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1. Chronic hepatitis B in Italy: New features of an old disease - Approaching the universal prevalence of hepatitis B e antigen-negative cases and the eradication of hepatitis D infection

Author

Sagnelli, Evangelista, Stroffolini, Tommaso, Mele, Alfonso, Imparato, Michele, Almasio, Piero L., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Sacchini, D., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G. M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A. I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frugiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., Spanneda, M., Sagnelli, Evangelista, Stroffolini, Tommaso, Mele, Alfonso, Imparato, Michele, Almasio, Piero L., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Sacchini, D., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G.M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A.I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frugiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., and Spanneda, M. more...

Subjects
Liver Cirrhosis, Adult, Male, Microbiology (medical), medicine.medical_specialty, Cirrhosis, Adolescent, Hepatitis D, Chronic, Hepatitis C virus, Hepacivirus, Liver Cirrhosi, medicine.disease_cause, Gastroenterology, Virus, Flaviviridae, Hepatitis B, Chronic, Seroepidemiologic Studies, Internal medicine, medicine, Humans, Hepatitis B e Antigens, Aged, Aged, 80 and over, Cross-Sectional Studie, Hepaciviru, biology, business.industry, Seroepidemiologic Studie, Hepatitis Delta Viru, Hepatitis B, Middle Aged, medicine.disease, biology.organism_classification, Hepatitis D, Virology, Alcoholism, Cross-Sectional Studies, Infectious Diseases, Italy, Disease Progression, Female, Hepatitis B e Antigen, Hepatitis D virus, Hepatitis Delta Virus, business, Human
Abstract

We evaluated 1336 hepatitis B surface antigen-positive subjects consecutively observed in 79 Italian hospitals over a 6-month period. The proportion of hepatitis B e antigen-negative cases was 86.4%, that of patients coinfected with hepatitis D virus was 9.7%, and the rate of patients coinfected with hepatitis C virus was 16.8%. Multiple logistic regression analysis showed that age >49 years, alcohol abuse, and anti-hepatitis D virus and anti-hepatitis C virus positivity were independent predictors of progression to liver cirrhosis. © 2007 by the Infectious Diseases Society of America. All rights reserved. more...

Published
2008

2. The importance of HCV on the burden of chronic liver disease in Italy: a multicenter prevalence study of 9,997 cases

Author

Sagnelli, Evangelista, Stroffolini, Tommaso, Mele, Alfonso, Almasio, Piero, Coppola, Nicola, Ferrigno, Luigina, Scolastico, Carlo, Onofrio, Mirella, Imparato, Michele, Filippini, Pietro, Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Sacchini, D., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G. M., Sereno, S., Clementi, C., Comandino, U. Visco, Gallo, A. I., Festi, D., Sabusco, G., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Furgiuele, P. L., Ferraro, M., Prestileo, T., Alessandri, A., Russello, M., Bellissima, P., Orifici, G., Pisani, G., Angioni, S., Lai, M., Spanneda, M., SAGNELLI E, STROFFOLINI T, MELE A, ALMASIO PL, COPPOLA N, FERRIGNO L, SCOLASTICO C, ONOFRIO M, IMPARATO M, FILIPPINI P, Sagnelli, Evangelista, Stroffolini, Tommaso, Mele, Alfonso, Almasio, Piero, Coppola, Nicola, Ferrigno, Luigina, Scolastico, Carlo, Onofrio, Mirella, Imparato, Michele, Filippini, Pietro, Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Sacchini, D., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G.M., Sereno, S., Clementi, C., Comandino, U. Visco, Gallo, A.I., Festi, D., Sabusco, G., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Furgiuele, P.L., Ferraro, M., Prestileo, T., Alessandri, A., Russello, M., Bellissima, P., Orifici, G., Pisani, G., Angioni, S., Lai, M., and Spanneda, M. more...

Subjects
Adult, Liver Cirrhosis, Male, Hepatitis B virus, HBsAg, Carcinoma, Hepatocellular, Cirrhosis, alcohol abuse, Hepatitis C virus, Hepacivirus, Chronic liver disease, medicine.disease_cause, Risk Factors, Virology, Prevalence, medicine, HBV, Humans, Aged, business.industry, Incidence, Liver Diseases, Liver Neoplasms, Hepatitis C, Middle Aged, Hepatitis B, medicine.disease, Alcoholism, Infectious Diseases, Italy, Hepatocellular carcinoma, Chronic Disease, HCV, Female, Viral hepatitis, business
Abstract

