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Your search keyword '"Buonomo, A. R."' showing total 28 results
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28 results on '"Buonomo, A. R."'

1. Clinical features of patients with home isolation SARS-COV-2 infection: A multicenter retrospective study in southern Italy

Author

Pisaturo M., De Angelis G., Maggi P., Sangiovanni V., Numis F. G., Gentile I., Masullo A., Rescigno C., Calabria G., Megna A. S., Gambardella M., Manzillo E., Giolitto G., Rossomando A., Buonomo A. R., Macera M., Messina V., Pagano A., Pisapia R., Farella N., Bosso G., Coppola N., Monari C., Sagnelli C., Russo G., Esposito V., Allegorico E., Biagio Pinchera, Catalano M., Salzillo A., Porta G., Scotto R., Pinchera B., Zappulo E., Viceconte G., Moriello N. S., Foggia M., Calo F., Rossomando A. M., Russo A., Liorre G., Paradiso L., Liberti A., Serra C., Vicario F. D., Minerva V., Selva V., Simeone F., De Pascalis S., Pontillo V., Pisaturo, M., De Angelis, G., Maggi, P., Sangiovanni, V., Numis, F. G., Gentile, I., Masullo, A., Rescigno, C., Calabria, G., Megna, A. S., Gambardella, M., Manzillo, E., Giolitto, G., Rossomando, A., Buonomo, A. R., Macera, M., Messina, V., Pagano, A., Pisapia, R., Farella, N., Bosso, G., Coppola, N., Monari, C., Sagnelli, C., Russo, G., Esposito, V., Allegorico, E., Biagio, Pinchera, Catalano, M., Salzillo, A., Porta, G., Scotto, R., Pinchera, B., Zappulo, E., Viceconte, G., Moriello, N. S., Foggia, M., Calo, F., Rossomando, A. M., Russo, A., Liorre, G., Paradiso, L., Liberti, A., Serra, C., Vicario, F. D., Minerva, V., Selva, V., Simeone, F., De Pascalis, S., Pontillo, V., Pisaturo, Mariantonietta, De Angelis, Giulia, Maggi, Paolo, Sangiovanni, Vincenzo, Numis, Fabio Giuliano, Gentile, Ivan, Masullo, Alfonso, Rescigno, Carolina, Calabria, Giosuele, Salomone Megna, Angelo, Gambardella, Michele, Manzillo, Elio, Giolitto, Giancarlo, Rossomando, Annamaria, Buonomo, Antonio Riccardo, Macera, Margherita, Messina, Vincenzo, Pagano, Antonio, Pisapia, Raffaella, Farella, Nunzia, Bosso, Giorgio, Coppola, Nicola, and Group, Covicam

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Isolation (health care), Science, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Home isolation, Mild clinical presentation, Disease, 030204 cardiovascular system & hematology, Asymptomatic, Article, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Epidemiology, medicine, 030212 general & internal medicine, Ecology, Evolution, Behavior and Systematics, business.industry, SARS-CoV-2 infection, Home management, Paleontology, COVID-19, Retrospective cohort study, Space and Planetary Science, mild clinical presentation, home management, home isolation, medicine.symptom, business
Abstract

To describe epidemiological and clinical features of patients confirmed as having SARS-CoV-2 infection and managed in isolation at home. We performed a multicenter retrospective study enrolling all SARS-CoV-2-positive adults evaluated from 28 February to 31 May 2020 at one of nine COVID-19 Units in southern Italy: we included patients receiving care at home and those admitted to hospital. We defined patients with not-severe disease if they were asymptomatic or experienced a mild infection that did not need oxygen (O2) therapy and those with a severe infection if hospitalized and required O2 therapy. We enrolled 415 patients with SARS-CoV-2 infection: 77 were managed in isolation at home, 338 required hospital management. The 77 patients in home isolation were less frequently male than hospitalized patients (55% vs. 64%; < 0.01) and were younger (median age 45 years (IQR:19) vs 62 (IQR 22); p < 0.01), had a lower Charlson comorbidity index (median 0 (IQR2) vs 6 (IQR 3); p < 0.01), and included fewer subjects with an underlying chronic disease (36% vs 59%; p < 0.01). According to a binomial logistic regression analysis, a younger age (OR: 0.96 (95% IC: 0.94–0.98), p < 0.01) and a low Charlson comorbidity index (OR: 0.66 (95% IC: 0.54 –0.83); p < 0.01) were independent factors associated with at-home management. The identification of subjects with SARS-CoV-2 infection who could be managed in home isolation is useful in clinical practice. A younger age and no comorbidities were identified as factors independently associated with home management.

Published
2021

2. Pneumocystis jirovecii pneumonia in an immunocompetent patient recovered from COVID-19

Author

Viceconte G., Buonomo A. R., Lanzardo A., Pinchera B., Zappulo E., Scotto R., Schiano Moriello N., Vargas M., Iacovazzo C., Servillo G., Gentile I., Francesco B., Letizia C., Carmela Domenica C. M., Mariarosaria C., Giovanni D. F., Maria F., Antonella G., Ivan G., Agnese G., Simona M., Fulvio M., Amerigo P., Laura R., Fabrizio S., Alessia S., Francesca S., Grazia T., Irene Z., Viceconte, G., Buonomo, A. R., Lanzardo, A., Pinchera, B., Zappulo, E., Scotto, R., Schiano Moriello, N., Vargas, M., Iacovazzo, C., Servillo, G., Gentile, I., Francesco, B., Letizia, C., Carmela Domenica, C. M., Mariarosaria, C., Giovanni, D. F., Maria, F., Antonella, G., Ivan, G., Agnese, G., Simona, M., Fulvio, M., Amerigo, P., Laura, R., Fabrizio, S., Alessia, S., Francesca, S., Grazia, T., and Irene, Z.

Subjects
0301 basic medicine, Microbiology (medical), 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), 030106 microbiology, 03 medical and health sciences, 0302 clinical medicine, parasitic diseases, Medicine, Pneumocystis jirovecii, In patient, 030212 general & internal medicine, Aspergillus, General Immunology and Microbiology, biology, business.industry, SARS-CoV-2, Pneumocystis jirovecii Pneumonia, COVID-19, General Medicine, biology.organism_classification, Virology, invasive fungal disease, Infectious Diseases, Pneumocystis carinii, lymphopaenia, Immunocompetence, business
Abstract

Background: Several cases of invasive fungal diseases in patients with COVID-19 have been reported, mostly due to Aspergillus spp., with anecdotic reports of Pneumocystis jirovecii pneumonia (PJP) as co-infections in immunocompromised patients. We describe the first case of PJP in an immunocompetent patient who recovered from COVID-19 pneumonia. Case description: Our patient was hospitalized for 18 d for respiratory failure due to Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) pneumonia and successfully treated with continuous positive airway pressure (CPAP) respiratory support, enoxaparin, ceftaroline and intravenous 6 mg of dexamethasone for 10 d, then with oral prednisone tapering. Despite his improved radiological and clinical conditions at discharge, he was admitted again after 18 d for worsening of respiratory conditions. Upon the second admission, a high-resolution CT-scan of the chest showed the development of new ground-glass opacities and P. jirovecii was detected on bronchoalveolar lavage fluid. A therapy with trimethoprim-sulphamethoxazole 20 mg/kg and methylprednisolone 40 mg i.v. bis in die (BID) was started, with improvement of clinical, biochemical and radiological conditions. Conclusions: COVID-19 patients may have multiple risk factors for development of PJP, in particular lymphopaenia and use of steroids. PJP must be ruled out with direct microbiological methods in patients presenting with radiologic and clinical features of possible or probable PJP, even in immunocompetent hosts.

Published
2021

3. Economic Consequences of Investing in Anti-HCV Antiviral Treatment from the Italian NHS Perspective: A Real-World-Based Analysis of PITER Data

