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1. Self-reported nonceliac wheat sensitivity in an outpatient digestive endoscopy center: high frequency but insufficient medical approach

Author: Antonio Carroccio, Pasquale Mansueto, Ornella Giambalvo, Roberto Sichera, Maurizio Soresi, Sergio Peralta, Simona Perricone, Francesco La Blasca, Mansueto, Pasquale, Soresi, Maurizio, Peralta, Sergio, Perricone, Simona, La Blasca, Francesco, Sichera, Roberto, Giambalvo, Ornella, and Carroccio, Antonio
Subjects: Diarrhea, Male, medicine.medical_specialty, Allergy, Settore MED/09 - Medicina Interna, Glutens, non-celiac wheat sensitivity, Colonoscopy, dyspepsia, Wheat Hypersensitivity, Asymptomatic, Endoscopy, Gastrointestinal, Diet, Gluten-Free, Intolerances, Internal medicine, Outpatients, medicine, Hypersensitivity, Humans, endoscopy, gastro-esophageal reflux, Depression (differential diagnoses), gluten-related disease, irritable bowel syndrome, Hepatology, medicine.diagnostic_test, investigation, business.industry, Gastroenterology, medicine.disease, Celiac Disease, GERD, Female, Self Report, medicine.symptom, business, Wheat allergy
Abstract: Objective: 'Self-reported wheat sensitivity' (SRWS) is a self-reported condition caused by wheat ingestion in the absence of celiac disease or wheat allergy. The aim of the study was to investigate the frequency and characteristics of SRWS in outpatients referred for digestive endoscopy. Methods: The study, performed at the University of Palermo, enrolled 496 outpatients. Results: Seven individuals (1.4%) had an already established diagnosis of celiac disease. The questionnaire was administered to the other 489 individuals: 98 subjects (20%) were SRWS, the remaining 391 served as controls (i.e. not-SRWS). SRWS patients were younger (P
Published: 2021

2. Wheat consumption leads to immune activation and symptom worsening in patients with familial mediterranean fever : a pilot randomized trial

Author: Antonio Carroccio, Pasquale Mansueto, Maurizio Soresi, Francesca Fayer, Diana Di Liberto, Erika Monguzzi, Marianna Lo Pizzo, Francesco La Blasca, Girolamo Geraci, Alice Pecoraro, Francesco Dieli, Detlef Schuppan, and Antonio Carroccio, Pasquale Mansueto, Maurizio Soresi, Francesca Fayer, Diana Di Liberto, Erika Monguzzi, Marianna Lo Pizzo, Francesco La Blasca, Girolamo Geraci, Alice Pecoraro, Francesco Dieli, Detlef Schuppan
Subjects: Adult, Male, non-celiac wheat sensitivity, CD14 lymphocytes, Lipopolysaccharide Receptors, 610 Medizin, lcsh:TX341-641, Wheat Hypersensitivity, Monocytes, Article, Double-Blind Method, AIDAI score, 610 Medical sciences, Humans, Triticum, Cross-Over Studies, interleukin-1beta, Tumor Necrosis Factor-alpha, CD14 lymphocyte, food and beverages, Familial Mediterranean Fever, Disease Progression, Female, tumor necrosis factor-α, lcsh:Nutrition. Foods and food supply, amylase trypsin inhibitor
Abstract: We have identified a clinical association between self-reported non-celiac wheat sensitivity (NCWS) and Familial Mediterranean Fever (FMF). Objectives: A) To determine whether a 2-week double-blind placebo-controlled (DBPC) cross-over wheat vs. rice challenge exacerbates the clinical manifestations of FMF, B) to evaluate innate immune responses in NCWS/FMF patients challenged with wheat vs. rice. The study was conducted at the Department of Internal Medicine of the University Hospital of Palermo and the Hospital of Sciacca, Italy. Six female volunteers with FMF/NCWS (mean age 36 &plusmn, 6 years) were enrolled, 12 age-matched non-FMF, NCWS females, and 8 sex- and age-matched healthy subjects served as controls. We evaluated: 1. clinical symptoms by the FMF-specific AIDAI (Auto-Inflammatory Diseases Activity Index) score, 2. serum soluble CD14 (sCD14), C-reactive protein (CRP), and serum amyloid A (SSA), 3. circulating CD14+ monocytes expressing interleukin (IL)-1&beta, and tumor necrosis factor (TNF)-&alpha, The AIDAI score significantly increased in FMF patients during DBPC with wheat, but not with rice (19 &plusmn, 6.3 vs. 7 &plusmn, 1.6, p = 0.028). sCD14 values did not differ in FMF patients before and after the challenge, but were higher in FMF patients than in healthy controls (median values 11357 vs. 8710 pg/ml, p = 0.002). The percentage of circulating CD14+/IL-1&beta, + and of CD14+/TNF-&alpha, + monocytes increased significantly after DBPC with wheat vs. baseline or rice challenge. Self-reported NCWS can hide an FMF diagnosis. Wheat ingestion exacerbated clinical and immunological features of FMF. Future studies performed on consecutive FMF patients recruited in centers for auto-inflammatory diseases will determine the real frequency and relevance of this association.
Published: 2020
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3. Risk perception and knowledge of COVID-19 in patients with celiac disease

Author: Miguel Montoro Huguet, Donald R. Duerksen, Juan Pablo Stefanolo, Julio C. Bai, Sonia I. Niveloni, Pasquale Mansueto, Antonio Carroccio, Peter H.R. Green, E. Smecuol, Caroline L Seiler, Elena F. Verdu, Luis Uzcanga Dominguez, Jason A. Tye-Din, Virginia López, María de la Paz Temprano, Elena Trucco, Vivas Santiago, Enrique de-Madaria, Alberto Caminero, Carolina Ciacci, Benjamin Lebwohl, Andrew S. Day, Carolina Olano, M Ines Pinto-Sanchez, Jamie Zhen, Zhen, Jamie, Stefanolo, Juan Pablo, Temprano, María de la Paz, Seiler, Caroline L, Caminero, Alberto, de-Madaria, Enrique, Huguet, Miguel Montoro, Santiago, Viva, Niveloni, Sonia Isabel, Smecuol, Edgardo Gustavo, Dominguez, Luis Uzcanga, Trucco, Elena, Lopez, Virginia, Olano, Carolina, Mansueto, Pasquale, Carroccio, Antonio, Green, Peter H, Duerksen, Donald, Day, Andrew S, Tye-Din, Jason A, Bai, Julio César, Ciacci, Carolina, Verdú, Elena F, Lebwohl, Benjamin, and Pinto-Sanchez, M Ines
Subjects: Risk, Male, medicine.medical_specialty, Population, Observational Study, Disease, Logistic regression, Odds, 03 medical and health sciences, 0302 clinical medicine, COVID-19 Testing, Celiac disease, Medicine, Humans, COVID-19, Celiac disease, Coronavirus, Gluten, Infection, Knowledge, Perception, Risk, education, Aged, education.field_of_study, COVID-19, Coronavirus, Gluten, Infection, Knowledge, Perception, SARS-CoV-2, Celiac Disease, business.industry, Public health, fungi, Gastroenterology, General Medicine, Odds ratio, Mental health, Risk perception, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business, Demography
Abstract: BACKGROUND We recently demonstrated that the odds of contracting coronavirus disease 2019 (COVID-19) in patients with celiac disease (CeD) is similar to that of the general population. However, how patients with CeD perceive their COVID-19 risk may differ from their actual risk. AIM To investigate risk perceptions of contracting COVID-19 in patients with CeD and determine the factors that may influence their perception. METHODS We distributed a survey throughout 10 countries between March and June 2020 and collected data on demographics, diet, COVID-19 testing, and risk perceptions of COVID-19 in patients with CeD. Participants were recruited through various celiac associations, clinic visits, and social media. Risk perception was assessed by asking individuals whether they believe patients with CeD are at an increased risk of contracting COVID-19 when compared to the general population. Logistic regression was used to determine the influencing factors associated with COVID-19 risk perception, such as age, sex, adherence to a gluten-free diet (GFD), and comorbidities such as cardiac conditions, respiratory conditions, and diabetes. Data was presented as adjusted odds ratios (aORs) RESULTS A total of 10737 participants with CeD completed the survey. From them, 6019 (56.1%) patients with CeD perceived they were at a higher risk or were unsure if they were at a higher risk of contracting COVID-19 compared to the non-CeD population. A greater proportion of patients with CeD perceived an increased risk of contracting COVID-19 when compared to infections in general due to their CeD (56.1% vs 26.7%, P < 0.0001). Consequently, 34.8% reported taking extra COVID-19 precautions as a result of their CeD. Members of celiac associations were less likely to perceive an increased risk of COVID-19 when compared to non-members (49.5% vs 57.4%, P < 0.0001). Older age (aOR: 0.99; 95%CI: 0.99 to 0.99, P < 0.001), male sex (aOR: 0.84; 95%CI: 0.76 to 0.93, P = 0.001), and strict adherence to a GFD (aOR: 0.89; 95%CI: 0.82 to 0.96, P = 0.007) were associated with a lower perception of COVID-19 risk and the presence of comorbidities was associated with a higher perception of COVID-19 risk (aOR: 1.38; 95%CI: 1.22 to 1.54, P < 0.001). CONCLUSION Overall, high levels of risk perceptions, such as those found in patients with CeD, may increase an individual's pandemic-related stress and contribute to negative mental health consequences. Therefore, it is encouraged that public health officials maintain consistent communication with the public and healthcare providers with the celiac community. Future studies specifically evaluating mental health in CeD could help determine the consequences of increased risk perceptions in this population.
Published: 2021

4. Frequency and clinical aspects of neurological and psychiatric symptoms in patients with non-celiac wheat sensitivity

Author: Marta Chiavetta, Alessandra Giuliano, Francesca Fayer, Stella Compagnoni, Ada Maria Florena, Francesco La Blasca, Aurelio Seidita, Antonio Carroccio, Pasquale Mansueto, Andrea Affronti, Maurizio Soresi, Daniele Castellucci, Francesca Mandreucci, Carroccio A., Soresi M., Chiavetta M., La Blasca F., Compagnoni S., Giuliano A., Fayer F., Mandreucci F., Castellucci D., Seidita A., Affronti A., Florena A.M., and Mansueto P.
Subjects: 0301 basic medicine, duodenal lymphocytosis, Adult, Male, medicine.medical_specialty, Lymphocytosis, non-celiac wheat sensitivity, Disease, Wheat Hypersensitivity, Gastroenterology, Article, Duodenal lymphocytosis, HLA, Irritable bowel syndrome, Multiple food hypersensitivity, Neuropsychiatric symptoms, Non-celiac wheat sensitivity, Adult, Celiac Disease, Female, Humans, Irritable Bowel Syndrome, Male, Nervous System Diseases, Wheat Hypersensitivity, Irritable Bowel Syndrome, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Ingestion, Humans, In patient, TX341-641, multiple food hypersensitivity, Irritable bowel syndrome, Nutrition and Dietetics, business.industry, Nutrition. Foods and food supply, medicine.disease, Wheat hypersensitivity, HLA, Celiac Disease, 030104 developmental biology, Duodenal mucosa, 030211 gastroenterology & hepatology, neuropsychiatric symptoms, Female, medicine.symptom, Nervous System Diseases, business, Clinical record, Food Science
Abstract: Background: Non-Celiac Wheat Sensitivity (NCWS) is characterized by both intestinal and extra-intestinal symptoms. The study aims to investigate the frequency of neuropsychiatric manifestations in NCWS patients and identify their clinical and demographic characteristics. Methods: 278 clinical records of NCWS patients, diagnosed by a double-blind placebo-controlled wheat challenge between 2006 and 2020, were retrospectively revised. Fifty-two patients with Celiac Disease (CD) and 54 patients with Irritable Bowel Syndrome (IBS) served as controls. Results: 87% of the NCWS patients had an IBS-like clinical presentation. The NCWS group showed a longer duration of symptoms, a higher frequency of positive serum anti-nuclear antibodies than CD and IBS patients, and a higher frequency of DQ2/DQ8 haplotypes and duodenal mucosa lymphocytosis than IBS controls. In addition, 50% of NCWS patients showed neuropsychiatric manifestations, while lower percentages were observed in CD (25%) and IBS (28%) controls. Neuropsychiatric symptoms in NCWS were more frequently associated with the male sex, longer duration of symptoms, and IBS-diarrhea-like clinical presentation. Conclusions: Our data suggest that in patients with IBS-like symptoms and neuropsychiatric manifestations of unknown cause, it could be useful to investigate a correlation of these symptoms with wheat ingestion to identify NCWS patients with this ‘atypical’ manifestation.
Published: 2021

5. The Risk of Contracting COVID-19 Is Not Increased in Patients With Celiac Disease

Author: Juan Pablo Stefanolo, Elena Trucco, Jamie Zhen, Edgardo Smecuol, Peter H.R. Green, Virginia López, Pasquale Mansueto, Elena F. Verdu, Premysl Bercik, Caroline L Seiler, María de la Paz Temprano, Carolina Olano, Miguel Montoro Huguet, Enrique de-Madaria, Andrew S. Day, Julio C. Bai, Luis Uscanga, Maria Ines Pinto-Sanchez, Santiago Vivas, Sonia I. Niveloni, Sebastian Tedesco, Benjamin Lebwohl, Antonio Carroccio, Jason A. Tye-Din, Alberto Caminero, Carolina Ciacci, Zhen, Jamie, Stefanolo, Juan Pablo, Temprano, Maria de la Paz, Tedesco, Sebastian, Seiler, Caroline, Caminero, Alberto Fernandez, Enrique de-Madaria, null, Huguet, Miguel Montoro, Vivas, Santiago, Niveloni, Sonia Isabel, Bercik, Premysl, Smecuol, Edgardo, Uscanga, Lui, Trucco, Elena, Lopez, Virginia, Olano, Carolina, Mansueto, Pasquale, Carroccio, Antonio, Green, Peter H R, Day, Andrew, Tye-Din, Jason, Bai, Julio Cesar, Ciacci, Carolina, Verdu, Elena, Lebwohl, Benjamin, Pinto-Sanchez, Maria Ines, Zhen J., Stefanolo J.P., Temprano M.D.L.P., Tedesco S., Seiler C., Caminero A.F., de-Madaria E., Huguet M.M., Vivas S., Niveloni S.I., Bercik P., Smecuol E., Uscanga L., Trucco E., Lopez V., Olano C., Mansueto P., Carroccio A., Green P.H.R., Day A., Tye-Din J., Bai J.C., Ciacci C., Verdu E.F., Lebwohl B., and Pinto-Sanchez M.I.
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Coronavirus disease 2019 (COVID-19), coronavirus, Disease, medicine.disease_cause, Article, 03 medical and health sciences, Diet, Gluten-Free, 0302 clinical medicine, Risk Factors, Surveys and Questionnaires, Pandemic, Odds Ratio, Medicine, Humans, In patient, Coronavirus, risk, Hepatology, business.industry, SARS-CoV-2, Case-control study, Gastroenterology, COVID-19, Odds ratio, infection, Celiac Disease, 030220 oncology & carcinogenesis, Case-Control Studies, gluten, 030211 gastroenterology & hepatology, Gluten free, Female, business
Abstract: The World Health Organization declared coronavirus disease-2019 (COVID-19) a global pandemic in March 2020. Since then, there are more than 34 million cases of COVID-19 leading to more than 1 million deaths worldwide. Numerous studies suggest that celiac disease (CeD), a chronic immune-mediated gastrointestinal condition triggered by gluten, is associated with an increased risk of respiratory infections.(1-3) However, how it relates to the risk of COVID-19 is unknown. To address this gap, we conducted a cross-sectional study to evaluate whether patients with self-reported CeD are at an increased risk of contracting COVID-19.
Published: 2021

6. TNF-α, IL-17, and IL-22 production in the rectal mucosa of nonceliac wheat sensitivity patients: role of adaptive immunity

Author: Francesco Dieli, Aurelio Seidita, Francesca Fayer, Antonio Carroccio, Maurizio Soresi, Marianna Lo Pizzo, Diana Di Liberto, Girolamo Geraci, Ada Maria Florena, Pasquale Mansueto, Antonio Giulio Giannone, Francesco La Blasca, Alberto D'Alcamo, Mansueto, Pasquale, Di Liberto, Diana, Fayer, Francesca, Soresi, Maurizio, Geraci, Girolamo, Giannone, Antonino Giulio, Seidita, Aurelio, D'Alcamo, Alberto, Blasca, Francesco La, Lo Pizzo, Marianna, Florena, Ada Maria, Dieli, Francesco, and Carroccio, Antonio
Subjects: Adult, Male, medicine.medical_specialty, Necrosis, Settore MED/09 - Medicina Interna, Physiology, non-celiac wheat sensitivity, Biopsy, TNF, Wheat Hypersensitivity, Adaptive Immunity, Gastroenterology, Interleukin 22, Pathogenesis, Young Adult, Immune system, Double-Blind Method, Antigens, CD, Physiology (medical), Internal medicine, medicine, IL-22, Humans, Mucous Membrane, Hepatology, business.industry, Tumor Necrosis Factor-alpha, Interleukins, Interleukin-17, Rectum, Colonoscopy, Middle Aged, Acquired immune system, Lymphocyte Subsets, IL-17, Tumor necrosis factor alpha, Female, Interleukin 17, medicine.symptom, business, CD8
Abstract: In recent years, a new gluten- or wheat-related disease has emerged, a condition labeled "nonceliac gluten sensitivity" (NCGS) or "nonceliac wheat sensitivity" (NCWS). NCWS pathogenesis is still uncertain and attributed to very different mechanisms. We aimed to study the different T-lymphocyte subsets in the rectal mucosa of NCWS patients to demonstrate the possible contribution of adaptative immune response. Twelve patients (11 women, 1 man, age range 23-61 yr, median 32 yr) with a definitive diagnosis of NCWS were recruited at random for the present study. They underwent rectal endoscopy with multiple mucosal biopsies at the end of a double-blind placebo-controlled (DBPC) wheat challenge when they reported the reappearance of the symptoms. As controls we included 11 "healthy patients", sex- and age-matched with the patients who underwent colonoscopy evaluation for rectal bleeding due to hemorrhoids. Cells freshly obtained from rectal tissue were stained to detect anti-CD45, anti-CD3, anti-CD4, and anti-CD8. Furthermore, intracellular staining was performed with anti-tumor necrosis factor (TNF)-α, anti-interleukin (IL)-17, and anti-IL-22. Production of TNF-α by CD45+, CD3+, CD4+, and CD8+ cells, as well as of IL-17 by CD4+ cells, was higher in the rectal tissue of NCWS patients than in controls. On the contrary, IL-22 production by CD8+ cells was lower in NCWS patients than in the controls. In NCWS patients diagnosed by DBPC wheat challenge, there is a complex immunological activation, with a significant role for the adaptive response.NEW & NOTEWORTHY Nonceliac wheat sensitivity (NCWS) is a syndrome characterized by symptoms triggered by gluten intake. The pathogenesis is still uncertain. Studies have shown a role for innate immunity. We demonstrated that production of TNF-α by CD45+, CD3+, CD4+, and CD8+ cells and of IL-17 by CD4+ cells is higher in the rectal tissue of NCWS patients than in controls. We clearly demonstrated that in patients with NCWS there is a significant role for the adaptive response.
Published: 2020

7. Autoimmunity Features in Patients With Non-Celiac Wheat Sensitivity

Author: Giuseppina Candore, Chiara Garlisi, Ada Maria Florena, Marcello Ciaccio, Pasquale Mansueto, Maurizio Soresi, Giacomo Caio, Alberto D'Alcamo, Antonio Carroccio, Roberto De Giorgio, Francesca Fayer, Aurelio Seidita, Caterina Maria Gambino, Girolamo Geraci, Umberto Volta, Bruna Lo Sasso, Francesco La Blasca, Mansueto, Pasquale, Soresi, Maurizio, Candore, Giuseppina, Garlisi, Chiara, Fayer, Francesca, Gambino, Caterina Maria, La Blasca, Francesco, Seidita, Aurelio, DʼAlcamo, Alberto, Lo Sasso, Bruna, Florena, Ada Maria, Geraci, Girolamo, Caio, Giacomo, Volta, Umberto, De Giorgio, Roberto, Ciaccio, Marcello, and Carroccio, Antonio
Subjects: Adult, Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Lymphocytosis, Anti-nuclear antibody, Autoimmunity, Wheat Hypersensitivity, medicine.disease_cause, Gastroenterology, Iodide Peroxidase, NO, Autoimmune Diseases, Autoimmune thyroiditis, 03 medical and health sciences, 0302 clinical medicine, Sex Factors, Thyroid peroxidase, Internal medicine, Surveys and Questionnaires, Medicine, Humans, Prospective Studies, Irritable bowel syndrome, Aged, Autoantibodies, Non-Celiac Wheat Sensitivity, Hepatology, biology, business.industry, Autoantibody, Age Factors, Middle Aged, medicine.disease, Haplotypes, Italy, 030220 oncology & carcinogenesis, Case-Control Studies, biology.protein, 030211 gastroenterology & hepatology, Female, medicine.symptom, business, Wheat allergy
Abstract: INTRODUCTION: Nonceliac wheat sensitivity (NCWS) is characterized by intestinal and extraintestinal manifestations consequent to wheat ingestion in subjects without celiac disease and wheat allergy. Few studies investigated the relationship between NCWS and autoimmunity. The aim of this study is to evaluate the frequency of autoimmune diseases (ADs) and autoantibodies in patients with NCWS. METHODS: Ninety-one patients (13 men and 78 women; mean age of 40.9 years) with NCWS, recruited in a single center, were included. Seventy-six healthy blood donors (HBD) and 55 patients with a diagnosis of irritable bowel syndrome (IBS) unrelated to NCWS served as controls. Autoantibodies levels were measured. Human leukocyte antigen haplotypes were determined, and duodenal histology performed in all patients carrying the DQ2/DQ8 haplotypes. Participants completed a questionnaire, and their medical records were reviewed to identify those with ADs. RESULTS: Twenty-three patients with NCWS (25.3%) presented with ADs; autoimmune thyroiditis (16 patients, 17.6%) was the most frequent. The frequency of ADs was higher in patients with NCWS than in HBD (P 5 0.002) and in patients with IBS (P 5 0.05). In the NCWS group, antinuclear antibodies tested positive in 71.4%vsHBD19.7%, and vs patients with IBS 21.8% (P < 0.0001 for both). The frequency of extractable nuclear antigen antibody (ENA) positivity was significantly higher in patients with NCWS (21.9%) than in HBD (0%) and patients with IBS (3.6%) (P 5 0.0001 and P 5 0.004, respectively). Among the patients with NCWS, 9.9% tested positive for antithyroglobulin, 16.5% for antithyroid peroxidase, and 14.3% for antiparietal cell antibodies; frequencies were not statistically different from controls. The presence of ADs was related to older age at NCWS diagnosis, female sex, duodenal lymphocytosis, and eosinophil infiltration. DISCUSSION: One in 4 patients withNCWS suffered from AD, and serum antinuclear antibodies were positive in a very high percentage of cases. These data led us to consider NCWS to be associated to ADs.
Published: 2020

8. Whole Cow’s Milk but Not Lactose Can Induce Symptoms in Patients with Self-Reported Milk Intolerance: Evidence of Cow’s Milk Sensitivity in Adults

Author: Ada Maria Florena, Francesco La Blasca, Beatrice Mantia, Chiara Garlisi, Pasquale Mansueto, Chiara Tinè, Alberto D'Alcamo, Maurizio Soresi, Aurelio Seidita, Antonio Carroccio, Francesca Fayer, Carroccio A., Soresi M., Mantia B., Fayer F., La Blasca F., Seidita A., D'alcamo A., Florena A.M., Tine C., Garlisi C., and Mansueto P.
Subjects: Adult, Male, medicine.medical_specialty, Placebo, Gastroenterology, Asymptomatic, Article, duodenal histology, Irritable Bowel Syndrome, chemistry.chemical_compound, Double-Blind Method, self-reported milk intolerance, IBS, Internal medicine, medicine, Animals, Humans, TX341-641, Prospective Studies, Lactose, Prospective cohort study, Cow’s milk protein allergy, Duodenal histology, HLA, IBS, Lactose hydrogen breath test, Lactose intolerance, Self‐reported milk intolerance, Irritable bowel syndrome, Retrospective Studies, lactose hydrogen breath test, Lactose intolerance, Nutrition and Dietetics, medicine.diagnostic_test, Nutrition. Foods and food supply, business.industry, medicine.disease, HLA, Food intolerance, lactose intolerance, Milk, Breath Tests, chemistry, Female, Self Report, Milk Hypersensitivity, medicine.symptom, business, Hydrogen breath test, cow’s milk protein allergy, Food Science
Abstract: Background: Lactose intolerance is the most frequent food intolerance, but many subjects with self-reported milk intolerance (SRMI) are asymptomatic at lactose hydrogen breath test (LHBT). The aim of this study was to evaluate the frequency of lactose intolerance in SRMI patients and their clinical characteristics. Methods: In a retrospective study, the clinical records of 314 SRMI patients (259 females, mean age: 39.1 ± 13.5 years) were reviewed; 102 patients with irritable bowel syndrome (IBS) served as controls. In a prospective study, 42 SRMI patients, negatives at the LHBT, underwent a double-blind, placebo-controlled (DBPC) whole cow’s milk challenge. Results: In the retrospective study, only 178 patients (56%) were lactose maldigesters and intolerant at LHBT; 68% of the subjects with SRMI were suffering from IBS; 74% reported dyspepsia (p = 0.0001 vs. IBS controls); and weight loss was recorded in 62 SRMI patients (20%) (p = 0.01 vs. IBS controls). Duodenal histology showed intra-epithelial lymphocytosis in about 60% of cases. In the prospective study, 36 patients (86%) experienced symptoms during the DBPC cow’s milk challenge, and only 4 patients (9%) reacted to placebo (p = 0.0001). Conclusions: A percentage of SRMI patients were not suffering from lactose intolerance. DBPC revealed that SRMI patients had clinical reactions when exposed to whole cow’s milk.
Published: 2021

