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1. Shear-wave elastography to predict hepatocellular carcinoma after hepatitis C virus eradication: A systematic review and meta-analysis

Author

Esposto, Giorgio, Santini, Paolo, Galasso, Linda, Mignini, Irene, Ainora, Maria Elena, Gasbarrini, Antonio, Zocco, Maria Assunta, Esposto G., Santini P., Galasso L., Mignini I., Ainora M. E., Gasbarrini A. (ORCID:0000-0002-7278-4823), Zocco M. A. (ORCID:0000-0002-0814-9542), Esposto, Giorgio, Santini, Paolo, Galasso, Linda, Mignini, Irene, Ainora, Maria Elena, Gasbarrini, Antonio, Zocco, Maria Assunta, Esposto G., Santini P., Galasso L., Mignini I., Ainora M. E., Gasbarrini A. (ORCID:0000-0002-7278-4823), and Zocco M. A. (ORCID:0000-0002-0814-9542)

Abstract

Background: Direct-acting antiviral agents (DAAs) are highly effective treatment for chronic hepatitis C (CHC) with a significant rate of sustained virologic response (SVR). The achievement of SVR is crucial to prevent additional liver damage and slow down fibrosis progression. The assessment of fibrosis degree can be performed with transient elastography, magnetic resonance elastography or shear-wave elastography (SWE). Liver elastography could function as a predictor for hepatocellular carcinoma (HCC) in CHC patients treated with DAAs. Aim: To explore the predictive value of SWE for HCC development after complete clearance of hepatitis C virus (HCV). Methods: A comprehensive literature search of clinical studies was performed to identify the ability of SWE to predict HCC occurrence after HCV clearance. In accordance with the study protocol, a qualitative and quantitative analysis of the evidence was planned. Results: At baseline and after 12 wk of follow-up, a trend was shown towards greater liver stiffness (LS) in those who go on to develop HCC compared to those who do not [baseline LS standardized mean difference (SMD): 1.15, 95% confidence interval (95%CI): 020-2.50; LS SMD after 12 wk: 0.83, 95%CI: 0.33-1.98]. The absence of a statistically significant difference between the mean LS in those who developed HCC or not may be related to the inability to correct for confounding factors and the absence of raw source data. There was a statistically significant LS SMD at 24 wk of follow-up between patients who developed HCC vs not (0.64; 95%CI: 0.04-1.24). Conclusion: SWE could be a promising tool for prediction of HCC occurrence in patients treated with DAAs. Further studies with larger cohorts and standardized timing of elastographic evaluation are needed to confirm these data.

Published
2024

2. P363 Multimodal dynamic ultrasound approach as predictor of response in patients with Crohn’s disease treated with ustekinumab

Author

Mignini, I, primary, Maresca, R, additional, Esposto, G, additional, Ainora, M E, additional, Liguori, A, additional, Cintoni, M, additional, Galasso, L, additional, Laterza, L, additional, Lopetuso, L R, additional, Garcovich, M, additional, Riccardi, L, additional, Gasbarrini, A, additional, Scaldaferri, F, additional, and Zocco, M A, additional

Published
2024
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3. The Role of Transabdominal Ultrasound Elastography in Gastrointestinal Non-Liver Diseases: Current Application and Future Prospectives

Author

Paratore, Mattia, Garcovich, Matteo, Ainora, Maria Elena, Del Vecchio, Livio Enrico, Cuccia, Giuseppe, Riccardi, Laura, Pompili, Maurizio, Gasbarrini, Antonio, Zocco, Maria Assunta, Paratore M., Garcovich M., Ainora M. E., Del Vecchio L. E., Cuccia G., Riccardi L., Pompili M. (ORCID:0000-0001-6699-7980), Gasbarrini A. (ORCID:0000-0002-7278-4823), Zocco M. A. (ORCID:0000-0002-0814-9542), Paratore, Mattia, Garcovich, Matteo, Ainora, Maria Elena, Del Vecchio, Livio Enrico, Cuccia, Giuseppe, Riccardi, Laura, Pompili, Maurizio, Gasbarrini, Antonio, Zocco, Maria Assunta, Paratore M., Garcovich M., Ainora M. E., Del Vecchio L. E., Cuccia G., Riccardi L., Pompili M. (ORCID:0000-0001-6699-7980), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Zocco M. A. (ORCID:0000-0002-0814-9542)

Abstract

Ultrasound imaging is the first-line investigation for patients with abdominal symptoms, as it effectively depicts the gastrointestinal tract and enables the diagnosis of multiple pathological conditions. Among different recent ultrasound technological advancements, elastography enables the evaluation of various tissue characteristics, such as neoplastic transformation or fibroinflammatory status. In recent years, ultrasound elastography has been utilized extensively for the study of liver diseases and in numerous other clinical settings, including gastrointestinal diseases. Current guidelines suggest the use of transabdominal ultrasound elastography to characterize bowel wall lesions, to assess gastrointestinal contractility, to diagnose and grade chronic pancreatitis; however, no specific indications are provided. In the present paper, we summarize the evidence concerning the application of different ultrasound elastography modalities in gastrointestinal non-liver diseases.

Published
2023

4. Ultrasound Elastography to Assess Age of Deep Vein Thrombosis: A Systematic Review

Author

Santini, Paolo, Esposto, Giorgio, Ainora, Maria Elena, Lupascu, Andrea, Gasbarrini, Antonio, Zocco, Maria Assunta, Pola, Roberto, Santini P., Esposto G., Ainora M. E., Lupascu A., Gasbarrini A. (ORCID:0000-0002-7278-4823), Zocco M. A. (ORCID:0000-0002-0814-9542), Pola R. (ORCID:0000-0001-5224-2931), Santini, Paolo, Esposto, Giorgio, Ainora, Maria Elena, Lupascu, Andrea, Gasbarrini, Antonio, Zocco, Maria Assunta, Pola, Roberto, Santini P., Esposto G., Ainora M. E., Lupascu A., Gasbarrini A. (ORCID:0000-0002-7278-4823), Zocco M. A. (ORCID:0000-0002-0814-9542), and Pola R. (ORCID:0000-0001-5224-2931)

Abstract

Background and aims: Deep-vein thrombosis (DVT) is a widely diffused condition, and its accurate staging has major clinical and therapeutic implications. Ultrasound elastography (UE) is a rapidly evolving imaging technique that allows quantification of elastic tissue properties and could play a crucial role in determining thrombus age. The aim of this review is to find clinical evidence regarding the application of UE in the evaluation of DVT and its usefulness in differentiating thrombosis age. Methods: A literature search of clinical studies was performed to identify the ability of UE of discriminate acute, subacute, and chronic DVT. Heterogeneity and publication bias were calculated. In accordance with the study protocol, a qualitative analysis of the evidence was planned. The results were summarized with a comprehensive summary table of study characteristics and baseline characteristics of participant patients. Results: Nine studies matched the predetermined eligibility requirements for this systematic review regarding the risk of bias; the greatest criticalities were found within the domains of patient selection and index test. Based on the quality assessment, two publications were excluded from the qualitative synthesis because of the presence of significant applicability concerns. Among the seven studies that were considered eligible for qualitative synthesis, four evaluated strain elastography and three evaluated shear-wave elastography. Despite significant differences concerning study design, thrombus age definitions, and patient characteristics, nearly all studies demonstrated an increase in thrombus stiffness according to DVT age. Conclusions: UE could play a key role in routine ultrasound examination of DVT. The measurement of thrombus stiffness has a high biological plausibility and its use is supported by the finding of a correlation between the stiffness and the progression of the DVT age.

Published
2023

5. Post-COVID-19 global health strategies: the need for an interdisciplinary approach

Author

Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Carfi, A., Ciciarello, F., LoMonaco, M. R., Martone, A. M., Marzetti, E., Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, R., Catalano, L., Picca, A., Savera, G., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, M. A., Sanguinetti, M., Cattani, P., Marchetti, S., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, M. C., Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, L., Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, L., Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Settanni C. R., Benvenuto F., Bramato G., Ciciarello F., Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Rota E., Salerno A., Tosato M., Tritto M., Calvani R. (ORCID:0000-0001-5472-2365), Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Taddei E., Stella L., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Crudo F., Longobardi Y., Tricarico L., Santantonio M., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Pata D., Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Lombardi F., Calabrese A., Sani G. (ORCID:0000-0002-9767-8752), Giuseppin G., Molinaro M., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Gigante L., Natalello G., Lizzio M. M., Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Nesci A. (ORCID:0000-0001-9466-1755), Popolla V., Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Carfi, A., Ciciarello, F., LoMonaco, M. R., Martone, A. M., Marzetti, E., Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, R., Catalano, L., Picca, A., Savera, G., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, M. A., Sanguinetti, M., Cattani, P., Marchetti, S., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, M. C., Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, L., Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, L., Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Settanni C. R., Benvenuto F., Bramato G., Ciciarello F., Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Rota E., Salerno A., Tosato M., Tritto M., Calvani R. (ORCID:0000-0001-5472-2365), Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Taddei E., Stella L., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Crudo F., Longobardi Y., Tricarico L., Santantonio M., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Pata D., Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Lombardi F., Calabrese A., Sani G. (ORCID:0000-0002-9767-8752), Giuseppin G., Molinaro M., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Gigante L., Natalello G., Lizzio M. M., Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Nesci A. (ORCID:0000-0001-9466-1755), and Popolla V.

Abstract

For survivors of severe COVID-19 disease, having defeated the virus is just the beginning of an uncharted recovery path. What follows after the acute phase of SARS-CoV-2 infection depends on the extension and severity of viral attacks in different cell types and organs. Despite the ridiculously large number of papers that have flooded scientific journals and preprint-hosting websites, a clear clinical picture of COVID-19 aftermath is vague at best. Without larger prospective observational studies that are only now being started, clinicians can retrieve information just from case reports and or small studies. This is the time to understand how COVID-19 goes forward and what consequences survivors may expect to experience. To this aim, a multidisciplinary post-acute care service involving several specialists has been established at the Fondazione Policlinico Universitario A. Gemelli IRCSS (Rome, Italy). Although COVID-19 is an infectious disease primarily affecting the lung, its multi-organ involvement requires an interdisciplinary approach encompassing virtually all branches of internal medicine and geriatrics. In particular, during the post-acute phase, the geriatrician may serve as the case manager of a multidisciplinary team. The aim of this article is to describe the importance of the interdisciplinary approach––coordinated by geriatrician––to cope the potential post-acute care needs of recovered COVID-19 patients.

Published
2020

6. Gut microbiota compositional and functional fingerprint in patients with alcohol use disorder and alcohol-associated liver disease

Author

Addolorato, G., Ponziani, F. R., Dionisi, T., Mosoni, C., Vassallo, G. A., Sestito, L., Petito, V., Picca, A., Marzetti, E., Tarli, C., Mirijello, A., Zocco, M. A., Lopetuso, L. R., Antonelli, M., Rando, M. M., Paroni Sterbini, F., Posteraro, B., Sanguinetti, M., Gasbarrini, A., Addolorato G. (ORCID:0000-0002-1522-9946), Ponziani F. R. (ORCID:0000-0002-5924-6238), Mosoni C., Sestito L., Petito V., Marzetti E. (ORCID:0000-0001-9567-6983), Tarli C., Mirijello A., Zocco M. A. (ORCID:0000-0002-0814-9542), Lopetuso L. R., Antonelli M. (ORCID:0000-0003-3007-1670), Rando M. M., Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), Gasbarrini A. (ORCID:0000-0002-7278-4823), Addolorato, G., Ponziani, F. R., Dionisi, T., Mosoni, C., Vassallo, G. A., Sestito, L., Petito, V., Picca, A., Marzetti, E., Tarli, C., Mirijello, A., Zocco, M. A., Lopetuso, L. R., Antonelli, M., Rando, M. M., Paroni Sterbini, F., Posteraro, B., Sanguinetti, M., Gasbarrini, A., Addolorato G. (ORCID:0000-0002-1522-9946), Ponziani F. R. (ORCID:0000-0002-5924-6238), Mosoni C., Sestito L., Petito V., Marzetti E. (ORCID:0000-0001-9567-6983), Tarli C., Mirijello A., Zocco M. A. (ORCID:0000-0002-0814-9542), Lopetuso L. R., Antonelli M. (ORCID:0000-0003-3007-1670), Rando M. M., Posteraro B. (ORCID:0000-0002-1663-7546), Sanguinetti M. (ORCID:0000-0002-9780-7059), and Gasbarrini A. (ORCID:0000-0002-7278-4823)

Abstract

Background & aims: Alcohol use disorder (AUD) represents the most common cause of liver disease. The gut microbiota plays a critical role in the progression of alcohol-related liver damage. Aim of this study was to characterize the gut microbial composition and function in AUD patients with alcohol-associated liver disease (AALD). Methods: This study included 36 AUD patients (14 with cirrhosis) who were active drinkers and an equal number of matched controls. Stool microbial composition, serum levels of lipopolysaccharide, cytokines/chemokines and gut microbiota functional profile were assessed. Results: AUD patients had a decreased microbial alpha diversity as compared to controls (0.092 vs 0.130, P =.047) and a specific gut microbial signature. The reduction of Akkermansia and the increase in Bacteroides were able to identify AUD patients with an accuracy of 93.4%. Serum levels of lipopolysaccharide (4.91 vs 2.43, P =.009) and pro-inflammatory mediators (tumour necrosis factor alpha 60.85 vs 15.08, P =.001; interleukin [IL] 1beta 4.43 vs 1.72, P =.0001; monocyte chemoattractant protein 1 225.22 vs 16.43, P =.006; IL6 1.87 vs 1.23, P =.008) were significantly increased in AUD patients compared to controls and in cirrhotic patients compared to non-cirrhotic ones (IL6 3.74 vs 1.39, P =.019; IL8 57.60 vs 6.53, P =.004). The AUD-associated gut microbiota showed an increased expression of gamma-aminobutyric acid (GABA) metabolic pathways and energy metabolism. Conclusions: AUD patients present a specific gut microbial fingerprint, associated with increased endotoxaemia, systemic inflammatory status and functional alterations that may be involved in the progression of the AALD and in the pathogenesis of AUD.

