Search

Your search keyword '"Bernasconi D"' showing total 12 results
Start Over Author "Bernasconi D" Publisher elsevier b.v.
12 results on '"Bernasconi D"'

1. Improving outcomes of in situ split liver transplantation in Italy over the last 25 years

Author

Lauterio, A, Cillo, U, Spada, M, Trapani, S, De Carlis, R, Bottino, G, Bernasconi, D, Scalamogna, C, Pinelli, D, Cintorino, D, D'Amico, F, Spagnoletti, G, Miggino, M, Romagnoli, R, Centonze, L, Caccamo, L, Baccarani, U, Carraro, A, Cescon, M, Vivarelli, M, Mazaferro, V, Ettorre, G, Rossi, M, Vennarecci, G, De Simone, P, Angelico, R, Agnes, S, Di Benedetto, F, Lupo, L, Zamboni, F, Zefelippo, A, Patrono, D, Diviacco, P, Laureiro, Z, Gringeri, E, Di Francesco, F, Lucianetti, A, Valsecchi, M, Gruttadauria, S, De Feo, T, Cardillo, M, De Carlis, L, Colledan, M, Andorno, E, Lauterio A., Cillo U., Spada M., Trapani S., De Carlis R., Bottino G., Bernasconi D., Scalamogna C., Pinelli D., Cintorino D., D'Amico F. E., Spagnoletti G., Miggino M., Romagnoli R., Centonze L., Caccamo L., Baccarani U., Carraro A., Cescon M., Vivarelli M., Mazaferro V., Ettorre G. M., Rossi M., Vennarecci G., De Simone P., Angelico R., Agnes S., Di Benedetto F., Lupo L. G., Zamboni F., Zefelippo A., Patrono D., Diviacco P., Laureiro Z. L., Gringeri E., Di Francesco F., Lucianetti A., Valsecchi M. G., Gruttadauria S., De Feo T., Cardillo M., De Carlis L., Colledan M., Andorno E., Lauterio, A, Cillo, U, Spada, M, Trapani, S, De Carlis, R, Bottino, G, Bernasconi, D, Scalamogna, C, Pinelli, D, Cintorino, D, D'Amico, F, Spagnoletti, G, Miggino, M, Romagnoli, R, Centonze, L, Caccamo, L, Baccarani, U, Carraro, A, Cescon, M, Vivarelli, M, Mazaferro, V, Ettorre, G, Rossi, M, Vennarecci, G, De Simone, P, Angelico, R, Agnes, S, Di Benedetto, F, Lupo, L, Zamboni, F, Zefelippo, A, Patrono, D, Diviacco, P, Laureiro, Z, Gringeri, E, Di Francesco, F, Lucianetti, A, Valsecchi, M, Gruttadauria, S, De Feo, T, Cardillo, M, De Carlis, L, Colledan, M, Andorno, E, Lauterio A., Cillo U., Spada M., Trapani S., De Carlis R., Bottino G., Bernasconi D., Scalamogna C., Pinelli D., Cintorino D., D'Amico F. E., Spagnoletti G., Miggino M., Romagnoli R., Centonze L., Caccamo L., Baccarani U., Carraro A., Cescon M., Vivarelli M., Mazaferro V., Ettorre G. M., Rossi M., Vennarecci G., De Simone P., Angelico R., Agnes S., Di Benedetto F., Lupo L. G., Zamboni F., Zefelippo A., Patrono D., Diviacco P., Laureiro Z. L., Gringeri E., Di Francesco F., Lucianetti A., Valsecchi M. G., Gruttadauria S., De Feo T., Cardillo M., De Carlis L., Colledan M., and Andorno E.