9. Relationship between kidney findings and systemic vascular damage in elderly hypertensive patients without overt cardiovascular disease

Author: Giulio Geraci, Giuseppe Mulè, Antonella Castiglia, Pasquale Mansueto, Emilia Scaduto, Gabriella Paladino, Antonio Granata, Santina Cottone, Calogero Geraci, Marta Maria Zammuto, Federica Zotta, Geraci, G., Mulè, G., Gabriella, P., Zammuto, M., Castiglia, A., Scaduto, E., Zotta, F., Geraci, C., Granata, A., Mansueto, P., and Cottone, S.
Subjects: Male, Settore MED/09 - Medicina Interna, Endocrinology, Diabetes and Metabolism, Statistics as Topic, Hemodynamics, Blood Pressure, Disease, 030204 cardiovascular system & hematology, Kidney, urologic and male genital diseases, Carotid Intima-Media Thickness, Elderly, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Ultrasonography, Doppler, Color, Pulse wave velocity, Subclinical infection, Blood Pressure and the Kidney, Carotid Arteries, medicine.anatomical_structure, Italy, Hypertension, cardiovascular system, Cardiology, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, Blood Flow Velocity, Glomerular Filtration Rate, medicine.medical_specialty, Renal function, Vascular disease, Renal disease, 03 medical and health sciences, Vascular Stiffness, English, Internal medicine, Internal Medicine, Humans, Renal haemodyanmic, Systemic vascular damage, Aged, Settore MED/14 - Nefrologia, business.industry, medicine.disease, Cross-Sectional Studies, Albuminuria, Vascular Resistance, business
Abstract: Few studies have investigated the influence of age on the relationships between systemic vascular damage, kidney dysfunction, and intrarenal hemodynamic changes in patients with hypertension without overt cardiovascular disease. The authors enrolled 126 elderly patients with hypertension (aged ≥65 years) and 350 nonelderly patients with hypertension (aged
Published: 2017

10. Body Mass Index and Associated Clinical Variables in Patients with Non-Celiac Wheat Sensitivity

Author: Antonio Carroccio, Pasquale Mansueto, Francesca Fayer, Maurizio Soresi, Alberto D'Alcamo, Francesco La Blasca, and Mansueto P., Soresi M., La Blasca F., Fayer F., D'Alcamo A., Carroccio A.
Subjects: 0301 basic medicine, Adult, Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Clinical variables, HLA haplotype, lcsh:TX341-641, autoimmune disease, Autoimmunity, Disease, Wheat Hypersensitivity, Overweight, Body Mass Index (BMI), Gastroenterology, Article, Body Mass Index, Celiac Disease (CD), 03 medical and health sciences, Irritable Bowel Syndrome (IBS), 0302 clinical medicine, Thinness, Weight loss, Internal medicine, HLA-DQ Antigens, medicine, Humans, In patient, autoimmune diseases, Irritable bowel syndrome, Retrospective Studies, Nutrition and Dietetics, business.industry, nutritional and metabolic diseases, Middle Aged, medicine.disease, Prognosis, 030104 developmental biology, Haplotypes, non-celiac wheat sensitivity (NCWS), 030211 gastroenterology & hepatology, Female, medicine.symptom, Underweight, business, lcsh:Nutrition. Foods and food supply, Body mass index, Food Science
Abstract: Background: Non-Celiac Wheat Sensitivity (NCWS) is still a largely undefined condition, due to the lack of a diagnostic marker. Few data are available about the nutritional characteristics of NCWS patients at diagnosis. Aims: To evaluate the proportion of NCWS patients who were underweight, normal weight, overweight, or obese at diagnosis, and to search for possible correlations between their Body Mass Index (BMI) and other NCWS-related disease characteristics. Patients and Methods: The clinical charts of 145 NCWS patients (125 F, 20 M, mean age 37.1 &plusmn, 11.4 years), diagnosed between January 2012 and March 2018, were reviewed. As a comparison, 84 celiac disease (CD) patients (73 F, 11 M, mean age 39.8 &plusmn, 13.9 years) were evaluated. All NCWS diagnoses were based on a double-blind placebo-controlled wheat challenge (DBPCWC) method. Results: BMI distribution was similar in the NCWS (6.2% underweight and 15.2% obese subjects) and CD patients (6% underweight and 7.1% obese subjects). Underweight NCWS subjects were significantly younger and had a shorter clinical history than the overweight or obese ones. Unlike the other NCWS patients, none of them had a DQ2 and/or DQ8 haplotype. Overweight and obese NCWS patients were more frequently suffering from associated autoimmune diseases than the other BMI categories (P = 0.05). Compared to the CD controls, NCWS patients showed a higher frequency of Irritable Bowel Syndrome (IBS)-like (P = 0.01) and extraintestinal symptoms (P = 0.03) and a longer clinical history (P = 0.04), whereas weight loss was more frequent in CD (P = 0.02). Conclusions: NCWS patients showed a BMI distribution similar to CD patients. However, NCWS was found to be a heterogenous condition that regards BMI, and clinical characteristics differed between the underweight and overweight/obese patients.
Published: 2019

11. Abdominal Ultrasound Does Not Reveal Significant Alterations in Patients With Nonceliac Wheat Sensitivity

Author: Antonino Terranova, Francesca Cavataio, Alberto D'Alcamo, Maurizio Soresi, Antonio Carroccio, Rosario Iacobucci, Francesco La Blasca, Pasquale Mansueto, Soresi, Maurizio, Mansueto, Pasquale, Terranova, Antonino, D'Alcamo, Alberto, La Blasca, Francesco, Cavataio, Francesca, Iacobucci, Rosario, and Carroccio, Antonio
Subjects: Adult, Male, medicine.medical_specialty, Non-Celiac Wheat sensitivity, Celiac Disease, Abdominal Ultrasound, Seronegative celiac disease, Double-blind placebo-controlled challenge, Settore MED/09 - Medicina Interna, Glutens, Wheat Hypersensitivity, Gastroenterology, 030218 nuclear medicine & medical imaging, Diagnosis, Differential, Irritable Bowel Syndrome, Diet, Gluten-Free, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Internal medicine, Elimination diet, Abdomen, Ascites, medicine, Humans, Mesenteric lymph nodes, Prospective Studies, Prospective cohort study, Irritable bowel syndrome, Ultrasonography, business.industry, Ultrasound, Middle Aged, medicine.disease, Celiac Disease, medicine.anatomical_structure, Female, 030211 gastroenterology & hepatology, Gluten free, medicine.symptom, Differential diagnosis, business
Abstract: GOALS: The goal of this study was (A) to evaluate abdominal ultrasound signs in nonceliac wheat sensitivity (NCWS) patients for features useful in diagnosis and (B) to compare these aspects with those of celiac patients to assess whether ultrasound can be useful in the differential diagnosis between NCWS and celiac disease (CD). BACKGROUND: NCWS diagnosis is difficult as no biomarkers of this condition have as yet been identified. In CD ultrasound aspects have been identified that have a good diagnostic accuracy. STUDY: We prospectively recruited 45 NCWS patients (11 males, 34 females; mean age 35.7 y). Three control groups were included: (A) 99 age-matched CD patients; (B) 18 patients with seronegative CD; (C) 50 patients with irritable bowel syndrome (IBS) who did not improve on a wheat-free diet. NCWS diagnosis was confirmed on the basis of an elimination diet and double-blind placebo-controlled (DBPC) challenge. Ultrasound sign investigation included: dilatation of the small bowel loops, thickening of the small bowel wall, hyperperistalsis, enlarged mesenteric lymph nodes, ascites, hyposplenism, altered diameter of the portal vein. RESULTS: NCWS patients showed a low frequency of pathologic ultrasound findings. Dilated or thickened loops appeared more often in CD patients than in NCWS patients (88.8% vs. 20%; P
Published: 2019

12. Implementation of the Frailty Index in hospitalized older patients: Results from the REPOSI register

Author: Matteo, Cesari, Carlotta, Franchi, Laura, Cortesi, Alessandro, Nobili, Ilaria, Ardoino, Pier Mannuccio Mannucci, Mauro, Tettamanti, Luca, Pasina, Francesco, Perticone, Francesco, Salerno, Salvatore, Corrao, Alessandra, Marengoni, Giuseppe, Licata, Francesco, Violi, Gino Roberto Corazza, Tarek Kamal Eldin, Maria Pia Donatella Di Blanca, Giovanna, Lanzo, Sarah, Astuto, Prisco, Domenico, Elena, Silvestri, Caterina, Cenci, Giacomo, Emmi, Gianni, Biolo, Gianfranco, Guarnieri, Michela, Zanetti, Giovanni, Fernandes, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Edoardo Alessandro Pulixi, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Teresa, Salvatore, Ferdinando Carlo Sasso, Domenico, Girelli, Olivieri, Oliviero, Thomas, Matteazzi, Mario, Barbagallo, Lidia, Plances, Roberta, Alcamo, Luigi, Calvo, Maria, Valenti, Marco, Zoli, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Giuseppe, Palasciano, Maria Ester Modeo, Maria, Peragine, Fabrizio, Pappagallo, Stefania, Pugliese, Carla Di Gennaro, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Cappellini, MARIA DOMENICA, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Marta, Mancarella, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Barbara Brignolo Ottolini, Giulia, Bonini, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Carbone, LUIGI MARIA, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Maria Rachele Meroni, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Cristina, Amione, Paolo, Fornengo, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giuseppe, Delitala, Vincenzo, Pretti, Maristella Salvatora Masala, Chiara, Pes, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Filippo Rossi Fanelli, Antonio, Amoroso, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Gabriella, D'Aurizio, Giuseppe, Romanelli, Claudia, Amolini, Deborah, Chiesa, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Giuseppe, Bellelli, Hajnalka, Szabo, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Giorgio, Sesti, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Agnelli, Giancarlo, Marchesini, Emanuela, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Aldo, Baritusso, Annalisa, Amabile, Elisabetta, Omenetto, Paolo, Scarinzi, Roberto, Manfredini, Christian, Molino, Marco, Pala, Fabio, Fabbian, Benedetta, Boari, Alfredo De Giorgi, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Claudio, Borghi, Enrico, Strocchi, Valeria De Sando, Ilaria, Pareo, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Raffaella, Valerio, Pasquale, Agosti, Flavia, Fontana, Francesca, Loparco, Caterina, Capobianco, Luigi, Fenoglio, Christian, Bracco, Alessia Valentina Giraudo, Elisa, Testa, Cristina, Serraino, Silvia, Fargion, Paola, Bonara, Giulia, Periti, Marianna, Porzio, Slivia, Tiraboschi, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Alessio, Conca, Giulia, Gobbo, Giada, Pallini, Miriam, Valenti, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Nicola Lucio Liberato, Alberto, Buratti, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Elena, Spazzini, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Paolo, Petitti, Antonio, Perciccante, Alessia, Coralli, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Cesare, Masala, Antonio, Mammarella, Valeria, Raparelli, Stefania, Basili, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Carla, Vallone, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Marta, Molaro, Bertolotti, Marco, Chiara, Mussi, Maria Vittoria Libbra, DI MICELI, Andrea, Pellegrini, Elisa, Lucia, Carulli, Francesca, Veltri, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Lidia, Colangelo, Tania, Falbo, Roberto De Giorgio, DALLA SERRA, Mauro, Valentina, Grasso, Eugenio, Ruggeri, Benzoni, Ilaria, Andrea, Salvi, Leonardi, Roberto, Chiara, Grassini, Ilenia, Mascherona, Minelli, Giorgio, Francesca, Maltese, Giampaolo, Damiani, William, Capeci, Mattioli, Massimo, Giuseppe Pio Martino, Biondi, Lorenzo, Monica, Ormas, Pietro, Pettinari, Roberto, Romiti, Silvia, Messina, Federica, Cavallaro, Riccardi, Ghio, Serena, Favorini, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Antonella, Afeltra, Pamela, Alemanno, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Julien, Blanco, Luca, Zanoli, Cattaneo, Marco Natale, Paola, Fracasso, Amoruso, MARIA VALENTINA, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Vittorio, Durante, Giovanna, Eusebi, Daniela, Tirotta, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Carlo, Vigorito, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesco, Scopelliti, Francesca, Gasparini, Melissa, Cocca, Alberto, Ballestrero, Fabio, Ferrando, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Giuseppe, Scattolin, Sergio, Martinelli, Mauro, Turrin, Leonardo, Sechi, Cristina, Catena, Gianluca, Colussi, Ramirez Duque Nieves, Muela Molinero Alberto, Abad Requejo Pedro, Lopez Pelaez Vanessa, Tamargo, Lara, Corbella Viros Xavier, Formiga, Francesc, Diez Manglano Jesus, Bejarano Tello Esperanza, Del Corral Behamonte Esther, Sevil Puras Maria, Manuel, Romero, Pinilla Llorente Blanca, Lopez Gonzalez-Cobos Cristina, Victoria, Villalba Garcia M., Lopez, Saez, Juan, Bosco, Sanz Baena Susana, Arroyo Gallego Marta, Gonzalez Becerra Concepcion, Fernandez Moyano Antonio, Mercedes Gomez Hernandez, Manuel Poyato Borrego, Pacheco Cuadros Raquel, Perez Rojas Florencia, Garcia Olid Beatriz, Carrascosa Garcia Sara, Gonzalez-Cruz Cervellera Alfonso, Peinado Martinez Marta, Sara Carrascosa Garcia, Ruiz Cantero Alberto, Albarracín Arraigosa Antonio, Godoy Guerrero Montserrat, Barón Ramos Miguel Ángel, Machin Jose Manuel, Novo Veleiro Ignacio, Alvela Suarez Lucía, Lopez, Alfonso, Rubal Bran David, Iñiguez Vazquez Iria, Rios Prego Monica, Cesari M., Franchi C., Cortesi L., Nobili A., Ardoino I., Mannucci P.M., Tettamanti M., Pasina L., Perticone F., Salerno F., Corrao S., Marengoni A., Licata G., Violi F., Corazza G.R., Eldin T.K., Di Blanca M.P.D., Lanzo G., Astuto S., Prisco D., Silvestri E., Cenci C., Emmi G., Biolo G., Guarnieri G., Zanetti M., Fernandes G., Chiuch M., Vanoli M., Grignani G., Casella G., Pulixi E.A., Bernardi M., Bassi S.L., Santi L., Zaccherini G., Mannarino E., Lupattelli G., Bianconi V., Paciullo F., Nuti R., Valenti R., Ruvio M., Cappelli S., Palazzuoli A., Salvatore T., Sasso F.C., Girelli D., Olivieri O., Matteazzi T., Barbagallo M., Plances L., Alcamo R., Calvo L., Valenti M., Zoli M., Arno R., Pasini F.L., Capecchi P.L., Bicchi M., Palasciano G., Modeo M.E., Peragine M., Pappagallo F., Pugliese S., Gennaro C.D., Postiglione A., Barbella M.R., De Stefano F., Cappellini M.D., Fabio G., Seghezzi S., De Amicis M.M., Mancarella M., Mari D., Rossi P.D., Damanti S., Ottolini B.B., Bonini G., Miceli E., Lenti M.V., Padula D., Murialdo G., Marra A., Cattaneo F., Secchi M.B., Ghelfi D., Anastasio L., Sofia L., Carbone M., Davi G., Guagnano M.T., Sestili S., Mancuso G., Calipari D., Bartone M., Meroni M.R., Perin P.C., Lorenzati B., Gruden G., Bruno G., Amione C., Fornengo P., Tassara R., Melis D., Rebella L., Delitala G., Pretti V., Masala M.S., Pes C., Bolondi L., Rasciti L., Serio I., Fanelli F.R., Amoroso A., Molfino A., Petrillo E., Zuccala G., Franceschi F., De Marco G., Chiara C., Marta S., D'aurizio G., Romanelli G., Amolini C., Chiesa D., Picardi A., Gentilucci U.V., Gallo P., Annoni G., Corsi M., Zazzetta S., Bellelli G., Szabo H., Arturi F., Succurro E., Rubino M., Sesti G., Loria P., Becchi M.A., Martucci G., Fantuzzi A., Maurantonio M., Serra M.G., Bleve M.A., Gasbarrone L., Sajeva M.R., Brucato A., Ghidoni S., Di Corato P., Agnelli G., Marchesini E., Fabris F., Carlon M., Turatto F., Baritusso A., Amabile A., Omenetto E., Scarinzi P., Manfredini R., Molino C., Pala M., Fabbian F., Boari B., De Giorgi A., Paolisso G., Rizzo M.R., Laieta M.T., Rini G., Mansueto P., Pepe I., Borghi C., Strocchi E., De Sando V., Pareo I., Sabba C., Vella F.S., Suppressa P., Valerio R., Agosti P., Fontana F., Loparco F., Capobianco C., Fenoglio L., Bracco C., Giraudo A.V., Testa E., Serraino C., Fargion S., Bonara P., Periti G., Porzio M., Tiraboschi S., Peyvandi F., Tedeschi A., Rossio R., Monzani V., Savojardo V., Folli C., Magnini M., Conca A., Gobbo G., Pallini G., Balduini C.L., Bertolino G., Provini S., Quaglia F., Dallegri F., Ottonello L., Liberale L., Chin W.S., Carassale L., Caporotundo S., Traisci G., De Feudis L., Di Carlo S., Liberato N.L., Buratti A., Tognin T., Bianchi G.B., Giaquinto S., Purrello F., Di Pino A., Piro S., Rozzini R., Falanga L., Spazzini E., Montrucchio G., Greco E., Tizzani P., Petitti P., Perciccante A., Coralli A., Salmi R., Gaudenzi P., Gamberini S., Semplicini A., Gottardo L., Vendemiale G., Serviddio G., Forlano R., Masala C., Mammarella A., Raparelli V., Basili S., Perri L., Landolfi R., Montalto M., Mirijello A., Vallone C., Bellusci M., Setti D., Pedrazzoli F., Guasti L., Castiglioni L., Maresca A., Squizzato A., Molaro M., Bertolotti M., Mussi C., Libbra M.V., Miceli A., Pellegrini E., Carulli L., Veltri F., Sciacqua A., Quero M., Bagnato C., Colangelo L., Falbo T., De Giorgio R., Serra M., Grasso V., Ruggeri E., Ilaria B., Salvi A., Leonardi R., Grassini C., Mascherona I., Minelli G., Maltese F., Damiani G., Capeci W., Mattioli M., Martino G.P., Biondi L., Ormas M., Pettinari P., Romiti R., Messina S., Cavallaro F., Ghio R., Favorini S., Col A.D., Minisola S., Afeltra A., Alemanno P., Marigliano B., Pipita M.E., Castellino P., Blanco J., Zanoli L., Cattaneo M., Fracasso P., Amoruso M.V., Saracco V., Fogliati M., Bussolino C., Durante V., Eusebi G., Tirotta D., Mete F., Gino M., Cittadini A., Vigorito C., Arcopinto M., Salzano A., Bobbio E., Marra A.M., Sirico D., Moreo G., Scopelliti F., Gasparini F., Cocca M., Ballestrero A., Ferrando F., Berra S., Dassi S., Nava M.C., Graziella B., Baldassarre S., Fragapani S., Galanti G., Mascherini G., Petri C., Stefani L., Girino M., Piccinelli V., Nasso F., Gioffre V., Pasquale M., Scattolin G., Martinelli S., Turrin M., Sechi L., Catena C., Colussi G., Nieves R.D., Alberto M.M., Pedro A.R., Vanessa L.P., Lara T., Xavier C.V., Francesc F., Jesus D.M., Esperanza B.T., Esther D.C.B., Maria S.P., Romero M., Blanca P.L., Cristina L.G.-C., Victoria V.G.M., Saez L., Bosco J., Susana S.B., Marta A.G., Concepcion G.B., Antonio F.M., Hernandez M.G., Borrego M.P., Raquel P.C., Florencia P.R., Beatriz G.O., Sara C.G., Alfonso G.-C.C., Marta P.M., Garcia S.C., Alberto R.C., Antonio A.A., Montserrat G.G., Angel B.R.M., Manuel M.J., Ignacio N.V., Lucia A.S., Alfonso L., David R.B., Iria I.V., Monica R.P., Cesari, M., Franchi, C., Cortesi, L., Nobili, A., Ardoino, I., Mannucci, P. M., Tettamanti, M., Pasina, L., Perticone, F., Salerno, F., Corrao, S., Marengoni, A., Licata, G., Violi, F., Corazza, G. R., Eldin, T. K., Di Blanca, M. P. D., Lanzo, G., Astuto, S., Prisco, D., Silvestri, E., Cenci, C., Emmi, G., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Chiuch, M., Vanoli, M., Grignani, G., Casella, G., Pulixi, E. A., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Zoli, M., Arno, R., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Pugliese, S., Gennaro, C. D., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mancarella, M., Mari, D., Rossi, P. D., Damanti, S., Ottolini, B. B., Bonini, G., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Davi, G., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Delitala, G., Pretti, V., Masala, M. S., Pes, C., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala, G., Franceschi, F., De Marco, G., Chiara, C., Marta, S., D'Aurizio, G., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Szabo, H., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Turatto, F., Baritusso, A., Amabile, A., Omenetto, E., Scarinzi, P., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Pareo, I., Sabba, C., Vella, F. S., Suppressa, P., Valerio, R., Agosti, P., Fontana, F., Loparco, F., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Tiraboschi, S., Peyvandi, F., Tedeschi, A., Rossio, R., Monzani, V., Savojardo, V., Folli, C., Magnini, M., Conca, A., Gobbo, G., Pallini, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Raparelli, V., Basili, S., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Bertolotti, M., Mussi, C., Libbra, M. V., Miceli, A., Pellegrini, E., Carulli, L., Veltri, F., Sciacqua, A., Quero, M., Bagnato, C., Colangelo, L., Falbo, T., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Ilaria, B., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Damiani, G., Capeci, W., Mattioli, M., Martino, G. P., Biondi, L., Ormas, M., Pettinari, P., Romiti, R., Messina, S., Cavallaro, F., Ghio, R., Favorini, S., Col, A. D., Minisola, S., Afeltra, A., Alemanno, P., Marigliano, B., Pipita, M. E., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Nieves, R. D., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Esther, D. C. B., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Alfonso, G. -C. C., Marta, P. M., Garcia, S. C., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Angel, B. R. M., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., Monica, R. P., Cesari, M, Franchi, C, Cortesi, L, Nobili, A, Ardoino, I, Mannucci, P, Tettamanti, M, Pasina, L, Perticone, F, Salerno, F, Corrao, S, Marengoni, A, Licata, G, Violi, F, Corazza, G, Eldin, T, Di Blanca, M, Lanzo, G, Astuto, S, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Chiuch, M, Vanoli, M, Grignani, G, Casella, G, Pulixi, E, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, F, Girelli, D, Olivieri, O, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, L, Valenti, M, Zoli, M, Arno, R, Pasini, F, Capecchi, P, Bicchi, M, Palasciano, G, Modeo, M, Peragine, M, Pappagallo, F, Pugliese, S, Gennaro, C, Postiglione, A, Barbella, M, De Stefano, F, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Mancarella, M, Mari, D, Rossi, P, Damanti, S, Ottolini, B, Bonini, G, Miceli, E, Lenti, M, Padula, D, 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M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Bertolotti, M, Mussi, C, Libbra, M, Miceli, A, Pellegrini, E, Carulli, L, Veltri, F, Sciacqua, A, Quero, M, Bagnato, C, Colangelo, L, Falbo, T, De Giorgio, R, Grasso, V, Ruggeri, E, Ilaria, B, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Damiani, G, Capeci, W, Mattioli, M, Martino, G, Biondi, L, Ormas, M, Pettinari, P, Romiti, R, Messina, S, Cavallaro, F, Ghio, R, Favorini, S, Col, A, Minisola, S, Afeltra, A, Alemanno, P, Marigliano, B, Pipita, M, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, M, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Scopelliti, F, Gasparini, F, Cocca, M, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffre, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Nieves, R, Alberto, M, Pedro, A, Vanessa, L, Lara, T, Xavier, C, Francesc, F, Jesus, D, Esperanza, B, Esther, D, Maria, S, Romero, M, Blanca, P, Cristina, L, Victoria, V, Saez, L, Bosco, J, Susana, S, Marta, A, Concepcion, G, Antonio, F, Hernandez, M, Borrego, M, Raquel, P, Florencia, P, Beatriz, G, Sara, C, Alfonso, G, Marta, P, Garcia, S, Alberto, R, Antonio, A, Montserrat, G, Angel, B, Manuel, M, Ignacio, N, Lucia, A, Alfonso, L, David, R, Iria, I, Monica, R, Franchi, Carlotta, Cortesi, Laura, Nobili, Alessandro, Ardoino, Ilaria, Mannucci, Pier Mannuccio, Tettamanti, Mauro, Pasina, Luca, Perticone, Francesco, Salerno, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Licata, Giuseppe, Violi, Francesco, Corazza, Gino Roberto, Eldin, Tarek Kamal, Di Blanca, Maria Pia Donatella, Lanzo, Giovanna, Astuto, Sarah, Prisco, Domenico, Silvestri, Elena, Cenci, Caterina, Emmi, Giacomo, Biolo, Gianni, Guarnieri, Gianfranco, Zanetti, Michela, Fernandes, Giovanni, Chiuch, Massimiliano, Vanoli, Massimo, Grignani, Giulia, Casella, Gianluca, Pulixi, Edoardo Alessandro, Bernardi, Mauro, Bassi, Silvia Li, Santi, Luca, Zaccherini, Giacomo, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Nuti, Ranuccio, Valenti, Roberto, Ruvio, Martina, Cappelli, Silvia, Palazzuoli, Alberto, Salvatore, Teresa, Sasso, Ferdinando Carlo, Girelli, Domenico, Olivieri, Oliviero, Matteazzi, Thoma, Barbagallo, Mario, Plances, Lidia, Alcamo, Roberta, Calvo, Luigi, Valenti, Maria, Zoli, Marco, Arnò, Raffaella, Pasini, Franco Laghi, Capecchi, Pier Leopoldo, Bicchi, Maurizio, Palasciano, Giuseppe, Modeo, Maria Ester, Peragine, Maria, Pappagallo, Fabrizio, Pugliese, Stefania, Gennaro, Carla Di, Postiglione, Alfredo, Barbella, Maria Rosaria, De Stefano, Francesco, Cappellini, Maria Domenica, Fabio, Giovanna, Seghezzi, Sonia, De Amicis, Margherita Migone, Mancarella, Marta, Mari, Daniela, Rossi, Paolo Dionigi, Damanti, Sarah, Ottolini, Barbara Brignolo, Bonini, Giulia, Miceli, Emanuela, Lenti, Marco Vincenzo, Padula, Donatella, Murialdo, Giovanni, Marra, Alessio, Cattaneo, Federico, Secchi, Maria Beatrice, Ghelfi, Davide, Anastasio, Luigi, Sofia, Lucia, Carbone, Maria, Davì, Giovanni, Guagnano, Maria Teresa, Sestili, Simona, Mancuso, Gerardo, Calipari, Daniela, Bartone, Mosè, Meroni, Maria Rachele, Perin, Paolo Cavallo, Lorenzati, Bartolomeo, Gruden, Gabriella, Bruno, Graziella, Amione, Cristina, Fornengo, Paolo, Tassara, Rodolfo, Melis, Deborah, Rebella, Lara, Delitala, Giuseppe, Pretti, Vincenzo, Masala, Maristella Salvatora, Pes, Chiara, Bolondi, Luigi, Rasciti, Leonardo, Serio, Ilaria, Fanelli, Filippo Rossi, Amoroso, Antonio, Molfino, Alessio, Petrillo, Enrico, Zuccalà, Giuseppe, Franceschi, Francesco, De Marco, Guido, Chiara, Cordischi, Marta, Sabbatini, D'Aurizio, Gabriella, Romanelli, Giuseppe, Amolini, Claudia, Chiesa, Deborah, Picardi, Antonio, Gentilucci, Umberto Vespasiani, Gallo, Paolo, Annoni, Giorgio, Corsi, Maurizio, Zazzetta, Sara, Bellelli, Giuseppe, Szabo, Hajnalka, Arturi, Franco, Succurro, Elena, Rubino, Mariangela, Sesti, Giorgio, Loria, Paola, Becchi, Maria Angela, Martucci, Gianfranco, Fantuzzi, Alessandra, Maurantonio, Mauro, Serra, Maria Grazia, Bleve, Maria Antonietta, Gasbarrone, Laura, Sajeva, Maria Rosaria, Brucato, Antonio, Ghidoni, Silvia, Di Corato, Paola, Agnelli, Giancarlo, Marchesini, Emanuela, Fabris, Fabrizio, Carlon, Michela, Turatto, Francesca, Baritusso, Aldo, Amabile, Annalisa, Omenetto, Elisabetta, Scarinzi, Paolo, Manfredini, Roberto, Molino, Christian, Pala, Marco, Fabbian, Fabio, Boari, Benedetta, De Giorgi, Alfredo, Paolisso, Giuseppe, Rizzo, Maria Rosaria, Laieta, Maria Teresa, Rini, Giovanbattista, Mansueto, Pasquale, Pepe, Ilenia, Borghi, Claudio, Strocchi, Enrico, De Sando, Valeria, Pareo, Ilaria, Sabbà, Carlo, Vella, Francesco Saverio, Suppressa, Patrizia, Valerio, Raffaella, Agosti, Pasquale, Fontana, Flavia, Loparco, Francesca, Capobianco, Caterina, Fenoglio, Luigi, Bracco, Christian, Giraudo, Alessia Valentina, Testa, Elisa, Serraino, Cristina, Fargion, Silvia, Bonara, Paola, Periti, Giulia, Porzio, Marianna, Tiraboschi, Slivia, Peyvandi, Flora, Tedeschi, Alberto, Rossio, Raffaella, Monzani, Valter, Savojardo, Valeria, Folli, Christian, Magnini, Maria, Conca, Alessio, Gobbo, Giulia, Pallini, Giada, Valenti, Miriam, Balduini, Carlo L., Bertolino, Giampiera, Provini, Stella, Quaglia, Federica, Dallegri, Franco, Ottonello, Luciano, Liberale, Luca, Chin, Wu Sheng, Carassale, Laura, Caporotundo, Silvia, Traisci, Giancarlo, De Feudis, Lucrezia, Di Carlo, Silvia, Liberato, Nicola Lucio, Buratti, Alberto, Tognin, Tiziana, Bianchi, Giovanni Battista, Giaquinto, Sabrina, Purrello, Francesco, Di Pino, Antonino, Piro, Salvatore, Rozzini, Renzo, Falanga, Lina, Spazzini, Elena, Montrucchio, Giuseppe, Greco, Elisabetta, Tizzani, Pietro, Petitti, Paolo, Perciccante, Antonio, Coralli, Alessia, Salmi, Raffaella, Gaudenzi, Piergiorgio, Gamberini, Susanna, Semplicini, Andrea, Gottardo, Lucia, Vendemiale, Gianluigi, Serviddio, Gaetano, Forlano, Roberta, Masala, Cesare, Mammarella, Antonio, Raparelli, Valeria, Basili, Stefania, Perri, Ludovica, Landolfi, Raffaele, Montalto, Massimo, Mirijello, Antonio, Vallone, Carla, Bellusci, Martino, Setti, Donatella, Pedrazzoli, Filippo, Guasti, Luigina, Castiglioni, Luana, Maresca, Andrea, Squizzato, Alessandro, Molaro, Marta, Bertolotti, Marco, Mussi, Chiara, Libbra, Maria Vittoria, Miceli, Andrea, Pellegrini, Elisa, Carulli, Lucia, Veltri, Francesca, Sciacqua, Angela, Quero, Michele, Bagnato, Chiara, Colangelo, Lidia, Falbo, Tania, De Giorgio, Roberto, Serra, Mauro, Grasso, Valentina, Ruggeri, Eugenio, Ilaria, Benzoni, Salvi, Andrea, Leonardi, Roberto, Grassini, Chiara, Mascherona, Ilenia, Minelli, Giorgio, Maltese, Francesca, Damiani, Giampaolo, Capeci, William, Mattioli, Massimo, Martino, Giuseppe Pio, Biondi, Lorenzo, Ormas, Monica, Pettinari, Pietro, Romiti, Roberto, Messina, Silvia, Cavallaro, Federica, Ghio, Riccardi, Favorini, Serena, Col, Anna Dal, Minisola, Salvatore, Colangelo, Luciano, Afeltra, Antonella, Alemanno, Pamela, Marigliano, Benedetta, Pipita, Maria Elena, Castellino, Pietro, Blanco, Julien, Zanoli, Luca, Cattaneo, Marco, Fracasso, Paola, Amoruso, Maria Valentina, Saracco, Valter, Fogliati, Marisa, Bussolino, Carlo, Durante, Vittorio, Eusebi, Giovanna, Tirotta, Daniela, Mete, Francesca, Gino, Miriam, Cittadini, Antonio, Vigorito, Carlo, Arcopinto, Michele, Salzano, Andrea, Bobbio, Emanuele, Marra, Alberto Maria, Sirico, Domenico, Moreo, Guido, Scopelliti, Francesco, Gasparini, Francesca, Cocca, Melissa, Ballestrero, Alberto, Ferrando, Fabio, Berra, Sergio, Dassi, Simonetta, Nava, Maria Cristina, Graziella, Bruno, Baldassarre, Stefano, Fragapani, Salvatore, Galanti, Giorgio, Mascherini, Gabriele, Petri, Cristian, Stefani, Laura, Girino, Margherita, Piccinelli, Valeria, Nasso, Francesco, Gioffrè, Vincenza, Pasquale, Maria, Scattolin, Giuseppe, Martinelli, Sergio, Turrin, Mauro, Sechi, Leonardo, Catena, Cristina, Colussi, Gianluca, Nieves, Ramirez Duque, Alberto, Muela Molinero, Pedro, Abad Requejo, Vanessa, Lopez Pelaez, Lara, Tamargo, Xavier, Corbella Viro, Francesc, Formiga, Jesus, Diez Manglano, Esperanza, Bejarano Tello, Esther, Del Corral Behamonte, Maria, Sevil Pura, Romero, Manuel, Blanca, Pinilla Llorente, Cristina, Lopez Gonzalez-Cobo, Victoria, Villalba Garcia M., Saez, Lopez, Bosco, Juan, Susana, Sanz Baena, Marta, Arroyo Gallego, Concepcion, Gonzalez Becerra, Antonio, Fernandez Moyano, Hernandez, Mercedes Gomez, Borrego, Manuel Poyato, Raquel, Pacheco Cuadro, Florencia, Perez Roja, Beatriz, Garcia Olid, Sara, Carrascosa Garcia, Alfonso, Gonzalez-Cruz Cervellera, Marta, Peinado Martinez, Garcia, Sara Carrascosa, Alberto, Ruiz Cantero, Antonio, Albarracín Arraigosa, Montserrat, Godoy Guerrero, Ángel, Barón Ramos Miguel, Manuel, Machin Jose, Ignacio, Novo Veleiro, Lucía, Alvela Suarez, Alfonso, Lopez, David, Rubal Bran, Iria, Iñiguez Vazquez, Monica, Rios Prego, and Alberto, M. M.
Subjects: Gerontology, Male, Multivariate analysis, Frailty, Internal medicine and geriatric wards, Multimorbidity, Physical and cognitive impairment, Internal Medicine, Psychological intervention, Predictive Value of Test, Severity of Illness Index, 0302 clinical medicine, Interquartile range, Frailty, Internal medicine and geriatric wards, Multimorbidity, Physical and cognitive impairment, 80 and over, Medicine, 030212 general & internal medicine, Prospective Studies, Hospital Mortality, Prospective cohort study, Multivariate Analysi, Aged, 80 and over, Prognosis, Aged, Female, Geriatric Assessment, Hospitalization, Humans, Italy, Multivariate Analysis, Predictive Value of Tests, Regression Analysis, Survival Analysis, Frail Elderly, Predictive value of tests, Survival Analysi, Cohort study, Human, Prognosi, Socio-culturale, Regression Analysi, 03 medical and health sciences, Severity of illness, Survival analysis, business.industry, Internal medicine and geriatric ward, Prospective Studie, business, 030217 neurology & neurosurgery
Abstract: Background Frailty is a state of increased vulnerability to stressors, associated to poor health outcomes. The aim of this study was to design and introduce a Frailty Index (FI; according to the age-related accumulation of deficit model) in a large cohort of hospitalized older persons, in order to benefit from its capacity to comprehensively weight the risk profile of the individual. Methods Patients aged 65 and older enrolled in the REPOSI register from 2010 to 2016 were considered in the present analyses. Variables recorded at the hospital admission (including socio-demographic, physical, cognitive, functional and clinical factors) were used to compute the FI. The prognostic impact of the FI on in-hospital and 12-month mortality was assessed. Results Among the 4488 patients of the REPOSI register, 3847 were considered eligible for a 34-item FI computation. The median FI in the sample was 0.27 (interquartile range 0.21–0.37). The FI was significantly predictive of both in-hospital (OR 1.61, 95%CI 1.38–1.87) and overall (HR 1.46, 95%CI 1.32–1.62) mortality, also after adjustment for age and sex. Conclusions The FI confirms its strong predictive value for negative outcomes. Its implementation in cohort studies (including those conducted in the hospital setting) may provide useful information for better weighting the complexity of the older person and accordingly design personalized interventions.
Published: 2018