Knowledge of the current epidemiology of chronic liver disease in Italy is mostly obsolete and fragmentary for the lack of up-to-date consistent data. In 2001, a 6-month prevalence study was undertaken in 79 hospitals to assess the characteristics of chronic liver disease in Italy. Both prevalent and incident cases were enrolled. A total of 9,997 patients were recruited, of whom 939 (9.4%) had normal liver biochemistry, 6,210 (62.1%) had chronic hepatitis, 1,940 (19.4%) had liver cirrhosis, and 341 (3.4%) had hepatocellular carcinoma (HCC). In 567 patients (5.7%) the diagnosis was not established. Hepatitis C virus (HCV) was found in 69.9% of the patients and was the only etiological factor in 56.3% of all the patients. Hepatitis B surface antigen (HBsAg) was present in the serum of 13.4% of the cases (in 10% it was the only etiological factor). A history of alcohol abuse was found in 23% of the cases (9.4% without viral infection). The prevalence of HCV-related cases was significantly lower in incident than in prevalent cases (44.9% vs. 59.9%, P < 0.0001), while the proportion of patients with alcohol abuse was much higher in incident than in prevalent cases (18.1% vs. 6.6%, P < 0.0001). These findings indicate that nearly one quarter of patients with chronic liver diseases in Italy have a severe disease such as liver cirrhosis and HCC represents a not negligible burden for the national health system. Hepatitis B fell in importance as an etiological factor. Hepatitis C is the important pathogenic factor for chronic liver disease in Italy. However, a comparison between the prevalent and incident cases suggests that in future HCV infection will also play a progressively decreasing role, in part as a consequence of treatment. © 2005 Wiley-Liss, Inc. more...

Published
2005

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3. The aetiology of chronic hepatitis in Italy: results from a multicentre national study

Author

Stroffolini, T., Sagnelli, E., Mele, A., Craxi, A., Almasio, P., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Daria, Sacchini, Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Pratico, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Paroli, Marino, De Sanctis, G. M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A. I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Imparato, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frigiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello Maurizio, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., Spanneda, M., Stroffolini, T, Sagnelli, E, Mele, A, Crax, A, Almasio, P, Coppola, Nicola, Italian Hospitals Collaborating, Group, Filippini, Pietro, Sagnelli, Caterina, STROFFOLINI T, SAGNELLI E, MELE A, CRAXI A, ALMASIO PL, ITALIAN HOSPITALS, COLLABORATING GROUP, Stroffolini, T., Sagnelli, E., Mele, A., Craxì, A., Almasio, P., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Daria, S., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G.M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A.I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Imparato, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frigiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello Maurizio, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., and Spanneda, M. more...

Subjects
Adult, Male, medicine.medical_specialty, HBsAg, Hepatitis D, Chronic, Epidemiology, Hepatitis C virus, Autoimmune hepatitis, medicine.disease_cause, Autoimmune Diseases, Hepatitis B, Chronic, Internal medicine, medicine, Prevalence, Humans, Hepatitis B virus, Hepatology, business.industry, Gastroenterology, Hepatitis C, Hepatitis B, Hepatitis C, Chronic, Middle Aged, medicine.disease, Hepatitis D, HBeAg, Italy, Immunology, Chronic hepatiti, Female, chronic hepatitis, epidemiology, italy, business
Abstract

Background: No recent national-level data on the aetiology of chronic hepatitis are available in Italy. Aim: To evaluate the current aetiology of chronic hepatitis in Italy. Patients: A total of 6210 chronic hepatitis patients (both prevalence and incident cases) consecutively admitted to 79 hospitals located throughout Italy were enrolled over a 6-month period in 2001. The hospitals were randomly selected through systematic cluster sampling. Results: The main agent associated with chronic hepatitis was hepatitis C virus, which was found in 76.5% of the patients (in 62.6% it was the only aetiologic factor). Hepatitis B surface antigen was present in the serum of 12.2% of the cases (in 9.2% it was the only aetiologic factor). Hepatitis B e antigen and hepatitis Delta were detected in 16.6% and 7.0%, respectively, of hepatitis B surface antigen-positive patients. A history of alcohol abuse was found in 19.2% of the cases (5.5% without viral infection). Autoimmune hepatitis and inborn metabolic disorders were extremely rare. The prevalence of hepatitis C virus-related cases was significantly lower in incident cases, compared to prevalent cases (55.1% versus 65.0%; p < 0.01). The mean alanine aminotransferase level was significantly higher in hepatitis B surface antigen-positive patients, compared to hepatitis B surface antigen-negative patients. The histology was less severe in non-viral-related cases. Conclusions: Hepatitis C virus is the most important pathogenic factor for chronic hepatitis in Italy; however, the comparison between prevalent and incident cases suggests that this infection will play a less important role in the future. A comparison with previous reports shows that both hepatitis B virus-related and hepatitis Delta virus-related cases are decreasing. © 2004 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. more...

