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1. Coffee and Microbiota: A Narrative Review

Author

Federico Rosa, Benedetta Marigliano, Sergio Mannucci, Marcello Candelli, Gabriele Savioli, Giuseppe Merra, Maurizio Gabrielli, Antonio Gasbarrini, Francesco Franceschi, and Andrea Piccioni

Subjects
coffee, coffee consumption, microbiota, gut microbiota, microbiome, Biology (General), QH301-705.5
Abstract

Coffee is one of the most widely consumed beverages in the world, which has important repercussions on the health of the individual, mainly because of certain compounds it contains. Coffee consumption exerts significant influences on the entire body, including the gastrointestinal tract, where a central role is played by the gut microbiota. Dysbiosis in the gut microbiota is implicated in the occurrence of numerous diseases, and knowledge of the microbiota has proven to be of fundamental importance for the development of new therapeutic strategies. In this narrative review, we thoroughly investigated the link between coffee consumption and its effects on the gut microbiota and the ensuing consequences on human health. We have selected the most significant articles published on this very interesting link, with the aim of elucidating the latest evidence about the relationship between coffee consumption, its repercussions on the composition of the gut microbiota, and human health. Based on the various studies carried out in both humans and animal models, it has emerged that coffee consumption is associated with changes in the gut microbiota, although further research is needed to understand more about this link and the repercussions for the whole organism.

Published
2024
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2. Teaching suturing skill to emergency physicians: the experience of a hands-on practical training in a laboratory simulation-based setting

Author

Alberto Manno, Marco Maria Pascale, Michele Cosimo Santoro, Angela Saviano, Andrea Benicchi, Maurizio Gabrielli, Marcello Covino, and Francesco Franceschi

Subjects
Suturing skill teaching, traumatic wound care, emergency medicine, medical education, Medicine (General), R5-920
Abstract

Both specialists and trainees in emergency medicine are often unaware of the principles of good suturing. Hands-on training course was proposed to both members of the staff (group A) and trainees (group B) of the emergency department of our hospital. Familiarity with all aspects of the operation, pre-course 0%, postcourse 79% (group A) and 85.71% (group B) - p

Published
2023
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3. Are Short-Stay Units Safe and Effective in the Treatment of Non-Variceal Upper Gastrointestinal Bleeding?

Author

Marcello Candelli, Maria Lumare, Maria Elena Riccioni, Antonio Mestice, Veronica Ojetti, Giulia Pignataro, Giuseppe Merra, Andrea Piccioni, Maurizio Gabrielli, Antonio Gasbarrini, and Francesco Franceschi

Subjects
gastrointestinal bleeding, short stay unit, emergency department, overcrowding, peptic ulcer, anticoagulant, Medicine (General), R5-920
Abstract

Introduction: Emergency Department (ED) overcrowding is a health, political, and economic problem of concern worldwide. The causes of overcrowding are an aging population, an increase in chronic diseases, a lack of access to primary care, and a lack of resources in communities. Overcrowding has been associated with an increased risk of mortality. The establishment of a Short Stay Unit (SSU) for conditions that cannot be treated at home but require treatment and hospitalization for up to 72 h may be a solution. SSU can significantly reduce hospital length of stay (LOS) for certain conditions but does not appear to be useful for other diseases. Currently, there are no studies addressing the efficacy of SSU in the treatment of non-variceal upper gastrointestinal bleeding (NVUGIB). Our study aims to evaluate the efficacy of SSU in reducing the need for hospitalization, LOS, hospital readmission, and mortality in patients with NVUGIB compared with admission to the regular ward. Materials and Methods: This was a retrospective, single-center observational study. Medical records of patients presenting with NVUGIB to ED between 1 April 2021, and 30 September 2022, were analyzed. We included patients aged >18 years who presented to ED with acute upper gastrointestinal tract blood loss. The test population was divided into two groups: Patients admitted to a normal inpatient ward (control) and patients treated at SSU (intervention). Clinical and medical history data were collected for both groups. The hospital LOS was the primary outcome. Secondary outcomes were time to endoscopy, number of blood units transfused, readmission to the hospital at 30 days, and in-hospital mortality. Results: The analysis included 120 patients with a mean age of 70 years, 54% of whom were men. Sixty patients were admitted to SSU. Patients admitted to the medical ward had a higher mean age. The Glasgow-Blatchford score, used to assess bleeding risk, mortality, and hospital readmission were similar in the study groups. Multivariate analysis after adjustment for confounders found that the only factor independently associated with shorter LOS was admission to SSU (p < 0.0001). Admission to SSU was also independently and significantly associated with a shorter time to endoscopy (p < 0.001). The only other factor associated with a shorter time to EGDS was creatinine level (p = 0.05), while home treatment with PPI was associated with a longer time to endoscopy. LOS, time to endoscopy, number of patients requiring transfusion, and number of units of blood transfused were significantly lower in patients admitted to SSU than in the control group. Conclusions: The results of the study show that treatment of NVUGIB in SSU can significantly reduce the time required for endoscopy, the hospital LOS, and the number of transfused blood units without increasing mortality and hospital readmission. Treatment of NVUGIB at SSU may therefore help to reduce ED overcrowding but multicenter randomized controlled trials are needed to confirm these data

Published
2023
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4. Prevalence and Outcome of Asthma in Adult Patients Admitted to the Emergency Department for COVID-19: A Case-Control Study

Author

Maurizio Gabrielli, Marcello Candelli, Giulia Pignataro, Veronica Ojetti, Marta Sacco Fernandez, Federico Rosa, Antonio Gasbarrini, Francesco Franceschi, and on behalf of GEMELLI AGAINST COVID

Subjects
asthma, COVID-19, emergency department, Technology, Engineering (General). Civil engineering (General), TA1-2040, Biology (General), QH301-705.5, Physics, QC1-999, Chemistry, QD1-999
Abstract

(1) Background: Viral respiratory infections are common triggers for asthma exacerbation, often leading patients to the emergency department (ED). COVID-19, the disease caused by the SARS-CoV-2 virus, typically presents with respiratory symptoms, from minor symptoms, up to and including severe acute respiratory failure. Data on the association between asthma and COVID-19 are conflicting, and those from an ED setting are scarce. Our aims were to assess the prevalence and outcome of patients with asthma admitted to the ED for COVID-19. (2) Methods: We performed a case-control study, extracting data from a registry of adult patients with confirmed COVID-19 consecutively admitted to the ED of our hospital between March 2020 and January 2021. (3) Results: We identified 83 patients with asthma out of 935 individuals (prevalence 8.9%). There were no significant differences between cases and controls regarding both the proportion of hospital admissions and patients with critical COVID-19. (OR 1.37; 95% CI 0.52–3.56; and (OR 0.74; 95% CI 0.31–1.78 respectively). (4) Conclusions: In patients admitted to the ED for COVID-19, the prevalence of asthma was not higher than expected, and asthma was not associated with a worse outcome, in terms of the rate of hospitalization and critical COVID-19 disease.