13. Risk factors for three-month mortality after discharge in a cohort of non-oncologic hospitalized elderly patients: Results from the REPOSI study

Author: Luca, Pasina, Laura, Cortesi, Mara, Tiraboschi, Alessandro, Nobili, Giovanna, Lanzo, Mauro, Tettamanti, Carlotta, Franchi, Pier Mannuccio Mannucci, Silvia, Ghidoni, Andrea, Assolari, Antonio, Brucato, Domenico, Prisco, Elena, Silvestri, Caterina, Cenci, Giacomo, Emmi, Gianni, Biolo, Gianfranco, Guarnieri, Michela, Zanetti, Giovanni, Fernandes, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Elmo, Mannarino, Graziana, Lupattelli, Vanessa, Bianconi, Francesco, Paciullo, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Teresa, Salvatore, Ferdinando Carlo Sasso, Domenico, Girelli, Oliviero, Olivieri, Thomas, Matteazzi, Mario, Barbagallo, Lidia, Plances, Roberta, Alcamo, Giuseppe, Licata, Luigi, Calvo, Maria, Valenti, Marco, Zoli, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Giuseppe, Palasciano, Maria Ester Modeo, Maria, Peragine, Fabrizio, Pappagallo, Stefania, Pugliese, Carla Di Gennaro, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Maria Domenica Cappellini, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Barbara Brignolo Ottolini, Gino Roberto Corazza, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Maria Rachele Meroni, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Cristina, Amione, Paolo, Fornengo, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giuseppe, Delitala, Vincenzo, Pretti, Maristella Salvatora Masala, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Filippo Rossi Fanelli, Antonio, Amoroso, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Giuseppe, Romanelli, Claudia, Amolini, Deborah, Chiesa, Alessandra, Marengoni, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Giuseppe, Bellelli, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Giorgio, Sesti, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Stefano, Carta, Sebastiana, Atzori, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Paola Di Corato, Giancarlo, Agnelli, Emanuela, Marchesini, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Aldo, Baritusso, Manfredini, Roberto, Christian, Molino, Marco, Pala, Fabbian, Fabio, Benedetta, Boari, Alfredo De Giorgi, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Claudio, Borghi, Enrico, Strocchi, Valeria De Sando, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Raffaella, Valerio, Caterina, Capobianco, Luigi, Fenoglio, Christian, Bracco, Alessia Valentina Giraudo, Elisa, Testa, Cristina, Serraino, Silvia, Fargion, Paola, Bonara, Giulia, Periti, Marianna, Porzio, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Francesco, Salerno, Alessio, Conca, Giulia, Gobbo, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Nicola Lucio Liberato, Alberto, Buratti, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Paolo, Petitti, Antonio, Perciccante, Alessia, Coralli, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Cesare, Masala, Antonio, Mammarella, Raparelli, Valeria, Francesco, Violi, Stefania, Basili, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Carla, Vallone, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Marta, Molaro, Marco, Bertolotti, Chiara, Mussi, Maria Vittoria Libbra, Andrea, Miceli, Elisa, Pellegrini, Lucia, Carulli, Francesco, Perticone, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Roberto, Corinaldesi, DE GIORGIO, Roberto, Mauro, Serra, Valentina, Grasso, Eugenio, Ruggeri, Andrea, Salvi, Roberto, Leonardi, Chiara, Grassini, Ilenia, Mascherona, Giorgio, Minelli, Francesca, Maltese, Armando, Gabrielli, Massimo, Mattioli, William, Capeci, Giuseppe Pio Martino, Salvatore, Corrao, Silvia, Messina, Riccardi, Ghio, Serena, Favorini, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Antonella, Afeltra, Pamela, Alemanno, Benedetta, Marigliano, Pietro, Castellino, Julien, Blanco, Luca, Zanoli, Marco, Cattaneo, Paola, Fracasso, Maria Valentina Amoruso, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Vittorio, Durante, Giovanna, Eusebi, Daniela, Tirotta, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesco, Scopelliti, Francesca, Gasparini, Melissa, Cocca, Nieves Ramirez Duque, Alberto Muela Molinero, Pedro Abad Requejo, Vanessa Lopez Pelaez, Lara, Tamargo, Xavier Corbella Viros, Francesc, Formiga, Jesus Diez Manglano, Esperanza Bejarano Tello, Esther Del Corral Behamonte, Maria Sevil Puras, Manuel, Romero, Blanca Pinilla Llorente, Cristina Lopez Gonzalez-Cobos, Victoria Villalba Garcia, M., Juan Bosco Lopez Saez, Susana Sanz Baena, Marta Arroyo Gallego, Concepcion Gonzalez Becerra, Antonio Fernandez Moyano, Mercedes Gomez Hernandez, Manuel Poyato Borrego, Raquel Pacheco Cuadros, Florencia Perez Rojas, Beatriz Garcia Olid, Sara Carrascosa Garcia, Alfonso Gonzalez-Cruz Cervellera, Marta Peinado Martinez, Alberto Ruiz Cantero, Antonio Albarracín Arraigosa, Montserrat Godoy Guerrero, Miguel Angel Barón Ramos, Jose Manuel Machin, Ignacio Novo Veleiro, Lucia Alvela Suarez, Alfonso, Lopez, David Rubal Bran, Iria Iñiguez Vazquez, and Monica Rios, Prego.
Subjects: Male, Aging, Pediatrics, Health (social science), Bedridden, 030204 cardiovascular system & hematology, Logistic regression, DISEASE, PALLIATIVE CARE, Bedridden Persons, 0302 clinical medicine, Risk Factors, 80 and over, Medicine, 030212 general & internal medicine, Hypoalbuminemia, Prospective Studies, Prospective cohort study, PREDICTORS, Aged, 80 and over, Frailty, Mortality, Prognosis, Aged, Female, Follow-Up Studies, Frail Elderly, Hospital Units, Humans, Internal Medicine, Italy, Logistic Models, Patient Discharge, Absolute risk reduction, CANCER, Severe dementia, Cohort, medicine.medical_specialty, Renal function, Socio-culturale, ILLNESS, VALIDATION, 03 medical and health sciences, SCORE, OLDER PATIENTS, business.industry, Mortality, Bedridden, Prognosis, Frailty, PALLIATIVE CARE, 6-MONTH MORTALITY, OLDER PATIENTS, VALIDATION, DISEASE, SCORE, PREDICTORS, ILLNESS, CANCER, ADULTS, ADULTS, medicine.disease, 6-MONTH MORTALITY, Physical therapy, Geriatrics and Gerontology, business, Gerontology
Abstract: Background Short-term prognosis, e.g. mortality at three months, has many important implications in planning the overall management of patients, particularly non-oncologic patients in order to avoid futile practices. The aims of this study were: i) to investigate the risk of three-month mortality after discharge from internal medicine and geriatric wards of non-oncologic patients with at least one of the following conditions: permanent bedridden status during the hospital stay; severely reduced kidney function; hypoalbuminemia; hospital admissions in the previous six months; severe dementia; ii) to establish the absolute risk difference of three-month mortality of bedridden compared to non-bedridden patients. Methods This prospective cohort study was run in 102 Italian internal medicine and geriatric hospital wards. The sample included all patients with three-months follow-up data. Bedridden condition was defined as the inability to walk or stand upright during the whole hospital stay. The following parameters were also recorded: estimated GFR ≤ 29 mL/min/1.73 m2; severe dementia; albuminemia ≪2.5 g/dL; hospital admissions in the six months before the index admission. Results Of 3915 patients eligible for the analysis, three-month follow-up were available for 2058, who were included in the study. Bedridden patients were 112 and the absolute risk difference of mortality at three months was 0.13 (CI 95% 0.08–0.19, p ≪ 0.0001). Logistic regression analysis also adjusted for age, sex, number of drugs and comorbidity index found that bedridden condition (OR 2.10, CI 95% 1.12–3.94), severely reduced kidney function (OR 2.27, CI 95% 1.22–4.21), hospital admission in the previous six months (OR 1.96, CI 95% 1.22–3.14), severe dementia (with total or severe physical dependence) (OR 4.16, CI 95% 2.39–7.25) and hypoalbuminemia (OR 2.47, CI 95% 1.12–5.44) were significantly associated with higher risk of three-month mortality. Conclusions Bedridden status, severely reduced kidney function, recent hospital admissions, severe dementia and hypoalbuminemia were associated with higher risk of three-month mortality in non-oncologic patients after discharge from internal medicine and geriatric hospital wards.
Published: 2018

14. Clinical Severity, Age, and Sex Overcome Cardiometabolic Morbidities but Not Stroke as Predictors of Mortality in Elderly Inpatients: Data From the REgistro POliterapie Società Italiana di Medicina Interna Registry

Author: Salvatore, Corrao, Alessandra, Marengoni, Giuseppe, Natoli, Alessandro, Nobili, Piermannuccio, Mannucci, Francesco, Perticone, Domenico, Prisco, Elena, Silvestri, Caterina, Cenci, Tommaso, Barnini, Giuseppe, Delitala, Stefano, Carta, Sebastiana, Atzori, Gianfranco, Guarnieri, Michela, Zanetti, Annalisa, Spalluti, Maria Grazia Serra, Maria Antonietta Bleve, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Laura, Gasbarrone, Giorgio, Maniscalco, Massimo, Gunelli, Daniela, Tirotta, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giancarlo, Agnelli, Emanuela, Marchesini, Elmo, Mannarino, Graziana, Lupattelli, Pamela, Rondelli, Francesco, Paciullo, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Maria Cristina Baroni, Marianna, Zardo, Manfredini, Roberto, Christian, Molino, Marco, Pala, Fabbian, Fabio, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Teresa, Salvatore, Ferdinando Carlo Sasso, Riccardo, Utili, Emanuele Durante Mangoni, Daniela, Pinto, Oliviero, Olivieri, Anna Maria Stanzial, Renato, Fellin, Volpato, Stefano, Sioulis, Fotini, Mario, Barbagallo, Ligia, Dominguez, Lidia, Plances, Daniela, D’Angelo, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Giuseppe, Licata, Luigi, Calvo, Maria, Valenti, Claudio, Borghi, Enrico, Strocchi, Elisa, Rebecca, Marco, Zoli, Elisa, Fabbri, Donatella, Magalotti, Alberto, Auteri, Anna Laura Pasqui, Luca, Puccetti, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Carlo, Sabbà, Francesco Saverio Vella, Alessandro, Marseglia, Chiara Valentina Luglio, Giuseppe, Palasciano, Maria Ester Modeo, Annamaria, Aquilino, Raffaele, Pallante, Stefania, Pugliese, Caterina, Capobianco, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Luigi, Fenoglio, Chiara, Brignone, Christian, Bracco, Alessia, Giraudo, Giuseppe, Musca, Olga, Cuccurullo, Luigi, Cricco, Alessandra, Fiorentini, Maria Domenica Cappellini, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Silvia, Fargion, Paola, Bonara, Mara, Bulgheroni, Rosa, Lombardi, Marianna, Porzio, Giulia, Periti, Fabio, Magrini, Ferdinando, Massari, Tatiana, Tonella, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Guido, Moreo, Barbara, Ferrari, Luisa, Roncari, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Silvia, Prolo, Maria Sole Lilleri, Giuliana, Micale, Mauro, Podda, Carlo, Selmi, Francesca, Meda, Francesco, Salerno, Silvia, Accordino, Alessio, Conca, Valentina, Monti, Gino Roberto Corazza, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Giovanni, Murialdo, Marta, Bovio, Franco, Dallegri, Luciano, Ottonello, Alessandra, Quercioli, Alessandra, Barreca, Maria Beatrice Secchi, Davide, Ghelfi, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Elisabetta, Bergami, Emanuela, Rizzioli, Carlo, Cagnoni, Luca, Bertone, Antonio, Manucra, Alberto, Buratti, Tiziana, Tognin, Nicola Lucio Liberato, Giordano, Bernasconi, Barbara, Nardo, Giovanni Battista Bianchi, Sabrina, Giaquinto, Giampiero, Benetti, Michela, Quagliolo, Giuseppe Riccardo Centenaro, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Francesco, Gullo, Michele, Cortellaro, Marina, Magenta, Francesca, Perego, Maria Rachele Meroni, Marco, Cicardi, Antonio Gidaro Marina Magenta, Andrea, Sacco, Antonio, Bonelli, Gaetano, Dentamaro, Renzo, Rozzini, Lina, Falanga, Alessandro, Giordano, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Giacomo, Fera, Maria Loreta Di Luca, Donatella, Renna, Antonio, Perciccante, Alessia, Coralli, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giorgio, Menardo, Stefania, Bottone, Elsa, Sferrazzo, Claudio, Ferri, Rinaldo, Striuli, Rosa, Scipioni, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Franco, Ricci, Cosimo, Morabito, Roberto, Fava, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Cesare, Masala, Antonio, Mammarella, Valeria, Raparelli, Filippo Rossi Fanelli, Massimo, Delfino, Antonio, Amoroso, Francesco, Violi, Stefania, Basili, Ludovica, Perri, Pietro, Serra, Vincenzo, Fontana, Marco, Falcone, Raffaele, Landolfi, Antonio, Grieco, Antonella, Gallo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Giuseppe, Romanelli, Caterina, Pirali, Claudia, Amolini, Enrico Agabiti Rosei, Damiano, Rizzoni, Luana, Castoldi, Antonio, Picardi, Umberto Vespasiani Gentilucci, Chiara, Mazzarelli, Paolo, Gallo, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Sara, Contini, Marta, Molaro, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Marco, Bertolotti, Chiara, Mussi, Roberto, Scotto, Maria Alice Ferri, Francesca, Veltri, Franco, Arturi, Elena, Succurro, Giorgio, Sesti, Umberto, Gualtieri, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Roberto, Corinaldesi, Roberto De Giorgio, Mauro, Serra, Valentina, Grasso, Eugenio, Ruggeri, Lorenzo Mauro Carozza, Fabio, Pignatti, Corrao, S., Marengoni, A., Natoli, G., Nobili, A., Mannucci, P., and Perticone, F.
Subjects: Male, Pediatrics, medicine.medical_specialty, REPOSI study, Clinical severity, age, stroke, risk factors, elderly, REPOSI study, Socio-culturale, 030204 cardiovascular system & hematology, Age and sex, elderly, Severity of Illness Index, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Metabolic Diseases, medicine, risk factors, Humans, Clinical severity, Hospital Mortality, Registries, 030212 general & internal medicine, Stroke, Aged, Aged, 80 and over, Inpatients, business.industry, Age Factors, medicine.disease, age, Italy, Cardiovascular Diseases, Female, Morbidity, Geriatrics and Gerontology, business
Published: 2016

