikov EY, Silachev DN, Jankauskas SS, Pevzner IB, Zorova LD, Zorov SD, Morosanova MA, Sola A, Jung M, Ventayol M, Mastora C, Buenestado S, Hotter G, Rong S, Shushakova N, Wensvoort G, Haller H, Gueler F, Pan MM, Zhang MH, Ni HF, Chen JF, Xu M, Liu BC, Morais C, Vesey DA, Johnson DW, Gobe GC, Godo M, Kaucsar T, Revesz C, Hamar P, Cheng Q, Wen J, Ma Q, Zhao J, Castellano G, Stasi A, Di Palma AM, Gigante M, Netti GS, Curci C, Intini A, Divella C, Prattichizzo C, Fiaccadori E, Pertosa G, Grandaliano G, Gesualdo L, Wei QW, Jing QQ, Ying NJ, Dong QZ, Yong G, Choi YJ, Kim MJ, Shin HS, Ryu ES, Choi HS, Kang DH, Pevzner IB, Pulkova NV, Plotnikov EY, Zorova LD, Silachev DN, Morosanova MA, Sukhikh GT, Zorov DB, Kim S, Lee J, Nam NJ, Na KY, Han JS, Ma SK, Joo SY, Kim CS, Choi JS, Bae EH, Lee J, Kim SW, Cernaro V, Medici MA, Donato V, Trimboli D, Lorenzano G, Santoro D, Montalto G, Buemi M, Longo V, Segreto HRC, Almeida W, Schor N, Ramos MF, Gomes L, Razvickas C, Schor N, Gueler F, Rong S, Gutberlet M, Meier M, Mengel M, Wacker D, Haller H, Hueper K, Uzum A, Ersoy R, Cakalagaoglu F, Karaman M, Kolatan E, Sahin O, Yilmaz O, Cirit M, Inal S, Koc E, Okyay GU, Pasaoglu O, Gonul I, Oyar E, Pasaoglu H, Guz G, Sabbatini M, Rossano R, Andreucci M, Pisani A, Riccio E, Choi DE, Jeong JY, Kim SS, Chang YK, Na KR, Lee KW, Shin YT, Silva AF, Teixeira VC, Schor N, Meszaros K, Koleganova-Gut N, Schaefer F, Ritz E, Walacides D, Ruskamp N, Rong S, Hueper K, Meier M, Haller H, Schiffer M, Gueler F, Marom O, Haick H, Nakhoul F, Chen JF, Liu H, Ni HF, Lv LL, Zhang MH, Tang RN, Zhang JD, Ma KL, Chen PS, Liu BC, Wu VC, Young GH, Chen YM, Ko WJ, Misiara GP, Coimbra TM, Silva GEB, Costa RS, Francescato HDC, Neto MM, Dantas M, Lindberg K, Olauson H, Amin R, Ponnusamy A, Goetz R, Mohammadi M, Canfield A, Kublickiene K, Larsson T, Rodriguez J, Reyes EP, Cortes PP, Fernandez R, Yoon HE, Koh ES, Chung S, Shin SJ, Pazzano D, Montalto G, Cernaro V, Lupica R, Torre F, Costantino G, Buemi M, Prieto M, Gonzalez-Buitrago JM, Lopez-Hernandez F, Lopez-Novoa JM, Morales AI, Vicente-Vicente L, Ferreira L, Christo JS, Reis LA, Simoes MJ, Passos CD, Schor NS, Shimizu MHM, Canale D, de Braganca AC, Andrade L, Luchi WM, Seguro AC, Canale D, de Braganca AC, Goncalves J, Shimizu MHM, Volpini RA, Andrade L, Seguro AC, Garrido P, Fernandes J, Ribeiro S, Vala H, Parada B, Alves R, Belo L, Costa E, Santos-Silva A, Reis F. AKI - experimental models. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Palmer S, Ruospo M, Pellgrini F, Strippoli GFM, Palmer S, Ruospo M, Natale P, Saglimbene V, Pellegrini F, Craig JC, Hegbrant J, Strippoli GFM, Ferraresi M, Pereno A, Castelluccia N, Clari R, Moro I, Colombi N, Di Giorgio G, Barbero S, Piccoli GB, Krishnan M, Bond TC, Brunelli S, Nissenson A, Kara B, Palmer S, Wong G, Craig JC, Strippoli GFM, Hanafusa N, Wakai K, Iseki K, Tsubakihara Y, Ogata S, Bikbov B, Tomilina N, Suleymanlar G, Altiparmak MR, Seyahi N, Trabulus S, Serdengecti K, Huang ST, Shu KH, Kao CH, Palmer S, Ruospo M, Natale P, Johnson DW, Craig JC, Gargano L, Saglimbene V, Pellegrini F, Strippoli GFM, Bernasconi AR, Waisman R, Lapidus A, Montoya P, Heguilen R, Suzuki A, Shoji T, Tsubakihara Y, Hayashi T, Tomida K, Guinsburg A, Thijssen S, Usvyat L, Xiao Q, van der Sande F, Marelli C, Etter M, Marcelli D, Levin N, Wang Y, Kotanko P, Kooman J, Schiller A, Schiller O, Andrei C, Mihaescu A, Olariu N, Anton C, Ivacson Z, Roman V, Berca S, Bansal V, Hwang SJ, Lee JJ, Lin MY, Chang JS, Okamura K, Kishi T, Miyazono M, Ikeda Y, Fukumitsu T, Sanai T, Reyes-Bahamonde J, Raimann J, Usvyat LA, Thijssen S, Van der Sande F, Kooman J, Levin N, Kotanko P, Allehbi AM, Bunani AD, Noor A, Laplante S, Rutherford P, Kulcsar I, Szegedi J, Ladanyi E, Torok M, Reusz G, Kiss I, Sparacino V, Agnello V, Di Gaetano P, Guaiana V, Almasio P, Rainone F, Merlino L, Ritchie JP, Marcatti M, Kalra PA, Toprak O, Quintaliani G, Ranocchia D, Germini F, Notargiacomo A, Ariete ML, Palmer S, Ruospo M, Pellegrini F, Strippoli GFM, Bunani AD, Bunani ED, Herrero Berron JC, Mon C, Ortiz M, Hinostroza J, Cobo G, Gallar P, Ortega O, Rodriguez Villarreal I, Oliet A, Digiogia C, Vigil A, Trigka K, Douzdampanis P, Aggelakou-Vaitsi M, Vaitsis N, Fourtounas K, Vigotti FN, Apostu AL, Boscolo M, Chegui LK, Ferrero S, Gallicchio M, Garassino G, Ionescu A, Portonero I, Tarea CA, Valentino E, Piccoli GB, Sikole A, Trajceska L, Gelev S, Dzekova P, Selim G, Amitov V, Borg Cauchi A, Buhagiar L, Calleja N, Demarco D, Nikitidou O, Liakopoulos V, Michalaki A, Demirtzi P, Christidou F, Papagianni A, Daskalopoulou E, Nikolaidis P, Dombros N, Vassallo DM, Chinnadurai R, Robinson H, Middleton R, Donne R, Saralegui I, Garcia O, Robledo C, Gabilondo E, Ortalda VVO, Tomei PPT, Yabarek TTY, Spatola LLS, Dalla Gassa AADG, Lupo AAL, Barril G, Quiroga JA, Arenas D, Cigarran S, Garcia N, Glez Parra E, Martin A, Bartolome J, Castillo I, Carreno V, Baamonde E, Bosch E, Perez G, Ramirez I, Checa MD, Palmer S, Ruospo M, Pellegrini F, Strippoli GFM, Shifris I, Dudar I, Rudenko A, Gonchar I, Mademtzoglou S, Tsikliras NC, Balaskas EV, Montalto G, Lupica R, Fazio MR, Aloisi C, Donato V, Lucisano S, Buemi M, Trimboli D, Cernaro V, Donia A, Denewar A, Khil M, Dudar I, Khil V, Shifris I. Epidemiology CKD 5D - A. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Saglimbene V, D'Alonzo D, Ruospo M, Vecchio M, Natale P, Gargano L, Nicolucci A, Pellegrini F, Craig JC, Triolo G, Procaccini DA, Santoro A, Di Giulio S, La Rosa S, Murgo A, Di Toro Mammarella R, Sambati M, D'Ambrosio N, Greco V, Giannoccaro G, Flammini A, Boccia E, Montalto G, Pagano S, Amarù S, Fici M, Lumaga GB, Mancini E, Veronesi M, Patregnani L, Querques M, Schiavone P, Chimienti S, Palumbo R, Di Franco D, Della Volpe M, Gori E, Salomone M, Iacono A, Moscoloni M, Treglia A, Casu D, Piras AM, Di Silva A, Mandreoli M, Lopez A, Quarello F, Catizone L, Russo G, Forcellini S, Maccarone M, Catucci G, Di Paolo B, Stingone A, D'Angelo B, Guastoni C, Pasquali S, Minoretti C, Bellasi A, Boscutti G, Martone M, David S, Schito F, Urban L, Di Iorio B, Caruso F, Mazzoni A, Musacchio R, Andreoli D, Cossu M, Li Cavoli G, Cornacchiari M, Granata A, Clementi A, Giordano R, Guastoni C, Barzaghi W, Valentini M, Hegbrant J, Tognoni G, Strippoli GFM. [Effects of dose of erythropoiesis stimulating agents on cardiovascular outcomes, quality of life and costs of haemodialysis. the clinical evaluation of the DOSe of erythropoietins (C.E. DOSE) Trial]. G Ital Nefrol 2013; 30:gin/00072.21. [PMID: 23832463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Anaemia is a risk factor for death, adverse cardiovascular outcomes and poor quality of life in patients with chronic kidney disease (CKD). Erythropoietin Stimulating Agents (ESA) are the most used treatment option. In observational studies, higher haemoglobin (Hb) levels (around 11-13 g/dL) are associated with improved survival and quality of life compared to Hb levels around 9-10 g/dL. Randomized studies found that targeting higher Hb levels with ESA causes an increased risk of death, mainly due to adverse cardiovascular outcomes. It is possible that this is mediated by ESA dose rather than haemoglobin concentration, although this hypothesis has never been formally tested. METHODS We present the protocol of the Clinical Evaluation of the Dose of Erythropoietins (C.E. DOSE) trial, which will assess the benefits and harms of a high versus a low ESA dose therapeutic strategy for the management of anaemia of end stage kidney disease (ESKD). This is a randomized, prospective open label blinded end-point (PROBE) design trial due to enroll 900 haemodialysis patients. Patients will be randomized 1:1 to 4000 UI/week i. v. versus 18000 UI/week i. v. of epoetin alfa, beta or any other epoetin in equivalent doses. The primary outcome of the trial is a composite of cardiovascular events. In addition, quality of life and costs of these two strategies will be assessed. The study has been approved and funded by the Italian Agency of Drugs (Agenzia Italiana del Farmaco (AIFA)) within the 2006 funding plan for independent research on drugs (registered at www.clinicaltrials.gov (NCT00827021)).