Published
2022
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5. Gastrointestinal Bleeding Due to NOACs Use: Exploring the Molecular Mechanisms

Author

Angela Saviano, Mattia Brigida, Carmine Petruzziello, Marcello Candelli, Maurizio Gabrielli, and Veronica Ojetti

Subjects
novel oral anticoagulants, NOACs, gastrointestinal bleeding, edoxaban, apixaban, rivaroxaban, Biology (General), QH301-705.5, Chemistry, QD1-999
Abstract

Novel oral anticoagulants (NOACs) are drugs approved for the prevention and treatment of many thromboembolic cardiovascular conditions as a safer alternative to warfarin. We reviewed studies published in PubMed®, UpToDate®, Web of Science®, and Cochrane® about NOACs’ risks and benefits in patients requiring anticoagulation, with a focus on gastrointestinal bleeding and on molecular and pathophysiological mechanisms underlying the risk of bleeding in patients treated with them. Apixaban resulted in a lower rate of gastrointestinal bleeding compared to dabigatran and rivaroxaban. However, data reported that gastrointestinal bleeding in patients treated with NOACs was less severe compared to warfarin. Studies show promising results on the increased and widespread use of NOACs in patients who require anticoagulation (for example—in case of atrial fibrillation or high risk of venous thromboembolism), reporting an overall lower risk of major bleeding events. The profile of NOACs was more effective and secure compared to warfarin, but a more careful medical prescription is required in patients who are at high risk of gastrointestinal bleeding.

Published
2022
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6. Adult Asthma Management in the Emergency Department during COVID-19 Pandemic: An Expert Opinion Survey

Author

Maurizio Gabrielli, Angela Saviano, Matteo Bonini, Cristina Boccabella, Cristiano Caruso, Maria Pia Ruggieri, Simone Bianconi, Leonello Fuso, Pietro Capuzi, Francesca De Marco, Laura Franza, and Francesco Franceschi

Subjects
asthma exacerbations, COVID-19, SARS-CoV-2, emergency department, adults, Technology, Engineering (General). Civil engineering (General), TA1-2040, Biology (General), QH301-705.5, Physics, QC1-999, Chemistry, QD1-999
Abstract

Adult patients with asthma often access the emergency department (ED) for the management of exacerbations or uncontrolled symptoms. Sometimes the first diagnosis of asthma occurs right in the ED. In the last couple of years, the COVID-19 pandemic spread around the world, causing an acute respiratory syndrome named SARS-CoV-2, characterized mainly by respiratory symptoms, such as cough and shortness of breath, in addition to fever. This clinical pattern partially overlaps with that caused by asthma, thus generating confusion in terms of diagnosis and management. It is also unclear whether asthma may be associated with a worse prognosis in COVID-19 infection. This expert opinion paper provides specific recommendations to ease the challenges related to adult patients with asthma admitted to the ED during the COVID-19 pandemic, with particular reference to diagnosis and treatment. Moreover, it provides well-defined indications to guide decisions on discharge, hospital admission, as well as follow-up. A panel of experts composed of emergency medicine physicians, pulmonologists and allergologists discussed, voted and approved all the recommendations.

Published
2022
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7. Sarilumab use in severe SARS-CoV-2 pneumonia

Author

Elisa Gremese, Antonella Cingolani, Silvia Laura Bosello, Stefano Alivernini, Barbara Tolusso, Simone Perniola, Francesco Landi, Maurizio Pompili, Rita Murri, Angelo Santoliquido, Matteo Garcovich, Michela Sali, Gennaro De Pascale, Maurizio Gabrielli, Federico Biscetti, Massimo Montalto, Alberto Tosoni, Giovanni Gambassi, Gian Ludovico Rapaccini, Amerigo Iaconelli, Lorenzo Zileri Del Verme, Luca Petricca, Anna Laura Fedele, Marco Maria Lizzio, Enrica Tamburrini, Gerlando Natalello, Laura Gigante, Dario Bruno, Lucrezia Verardi, Eleonora Taddei, Angelo Calabrese, Francesco Lombardi, Roberto Bernabei, Roberto Cauda, Francesco Franceschi, Raffaele Landolfi, Luca Richeldi, Maurizio Sanguinetti, Massimo Fantoni, Massimo Antonelli, and Antonio Gasbarrini

Subjects
Severe sars-cov-2 pneumonia, Sarilumab, Inflammation, Medicine (General), R5-920
Abstract

Background: Interleukin-6 signal blockade showed preliminary beneficial effects in treating inflammatory response against SARS-CoV-2 leading to severe respiratory distress. Herein we describe the outcomes of off-label intravenous use of Sarilumab in severe SARS-CoV-2-related pneumonia. Methods: 53 patients with SARS-CoV-2 severe pneumonia received intravenous Sarilumab; pulmonary function improvement or Intensive Care Unit (ICU) admission rate in medical wards, live discharge rate in ICU treated patients and safety profile were recorded. Sarilumab 400 mg was administered intravenously on day 1, with eventual additional infusion based on clinical judgement, and patients were followed for at least 14 days, unless previously discharged or dead. Findings: Of the 53 SARS-CoV-2pos patients receiving Sarilumab, 39(73·6%) were treated in medical wards [66·7% with a single infusion; median PaO2/FiO2:146(IQR:120–212)] while 14(26·4%) in ICU [92·6% with a second infusion; median PaO2/FiO2: 112(IQR:100–141.5)].Within the medical wards, 7(17·9%) required ICU admission, 4 of whom were re-admitted to the ward within 5–8 days. At 19 days median follow-up, 89·7% of medical inpatients significantly improved (46·1% after 24 h, 61·5% after 3 days), 70·6% were discharged from the hospital and 85·7% no longer needed oxygen therapy. Within patients receiving Sarilumab in ICU, 64·2% were discharged from ICU to the ward and 35·8% were still alive at the last follow-up. Overall mortality rate was 5·7%. Interpretation: IL-6R inhibition appears to be a potential treatment strategy for severe SARS-CoV-2 pneumonia and intravenous Sarilumab seems a promising treatment approach showing, in the short term, an important clinical outcome and good safety.