Published
2004

4. A survey of adverse events in 11,241 patients with chronic viral hepatitis treated with alfa interferon

Author

Fattovich, G., Giustina, G., Favarato, S., Ruol, A., Macarri, G., Orlandi, E., Iaquinto, G., Ambrosone, L., Francavilla, A., Pastore, G., Santantonio, M. T., Romagno, D., Bolondi, L., Sofia, S., Marchesini, A., Pisi, E., Mazzella, G., Roda, E., Attaro, L., Chiodo, E., Mori, E., Verucchi, G., Lanzini, A., Salmi, A., Calvi, B., Bozzetti, E., Radaeli, E., Bernasconi, M., Pilleri, G., Bacca, D., Romano, G., Mastrapasqua, G., Cozzolongo, R., Cacopardo, B., Nunnari, A., Blasi, A., Sala, L. O., Minoli, G., Sangiovanni, A., Spinzi, G. C., Colombo, A., Camassa, M., Riva, D., Maggi, G., Boccia, S., Gualandi, G., Nucci, A., Pacini, F., Marino, N., Mazzotta, E., La Mura, A., Pompei, A. G., Casinelli, K., Petrosillo, N., Giacchino, R., Timitilli, A., Spiga, E., Corsetti, M., Menicagli, V., Tucci, A., Bissoli, E., Raimondo, G., Rodino, G., Bellobuono, A., Ideo, G., Colombo, M., Pacchetti, S., Rumi, M. R., Battezzati, P. M., Bruno, S., Podda, M., Zuin, M., Fargion, S., Fiorelli, G., Gellmann, E., Vandelli, C., Ventura, E., Manenti, F., Villa, E., Caporaso, N., Coltorti, M., Morisco, E., Del Vecchio-Blanco, C., di Santolo, S. S., Di Nunzio, S., Ruggiero, G., Zampino, R., Ascione, A., De Luca, M., Galeota-Lanza, A., Aprea, L., Sagnelli, E., Felaco, E. M., Piccinino, E., Ballare, M., Monteverde, A., Tappero, G., Sanna, G., Alberti, A., Bonetti, P., Casarin, C., Diodati, G., Tremolada, E., Naccarato, R., Chiaramonte, M., Floreani, M. R., Almasio, P., Craxi, A., Loiacono, O., Pagliaro, L., Fiaccadori, E., Giuberti, T., Belloni, G., Bernardini, E., Buscarini, L., Sbolli, G., Giudici-Cipriani, A., Marenco, G., Mazzaro, C., Massari, M., Fornaciari, G., Plancher, A., Gasbarrini, G., Grieco, A., Luchetti, R., Rapaccini, G. L., Bombardieri, G., Di Virgilio, D., Bruno, G., Ricci, G. L., Hassan, G., Mari, T., Scalisi, I., Colloredo, G., Frunzio, A., Tabone, M., Costa, C., Rosina, E., Saracco, G., Verme, G., Frezza, M., Urban, E., Capra, E., Casaril, M., Corrocher, R., and Benetti, G. P. more...

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Hepatitis, Viral, Human, Alpha interferon, Poison control, Chronic viral hepatitis, Interferon alfa, Side effects, Gastroenterology, Autoimmune Diseases, Internal medicine, Medicine, Humans, Adverse effect, Child, Aged, Retrospective Studies, Hepatitis, Hepatology, business.industry, Thyroid disease, Mental Disorders, Infant, Newborn, Infant, Middle Aged, medicine.disease, Recombinant Proteins, Surgery, Bone marrow suppression, Child, Preschool, Chronic Disease, Interferon Type I, Female, business, Viral hepatitis, medicine.drug
Abstract

Aims: The aim of this study was to assess the incidence of fatal, life-threatening side effects and the de novo appearance of non-hepatic morbidity during interferon alfa therapy for chronic viral hepatitis. The relationship of these adverse events to actual total dose and duration of interferon was also evaluated. Methods: We conducted a retrospective study at 73 Italian centers of 11 241 consecutive patients with chronic vital hepatitis who underwent interferon alfa treatment. Results: Five patients died during interferon therapy due to liver failure ( n =4) or complications arising from sepsis. Life-threatening side effects were observed in eight patients: two cases where depression developed and led to a suicide attempt and six patients with bone marrow suppression (granulocytes 3 or platelets 3 ). These symptoms and signs completely disappeared after interferon withdrawal. During interferon treatment, 131 patients developed the following de novo non-hepatic disorders: symptomatic thyroid disease ( n =71), impotence ( n =5), systemic autoimmune disease ( n =5), immune-mediated dermatologic disease ( n =14), diabetes mellitus ( n =10), cardiovascular disease ( n =7), psychosis n =10), seizures ( n =4), peripheral neuropathy ( n =3) and hemolytic anemia ( n =2). Most of these complications are reversible or can be ameliorated. Fatal or life-threatening side effects were not related to actual total dose or duration of interferon alfa, while the majority of patients with de novo non-hepatic morbidity received medium/high doses ( > 200 million units) of interferon alfa or were treated for periods longer than 16 weeks (68% and 80%, respectively). Conclusions: Treatment with interferon alfa may have fatal or life-threatening side effects, their incidence in this study being low (0.04% and 0.07%, respectively) and perhaps no different than in untreated patients with chronic viral hepatitis. Moreover de novo non-hepatic morbidity occurred in 1.2% of patients, and the dose and duration of interferon therapy seem important in determining the frequency of this complication. The development of clinically-overt thyroid disease was most common. more...

Published
1996

5. [Roxatidine in the treatment of gastroduodenal mucosal lesions in hepatic cirrhosis]

Author

Sardini, C., Ventura, Paolo, Abbati, G. L., Rigo, G., Cioni, G., Cristani, A., Tincani, E., and Ventura, E.