Author

Marcellusi, Andrea, Viti, Raffaella, Kondili, Loreta A., Rosato, Stefano, Vella, Stefano, Mennini, Francesco Saverio, Kondili, L. A., Vella, S., Quaranta, M. G., Rosato, S., Tosti, M. E., Weimer, L. E., Ferrigno, L., D’Angelo, F., Falzano, L., Benedetti, A., Schiadà, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Drenaggi, D., Mazzaro, C., Angarano, G., Milella, M., Di Leo, A., Rendina, M., Contaldo, A., Iannone, A., La Fortezza, F., Rizzi, M., Cologni, G., Bolondi, L., Benevento, F., Serio, I., Andreone, P., Caraceni, P., Guarneri, V., Margotti, M., Simonetti, G., Mazzella, G., Verucchi, G., Donati, V., Mian, Peter, Rimenti, G., Rossini, A., Contessi, G. B., Castelli, Fulvio, Zaltron, S., Spinetti, A., Odolini, S., Leandro, G., Cozzolongo, R., Zappimbulso, M., Russello, M., Benigno, R., Coco, C., Torti, C., Costa, C., Greco, G., Mazzitelli, M., Pisani, V., Cosco, Lucia, Quintieri, F., De Siena, Martina, Giancotti, F., Vecchiet, J., Falasca, K., Mastroianni, A., Apuzzo, G., Chidichimo, L., Foschi, F. G., Dall’Aglio, A. C., Libanore, M., Segala, D., Sighinolfi, L., Bartolozzi, D., Salomoni, E., Blanc, P., Baragli, F., DelundefinedPin, B., Mariabelli, E., Mazzotta, F., Poggi, A., Zignego, A. L., Monti, M., Madia, Francesca, Xheka, A., Cela, E. M., Santantonio, T. A., Bruno, S. R., Viscoli, C., Alessandrini, A. I., Curti, C., DiundefinedBiagio, A., Nicolini, L. A., Balletto, E., Mastroianni, Chiara, Blerta, K., Prati, D., Raffaele, L., Andreoletti, M., Perboni, G., Costa, P., Manzini, L., Raimondo, G., Filomia, R., Lazzarin, A., Morsica, G., Salpietro, S., Puoti, M., Baiguera, C., Vassalli, S., Rumi, M. G., Labanca, S., Zuin, M., Giorgini, A., Orellana, D., D’ArminioundefinedMonforte, A., Debona, A., Solaro, S., Fargion, S., Valenti, L., Periti, G., Pelusi, S., Galli, M., Calvi, E., Milazzo, L., Peri, A., Lampertico, P., Borghi, Margherita, D’Ambrosio, R., Degasperi, E., Vinci, Maria Rosaria, Villa, E., Bernabucci, V., Bristot, Luca, Pereira, F., Chessa, L., Pasetto, M. C., Loi, M., Gori, A., Beretta, I., Pastore, V., Soria, A., Strazzabosco, M., Ciaccio, A., Gemma, M., Borgia, G., Foggia, A., Zappulo, E., Gentile, I., Buonomo, A. R., Abrescia, N., Maddaloni, A., Caporaso, N., Morisco, F., Camera, S., Donnarumma, L., Coppola, C., Amoruso, D. C., Staiano, L., Saturnino, M. R., Coppola, N., Martini, S., Monari, C., Federico, Alex, Dallio, M., Loguercio, C., Gaeta, G. B., Brancaccio, G., Nardone, G., Sgamato, C., D’Adamo, G., Alberti, A., Gonzo, M., Piovesan, S., Chemello, L., Buggio, A., Cavalletto, L., Barbaro, F., Castelli, Enrico, Floreani, A., Cazzagon, N., Franceschet, I., Russo, F. P., Zanetto, A., Franceschet, E., Madonia, S., Cannizzaro, Maria Chiara, Montalto, G., Licata, A., Capitano, A. R., Craxì, A., Petta, S., Calvaruso, V., Rini, F., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Bruno, R., Lombardi, A., Zuccaro, V., Gulminetti, R., Asti, A., Villaraggia, M., Mondelli, M., Ludovisi, S., Baldelli, F., Di Candilo, F., Parruti, G., Di Stefano, Paolo, Sozio, F., Gizzi, M. C., Brunetto, M. R., Colombatto, P., Coco, B., Surace, L., Foti, G., Pellicano, S., Fornaciari, G., Schianchi, S., Vignoli, P., Massari, M., Corsini, R., Garlassi, E., Ballardini, G., Andreoni, M., Cerva, C., Angelico, M., Gasbarrini, Antonio, Siciliano, M., Nosotti, L., Taliani, G., Biliotti, E., Santori, M., Spaziante, M., Tamburini, F., Vullo, V., D’Ettorre, G., Cavallari, E. N., Gebremeskel, T. S., Pavone, P., Cauda, Roberto, Cingolani, Antonella, Lamonica, S., D’Offizi, G., Lionetti, R., Visco Comandini, U., Grieco, Antonio, D’Aversa, F., Picardi, A., De Vincentis, A., Galati, G., Gallo, Patrizia, Dell’Unto, C., Aghemo, A., Gatti Comini, A., Persico, M., Masarone, M., Anselmo, M., De Leo, P., Marturano, Monia, Brunelli, E., Ridolfi, F., Schimizzi, A. M., Ayoubi Khajekini, M., Framarin, L., Di Perri, G., Cariti, G., Boglione, L., Cardellino, C., Marinaro, L., Saracco, G. M., Ciancio, A., Toniutto, P., Alterini, G., Capra, F., Ieluzzi, D., Marcellusi, A, Viti, R, Kondili, L, Rosato, S, Vella, S, Mennini, F, Quaranta, M, Tosti, M, Weimer, L, Ferrigno, L, D'Angelo, F, Falzano, L, Benedetti, A, Schiada, L, Cucco, M, Giacometti, A, Brescini, L, Castelletti, S, Drenaggi, D, Mazzaro, C, Angarano, G, Milella, M, Dileo, A, Rendina, M, Contaldo, A, Iannone, A, La Fortezza, F, Rizzi, M, Cologni, G, Bolondi, L, Benevento, F, Serio, I, Andreone, P, Caraceni, P, Guarneri, V, Margotti, M, Simonetti, G, Mazzella, G, Verucchi, G, Donati, V, Mian, P, Rimenti, G, Rossini, A, Contessi, G, Castelli, F, Zaltron, S, Spinetti, A, Odolini, S, Leandro, G, Cozzolongo, R, Zappimbulso, M, Russello, M, Benigno, R, Coco, C, Torti, C, Costa, C, Greco, G, Mazzitelli, M, Pisani, V, Cosco, L, Quintieri, F, Desiena, M, Giancotti, F, Vecchiet, J, Falasca, K, Mastroianni, A, Apuzzo, G, Chidichimo, L, Foschi, F, Dall'Aglio, A, Libanore, M, Segala, D, Sighinolfi, L, Bartolozzi, D, Salomoni, E, Blanc, P, Baragli, F, Delpin, B, Mariabelli, E, Mazzotta, F, Poggi, A, Zignego, A, Monti, M, Madia, F, Xheka, A, Cela, E, Santantonio, T, Bruno, S, Viscoli, C, Alessandrini, A, Curti, C, Dibiagio, A, Nicolini, L, Balletto, E, Mastroianni, C, Blerta, K, Prati, D, Raffaele, L, Andreoletti, M, Perboni, G, Costa, P, Manzini, L, Raimondo, G, Filomia, R, Lazzarin, A, Morsica, G, Salpietro, S, Puoti, M, Baiguera, C, Vassalli, S, Rumi, M, Labanca, S, Zuin, M, Giorgini, A, Orellana, D, D'Arminiomonforte, A, Debona, A, Solaro, S, Fargion, S, Valenti, L, Periti, G, Pelusi, S, Galli, M, Calvi, E, Milazzo, L, Peri, A, Lampertico, P, Borghi, M, D'Ambrosio, R, Degasperi, E, Vinci, M, Villa, E, Bernabucci, V, Bristot, L, Pereira, F, Chessa, L, Pasetto, M, Loi, M, Gori, A, Beretta, I, Pastore, V, Soria, A, Strazzabosco, M, Ciaccio, A, Gemma, M, Borgia, G, Foggia, A, Zappulo, E, Gentile, I, Buonomo, A, Abrescia, N, Maddaloni, A, Caporaso, N, Morisco, F, Camera, S, Donnarumma, L, Coppola, C, Amoruso, D, Staiano, L, Saturnino, M, Coppola, N, Martini, S, Monari, C, Federico, A, Dallio, M, Loguercio, C, Gaeta, G, Brancaccio, G, Nardone, G, Sgamato, C, D'Adamo, G, Alberti, A, Gonzo, M, Piovesan, S, Chemello, L, Buggio, A, Cavalletto, L, Barbaro, F, Castelli, E, Floreani, A, Cazzagon, N, Franceschet, I, Russo, F, Zanetto, A, Franceschet, E, Madonia, S, Cannizzaro, M, Montalto, G, Licata, A, Capitano, A, Craxi, A, Petta, S, Calvaruso, V, Rini, F, Ferrari, C, Negri, E, Orlandini, A, Pesci, M, Bruno, R, Lombardi, A, Zuccaro, V, Gulminetti, R, Asti, A, Villaraggia, M, Mondelli, M, Ludovisi, S, Baldelli, F, Di Candilo, F, Parruti, G, Di Stefano, P, Sozio, F, Gizzi, M, Brunetto, M, Colombatto, P, Coco, B, Surace, L, Foti, G, Pellicano, S, Fornaciari, G, Schianchi, S, Vignoli, P, Massari, M, Corsini, R, Garlassi, E, Ballardini, G, Andreoni, M, Cerva, C, Angelico, M, Gasbarrini, A, Siciliano, M, De Siena, M, Nosotti, L, Taliani, G, Biliotti, E, Santori, M, Spaziante, M, Tamburini, F, Vullo, V, D'Ettorre, G, Cavallari, E, Gebremeskel, T, Pavone, P, Cauda, R, Cingolani, A, Lamonica, S, D'Offizi, G, Lionetti, R, Visco Comandini, U, Grieco, A, D'Aversa, F, Picardi, A, De Vincentis, A, Galati, G, Gallo, P, Dell'Unto, C, Aghemo, A, Gatti Comini, A, Persico, M, Masarone, M, Anselmo, M, De Leo, P, Marturano, M, Brunelli, E, Ridolfi, F, Schimizzi, A, Ayoubi Khajekini, M, Framarin, L, Di Perri, G, Cariti, G, Boglione, L, Cardellino, C, Marinaro, L, Saracco, G, Ciancio, A, Toniutto, P, Alterini, G, Capra, F, Ieluzzi, D, Kondili LA, Vella S, Quaranta MG, Rosato S, Tosti ME, Weimer LE, Ferrigno L, D'Angelo F, Falzano L, Benedetti A, Schiadà L, Cucco M, Giacometti A, Brescini L, Castelletti S, Drenaggi D, Mazzaro C, Angarano G, Milella M, Di Leo A, Rendina M, Contaldo A, Iannone A, La Fortezza F, Rizzi M, Cologni G, Bolondi L, Benevento F, Serio I, Andreone P, Caraceni P, Guarneri V, Margotti M, Simonetti G, Mazzella G, Verucchi G, Donati V, Mian P, Rimenti G, Rossini A, Contessi GB, Castelli F, Zaltron S, Spinetti A, Odolini S, Leandro G, Cozzolongo R, Zappimbulso M, Russello M, Benigno R, Coco C, Torti C, Costa C, Greco G, Mazzitelli M, Pisani V, Cosco L, Quintieri F, De Siena M, Giancotti F, Vecchiet J, Falasca K, Mastroianni A, Apuzzo G, Chidichimo L, Foschi FG, Dall'Aglio AC, Libanore M, Segala D, Sighinolfi L, Bartolozzi D, Salomoni E, Blanc P, Baragli F, Del Pin B, Mariabelli E, Mazzotta F, Poggi A, Zignego AL, Monti M, Madia F, Xheka A, Cela EM, Santantonio TA, Bruno SR, Viscoli C, Alessandrini AI, Curti C, Di Biagio A, Nicolini LA, Balletto E, Mastroianni C, Blerta K, Prati D, Raffaele L, Andreoletti M, Perboni G, Costa P, Manzini L, Raimondo G, Filomia R, Lazzarin A, Morsica G, Salpietro S, Puoti M, Baiguera C, Vassalli S, Rumi MG, Labanca S, Zuin M, Giorgini A, Orellana D, D'Arminio Monforte A, Debona A, Solaro S, Fargion S, Valenti L, Periti G, Pelusi S, Galli M, Calvi E, Milazzo L, Peri A, Lampertico P, Borghi M, D'Ambrosio R, Degasperi E, Vinci M, Villa E, Bernabucci V, Bristot L, Pereira F, Chessa L, Pasetto MC, Loi M, Gori A, Beretta I, Pastore V, Soria A, Strazzabosco M, Ciaccio A, Gemma M, Borgia G, Foggia A, Zappulo E, Gentile I, Buonomo AR, Abrescia N, Maddaloni A, Caporaso N, Morisco F, Camera S, Donnarumma L, Coppola C, Amoruso DC, Staiano L, Saturnino MR, Coppola N, Martini S, Monari C, Federico A, Dallio M, Loguercio C, Gaeta GB, Brancaccio G, Nardone G, Sgamato C, D'Adamo G, Alberti A, Gonzo M, Piovesan S, Chemello L, Buggio A, Cavalletto L, Barbaro F, Castelli E, Floreani A, Cazzagon N, Franceschet I, Russo FP, Zanetto A, Franceschet E, Madonia S, Cannizzaro M, Montalto G, Licata A, Capitano AR, Craxì A, Petta S, Calvaruso V, Rini F, Ferrari C, Negri E, Orlandini A, Pesci M, Bruno R, Lombardi A, Zuccaro V, Gulminetti R, Asti A, Villaraggia M, Mondelli M, Ludovisi S, Baldelli F, Di Candilo F, Parruti G, Di Stefano P, Sozio F, Gizzi MC, Brunetto MR, Colombatto P, Coco B, Surace L, Foti G, Pellicano S, Fornaciari G, Schianchi S, Vignoli P, Massari M, Corsini R, Garlassi E, Ballardini G, Andreoni M, Cerva C, Angelico M, Gasbarrini A, Siciliano M, De Siena M, Nosotti L, Taliani G, Biliotti E, Santori M, Spaziante M, Tamburini F, Vullo V, D'Ettorre G, Cavallari EN, Gebremeskel TS, Pavone P, Cauda R, Cingolani A, Lamonica S, D'Offizi G, Lionetti R, Visco Comandini U, Grieco A, D'Aversa F, Picardi A, De Vincentis A, Galati G, Gallo P, Dell'Unto C, Aghemo A, Gatti Comini A, Persico M, Masarone M, Anselmo M, De Leo P, Marturano M, Brunelli E, Ridolfi F, Schimizzi AM, Ayoubi Khajekini M, Framarin L, Di Perri G, Cariti G, Boglione L, Cardellino C, Marinaro L, Saracco GM, Ciancio A, Toniutto P, Alterini G, Capra F, Ieluzzi D., Marcellusi, A., Viti, R., Kondili, L. A., Rosato, S., Vella, S., Mennini, F. S., Quaranta, M. G., Tosti, M. E., Weimer, L. E., Ferrigno, L., D'Angelo, F., Falzano, L., Benedetti, A., Schiada, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Drenaggi, D., Mazzaro, C., Angarano, G., Milella, M., Dileo, A., Rendina, M., Contaldo, A., Iannone, A., La Fortezza, F., Rizzi, M., Cologni, G., Bolondi, L., Benevento, F., Serio, I., Andreone, P., Caraceni, P., Guarneri, V., Margotti, M., Simonetti, G., Mazzella, G., Verucchi, G., Donati, V., Mian, P., Rimenti, G., Rossini, A., Contessi, G. B., Castelli, F., Zaltron, S., Spinetti, A., Odolini, S., Leandro, G., Cozzolongo, R., Zappimbulso, M., Russello, M., Benigno, R., Coco, C., Torti, C., Costa, C., Greco, G., Mazzitelli, M., Pisani, V., Cosco, L., Quintieri, F., Desiena, M., Giancotti, F., Vecchiet, J., Falasca, K., Mastroianni, A., Apuzzo, G., Chidichimo, L., Foschi, F. G., Dall'Aglio, A. C., Libanore, M., Segala, D., Sighinolfi, L., Bartolozzi, D., Salomoni, E., Blanc, P., Baragli, F., Delpin, B., Mariabelli, E., Mazzotta, F., Poggi, A., Zignego, A. L., Monti, M., Madia, F., Xheka, A., Cela, E. M., Santantonio, T. A., Bruno, S. R., Viscoli, C., Alessandrini, A. I., Curti, C., Dibiagio, A., Nicolini, L. A., Balletto, E., Mastroianni, C., Blerta, K., Prati, D., Raffaele, L., Andreoletti, M., Perboni, G., Costa, P., Manzini, L., Raimondo, G., Filomia, R., Lazzarin, A., Morsica, G., Salpietro, S., Puoti, M., Baiguera, C., Vassalli, S., Rumi, M. G., Labanca, S., Zuin, M., Giorgini, A., Orellana, D., D'Arminiomonforte, A., Debona, A., Solaro, S., Fargion, S., Valenti, L., Periti, G., Pelusi, S., Galli, M., Calvi, E., Milazzo, L., Peri, A., Lampertico, P., Borghi, M., D'Ambrosio, R., Degasperi, E., Vinci, M., Villa, E., Bernabucci, V., Bristot, L., Pereira, F., Chessa, L., Pasetto, M. C., Loi, M., Gori, A., Beretta, I., Pastore, V., Soria, A., Strazzabosco, M., Ciaccio, A., Gemma, M., Borgia, G., Foggia, A., Zappulo, E., Gentile, I., Buonomo, A. R., Abrescia, N., Maddaloni, A., Caporaso, N., Morisco, F., Camera, S., Donnarumma, L., Coppola, C., Amoruso, D. C., Staiano, L., Saturnino, M. R., Coppola, N., Martini, S., Monari, C., Federico, A., Dallio, M., Loguercio, C., Gaeta, G. B., Brancaccio, G., Nardone, G., Sgamato, C., D'Adamo, G., Alberti, A., Gonzo, M., Piovesan, S., Chemello, L., Buggio, A., Cavalletto, L., Barbaro, F., Castelli, E., Floreani, A., Cazzagon, N., Franceschet, I., Russo, F. P., Zanetto, A., Franceschet, E., Madonia, S., Cannizzaro, M., Montalto, G., Licata, A., Capitano, A. R., Craxi, A., Petta, S., Calvaruso, V., Rini, F., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Bruno, R., Lombardi, A., Zuccaro, V., Gulminetti, R., Asti, A., Villaraggia, M., Mondelli, M., Ludovisi, S., Baldelli, F., Di Candilo, F., Parruti, G., Di Stefano, P., Sozio, F., Gizzi, M. C., Brunetto, M. R., Colombatto, P., Coco, B., Surace, L., Foti, G., Pellicano, S., Fornaciari, G., Schianchi, S., Vignoli, P., Massari, M., Corsini, R., Garlassi, E., Ballardini, G., Andreoni, M., Cerva, C., Angelico, M., Gasbarrini, A., Siciliano, M., De Siena, M., Nosotti, L., Taliani, G., Biliotti, E., Santori, M., Spaziante, M., Tamburini, F., Vullo, V., D'Ettorre, G., Cavallari, E. N., Gebremeskel, T. S., Pavone, P., Cauda, R., Cingolani, A., Lamonica, S., D'Offizi, G., Lionetti, R., Visco Comandini, U., Grieco, A., D'Aversa, F., Picardi, A., De Vincentis, A., Galati, G., Gallo, P., Dell'Unto, C., Aghemo, A., Gatti Comini, A., Persico, M., Masarone, M., Anselmo, M., De Leo, P., Marturano, M., Brunelli, E., Ridolfi, F., Schimizzi, A. M., Ayoubi Khajekini, M., Framarin, L., Di Perri, G., Cariti, G., Boglione, L., Cardellino, C., Marinaro, L., Saracco, G. M., Ciancio, A., Toniutto, P., Alterini, G., Capra, F., Ieluzzi, D., Marcellusi, Andrea, Viti, Raffaella, Kondili, Loreta A., Rosato, Stefano, Vella, Stefano, Mennini, Francesco Saverio, Kondili, L.A., Quaranta, M.G., Tosti, M.E., Weimer, L.E., D’Angelo, F., Schiadà, L., Di&nbsp, Leo, A., Contessi, G.B., De&nbsp, Siena, M., Foschi, F.G., Dall’Aglio, A.C., Del&nbsp, Pin, B., Zignego, A.L., Cela, E.M., Santantonio, T.A., Bruno, S.R., Alessandrini, A.I., Biagio, A., Nicolini, L.A., Rumi, M.G., D’Arminio&nbsp, Monforte, A., D’Ambrosio, R., Pasetto, M.C., Buonomo, A.R., Amoruso, D.C., Saturnino, M.R., Gaeta, G.B., D’Adamo, G., Russo, F.P., Capitano, A.R., Craxì, A., Gizzi, M.C., Brunetto, M.R., D’Ettorre, G., Cavallari, E.N., Gebremeskel, T.S., D’Offizi, G., D’Aversa, F., Dell’Unto, C., Schimizzi, A.M., Saracco, G.M., Cosco, Alfredo, Dall’Aglio, A. C., Salomoni, Valentina, Nicolini, Elvira, Calvi, Marta, Soria, Giovanni, D'Adamo, Danilo, ALONSO ALBERTI, MARIA PALOMA CARMEN, Orlandini, Giovanni, DE ASTIS, Fabio, Sozio, Concetta, Terzini, Angelico, DE SIENA, ANDREA URIEL, Taliani, Sabrina, Spaziante, Agata, Lamonica, Emilia, and Capra, Carlo