Published
2020
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8. Liver Injury in Patients Hospitalized for COVID-19: Possible Role of Therapy

Author

Maurizio Gabrielli, Laura Franza, Alessandra Esperide, Irene Gasparrini, Antonio Gasbarrini, Francesco Franceschi, and on behalf of GEMELLI AGAINST COVID

Subjects
SARS-CoV2, COVID-19, liver, injury, drugs, NIV, Medicine
Abstract

Patients with COVID-19 show a high prevalence of liver injury. The pattern of this liver damage is still not fully understood. Different etiopathogenetic factors may concur; from a direct cytopathic effect, once the virus binds to the ACE-2 receptors, to the immune-mediated collateral damage, due to cytokine storm. The presence of pre-existing chronic liver disease is a contributing factor for acute organ damage during SARS-CoV2 infection. Last but not least, treatments probably play a role, also, in determining hepatotoxicity: many of the drugs we have used or are still using to treat COVID-19, combined with non-invasive ventilation, are known to sometimes determine acute liver injury. Although liver damage associated with COVID-19 is often transient and can resolve without any special treatment, it is important to understand the underlying mechanisms, particularly to better treat its more severe forms.

Published
2022
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9. Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina.

Author

Gaetano Antonio Lanza, Erica Mencarelli, Veronica Melita, Antonio Tota, Maurizio Gabrielli, Filippo Sarullo, Chiara Cordischi, Annalisa Potenza, Silvia Cardone, Antonio De Vita, Antonio Bisignani, Laura Manfredonia, Giuseppa Caccamo, Giuseppe Vitale, Silvia Baroni, Mirca Antenucci, Filippo Crea, and Francesco Franceschi

Subjects
Medicine, Science
Abstract

BACKGROUND:Previous studies showed that troponin blood levels may increase after exercise. In this study we assessed whether, among patients admitted with suspected unstable angina, the increase in high-sensitive troponin T (hs-TnT) levels after exercise stress test (EST) might help identify those with obstructive coronary artery disease (CAD) and predict symptom recurrence during short term follow-up. METHODS:Maximal treadmill EST was performed in 69 consecutive patients admitted to the emergency room with a suspicion of unstable angina (acute chest pain but confirmed normal serum levels of cardiac troponins) was measured before and 4 hours after EST. Coronary angiography was performed in 22 patients (32.8%). RESULTS:hs-TnT increased after EST compared to baseline in the whole population (from 0.84±0.65 to 1.17±0.87 ng/dL, p

Published
2019
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10. Is BMI Associated with COVID-19 Severity? A Retrospective Observational Study

Author

Marcello Candelli, Giulia Pignataro, Angela Saviano, Veronica Ojetti, Maurizio Gabrielli, Andrea Piccioni, Antonio Gullì, Massimo Antonelli, Antonio Gasbarrini, and Francesco Franceschi

Subjects
Pharmacology, SARS-CoV-2, Organic Chemistry, Settore MED/09 - MEDICINA INTERNA, Biochemistry, Is BMI Associated with COVID-19 Severity? A Retrospective Observational, BMI, Risk Factors, Drug Discovery, ICU, Molecular Medicine, Obesity, Mortality, Covid-19
Abstract

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

Published
2023

11. Autonomic dysfunction in non-critically ill COVID-19 patients during the acute phase of disease: an observational, cross-sectional study

Author

Irene Scala, Simone Bellavia, Marco Luigetti, Valerio Brunetti, Aldobrando Broccolini, Maurizio Gabrielli, Lorenzo Zileri Dal Verme, Paolo Calabresi, Giacomo Della Marca, and Giovanni Frisullo

Subjects
COMPASS-31, Orthostatic hypotension, SARS-CoV-2, Autonomic dysfunction, COVID-19, Dermatology, General Medicine, Dysautonomia, Psychiatry and Mental health, Settore MED/26 - NEUROLOGIA, Cross-Sectional Studies, Autonomic Nervous System Diseases, Orthostatic Intolerance, Humans, Neurology (clinical)
Abstract

Introduction Evidence is emerging about an extra-pulmonary involvement of SARS-CoV-2, including the nervous system. Autonomic dysfunction in patients recovering from acute coronavirus disease 2019 (COVID-19) has been recently described. Dysautonomic symptoms have been reported in the acute phase of the disease, but clear evidence is lacking, especially in the non-critical forms of the infection. Objective The aim of this study is to assess the prevalence of dysautonomia in acute, non-critically ill COVID-19 patients. Methods In this observational, cross-sectional study, we compared 38 non-critically ill patients with acute COVID-19 (COVID + group) to 38 healthy volunteers (COVID − group) in order to assess the prevalence of signs and symptoms of dysautonomia through the administration of the composite autonomic symptom score 31 (COMPASS-31) and an active standing test. Comparisons between groups were performed by means of both univariate and multivariate analyses. Results The prevalence of orthostatic hypotension was significantly higher in the COVID + group. Higher total scores of COMPASS-31 were observed in the COVID + group than controls. Significant differences between groups emerged in the secretomotor, orthostatic intolerance, and gastrointestinal COMPASS-31 domains. All these results maintained the statistical significance after the adjustment for concomitant drugs with a known effect on the autonomic nervous system assumed by the study participants, except for the differences in the gastrointestinal domain of COMPASS-31. Conclusion Our results suggest that an autonomic dysfunction could be an early manifestation of COVID-19, even in the contest of mild forms of the infection.