Abstract

Background & Aims: Split liver transplant(ation) (SLT) is still considered a challenging procedure that is by no means widely accepted. We aimed to present data on 25-year trends in SLT in Italy, and to investigate if, and to what extent, outcomes have improved nationwide during this time. Methods: The study included all consecutive SLTs performed from May 1993 to December 2019, divided into three consecutive periods: 1993–2005, 2006–2014, and 2015–2019, which match changes in national allocation policies. Primary outcomes were patient and graft survival, and the relative impact of each study period. Results: SLT accounted for 8.9% of all liver transplants performed in Italy. A total of 1,715 in situ split liver grafts were included in the analysis: 868 left lateral segments (LLSs) and 847 extended right grafts (ERGs). A significant improvement in patient and graft survival (p <0.001) was observed with ERGs over the three periods. Predictors of graft survival were cold ischaemia time (CIT) <6 h (p = 0.009), UNOS status 2b (p <0.001), UNOS status 3 (p = 0.009), and transplant centre volumes: 25–50 cases vs. <25 cases (p = 0.003). Patient survival was significantly higher with LLS grafts in period 2 vs. period 1 (p = 0.008). No significant improvement in graft survival was seen over the three periods, where predictors of graft survival were CIT <6 h (p = 0.007), CIT <6 h vs. ≥10 h (p = 0.019), UNOS status 2b (p = 0.038), and UNOS status 3 (p = 0.009). Retransplantation was a risk factor in split liver graft recipients, with significantly worse graft and patient survival for both types of graft (p <0.001). Conclusions: Our analysis showed Italian SLT outcomes to have improved over the last 25 years. These results could help to dispel reservations regarding the use of this procedure. Impact and implications: Split liver transplant(ation) (SLT) is still considered a challenging procedure and is by no means widely accepted. This study included all

Published
2023

2. Normalization of serum immunoglobulin G levels is associated with improved transplant-free survival in patients with autoimmune hepatitis

Author

Gerussi, A, Halliday, N, Saffioti, F, Bernasconi, D, Roccarina, D, Marshall, A, Thorburn, D, Gerussi A., Halliday N., Saffioti F., Bernasconi D. P., Roccarina D., Marshall A., Thorburn D., Gerussi, A, Halliday, N, Saffioti, F, Bernasconi, D, Roccarina, D, Marshall, A, Thorburn, D, Gerussi A., Halliday N., Saffioti F., Bernasconi D. P., Roccarina D., Marshall A., and Thorburn D.

Abstract

Background: There is limited evidence linking achievement of biochemical response with outcomes in Autoimmune Hepatitis (AIH), and it is unclear whether normalization of serum immunoglobulin G (IgG) levels influences prognosis. Aims: We aimed to investigate factors associated with death or liver transplantation in patients affected by AIH. Methods: We undertook a retrospective analysis of all AIH patients attending a tertiary liver unit since 1980. Patients not meeting established diagnostic criteria for AIH or with a follow-up shorter than 18 months were excluded. Results: 107 patients meeting inclusion criteria were included in the study. Mean age at diagnosis was 44 years, 29 patients (27.1%) had cirrhosis at baseline. Median follow-up was 79 months, and 70 patients (79.5%) reached biochemical response. Biochemical response was associated with reduced hazard of liver transplant or death (HR 0.07, 95% CI 0.01–0.46), whereas cirrhosis at diagnosis was an independent predictor of liver transplantation or death (Hazard ratio (HR) 11.8, 95%, confidence interval (CI) 1.18–117.4). Lack of normalization of serum IgG levels was associated with reduced 5-year transplant-free survival (95% in patients normalizing, compared to 86%, p = 0.02). Conclusion: Normalization of serum IgG levels alone translates in better transplant-free survival in patients with AIH and should be a treatment target along with transaminases.

Published
2020

3. Treatment of hepatocarcinoma beyond the milan criteria. A weighted comparative study of surgical resection versus chemoembolization

Author

Famularo, S, Di Sandro, S, Giani, A, Bernasconi, D, Lauterio, A, Ciulli, C, Rampoldi, A, Corso, R, De Carlis, R, Romano, F, Braga, M, Gianotti, L, De Carlis, L, Famularo S., Di Sandro S., Giani A., Bernasconi D. P., Lauterio A., Ciulli C., Rampoldi A. G., Corso R., De Carlis R., Romano F., Braga M., Gianotti L., De Carlis L., Famularo, S, Di Sandro, S, Giani, A, Bernasconi, D, Lauterio, A, Ciulli, C, Rampoldi, A, Corso, R, De Carlis, R, Romano, F, Braga, M, Gianotti, L, De Carlis, L, Famularo S., Di Sandro S., Giani A., Bernasconi D. P., Lauterio A., Ciulli C., Rampoldi A. G., Corso R., De Carlis R., Romano F., Braga M., Gianotti L., and De Carlis L.