Subjects
Liver Cirrhosis, Pediatrics, Time Factors, Settore MED/09 - Medicina Interna, National Health Programs, ERADICATION, OUTBREAK, antiviral treatment, anti HCV, economic consequences, Hepacivirus, LIVER FIBROSIS, Severity of Illness Index, Health Services Accessibility, COST-EFFECTIVENESS, Indirect costs, 0302 clinical medicine, Epidemiology, virus infection, 030212 general & internal medicine, health care economics and organizations, cost effectiveness, 030503 health policy & services, Health Policy, Health services research, health, Hepatitis C, Markov Chains, chronic hepatitis C, virus infection, fibrosis progression, cost effectiveness, liver fibrosis, Italy, Pharmacology, Public Health, Environmental and Occupational Health, Cohort, Settore SECS-P/03 - Scienza delle Finanze, Disease Progression, Public Health, 0305 other medical science, Viral hepatitis, Anti-HCV antiviral treatment, CHRONIC HEPATITIS-C, medicine.medical_specialty, Genotype, Settore MED/12 - GASTROENTEROLOGIA, VIRUS-INFECTION, Antiviral Agents, NO, 03 medical and health sciences, Cost Savings, Humans, medicine, MANAGEMENT, chronic hepatitis C, INDUCED DISEASES, METAANALYSIS, Health economics, business.industry, Public health, Environmental and Occupational Health, medicine.disease, FIBROSIS PROGRESSION, business
Abstract

OBJECTIVE:\ud We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy.\ud \ud METHODS:\ud A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered.\ud \ud RESULTS:\ud The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively.\ud \ud CONCLUSIONS:\ud This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV.

Published
2019

4. Risk of invasive fungal infections among patients treated with disease modifying treatments for multiple sclerosis: a comprehensive review

Author

Antonio Reia, Riccardo Scotto, Emanuela Zappulo, Marcello Moccia, E. Pisano, Antonio Riccardo Buonomo, Ivan Gentile, Giulio Viceconte, V. Brescia Morra, Scotto, R., Reia, A., Buonomo, A. R., Moccia, M., Viceconte, G., Pisano, E., Zappulo, E., Brescia Morra, V., and Gentile, I.

Subjects
Risk, medicine.medical_specialty, Multiple Sclerosis, medicine.drug_class, Opportunistic Infection, Disease, Opportunistic Infections, Monoclonal antibody, Immunosuppressive Agent, Immunologic Factor, Disease modifying treatment, Internal medicine, parasitic diseases, Humans, Immunologic Factors, Medicine, Invasive Fungal Infection, Pharmacology (medical), monoclonal antibodie, business.industry, Multiple sclerosis, General Medicine, medicine.disease, infection, invasive fungal disease, multiple sclerosi, business, Immunosuppressive Agents, Invasive Fungal Infections, Human
Abstract

Introduction: Disease modifying treatments are commonly used in the treatment of multiple sclerosis. As different opportunistic infections have been reported, concerns are also raised regarding the risk of invasive fungal infections. Areas covered: Both clinical trials and observational studies on safety and efficacy of diseases modifying treatment for multiple sclerosis were reviewed and data regarding the occurrence of invasive fungal infections were reported. Papers evaluating the following drugs were reviewed: rituximab, ocrelizumab, alemtuzumab, fingolimod, natalizumab, dimethyl fumarate, interferon, glatiramer acetate, cladribine, teriflunomide. Expert opinion: Overall, the occurrence of invasive fungal infections was low, with most infective events reported among patients treated with monoclonal antibodies and fingolimod. Aspergillosis and cryptococcal meningitidis were the most representative fungal infections. Although not common, these infections may be difficult to diagnose and their fatality rate is often high. For this reason, screening protocols for fungal infections must be implemented in the clinical practice when managing patients with MS.

Published
2021

5. Update on infective complications in patients treated with alemtuzumab for multiple sclerosis: review and meta-analysis of real-world and randomized studies

Author

Antonio Carotenuto, Cinzia Valeria Russo, Emanuela Zappulo, Marcello Moccia, Giulio Viceconte, Antonio Riccardo Buonomo, Alberto Enrico Maraolo, Ivan Gentile, Buonomo, A. R., Viceconte, G., Zappulo, E., Maraolo, A. E., Russo, C. V., Carotenuto, A., Moccia, M., and Gentile, I.

Subjects
medicine.medical_specialty, Multiple Sclerosis, Immunologic Factors, opportunistic infection, Opportunistic Infections, Severity of Illness Index, law.invention, Immunologic Factor, Randomized controlled trial, law, Internal medicine, Severity of illness, medicine, Prevalence, Humans, Pharmacology (medical), In patient, monoclonal antibodie, Alemtuzumab, Randomized Controlled Trials as Topic, business.industry, Multiple sclerosis, General Medicine, medicine.disease, multiple sclerosi, Meta-analysis, business, Human, medicine.drug
Abstract

Objective: We aimed to systematically assess the pooled prevalence of infective complications in randomized controlled trials (RCTs) and real-world studies (RWSs) investigating alemtuzumab treatment in multiple sclerosis (MS), also looking at selected infections and their severity. Methods: We included in the analysis RCTs and RWSs investigating the use of alemtuzumab in MS in which infective complications were reported, as well as case reports of rare infections. We conducted a meta-analysis of proportions and a random effect model meta-regression to investigate heterogeneity. Results: The pooled prevalence of infective complications in alemtuzumab treated MS patients is 24%. The most common reported infections are respiratory tract infections (47%) and the most part of the infections are mild-to-moderate (85%). Severe infections account for 6% of the total estimate. We found first-time-reported cases of invasive aspergillosis, hepatitis E virus infection, EBV hepatitis, and cerebral toxoplasmosis. The prevalence of infections is higher in studies conducted before 2009, and in studies with higher proportion of male participants. Conclusions: Clinicians should be aware that the prevalence of serious infections during alemtuzumab can be higher than expected from RCTs. Peculiar opportunistic infections should be considered when evaluating a patient treated with alemtuzumab who develops signs of infection.

Published
2021

6. Case Report: Discovery a Novel SARS-CoV-2 Variant in a Six-Months Long-Term Swab Positive Female Suffering From Non-Hodgkin Lymphoma

Author

Ettore Capoluongo, Carmela Nardelli, Maria Valeria Esposito, Antonio Riccardo Buonomo, Monica Gelzo, Biagio Pinchera, Emanuela Zappulo, Giulio Viceconte, Giuseppe Portella, Mario Setaro, Ivan Gentile, Giuseppe Castaldo, Capoluongo, E., Nardelli, C., Esposito, M. V., Buonomo, A. R., Gelzo, M., Pinchera, B., Zappulo, E., Viceconte, G., Portella, G., Setaro, M., Gentile, I., and Castaldo, G.

Subjects
0301 basic medicine, Cancer Research, ORF3a, Case Report, long-term infection, Virus, Frameshift mutation, 03 medical and health sciences, 0302 clinical medicine, Immune system, Immunophenotyping, medicine, Seroconversion, RC254-282, Immunodeficiency, whole genome sequencing, business.industry, SARS-CoV-2, Immunogenicity, non-Hodgkin lymphoma, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Lymphoma, novel variant, 030104 developmental biology, Oncology, Immunology, business, 030217 neurology & neurosurgery
Abstract

BackgroundWe report the case of a woman with non-Hodgkin lymphoma who remained positive on the molecular assay for SARS-CoV-2 for six months: she has never experienced a severe form of COVID-19 although in absence of seroconversion.MethodsThe whole SARS-CoV-2 genome analysis was performed by the CleanPlex SARS-CoV-2 Research and Surveillance NGS Panel (PARAGON GENOMICS, Hayward, USA).ResultsWe found twenty-two mutations in SARS-CoV-2 genome and a novel deleterious ORF3a frameshift c.766_769del corresponding to a unique and novel lineage. The region affected by this frameshift variant is reported as being important in determining SARS-CoV-2 immunogenicity. Patient’s immunophenotype showed the absence of B lymphocytes and significantly reduced T-cell count. Only after the treatment with hyperimmune plasma she finally became negative on the swab.ConclusionsOur findings could be helpful in the management of patients with immunodeficiency, particularly when novel variants, potentially altering the virus immune response, are present.