Published
2020

7. Fatigue in Covid-19 survivors: The potential impact of a nutritional supplement on muscle strength and function

Author

Galluzzo, Vincenzo, Zazzara, Maria Beatrice, Ciciarello, Francesca, Savera, Giulia, Pais, C., Calvani, Riccardo, Picca, A., Marzetti, Emanuele, Landi, Francesco, Tosato, Matteo, Steering, Committee, Gremese, Elisa, Coordination, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Field, Investigator, Gastroenterology, Team, Porcari, Serena, Settanni, Carlo Romano, Geriatric, Team, Benvenuto, F., Bramato, Giulia, Brandi, Vincenzo, Carfi, A., Fabrizi, Sofia, Lo Monaco, Maria Rita, Martone, Anna Maria, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tritto, M., Catalano, Lucio, Damiano, Francesco Paolo, Rocconi, Alessandra, Galliani, Alessandro, Spaziani, G., Tupputi, Salvatore, Cocchi, Camilla, Pirone, Flavia, D'Ignazio, F., Cacciatore, Stefano, Infectious disease, Team, Cauda, Roberto, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Dusina, A., Internal Medicine, Team, Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Microbiology, Team, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Posteraro, Brunella, Sali, M., Neurology, Team, Bizzarro, Alessandra, Lauria, Alessandra, Ophthalmology, Team, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Otolaryngology, Team, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Pediatric, Team, Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Pneumology, Team, Richeldi, Luca, Lombardi, F., Calabrese, Anna Chiara, Leone, Paolo Maria, Calvello, M. R., Intini, Enrica, Montemurro, G., Psychiatric, Team, Sani, Gabriele, Janiri, Delfina, Simonetti, Alessio, Giuseppin, G., Molinaro, M., Odica, M., Radiology, Team, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Rheumatology, Team, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Fedele, Anna Laura, Lizzio, Marco Maria, Tolusso, Barbara, Di Mario, Clara, Alivernini, Stefano, Vascular, Team, Santoliquido, Angelo, Santoro, L., Di Giorgio, A., Nesci, A., Popolla, Valentina, Galluzzo V., Zazzara M. B., Ciciarello F., Savera G., Calvani R. (ORCID:0000-0001-5472-2365), Marzetti E. (ORCID:0000-0001-9567-6983), Landi F. (ORCID:0000-0002-3472-1389), Tosato M., Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Porcari S., Settanni C. R., Bramato G., Brandi V., Fabrizi S., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Pagano F. C., Rocchi S., Salerno A., Catalano L., Damiano F. P., Rocconi A., Galliani A., Tupputi S., Cocchi C., Pirone F., Cacciatore S., Cauda R. (ORCID:0000-0002-1498-4229), Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Calabrese A., Leone P. M., Intini E., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Simonetti A., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Fedele A. L., Lizzio M. M., Tolusso B. (ORCID:0000-0002-9108-6609), Di Mario C., Alivernini S. (ORCID:0000-0002-7383-4212), Santoliquido A. (ORCID:0000-0003-1539-4017), Popolla V., Galluzzo, Vincenzo, Zazzara, Maria Beatrice, Ciciarello, Francesca, Savera, Giulia, Pais, C., Calvani, Riccardo, Picca, A., Marzetti, Emanuele, Landi, Francesco, Tosato, Matteo, Steering, Committee, Gremese, Elisa, Coordination, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Field, Investigator, Gastroenterology, Team, Porcari, Serena, Settanni, Carlo Romano, Geriatric, Team, Benvenuto, F., Bramato, Giulia, Brandi, Vincenzo, Carfi, A., Fabrizi, Sofia, Lo Monaco, Maria Rita, Martone, Anna Maria, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tritto, M., Catalano, Lucio, Damiano, Francesco Paolo, Rocconi, Alessandra, Galliani, Alessandro, Spaziani, G., Tupputi, Salvatore, Cocchi, Camilla, Pirone, Flavia, D'Ignazio, F., Cacciatore, Stefano, Infectious disease, Team, Cauda, Roberto, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Dusina, A., Internal Medicine, Team, Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Microbiology, Team, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Posteraro, Brunella, Sali, M., Neurology, Team, Bizzarro, Alessandra, Lauria, Alessandra, Ophthalmology, Team, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Otolaryngology, Team, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Pediatric, Team, Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Pneumology, Team, Richeldi, Luca, Lombardi, F., Calabrese, Anna Chiara, Leone, Paolo Maria, Calvello, M. R., Intini, Enrica, Montemurro, G., Psychiatric, Team, Sani, Gabriele, Janiri, Delfina, Simonetti, Alessio, Giuseppin, G., Molinaro, M., Odica, M., Radiology, Team, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Rheumatology, Team, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Fedele, Anna Laura, Lizzio, Marco Maria, Tolusso, Barbara, Di Mario, Clara, Alivernini, Stefano, Vascular, Team, Santoliquido, Angelo, Santoro, L., Di Giorgio, A., Nesci, A., Popolla, Valentina, Galluzzo V., Zazzara M. B., Ciciarello F., Savera G., Calvani R. (ORCID:0000-0001-5472-2365), Marzetti E. (ORCID:0000-0001-9567-6983), Landi F. (ORCID:0000-0002-3472-1389), Tosato M., Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Porcari S., Settanni C. R., Bramato G., Brandi V., Fabrizi S., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Martone A. M., Pagano F. C., Rocchi S., Salerno A., Catalano L., Damiano F. P., Rocconi A., Galliani A., Tupputi S., Cocchi C., Pirone F., Cacciatore S., Cauda R. (ORCID:0000-0002-1498-4229), Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Posteraro B. (ORCID:0000-0002-1663-7546), Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Calabrese A., Leone P. M., Intini E., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Simonetti A., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Fedele A. L., Lizzio M. M., Tolusso B. (ORCID:0000-0002-9108-6609), Di Mario C., Alivernini S. (ORCID:0000-0002-7383-4212), Santoliquido A. (ORCID:0000-0003-1539-4017), and Popolla V.

Abstract

Background: Fatigue with reduced tolerance to exercise is a common persistent long-lasting feature amongst COVID-19 survivors. The assessment of muscle function in this category of patients is often neglected.Aim.: To evaluate the potential impact of a daily supplementation based on amino acids, minerals, vi-tamins, and plant extracts (Apportal (R)) on muscle function, body composition, laboratory parameters and self-rated health in a small group of COVID-19 survivors affected by fatigue.Methods: Thirty participants were enrolled among patients affected by physical fatigue during or after acute COVID-19 and admitted to the post-COVID-19 outpatient service at Fondazione Policlinico Gemelli in Rome between 1st March 2021 and 30th April 2021. All participants were evaluated at first visit (t0) and at control visit (t1), after taking a daily sachet of Apportal (R) for 28 days. Muscle function was analyzed using hand grip strength test, exhaustion strength time and the number of repetitions at one -minute chair stand test. Body composition was assessed with bioelectrical impedance analysis (BIA). Laboratory parameters, including standard blood biochemistry and ferritin levels, were evaluated at the first visit and during the control visit. A quick evaluation of self-rated health, before COVID-19, at t0 and t1, was obtained through a visual analogue scale (VAS). Results: Participants aged 60 years and older were 13 (43%). Females represented the 70% of the study sample. Participants hospitalized for COVID-19 with low -flow oxygen supplementation represented the 43.3% of the study sample while 3.3% received noninvasive ventilation (NIV) or invasive ventilation. Hand grip strength improved from 26.3 Kg to 28.9 Kg (p < 0.05) at t1 as compared to t0. The mean time of strength exhaustion increased from 31.7 s (sec) at t0 to 47.5 s at t1 (p < 0.05). Participants performed a higher number of repetitions (28.3 vs. 22.0; p < 0.05) during the one-minute chair stand test at

Published
2022

8. Risk factors for portal vein thrombosis or venous thromboembolism in a large cohort of hospitalized cirrhotic patients

Author

Faccia, M., Santopaolo, Francesco, Gasbarrini, Antonio, Pompili, Maurizio, Zocco, Maria Assunta, Ponziani, Francesca Romana, Santopaolo F., Gasbarrini A. (ORCID:0000-0002-7278-4823), Pompili M. (ORCID:0000-0001-6699-7980), Zocco M. A. (ORCID:0000-0002-0814-9542), Ponziani F. R. (ORCID:0000-0002-5924-6238), Faccia, M., Santopaolo, Francesco, Gasbarrini, Antonio, Pompili, Maurizio, Zocco, Maria Assunta, Ponziani, Francesca Romana, Santopaolo F., Gasbarrini A. (ORCID:0000-0002-7278-4823), Pompili M. (ORCID:0000-0001-6699-7980), Zocco M. A. (ORCID:0000-0002-0814-9542), and Ponziani F. R. (ORCID:0000-0002-5924-6238)

Abstract

Background: Portal vein thrombosis (PVT) and venous thromboembolism (VTE) are fearsome complications of liver cirrhosis. Objectives: To assess the prevalence and the main risk factors for venous thrombotic complications in hospitalized cirrhotic patients. Patients/methods: We retrospectively reviewed electronic administrative discharge data of 19461 cirrhotic patients hospitalized over a 35-year period; univariate and multivariate logistic regression was used to asses risk factors for PVT or VTE and their impact on hospital stay and mortality. Results: 382 out of 7445 patients (5.1%) were diagnosed with PVT and 95 (1.3%) with VTE. Liver cirrhosis complications were observed in 45% of patients. Hepatic encephalopathy (HE) (OR 13.88 [10.76–17.98] p < 0.0001), endoscopic signs of portal hypertension (OR 1.33 [1.02–1.75] p = 0.02), hepatocellular carcinoma (HCC) (OR 4.59 [3.6–5.84] p < 0.0001), diabetes (OR 1.68 [1.27–2.22] p = 0.0001), abdominal surgery/invasive procedures (OR 2.03 [1.56–2.64] p < 0.0001) emerged as independent predictors of PVT. Higher risk of VTE was observed in patients with HE (OR 3.21 [1.78–5.79] p < 0.0001), HCC (OR 1.98 [1.23–3.19] p = 0.002) or other tumors (OR 2.48 [1.42–4.32] p = 0.001), acute illnesses (infections OR 3.01 [1.84–5.05] p = 0.0001; cardiac/respiratory insufficiency OR 2.4 [1.27–4.53] p = 0.003; acute myocardial infarction/stroke OR 7.86 [1.76–35.12] p = 0.003). VTE was the only independent predictor of in-hospital mortality (OR 4.45 [1.05–18.81] p = 0.042). Conclusions: Liver disease complications related to portal hypertension, HCC or other tumors, diabetes, acute illnesses (i.e. infections, cardiac/pulmonary insufficiency, acute myocardial infarction/stroke) and abdominal interventions are associated with increased risk of PVT or VTE in hospitalized cirrhotic patients, and should be considered to define personalized preemptive approaches.

Published
2022

9. Correlation Between QElaXto Techniques and Supersonic Imagine for Liver Stiffness Quantification in Chronic Liver Disease

Author

Garcovich, M., Faccia, M., Di Stasio, Enrico, Riccardi, Laura, Zocco, Maria Assunta, Ainora, Maria Elena, Vecchio, Fabio Maria, Mingrone, Geltrude, Gasbarrini, Antonio, Pompili, Maurizio, Di Stasio E. (ORCID:0000-0003-1047-4261), Riccardi L., Zocco M. A. (ORCID:0000-0002-0814-9542), Ainora M. E., Vecchio F. M. (ORCID:0000-0002-9197-2264), Mingrone G. (ORCID:0000-0003-2021-528X), Gasbarrini A. (ORCID:0000-0002-7278-4823), Pompili M. (ORCID:0000-0001-6699-7980), Garcovich, M., Faccia, M., Di Stasio, Enrico, Riccardi, Laura, Zocco, Maria Assunta, Ainora, Maria Elena, Vecchio, Fabio Maria, Mingrone, Geltrude, Gasbarrini, Antonio, Pompili, Maurizio, Di Stasio E. (ORCID:0000-0003-1047-4261), Riccardi L., Zocco M. A. (ORCID:0000-0002-0814-9542), Ainora M. E., Vecchio F. M. (ORCID:0000-0002-9197-2264), Mingrone G. (ORCID:0000-0003-2021-528X), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Pompili M. (ORCID:0000-0001-6699-7980)

Abstract

Objectives: Intersystem variability in liver stiffness (LS) quantification with ultrasound shear wave elastography (SWE) precludes direct comparison of results obtained with different equipment. The aim of this study was to investigate the agreement between point-SWE and 2-dimensional-SWE with Esaote-MyLab 9 (p-QElaXto and 2D-QElaXto, respectively) and 2D-SWE with SuperSonic Imagine (SSI) in order to assess specific LS thresholds for fibrosis staging with QElaXto techniques, using SSI as a reference standard. Methods: A total of 235 compensated chronic liver disease (CLD) patients without comorbidities potentially affecting LS were enrolled in the study. Among them, 101 patients underwent also liver biopsy. Agreement between the equipment was assessed with Pearson coefficient and Bland–Altman analysis, while cut-off values were calculated with receiver operating characteristics analysis. Results: Correlation between 2D-QElaXto and p-QElaXto with SSI resulted very good (r = 0.898 and r = 0.866), especially in precirrhotic stages, with a mean difference between LS values of −1.3 kPa for 2D-QElaXto and −0.6 kPa for p-QElaXto compared with SSI. Cut-off thresholds for diagnosing fibrosis ≥F2, ≥F3, and F4 in non-HBV-related CLD were, respectively, 5.5, 8.0, and 10.6 kPa for 2D-QElaXto and 6.1, 8.1, and 11.7 kPa for p-QElaXto. All three SWE techniques were effective in differentiating significant fibrosis ≥F2 from mild or absent fibrosis in the subgroup of patients submitted to biopsy and showed good feasibility. Conclusions: Correlation between QElaXto techniques and SSI in LS measurements is very good. Our study identifies for the first time cut-off thresholds for fibrosis staging in non-HBV-related CLD using two QElaXto techniques.