Published
2022

12. Risk of burnout and stress in physicians working in a COVID team: A longitudinal survey

Author

Lorenzo Maria Vetrone, Luisa Sestito, Mariangela Antonelli, Angelo Porfidia, Antonio Gasbarrini, Tommaso Dionisi, Laura Franza, Maurizio Sanguinetti, Francesco Antonio Mancarella, Riccardo Inchingolo, Francesco Santopaolo, Silvia Bosello, Caterina Guidone, Vincenzo Bove, Martina De Siena, Carlo Romano Settanni, Luca Miele, Giuseppe Zuccalà, Raffaele Iorio, Andrea FLEX, Benedetta Simeoni, Lucia Cerrito, Nicola Acampora, Maurizio Gabrielli, Simone Perniola, Maria Valeria Matteo, Angelo Carfì, Domenico Fusco, Valerio Pontecorvi, Christian Barillaro, Paolo Santini, Antonella Giampietro, Davide Moschese, Impagnatiello Michele, Gabriele Pulcini, Martina Petrucci, Francesco De Vito, Luca Petricca, LUCREZIA VERARDI, Francesca Raffaelli, Francesco Lombardi, Luca Sabia, Marcello Covino, Anna Maria Martone, Gerlando Natalello, Fabio Del Zompo, Giuseppe Parrinello, Gabriele Rumi, Federico Rosa, and Emanuele Marzetti

Subjects
2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Burnout syndrome, Specialty, Burnout, Burnout, Psychological, Lower risk, Physicians, Surveys and Questionnaires, medicine, Humans, Longitudinal Studies, Emotional exhaustion, Pandemics, Psychiatry, Original Paper, burnout, business.industry, SARS-CoV-2, covid 19, Settore MED/09 - MEDICINA INTERNA, COVID-19, General Medicine, Original Papers, Cross-Sectional Studies, Physical therapy, business
Abstract

Background and aims The COVID‐19 pandemic represents a source of stress and potential burnout for many physicians. This single‐site survey aimed at assessing perceived stress and risk to develop burnout syndrome among physicians operating in COVID wards. Methods This longitudinal survey evaluated stress and burnout in 51 physicians operating in the COVID team of Gemelli Hospital, Italy. Participants were asked to complete the Maslach Burnout Inventory (MBI) and the Perceived Stress Questionnaire on a short run (PSQs) (referring to the past 7 days) at baseline (T0) and then for four weeks (T1‐T4). Perceived Stress Questionnaire on a long run (PSQl) (referring to the past 2 years) was completed only at T0. Results Compared with physicians board‐certified in internal medicine, those board‐certified in other disciplines showed higher scores for the Emotional Exhaustion (EE) score of the MBI scale (P

Published
2021

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

Author

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

Subjects
2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Emergency department, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, asthma, medicine.disease, Hospitalization, Emergency medicine, CE-Research Letter to the Editor, SARS-CoV2, Emergency Medicine, Internal Medicine, medicine, Prevalence, Humans, In patient, business, Emergency Service, Hospital, Asthma, Retrospective Studies
Published
2021

14. Instrumental Evaluation of COVID-19 Related Dysautonomia in Non-Critically-Ill Patients: An Observational, Cross-Sectional Study

Author

Simone Bellavia, Irene Scala, Marco Luigetti, Valerio Brunetti, Maurizio Gabrielli, Lorenzo Zileri Dal Verme, Serenella Servidei, Paolo Calabresi, Giovanni Frisullo, and Giacomo Della Marca

Subjects
dysautonomia, SARS-CoV-2, autonomic dysfunction, heart rate variability, COVID-19, General Medicine, Sudoscan, automated pupillometry, pulse transit time, Article, Settore MED/26 - NEUROLOGIA, Medicine
Abstract

Coronavirus disease-19 (COVID-19) is a predominantly respiratory syndrome. Growing reports about a SARS-CoV-2 neurological involvement, including autonomic dysfunction (AD), have been reported, mostly in critically-ill patients, or in the long-COVID syndrome. In this observational, cross-sectional study, we investigated the prevalence of AD in 20 non-critically-ill COVID-19 patients (COVID+ group) in the acute phase of the disease through a composite instrumental evaluation consisting of Sudoscan, automated pupillometry, heart rate variability (HRV), and pulse transit time (PTT). All the parameters were compared to a control group of 20 healthy volunteers (COVID− group). COVID+ group presented higher values of pupillary dilatation velocities, and baseline pupil diameter than COVID− subjects. Moreover, COVID+ patients presented a higher incidence of feet sudomotor dysfunction than COVID− group. No significant differences emerged in HRV and PTT parameters between groups. In this study we observed the occurrence of autonomic dysfunction in the early stage of the disease.

Published
2021

15. COVID-19 and thrombotic complications: Pulmonary thrombosis rather than embolism?

Author

Maurizio Gabrielli, Francesco Franceschi, Alessandra Esperide, Priscilla Lamendola, and Federico Valletta

Subjects
2019-20 coronavirus outbreak, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Settore MED/09 - MEDICINA INTERNA, COVID-19, Hematology, medicine.disease, Thrombosis, Article, Venous thrombosis, Pneumonia, thrombotic complications, Embolism, Internal medicine, medicine, Cardiology, business, Thrombotic complication, Pulmonary thrombosis
Published
2020
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16. COVID-19 and intestinal inflammation: Role of fecal calprotectin

Author

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

Subjects
Adult, Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Settore MED/12 - GASTROENTEROLOGIA, Pneumonia, Viral, Severity of Illness Index, Gastroenterology, Betacoronavirus, Feces, Intestinal mucosa, Intestinal inflammation, Internal medicine, Settore MED/41 - ANESTESIOLOGIA, medicine, Humans, Viral, Intestinal Mucosa, Letter to the Editor, Pandemics, Leukocyte L1 Antigen Complex, Hepatology, SARS-CoV-2, business.industry, Settore MED/09 - MEDICINA INTERNA, COVID-19, Pneumonia, Middle Aged, fecal calprotectin, Case-Control Studies, Female, Calprotectin, Coronavirus Infections, business, Biomarkers
Published
2020