Abstract

Background: Optimal treatment of hepatocellular carcinoma (HCC) beyond the Milan criteria (MC) is debated. The aim of the study was to assess overall-survival (OS) and disease-free-survival (DFS) for HCC beyond MC when treated by trans-arterial-chemoembolization (TACE) or surgical resection (SR). Method: between 2005 and 2015, all patients with a first diagnosis of HCC beyond MC(1 nodule>5 cm, or 3 nodules>3 cm without macrovascular invasion) were evaluated. Analyses were carried out through Kaplan–Meier, Cox models and the inverse probability weighting (IPW) method to reduce allocation bias. Sub-analyses have been performed for multinodular and single large tumors compared with a MC-IN cohort. Results: 226 consecutive patients were evaluated: 118 in SR group and 108 in TACE group. After IPW, the two pseudo-populations were comparable for tumor burden and liver function. In the SR group, 1–5 years OS rates were 72.3% and 35% respectively and 92.7% and 39.3% for TACE (p = 0.500). The median DFS was 8 months (95%CI:8–9) for TACE, and 11 months (95%CI:9–12) for SR (p < 0.001). TACE was an independent predictor for recurrence (HR 1.5; 95%CI: 1.1–2.1; p = 0.015). Solitary tumors > 5 cm and multinodular disease had comparable OS and DFS as Milan-IN group (p > 0.05). Conclusion: Surgery allowed a better control than TACE in patient bearing HCC beyond MC. This translated into a significant benefit in terms of DFS but not OS.

Published
2020

4. Benchmarking postoperative outcomes after open liver surgery for cirrhotic patients with hepatocellular carcinoma in a national cohort

Author

Famularo, S., Russolillo, N., Donadon, M., Cipriani, F., Ardito, Francesco, Perri, P., Giani, A., De Stefano, F., Lai, Q., Molfino, S., Zanello, M., Iaria, M., La Barba, G., Pinotti, E., Germani, P., Conci, S., Ferrari, C., Fumagalli, L., Romano, M., Antonucci, A., Zimmitti, Giuseppe, Troci, A., Floridi, A., Ferraro, V., Patauner, S., Frena, A., Memeo, R., Crespi, M., Hilal, M. A., Zanus, G., Chiarelli, M., Percivale, A., Ruzzenente, A., Tarchi, P., Zago, M., Ercolani, G., Dalla Valle, R., Jovine, E., Baiocchi, G. L., Rossi, M., Maestri, M., Romano, F., Grazi, G. L., Giuliante, Felice, Aldrighetti, L., Ferrero, A., Torzilli, G., Costa, G., Milana, F., Fazio, F., Ratti, F., Razionale, Francesco, De Peppo, V., Carissimi, F., Paolo Graziano, G. M., Laurerio, Z. L., Giuffrida, M., Cucchetti, A., Montuori, M., Cosola, D., Corleone, P., Lazzari, G., Franceschi, A., Calcagno, P., Salvador, L., Manzoni, A., Pennacchi, L., Libia, A., Notte, F., Bernasconi, D. P., Mori, S., Gaudesi, D., Ardito F. (ORCID:0000-0003-1596-2862), Zimmitti G. (ORCID:0000-0003-4925-4012), Giuliante F. (ORCID:0000-0001-9517-8220), Razionale F., Famularo, S., Russolillo, N., Donadon, M., Cipriani, F., Ardito, Francesco, Perri, P., Giani, A., De Stefano, F., Lai, Q., Molfino, S., Zanello, M., Iaria, M., La Barba, G., Pinotti, E., Germani, P., Conci, S., Ferrari, C., Fumagalli, L., Romano, M., Antonucci, A., Zimmitti, Giuseppe, Troci, A., Floridi, A., Ferraro, V., Patauner, S., Frena, A., Memeo, R., Crespi, M., Hilal, M. A., Zanus, G., Chiarelli, M., Percivale, A., Ruzzenente, A., Tarchi, P., Zago, M., Ercolani, G., Dalla Valle, R., Jovine, E., Baiocchi, G. L., Rossi, M., Maestri, M., Romano, F., Grazi, G. L., Giuliante, Felice, Aldrighetti, L., Ferrero, A., Torzilli, G., Costa, G., Milana, F., Fazio, F., Ratti, F., Razionale, Francesco, De Peppo, V., Carissimi, F., Paolo Graziano, G. M., Laurerio, Z. L., Giuffrida, M., Cucchetti, A., Montuori, M., Cosola, D., Corleone, P., Lazzari, G., Franceschi, A., Calcagno, P., Salvador, L., Manzoni, A., Pennacchi, L., Libia, A., Notte, F., Bernasconi, D. P., Mori, S., Gaudesi, D., Ardito F. (ORCID:0000-0003-1596-2862), Zimmitti G. (ORCID:0000-0003-4925-4012), Giuliante F. (ORCID:0000-0001-9517-8220), and Razionale F.