Subjects
Adult, Liver Cirrhosis, Male, Stomach Diseases, cirrosi epatica, Middle Aged, ipertensione portale, gastropatia congestizia, Histamine H2 Antagonists, Piperidines, Gastric Mucosa, Humans, Female, Roxatidina, Duodenal Diseases, Intestinal Mucosa, Aged
Abstract

In about 50% of patients with liver cirrhosis, upper digestive bleeding is not due to oesaphageal varices rupture, but to a group of peculiar mucosal lesions usually referred as "congestive gastropathy" and "hepatogenic ulcer". The pathogenesis of such mucosal damage is still unclear: an important causative role is commonly thought to be played by portal hypertension, but the role of peptical pathway and of the mucosal barrier impairment must not be underscored as well. Aim of this study was to evaluate the effect of roxatidine in the long-term treatment of mucosal damage in 19 patients with liver cirrhosis. Patients showed a good tolerance and no side effects. The improvement of endoscopic pattern after a three months period of roxatidine therapy was statistically significant; moreover there was no occurrence of digestive bleeding. In conclusion, H2 antagonist may be considered as the drug of choice for the treatment of mucosal damage in patients with liver cirrhosis, for both its safety and effectiveness. more...

Published
1994

6. [The activity of misoprostol on the gastric and duodenal mucosal damage in patients with liver cirrhosis]

Author

Abbati, G., Cioni, G., Cristani, A., Rigo, G., Vignoli, A., Ventura, Paolo, Tincani, E., and Ventura, E.

Subjects
Liver Cirrhosis, Male, Duodenum, cirrosi epatica, Middle Aged, Misoprostolo, gastropatia congestizia, Gastric Mucosa, Chronic Disease, Drug Evaluation, Humans, Female, Endoscopy, Digestive System, Intestinal Mucosa, Misoprostol, Aged
Abstract

Twenty-five liver cirrhosis patients with endoscopically demonstrated gastro-duodenal mucosal damage (microhemorrhages, erosions, ulcers) were treated with misoprostol (prostaglandin E1) 400 mg/die. Eleven patients (44%) had abdominal pain and diarrhea and stopped treatment. Three months later, a new endoscopy was performed in the 11 patients that completed the study (3 patients were lost at follow up). Mucosal damage was stable in 5 patients (45%) and improved in 6 patients (55%), with complete absence of mucosal lesions in 2 patients (P = 0.027, Wilcoxon Ranks test). No case of worsening was observed and no patient had digestive bleeding during treatment. Digestive bleeding is a common complication of liver cirrhosis, originating in about 50% of cases from gastro-duodenal mucosal damage. Misoprostol suggests itself as a possible alternative therapy to the drugs usually utilized in these lesions (beta-blockers, H2-inhibitors), but individual intolerance is frequent and must be preliminary excluded. more...

Published
1993

7. Incidence and clinical significance of elevated fibrin(ogen) degradation product and/or D-dimer levels in liver cirrhosis patients

Author

Cioni, G, Cristani, A, Mussini, Cristina, Grandi, S, Pentore, R, Tizzanini, W, Zagni, G, Ventura, E., and Zeneroli, Maria Luisa

Subjects
Adult, Aged, 80 and over, Liver Cirrhosis, Male, Analysis of Variance, Fibrin, Platelet Count, cirrhosis, Fibrinogen, liver, Blood Coagulation Disorders, Disseminated Intravascular Coagulation, Middle Aged, Fibrin Fibrinogen Degradation Products, Humans, Female, Prothrombin, Aged
Abstract

Fibrin(ogen) degradation product (FDP) and D-dimer levels were evaluated in 168 liver cirrhosis (LC) patients without evidence of bleeding. Eighty-two (48%) had FDP higher than 10 micrograms/ml; only 43 of them had a concomitant increase of D-dimer. These alterations were more frequent in older and decompensated patients and correlated to the Child-Turcotte score. In the patients with elevated FDP and/or D-dimer levels the mean values of platelets, prothrombin activity and fibrinogen were not significantly different from those of the other patients and remained fairly stable over the period of the study. Finally, an increase of FDP is frequent in LC and this may suggest a diagnosis of disseminated intravascular coagulation (DIC), but a concomitant increase of D-dimer is rarely detectable, thus excluding this diagnosis. Moreover, even in the cases with increased levels of D-dimer the presence of clinical or laboratory evidence of a consumption coagulopathy, expression of a manifest DIC, seems to be unusual. more...

Published
1990

8. Computer analysis of continuous blood pressure recordings in essential hypertension

Author

Andrea Semplicini, Pessina, A. C., Palatini, P., Mormino, P., Casiglia, E., Ventura, E., and Dal Palù, C.

Subjects
Adult, Adolescent, Computers, Hypertension, Humans, Blood Pressure, Middle Aged, Monitoring, Physiologic
Abstract

Blood pressure signals recorded continuously in ambulatory patients were analyzed by an IBM 370 computer and the systolic and diastolic values of each pressure cycle presented in form of a histogram. The results of pressure recordings in patients with 'borderline or labile' and 'established' hypertension are presented and discussed. more...

