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1. Is BMI Associated with COVID-19 Severity? A Retrospective Observational Study

Author: Candelli, Marcello, Pignataro, Giulia, Saviano, Angela, Ojetti, Veronica, Gabrielli, Maurizio, Piccioni, Andrea, Gullì, Antonio, Antonelli, Massimo, Gasbarrini, Antonio, Franceschi, Francesco, Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Candelli, Marcello, Pignataro, Giulia, Saviano, Angela, Ojetti, Veronica, Gabrielli, Maurizio, Piccioni, Andrea, Gullì, Antonio, Antonelli, Massimo, Gasbarrini, Antonio, Franceschi, Francesco, Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), and Franceschi, Francesco (ORCID:0000-0001-6266-445X)
Abstract: Background: Coronavirus-19 disease (COVID-19) is an infection with high morbidity and mortality. Obesity and low body mass index (BMI) have both been linked to severe COVID-19, but recent studies have failed to confirm these associations. Objectives: The aim of this study was to examine the relationship between BMI and disease progression in hospitalised patients with COVID-19. Methods: We performed a monocentric, retrospective observational study at the Fondazione Policlinico Gemelli in Rome. We enrolled 1544 (977 men) patients who presented to the emergency department with a positive COVID-19 test between January and December 2021. We divided patients into five classes based on BMI. Demographic, clinical, laboratory, and radiological data were collected for all patients. Results: Of the 1544 patients, 1297 recovered after hospitalization, whereas 247 (16%) died. Of those who died, 16/247 (6.5%) had a BMI below18.5 kg/m2, 72/247 (29%) had a BMI between 18.5 and 24.99 kg/m2, 103/247 (42%) had a BMI between 25 and 29.99 kg/m2, 36/247 (15%) had a BMI between 30 and 35 kg/m2, and 20/247 (8%) had a BMI above 35 kg/m2. After adjusting the results for age, sex, and concomitant diseases using multivariate logistic regression, we found a significantly increased risk of intensive care unit (ICU) admission in severely obese patients (BMI > 35) compared to normal weight patients (BMI: 18.5-24.99) (p > 0.001). Mortality was not associated with BMI. Conclusion: We confirm that severe obesity is a risk factor for ICU admission in patients with COVID-19. No association was found between BMI and mortality.
Published: 2023

2. The Impact of Smoking on Microbiota: A Narrative Review

Author: Cicchinelli, Sara, Rosa, Federico, Manca, Federica, Zanza, Christian, Ojetti, Veronica, Covino, Marcello, Candelli, Marcello, Gasbarrini, Antonio, Franceschi, Francesco, Piccioni, Andrea, Ojetti, Veronica (ORCID:0000-0002-8953-0707), Covino, Marcello (ORCID:0000-0002-6709-2531), Candelli, Marcello (ORCID:0000-0001-8443-7880), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Cicchinelli, Sara, Rosa, Federico, Manca, Federica, Zanza, Christian, Ojetti, Veronica, Covino, Marcello, Candelli, Marcello, Gasbarrini, Antonio, Franceschi, Francesco, Piccioni, Andrea, Ojetti, Veronica (ORCID:0000-0002-8953-0707), Covino, Marcello (ORCID:0000-0002-6709-2531), Candelli, Marcello (ORCID:0000-0001-8443-7880), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), and Franceschi, Francesco (ORCID:0000-0001-6266-445X)
Abstract: Cigarette smoke is a classic risk factor for many diseases. The microbiota has been recently indicated as a new, major player in human health. Its deregulation-dysbiosis-is considered a new risk factor for several illnesses. Some studies highlight a cross-interaction between these two risk factors-smoke and dysbiosis-that may explain the pathogenesis of some diseases. We searched the keywords '' smoking OR smoke AND microbiota '' in the title of articles on PubMed((R)), UptoDate((R)), and Cochrane((R)). We included articles published in English over the last 25 years. We collected approximately 70 articles, grouped into four topics: oral cavity, airways, gut, and other organs. Smoke may impair microbiota homeostasis through the same harmful mechanisms exerted on the host cells. Surprisingly, dysbiosis and its consequences affect not only those organs that are in direct contact with the smoke, such as the oral cavity or the airways, but also involve distant organs, such as the gut, heart, vessels, and genitourinary tract. These observations yield a deeper insight into the mechanisms implicated in the pathogenesis of smoke-related diseases, suggesting a role of dysbiosis. We speculate that modulation of the microbiota may help prevent and treat some of these illnesses.
Published: 2023

3. Effect of COVID-19 Vaccination on the In-Hospital Prognosis of Patients Admitted during Delta and Omicron Waves in Italy

Author: Cianci, Rossella, Franza, Laura, Pignataro, Giulia, Massaro, Maria Grazia, Rio, Pierluigi, Tota, Antonio, Ocarino, Francesca, Sacco Fernandez, Marta, Franceschi, Francesco, Gasbarrini, Antonio, Gambassi, Giovanni, Candelli, Marcello, Cianci, Rossella (ORCID:0000-0001-5378-8442), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Gambassi, Giovanni (ORCID:0000-0002-7030-9359), Candelli, Marcello (ORCID:0000-0001-8443-7880), Cianci, Rossella, Franza, Laura, Pignataro, Giulia, Massaro, Maria Grazia, Rio, Pierluigi, Tota, Antonio, Ocarino, Francesca, Sacco Fernandez, Marta, Franceschi, Francesco, Gasbarrini, Antonio, Gambassi, Giovanni, Candelli, Marcello, Cianci, Rossella (ORCID:0000-0001-5378-8442), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Gambassi, Giovanni (ORCID:0000-0002-7030-9359), and Candelli, Marcello (ORCID:0000-0001-8443-7880)
Abstract: All-cause mortality related to the SARS-CoV-2 infection has declined from the first wave to subsequent waves, probably through vaccination programs and the availability of effective antiviral therapies. Our study aimed to evaluate the impact of the SARS-CoV-2 vaccination on the prognosis of infected patients. Overall, we enrolled 545 subjects during the Delta variant wave and 276 ones during the Omicron variant wave. Data were collected concerning vaccination status, clinical parameters, comorbidities, lung involvement, laboratory parameters, and pharmacological treatment. Outcomes were admission to the intensive care unit (ICU) and 30-day all-cause mortality. Overall, the final sample included 821 patients with a mean age of 62 +/- 18 years [range 18-100], and 59% were men. Vaccinated patients during the Delta wave were 37% (over 3/4 with two doses), while during the Omicron wave they were 57%. Vaccinated patients were older (68 vs. 57 years), and 62% had at least one comorbidity Admission to the ICU was 20%, and the mortality rate at 30 days was 14%. ICU admissions were significantly higher during the Delta wave than during Omicron (OR 1.9, 95% CI 1.2-3.1), while all-cause mortality did not differ. Unvaccinated patients had a higher risk of ICU admission (OR 2.0, 95% CI 1.3-3.1) and 30-day all-cause mortality (OR 1.7, 95% CI 1.3-2.7). Results were consistent for both Delta and Omicron variants. Overall, vaccination with at least two doses was associated with a reduced need for ICU admission. Even one shot of the vaccine was associated with a significantly reduced 30-day mortality.
Published: 2023

4. Familial Hypercholesterolemia and Acute Coronary Syndromes: The Microbiota-Immunity Axis in the New Diagnostic and Prognostic Frontiers

Author: Piccioni, Andrea, Niccolai, Elena, Rozzi, Gloria, Spaziani, Giacomo, Zanza, Christian, Candelli, Marcello, Covino, Marcello, Gasbarrini, Antonio, Franceschi, Francesco, Amedei, Amedeo, Candelli, Marcello (ORCID:0000-0001-8443-7880), Covino, Marcello (ORCID:0000-0002-6709-2531), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Piccioni, Andrea, Niccolai, Elena, Rozzi, Gloria, Spaziani, Giacomo, Zanza, Christian, Candelli, Marcello, Covino, Marcello, Gasbarrini, Antonio, Franceschi, Francesco, Amedei, Amedeo, Candelli, Marcello (ORCID:0000-0001-8443-7880), Covino, Marcello (ORCID:0000-0002-6709-2531), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), and Franceschi, Francesco (ORCID:0000-0001-6266-445X)
Abstract: Familial hypercholesterolemia is a common genetic disorder with a propensity towards early onset of atherosclerotic cardiovascular disease (CVD). The main goal of therapy is to reduce the LDL cholesterol and the current treatment generally consists of statin, ezetimibe and PCSK9 inhibitors. Unfortunately, lowering LDL cholesterol may be difficult for many reasons such as the variation of response to statin therapy among the population or the high cost of some therapies (i.e., PCSK9 inhibitors). In addition to conventional therapy, additional strategies may be used. The gut microbiota has been recently considered to play a part in chronic systemic inflammation and hence in CVD. Several studies, though they are still preliminary, consider dysbiosis a risk factor for various CVDs through several mechanisms. In this review, we provide an update of the current literature about the intricate relation between the gut microbiota and the familial hypercholesterolemia.
Published: 2023

5. Pancreatic Cancer Resistance to Treatment: The Role of Microbiota

Author: Nista, Enrico Celestino, Del Gaudio, Angelo, Del Vecchio, Livio Enrico, Mezza, Teresa, Pignataro, Giulia, Piccioni, Andrea, Gasbarrini, Antonio, Franceschi, Francesco, Candelli, Marcello, Mezza, Teresa (ORCID:0000-0001-5407-9576), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Candelli, Marcello (ORCID:0000-0001-8443-7880), Nista, Enrico Celestino, Del Gaudio, Angelo, Del Vecchio, Livio Enrico, Mezza, Teresa, Pignataro, Giulia, Piccioni, Andrea, Gasbarrini, Antonio, Franceschi, Francesco, Candelli, Marcello, Mezza, Teresa (ORCID:0000-0001-5407-9576), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Franceschi, Francesco (ORCID:0000-0001-6266-445X), and Candelli, Marcello (ORCID:0000-0001-8443-7880)
Abstract: Pancreatic cancer (PC) is an aggressive malignancy and the fourth leading cause of cancer death in the United States and Europe. It is estimated that PC will be the second leading cause of cancer death by 2030. In addition to late diagnosis, treatment resistance is a major cause of shortened survival in pancreatic cancer. In this context, there is growing evidence that microbes play a regulatory role, particularly in therapy resistance and in creating a microenvironment in the tumor, that favors cancer progression. The presence of certain bacteria belonging to the gamma-proteobacteria or mycoplasmas appears to be associated with both pharmacokinetic and pharmacodynamic changes. Recent evidence suggests that the microbiota may also play a role in resistance mechanisms to immunotherapy and radiotherapy. However, the interactions between microbiota and therapy are bilateral and modulate therapy tolerance. Future perspectives are increasingly focused on elucidating the role of the microbiota in tumorigenesis and processes of therapy resistance, and a better understanding of these mechanisms may provide important opportunities to improve survival in these patients.
Published: 2023

6. Is BMI Associated with Covid-19 Severity? A Retrospective Observational Study

Author: Candelli, Marcello, Pignataro, Giulia, Saviano, Angela, Ojetti, Veronica, Gabrielli, Maurizio, Piccioni, Andrea, Gullì, Antonio, Antonelli, Massimo, Gasbarrini, Antonio, Franceschi, Francesco, Candelli, Marcello (ORCID:0000-0001-8443-7880), Saviano, Angela (ORCID:0000-0002-2820-7180), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Candelli, Marcello, Pignataro, Giulia, Saviano, Angela, Ojetti, Veronica, Gabrielli, Maurizio, Piccioni, Andrea, Gullì, Antonio, Antonelli, Massimo, Gasbarrini, Antonio, Franceschi, Francesco, Candelli, Marcello (ORCID:0000-0001-8443-7880), Saviano, Angela (ORCID:0000-0002-2820-7180), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), and Franceschi, Francesco (ORCID:0000-0001-6266-445X)
Abstract: Background: Coronavirus-19 disease (Covid-19) is an infection with high morbidity and mortality. Obesity and low body mass index (BMI) have both been linked to severe Covid-19, but recent studies have failed to confirm these associations. Objectives: The aim of this study was to examine the relationship between BMI and disease progression in hospitalised patients with Covid-19. Methods: We performed a monocentric, retrospective observational study at the Fondazione Policlinico Gemelli in Rome. We enrolled 1544 (977 men) patients who presented to the emergency department with a positive Covid-19 test between January and December 2021. We divided patients into five classes based on BMI. Demographic, clinical, laboratory, and radiological data were collected for all patients. Results: Of the 1544 patients, 1297 recovered after hospitalization, whereas 247 (16%) died. Of those who died, 16/247 (6.5%) had a BMI below18.5 kg/m2, 72/247 (29%) had a BMI between 18.5 and 24.99 kg/m2, 103/247 (42%) had a BMI between 25 and 29.99 kg/m2, 36/247 (15%) had a BMI between 30 and 35 kg/m2, and 20/247 (8%) had a BMI above 35 kg/m2. After adjusting the results for age, sex, and concomitant diseases using multivariate logistic regression, we found a significantly increased risk of intensive care unit (ICU) admission in severely obese patients (BMI > 35) compared to normal weight patients (BMI: 18.5-24.99) (p > 0.001). Mortality was not associated with BMI. Conclusion: We confirm that severe obesity is a risk factor for ICU admission in patients with Covid-19. No association was found between BMI and mortality.
Published: 2023

7. The Impact of Smoking on Microbiota: A Narrative Review

Author: Cicchinelli, Sara, Rosa, Federico, Manca, Federica, Zanza, Christian, Ojetti, Veronica, Covino, Marcello, Candelli, Marcello, Gasbarrini, Antonio, Franceschi, Francesco, Piccioni, Andrea, Ojetti, Veronica (ORCID:0000-0002-8953-0707), Covino, Marcello (ORCID:0000-0002-6709-2531), Candelli, Marcello (ORCID:0000-0001-8443-7880), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Cicchinelli, Sara, Rosa, Federico, Manca, Federica, Zanza, Christian, Ojetti, Veronica, Covino, Marcello, Candelli, Marcello, Gasbarrini, Antonio, Franceschi, Francesco, Piccioni, Andrea, Ojetti, Veronica (ORCID:0000-0002-8953-0707), Covino, Marcello (ORCID:0000-0002-6709-2531), Candelli, Marcello (ORCID:0000-0001-8443-7880), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), and Franceschi, Francesco (ORCID:0000-0001-6266-445X)
Abstract: Cigarette smoke is a classic risk factor for many diseases. The microbiota has been recently indicated as a new, major player in human health. Its deregulation-dysbiosis-is considered a new risk factor for several illnesses. Some studies highlight a cross-interaction between these two risk factors-smoke and dysbiosis-that may explain the pathogenesis of some diseases. We searched the keywords '' smoking OR smoke AND microbiota '' in the title of articles on PubMed((R)), UptoDate((R)), and Cochrane((R)). We included articles published in English over the last 25 years. We collected approximately 70 articles, grouped into four topics: oral cavity, airways, gut, and other organs. Smoke may impair microbiota homeostasis through the same harmful mechanisms exerted on the host cells. Surprisingly, dysbiosis and its consequences affect not only those organs that are in direct contact with the smoke, such as the oral cavity or the airways, but also involve distant organs, such as the gut, heart, vessels, and genitourinary tract. These observations yield a deeper insight into the mechanisms implicated in the pathogenesis of smoke-related diseases, suggesting a role of dysbiosis. We speculate that modulation of the microbiota may help prevent and treat some of these illnesses.
Published: 2023

8. Nutrition in Acute Pancreatitis: From the Old Paradigm to the New Evidence

Author: De Lucia, Sara Sofia, Candelli, Marcello, Polito, Giorgia, Maresca, Rossella, Mezza, Teresa, Schepis, Tommaso, Pellegrino, Antonio Agostino, Zileri Dal Verme, Lorenzo, Nicoletti, Alberto, Franceschi, Francesco, Gasbarrini, Antonio, Nista, Enrico Celestino, Candelli, Marcello (ORCID:0000-0001-8443-7880), Mezza, Teresa (ORCID:0000-0001-5407-9576), Pellegrino, Antonio, Franceschi, Francesco (ORCID:0000-0001-6266-445X), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), De Lucia, Sara Sofia, Candelli, Marcello, Polito, Giorgia, Maresca, Rossella, Mezza, Teresa, Schepis, Tommaso, Pellegrino, Antonio Agostino, Zileri Dal Verme, Lorenzo, Nicoletti, Alberto, Franceschi, Francesco, Gasbarrini, Antonio, Nista, Enrico Celestino, Candelli, Marcello (ORCID:0000-0001-8443-7880), Mezza, Teresa (ORCID:0000-0001-5407-9576), Pellegrino, Antonio, Franceschi, Francesco (ORCID:0000-0001-6266-445X), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: The nutritional management of acute pancreatitis (AP) patients has widely changed over time. The "pancreatic rest" was the cornerstone of the old paradigm, and nutritional support was not even included in AP management. Traditional management of AP was based on intestinal rest, with or without complete parenteral feeding. Recently, evidence-based data underlined the superiority of early oral or enteral feeding with significantly decreased multiple-organ failure, systemic infections, surgery need, and mortality rate. Despite the current recommendations, experts still debate the best route for enteral nutritional support and the best enteral formula. The aim of this work is to collect and analyze evidence over the nutritional aspects of AP management to investigate its impact. Moreover, the role of immunonutrition and probiotics in modulating inflammatory response and gut dysbiosis during AP was extensively studied. However, we have no significant data for their use in clinical practice. This is the first work to move beyond the mere opposition between the old and the new paradigm, including an analysis of several topics still under debate in order to provide a comprehensive overview of nutritional management of AP.
Published: 2023