Abstract

Background: Benchmark analysis for open liver surgery for cirrhotic patients with hepatocellular carcinoma (HCC) is still undefined. Methods: Patients were identified from the Italian national registry HE.RC.O.LE.S. The Achievable Benchmark of Care (ABC) method was employed to identify the benchmarks. The outcomes assessed were the rate of complications, major comorbidities, post-operative ascites (POA), post-hepatectomy liver failure (PHLF), 90-day mortality. Benchmarking was stratified for surgical complexity (CP1, CP2 and CP3). Results: A total of 978 of 2698 patients fulfilled the inclusion criteria. 431 (44.1%) patients were treated with CP1 procedures, 239 (24.4%) with CP2 and 308 (31.5%) with CP3 procedures. Patients submitted to CP1 had a worse underlying liver function, while the tumor burden was more severe in CP3 cases. The ABC for complications (13.1%, 19.2% and 28.1% for CP1, CP2 and CP3 respectively), major complications (7.6%, 11.1%, 12.5%) and 90-day mortality (0%, 3.3%, 3.6%) increased with the surgical difficulty, but not POA (4.4%, 3.3% and 2.6% respectively) and PHLF (0% for all groups). Conclusion: We propose benchmarks for open liver resections in HCC cirrhotic patients, stratified for surgical complexity. The difference between the benchmark values and the results obtained during everyday practice reflects the room for potential growth, with the aim to encourage constant improvement among liver surgeons.

Published
2022

5. Estimating liver function in a large cirrhotic cohort: Signal intensity of gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI

Author

Ippolito, D, Famularo, S, Giani, A, Orsini, E, Pecorelli, A, Pinotti, E, Gandola, D, Romano, F, Sironi, S, Bernasconi, D, Gianotti, L, Orsini, EB, GANDOLA, DAVIDE GIACOMO, Bernasconi, DP, Ippolito, D, Famularo, S, Giani, A, Orsini, E, Pecorelli, A, Pinotti, E, Gandola, D, Romano, F, Sironi, S, Bernasconi, D, Gianotti, L, Orsini, EB, GANDOLA, DAVIDE GIACOMO, and Bernasconi, DP