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Stroffolini T, Spadaro A, Di Marco V, Scifo G, Russello M, Montalto G, Bertino G, Surace L, Caroleo B, Foti G, Portelli V, Madonia S, Sapienza M, Cosco L, Frugiuele P, Galdieri A, Brandolino N, Siciliano R, Bruno S, Almasio PL. Current practice of chronic hepatitis B treatment in Southern Italy. Eur J Intern Med 2012; 23:e124-7. [PMID: 22726382 DOI: 10.1016/j.ejim.2012.03.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Revised: 03/15/2012] [Accepted: 03/31/2012] [Indexed: 11/25/2022]
Abstract
BACKGROUND Treatment choice for chronic HBV infection is a continuously evolving issue, with a wide range of options. We aimed to evaluate the current practice of HBV therapies in the real world in Southern Italy. METHODS A prospective study enrolling over a six month period (February-July 2010) all consecutive HBsAg positive subjects, never previously treated, referred to 16 liver units in two Southern Italy regions (Calabria and Sicily). RESULTS Out of 247 subjects evaluated, 116 (46.9%) had HBV-DNA undetectable or lower than 2000 UI/ml. There were 108 (43.7%) inactive carriers, 103 (41.7%) chronic hepatitis, and 36 (14.6%) liver cirrhosis. Antiviral treatment was planned in 94 (38.0%) patients (26 cases with Interferon or Pegylated Interferon and 68 with nucleos(t)ides analogues). As many as 49.5% of subjects with chronic hepatitis did not receive antiviral treatment. DISCUSSION The majority of chronic HBsAg carrier referring centres for evaluation were not considered suitable for antiviral treatment. Nucleos(t)ides analogues are the preferred first choice for therapy. A long-lasting period of observation may be needed to make appropriate therapeutic decisions in several cases.
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Affiliation(s)
- T Stroffolini
- Department of Infectious and Tropical Diseases, Policlinico Umberto I, Rome, Italy
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Stroffolini T, Spadaro A, Di Marco V, Scifo G, Russello M, Montalto G, Bertino G, Surace L, Caroleo B, Foti G, Portelli V, Madonia S, Sapienza M, Cosco L, Frugiuele P, Galdieri A, Brandolino N, Siciliano R, Bruno S, Almasio PL. Current practice of chronic hepatitis B treatment in Southern Italy. Eur J Intern Med 2012. [PMID: 22726382 DOI: 10.1016/-j.ejim.2012.03.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Treatment choice for chronic HBV infection is a continuously evolving issue, with a wide range of options. We aimed to evaluate the current practice of HBV therapies in the real world in Southern Italy. METHODS A prospective study enrolling over a six month period (February-July 2010) all consecutive HBsAg positive subjects, never previously treated, referred to 16 liver units in two Southern Italy regions (Calabria and Sicily). RESULTS Out of 247 subjects evaluated, 116 (46.9%) had HBV-DNA undetectable or lower than 2000 UI/ml. There were 108 (43.7%) inactive carriers, 103 (41.7%) chronic hepatitis, and 36 (14.6%) liver cirrhosis. Antiviral treatment was planned in 94 (38.0%) patients (26 cases with Interferon or Pegylated Interferon and 68 with nucleos(t)ides analogues). As many as 49.5% of subjects with chronic hepatitis did not receive antiviral treatment. DISCUSSION The majority of chronic HBsAg carrier referring centres for evaluation were not considered suitable for antiviral treatment. Nucleos(t)ides analogues are the preferred first choice for therapy. A long-lasting period of observation may be needed to make appropriate therapeutic decisions in several cases.
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Affiliation(s)
- T Stroffolini
- Department of Infectious and Tropical Diseases, Policlinico Umberto I, Rome, Italy
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Levi Sandri GB, Lai Q, Morabito V, Garofalo M, Guglielmo N, Melandro F, Di Laudo M, Montalto G, Lucatelli P, Berloco PB. Later diagnosed with a neuroendocrine tumor, case report of a 60-year-old. Clin Ter 2012; 163:e325-e326. [PMID: 23099981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Neuroendocrine tumours of the colon and rectum are infrequent. Clinical manifestations are not different from standard adenocarcinoma. Symptoms are non specific; the most common are abdominal pain, nausea and vomiting, weight loss and gastrointestinal blood loss. We report an advanced case of transverse colon neuroendocrine carcinoma with multiple metastasis. When these tumours are diagnosed, they have distance disease related to a poor prognosis for the patient. Surgery is the treatment that can offer a greater chance of survival to these patients.
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Affiliation(s)
- G B Levi Sandri
- Department of General Surgery and Organ Transplantation, University of Rome La Sapienza, Rome, Italy.
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Forte A, Zullino A, Manfredelli S, Montalto G, Bezzi M. Incisional hernia surgery: report on 283 cases. Eur Rev Med Pharmacol Sci 2011; 15:644-648. [PMID: 21796868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND AND OBJECTIVES Despite the improvement of the surgical technique and several experiences reported in literature about prosthetic incisional hernioplasty, the prevalence rate of recurrence and of the classic complications has not changed over the years. We analyze our caseload, establishing some technical cornerstones in order to reduce their occurrence. PATIENTS AND METHODS 283 patients underwent incisional hernioplasty in our Department of Surgery in the decade 1999-2008. They were retrospectively divided into four groups (A-D) according to the surgical technique adopted for a comparative analysis: A, 37 primary direct closure; B, 207 Rives-Stoppa procedures; C, 9 Chevrel procedures; D, 30 intraperitoneal repairs. The outcomes were considered in terms of postoperative surgical complications. RESULTS In total, we observed 11 cases of hernia recurrence (3.9%), 13 cases of infections (4.6%), 7 cases of seroma/hematoma (2.4%) and one case of acute respiratory insufficiency. DISCUSSION The Rives-Stoppa procedure is, among all those practised, the treatment of choice in incisional hernioplasty. Thanks to the introduction of some simple modifications to this technique and preventing the postoperative infections, we obtained excellent results in terms of recurrence rate (only 1 case on 207 patients, 0.48%) and morbidity.