Published
2022

10. Residual respiratory impairment after COVID-19 pneumonia

Author

Lombardi, F., Calabrese, Anna Chiara, Iovene, Bruno, Pierandrei, C., Lerede, M., Varone, Francesco, Richeldi, Luca, Sgalla, Giacomo, Landi, Francesco, Gremese, Elisa, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Romano Settanni, C., Benvenuto, F., Bramato, Giulia, Carfi, A., Ciciarello, Francesca, Lo Monaco, Maria Rita, Maria Martone, A., Marzetti, Emanuele, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tosato, Matteo, Tritto, M., Calvani, Riccardo, Catalano, Lucio, Picca, A., Savera, Giulia, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Assunta Zocco, M., Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Bizzarro, Alessandra, Lauria, Alessandra, Rizzo, Stanislao, Cristina Savastano, M., Gambini, Gloria, Grazia Cozzupoli, M., Culiersi, Carola, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Sani, Gabriele, Janiri, Delfina, Giuseppin, G., Molinaro, M., Modica, Marco, Natale, Luigi, Rita Larici, A., Marano, Riccardo, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Laur, a. Fedele A., Maria Lizzio, M., Santoliquido, Angelo, Santoro, L., Nesci, A., Popolla, Valentina, Calabrese A., Iovene B., Varone F., Richeldi L. (ORCID:0000-0001-8594-1448), Sgalla G. (ORCID:0000-0003-3130-9388), Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Bramato G., Ciciarello F., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Salerno A., Tosato M., Calvani R. (ORCID:0000-0001-5472-2365), Catalano L., Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Gambini G., Culiersi C., Cesare Passali G. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Santoliquido A. (ORCID:0000-0003-1539-4017), Popolla V., Lombardi, F., Calabrese, Anna Chiara, Iovene, Bruno, Pierandrei, C., Lerede, M., Varone, Francesco, Richeldi, Luca, Sgalla, Giacomo, Landi, Francesco, Gremese, Elisa, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Romano Settanni, C., Benvenuto, F., Bramato, Giulia, Carfi, A., Ciciarello, Francesca, Lo Monaco, Maria Rita, Maria Martone, A., Marzetti, Emanuele, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, E., Salerno, Andrea Maria, Tosato, Matteo, Tritto, M., Calvani, Riccardo, Catalano, Lucio, Picca, A., Savera, Giulia, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Assunta Zocco, M., Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Bizzarro, Alessandra, Lauria, Alessandra, Rizzo, Stanislao, Cristina Savastano, M., Gambini, Gloria, Grazia Cozzupoli, M., Culiersi, Carola, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, F., Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, M., Buonsenso, Danilo, Valentini, Piero, Pata, D., Sinatti, Dario, De Rose, Cristina, Sani, Gabriele, Janiri, Delfina, Giuseppin, G., Molinaro, M., Modica, Marco, Natale, Luigi, Rita Larici, A., Marano, Riccardo, Paglionico, A., Petricca, Luca, Gigante, Lavinia, Natalello, G., Laur, a. Fedele A., Maria Lizzio, M., Santoliquido, Angelo, Santoro, L., Nesci, A., Popolla, Valentina, Calabrese A., Iovene B., Varone F., Richeldi L. (ORCID:0000-0001-8594-1448), Sgalla G. (ORCID:0000-0003-3130-9388), Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Bramato G., Ciciarello F., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Salerno A., Tosato M., Calvani R. (ORCID:0000-0001-5472-2365), Catalano L., Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Gambini G., Culiersi C., Cesare Passali G. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Longobardi Y., Tricarico L., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Sinatti D., De Rose C., Sani G. (ORCID:0000-0002-9767-8752), Janiri D., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Marano R. (ORCID:0000-0003-2710-2093), Petricca L., Gigante L., Santoliquido A. (ORCID:0000-0003-1539-4017), and Popolla V.

Abstract

Introduction: The novel coronavirus SARS-Cov-2 can infect the respiratory tract causing a spectrum of disease varying from mild to fatal pneumonia, and known as COVID-19. Ongoing clinical research is assessing the potential for long-term respiratory sequelae in these patients. We assessed the respiratory function in a cohort of patients after recovering from SARS-Cov-2 infection, stratified according to PaO2/FiO2 (p/F) values. Method: Approximately one month after hospital discharge, 86 COVID-19 patients underwent physical examination, arterial blood gas (ABG) analysis, pulmonary function tests (PFTs), and six-minute walk test (6MWT). Patients were also asked to quantify the severity of dyspnoea and cough before, during, and after hospitalization using a visual analogic scale (VAS). Seventy-six subjects with ABG during hospitalization were stratified in three groups according to their worst p/F values: above 300 (n = 38), between 200 and 300 (n = 30) and below 200 (n = 20). Results: On PFTs, lung volumes were overall preserved yet, mean percent predicted residual volume was slightly reduced (74.8 ± 18.1%). Percent predicted diffusing capacity for carbon monoxide (DLCO) was also mildly reduced (77.2 ± 16.5%). Patients reported residual breathlessness at the time of the visit (VAS 19.8, p < 0.001). Patients with p/F below 200 during hospitalization had lower percent predicted forced vital capacity (p = 0.005), lower percent predicted total lung capacity (p = 0.012), lower DLCO (p < 0.001) and shorter 6MWT distance (p = 0.004) than patients with higher p/F. Conclusion: Approximately one month after hospital discharge, patients with COVID-19 can have residual respiratory impairment, including lower exercise tolerance. The extent of this impairment seems to correlate with the severity of respiratory failure during hospitalization.

Published
2021

11. The role of elastography in non-Alcoholic fatty liver disease

Author

Liguori, Antonio, Ainora, Maria Elena, Riccardi, Laura, Dematthaeis, N., Pizzolante, Fabrizio, Gasbarrini, Antonio, Zocco, Maria Assunta, Grieco, Antonio, Rapaccini, Gian Ludovico, Miele, Luca, Liguori A., Ainora M. E., Riccardi L., Pizzolante F., Gasbarrini A. (ORCID:0000-0002-7278-4823), Zocco M. A. (ORCID:0000-0002-0814-9542), Grieco A. (ORCID:0000-0002-0544-8993), Rapaccini G. (ORCID:0000-0002-6467-857X), Miele L. (ORCID:0000-0003-3464-0068), Liguori, Antonio, Ainora, Maria Elena, Riccardi, Laura, Dematthaeis, N., Pizzolante, Fabrizio, Gasbarrini, Antonio, Zocco, Maria Assunta, Grieco, Antonio, Rapaccini, Gian Ludovico, Miele, Luca, Liguori A., Ainora M. E., Riccardi L., Pizzolante F., Gasbarrini A. (ORCID:0000-0002-7278-4823), Zocco M. A. (ORCID:0000-0002-0814-9542), Grieco A. (ORCID:0000-0002-0544-8993), Rapaccini G. (ORCID:0000-0002-6467-857X), and Miele L. (ORCID:0000-0003-3464-0068)

Abstract

Non-Alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide and its prevalence is even higher in patients with risk factors such as type 2 diabetes and obesity. Liver biopsy is the gold standard for diagnosis of non-Alcoholic steatohepatitis (NASH), particularly for the assessment of fibrosis stage that is a key prognostic factor. Noninvasive methods for assessment of liver fibrosis are a huge need in contemporary hepatology in order to stratify patient s risk of advanced and progressive liver disease. In this perspective different imaging techniques have been developed in last decades and showed high performance in liver fibrosis evaluation. Strengths and weaknesses of all imaging methods are summarized in this review. (Cite this article as: Liguori A, Ainora ME, Riccardi L, De Matthaeis N, Pizzolante F, Gasbarrini A, et al. The role of elastography in non-Alcoholic fatty liver disease. Minerva Gastroenterol.

Published
2021

12. Clinical characteristics of metabolic associated fatty liver disease (MAFLD) in subjects with myotonic dystrophy type 1 (DM1)

Author

Miele, Luca, Perna, Alessia, Dajko, M., Zocco, Maria Assunta, De Magistris, A., Nicoletti, Tommaso Filippo, Biolato, Marco, Marrone, Giuseppe, Liguori, Antonio, Maccora, Daria, Valenza, Venanzio, Rossi, Salvatore, Riso, V., Di Natale, Daniele, Gasbarrini, Antonio, Grieco, A., Silvestri, Gabriella, Miele L. (ORCID:0000-0003-3464-0068), Perna A., Zocco M. A. (ORCID:0000-0002-0814-9542), Nicoletti T. F., Biolato M., Marrone G., Liguori A., Maccora D., Valenza V. (ORCID:0000-0002-0023-6625), Rossi S., Di Natale D., Gasbarrini A. (ORCID:0000-0002-7278-4823), Silvestri G. (ORCID:0000-0002-1950-1468), Miele, Luca, Perna, Alessia, Dajko, M., Zocco, Maria Assunta, De Magistris, A., Nicoletti, Tommaso Filippo, Biolato, Marco, Marrone, Giuseppe, Liguori, Antonio, Maccora, Daria, Valenza, Venanzio, Rossi, Salvatore, Riso, V., Di Natale, Daniele, Gasbarrini, Antonio, Grieco, A., Silvestri, Gabriella, Miele L. (ORCID:0000-0003-3464-0068), Perna A., Zocco M. A. (ORCID:0000-0002-0814-9542), Nicoletti T. F., Biolato M., Marrone G., Liguori A., Maccora D., Valenza V. (ORCID:0000-0002-0023-6625), Rossi S., Di Natale D., Gasbarrini A. (ORCID:0000-0002-7278-4823), and Silvestri G. (ORCID:0000-0002-1950-1468)

Abstract

Background: Myotonic dystrophy type 1 (DM1) is a rare inherited neuromuscular disease associated with insulin resistance, and its association with metabolically associated fatty liver disease (MAFLD) has never been explored in prospective studies. The aim of this study was to assess the clinical features of MAFLD in DM1 patients. Methods: We investigated the prevalence and the diagnostic features of MAFLD in a cohort of 29 outpatient fully characterized DM1 patients; afterward, we compared the selected cohort of DM1-MAFLD individuals with a propensity-matched cohort of non-DM1-MAFLD Results: 13/29 (44.83%) DM1 patients received a clinical diagnosis of MAFLD. Compared to DM1 patients with normal liver, DM1-MAFLD individuals showed a higher male prevalence (p = 0.008), BMI (p = 0.014), HOMA score (p = 0.012), and GGT levels (p = 0.050). The statistical comparison showed that the DM1-MAFLD group had a more severe MAFLD according to the FIB4 score than non-DM1-MAFLD patients. This association of a more severe form of liver disease with DM1 remained significant after logistic regression analysis (OR: 6.12, 95% CI 1.44- 26.55).

Published
2021

13. Focal nodular hyperplasia: new findings at Doppler ultrasonography

Author

Vidili G., Piscaglia F., Ainora M. E., Solinas G., Sagrini E., Gianstefani A., Cintoni M., Gasbarrini A., Zocco M. A., Vidili G., Piscaglia F., Ainora M.E., Solinas G., Sagrini E., Gianstefani A., Cintoni M., Gasbarrini A., and Zocco M.A.

Subjects
Adult, Male, FNH, Focal Nodular Hyperplasia, Settore MED/12 - GASTROENTEROLOGIA, Settore MED/09 - MEDICINA INTERNA, Humans, Female, Ultrasonography, Doppler, Color Doppler, Ultrasound imaging, Venous Doppler signal
Abstract

OBJECTIVE: The aim of our study was to explore the features of focal nodular hyperplasia (FNH) at Doppler ultrasonography, analyzing specifically the presence of intratumoral venous flow in patients with an established diagnosis of FNH. Previous studies showed that using a venous Doppler spectrum, intratumoral vessels are often depicted in hepatocellular adenoma (HCA) but less frequently in FNH. PATIENTS AND METHODS: Forty-five FNHs from thirty-three consecutive patients (26 female, 7 male; mean±SD age: 40±13) underwent color Doppler ultrasonography and spectral analysis according to a standardized protocol. FNH diagnosis was established by the presence of typical behavior at contrast-enhanced ultrasound (CEUS) associated with another imaging technique (contrast-enhanced computed tomography [ceCT] or contrast-enhanced magnetic resonance [ceMR]). A biopsy was performed when imaging was inconclusive. All data concerning Doppler analysis were reviewed by two more operators, blinded to the final diagnosis, and the interobserver agreement for the presence of venous Doppler signal was determined by Cohen’s Kappa. RESULTS: Of the 33 patients, 24 had a single solitary focus, and 9 had multiple foci. Lesion diameter ranged between 1.2 and 8.9 cm (mean ± SD 3.2±1.6 cm). The central feeding artery with the typical arterial spectrum was detected in all 45 lesions, whereas the spoke-wheel sign was observed in 18 cases (40%). A venous Doppler signal was detected in 35 FNHs (77.8%), and in 60% of them, it was identified in the center of the lesion. CONCLUSIONS: Venous Doppler signal located in the center of the lesion suspected to be a hypervascular benign lesion cannot be considered a typical HCA feature since it has been detected in a high percentage of FNH cases.