9. Gut Microbiota, LADA, and Type 1 Diabetes Mellitus: An Evolving Relationship

Author: Piccioni, Andrea, Rosa, Federico, Mannucci, Sergio, Manca, Federica, Merra, Giuseppe, Chiloiro, Sabrina, Candelli, Marcello, Covino, Marcello, Gasbarrini, Antonio, Franceschi, Francesco, Chiloiro, Sabrina (ORCID:0000-0001-9241-2392), Candelli, Marcello (ORCID:0000-0001-8443-7880), Covino, Marcello (ORCID:0000-0002-6709-2531), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Piccioni, Andrea, Rosa, Federico, Mannucci, Sergio, Manca, Federica, Merra, Giuseppe, Chiloiro, Sabrina, Candelli, Marcello, Covino, Marcello, Gasbarrini, Antonio, Franceschi, Francesco, Chiloiro, Sabrina (ORCID:0000-0001-9241-2392), Candelli, Marcello (ORCID:0000-0001-8443-7880), Covino, Marcello (ORCID:0000-0002-6709-2531), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), and Franceschi, Francesco (ORCID:0000-0001-6266-445X)
Abstract: There is much evidence confirming the crucial role played by the gut microbiota in modulating the immune system in the onset of autoimmune diseases. In this article, we focus on the relationship between alterations in the microbiome and the onset of diabetes mellitus type 1 and LADA, in light of the latest evidence. We will then look at both how the role of the gut microbiota appears to be increasingly crucial in the pathogenesis of these disorders and how this aspect may be instrumental in the development of new potential therapeutic strategies that modulate the gut microbiota, such as probiotics, prebiotics, and fecal microbiota transplantation.
Published: 2023

10. Gut Microbiota and Autoimmune Diseases: A Charming Real World Together with Probiotics

Author: Piccioni, Andrea, Cicchinelli, Sara, Valletta, Federico, De Luca, Giulio, Longhitano, Yaroslava, Candelli, Marcello, Ojetti, Veronica, Sardeo, Francesco, Navarra, Simone, Covino, Marcello, Franceschi, Francesco, Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Covino, Marcello (ORCID:0000-0002-6709-2531), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Piccioni, Andrea, Cicchinelli, Sara, Valletta, Federico, De Luca, Giulio, Longhitano, Yaroslava, Candelli, Marcello, Ojetti, Veronica, Sardeo, Francesco, Navarra, Simone, Covino, Marcello, Franceschi, Francesco, Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Covino, Marcello (ORCID:0000-0002-6709-2531), and Franceschi, Francesco (ORCID:0000-0001-6266-445X)
Abstract: Background: The role of gut microbiota in human disease is fascinating for hundreds of researchers worldwide. Many works have highlighted that gut microbiota modulates the immune system and that its disruption can trigger autoimmune and inflammatory immune-mediated diseases. Probiotics are able to positively modify microbiota composition. Objective: The aim of this review is to report the most important findings regarding the effects of probiotics administration in the most common autoimmune disease and inflammatory immune-mediated diseases. Methods: Literature research was performed in PubMed, Google Scholar, and Medline, as well as in specific journal websites using the keywords: "autoimmunity", "microbiota", and "probiotics". The article selection has been made independently by three authors, and controversies have been solved by a fourth researcher. Only English-language articles were included and preference was given to clinical trials, meta-analysis, and case series. After the review process, 68 articles have been considered. Results: Relying on this evidence, many studies have investigated the potential of probiotics in restoring gut eubiosis, thus affecting pathogenesis, clinical manifestations, and course of these pathologies. Even in the light of few and sometimes contradictory studies, physicians should start to consider these preliminary findings when approaching patients suffering from autoimmune disease. After an accurate case-by-case evaluation of potential candidates, probiotics might be introduced besides the standard therapeutic plan as supportive measures.
Published: 2022

11. Clinical Implications of Helicobacter pylori Antibiotic Resistance in Italy: A Review of the Literature

Author: Nista, Enrico Celestino, Pellegrino, Antonio Agostino, Giuli, Lucia, Candelli, Marcello, Schepis, Tommaso, De Lucia, Sara Sofia, Ojetti, Veronica, Franceschi, Francesco, Gasbarrini, Antonio, Pellegrino, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Nista, Enrico Celestino, Pellegrino, Antonio Agostino, Giuli, Lucia, Candelli, Marcello, Schepis, Tommaso, De Lucia, Sara Sofia, Ojetti, Veronica, Franceschi, Francesco, Gasbarrini, Antonio, Pellegrino, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Franceschi, Francesco (ORCID:0000-0001-6266-445X), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: Helicobacter pylori (H. pylori) resistance to antibiotics has increased worldwide in recent decades, especially to clarithromycin. As a result, the World Health Organization (WHO) identified clarithromycin-resistant H. pylori as a "high priority" pathogen in 2017. As international guidelines recommend empirical therapy as first-line treatment, it is crucial to know local resistance rates and history of antibiotic use to determine the most appropriate first-line antibiotic treatment. Italy is one of the European countries with the highest prevalence of H. pylori infection and the highest percentage of antibiotic-resistant H. pylori. The aim of this review is to summarize all data on H. pylori antibiotic resistance in Italy in order to quantify the current rate and determine the most effective therapeutic approach. The study confirms an elevated level of resistance to clarithromycin, metronidazole, and levofloxacin in Italy. In addition, our results show a satisfactory eradication rate for a bismuth-based regimen when used as first- or second-line treatment. Naive patients are also successfully treated with clarithromycin-based quadruple therapies. Considering the good results of bismuth-based therapy as recovery therapy, this argues for the potential use of clarithromycin quadruple therapy as a first-line treatment.
Published: 2022

12. Autoimmune Pancreatitis: From Pathogenesis to Treatment

Author: Nista, Enrico Celestino, De Lucia, Sara Sofia, Manilla, Vittoria, Schepis, Tommaso, Pellegrino, Antonio Agostino, Ojetti, Veronica, Pignataro, Giulia, Zileri Dal Verme, Lorenzo, Franceschi, Francesco, Gasbarrini, Antonio, Candelli, Marcello, Pellegrino, Antonio, Ojetti, Veronica (ORCID:0000-0002-8953-0707), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Candelli, Marcello (ORCID:0000-0001-8443-7880), Nista, Enrico Celestino, De Lucia, Sara Sofia, Manilla, Vittoria, Schepis, Tommaso, Pellegrino, Antonio Agostino, Ojetti, Veronica, Pignataro, Giulia, Zileri Dal Verme, Lorenzo, Franceschi, Francesco, Gasbarrini, Antonio, Candelli, Marcello, Pellegrino, Antonio, Ojetti, Veronica (ORCID:0000-0002-8953-0707), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), and Candelli, Marcello (ORCID:0000-0001-8443-7880)
Abstract: Autoimmune pancreatitis (AIP) is a rare disease. The diagnosis of AIP is difficult and should be made by a comprehensive evaluation of clinical, radiological, serological, and pathological findings. Two different types of AIP have been identified: autoimmune pancreatitis type 1 (AIP-1), which is considered a pancreatic manifestation of multiorgan disease related to IgG4, and autoimmune pancreatitis type 2 (AIP-2), which is considered a pancreas-specific disease not related to IgG4. Although the pathophysiological conditions seem to differ between type 1 and type 2 pancreatitis, both respond well to steroid medications. In this review, we focused on the pathogenesis of the disease to develop a tool that could facilitate diagnosis and lead to the discovery of new therapeutic strategies to combat autoimmune pancreatitis and its relapses. The standard therapy for AIP is oral administration of corticosteroids. Rituximab (RTX) has also been proposed for induction of remission and maintenance therapy in relapsing AIP-1. In selected patients, immunomodulators such as azathioprine are used to maintain remission. The strength of this review, compared with previous studies, is that it focuses on the clear difference between the two types of autoimmune pancreatitis with a clearly delineated and separate pathogenesis. In addition, the review also considers various therapeutic options, including biologic drugs, such as anti-tumor necrosis factor (TNF) therapy, a well-tolerated and effective second-line therapy for AIP type 2 relapses or steroid dependence. Other biologic therapies are also being explored that could provide a useful therapeutic alternative to corticosteroids and immunosuppressants, which are poorly tolerated due to significant side effects.
Published: 2022

13. Gut Microbiota and Clostridium difficile: What We Know and the New Frontiers

Author: Piccioni, Andrea, Rosa, Federico, Manca, Federica, Pignataro, Giulia, Zanza, Christian, Savioli, Gabriele, Covino, Marcello, Ojetti, Veronica, Gasbarrini, Antonio, Franceschi, Francesco, Candelli, Marcello, Covino, Marcello (ORCID:0000-0002-6709-2531), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Candelli, Marcello (ORCID:0000-0001-8443-7880), Piccioni, Andrea, Rosa, Federico, Manca, Federica, Pignataro, Giulia, Zanza, Christian, Savioli, Gabriele, Covino, Marcello, Ojetti, Veronica, Gasbarrini, Antonio, Franceschi, Francesco, Candelli, Marcello, Covino, Marcello (ORCID:0000-0002-6709-2531), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Franceschi, Francesco (ORCID:0000-0001-6266-445X), and Candelli, Marcello (ORCID:0000-0001-8443-7880)
Abstract: Our digestive system, particularly our intestines, harbors a vast amount of microorganisms, whose genetic makeup is referred to as the microbiome. Clostridium difficile is a spore-forming Gram-positive bacterium, which can cause an infection whose symptoms range from asymptomatic colonization to fearsome complications such as the onset of toxic megacolon. The relationship between gut microbiota and Clostridium difficile infection has been studied from different perspectives. One of the proposed strategies is to be able to specifically identify which types of microbiota alterations are most at risk for the onset of CDI. In this article, we understood once again how crucial the role of the human microbiota is in health and especially how crucial it becomes, in the case of its alteration, for the individual's disease. Clostridium difficile infection is an emblematic example of how a normal and physiological composition of the human microbiome can play a very important role in immune defense against such a fearsome disease.
Published: 2022

14. Gastrointestinal Bleeding Due to NOACs Use: Exploring the Molecular Mechanisms

Author: Saviano, Angela, Brigida, Mattia, Petruzziello, Carmine, Candelli, Marcello, Gabrielli, Maurizio, Ojetti, Veronica, Saviano, Angela (ORCID:0000-0002-2820-7180), Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Saviano, Angela, Brigida, Mattia, Petruzziello, Carmine, Candelli, Marcello, Gabrielli, Maurizio, Ojetti, Veronica, Saviano, Angela (ORCID:0000-0002-2820-7180), Candelli, Marcello (ORCID:0000-0001-8443-7880), and Ojetti, Veronica (ORCID:0000-0002-8953-0707)
Abstract: Novel oral anticoagulants (NOACs) are drugs approved for the prevention and treatment of many thromboembolic cardiovascular conditions as a safer alternative to warfarin. We reviewed studies published in PubMed(R), UpToDate(R), Web of Science(R), and Cochrane(R) about NOACs' risks and benefits in patients requiring anticoagulation, with a focus on gastrointestinal bleeding and on molecular and pathophysiological mechanisms underlying the risk of bleeding in patients treated with them. Apixaban resulted in a lower rate of gastrointestinal bleeding compared to dabigatran and rivaroxaban. However, data reported that gastrointestinal bleeding in patients treated with NOACs was less severe compared to warfarin. Studies show promising results on the increased and widespread use of NOACs in patients who require anticoagulation (for example-in case of atrial fibrillation or high risk of venous thromboembolism), reporting an overall lower risk of major bleeding events. The profile of NOACs was more effective and secure compared to warfarin, but a more careful medical prescription is required in patients who are at high risk of gastrointestinal bleeding.
Published: 2022

15. The Gut Microbiota-Brain Axis in Acute Neurological Disease: Focus on Stroke

Author: Saviano, Angela, Gayani, Gunawardena, Migneco, Alessio, Candelli, Marcello, Franceschi, Francesco, Ojetti, Veronica, Zanza, Christian, Longhitano, Yaroslava, Saviano, Angela (ORCID:0000-0002-2820-7180), Candelli, Marcello (ORCID:0000-0001-8443-7880), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Saviano, Angela, Gayani, Gunawardena, Migneco, Alessio, Candelli, Marcello, Franceschi, Francesco, Ojetti, Veronica, Zanza, Christian, Longhitano, Yaroslava, Saviano, Angela (ORCID:0000-0002-2820-7180), Candelli, Marcello (ORCID:0000-0001-8443-7880), Franceschi, Francesco (ORCID:0000-0001-6266-445X), and Ojetti, Veronica (ORCID:0000-0002-8953-0707)
Abstract: The gut microbiota is one of the great innovations of modern medicine. In the modern microbiota revolution era, more comprehensive and in-depth studies have been performed regarding the microbial gut communities and their impact on acute and chronic diseases, including those of the nervous system as acute neurological diseases. The microbiota has changed our knowledge of medical conditions; in particular, considering stroke (both ischemic and hemorrhagic), literature studies, experimental and clinical researches indicate that the individual's risk and outcomes are substantially impacted by the gut microbiota. The aim of our review article is to investigate and discuss the recent insights into the emerging role of this complex "gut microbiota-brain axis" in affecting some acute neurological diseases, such as stroke, responsible for a significant number of deaths worldwide. We performed electronic research on PubMed (R) and collected articles published in the last ten years, finding that changes in the gut microbiota composition could affect various aspects of stroke pathophysiology and individual predisposition, risk, and outcomes. Our review article suggests that there is a strong connection between the gut microbiota and the brain, both in health and in acute neurological diseases such as stroke. Investigating and exploring this relationship can be a challenge useful to learn more about this disabling/deadly condition, and it can be a useful tool to identify novel potential therapeutic approaches, improving an individual's outcomes and life.
Published: 2022