Published
1981

9. [Determination of serum ferritin in porphyria cutanea tarda. A reliable sign of hepatic siderosis]

Author

Gibertini, P., Rocchi, Emilio, Cassanelli, M., Antonello Pietrangelo, Coppini, M., and Ventura, E.

Subjects
Adult, Male, Porphyrias, Erythrocytes, Siderosis, Liver, Liver Diseases, Ferritins, Humans, Uroporphyrinogen Decarboxylase, Middle Aged, Aged
Abstract

Some parameters of iron metabolism in 26 patients with porphyria cutanea tarda (PCT) which is often associated with mild iron overload and hepatic siderosis, are studied. Serum iron, percent transferrin saturation and ferritin were pathologically increased. Statistical comparisons were performed between PCT patients and healthy controls, liver disease patients (cirrhosis, chronic active hepatitis) and patients with associated liver siderosis (alcoholic cirrhosis, cirrhosis and chronic active hepatitis in thalassemia). Ferritin levels are higher in patients with porphyria than in healthy controls (p less than 0,001) and in patients without liver siderosis (p less than 0,001). No statistical difference is observed between patients with porphyria and patients with siderosis. A significant decrease in ferritin levels is registered after venesection therapy. The conclusion is drawn that serum ferritin increase in PCT is related to hepatic iron store amounts rather than hepatic necrosis. It is assumed that ferritin follow-up during phlebotomy therapy and also during remission is useful to indicate the exhaustion or an early replenishment of hepatic iron stores. more...

Published
1984

11. [Hypotensive effect and changes of arterial pressure variability induced by treatment with labetalol in patients with slight and moderate arterial hypertension]

Author

Palatini, Paolo, Pessina, ACHILLE CESARE, Sperti, G, Ventura, E, Agnoletto, V, Semplicini, Andrea, Hlede, M, Gava, R, Mormino, P, and Dal Palù, C.

Subjects
Ethanolamines, Heart Rate, Hypertension, Hemodynamics, Humans, Blood Pressure, Labetalol
Abstract

To evaluate the hypotensive efficacy of labetalol (600 mg/day) six mild to moderate hypertensive patients were studied by the indirect continuous blood pressure monitoring with the Del Mar Avionics Pressurometer 111 degrees. This technique gives a much larger number of blood pressure values in a greater variety of conditions than the conventional Riva-Rocci sphygmomanometer. After one month of continuous therapy there was a substantial reduction in systolic and diastolic pressure. The increased index of Kurtosis revealed a decreased blood pressure variability. The circadian changes of blood pressure were not significantly affected, but the morning peak was smoothed by labetalol. more...

Published
1983

12. Circulating pro- and antioxidant factors in iron and porphyrin metabolism disorders

Author

Rocchi, E., Casalgrandi, G., Masini, A., Giovannini, F., Ceccarelli, D., Ferrali, M., Sergio Marchini, and Ventura, E.

Subjects
Male, Porphyria Cutanea Tarda, antioxidant system, haemochromatosis, oxidant system, Humans, Female, Hemochromatosis, Middle Aged, Reactive Oxygen Species, Antioxidants
Abstract

Porphyria cutanea tarda and haemochromatosis are taken to be spontaneous human models of oxidative cellular damage, with an increased risk of fibrosis and cancer evolution.To define the relative pro-oxidant roles of porphyrin and iron, in their different molecular forms, and their effects on antioxidant biological systems.A group of 17 patients with porphyria cutanea tarda and a group of 14 patients with primary and secondary haemochromatosis, were compared with 21 healthy controls.Plasma retinol, tocopherol, alpha- and beta-carotene, ascorbic acid, glutathione, malonyldialdehyde and red blood cell free iron were determined using high performance liquid chromatography.Only a modest increase in iron stores was demonstrated in the porphyria cutanea tarda group; in the haemochromatosis patients ferritin levels were almost seven times higher. By contrast, there was a sharp and virtually identical increase in red blood cell free iron and malonyldialdehyde in both the patient groups. A significant reduction was observed in retinol, alpha-, beta-carotene and red blood cell glutathione levels being more marked in porphyria cutanea tarda than in haemochromatosis patients.The study confirms the strong pro-oxidant effects of porphyrins in vivo, through an induction of the free toxic iron form, even though the total iron pool is not greatly expanded. The additional free-iron and porphyrin oxidant effects are documented both in red blood cell and plasma in the porphyria cutanea tarda group. It confirmed that aging exerts a negative influence in terms of pro- and antioxidant balance in all cases, but particularly in the haemochromatosis group. more...