15. Self-Reported Non-Celiac Wheat Sensitivity in High School Students: Demographic and Clinical Characteristics

Author: Antonio Carroccio, Ornella Giambalvo, Rosario Iacobucci, Alberto D'Alcamo, Francesco La Blasca, Pasquale Mansueto, Carroccio, A., Giambalvo, O., Blasca, F., Iacobucci, R., D'Alcamo, A., and Mansueto, P.
Subjects: 0301 basic medicine, Male, Pediatrics, Settore MED/09 - Medicina Interna, Disease, Wheat Hypersensitivity, Epidemiology, Established diagnosis, Sicily, Triticum, Non-Celiac Wheat Sensitivity, education.field_of_study, Nutrition and Dietetics, teenagers, Validated questionnaire, Self-Reported, High School Students, Demographic Characteristics, Clinical Characteristics, self-reported non-celiac wheat sensitivity, non-celiac gluten-sensitivity, epidemiology, prevalence, IBS, food allergy, Female, Non-celiac gluten sensitivity, lcsh:Nutrition. Foods and food supply, medicine.medical_specialty, Adolescent, Glutens, Population, lcsh:TX341-641, Article, 03 medical and health sciences, Diet, Gluten-Free, medicine, Humans, education, Students, Demographic Characteristic, High School Student, 030109 nutrition & dietetics, business.industry, Mean age, medicine.disease, Celiac Disease, Case-Control Studies, Self Report, business, Food Science
Abstract: Background: Non-Celiac Wheat Sensitivity (NCWS) has recently been included among the gluten-related disorders. As no biomarkers of this disease exist, its frequency has been estimated based on self-reported symptoms, but to date no data are available about self-reported NCWS in teenagers. Aim: To explore the prevalence of self-reported NCWS in a group of high school students and to study their demographic and clinical characteristics. Methods: The study was performed between April 2015 and January 2016 in two high schools of a coastal town in the south of Sicily (Italy). A total of 555 students (mean age 17 years, 191 male, 364 female) completed a modified validated questionnaire for self-reported NCWS. The subjects who self-reported NCWS were then compared with all the others. Results: Seven individuals (1.26%) had an established diagnosis of CD. The prevalence of self-reported NCWS was 12.2%, and 2.9% were following a gluten-free diet (GFD). Only 15 out of 68 (23%) NCWS self-reporters had consulted a doctor for this problem and only nine (14%) had undergone serological tests for celiac disease. The NCWS self-reporters very often had IBS symptoms (44%). Conclusions: Self-reported NCWS was found to be common in teenagers, with a frequency of 12.2%; the frequency of GFD use was 2.9%, which was much higher than the percentage of known CD in the same population (1.26%). A greater awareness of the possible implications on the part of the subjects involved, and a more thorough medical approach to the study of self-reported wheat-induced symptoms are required.
Published: 2017
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16. Defining aging phenotypes and related outcomes: Clues to recognize frailty in hospitalized older patients

Author: Marcucci, Maura, Carlotta, Franchi, Alessandro, Nobili, Pier Mannuccio Mannucci, Ilaria, Ardoino, Mauro, Tettamanti, Luca, Pasina, Francesco, Perticone, Francesco, Salerno, Salvatore, Corrao, Giuseppe, Licata, Francesco, Violi, Gino Roberto Corazza, Tarek Kamal Eldin, Maria Pia Donatella Di Blanca, Prisco, Domenico, Elena, Silvestri, Caterina, Cenci, Giacomo, Emmi, Gianni, Biolo, Gianfranco, Guarnieri, Michela, Zanetti, Giovanni, Fernandes, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Teresa, Salvatore, Ferdinando Carlo Sasso, Domenico, Girelli, Olivieri, Oliviero, Thomas, Matteazzi, Mario, Barbagallo, Lidia, Plances, Roberta, Alcamo, Luigi, Calvo, Maria, Valenti, Marco, Zoli, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Giuseppe, Palasciano, Maria Ester Modeo, Maria, Peragine, Fabrizio, Pappagallo, Stefania, Pugliese, Carla Di Gennaro, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Cappellini, MARIA DOMENICA, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Barbara Brignolo Ottolini, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Carbone, LUIGI MARIA, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Maria Rachele Meroni, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Cristina, Amione, Paolo, Fornengo, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giuseppe, Delitala, Vincenzo, Pretti, Maristella Salvatora Masala, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Filippo Rossi Fanelli, Antonio, Amoroso, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Giuseppe, Romanelli, Claudia, Amolini, Deborah, Chiesa, Alessandra, Marengoni, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Giuseppe, Bellelli, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Giorgio, Sesti, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Stefano, Carta, Sebastiana, Atzori, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Agnelli, Giancarlo, Marchesini, Emanuela, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Aldo, Baritusso, Roberto, Manfredini, Christian, Molino, Marco, Pala, Fabio, Fabbian, Benedetta, Boari, Alfredo De Giorgi, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Claudio, Borghi, Enrico, Strocchi, Valeria De Sando, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Raffaella, Valerio, Caterina, Capobianco, Luigi, Fenoglio, Christian, Bracco, Alessia Valentina Giraudo, Elisa, Testa, Cristina, Serraino, Silvia, Fargion, Paola, Bonara, Giulia, Periti, Marianna, Porzio, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Alessio, Conca, Giulia, Gobbo, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Nicola Lucio Liberato, Alberto, Buratti, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Paolo, Petitti, Antonio, Perciccante, Alessia, Coralli, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Cesare, Masala, Antonio, Mammarella, Valeria, Raparelli, Stefania, Basili, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Carla, Vallone, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Marta, Molaro, Bertolotti, Marco, Chiara, Mussi, Maria Vittoria Libbra, DI MICELI, Andrea, Pellegrini, Elisa, Lucia, Carulli, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Roberto, Corinaldesi, Roberto De Giorgio, DALLA SERRA, Mauro, Valentina, Grasso, Eugenio, Ruggeri, Andrea, Salvi, Leonardi, Roberto, Chiara, Grassini, Ilenia, Mascherona, Minelli, Giorgio, Francesca, Maltese, Armando, Gabrielli, Mattioli, Massimo, William, Capeci, Giuseppe Pio Martino, Silvia, Messina, Riccardi, Ghio, Serena, Favorini, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Antonella, Afeltra, Pamela, Alemanno, Benedetta, Marigliano, Pietro, Castellino, Julien, Blanco, Luca, Zanoli, Cattaneo, Marco Natale, Paola, Fracasso, Amoruso, MARIA VALENTINA, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Vittorio, Durante, Giovanna, Eusebi, Daniela, Tirotta, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesco, Scopelliti, Francesca, Gasparini, Melissa, Cocca, Ramirez Duque Nieves, Muela Molinero Alberto, Abad Requejo Pedro, Lopez Pelaez Vanessa, Tamargo, Lara, Corbella Viros Xavier, Formiga, Francesc, Diez Manglano Jesus, Bejarano Tello Esperanza, Del Corral Behamonte Esther, Sevil Puras Maria, Manuel, Romero, Pinilla Llorente Blanca, Lopez Gonzalez-Cobos Cristina, Victoria, Villalba Garcia M., Lopez, Saez, Juan, Bosco, Sanz Baena Susana, Arroyo Gallego Marta, Gonzalez Becerra Concepcion, Fernandez Moyano Antonio, Mercedes Gomez Hernandez, Manuel Poyato Borrego, Pacheco Cuadros Raquel, Perez Rojas Florencia, Garcia Olid Beatriz, Carrascosa Garcia Sara, Gonzalez-Cruz Cervellera Alfonso, Peinado Martinez Marta, Ruiz Cantero Alberto, Albarracín Arraigosa Antonio, Godoy Guerrero Montserrat, Barón Ramos Miguel Ángel, Machin Jose Manuel, Novo Veleiro Ignacio, Alvela Suarez Lucía, Lopez, Alfonso, Rubal Bran David, Iñiguez Vazquez Iria, Rios Prego Monica, Marcucci, M., Franchi, C., Nobili, A., Mannucci, P. M., Ardoino, I., Tettamanti, M., Pasina, L., Perticone, F., Salerno, F., Corrao, S., Marengoni, A., Licata, G., Violi, F., Corazza, G. R., Eldin, T. K., Di Blanca, M. P. D., Djade, C. D., Cortesi, L., Prisco, D., Silvestri, E., Cenci, C., Emmi, G., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Vanoli, M., Grignani, G., Casella, G., Bernardi, M., Bassi, S. L., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Zoli, M., Arno, R., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Pugliese, S., Di Gennaro, C., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mari, D., Rossi, P. D., Damanti, S., Ottolini, B. B., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Leiter, Sofia, Carbone, M., Davi, G., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Delitala, G., Pretti, V., Masala, M. S., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala, G., Franceschi, F., De Marco, G., Chiara, C., Marta, S., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Carta, S., Atzori, S., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Turatto, F., Baritusso, A., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Sabba, C., Vella, F. S., Suppressa, P., Valerio, R., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Peyvandi, F., Tedeschi, A., Rossio, R., Monzani, V., Savojardo, V., Folli, C., Magnini, M., Conca, A., Gobbo, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Raparelli, V., Basili, S., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Bertolotti, M., Mussi, C., Libbra, M. V., Miceli, A., Pellegrini, E., Carulli, L., Sciacqua, A., Quero, M., Bagnato, C., Corinaldesi, R., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Gabrielli, A., Mattioli, M., Capeci, W., Martino, G. P., Messina, S., Ghio, R., Favorini, S., Dal Col, A., Minisola, S., Colangelo, L., Afeltra, A., Alemanno, P., Marigliano, B., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Nieves, R. D., Alberto, M. M., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Esther, D. C. B., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Alfonso, G. -C. C., Marta, P. M., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Angel, B. R. M., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., Monica, R. P., Sofia, L., Marcucci, M, Franchi, C, Nobili, A, Mannucci, P, Ardoino, I, Tettamanti, M, Pasina, L, Perticone, F, Salerno, F, Corrao, S, Marengoni, A, Licata, G, Violi, F, Corazza, G, Eldin, T, Di Blanca, M, Djade, C, Cortesi, L, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Vanoli, M, Grignani, G, Casella, G, Bernardi, M, Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, F, Girelli, D, Olivieri, O, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, L, Valenti, M, Zoli, M, Arno, R, Pasini, F, Capecchi, P, Bicchi, M, Palasciano, G, Modeo, M, Peragine, M, Pappagallo, F, Pugliese, S, Di Gennaro, C, Postiglione, A, Barbella, M, De Stefano, F, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Mari, D, Rossi, P, Damanti, S, Ottolini, B, Miceli, E, Lenti, M, Padula, D, Murialdo, G, Marra, A, Cattaneo, F, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Davi, G, Guagnano, M, Sestili, S, Mancuso, G, Calipari, D, Bartone, M, Meroni, M, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Amione, C, Fornengo, P, Tassara, R, Melis, D, Rebella, L, Delitala, G, Pretti, V, Masala, M, Bolondi, L, Rasciti, L, Serio, I, Fanelli, F, Amoroso, A, Molfino, A, Petrillo, E, Zuccala, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, Romanelli, G, Amolini, C, Chiesa, D, Picardi, A, Gentilucci, U, Gallo, P, Annoni, G, Corsi, M, Zazzetta, S, Bellelli, G, Arturi, F, Succurro, E, Rubino, M, Sesti, G, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Carta, S, Atzori, S, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Di Corato, P, Agnelli, G, Marchesini, E, Fabris, F, Carlon, M, Turatto, F, Baritusso, A, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Boari, B, De Giorgi, A, Paolisso, G, Rizzo, M, Laieta, M, Rini, G, Mansueto, P, Pepe, I, Borghi, C, Strocchi, E, De Sando, V, Sabba, C, Vella, F, Suppressa, P, Valerio, R, Capobianco, C, Fenoglio, L, Bracco, C, Giraudo, A, Testa, E, Serraino, C, Fargion, S, Bonara, P, Periti, G, Porzio, M, Peyvandi, F, Tedeschi, A, Rossio, R, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Conca, A, Gobbo, G, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Dallegri, F, Ottonello, L, Liberale, L, Chin, W, Carassale, L, Caporotundo, S, Traisci, G, De Feudis, L, Di Carlo, S, Liberato, N, Buratti, A, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Montrucchio, G, Greco, E, Tizzani, P, Petitti, P, Perciccante, A, Coralli, A, Salmi, R, Gaudenzi, P, Gamberini, S, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Masala, C, Mammarella, A, Raparelli, V, Basili, S, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Bertolotti, M, Mussi, C, Libbra, M, Miceli, A, Pellegrini, E, Carulli, L, Sciacqua, A, Quero, M, Bagnato, C, Corinaldesi, R, De Giorgio, R, Grasso, V, Ruggeri, E, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Gabrielli, A, Mattioli, M, Capeci, W, Martino, G, Messina, S, Ghio, R, Favorini, S, Dal Col, A, Minisola, S, Colangelo, L, Afeltra, A, Alemanno, P, Marigliano, B, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, M, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Scopelliti, F, Gasparini, F, Cocca, M, Nieves, R, Alberto, M, Pedro, A, Vanessa, L, Lara, T, Xavier, C, Francesc, F, Jesus, D, Esperanza, B, Esther, D, Maria, S, Romero, M, Blanca, P, Cristina, L, Victoria, V, Saez, L, Bosco, J, Susana, S, Marta, A, Concepcion, G, Antonio, F, Hernandez, M, Borrego, M, Raquel, P, Florencia, P, Beatriz, G, Sara, C, Alfonso, G, Marta, P, Alberto, R, Antonio, A, Montserrat, G, Angel, B, Manuel, M, Ignacio, N, Lucia, A, Alfonso, L, David, R, Iria, I, and Monica, R
Subjects: Background: Because frailty is a complex phenomenon associated with poor outcomes, the identification of patient profiles with different care needs might be of greater practical help than to look for a unifying definition. This study aimed at identifying aging phenotypes and their related outcomes in order to recognize frailty in hospitalized older patients. Methods: Patients aged 65 or older enrolled in internal medicine and geriatric wards participating in the REPOSI registry. Relationships among variables associated to sociodemographic, physical, cognitive, functional, and medical status were explored using a multiple correspondence analysis. The hierarchical cluster analysis was then performed to identify possible patient profiles. Multivariable logistic regression was used to verify the association between clusters and outcomes (in-hospital mortality and 3-month postdischarge mortality and rehospitalization). Results: 2,841 patients were included in the statistical analyses. Four clusters were identified: the healthiest (I), those with multimorbidity (II), the functionally independent women with osteoporosis and arthritis (III), and the functionally dependent oldest old patients with cognitive impairment (IV). There was a significantly higher in-hospital mortality in Cluster II (odds ratio [OR] = 2.27, 95% confidence interval [CI] = 1.15-4.46) and Cluster IV (OR = 5.15, 95% CI = 2.58-10.26) and a higher 3-month mortality in Cluster II (OR = 1.66, 95% CI = 1.13-2.44) and Cluster IV (OR = 1.86, 95% CI = 1.15-3.00) than in Cluster I. Conclusions: Using alternative analytical techniques among hospitalized older patients, we could distinguish different frailty phenotypes, differently associated with adverse events. The identification of different patient profiles can help defining the best care strategy according to specific patient needs, Male, Aging, Osteoporosis, we could distinguish different frailty phenotypes, 030204 cardiovascular system & hematology, Logistic regression, 0302 clinical medicine, Internal medicine and geriatric wards, Aging phenotype, 80 and over, Medicine, Cluster analysi, LS4_4, 95% CI = 1.15-3.00) than in Cluster I. Conclusions: Using alternative analytical techniques among hospitalized older patients, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Prospective cohort study, physical, Outcome, 95% CI = 2.58-10.26) and a higher 3-month mortality in Cluster II (OR = 1.66, Aged, 80 and over, Frailty, 95% confidence interval [CI] = 1.15-4.46) and Cluster IV (OR = 5.15, Cognition, Hospitalization, Phenotype, aging phenotypes, cluster analysis, frailty, internal medicine and geriatric wards, outcomes, Female, 841 patients were included in the statistical analyses. Four clusters were identified: the healthiest (I), Human, medicine.medical_specialty, the identification of patient profiles with different care needs might be of greater practical help than to look for a unifying definition. This study aimed at identifying aging phenotypes and their related outcomes in order to recognize frailty in hospitalized older patients. Methods: Patients aged 65 or older enrolled in internal medicine and geriatric wards participating in the REPOSI registry. Relationships among variables associated to sociodemographic, Frail Elderly, Socio-culturale, Aging phenotypes, Cluster analysis, Outcomes, Aged, Humans, Geriatric Assessment, cognitive, 03 medical and health sciences, Multiple correspondence analysis, Internal medicine, differently associated with adverse events. The identification of different patient profiles can help defining the best care strategy according to specific patient needs, Adverse effect, Background: Because frailty is a complex phenomenon associated with poor outcomes, Aging phenotypes, Cluster analysis, Frailty, Internal medicine and geriatric wards, Outcomes, 95% CI = 1.13-2.44) and Cluster IV (OR = 1.86, business.industry, and the functionally dependent oldest old patients with cognitive impairment (IV). There was a significantly higher in-hospital mortality in Cluster II (odds ratio [OR] = 2.27, Settore MED/09 - MEDICINA INTERNA, and medical status were explored using a multiple correspondence analysis. The hierarchical cluster analysis was then performed to identify possible patient profiles. Multivariable logistic regression was used to verify the association between clusters and outcomes (in-hospital mortality and 3-month postdischarge mortality and rehospitalization). Results: 2, Odds ratio, medicine.disease, Confidence interval, Internal medicine and geriatric ward, Prospective Studie, functional, Physical therapy, Geriatrics and Gerontology, business
Abstract: Background Because frailty is a complex phenomenon associated with poor outcomes, the identification of patient profiles with different care needs might be of greater practical help than to look for a unifying definition. This study aimed at identifying aging phenotypes and their related outcomes in order to recognize frailty in hospitalized older patients. Methods Patients aged 65 or older enrolled in internal medicine and geriatric wards participating in the REPOSI registry. Relationships among variables associated to sociodemographic, physical, cognitive, functional, and medical status were explored using a multiple correspondence analysis. The hierarchical cluster analysis was then performed to identify possible patient profiles. Multivariable logistic regression was used to verify the association between clusters and outcomes (in-hospital mortality and 3-month postdischarge mortality and rehospitalization). Results 2,841 patients were included in the statistical analyses. Four clusters were identified: the healthiest (I); those with multimorbidity (II); the functionally independent women with osteoporosis and arthritis (III); and the functionally dependent oldest old patients with cognitive impairment (IV). There was a significantly higher in-hospital mortality in Cluster II (odds ratio [OR] = 2.27, 95% confidence interval [CI] = 1.15-4.46) and Cluster IV (OR = 5.15, 95% CI = 2.58-10.26) and a higher 3-month mortality in Cluster II (OR = 1.66, 95% CI = 1.13-2.44) and Cluster IV (OR = 1.86, 95% CI = 1.15-3.00) than in Cluster I. Conclusions Using alternative analytical techniques among hospitalized older patients, we could distinguish different frailty phenotypes, differently associated with adverse events. The identification of different patient profiles can help defining the best care strategy according to specific patient needs.
Published: 2017