Abstract

Background: To assess whether gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI study is useful to estimate liver function in comparison to the presence or absence of cirrhosis, Child Pugh (CP), Model for End-stage Liver Disease (MELD), ALBI scores and biochemical test. Methods: We retrospectively reviewed all consecutive Gd-EOB-DTPA-enhanced-MRI studies performed between 2010 and 2016 in patients with focal liver lesions undergoing clinical evaluation. Patients were divided in study and control group according to the presence of cirrhosis, and then classified by CP, MELD and ALBI. Signal intensity was calculated through the liver-to-muscle ratio in portal- (SI-POR) and hepatobiliary-phase(SI-HEP). Results: Three-hundred-three Gd-EOB-DTPA liver-enhanced-MRI studies were included. One-hundred-ninety-one patients (63%) were cirrhotic. SI-HEP was significantly lower in cirrhotic group (0.55 ± 0.29 vs 0.66 ± 0.40, p = 0.004).The SI-HEP progressively decreased from CP-A to CP-C (0.59 ± 0.28 to 0.25 ± 0.19, p < 0.0001) and a significant difference was found between MELD ≤ 9 and MELD > 9 groups (0.61 ± 0.31 vs 0.49 ± 0.28, p = 0.007). No differences between ALBI grades were evident. Among biochemical parameters a moderate correlation was found among SI-HEP and total bilirubin, AST and albumin. Conclusion: SI-HEP after Gd-EOB-DTPA-enhanced-MRI effectively stratified patients with different Child Pugh grades and MELD scores. This technique could hence be useful as a novel radiological marker to estimate the underlying liver function.

Published
2019

7. Detection of hepatocellular carcinoma's microvascular invasion at the preoperative CT scan: Artificial intelligence meets radiomics.

Author

Famularo, S., Donadon, M., Penzo, C., Bortolotto, M., Maino, C., Marescaux, J., Diana, M., Romano, F., Giuliante, F., Ardito, F., Grazi, G.L., Bernasconi, D., and Torzilli, G.

Abstract

Microvascular invasion(MVI) is the main risk factor for overall mortality and recurrence after surgery for hepatocellular carcinoma(HCC). Its diagnosis can be made only postoperatively on the histological specimen. to train machine-learning models to predict MVI on preoperative CT scan (fig.1). Clinical data and 3-phases CT scans were retrospectively collected among 4 Italian centres. After an initial manual segmentation, an algorithm was developed to automatically identify the liver and the tumor on CT scans. Radiomics features were automatically extracted from the tumoral, peritumoral and healthy liver areas in each phase. Principal component analysis (PCA) was performed to reduce the dimensions of the dataset. Data were divided between training (70%) and test (30%) sets. Random-Forest (RF), fully connected Artificial neural network (neuralnet) and extreme gradient boosting (XGB) models were fitted to predict MVI. Hyperparameters tuning was made to reduce the out-of-bag error. Between 2008 and 2022, 218 consecutive preoperative CT scans of patients affected by HCC and submitted to surgery were collected. At the histological specimen 33.02% patients had MVI. The Jaccard index between manual and algorithm segmentations was 90%. First and second order radiomics features were extracted, obtaining 672 variables per patient. PCA selected 58 dimensions explaining >95% of the variance. After standardization and normalization, RF, neuralnet and XGB were fitted to predict the presence of MVI. Tuning parameters were: 1) RF: n.tree=500, mtry=30; 2) Neuralnet: 2 hidden layer with 40 and 20 neurons, learning rate= 0.001, threshold for termination= 1%, activation function= sigmoid; 3) XGB: nrounds = 100, max_depth = 3, eta = 0.3. The models were then fitted in the testset to estimate prediction accuracy by confusion-matrix. RF was the best performer (Acc=98.4%, 95%CI: 0.91-0.99, Sens: 95.2%, Spec: 100%, PPV: 100% and NPV: 97.7%, fig.2). RF model predicted automatically MVI with a never-before reached accuracy [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

8. Cross-clade immune responses to Gag p24 in patients infected with different HIV-1 subtypes and correlation with HLA class I and II alleles

Author

Gudmundsdotter, L., Bernasconi, D., Hejdeman, B., Sandstrom, E., Alaeus, A., Lidman, K., Ensoli, B., Wahren, B., and Buttò, S.

Subjects
*HIV-positive persons, *HLA class II antigens, *GTPASE-activating protein, *IMMUNE response, *EPITOPES, *T cells, *MEDICAL care
Abstract

Abstract: Individuals infected with different subtypes of HIV-1 (A, B, C, D, CRF01_AE and CRF02_AG) were analyzed for their antigen-specific immune response with respect to their HLA genetics. The p24 Gag protein was selected for analysis, since previous studies of the same cohort of patients had shown that almost 80% of these individuals responded to Gag peptides of subtypes A, B and/or C. A large number of Gag antigen-specific responses were recorded. Both previously recognized as well as new epitopes were identified, assumed to bind HLA classes I and/or II. Fifteen individuals showed class I cellular responses to T cell epitopes irrespective of the infecting virus subtype. For five individuals infected with subtypes A, B, D and CRF02_AG, new T cell epitopes are described. Responses related to the patient''s class I alleles are frequent, and several new putative class II responses were found. [Copyright &y& Elsevier]

Published
2008
Full Text
View/download PDF

9. Sensitivity of the thermohaline circulation during the Messinian: Toward constraining the dynamics of Mediterranean deoxygenation.