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Affiliation(s)
- A Forte
- IV Postgraduate School of General Surgery, Department of Surgery E Durante, Sapienza University, Rome, Italy.
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22
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Soresi M, Pirrone G, Giannitrapani L, Iacono G, Di Prima L, La Spada E, Di Fede G, Ambrosiano G, Montalto G, Carroccio A. A key role for abdominal ultrasound examination in "difficult" diagnoses of celiac disease. Ultraschall Med 2011; 32 Suppl 1:S53-S61. [PMID: 20235005 DOI: 10.1055/s-0028-1110009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE To evaluate the usefulness of abdominal ultrasound examination (US) for the diagnostic workup of cases of suspected CD involving negative serum antibodies and difficult diagnosis. MATERIALS AND METHODS 524 consecutive patients with symptoms of suspected CD underwent an extensive diagnostic workup. 76 (14 %) were excluded since they were positive for serum anti-tTG and/or EmA antibodies. 377 were excluded since they were diagnosed with something other than CD or did not have the alleles encoding for HLA DQ 2 or DQ 8. A diagnosis of CD with negative serum antibodies was probable in 71 patients who underwent abdominal US and duodenal biopsy for histology evaluation. RESULTS Intestinal histology and subsequent clinical and histological follow-up confirmed the CD diagnosis in 12 patients (GROUP 1) and excluded it in 59 subjects (GROUP 2). Abdominal US showed that the presence of dilated bowel loops and a thickened small bowel wall had a sensitivity of 83 % and a negative predictive value (NPV) of 95 % in CD diagnosis. Furthermore, in 11 of the 12 CD seronegative patients there was at least one of these two abdominal US signs. Therefore, considering the presence of one of these two signs, abdominal US sensitivity increased to 92 % and NPV to 98 %. CONCLUSION Abdominal US is useful in the diagnostic workup of patients with a high clinical suspicion of CD but with negative serology.
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Affiliation(s)
- M Soresi
- Department of Clinical Medicine and Emerging Pathologies, University of Palermo, Palermo, Italy
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Affronti M, Mansueto P, Soresi M, Abbene AM, Affronti A, Valenti M, Giannitrapani L, Montalto G. Low-grade fever: how to distinguish organic from non-organic forms. Int J Clin Pract 2010; 64:316-21. [PMID: 20456171 DOI: 10.1111/j.1742-1241.2009.02256.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND AIM Low-grade fever (LGF) is defined as a body temperature between 37.5 and 38.3 degrees C, which is below the classical value reported for fever of unknown origin (FUO). We attempted to characterise its epidemiology, aetiology and clinical aspects to improve the methodological approach to diagnosis. DESIGN AND METHODS We reviewed and evaluated a survey of patients with LGF, followed as outpatients of our Department, a tertiary referral centre from 1997 to 2008. The same classifications were applied for classical FUO, and in the patients diagnosed with LGF, we also investigated for habitual hyperthermia (HH). RESULTS Seventy-three patients were selected and divided into two groups: group A included 32 patients classified with organic fever and group B included 41 patients with HH. Aetiology of organic LGF was: infectious disease 59%; neoplasm 3.1%; inflammatory non-infectious disease 6.2%; miscellaneous 18.7%; undiagnosed 12.5%. Mean age was significantly higher in the organic fever than in the HH group (p < 0.02). Splenomegaly and loss of weight were significantly associated with organic fever (p < 0.05), while dizziness and general malaise were associated with HH. Lack of any pathological signs at physical examination was significantly more frequent in HH (p < 0.0001). Among the biochemical tests, white blood cells and C-reactive protein were more frequently above normal limits in group A than in group B (p < 0.05). CONCLUSIONS In our experience, LGF requires the same methodological diagnostic approach as FUO, because there is no relationship between body temperature values and the severity of the underlying diseases, and the aetiological spectrum is also the same.
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Affiliation(s)
- M Affronti
- Department of Clinical Medicine and Emerging Pathologies, University of Palermo, Palermo, Italy
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24
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Gioviale M, Damiano G, Montalto G, Buscemi G, Romano M, Lo Monte A. Isolation and Culture of β-Like Cells From Porcine Wirsung Duct. Transplant Proc 2009; 41:1363-6. [DOI: 10.1016/j.transproceed.2009.02.062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Andriulli A, Cursaro C, Cozzolongo R, Iacobellis A, Valvano MR, Mangia A, Minerva N, Bacca D, Stanzione M, Scuteri A, Montalto G, Andreone P. Early discontinuation of ribavirin in HCV-2 and HCV-3 patients responding to Peg-interferon alpha-2a and ribavirin. J Viral Hepat 2009; 16:28-35. [PMID: 18761603 DOI: 10.1111/j.1365-2893.2008.01044.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Guidelines for the treatment of patients infected with hepatitis C virus of genotypes 2 and 3 (HCV-2 and HCV-3, respectively) recommend a 24-week course of Peg-interferon (Peg-IFN) alpha-2a combined with ribavirin, despite 50% of patients in registration trials attaining a sustained virologic response (SVR) following Peg-IFN alpha-2a monotherapy. The aim of this study was to delineate patient characteristics that might help to identify individuals likely to benefit from ribavirin discontinuation. One hundred and forty-four HCV-2- and HCV-3-infected patients initiated Peg-IFN alpha-2a (180 microg/week) and ribavirin (1000 or 1200 mg/day); those with viral clearance at week 4 were randomized to either Peg-IFN alpha-2a monotherapy (n = 59) or continuing combination therapy (n = 61) until week 12. Overall, all but one patient with a rapid virologic response (RVR) responded by the end of therapy and the overall SVR rates were lower after discontinuation of ribavirin (54%vs 82%; P < 0.001). In RVR patients who discontinued ribavirin, low baseline viraemia helped predict SVR (odds ratio 11.2, 95% CI 2.7-47.1). SVR rates were similar in patients receiving mono- or combination therapy with low (< or =300,000 IU/mL) and intermediate viraemia (86%vs 81% and 70%vs 71%, 86% refers to low viraemic patients receiving monotherapy and 81% to those receiving combination therapy. Similarly, 70% refers to patients with intermediate viraemic levels receiving monotherapy and 71% to those receiving combination therapy), but different in those with high (>700,000 IU/mL) viraemia (37%vs 88%; P = 0.004). Thus in HCV-2- and HCV-3-infected patients, withdrawal of ribavirin and continuation of Peg-IFN alpha-2a monotherapy may be appropriate to attain an SVR, providing viraemia is cleared early during therapy and associated with low baseline viral load. These results warrant future investigations, as discontinuing ribavirin could lead to considerable savings in cost and quality of life related to over-treatment.
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Affiliation(s)
- A Andriulli
- Gastroenterology Unit, Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy.
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La Spada E, Micalizzi A, La Spada M, Quartarano P, Nugara G, Soresi M, Affronti M, Montalto G. [Abnormal liver function in brucellosis]. Infez Med 2008; 16:148-153. [PMID: 18843212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We assessed the prevalence of impaired liver function in 47 patients suffering from brucellosis consecutively admitted to our department over the last five years. Parameters of liver function and ultrasound of the upper abdomen were performed at entry and at the end of treatment. On admission, mean transaminase values were elevated and significantly higher than at recovery (p 0.001): 38 percent and 53 percent of patients had elevated baseline values of GOT and GPT vs 13 and 19% at the end of treatment, respectively. Mean serum values of alkaline phosphatase (AP) were within normal limits on admission, although in 12 of them serum values were elevated. The same proportion was seen for gamma-glutamyltranspeptidase. Both transaminases and AP were elevated in 8 patients (17 percent). There were no significant differences in serum values of albumin and bilirubin before and after therapy. The platelet count slightly decreased, but not significantly, during the acute phase of disease. At ultrasound one third of the patients showed hepatomegaly with a hepatitis-like pattern and 40 percent of patients had splenomegaly. In conclusion, this study confirms data in the literature showing a high frequency of liver impairment during the course of brucellosis, which is usually mild-moderate.