17. Pattern of in-hospital changes in drug use in the older people from 2010 to 2016

Author: Carlotta, Franchi, Ilaria, Ardoino, Alessandro, Nobili, Luca, Pasina, Pier Mannuccio Mannucci, Alessandra, Marengoni, Francesco, Perticone, Mauro, Tettamanti, Francesco, Salerno, Salvatore, Corrao, Giuseppe, Licata, Francesco, Violi, Gino Roberto Corazza, Marcucci, Maura, Tarek Kamal Eldin, Maria Pia Donatella Di Blanca, Giovanna, Lanzo, Sarah, Astuto, Laura, Cortesi, Prisco, Domenico, Elena, Silvestri, Caterina, Cenci, Giacomo, Emmi, Gianni, Biolo, Gianfranco, Guarnieri, Michela, Zanetti, Giovanni, Fernandes, Massimiliano, Chiuch, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Edoardo Alessandro Pulixi, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giacomo, Zaccherini, Mannarino, Elmo, Lupattelli, Graziana, Bianconi, Vanessa, Paciullo, Francesco, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Alberto, Palazzuoli, Teresa, Salvatore, Ferdinando Carlo Sasso, Domenico, Girelli, Oliviero, Olivieri, Thomas, Matteazzi, Mario, Barbagallo, Lidia, Plances, Roberta, Alcamo, Luigi, Calvo, Maria, Valenti, Marco, Zoli, Raffaella, Arnò, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Giuseppe, Palasciano, Maria Ester Modeo, Maria, Peragine, Fabrizio, Pappagallo, Stefania, Pugliese, Carla Di Gennaro, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Cappellini, MARIA DOMENICA, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Marta, Mancarella, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Barbara Brignolo Ottolini, Giulia, Bonini, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Giovanni, Murialdo, Alessio, Marra, Federico, Cattaneo, Maria Beatrice Secchi, Davide, Ghelfi, Luigi, Anastasio, Lucia, Sofia, Carbone, LUIGI MARIA, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Maria Rachele Meroni, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Cristina, Amione, Paolo, Fornengo, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giuseppe, Delitala, Vincenzo, Pretti, Maristella Salvatora Masala, Chiara, Pes, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Filippo Rossi Fanelli, Antonio, Amoroso, Alessio, Molfino, Enrico, Petrillo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Gabriella, D’Aurizio, Giuseppe, Romanelli, Claudia, Amolini, Deborah, Chiesa, Antonio, Picardi, Umberto Vespasiani Gentilucci, Paolo, Gallo, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Giuseppe, Bellelli, Hajnalka, Szabo, Franco, Arturi, Elena, Succurro, Mariangela, Rubino, Giorgio, Sesti, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Maria Grazia Serra, Maria Antonietta Bleve, Laura, Gasbarrone, Maria Rosaria Sajeva, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Agnelli, Giancarlo, Marchesini, Emanuela, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Aldo, Baritusso, Annalisa, Amabile, Elisabetta, Omenetto, Paolo, Scarinzi, Roberto, Manfredini, Christian, Molino, Marco, Pala, Fabio, Fabbian, Benedetta, Boari, Alfredo De Giorgi, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Claudio, Borghi, Enrico, Strocchi, Valeria De Sando, Ilaria, Pareo, Carlo, Sabbà, Francesco Saverio Vella, Patrizia, Suppressa, Raffaella, Valerio, Pasquale, Agosti, Flavia, Fontana, Francesca, Loparco, Caterina, Capobianco, Luigi, Fenoglio, Christian, Bracco, Alessia Valentina Giraudo, Elisa, Testa, Cristina, Serraino, Silvia, Fargion, Paola, Bonara, Giulia, Periti, Marianna, Porzio, Slivia, Tiraboschi, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Alessio, Conca, Giulia, Gobbo, Giada, Pallini, Miriam, Valenti, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Franco, Dallegri, Luciano, Ottonello, Luca, Liberale, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Nicola Lucio Liberato, Alberto, Buratti, Tiziana, Tognin, Giovanni Battista Bianchi, Sabrina, Giaquinto, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Renzo, Rozzini, Lina, Falanga, Elena, Spazzini, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Paolo, Petitti, Antonio, Perciccante, Alessia, Coralli, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Cesare, Masala, Antonio, Mammarella, Valeria, Raparelli, Stefania, Basili, Ludovica, Perri, Raffaele, Landolfi, Massimo, Montalto, Antonio, Mirijello, Carla, Vallone, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Marta, Molaro, Bertolotti, Marco, Chiara, Mussi, Maria Vittoria Libbra, DI MICELI, Andrea, Pellegrini, Elisa, Lucia, Carulli, Francesca, Veltri, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Lidia, Colangelo, Tania, Falbo, Roberto De Giorgio, DALLA SERRA, Mauro, Valentina, Grasso, Eugenio, Ruggeri, Benzoni, Ilaria, Andrea, Salvi, Leonardi, Roberto, Chiara, Grassini, Ilenia, Mascherona, Minelli, Giorgio, Francesca, Maltese, Giampaolo, Damiani, William, Capeci, Mattioli, Massimo, Giuseppe Pio Martino, Biondi, Lorenzo, Monica, Ormas, Pietro, Pettinari, Roberto, Romiti, Silvia, Messina, Federica, Cavallaro, Riccardi, Ghio, Serena, Favorini, Anna Dal Col, Salvatore, Minisola, Luciano, Colangelo, Antonella, Afeltra, Pamela, Alemanno, Benedetta, Marigliano, Maria Elena Pipita, Pietro, Castellino, Julien, Blanco, Luca, Zanoli, Cattaneo, Marco Natale, Paola, Fracasso, Amoruso, MARIA VALENTINA, Valter, Saracco, Marisa, Fogliati, Carlo, Bussolino, Vittorio, Durante, Giovanna, Eusebi, Daniela, Tirotta, Francesca, Mete, Miriam, Gino, Antonio, Cittadini, Carlo, Vigorito, Michele, Arcopinto, Andrea, Salzano, Emanuele, Bobbio, Alberto Maria Marra, Domenico, Sirico, Guido, Moreo, Francesco, Scopelliti, Francesca, Gasparini, Melissa, Cocca, Alberto, Ballestrero, Fabio, Ferrando, Sergio, Berra, Simonetta, Dassi, Maria Cristina Nava, Bruno, Graziella, Stefano, Baldassarre, Salvatore, Fragapani, Giorgio, Galanti, Gabriele, Mascherini, Cristian, Petri, Laura, Stefani, Margherita, Girino, Valeria, Piccinelli, Francesco, Nasso, Vincenza, Gioffrè, Maria, Pasquale, Giuseppe, Scattolin, Sergio, Martinelli, Mauro, Turrin, Leonardo, Sechi, Cristina, Catena, Gianluca, Colussi, Ramirez Duque Nieves, Muela Molinero Alberto, Abad Requejo Pedro, Lopez Pelaez Vanessa, Tamargo, Lara, Corbella Viros Xavier, Formiga, Francesc, Diez Manglano Jesus, Bejarano Tello Esperanza, Del Corral Behamonte Esther, Sevil Puras Maria, Manuel, Romero, Pinilla Llorente Blanca, Lopez Gonzalez-Cobos Cristina, Victoria, Villalba Garcia M., Lopez, Saez, Juan, Bosco, Sanz Baena Susana, Arroyo Gallego Marta, Gonzalez Becerra Concepcion, Fernandez Moyano Antonio, Mercedes Gomez Hernandez, Manuel Poyato Borrego, Pacheco Cuadros Raquel, Perez Rojas Florencia, Garcia Olid Beatriz, Carrascosa Garcia Sara, Gonzalez-Cruz Cervellera Alfonso, Peinado Martinez Marta, Sara Carrascosa Garcia, Ruiz Cantero Alberto, Albarracín Arraigosa Antonio, Godoy Guerrero Montserrat, Barón Ramos Miguel Ángel, Machin Jose Manuel, Novo Veleiro Ignacio, Alvela Suarez Lucía, Lopez, Alfonso, Rubal Bran David, Iñiguez Vazquez Iria, Rios Prego Monica, Franchi C., Ardoino I., Nobili A., Pasina L., Mannucci P.M., Marengoni A., Perticone F., REPOSI investigators., Barbagallo M., Dominguez Rodríguez L.J., Franchi, C., Ardoino, I., Nobili, A., Pasina, L., Mannucci, P. M., Marengoni, A., Perticone, F., Tettamanti, M., Salerno, F., Corrao, S., Licata, G., Violi, F., Corazza, G. R., Marcucci, M., Eldin, T. K., Donatella Di Blanca, M. P., Lanzo, G., Astuto, S., Cortesi, L., Prisco, D., Silvestri, E., Cenci, C., Emmi, G., Biolo, G., Guarnieri, G., Zanetti, M., Fernandes, G., Chiuch, M., Vanoli, M., Grignani, G., Casella, G., Pulixi, E. A., Bernardi, M., Li Bassi, S., Santi, L., Zaccherini, G., Mannarino, E., Lupattelli, G., Bianconi, V., Paciullo, F., Nuti, R., Valenti, R., Ruvio, M., Cappelli, S., Palazzuoli, A., Salvatore, T., Sasso, F. C., Girelli, D., Olivieri, O., Matteazzi, T., Barbagallo, M., Plances, L., Alcamo, R., Calvo, L., Valenti, M., Zoli, M., Arno, R., Pasini, F. L., Capecchi, P. L., Bicchi, M., Palasciano, G., Modeo, M. E., Peragine, M., Pappagallo, F., Pugliese, S., Di Gennaro, C., Postiglione, A., Barbella, M. R., De Stefano, F., Cappellini, M. D., Fabio, G., Seghezzi, S., De Amicis, M. M., Mancarella, M., Mari, D., Rossi, P. D., Damanti, S., Ottolini, B. B., Bonini, G., Miceli, E., Lenti, M. V., Padula, D., Murialdo, G., Marra, A., Cattaneo, F., Secchi, M. B., Ghelfi, D., Anastasio, L., Sofia, L., Carbone, M., Davi, G., Guagnano, M. T., Sestili, S., Mancuso, G., Calipari, D., Bartone, M., Meroni, M. R., Perin, P. C., Lorenzati, B., Gruden, G., Bruno, G., Amione, C., Fornengo, P., Tassara, R., Melis, D., Rebella, L., Delitala, G., Pretti, V., Masala, M. S., Pes, C., Bolondi, L., Rasciti, L., Serio, I., Fanelli, F. R., Amoroso, A., Molfino, A., Petrillo, E., Zuccala, G., Franceschi, F., De Marco, G., Chiara, C., Marta, S., D'Aurizio, G., Romanelli, G., Amolini, C., Chiesa, D., Picardi, A., Gentilucci, U. V., Gallo, P., Annoni, G., Corsi, M., Zazzetta, S., Bellelli, G., Szabo, H., Arturi, F., Succurro, E., Rubino, M., Sesti, G., Loria, P., Becchi, M. A., Martucci, G., Fantuzzi, A., Maurantonio, M., Serra, M. G., Bleve, M. A., Gasbarrone, L., Sajeva, M. R., Brucato, A., Ghidoni, S., Di Corato, P., Agnelli, G., Marchesini, E., Fabris, F., Carlon, M., Turatto, F., Baritusso, A., Amabile, A., Omenetto, E., Scarinzi, P., Manfredini, R., Molino, C., Pala, M., Fabbian, F., Boari, B., De Giorgi, A., Paolisso, G., Rizzo, M. R., Laieta, M. T., Rini, G., Mansueto, P., Pepe, I., Borghi, C., Strocchi, E., De Sando, V., Pareo, I., Sabba, C., Vella, F. S., Suppressa, P., Valerio, R., Agosti, P., Fontana, F., Loparco, F., Capobianco, C., Fenoglio, L., Bracco, C., Giraudo, A. V., Testa, E., Serraino, C., Fargion, S., Bonara, P., Periti, G., Porzio, M., Tiraboschi, S., Peyvandi, F., Tedeschi, A., Rossio, R., Monzani, V., Savojardo, V., Folli, C., Magnini, M., Conca, A., Gobbo, G., Pallini, G., Balduini, C. L., Bertolino, G., Provini, S., Quaglia, F., Dallegri, F., Ottonello, L., Liberale, L., Chin, W. S., Carassale, L., Caporotundo, S., Traisci, G., De Feudis, L., Di Carlo, S., Liberato, N. L., Buratti, A., Tognin, T., Bianchi, G. B., Giaquinto, S., Purrello, F., Di Pino, A., Piro, S., Rozzini, R., Falanga, L., Spazzini, E., Montrucchio, G., Greco, E., Tizzani, P., Petitti, P., Perciccante, A., Coralli, A., Salmi, R., Gaudenzi, P., Gamberini, S., Semplicini, A., Gottardo, L., Vendemiale, G., Serviddio, G., Forlano, R., Masala, C., Mammarella, A., Raparelli, V., Basili, S., Perri, L., Landolfi, R., Montalto, M., Mirijello, A., Vallone, C., Bellusci, M., Setti, D., Pedrazzoli, F., Guasti, L., Castiglioni, L., Maresca, A., Squizzato, A., Molaro, M., Bertolotti, M., Mussi, C., Libbra, M. V., Miceli, A., Pellegrini, E., Carulli, L., Veltri, F., Sciacqua, A., Quero, M., Bagnato, C., Colangelo, L., Falbo, T., De Giorgio, R., Serra, M., Grasso, V., Ruggeri, E., Ilaria, B., Salvi, A., Leonardi, R., Grassini, C., Mascherona, I., Minelli, G., Maltese, F., Damiani, G., Capeci, W., Mattioli, M., Martino, G. P., Biondi, L., Ormas, M., Pettinari, P., Romiti, R., Messina, S., Cavallaro, F., Ghio, R., Favorini, S., Dal Col, A., Minisola, S., Afeltra, A., Alemanno, P., Marigliano, B., Pipita, M. E., Castellino, P., Blanco, J., Zanoli, L., Cattaneo, M., Fracasso, P., Amoruso, M. V., Saracco, V., Fogliati, M., Bussolino, C., Durante, V., Eusebi, G., Tirotta, D., Mete, F., Gino, M., Cittadini, A., Vigorito, C., Arcopinto, M., Salzano, A., Bobbio, E., Marra, A. M., Sirico, D., Moreo, G., Scopelliti, F., Gasparini, F., Cocca, M., Ballestrero, A., Ferrando, F., Berra, S., Dassi, S., Nava, M. C., Graziella, B., Baldassarre, S., Fragapani, S., Galanti, G., Mascherini, G., Petri, C., Stefani, L., Girino, M., Piccinelli, V., Nasso, F., Gioffre, V., Pasquale, M., Scattolin, G., Martinelli, S., Turrin, M., Sechi, L., Catena, C., Colussi, G., Nieves, R. D., Alberto, M. M., Pedro, A. R., Vanessa, L. P., Lara, T., Xavier, C. V., Francesc, F., Jesus, D. M., Esperanza, B. T., Esther, D. C. B., Maria, S. P., Romero, M., Blanca, P. L., Cristina, L. G. -C., Victoria, V. G. M., Saez, L., Bosco, J., Susana, S. B., Marta, A. G., Concepcion, G. B., Antonio, F. M., Hernandez, M. G., Borrego, M. P., Raquel, P. C., Florencia, P. R., Beatriz, G. O., Sara, C. G., Alfonso, G. -C. C., Marta, P. M., Garcia, S. C., Alberto, R. C., Antonio, A. A., Montserrat, G. G., Angel, B. R. M., Manuel, M. J., Ignacio, N. V., Lucia, A. S., Alfonso, L., David, R. B., Iria, I. V., Monica, R. P., Franchi, C, Ardoino, I, Nobili, A, Pasina, L, Mannucci, P, Marengoni, A, Perticone, F, Tettamanti, M, Salerno, F, Corrao, S, Licata, G, Violi, F, Corazza, G, Marcucci, M, Eldin, T, Donatella Di Blanca, M, Lanzo, G, Astuto, S, Cortesi, L, Prisco, D, Silvestri, E, Cenci, C, Emmi, G, Biolo, G, Guarnieri, G, Zanetti, M, Fernandes, G, Chiuch, M, Vanoli, M, Grignani, G, Casella, G, Pulixi, E, Bernardi, M, Li Bassi, S, Santi, L, Zaccherini, G, Mannarino, E, Lupattelli, G, Bianconi, V, Paciullo, F, Nuti, R, Valenti, R, Ruvio, M, Cappelli, S, Palazzuoli, A, Salvatore, T, Sasso, F, Girelli, D, Olivieri, O, Matteazzi, T, Barbagallo, M, Plances, L, Alcamo, R, Calvo, L, Valenti, M, Zoli, M, Arno, R, Pasini, F, Capecchi, P, Bicchi, M, Palasciano, G, Modeo, M, Peragine, M, Pappagallo, F, Pugliese, S, Di Gennaro, C, Postiglione, A, Barbella, M, De Stefano, F, Cappellini, M, Fabio, G, Seghezzi, S, De Amicis, M, Mancarella, M, Mari, D, Rossi, P, Damanti, S, Ottolini, B, Bonini, G, Miceli, E, Lenti, M, Padula, D, Murialdo, G, Marra, A, Cattaneo, F, Secchi, M, Ghelfi, D, Anastasio, L, Sofia, L, Carbone, M, Davi, G, Guagnano, M, Sestili, S, Mancuso, G, Calipari, D, Bartone, M, Meroni, M, Perin, P, Lorenzati, B, Gruden, G, Bruno, G, Amione, C, Fornengo, P, Tassara, R, Melis, D, Rebella, L, Delitala, G, Pretti, V, Masala, M, Pes, C, Bolondi, L, Rasciti, L, Serio, I, Fanelli, F, Amoroso, A, Molfino, A, Petrillo, E, Zuccala, G, Franceschi, F, De Marco, G, Chiara, C, Marta, S, D'Aurizio, G, Romanelli, G, Amolini, C, Chiesa, D, Picardi, A, Gentilucci, U, Gallo, P, Annoni, G, Corsi, M, Zazzetta, S, Bellelli, G, Szabo, H, Arturi, F, Succurro, E, Rubino, M, Sesti, G, Loria, P, Becchi, M, Martucci, G, Fantuzzi, A, Maurantonio, M, Serra, M, Bleve, M, Gasbarrone, L, Sajeva, M, Brucato, A, Ghidoni, S, Di Corato, P, Agnelli, G, Marchesini, E, Fabris, F, Carlon, M, Turatto, F, Baritusso, A, Amabile, A, Omenetto, E, Scarinzi, P, Manfredini, R, Molino, C, Pala, M, Fabbian, F, Boari, B, De Giorgi, A, Paolisso, G, Rizzo, M, Laieta, M, Rini, G, Mansueto, P, Pepe, I, Borghi, C, Strocchi, E, De Sando, V, Pareo, I, Sabba, C, Vella, F, Suppressa, P, Valerio, R, Agosti, P, Fontana, F, Loparco, F, Capobianco, C, Fenoglio, L, Bracco, C, Giraudo, A, Testa, E, Serraino, C, Fargion, S, Bonara, P, Periti, G, Porzio, M, Tiraboschi, S, Peyvandi, F, Tedeschi, A, Rossio, R, Monzani, V, Savojardo, V, Folli, C, Magnini, M, Conca, A, Gobbo, G, Pallini, G, Balduini, C, Bertolino, G, Provini, S, Quaglia, F, Dallegri, F, Ottonello, L, Liberale, L, Chin, W, Carassale, L, Caporotundo, S, Traisci, G, De Feudis, L, Di Carlo, S, Liberato, N, Buratti, A, Tognin, T, Bianchi, G, Giaquinto, S, Purrello, F, Di Pino, A, Piro, S, Rozzini, R, Falanga, L, Spazzini, E, Montrucchio, G, Greco, E, Tizzani, P, Petitti, P, Perciccante, A, Coralli, A, Salmi, R, Gaudenzi, P, Gamberini, S, Semplicini, A, Gottardo, L, Vendemiale, G, Serviddio, G, Forlano, R, Masala, C, Mammarella, A, Raparelli, V, Basili, S, Perri, L, Landolfi, R, Montalto, M, Mirijello, A, Vallone, C, Bellusci, M, Setti, D, Pedrazzoli, F, Guasti, L, Castiglioni, L, Maresca, A, Squizzato, A, Molaro, M, Bertolotti, M, Mussi, C, Libbra, M, Miceli, A, Pellegrini, E, Carulli, L, Veltri, F, Sciacqua, A, Quero, M, Bagnato, C, Colangelo, L, Falbo, T, De Giorgio, R, Grasso, V, Ruggeri, E, Ilaria, B, Salvi, A, Leonardi, R, Grassini, C, Mascherona, I, Minelli, G, Maltese, F, Damiani, G, Capeci, W, Mattioli, M, Martino, G, Biondi, L, Ormas, M, Pettinari, P, Romiti, R, Messina, S, Cavallaro, F, Ghio, R, Favorini, S, Dal Col, A, Minisola, S, Afeltra, A, Alemanno, P, Marigliano, B, Pipita, M, Castellino, P, Blanco, J, Zanoli, L, Cattaneo, M, Fracasso, P, Amoruso, M, Saracco, V, Fogliati, M, Bussolino, C, Durante, V, Eusebi, G, Tirotta, D, Mete, F, Gino, M, Cittadini, A, Vigorito, C, Arcopinto, M, Salzano, A, Bobbio, E, Sirico, D, Moreo, G, Scopelliti, F, Gasparini, F, Cocca, M, Ballestrero, A, Ferrando, F, Berra, S, Dassi, S, Nava, M, Graziella, B, Baldassarre, S, Fragapani, S, Galanti, G, Mascherini, G, Petri, C, Stefani, L, Girino, M, Piccinelli, V, Nasso, F, Gioffre, V, Pasquale, M, Scattolin, G, Martinelli, S, Turrin, M, Sechi, L, Catena, C, Colussi, G, Nieves, R, Alberto, M, Pedro, A, Vanessa, L, Lara, T, Xavier, C, Francesc, F, Jesus, D, Esperanza, B, Esther, D, Maria, S, Romero, M, Blanca, P, Cristina, L, Victoria, V, Saez, L, Bosco, J, Susana, S, Marta, A, Concepcion, G, Antonio, F, Hernandez, M, Borrego, M, Raquel, P, Florencia, P, Beatriz, G, Sara, C, Alfonso, G, Marta, P, Garcia, S, Alberto, R, Antonio, A, Montserrat, G, Angel, B, Manuel, M, Ignacio, N, Lucia, A, Alfonso, L, David, R, Iria, I, and Monica, R
Subjects: Registrie, Male, pharmacoepidemiology, Epidemiology, Discharged alive, 030204 cardiovascular system & hematology, internal medicine and geriatric ward, drug use, excessive polypharmacy, internal medicine and geriatric wards, older people, polypharmacy, 0302 clinical medicine, Drug Prescription, Risk Factors, 80 and over, Pharmacology (medical), 030212 general & internal medicine, Registries, At-Risk Population, media_common, Aged, 80 and over, Overtime, drug use, excessive polypharmacy, internal medicine and geriatric wards, older people, pharmacoepidemiology, polypharmacy, Pharmacoepidemiology, Hospitalization, Italy, Female, Medical emergency, Human, Drug, medicine.medical_specialty, media_common.quotation_subject, Socio-culturale, Drug Prescriptions, 03 medical and health sciences, Hospital discharge, medicine, Internal Medicine, Humans, Aged, Polypharmacy, Inpatients, business.industry, Risk Factor, medicine.disease, Emergency medicine, Older people, business
Abstract: Purpose: To assess the pattern of in-hospital changes in drug use in older patients from 2010 to 2016. Methods: People aged 65years or more acutely hospitalized in those internal medicine and geriatric wards that did continuously participate to the REgistro POliterapie Società Italiana di Medicina Interna register from 2010 to 2016 were selected. Drugs use were categorized as 0 to 1 drug (very low drug use), 2 to 4 drugs (low drug use), 5 to 9 drugs (polypharmacy), and 10 or more drugs (excessive polypharmacy). To assess whether or not prevalence of patients in relation to drug use distribution changed overtime, adjusted prevalence ratios (PRs) was estimated with log-binomial regression models. Results: Among 2120 patients recruited in 27 wards continuously participating to data collection, 1882 were discharged alive and included in this analysis. The proportion of patients with very low drug use (0-1 drug) at hospital discharge increased overtime, from 2.7% in 2010 to 9.2% in 2016. Results from a log-logistic adjusted model confirmed the increasing PR of these very low drug users overtime (particularly in 2014 vs 2012, PR 1.83 95% CI 1.14-2.95). Moreover, from 2010 to 2016, there was an increasing number of patients who, on polypharmacy at hospital admission, abandoned it at hospital discharge, switching to the very low drug use group. Conclusion: This study shows that in internal medicine and geriatric wards continuously participating to the REgistro POliterapie Società Italiana di Medicina Interna register, the proportion of patients with a very low drug use at hospital discharge increased overtime, thus reducing the therapeutic burden in this at risk population.
Published: 2017

18. Antipsychotic prescription and mortality in hospitalized older persons

Author: Deborah, Chiesa, Alessandra, Marengoni, Alessandro, Nobili, Mauro, Tettamanti, Luca, Pasina, Carlotta, Franchi, Codjo, D Djade, Salvatore, Corrao, Francesco, Salerno, Maura, Marcucci, Giuseppe, Romanelli, Pier Mannuccio Mannucci, Domenico, Prisco, Elena, Silvestri, Caterina, Cenci, Tommaso, Barnini, Giuseppe, Delitala, Stefano, Carta, Sebastiana, Atzori, Gianfranco, Guarnieri, Michela, Zanetti, Annalisa, Spalluti, Maria Grazia Serra, Maria Antonietta Bleve, Massimo, Vanoli, Giulia, Grignani, Gianluca, Casella, Laura, Gasbarrone, Giorgio, Maniscalco, Massimo, Gunelli, Daniela, Tirotta, Antonio, Brucato, Silvia, Ghidoni, Paola Di Corato, Mauro, Bernardi, Silvia Li Bassi, Luca, Santi, Giancarlo, Agnelli, Emanuela, Marchesini, Elmo, Mannarino, Graziana, Lupattelli, Pamela, Rondelli, Francesco, Paciullo, Fabrizio, Fabris, Michela, Carlon, Francesca, Turatto, Maria Cristina Baroni, Marianna, Zardo, Manfredini, Roberto, Christian, Molino, Marco, Pala, Fabbian, Fabio, Ranuccio, Nuti, Roberto, Valenti, Martina, Ruvio, Silvia, Cappelli, Giuseppe, Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Teresa, Salvatore, Ferdinando Carlo Sasso, Riccardo, Utili, Emanuele Durante Mangoni, Daniela, Pinto, Oliviero, Olivieri, Anna Maria Stanzial, Fellin, Renato, Volpato, Stefano, Sioulis, Fotini, Mario, Barbagallo, Ligia, Dominguez, Lidia, Plances, Daniela, D’Angelo, Giovanbattista, Rini, Pasquale, Mansueto, Ilenia, Pepe, Giuseppe, Licata, Luigi, Calvo, Maria, Valenti, Claudio, Borghi, Enrico, Strocchi, Elisa Rebecca Rinaldi, Marco, Zoli, Elisa, Fabbri, Donatella, Magalotti, Alberto, Auteri, Anna Laura Pasqui, Luca, Puccetti, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio, Bicchi, Carlo, Sabbà, Francesco Saverio Vella, Alessandro, Marseglia, Chiara Valentina Luglio, Giuseppe, Palasciano, Maria Ester Modeo, Annamaria, Aquilino, Pallante, Raffaele, Stefania, Pugliese, Caterina, Capobianco, Alfredo, Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Luigi, Fenoglio, Chiara, Brignone, Christian, Bracco, Alessia, Giraudo, Giuseppe, Musca, Olga, Cuccurullo, Luigi, Cricco, Alessandra, Fiorentini, Maria Domenica Cappellini, Giovanna, Fabio, Sonia, Seghezzi, Margherita Migone De Amicis, Silvia, Fargion, Paola, Bonara, Mara, Bulgheroni, Rosa, Lombardi, Marianna, Porzio, Giulia, Periti, Fabio, Magrini, Ferdinando, Massari, Tatiana, Tonella, Flora, Peyvandi, Alberto, Tedeschi, Raffaella, Rossio, Guido, Moreo, Barbara, Ferrari, Luisa, Roncari, Valter, Monzani, Valeria, Savojardo, Christian, Folli, Maria, Magnini, Daniela, Mari, Paolo Dionigi Rossi, Sarah, Damanti, Silvia, Prolo, Maria Sole Lilleri, Giuliana, Micale, Mauro, Podda, Carlo, Selmi, Francesca, Meda, Silvia, Accordino, Alessio, Conca, Valentina, Monti, Gino Roberto Corazza, Emanuela, Miceli, Marco Vincenzo Lenti, Donatella, Padula, Balduini, Carlo L., Giampiera, Bertolino, Stella, Provini, Federica, Quaglia, Giovanni, Murialdo, Marta, Bovio, Franco, Dallegri, Luciano, Ottonello, Alessandra, Quercioli, Alessandra, Barreca, Maria Beatrice Secchi, Davide, Ghelfi, Wu Sheng Chin, Laura, Carassale, Silvia, Caporotundo, Luigi, Anastasio, Lucia, Sofia, Maria, Carbone, Giancarlo, Traisci, Lucrezia De Feudis, Silvia Di Carlo, Giovanni, Davì, Maria Teresa Guagnano, Simona, Sestili, Elisabetta, Bergami, Emanuela, Rizzioli, Carlo, Cagnoni, Luca, Bertone, Antonio, Manucra, Alberto, Buratti, Tiziana, Tognin, Nicola Lucio Liberato, Giordano, Bernasconi, Barbara, Nardo, Giovanni Battista Bianchi, Sabrina, Giaquinto, Giampiero, Benetti, Michela, Quagliolo, Giuseppe Riccardo Centenaro, Francesco, Purrello, Antonino Di Pino, Salvatore, Piro, Gerardo, Mancuso, Daniela, Calipari, Mosè, Bartone, Francesco, Gullo, Michele, Cortellaro, Marina, Magenta, Francesca, Perego, Maria Rachele Meroni, Marco, Cicardi, Antonio Gidaro Marina Magenta, Andrea, Sacco, Antonio, Bonelli, Gaetano, Dentamaro, Renzo, Rozzini, Lina, Falanga, Alessandro, Giordano, Paolo Cavallo Perin, Bartolomeo, Lorenzati, Gabriella, Gruden, Graziella, Bruno, Giuseppe, Montrucchio, Elisabetta, Greco, Pietro, Tizzani, Giacomo, Fera, Maria Loreta Di Luca, Donatella, Renna, Antonio, Perciccante, Alessia, Coralli, Rodolfo, Tassara, Deborah, Melis, Lara, Rebella, Giorgio, Menardo, Stefania, Bottone, Elsa, Sferrazzo, Claudio, Ferri, Rinaldo, Striuli, Rosa, Scipioni, Raffaella, Salmi, Piergiorgio, Gaudenzi, Susanna, Gamberini, Franco, Ricci, Cosimo, Morabito, Roberto, Fava, Andrea, Semplicini, Lucia, Gottardo, Gianluigi, Vendemiale, Gaetano, Serviddio, Roberta, Forlano, Luigi, Bolondi, Leonardo, Rasciti, Ilaria, Serio, Cesare, Masala, Antonio, Mammarella, Raparelli, Valeria, Filippo Rossi Fanelli, Massimo, Delfino, Antonio, Amoroso, Francesco, Violi, Stefania, Basili, Ludovica, Perri, Pietro, Serra, Vincenzo, Fontana, Marco, Falcone, Raffaele, Landolfi, Antonio, Grieco, Antonella, Gallo, Giuseppe, Zuccalà, Francesco, Franceschi, Guido De Marco, Cordischi, Chiara, Sabbatini, Marta, Martino, Bellusci, Donatella, Setti, Filippo, Pedrazzoli, Caterina, Pirali, Claudia, Amolini, Enrico Agabiti Rosei, Damiano, Rizzoni, Luana, Castoldi, Antonio, Picardi, Umberto Vespasiani Gentilucci, Chiara, Mazzarelli, Paolo, Gallo, Luigina, Guasti, Luana, Castiglioni, Andrea, Maresca, Alessandro, Squizzato, Sara, Contini, Marta, Molaro, Giorgio, Annoni, Maurizio, Corsi, Sara, Zazzetta, Marco, Bertolotti, Chiara, Mussi, Roberto, Scotto, Maria Alice Ferri, Francesca, Veltri, Franco, Arturi, Elena, Succurro, Giorgio, Sesti, Umberto, Gualtieri, Francesco, Perticone, Angela, Sciacqua, Michele, Quero, Chiara, Bagnato, Paola, Loria, Maria Angela Becchi, Gianfranco, Martucci, Alessandra, Fantuzzi, Mauro, Maurantonio, Roberto, Corinaldesi, DE GIORGIO, Roberto, Mauro, Serra, Valentina, Grasso, Eugenio, Ruggeri, Lorenzo Mauro Carozza, Fabio, Pignatti., Chiesa, D., Marengoni, A., Nobili, A., Tettamanti, M., Pasina, L., Franchi, C., Djade, C., Corrao, S., Salerno, F., Marcucci, M., Romanelli, G., and Mannucci, P.
Subjects: Male, Socio-culturale, Older person, Antipsychotic, Cognition, Economica, Antipsychotics, Hospitalization, Mortality, Older persons, Gerontology, Geriatrics and Gerontology, Psychiatry and Mental Health, Humans, Psychomotor Agitation, Aged, antipsychotics, hospitalization, mortality, older persons, Aged, 80 and over, Mental Disorders, Patient Discharge, antipsychotics, Italy, hospitalization, mortality, older persons, Dementia, Female, Antipsychotic Agents
Abstract: Background: Recent scientific reports have shown that older persons treated with antipsychotics for dementia-related behavioural symptoms have increased mortality. However, the impact of these drugs prescribed during hospitalization has rarely been assessed. We aimed to investigate whether antipsychotics are associated with an increased risk of mortality during hospitalization and at 3-month follow-up in elderly inpatients. Methods: We analyzed data gathered during two waves (2010 and 2012) by the REPOSI (Registro Politerapie SocietÃ Italiana Medicina Interna). All new prescriptions of antipsychotic drugs during hospitalization, whether maintained or discontinued at discharge, were collected, and logistic regression models were used to analyze their association with in-hospital and 3-month mortality. Covariates were age, sex, the Short Blessed Test (SBT) score, and the Cumulative Illness Rating Scale. Results: Among 2703 patients included in the study, 135 (5%) received new prescriptions for antipsychotic drugs. The most frequently prescribed antipsychotic during hospitalization and eventually maintained at discharge was haloperidol (38% and 36% of cases, respectively). Patients newly prescribed with antipsychotics were older and had a higher Cumulative Illness Rating Scale comorbidity index both at admission and at discharge compared to those who did not receive a prescription. Of those prescribed antipsychotics, 71% had an SBT score â¥10 (indicative of dementia), 12% had an SBT score of 5-9 (indicative of questionable dementia); and 17% had an SBT score
Published: 2017