Published
2020

14. Platelet count does not predict bleeding in cirrhotic patients: Results from the PRO-LIVER Study

Author

Basili, S. a, Raparelli, V. b., Napoleone, L. b., Talerico, G. a., Corazza, G. R. c., Perticone, F. d., Sacerdoti, D. e., Andriulli, A. f., Licata, A. g., Pietrangelo, A., Picardi, A. i., Raimondo, G. j., Violi, F., Palasciano, G., D’Alitto, F., Palmieri, V. O., Santovito, D., Michele, Di, Croce, D., Brocco, G., Fasolato, S., Cecchetto, S., Bombonato, L., Bertoni, G., Restuccia, M., Andreozzi, T., Liguori, P., Caroleo, M. L., Perticone, B., Staltari, M., Manfredini, O., Giorgi, De, Averna, A., Giammanco, M., Granito, A., Pettinari, A., Marinelli, I., Bolondi, S., Falsetti, L., Salvi, L., Durante-Mangoni, A., Cesaro, E., Farinaro, F., Ragone, V., Morana, E., Ippolito, I., Iacobellis, A., Niro, A., Merla, G., Maimone, A., Cacciola, S., Varvara, I., Drenaggi, D., Staffolani, D., Vespasiani-Gentilucci, S., Galati, U., Gallo, G., Davì, P., Schiavone, G., Santilli, C., Tana, F., Soresi, C., Bianchi, Giovanni, Carderi, B., Pinto, I., Tuttolomondo, A., Ferrari, A., Gresele, G., Fierro, P., Morelli, T., Laffi, O., Romanelli, G., Arena, R. G., Stasi, U., Gasbarrini, A., Garcovich, M., Zocco, M. A., Riccardi, L., Ainora, M. E., Capeci, W., Martino, Giuseppe, Nobili, P., Cavallo, L., Frugiuele, M., Greco, P., Ventura, P., Cuoghi, C., Marcacci, M., Serviddio, G., Vendemiale, G., Villani, R., Gargano, R., Vidili, G., Cesare, Di, Masala, V., Delitala, M., Invernizzi, G., Vincenzo, P., Minno, Di, Tufano, G., Purrello, A., Privitera, F., Forgione, G., Curigliano, A., Senzolo, V., Rodríguez-Castro, M., Giannelli, K. I., Serra, G., Neri, C., Pignataro, S., Rizzetto, P., Debernardi, M., Svegliati, V. W., Bergamaschi, B. G., Masotti, G., Costanzo, M., Antonio, F., Angelico, F., Del, Ben, Polimeni, M., Proietti, L., Cangemi, M., Romiti, R., Toriello, G. F., Sperduti, F., Santangelo, N., Visioli, G., Todisco, G., Vestri, Anna, Farcomeni, R., Corrao, A., Gobbi, S., Corradini, E., Costantino, G., Tripepi, G., Angelico, M., Bolondi, L., D’Amico, G., Franchis, De, Gatta, R., Tassone, A., Anzaldi, E. J., Barone, M., Bazzini, M., Bianchi, C., Boari, P. I., Bracco, B., Buonauro, C., Buttà, A., Buzzetti, E., Calabria, S., Caradio, F., Carleo, P., Carrabba, Maria, Castorani, D., Cecchetto, L., Cicco, L., Cimini, S., Colombo, C., B. M., Vuono, De, Denegri, S., Del, Corso, Giosia, Di, Donnarumma, P., Giorgini, E., Grassi, P., Grembiale, D., Hijazi, A., Iamele, D., Lorusso, L., Marchese, G., Marra, Alberto, Masala, M., Miceli, M., Montebianco, G., Murgia, A. L., Naccarato, G., Padula, P., Pattoneri, D., Perego, P., Pesce, F., Petramala, P., Piano, L., Pinto, S., Pinna, D., Pignataro, M., Pretti, F. S., Pucci, V., Salinaro, G., Salzano, F., Santarossa, A., Scarpini, C., Scicali, F., Sirico, R., Suppressa, D., Talia, P., Torres, M., Traversa, D., Vazzana, M., Vecchio, Claudia, Vettore, R., Vitale, E., Basili, S., Raparelli, V., Napoleone, L., Talerico, G., Corazza, G.R., Perticone, F., Sacerdoti, D., Andriulli, A., Licata, A., Pietrangelo, A., Picardi, A., Raimondo, G., Violi, F., Palasciano, Giuseppe, D’Alitto, Felicia, Palmieri, Vincenzo Ostilio, Santovito, Daniela, Di Michele, Dario, Croce, Giuseppe, Brocco, Silvia, Fasolato, Silvano, Cecchetto, Lara, Bombonato, Giancarlo, Bertoni, Michele, Restuccia, Tea, Andreozzi, Paola, Liguori, Maria Livia, Caroleo, Benedetto, Perticone, Maria, Staltari, Orietta, Manfredini, Roberto, De Giorgi, Alfredo, Averna, Maurizio, Giammanco, Antonina, Granito, Alessandro, Pettinari, Irene, Marinelli, Sara, Bolondi, Luigi, Falsetti, Lorenzo, Salvi, Aldo, Durante-Mangoni, Emanuele, Cesaro, Flavio, Farinaro, Vincenza, Ragone, Enrico, Morana, Ignazio, Ippolito, Antonio, Iacobellis, Angelo, Niro, Grazia, Merla, Antonio, Maimone, Sergio, Cacciola, Irene, Varvara, Doriana, Drenaggi, Davide, Staffolani, Silvia, Vespasiani-Gentilucci, Umberto, Galati, Giovanni, Gallo, Paolo, Davì, Giovanni, Schiavone, Cosima, Santilli, Francesca, Tana, Claudio, Soresi, Maurizio, Bianchi Giovanni, Battista, Carderi, Isabella, Pinto, Antonio, Tuttolomondo, Antonino, Ferrari, Giovanni, Gresele, Paolo, Fierro, Tiziana, Morelli, Olivia, Laffi, Giacomo, Romanelli, Roberto Giulio, Arena, Umberto, Stasi, Cristina, Gasbarrini, Antonio, Garcovich, Matteo, Zocco, Maria Assunta, Riccardi, Laura, Ainora, Maria Elena, Capeci, William, Martino Giuseppe, Pio, Nobili, Lorenzo, Cavallo, Maurizio, Frugiuele, Pierluigi, Greco, Antonio, Ventura, Paolo, Cuoghi, Chiara, Marcacci, Matteo, Serviddio, Gaetano, Vendemiale, Gianluigi, Villani, Rosanna, Gargano, Ruggiero, Vidili, Gianpaolo, Di Cesare, Valentina, Masala, Maristella, Delitala, Giuseppe, Invernizzi, Pietro, Vincenzo, Ronca, Di Minno, Giovanni, Tufano, Antonella, Purrello, Francesco, Privitera, Graziella, Forgione, Alessandra, Curigliano, Valentina, Senzolo, Marco, Rodríguez-Castro, Kryssia Isabel, Giannelli, Gianluigi, Serra, Carla, Neri, Sergio, Pignataro, Pietro, Rizzetto, Mario, Debernardi, Venon Wilma, Svegliati, Baroni Gianluca, Bergamaschi, Gaetano, Masotti, Michela, Costanzo, Filippo, Antonio, Figliomeni, Angelico, Francesco, Del Ben, Maria, Polimeni, Licia, Proietti, Marco, Cangemi, Roberto, Romiti Giulio, Francesco, Toriello, Filippo, Sperduti, Nicolò, Santangelo, Giuseppe, Visioli, Giacomo, Todisco, Tommaso, Vestri Anna, Rita, Farcomeni, Alessio, Corrao, Salvatore, Gobbi, Paolo, Corradini, Elena, Costantino, Giorgio, Tripepi, Giovanni, Angelico, Mario, D’Amico, Gennaro, De Franchis, Roberto, Gatta, Angelo, Tassone, Eliezer Joseph, Anzaldi, Massimiliano, Barone, Milena, Bazzini, Cristina, Bianchi, Paola Ilaria, Boari, Benedetta, Bracco, Christian, Buonauro, Agostino, Buttà, Carmelo, Buzzetti, Elena, Calabria, Stefano, Caradio, Federica, Carleo, Pietro, Carrabba Maria, Domenica, Castorani, Luigi, Cicco, Sebastiano, Cimini, Claudia, Colombo, Barbara Maria, De Vuono, Stefano, Denegri, Andrea, Del Corso, Lisette, Di Giosia, Paolo, Donnarumma, Emilia, Giorgini, Paolo, Grassi, Davide, Grembiale, Alessandro, Hijazi, Daniel, Iamele, Luigi, Lorusso, Giusi, Marchese, Alessandra, Marra Alberto, Maria, Miceli, Giuseppe, Montebianco, Abenavoli Ludovico, Murgia, Giuseppe, Naccarato, Paola, Padula, Donatella, Pattoneri, Paolo, Perego, Francesca, Pesce, Paola, Petramala, Luigi, Piano, Salvatore, Pinto, Daniela, Pinna, Miriam, Pignataro, Francesca Serena, Pretti, Vincenzo, Pucci, Giacomo, Salinaro, Francesco, Salzano, Andrea, Santarossa, Claudia, Scarpini, Francesca, Scicali, Roberto, Sirico, Domenico, Suppressa, Patrizia, Talia, Michela, Torres, Daniele, Traversa, Matteo, Vazzana, Natale, Vecchio Claudia, Rita, Vettore, Elia, Vitale, Francesco, Basili, S, Raparelli, V, Napoleone, L, Talerico, G, Corazza, G, Perticone, F, Sacerdoti, D, Andriulli, A, Licata, A, Pietrangelo, A, Picardi, A, Raimondo, G, Violi, F, Palasciano, G, D'Alitto, F, Palmieri, V, Santovito, D, Di Michele, D, Croce, G, Brocco, S, Fasolato, S, Cecchetto, L, Bombonato, G, Bertoni, M, Restuccia, T, Andreozzi, P, Liguori, M, Caroleo, B, Perticone, M, Staltari, O, Manfredini, R, De Giorgi, A, Averna, M, Giammanco, A, Granito, A, Pettinari, I, Marinelli, S, Bolondi, L, Falsetti, L, Salvi, A, Durante-Mangoni, E, Cesaro, F, Farinaro, V, Ragone, E, Morana, I, Ippolito, A, Iacobellis, A, Niro, G, Merla, A, Maimone, S, Cacciola, I, Varvara, D, Drenaggi, D, Staffolani, S, Vespasiani-Gentilucci, U, Galati, G, Gallo, P, Davi, G, Schiavone, C, Santilli, F, Tana, C, Soresi, M, Bianchi Giovanni, B, Carderi, I, Pinto, A, Tuttolomondo, A, Ferrari, G, Gresele, P, Fierro, T, Morelli, O, Laffi, G, Romanelli, R, Arena, U, Stasi, C, Gasbarrini, A, Garcovich, M, Zocco, M, Riccardi, L, Ainora, M, Capeci, W, Martino Giuseppe, P, Nobili, L, Cavallo, M, Frugiuele, P, Greco, A, Ventura, P, Cuoghi, C, Marcacci, M, Serviddio, G, Vendemiale, G, Villani, R, Gargano, R, Vidili, G, Di Cesare, V, Masala, M, Delitala, G, Invernizzi, P, Vincenzo, R, Di Minno, G, Tufano, A, Purrello, F, Privitera, G, Forgione, A, Curigliano, V, Senzolo, M, Rodriguez-Castro, K, Giannelli, G, Serra, C, Neri, S, Pignataro, P, Rizzetto, M, Debernardi, V, Svegliati, B, Bergamaschi, G, Masotti, M, Costanzo, F, Antonio, F, Angelico, F, Del Ben, M, Polimeni, L, Proietti, M, Cangemi, R, Romiti, G, Toriello, F, Sperduti, N, Santangelo, G, Visioli, G, Todisco, T, Vestri Anna, R, Farcomeni, A, Corrao, S, Gobbi, P, Corradini, E, Costantino, G, Tripepi, G, Angelico, M, D'Amico, G, De Franchis, R, Gatta, A, Tassone, E, Anzaldi, M, Barone, M, Bazzini, C, Bianchi, P, Boari, B, Bracco, C, Buonauro, A, Butta, C, Buzzetti, E, Calabria, S, Caradio, F, Carleo, P, Carrabba Maria, D, Castorani, L, Cicco, S, Cimini, C, Colombo, B, De Vuono, S, Denegri, A, Del Corso, L, Di Giosia, P, Donnarumma, E, Giorgini, P, Grassi, D, Grembiale, A, Hijazi, D, Iamele, L, Lorusso, G, Marchese, A, Marra, A, Miceli, G, Montebianco, A, Murgia, G, Naccarato, P, Padula, D, Pattoneri, P, Perego, F, Pesce, P, Petramala, L, Piano, S, Pinto, D, Pinna, M, Pignataro, F, Pretti, V, Pucci, G, Salinaro, F, Salzano, A, Santarossa, C, Scarpini, F, Scicali, R, Sirico, D, Suppressa, P, Talia, M, Torres, D, Traversa, M, Vazzana, N, Vecchio Claudia, R, Vettore, E, Vitale, F, S Basili, V Raparelli, L Napoleone, G Talerico, G Corazza, F Perticone, D Sacerdoti, A Andriulli, A Licata, A Pietrangelo, A Picardi, G Raimondo, F Violi, MD on behalf of PRO-LIVER Collaborator, Palasciano Giuseppe, D’Alitto Felicia, Palmieri Vincenzo Ostilio, Santovito Daniela, Di Michele Dario, Croce Giuseppe, Brocco Silvia, Fasolato Silvano, Cecchetto Lara, Bombonato Giancarlo, Bertoni Michele, Restuccia Tea, Andreozzi Paola, Liguori Maria Livia, Caroleo Benedetto, Perticone Maria, Staltari Orietta, Manfredini Roberto, De Giorgi Alfredo, Averna Maurizio, Giammanco Antonina, Granito Alessandro, Pettinari Irene, Marinelli Sara, Bolondi Luigi, Falsetti Lorenzo, Salvi Aldo, Durante-Mangoni Emanuele, Cesaro Flavio, Farinaro Vincenza, Ragone Enrico, Morana Ignazio, Ippolito Antonio, Iacobellis Angelo, Niro Grazia, Merla Antonio, Maimone Sergio, Cacciola Irene, Varvara Doriana, Drenaggi Davide, Staffolani Silvia, Vespasiani-Gentilucci Umberto, Galati Giovanni, Gallo Paolo, Davi Giovanni, Schiavone Cosima, Santilli Francesca, Tana Claudio, Soresi Maurizio, Bianchi Giovanni Battista, Carderi Isabella, Pinto Antonio, Tuttolomondo Antonino, Ferrari Giovanni, Gresele Paolo, Fierro Tiziana, Morelli Olivia, Laffi Giacomo, Romanelli Roberto Giulio, Arena Umberto, Stasi Cristina, Gasbarrini Antonio, Garcovich Matteo, Zocco Maria Assunta, Riccardi Laura, Ainora Maria Elena, Capeci William, Martino Giuseppe Pio, Nobili Lorenzo, Cavallo Maurizio, Frugiuele Pierluigi, Greco Antonio, Ventura Paolo, Cuoghi Chiara, Marcacci Matteo, Serviddio Gaetano, Vendemiale Gianluigi, Villani Rosanna, Gargano Ruggiero, Vidili Gianpaolo, Di Cesare Valentina, Masala Maristella, Delitala Giuseppe, Invernizzi Pietro, Vincenzo Ronca, Di Minno Giovanni, Tufano Antonella, Purrello Francesco, Privitera Graziella, Forgione Alessandra, Curigliano Valentina, Senzolo Marco, Rodríguez-Castro Kryssia Isabel, Giannelli Gianluigi, Serra Carla, Neri Sergio, Pignataro Pietro, Rizzetto Mario, Debernardi Venon Wilma, Svegliati Baroni Gianluca, Bergamaschi Gaetano, Masotti Michela, Costanzo Filippo, Antonio Figliomeni, Angelico Francesco, Del Ben Maria, Polimeni Licia, Proietti Marco, Cangemi Roberto, Romiti Giulio Francesco, Toriello Filippo, Sperduti Nicolò, Santangelo Giuseppe, Visioli Giacomo, Todisco Tommaso, Vestri Anna Rita, Farcomeni Alessio, Corrao Salvatore, Gobbi Paolo, Corradini Elena, Costantino Giorgio, Tripepi Giovanni, Angelico Mario, D’Amico Gennaro, de Franchis Roberto, Gatta Angelo, Tassone Eliezer Joseph, Anzaldi Massimiliano, Barone Milena, Bazzini Cristina, Bianchi Paola Ilaria, Boari Benedetta, Bracco Christian, Buonauro Agostino, Buttà Carmelo, Buzzetti Elena, Calabria Stefano, Caradio Federica, Carleo Pietro, Carrabba Maria Domenica, Castorani Luigi, Cicco Sebastiano, Cimini Claudia, Colombo Barbara Maria, De Vuono Stefano, Denegri Andrea, Del Corso Lisette, Di Giosia Paolo, Donnarumma Emilia, Giorgini Paolo, Grassi Davide, Grembiale Alessandro, Hijazi Daniel, Iamele Luigi, Lorusso Giusi, Marchese Alessandra, Marra Alberto Maria, Miceli Giuseppe, Montebianco Abenavoli Ludovico, Murgia Giuseppe, Naccarato Paola, Padula Donatella, Pattoneri Paolo, Perego Francesca, Pesce Paola, Petramala Luigi, Piano Salvatore, Pinto Daniela, Pinna Miriam, Pignataro Francesca Serena, Pretti Vincenzo, Pucci Giacomo, Salinaro Francesco, Salzano Andrea, Santarossa Claudia, Scarpini Francesca, Scicali Roberto, Sirico Domenico, Suppressa Patrizia, Talia Michela, Torres Daniele, Traversa Matteo, Vazzana Natale, Vecchio Claudia Rita, Vettore Elia, Vitale Francesco, Corazza, G. R., Guidacci, Raimondo, Palasciano, G., D'Alitto, F., Palmieri, V. O., Santovito, D., Di Michele, D., Croce, G., Brocco, S., Fasolato, S., Cecchetto, L., Bombonato, G., Bertoni, M., Restuccia, T., Andreozzi, P., Liguori, M. L., Caroleo, B., Perticone, M., Staltari, O., Manfredini, R., De Giorgi, A., Averna, M., Giammanco, A., Granito, A., Pettinari, I., Marinelli, S., Bolondi, L., Falsetti, L., Salvi, A., Durante-Mangoni, E., Cesaro, F., Farinaro, V., Ragone, E., Morana, I., Ippolito, A., Iacobellis, A., Niro, G., Merla, A., Maimone, S., Cacciola, I., Varvara, D., Drenaggi, D., Staffolani, S., Vespasiani-Gentilucci, U., Galati, G., Gallo, P., Davi, G., Schiavone, C., Santilli, F., Tana, C., Soresi, M., Bianchi Giovanni, B., Carderi, I., Pinto, A., Tuttolomondo, A., Ferrari, G., Gresele, P., Fierro, T., Morelli, O., Laffi, G., Romanelli, R. G., Arena, U., Stasi, C., Gasbarrini, A., Garcovich, M., Zocco, M. A., Riccardi, L., Ainora, M. E., Capeci, W., Martino Giuseppe, P., Nobili, L., Cavallo, M., Frugiuele, P., Greco, A., Ventura, P., Cuoghi, C., Marcacci, M., Serviddio, G., Vendemiale, G., Villani, R., Gargano, R., Vidili, G., Di Cesare, V., Masala, M., Delitala, G., Invernizzi, P., Vincenzo, R., Di Minno, G., Tufano, A., Purrello, F., Privitera, G., Forgione, A., Curigliano, V., Senzolo, M., Rodriguez-Castro, K. I., Giannelli, G., Serra, C., Neri, S., Pignataro, P., Rizzetto, M., Debernardi, V. W., Svegliati, B. G., Bergamaschi, G., Masotti, M., Costanzo, F., Antonio, F., Angelico, F., Del Ben, M., Polimeni, L., Proietti, M., Cangemi, R., Romiti, G. F., Toriello, F., Sperduti, N., Santangelo, G., Visioli, G., Todisco, T., Vestri Anna, R., Farcomeni, A., Corrao, S., Gobbi, P., Corradini, E., Costantino, G., Tripepi, G., Angelico, M., D'Amico, G., De Franchis, R., Gatta, A., Tassone, E. J., Anzaldi, M., Barone, M., Bazzini, C., Bianchi, P. I., Boari, B., Bracco, C., Buonauro, A., Butta, C., Buzzetti, E., Calabria, S., Caradio, F., Carleo, P., Carrabba Maria, D., Castorani, L., Cicco, S., Cimini, C., Colombo, B. M., De Vuono, S., Denegri, A., Del Corso, L., Di Giosia, P., Donnarumma, E., Giorgini, P., Grassi, D., Grembiale, A., Hijazi, D., Iamele, L., Lorusso, G., Marchese, A., Marra, A. M., Miceli, G., Montebianco, A. L., Murgia, G., Naccarato, P., Padula, D., Pattoneri, P., Perego, F., Pesce, P., Petramala, L., Piano, S., Pinto, D., Pinna, M., Pignataro, F. S., Pretti, V., Pucci, G., Salinaro, F., Salzano, A., Santarossa, C., Scarpini, F., Scicali, R., Sirico, D., Suppressa, P., Talia, M., Torres, D., Traversa, M., Vazzana, N., Vecchio Claudia, R., Vettore, E., and Vitale, F.