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Affiliation(s)
- E La Spada
- Dipartimento di Medicina Clinica e delle Patologie Emergenti, Cattedra di Medicina Interna, Universita di Palermo, Italy
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Montalto G, Li Vecchi M, Sesti R, Santoro D, Savica V, Bellinghieri G. Epidemiology of Hepatitis C Virus Infection in Hemodialysis Patients of Sicily. Int J Artif Organs 2008; 31:745-6. [DOI: 10.1177/039139880803100810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- G. Montalto
- Cattedra di Medicina Interna, Università di Palermo, Palermo
| | - M. Li Vecchi
- Cattedra di Nefrologia, Università di Palermo, Palermo - Italy
| | - R. Sesti
- Cattedra di Medicina Interna, Università di Palermo, Palermo
| | - D. Santoro
- Cattedra di Nefrologia, Università di Messina, Messina - Italy
| | - V. Savica
- Cattedra di Nefrologia, Università di Messina, Messina - Italy
| | - G. Bellinghieri
- Cattedra di Nefrologia, Università di Messina, Messina - Italy
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Pansini F, Gargano L, Sambati M, Dambrosio N, D'Altri C, Giannoccaro G, Boccia E, Cecilia A, Di Toro Mammarella R, Flammini A, La Rosa S, Fici M, Sabella V, Falco M, Montalto G, Rindone F, Murgo AM, Greco V, Giannetto M, D'Agostino F, Pellegrini F, Invernizzi C, Strippoli GFM, Manno C. [Patient satisfaction in hemodialysis: a pilot cross-sectional analysis and a review]. G Ital Nefrol 2007; 24:584-594. [PMID: 18278762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Assessment of patient satisfaction is not performed routinely in many healthcare institutions. In this review, we discuss methodological aspects of assessment of patient satisfaction in hemodialysis. We also present a pilot study conducted in the Gambro Healthcare Italy dialysis clinics network. METHODS Patient satisfaction was assessed in a network of hemodialysis units by using an internally validated Italian translation of the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) questionnaire. A cross-sectional analytic study design was used and data analysed with univariate and multivariate hierarchical logistic regression to explore correlates of the risk of being unsatisfied with dialysis treatment. Covariates which were considered include a series of over 20 clinical, demographic, organizational and structural aspects. In addition, unexplained inter-centre residual variability due to 'case-mix' was explored and plotted. RESULTS Seventeen dialysis units participated in this cross-sectional analysis and 758/1001 (75.7%) provided answers to the questionnaires. There was a statistically significant association on multivariate hierarchical analysis between the risk of being unsatisfied with dialysis treatment and interdialysis body weight gain (unit of increase: 1 kg, p=0.004). On the contrary, the risk of unsatisfaction with dialysis treatment was significantly lower in patients with higher dry weight (unit of increase: 1 kg, p=0.002). Our multivariate hierarchical analysis identified some residual variability between dialysis units (n=6 outliers) which may not be explained by any of over 20 potential confounding covariates which were explored. CONCLUSIONS Assessment of ''customer satisfaction'' is standard practice in private for profit product companies in general but needs to be increasingly recognized as a standard in both public and private providers of healthcare services. Social research methods, which are used for this type of analysis, need to be fine tuned and actively implemented in order to better understand how we may influence the quality of service we provide to our patients and the level at which they rate it.
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Affiliation(s)
- F Pansini
- Dipartimento dell'Emergenza e Trapianti d'Organo (DETO), Università degli Studi, Bari, Italy
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Abstract
The liver is morphologically and functionally modulated by sex hormones. Long-term use of oral contraceptives (OCs) and anabolic androgenic steroids (AASs) can induce both benign (hemangioma, adenoma, and focal nodular hyperplasia [FNH]) and malignant (hepatocellular carcinoma [HCC]) hepatocellular tumors. Hepatic adenomas (HAs) are rare, benign neoplasms usually occurring in young women, the development and the complications of which have been related to the strength of OCs and the duration of their use. HA incidence has fallen since the introduction of pills containing smaller amounts of estrogens. FNH is a benign lesion, most commonly seen in young women, which is thought to represent a local hyperplastic response of hepatocytes to a vascular abnormality. Because of the female predominance and the young age at onset, a role of female hormones has been suggested. Furthermore, a large proportion of women with FNH (50-75%) are OC users. Liver hemangiomas (LHs) are the most common benign liver tumors and are seen more commonly in young adult females. The female predilection and clinical observations of LH growth under conditions of estrogenic exposure suggest a possible role for estrogen in the pathogenesis of LHs. HCC has become one of the most widespread tumors in the world in recent years, representing the sixth leading cancer and the third most common cause of death from cancer. Apart from liver cirrhosis, numerous other factors responsible for its onset have been proposed: hepatitis infections from virus B (HBV) and C (HCV), alcohol, smoking, and aflatoxin. However, regardless of etiology, chronic liver diseases progress at unequal rates in the two sexes, with the major sequelae, such as cirrhosis and HCC, being more frequent in men than in women. These epidemiological data have prompted researchers to investigate the relationship between sex hormones and liver tumors. The human liver expresses estrogen and androgen receptors and experimentally both androgens and estrogens have been implicated in stimulating hepatocyte proliferation and may act as liver tumor inducers or promoters.
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Affiliation(s)
- L Giannitrapani
- Dipartimento di Medicina Clinica e Patologie Emergenti, Università di Palermo, Palermo, Italy
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Soresi M, Tripi S, Franco V, Giannitrapani L, Alessandri A, Rappa F, Vuturo O, Montalto G. Impact of liver steatosis on the antiviral response in the hepatitis C virus-associated chronic hepatitis. Liver Int 2006; 26:1119-25. [PMID: 17032413 DOI: 10.1111/j.1478-3231.2006.01347.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
BACKGROUND/AIM Liver steatosis (LS) has been variably associated with chronic hepatitis C (CHC) but whether it affects sustained virological response to antiviral treatment and by what mechanisms is a question still under debate, at least for some genotypes. The aim of this work was to assess the frequency of LS, its relationship with host and viral factors and to what extent it can influence the response to antiviral combination therapy with pegylated interferon (INF)+ribavirin in a group of patients with CHC from a single center. PATIENTS One hundred and twelve patients with histologically proven CHC were treated with Peg INF-alpha 2a 180 microg a week subcutaneously for 48 weeks plus ribavirin 1000 or 1200 mg/day, according to the patient's body weight. Steatosis was graded according to Brunt et al. RESULTS Forty-six out of 112 patients (41.1%) were sustained virological responders (SVR). Seventy-two out of 112 (64.3%) presented with LS at histology; in this group, there were 24 patients (33.3%) with SVR compared with 22 (55%) of the non-steatosis group (chi(2)=6.5, P<0.02). Variables associated with the steatosis group were: higher serum levels of AST (P<0.04), alanine aminotransferase (P<0.02), gamma-GT (P<0.004), genotype 3a (P<0.03) and severity of histology (staging P<0.05) but at multiple linear regression analysis only genotype 3a and staging were significantly associated with LS. In the SVR group, age and body mass index (BMI) were significantly lower (P<0001 and P<0.03, respectively) compared with non-responders; moreover, genotype 1 was more frequent in the NR group, while genotype 3 was more frequent in the SVR group. At histology, grading and staging were also lower in the SVR group. Multiple logistic regression showed that only the grade of steatosis and genotype 3a were the variables independently associated with SVR. CONCLUSIONS This study showed a frequency of LS on the higher side of the range so far reported in the literature and confirmed that it negatively influences response to therapy. Genotype1 was confirmed to be the most frequent type in our area. It is more frequent in patients with mild-moderate steatosis and seems to condition therapeutic response negatively, together with BMI and age. In contrast, genotype 3a is more frequent in patients with severe steatosis, but is a favorable predictor of successful therapy.
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Affiliation(s)
- M Soresi
- Cattedra di Medicina Interna e Cattedra di Medicina d'Urgenza, Dipartimento di Medicina, Clinica e delle Patologie Emergenti, Università di Palermo, Cattedra di Anatomia Patologia, Palermo, Italy
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Mangia A, Spinzi G, Vuturo O, Pazienza V, Iacobellis A, Piattelli M, Giacobbe A, Leandro G, Piermanni V, Minoli G, Montalto G, Andriulli A. Viral clearance in HCV viraemic patients with normal alanine aminotransferase after combination therapy: a controlled, open-labelled study. Aliment Pharmacol Ther 2004; 19:331-7. [PMID: 14984380 DOI: 10.1111/j.1365-2036.2004.01844.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND In patients with chronic hepatitis C virus infection and persistently normal alanine aminotransferase levels, liver fibrosis has been reported in 0-22% of cases and advanced liver disease in 5-10% of cases. AIM To determine whether patients with persistently normal alanine aminotransferase levels clear infection after anti-viral therapy at equal or different rates from infected patients with raised alanine aminotransferase levels. METHODS Thirty-five hepatitis C virus RNA-positive patients with fibrosis at liver histology (Group 1) were matched for genotype, sex, age and histology with patients with raised alanine aminotransferase levels (Group 2). Both groups were treated with 3 MU interferon-alpha2b plus ribavirin (1000-1200 mg) for 12 months. RESULTS End-of-therapy response was achieved in 71.4%[95% confidence interval (CI), 56.4-86.3] of patients in Group 1 and in 52.3% (95% CI, 42.8-61.9) of those in Group 2 (P = 0.04). At week 72, 22 patients (62.8%; 95% CI, 46.8-78.1) in Group 1 and 50 patients (47.5%; 95% CI, 38.0-57.1) in Group 2 showed a sustained virological response (P = 0.11). Non-1 genotype was the only independent predictor of sustained response (P = 0.002), with an odds ratio of 3.45 (95% CI, 1.58-7.50). At month 3 of therapy, the positive predictive values for non-response were 100% and 96% in Groups 1 and 2, respectively. CONCLUSIONS Interferon and ribavirin induce comparable sustained virological response in patients with persistently normal or raised alanine aminotransferase levels. Stage 1 fibrosis, rather than alanine aminotransferase levels, may be the criterion on which to decide whether or not to treat patients with persistently normal alanine aminotransferase levels.