19. Persistence of Nonceliac Wheat Sensitivity, Based on Long-term Follow-up

Author: Ada Maria Florena, Giuseppe Iacono, Francesca Fayer, Antonio Carroccio, A. Arini, Francesco La Blasca, Francesca Cavataio, Girolamo Geraci, Alberto D'Alcamo, Pasquale Mansueto, Maurizio Soresi, Rosario Iacobucci, Carroccio, A., D'Alcamo, A., Iacono, G., Soresi, M., Iacobucci, R., Arini, A., Geraci, G., Fayer, F., Cavataio, F., La Blasca, F., Florena, A., and Mansueto, P.
Subjects: Adult, Male, medicine.medical_specialty, Pathology, Settore MED/09 - Medicina Interna, Long term follow up, Nonceliac Wheat Sensitivity, Wheat Hypersensitivity, Persistence (computer science), Persistence, Diet, Gluten-Free, 03 medical and health sciences, 0302 clinical medicine, Food allergy, Surveys and Questionnaires, Internal medicine, medicine, Humans, Prospective Studies, Irritable bowel syndrome, Hepatology, Long-term Follow-up, business.industry, Gastroenterology, Middle Aged, medicine.disease, 030220 oncology & carcinogenesis, Chronic Disease, Patient Compliance, Female, 030211 gastroenterology & hepatology, Symptom Assessment, business, Follow-Up Studies
Abstract: We investigated how many patients with a diagnosis of nonceliac wheat sensitivity (NCWS) still experienced wheat sensitivity after a median follow-up time of 99 months. We collected data from 200 participants from a previous study of NCWS, performed between July and December 2016 in Italy; 148 of these individuals were still on a strict wheat- free diet. In total, 175 patients (88%) improved (had fewer symptoms) after a diagnosis of NCWS; 145 of 148 patients who adhered strictly to a gluten-free diet (98%) had reduced symptoms, compared with 30 of 52 patients who did not adhere to a gluten-free diet (58%) (P < .0001). Of the 22 patients who repeated the double-blind, placebo- controlled challenge, 20 reacted to wheat. We conclude that NCWS is a persistent condition. Clinicaltrials.gov registration number: NCT02823522.
Published: 2017

20. Contact dermatitis due to nickel allergy in patients suffering from non-celiac wheat sensitivity

Author: Liana Bosco, Rosario Iacobucci, Francesca Cavataio, Alberto D'Alcamo, Antonio Carroccio, Maurizio Soresi, Giuseppe Iacono, Francesca Fayer, Pasquale Mansueto, Laura Di Stefano, Francesco La Blasca, A. Arini, Girolamo Geraci, D'Alcamo, A., Mansueto, P., Soresi, M., Iacobucci, R., La Blasca, F., Geraci, G., Cavataio, F., Fayer, F., Arini, A., DI STEFANO, L., Iacono, G., Bosco, L., and Carroccio, A.
Subjects: Adult, Male, 0301 basic medicine, Nickel allergy, medicine.medical_specialty, Letter, Settore MED/09 - Medicina Interna, Non-celiac wheat sensitivity, non-celiac wheat insensitivity, Wheat Hypersensitivity, Article, cutaneous symptoms, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Nickel, Hypersensitivity, medicine, Cutaneous symptom, Humans, Ingestion, In patient, Prospective Studies, Prospective cohort study, systemic nickel allergy syndrome, Triticum, Irritable bowel syndrome, Nutrition and Dietetics, business.industry, Case-control study, Patch test, non‐celiac wheat sensitivity, nickel allergy, irritable bowel syndrome, Cutaneous symptoms, Food Science, Patch Tests, medicine.disease, intradermal testing, Dermatology, Surgery, non-celiac wheat sensitivity, 030104 developmental biology, Case-Control Studies, Dermatitis, Allergic Contact, Female, 030211 gastroenterology & hepatology, business, Contact dermatitis
Abstract: Background: Non‐celiac wheat sensitivity (NCWS) is a new clinical entity in the world of gluten‐related diseases. Nickel, the most frequent cause of contact allergy, can be found in wheat and results in systemic nickel allergy syndrome and mimics irritable bowel syndrome (IBS). Objective: To evaluate the frequency of contact dermatitis due to nickel allergy in NCWS patients diagnosed by a double‐blind placebo‐controlled(DBPC)challenge,and to identify the characteristics of NCWS patients with nickel allergy. Methods: We performed a prospective study of 60 patients (54 females, 6 males; mean age 34.1 ± 8.1 years) diagnosed with NCWS from December 2014 to November 2016; 80 age‐ and sex‐matched subjects with functional gastrointestina l symptoms served as controls. Patients reporting contact dermatitis related to nickel‐containing objects underwent nickel patch test (Clinicaltrials.gov registration number: NCT02750735).Results: Six out of sixty patients (10%) with NCWS suffered from contact dermatitis and nickel allergy and this frequency was statistically higher (p = 0.04)than observed in the control group(5%. The main clinical characteristic of NCWS patients with nickel allergy was a higher frequency of cutaneous symptoms after wheat ingestion compared to NCWS patients who did not suffer from nickel allergy (p < 0.0001. Conclusions: Contact dermatitis and nickel allergy are more frequent in NCWS patients than in subjects with functional gastrointestinal disorders;furthermore, these patients had a very high frequency of cutaneous manifestations after wheat ingestion. Nickel allergy should be evaluated in NCWS patients who have cutaneous manifestations after wheat ingestion.
Published: 2017

21. PREVALENCE OF ANTIBODIES ANTI-BARTONELLA HENSELAEIN WESTERN SICILY: CHILDREN, BLOOD DONORS, AND CATS

Author: Salvatore Di Rosa, Francesco Arcoleo, Maria Francesca Di Gregorio, Anna Micalizzi, Giustina Vitale, Ilenia Pepe, Floriana Bonura, Letizia Palillo, Enrico Cillari, Giovam Battista Rini, Affronti M, Pasquale Mansueto, and Aurelio Seidita
Subjects: Adult, Male, Bartonella, Adolescent, Clinical Biochemistry, Immunology, Blood Donors, Young Adult, medicine, Animals, Humans, Immunology and Allergy, Seroprevalence, Child, Fluorescent Antibody Technique, Indirect, Sicily, Direct fluorescent antibody, Antigens, Bacterial, Bartonella henselae, CATS, biology, Infant, Cat-scratch disease, Middle Aged, biology.organism_classification, medicine.disease, Antibodies, Bacterial, Virology, Medical Laboratory Technology, Titer, Immunoglobulin M, Child, Preschool, Immunoglobulin G, Cats, biology.protein, Female, Antibody
Abstract: To evaluate seroprevalence of B. henselae infection both in Sicilian children and healthy blood donors. Furthermore, circulation of Bartonella in the natural reservoir was also studied. Two hundred forty-three children, living in Sicily (Palermo), affected by various diseases, without clinical features suggesting B. henselae infection, together with 122 healthy blood donors were serologically investigated for IgG and IgM antibodies by indirect fluorescent antibody test (IFAT). One hundred twenty stray and 62 pet cats were also analyzed only for IgG. Among children 25.1% had IgG antibodies to B. henselae; 18.5% showed a titer 1:64, 2.4% 1:128, 2.4% 1:256, 0.8% 1:512, 0.4% 1:1024, and 0.4% 1:5120. Among healthy blood donors 11.4% had IgG class antibodies to B. henselae; 9.8% showed a titer 1:64 and 1.6% 1:128. All the human serum samples did not show positive results for B. henselae IgM class antibodies. Stray cats (68.3%) and pet cats (35.4%) also had IgG class antibodies to B. henselae. We demonstrated high frequency of serologic evidence of past B. henselae infection, in young Italian children, affected by various diseases, apparently free of any clinical features suggesting B. henselae infection. This observation is supported by high circulation of Bartonella in cats.
Published: 2012

22. A Cytologic Assay for Diagnosis of Food Hypersensitivity in Patients With Irritable Bowel Syndrome

Author: Lidia Di Prima, M.L. Lospalluti, Giuseppe Iacono, Maria Barrale, Antonio Carroccio, Gaetana Di Fede, Pasquale Mansueto, Giuseppe Ambrosiano, Giuseppe Pirrone, Ignazio Brusca, Stella Maria La Chiusa, Carroccio, A, Brusca, I, Mansueto, P, Pirrone, G, Barrale M, Di Prima, L, Ambrosiano, G, Iacono, G, Lospalluti, ML, La Chiusa, SM, and Di Fede, G
Subjects: Adult, Male, food hypersensitivity, Settore MED/09 - Medicina Interna, Adolescent, Cytologic assay, irritable bowel disease, Cytological Techniques, Platelet Membrane Glycoproteins, Immunoglobulin E, Sensitivity and Specificity, Irritable Bowel Syndrome, Young Adult, Antigen, Antigens, CD, Elimination diet, medicine, Animals, Humans, Young adult, Cells, Cultured, Irritable bowel syndrome, Hepatology, biology, CD63, Tetraspanin 30, business.industry, Gastroenterology, Allergens, Middle Aged, medicine.disease, Basophils, Basophil activation, Immunology, biology.protein, Female, Antibody, business
Abstract: BACKGROUND & AIMS: A percentage of patients with symptoms of irritable bowel syndrome (IBS) suffer from food hypersensitivity (FH) and improve on a food-elimination diet. No assays have satisfactory levels of sensitivity for identifying patients with FH. We evaluated the efficacy of an in vitro basophil activation assay in the diagnosis of FH in IBS-like patients. METHODS: Blood samples were collected from 120 consecutive patients diagnosed with IBS according to Rome II criteria. We analyzed in vitro activation of basophils by food allergens (based on levels of CD63 expression), as well as total and food-specific immunoglobulin (Ig)E levels in serum. Effects of elimination diets and double-blind food challenges were used as standards for FH diagnosis. RESULTS: Twenty-four of the patients (20%) had FH (cow's milk and/or wheat hypersensitivity); their symptom scores improved significantly when they were placed on an elimination diet. Patients with FH differed from other IBS patients in that they had a longer duration of clinical history, a history of FH as children, and an increased frequency of self-reported FH; they also had hypersensitivities to other antigens (eg, egg or soy). The basophil activation assay diagnosed FH with 86% sensitivity, 88% specificity, and 87% accuracy; this level of sensitivity was significantly higher than that of serum total IgE or food-specific IgE assays. CONCLUSIONS: A cytometric assay that quantifies basophils after stimulation with food antigens based on cell-surface expression of CD63 had high levels of sensitivity, specificity, and accuracy in diagnosing FH. This assay might be used to diagnose FH in patients with IBS-like symptoms.
Published: 2010

23. Fever of unknown origin in a Mediterranean survey from a division of internal medicine: report of 91 cases during a 12-year-period (1991–2002)

Author: Gabriele Di Lorenzo, Manfredi Rizzo, Serafino Mansueto, Affronti M, Giustina Vitale, Salvatore Di Rosa, Giovam Battista Rini, and Pasquale Mansueto
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Registration system, Diagnostic tools, Fever of Unknown Origin, Internal medicine, Prevalence, Internal Medicine, medicine, Humans, Fever of unknown origin, Prospective cohort study, Aged, Retrospective Studies, business.industry, Retrospective cohort study, Middle Aged, Prognosis, medicine.disease, Italy, Collagen vascular disease, Emergency Medicine, Female, business
Abstract: Despite the availability of all advanced diagnostic tools, fever of unknown origin (FUO) remains a diagnostic challenge for physicians. The objective was to define, through a retrospective study, the categories of the diseases of Sicilian patients admitted at the Department of Clinical Medicine and Emerging Diseases, University of Palermo, Italy, for classical FUO. Using the registration system for patients admitted from 1991 to 2002, 508 charts of patients admitted because of fever were reviewed. Of these, only 91 patients fulfilled the criteria for classical FUO. The origin of FUO was diagnosed in 62 (68.1%) patients. Infection was the most common cause of FUO with 29 cases (31.8% of total of FUO), neoplasms accounted for 13 cases (14.2%), collagen vascular disease for 11 cases (12.0%), and miscellaneous for 9 cases (9.8%). Undiagnosed FUO were 29 (31.8%) and, of them, 22 cases were followed-up for 2 years. A definite diagnosis could be established only in 8 cases, 13 subjects completely recovered and 4 of them died. In the 73.4% of cases, the FUO have been the result of misleading factors in the diagnostic approaches as made by the physician. The results of our study are similar to those already reported by other authors in other populations, with infections as first, neoplasm as second, and collagen vascular diseases as third most important causes of FUO. In our study the prognosis for undiagnosed FUO cases was good, but a definite diagnosis could be established only in few cases. Therefore, further multicentric, prospective studies of good design are required.
Published: 2008

24. Similarity and differences in elderly patients with fixed airflow obstruction by asthma and by chronic obstructive pulmonary disease

Author: Alberto D'Alcamo, Cristina Farina, Maria Esposito-Pellitteri, Francesco Gervasi, Gabriele Di Lorenzo, Gaetana Di Fede, Maria Stefania Leto-Barone, Calogero Caruso, Giovam Battista Rini, Vito Ditta, Claudia Lo Bianco, Pasquale Mansueto, DI LORENZO G, MANSUETO P, DITTA V, ESPOSITO-PELLITTERI M, LO BIANCO C, LETO-BARONE MS, D'ALCAMO A, FARINA C, DI FEDE G, GERVASI F, CARUSO C, and RINI G
Subjects: Male, Pulmonary and Respiratory Medicine, Vital capacity, medicine.medical_specialty, Settore MED/09 - Medicina Interna, asthma, chronic obstructive pulmonary disease, Neutrophils, Vital Capacity, chronic obstructive pulmonary disease, Gastroenterology, Pulmonary function testing, Pulmonary Disease, Chronic Obstructive, FEV1/FVC ratio, Elderly, DLCO, Forced Expiratory Volume, Internal medicine, medicine, Humans, elderly patients, fixed airflow obstruction, asthma, Aged, Asthma, COPD, Eosinophil cationic protein, business.industry, Chronic obstructive pulmonary disease, Respiratory disease, Sputum, medicine.disease, Respiratory Function Tests, elderly patient, respiratory tract diseases, Surgery, Eosinophils, Female, business
Abstract: SummaryBackgroundEpidemiologic studies have demonstrated that elderly patients with fixed airflow obstruction can be affected by asthma or chronic obstructive pulmonary disease (COPD).MethodsWe studied 49 consecutive elderly outpatients, presenting fixed airflow obstruction, by clinical history (smoking), pulmonary function tests, blood gas analysis, and induced sputum.ResultsThe age was not different in patients with COPD (n=28) and asthma (n=21) (70.2±3.9 years vs. 69.6±3.7 years), also the degree of fixed airflow obstruction was similar (FEV1: 58.3±1.5% vs. 59.0±1.4% of predicted). Patients with asthma had significantly more eosinophils in peripheral blood (0.43±0.05×10−3μL vs. 0.27±0.1×10−3μL, P
Published: 2008

25. High Proportions of People With Nonceliac Wheat Sensitivity Have Autoimmune Disease or Antinuclear Antibodies

Author: Pasquale Mansueto, Carmelo Sciumè, Giuseppe Iacono, Maurizio Soresi, Girolamo Geraci, Antonio Carroccio, Francesca Cavataio, Alberto D'Alcamo, Aurelio Seidita, Carroccio, A., D'Alcamo, A., Cavataio, F., Soresi, M., Seidita, A., Sciume', C., Geraci, G., Iacono, G., and Mansueto, P.
Subjects: Adult, Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Anti-nuclear antibody, Nonceliac Wheat Sensitivity, Autoimmune Disease, Antinuclear Antibodies, Wheat Hypersensitivity, Thyroiditis, Autoimmune Diseases, Risk Factors, Internal medicine, HLA-DQ Antigens, medicine, Prevalence, Humans, Prospective Studies, Prospective cohort study, Irritable bowel syndrome, Retrospective Studies, Autoimmune disease, Hepatology, business.industry, Medical record, Gastroenterology, HLA-DQ2, Retrospective cohort study, Middle Aged, medicine.disease, Celiac Disease, Haplotypes, Italy, Antibodies, Antinuclear, Immunology, Female, business, Biomarkers
Abstract: BACKGROUND & AIMS: There is much interest in wheat sensitivity among people without celiac disease (CD), but little is known about any risks associated with the condition. We evaluated the prevalence of autoimmune diseases (ADs) among patients with nonceliac wheat sensitivity (NCWS), and investigated whether they carry antinuclear antibodies (ANA). METHODS: We performed a retrospective study of 131 patients diagnosed with NCWS (121 female; mean age, 29.1 years) at 2 hospitals in Italy from January 2001 through June 2011. Data were also collected from 151 patients with CD or irritable bowel syndrome (IBS) (controls). Patient medical records were reviewed to identify those with ADs. We also performed a prospective study of 42 patients (38 female; mean age, 34 years) diagnosed with NCWS from July 2011 through March 2014 at 3 hospitals in Italy. One hundred age- and sex-matched subjects with CD or IBS served as controls. Serum samples were collected from all subjects and ANA levels were measured by immunofluorescence analysis. Participants completed a questionnaire and their medical records were reviewed to identify those with ADs. RESULTS: In the retrospective analysis, similar portions of subjects with NCWS (29%) and CD (29%) developed ADs (mainly Hashimoto's thyroiditis, 29 cases), compared with a smaller proportion of subjects with IBS (4%) (P < .001). In the prospective study, 24% of subjects with NCWS, 20% of subjects with CD, and 2% of subjects with IBS developed ADs (P < .001). In the retrospective study, serum samples tested positive for ANA in 46% of subjects with NCWS (median titer, 1:80), 24% of subjects with CD (P < .001), and 2% of subjects IBS (P < .001); in the prospective study, serum samples were positive for ANA in 28% of subjects with NCWS, 7.5% of subjects with CD (P = .02), and 6% of subjects with IBS (P = .005 vs patients with NCWS). ANA positivity was associated with the presence of the HLA DQ2/DQ8 haplotypes (P < .001). CONCLUSIONS: Higher proportions of patients with NCWS or CD develop autoimmune disorders, are ANA positive, and showed DQ2/DQ8 haplotypes compared with patients with IBS.
Published: 2015

26. Tacrolimus ointment in nickel sulphate–induced steroid-resistant allergic contact dermatitis

Author: Pasquale Mansueto, Maria Esposito Pellitteri, Maria Luisa Pacor, Giovam Battista Rini, Roberto Corrocher, Gabriele Di Lorenzo, Simonetta Friso, Gaetana Di Fede, and Nicola Martinelli
Subjects: Adult, Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, Erythema, Drug Resistance, Nickel sulphate, Placebo, Tacrolimus, Ointments, Double-Blind Method, Adrenal Cortex Hormones, Nickel, medicine, Humans, Immunology and Allergy, Adverse effect, Allergic contact dermatitis, business.industry, General Medicine, Middle Aged, medicine.disease, Steroid resistant, Dermatology, surgical procedures, operative, Dermatitis, Allergic Contact, Irritants, Itching, Female, medicine.symptom, business, Immunosuppressive Agents
Abstract: Tacrolimus ointment is a topical immunomodulator. Currently, there is available evidence regarding the potential use of topical tacrolimus in a range of dermatological disorders. The aim of this study was to evaluate the efficacy and safety of tacrolimus ointment 0.1% for the nickel sulfate-induced steroid-resistant allergic contact dermatitis (ACD). A randomized, double-blind, placebo-controlled, parallel-group study design was performed in a total of 28 patients affected by nickel sulfate-induced steroid-resistant ACD after a 14-day run-in period. Then, the enrolled patients were randomized into two subgroups. Group A was treated with tacrolimus for 14 days and finally observed for a 7-day follow-up period. Group B, instead, was treated with placebo (vehicle). Four major symptoms (erythema, oozing, scaling, and itching) were considered as outcomes during the different phases of the study. In group A, during the treatment period with tacrolimus, a significant improvement was observed in all four considered symptoms. On the other hand, no improvement in symptoms was observed in the placebo-treated group B. Local adverse events in the tacrolimus-treated group, such as burning/itching at the application site, were transient and well tolerated. No patients withdrew because of burning/itching. In our study, tacrolimus ointment 0.1% appeared to be both effective and safe in the treatment of nickel sulfate-induced steroid-resistant ACD.
Published: 2006