16. Asthma in patients admitted to emergency department for COVID-19: prevalence and risk of hospitalization

Author: Gabrielli, Maurizio, Pignataro, Giulia, Candelli, Marcello, Sacco Fernandez, Marta, Bizzarri, Martina, Esperide, Alessandra, Franceschi, Francesco, Abbate, Valeria, Nicola, Acampora, Addolorato, Giovanni, Agostini, Fabiana, Ainora, Maria Elena, Akacha, Karim, Amato, Elena, Andreani, Francesca, Andriollo, Gloria, Annetta, Maria Giuseppina, Annicchiarico, Brigida Eleonora, Mariangela, Antonelli, Antonucci, Gabriele, Marco, Anzellotti Gian, Armuzzi, Alessandro, Baldi, Fabiana, Barattucci, Ilaria, Barillaro, Christian, Fabiana, Barone, Bellantone, Rocco Domenico Alfonso, Andrea, Bellieni, Bello, Giuseppe, Benicchi, Andrea, Benvenuto, Francesca, Berardini, Ludovica, Berloco, Filippo, Bernabei, Roberto, Bianchi, Antonio, Biasucci, Daniele Guerino, Biasucci, Luigi Marzio, Stefano, Bibbò, Bini, Alessandra, Alessandra, Bisanti, Biscetti, Federico, Bocci, Maria Grazia, Nicola, Bonadia, Bongiovanni, Filippo, Borghetti, Alberto, Bosco, Giulia, Bosello, Silvia Laura, Bove, Vincenzo, Bramato, Giulia, Brandi, Vincenzo, Teresa, Bruni, Bruno, Carmine, Bruno, Dario, Bungaro, Maria Chiara, Buonomo, Alessandro, Livia, Burzo, Angelo, Calabrese, Rosaria, Calvello Maria, Andrea, Cambieri, Cambise, Chiara, Camma, Giulia, Gennaro, Canistro, Antonello, Cantanale, Capalbo, Gennaro, Capaldi, Lorenzo, Capone, Emanuele, Capristo, Esmeralda, Carbone, Luigi, Silvia, Cardone, Carelli, Simone, Carfi', Angelo, Annamaria, Carnicelli, Caruso, Cristiano, Antonio, Casciaro Francesco, Catalano, Lucio, Cauda, Roberto, Cecchini, Andrea Leonardo, Cerrito, Lucia, Melania, Cesarano, Chiarito, Annalisa, Cianci, Rossella, Cicetti, Marta, Cicchinelli, Sara, Arturo, Ciccullo, Ciciarello, Francesca, Cingolani, Antonella, Cipriani, Maria Camilla, Consalvo, Ludovica Maria, Coppola, Gaetano, Corbo, Giuseppe Maria, Corsello, Andrea, Costante, Federico, Matteo, Costanzi, Covino, Marcello, Davide, Crupi, Lucio, Cutuli Salvatore, D'Addio, Stefano, D'Alessandro, Alessia, D'Alfonso, Maria Elena, D'Angelo, Emanuela, Francesca, D’Aversa, Damiano, Fernando, De Maria, Berardinis Gian, De Cunzo, Tommaso, De Gaetano Donati, Katleen, De Luca, Giulio, De Matteis, Giuseppe, De Pascale, Gennaro, De Paolo, Santi, De Martina, Siena, De Francesco, Vito, Del Valeria, Gatto, Del Paola, Giacomo, Del Fabio, Zompo, Maria, Dell’Anna Antonio, Della Davide, Polla, Di Luca, Gialleonardo, Di Simona, Giambenedetto, Di Roberta, Luca, Di Luca, Maurizio, Di Mariangela, Muro, Alex, Dusina, Davide, Eleuteri, Alessandra, Esperide, Daniele, Facheci, Domenico, Faliero, Cinzia, Falsiroli, Massimo, Fantoni, Annalaura, Fedele, Daniela, Feliciani, Cristina, Ferrante, Giuliano, Ferrone, Rossano, Festa, Chiara, Fiore Maria, Andrea, Flex, Evelina, Forte, Francesco, Franceschi, Alessandra, Francesconi, Laura, Franza, Barbara, Funaro, Mariella, Fuorlo, Domenico, Fusco, Maurizio, Gabrielli, Eleonora, Gaetani, Claudia, Galletta, Antonella, Gallo, Giovanni, Gambassi, Matteo, Garcovich, Antonio, Gasbarrini, Irene, Gasparrini, Silvia, Gelli, Antonella, Giampietro, Laura, Gigante, Gabriele, Giuliano, Giorgia, Giuliano, Bianca, Giupponi, Elisa, Gremese, Grieco, Domenico Luca, Manuel, Guerrera, Valeria, Guglielmi, Caterina, Guidone, Antonio, Gullì, Amerigo, Iaconelli, Aurora, Iafrati, Ianiro, Gianluca, Angela, Iaquinta, Michele, Impagnatiello, Riccardo, Inchingolo, Enrica, Intini, Raffaele, Iorio, Maria, Izzi Immacolata, Tamara, Jovanovic, Cristina, Kadhim, Rosa, La Macchia, Ignazio, La Milia Daniele, Francesco, Landi, Giovanni, Landi, Rosario, Landi, Raffaele, Landolfi, Massimo, Leo, Maria, Leone Paolo, Laura, Levantesi, Antonio, Liguori, Rosa, Liperoti, Maria, Lizzio Marco, Rita, Lo Monaco Maria, Pietro, Locantore, Francesco, Lombardi, Gianmarco, Lombardi, Loris, Lopetuso, Valentina, Loria, Raffaella, Losito Angela, Patricia, Lucia Mothanje Barbara, Francesco, Macagno, Noemi, Macerola, Giampaolo, Maggi, Giuseppe, Maiuro, Francesco, Mancarella, Francesca, Mangiola, Alberto, Manno, Debora, Marchesini, Marco, Maresca Gian, Giuseppe, Marrone, Ilaria, Marti, Maria, Martone Anna, Marzetti, Emanuele, Chiara, Mattana, Valeria, Matteo Maria, Riccardo, Maviglia, Ada, Mazzarella, Carmen, Memoli, Miele, Luca, Alessio, Migneco, Irene, Mignini, Alessandro, Milani, Domenico, Milardi, Massimo, Montalto, Giuliano, Montemurro, Flavia, Monti, Montini, Luca, Christian, Morena Tony, Vincenzina, Morra, Davide, Moschese, Ambra, Murace Celeste, Martina, Murdolo, Rita, Murri, Marco, Napoli, Elisabetta, Nardella, Gerlando, Natalello, Daniele, Natalini, Maria, Navarra Simone, Antonio, Nesci, Alberto, Nicoletti, Rocco, Nicoletti, Filippo, Nicoletti Tommaso, Rebecca, Nicolò, Nicola, Nicolotti, Celestino, Nista Enrico, Eugenia, Nuzzo, Marco, Oggiano, Veronica, Ojetti, Cosimo, Pagano Francesco, Gianfranco, Paiano, Cristina, Pai, Federico, Paolillo, Federico, Pallavicini, Andrea, Palombo, Alfredo, Papa, Domenico, Papanice, Giovanni, Papparella Luigi, Mattia, Paratore, Giuseppe, Parrinello, Giuliana, Pasciuto, Pierpaolo, Pasculli, Giovanni, Pecorini, Simone, Perniola, Erika, Pero, Luca, Petricca, Martina, Petrucci, Chiara, Picarelli, Andrea, Piccioni, Annalisa, Piccolo, Edoardo, Piervincenzi, Giulia, Pignataro, Raffaele, Pignataro, Gabriele, Pintaudi, Luca, Pisapia, Marco, Pizzoferrato, Fabrizio, Pizzolante, Roberto, Pola, Caterina, Policola, Maurizio, Pompili, Flavia, Pontecorvi, Valerio, Pontecorvi, Francesca, Ponziani, Valentina, Popolla, Enrica, Porceddu, Angelo, Porfidia, Maria, Porro Lucia, Annalisa, Potenza, Francesca, Pozzana, Giuseppe, Privitera, Daniela, Pugliese, Gabriele, Pulcini, Simona, Racco, Francesca, Raffaelli, Vittoria, Ramunno, Ludovico, Rapaccini Gian, Richeldi, Luca, Rinninella, Emanuele, Sara, Rocchi, Bruno, Romanò, Stefano, Romano, Federico, Rosa, Laura, Rossi, Raimondo, Rossi, Enrica, Rossini, Elisabetta, Rota, Fabiana, Rovedi, Carlotta, Rubino, Gabriele, Rumi, Andrea, Russo, Luca, Sabia, Andrea, Salerno, Sara, Salini, Lucia, Salvatore, Dehara, Samori, Sandroni, Claudio, Maurizio, Sanguinetti, Luca, Santarelli, Paolo, Santini, Danilo, Santolamazza, Angelo, Santoliquido, Francesco, Santopaolo, Cosimo, Santoro Michele, Francesco, Sardeo, Caterina, Sarnari, Angela, Saviano, Luisa, Saviano, Scaldaferri, Franco, Roberta, Scarascia, Tommaso, Schepi, Francesca, Schiavello, Giancarlo, Scoppettuolo, Davide, Sedda, Flaminio, Sessa, Luisa, Sestito, Carlo, Settanni, Matteo, Siciliano, Valentina, Siciliano, Rossella, Sicuranza, Benedetta, Simeoni, Jacopo, Simonetti, Andrea, Smargiassi, Maurizio, Soave Paolo, Chiara, Sonnino, Domenico, Staiti, Claudia, Stella, Leonardo, Stella, Eleonora, Stival, Eleonora, Taddei, Rossella, Talerico, Elio, Tamburello, Enrica, Tamburrini, Sofia, Tanzarella Eloisa, Elena, Tarascio, Claudia, Tarli, Alessandra, Tersali, Pietro, Tilli, Jacopo, Timpano, Enrico, Torelli, Flavia, Torrini, Matteo, Tosato, Alberto, Tosoni, Luca, Tricoli, Marcello, Tritto, Mario, Tumbarello, Maria, Tummolo Anita, Sole, Vallecoccia Maria, Federico, Valletta, Francesco, Varone, Francesco, Vassalli, Giulio, Ventura, Lucrezia, Verardi, Lorenzo, Vetrone, Giuseppe, Vetrugno, Elena, Visconti, Felicia, Visconti, Andrea, Viviani, Raffaella, Zaccaria, Carmelina, Zaccone, Lorenzo, Zelano, Lorenzo, Zileri Dal Verme, Giuseppe, Zuccalà, Candelli, Marcello (ORCID:0000-0001-8443-7880), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Valeria, Abbate, Giovanni, Addolorato (ORCID:0000-0002-1522-9946), Fabiana, Agostini, Elena, Ainora Maria, Karim, Akacha, Elena, Amato, Francesca, Andreani, Gloria, Andriollo, Giuseppina, Annetta Maria (ORCID:0000-0001-7574-1311), Eleonora, Annicchiarico Brigida, Gabriele, Antonucci, Alessandro, Armuzzi (ORCID:0000-0003-1572-0118), Fabiana, Baldi, Ilaria, Barattucci, Christian, Barillaro, Alfonso, Bellantone Rocco Domenico (ORCID:0000-0002-0844-3469), Giuseppe, Bello (ORCID:0000-0003-2648-7235), Andrea, Benicchi, Francesca, Benvenuto, Ludovica, Berardini, Filippo, Berloco, Roberto, Bernabei (ORCID:0000-0002-9197-004X), Antonio, Bianchi, Guerino, Biasucci Daniele, Marzio, Biasucci Luigi (ORCID:0000-0002-6921-6497), Alessandra, Bini, Federico, Biscetti (ORCID:0000-0001-7449-657X), Grazia, Bocci Maria, Filippo, Bongiovanni, Alberto, Borghetti, Giulia, Bosco, Silvia, Bosello (ORCID:0000-0002-4837-447X), Vincenzo, Bove, Giulia, Bramato, Vincenzo, Brandi, Carmine, Bruno, Dario, Bruno, Chiara, Bungaro Maria, Alessandro, Buonomo, Chiara, Cambise, Giulia, Cammà, Marcello, Candelli (ORCID:0000-0001-8443-7880), Gennaro, Capalbo, Lorenzo, Capaldi, Emanuele, Capone, Esmeralda, Capristo (ORCID:0000-0002-5753-3495), Luigi, Carbone, Simone, Carelli, Angelo, Carfì, Cristiano, Caruso, Lucio, Catalano, Roberto, Cauda (ORCID:0000-0002-1498-4229), Leonardo, Cecchini Andrea, Lucia, Cerrito, Annalisa, Chiarito, Rossella, Cianci (ORCID:0000-0001-5378-8442), Marta, Cicetti, Sara, Cicchinelli, Francesca, Ciciarello, Antonella, Cingolani (ORCID:0000-0002-3793-2755), Camilla, Cipriani Maria, Ludovica, Consalvo Maria, Gaetano, Coppola, Maria, Corbo Giuseppe (ORCID:0000-0002-8104-4659), Andrea, Corsello, Federico, Costante, Marcello, Covino (ORCID:0000-0002-6709-2531), Stefano, D’Addio, Alessia, D’Alessandro, Elena, D’alfonso Maria, Emanuela, D’Angelo, Fernando, Damiano (ORCID:0000-0003-0960-0232), De Tommaso, Cunzo, de Katleen, Gaetano Donati, De Giulio, Luca, De Giuseppe, Matteis, De Gennaro, Pascale (ORCID:0000-0002-8255-0676), Luca, Grieco Domenico (ORCID:0000-0002-4557-6308), Gianluca, Ianiro (ORCID:0000-0002-8318-0515), Emanuele, Marzetti (ORCID:0000-0001-9567-6983), Luca, Miele (ORCID:0000-0003-3464-0068), Luca, Montini (ORCID:0000-0003-4602-5134), Luca, Richeldi (ORCID:0000-0001-8594-1448), Emanuele, Rinninella (ORCID:0000-0002-9165-2367), Claudio, Sandroni (ORCID:0000-0002-8878-2611), Franco, Scaldaferri (ORCID:0000-0001-8334-7541), Gabrielli, Maurizio, Pignataro, Giulia, Candelli, Marcello, Sacco Fernandez, Marta, Bizzarri, Martina, Esperide, Alessandra, Franceschi, Francesco, Abbate, Valeria, Nicola, Acampora, Addolorato, Giovanni, Agostini, Fabiana, Ainora, Maria Elena, Akacha, Karim, Amato, Elena, Andreani, Francesca, Andriollo, Gloria, Annetta, Maria Giuseppina, Annicchiarico, Brigida Eleonora, Mariangela, Antonelli, Antonucci, Gabriele, Marco, Anzellotti Gian, Armuzzi, Alessandro, Baldi, Fabiana, Barattucci, Ilaria, Barillaro, Christian, Fabiana, Barone, Bellantone, Rocco Domenico Alfonso, Andrea, Bellieni, Bello, Giuseppe, Benicchi, Andrea, Benvenuto, Francesca, Berardini, Ludovica, Berloco, Filippo, Bernabei, Roberto, Bianchi, Antonio, Biasucci, Daniele Guerino, Biasucci, Luigi Marzio, Stefano, Bibbò, Bini, Alessandra, Alessandra, Bisanti, Biscetti, Federico, Bocci, Maria Grazia, Nicola, Bonadia, Bongiovanni, Filippo, Borghetti, Alberto, Bosco, Giulia, Bosello, Silvia Laura, Bove, Vincenzo, Bramato, Giulia, Brandi, Vincenzo, Teresa, Bruni, Bruno, Carmine, Bruno, Dario, Bungaro, Maria Chiara, Buonomo, Alessandro, Livia, Burzo, Angelo, Calabrese, Rosaria, Calvello Maria, Andrea, Cambieri, Cambise, Chiara, Camma, Giulia, Gennaro, Canistro, Antonello, Cantanale, Capalbo, Gennaro, Capaldi, Lorenzo, Capone, Emanuele, Capristo, Esmeralda, Carbone, Luigi, Silvia, Cardone, Carelli, Simone, Carfi', Angelo, Annamaria, Carnicelli, Caruso, Cristiano, Antonio, Casciaro Francesco, Catalano, Lucio, Cauda, Roberto, Cecchini, Andrea Leonardo, Cerrito, Lucia, Melania, Cesarano, Chiarito, Annalisa, Cianci, Rossella, Cicetti, Marta, Cicchinelli, Sara, Arturo, Ciccullo, Ciciarello, Francesca, Cingolani, Antonella, Cipriani, Maria Camilla, Consalvo, Ludovica Maria, Coppola, Gaetano, Corbo, Giuseppe Maria, Corsello, Andrea, Costante, Federico, Matteo, Costanzi, Covino, Marcello, Davide, Crupi, Lucio, Cutuli Salvatore, D'Addio, Stefano, D'Alessandro, Alessia, D'Alfonso, Maria Elena, D'Angelo, Emanuela, Francesca, D’Aversa, Damiano, Fernando, De Maria, Berardinis Gian, De Cunzo, Tommaso, De Gaetano Donati, Katleen, De Luca, Giulio, De Matteis, Giuseppe, De Pascale, Gennaro, De Paolo, Santi, De Martina, Siena, De Francesco, Vito, Del Valeria, Gatto, Del Paola, Giacomo, Del Fabio, Zompo, Maria, Dell’Anna Antonio, Della Davide, Polla, Di Luca, Gialleonardo, Di Simona, Giambenedetto, Di Roberta, Luca, Di Luca, Maurizio, Di Mariangela, Muro, Alex, Dusina, Davide, Eleuteri, Alessandra, Esperide, Daniele, Facheci, Domenico, Faliero, Cinzia, Falsiroli, Massimo, Fantoni, Annalaura, Fedele, Daniela, Feliciani, Cristina, Ferrante, Giuliano, Ferrone, Rossano, Festa, Chiara, Fiore Maria, Andrea, Flex, Evelina, Forte, Francesco, Franceschi, Alessandra, Francesconi, Laura, Franza, Barbara, Funaro, Mariella, Fuorlo, Domenico, Fusco, Maurizio, Gabrielli, Eleonora, Gaetani, Claudia, Galletta, Antonella, Gallo, Giovanni, Gambassi, Matteo, Garcovich, Antonio, Gasbarrini, Irene, Gasparrini, Silvia, Gelli, Antonella, Giampietro, Laura, Gigante, Gabriele, Giuliano, Giorgia, Giuliano, Bianca, Giupponi, Elisa, Gremese, Grieco, Domenico Luca, Manuel, Guerrera, Valeria, Guglielmi, Caterina, Guidone, Antonio, Gullì, Amerigo, Iaconelli, Aurora, Iafrati, Ianiro, Gianluca, Angela, Iaquinta, Michele, Impagnatiello, Riccardo, Inchingolo, Enrica, Intini, Raffaele, Iorio, Maria, Izzi Immacolata, Tamara, Jovanovic, Cristina, Kadhim, Rosa, La Macchia, Ignazio, La Milia Daniele, Francesco, Landi, Giovanni, Landi, Rosario, Landi, Raffaele, Landolfi, Massimo, Leo, Maria, Leone Paolo, Laura, Levantesi, Antonio, Liguori, Rosa, Liperoti, Maria, Lizzio Marco, Rita, Lo Monaco Maria, Pietro, Locantore, Francesco, Lombardi, Gianmarco, Lombardi, Loris, Lopetuso, Valentina, Loria, Raffaella, Losito Angela, Patricia, Lucia Mothanje Barbara, Francesco, Macagno, Noemi, Macerola, Giampaolo, Maggi, Giuseppe, Maiuro, Francesco, Mancarella, Francesca, Mangiola, Alberto, Manno, Debora, Marchesini, Marco, Maresca Gian, Giuseppe, Marrone, Ilaria, Marti, Maria, Martone Anna, Marzetti, Emanuele, Chiara, Mattana, Valeria, Matteo Maria, Riccardo, Maviglia, Ada, Mazzarella, Carmen, Memoli, Miele, Luca, Alessio, Migneco, Irene, Mignini, Alessandro, Milani, Domenico, Milardi, Massimo, Montalto, Giuliano, Montemurro, Flavia, Monti, Montini, Luca, Christian, Morena Tony, Vincenzina, Morra, Davide, Moschese, Ambra, Murace Celeste, Martina, Murdolo, Rita, Murri, Marco, Napoli, Elisabetta, Nardella, Gerlando, Natalello, Daniele, Natalini, Maria, Navarra Simone, Antonio, Nesci, Alberto, Nicoletti, Rocco, Nicoletti, Filippo, Nicoletti Tommaso, Rebecca, Nicolò, Nicola, Nicolotti, Celestino, Nista Enrico, Eugenia, Nuzzo, Marco, Oggiano, Veronica, Ojetti, Cosimo, Pagano Francesco, Gianfranco, Paiano, Cristina, Pai, Federico, Paolillo, Federico, Pallavicini, Andrea, Palombo, Alfredo, Papa, Domenico, Papanice, Giovanni, Papparella Luigi, Mattia, Paratore, Giuseppe, Parrinello, Giuliana, Pasciuto, Pierpaolo, Pasculli, Giovanni, Pecorini, Simone, Perniola, Erika, Pero, Luca, Petricca, Martina, Petrucci, Chiara, Picarelli, Andrea, Piccioni, Annalisa, Piccolo, Edoardo, Piervincenzi, Giulia, Pignataro, Raffaele, Pignataro, Gabriele, Pintaudi, Luca, Pisapia, Marco, Pizzoferrato, Fabrizio, Pizzolante, Roberto, Pola, Caterina, Policola, Maurizio, Pompili, Flavia, Pontecorvi, Valerio, Pontecorvi, Francesca, Ponziani, Valentina, Popolla, Enrica, Porceddu, Angelo, Porfidia, Maria, Porro Lucia, Annalisa, Potenza, Francesca, Pozzana, Giuseppe, Privitera, Daniela, Pugliese, Gabriele, Pulcini, Simona, Racco, Francesca, Raffaelli, Vittoria, Ramunno, Ludovico, Rapaccini Gian, Richeldi, Luca, Rinninella, Emanuele, Sara, Rocchi, Bruno, Romanò, Stefano, Romano, Federico, Rosa, Laura, Rossi, Raimondo, Rossi, Enrica, Rossini, Elisabetta, Rota, Fabiana, Rovedi, Carlotta, Rubino, Gabriele, Rumi, Andrea, Russo, Luca, Sabia, Andrea, Salerno, Sara, Salini, Lucia, Salvatore, Dehara, Samori, Sandroni, Claudio, Maurizio, Sanguinetti, Luca, Santarelli, Paolo, Santini, Danilo, Santolamazza, Angelo, Santoliquido, Francesco, Santopaolo, Cosimo, Santoro Michele, Francesco, Sardeo, Caterina, Sarnari, Angela, Saviano, Luisa, Saviano, Scaldaferri, Franco, Roberta, Scarascia, Tommaso, Schepi, Francesca, Schiavello, Giancarlo, Scoppettuolo, Davide, Sedda, Flaminio, Sessa, Luisa, Sestito, Carlo, Settanni, Matteo, Siciliano, Valentina, Siciliano, Rossella, Sicuranza, Benedetta, Simeoni, Jacopo, Simonetti, Andrea, Smargiassi, Maurizio, Soave Paolo, Chiara, Sonnino, Domenico, Staiti, Claudia, Stella, Leonardo, Stella, Eleonora, Stival, Eleonora, Taddei, Rossella, Talerico, Elio, Tamburello, Enrica, Tamburrini, Sofia, Tanzarella Eloisa, Elena, Tarascio, Claudia, Tarli, Alessandra, Tersali, Pietro, Tilli, Jacopo, Timpano, Enrico, Torelli, Flavia, Torrini, Matteo, Tosato, Alberto, Tosoni, Luca, Tricoli, Marcello, Tritto, Mario, Tumbarello, Maria, Tummolo Anita, Sole, Vallecoccia Maria, Federico, Valletta, Francesco, Varone, Francesco, Vassalli, Giulio, Ventura, Lucrezia, Verardi, Lorenzo, Vetrone, Giuseppe, Vetrugno, Elena, Visconti, Felicia, Visconti, Andrea, Viviani, Raffaella, Zaccaria, Carmelina, Zaccone, Lorenzo, Zelano, Lorenzo, Zileri Dal Verme, Giuseppe, Zuccalà, Candelli, Marcello (ORCID:0000-0001-8443-7880), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Valeria, Abbate, Giovanni, Addolorato (ORCID:0000-0002-1522-9946), Fabiana, Agostini, Elena, Ainora Maria, Karim, Akacha, Elena, Amato, Francesca, Andreani, Gloria, Andriollo, Giuseppina, Annetta Maria (ORCID:0000-0001-7574-1311), Eleonora, Annicchiarico Brigida, Gabriele, Antonucci, Alessandro, Armuzzi (ORCID:0000-0003-1572-0118), Fabiana, Baldi, Ilaria, Barattucci, Christian, Barillaro, Alfonso, Bellantone Rocco Domenico (ORCID:0000-0002-0844-3469), Giuseppe, Bello (ORCID:0000-0003-2648-7235), Andrea, Benicchi, Francesca, Benvenuto, Ludovica, Berardini, Filippo, Berloco, Roberto, Bernabei (ORCID:0000-0002-9197-004X), Antonio, Bianchi, Guerino, Biasucci Daniele, Marzio, Biasucci Luigi (ORCID:0000-0002-6921-6497), Alessandra, Bini, Federico, Biscetti (ORCID:0000-0001-7449-657X), Grazia, Bocci Maria, Filippo, Bongiovanni, Alberto, Borghetti, Giulia, Bosco, Silvia, Bosello (ORCID:0000-0002-4837-447X), Vincenzo, Bove, Giulia, Bramato, Vincenzo, Brandi, Carmine, Bruno, Dario, Bruno, Chiara, Bungaro Maria, Alessandro, Buonomo, Chiara, Cambise, Giulia, Cammà, Marcello, Candelli (ORCID:0000-0001-8443-7880), Gennaro, Capalbo, Lorenzo, Capaldi, Emanuele, Capone, Esmeralda, Capristo (ORCID:0000-0002-5753-3495), Luigi, Carbone, Simone, Carelli, Angelo, Carfì, Cristiano, Caruso, Lucio, Catalano, Roberto, Cauda (ORCID:0000-0002-1498-4229), Leonardo, Cecchini Andrea, Lucia, Cerrito, Annalisa, Chiarito, Rossella, Cianci (ORCID:0000-0001-5378-8442), Marta, Cicetti, Sara, Cicchinelli, Francesca, Ciciarello, Antonella, Cingolani (ORCID:0000-0002-3793-2755), Camilla, Cipriani Maria, Ludovica, Consalvo Maria, Gaetano, Coppola, Maria, Corbo Giuseppe (ORCID:0000-0002-8104-4659), Andrea, Corsello, Federico, Costante, Marcello, Covino (ORCID:0000-0002-6709-2531), Stefano, D’Addio, Alessia, D’Alessandro, Elena, D’alfonso Maria, Emanuela, D’Angelo, Fernando, Damiano (ORCID:0000-0003-0960-0232), De Tommaso, Cunzo, de Katleen, Gaetano Donati, De Giulio, Luca, De Giuseppe, Matteis, De Gennaro, Pascale (ORCID:0000-0002-8255-0676), Luca, Grieco Domenico (ORCID:0000-0002-4557-6308), Gianluca, Ianiro (ORCID:0000-0002-8318-0515), Emanuele, Marzetti (ORCID:0000-0001-9567-6983), Luca, Miele (ORCID:0000-0003-3464-0068), Luca, Montini (ORCID:0000-0003-4602-5134), Luca, Richeldi (ORCID:0000-0001-8594-1448), Emanuele, Rinninella (ORCID:0000-0002-9165-2367), Claudio, Sandroni (ORCID:0000-0002-8878-2611), and Franco, Scaldaferri (ORCID:0000-0001-8334-7541)
Published: 2021