Published
2021

7. Clinical features and comorbidity pattern of HCV infected migrants compared to native patients in care in Italy: A real-life evaluation of the PITER cohort

Author

Maria Giovanna Quaranta, Luigina Ferrigno, Xhimi Tata, Franca D'Angelo, Marco Massari, Carmine Coppola, Elisa Biliotti, Alessia Giorgini, Diletta Laccabue, Alessia Ciancio, Pier Luigi Blanc, Marzia Margotti, Donatella Ieluzzi, Maurizia Rossana Brunetto, Francesco Barbaro, Francesco Paolo Russo, Ilaria Beretta, Giulia Morsica, Gabriella Verucchi, Annalisa Saracino, Massimo Galli, Loeta A. Kondili, Cesare Mazzaro, Manuela Bertola, Ornella Schioppa, Antonio Benedetti, Laura Schiadà, Monica Cucco, Andrea Giacometti, Laura Brescini, Sefora Castelletti, Alessandro Fiorentini, Gioacchino Angarano, Michele Milella, Alfredo Di Leo, Maria Rendina, Fulvio Salvatore D'abramo, Chiara Lillo, Andrea Iannone, Mariano Piazzolla, Lorenzo Badia, Fabio Piscaglia, Francesca Benevento, Ilaria Serio, Francesco Castelli, Serena Zaltron, Angiola Spinetti, Silvia Odolini, Raffaele Bruno, Mario Mondelli, Luchino Chessa, Martina Loi, Carlo Torti, Chiara Costa, Maria Mazzitelli, Vincenzo Pisani, Vincenzo Scaglione, Enrico Maria Trecarichi, Anna Linda Zignego, Monica Monti, Francesco Madia, Letizia Attala, Piera Pierotti, Elena Salomoni, Elisa Mariabelli, Teresa Antonia Santantonio, Serena Rita Bruno, Ester Marina Cela, Matteo Bassetti, Giovanni Mazzarello, Anna Ida Alessandrini, Antonio Di Biagio, Laura Ambra Nicolini, Giovanni Raimondo, Roberto Filomia, Alessio Aghemo, Rossella Meli, Adriano Lazzarin, Stefania Salpietro, Anna Ludovica Fracanzani, Erika Fatta, Rosa Lombardi, Pietro Lampertico, Marta Borghi, Roberta D'ambrosio, Elisabetta Degasperi, Massimo Puoti, Chiara Baiguera, Federico D'amico, Maria Vinci, Maria Grazia Rumi, Massimo Zuin, Paola Zermiani, Pietro Andreone, Paolo Caraceni, Valeria Guarneri, Erica Villa, Veronica Bernabucci, Laura Bristot, Maria Luisa Paradiso, Guglielmo Migliorino, Alessandra Gambaro, Giuseppe Lapadula, Anna Spolti, Alessandro Soria, Pietro Invernizzi, Antonio Ciaccio, Martina LucÀ, Federica Malinverno, Laura Ratti, Daniela Caterina Amoruso, Federica Pisano, Ferdinando Scarano, Laura Staiano, Filomena Morisco, Valentina Cossiga, Ivan Gentile, Antonio Riccardo Buonomo, Maria Foggia, Emanuela Zappulo, Alessandro Federico, Marcello Dallio, Nicola Coppola, Caterina Sagnelli, Salvatore Martini, Caterina Monari, Gerardo Nardone, Costantino Sgamato, Liliana Chemello, Luisa Cavalletto, Daniela Sterrantino, Alberto Zanetto, Paola Zanaga, Giuseppina Brancaccio, Antonio Craxì, Salvatore Petta, Vincenza Calvaruso, Luciano Crapanzano, Salvatore Madonia, Marco Cannizzaro, Erica Maria Bruno, Anna Licata, Simona Amodeo, Adele Rosaria Capitano, Carlo Ferrari, Elisa Negri, Alessandra Orlandini, Marco Pesci, Roberto Gulminetti, Layla Pagnucco, Giustino Parruti, Paola Di Stefano, Barbara Coco, Romina Corsini, Elisa Garlassi, Massimo Andreoni, Elisabetta Teti, Carlotta Cerva, Lorenzo Baiocchi, Giuseppe Grassi, Antonio Gasbarrini, Maurizio Pompili, Martina De Siena, Gloria Taliani, Martina Spaziante, Marcello Persico, Mario Masarone, Andrea Aglitti, Gemma Calvanese, Marco Anselmo, Pasqualina De Leo, Monica Marturano, Giorgio Maria Saracco, Quaranta M.G., Ferrigno L., Tata X., D'Angelo F., Massari M., Coppola C., Biliotti E., Giorgini A., Laccabue D., Ciancio A., Blanc P.L., Margotti M., Ieluzzi D., Brunetto M.R., Barbaro F., Russo F.P., Beretta I., Morsica G., Verucchi G., Saracino A., Galli M., Kondili L.A., Mazzaro C., Bertola M., Benedetti A., Schiada L., Cucco M., Giacometti A., Brescini L., Castelletti S., Fiorentini A., Angarano G., Milella M., Leo A.D., Rendina M., Salvatore D'ABRAMO F., Lillo C., Iannone A., Piazzolla M., Badia L., Piscaglia F., Benevento F., Serio I., Castelli F., Zaltron S., Spinetti A., Odolini S., Bruno R., Mondelli M., Chessa L., Loi M., Torti C., Costa C., Mazzitelli M., Pisani V., Scaglione V., Trecarichi E.M., Zignego A.L., Monti M., Madia F., Attala L., Pierotti P., Salomoni E., Mariabelli E., Santantonio T.A., Bruno S.R., Cela E.M., Bassetti M., Mazzarello G., Alessandrini A.I., Biagio A.D., Nicolini L.A., Raimondo G., Filomia R., Aghemo A., Meli R., Lazzarin A., Salpietro S., Fracanzani A.L., Fatta E., Lombardi R., Lampertico P., Borghi M., D'ambrosio R., Degasperi E., Puoti M., Baiguera C., D'AMICO F., Vinci M., Rumi M.G., Zuin M., Zermiani P., Andreone P., Caraceni P., Guarneri V., Villa E., Bernabucci V., Bristot L., Paradiso M.L., Migliorino G., Gambaro A., Lapadula G., Spolti A., Soria A., Invernizzi P., Ciaccio A., LucA M., Malinverno F., Ratti L., Amoruso D.C., Pisano F., Scarano F., Staiano L., Morisco F., Cossiga V., Gentile I., Buonomo A.R., Foggia M., Zappulo E., Federico A., Dallio M., Coppola N., Sagnelli C., Martini S., Monari C., Nardone G., Sgamato C., Chemello L., Cavalletto L., Sterrantino D., Zanetto A., Zanaga P., Brancaccio G., Craxi A., Petta S., Calvaruso V., Crapanzano L., Madonia S., Cannizzaro M., Bruno E.M., Licata A., Amodeo S., Capitano A.R., Ferrari C., Negri E., Orlandini A., Pesci M., Gulminetti R., Pagnucco L., Parruti G., Stefano P.D., Coco B., Corsini R., Garlassi E., Andreoni M., Teti E., Cerva C., Baiocchi L., Grassi G., Gasbarrini A., Pompili M., Siena M.D., Taliani G., Spaziante M., Persico M., Masarone M., Aglitti A., Calvanese G., Anselmo M., Leo P.D., Marturano M., Saracco G.M., Quaranta, M, Ferrigno, L, Tata, X, D'Angelo, F, Massari, M, Coppola, C, Biliotti, E, Giorgini, A, Laccabue, D, Ciancio, A, Blanc, P, Margotti, M, Ieluzzi, D, Brunetto, M, Barbaro, F, Russo, F, Beretta, I, Morsica, G, Verucchi, G, Saracino, A, Galli, M, Kondili, L, Mazzaro, C, Bertola, M, Benedetti, A, Schiada, L, Cucco, M, Giacometti, A, Brescini, L, Castelletti, S, Fiorentini, A, Angarano, G, Milella, M, Leo, A, Rendina, M, Salvatore D'ABRAMO, F, Lillo, C, Iannone, A, Piazzolla, M, Badia, L, Piscaglia, F, Benevento, F, Serio, I, Castelli, F, Zaltron, S, Spinetti, A, Odolini, S, Bruno, R, Mondelli, M, Chessa, L, Loi, M, Torti, C, Costa, C, Mazzitelli, M, Pisani, V, Scaglione, V, Trecarichi, E, Zignego, A, Monti, M, Madia, F, Attala, L, Pierotti, P, Salomoni, E, Mariabelli, E, Santantonio, T, Bruno, S, Cela, E, Bassetti, M, Mazzarello, G, Alessandrini, A, Biagio, A, Nicolini, L, Raimondo, G, Filomia, R, Aghemo, A, Meli, R, Lazzarin, A, Salpietro, S, Fracanzani, A, Fatta, E, Lombardi, R, Lampertico, P, Borghi, M, D'Ambrosio, R, Degasperi, E, Puoti, M, Baiguera, C, D'Amico, F, Vinci, M, Rumi, M, Zuin, M, Zermiani, P, Andreone, P, Caraceni, P, Guarneri, V, Villa, E, Bernabucci, V, Bristot, L, Paradiso, M, Migliorino, G, Gambaro, A, Lapadula, G, Spolti, A, Soria, A, Invernizzi, P, Ciaccio, A, Luca, M, Malinverno, F, Ratti, L, Amoruso, D, Pisano, F, Scarano, F, Staiano, L, Morisco, F, Cossiga, V, Gentile, I, Buonomo, A, Foggia, M, Zappulo, E, Federico, A, Dallio, M, Coppola, N, Sagnelli, C, Martini, S, Monari, C, Nardone, G, Sgamato, C, Chemello, L, Cavalletto, L, Sterrantino, D, Zanetto, A, Zanaga, P, Brancaccio, G, Craxi, A, Petta, S, Calvaruso, V, Crapanzano, L, Madonia, S, Cannizzaro, M, Bruno, E, Licata, A, Amodeo, S, Capitano, A, Ferrari, C, Negri, E, Orlandini, A, Pesci, M, Gulminetti, R, Pagnucco, L, Parruti, G, Stefano, P, Coco, B, Corsini, R, Garlassi, E, Andreoni, M, Teti, E, Cerva, C, Baiocchi, L, Grassi, G, Gasbarrini, A, Pompili, M, Siena, M, Taliani, G, Spaziante, M, Persico, M, Masarone, M, Aglitti, A, Calvanese, G, Anselmo, M, Leo, P, Marturano, M, Saracco, G, Quaranta, M. G., Ferrigno, L., Tata, X., D'Angelo, F., Massari, M., Coppola, C., Biliotti, E., Giorgini, A., Laccabue, D., Ciancio, A., Blanc, P. L., Margotti, M., Ieluzzi, D., Brunetto, M. R., Barbaro, F., Russo, F. P., Beretta, I., Morsica, G., Verucchi, G., Saracino, A., Galli, M., Kondili, L. A., Mazzaro, C., Bertola, M., Benedetti, A., Schiada, L., Cucco, M., Giacometti, A., Brescini, L., Castelletti, S., Fiorentini, A., Angarano, G., Milella, M., Leo, A. D., Rendina, M., Salvatore D'ABRAMO, F., Lillo, C., Iannone, A., Piazzolla, M., Badia, L., Piscaglia, F., Benevento, F., Serio, I., Castelli, F., Zaltron, S., Spinetti, A., Odolini, S., Bruno, R., Mondelli, M., Chessa, L., Loi, M., Torti, C., Costa, C., Mazzitelli, M., Pisani, V., Scaglione, V., Trecarichi, E. M., Zignego, A. L., Monti, M., Madia, F., Attala, L., Pierotti, P., Salomoni, E., Mariabelli, E., Santantonio, T. A., Bruno, S. R., Cela, E. M., Bassetti, M., Mazzarello, G., Alessandrini, A. I., Biagio, A. D., Nicolini, L. A., Raimondo, G., Filomia, R., Aghemo, A., Meli, R., Lazzarin, A., Salpietro, S., Fracanzani, A. L., Fatta, E., Lombardi, R., Lampertico, P., Borghi, M., D'Ambrosio, R., Degasperi, E., Puoti, M., Baiguera, C., D'Amico, F., Vinci, M., Rumi, M. G., Zuin, M., Zermiani, P., Andreone, P., Caraceni, P., Guarneri, V., Villa, E., Bernabucci, V., Bristot, L., Paradiso, M. L., Migliorino, G., Gambaro, A., Lapadula, G., Spolti, A., Soria, A., Invernizzi, P., Ciaccio, A., Luca, M., Malinverno, F., Ratti, L., Amoruso, D. C., Pisano, F., Scarano, F., Staiano, L., Morisco, F., Cossiga, V., Gentile, I., Buonomo, A. R., Foggia, M., Zappulo, E., Federico, A., Dallio, M., Coppola, N., Sagnelli, C., Martini, S., Monari, C., Nardone, G., Sgamato, C., Chemello, L., Cavalletto, L., Sterrantino, D., Zanetto, A., Zanaga, P., Brancaccio, G., Craxi, A., Petta, S., Calvaruso, V., Crapanzano, L., Madonia, S., Cannizzaro, M., Bruno, E. M., Licata, A., Amodeo, S., Capitano, A. R., Ferrari, C., Negri, E., Orlandini, A., Pesci, M., Gulminetti, R., Pagnucco, L., Parruti, G., Stefano, P. D., Coco, B., Corsini, R., Garlassi, E., Andreoni, M., Teti, E., Cerva, C., Baiocchi, L., Grassi, G., Gasbarrini, A., Pompili, M., Siena, M. D., Taliani, G., Spaziante, M., Persico, M., Masarone, M., Aglitti, A., Calvanese, G., Anselmo, M., Leo, P. D., Marturano, M., and Saracco, G. M.