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Affiliation(s)
- A Mangia
- Division of Gastroenterology, 'Casa Sollievo della Sofferenza' Hospital, IRCCS, S. Giovanni Rotondo, Italy.
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Gentileschi P, Di Paola M, Catarci M, Santoro E, Montemurro L, Carlini M, Nanni E, Alessandroni L, Angeloni R, Benini B, Cristini F, Dalla Torre A, De Stefano C, Gatto A, Gossetti F, Manfroni S, Mascagni P, Masoni L, Montalto G, Polito D, Puce E, Silecchia G, Terenzi A, Valle M, Vita S, Zanarini T. Bile duct injuries during laparoscopic cholecystectomy: a 1994-2001 audit on 13,718 operations in the area of Rome. Surg Endosc 2003; 18:232-6. [PMID: 14691705 DOI: 10.1007/s00464-003-8815-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2003] [Accepted: 07/29/2003] [Indexed: 12/12/2022]
Abstract
BACKGROUND Bile duct injuries (BDIs) during laparoscopic cholecystectomy (LC) still are reported with greater frequency than during open cholecystectomy (OC). METHODS In 1999, a retrospective study evaluating the incidence of BDIs during LC in the area of Rome from 1994 to 1998 (group A) was performed. In addition, a prospective audit was started, ending in December 2001 (group B). RESULTS In group A, 6,419 LCs were performed (222 were converted to OC; 3.4%). In group B, 7,299 LCs were performed (225 were converted to OC; 3.1%). Seventeen BDIs (0.26%) occurred in group A and 16 (0.22%) in group B. Overall, mortality and major morbidity rates were 12.1% and 30.3%, respectively, without significant differences between the two groups. CONCLUSIONS The incidence and clinical relevance of BDIs during LC in the area of Rome appeared to be stable over the past 8 years and were not influenced by the use of a prospective audit, as compared with a retrospective survey.
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Affiliation(s)
- P Gentileschi
- Lap Group Roma, Gruppo Laparoscopico Romano, Via A. Borelli 5, 00161 Roma, Italy.
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Soresi M, Bonfissuto G, Magliarisi C, Riili A, Terranova A, Di Giovanni G, Bascone F, Carroccio A, Tripi S, Montalto G. Ultrasound detection of abdominal lymph nodes in chronic liver diseases. A retrospective analysis. Clin Radiol 2003; 58:372-7. [PMID: 12727165 DOI: 10.1016/s0009-9260(03)00055-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To retrospectively evaluate the prevalence of lymph nodes of the hepato-duodenal ligament in a group of patients with chronic liver disease of various aetiologies and to investigate what clinical, aetiological and laboratory data may lead to their appearance. MATERIALS AND METHODS One thousand and three patients (554 men, 449 women) were studied, including 557 with chronic hepatitis and 446 with liver cirrhosis. The presence of lymph nodes near the trunk of the portal vein, hepatic artery, celiac axis, superior mesenteric vein and pancreas head was investigated using ultrasound. RESULTS Lymph nodes were detected in 394 out of the 1003 study patients (39.3%); their number ranged from one to four, with a diameter ranging between 0.8 and 4 cm. The highest prevalence was in the subgroup of patients with primary biliary cirrhosis (87.5%), followed by patients with hepatitis C virus (HCV; 42%), patients with HCV and hepatitis B virus (HBV; 41.3%), autoimmune hepatitis (40%), and HBV alone (21.2%). In the alcoholic and idiopathic subgroups prevalence was 9.5%, while in the non-alcoholic steatohepatitis and haemochromatosis subgroups it was 0%. HCV RNA was present in 97 out of 103 lymph node-positive patients and in 141 out of 168 lymph node-negative HCV-negative patients (p<0.003). Lymphadenopathy frequency increased as the liver disease worsened (chi(2) MH=74.3; p<0.0001). CONCLUSION Despite the limitations of a retrospective study, our data indicate a high prevalence of lymphadenopathy in liver disease patients; ultrasound evidence of lymph nodes of the hepato-duodenal ligament in a given liver disease may most likely suggest a HCV or an autoimmune aetiology and a more severe histological picture.
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Affiliation(s)
- M Soresi
- Cattedra di Medicina Interna, Università di Palermo, via del Vespro 141, 90127, Palermo, Italy
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Soresi M, Bascone F, Magliarisi C, Campagna P, Di Giovanni G, Riili A, Carroccio A, Montalto G. Hemodynamic changes in splanchnic circulation after orthotopic liver transplantation in patients with liver cirrhosis. Abdom Imaging 2002; 27:541-5. [PMID: 12172993 DOI: 10.1007/s00261-001-0101-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Liver cirrhosis increases portal vein pressure and alters the splanchnic circulation. With Doppler sonography, we investigated the hemodynamic changes in the portal vein, superior mesenteric artery, hepatic and splenic arteries and spleen size in a group of patients with end-stage liver disease before and after orthotopic liver transplantation (OLT). METHODS Ten patients (seven male, three female; mean age = 48.8 +/- 7.6 years) who underwent OLT for liver cirrhosis mainly associated with hepatitis C virus infection completed the study. The control group consisted of 10 patients matched by sex and age who had no gastroenterologic or vascular diseases. All patients underwent duplex Doppler sonography (Toshiba SSA 270A with a 3.5-MHz probe) after 24 h of fasting (baseline) and then 6 and 12 months after OLT. The following parameters, expressed as the mean of three measurements, were evaluated: portal flow velocity (PFV), pulsatility index of the superior mesenteric artery (MAPI), resistance indexes of the hepatic (HARI) and splenic (SARI) arteries, and longitudinal diameter of the spleen (LDS). RESULTS PFV in the pre-OLT phase was significantly lower in the patients than in the controls ( p < 0.0001); it progressively and significantly increased over baseline levels at 6 and 12 months ( p < 0.0001), approaching control values. LDS in the pre-OLT phase was significantly higher than in controls ( p < 0.0001); after OLT, it decreased significantly compared with baseline values ( p < 0.005). The MAPI of patients in the pre-OLT phase was lower than that in controls ( p < 0.0001); post-OLT, it progressively increased and reached values that were significantly above baseline at 12 months ( p < 0.005). In the pre-OLT phase, the HARI and SARI were significantly higher than in controls ( p < 0.04); 6 and 12 months after OLT, those values were significantly below baseline values ( p < 0.001), and there was no significant difference from control values. CONCLUSION These data show that many of the hemodynamic parameters typical of decompensated cirrhosis improve progressively within 12 months after transplantation.