17. A machine-learning parsimonious multivariable predictive model of mortality risk in patients with Covid-19

Author: Murri, Rita, Lenkowicz, Jacopo, Masciocchi, Carlotta, Iacomini, Chiara, Fantoni, Massimo, Damiani, Andrea, Marchetti, Antonio, Sergi, Paolo Domenico Angelo, Arcuri, Giovanni, Cesario, Alfredo, Patarnello, Stefano, Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Armuzzi, Alessandro, Barba, Marta, Baroni, Silvia, Bellesi, Silvia, Bentivoglio, Annarita, Biasucci, Luigi Marzio, Biscetti, Federico, Candelli, Marcello, Capalbo, Gennaro, Cattani Franchi, Paola, Chiusolo, Patrizia, Cingolani, Antonella, Corbo, Giuseppe Maria, Covino, Marcello, Cozzolino, Angela Maria, D’Alfonso, Marilena, De Angelis, Giulia, De Pascale, Gennaro, Frisullo, Giovanni, Gabrielli, Maurizio, Gambassi, Giovanni, Garcovich, Matteo, Gremese, Elisa, Grieco, Domenico Luca, Iaconelli, Amerigo, Iorio, Raffaele, Landi, Francesco, Larici, Annarita, Liuzzo, Giovanna, Maviglia, Riccardo, Miele, Luca, Montalto, Massimo, Natale, Luigi, Nicolotti, Nicola, Ojetti, Veronica, Pompili, Maurizio, Posteraro, Brunella, Rapaccini, Gianni, Rinaldi, Riccardo, Rossi, Elena, Santoliquido, Angelo, Sica, Simona, Tamburrini, Enrica, Teofili, Luciana, Testa, Antonia Carla, Tosoni, Alberto, Trani, Carlo, Varone, Francesco, Zileri Dal Verme, Lorenzo, Null, Null, Murri, Rita (ORCID:0000-0003-4263-7854), Fantoni, Massimo (ORCID:0000-0001-6913-8460), Cesario, Alfredo (ORCID:0000-0003-4687-0709), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Bellantone, Rocco (ORCID:0000-0002-0844-3469), Bernabei, Roberto (ORCID:0000-0002-9197-004X), Boccia, Stefania (ORCID:0000-0002-1864-749X), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Cauda, Roberto (ORCID:0000-0002-1498-4229), Colosimo, Cesare (ORCID:0000-0003-3800-3648), Crea, Filippo (ORCID:0000-0001-9404-8846), De Maria, Ruggero (ORCID:0000-0003-2255-0583), De Stefano, Valerio (ORCID:0000-0002-5178-5827), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Parolini, Ornella (ORCID:0000-0002-5211-6430), Richeldi, Luca (ORCID:0000-0001-8594-1448), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), Zega, Maurizio (ORCID:0000-0002-7821-2615), Scambia, Giovanni (ORCID:0000-0003-2758-1063), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Barba, Marta (ORCID:0000-0001-6084-7666), Baroni, Silvia (ORCID:0000-0002-3410-2617), Biasucci, Luigi Marzio (ORCID:0000-0002-6921-6497), Biscetti, Federico (ORCID:0000-0001-7449-657X), Candelli, Marcello (ORCID:0000-0001-8443-7880), Cattani, Paola (ORCID:0000-0003-4678-4763), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Cingolani, Antonella (ORCID:0000-0002-3793-2755), Corbo, Giuseppe (ORCID:0000-0002-8104-4659), Covino, Marcello (ORCID:0000-0002-6709-2531), De Angelis, Giulia (ORCID:0000-0002-7087-7399), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Gambassi, Giovanni (ORCID:0000-0002-7030-9359), Gremese, Elisa (ORCID:0000-0002-2248-1058), Grieco, Domenico Luca (ORCID:0000-0002-4557-6308), Iorio, Raffaele (ORCID:0000-0002-6270-0956), Landi, Francesco (ORCID:0000-0002-3472-1389), Liuzzo, Giovanna (ORCID:0000-0002-5714-0907), Miele, Luca (ORCID:0000-0003-3464-0068), Montalto, Massimo (ORCID:0000-0001-8819-3684), Natale, Luigi (ORCID:0000-0002-7949-5119), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Posteraro, Brunella (ORCID:0000-0002-1663-7546), Rossi, Elena (ORCID:0000-0002-7572-9379), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Tamburrini, Enrica (ORCID:0000-0003-4930-426X), Teofili, Luciana (ORCID:0000-0002-7214-1561), Testa, Antonia (ORCID:0000-0003-2217-8726), Trani, Carlo (ORCID:0000-0001-9777-013X), Verme, Lorenzo Zileri Dal, Murri, Rita, Lenkowicz, Jacopo, Masciocchi, Carlotta, Iacomini, Chiara, Fantoni, Massimo, Damiani, Andrea, Marchetti, Antonio, Sergi, Paolo Domenico Angelo, Arcuri, Giovanni, Cesario, Alfredo, Patarnello, Stefano, Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Armuzzi, Alessandro, Barba, Marta, Baroni, Silvia, Bellesi, Silvia, Bentivoglio, Annarita, Biasucci, Luigi Marzio, Biscetti, Federico, Candelli, Marcello, Capalbo, Gennaro, Cattani Franchi, Paola, Chiusolo, Patrizia, Cingolani, Antonella, Corbo, Giuseppe Maria, Covino, Marcello, Cozzolino, Angela Maria, D’Alfonso, Marilena, De Angelis, Giulia, De Pascale, Gennaro, Frisullo, Giovanni, Gabrielli, Maurizio, Gambassi, Giovanni, Garcovich, Matteo, Gremese, Elisa, Grieco, Domenico Luca, Iaconelli, Amerigo, Iorio, Raffaele, Landi, Francesco, Larici, Annarita, Liuzzo, Giovanna, Maviglia, Riccardo, Miele, Luca, Montalto, Massimo, Natale, Luigi, Nicolotti, Nicola, Ojetti, Veronica, Pompili, Maurizio, Posteraro, Brunella, Rapaccini, Gianni, Rinaldi, Riccardo, Rossi, Elena, Santoliquido, Angelo, Sica, Simona, Tamburrini, Enrica, Teofili, Luciana, Testa, Antonia Carla, Tosoni, Alberto, Trani, Carlo, Varone, Francesco, Zileri Dal Verme, Lorenzo, Null, Null, Murri, Rita (ORCID:0000-0003-4263-7854), Fantoni, Massimo (ORCID:0000-0001-6913-8460), Cesario, Alfredo (ORCID:0000-0003-4687-0709), Antonelli, Massimo (ORCID:0000-0003-3007-1670), Bellantone, Rocco (ORCID:0000-0002-0844-3469), Bernabei, Roberto (ORCID:0000-0002-9197-004X), Boccia, Stefania (ORCID:0000-0002-1864-749X), Calabresi, Paolo (ORCID:0000-0003-0326-5509), Cauda, Roberto (ORCID:0000-0002-1498-4229), Colosimo, Cesare (ORCID:0000-0003-3800-3648), Crea, Filippo (ORCID:0000-0001-9404-8846), De Maria, Ruggero (ORCID:0000-0003-2255-0583), De Stefano, Valerio (ORCID:0000-0002-5178-5827), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Parolini, Ornella (ORCID:0000-0002-5211-6430), Richeldi, Luca (ORCID:0000-0001-8594-1448), Sanguinetti, Maurizio (ORCID:0000-0002-9780-7059), Zega, Maurizio (ORCID:0000-0002-7821-2615), Scambia, Giovanni (ORCID:0000-0003-2758-1063), Valentini, Vincenzo (ORCID:0000-0003-4637-6487), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Barba, Marta (ORCID:0000-0001-6084-7666), Baroni, Silvia (ORCID:0000-0002-3410-2617), Biasucci, Luigi Marzio (ORCID:0000-0002-6921-6497), Biscetti, Federico (ORCID:0000-0001-7449-657X), Candelli, Marcello (ORCID:0000-0001-8443-7880), Cattani, Paola (ORCID:0000-0003-4678-4763), Chiusolo, Patrizia (ORCID:0000-0002-1355-1587), Cingolani, Antonella (ORCID:0000-0002-3793-2755), Corbo, Giuseppe (ORCID:0000-0002-8104-4659), Covino, Marcello (ORCID:0000-0002-6709-2531), De Angelis, Giulia (ORCID:0000-0002-7087-7399), De Pascale, Gennaro (ORCID:0000-0002-8255-0676), Gambassi, Giovanni (ORCID:0000-0002-7030-9359), Gremese, Elisa (ORCID:0000-0002-2248-1058), Grieco, Domenico Luca (ORCID:0000-0002-4557-6308), Iorio, Raffaele (ORCID:0000-0002-6270-0956), Landi, Francesco (ORCID:0000-0002-3472-1389), Liuzzo, Giovanna (ORCID:0000-0002-5714-0907), Miele, Luca (ORCID:0000-0003-3464-0068), Montalto, Massimo (ORCID:0000-0001-8819-3684), Natale, Luigi (ORCID:0000-0002-7949-5119), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Posteraro, Brunella (ORCID:0000-0002-1663-7546), Rossi, Elena (ORCID:0000-0002-7572-9379), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Tamburrini, Enrica (ORCID:0000-0003-4930-426X), Teofili, Luciana (ORCID:0000-0002-7214-1561), Testa, Antonia (ORCID:0000-0003-2217-8726), Trani, Carlo (ORCID:0000-0001-9777-013X), and Verme, Lorenzo Zileri Dal
Abstract: The COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher risk of death. The training cohort included all patients admitted to Fondazione Policlinico Gemelli with COVID-19 from March 5, 2020, to November 5, 2020. Afterward, the model was tested on all patients admitted to the same hospital with COVID-19 from November 6, 2020, to February 5, 2021. The primary outcome was in-hospital case-fatality risk. The out-of-sample performance of the model was estimated from the training set in terms of Area under the Receiving Operator Curve (AUROC) and classification matrix statistics by averaging the results of fivefold cross validation repeated 3-times and comparing the results with those obtained on the test set. An explanation analysis of the model, based on the SHapley Additive exPlanations (SHAP), is also presented. To assess the subsequent time evolution, the change in paO2/FiO2 (P/F) at 48 h after the baseline measurement was plotted against its baseline value. Among the 921 patients included in the training cohort, 120 died (13%). Variables selected for the model were age, platelet count, SpO2, blood urea nitrogen (BUN), hemoglobin, C-reactive protein, neutrophil count, and sodium. The results of the fivefold cross-validation repeated 3-times gave AUROC of 0.87, and statistics of the classification matrix to the Youden index as follows: sensitivity 0.840, specificity 0.774, negative predictive value 0.971. Then, the model was tested on a new population (n=1463) in which the case-fatality rate was 22.6%. The test model showed AUROC 0.818, sensitivity 0.813, specificity 0.650, negative predictive value 0.922. Considering the first quartile of the predicted risk score (low-risk score gro
Published: 2021

18. Lactobacillus Reuteri DSM 17938 (Limosilactobacillus reuteri) in Diarrhea and Constipation: Two Sides of the Same Coin?