Subjects
Liver Cirrhosis, Male, Settore MED/09 - Medicina Interna, 030204 cardiovascular system & hematology, Gastroenterology, Severity of Illness Index, cjirrhosis, ACTIVATION, 0302 clinical medicine, Risk Factors, Medicine, Platelet, Prospective Studies, Prospective cohort study, RISK, Aged, 80 and over, medicine.diagnostic_test, PRO-LIVER, Platelet, cirrhosis, gastrointestinal bleeding, ASSOCIATION, Middle Aged, Prognosis, Italy, 030211 gastroenterology & hepatology, Female, Gastrointestinal Hemorrhage, Human, Adult, Platelets, medicine.medical_specialty, Prognosi, Liver Cirrhosi, MEDLINE, COAGULATION, gastrointestinal bleeding, Socio-culturale, Hemorrhage, Hepatology, Follow-Up Studie, 03 medical and health sciences, Text mining, Internal medicine, Severity of illness, ENDOTOXEMIA, Pro-Liver Study, Humans, HEMOSTASIS, International Normalized Ratio, Aged, Proportional Hazards Models, Prothrombin time, Cirrhosi, Platelet Count, Bleeding, Liver Cirrhosis, business.industry, Proportional hazards model, Platelet Count, Risk Factor, cirrhosis, bleeding, Thrombocytopenia, Prospective Studie, THROMBOSIS, Platelets, cjirrhosis, bleeding, PRO-LIVER, Proportional Hazards Model, Prothrombin Time, business, DECOMPENSATED CIRRHOSIS, Follow-Up Studies
Abstract

OBJECTIVES: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear. METHODS: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of ∼4 years. RESULTS: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64±37 years; 47% Child–Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800–1,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.89%/year for major and minor bleeding, respectively). Fifty-two (18.6%) patients experienced a major (n=34) or minor (n=18) bleeding event, predominantly from gastrointestinal origin. Platelet counts progressively decreased with the worsening of liver disease and were similar in patients with or without major or minor bleeding: a platelet count ≤50×103/μl was detected in 3 (6%) patients with and in 20 (9%) patients without any bleeding event. Conversely, prothrombin time-international normalized ratio was slightly higher in patients with overall or major bleeding. On Cox proportional hazard analysis, only a previous gastrointestinal bleeding (hazard ratio (HR): 1.96; 95% confidence interval: 1.11–3.47; P=0.020) and encephalopathy (HR: 2.05; 95% confidence interval: 1.16–3.62; P=0.013) independently predicted overall bleeding events. CONCLUSIONS: Platelet count does not predict unprovoked major or minor bleeding in cirrhotic patients.

Published
2018

15. Focal nodular hyperplasia: New findings at Doppler ultrasonography

Author

Vidili, G., Piscaglia, F., Ainora, Maria Elena, Solinas, G., Sagrini, E., Gianstefani, A., Cintoni, Marco, Gasbarrini, Antonio, Zocco, Maria Assunta, Ainora M. E., Cintoni M. (ORCID:0000-0002-9610-0748), Gasbarrini A. (ORCID:0000-0002-7278-4823), Zocco M. A. (ORCID:0000-0002-0814-9542), Vidili, G., Piscaglia, F., Ainora, Maria Elena, Solinas, G., Sagrini, E., Gianstefani, A., Cintoni, Marco, Gasbarrini, Antonio, Zocco, Maria Assunta, Ainora M. E., Cintoni M. (ORCID:0000-0002-9610-0748), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Zocco M. A. (ORCID:0000-0002-0814-9542)

Abstract

OBJECTIVE: The aim of our study was to explore the features of focal nodular hyperplasia (FNH) at Doppler ultrasonography, analyzing specifically the presence of intratumoral venous flow in patients with an established diagnosis of FNH. Previous studies showed that using a venous Doppler spectrum, intratumoral vessels are often depicted in hepatocellular adenoma (HCA) but less frequently in FNH. PATIENTS AND METHODS: Forty-five FNHs from thirty-three consecutive patients (26 female, 7 male; mean±SD age: 40±13) underwent color Doppler ultrasonography and spectral analysis according to a standardized protocol. FNH diagnosis was established by the presence of typical behavior at contrast-enhanced ultrasound (CEUS) associated with another imaging technique (contrast-enhanced computed tomography [ceCT] or contrast-enhanced magnetic resonance [ceMR]). A biopsy was performed when imaging was inconclusive. All data concerning Doppler analysis were reviewed by two more operators, blinded to the final diagnosis, and the interobserver agreement for the presence of venous Doppler signal was determined by Cohen’s Kappa. RESULTS: Of the 33 patients, 24 had a single solitary focus, and 9 had multiple foci. Lesion diameter ranged between 1.2 and 8.9 cm (mean ± SD 3.2±1.6 cm). The central feeding artery with the typical arterial spectrum was detected in all 45 lesions, whereas the spoke-wheel sign was observed in 18 cases (40%). A venous Doppler signal was detected in 35 FNHs (77.8%), and in 60% of them, it was identified in the center of the lesion. CONCLUSIONS: Venous Doppler signal located in the center of the lesion suspected to be a hypervascular benign lesion cannot be considered a typical HCA feature since it has been detected in a high percentage of FNH cases.

Published
2020

16. A new ultrasound score for the assessment and follow-up of chronic pancreatitis: The ‘Gemelli USCP score’

Author

Pagliari, D., Ainora, Maria Elena, Brizi, Maria Gabriella, Cintoni, M., Rinninella, Emanuele, Attili, Fabia, Mancarella, Francesco Antonio, Garcovich, M., Riccardi, Laura, Pompili, Maurizio, Gasbarrini, Antonio, Manfredi, Riccardo, Zocco, Maria Assunta, Ainora M. E., Brizi M. G. (ORCID:0000-0002-3704-6796), Rinninella E. (ORCID:0000-0002-9165-2367), Attili F., Mancarella F. A., Riccardi L., Pompili M. (ORCID:0000-0001-6699-7980), Gasbarrini A. (ORCID:0000-0002-7278-4823), Manfredi R. (ORCID:0000-0002-4972-9500), Zocco M. A. (ORCID:0000-0002-0814-9542), Pagliari, D., Ainora, Maria Elena, Brizi, Maria Gabriella, Cintoni, M., Rinninella, Emanuele, Attili, Fabia, Mancarella, Francesco Antonio, Garcovich, M., Riccardi, Laura, Pompili, Maurizio, Gasbarrini, Antonio, Manfredi, Riccardo, Zocco, Maria Assunta, Ainora M. E., Brizi M. G. (ORCID:0000-0002-3704-6796), Rinninella E. (ORCID:0000-0002-9165-2367), Attili F., Mancarella F. A., Riccardi L., Pompili M. (ORCID:0000-0001-6699-7980), Gasbarrini A. (ORCID:0000-0002-7278-4823), Manfredi R. (ORCID:0000-0002-4972-9500), and Zocco M. A. (ORCID:0000-0002-0814-9542)

Abstract

Background: : Ultrasound (US) is frequently the first line imaging technique used in patients with abdominal pain and clinical suspicion of chronic pancreatitis (CP), but its role in the diagnosis and follow-up of CP is still controversial. Aims: : We aimed to develop a dedicated score for the US staging of CP and to evaluate the agreement of this score with standard imaging techniques. Methods: : Ninety consecutive patients with a diagnosis of CP referred to the pancreatic outpatient clinic of A. Gemelli Hospital between June and September 2018 were recruited in the study. Patients underwent pancreatic US to evaluate different morphological parameters to develop an US based score system, called the Gemelli UltraSound Chronic Pancreatitis (USCP) score. Results: : The Gemelli USCP score significantly increased according to the Cambridge score for both mean value (p<0.0001) and each parameter evaluated (p<0.0001). Moreover, we found a significant correlation between the score and laboratory parameters related to pancreatic exocrine insufficiency such as vitamin D, B9, and B12 deficiency and fecal elastase values (p<0.0001). Conclusions: : The development of a dedicated US score could be useful in the follow up of patients with CP as alternative non-invasive technique to standard radiological imaging.