13. HCV infection is a risk factor for gallstone disease in liver cirrhosis: an Italian epidemiological survey

Author

Stroffolini, T., Sagnelli, E., Mele, A., Cottone, C., Almasio, P. L., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Daria, S., MINOLI, MARIA LAURA, Gazzaniga, V., Segato, S., ORIOLO, MARIA, Parlotto, A., Ghersetti, M., CAPRA, FRANCESCA, Muratori, R., Sama, C., BOCCIA, SARA, Verdianelli, G., PRATICO', ANTONIO, GRANDI, MARIO, VENTURA, ELISA, Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., SOLINAS, ALICE, Paroli, M., De Sanctis, G. M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A. I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Imparato, M., Filippini, P., Morisco, F., Liberti, A., BORGIA, GIULIO CESARE, Scarpellino, F., Persico, M., Sagnelli, C., COPPOLA, CLAUDIO, Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frugiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello Maurizio, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., Spanneda, M., Stroffolini, T., Sagnelli, E., Mele, A., Cottone, C., Almasio, P.L., Traverso, A., Arrigoni, A., Torchio, M., Garbagnoli, P., Del Mastro, B., Romano, P., Vanni, R., Brusita, D., Meucci, P., Cassola, G., Borzio, M., Bellobuono, A., De Bona, A., Re, T., Del Poggio, P., Baisini, O., Colombo, A., Attolini, C., Daria, S., Minoli, L., Gazzaniga, V., Segato, S., Oriolo, M., Parlotto, A., Ghersetti, M., Capra, F., Muratori, R., Sama, C., Boccia, S., Verdianelli, G., Praticò, A., Grandi, M., Ventura, E., Cantoni, F., Vincenti, A., Nerli Alessandro, A., Galeazzi, L., Solinas, A., Paroli, M., De Sanctis, G.M., Sereno, S., Clementi, C., Visco Comandino, U., Gallo, A.I., Festi, D., Sabusco, G., Coppola, N., Scolastico, C., Onofrio, M., Imparato, M., Filippini, P., Morisco, F., Liberti, A., Borgia, G., Scarpellino, F., Persico, M., Sagnelli, C., Coppola, C., Caserta, L., Elia, A., De Vita, G., Lanzotti, A., Pizzolante, L., Messina, V., Fiore, G., Agostinacchio, E., Santantonio, T., Mazzola, M., Vinelli, F., Campagna, A., Cataldini, S., Monelli, I., Lascaro, M., Polimeri, N., Frugiuele, P., Ferraro, M., Prestileo, T., Alessandri, A., Russello Maurizio, M., Bellissima, P., Orifici, G., Pisani, G., Angioini, S., Lai, M., and Spanneda, M. more...

Subjects
Liver Cirrhosis, Adult, Male, HBsAg, medicine.medical_specialty, Cirrhosis, Alcohol Drinking, Liver Cirrhosi, Gallbladder disease, Prevalence, Infectious Disease, Gallstones, Gastroenterology, Liver disease, Risk Factors, Virology, Internal medicine, HBV, medicine, Humans, Cholecystectomy, Risk factor, Aged, Cirrhosi, Hepatology, business.industry, Risk Factor, Hepatitis C, Hepatitis C, Chronic, Middle Aged, medicine.disease, Infectious Diseases, Italy, Gallstone, HCV, Chronic hepatiti, Female, business, Human
Abstract

We assessed the prevalence of gallbladder disease (i.e. gallstones plus cholecystectomy) among patients with liver disease and its association with the severity and aetiology of hepatic injury. Subjects, referred to 79 Italian hospitals, were enrolled in a 6-month period. The independent effect of the severity and aetiology of liver disease on gallstone disease prevalence was assessed by multiple logistic regression analysis. Overall, 4867 subjects tested anti-hepatitis C virus (HCV) positive alone, 839 were hepatitis B virus surface antigen (HBsAg) alone, and 652 had an excessive alcohol intake. The prevalence of gallstone disease was 23.3% in anti-HCV-positive patients, 12.4% in HBsAg positive and 24.2% in subjects reporting excessive alcohol intake, respectively. Gallstone disease prevalence increased by age in each aetiological category. The proportion of patients with gallstone disease who had a cholecystectomy was the highest in HCV+ subjects. After adjusting for the confounding effect of age and body mass index, compared with patients with less severe liver disease, subjects with HCV-related cirrhosis, but not those with alcohol-related cirrhosis, were more likely to have gallstone disease. Subjects with HCV-related cirrhosis (OR 2.13, 95% CI: 1.38-3.26) were more likely to have gallstone disease when compared with those with HBV-related cirrhosis. HCV infection is a risk factor for gallstone disease. In Italy, the high prevalence of HCV infection among cirrhotic patients has important implications, as cholecystectomy in these subjects is associated with high risk of morbidity and mortality. © 2007 The Authors. more...

Published
2007
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14. Programming of Intestinal Epithelial Differentiation by IL-33 Derived from Pericryptal Fibroblasts in Response to Systemic Infection

Author

Markus Kindermann, Manuela Hefele, Tamar Mchedlidze, Markus F. Neurath, Stefan Wirtz, Claudia Günther, Christoph Becker, Gui-Wei He, Stefania Vetrano, Silvio Danese, Sebastian Foersch, Mousumi Mahapatro, Elisa Giner-Ventura, Mahapatro, M, Foersch, S, Hefele, M, He, Gw, Giner-Ventura, E, Mchedlidze, T, Kindermann, M, Vetrano, S, Danese, S, Gunther, C, Neurath, Mf, Wirtz, S, and Becker, C more...