Author: Saviano, Angela, Brigida, Mattia, Migneco, Alessio, Gunawardena, Gayani, Zanza, Christian, Candelli, Marcello, Franceschi, Francesco, Ojetti, Veronica, Saviano, Angela (ORCID:0000-0002-2820-7180), Candelli, Marcello (ORCID:0000-0001-8443-7880), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Saviano, Angela, Brigida, Mattia, Migneco, Alessio, Gunawardena, Gayani, Zanza, Christian, Candelli, Marcello, Franceschi, Francesco, Ojetti, Veronica, Saviano, Angela (ORCID:0000-0002-2820-7180), Candelli, Marcello (ORCID:0000-0001-8443-7880), Franceschi, Francesco (ORCID:0000-0001-6266-445X), and Ojetti, Veronica (ORCID:0000-0002-8953-0707)
Abstract: Background and Objectives: Lactobacillus reuteri DSM 17938 (L. reuteri) is a probiotic that can colonize different human body sites, including primarily the gastrointestinal tract, but also the urinary tract, the skin, and breast milk. Literature data showed that the administration of L. reuteri can be beneficial to human health. The aim of this review was to summarize current knowledge on the role of L. reuteri in the management of gastrointestinal symptoms, abdominal pain, diarrhea and constipation, both in adults and children, which are frequent reasons for admission to the emergency department (ED), in order to promote the best selection of probiotic type in the treatment of these uncomfortable and common symptoms. Materials and Methods: We searched articles on PubMed(R) from January 2011 to January 2021. Results: Numerous clinical studies suggested that L. reuteri may be helpful in modulating gut microbiota, eliminating infections, and attenuating the gastrointestinal symptoms of enteric colitis, antibiotic-associated diarrhea (also related to the treatment of Helicobacter pylori (HP) infection), irritable bowel syndrome, inflammatory bowel disease, and chronic constipation. In both children and in adults, L. reuteri shortens the duration of acute infectious diarrhea and improves abdominal pain in patients with colitis or inflammatory bowel disease. It can ameliorate dyspepsia and symptoms of gastritis in patients with HP infection. Moreover, it improves gut motility and chronic constipation. Conclusion: Currently, probiotics are widely used to prevent and treat numerous gastrointestinal disorders. In our opinion, L. reuteri meets all the requirements to be considered a safe, well-tolerated, and efficacious probiotic that is able to contribute to the beneficial effects on gut-human health, preventing and treating many gastrointestinal symptoms, and speeding up the recovery and discharge of patients accessing the emergency department.
Published: 2021

19. Cytotoxin-associated gene antigen-positive strains of Helicobacter pylori and recurring acute coronary syndromes

Author: Niccoli, Giampaolo, Roberto, Marco, D'Amario, Domenico, Scalone, Giancarla, Fracassi, Francesco, Cosentino, Nicola, Candelli, Marcello, Franceschi, Francesco, Crea, Filippo, Niccoli, Giampaolo (ORCID:0000-0002-3187-6262), Candelli, Marcello (ORCID:0000-0001-8443-7880), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Crea, Filippo (ORCID:0000-0001-9404-8846), Niccoli, Giampaolo, Roberto, Marco, D'Amario, Domenico, Scalone, Giancarla, Fracassi, Francesco, Cosentino, Nicola, Candelli, Marcello, Franceschi, Francesco, Crea, Filippo, Niccoli, Giampaolo (ORCID:0000-0002-3187-6262), Candelli, Marcello (ORCID:0000-0001-8443-7880), Franceschi, Francesco (ORCID:0000-0001-6266-445X), and Crea, Filippo (ORCID:0000-0001-9404-8846)
Abstract: BACKGROUND: Cytotoxin-associated gene antigen (CagA)-positive strains of Helicobacter pylori have previously been associated with acute coronary syndromes. However, the role of CagA-positive strains of Helicobacter pylori in recurring cardiac events after ST-segment elevation myocardial infarction (STEMI) has not yet been assessed. METHODS: We enrolled 181 consecutive patients (155 men, mean age 64±13 years) presenting with STEMI. In all patients, serum levels of IgG anti-CagA were assessed. Levels of IgG anti-hepatitis A virus were also evaluated in all patients in order to exclude the presence of a bystander activation of the immune system. Finally, a previous history of acute coronary syndrome and the rate of major adverse cardiovascular events as a composite of cardiovascular death, recurring myocardial infarction and target lesion revascularisation within 2 years follow-up were evaluated. RESULTS: Anti-CagA IgG seropositive patients presented more frequently with a previous history of acute coronary syndrome compared with seronegative patients (28.3% vs. 14%, P=0.019). Interestingly, no differences were observed between anti-CagA IgG seropositive and anti-CagA IgG seronegative patients concerning the prevalence of anti-hepatitis A virus IgG seropositivity (20% vs. 21.4%, P=0.48). At 2-year follow-up, 40 patients experienced major adverse cardiovascular events. The major adverse cardiovascular event rate was higher in anti-CagA IgG seropositive compared with seronegative patients (hazard ratio 2.25, 95% confidence interval 1.34-2.95, P=0.013), which was confirmed at Cox multivariate analysis (hazard ratio 2.33, 95% confidence interval 1.30-3.14, P=0.009). CONCLUSIONS: CagA-positive strains of Helicobacter pylori seem to be involved in the pathogenesis of recurring acute coronary syndromes, and seropositivity for anti-CagA IgG predicts prognosis after STEMI, possibly due to the increased risk of recurring cardiac events.
Published: 2017

20. Cytotoxin-associated gene antigen-positive strains of Helicobacter pylori and recurring acute coronary syndromes

Author: Niccoli, Giampaolo, Roberto, Marco, D'Amario, Domenico, Scalone, Giancarla, Fracassi, Francesco, Cosentino, Nicola, Candelli, Marcello, Franceschi, Francesco, Crea, Filippo, Niccoli, Giampaolo (ORCID:0000-0002-3187-6262), Candelli, Marcello (ORCID:0000-0001-8443-7880), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Crea, Filippo (ORCID:0000-0001-9404-8846), Niccoli, Giampaolo, Roberto, Marco, D'Amario, Domenico, Scalone, Giancarla, Fracassi, Francesco, Cosentino, Nicola, Candelli, Marcello, Franceschi, Francesco, Crea, Filippo, Niccoli, Giampaolo (ORCID:0000-0002-3187-6262), Candelli, Marcello (ORCID:0000-0001-8443-7880), Franceschi, Francesco (ORCID:0000-0001-6266-445X), and Crea, Filippo (ORCID:0000-0001-9404-8846)
Abstract: BACKGROUND: Cytotoxin-associated gene antigen (CagA)-positive strains of Helicobacter pylori have previously been associated with acute coronary syndromes. However, the role of CagA-positive strains of Helicobacter pylori in recurring cardiac events after ST-segment elevation myocardial infarction (STEMI) has not yet been assessed. METHODS: We enrolled 181 consecutive patients (155 men, mean age 64±13 years) presenting with STEMI. In all patients, serum levels of IgG anti-CagA were assessed. Levels of IgG anti-hepatitis A virus were also evaluated in all patients in order to exclude the presence of a bystander activation of the immune system. Finally, a previous history of acute coronary syndrome and the rate of major adverse cardiovascular events as a composite of cardiovascular death, recurring myocardial infarction and target lesion revascularisation within 2 years follow-up were evaluated. RESULTS: Anti-CagA IgG seropositive patients presented more frequently with a previous history of acute coronary syndrome compared with seronegative patients (28.3% vs. 14%, P=0.019). Interestingly, no differences were observed between anti-CagA IgG seropositive and anti-CagA IgG seronegative patients concerning the prevalence of anti-hepatitis A virus IgG seropositivity (20% vs. 21.4%, P=0.48). At 2-year follow-up, 40 patients experienced major adverse cardiovascular events. The major adverse cardiovascular event rate was higher in anti-CagA IgG seropositive compared with seronegative patients (hazard ratio 2.25, 95% confidence interval 1.34-2.95, P=0.013), which was confirmed at Cox multivariate analysis (hazard ratio 2.33, 95% confidence interval 1.30-3.14, P=0.009). CONCLUSIONS: CagA-positive strains of Helicobacter pylori seem to be involved in the pathogenesis of recurring acute coronary syndromes, and seropositivity for anti-CagA IgG predicts prognosis after STEMI, possibly due to the increased risk of recurring cardiac events.
Published: 2016

21. A simplified way for the urgent treatment of somatic pain in patients admitted to the emergency room: the SUPER algorithm

Author: Franceschi, Francesco, Marsiliani, Davide, Alesi, Andrea, Ojetti, Veronica, Candelli, Marcello, Gabrielli, Maurizio, D'Aurizio, Gabriella, Gilardi, Emanuele, Adducci, Enrica, Proietti, Rodolfo, Buccelletti, Francesco, Franceschi, Francesco (ORCID:0000-0001-6266-445X), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Candelli, Marcello (ORCID:0000-0001-8443-7880), Adducci, Enrica (ORCID:0000-0002-8977-762X), Proietti, Rodolfo (ORCID:0000-0003-1137-9928), Franceschi, Francesco, Marsiliani, Davide, Alesi, Andrea, Ojetti, Veronica, Candelli, Marcello, Gabrielli, Maurizio, D'Aurizio, Gabriella, Gilardi, Emanuele, Adducci, Enrica, Proietti, Rodolfo, Buccelletti, Francesco, Franceschi, Francesco (ORCID:0000-0001-6266-445X), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Candelli, Marcello (ORCID:0000-0001-8443-7880), Adducci, Enrica (ORCID:0000-0002-8977-762X), and Proietti, Rodolfo (ORCID:0000-0003-1137-9928)
Abstract: Somatic pain is one of the most frequent symptoms reported by patients presenting to the emergency department (ED), but, in spite of this, it is very often underestimated and under-treated. Moreover, pain-killers prescriptions are usually related to the medical examination, leading to a delay in its administration, thus worsening the patient's quality of life. With our study, we want to define and validate a systematic and homogeneous approach to analgesic drugs administration, testing a new therapeutic algorithm in terms of earliness, safety, and efficacy. 442 consecutive patients who accessed our ED for any kind of somatic pain were enrolled, and then randomly divided into two groups: group A follow the normal process of access to pain-control drugs, and group B follow our SUPER algorithm for early administration of drugs to relieve pain directly from triage. We excluded from the study, patients with abdominal pain referred to the surgeon, patients with headache, recent history of trauma, history of drug allergies, and life-threatening conditions or lack of cooperation. Drugs used in the study were those available in our ED, such as paracetamol, paracetamol/codeine, ketorolac-tromethamine, and tramadol-hydrochloride. Pain level, risk factors, indication, and contraindication of each drug were taken into account in our SUPER algorithm for a rapid and safe administration of it. The Verbal Numeric Scale (VNS) and the Visual Analog Scale (VAS) were used to verify the patient's health and perception of it. Only 59 patient from group A (27.1 %) received analgesic therapy (at the time of the medical examination) compared to 181 patients (100 %) of group B (p < 0.001). Group B patients, received analgesic therapy 76 min before group A subjects (p < 0.01), resulting in a significant lower VNS (7.31 ± 1.68 vs 4.75 ± 2.3; p < 0.001), and a superior VAS after discharge (54.43 ± 22.16 vs 61.30 ± 19.13; p < 0.001) compared to group A subjects. No significant differences concern
Published: 2015

22. Discrimination between incomplete and atypical Kawasaki syndrome versus other febrile diseases in childhood: results from an international registry-based study

Author: Falcini, F., Ozen, S., Magni Manzoni, S., Candelli, Marcello, Ricci, L., Martini, G., Cuttica, R. j., Oliveira, S., Calabri, G. b., Zulian, F., Pistorio, A., La Torre, F., Rigante, Donato, Candelli, Marcello (ORCID:0000-0001-8443-7880), Rigante, Donato (ORCID:0000-0001-7032-7779), Falcini, F., Ozen, S., Magni Manzoni, S., Candelli, Marcello, Ricci, L., Martini, G., Cuttica, R. j., Oliveira, S., Calabri, G. b., Zulian, F., Pistorio, A., La Torre, F., Rigante, Donato, Candelli, Marcello (ORCID:0000-0001-8443-7880), and Rigante, Donato (ORCID:0000-0001-7032-7779)
Abstract: OBJECTIVES: Kawasaki syndrome (KS) is an acute systemic vasculitis of unknown origin predominantly affecting young children. Early diagnosis is crucial to prevent cardiac complications. However, the differential diagnosis of patients with the incomplete or atypical form of the disease poses a heavy challenge for the paediatrician. Our aim was to evaluate the prevalence of incomplete and atypical cases among children with KS and to identify clinical and laboratory variables that may help differentiate incomplete and atypical KS from other febrile diseases at this age. METHODS: We established an international registry to recruit patients with KS, including those with incomplete and atypical forms. The control group included age-matched febrile children admitted to the hospital with a variety of diseases mimicking KS. The aim was to define clinical or laboratory clues to help in the discrimination of incomplete and atypical KS patients from others. RESULTS: Two hundred and twenty-eight patients with incomplete KS (78%) and atypical KS (22%) were compared to 71 children with other febrile diseases. Patients with incomplete and atypical KS presented a statistically significant higher frequency of mucosal changes, conjunctivitis, extremity abnormalities and perineal desquamation compared to the group of other febrile diseases. In addition, C-reactive protein and platelet counts were significantly higher in incomplete and atypical KS compared to the other group. CONCLUSIONS: This is the largest series of incomplete and atypical KS patients of non East-Asian ancestry: we suggest that in patients with the aforementioned clinical features and laboratory evidence of systemic inflammation in terms of increased C-reactive protein and platelet counts an echocardiogram should be performed and diagnosis of KS considered.
Published: 2012

23. High reinfection rate of Helicobacter pylori in young type 1 diabetic patients: a three-year follow-up study

Author: Candelli, Marcello, Rigante, Donato, Schiavino, Alessandra, Gabrielli, Maurizio, Crea, F, Minguell Del Lungo, Laura, Pignataro, Giulia, Sacco, E, Monaco, Serena, Gentiloni Silveri, Nicolo', Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Rigante, Donato (ORCID:0000-0001-7032-7779), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Candelli, Marcello, Rigante, Donato, Schiavino, Alessandra, Gabrielli, Maurizio, Crea, F, Minguell Del Lungo, Laura, Pignataro, Giulia, Sacco, E, Monaco, Serena, Gentiloni Silveri, Nicolo', Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Rigante, Donato (ORCID:0000-0001-7032-7779), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: BACKGROUND: Several studies have demonstrated that Helicobacter pylori (H. pylori) eradication does not affect metabolic control in diabetic patients. The prevalence of H. pylori infection and reinfection rate in adult diabetic patients seems to be higher than in controls. AIM OF THE STUDY: To evaluate the reinfection rate of H. pylori three years after a standard eradicating treatment and the late effect of eradication upon metabolic control in young diabetic patients. METHODS: We enrolled 75 diabetic patients and 99 controls, from previous our studies in which we had evaluated H. pylori infection. In all subjects we re-evaluated the presence of H. pylori by means of 13C-Urea Breath Test, metabolic control and the prevalence of gastrointestinal symptoms. The effect of age, sex and socio-economic factors on H. pylori reinfection were also evaluated. RESULTS: The prevalence of H. pylori infection was higher in diabetic patients (17/69, 24%) than in dyspeptic controls of similar age, gender and socio-economical status after three years of follow-up. The reinfection rate was higher in diabetic patients than in controls. Multivariate analysis confirmed that age and socio-economical status were independently associated with H. pylori reinfection. CONCLUSIONS: Young patients with diabetes present a higher risk of H. pylori gastric reinfection than controls. In addition, age and mean annual income are associated with reinfection.
Published: 2012

24. Liver involvement in hereditary hemorrhagic telangiectasia: can breath test unmask impaired hepatic first-pass effect?