27. Nonceliac wheat sensitivity in the context of multiple food hypersensitivity: new data from confocal endomicroscopy

Author: Pasquale Mansueto, Antonio Carroccio, Alberto D'Alcamo, Carroccio, A., D'Alcamo, A., and Mansueto, P.
Subjects: Male, Pathology, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Duodenum, Confocal, Context (language use), Nonceliac wheat sensitivity, multiple food hypersensitivity, confocal endomicroscopy, Endoscopy, Gastrointestinal, Irritable Bowel Syndrome, Endomicroscopy, medicine, Humans, Sensitivity (control systems), Intestinal Mucosa, Microscopy, Confocal, Hepatology, business.industry, Gastroenterology, Food hypersensitivity, Food, Female, business, Food Hypersensitivity
Abstract: Dear Editor, We enjoyed reading the article by Fritscher-Ravens et al who showed, by confocal endomicroscopy, that candidate food antigens caused immediate duodenal mucosa damage in irritable bowel syndrome (IBS) patients with a prolonged clinical history of symptoms after meals. Their in vivo data add evidence to the relationship between IBS and food allergy and seem to reinforce our hypothesis that a percentage of “nonceliac wheat sensitive” (NCWS) -patients with an IBS-like clinical presentation could suffer from non-immunoglobulin E-mediated wheat allergy. However, we would suggest that the very high percentage of positive confocal laser endomicroscopy patients (CLE) -22 out of 36- found in the study of Fritscher-Ravens et al could depend on their inclusion criteria (refractory daily symptoms >1 year, daily shortly after meal symptoms); in our experience, the frequency of food hypersensitivity diagnosed by double-blind, placebo-controlled (DBPC) food challenges in IBS is slightly 25 IEL per 100 EC in the duodenal mucosa, very probably missed the group of NCWS patients who had an immunologic pathogenesis at the basis of their troubles. However, in our opinion, NCWS is a heterogeneous condition, which includes different subgroups of patients and the “allergic hypothesis” does not exclude that, in other NCWS patients, wheat amylase trypsin inhibitors or fermentable sugars4 could be the main pathogenetic triggers. Finally, we think that the authors showed that CLE is an excellent instrument to demonstrate food-related reactions in IBS and to separate a subgroup of the NCWS -those with non-immunoglobulin E-mediated wheat hypersensitivity- from the confuse melting pot that NCWS still is. However, awaiting a wider diffusion of this endoscopic means, and taking into account that the economic resources are decreasing in developed countries, it would be very important to correlate the CLE finding with simpler, noninvasive biomarkers. In this respect, it would be interesting to know whether CLE findings correlate with the eosinophil cationic protein concentrations in the stools or with the flow cytometric allergen stimulation assay results, biomarkers that showed a good concordance with the DBPC challenge results in IBS patients.
Published: 2014

28. Role of TLR4 Receptor Polymorphisms in Boutonneuse Fever

Author: Carmela Rita Balistreri, Serafino Mansueto, Claudio Franceschi, G. Di Lorenzo, Giuseppina Candore, Calogero Caruso, Rini Gb, Pasquale Mansueto, Enrico Cillari, Domenico Lio, Giuseppina Colonna-Romano, Balistreri C.R., Candore G., Lio D., Colonna-Romano G., Di Lorenzo G., Mansueto P., Rini G., Mansueto S., Cillari E., Franceschi C., Caruso C., BALISTRERI CR, CANDORE G, LIO D, COLONNA-ROMANO G, DI LORENZO G, MANSUETO P, RINI GB, MANSUETO S, CILLARI E, FRANCESCHI C, and CARUSO C
Subjects: Adult, Male, Settore MED/09 - Medicina Interna, Genotype, media_common.quotation_subject, Immunology, Boutonneuse Fever, polymorphism, 03 medical and health sciences, 0302 clinical medicine, Gene Frequency, Polymorphism (computer science), medicine, Humans, Immunology and Allergy, TLR4 receptor, Allele, polymorphisms, Boutonneuse fever, Sicily, Allele frequency, Alleles, Aged, media_common, Aged, 80 and over, Pharmacology, Polymorphism, Genetic, business.industry, Longevity, DNA, Middle Aged, medicine.disease, Toll-Like Receptor 4, Rickettsiosis, 030220 oncology & carcinogenesis, TLR4, Female, business, 030215 immunology
Abstract: The genetics of the interaction between host and microbes plays an essential role in the survival of the individual and attainment of longevity. The activation of toll-like receptor (TLR)4 plays a key role in natural and clonotypic immune responses. We evaluated whether TLR4 genotype is a component of genetic background protective versus rickettsiosis and whether this background influences longevity. We genotyped for +896A/G TLR4 polymorphism 78 patients affected by Boutonneuse fever, 78 age-matched controls and 78 advanced age individuals from Sicily. The +869G allele, that attenuates receptor signalling, was significantly overrepresented in patients in comparison with age-matched controls. By analyzing data according to gender, this allele was significantly higher in female patients when compared to advanced age women. Pro-inflammatory responses are programmed to resist fatal infections. So, it is not surprising that the genetic background of people that survive to an advanced age may be protective against infections. However, this seems to occur in women but not in men. In a previous study, the +896G TLR4 allele was overrepresented in advanced age men and underrepresented in men affected by myocardial infarction. Thus, previous and present results tend to agree with the suggestion that men and women may follow different trajectories to reach longevity. For men it might be more important to control atherogenesis, whereas for women it might be more important to control infectious diseases.
Published: 2005

29. A multicentre case control study on complicated coeliac disease: two different patterns of natural history, two different prognoses

Author: Sergio Segato, Gino Roberto Corazza, Carolina Ciacci, Rachele Ciccocioppo, Annalisa Schiepatti, Anna D'Odorico, Anna Chiara Piscaglia, Giovanni de Pretis, A. Marchese, Umberto Volta, Alida Andrealli, Pasquale Mansueto, Marco Astegiano, Francesca Ferretti, Italo De Vitis, Paolo G. Gobbi, Federico Biagi, Matteo Neri, Alberto Meggio, Giuseppe Ambrosiano, Antonio Gasbarrini, Giacomo Caio, Antonio Carroccio, Fabiana Zingone, Biagi, F, Marchese. A, Ferretti, F, Ciccocioppo, R, Schiepatti, A, Volta, U, Caio, G, Ciacci, C, Zingone, F, D'Odorico, A, Carroccio, A, Ambrosiano, G, Mansueto, P, Gasbarrini, A, Piscaglia, AC, Andrealli, A, Astegiano, M, Segato, S, Neri, M, Meggio, A, de Pretis, G, De Vitis, I, Gobbi, P, Corazza, GR, Biagi F, Marchese A, Ferretti F, Ciccocioppo R, Schiepatti A, Volta U, Caio G, Ciacci C, Zingone F, D'Odorico A, Carroccio A, Ambrosiano G, Mansueto P, Gasbarrini A, Piscaglia AC, Andrealli A, Astegiano M, Segato S, Neri M, Meggio A, de Pretis G, De Vitis I, Gobbi P, and Corazza GR
Subjects: Male, Complications, Settore MED/09 - Medicina Interna, Lymphoma, Small, Gastroenterology, Coeliac disease, Enteropathy-Associated T-Cell Lymphoma, Intestine, Small, Medicine, Celiac disease, Enteropathy, Treatment Failure, INTESTINAL T-CELL LYMPHOMA, GLUTEN FREE DIET, General Medicine, complicated coeliac disease, natural history, prognosis, Ileitis, Middle Aged, Prognosis, Enteritis, Intestine, Natural history, Adult, Aged, Carcinoma, Case-Control Studies, Celiac Disease, Collagenous Sprue, Disease Progression, Female, Humans, Intestinal Neoplasms, Jejunal Diseases, Lymphoma, B-Cell, Diet, Gluten-Free, Gluten-free diet, Enteropathy-associated T-cell lymphoma, prognosi, Research Article, medicine.medical_specialty, Glutens, Settore MED/12 - GASTROENTEROLOGIA, complications/drug therapy/mortality, Myocytes, celiac disease, NO, Internal medicine, complications/drug therapy/mortality, Survival rate, CELIAC DISEASE, Myocytes, business.industry, B-Cell, Case-control study, nutritional and metabolic diseases, Hepatology, medicine.disease, digestive system diseases, Diet, EATL, Gluten-Free, Gluten free, business, Complication, coeliac disease
Abstract: Background: Coeliac disease is a common enteropathy characterized by an increased mortality mainly due to its complications. The natural history of complicated coeliac disease is characterised by two different types of course: patients with a new diagnosis of coeliac disease that do not improve despite a strict gluten-free diet (type A cases) and previously diagnosed coeliac patients that initially improved on a gluten-free diet but then relapsed despite a strict diet (type B cases). Our aim was to study the prognosis and survival of A and B cases. Methods: Clinical and laboratory data from coeliac patients who later developed complications (A and B cases) and sex- and age-matched coeliac patients who normally responded to a gluten-free diet (controls) were collected among 11 Italian centres. Results: 87 cases and 136 controls were enrolled. Complications tended to occur rapidly after the diagnosis of coeliac disease and cumulative survival dropped in the first months after diagnosis of complicated coeliac disease. Thirty-seven cases died (30/59 in group A, 7/28 in group B). Type B cases presented an increased survival rate compared to A cases. Conclusions: Complicated coeliac disease is an extremely serious condition with a high mortality and a short survival. Survival depends on the type of natural history.
Published: 2014

30. Low incidence but poor prognosis of complicated coeliac disease: A retrospective multicentre study

Author: Gino Roberto Corazza, A. Marchese, Antonio Carroccio, Giuseppe Ambrosiano, Pasquale Mansueto, Fabiana Zingone, E. Borsotti, Umberto Volta, Carolina Ciacci, Federico Biagi, Giacomo Caio, Paolo G. Gobbi, Biagi F, Gobbi P, Marchese A, Borsotti E, Zingone F, Ciacci C, Volta U, Caio G, Carroccio A, Ambrosiano G, Mansueto P, Corazza GR, Biagi, F., Gobbi, P., Marchese, A., Borsotti, E., Zingone, F., Ciacci, C., Volta, U., Caio, G., Carroccio, A., Ambrosiano, G., Mansueto, P., and Corazza, G.
Subjects: Adult, Male, Pediatrics, medicine.medical_specialty, Poor prognosis, Lymphoma, B-Cell, Settore MED/09 - Medicina Interna, Complications, CELIAC DISEASE, complicated coeliac disease, Kaplan-Meier Estimate, Gastroenterology, Coeliac disease, NO, Cohort Studies, Enteropathy-Associated T-Cell Lymphoma, Refractory, Internal medicine, Epidemiology, Intestinal Neoplasms, Intestine, Small, medicine, Prevalence, Humans, Aged, Retrospective Studies, Hepatology, business.industry, Incidence (epidemiology), Incidence, Carcinoma, Curve analysis, nutritional and metabolic diseases, Middle Aged, medicine.disease, Prognosis, digestive system diseases, Lymphoma, Italy, Abdominal Neoplasms, Case-Control Studies, Cohort, Female, business
Abstract: Background Coeliac disease is a chronic enteropathy characterized by an increased mortality caused by its complications, mainly refractory coeliac disease, small bowel carcinoma and abdominal lymphoma. Aim of the study was to study the epidemiology of complications in patients with coeliac disease. Methods Retrospective multicenter case–control study based on collection of clinical and laboratory data. The incidence of complicated coeliac disease was studied among coeliac patients directly diagnosed in four Italian centres. Patients referred to these centres after a diagnosis of coeliac disease and/or complicated coeliac disease in other hospitals were therefore excluded. Results Between 1/1999 and 10/2011, 1840 adult coeliac patients were followed up for 7364.3 person-years. Fourteen developed complications. Since five patients died, at the end of the observation period (10/2011), the prevalence of complicated coeliac disease was 9/1835 (1/204, 0.49%, 95% CI 0.2–0.9%). The annual incidence of complicated coeliac disease in the study period was 14/7364 (0.2%, 95% CI 0.1–0.31%). Although complications tend to occur soon after the diagnosis of coeliac disease, Kaplan–Meier curve analysis showed that they can actually occur at any time after the diagnosis of coeliac disease. Conclusions Complications of coeliac disease in our cohort were quite rare, though characterised by a very high mortality.
Published: 2014

31. Response to Cueto Rúa et al

Author: Pasquale Mansueto, Alberto D'Alcamo, Antonio Carroccio, Carroccio, A, D'Alcamo, A, and Mansueto, P
Subjects: Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Hepatology, business.industry, General surgery, Non-celiac gluten sensitivity, Gastroenterology, Gliadin, Surgery, medicine, Humans, Female, business, Food Hypersensitivity, Triticum, Autoantibodies
Published: 2013

32. Modifications of general parameters of immune activation in the sera of Sicilian patients with Boutonneuse fever

Author: Enrico Cillari, Serafino Mansueto, A. Spinelli, Pasquale Mansueto, Giustina Vitale, Salvatore Milano, C. Mocciaro, N. Chifari, P. Colletti, Francesco Arcoleo, G. Gambino, and Affronti M
Subjects: Adult, Male, Cellular immunity, CD8 Antigens, CD3, Immunology, Boutonneuse Fever, Immune system, T-Lymphocyte Subsets, medicine, Humans, Immunology and Allergy, Aged, biology, Beta-2 microglobulin, Histocompatibility Antigens Class I, Middle Aged, medicine.disease, biology.organism_classification, Boutonneuse fever, Rickettsia, Solubility, CD4 Antigens, biology.protein, Female, Original Article, beta 2-Microglobulin, Rickettsia conorii, CD8
Abstract: SUMMARYThe serum levels of β2-microglobulin (β2-M), soluble HLA class I antigen (sHLA-I), soluble CD4 (sCD4) and CD8 (sCD8) were studied in 98 Sicilian patients with Boutonneuse fever (BF). In different stages of infection all markers were significantly increased in sera from Sicilian patients with acute BF compared with healthy controls. sCD8 and sHLA-I reached the peak in the second week after the onset of symptoms, whereas sCD4 and β2-M reached the peak in the first week. Afterwards sCD8 decreased to the levels of controls within the third week, the other parameters decreased later and were unmodified until the third week of infection. Significant correlations were found between sCD4 and sCD8 and the sIL-2R, as well as between serum levels of β2-M and sCD8. The reduction of CD3+ and CD4+ and the increase of CD8+ T cells in the blood indicate that these cells are involved in the response to rickettsia, and their activation might be in part responsible for the release of sCD4 and sCD8. Our data suggest that these soluble markers, indexes of immune activation of T cells both in the circulation and the affected tissues, may be used in monitoring BF evolution.
Published: 1998

33. Non-celiac wheat sensitivity is a more appropriate label than non-celiac gluten sensitivity

Author: Pasquale Mansueto, Giovam Battista Rini, Antonio Carroccio, Carroccio, A, Rini, G, and Mansueto, P
Subjects: Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Non-celiac wheat sensitivity, non-celiac gluten sensitivity, Hepatology, Glutens, business.industry, Gastroenterology, medicine.disease, Irritable Bowel Syndrome, Diet, Gluten-Free, Internal medicine, Medicine, Humans, Gluten free, Female, Sensitivity (control systems), business, Non-celiac gluten sensitivity, Irritable bowel syndrome
Published: 2013

34. Oligo-antigenic diet in the treatment of chronic anal fissures. Evidence for a relationship between food hypersensitivity and anal fissures

Author: Pasquale Mansueto, Giovam Battista Rini, Giuditta Morfino, Alberto D'Alcamo, Sebastiano Bonventre, Gregorio Scerrino, Gaspare Gulotta, Emiliano Maresi, Maurizio Soresi, Antonio Carroccio, Valentina Di Paola, Giuseppe Iacono, Carroccio,A, Mansueto,P, Morfino,G, D'Alcamo,A, Di Paola,V, Iacono,G, Soresi,M, Scerrino,G, Maresi,E, Gulotta,G, Rini,G, and Bonventre S.
Subjects: Adult, Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Constipation, Manometry, Treatment outcome, Food habits, Settore MED/08 - Anatomia Patologica, Gastroenterology, Fissure in ano, law.invention, Leukocyte Count, Feeding behavior, Randomized controlled trial, Double-Blind Method, law, Recurrence, Internal medicine, medicine, Humans, Lymphocyte Count, Lymphocytes, Intestinal Mucosa, Triticum, Hepatology, business.industry, Feeding Behavior, Middle Aged, Milk Proteins, Settore MED/45 - Scienze Infermieristiche Generali, Cliniche E Pediatriche, Food hypersensitivity, Surgery, Eosinophils, Settore MED/18 - Chirurgia Generale, Chronic disease, Treatment Outcome, Chronic Disease, fissure, Female, Fissure in Ano, hypersensitivity, medicine.symptom, Milk Hypersensitivity, business, Food Hypersensitivity
Abstract: OBJECTIVES: Patients with chronic constipation due to food hypersensitivity (FH) had an elevated anal sphincter resting pressure. No studies have investigated a possible role of FH in anal fissures (AFs). We aimed to evaluate (1) the effectiveness of diet in curing AFs and to evaluate (2) the clinical effects of a double-blind placebo-controlled (DBPC) challenge, using cow's milk protein or wheat. METHODS: One hundred and sixty-one patients with AFs were randomized to receive a "true-elimination diet" or a "sham-elimination diet" for 8 weeks; both groups also received topical nifedipine and lidocaine. Sixty patients who were cured with the "true-elimination diet" underwent DBPC challenge in which cow's milk and wheat were used. RESULTS: At the end of the study, 69% of the "true-diet group" and 45% of the "sham-diet group" showed complete healing of AFs (P
Published: 2013

35. Non-celiac wheat sensitivity as an allergic condition: personal experience and narrative review

Author: Alberto D'Alcamo, Pasquale Mansueto, Giuseppe Iacono, Antonio Carroccio, Carroccio, A, Mansueto, P, D'Alcamo, A, and Iacono, G.
Subjects: Male, Pathology, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Non-celiac wheat sensitivity, Gastrointestinal Diseases, MEDLINE, Allergic condition, Irritable Bowel Syndrome, Double-Blind Method, Medicine, Humans, Sensitivity (control systems), Triticum, food allergy, Hepatology, business.industry, Gastroenterology, nutritional and metabolic diseases, food and beverages, digestive system diseases, Celiac Disease, Immunoglobulin G, Narrative review, Female, business, Food Hypersensitivity, Clinical psychology
Abstract: Non-celiac wheat sensitivity (NCWS) is a newly described clinical entity characterized by symptoms, which can involve the gastrointestinal tract, the nervous system, the skin, and other organs. There is little data on the pathogenesis of NCWS and it is probable that different pathogenic mechanisms are involved in the different clinical manifestations of the disease. The only common denominator of NCWS "syndrome" is wheat consumption: the symptoms disappear on exclusion of wheat from the diet, and reappear on wheat consumption. The objective of this study was to review our prior data regarding NCWS and to review relevant medical literature regarding NCWS, with particular attention to the hypothesis that NCWS patients could suffer from non-immunoglobulin E (IgE)-mediated wheat allergy.We reviewed our data on 276 patients diagnosed with NCWS by means of double-blind placebo-controlled (DBPC) wheat challenge. The data indicating a possible wheat allergy diagnosis were examined and other data in the literature were reviewed; we review the role of serum immunoglobulin G antibodies and the basophil activation assay in food allergy, and the histology findings in the food allergy diagnosis.The comparison between patients suffering from NCWS and presenting with irritable bowel syndrome (IBS) and controls with IBS not due to NCWS showed that NCWS was characterized by: a personal history of food allergy in the pediatric age (0.01), coexistent atopic diseases (0.0001), positive serum anti-gliadin (0.0001) and anti-betalactoglobulin (0.001) antibodies, positive cytofluorimetric assay revealing in vitro basophil activation by food antigens (0.0001), and a presence of eosinophils in the intestinal mucosa biopsies (0.0001).Patients with NCWS and multiple food sensitivity show several clinical, laboratory, and histological characteristics that suggest they might be suffering from non-IgE-mediated food allergy. However, other pathogenic mechanisms need to be considered.
Published: 2013

36. Response to Molina-Infante et al

Author: Antonio Carroccio, Pasquale Mansueto, Carroccio A, and Mansueto P
Subjects: Male, Settore MED/09 - Medicina Interna, Hepatology, business.industry, Non-celiac gluten sensitivity, Gastroenterology, Computational biology, medicine.disease, Gliadin, medicine, Humans, Female, business, Food Hypersensitivity, Triticum, Autoantibodies
Published: 2013

37. Response to Villanacci et al

Author: Ada Maria Florena, Pasquale Mansueto, Antonio Carroccio, Claudio Tripodo, Carroccio A, Mansueto P, Tripodo C, and Florena AM
Subjects: Male, medicine.medical_specialty, Pathology, Settore MED/09 - Medicina Interna, Hepatology, business.industry, Non-celiac gluten sensitivity, Gastroenterology, Gluten sensitivity, medicine.disease, Coeliac disease, Gliadin, Internal medicine, Medicine, Humans, Female, business, Irritable bowel syndrome, Food Hypersensitivity, Triticum, Autoantibodies
Abstract: REFERENCES 1 . Carroccio A , Mansueto P , Iacono G et al. Nonceliac wheat sensitivity diagnosed by doubleblind placebo-controlled challenge: exploring a new clinical entity . Am J Gastroenterol 2013 (this issue) . 2 . Ludvigsson JF , Le$ er DA , Bai JC et al. " e Oslo de! nitions for coeliac disease and related terms . Gut 2013 ; 62 : 43 – 52 . 3 . Sapone A , Bai JC , Ciacci C et al. Spectrum of gluten-related disorders: consensus on new nomenclature and classi! cation . BMC Med 2012 ; 10 – 13 . 4 . Ferch CC , Chey WD . Irritable bowel syndrome and gluten sensitivity without celiac disease: separating the wheat from the cha% . Gastroenterology 2012 ; 142 : 664 – 6 . 5 . Biesiekierski JR , Newnham ED , Muir JG et al. Failure to con! rm the existence of non-coeliac gluten sensitivity (NCGS): a non-condition or inappropriate study design? J Gastroenterol Hepatol 2012 ; 27 (Suppl 4) : 124 – 5 . 6 . Hayat M , Cairns A , Dixon MF et al. Quantitation of intraepithelial lymphocytes in human duodenum: what is normal? J Clin Pathol 2002 ; 55 : 393 – 4 .
Published: 2013

38. A comparison between two different in vitro basophil activation tests for gluten- and cow's milk protein sensitivity in irritable bowel syndrome (IBS)-like patients

Author: Ignazio Brusca, Stella Maria La Chiusa, Delia Sprini, Maria Barrale, Antonio Carroccio, Aurelio Seidita, Maurizio Soresi, Pasquale Mansueto, Giuseppe Iacono, Alberto D'Alcamo, Carroccio, A, Brusca, I, Mansueto, P, D'alcamo, A, Barrale, M, Soresi, M, Seidita, A, La Chiusa, SM, Iacono, G, and Sprini, D
Subjects: Adult, Male, Settore MED/09 - Medicina Interna, Adolescent, Glutens, Clinical Biochemistry, gluten-sensitivity, Irritable Bowel Syndrome, Young Adult, Elimination diet, Medicine, Humans, Young adult, Irritable bowel syndrome, Triticum, Whole blood, Aged, chemistry.chemical_classification, CD63, business.industry, Biochemistry (medical), General Medicine, Middle Aged, medicine.disease, Milk Proteins, Gluten, In vitro, Basophils, Basophil activation, Celiac Disease, basophil activation test, irritable bowel syndrome, chemistry, Immunology, Female, Milk Hypersensitivity, business
Abstract: Background: The diagnosis of food hypersensitivity (FH) in adult patients with gastrointestinal symptoms, beyond the immediate IgE-mediated clinical manifestations, is very often difficult. The aims of our study were to: 1) evaluate the frequency of FH in patients with irritable bowel syndrome (IBS)-like clinical presentation; and 2) compare the diagnostic accuracy of two different methods of in vitro basophil activation tests. Methods: Three hundred and five patients (235 females, age range 18–66 years) were included and underwent a diagnostic elimination diet and successive double-blind placebo-controlled (DBPC) challenges. Two different methods of in vitro basophil activation tests (BAT) (CD63 expression after in vitro wheat or cow’s milk proteins stimulation) were evaluated: one was performed on separated leukocytes, and the other on whole blood. Results: Ninety patients of the 305 studied (29.5%) were positive to the challenges and were diagnosed as suffering from FH. BAT on separate leukocytes showed a sensitivity of 86% and a specificity of 91% in FH diagnosis. BAT on whole blood showed a sensitivity of 15%–20% and a specificity of 73% in FH diagnosis (p Conclusions: About one third of the IBS patients included in the study were suffering from FH and were cured on the elimination diet. The BAT based on CD63 detection on whole blood samples did not work in FH diagnosis and showed a significantly lower sensitivity, specificity and diagnostic accuracy than the assay based on separated leukocytes.
Published: 2013

39. Comparison of the effects of salmeterol and salbutamol on clinical activity and eosinophil cationic protein serum levels during the pollen season in atopic asthmatics