Subjects
0301 basic medicine, Salmonella typhimurium, Cellular differentiation, Population, Notch signaling pathway, Mice, Transgenic, Biology, digestive system, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, Intestine, Small, medicine, Animals, Humans, Cell Lineage, Progenitor cell, Intestinal Mucosa, education, lcsh:QH301-705.5, Cell Proliferation, education.field_of_study, Salmonella Infections, Animal, Receptors, Notch, Cell growth, Cell Differentiation, Epithelial Cells, Fibroblasts, Interleukin-33, Intestinal epithelium, Interleukin-1 Receptor-Like 1 Protein, Cell biology, Mice, Inbred C57BL, 030104 developmental biology, medicine.anatomical_structure, lcsh:Biology (General), Organ Specificity, Immunology, Paneth cell, Signal transduction, 030215 immunology, Signal Transduction
Abstract

SummaryThe intestinal epithelium constitutes an efficient barrier against the microbial flora. Here, we demonstrate an unexpected function of IL-33 as a regulator of epithelial barrier functions. Mice lacking IL-33 showed decreased Paneth cell numbers and lethal systemic infection in response to Salmonella typhimurium. IL-33 was produced upon microbial challenge by a distinct population of pericryptal fibroblasts neighboring the intestinal stem cell niche. IL-33 programmed the differentiation of epithelial progenitors toward secretory IEC including Paneth and goblet cells. Finally, IL-33 suppressed Notch signaling in epithelial cells and induced expression of transcription factors governing differentiation into secretory IEC. In summary, we demonstrate that gut pericryptal fibroblasts release IL-33 to translate bacterial infection into an epithelial response to promote antimicrobial defense. more...

Published
2015

15. The role of antitissue transglutaminase assay for the diagnosis and monitoring of coeliac disease: A French-Italian multicentre study

Author

Tonutti E., Visentini D., Bizzaro N., Caradonna M., Cerni L., Villalta D., Tozzoli R. F Ferrara, M Barraco, E Migali, D Mariotti, G Danzi, ML Martino, M Danzi, M Baldassarre, G Di Bitonto, M Ciccarelli, D Riello, G Bertiato, G Pedicini, RC Bocchino, F Moccia, G Alessio, P Amboni, C Ottomano, U Volta, A Granito, N Carabellese, R Amato, G Aurnia, C Spagnulo, P Clemen, F Coppola, G Spagnoletti, M Spina, T Trigilia, F Branciforte, L Giancotti, M Apollini, B Malamisura, A Sofia, M Boffardi, F Antico, P Arigliano, G Marcer, E Sala, ML Grassi, G Giana, C Staffa, V Cova, M Martinelli, A Calabrò, D Renzi, D Nigro, D Macchia, M Manfredi, E Cammelli, G Castellucci, L Ferraro, L Marchetti, G Garelli, M Colombo, E Castellano, M Cingolani, A Sabatino, A Di Blasi, M Golato, A Carlucci, G Spagnuolo, G Trivisonno, V Castelli, S Babbini, V Marrè, G Meli, S Amoroso, M Montesanti, E Mei, S Armelloni, C Gerosa, C Marcellino, C Gallo, R Pozzoli, M Peracchi, MT Bardella, C Trovato, VS Arosio, R Malberti, F Rea, MR Di Domenico, A Sergio, P Iardino, V Formicola, G Tamburro, A Massari, M Cirella, E Rondinella, A Pignero, D Scognamiglio, S Spagnuolo, S Orefice, V Romano, B Pennucci, A Maglione, S Lavecchia, A Rubino, O Leone, N Cantieri, F Michelutti, G Guariso, D Basso, S Teresi, E Gucciardino, M Di Gregorio, MA Trippiedi, P Greco, R Guadagna, E Maltese, T Imbastaro, G Lombardi, A Rossi, E Savi, L Spada, D Villalta, G Tabellini, M Saccarola, P Palumbo, G Marinucci, PM Strappini, F Viola, M Barbato, Roma, N Bizzaro, P Pasini, F Minetti, M Scogna, M Vascotto, G Morgese, F Bascietto, P Cantelmi, F Bulacanti, D Bassetti, S Santer, D Prizzon, S Loperfido, S Martelossi, T Not, A Ventura, E Tonutti, D Visentini, S Finazzi, S Salvatore, GV Melzi d’Eril, D Wolf, M Montesanto, M Negri, MG Azzeni, R Giordano, M Farina, S Micieli, V Gouilleux, O Bandin, A Tridon, M Meyer, F Bienvenu, G Beaune, S Jego, M San Marco, D Bernard, J Sarles, J Sahel, D Carre, S Benzaken, JF Demarquay, C Johanet, JJ Baudon., Tonutti E., Visentini D., Bizzaro N., Caradonna M., Cerni L., Villalta D., Tozzoli R. F Ferrara, M Barraco, E Migali, D Mariotti, G Danzi, ML Martino, M Danzi, M Baldassarre, G Di Bitonto, M Ciccarelli, D Riello, G Bertiato, G Pedicini, RC Bocchino, F Moccia, G Alessio, P Amboni, C Ottomano, U Volta, A Granito, N Carabellese, R Amato, G Aurnia, C Spagnulo, P Clemen, F Coppola, G Spagnoletti, M Spina, T Trigilia, F Branciforte, L Giancotti, M Apollini, B Malamisura, A Sofia, M Boffardi, F Antico, P Arigliano, G Marcer, E Sala, ML Grassi, G Giana, C Staffa, V Cova, M Martinelli, A Calabrò, D Renzi, D Nigro, D Macchia, M Manfredi, E Cammelli, G Castellucci, L Ferraro, L Marchetti, G Garelli, M Colombo, E Castellano, M Cingolani, A Sabatino, A Di Blasi, M Golato, A Carlucci, G Spagnuolo, G Trivisonno, V Castelli, S Babbini, V Marrè, G Meli, S Amoroso, M Montesanti, E Mei, S Armelloni, C Gerosa, C Marcellino, C Gallo, R Pozzoli, M Peracchi, MT Bardella, C Trovato, VS Arosio, R Malberti, F Rea, MR Di Domenico, A Sergio, P Iardino, V Formicola, G Tamburro, A Massari, M Cirella, E Rondinella, A Pignero, D Scognamiglio, S Spagnuolo, S Orefice, V Romano, B Pennucci, A Maglione, S Lavecchia, A Rubino, O Leone, N Cantieri, F Michelutti, G Guariso, D Basso, S Teresi, E Gucciardino, M Di Gregorio, MA Trippiedi, P Greco, R Guadagna, E Maltese, T Imbastaro, G Lombardi, A Rossi, E Savi, L Spada, D Villalta, G Tabellini, M Saccarola, P Palumbo, G Marinucci, PM Strappini, F Viola, M Barbato, Roma, and N Bizzaro, P Pasini, F Minetti, M Scogna, M Vascotto, G Morgese, F Bascietto, P Cantelmi, F Bulacanti, D Bassetti, S Santer, D Prizzon, S Loperfido, S Martelossi, T Not, A Ventura, E Tonutti, D Visentini, S Finazzi, S Salvatore, GV Melzi d’Eril, D Wolf, M Montesanto, M Negri, MG Azzeni, R Giordano, M Farina, S Micieli, V Gouilleux, O Bandin, A Tridon, M Meyer, F Bienvenu, G Beaune, S Jego, M San Marco, D Bernard, J Sarles, J Sahel, D Carre, S Benzaken, JF Demarquay, C Johanet, JJ Baudon. more...