Author: Candelli, Marcello, Pompili, Maurizio, Suppressa, P, Lenato, Gm, Bosco, Giulia, Rapaccini, Gl, Gasbarrini, Antonio, Scardapane, A, Sabbà, C., Candelli, Marcello (ORCID:0000-0001-8443-7880), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Candelli, Marcello, Pompili, Maurizio, Suppressa, P, Lenato, Gm, Bosco, Giulia, Rapaccini, Gl, Gasbarrini, Antonio, Scardapane, A, Sabbà, C., Candelli, Marcello (ORCID:0000-0001-8443-7880), Pompili, Maurizio (ORCID:0000-0001-6699-7980), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: Hepatic arteriovenous malformations (HAVMs) in hereditary hemorrhagic telangiectasia (HHT) have long been considered to have scarce clinical significance in most cases. Nevertheless, data are lacking regarding the influence of HAVMs on the liver first-pass effect on drugs in HHT patients. To gain insight into the effect of HAVMs on hepatic drug clearance by means of two specific (13)C-labeled probes, namely the (13)C-methacetin and (13)C-aminopyrine, 46 HHT patients and 44-matched healthy controls were enrolled. The liver first-pass effect was studied by the (13)C-based breath test using methacetin and aminopyrine. The methacetin breath test showed statistically significant reduced metabolism rates (p < 0.0001) in HHT when compared with controls, both in patients with and without CT-detectable HAVMs, and when expressed both as cumulative (13)C-percentage dose per hour and as (13)C-percentage peak after 15 min. In contrast, no significant difference was found between HHT and controls regarding aminopyrin metabolism rates. In HHT, (13)C%-methacetin breath test values are significantly lower than those found in normal subjects, probably due to the effect of hepatic shunts. A reduced perfusion and an impaired hepatic metabolism might affect hepatic drug clearance in HHT. Therefore, an appropriate dosage adjustments should be considered when high-hepatic-metabolism drugs are administered to HHT patients.
Published: 2012

25. Serum interleukin-18 in children with Henoch-Schonlein purpura: a promising marker of disease activity?

Author: Rigante, Donato, Zampetti, Anna, Bersani, Giulia, Candelli, Marcello, Piras, Andrea, Rendeli, Claudia, Antuzzi, Daniela, Feliciani, Claudio, Stabile, Achille, Rigante, Donato (ORCID:0000-0001-7032-7779), Candelli, Marcello (ORCID:0000-0001-8443-7880), Rendeli, Claudia (ORCID:0000-0002-5948-1617), Antuzzi, Daniela (ORCID:0000-0002-2951-5425), Rigante, Donato, Zampetti, Anna, Bersani, Giulia, Candelli, Marcello, Piras, Andrea, Rendeli, Claudia, Antuzzi, Daniela, Feliciani, Claudio, Stabile, Achille, Rigante, Donato (ORCID:0000-0001-7032-7779), Candelli, Marcello (ORCID:0000-0001-8443-7880), Rendeli, Claudia (ORCID:0000-0002-5948-1617), and Antuzzi, Daniela (ORCID:0000-0002-2951-5425)
Abstract: Henoch-Schönlein purpura (HSp) is the most common systemic vasculitis of childhood with typical skin involvement and concurrent signs involving joints, gastrointestinal tube and kidney. HSp pathogenesis is still far to be definitely unraveled, though a knotty cytokine complex is believed to contribute in its intimate processes. Aim of our evaluation was to establish the relationship between serum levels of interleukin (IL)-18 and disease outcome and establish its feasibility to provide a marker of disease activity or even a prognostic tool in the clinical practice. We examined clinical/laboratory variables and serum IL-18 in 17 unselected children hospitalized during the last year for HSp, diagnosed by EULAR/PRINTO/PRES criteria; the same patients were re-evaluated after 6 months too. All results were compared with 25 age-matched healthy controls. IL-12 and IL-6 were also evaluated in a cohort of the same patients and compared with controls. General and clinical variables (sex, edema of the extremities, gastrointestinal or renal complications, relapses and renal involvement at 6 months) had no relationship with cytokine levels. Serum IL-18 and IL-6 levels were found significantly increased at diagnosis in HSp patients when compared with healthy controls. After 6 months serum IL-18 and IL-12 levels were significantly decreased in patients, while IL-12 and IL-6 levels were significantly increased if compared with healthy controls. Though preliminary and expecting further confirmation on a larger sample, our data support the conclusion that serum IL-18 levels reflect HSp activity.
Published: 2011

26. Evaluation of gastric emptying and gastrointestinal symptoms in dyspeptic patients before and after hydropinic therapy

Author: Gasbarrini, Giovanni Battista, Merra, Giuseppe, Candelli, Marcello, Cittadini, Achille Renato Maria, Sgambato, Alessandro, Gentiloni Silveri, Nicolo', Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Cittadini, Achille, Sgambato, Alessandro (ORCID:0000-0002-9487-4563), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Gasbarrini, Giovanni Battista, Merra, Giuseppe, Candelli, Marcello, Cittadini, Achille Renato Maria, Sgambato, Alessandro, Gentiloni Silveri, Nicolo', Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Cittadini, Achille, Sgambato, Alessandro (ORCID:0000-0002-9487-4563), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: Dispepsy is one of the most diffuse syndromes in general population. The high number of subjects affected from this pathology and the very annoying symptomatology does so as that the pharmaceutical costs of antacids and of prokinetics are very high. Aim of the study is to assess if a hydropinic therapy is able to facilitate digestive processes of the dispeptic patients accelerating gastric emptying. The 30 recruited subjects, 20 patients and 10 healthy volunteers, have answered to test about their symptoms and have executed a 13C octanoic acid breath test in order to estimate the gastric emptying to a basal time, and 30 days after supplementation of mineral water, 1.5 liters/day, for 21 days. At the end of the study, both the time of gastric emptying and the gastrointestinal symptoms improved after the hydropinic therapy, demonstrating that a supplementazione with mineral water can induce a benefit in the dispeptics subjects.
Published: 2010

27. CagA antigen of Helicobacter pylori and coronary instability: insight from a clinico-pathological study and a meta-analysis of 4241 cases

Author: Franceschi, Francesco, Niccoli, Giampaolo, Ferrante, Giuseppe, Gasbarrini, Antonio, Baldi, A, Candelli, Marcello, Feroce, F, Saulnier, Nathalie, Conte, Micaela, Roccarina, Davide, Lanza, Gaetano Antonio, Gasbarrini, Giovanni Battista, Gentiloni, Sn, Crea, Filippo, Franceschi, Francesco (ORCID:0000-0001-6266-445X), Niccoli, Giampaolo (ORCID:0000-0002-3187-6262), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Candelli, Marcello (ORCID:0000-0001-8443-7880), Lanza, Gaetano Antonio (ORCID:0000-0003-2187-6653), Crea, Filippo (ORCID:0000-0001-9404-8846), Franceschi, Francesco, Niccoli, Giampaolo, Ferrante, Giuseppe, Gasbarrini, Antonio, Baldi, A, Candelli, Marcello, Feroce, F, Saulnier, Nathalie, Conte, Micaela, Roccarina, Davide, Lanza, Gaetano Antonio, Gasbarrini, Giovanni Battista, Gentiloni, Sn, Crea, Filippo, Franceschi, Francesco (ORCID:0000-0001-6266-445X), Niccoli, Giampaolo (ORCID:0000-0002-3187-6262), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Candelli, Marcello (ORCID:0000-0001-8443-7880), Lanza, Gaetano Antonio (ORCID:0000-0003-2187-6653), and Crea, Filippo (ORCID:0000-0001-9404-8846)
Abstract: Cytotoxin-associated gene-A (CagA) antigen is expressed by some virulent strains of Helicobacter pylori (H. pylori). The role of CagA antigen in coronary instability is unknown. We performed a clinico-pathological study and a meta-analysis in the attempt to shed new light on this complex issue. METHODS: In the clinico-pathological study, 38 patients with unstable angina (UA), 25 patients with stable angina (SA), 21 patients with normal coronary arteries (NCA) and 50 age and sex matched healthy volunteers were enrolled. Serology for CagA was assessed in all patients. Specimens of atherosclerotic plaques were obtained from all patients by directional coronary atherectomy, and prepared for immunohistochemistry using anti-CagA monoclonal antibodies. The meta-analysis includes 9 studies assessing the association between seropositivity to CagA strains and acute coronary events. RESULTS: The titre of anti-CagA antibodies was significantly higher in patients with unstable angina (161+/-90 RU/ml) compared to those with stable angina (83+/-59 RU/ml p<0.02), NCA (47.3+/-29 RU/ml p<0.01) and healthy controls (73+/-69 p<0.02). Anti-CagA antibodies recognized antigens localized inside coronary atherosclerotic plaques in all specimens from both stable and unstable patients. In the meta-analysis, seropositivity to CagA was significantly associated with the occurrence of acute coronary events with an odds ratio (OR) of 1.34 (95% CI, 1.15-1.58, p=0.0003). CONCLUSIONS: Taken together these findings suggest that in a subset of patients with unstable angina, an intense immune response against CagA-positive H. pylori strains might be critical to precipitate coronary instability mediated by antigen mimicry between CagA antigen and a protein contained in coronary atherosclerotic plaques.
Published: 2009

28. 13C-methionine breath tests for mitochondrial liver function assessment

Author: Candelli, Marcello, Miele, Luca, Armuzzi, Alessandro, Nista, Ec, Pignataro, Giuseppe, Fini, Lucia, Cazzato, Ia, Zocco, Maria Assunta, Bartolozzi, F, Gasbarrini, Giovanni Battista, Grieco, Antonio, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Miele, Luca (ORCID:0000-0003-3464-0068), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Grieco, Antonio (ORCID:0000-0002-0544-8993), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Candelli, Marcello, Miele, Luca, Armuzzi, Alessandro, Nista, Ec, Pignataro, Giuseppe, Fini, Lucia, Cazzato, Ia, Zocco, Maria Assunta, Bartolozzi, F, Gasbarrini, Giovanni Battista, Grieco, Antonio, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Miele, Luca (ORCID:0000-0003-3464-0068), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Grieco, Antonio (ORCID:0000-0002-0544-8993), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: 13C-methionine breath test has been proposed as a non-invasive tool for the assessment of human hepatic mithocondrial function. Two methionine breath labeled with 13C in differents point of his molecular structure have been used for breath test analisys. Aim of this study was to compare two differently 13C-labeled methionines in the evaluation of mitochondrial oxidation in basal conditions and after an acute oxidative stress. 15 healthy male subjects (mean age 30.5 +/- 3.1) received [methyl-13C]-methionine dissolved in water. Breath samples were taken at baseline and and 10, 20, 30, 45, 60, 75, 90, 105 and 120 minutes after the ingestion of the labeled substrate. Forthy-eight hours later, subjects underwent the same test 30 minutes after ethanol ingestion (0,3 g/kg of body weight). Seven-day later, subjects underwent breath test using (L-methionine-1-13COOH) as substrate, in basal condition and after ethanol ingestion. At basal condition, the cumulative percentage of 13CO2 recovered in breath during the test period (%cum-dose) was higher using L-methionine-1-13COOH than [methyl-13C]-methionine (10.25 +/- 1.0 vs 4.07 +/- 0.8; p < 0.01). After ethanol ingestion, % cum dose was significantly decreased at 60 and 120 minutes with both methionines (120 min: 10.25 +/- 1.0 vs 5.03% +/- 1.8; < 0.01 and 4.07 +/- 0.8 vs 2.16% +/- 0.9; p < 0.01, respectively). However, %cum-dose during L-methionine-1-13C-breath test was significantly lower than that observed during methyl-13C-methionine breath test (120 minutes: 5.03% +/- 1.8 vs 2.16% +/- 0.9; p < 0.01). In conclusion, breath test based on L-methionine-1-13COOH seems to show a greater reliability when compared to [methyl-13C]-methionine to assess mitochondrial function because a larger amount of labeled carbon that reaches the Krebs' cicle.
Published: 2008

29. Use of oxycodone in polytrauma patients: the 'Gemelli' experience

Author: Franceschi, Francesco, Marini, Maria Giulia, Ursella, Stefano, Carbone, Lorenzo, Candelli, Marcello, Pignataro, Giulia, Gabrielli, Maurizio, Santarelli, Luca, Ojetti, Veronica, Giupponi, Bianca, Fiore, Valentina, Barbaro, Francesco, De Marco, Guido, Buccelletti, Francesco, Mancini, Floriana, Roccarina, Davide, Gigante, Giovanni, Gasbarrini, Antonio, Gasbarrini, Giovanni Battista, Silveri, Ng, Franceschi, Francesco (ORCID:0000-0001-6266-445X), Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Franceschi, Francesco, Marini, Maria Giulia, Ursella, Stefano, Carbone, Lorenzo, Candelli, Marcello, Pignataro, Giulia, Gabrielli, Maurizio, Santarelli, Luca, Ojetti, Veronica, Giupponi, Bianca, Fiore, Valentina, Barbaro, Francesco, De Marco, Guido, Buccelletti, Francesco, Mancini, Floriana, Roccarina, Davide, Gigante, Giovanni, Gasbarrini, Antonio, Gasbarrini, Giovanni Battista, Silveri, Ng, Franceschi, Francesco (ORCID:0000-0001-6266-445X), Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: INTRODUCTION: This is the first study investigating the effect of oxycodone in polytrauma patients. The management of pain in polytrauma patients has become a very relevant issue. Nonsteroidal anti-inflammatory drugs (NSAIDs) represent the most used drugs in polytrauma patients, even though their use is associated with an increased hemorrhagic risk. Previous studies have demonstrated the efficacy of oxycodone for the treatment of acute pain. The aim of this study was to assess the efficacy of oxycodone administration in polytrauma patients, with minor injuries. PATIENTS AND METHODS: 15 polytrauma patients (10 males, mean age 40 +/- 13 years; 5 females, mean age 49 +/- 26 years) were admitted to the Emergency Department of the Catholic University, A. Gemelli Hospital in Rome, Italy. All patients underwent physical examination, FAST ultrasound, total body CT scanning and blood tests. Three patients had multiple costal fractures, three had pelvic fracture, two had tibial fracture, five had vertebral fractures, one patient had clavicle fracture and ulnar fracture, one patient a severe trauma of the left leg, which required amputation. Five patients also reported minor head trauma, with a Glasgow Coma Score (GCS) 15. All patients reported abdominal trauma, while none of them had severe thoracic or kidney damage. Patients with head trauma also underwent a second CT head scanning 12 hours after admission, which excluded the occurrence of cerebral damage. All patients were then treated with oral administration of oxycodone 10 mg two times per day (bid) for 3 days. Pain intensity, before and after the administration of oxycodone, was evaluated using a scale ranging from 0 to 10. RESULTS: The mean pain score at admission was 8 +/- 0.7. All patients reported significant pain improvement after the administration of oxycodone (8 +/- 0.7 vs 1.8 +/- 0.9; p < 0.0001). A dosage increase of oxycodone from 20 to 40 mg bid was required in only one patient with a clavicle fracture. T
Published: 2008

30. High prevalence of Cag-A positive H. pylori strains in ischemic stroke: a primary care multicenter study.

Author: De Bastiani, R, Gabrielli, Maurizio, Ubaldi, E, Benedetto, R, Sanna, Giangiuseppe, Cottone, C, Candelli, Marcello, Zocco, Maria Assunta, Saulnier, Nathalie, Santoliquido, Angelo, Papaleo, Pierangelo, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), De Bastiani, R, Gabrielli, Maurizio, Ubaldi, E, Benedetto, R, Sanna, Giangiuseppe, Cottone, C, Candelli, Marcello, Zocco, Maria Assunta, Saulnier, Nathalie, Santoliquido, Angelo, Papaleo, Pierangelo, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: BACKGROUND: Previous studies suggested an association between CagA-positive H. pylori strains and ischemic stroke. The aim of the present study was to assess the prevalence of Helicobacter pylori infection and CagA status in patients with atherosclerotic stroke in the primary care setting. MATERIALS AND METHODS: A total of 106 consecutive patients (age 76.6 +/- 8 years; males 52%) with well-documented history of atherosclerotic stroke and 106 sex-age- (age 76.5 +/- 9 years; males 52%) and social background-matched controls without relevant vascular diseases. Risk factors for ischemic stroke were recorded in all subjects. H. pylori infection was assessed by[13]C-urea breath test. A serologic assay for specific IgG against CagA was performed in infected subjects. RESULTS: A trend toward a higher prevalence of H. pylori was observed in cases (63%) with respect to controls (54%) without reaching a statistical significance. CagA positivity was associated to a higher risk of atherosclerotic stroke (adjusted odds ratio 2.69, 95% confidence interval 1.37-5.30). CONCLUSIONS: Our findings suggest that CagA-positive strains of H. pylori are significantly associated to atherosclerotic stroke. This is not a merely confirmative study since it has been performed for the first time in the primary care setting and included only subjects with an active infection.
Published: 2008

31. 13C-methionine breath tests for mitochondrial liver function assessment.