Author

Mancini, A.M., Gennari, R., Lozar, F., Natalicchio, M., Della Porta, G., Bernasconi, D., Pellegrino, L., Dela Pierre, F., Martire, L., and Negri, A.

Subjects
*OCEAN temperature, *MERIDIONAL overturning circulation, *DEOXYGENATION, *GLOBAL warming, *ECOLOGICAL disturbances, *CLIMATE change
Abstract

During the Messinian, the sensitivity of the Mediterranean Basin to ecosystem perturbation was enhanced in response to the progressive restriction of water exchange with the Atlantic Ocean. The widespread deposition of organic-rich layers (i.e. sapropel) during the Messinian testifies the perturbation of the carbon and oxygen cycles; indeed, these sediments were deposited under conditions of oxygen starvation, presumably in response to a periodic deterioration of the thermohaline circulation strength. Disentangling the causes, the effect and magnitude of the thermohaline circulation weakening during the geological past is crucial for better constraining present and near-future deoxygenation dynamics in the Mediterranean region under the current climate warming. For this purpose, we investigate a Messinian sapropel-bearing succession cropping out at Monte dei Corvi (Ancona, central Italy) with mineralogical, petrographic, micropaleontological and stable Carbon and Oxygen isotopic analyses. We show that sapropel layers were deposited in response to an increase of the sea surface buoyancy, which hampered the thermohaline circulation and thus the oxygenation of bottom water, in turn affecting the bioturbating organisms. Within the lithological cycle, the recovery of an efficient thermohaline circulation is recorded by thin packstone layers underlying the marly limestone/marlstone, which record intense bottom currents. The marly limestone/marlstone accumulated during periods of intense primary productivity and organic carbon export to the sea bottom, which promoted bottom hypoxia but not organic matter preservation. We infer that these lithological changes resulted from variations in the Adriatic Deep Water formation system, controlled by precession-driven climatic and oceanographic changes. By integrating previously published Sea Surface Temperature (SST) with new isotopic and mineralogical data, we show that variations in Sea Surface Salinity (SSS) were the leading factor controlling sapropel deposition, minimizing the role of primary productivity. The SSTs characterizing the sapropel deposits are close to the range of those projected in the Eastern Mediterranean at the end of this century under climate warming. In this scenario, future warming will be coupled with SSS increase, which will counteract the density loss provided by temperature, making the bottom deoxygenation in the Eastern Mediterranean abysses unlikely. However, additional forcing, such as winter heat waves and eutrophication, could contribute to negatively affecting the Mediterranean oxygen balance and should be considered in model-based projections. • The Monte dei Corvi recorded the changes in the ADW formation during the Messinian. • The bottom deoxygenation resulted from variations in the freshwater input. • Future deoxygenation in Mediterranean can be provided by productivity or heatwaves. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

10. Amplified antigen-specific immune responses in HIV-1 infected individuals in a double blind DNA immunization and therapy interruption trial

Author

Gudmundsdotter, L., Wahren, B., Haller, B.K., Boberg, A., Edbäck, U., Bernasconi, D., Buttò, S., Gaines, H., Imami, N., Gotch, F., Lori, F., Lisziewicz, J., Sandström, E., and Hejdeman, B.