Published
2020

17. Seroprevalence of anti-SARS-CoV-2 IgG antibodies in children with household exposure to adults with COVID-19: Preliminary findings

Author

Buonsenso, Danilo, Valentini, Piero, De Rose, Cristina, Pata, Davide, Sinatti, Dario, Speziale, Domenico, Ricci, R., Carfi, A., Landi, Francesco, Ferrari, V., De Maio, Flavio, Palucci, Ivana, Sanguinetti, Maurizio, Sali, Michela, Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Ciciarello, F., Lo Monaco, M. R., Martone, A. M., Marzetti, Emanuele, Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, Riccardo, Catalano, L., Picca, A., Savera, G., Cauda, R., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, Maria Assunta, Sanguinetti, M., Cattani Franchi, Paola, Marchetti, S., Posteraro, Brunella, Sali, M., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, Maria Cristina, Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, Luca, Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, Luigi, Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Tolusso, B., Alivernini, S., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), De Rose C., Pata D., Sinatti D., Speziale D., Landi F. (ORCID:0000-0002-3472-1389), De Maio F., Palucci I., Sanguinetti M. (ORCID:0000-0002-9780-7059), Sali M. (ORCID:0000-0003-3609-2990), Marzetti E. (ORCID:0000-0001-9567-6983), Calvani R. (ORCID:0000-0001-5472-2365), Zocco M. A. (ORCID:0000-0002-0814-9542), Cattani P. (ORCID:0000-0003-4678-4763), Posteraro B. (ORCID:0000-0002-1663-7546), Savastano M. C. (ORCID:0000-0003-1397-4333), Richeldi L. (ORCID:0000-0001-8594-1448), Natale L. (ORCID:0000-0002-7949-5119), Buonsenso, Danilo, Valentini, Piero, De Rose, Cristina, Pata, Davide, Sinatti, Dario, Speziale, Domenico, Ricci, R., Carfi, A., Landi, Francesco, Ferrari, V., De Maio, Flavio, Palucci, Ivana, Sanguinetti, Maurizio, Sali, Michela, Landi, F., Gremese, E., Bernabei, R., Fantoni, M., Gasbarrini, A., Settanni, C. R., Benvenuto, F., Bramato, G., Ciciarello, F., Lo Monaco, M. R., Martone, A. M., Marzetti, Emanuele, Napolitano, C., Pagano, F., Rocchi, S., Rota, E., Salerno, A., Tosato, M., Tritto, M., Calvani, Riccardo, Catalano, L., Picca, A., Savera, G., Cauda, R., Tamburrini, E., Borghetti, A., Di Gianbenedetto, S., Murri, R., Cingolani, A., Ventura, G., Taddei, E., Moschese, D., Ciccullo, A., Stella, L., Addolorato, G., Franceschi, F., Mingrone, G., Zocco, Maria Assunta, Sanguinetti, M., Cattani Franchi, Paola, Marchetti, S., Posteraro, Brunella, Sali, M., Bizzarro, A., Lauria, A., Rizzo, S., Savastano, Maria Cristina, Gambini, G., Cozzupoli, G. M., Culiersi, C., Passali, G. C., Paludetti, G., Galli, J., Crudo, F., Di Cintio, G., Longobardi, Y., Tricarico, L., Santantonio, M., Buonsenso, D., Valentini, P., Pata, D., Sinatti, D., De Rose, C., Richeldi, Luca, Lombardi, F., Calabrese, A., Sani, G., Janiri, D., Giuseppin, G., Molinaro, M., Modica, M., Natale, Luigi, Larici, A. R., Marano, R., Paglionico, A., Petricca, L., Gigante, L., Natalello, G., Fedele, A. L., Lizzio, M. M., Tolusso, B., Alivernini, S., Santoliquido, A., Santoro, L., Nesci, A., Popolla, V., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), De Rose C., Pata D., Sinatti D., Speziale D., Landi F. (ORCID:0000-0002-3472-1389), De Maio F., Palucci I., Sanguinetti M. (ORCID:0000-0002-9780-7059), Sali M. (ORCID:0000-0003-3609-2990), Marzetti E. (ORCID:0000-0001-9567-6983), Calvani R. (ORCID:0000-0001-5472-2365), Zocco M. A. (ORCID:0000-0002-0814-9542), Cattani P. (ORCID:0000-0003-4678-4763), Posteraro B. (ORCID:0000-0002-1663-7546), Savastano M. C. (ORCID:0000-0003-1397-4333), Richeldi L. (ORCID:0000-0001-8594-1448), and Natale L. (ORCID:0000-0002-7949-5119)

Abstract

Weather and the susceptibility of children to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is still a debated question and currently a hot topic, particularly in view of important decisions regarding opening schools. Therefore, we performed this prospective analysis of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies in children with known household exposure to SARS-CoV-2 and compared their IgG status with the other adults exposed to the index case in the same household. A total of 30 families with a documented COVID-19 index case were included. A total of 44 out of 80 household contacts (55%) of index patients had anti SARS-CoV-2 IgG antibodies. In particular, 16/27 (59,3%) adult partners had IgG antibodies compared with 28/53 (52,3%) of pediatric contacts (p >.05). Among the pediatric population, children ≥5 years of age had a similar probability of having SARS-CoV-2 IgG antibodies (21/39, 53.8%) compared to those less than 5 years old (7/14, 50%) (p >.05). Adult partners and children also had a similar probability of having SARS-CoV-2 IgG antibodies. Interestingly, 10/28 (35.7%) of children and 5/27 (18.5%) of adults with SARS-CoV-2 IgG antibodies were previously diagnosed as COVID-19 cases. Our study shows evidence of a high rate of IgG antibodies in children exposed to SARS-CoV-2. This report has public health implications, highlighting the need to establish appropriate guidelines for school openings and other social activities related to childhood.

Published
2020

18. Post-COVID-19 global health strategies: the need for an interdisciplinary approach

Author

Landi, Francesco, Gremese, Elisa, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Settanni, Carlo Romano, Benvenuto, Francesca, Bramato, Giulia, Carfi, A., Ciciarello, Francesca, Lomonaco, M. R., Martone, Anna Maria, Marzetti, Emanuele, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, Elisabetta, Salerno, A., Tosato, Matteo, Tritto, Marcello, Calvani, Riccardo, Catalano, Lucio, Picca, A., Savera, Giulia, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, Eleonora, Moschese, D., Ciccullo, A., Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Bizzarro, Alessandra, Lauria, Alessandra, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, Fabrizio, Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, Mariaconsiglia, Buonsenso, Danilo, Valentini, Piero, Pata, Davide, Sinatti, Dario, De Rose, Cristina, Richeldi, Luca, Lombardi, F., Calabrese, Anna Chiara, Sani, Gabriele, Janiri, D., Giuseppin, Giulia, Molinaro, Marzia, Modica, Marco, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Paglionico, A., Petricca, L., Gigante, Laura, Natalello, Gerlando, Fedele, A. L., Lizzio, Marco Maria, Santoliquido, Angelo, Santoro, Luca, Nesci, Domenico Arturo, Popolla, Valentina, Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Settanni C. R., Benvenuto F., Bramato G., Ciciarello F., Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Rota E., Tosato M., Tritto M., Calvani R. (ORCID:0000-0001-5472-2365), Catalano L., Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Taddei E., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Crudo F., Longobardi Y., Tricarico L., Santantonio M., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Pata D., Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Calabrese A., Sani G. (ORCID:0000-0002-9767-8752), Giuseppin G., Molinaro M., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Gigante L., Natalello G., Lizzio M. M., Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Nesci A. (ORCID:0000-0001-9466-1755), Popolla V., Landi, Francesco, Gremese, Elisa, Bernabei, Roberto, Fantoni, Massimo, Gasbarrini, Antonio, Settanni, Carlo Romano, Benvenuto, Francesca, Bramato, Giulia, Carfi, A., Ciciarello, Francesca, Lomonaco, M. R., Martone, Anna Maria, Marzetti, Emanuele, Napolitano, C., Pagano, Francesco Cosimo, Rocchi, Sara, Rota, Elisabetta, Salerno, A., Tosato, Matteo, Tritto, Marcello, Calvani, Riccardo, Catalano, Lucio, Picca, A., Savera, Giulia, Tamburrini, Enrica, Borghetti, Alberto, Di Gianbenedetto, S., Murri, Rita, Cingolani, Antonella, Ventura, Giulio, Taddei, Eleonora, Moschese, D., Ciccullo, A., Stella, L., Addolorato, Giovanni, Franceschi, Francesco, Mingrone, Geltrude, Zocco, Maria Assunta, Sanguinetti, Maurizio, Cattani Franchi, Paola, Marchetti, Simona, Bizzarro, Alessandra, Lauria, Alessandra, Rizzo, Stanislao, Savastano, Maria Cristina, Gambini, Gloria, Cozzupoli, G. M., Culiersi, Carola, Passali, Giulio Cesare, Paludetti, Gaetano, Galli, Jacopo, Crudo, Fabrizio, Di Cintio, G., Longobardi, Ylenia, Tricarico, Laura, Santantonio, Mariaconsiglia, Buonsenso, Danilo, Valentini, Piero, Pata, Davide, Sinatti, Dario, De Rose, Cristina, Richeldi, Luca, Lombardi, F., Calabrese, Anna Chiara, Sani, Gabriele, Janiri, D., Giuseppin, Giulia, Molinaro, Marzia, Modica, Marco, Natale, Luigi, Larici, Anna Rita, Marano, Riccardo, Paglionico, A., Petricca, L., Gigante, Laura, Natalello, Gerlando, Fedele, A. L., Lizzio, Marco Maria, Santoliquido, Angelo, Santoro, Luca, Nesci, Domenico Arturo, Popolla, Valentina, Landi F. (ORCID:0000-0002-3472-1389), Gremese E. (ORCID:0000-0002-2248-1058), Bernabei R. (ORCID:0000-0002-9197-004X), Fantoni M. (ORCID:0000-0001-6913-8460), Gasbarrini A. (ORCID:0000-0002-7278-4823), Settanni C. R., Benvenuto F., Bramato G., Ciciarello F., Martone A. M., Marzetti E. (ORCID:0000-0001-9567-6983), Pagano F., Rocchi S., Rota E., Tosato M., Tritto M., Calvani R. (ORCID:0000-0001-5472-2365), Catalano L., Savera G., Tamburrini E. (ORCID:0000-0003-4930-426X), Borghetti A., Murri R. (ORCID:0000-0003-4263-7854), Cingolani A. (ORCID:0000-0002-3793-2755), Ventura G. (ORCID:0000-0002-0304-7264), Taddei E., Addolorato G. (ORCID:0000-0002-1522-9946), Franceschi F. (ORCID:0000-0001-6266-445X), Mingrone G. (ORCID:0000-0003-2021-528X), Zocco M. A. (ORCID:0000-0002-0814-9542), Sanguinetti M. (ORCID:0000-0002-9780-7059), Cattani P. (ORCID:0000-0003-4678-4763), Marchetti S., Bizzarro A., Lauria A., Rizzo S. (ORCID:0000-0001-6302-063X), Savastano M. C. (ORCID:0000-0003-1397-4333), Gambini G., Culiersi C., Passali G. C. (ORCID:0000-0002-8176-0962), Paludetti G. (ORCID:0000-0003-2480-1243), Galli J. (ORCID:0000-0001-6353-6249), Crudo F., Longobardi Y., Tricarico L., Santantonio M., Buonsenso D., Valentini P. (ORCID:0000-0001-6095-9510), Pata D., Sinatti D., De Rose C., Richeldi L. (ORCID:0000-0001-8594-1448), Calabrese A., Sani G. (ORCID:0000-0002-9767-8752), Giuseppin G., Molinaro M., Modica M., Natale L. (ORCID:0000-0002-7949-5119), Larici A. R. (ORCID:0000-0002-1882-6244), Marano R. (ORCID:0000-0003-2710-2093), Gigante L., Natalello G., Lizzio M. M., Santoliquido A. (ORCID:0000-0003-1539-4017), Santoro L., Nesci A. (ORCID:0000-0001-9466-1755), and Popolla V.

Abstract

For survivors of severe COVID-19 disease, having defeated the virus is just the beginning of an uncharted recovery path. What follows after the acute phase of SARS-CoV-2 infection depends on the extension and severity of viral attacks in different cell types and organs. Despite the ridiculously large number of papers that have flooded scientific journals and preprint-hosting websites, a clear clinical picture of COVID-19 aftermath is vague at best. Without larger prospective observational studies that are only now being started, clinicians can retrieve information just from case reports and or small studies. This is the time to understand how COVID-19 goes forward and what consequences survivors may expect to experience. To this aim, a multidisciplinary post-acute care service involving several specialists has been established at the Fondazione Policlinico Universitario A. Gemelli IRCSS (Rome, Italy). Although COVID-19 is an infectious disease primarily affecting the lung, its multi-organ involvement requires an interdisciplinary approach encompassing virtually all branches of internal medicine and geriatrics. In particular, during the post-acute phase, the geriatrician may serve as the case manager of a multidisciplinary team. The aim of this article is to describe the importance of the interdisciplinary approach––coordinated by geriatrician––to cope the potential post-acute care needs of recovered COVID-19 patients.