17. No association between post-exercise high-sensitivity troponin T levels and CAD

Author

Francesco Franceschi, Gaetano Antonio Lanza, Filippo Crea, Priscilla Lamendola, Maurizio Gabrielli, and Silvia Baroni

Subjects
medicine.medical_specialty, business.industry, CAD, Coronary Artery Disease, High Sensitivity Troponin T, Troponin T, Internal medicine, Post exercise, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Cardiology, medicine, Exercise Test, Humans, Cardiology and Cardiovascular Medicine, business
Published
2020

18. Post-exercise high-sensitivity troponin T levels in patients with suspected unstable angina

Author

Mirca Antenucci, Filippo Crea, Gaetano Antonio Lanza, Giuseppe Vitale, L Manfredonia, Francesco Franceschi, Annalisa Potenza, Antonio De Vita, Silvia Baroni, Chiara Cordischi, Antonio Tota, Filippo M. Sarullo, Silvia Cardone, Erica Mencarelli, Giuseppa Caccamo, Antonio Bisignani, Veronica Melita, and Maurizio Gabrielli

Subjects
Male, Cardiovascular Procedures, Coronary Artery Disease, 030204 cardiovascular system & hematology, Cardiovascular Medicine, Chest pain, Coronary Angiography, Biochemistry, Vascular Medicine, Diagnostic Radiology, Angina, Coronary artery disease, Electrocardiography, 0302 clinical medicine, Endocrinology, Ischemia, Medicine and Health Sciences, Coronary Heart Disease, Cardiovascular Imaging, education.field_of_study, Multidisciplinary, Troponin T, biology, Radiology and Imaging, Angiography, Middle Aged, musculoskeletal system, Troponin, Bioassays and Physiological Analysis, N/A, Cardiology, Medicine, Female, medicine.symptom, Research Article, medicine.medical_specialty, Imaging Techniques, Endocrine Disorders, Science, Population, Surgical and Invasive Medical Procedures, Research and Analysis Methods, 03 medical and health sciences, Diagnostic Medicine, Internal medicine, Heart rate, medicine, Diabetes Mellitus, Humans, Angina, Unstable, education, Exercise, Aged, business.industry, Unstable angina, Settore MED/09 - MEDICINA INTERNA, Electrophysiological Techniques, Angioplasty, Biology and Life Sciences, Proteins, 030229 sport sciences, medicine.disease, Cytoskeletal Proteins, Metabolic Disorders, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, biology.protein, Exercise Test, Cardiac Electrophysiology, business, Coronary Angioplasty, Biomarkers
Abstract

Background Previous studies showed that troponin blood levels may increase after exercise. In this study we assessed whether, among patients admitted with suspected unstable angina, the increase in high-sensitive troponin T (hs-TnT) levels after exercise stress test (EST) might help identify those with obstructive coronary artery disease (CAD) and predict symptom recurrence during short term follow-up. Methods Maximal treadmill EST was performed in 69 consecutive patients admitted to the emergency room with a suspicion of unstable angina (acute chest pain but confirmed normal serum levels of cardiac troponins) was measured before and 4 hours after EST. Coronary angiography was performed in 22 patients (32.8%). Results hs-TnT increased after EST compared to baseline in the whole population (from 0.84±0.65 to 1.17±0.87 ng/dL, p

Published
2019

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

Author

Andrea Alesi, Veronica Ojetti, Francesco Franceschi, Rodolfo Proietti, Maria Grazia Mancini, Marcello Candelli, Maurizio Gabrielli, Francesco Buccelletti, Gabriella D’Aurizio, Enrica Adducci, Emanuele Gilardi, and Davide Marsiliani

Subjects
Adult, Male, Abdominal pain, Visual analogue scale, NSAIDs, Analgesic, Nociceptive Pain, Internal Medicine, Medicine, Humans, Pain treatment, Contraindication, Pain Measurement, Acetaminophen, Analgesics, business.industry, Codeine, Settore MED/09 - MEDICINA INTERNA, Emergency department, Emergency Department, Middle Aged, Triage, Pain management, Italy, Anesthesia, Emergency Medicine, Female, medicine.symptom, business, Emergency Service, Hospital, Algorithm, Algorithms, medicine.drug
Abstract

Somatic pain is one of the most frequent symptoms reported by patients presenting to the emergency department (ED), but, in spite of this, it is very often underestimated and under-treated. Moreover, pain-killers prescriptions are usually related to the medical examination, leading to a delay in its administration, thus worsening the patient's quality of life. With our study, we want to define and validate a systematic and homogeneous approach to analgesic drugs administration, testing a new therapeutic algorithm in terms of earliness, safety, and efficacy. 442 consecutive patients who accessed our ED for any kind of somatic pain were enrolled, and then randomly divided into two groups: group A follow the normal process of access to pain-control drugs, and group B follow our SUPER algorithm for early administration of drugs to relieve pain directly from triage. We excluded from the study, patients with abdominal pain referred to the surgeon, patients with headache, recent history of trauma, history of drug allergies, and life-threatening conditions or lack of cooperation. Drugs used in the study were those available in our ED, such as paracetamol, paracetamol/codeine, ketorolac-tromethamine, and tramadol-hydrochloride. Pain level, risk factors, indication, and contraindication of each drug were taken into account in our SUPER algorithm for a rapid and safe administration of it. The Verbal Numeric Scale (VNS) and the Visual Analog Scale (VAS) were used to verify the patient's health and perception of it. Only 59 patient from group A (27.1 %) received analgesic therapy (at the time of the medical examination) compared to 181 patients (100 %) of group B (p < 0.001). Group B patients, received analgesic therapy 76 min before group A subjects (p < 0.01), resulting in a significant lower VNS (7.31 ± 1.68 vs 4.75 ± 2.3; p < 0.001), and a superior VAS after discharge (54.43 ± 22.16 vs 61.30 ± 19.13; p < 0.001) compared to group A subjects. No significant differences concerning side effects were observed between group A and group B patients. Early administration of a pain-control therapy directly from triage is safe and effective, and significantly improves patients perceptions of their own health.