Subjects
*GENE amplification, *IMMUNE response, *HIV-positive persons, *DNA vaccines, *IMMUNOTHERAPY, *ANTIRETROVIRAL agents, *TRANSDERMAL medication, *VIRAL replication
Abstract

Abstract: Immunotherapy in patients with HIV-1 infection aims to restore and broaden immunological competence, reduce viral load and thereby permit longer periods without combined antiretroviral treatment (cART). Twelve HIV-1-infected patients on cART were immunized on the skin with DNA plasmids containing genes of several HIV-1 subtypes with or without the addition of hydroxyurea (HU), or with placebo. The mean net gain of HIV-specific CD8+ T cell responses were higher and broader in the HIV DNA vaccine groups compared to non-vaccinated individuals (p <0.05). The vaccine-induced immune responses per se had no direct effect on viral replication. In all patients combined, including placebo, the viral set point after a final structured therapy interruption (STI) was lower than prior to initiation of cART (p =0.003). Nadir CD4 levels appeared to strongly influence the post-STI viral titers. After the sixth immunization or placebo, patients could stay off cART for a median time of 15 months. The study shows that HIV DNA immunization induces broader and higher magnitudes of HIV-specific immune responses compared to structured therapy interruptions alone. Although compromised by small numbers of patients, the study also demonstrates that well-monitored STI may safely function as an immunological read out of HIV vaccine efficacy. [Copyright &y& Elsevier]

Published
2011
Full Text
View/download PDF

11. Estimating liver function in a large cirrhotic cohort: Signal intensity of gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI

Author

Alessandro Giani, Luca Gianotti, Davide Gandola, Davide Paolo Bernasconi, Sandro Sironi, Anna Pecorelli, E Pinotti, Fabrizio Romano, Davide Ippolito, Simone Famularo, Eleonora Benedetta Orsini, Ippolito, D, Famularo, S, Giani, A, Orsini, E, Pecorelli, A, Pinotti, E, Gandola, D, Romano, F, Sironi, S, Bernasconi, D, and Gianotti, L

Subjects
Gadolinium DTPA, Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, Bilirubin, Contrast Media, Gastroenterology, Liver cirrhosi, 03 medical and health sciences, chemistry.chemical_compound, Liver disease, 0302 clinical medicine, Magnetic resonance imaging, Liver Function Tests, Internal medicine, medicine, Humans, Aged, Retrospective Studies, Hepatology, medicine.diagnostic_test, business.industry, Albumin, Gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI, Middle Aged, medicine.disease, Image Enhancement, chemistry, Italy, Liver, 030220 oncology & carcinogenesis, Liver function test, Cohort, 030211 gastroenterology & hepatology, Female, Liver function, business, Liver function tests
Abstract

Background: To assess whether gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid-enhanced MRI study is useful to estimate liver function in comparison to the presence or absence of cirrhosis, Child Pugh (CP), Model for End-stage Liver Disease (MELD), ALBI scores and biochemical test. Methods: We retrospectively reviewed all consecutive Gd-EOB-DTPA-enhanced-MRI studies performed between 2010 and 2016 in patients with focal liver lesions undergoing clinical evaluation. Patients were divided in study and control group according to the presence of cirrhosis, and then classified by CP, MELD and ALBI. Signal intensity was calculated through the liver-to-muscle ratio in portal- (SI-POR) and hepatobiliary-phase(SI-HEP). Results: Three-hundred-three Gd-EOB-DTPA liver-enhanced-MRI studies were included. One-hundred-ninety-one patients (63%) were cirrhotic. SI-HEP was significantly lower in cirrhotic group (0.55 ± 0.29 vs 0.66 ± 0.40, p = 0.004).The SI-HEP progressively decreased from CP-A to CP-C (0.59 ± 0.28 to 0.25 ± 0.19, p < 0.0001) and a significant difference was found between MELD ≤ 9 and MELD > 9 groups (0.61 ± 0.31 vs 0.49 ± 0.28, p = 0.007). No differences between ALBI grades were evident. Among biochemical parameters a moderate correlation was found among SI-HEP and total bilirubin, AST and albumin. Conclusion: SI-HEP after Gd-EOB-DTPA-enhanced-MRI effectively stratified patients with different Child Pugh grades and MELD scores. This technique could hence be useful as a novel radiological marker to estimate the underlying liver function.

Published
2019

Catalog

Books, media, physical & digital resources
See catalog results