Published
2020

22. Madelung's disease and acute alcoholic hepatitis: case report and review of literature

Author

Vassallo, G A, Mirijello, Antonio, Tarli, Claudia, Rando, Maria Margherita, Antonelli, Massimo, Garcovich, Simone, Zocco, Maria Assunta, Sestito, L, Mosoni, Carolina, Dionisi, T, D'Addio, Stefano, Tosoni, A, Gasbarrini, Antonio, Addolorato, Giovanni, Mirijello, A, Tarli, C, Rando, M M, Antonelli, M (ORCID:0000-0003-3007-1670), Garcovich, M (ORCID:0000-0001-8967-6688), Zocco, M A (ORCID:0000-0002-0814-9542), Mosoni, C, D'Addio, S, Gasbarrini, A (ORCID:0000-0002-7278-4823), Addolorato, G (ORCID:0000-0002-1522-9946), Vassallo, G A, Mirijello, Antonio, Tarli, Claudia, Rando, Maria Margherita, Antonelli, Massimo, Garcovich, Simone, Zocco, Maria Assunta, Sestito, L, Mosoni, Carolina, Dionisi, T, D'Addio, Stefano, Tosoni, A, Gasbarrini, Antonio, Addolorato, Giovanni, Mirijello, A, Tarli, C, Rando, M M, Antonelli, M (ORCID:0000-0003-3007-1670), Garcovich, M (ORCID:0000-0001-8967-6688), Zocco, M A (ORCID:0000-0002-0814-9542), Mosoni, C, D'Addio, S, Gasbarrini, A (ORCID:0000-0002-7278-4823), and Addolorato, G (ORCID:0000-0002-1522-9946)

Abstract

N/A

Published
2019

27. Moxifloxacin-Based Anti Helicobacter pylori Therapy

Author

Nista, E. C., Carloni, E., Candelli, M., Cazzato, I. A., Gabrielli, M., Zocco, M. A., Finizio, R., Santarelli, L., Franceschi, F., Di Giorgio, A., Fini, L., Cammarota, G., Gasbarrini, G., and Gasbarrini, A.

Published
2003

34. Contrast ultrasound LI-RADS LR-5 identifies hepatocellular carcinoma in cirrhosis in a multicenter restropective study of 1,006 nodules

Author

Terzi, E., Iavarone, M., Pompili, Maurizio, Veronese, L., Cabibbo, G., Fraquelli, M., Riccardi, Laura, De Bonis, L., Sangiovanni, A., Leoni, S., Zocco, Maria Assunta, Rossi, S., Alessi, N., Wilson, S. R., Piscaglia, F., Granito, A., Salvatore, Vincenza, Tovoli, F., Manini, M. A., Rapaccini, Gian Ludovico, Ainora, Maria Elena, Ravetta, V., Ghittoni, G., Ventra, A., Mogavero, G., Pompili M. (ORCID:0000-0001-6699-7980), Riccardi L., Zocco M. A. (ORCID:0000-0002-0814-9542), Salvatore V., Rapaccini G. L. (ORCID:0000-0002-6467-857X), Ainora M. E., Terzi, E., Iavarone, M., Pompili, Maurizio, Veronese, L., Cabibbo, G., Fraquelli, M., Riccardi, Laura, De Bonis, L., Sangiovanni, A., Leoni, S., Zocco, Maria Assunta, Rossi, S., Alessi, N., Wilson, S. R., Piscaglia, F., Granito, A., Salvatore, Vincenza, Tovoli, F., Manini, M. A., Rapaccini, Gian Ludovico, Ainora, Maria Elena, Ravetta, V., Ghittoni, G., Ventra, A., Mogavero, G., Pompili M. (ORCID:0000-0001-6699-7980), Riccardi L., Zocco M. A. (ORCID:0000-0002-0814-9542), Salvatore V., Rapaccini G. L. (ORCID:0000-0002-6467-857X), and Ainora M. E.

Abstract

Background & Aims: The use of contrast enhanced ultrasound (CEUS) for the diagnosis of hepatocellular carcinoma (HCC) in cirrhosis was questioned because of the risk of a false positive diagnosis in cases of cholangiocarcinoma. The American College of Radiology has recently released a scheme (CEUS Liver Imaging Reporting and Data System [LI-RADS®]) to classify lesions at risk of HCC investigated by CEUS. The aim of the present study was to validate this LI-RADS scheme for the diagnosis of HCC. Methods: A total of 1,006 nodules from 848 patients with chronic liver disease at risk of HCC were collected in five Italian centers and retrospectively analyzed. Nodules were classified as LR-5, (HCC) if ≥1 cm with arterial phase hyperenhancement, and late washout (onset ≥60 s after contrast injection) of mild degree. Rim enhancement and/or early and/or marked washout qualified lesions as LR-M (malignant, but not specific for HCC). Other combinations qualified lesions at intermediate risk for HCC (LR-3) or probable HCC (LR-4). Diagnostic reference standard was CT/MRI diagnosis of HCC (n = 506) or histology (n = 500). Results: The median nodule size was 2 cm. Of 1,006 nodules, 820 (81%) were HCC, 40 (4%) were cholangiocarcinoma, 116 (11%) regenerative nodules (±dysplastic). The LR-5 category (52% of all nodules) was 98.5% predictive of HCC, with no risk of misdiagnosis for pure cholangiocarcinoma. Sensitivity for HCC was 62%. All LR-M nodules were malignant and the majority of non-hepatocellular origin. Over 75% of cholangiocarcinomas were LR-M. The LR-3 category included 203 lesions (HCC 96 [47%]) and the LR-4 202 (HCC 173 [87%]). Conclusions: The CEUS LI-RADS class LR-5 is highly specific for HCC, enabling its use for a confident non-invasive diagnosis. Lay summary: This is a retrospective study of approximately 1,000 focal lesions at risk for hepatocellular carcinoma (HCC). Herein, we demonstrate that the refined definition of the typical contrast enhanced ultrasound pa

Published
2018

35. A novel ultrasound-based vascular calcification score (CALCS) to detect subclinical atherosclerosis

Author

Flore, Roberto Antonio, Zocco, Maria Assunta, Ainora, Maria Elena, Fonnesu, C., Nesci, Domenico Arturo, Gasbarrini, Antonio, Ponziani, Francesca Romana, Flore R. (ORCID:0000-0003-1659-1338), Zocco M. A. (ORCID:0000-0002-0814-9542), Ainora M. E., Nesci A. (ORCID:0000-0001-9466-1755), Gasbarrini A. (ORCID:0000-0002-7278-4823), Ponziani F. R. (ORCID:0000-0002-5924-6238), Flore, Roberto Antonio, Zocco, Maria Assunta, Ainora, Maria Elena, Fonnesu, C., Nesci, Domenico Arturo, Gasbarrini, Antonio, Ponziani, Francesca Romana, Flore R. (ORCID:0000-0003-1659-1338), Zocco M. A. (ORCID:0000-0002-0814-9542), Ainora M. E., Nesci A. (ORCID:0000-0001-9466-1755), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Ponziani F. R. (ORCID:0000-0002-5924-6238)

Abstract

OBJECTIVE: To quantify non-coronary vascular calcifications (VC) in asymptomatic patients at low-intermediate cardiovascular risk by a new color Doppler ultrasound (DUS)-based score (the carotid, aortic, lower limbs calcium score, CALCs), and to correlate this score with classical parameters associated with cardiovascular risk [carotid intima media thickness (IMT), and arterial stiffness (AS)].PATIENTS AND METHODS: All consecutive asymptomatic patients who underwent a screening DUS of non-coronary circulation were evaluated and patients at low-intermediate cardiovascular risk were selected according to Framingham risk score (FRS).Among them, we enrolled 70 patients with US evidence of VC and 71 age, sex and FRS matched controls. The presence of VC was correlated with classical markers of cardiovascular risk, such as AS and intima-media thickness (IMT). AS, expressed as pulse wave velocity (PWV) and arterial distensibility, carotid IMT and CALCs were measured for both groups. AS and c-IMT were assessed by a new Radio-Frequency (RF) DUS-based method. CALCs was generated by our previously described B-mode DUS-based method according to number/size of VC in 11 non-coronary segments (range 0-33).RESULTS: Patients with VC presented higher AS and IMT values than controls (PWV 8.34 +/- 0.98 m/s vs. 6.74 +/- 0.68 m/s, p<0.0001; arterial distensibility 267 12 mm vs. 315 65 mm, p=0.001; IMT 687 132 mm vs. 572 91 mm, p<0.0001). Mean CALCs of patients with VC was 8.41 +/- 7.78. CALCs were significantly correlated with c-IMT (p<0.0001; r=0.3), PWV (p<0.0001; r=0.4) and arterial distensibility (p=0.002; r=-0.1).CONCLUSIONS: DUS-based CALCs is highly correlated with other validated markers of sub clinical atherosclerosis, such as c-IMT and AS. Our results demonstrated the ability of CALCs to identify individual predictive factors beyond the traditional risk factors by quantifying an interesting and novel step of the atherogenic pro cess. Future studies on larger series a

Published
2018

36. Usefulness of contrast-enhanced ultrasound (CEUS) in Inflammatory Bowel Disease (IBD)

Author

Pecere, Silvia, Holleran, G., Ainora, Maria Elena, Garcovich, M., Scaldaferri, Franco, Gasbarrini, Antonio, Zocco, Maria Assunta, Pecere S., Ainora M. E., Scaldaferri F. (ORCID:0000-0001-8334-7541), Gasbarrini A. (ORCID:0000-0002-7278-4823), Zocco M. A. (ORCID:0000-0002-0814-9542), Pecere, Silvia, Holleran, G., Ainora, Maria Elena, Garcovich, M., Scaldaferri, Franco, Gasbarrini, Antonio, Zocco, Maria Assunta, Pecere S., Ainora M. E., Scaldaferri F. (ORCID:0000-0001-8334-7541), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Zocco M. A. (ORCID:0000-0002-0814-9542)

Abstract

Intestinal ultrasonography has emerged as a cheap, non-invasive and readily accessible modality for the assessment of a number of gastroenterological diseases. Over the last decade, particularly due to the widespread use of biological agents in Inflammatory Bowel Disease (IBD), guidelines regarding management and follow-up advise more regular disease assessment and surveillance in order to guide treatment adjustments, and provide more personalised care. Given the young age of the majority of patients with IBD the availability of an alternative modality to harmful radiation or the risks of endoscopy for this indication offers an appealing advantage. Intestinal ultrasonography has been shown to be as sensitive and specific for detecting IBD as both computed tomography and magnetic resonance enterography, and endoscopic evaluation. More recent developments in the technology of ultrasonography equipment and the use of intravenous contrast agents (contrast enhanced ultrasonography, known as CEUS), have significantly increased the ability to both detect disease location, determine the disease activity and also potentially the difference between fibrotic and inflammatory segments. This review focusses specifically on the value of CEUS for the diagnosis of both Crohn's disease and Ulcerative Colitis, in determining disease activity, extraintestinal complications, determination of fibrosis as well as its more recent use in assessing and predicting response to biological and immunosuppressive therapies.

Published
2018

37. Post-liver transplant intrahepatic cholestasis: etiology, clinical presentation, therapy

Author

Ponziani, F. R., Bhoori, S., Pompili, M., Zocco, M. A., Biolato, M., Marrone, G., Antonio Gasbarrini, Mazzaferro, V., and Grieco, A.

Subjects
Intrahepatic, Reoperation, Cholestasis, Settore MED/12 - GASTROENTEROLOGIA, Cholestasis, Intrahepatic, Humans, Liver Transplantation, gamma-Glutamyltransferase
Abstract

Post-liver transplant intrahepatic cholestasis is consequent to the impairment of bile flow or formation. It may develop in the early (within 6 months) or in the late (more than 6 months) post-liver transplant period and different causes may be recognized according to the time elapsed from a liver transplant. The raise at various degrees of serum bilirubin, alkaline phosphatase, and gamma-glutamyl transpeptidase, with or without increased transaminases levels, are common hematochemical findings. Liver histology is helpful for diagnostic assessment, and sometimes crucial to differentiate among possible causes of cholestasis. Although timely treatment of underling conditions as well as supportive care may resolve post-liver transplant intrahepatic cholestasis, the risk of graft loss and retransplantation are remarkable. For this reason, post-liver transplant intrahepatic cholestasis should be managed in collaboration with the LT center, and treatment should be devolved to expert hepatologists.