Author: Grieco, Antonio, Candelli, Marcello, Miele, Luca, Armuzzi, Alessandro, Nista, Enrico Celestino, Pignataro, Giulia, Fini, Lucia, Cazzato, Immacolata Alessia, Zocco, Maria Assunta, Bartolozzi, F, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Grieco, Antonio (ORCID:0000-0002-0544-8993), Candelli, Marcello (ORCID:0000-0001-8443-7880), Miele, Luca (ORCID:0000-0003-3464-0068), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Grieco, Antonio, Candelli, Marcello, Miele, Luca, Armuzzi, Alessandro, Nista, Enrico Celestino, Pignataro, Giulia, Fini, Lucia, Cazzato, Immacolata Alessia, Zocco, Maria Assunta, Bartolozzi, F, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Grieco, Antonio (ORCID:0000-0002-0544-8993), Candelli, Marcello (ORCID:0000-0001-8443-7880), Miele, Luca (ORCID:0000-0003-3464-0068), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: 13C-methionine breath test has been proposed as a non-invasive tool for the assessment of human hepatic mithocondrial function. Two methionine breath labeled with 13C in differents point of his molecular structure have been used for breath test analisys. Aim of this study was to compare two differently 13C-labeled methionines in the evaluation of mitochondrial oxidation in basal conditions and after an acute oxidative stress. 15 healthy male subjects (mean age 30.5 +/- 3.1) received [methyl-13C]-methionine dissolved in water. Breath samples were taken at baseline and and 10, 20, 30, 45, 60, 75, 90, 105 and 120 minutes after the ingestion of the labeled substrate. Forthy-eight hours later, subjects underwent the same test 30 minutes after ethanol ingestion (0,3 g/kg of body weight). Seven-day later, subjects underwent breath test using (L-methionine-1-13COOH) as substrate, in basal condition and after ethanol ingestion. At basal condition, the cumulative percentage of 13CO2 recovered in breath during the test period (%cum-dose) was higher using L-methionine-1-13COOH than [methyl-13C]-methionine (10.25 +/- 1.0 vs 4.07 +/- 0.8; p < 0.01). After ethanol ingestion, % cum dose was significantly decreased at 60 and 120 minutes with both methionines (120 min: 10.25 +/- 1.0 vs 5.03% +/- 1.8; < 0.01 and 4.07 +/- 0.8 vs 2.16% +/- 0.9; p < 0.01, respectively). However, %cum-dose during L-methionine-1-13C-breath test was significantly lower than that observed during methyl-13C-methionine breath test (120 minutes: 5.03% +/- 1.8 vs 2.16% +/- 0.9; p < 0.01). In conclusion, breath test based on L-methionine-1-13COOH seems to show a greater reliability when compared to [methyl-13C]-methionine to assess mitochondrial function because a larger amount of labeled carbon that reaches the Krebs' cicle.
Published: 2008

32. Gender affects 13C-ketoisocaproic acid breath test

Author: Candelli, Marcello, Armuzzi, Alessandro, Miele, Luca, Nista, Ec, Pignataro, Giulia, Zileri Dal Verme, Lorenzo, Grieco, Antonio, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Miele, Luca (ORCID:0000-0003-3464-0068), Grieco, Antonio (ORCID:0000-0002-0544-8993), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Candelli, Marcello, Armuzzi, Alessandro, Miele, Luca, Nista, Ec, Pignataro, Giulia, Zileri Dal Verme, Lorenzo, Grieco, Antonio, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Miele, Luca (ORCID:0000-0003-3464-0068), Grieco, Antonio (ORCID:0000-0002-0544-8993), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: BACKGROUND AND AIMS: 13C-Ketoisocaproic Acid Breath Test (13C-Kica-BT) has been proposed to assess mitochondrial function. Aim of this study is to evaluate whether gender affects mithocondrial oxidation by means of 13C-Kica-BT in healthy subjects in basal conditions and after an acute oxidative stress induced by ethanol. METHODOLOGY: 50 healthy volunteers were given 1 mg/kg of 13C-Kica together with 20 mg/kg of L-leucine dissolved in 200 ml of orange juice. Breath samples were taken at baseline, every 5 minutes for 45 minutes and then every 15 minutes until 2 hours. Forty-eight hours later the test was repeated 30 min after ethanol ingestion (0.5 g/kg body weight). 13CO2 enrichment in breath was analyzed by isotope ratio/mass spectrometry. Statistical analysis was performed using the student's t test. RESULTS: At baseline conditions, the percentage of Ketoisocaproic acid in 2 hours was significantly higher in females than in males. Ethanol significantly reduces the oxidation of Ketoisocaproic acid. Conversely, no differences were observed between groups after the ethanol oral load. CONCLUSIONS: Decarboxylation of 13C-Kica was significantly higher in females than in males. Ethanol decreases Kica decarboxylation in particular in women. Further studies remain needed to establish whether sexual hormones could interfere with the metabolism of Kica.
Published: 2007

33. Serum macrophage migration inhibitory factor (MIF) in the intercritical phase of hereditary periodic fevers and its relationship with the -173 MIF gene polymorphism

Author: Rigante, Donato, Flex, Andrea, Federico, Gilda, Pola, Roberto, Candelli, Marcello, Manna, Raffaele, Pugliese, Anna Lisa, Cerquaglia, Claudia, Compagnone, Adele, Stabile, Achille, Rigante, Donato (ORCID:0000-0001-7032-7779), Flex, Andrea (ORCID:0000-0003-2664-4165), Pola, Roberto (ORCID:0000-0001-5224-2931), Candelli, Marcello (ORCID:0000-0001-8443-7880), Manna, Raffaele (ORCID:0000-0003-1560-3907), Rigante, Donato, Flex, Andrea, Federico, Gilda, Pola, Roberto, Candelli, Marcello, Manna, Raffaele, Pugliese, Anna Lisa, Cerquaglia, Claudia, Compagnone, Adele, Stabile, Achille, Rigante, Donato (ORCID:0000-0001-7032-7779), Flex, Andrea (ORCID:0000-0003-2664-4165), Pola, Roberto (ORCID:0000-0001-5224-2931), Candelli, Marcello (ORCID:0000-0001-8443-7880), and Manna, Raffaele (ORCID:0000-0003-1560-3907)
Abstract: OBJECTIVES: To examine the association of the -173 single-nucleotide G/C polymorphism of the macrophage migration inhibitory factor gene (MIF) and serum macrophage migration inhibitory factor (MIF) concentrations in a group of Italian patients with hereditary periodic fevers (HPF), tested during a symptom-free phase of their disease. METHODS: Genomic DNA for MIF and serum MIF were evaluated in 22 patients with HPF and compared with healthy controls of the same ethnic group. The MIF-173G/C polymorphism was genotyped using polymerase chain reaction (PCR) and visualized by ethidium bromide staining. Serum MIF levels were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: MIF-173*C allele frequency and MIF serum concentrations were significantly higher in patients with HPF than in controls, with no statistically significant difference between familial Mediterranean fever (FMF) and hyperimmunoglobulinaemia D/periodic fever syndrome (HIDS) and no correlation with specific MIF genotypes. CONCLUSIONS: The MIF-173*C allele was found more frequently in patients with HPF than in controls and MIF serum concentrations were considerably elevated in attack-free phases, suggesting a persistent state of subclinical cytokine activation with MIF involvement in the autoinflammatory cascade.
Published: 2007

34. -Accuracy of laryngeal examination during upper gastrointestinal endoscopy for premalignancy screening: prospective study in patients with and without reflux symptoms.

Author: Cammarota, Giovanni, Galli, Jacopo, Agostino, Stefania, De Corso, Eugenio, Rigante, Mario, Cianci, Rossella, Cesaro, Paola, Nista, Enrico Celestino, Candelli, Marcello, Gasbarrini, Antonio, Gasbarrini, Giovanni Battista, Cammarota, Giovanni (ORCID:0000-0002-3626-6148), Galli, Jacopo (ORCID:0000-0001-6353-6249), Rigante, Mario (ORCID:0000-0002-6111-0786), Cianci, Rossella (ORCID:0000-0001-5378-8442), Candelli, Marcello (ORCID:0000-0001-8443-7880), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Cammarota, Giovanni, Galli, Jacopo, Agostino, Stefania, De Corso, Eugenio, Rigante, Mario, Cianci, Rossella, Cesaro, Paola, Nista, Enrico Celestino, Candelli, Marcello, Gasbarrini, Antonio, Gasbarrini, Giovanni Battista, Cammarota, Giovanni (ORCID:0000-0002-3626-6148), Galli, Jacopo (ORCID:0000-0001-6353-6249), Rigante, Mario (ORCID:0000-0002-6111-0786), Cianci, Rossella (ORCID:0000-0001-5378-8442), Candelli, Marcello (ORCID:0000-0001-8443-7880), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: BACKGROUND AND STUDY AIMS: Gastroesophageal reflux disease may be associated with laryngeal damage caused by reflux material. The aim of this study was to investigate the accuracy of laryngeal examinations during routine upper gastrointestinal endoscopy as a method of screening for major laryngeal injury in a series of patients with reflux symptoms. PATIENTS AND METHODS: A total of 100 consecutive patients with reflux symptoms and 100 control individuals underwent upper gastrointestinal endoscopy with standard or high-resolution magnifying video endoscopes. Any laryngeal abnormalities were initially identified by the gastroenterologist before the scope was inserted into the esophagus. All of the examinations were recorded on video and subsequently reevaluated by an otorhinolaryngologist. All of the patients underwent standard laryngoscopy as a reference procedure. RESULTS: All of the patients completed the study. The sensitivity, specificity, negative predictive value, and positive predictive value of the preliminary laryngeal exploration for detecting laryngeal abnormalities (such as laryngitis and vocal leukoplakia) were 90%, 90%, 92%, and 89%, respectively. High-resolution magnifying endoscopy had a higher sensitivity and specificity than standard endoscopy for detecting laryngeal pathology. Two patients were found to have laryngeal leukoplakia. CONCLUSIONS: This study shows that preliminary diagnosis of laryngeal disorders can be accurately carried out by the gastroenterologist when patients are undergoing upper endoscopy for reflux symptoms. This approach could also be helpful for the timely diagnosis of major reflux-related laryngeal disease
Published: 2006

35. Interaction between Helicobacter pylori infection and untreated coeliac disease on gastric histological pattern.

Author: Santarelli, Luca, Gabrielli, Maurizio, Santoliquido, Angelo, Cuoco, L, Cazzato, Immacolata Alessia, Candelli, Marcello, Nista, Enrico Celestino, De Lorenzo, A, Gentiloni Silveri, Nicolo', Pola, Paolo, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Candelli, Marcello (ORCID:0000-0001-8443-7880), De Lorenzo , A, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Santarelli, Luca, Gabrielli, Maurizio, Santoliquido, Angelo, Cuoco, L, Cazzato, Immacolata Alessia, Candelli, Marcello, Nista, Enrico Celestino, De Lorenzo, A, Gentiloni Silveri, Nicolo', Pola, Paolo, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Candelli, Marcello (ORCID:0000-0001-8443-7880), De Lorenzo , A, and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: OBJECTIVE: Helicobacter pylori infection is the major agent of gastric damage. Coeliac disease may affect the morphology and function of the entire gastrointestinal tract from the stomach to the colon. The aim of this study was to assess the gastric histological pattern in patients with H. pylori and untreated coeliac disease. MATERIAL AND METHODS: We retrospectively enrolled 183 H. pylori-positive patients with (85, group A) and without (98, group B) untreated coeliac disease. The groups were similar for age, gender and smoking habit, and all the patients came from the same geographical area. Histological evaluation of gastric pattern was performed on 4 biopsies (2 in the antrum, 2 in the corpus). Gastric damage was classified according to the modified Sydney System. Diagnosis of H. pylori infection was based on positivity to histology. The chi-square test was used to assess differences between groups. A p-value <0.05 was considered significant. RESULTS: Group A showed a significantly higher prevalence of follicular gastritis than group B (23.5% versus 12.2%, p=0.045). A significantly lower prevalence of atrophic gastritis was observed in group A compared with that in group B (6% versus 22.5%, p=0.002). The prevalence of chronic superficial gastritis, activity degree and intestinal metaplasia was similar between the two groups. CONCLUSIONS: In patients with H. pylori infection, untreated coeliac disease could represent a risk factor for follicular gastritis and is associated with a lower prevalence of atrophic gastritis. The complex interaction between H. pylori and untreated coeliac disease on Th-1/Th-2 balance in the gastric mucosa could explain these results
Published: 2006

36. Efficacy of Lactobacillus GG in maintaining remission of ulcerative colitis.

Author: Zocco, M. A, Dal Verme, L. Z, Cremonini, Filippo, Piscaglia, A. C, Nista, E. C, Candelli, Marcello, Novi, M, Rigante, Donato, Cazzato, I. A, Ojetti, Veronica, Armuzzi, Alessandro, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Rigante, Donato (ORCID:0000-0001-7032-7779), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Zocco, M. A, Dal Verme, L. Z, Cremonini, Filippo, Piscaglia, A. C, Nista, E. C, Candelli, Marcello, Novi, M, Rigante, Donato, Cazzato, I. A, Ojetti, Veronica, Armuzzi, Alessandro, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Rigante, Donato (ORCID:0000-0001-7032-7779), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: BACKGROUND: Aminosalicylates are the mainstay of therapy to prevent relapse of quiescent ulcerative colitis. The rationale for using probiotics is based on the evidence implicating intestinal bacteria in the pathogenesis of this disorder. AIM: To evaluate the efficacy of Lactobacillus GG alone or in combination with mesalazine vs. mesalazine as maintenance treatment in ulcerative colitis. PATIENTS AND METHODS: 187 ulcerative colitis patients with quiescent disease were randomized to receive Lactobacillus GG 18 x 10(9) viable bacteria/day (65 patients), mesalazine 2400 mg/day (60 patients) or Lactobacillus GG + mesalazine (62 patients). Disease activity index, endoscopic and histological scores were determined at 0, 6 and 12 months and in case of relapse. The primary end point was to evaluate sustained remission. RESULTS: Overall analysis showed no difference in relapse rate at 6 (P = 0.44) and 12 months (P = 0.77) among the three treatment groups. However, the treatment with Lactobacillus GG seems to be more effective than standard treatment with mesalazine in prolonging the relapse-free time (P < 0.05). CONCLUSIONS: Lactobacillus GG seems to be effective and safe for maintaining remission in patients with ulcerative colitis, and it could represent a good therapeutic option for preventing relapse in this group of patients.
Published: 2006

37. Levofloxacin-based triple therapy in first-line treatment for Helicobacter pylori eradication

Author: Nista, Ec, Candelli, Marcello, Zocco, Maria Assunta, Cremonini, Filippo, Ojetti, Veronica, Finizio, Rosalba, Spada, Cristiano, Cammarota, Giovanni, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Spada, Cristiano (ORCID:0000-0002-5692-0960), Cammarota, Giovanni (ORCID:0000-0002-3626-6148), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Nista, Ec, Candelli, Marcello, Zocco, Maria Assunta, Cremonini, Filippo, Ojetti, Veronica, Finizio, Rosalba, Spada, Cristiano, Cammarota, Giovanni, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Spada, Cristiano (ORCID:0000-0002-5692-0960), Cammarota, Giovanni (ORCID:0000-0002-3626-6148), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: BACKGROUND: The standard first-line therapies for Helicobacter pylori eradication are based on clarithromycin and amoxicillin or metronidazole. Recent studies suggested levofloxacin as an alternative option for both first-and second-line H. pylori eradication treatment. AIMS: To compare efficacy and tolerability of two different 7-day standard triple therapies versus 7-day levofloxacin-based triple therapy in first-line treatment for H. pylori infection. METHODS: Three hundred consecutive H. pylori positive patients were randomized to receive: clarithromycin, amoxicillin, esomeprazole (Group A: N = 100); clarithromycin, metronidazole, esomeprazole (Group B: N = 100); or clarithromycin, levofloxacin, esomeprazole (Group C: N = 100). H. pylori status was rechecked by (13)C urea breath test 6 wk after the end of therapy. RESULTS: Sixteen out of 300 patients discontinued treatment because of the occurrence of side effects (Group A, 5; Group B, 7; Group C, 4). The eradication rates in intention to treat (ITT) and per protocol (PP) analyses were: Group A, 75% and 79%; Group B, 72% and 77.4%; and Group C, 87% and 90.6%. The eradication rate achieved with levofloxacin-based triple therapy was significantly higher than that with standard therapies in either ITT (87%vs 75%, p <0.05; 87%vs 72%, p <0.01;) or PP analysis (90.6%vs 79%, p <0.05; 90.6 vs 77.4, p <0.05). No difference was found between standard triple therapies. The incidence of side effects was similar among groups. CONCLUSIONS: A 7-day levofloxacin-based triple therapy can achieve higher H. pylori eradication rates than standard regimens. These data suggest levofloxacin-based regimens can be the most effective in first-line anti-H. pylori therapy, at least in the Italian population.
Published: 2006

38. Idiopathic chronic urticaria and celiac disease

Author: Schiavino, Domenico, Gabrielli, Maurizio, Candelli, Marcello, Cremonini, Filippo, Ojetti, Veronica, Santarelli, Luca, Nista, Enrico Celestino, Nucera, Eleonora, Patriarca, Giampiero, Gasbarrini, Antonio, Gasbarrini, Giovanni Battista, Pola, Paolo, Schiavino, Domenico (ORCID:0000-0003-3824-0619), Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Nucera, Eleonora (ORCID:0000-0002-0565-7680), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Schiavino, Domenico, Gabrielli, Maurizio, Candelli, Marcello, Cremonini, Filippo, Ojetti, Veronica, Santarelli, Luca, Nista, Enrico Celestino, Nucera, Eleonora, Patriarca, Giampiero, Gasbarrini, Antonio, Gasbarrini, Giovanni Battista, Pola, Paolo, Schiavino, Domenico (ORCID:0000-0003-3824-0619), Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Nucera, Eleonora (ORCID:0000-0002-0565-7680), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: N/A
Published: 2005

39. Treatment of H. pylori infection: a review.

Author: Candelli, Marcello, Nista, Enrico Celestino, Carloni, Emilia, Pignataro, Giulia, Zocco, Maria Assunta, Cazzato, Immacolata Alessia, Di Campli, Cristiana, Fini, Lucia, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Candelli, Marcello, Nista, Enrico Celestino, Carloni, Emilia, Pignataro, Giulia, Zocco, Maria Assunta, Cazzato, Immacolata Alessia, Di Campli, Cristiana, Fini, Lucia, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: Helicobacter pylori infection has been indicated as the main pathogenic factor in the development of chronic gastritis, peptic ulcer disease, and gastric malignancies. Although the vast majority of infected subjects do not carry but a mild, asymptomatic gastritis, still there are some cases in which the eradication of the infection appears mandatory. This review addresses current anti-Helicobacter regimens and pharmacological resources, and highlights the pros and cons of each of them, according to the most recent and reliable clinical trials. Also, basic recommendations are given, regarding treatment choice in the event of the failure of a first or second line eradicating strategy, and about the implementation of standard regimens with newer antibacterial devices as probiotics. PMID: 15720247 [PubMed - indexed for MEDLINE]
Published: 2005

40. -Can 13C urea breath test predict resistance to therapy in Helicobacter pylori infection?