Published
2015

20. Liquid melevodopa versus standard levodopa in patients with Parkinson disease and small intestinal bacterial overgrowth

Author

Antonio Gasbarrini, Francesco Bove, Anna Rita Bentivoglio, Maurizio Gabrielli, Enzo Ragazzoni, Alfonso Fasano, Serena Fortuna, Maria Assunta Zocco, Stefano Marconi, and Annalisa Tortora

Subjects
Male, medicine.medical_specialty, Levodopa, Urea breath test, Settore MED/12 - GASTROENTEROLOGIA, Gastroenterology, Severity of Illness Index, Rifaximin, Helicobacter Infections, Antiparkinson Agents, Lactulose, chemistry.chemical_compound, Gastrointestinal Agents, Internal medicine, Small intestinal bacterial overgrowth, medicine, Humans, Pharmacology (medical), Melevodopa, liquid melevodopa, Aged, Pharmacology, Analysis of Variance, medicine.diagnostic_test, Helicobacter pylori, business.industry, Area under the curve, Parkinson Disease, bacterial overgrowth, Middle Aged, medicine.disease, Rifamycins, Surgery, Glucose, chemistry, Breath Tests, Concomitant, Female, Neurology (clinical), business, medicine.drug
Abstract

Objectives Patients with Parkinson disease exhibit a highly increased prevalence of small intestinal bacterial overgrowth (SIBO), which has been also associated with the severity of motor fluctuations. Aim of this study was to test the efficacy of liquid levodopa with higher bioavailability in patients with SIBO. Methods Thirty-three patients with Parkinson disease underwent both lactulose and glucose breath tests to assess the presence of SIBO. A urea breath test was performed to assess the presence of a concomitant Helicobacter pylori infection. Patients were challenged with 250 mg of levodopa and 314 mg of levodopa methylester. Drug challenges were performed on different days and at baseline and 1 month after SIBO eradication. During the tests, the motor condition and the plasma levodopa concentrations were evaluated. Results At baseline, the onset of motor benefit was significantly shorter after melevodopa than after standard levodopa, as confirmed by the latency to motor on condition and t max (time to the on condition, 28.8±11.5 vs 55.5±40.2 minutes; P=0.0004; and t max, 28.2±9.7 vs 50.0±11.0 minutes; P=0.002). The duration of the on time or area under the curve was not significantly different. The underlying gastrointestinal condition did not influence these results. Conclusions The reduction of the latency to the on condition in the absence of a reduction of the on duration is a promising feature of melevodopa because this effect would increase the total daily on duration. Future studies that evaluate the usefulness of melevodopa beyond the acute challenge (eg, using motor diaries) in patients with gastrointestinal infections are warranted.

Published
2014

21. ag)Association between hypothyroidism and small intestinal bacterial overgrowth

Author

S. Sottili, Andrea Lupascu, Ernesto Cristiano Lauritano, Emidio Scarpellini, Marialuisa Novi, Michele Serricchio, Antonio Gasbarrini, Giovanni Gasbarrini, Antonio Laginestra, Giovanni Cammarota, Maurizio Gabrielli, Alfredo Pontecorvi, and Anna Lisa Bilotta

Subjects
Adult, Male, medicine.medical_specialty, Thyroid Hormones, endocrine system diseases, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Levothyroxine, small intestinal bacterial overgrowth, Biochemistry, Rifaximin, Autoimmune thyroiditis, chemistry.chemical_compound, Endocrinology, Gastrointestinal Agents, Hypothyroidism, Internal medicine, Small intestinal bacterial overgrowth, Intestine, Small, medicine, Humans, Decontamination, Breath test, medicine.diagnostic_test, Bacteria, business.industry, Biochemistry (medical), Thyroid, Settore MED/09 - MEDICINA INTERNA, Settore MED/13 - ENDOCRINOLOGIA, medicine.disease, Rifamycins, Small intestine, Anti-Bacterial Agents, medicine.anatomical_structure, chemistry, Breath Tests, Data Interpretation, Statistical, Female, business, medicine.drug, Hormone, Hydrogen
Abstract

Small intestinal bacterial overgrowth is defined as an abnormally high bacterial population level in the small intestine. Intestinal motor dysfunction associated with hypothyroidism could predispose to bacterial overgrowth. Luminal bacteria could modulate gastrointestinal symptoms and interfere with levothyroxine absorption. The aims of the present study were to assess the prevalence and clinical pattern of bacterial overgrowth in patients with a history of overt hypothyroidism and the effects of bacterial overgrowth decontamination on thyroid hormone levels.A total of 50 consecutive patients with a history of overt hypothyroidism due to autoimmune thyroiditis was enrolled. Diagnosis of bacterial overgrowth was based on positivity to a hydrogen glucose breath test. Bacterial overgrowth positive patients were treated with 1,200 mg rifaximin each day for a week. A glucose breath test, gastrointestinal symptoms, and thyroid hormone plasma levels were reassessed 1 month after treatment.A total of 27 patients with a history of hypothyroidism demonstrated a positive result to the breath test (27 of 50, 54%), compared with two in the control group (two of 40, 5%). The difference was statistically significant (P0.001). Abdominal discomfort, flatulence, and bloating were significantly more prevalent in the bacterial overgrowth positive group. These symptoms significantly improved after antibiotic decontamination. Thyroid hormone plasma levels were not significantly affected by successful bacterial overgrowth decontamination.The history of overt hypothyroidism is associated with bacterial overgrowth development. Excess bacteria could influence clinical gastrointestinal manifestations. Bacterial overgrowth decontamination is associated with improved gastrointestinal symptoms. However, fermenting carbohydrate luminal bacteria do not interfere with thyroid hormone levels.