Published
2017

39. Liver Resection versus Radiofrequency Ablation plus Transcatheter Arterial Chemoembolization in Cirrhotic Patients with Solitary Large Hepatocellular Carcinoma

Author

Saviano, Angela, Iezzi, Roberto, Giuliante, Felice, Salvatore, L., Mele, C., Posa, Alessandro, Ardito, Francesco, De Gaetano, Anna Maria, Pompili, Maurizio, Rinninella, Emanuele, Zocco, Maria Assunta, Riccardi, Laura, Annicchiarico, Brigida Eleonora, Siciliano, M., De Matthaeis, Nicoletta, Grieco, Antonio, Rapaccini, Gian Ludovico, Gasbarrini, Antonio, Saviano A. (ORCID:0000-0002-2820-7180), Iezzi R. (ORCID:0000-0002-2791-481X), Giuliante F. (ORCID:0000-0001-9517-8220), Posa A., Ardito F. (ORCID:0000-0003-1596-2862), De Gaetano A. M. (ORCID:0000-0002-7493-9462), Pompili M. (ORCID:0000-0001-6699-7980), Rinninella E. (ORCID:0000-0002-9165-2367), Zocco M. A. (ORCID:0000-0002-0814-9542), Riccardi L., Annicchiarico B. E., De Matthaeis N., Grieco A. (ORCID:0000-0002-0544-8993), Rapaccini G. L. (ORCID:0000-0002-6467-857X), Gasbarrini A. (ORCID:0000-0002-7278-4823), Saviano, Angela, Iezzi, Roberto, Giuliante, Felice, Salvatore, L., Mele, C., Posa, Alessandro, Ardito, Francesco, De Gaetano, Anna Maria, Pompili, Maurizio, Rinninella, Emanuele, Zocco, Maria Assunta, Riccardi, Laura, Annicchiarico, Brigida Eleonora, Siciliano, M., De Matthaeis, Nicoletta, Grieco, Antonio, Rapaccini, Gian Ludovico, Gasbarrini, Antonio, Saviano A. (ORCID:0000-0002-2820-7180), Iezzi R. (ORCID:0000-0002-2791-481X), Giuliante F. (ORCID:0000-0001-9517-8220), Posa A., Ardito F. (ORCID:0000-0003-1596-2862), De Gaetano A. M. (ORCID:0000-0002-7493-9462), Pompili M. (ORCID:0000-0001-6699-7980), Rinninella E. (ORCID:0000-0002-9165-2367), Zocco M. A. (ORCID:0000-0002-0814-9542), Riccardi L., Annicchiarico B. E., De Matthaeis N., Grieco A. (ORCID:0000-0002-0544-8993), Rapaccini G. L. (ORCID:0000-0002-6467-857X), and Gasbarrini A. (ORCID:0000-0002-7278-4823)

Abstract

Purpose To compare liver resection (LR) with single-step, balloon-occluded radiofrequency (RF) ablation plus drug-eluting embolics transarterial chemoembolization in cirrhotic patients with single hepatocellular carcinoma (HCC) ≥ 3 cm. Materials and Methods From 2010 to 2014, 25 patients with compensated cirrhosis and single HCC ≥ 3 cm (median size 4.5 cm; range, 3.0–6.8 cm) not suitable for LR or liver transplantation were treated with RF ablation plus transarterial chemoembolization in a prospective observational single-center pilot study; all patients had complete tumor necrosis after treatment. A retrospective control group included 29 patients (median HCC size 4.0 cm; range, 3.0–7.4 cm) who underwent LR. RF ablation plus transarterial chemoembolization group included more patients with severe portal hypertension (65.5% vs 35.0%, P =.017). Primary endpoints were overall survival (OS) and tumor recurrence (TR) rates. Results One death and 1 major complication (4%) were observed in LR group. No major complications were reported in RF ablation plus transarterial chemoembolization group (P =.463). OS rates at 1 and 3 years were 91.8% and 79.3% in LR group and 89.4% and 48.2% in RF ablation plus transarterial chemoembolization group (P = 0.117). TR rates at 1 and 3 years were 29.5% and 45.0% in LR group and 42.4% and 76.0% in RF ablation plus transarterial chemoembolization group (P =.034). Local tumor progression (LTP) rates at 3 years were significantly lower in LR group (21.8% vs 58.1%, P =.005). Similar results were found in patients with HCC ≤ 5 cm (TR rates 35.4% vs 75.1%, P =.016; LTP 16.0% vs 55.7%, P =.013). Conclusions LR achieved lower TR and LTP rates than RF ablation plus transarterial chemoembolization, but 3-years OS rates were not statistically different between the 2 groups. RF ablation plus transarterial chemoembolization is an effective treatment option in patients with compensated cirrhosis and solitary HCC ≥ 3 cm unsuitable for LR.

Published
2017

40. Post-liver transplant intrahepatic cholestasis: etiology, clinical presentation, therapy

Author

Ponziani, F. R, Bhoori, S, Pompili, Maurizio, Zocco, M. A, Biolato, Marco, Marrone, Giuseppe, Gasbarrini, Antonio, Mazzaferro, V, Grieco, Antonio, Pompili, Maurizio (ORCID:0000-0001-6699-7980), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Grieco, Antonio (ORCID:0000-0002-0544-8993), Ponziani, F. R, Bhoori, S, Pompili, Maurizio, Zocco, M. A, Biolato, Marco, Marrone, Giuseppe, Gasbarrini, Antonio, Mazzaferro, V, Grieco, Antonio, Pompili, Maurizio (ORCID:0000-0001-6699-7980), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), and Grieco, Antonio (ORCID:0000-0002-0544-8993)

Abstract

n/a

Published
2017

41. Transarterial chemoembolization with degradable starch microspheres (DSM-TACE): an alternative option for advanced HCC patients? Preliminary results

Author

Iezzi, R., Pompili, M., Nestola, M., Siciliano, M., Annicchiarico, E., Zocco, M. A., Emanuele Rinninella, Posa, A., Antonuccio, G. E., Gasbarrini, A., and Bonomo, L.

Subjects
Complementary Therapies, Carcinoma, Hepatocellular, Settore MED/12 - GASTROENTEROLOGIA, Settore MED/09 - MEDICINA INTERNA, Liver Neoplasms, Humans, Chemoembolization, Pilot Projects, Starch, HCC, Chemoembolization, Therapeutic, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA
Abstract

To assess safety, feasibility and effectiveness of transarterial chemoembolization with degradable-starch-microspheres (DSM-TACE) in the treatment of patients with advanced hepatocellular carcinoma (HCC) dismissing or ineligible for multikinase-inhibitor chemotherapy administration (Sorafenib) due to unbearable side effects or clinical contraindications.Six consecutive advanced HCC patients dismissing Sorafenib because of unbearable side effects or worsened clinical conditions were enrolled in our prospective single-center pilot study. DSM-TACE was performed via a lobar approach, based on extent and distribution of the disease (1 treatment session for every lobe involved, with a 2-week interval in case of bilobar disease). Tumor response based on mRECIST criteria was evaluated on MD-CT performed at 1 month after "complete treatment" and every 3 months thereafter.Eleven treatments were performed, and technical success was achieved in all patients. No intra/peri-procedural death/major complications occurred. No signs of liver failure or systemic toxicity were detected. At one month follow-up, 5 partial responses (83.3%) and 1 progression disease (16.6%) with an overall disease control (ODC) of 83.3% were observed. In two patients with ODC and residual viable tumor higher than 50%, a repeated DSM-TACE treatment was performed. During the mean follow-up of 11 months (range: 4-14 months), an ODC of 66.6% was obtained. Progression-free survival was 5.5 months with a cumulative 6-month and 1-year overall survival rates of 83.3% and 66.6%, respectively.DSM-TACE seems to be a promising option for advanced HCC patients ineligible for Sorafenib administration or dismissing it due to progressive disease or unbearable side effects.

Published
2016

42. Madelung's disease and acute alcoholic hepatitis: case report and review of literature.

Author

VASSALLO, G. A., MIRIJELLO, A., TARLI, C., RANDO, M. M., ANTONELLI, M., GARCOVICH, M., ZOCCO, M. A., SESTITO, L., MOSONI, C., DIONISI, T., D'ADDIO, S., TOSONI, A., GASBARRINI, A., and ADDOLORATO, G.

Abstract

Madelung's disease is a rare condition characterized by symmetric growth of fatty tumors (lipomas) around the neck, shoulders, upper arms, and trunk. It often affects men with a history of alcohol abuse. Here we report a review of the literature about this disease together with the description of a patient affected by Madelung's disease and acute alcoholic hepatitis. [ABSTRACT FROM AUTHOR]

Published
2019

43. Spleen ultrasound elastography: state of the art and future directions - a systematic review.

Author

GIBIINO, G., GARCOVICH, M., AINORA, M. E., and ZOCCO, M. A.

Abstract

OBJECTIVE: An early and accurate diagnosis of clinically significant portal hypertension is mandatory for a correct prediction and management of the complications usually observed in patients affected by chronic liver disease (CLD). Spleen stiffness measurement is arising as a promising non-invasive technique, giving a reliable measure of haemodynamic changes occurring during cirrhosis progression, but contrasting data are available to date. MATERIALS AND METHODS: A systematic review was performed including the several studies dealing with the spleen stiffness measurement in the evaluation of portal hypertension in adult patients affected by hepatic or extra-hepatic portal hypertension (PH). Results were organized in technical classification from the first one-dimensional device (TE) to the latest ultrasound elastographic techniques (pSWE and 2D-SWE). RESULTS: We evaluated a total of nearly twenty studies dealing with all available elastographic techniques that were usually compared with HVPG, which is the gold standard for diagnosing the presence of PH. Spleen stiffness showed overall a good diagnostic accuracy to diagnose clinically significant PH in CLD, in some cases even with reliable cut-off values for severe PH. CONCLUSIONS: Spleen ultrasound elastography could be an accurate non-invasive tool for assessing the presence of portal hypertension. However, the different techniques available to date and the various cut-off values suggested might still limit the impact on clinical practice. [ABSTRACT FROM AUTHOR]

Published
2019

44. Transarterial chemoembolization with degradable starch microspheres (DSM-TACE): an alternative option for advanced HCC patients? Preliminary results

Author

Iezzi, Roberto, Pompili, Maurizio, Nestola, Massimiliano, Siciliano, Massimo, Annicchiarico, Brigida Eleonora, Zocco, Maria Assunta, Rinninella, Emanuele, Posa, Alessandro, Antonuccio, G. E. M, Gasbarrini, Antonio, Bonomo, Lorenzo, Iezzi, Roberto (ORCID:0000-0002-2791-481X), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Zocco, M. A (ORCID:0000-0002-0814-9542), Rinninella, Emanuele (ORCID:0000-0002-9165-2367), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Bonomo, Lorenzo (ORCID:0000-0001-5101-9367), Iezzi, Roberto, Pompili, Maurizio, Nestola, Massimiliano, Siciliano, Massimo, Annicchiarico, Brigida Eleonora, Zocco, Maria Assunta, Rinninella, Emanuele, Posa, Alessandro, Antonuccio, G. E. M, Gasbarrini, Antonio, Bonomo, Lorenzo, Iezzi, Roberto (ORCID:0000-0002-2791-481X), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Zocco, M. A (ORCID:0000-0002-0814-9542), Rinninella, Emanuele (ORCID:0000-0002-9165-2367), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), and Bonomo, Lorenzo (ORCID:0000-0001-5101-9367)

Abstract

OBJECTIVE: To assess safety, feasibility and effectiveness of transarterial chemoembolization with degradable-starch-microspheres (DSM-TACE) in the treatment of patients with advanced hepatocellular carcinoma (HCC) dismissing or ineligible for multikinase-inhibitor chemotherapy administration (Sorafenib) due to unbearable side effects or clinical contraindications. PATIENTS AND METHODS: Six consecutive advanced HCC patients dismissing Sorafenib because of unbearable side effects or worsened clinical conditions were enrolled in our prospective single-center pilot study. DSM-TACE was performed via a lobar approach, based on extent and distribution of the disease (1 treatment session for every lobe involved, with a 2-week interval in case of bilobar disease). Tumor response based on mRECIST criteria was evaluated on MD-CT performed at 1 month after "complete treatment" and every 3 months thereafter. RESULTS: Eleven treatments were performed, and technical success was achieved in all patients. No intra/peri-procedural death/major complications occurred. No signs of liver failure or systemic toxicity were detected. At one month follow-up, 5 partial responses (83.3%) and 1 progression disease (16.6%) with an overall disease control (ODC) of 83.3% were observed. In two patients with ODC and residual viable tumor higher than 50%, a repeated DSM-TACE treatment was performed. During the mean follow-up of 11 months (range: 4-14 months), an ODC of 66.6% was obtained. Progression-free survival was 5.5 months with a cumulative 6-month and 1-year overall survival rates of 83.3% and 66.6%, respectively. CONCLUSIONS: DSM-TACE seems to be a promising option for advanced HCC patients ineligible for Sorafenib administration or dismissing it due to progressive disease or unbearable side effects.

Published
2016

46. A novel ultrasound-based vascular calcification score (CALCS) to detect subclinical atherosclerosis.

Author

FLORE, R., ZOCCO, M. A., AINORA, M. E., FONNESU, C., NESCI, A., GASBARRINI, A., and PONZIANI, F. R.

Abstract

OBJECTIVE: To quantify non-coronary vascular calcifications (VC) in asymptomatic patients at low-intermediate cardiovascular risk by a new color Doppler ultrasound (DUS)-based score (the carotid, aortic, lower limbs calcium score, CALCs), and to correlate this score with classical parameters associated with cardiovascular risk [carotid intima media thickness (IMT), and arterial stiffness (AS)]. PATIENTS AND METHODS: All consecutive asymptomatic patients who underwent a screening DUS of non-coronary circulation were evaluated and patients at low-intermediate cardiovascular risk were selected according to Framingham risk score (FRS). Among them, we enrolled 70 patients with US evidence of VC and 71 age, sex and FRS matched controls. The presence of VC was correlated with classical markers of cardiovascular risk, such as AS and intima-media thickness (IMT). AS, expressed as pulse wave velocity (PWV) and arterial distensibility, carotid IMT and CALCs were measured for both groups. AS and c-IMT were assessed by a new Radio-Frequency (RF) DUS-based method. CALCs was generated by our previously described B-mode DUSbased method according to number/size of VC in 11 non-coronary segments (range 0-33). RESULTS: Patients with VC presented higher AS and IMT values than controls (PWV 8.34±0.98 m/s vs. 6.74±0.68 m/s, p<0.0001; arterial distensibility 267±12 mm vs. 315±65 mm, p=0.001; IMT 687±132 mm vs. 572±91 mm, p<0.0001). Mean CALCs of patients with VC was 8.41±7.78. CALCs were significantly correlated with c-IMT (p<0.0001; r=0.3), PWV (p<0.0001; r=0.4) and arterial distensibility (p=0.002; r=-0.1). CONCLUSIONS: DUS-based CALCs is highly correlated with other validated markers of subclinical atherosclerosis, such as c-IMT and AS. Our results demonstrated the ability of CALCs to identify individual predictive factors beyond the traditional risk factors by quantifying an interesting and novel step of the atherogenic process. Future studies on larger series and with adequate follow up are necessary to confirm these results and to evaluate the role of this new marker in monitoring calcific atherosclerosis progression. [ABSTRACT FROM AUTHOR]

Published
2018

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