Author: Cremonini, Filippo, Bartolozzi, F, Armuzzi, Alessandro, Zocco, Maria Assunta, Santarelli, Luca, Gabrielli, Maurizio, Candelli, Marcello, Nista, Enrico Celestino, Santoliquido, Angelo, Gasbarrini, Antonio, Bartolozzi , F, Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Candelli, Marcello (ORCID:0000-0001-8443-7880), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Cremonini, Filippo, Bartolozzi, F, Armuzzi, Alessandro, Zocco, Maria Assunta, Santarelli, Luca, Gabrielli, Maurizio, Candelli, Marcello, Nista, Enrico Celestino, Santoliquido, Angelo, Gasbarrini, Antonio, Bartolozzi , F, Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Candelli, Marcello (ORCID:0000-0001-8443-7880), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: BACKGROUND/AIMS: Results of 13C urea breath test (UBT), a noninvasive test for detecting active H. pylori infection, have been regarded also numerically for a possible predictive value on bacterial load and entity of mucosal inflammation. In the present study we wished to determine whether there is a particular value of Delta Over Baseline (DOB) result which could predict resistance to anti-H. pylori therapy. METHODOLOGY: 570 subjects from 1376 tested received a standard triple anti-H. pylori regimen. After a minimum of 6 weeks subjects underwent control UBT testing. Correlation of DOB values at diagnostic and control UBT and sensitivity of different DOB levels to predict resistance to therapy were calculated using simple linear correlation and Bayes' theorem, respectively. RESULTS: Modest linear correlation was observed between DOB values (r2=0.28). The value of 13.0 at diagnostic UBT showed a sensitivity of 65.5% to predict and further positivity at control testing. CONCLUSIONS: In our large series, UBT numerical DOB value weakly predicted resistance to first-line anti-H. pylori therapy
Published: 2005

41. -Azithromycin on soluble cell adhesion molecules and markers of inflammation in survivors of an acute coronary syndrome

Author: Gabrielli, Maurizio, Candelli, Marcello, Santarelli, Luca, Pola, Paolo, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Gabrielli, Maurizio, Candelli, Marcello, Santarelli, Luca, Pola, Paolo, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Published: 2005

42. -Decreased mitochondrial oxidative capacity in hereditary tyrosinemia type 1

Author: Rigante, Donato, Gasbarrini, Antonio, Nista, Enrico Celestino, Candelli, Marcello, Rigante, Donato (ORCID:0000-0001-7032-7779), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Candelli, Marcello (ORCID:0000-0001-8443-7880), Rigante, Donato, Gasbarrini, Antonio, Nista, Enrico Celestino, Candelli, Marcello, Rigante, Donato (ORCID:0000-0001-7032-7779), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), and Candelli, Marcello (ORCID:0000-0001-8443-7880)
Published: 2005

43. -Idiopathic chronic urticaria and celiac disease

Author: Gabrielli, Maurizio, Candelli, Marcello, Cremonini, Filippo, Ojetti, Veronica, Santarelli, Luca, Nista, Enrico Celestino, Nucera, Eleonora, Schiavino, Domenico, Patriarca, Giampiero, Gasbarrini, Giovanni Battista, Pola, Paolo, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Nucera, Eleonora (ORCID:0000-0002-0565-7680), Schiavino, Domenico (ORCID:0000-0003-3824-0619), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Gabrielli, Maurizio, Candelli, Marcello, Cremonini, Filippo, Ojetti, Veronica, Santarelli, Luca, Nista, Enrico Celestino, Nucera, Eleonora, Schiavino, Domenico, Patriarca, Giampiero, Gasbarrini, Giovanni Battista, Pola, Paolo, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Nucera, Eleonora (ORCID:0000-0002-0565-7680), Schiavino, Domenico (ORCID:0000-0003-3824-0619), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: Idiopathic chronic urticaria (ICU) is a chronic relapsing cutaneous disease. Some case reports or studies on small series of celiac disease (CD) patients have suggested a possible association between CD and ICU. The aim of this study was to assess the prevalence of CD in a population of adults ICU patients with respect to healthy controls. We consecutively enrolled 80 patients affected by ICU and 264 blood donors as the control population without a history of ICU. Serum anti-transglutaminase IgG and anti-endomysium IgA antibodies were evaluated in all subjects. In the case of positivity to serology, diagnosis was confirmed by duodenal biopsy. One of 80 (1.25%) ICU patients were positive to both anti-transglutaminase and anti-endomysium antibodies. Duodenal biopsy showed partial villous atrophy. One control of 264 (0.38%) had CD. No statistical difference was found in the prevalence of CD between the two groups. ICU patients do not seem to bear a greater risk for CD compared to the general population.
Published: 2005

44. -Improvement of mitochondrial function evaluated by ketoisocaproic acid breath test in patients with HCV infection undergoing albumin dialysis

Author: Zocco, Maria Assunta, Di Campli, Cristiana, Gaspari, Rita, Candelli, Marcello, Nista, Enrico Celestino, Zileri Dal Verme, Lorenzo, Di Gioacchino, Giorgia, Santoliquido, Angelo, Flore, Roberto Antonio, Tondi, Paolo, Proietti, Rodolfo, Pola, Paolo, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Gaspari, Rita (ORCID:0000-0003-0141-3686), Candelli, Marcello (ORCID:0000-0001-8443-7880), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Flore, Roberto Antonio (ORCID:0000-0003-1659-1338), Tondi, Paolo (ORCID:0000-0003-1654-2448), Proietti, Rodolfo (ORCID:0000-0003-1137-9928), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Zocco, Maria Assunta, Di Campli, Cristiana, Gaspari, Rita, Candelli, Marcello, Nista, Enrico Celestino, Zileri Dal Verme, Lorenzo, Di Gioacchino, Giorgia, Santoliquido, Angelo, Flore, Roberto Antonio, Tondi, Paolo, Proietti, Rodolfo, Pola, Paolo, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Gaspari, Rita (ORCID:0000-0003-0141-3686), Candelli, Marcello (ORCID:0000-0001-8443-7880), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Flore, Roberto Antonio (ORCID:0000-0003-1659-1338), Tondi, Paolo (ORCID:0000-0003-1654-2448), Proietti, Rodolfo (ORCID:0000-0003-1137-9928), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: BACKGROUND AND AIM: Oxidative injury occurs as a direct result of hepatitis C virus (HCV) core protein expression both in vitro and in vivo, and may be due to a direct effect on mitochondria. The ketoisocaproic acid (KICA) breath test is a simple, reliable, and noninvasive test to evaluate hepatic mitochondrial function. Albumin dialysis (MARS) is an effective bridge treatment for patients with acute failure superimposed on chronic liver disease. The aim of our study was to evaluate the improvement of mitochondrial function measured by KICA in patients undergoing MARS for acute-on-chronic HCV liver failure. MATERIALS AND METHODS: Five patients with HCV chronic infection undergoing MARS treatment for acute decompensation were enrolled. Before and after each MARS treatment, patients underwent blood testing for the main hematochemical parameters as well as for mitochondrial function by the KICA breath test and the arterial ketone bodies ratio (AKBR). RESULTS: MARS treatment effectively decreased the serum level of total bilirubin, bile acids, urea, and ammonium. Moreover, MARS treatment produced an increase in AKBR and in the cumulative percentage of (13)CO(2) recovered in exhaled air 2 hours after KICA ingestion. CONCLUSION: Liver mitochondrial function appears to be beneficially affected by MARS treatment.
Published: 2005

45. -The decrease in cytokine concentration during albumin dialysis correlates with the prognosis of patients with acute on chronic liver failure

Author: Di Campli, Cristiana, Zocco, Maria Assunta, Gaspari, Rita, Novi, Maria Luisa, Candelli, Marcello, Santoliquido, Angelo, Flore, Roberto Antonio, Tondi, Paolo, Proietti, Rodolfo, Gasbarrini, Giovanni Battista, Pola, Paolo, Gasbarrini, Antonio, Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Gaspari, Rita (ORCID:0000-0003-0141-3686), Candelli, Marcello (ORCID:0000-0001-8443-7880), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Flore, Roberto Antonio (ORCID:0000-0003-1659-1338), Tondi, Paolo (ORCID:0000-0003-1654-2448), Proietti, Rodolfo (ORCID:0000-0003-1137-9928), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Di Campli, Cristiana, Zocco, Maria Assunta, Gaspari, Rita, Novi, Maria Luisa, Candelli, Marcello, Santoliquido, Angelo, Flore, Roberto Antonio, Tondi, Paolo, Proietti, Rodolfo, Gasbarrini, Giovanni Battista, Pola, Paolo, Gasbarrini, Antonio, Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Gaspari, Rita (ORCID:0000-0003-0141-3686), Candelli, Marcello (ORCID:0000-0001-8443-7880), Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Flore, Roberto Antonio (ORCID:0000-0003-1659-1338), Tondi, Paolo (ORCID:0000-0003-1654-2448), Proietti, Rodolfo (ORCID:0000-0003-1137-9928), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: BACKGROUND AND AIM: The clearance of plasma cytokines by means of albumin dialysis (MARS) has been demonstrated in various studies involving patients affected by either acute liver failure (ALF) or acute on chronic liver failure. The aim of the study was to measure the plasma levels of TNF-alpha, IL-6, and IL-1beta in patients with ALF after each MARS treatment to evaluate the relationship between variations in cytokines levels and patient prognosis. MATERIALS AND METHODS: Ten patients with ALF undergoing several MARS treatments were enrolled (group 1). Blood samples were collected before and after each MARS treatment to measure TNF-alpha, IL-6, and IL-1beta, and other hematochemical parameters. We also enrolled 10 patients with ALF who underwent standard therapy (group 2) as well as a control group of 10 healthy subjects matched for sex and age (group 3). RESULTS: MARS reduced total bilirubin levels, biliary acids, BUN, ammonia, TNF-alpha, IL-6, and IL-1beta (P < .05). Moreover, the reduction in inflammatory cytokines levels and improved prognosis were related. CONCLUSIONS: We confirmed the therapeutic efficacy of MARS treatment for ALF, which appeared to be related to removal of toxins and inflammatory cytokines determine that which patients prognosis.
Published: 2005

46. -Moxifloxacin-based strategies for first-line treatment of Helicobacter pylori infection.

Author: Nista, Enrico Celestino, Candelli, Marcello, Zocco, Maria Assunta, Cazzato, Immacolata Alessia, Cremonini, Filippo, Ojetti, Veronica, Santoro, Marco, Finizio, R, Pignataro, Giulia, Cammarota, Giovanni, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Cammarota, Giovanni (ORCID:0000-0002-3626-6148), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Nista, Enrico Celestino, Candelli, Marcello, Zocco, Maria Assunta, Cazzato, Immacolata Alessia, Cremonini, Filippo, Ojetti, Veronica, Santoro, Marco, Finizio, R, Pignataro, Giulia, Cammarota, Giovanni, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Ojetti, Veronica (ORCID:0000-0002-8953-0707), Cammarota, Giovanni (ORCID:0000-0002-3626-6148), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: BACKGROUND: Standard anti-Helicobacter pylori therapy may not achieve a satisfactory eradication rate. Fluoroquinolones, such as moxifloxacin, are safe and promising agents for H. pylori eradication. AIM: To compare the efficacy of two 1-week moxifloxacin-based H. pylori eradication regimens with two standard treatments. METHODS: Three hundred and twenty H. pylori-positive subjects were randomized into four groups to receive: moxifloxacin, amoxicillin, esomeprazole (Group MAE); moxifloxacin, tinidazole and esomeprazole (Group MTE); standard triple therapies with clarithromycin, amoxicillin and esomeprazole (Group CAE) or tinidazole (Group CTE) for 7 days. H. pylori status was re-assessed 6 weeks after the end of therapy by 13C urea breath test. RESULTS: Three hundred and twenty patients completed the efficacy analysis per protocol; H. pylori eradication rate in group MTE was 90% (72 of 80) and 92% (72 of 78), in group MAE was 88% (70 of 80) and 89%, (70 of 79) in Group CAE was 73% (58 of 80) and 78% (58 of 74), and in Group CTE was 75% (60 of 80) and 79% (60 of 76), respectively, in intention-to-treat and in per protocol analyses. Eradication rates of moxifloxacin-based triple therapies were significantly higher than that observed using standard triple schemes. The incidence of side effects was significantly lower in moxifloxacin groups than in control groups. CONCLUSIONS: Seven-day moxifloxacin-based triple therapies provide optimal eradication rates with a good compliance when compared with the standard triple therapy schemes.
Published: 2005

47. 13C-breath tests in the study of mitochondrial liver function

Author: Candelli, Marcello, Cazzato, Ia, Zocco, Maria Assunta, Nista, Ec, Fini, Lucia, Armuzzi, Alessandro, Camise, V, Santoro, Marco, Miele, Luca, Grieco, Antonio, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Miele, Luca (ORCID:0000-0003-3464-0068), Grieco, Antonio (ORCID:0000-0002-0544-8993), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Candelli, Marcello, Cazzato, Ia, Zocco, Maria Assunta, Nista, Ec, Fini, Lucia, Armuzzi, Alessandro, Camise, V, Santoro, Marco, Miele, Luca, Grieco, Antonio, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Armuzzi, Alessandro (ORCID:0000-0003-1572-0118), Miele, Luca (ORCID:0000-0003-3464-0068), Grieco, Antonio (ORCID:0000-0002-0544-8993), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: Breath tests for "dynamic" liver function evaluation have been proposed several years ago. A variety of carbon-labelled breath tests for the assessment of mitochondrial, microsomal and cytosolic liver function have been described with the aim to increase data on liver disease staging, prognosis, and response to therapy. In the last years a great interest is developed about the use of breath test for liver mitochondrial function evaluation since it results impaired in a wide range of liver diseases either of genetic or acquired origin. In these cases mitochondrial oxidative metabolism of some substrates, as far as recovery of the hepatic energy state after a metabolic insult, results impaired because of the disfunction of the electron transport chain and/or ATP synthesis. Ketoisocaproic acid and methionine are the best studied carbon-labelled substrates for the investigation of mitochondrial functional damages related to structural alterations that occur in many liver diseases. Although these tests are simple, cost-effective and safe, to date there is still not general approval for their usefulness in clinical settings since they should fulfill several requirements to overcome the drawbacks of traditional quantitative tests. On the other hand, this field is relatively young and further studies are needed in order to assess the suitable substrate for the evaluation of the complex mitochondrial metabolism both in healthy subjects and in patients with liver disease.
Published: 2004

48. Chronic infections and migraine

Author: Candelli, Marcello, Gabrielli, N, Santoliquido, Martino, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Candelli, Marcello, Gabrielli, N, Santoliquido, Martino, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: Chronic infections and migraine
Published: 2004

49. Atrophic gastritis as a cause of hyperhomocysteinaemia

Author: Santarelli, Luca, Gabrielli, Maurizio, Cremonini, Filippo, Santoliquido, Angelo, Candelli, Marcello, Nista, Ec, Pola, Paolo, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Candelli, Marcello (ORCID:0000-0001-8443-7880), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Santarelli, Luca, Gabrielli, Maurizio, Cremonini, Filippo, Santoliquido, Angelo, Candelli, Marcello, Nista, Ec, Pola, Paolo, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Santoliquido, Angelo (ORCID:0000-0003-1539-4017), Candelli, Marcello (ORCID:0000-0001-8443-7880), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: Hyperhomocysteinaemia is an independent risk factor for atherosclerosis. It is often related to low levels of vitamin B12 and/or folate, enzymatic co-factors of methionine metabolism. Atrophic gastritis, often caused by Helicobacter pylori infection, may impair vitamin absorption.
Published: 2004

50. A) Bacillus clausii therapy to reduce side-effects of anti-Helicobacter pylori treatment: randomized, double-blind, placebo controlled trial.

Author: Nista, Enrico Celestino, Candelli, Marcello, Cremonini, Filippo, Cazzato, Immacolata Alessia, Zocco, Maria Assunta, Franceschi, Francesco, Cammarota, Giovanni, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Cammarota, Giovanni (ORCID:0000-0002-3626-6148), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Nista, Enrico Celestino, Candelli, Marcello, Cremonini, Filippo, Cazzato, Immacolata Alessia, Zocco, Maria Assunta, Franceschi, Francesco, Cammarota, Giovanni, Gasbarrini, Giovanni Battista, Gasbarrini, Antonio, Candelli, Marcello (ORCID:0000-0001-8443-7880), Zocco, Maria Assunta (ORCID:0000-0002-0814-9542), Franceschi, Francesco (ORCID:0000-0001-6266-445X), Cammarota, Giovanni (ORCID:0000-0002-3626-6148), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)
Abstract: The incidences of nausea, diarrhoea and epigastric pain in patients treated with B. clausii were significantly lower than in placebo group, in both PP and ITT analysis. Equally, intensity of nausea and diarrhoea in patients treated with B. clausii was significantly lower than in placebo group. There were no differences in adherence to treatment and H. pylori eradication rates between groups. Conclusion : In symptom-free, H. pylori-positive subjects B. clausii bacteriotherapy reduces the incidence of the most common side-effects related to anti-H. pylori antibiotic therapy compared with placebo
Published: 2004

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