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Affiliation(s)
- M Soresi
- Istituto di Medicina Interna e Geriatria, Cattedra di Medicina Interna, Università di Palermo, 141 via del Vespro, 90127 Palermo, Italy
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Artini M, Cariani E, Almerighi C, Fulco M, Rossini A, Pietropaolo L, Stivali G, Montalto G, Caratozzolo M, Girelli G, Grimali E, Costanzo A, Levrero M, Balsano C. Prevalence and genomic variability of transfusion transmitted virus in Italian cryptogenic chronic liver disease and healthy blood donors. Dig Liver Dis 2002; 34:570-6. [PMID: 12502213 DOI: 10.1016/s1590-8658(02)80090-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Infection with transfusion transmitted virus, a new member of the Parvoviridae family, has been found in patients both with chronic and fulminant post-transfusion cryptogenic hepatitis. AIM To evaluate the prevalence and clinical impact of transfusion transmitted virus infection in Italy. PATIENTS AND METHODS Studies were carried out on 256 patients and control subjects from three centres from Northern, Central and Southern Italy (92 nonA-nonC chronic hepatitis, 10 acute non fulminant cryptogenic hepatitis, 41 hepatitis C virus-related chronic hepatitis and 113 blood donors). Serum transfusion transmitted virus was detected by nested polymerase chain reaction using two overlapping sets of primers. RESULTS A total of 52 of the 92 patients (54.3%) with chronic cryptogenic liver disease and 17 of the 41 hepatitis C virus chronic hepatitis patients (41.4%) were transfusion transmitted virus-DNA positive. Transfusion transmitted virus co-infection in hepatitis C virus patients was not associated with either a higher severity of liver histology or higher alanine transaminase levels or signs of cholestasis, transfusion transmitted virus was found in 48 out of 113 (42.4%) blood donors. In the majority of samples, transfusion transmitted virus DNA was detected with only one of the two sets of primers used. Genotyping and phylogenetic analysis performed on 21 randomly selected viral isolates showed the presence of both type 1 and type 2 transfusion transmitted virus and allowed identification of two isolates with high homology to genotype 6, described, so far, mostly in Japan. CONCLUSIONS Transfusion transmitted virus type 1 and 2 infection is common among blood donors and patients with liver disease in Italy. The pathogenic potential of transfusion transmitted virus type 1 and 2 in nonA-nonC hepatitis patients is unlikely but further studies are needed to evaluate the epidemiological and clinical impact of other transfusion transmitted virus subtypes.
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Affiliation(s)
- M Artini
- Laboratory of Gene Expression, A. Cesalpino Foundation, University of Rome La Sapienza, Rome, Italy
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Giannitrapani L, Cervello M, Soresi M, Notarbartolo M, La Rosa M, Virruso L, D'Alessandro N, Montalto G. Circulating IL-6 and sIL-6R in patients with hepatocellular carcinoma. Ann N Y Acad Sci 2002. [PMID: 12095927 DOI: 10.1111/j.1749-6632.2002.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Interleukin-6 plays a central role in regulating the immune system, hematopoiesis, and acute phase reaction. It interacts with a receptor complex consisting of a specific ligand-binding protein (IL-6R, gp80) and a signal transduction protein (gp130). In this report, serum levels of IL-6 and a soluble form of the interleukin-6 receptor (sIL-6R) were evaluated in patients with hepatocellular carcinoma. The correlation between IL-6 and sIL-6R values, the stage of hepatocellular carcinoma, and main liver function tests was also studied.
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Affiliation(s)
- L Giannitrapani
- Istituto di Medicina Interna e Geriatria, Università di Palermo, Palermo, Italy
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Giannitrapani L, Cervello M, Soresi M, Notarbartolo M, La Rosa M, Virruso L, D'Alessandro N, Montalto G. Circulating IL-6 and sIL-6R in patients with hepatocellular carcinoma. Ann N Y Acad Sci 2002. [PMID: 12095927 DOI: 10.1111/j.1749-6632.2002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Interleukin-6 plays a central role in regulating the immune system, hematopoiesis, and acute phase reaction. It interacts with a receptor complex consisting of a specific ligand-binding protein (IL-6R, gp80) and a signal transduction protein (gp130). In this report, serum levels of IL-6 and a soluble form of the interleukin-6 receptor (sIL-6R) were evaluated in patients with hepatocellular carcinoma. The correlation between IL-6 and sIL-6R values, the stage of hepatocellular carcinoma, and main liver function tests was also studied.
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Affiliation(s)
- L Giannitrapani
- Istituto di Medicina Interna e Geriatria, Università di Palermo, Palermo, Italy
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39
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Cervello M, Giannitrapani L, La Rosa M, Notarbartolo M, D'Alessandro N, Virruso L, Iovanna JL, Montalto G. Expression of HIP/PAP mRNA in human hepatoma cell lines. Ann N Y Acad Sci 2002; 963:53-8. [PMID: 12095928 DOI: 10.1111/j.1749-6632.2002.tb04094.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The present study attempts to shed more light on the role of hepatocarcinoma-intestine-pancreas/pancreatic associated protein (HIP/PAP) in hepatoma cells. We initially examined, by reverse transcription-polymerase chain reaction (RT-PCR), the HIP/PAP transcripts present in human hepatoma cell lines of different origins and with different grades of differentiation and genetic profiles. We also used DNA sequencing analysis to investigate the structure of the HIP/PAP gene. Further investigation is necessary to define the role of HIP/PAP during the development of human hepatocellular carcinoma and to ascertain whether the use of different transcripts is helpful in regulating HIP/PAP expression in transformed liver cells.
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Affiliation(s)
- M Cervello
- Istituto di Biologia dello Sviluppo, C.N.R., Palermo, Italy.
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40
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Giannitrapani L, Cervello M, Soresi M, Notarbartolo M, La Rosa M, Virruso L, D'Alessandro N, Montalto G. Circulating IL-6 and sIL-6R in patients with hepatocellular carcinoma. Ann N Y Acad Sci 2002; 963:46-52. [PMID: 12095927 DOI: 10.1111/j.1749-6632.2002.tb04093.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Interleukin-6 plays a central role in regulating the immune system, hematopoiesis, and acute phase reaction. It interacts with a receptor complex consisting of a specific ligand-binding protein (IL-6R, gp80) and a signal transduction protein (gp130). In this report, serum levels of IL-6 and a soluble form of the interleukin-6 receptor (sIL-6R) were evaluated in patients with hepatocellular carcinoma. The correlation between IL-6 and sIL-6R values, the stage of hepatocellular carcinoma, and main liver function tests was also studied.
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Affiliation(s)
- L Giannitrapani
- Istituto di Medicina Interna e Geriatria, Università di Palermo, Palermo, Italy
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41
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Soresi M, Amplo M, Agliastro R, Sesti R, Di Giovanni G, Magliarisi C, Belvedere M, Carroccio A, Montalto G. Screening for autoantibodies to tissue transglutaminase reveals a low prevalence of celiac disease in blood donors with cryptogenic hypertransaminasemia. Digestion 2002; 64:87-91. [PMID: 11684821 DOI: 10.1159/000048845] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Patients with chronic cryptogenic hypertransaminasemia are at high risk of developing celiac disease (CD). In fact, among the various serological disorders, CD patients at onset frequently present hypertransaminasemia. In this study, we evaluated usefulness and reliability of the new test for antitissue transglutaminase (tTG) in screening for CD as well as in estimating the prevalence of CD in a population of blood donors presenting unexplained hypertransaminasemia at donation. Controls were 180 consecutive healthy donors without hypertransaminasemia and 20 CD patients with known antiendomysial antibody (EmA) positivity. Out of 22,204 blood donors over a period of 2 years, we found 258 subjects (1.2%) with cryptogenic hypertransaminasemia. Four of these subjects (1.5%) were positive for anti-tTG, but only 3 of them were positive for EmA. EmA were negative in all the remaining hypertransaminasemia subjects. In the control groups, anti-tTG antibodies were negative in all the 180 healthy donors without hypertransaminasemia, but positive in all the CD patients known to be EmA positive. 3 of the 4 subjects positive for anti-tTG, including 2 who were also EmA positive, underwent biopsy of the distal duodenal mucosa which showed a picture compatible with CD only in the 2 patients with concomitant EmA positivity. After 3 months of gluten-free diet, the serum transaminase values normalized in these 2 patients. In conclusion, the prevalence of CD in our blood bank population was lower than that reported in other similar studies, but the new test for anti-tTG showed a good sensitivity and reliability, and, therefore, it can be proposed as a first-level test in screening for CD in selected populations such as subjects with hypertransaminasemia.