Subjects
Immunoglobulin A, Adult, Male, Adolescent, Tissue transglutaminase, Reproducibility of Result, Enzyme-Linked Immunosorbent Assay, Autoantigens, Sensitivity and Specificity, Coeliac disease, Pathology and Forensic Medicine, Serology, Antigen, Autoantigen, Immunopathology, Humans, Medicine, Age Factor, Child, Autoantibodies, Transglutaminases, biology, business.industry, Age Factors, Reproducibility of Results, Infant, Original Articles, General Medicine, Biomarker, medicine.disease, Autoantibodie, Celiac Disease, Child, Preschool, Immunoglobulin G, Immunology, biology.protein, Gluten free, Female, Antibody, business, Biomarkers, Human
Abstract

Aims: Tissue transglutaminase (tTG) was recently identified as the major autoantigen in coeliac disease. The aim of this multicentre study was to evaluate the impact of a new immunoenzymatic assay for the detection of IgA anti-tGT antibodies. Methods: Seventy four Italian and French clinical laboratories participated in this study; anti-tTG IgA with an enzyme linked immunosorbent assay (ELISA) method using guinea pig liver extract as the coating antigen, anti-endomysium IgA autoantibodies (EMA), and total serum IgA were determined in 7948 patients, 1162 of whom had coeliac disease (737 untreated cases and 425 on a gluten free diet). A proportion of the sera were then sent to a reference laboratory for anti-tTG retesting with an ELISA method using recombinant human tTG antigen. Results: Seven thousand four hundred and fifty eight (93.8%) sera were EMA/antiguinea pig tTG concordant (positive or negative); 490 (6.2%) were non-concordant. The sensitivity of EMA and antiguinea pig tTG in the 737 untreated patients with coeliac disease was 92.1% and 94.8%, respectively, and the specificity was 99.8% and 99.2%, respectively. Retesting of the discordant sera showed that of the 162 sera classified as EMA negative/antiguinea pig tTG positive, only 49 were positive for human recombinant anti-tTG, and that 39 of these were also EMA positive. Furthermore, of the 36 sera classified as EMA positive/antiguinea pig tTG negative, only two were confirmed as EMA positive. Conclusions: The antiguinea pig tTG assay is more sensitive but less specific than EMA, whereas the antihuman recombinant tTG assay is far more specific and just as sensitive as antiguinea pig tTG. Testing for EMA presents considerable interpretative problems and is difficult to standardise. more...

Published
2003