Published
2007

22. Small intestinal bacterial overgrowth: diagnosis and treatment

Author

Veronica Ojetti, Ernesto Cristiano Lauritano, Antonio Gasbarrini, Andrea Lupascu, Maurizio Gabrielli, Giovanni Gasbarrini, and Emidio Scarpellini

Subjects
medicine.medical_specialty, Malabsorption, business.industry, Settore MED/12 - GASTROENTEROLOGIA, digestive, oral, and skin physiology, Gastroenterology, General Medicine, Bacterial Infections, medicine.disease, Steatorrhea, Anti-Bacterial Agents, Diarrhea, Lactulose, Bloating, Internal medicine, Small intestinal bacterial overgrowth, Intestine, Small, medicine, Humans, medicine.symptom, Flatulence, business, Irritable bowel syndrome, medicine.drug
Abstract

Small intestinal bacterial overgrowth (SIBO) is a clinical condition characterized by a malabsorption syndrome due to an increase in microorganisms within the small intestine. The main mechanisms restricting bacterial colonization in the upper gut are the gastric acid barrier, mucosal and systemic immunity and intestinal clearance. When these mechanisms fail, bacterial overgrowth develops. Diarrhea, steatorrhea, chronic abdominal pain, bloating and flatulence are common symptoms and are similar to those observed in irritable bowel syndrome. Breath tests (glucose and/or lactulose breath tests) have been proposed as a sensitive and simple tool for the diagnosis of bacterial overgrowth, being non-invasive and inexpensive compared to the gold standard represented by the culture of intestinal aspirates. Antibiotic therapy is the cornerstone of SIBO treatment. Current SIBO treatment is based on empirical courses of broad-spectrum antibiotics since few controlled studies concerning the choice and duration of antibiotic therapy are available at present.

Published
2007

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

Author

Antonio Gasbarrini, Lucio Cuoco, Nicolò Gentiloni Silveri, Luca Santarelli, Alessia Cazzato, Giovanni Gasbarrini, Marcello Candelli, Maurizio Gabrielli, Angelo Santoliquido, Paolo Pola, Enrico Celestino Nista, and Antonino De Lorenzo

Subjects
Male, Adult, medicine.medical_specialty, Pathology, Atrophic gastritis, Spirillaceae, Settore MED/12 - GASTROENTEROLOGIA, Smoking, Retrospective Studies, Middle Aged, Female, Celiac Disease, Helicobacter pylori, Helicobacter Infections, Humans, Gastroenterology, Group B, Coeliac disease, Internal medicine, Medicine, Settore MED/49 - Scienze Tecniche Dietetiche Applicate, Antrum, biology, business.industry, Stomach, Histology, biology.organism_classification, medicine.disease, digestive system diseases, medicine.anatomical_structure, Hp, business
Abstract

Helicobacter pylori infection is the major agent of gastric damage. Coeliac disease may affect the morphology and function of the entire gastrointestinal tract from the stomach to the colon. The aim of this study was to assess the gastric histological pattern in patients with H. pylori and untreated coeliac disease.We retrospectively enrolled 183 H. pylori-positive patients with (85, group A) and without (98, group B) untreated coeliac disease. The groups were similar for age, gender and smoking habit, and all the patients came from the same geographical area. Histological evaluation of gastric pattern was performed on 4 biopsies (2 in the antrum, 2 in the corpus). Gastric damage was classified according to the modified Sydney System. Diagnosis of H. pylori infection was based on positivity to histology. The chi-square test was used to assess differences between groups. A p-value0.05 was considered significant.Group A showed a significantly higher prevalence of follicular gastritis than group B (23.5% versus 12.2%, p=0.045). A significantly lower prevalence of atrophic gastritis was observed in group A compared with that in group B (6% versus 22.5%, p=0.002). The prevalence of chronic superficial gastritis, activity degree and intestinal metaplasia was similar between the two groups.In patients with H. pylori infection, untreated coeliac disease could represent a risk factor for follicular gastritis and is associated with a lower prevalence of atrophic gastritis. The complex interaction between H. pylori and untreated coeliac disease on Th-1/Th-2 balance in the gastric mucosa could explain these results.

Published
2006

24. Idiopathic chronic urticaria and celiac disease

Author

Eleonora Nucera, Giovanni Gasbarrini, Paolo Pola, Enrico Celestino Nista, Filippo Cremonini, Marcello Candelli, Maurizio Gabrielli, Veronica Ojetti, Antonio Gasbarrini, Domenico Schiavino, Luca Santarelli, and Giampiero Patriarca

Subjects
Adult, Male, medicine.medical_specialty, Physiology, Population, Disease, urticaria and celiac disease, Gastroenterology, Coeliac disease, Serology, urticaria, Risk Factors, Internal medicine, Prevalence, medicine, Humans, education, Autoimmune disease, education.field_of_study, biology, business.industry, Settore MED/09 - MEDICINA INTERNA, Case-control study, Middle Aged, Hepatology, medicine.disease, Celiac Disease, Case-Control Studies, Chronic Disease, Anti-transglutaminase antibodies, Immunology, biology.protein, Female, business
Abstract

Idiopathic chronic urticaria (ICU) is a chronic relapsing cutaneous disease. Some case reports or studies on small series of celiac disease (CD) patients have suggested a possible association between CD and ICU. The aim of this study was to assess the prevalence of CD in a population of adults ICU patients with respect to healthy controls. We consecutively enrolled 80 patients affected by ICU and 264 blood donors as the control population without a history of ICU. Serum anti-transglutaminase IgG and anti-endomysium IgA antibodies were evaluated in all subjects. In the case of positivity to serology, diagnosis was confirmed by duodenal biopsy. One of 80 (1.25%) ICU patients were positive to both anti-transglutaminase and anti-endomysium antibodies. Duodenal biopsy showed partial villous atrophy. One control of 264 (0.38%) had CD. No statistical difference was found in the prevalence of CD between the two groups. ICU patients do not seem to bear a greater risk for CD compared to the general population.

Published
2005

25. Primary autoimmune haemolytic anaemia and coeliac disease

Author

Giovanni Gasbarrini, Francesco Franceschi, Antonio Gasbarrini, Maurizio Gabrielli, G Girelli, Paolo Pola, Enrico Celestino Nista, Alessia Villita, Marcello Candelli, Luca Santarelli, Filippo Cremonini, and Giuseppe Merra

Subjects
Hemolytic anemia, Adult, Male, medicine.medical_specialty, Settore MED/09, Gastroenterology, Coeliac disease, Intestinal malabsorption, Risk Factors, Internal medicine, Immunopathology, medicine, Humans, Serologic Tests, Autoimmune disease, business.industry, Settore MED/09 - MEDICINA INTERNA, Anemia, Middle Aged, medicine.disease, Celiac Disease, Case-Control Studies, Immunology, Female, Anemia, Hemolytic, Autoimmune, business, Hemolytic, human activities, Autoimmune
Abstract

(2004). Primary autoimmune haemolytic anaemia and coeliac disease. Scandinavian Journal of Gastroenterology: Vol. 39, No. 6, pp. 605-606.