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Affiliation(s)
- M Soresi
- Cattedra di Medicina Interna, Università di Palermo, Palermo, Italia
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Carroccio A, Iacono G, D'Amico D, Cavataio F, Teresi S, Caruso C, Di PL, Colombo A, D'Arpa F, Florena A, Notarbartolo A, Montalto G. Production of anti-endomysial antibodies in cultured duodenal mucosa: usefulness in coeliac disease diagnosis. Scand J Gastroenterol 2002; 37:32-8. [PMID: 11843032 DOI: 10.1080/003655202753387329] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although anti-endomysial antibodies (EmA) have been found in the supernatants of cultured intestinal mucosa from patients with coeliac disease (CD), in no study has the clinical reliability of this new diagnostic tool been investigated. Our aims were to evaluate the clinical usefulness of the in vitro production of EmA in CD diagnosis in consecutive patients with suspected CD, and to evaluate the reliability of the in vitro challenge in CD patients on a gluten-free diet (GFD). METHODS For the former aim, consecutive patients who were due to undergo intestinal biopsy for suspected diagnosis of CD were enrolled: according to the final diagnosis, these patients were divided into two groups: Group 1 comprised 91 newly diagnosed CD patients (40 males; age range 7 months to 84 years), Group 2 included 100 subjects with diseases other than CD (44 males; age range 9 months to 76 years). For the latter aim, we also studied 21 CD patients on a gluten-free diet after 16-123 months (8 males; age range 3-51 years), with normal intestinal architecture (Group 3) and 22 patients who served as controls (12 males; age range 4-60 years) with gastroesophageal reflux disease-like symptoms (Group 4). All patients underwent determination of serum anti-gliadin (AGA) and EmA antibodies, histology evaluation of the intestinal biopsies and EmA assay in the supernatants of in vitro gliadin-challenged duodenal mucosa. RESULTS EmA assay in the supernatants showed a sensitivity and specificity of 96% and 100%, respectively; these were not significantly different from those observed for serum EmA (88% and 99%, respectively). However, EmA assay in the supernatants was useful in CD patients with mild intestinal histology lesions (infiltrative/hyperplastic type): in this subgroup it was positive in 9/12 of cases, but serum EmA was positive in only 2/12. As regards the reliability of the in vitro gliadin challenge, EmA production in supernatants was recorded only in 10/21 CD patients on a gluten-free diet. The patients with a positive in vitro challenge had a higher number of intra-epithelial lymphocytes than patients with a negative challenge. CONCLUSIONS 1) EmA assay in the medium of cultured intestinal biopsy can detect gluten-sensitive enteropathy, characterized by an infiltrative/hyperplastic histological pattern, which is often associated with negative serum EmA. 2) The in vitro challenge in CD patients on a gluten-free diet detects EmA production in the culture medium only in half of the cases and other studies must be performed to evaluate whether EmA production after in vitro challenge can be considered a reliable test for confirming CD diagnosis.
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Affiliation(s)
- A Carroccio
- Internal Medicine, University Hospital of Palermo, Italy.
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Montalto G, Tripi S, Vuturo O, Di Gaetano G, Soresi M, Spadaro A, Aiello A, Russello M, Benigno R, Siciliano R. Randomised Trial of Two Different Daily Doses of Interferon-?? versus Classical Therapy in Treatment-Na??ve Patients with Chronic Hepatitis C. Clin Drug Investig 2002; 22:623-631. [DOI: 10.2165/00044011-200222090-00007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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Abstract
Some cases of Ménétrier's disease associated with Helicobacter pylori (HP) have recently been reported in the literature. We report here the case of a 51-year-old man with a diagnosis of Ménétrier's disease who had previously been unsuccessfully treated with H(2) antagonists. A subsequent demonstration of HP infection led us to treat the patient with an eradicating therapy which prompted complete regression of clinical symptoms, resolution of the gastric endoscopic picture, and absence of HP on gastric histology. This result, in accordance with others in the literature, indicates an eventual association of HP infection with Ménétrier's disease and that consequent therapy is mandatory.
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Affiliation(s)
- G Di Vita
- Dipartimento Discipline Chirurgiche, Anatomiche ed Oncologiche, Prima Divisione di Chirurgia Generale, Università di Palermo, Italia
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Carroccio A, Guarino A, Zuin G, Verghi F, Berni Canani R, Fontana M, Bruzzese E, Montalto G, Notarbartolo A. Efficacy of oral pancreatic enzyme therapy for the treatment of fat malabsorption in HIV-infected patients. Aliment Pharmacol Ther 2001; 15:1619-25. [PMID: 11564002 DOI: 10.1046/j.1365-2036.2001.01070.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Abstract
BACKGROUND Nutrient malabsorption is a negative prognostic factor in acquired immunodeficiency syndrome and recent studies have shown that pancreatic insufficiency is a codetermining factor of malabsorption. AIMS To evaluate the effectiveness of open-label oral pancreatic enzyme supplementation therapy in acquired immunodeficiency syndrome patients with fat malabsorption. PATIENTS AND METHODS Twenty-four consecutive patients with human immunodeficiency virus infection and fat malabsorption were recruited (11 males, 13 females; median age, 9.1 years). Faecal fat loss was evaluated by steatocrit assay at entry to the study (T-0), after 2 weeks (T-1) without pancreatic enzyme treatment and after a further 2 weeks (T-2) of treatment with pancreatic extracts (Creon 10 000 at a dose of 1000 units of lipase per gram of ingested dietary fat). Faecal elastase-1 and chymotrypsin were assayed at entry. RESULTS Six patients (25%) had abnormally low elastase-1 and/or chymotrypsin faecal concentration. In all patients, steatocrit values were elevated at both T-0 and T-1. Five patients proved intolerant to pancreatic enzyme treatment because of the onset of abdominal pain, and therapy was discontinued. In the 19 patients who concluded the study, steatocrit values during pancreatic enzyme treatment (T-2) were significantly lower than at entry (P < 0.0001). At T-2, in eight of 19 patients, steatocrit values were within the normal limit and the frequency of cases cured or improved on pancreatic enzyme therapy (at T-2) was significantly higher than that observed during the previous study period without enzyme treatment (T-1) (P < 0.01). A positive significant correlation was found between steatocrit values at entry and the Centers for Disease Control class (P < 0.0005); also, the decrease in steatocrit values during pancreatic enzyme therapy (difference between steatocrit value at T-2 and steatocrit value at T-0) positively correlated with the Centers for Disease Control class (P < 0.05). CONCLUSIONS This pilot, open-label study showed that pancreatic enzyme supplementation therapy is highly effective in reducing faecal fat loss in human immunodeficiency virus-infected patients with nutrient malabsorption. Further double-blind studies must be undertaken to verify these results and, if they are confirmed, pancreatic enzymes can be added to our weapons in the fight against human immunodeficiency virus-associated nutrient malabsorption.
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Affiliation(s)
- A Carroccio
- Internal Medicine, University Hospital of Palermo, via Coffaro 25, 90124 Palermo, Italy.
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Carroccio A, Giannitrapani L, Soresi M, Not T, Iacono G, Di Rosa C, Panfili E, Notarbartolo A, Montalto G. Guinea pig transglutaminase immunolinked assay does not predict coeliac disease in patients with chronic liver disease. Gut 2001; 49:506-11. [PMID: 11559647 PMCID: PMC1728470 DOI: 10.1136/gut.49.4.506] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND It has been suggested that serological screening for coeliac disease (CD) should be performed in patients with chronic unexplained hypertransaminasaemia. AIMS To evaluate the specificity for CD diagnosis of serum IgA antitissue transglutaminase (tTG) determination in consecutive patients with chronic hypertransaminasaemia using the most widely utilised ELISA based on tTG from guinea pig as the antigen. PATIENTS AND METHODS We studied 98 patients with chronic hypertransaminasaemia, evaluated for the first time in a hepatology clinic. Serum anti-tTG and antiendomysial (EmA) assays were performed. Patients positive for EmA and/or anti-tTG were proposed for intestinal biopsy. Finally, all sera were reassayed for anti-tTG using an ELISA based on human recombinant tTG as the antigen. RESULTS A total of 94/98 hypertransaminasaemic patients were positive for hepatitis virus markers, with 82/98 (83%) positive for anti-hepatitis C virus. Liver histology showed that most patients had mild or moderate chronic hepatitis while severe fibrosis or overt liver cirrhosis was found in 20/98. CD screening showed that 15/98 (16%) hypertransaminasaemic subjects had anti-tTG values in the same range as CD patients; however, IgA EmA were positive in only 2/98 (2%). Distal duodenal biopsy, performed in nine patients, showed subtotal villous atrophy in the two EmA+/anti-tTG+ patients but was normal in 7/7 EmA-/anti-tTG+ subjects. The presence of anti-tTG+ values in EmA- patients was unrelated to particular gastrointestinal symptoms, other associated diseases, severity of liver histology, or distribution of viral hepatitis markers. There was a significantly higher frequency of positive serum autoantibodies (antinuclear, antimitochondrial, antismooth muscle, and anti-liver-kidney microsomal antibodies) in anti-tTG+/EmA- patients than in the other subjects (9/13 v 10/83; p<0.003). Also, a correlation was found between serum gamma globulin and anti-tTG values (p<0.01). When sera were tested with the ELISA based on human tTG as the antigen, no false positive results were observed: only the two EmA+ patients with atrophy of the intestinal mucosa were positive for anti-tTG while all others were negative, including those false positive in the ELISA based on guinea pig tTG as the antigen. CONCLUSIONS In patients with elevated transaminases and chronic liver disease there was a high frequency of false positive anti-tTG results using the ELISA based on tTG from guinea pig as the antigen. Indeed, the presence of anti-tTG did not correlate with the presence of EmA or CD. These false positives depend on the presence of hepatic proteins in the commercial tTG obtained from guinea pig liver and disappear when human tTG is used as the antigen in the ELISA system. We suggest that the commonly used tTG ELISA based on guinea pig antigen should not be used as a screening tool for CD in patients with chronic liver disease.