Subjects
Male, HCV genotypes, Ethnic group, Linked-to-care patient, Comorbidity, Hepacivirus, Logistic regression, medicine.disease_cause, Comorbidities, Direct acting antivirals, HCV Cohort, Linked-to-care patients, Aged, Antiviral Agents, Coinfection, Female, Hepatitis C, Chronic, Humans, Italy, Middle Aged, Transients and Migrants, 0302 clinical medicine, Medicine, Chronic, Gastroenterology, virus diseases, Hepatitis C, Life evaluation, 030220 oncology & carcinogenesis, Cohort, 030211 gastroenterology & hepatology, Comorbiditie, Human, Hepatitis C virus, Settore MED/12 - GASTROENTEROLOGIA, 03 medical and health sciences, Disease severity, Antiviral Agent, Hepaciviru, Hepatology, business.industry, Settore MED/09 - MEDICINA INTERNA, medicine.disease, digestive system diseases, Direct acting antiviral, business, Demography
Abstract

Background: Direct-acting antivirals are highly effective for the treatment of hepatitis C virus (HCV) infection, regardless race/ethnicity. We aimed to evaluate demographic, virological and clinical data of HCV-infected migrants vs. natives consecutively enrolled in the PITER cohort. Methods: Migrants were defined by country of birth and nationality that was different from Italy. Mann-Whitney U test, Chi-squared test and multiple logistic regression were used. Results: Of 10,669 enrolled patients, 301 (2.8%) were migrants: median age 47 vs. 62 years, (p < 0.001), females 56.5% vs. 45.3%, (p < 0.001), HBsAg positivity 3.8% vs. 1.4%, (p < 0.05). Genotype 1b was prevalent in both groups, whereas genotype 4 was more prevalent in migrants (p < 0.05). Liver disease severity and sustained virologic response (SVR) were similar. A higher prevalence of comorbidities was reported for natives compared to migrants (p < 0.05). Liver disease progression cofactors (HBsAg, HIV coinfection, alcohol abuse, potential metabolic syndrome) were present in 39.1% and 47.1% (p > 0.05) of migrants and natives who eradicated HCV, respectively. Conclusion: Compared to natives, HCV-infected migrants in care have different demographics, HCV genotypes, viral coinfections and comorbidities and similar disease severity, SVR and cofactors for disease progression after HCV eradication. A periodic clinical assessment after HCV eradication in Italians and migrants with cofactors for disease progression is warranted.

Published
2021

8. Changing epidemiology of patients treated with direct acting antivirals for HCV and persistently high SVR12 in an endemic area for HCV infection in Italy: real-life ‘LIver Network Activity’ (LINA) cohort update results

Author

Salvatore Martini, Simona Mercinelli, Nicola Coppola, Biagio Pinchera, Vincenzo Messina, Carmine Coppola, G. Stornaiuolo, Maria Stanzione, Mariagiovanna Nerilli, Riccardo Scotto, Antonio Riccardo Buonomo, Ivan Gentile, Laura Staiano, Stefania De Pascalis, Letizia Cattaneo, Scotto, R., Buonomo, A. R., De Pascalis, S., Nerilli, M., Pinchera, B., Staiano, L., Mercinelli, S., Cattaneo, L., Stanzione, M., Stornaiuolo, G., Martini, S., Messina, V., Coppola, C., Coppola, N., Gentile, I., Scotto, Riccardo, Buonomo, Antonio Riccardo, De Pascalis, Stefania, Nerilli, Mariagiovanna, Pinchera, Biagio, Staiano, Laura, Mercinelli, Simona, Cattaneo, Letizia, Stanzione, Maria, Stornaiuolo, Gianfranca, Martini, Salvatore, Messina, Vincenzo, Coppola, Carmine, Coppola, Nicola, and Gentile, Ivan

Subjects
Research design, Cyclopropanes, Liver Cirrhosis, Male, Cirrhosis, Aminoisobutyric Acids, Pyrrolidines, Sustained Virologic Response, Hepacivirus, DIRECT ACTING ANTIVIRALS, Liver disease, 0302 clinical medicine, Epidemiology, Prospective Studies, Prospective cohort study, Sulfonamides, Gastroenterology, Imidazoles, Endemic area, Middle Aged, Italy, 030220 oncology & carcinogenesis, Cohort, HCV, 030211 gastroenterology & hepatology, Female, epidemiology, Adult, medicine.medical_specialty, Genotype, Proline, Lactams, Macrocyclic, Antiviral Agents, Heterocyclic Compounds, 4 or More Rings, 03 medical and health sciences, Age Distribution, Leucine, Internal medicine, Quinoxalines, medicine, Humans, real-life, Aged, Benzofurans, Retrospective Studies, DAA, Hepatology, business.industry, Hepatitis C, Chronic, medicine.disease, Amides, SVR12, Benzimidazoles, Carbamates, business
Abstract

Background: Second generation direct acting antivirals (DAAs) drastically changed the landscape of chronic HCV (CHCV). Aim of this paper was to assess the effectiveness of DAAs, also looking at the demographic characteristics of subjects enrolled. Research design and methods: Ambispective multi-center real-life study conducted among patients with CHCV treated with DAAs in Campania Region (Southern Italy). Patient were enrolled in two cohorts according to time of enrolment. Results: 1,479 patients were enrolled. Patients aged ≥60 years were 74.7% in the historic cohort (953 patients) and 70.2% in the prospective cohort (526 patients. Patients aged ≥ 60 years showed a higher prevalence of genotype 1b (p

Published
2021

9. A standardized polyphenol mixture extracted from poplar-type propolis for remission of symptoms of uncomplicated upper respiratory tract infection (URTI): A monocentric, randomized, double-blind, placebo-controlled clinical trial

Author

Roberto Sacchi, Giuseppe Caruso, Emanuele Ugo Garzarella, Bruno Bocchino, Maria D'Avino, Maria Daglia, Gian Carlo Tenore, Antonio Riccardo Buonomo, Fabio Galeotti, C. Esposito, Vincenzo Zaccaria, Esposito, C., Garzarella, E. U., Bocchino, B., D'Avino, M., Caruso, G., Buonomo, A. R., Sacchi, R., Galeotti, F., Tenore, G. C., Zaccaria, V., and Daglia, M

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Pharmaceutical Science, Administration, Oral, Placebo, Propolis, Placebos, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Double-Blind Method, Internal medicine, Drug Discovery, medicine, Sore throat, Ingestion, Humans, Respiratory Tract Infections, 030304 developmental biology, Aged, Pharmacology, 0303 health sciences, Respiratory tract infections, Poplar-type propolis, Randomized controlled clinical trial, Standard polyphenol mixture, Upper respiratory tract infection, business.industry, Polyphenols, Pharyngitis, Middle Aged, medicine.disease, Clinical trial, medicine.anatomical_structure, Upper respiratory tract infection, Treatment Outcome, Complementary and alternative medicine, 030220 oncology & carcinogenesis, Molecular Medicine, Female, medicine.symptom, business, Respiratory tract
Abstract

Background The most common symptoms of mild upper respiratory tract infections (URTIs) are sore throat, muffled dysphonia, and swelling and redness of the throat, which result from the inflammation process following acute bacterial or viral infection. Hypothesis/purpose As propolis is a natural resinous substance traditionally used to maintain oral cavity and upper respiratory tract health due to its antimicrobial and anti-inflammatory properties, the aim of this study is to evaluate the efficacy of an oral spray based on poplar-type propolis extract with a known and standardized polyphenol content, on the remission of the symptoms associated with mild uncomplicated URTIs. Study design A monocentric, randomized, double-blind, placebo-controlled clinical trial was performed. Methods This study was conducted in 122 healthy adults who had perceived mild upper respiratory tract infections. Participants, randomly assigned to receive either propolis oral spray (N = 58) or placebo (N = 64), underwent four visits (baseline = t0, after 3 days = t1 and after 5 days = t2 and after a follow-up of 15 days = t3) in an outpatient setting. Propolis oral spray total polyphenol content was 15 mg/ml. The dosage was 2-4 sprays three times/day (corresponding to 12-24 mg of polyphenols/day), for five days. The duration of the study was 8 weeks. Results After 3 days of treatment, 83% of subjects treated with propolis oral spray had remission of symptoms, while 72% of subjects in the placebo group had at least one remaining symptom. After five days, all subjects had recovered from all symptoms. This means that resolution from mild uncomplicated URTIs took place two days earlier, instead of taking place in five days as recorded in the control group. There was no relationship between the ingestion of propolis oral spray or placebo and adverse reactions. Conclusion Propolis oral spray can be used to improve both bacterial and viral uncomplicated URTI symptoms in a smaller number of days without the use of pharmacological treatment, leading to a prompt symptom resolution.

Published
2020

10. Novel strategies for the management of bacterial and fungal infections in patients with liver cirrhosis: focus on new antimicrobials

Author

Nicola Schiano Moriello, Antonio Riccardo Buonomo, Salatore Nappa, Biagio Pinchera, Ivan Gentile, Emanuela Zappulo, Riccardo Scotto, Alberto Enrico Maraolo, Maraolo, A. E., Scotto, R., Zappulo, E., Pinchera, B., Schiano Moriello, N., Nappa, S., Buonomo, A. R., and Gentile, I.

Subjects
0301 basic medicine, Microbiology (medical), Liver Cirrhosis, medicine.medical_specialty, Cirrhosis, Antifungal Agents, 030106 microbiology, Population, multidrug-resistant pathogen, Microbiology, Liver cirrhosi, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Immune system, Virology, Internal medicine, Drug Resistance, Multiple, Bacterial, Drug Resistance, Multiple, Fungal, medicine, novel beta-lactams, Humans, 030212 general & internal medicine, education, education.field_of_study, business.industry, fungal infection, bacterial infection, Bacterial Infections, Antimicrobial, medicine.disease, Review article, Anti-Bacterial Agents, Infectious Diseases, Tolerability, Mycoses, Etiology, business
Abstract

Introduction: Liver cirrhosis is a frequent condition caused by different etiologies. Bacterial and fungal infections are common complications, representing an independent prognostic stage in patients with cirrhosis, dramatically worsening their clinical outcomes. Areas covered: The present review article addresses manifold points and to this purpose an inductive literature search of MEDLINE database through PubMed was performed. First, it provides an overview on the mechanisms underlying immune disfunctions in patients with cirrhosis, who are prone to develop infections being at higher risk than the general population. Second, commonest types of bacterial and fungal infections in patients with advanced liver disease are described, focusing on their deleterious impact as decompensating events. Third, the rise of multidrug-resistant (MDR) bacteria and fungi as causative agents of infection in cirrhotic subjects is illustrated. Eventually, the most promising novel therapeutic options against MDR pathogens and fungi are reviewed. Expert opinion: The management of bacterial and fungal infections in patients with cirrhosis is difficult, due to the frequent co-existence of renal impairment, low platelet count and other conditions that limit the antimicrobial choice. New antibacterial and antifungal compounds may overcome this issue by providing a better tolerability profile, along with equal or superior efficacy compared with older drugs.

Published
2020

11. Efficacy and safety of a fixed dose combination tablet of asunaprevir + beclabuvir + daclatasvir for the treatment of Hepatitis C

Author

Alberto Enrico Maraolo, Riccardo Scotto, Biagio Pinchera, Antonio Riccardo Buonomo, Emanuela Zappulo, Ivan Gentile, Zappulo, E., Scotto, R., Buonomo, A. R., Maraolo, A. E., Pinchera, B., and Gentile, I.