Published
2004

26. Raynaud's phenomenon and celiac disease

Author

Giovanni Gasbarrini, Marcello Candelli, Luca Santarelli, Paolo Pola, Enrico Celestino Nista, Antonio Gasbarrini, Maurizio Gabrielli, and Angelo Santoliquido

Subjects
Adult, Male, medicine.medical_specialty, Comorbidity, Disease, Risk Assessment, Cohort Studies, Humans, Medicine, Hepatology, celiac sprue, business.industry, Incidence, Settore MED/09 - MEDICINA INTERNA, Gastroenterology, Follow up studies, Raynaud Disease, Dermatology, Immunoglobulin A, Celiac Disease, Antibodies, Antinuclear, Case-Control Studies, Immunology, Female, business, Follow-Up Studies
Published
2003

27. Latent coeliac disease, hyperhomocysteinemia and pulmonary thromboembolism: a close link?

Author

Giovanni Gasbarrini, Maurizio Gabrielli, Angelo Santoliquido, Paolo Pola, and Antonio Gasbarrini

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, Hyperhomocysteinemia, animal diseases, Settore MED/12 - GASTROENTEROLOGIA, Coeliac disease, Folic Acid, Internal medicine, Thromboembolism, Medicine, Venous Thrombosis, business.industry, Vascular biology, nutritional and metabolic diseases, Hematology, Middle Aged, medicine.disease, Thrombosis, digestive system diseases, Pulmonary embolism, Venous thrombosis, Celiac Disease, Folic acid, cardiovascular system, Cardiology, business, Pulmonary Embolism
Abstract

Latent coeliac disease, hyperhomocysteinemia and pulmonary thromboembolism: a close link?

Published
2003

28. Resolution of migraine with aura after successful treatment of a pituitary microadenoma

Author

Luca Santarelli, Maurizio Gabrielli, Antonio Gasbarrini, Demetrio De Martini, Paolo Pola, C. Padalino, Mario Giacovazzo, and G Fiore

Subjects
Adenoma, medicine.medical_specialty, business.industry, Resolution (electron density), Migraine with Aura, Settore MED/09 - MEDICINA INTERNA, General Medicine, Pituitary neoplasm, medicine.disease, Bromocriptine, Migraine with aura, Anesthesia, Dopamine Agonists, Medicine, Pituitary Neoplasms, Neurology (clinical), Radiology, medicine.symptom, business, Pituitary microadenoma, medicine.drug
Published
2002

29. Probiotics in antibiotic-associated diarrhoea

Author

Marcello Candelli, Maurizio Gabrielli, Antonio Gasbarrini, Filippo Cremonini, Giovanni Gasbarrini, S. Di Caro, Andrea Lupascu, Enrico Celestino Nista, and Luca Santarelli

Subjects
Diarrhea, medicine.medical_specialty, Bifidobacterium longum, Settore MED/12 - GASTROENTEROLOGIA, Gastroenterology, Microbiology, law.invention, Clostridium Difficile Colitis, Probiotic, Saccharomyces, Lactobacillus acidophilus, Lactobacillus rhamnosus, law, Internal medicine, medicine, Humans, Enterocolitis, Pseudomembranous, Bifidobacterium, Hepatology, biology, business.industry, food and beverages, biology.organism_classification, Lactobacillus, probiotics, business, Saccharomyces boulardii, Enterococcus faecium
Abstract

Antibiotic-associated diarrhoea is a common event. In some cases, it could represent a life-threatening event. Clostridium difficile colitis is a further distinct complication of antibiotic administration. Treatment options for antibiotic-associated diarrhoea and Clostridium difficile colitis include supplementation with several types of probiotics, as overviewed in this paper. Three randomised, double-blind, controlled clinical trials show a therapeutic effect of Saccharomyces boulardii in antibiotic-associated diarrhoea. The efficacy of Lactobacillus acidophilus and bulgaricus has also been ascertained in two double-blind controlled studies. Other studies focusing on Lactobacillus as a new preventive agent for antibiotic-associated diarrhoea are not double-blind. Among these, a positive effect of Lactobacillus rhamnosus GG, Bifidobacterium longum and Enterococcus faecium SF68 has been reported. Effectiveness of probiotics in antibiotic-associated diarrhoea has, therefore, a consistent scientific rationale, however few studies have performed an assessment of bacterial recovery in stools, and this approach may be helpful in deciding a more rigorous dose standardisation.

Published
2002

30. Role for chronic infections in atherosclerosis?

Author

Antonio Gasbarrini, Luca Santarelli, and Maurizio Gabrielli

Subjects
Immunoglobulin A, Arteriosclerosis, Congenital cytomegalovirus infection, medicine.disease_cause, Sensitivity and Specificity, Immunoglobulin G, Immune system, Risk Factors, Physiology (medical), medicine, Humans, infections, biology, business.industry, Settore MED/09 - MEDICINA INTERNA, medicine.disease, Virology, Herpes simplex virus, Chronic Disease, Immunology, biology.protein, Antibody, atherosclerosis, Cardiology and Cardiovascular Medicine, business, C pneumoniae
Abstract

To the Editor: The study by Espinola-Klein et al1 showed a significant association between infectious burden ( C pneumoniae, H pylori, cytomegalovirus, herpes simplex virus 2 ) and the extent of atherosclerosis; moreover, the risk for future death was increased by the number of infectious pathogens, especially in patients with advanced atherosclerosis. The specific IgG or IgA antibodies used in the study, however, do not necessarily distinguish between persistence of infections and only a previous contact. Other more sensitive markers of actual infections are available: specific IgG-containing immune complexes for C pneumoniae 2; the 13 …

Published
2002

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