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Affiliation(s)
- A Carroccio
- Internal Medicine, University Hospital of Palermo, Palermo, Italy.
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47
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Custro N, Carroccio A, Ganci A, Scafidi V, Campagna P, Di Prima L, Montalto G. Glycemic homeostasis in chronic viral hepatitis and liver cirrhosis. Diabetes Metab 2001; 27:476-81. [PMID: 11547221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
OBJECTIVES This study aimed at investigating the respective impacts of virus-related chronic hepatitis (CH) and liver cirrhosis (LC) on glycemic homeostasis, with reference to grading and/or staging of liver disease and to contribution of the two main responsible viruses. MATERIAL AND METHODS The glycometabolic features of 82 patients with CH (B-related 16, and C-related 66) and 145 with LC (B-related 24, and C-related 121) were evaluated. RESULTS Impaired glucose tolerance (IGT) was detected in 9 (11.0%) and diabetes mellitus (DM) in 6 (7.3%) of the CH patients [(P<0.05 vs controls, in both cases; respective odds ratios (95% CI): 2.6 (1.1-6.3), and 4.0 (1.2-13.2)]. IGT was detected in 86 (59.3%) and DM in 34 (23.4%) of the LC patients [(P=0.000 vs controls, in both cases; respective odds ratios: 10.0 (7.0-14.4), and 5.5 (3.5-8.5)]. The odds ratios for the prevalence of IGT and DM in the LC patients were 11.8 (5.2-27.5) and 3.9 (1.5-10.8), compared with the CH patients. In the CH patients, glycometabolic failure was significantly related to age (P=0.026), but not to grading and staging, and in the LC patients to Pugh-Child score (P=0.037). IGT was found in 17/40 (42.5%) HBV-related patients and in 13/40 (32.5) matched HCV-related patients. DM was found in 9/40 (22.5%) HBV-related patients and in 10/40 (25.0%) HCV-related matched patients, without significant difference in the respective proportions. CONCLUSION The prevalence of DM associated to virus-related CH is on average four times higher than in the general population, independently of the histopathological picture of disease. Virus-related LC further increases the prevalence of both IGT and DM, independently of sex and age, but in relationship with the severity of disease. HBV and HCV infections do not appear to have a different impact on glycemic homeostasis.
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Affiliation(s)
- N Custro
- Istituto di Medicina Interna e Geriatria, University of Palermo, via del Vespro, 141, Palermo, Italy
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48
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Abstract
In patients with coeliac disease, a regression of intestinal damage without a gluten-free diet is a very rare event. We describe a young child with diarrhoea, intestinal mucosa atrophy and positive serum anti-endomysial and anti-tissue transglutaminase (anti-tTG) antibodies during intestinal giardiasis infection. He showed normal intestinal mucosa architecture and negative anti-endomysial and anti-tTG antibodies after his giardiasis was cured, although he continued to assume a normal diet. Re-evaluations on a 6-monthly basis showed that he was symptom free, and all haemato-chemical parameters were within normal limits. Three years after the initial diagnosis, a third intestinal biopsy showed: normal mucosa architecture; an increase in the intra-epithelial CD3+ and gamma/delta+ lymphocyte counts; and immunoglobulin-A anti-endomysial antibody detection in the supernatant of the intestinal mucosa culture incubated with gliadin. An active coeliac disease status, with intestinal mucosa atrophy, may regress to a latent coeliac disease status with normal intestinal mucosa histology after removal of the environmental factors that have presumably precipitated mucosa damage. Serum anti-endomysial and anti-tTG antibody behaviour is not a permanent, life-long feature and this must recommend the repetition of anti-endomysial or anti-tTG antibody assays in the same patient whenever coeliac disease diagnosis is again suspected, irrespective of previous negativity.
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Affiliation(s)
- A Carroccio
- Department of Internal Medicine, University Hospital of Palermo, via Coffaro 25, 90124 Palermo, Italy.
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49
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Abstract
We report the case of a 53-year-old man with inflammatory pseudotumor (IPT) of the liver and spleen. This concomitant association has rarely been reported. The patient presented with a hypoechoic mass in the liver and a clinical picture of recurrent sepsis; hematochemical exams and imaging data were nonspecific. Antibiotic therapy improved the clinical course, but did not resolve it definitively. After 50 days of therapy, as the hepatic mass decreased a similar lesion appeared in the spleen. The final diagnosis was made on splenectomy and an intra-operative biopsy of the residual liver lesion. The diagnostic problems encountered in this very rare association of IPT of the liver and spleen were similar to those for isolated IPT in the respective single organ sites. After 15 months of follow-up, the patient is in good health and no recurrence of symptoms or masses has been observed.
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Affiliation(s)
- G Di Vita
- Dipartimento Discipline Chirurgiche, Anatomiche ed Oncologiche, 1st Divisione di Chirurgia Generale, Italy
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Carroccio A, Verghi F, Santini B, Lucidi V, Iacono G, Cavataio F, Soresi M, Ansaldi N, Castro M, Montalto G. Diagnostic accuracy of fecal elastase 1 assay in patients with pancreatic maldigestion or intestinal malabsorption: a collaborative study of the Italian Society of Pediatric Gastroenterology and Hepatology. Dig Dis Sci 2001; 46:1335-42. [PMID: 11414313 DOI: 10.1023/a:1010687918252] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Several reports have indicated that fecal elastase-1 (EL-1) determination is a new, sensitive, and specific noninvasive pancreatic function test; however, very few patients with malabsorption due to small intestine diseases have been included in the previous studies. The aim of the study was to compare the diagnostic accuracy of fecal EL-1 and fecal chymotrypsin (FCT) in distinguishing between pancreatic maldigestion and intestinal malabsorption. Three groups of subjects were studied: group A included 49 patients with known cystic fibrosis (25 males, median age 5 years); group B included 43 subjects with various small intestine diseases (17 males, median age 6 years); and group C included 45 children without any history of gastrointestinal disease (22 males, median age 5 years). In all patients, stools were collected for 72 h on a standard diet and fecal EL-1, FCT, and steatocrit tests were performed. Both EL-1 and FCT were below normal limits in all CF patients with pancreatic maldigestion not treated with pancreatic enzyme (100% sensitivity for both assays); El-1, but not FCT, was also below normal in all the CF patients with pancreatic maldigestion treated with pancreatic extracts. Both EL-1 and FCT values in the CF group were significantly lower than in subjects with various small intestinal diseases and in children without any history of gastrointestinal disease (P < 0.0001). FCT, but not EL-1, values showed an inverse statistically significant correlation with steatocrit values in the whole CF group (P < 0.001); FCT was below normal in three of four CF patients with steatorrhea on pancreatic enzyme therapy. Both EL-1 and FCT had 100% specificity when calculated in children without any history of gastrointestinal disease; in contrast, specificity was 86% for EL-1 and 76% for FCT if we considered the control group with small intestinal diseases: low EL-1 was observed in two cases of intestinal giardiasis, two cases of short bowel syndrome, one case of celiac disease, and one case of intestinal pseudobstruction; FCT was abnormal in four cases of intestinal giardiasis, three cases of celiac disease, one case of short bowel syndrome, one case of Crohn's disease, and one case of intestinal pseudobstruction. Diagnostic accuracy was 92% for fecal EL-1 and 82% for FCT. Steatocrit values were over the normal limit in 11 patients with small intestine diseases; in 7/11 of these patients at least one of the pancreatic test results was below the normal limit. In conclusions, in patients with CF, fecal EL-1 determination is not more sensitive than FCT in identifying pancreatic maldigestion; however, fecal EL-1 assay is more specific than FCT determination in distinguishing pancreatic maldigestion from intestinal malabsorption.
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Affiliation(s)
- A Carroccio
- Internal Medicine, University Hospital of Palermo, Italy
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