Subjects
Liver Cirrhosis, medicine.medical_specialty, Indoles, Pyrrolidines, Cirrhosis, Daclatasvir, Genotype, Sustained Virologic Response, Hepatitis C virus, Fixed-dose combination, interferon-free combination, Hepacivirus, medicine.disease_cause, Antiviral Agents, Gastroenterology, chemistry.chemical_compound, Internal medicine, medicine, Humans, Pharmacology (medical), Beclabuvir, DAA, Pharmacology, Sulfonamides, business.industry, Imidazoles, BMS-79125, DCV-TRIO, food and beverages, Valine, General Medicine, Hepatitis C, Benzazepines, Hepatitis C, Chronic, Isoquinolines, medicine.disease, Drug Combinations, Chronic infection, Treatment Outcome, chemistry, Ximency®, HCV, Asunaprevir, Carbamates, business, Tablets, medicine.drug
Abstract

Introduction: Hepatitis C virus (HCV) is estimated to infect approximately 70 million people worldwide. If left untreated, chronic infection can progress to cirrhosis, liver failure or hepatocellular carcinoma. The advent of new direct-acting antivirals (DAA) has revolutionized patients’ chances of treatment and viral elimination. Currently, several DAA options are available on the market. Areas covered: This review focuses on the pharmacokinetics, efficacy, tolerability and safety profile of DCV-TRIO, a twice-daily fixed-dose combination of daclatasvir, asunaprevir and beclabuvir approved in Japan for the treatment of genotype 1 HCV infection. Expert opinion: The DCV-TRIO combination achieved good response rates in genotype 1 patients (SVR12 ≥ 95% in naïve subtype 1b), independently from IL28B genotype, cirrhotic status and prior interferon exposure. On the other hand, unsatisfying response rates were reported in DAA-experienced patients and the risk of RAS selection should not be underestimated. Moreover, DCV-TRIO lacks differentiation from its earlier-launched DAA rivals, presents an inconvenient twice-daily dosing schedule and is not recommended in patients with advanced liver and kidney disease. All these drawbacks considerably limit its effective commercial potential. However, it can be a therapeutic option against HCV in tailored approaches according to the needs of different markets across the world. Abbreviations AE: adverse event; ALT: alanine aminotransferase; AST: aspartate aminotransferase; ASV: asunaprevir; AUC: area under the curve; BCRP: Breast Cancer Resistance Protein; BCV: boceprevir; BID: bis in die; CI: confidence intervals; CLcr: creatinine clearance; DAA: direct acting antivirals; DCV: daclatasvir; EC50: Half maximal effective concentration; GT: genotype; HCV: Hepatitis C virus; IFN: Interferon; NHL: non-Hodgkin lymphoma; OATP: Organic anion transporting polypeptides; OR: odds ratio; P-gp: P-glycoprotein; PK: pharmacokinetics; QD: quo die; RAS: resistance-associated substitutions; SVR: sustained virological response; USD: Unites States dollar.

Published
2020

12. Efficacy and safety of ceftolozane/tazobactam as therapeutic option for complicated skin and soft tissue infections by MDR/XDR Pseudomonas aeruginosa in patients with impaired renal function: a case series from a single-center experience

Author

Alberto Enrico Maraolo, Serena Parente, Emanuela Zappulo, Ivan Gentile, Antonio Riccardo Buonomo, Riccardo Scotto, Maria Foggia, P Congera, Buonomo, A. R., Maraolo, A. E., Scotto, R., Foggia, M., Zappulo, E., Congera, P., Parente, S., and Gentile, I.

Subjects
0301 basic medicine, Microbiology (medical), medicine.medical_specialty, Tazobactam, Antibiotic resistance, 030106 microbiology, Renal function, Single Center, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Pseudomonas Infections, 030212 general & internal medicine, Adverse effect, Aged, Aged, 80 and over, business.industry, Pseudomonas aeruginosa, Soft Tissue Infections, Skin and soft tissue infections, General Medicine, Skin Diseases, Bacterial, Middle Aged, Kidney disease, medicine.disease, Ceftolozane/tazobactam, Anti-Bacterial Agents, Cephalosporins, Regimen, Infectious Diseases, Treatment Outcome, Ceftolozane, business, medicine.drug
Abstract

Introduction: Pseudomonas aeruginosa (PA) is a known cause of skin and soft tissue infections (SSTIs). Therapeutic options against multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of PA are limited, especially in patients with impaired renal function. Ceftolozane/tazobactam (C/T) is a novel beta-lactam/beta-lactamase inhibitor with powerful anti-PA activity. Thanks to its characteristics, it appears to be the best available anti-pseudomonal drug in many clinical scenarios. A case series of four adult patients followed between January 2018 and May 2019 is reported. All subjects presented complicated SSTIs by MDR- or XDR-PA and were affected by chronic kidney disease. Results: C/T was used as a monotherapy in three cases and in combination regimen in the remaining case. In two cases, C/T was the first-line option, in the remaining ones was the salvage treatment. All patients were successfully treated without worsening of renal function and without any other adverse events. Conclusions: C/T may represent a useful option against MDR- and XDR-PA strains responsible of complicated SSTIs in patients affected by impaired renal function.

Published
2020

13. Direct acting antivirals treatment for hepatitis C virus infection does not increase the incidence of de novo hepatocellular carcinoma occurrence: Results from an Italian real-life cohort (LINA cohort)

Author

Riccardo Scotto, Grazia Tosone, Salvatore Nappa, Mariarosaria Saturnino, Costanza Maria Rapillo, Giulio Viceconte, Ivan Gentile, Stefania De Pascalis, Carmine Coppola, Salvatore Martini, Federica Portunato, Antonio Riccardo Buonomo, Ferdinando Scarano, Laura Staiano, Mariantonietta Pisaturo, Nicola Coppola, Biagio Pinchera, Buonomo, A. R., Scotto, R., Coppola, C., Pinchera, B., Viceconte, G., Rapillo, C. M., Staiano, L., Saturnino, M., Scarano, F., Portunato, F., Pisaturo, M., De Pascalis, S., Martini, S., Tosone, G., Nappa, S., Coppola, N., and Gentile, I.

Subjects
Male, medicine.medical_specialty, real-world, Carcinoma, Hepatocellular, Hepatitis C virus, medicine.disease_cause, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, direct acting antiviral, Internal medicine, medicine, 030212 general & internal medicine, Prospective cohort study, Survival analysis, Aged, Antiviral Agent, business.industry, Incidence (epidemiology), Incidence, General Medicine, Hepatitis C, hepatocellular carcinoma, Hepatitis C, Chronic, Middle Aged, medicine.disease, Survival Analysis, digestive system diseases, Prospective Studie, Italy, Liver Neoplasm, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Cohort, HCV, Female, Cohort Studie, business, Cohort study, Human
Abstract

The effectiveness of direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection is ascertained. However, some authors raised the issue of an increased incidence of de novo hepatocellular carcinoma (HCC) in patients treated with DAAs. Aim of the study was to evaluate the rate of HCC occurrence in a real-life cohort of patients who received anti-HCV treatment with DAAs.A prospective multicentre study was conducted. All adult patients with HCV infection who received treatment between March 2015 and December 2017 in 4 hospital of Campania region (South Italy) with at least 6 months of follow-up were enrolled.A total of 323 patients were included in the study. Most patients had HCV genotype 1b (61.8%). The overall SVR12 rate was 95.5%. Median time of observation was 10 months. The incidence rate of HCC was 0.2 per 100 person-months (crude incidence rate 3.4%, 95 confidence interval: 1.5%-5.3%). The median time for HCC occurrence was 11 months. HCC occurrence rate was significantly higher among patients who did not achieve SVR12 compared with patients who did (28.6% vs 2.8%, P

Published
2020

14. Ceftolozane/tazobactam for difficult-to-treat Pseudomonas aeruginosa infections: A systematic review of its efficacy and safety for off-label indications

Author

Carlo Torti, Enrico Maria Trecarichi, Alberto Enrico Maraolo, Maria Mazzitelli, Ivan Gentile, Antonio Riccardo Buonomo, Maraolo, A. E., Mazzitelli, M., Trecarichi, E. M., Buonomo, A. R., Torti, C., and Gentile, I.

Subjects
0301 basic medicine, Microbiology (medical), Tazobactam, medicine.medical_specialty, 030106 microbiology, Extensively drug-resistant, Cutis, Off-label use, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Enterobacteriaceae, Drug Resistance, Multiple, Bacterial, Internal medicine, medicine, Humans, Pseudomonas Infections, Pharmacology (medical), Multidrug-resistant, 030212 general & internal medicine, Adverse effect, business.industry, Pseudomonas aeruginosa, Soft Tissue Infections, Enterobacteriaceae Infections, General Medicine, medicine.disease, Ceftolozane/tazobactam, Anti-Bacterial Agents, Cephalosporins, Multiple drug resistance, Observational Studies as Topic, Pneumonia, Infectious Diseases, Urinary Tract Infections, Systematic review, Intraabdominal Infections, Ceftolozane, Real-life use, business, medicine.drug
Abstract

Ceftolozane/tazobactam (C/T) is a novel β-lactam/β-lactamase inhibitor combination targeting Enterobacteriaceae and Pseudomonas aeruginosa (PA). It is approved in adult patients for complicated urinary tract infections (cUTIs) and complicated intra-abdominal infections (cIAIs) as well as for nosocomial pneumonia. It displays excellent activity against PA, even multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains. The aim of this systematic review (PROSPERO protocol no. CRD42019117350) was to summarise the available evidence from observational studies regarding the efficacy and safety of off-label use of C/T when administered to treat MDR- or XDR-PA infections. The MEDLINE and Embase databases were screened from inception up to 30 June 2019. Studies were deemed eligible if they described real-life use of C/T in the case of MDR- or XDR-PA infections for non-approved indications. Exclusion criteria were cIAIs, cUTIs, pneumonia (unless occurring in a paediatric population) and infections by non-MDR/XDR-PA. Thirty articles fulfilled the inclusion criteria. In total, 130 cases of MDR- or XDR-PA infections treated with C/T in 128 patients were described. The most relevant off-label uses were skin and soft-tissue infection (49/30; 37.7%), bone and joint infection (42/130; 32.3%) and bloodstream infection (23/130; 17.7%). Five cases involved paediatric patients. The overall clinical success rate was 76.2%. The most common adverse event was hypokalaemia (4.2%, in 48 evaluable cases). C/T may be a useful therapeutic option for difficult-to-treat infections by PA even outside the framework of approved indications. Further studies are necessary to better define new indications for the drug.

Published
2020

15. Risk of opportunistic infections in patients treated with alemtuzumab for multiple sclerosis

Author

Emanuela Zappulo, Guglielmo Borgia, Riccardo Scotto, Antonio Riccardo Buonomo, Giulio Viceconte, Ivan Gentile, Buonomo, A. R., Zappulo, E., Viceconte, G., Scotto, R., Borgia, G., and Gentile, I.

Subjects
0301 basic medicine, Drug, medicine.medical_specialty, Prognosi, medicine.drug_class, media_common.quotation_subject, Opportunistic Infection, 030106 microbiology, Opportunistic Infections, Monoclonal antibody, Severity of Illness Index, 03 medical and health sciences, Multiple Sclerosis, Relapsing-Remitting, 0302 clinical medicine, Antigen, Risk Factors, Internal medicine, RRMS, Product Surveillance, Postmarketing, medicine, Humans, Pharmacology (medical), Prophylaxi, Adverse effect, monoclonal antibodie, Alemtuzumab, Anti CD-52, Randomized Controlled Trials as Topic, media_common, biology, business.industry, Risk Factor, Multiple sclerosis, General Medicine, Prognosis, medicine.disease, Monoclonal, biology.protein, Antibody, business, biological therapie, 030217 neurology & neurosurgery, Human, medicine.drug
Abstract

Alemtuzumab is a monoclonal anti CD-52 antibody recently approved for use in relapsing-remitting multiple sclerosis(MS). Given that the targeted antigen is primarily expressed on B and T lymphocytes, the administration of this biological drug is associated with rapid but protracted peripheral lymphopenia.The impact on infective risk of this immune impairment is still to be fully understood. In this review, we attempt to summarize all the available literature concerning opportunistic infections occurring in patients with MS receiving alemtuzumab. Infective adverse events were observed in more than 70% of patients in phase 2/3 RCTs, mainly of mild-to-moderate severity. Nevertheless, several post-marketing reports documented cases of serious, rare, and unexpected infections.Predictive risk factors and prognostic features of opportunistic infections in this setting still need to be exactly assessed. At present, the only recommended preventive measures consist in anti-herpetic prophylaxis, Listeria-free diet, Tuberculosis prophylaxis and annual Papillomavirus screening. Given the non-negligible risk of unpredicted infective events, we advise physicians to take into account patients' history of infectious diseases and vaccine status and to consider supplementary prophylactic strategies, including screening for Toxoplasma gondii and viral hepatitis serostatus as well as pre-emptive approaches to avert CMV reactivation and Pneumocystosis.

Published
2018

16. Successful treatment of KPC-MDR septic shock with ceftazidime-avibactam in a pediatric critically ill patient

Author

Carmine Iacovazzo, Giuseppe Servillo, Pasquale Buonanno, Antonio Riccardo Buonomo, Maria Vargas, Vargas, M., Buonomo, A. R., Buonanno, P., Iacovazzo, C., and Servillo, G.

Subjects
0301 basic medicine, medicine.medical_specialty, Klebsiella, medicine.drug_class, Avibactam, 030106 microbiology, Cephalosporin, Ceftazidime, Pediatric critically ill patient, Infectious and parasitic diseases, RC109-216, Article, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, law, Septic shock, medicine, 030212 general & internal medicine, Intensive care medicine, biology, Critically ill, business.industry, Ceftazidime-avibactam, biology.organism_classification, medicine.disease, Ceftazidime/avibactam, Intensive care unit, Infectious Diseases, chemistry, business, medicine.drug
Abstract

Ceftazidime–avibactam is a combination agent consisting of the β-lactamase inhibitor avibactam and the broad-spectrum cephalosporin ceftazidime. There are no published case reports or studies evaluating the use of CAZ-AVI in pediatric critically ill patients. We report a case of a successful treatment of septic shock due to Klebsiella pneumonie (KP) in a 14-years-old boy (body weight 50 kg) admitted in intensive care unit (ICU). Keywords: Ceftazidime-avibactam, Septic shock, Pediatric critically ill patient

Published
2019

17. Direct-acting antivirals improve endothelial function in patients with chronic hepatitis: a prospective cohort study

Author

Francesco Borgia, Consalvo Mattia, Ivan Gentile, Riccardo Scotto, Pasquale Ambrosino, Biagio Pinchera, Matteo Nicola Dario Di Minno, Ilenia Calcaterra, Antonio Riccardo Buonomo, Manuel Crispo, Di Minno, M. N. D., Ambrosino, P., Buonomo, A. R., Pinchera, B., Calcaterra, ILENIA LORENZA, Crispo, M., Scotto, R., Borgia, F., Mattia, C., and Gentile, I.

Subjects
Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, Direct-acting antiviral agent, Hepatitis C virus, Cardiovascular risk factors, Hepacivirus, 030204 cardiovascular system & hematology, medicine.disease_cause, DIRECT ACTING ANTIVIRALS, Chronic hepatitis C, Risk profile, Gastroenterology, Antiviral Agents, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Chronic hepatitis, Internal medicine, Internal Medicine, medicine, Humans, In patient, 030212 general & internal medicine, Endothelium, Prospective Studies, Prospective cohort study, Aged, Hepatitis, Chronic, business.industry, Endothelial function, chronic hepatitis C, direct-acting antiviral agents, endothelial function, Middle Aged, Protective Factors, medicine.disease, Hepatitis C, Italy, Emergency Medicine, Female, business
Abstract

Hepatitis C virus (HCV) infection is associated with increased cardiovascular risk. We evaluated effects of direct-acting antiviral agents (DAAs) on flow-mediated dilation (FMD), a recognized marker of cardiovascular risk. We evaluated FMD and post-ischemic hyperemia (PIH) in consecutive HCV out-patients before starting DAAs, at the end of treatment (Teot) and 12 weeks thereafter. In 22 HCV subjects (age 64.0 years), baseline FMD was 4.52% ± 1.90 and PIH of 5814.4 (IQR 3786.9–7861.9). At (Teot), all patients showed undetectable levels of HCV-RNA and FMD changed from 4.52% ± 1.90 to 9.39% ± 4.06 (p

Published
2019

18. Interferon-free regimens improve kidney function in patients with chronic hepatitis C infection

Author

Salvatore Martini, Daniela Caterina Amoruso, Stefania De Pascalis, Antonio Riccardo Buonomo, Federica Portunato, Ivan Gentile, Mariantonietta Pisaturo, Nicola Coppola, Biagio Pinchera, Laura Staiano, Carmine Coppola, Riccardo Scotto, Coppola, N., Portunato, F., Buonomo, A. R., Staiano, L., Scotto, R., Pinchera, B., De Pascalis, S., Amoruso, D. C., Martini, S., Pisaturo, M., Coppola, C., Gentile, I., Coppola, Nicola, Portunato, Federica, Buonomo, Antonio Riccardo, Staiano, Laura, Scotto, Riccardo, Pinchera, Biagio, De Pascalis, Stefania, Amoruso, Daniela Caterina, Martini, Salvatore, Pisaturo, Mariantonietta, Coppola, Carmine, and Gentile, Ivan

Subjects
Male, Nephrology, medicine.medical_specialty, Cirrhosis, Hepatitis C virus, 030232 urology & nephrology, Renal function, 030204 cardiovascular system & hematology, medicine.disease_cause, Antiviral Agents, Gastroenterology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, medicine, CKD, eGFR, Humans, Aged, DAA, Antiviral Agent, business.industry, Recovery of Function, Hepatitis C, Hepatitis C, Chronic, Middle Aged, Symptom Flare Up, medicine.disease, HCV infection, Regimen, Treatment Outcome, Interferon, Female, Interferons, Cohort Studie, business, Viral load, Human, Glomerular Filtration Rate
Abstract

Background and aim: The impact of directly acting antiviral agent (DAA) regimens on renal function is not well defined and quite controversial. We evaluated the effect of DAAs on kidney function and the factors associated with an improvement or worsening. Patients and methods: The changes in estimated glomerular filtration rate (eGFR) in a cohort of 403 patients treated with a DAA regimen were evaluated. Results: The overall sustained virological response (SVR12) rate was 98%. The median eGFR progressively increased throughout treatment from 84.54ml/min/1.73m2 (IQR 70.8–97.3) to 88.12ml/min/1.73m2. Conversely, rates of patients with a eGFR more than 60ml/min/1.73m2 progressively increased from 83.1% at baseline to 87.8% at 12weeks post-treatment (p < 0.05). Considering the change in eGFR according to the different factors, a significant improvement in eGFR was observed in the patients without diabetes (p < 0.001), in those with cirrhosis (p < 0.05), in those receiving a Sof-based regimen (p < 0.01) or not receiving RBV (p < 0.05), in those with a baseline eGFR less than 60ml/min/1.73m2 (p < 0.001) and in those with SVR (p < 0.05). An improvement in eGFR (defined as an increase in baseline eGFR of at least 10ml/min/1.73m2) was observed in 148 patients (36.7%). At multivariate analysis, age (aHR 0.96; 95 CI 0.93–0.99, p < 0.01) and a diagnosis of diabetes (aHR 0.02; 95 CI 0.20–0.87, p < 0.05) were inversely and independently associated with improvement in renal function, while the presence of Child–Pugh B cirrhosis at baseline was associated with an improvement in renal function (aHR 3.07; 95 CI 1.49–6.30, p < 0.01). Conclusions: DAAs correlate with an improvement in renal function, underlining the importance of hepatitis C virus eradication to achieve also an improvement in extra-hepatic disorders.

Published
2019

19. Incidence and predictive risk factors of infective events in patients with multiple sclerosis treated with agents targeting CD20 and CD52 surface antigens

Author

Ivan Gentile, Roberta Lanzillo, Agostino Nozzolillo, Antonio Riccardo Buonomo, Cinzia Valeria Russo, Emanuela Zappulo, Giulia Scalia, Francesco Saccà, Grazia Tosone, Riccardo Scotto, Zappulo, E., Buonomo, A. R., Sacca, F., Russo, C. V., Scotto, R., Scalia, G., Nozzolillo, A., Lanzillo, R., Tosone, G., and Gentile, I.

Subjects
medicine.medical_specialty, CD52, Multiple sclerosis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Major Article, medicine, 030212 general & internal medicine, Alemtuzumab, Monoclonal antibodie, business.industry, Hazard ratio, CMV, Retrospective cohort study, medicine.disease, Infectious Diseases, Oncology, Rituximab, Ocrelizumab, monoclonal antibodies, Lymphocytopenia, business, Infection, 030217 neurology & neurosurgery, medicine.drug
Abstract

Objective Monoclonal antibodies (MAbs) directed against the CD20 and CD52 antigens are used increasingly in patients with multiple sclerosis (MS). Several life-threatening opportunistic infections have been reported in postmarketing case series. The aim of this study was to investigate the incidence of infections and associated prognostic factors during the first year of treatment in patients receiving anti-CD20 (ocrelizumab or rituximab) or anti-CD52 MAbs (alemtuzumab). Methods A retrospective study was conducted in patients with MS referring to the Neurodegenerative Diseases Center at the University of Naples Federico II who received MAbs between November 2015 and June 2018. Results A total of 163 patients were enrolled. Approximately 40% of patients experienced lymphocytopenia during treatment. Eighty-six infective events were reported in 67 patients (41%). Bacterial infections were significantly more frequent with anti-CD20, whereas viral infections prevailed with alemtuzumab. Cytomegalovirus reactivation rates were significantly higher in the alemtuzumab group than in patients on anti-CD20 (51% vs 6%, P < .001). The overall annualized infection rate was 1.1 per patient-year, higher in patients on anti-CD52 versus those on anti-CD20 regimens (1.5 vs 0.8 per patient-year). Alemtuzumab treatment, prior exposure to ≥2 MS drugs, and iatrogenic immune impairment significantly and independently predicted an infection event (adjusted hazard ratio [aHR], 2.7; P = .013; aHR, 1.7; P = .052; and aHR, 2.9; P = .004; respectively). Conclusions Given their considerable infection risk, MS patients receiving MAbs should undergo timely follow up and tailored preventive interventions. Anti-CD52–based treatment, prior exposure to MS drugs, and on-treatment immune impairment are significant predictive factors of infection and their evaluation could help clinicians to stratify a patient’s risk of infection., A high incidence of infections was observed in patients with multiple sclerosis (MS) receiving anti-CD20 and -CD52 agents. Cytomegalovirus reactivation rates were particularly high in Alemtuzumab-treated patients. Alemtuzumab treatment, prior exposure to MS drugs, and iatrogenic immune impairment were identified as independent risk factors for infections.

Published
2019

20. Bacterial and CMV pneumonia in a patient treated with alemtuzumab for multiple sclerosis

Author

Ivan Gentile, Emanuela Zappulo, Federico De Zottis, Francesco Saccà, Guglielmo Borgia, Roberta Lanzillo, Antonio Carotenuto, Antonio Riccardo Buonomo, Cinzia Valeria Russo, Buonomo, A. R., Sacca, F., Zappulo, E., De Zottis, F., Lanzillo, R., Gentile, I., Carotenuto, A., Borgia, G., and Russo, C. V.

Subjects
Cytomegalovirus Infection, Male, Multiple Sclerosis, CD52, Pneumonia, Viral, Congenital cytomegalovirus infection, Antibodies, Monoclonal, Humanized, 03 medical and health sciences, Opportunistic infection, 0302 clinical medicine, Immune system, Interferon, Multiple Sclerosi, medicine, Pneumonia, Bacterial, Humans, 030212 general & internal medicine, Alemtuzumab, business.industry, Multiple sclerosis, Bacterial pneumonia, CMV, General Medicine, Middle Aged, medicine.disease, Neurology, Cytomegalovirus Infections, Immunology, Neurology (clinical), Complication, business, 030217 neurology & neurosurgery, medicine.drug, Human
Abstract

Alemtuzumab (a drug highly active in multiple sclerosis) is a humanized monoclonal antibody targeting the surface molecule CD52. It causes a rapid depletion of innate and adaptive immune cells with a peak during the first month after infusion. Infection rates in alemtuzumab-treated patients with multiple sclerosis in clinical trials were higher in than in interferon beta-treated patients. Cytomegalovirus (CMV) primary infections and reactivations have been reported in this setting of patients. We describe the case of a patient that developed both viral (CMV) and bacterial pneumonia one month after alemtuzumab infusion for multiple sclerosis. Physicians dealing with this drug should be aware of this serious but treatable complication.

Published
2019

21. Invasive pulmonary aspergillosis and pulmonary tuberculosis in a patient treated with infliximab for Crohn's disease

Author

Debora Compare, Giulio Viceconte, Emanuela Zappulo, Maria Vargas, Giuseppe Servillo, Guglielmo Borgia, Antonio Riccardo Buonomo, Gerardo Nardone, Ivan Gentile, Carmine Iacovazzo, Buonomo, A. R., Viceconte, G., Compare, D., Vargas, M., Iacovazzo, Carmine, Zappulo, E., Nardone, G., Servillo, G., Borgia, G., and Gentile, I.

Subjects
0301 basic medicine, medicine.medical_specialty, Tuberculosis, Pleural effusion, 030106 microbiology, Infectious and parasitic diseases, RC109-216, Amiodarone, Invasive pulmonary aspergillosis, Article, 03 medical and health sciences, 0302 clinical medicine, Maintenance therapy, Moxifloxacin, Internal medicine, medicine, 030212 general & internal medicine, business.industry, Isavuconazole, Invasive pulmonary aspergillosi, medicine.disease, Infliximab, Pneumonia, Infectious Diseases, Respiratory failure, business, medicine.drug
Abstract

Highlights • Pulmonary TB together with invasive pulmonary aspergillosis due to infliximab therapy has been occasionally described. • Other than tuberculosis reactivation, TNF-α antagonists may be associated with other opportunistic infections such as invasive aspergillosis. • Interactions among rifamycins, antifungal and antiarrhythmic drugs are complex and may require the choice of second line therapies. • Isavuconazole may have a better interaction profile with amiodarone and antitubercular therapy than voriconazole., We report a case of concurrent development of active pulmonary tuberculosis and invasive pulmonary aspergillosis (IPA) in a patient who received therapy with infliximab for Crohn’s disease. He has been treated with antitubercular therapy and liposomal amphotericin B for 8 weeks. His clinical course was complicated by paroxysmal atrial fibrillation requiring maintenance therapy with amiodarone, respiratory failure due both to pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamases (ESBL)-producing Klebsiella pneumoniae and pleural effusion requiring chest drainage. At discharge, a maintenance regimen based on the administration of isavuconazole 200 mg daily, moxifloxacin 400 mg daily and isoniazid 300 mg daily was chosen to avoid multiple drug-drug interaction between rifamycins, antifungal triazole agents and antiarrhythmic drugs. At 3 months of follow-up his clinical conditions were dramatically improved, high resolution chest tomography (HRCT) showed reduction of parenchymal lesions and no changes both in sinus rhythm and QTc interval were noticed. Besides the complexity and the peculiarity of the clinical scenario, this case underlines the risk of invasive fungal infections linked to the administration of TNF-α antagonists in gastroenterological setting and the importance of accurate evaluation of drug-drug interactions when choosing the antimicrobial therapies.

Published
2019

22. An update on recent developments in the search for hepatitis C virus therapies with pan-genotypic efficacy

Author

Riccardo Scotto, Antonio Riccardo Buonomo, Guglielmo Borgia, Borgia, G., Scotto, R., and Buonomo, A. R.

Subjects
Pharmacology, Antiviral Agent, Hepaciviru, Genotype, business.industry, Hepatitis C virus, General Medicine, Hepacivirus, Hepatitis C, Chronic, medicine.disease_cause, Virology, Antiviral Agents, Drug Development, medicine, Humans, Pharmacology (medical), business
Published
2019

23. The role of curcumin in liver diseases

Author

Michele Arcopinto, Alberto M. Marra, Riccardo Scotto, Andrea Salzano, Salvatore Nappa, Roberta D'Assante, Emanuela Zappulo, Antonio Riccardo Buonomo, Guglielmo Borgia, Ivan Gentile, Buonomo, A. R., Scotto, R., Nappa, S., Arcopinto, M., Salzano, A., Marra, A. M., D'Assante, R., Zappulo, E., Borgia, G., and Gentile, I.

Subjects
medicine.medical_specialty, Cirrhosis, business.industry, Liver fibrosis, Hepatitis C virus, lcsh:R, MEDLINE, lcsh:Medicine, General Medicine, medicine.disease_cause, medicine.disease, Gastroenterology, chemistry.chemical_compound, chemistry, Internal medicine, Commentary, medicine, Curcumin, business
Published
2019

24. Real-world efficacy and safety of pangenotypic direct-acting antivirals against hepatitis C virus infection

Author

Riccardo Scotto, Biagio Pinchera, Emanuela Zappulo, Alberto Enrico Maraolo, Nicola Schiano Moriello, Antonio Riccardo Buonomo, Guglielmo Borgia, Ivan Gentile, Scotto, R., Buonomo, A. R., Moriello, N. S., Maraolo, A. E., Zappulo, E., Pinchera, B., Gentile, I., and Borgia, G.

Subjects
Drug, medicine.medical_specialty, Genotype, Sustained Virologic Response, Sofosbuvir, Hepatitis C virus, media_common.quotation_subject, Voxilaprevir, medicine.disease_cause, Direct-acting antiviral, Antiviral Agents, 03 medical and health sciences, 0302 clinical medicine, Glecaprevir, Internal medicine, medicine, Humans, media_common, Pangenotypic drug, Velpatasvir, Pharmacology, business.industry, Pibrentasvir, General Medicine, Hepatitis C, Chronic, Discontinuation, Clinical trial, Real-world, 030220 oncology & carcinogenesis, HCV, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract

Background: Advances in the development of Direct-Acting Antivirals (DAAs), particularly pangenotypic drugs, have led to a high rate of hepatitis C virus (HCV) eradication. Notably, real- world studies have confirmed the efficacy and safety of pangenotypic DAA combinations reported in registration trials. The aim of this study was to review the treatment recommendations, and the efficacy and safety data of anti-HCV pangenotypic drugs reported in registration clinical trials and in recent real-life cohort studies. Methods: We reviewed the efficacy and safety data of pangenotypic anti-HCV drug combinations reported in original articles and in online conference abstracts. Results: Current pangenotypic drug combinations resulted in very high rates of sustained virologic response and few adverse reactions in real-life settings. SVR12 rates in real-life studies ranged from 90-100% depending on the pangenotypic combination, the HCV genotype and the stage of liver disease. Most adverse reactions reported in real-life settings were mild in intensity and rarely led to treatment discontinuation. These results are in accordance with those of clinical trials. Conclusion: Pangenotypic DAAs result in very high rates of sustained virologic responses and are well tolerated. However, they are contraindicated in patients with decompensated cirrhosis or advanced chronic kidney disease who failed previous DDA-based treatment. Further research is required to customize treatment to “unpackage” current DAA combinations and to develop generic drugs against HCV.

Published
2019

25. Severe Vitamin D deficiency increases mortality among patients with liver cirrhosis regardless of the presence of HCC

Author

Ivan Gentile, Biagio Pinchera, Giuseppe Perruolo, Mariagiovanna Nerilli, Emanuela Zappulo, Riccardo Scotto, Salvatore Nappa, Antonio Riccardo Buonomo, Pietro Formisano, Buonomo, A. R., Scotto, R., Zappulo, E., Nerilli, Mariagiovanna, Pinchera, B., Perruolo, G., Formisano, P., Nappa, S., and Gentile, I.

Subjects
Liver Cirrhosis, Male, Cancer Research, medicine.medical_specialty, Cirrhosis, Carcinoma, Hepatocellular, Hepatocellular carcinoma, Liver Cirrhosi, Gastroenterology, Severity of Illness Index, General Biochemistry, Genetics and Molecular Biology, vitamin D deficiency, Disease-Free Survival, Cohort Studies, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Overall survival, Humans, In patient, Mortality, Vitamin D, Proportional Hazards Models, Aged, Pharmacology, Cirrhosi, Vitamin D deficiency, Proportional hazards model, business.industry, Risk Factor, Liver Neoplasms, hepatocellular carcinoma, mortality, risk factors, Middle Aged, medicine.disease, digestive system diseases, Liver, Liver Neoplasm, 030220 oncology & carcinogenesis, Proportional Hazards Model, Female, Cohort Studie, business, Research Article, Human
Abstract

Background: The aim of this study was to investigate the association between vitamin D deficiency (10 ng/ml (p=0.003), vitamin D deficiency (p

Published
2019
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26. Treatment with direct-acting antivirals improves the clinical outcome in patients with HCV-related decompensated cirrhosis: results from an Italian real-life cohort (Liver Network Activity-LINA cohort)

Author

Laura Staiano, Nicola Coppola, Grazia Tosone, Stefania De Pascalis, Carmine Coppola, Daniela Caterina Amoruso, Riccardo Scotto, Guglielmo Borgia, Margherita Macera, Federica Portunato, Giulio Viceconte, Antonio Riccardo Buonomo, Teresa De Simone, Salvatore Martini, Ivan Gentile, Gentile, I., Scotto, R., Coppola, C., Staiano, L., Amoruso, D. C., De Simone, T., Portunato, F., De Pascalis, S., Martini, S., Macera, M., Viceconte, G., Tosone, G., Buonomo, A. R., Borgia, G., and Coppola, N.

Subjects
Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, Hepatitis C virus, Liver Cirrhosi, medicine.disease_cause, Direct-acting antiviral, Gastroenterology, Antiviral Agents, Decompensated cirrhosi, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Liver Function Tests, Internal medicine, Medicine, Humans, Prospective Studies, Aged, Antiviral Agent, Hepatology, business.industry, Liver Function Test, Hepatitis C, Chronic, medicine.disease, Colorectal surgery, Discontinuation, Prospective Studie, Treatment Outcome, Liver, 030220 oncology & carcinogenesis, Cohort, 030211 gastroenterology & hepatology, Female, Liver function, business, Hepatitis C viru, Human
Abstract

Background: Direct-acting antivirals (DAAs) are safe and effective for the treatment of HCV infection. However, data regarding their efficacy in patients with Child–Pugh B cirrhosis are scarce and their capability in improving liver function is debated. The aim of our study was to assess the clinical benefits of treatment with DAA in subjects with Child–Pugh B cirrhosis. Methods: We conducted a prospective multicentre study among patients with Child–Pugh B cirrhosis of an Italian real-life HCV cohort (LINA cohort) who received treatment with DAAs. Results: Among 89 patients enrolled, the rate of sustained virologic response 12 was 95.5%. No discontinuation occurred, no patient died during treatment. Most patients had Genotype 1 (1b 61.8%, 1a 11.2%). Conversely, 22.5%, 1.1% and 3.4% of patients had Genotype 2, 3 and 4, respectively. At last observation, 61.8% of patients switched to a Class A cirrhosis, 33.7% remained in Class B and 4.5 worsened to Child C (p < 0.001). Liver parameters significantly improved from baseline to 12weeks after the end of treatment. Previous anti-HCV treatments and the presence of decompensated cirrhosis at 1month of treatment were significantly associated with a decompensated cirrhosis at the last observation. Conclusions: Treatment with DAA in patients with Child–Pugh B cirrhosis is safe and leads to a very high rate of viral clearance, a significant rate of re-compensation and an improvement in liver function. Further studies are needed to assess the impact of treatment on survival and quality of life in long-term follow-up.

Published
2018

27. Does compulsory vaccination limit personal freedom? Ethical issues

Author

Claudia Casella, Riccardo Scotto, Salvatore Nappa, Nicola Schiano Moriello, Faiz Ur Rehman Saleem, Emanuele Capasso, Ivan Gentile, Guglielmo Borgia, Vincenzo Graziano, Antonio Riccardo Buonomo, Mariano Paternoster, Paternoster, M., Scotto, R., Saleem, F. U. R., Buonomo, A. R., Moriello, N. S., Casella, C., Capasso, E., Nappa, S., Gentile, I., Borgia, G., and Graziano, V.

Subjects
Government, Ethical issues, Human rights, business.industry, infectious disease, media_common.quotation_subject, Vaccination, General Medicine, Law, Medicine, epidemiology, Disease prevention, Limit (mathematics), Personal freedom, business, Medical ethics, media_common
Abstract

Background Despite vaccinations are scientifically proven to be safe and effective public controversies limit their application in many countries. Aims Aim of this review is to provide an overview of biological effects of vaccination and a picture of the ethical dilemmas about compulsory vaccination. Methods We conducted a review on the literature about the subject. Recent news were also included. Results Vaccines are the best weapon against many infectious diseases. The spread of false beliefs among people have led the government authorities to increase compulsory vaccination in order to embank new outbreaks of preventable infectious diseases. Conclusion Even if compulsory is quite drastic approach it could be the on only way to reach an adequate coverage and protect immunoexpressed subjects.

Published
2018

28. Erectile dysfunction in patients with chronic viral hepatitis: a systematic review of the literature

Author

Andrea Rossi, Gianluca d’Anzeo, Carmine Sciorio, Ivan Gentile, Guglielmo Borgia, Ferdinando Fusco, Vincenzo Mirone, Antonio Riccardo Buonomo, Roberta d'Emmanuele di Villa Bianca, Fusco, Ferdinando, G., D’Anzeo, A., Rossi, C., Sciorio, Buonomo, ANTONIO RICCARDO, D'EMMANUELE DI VILLA BIANCA, Roberta, Borgia, Guglielmo, Mirone, Vincenzo, Gentile, Ivan, Fusco, F., D’Anzeo, G., Rossi, A., Sciorio, C., Buonomo, A R., d’Emmanuele di Villa Bianca, R., Borgia, G., Mirone, V., and Gentile, I.

Subjects
Male, medicine.medical_specialty, Hepatitis D, Chronic, Hepatitis C virus, medicine.disease_cause, Antiviral Agents, Hepatitis B, Chronic, Erectile Dysfunction, Epidemiology, medicine, Humans, Testosterone, Pharmacology (medical), In patient, Intensive care medicine, Pharmacology, Hepatitis B virus, Hepatitis, business.industry, General Medicine, Hepatitis C, Chronic, Phosphodiesterase 5 Inhibitors, medicine.disease, Sexual dysfunction, Erectile dysfunction, Immunology, medicine.symptom, business, Viral hepatitis
Abstract

This article reviews the literature on epidemiology and pathogenetic factors of erectile dysfunction in patients with chronic viral hepatic (CVH) diseases in men and the potential implications for diagnosis and treatment.A search to identify original articles, reviews and any other article suitable for the purposes of this review was conducted by combining the following terms: erectile dysfunction and/or sexual dysfunction, chronic viral hepatitis, hepatitis B virus infection and hepatitis C virus infection.The results of this review have led to the following main observations: i) there is scarce documentation on the association between CVH and sexual dysfunction; ii) hormonal impairment seems to be a major component in the development of erectile dysfunction in CVH; however, published evidence concerning the contribution of other pathogenetic factors is rare and inconclusive and iii) available treatment options for CVH potentially contribute to the development of sexual dysfunction in these patients. Due to the scarce body of evidence, more research is needed to better clarify the mechanisms underlying the association between CVH and sexual dysfunction, the impact of therapy and associated comorbidities on sexual dysfunction and the role of pharmacological treatments in the management of these patients.

Published
2013

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