Author: G. Di Lorenzo, F. Norrito, F. Purello D’Ambrosio, M. Melluso, Morici G, Pasquale Mansueto, and G. Barbagallo Sangiorgi
Subjects: Adult, Hypersensitivity, Immediate, Male, medicine.medical_specialty, medicine.drug_class, Immunology, Cell Count, Peak Expiratory Flow Rate, Leukocyte Count, Ribonucleases, immune system diseases, Forced Expiratory Volume, Bronchodilator, Internal medicine, medicine, Humans, Immunology and Allergy, Albuterol, Eosinophil degranulation, Salmeterol Xinafoate, Asthma, Eosinophil cationic protein, Cross-Over Studies, business.industry, Eosinophil Granule Proteins, Rhinitis, Allergic, Seasonal, Blood Proteins, Middle Aged, respiratory system, Eosinophil, medicine.disease, respiratory tract diseases, Eosinophils, Endocrinology, medicine.anatomical_structure, Salbutamol, Pollen, Female, Salmeterol, business, circulatory and respiratory physiology, medicine.drug
Abstract: In atopic asthma there is strong evidence of eosinophils playing an active role in pathogenesis. Some investigations demonstrated that eosinophil cationic protein (ECP) serum levels increased in atopic patients with asthma during pollen season.The aim of the study was to evaluate the effects of short-term (1 week) beta 2-agonist treatment on lung function and eosinophil activity in asthmatic patients.We used an open, randomized, cross-over design to compare the effects of salbutamol (200 micrograms q.i.d.) and salmeterol (50 micrograms b.i.d.) on peak expiratory flow rate (PEFR), blood eosinophil count and serum levels of ECP as a measure of eosinophil activity in 20 mild atopic asthmatics.Morning and evening PEFR values were both significantly higher during salmeterol treatment than during the salbutamol period. Conversely, both morning and evening daily asthma symptom scores were significantly lower during salmeterol treatment compared with those recorded during the salbutamol period. The mean basal eosinophil blood count on salmeterol treatment (601 +/- 189 mm3) was not higher than the mean count on salbutamol treatment (612 +/- 204 mm3). After both treatments the mean eosinophil blood counts were unchanged (619 +/- 189 mm3 and 576 +/- 212 mm3, respectively). No significant differences in blood eosinophil counts were observed between or within treatments at any time. No significant difference was observed in baseline mean ECP serum concentration (43.8 +/- 26.3 micrograms/L on salmeterol treatment and 41.7 +/- 29.8 micrograms/L on salbutamol treatment, respectively). After salmeterol treatment the mean ECP serum concentration had fallen significantly to 20.9 +/- 18.6 micrograms/L (P0.01), whereas after salbutamol treatment it was unchanged (42.0 +/- 25.1 micrograms/L). Salmeterol treatment produced a decrease in ECP serum levels without any changes in blood eosinophil count.This study demonstrates that salmeterol affords a significant improvement in asthma control during the pollen season, measured by both subjective and objective parameters, compared with salbutamol. This greater efficacy may be related to inhibition of eosinophil degranulation during the pollen season.
Published: 1995

40. Serum levels of soluble CD30 in adult patients affected by atopic dermatitis and its relation to age, duration of disease and Scoring Atopic Dermatitis index

Author: Rosaria Alba Merendino, Gabriele Di Lorenzo, Nicola Martinelli, Sebastiano Gangemi, Serafina Paola Cannavò, Pasquale Mansueto, Paola Lucia Minciullo, Rini Gb, Roberto Corrocher, and Maria Luisa Pacor
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Immunology, Population, Ki-1 Antigen, Disease, Severity of Illness Index, Dermatitis, Atopic, Serum sCD30, SCORAD, Soluble cd30, immune system diseases, Severity of illness, lcsh:Pathology, medicine, Humans, education, Atopic dermatitis, Asthma, education.field_of_study, Adult patients, medicine.diagnostic_test, business.industry, Age Factors, Cell Biology, medicine.disease, Dermatology, body regions, Solubility, Female, business, Biomarkers, Research Article, lcsh:RB1-214
Abstract: The value of CD30 and the soluble circulating fragment of CD30 (sCD30) for atopic dermatitis (AD) remains unclear. In particular, little is known about the effects of age, duration of disease and Scoring Atopic Dermatitis index (SCORAD) on the levels of serum sCD30 in patients affected by AD. In the present study, we have analysed serum sCD30 levels of adult patients affected by AD. The study's population includes 18 non-smoking outpatients, with a diagnosis of AD. As a control group we studied 18 non-atopic subjects from laboratory staff, matched for sex and age. These subjects had no history of AD, urticaria or seasonal or perennial rhinitis or asthma, and had negative skin prick test to a panel of allergens.The sCD30 serum levels were clearly higher in patients affected by AD (14.2±9.0 IU/ml) than in healthy subjects (1.2±0.8 IU/ml)(P<0.001). No differences were observed between males and females affected by atopic dermatitis, regarding age, duration of disease and SCORAD. Significant correlations were found between serum levels of sCD30 levels and age (r=−0.55; 95% confidence interval (CI) forr(Fisher's z transformed)=−0.81 to −0.12;P=0.01), duration of the disease (months) (r=−0.64; 95% CI forr(Fisher's z transformed)=−0.85 to −0.24;P=0.004) and SCORADr=−0.74; 95% CI forr(Fisher's z transformed)=−0.89 to −0.42;P=0.004).As demonstrated by the close correlation with age, duration of disease and SCORAD, serum levels of sCD30 appear to be an additional marker for the follow-up of AD.
Published: 2003

41. Dairy calcium intake and lifestyle risk factors for bone loss in hiv-infected and uninfected mediterranean subjects

Author: Giuseppe Montalto, Giuseppe Caruso, Fabio Tramuto, S. Madonia, Giovanni Mazzola, Maurizio Soresi, Valentina Li Vecchi, Lydia Giannitrapani, Sara La Sala, Pasquale Mansueto, Claudia Colomba, Paola Di Carlo, Li Vecchi, V, Soresi, M, Giannitrapani, L, Mazzola, G, La Sala, S, Tramuto, F, Caruso, G, Colomba, C, Mansueto, P, Madonia, S, Montalto, G, and Di Carlo, P
Subjects: musculoskeletal diseases, Adult, Male, medicine.medical_specialty, FRAX, Settore MED/09 - Medicina Interna, Bone density, Settore MED/17 - Malattie Infettive, Osteoporosis, HIV Infections, lcsh:Infectious and parasitic diseases, Bone remodeling, Absorptiometry, Photon, Bone Density, Risk Factors, Surveys and Questionnaires, Internal medicine, Vitamin D and neurology, Bone mineral density, Humans, Medicine, lcsh:RC109-216, Life Style, Bone mineral, Mediterranean Region, business.industry, Osteopenia, Case-control study, Osteoporosi, HIV, Middle Aged, Dairy intake, medicine.disease, Diet, Infectious Diseases, Endocrinology, Case-Control Studies, Calcium, Female, business, Settore MED/36 - Diagnostica Per Immagini E Radioterapia, Research Article
Abstract: Background Despite the reported high prevalence of osteoporosis in the human immunodeficiency virus (HIV)-population, there have been no previous studies examining dairy calcium intake and bone mineral density (BMD) in HIV-subjects. We assessed the prevalence of low BMD in HIV-infected and uninfected subjects and analyzed the effects of calcium intake, lifestyle and HIV-related risk factors on BMD. Methods One hundred and twelve HIV-infected subjects were consecutively enrolled. Seventy- six HIV-uninfected subjects matched for age and sex were enrolled as the control group. The HIV-subjects were interviewed about lifestyle habits and completed a weekly food-frequency questionnaire to estimate calcium intake. HIV-RNA, CD4+ T-cell count and data on antiretroviral therapy were also recorded. Both biochemical bone turnover markers and BMD, assessed by dual-energy radiographic absorptiometry (DXA) were recorded in the HIV-cases and controls. We also calculated the 10-year fracture risks using the WHO FRAX equation. Results Osteoporosis prevalence was significantly higher in the HIV-cases than controls (p < 0.05). BMI values were positively correlated with BMD (p < 0.05). Vitamin D levels were lower in the HIV-subjects (p < 0.02). No correlation was found with daily calcium intake. BMI values were significantly correlated with dairy intake quartiles (p < 0.003). In HIV-subjects, the mean of FRAX score was 1.2 % for hip and 4.7 % for major osteoporotic fractures. On multivariate analysis of the lumbar spine DXA T-score, age (p < 0.005) and HIV/hepatitis C virus co-infection (p < 0.0001) were negatively correlated with BMD, while yogurt intake was a protective predictor of BMD (p < 0.05). In the femur DXA T-score, age (p < 0.01), nadir CD4 + T-cell count < 200 cells/μL (p < 0.05) and drug addiction ( p < 0.0001) were negatively correlated with BMD. Conclusions Among the foods rich in calcium, yogurt was a protective predictor of BMD in HIV-subjects. HIV/HCV co-infection, nadir CD4 + T-cell count < 200 cells/μL and drug addiction were independent predictors of severe BMD. Promoting behavioral changes in food intake and lifestyle, aimed at the primary prevention of bone disease in the chronically-infected subjects seems to be essential for implementing medical intervention in these cases.
Published: 2012

42. Multiple sclerosis-like neurological manifestations in a coeliac patient: nothing is as it seems

Author: Pasquale Mansueto, Antonio Carroccio, Laura Di Stefano, Alberto D'Alcamo, Mansueto, P., Di Stefano, L., D'Alcamo, A., and Carroccio, A.
Subjects: Male, Nervous system, medicine.medical_specialty, Multiple Sclerosis, Settore MED/09 - Medicina Interna, Gastroenterology, Cobalamin, Article, Coeliac disease, Diagnosis, Differential, Multiple sclerosis, coeliac disease, chemistry.chemical_compound, Folic Acid, Erectile Dysfunction, Internal medicine, medicine, Humans, Multiple sclerosi, Paresthesia, Vitamin B12, business.industry, Brain, Vitamin B 12 Deficiency, General Medicine, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Decreased Libido, Surgery, Celiac Disease, Erectile dysfunction, medicine.anatomical_structure, Spinal Cord, chemistry, Vitamin B Complex, Differential diagnosis, business
Abstract: Cobalamin (vitamin B12) deficiency occurs with several disorders, involving different organs and systems, including blood, bowel, nervous system and eyes. Although the most important features are usually haematological ones, presence of neurological involvement, in the absence of blood count alterations, has just been described in the literature. Here we report the case of a 48-year-old man, suffering from coeliac disease for approximately 5 years, vegetarian, who was admitted to our department, referring dysaesthesia of the left lower limb, decreased libido and erectile dysfunction. Vitamin B12 deficiency was proved, even in the absence of blood count alteration, and treated with a vitamin supplement, resulting in complete remission.
Published: 2012

43. Significance of persistence of antibodies against Leishmania infantum in Sicilian patients affected by acute visceral leishmaniasis

Author: Salvatore Di Rosa, Giovam Battista Rini, Giustina Vitale, Nicola Napoli, Enrico Cillari, Serafino Mansueto, Pasquale Mansueto, Aurelio Seidita, Francesco Arcoleo, Inglese Elvira, Gaetana Di Fede, Francesca Scozzari, Ilenia Pepe, Mansueto, P., Pepe, I., Seidita, A., Scozzari, F., Vitale, G., Arcoleo, F., Elvira, I., Cillari, E., Rini, G., Napoli, N., Di Rosa, S., Mansueto, S., and Di Fede, G.
Subjects: Adult, Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Time Factors, Adolescent, sicilian patient, acute visceral leishmaniasis, Antibodies, Protozoan, Fluorescent Antibody Technique, General Biochemistry, Genetics and Molecular Biology, Persistence (computer science), Young Adult, Recurrence, Internal medicine, parasitic diseases, Medicine, Humans, Young adult, Leishmania infantum, antibodies, sicilian patients, Sicily, Aged, Aged, 80 and over, Hematology, biology, business.industry, Leishmaniasis, General Medicine, Middle Aged, medicine.disease, biology.organism_classification, Virology, Titer, Visceral leishmaniasis, antibodie, Immunoglobulin G, Immunology, biology.protein, Leishmaniasis, Visceral, Female, Antibody, business
Abstract: The background of this article is as follows: Few data are available about the persistence of serum-specific IgG antibodies to L. infantum after acute VL. The objective of this article is to evaluate the persistence of antibodies against L. infantum in patients healed from acute VL, and the kinetic of the same antibodies observed in 2 cases of VL relapse and 2 cases of resistance to therapy. The methods which we used to obtain our objective are the following: 55 apparently immunocompetent, HIV-negative patients were examined for antibodies to L. infantum by IFAT over 14 years period, and we got the following results: Serum-specific IgG antibodies titers decrease slowly, but constantly. In the patients with a diagnosis of VL relapse, the kinetic of antibodies was characterized by an initial reduction, and a subsequent antibody levels rapidly increase, while in the patients with a clinical and parasitological diagnosis of VL not responding to specific therapy, we demonstrated persistent high level of antibodies to L. infantum. Finally, we conclude that specific antibodies to L. infantum might persist for many years, and decrease slowly, but steadily. The persistence of these specific antibodies is not related to poor therapeutic response or prognosis, but an acute increase in their levels might be a sentinel of a VL relapse, while persistence of high antibody levels could suggest a resistance to therapy.
Published: 2011

44. Antiendomysium antibodies assay in the culture medium of intestinal mucosa: an accurate method for celiac disease diagnosis

Author: Ada Maria Florena, Lidia Di Prima, Giuseppe Pirrone, Antonio Carroccio, Pasquale Mansueto, Gaetana Di Fede, Saverio Teresi, Giuseppe Ambrosiano, Carmelo Sciumè, Maurizio Soresi, Franco Barbaria, Giuseppina Campisi, Ilenia Pepe, Francesca Cavataio, Giuseppe Iacono, Girolamo Geraci, Carroccio, A, Iacono, G, Di Prima, L, Pirrone, G, Cavataio, F, Ambrosiano, G, Sciumè, C, Geraci, G, Florena, AM, Teresi, S, Barbaria, F, Pepe, I, Campisi, G, Mansueto, P, Soresi, M, and Di Fede, G
Subjects: Adult, Male, medicine.medical_specialty, Pathology, Settore MED/09 - Medicina Interna, Adolescent, Tissue transglutaminase, Duodenum, Biopsy, Muscle Fibers, Skeletal, celiac disease, culture system, diagnosis, intestinal histology, serum antiendomysium, Disease, Human leukocyte antigen, Gastroenterology, Antiendomysium antibodies, Tissue Culture Techniques, Young Adult, Intestinal mucosa, Internal medicine, Medicine, Humans, Villous atrophy, Intestinal Mucosa, Child, False Negative Reactions, Aged, Autoantibodies, Transglutaminases, Hepatology, biology, medicine.diagnostic_test, business.industry, Infant, Middle Aged, Culture Media, Celiac Disease, Child, Preschool, biology.protein, Female, Antibody, business, Epidemiologic Methods, Biomarkers
Abstract: Background Celiac disease (CD) diagnosis is becoming more difficult as patients with no intestinal histology lesions may also be suffering from CD. Aim To evaluate the diagnostic accuracy of antiendomysium (EmA) assay in the culture medium of intestinal biopsies for CD diagnosis. Patients and methods The clinical charts of 418 patients with CD and 705 non-CD controls who had all undergone EmA assay in the culture medium were reviewed. Results EmA assay in the culture medium had a higher sensitivity (98 vs. 80%) and specificity (99 vs. 95%) than serum EmA/antibodies to tissue transglutaminase (anti-tTG) assay. All patients with CD who were tested as false-negatives for serum EmA and/or anti-tTG (32 adults and 39 children) carried the human leukocyte antigen alleles associated to CD. Furthermore, during the follow-up, four patients with negative-serum EmA/anti-tTG, normal villi architecture, and positive-EmAs in the culture medium, developed villous atrophy and underwent gluten-free diet with consequent resolution of the symptoms and complete intestinal histology recovery. Conclusion EmA assay in the culture medium should be included in the diagnostic criteria for CD diagnosis in 'seronegative' patients. Eur J Gastroenterol Hepatol 23:1018-1023 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
Published: 2011

45. The old and new tests for celiac disease: which is the best test combination to diagnose celiac disease in pediatric patients?

Author: Maria Barrale, Elio Tonutti, Antonio Carroccio, Filippo M. Sarullo, Ignazio Brusca, Nicola Bizzaro, Stella Maria La Chiusa, Danilo Villalta, Giuseppe Iacono, Pasquale Mansueto, Renato Tozzoli, Brusca, I., Carroccio, A., Tonutti, E., Villalta, D., Tozzoli, R., Barrale, M., Sarullo, F., Mansueto, P., Chiusa, S., Iacono, G., and Bizzaro, N.
Subjects: Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Tissue transglutaminase, Clinical Biochemistry, Fluorescent Antibody Technique, Diagnostic accuracy, Enzyme-Linked Immunosorbent Assay, Disease, Gastroenterology, Sensitivity and Specificity, Antigen, Internal medicine, medicine, Humans, celiac disease, diagnostic test, pediatric patients, biology, business.industry, Clinical Laboratory Techniques, Biochemistry (medical), Infant, General Medicine, Reference Standards, Endomysium, medicine.anatomical_structure, Case-Control Studies, Child, Preschool, Elisa test, biology.protein, Female, Antibody, Gliadin, business
Abstract: BACKGROUND In the diagnosis of celiac disease (CD), serum assays for anti-endomysium (EMA) and anti-transglutaminase (anti-tTG) antibodies have excellent diagnostic accuracy. However, these assays are less sensitive in young pediatric patients. Recently, a new ELISA test using deamidated gliadin peptides (DGP) as antigen has proved to be very sensitive and specific even in pediatric patients. In addition, anti-actin IgA antibodies (AAA) is another test that can be used in CD patients because antibody concentrations correlate with the degree of villous atrophy. This study evaluated the clinical accuracy of anti-tTG, EMA, AGA, anti-DGP and AAA and the effectiveness of these in different combinations for diagnosing CD in a large cohort of pediatric patients. METHODS Sera of 150 children under 6 years of age were tested: 95 patients had a diagnosis of CD, while 55 patients who did not suffer from CD were used as controls. Anti-DGP IgA/IgG and AAA were assayed with ELISA kits, while anti-tTG IgA/IgG and AGA IgG/IgA were assayed using a quantitative fluoroimmunoassay. The EMA test was conducted by indirect immunofluorescence. RESULTS Seventy-six of 95 (80%) CD patients were positive for DGP IgA and/or tTG IgA. Eighty of 95 (84.2%) patients were positive for DGP IgG and/or tTG IgA. None of the controls were positive for these antibodies. Eighty-four of 95 (88.4%) patients and 8/55 (14.5%) controls were positive for AAA and/or anti-tTG IgA. CONCLUSIONS In very young children, association of anti-tTG IgA with anti-DGP IgG is the best test combination for diagnosing CD, yielding a cumulative sensitivity of 84.2% and a specificity of 100%.
Published: 2011

46. Fecal assays detect hypersensitivity to cow's milk protein and gluten in adults with irritable bowel syndrome

Author: Maurizio Soresi, Giuseppe Iacono, Gaetana Di Fede, Pasquale Mansueto, Alberto D'Alcamo, Antonio Carroccio, Giuseppe Ambrosiano, M.L. Lospalluti, Ilenia Pepe, Ignazio Brusca, Stella Maria La Chiusa, Carroccio, A, Brusca, I, Mansueto, P, Soresi, M, D'Alcamo, A, Ambrosiano, G, Pepe, I, Iacono, G, Lospalluti, ML, La Chiusa, SM, and di Fede, G
Subjects: Adult, Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Fecal Calprotectin, Adolescent, Glutens, Tryptase, Wheat Hypersensitivity, Gastroenterology, Irritable Bowel Syndrome, Placebos, Feces, Young Adult, fluids and secretions, Double-Blind Method, Internal medicine, Elimination diet, medicine, Humans, Irritable bowel syndrome, chemistry.chemical_classification, Eosinophil cationic protein, Hepatology, biology, business.industry, Oral food challenge, Eosinophil Cationic Protein, Middle Aged, medicine.disease, Gluten, Diet, chemistry, Gluten Sensitivity, Immunology, biology.protein, Female, Tryptases, Calprotectin, Cow’s Milk Protein Hypersensitivity, Milk Hypersensitivity, business, Leukocyte L1 Antigen Complex, Fecal Tryptase, Fecal Eosinophil Cationic Protein
Abstract: Background & Aims Some patients with irritable bowel syndrome (IBS)-like symptoms suffer from food hypersensitivity (FH); their symptoms improve when they are placed on elimination diets. No assays identify patients with FH with satisfactory levels of sensitivity. We determined the frequency of FH among patients with symptoms of IBS and the ability of fecal assays for tryptase, eosinophil cationic protein (ECP), or calprotectin to diagnose FH. Methods The study included 160 patients with IBS, 40 patients with other gastrointestinal diseases, and 50 healthy individuals (controls). At the start of the study, patients completed a symptom severity questionnaire, fecal samples were assayed, and levels of specific immunoglobulin E were measured. Patients were observed for 4 weeks, placed on an elimination diet (without cow's milk and derivatives, wheat, egg, tomato, and chocolate) for 4 weeks, and kept a diet diary. Those who reported improvements after the elimination diet period were then diagnosed with FH, based on the results of a double-blind, placebo-controlled, oral food challenge (with cow's milk proteins and then with wheat proteins). Results Forty of the patients with IBS (25%) were found to have FH. Levels of fecal ECP and tryptase were significantly higher among patients with IBS and FH than those without FH. The ECP assay was the most accurate assay for diagnosis of FH, showing 65% sensitivity and 91% specificity. Conclusions Twenty-five percent of patients with IBS have FH. These patients had increased levels of fecal ECP and tryptase, indicating that they might cause inflammation in patients with IBS. Fecal assays for ECP could be used to identify FH in patients with IBS.
Published: 2010

47. Isolation and characterization of Bartonella quintana from parotid gland of an immunocompetent man

Author: Pasquale Mansueto, Giustina Vitale, Anna Micalizzi, Cinzia Incandela, Salvatore Incandela, Vitale, G., Incandela, S., Incandela, C., Micalizzi, A., and Mansueto, P.
Subjects: Male, Microbiology (medical), Pathology, medicine.medical_specialty, Igm antibody, Anti-Inflammatory Agents, Case Reports, Immunoglobulin G, Microbiology, B. quintana, stomatognathic system, Bartonella quintana, Lymphadenitis, medicine, Humans, biology, Middle Aged, bacterial infections and mycoses, biology.organism_classification, medicine.disease, Isolation (microbiology), Antibodies, Bacterial, Trench Fever, parotid gland, Trench fever, Anti-Bacterial Agents, Parotid gland, stomatognathic diseases, medicine.anatomical_structure, Immunoglobulin M, biology.protein, bacteria, Steroids, Parotid Diseases
Abstract: We describe a case of the isolation of Bartonella quintana from the parotid gland of an apparently healthy man. Pathological examination showed intraparotid granulomatous abscessual lymphadenitis. Diagnosis was made on the basis of high titers of immunoglobulin G (IgG) and IgM antibodies and of culture isolation of a causative agent from parotid aspirate.
Published: 2009

48. Comparative effect of tacrolimus 0.1% ointment and clobetasol 0.05% ointment in patients with oral lichen planus

Author: Stefano Gelio, Domenico Biasi, Giovanni Corrocher, Nicola Martinelli, Pasquale Mansueto, Maria Luisa Pacor, Roberto Corrocher, Gabriele Di Lorenzo, Giorgio Lombardo, Pier Francesco Nocini, Andrea Fior, Lisa Maria Bambara, CORROCHER G, DI LORENZO G, MARTINELLI N, MANSUETO P, BIASI D, NOCINI PF, LOMBARDO G, FIOR A, CORROCHER R, BAMBARA LM, GELIO S, and PACOR ML
Subjects: Adult, Male, medicine.medical_specialty, Settore MED/09 - Medicina Interna, medicine.drug_class, Anti-Inflammatory Agents, tacrolimus ointment, clobetasol ointment, oral lichen planus, law.invention, Ointment Bases, Randomized controlled trial, law, Oral administration, Facial Pain, medicine, Humans, Saliva, tacrolimus, business.industry, clobetasol, medicine.disease, Dermatology, Tacrolimus, Calcineurin, stomatognathic diseases, Periodontics, Corticosteroid, Oral lichen planus, Female, Clobetasol propionate, business, Epidemiologic Methods, Immunosuppressive Agents, medicine.drug, Lichen Planus, Oral
Abstract: Background Oral lichen planus (OLP) is considered to be an autoimmune disease of unknown aetiology that affects the mucosae, especially the oral cavity. Objective We compared tacrolimus 0.1% ointment and clobetasol 0.05% ointment for the treatment of OLP. Patients and methods A total of 32 patients (20 females and 12 males; all white, Italian origin, mean age of 43.6+/-18.4 years; 16 patients per treatment group) were treated with tacrolimus or clobetasol ointment for 4 weeks in a randomized, double-blind, clinical trial. Pain severity, burning sensation, and mucosal lesion extension were assessed using a four-point scale. Results At the end of the treatment period, symptom scores were significantly lower in the tacrolimus group than in the clobetasol group. Conclusion The results of this study suggest that tacrolimus 0.1% ointment is more effective than clobetasol propionate 0.05% ointment in the treatment of OLP. However, other studies are needed to confirm the effectiveness of this treatment before it can be recommended for use in clinical practice.
Published: 2008

49. Relationship Between Human Leucocyte Antigen Class I and Class II and Chronic Idiopathic Urticaria Associated With Aspirin and/or NSAIDs Hypersensitivity

Author: Nicola Martinelli, Gaetana Di Fede, Giovam Battista Rini, Maria Esposito-Pellitteri, Pasquale Mansueto, Roberto Corrocher, Maria Luisa Pacor, P. Pradella, Laura Uxa, Gabriele Di Lorenzo, PACOR ML, DI LORENZO G, MANSUETO P, MARTINELLI N, ESPOSITO-PELLITTERI M, PRADELLA P, UXA L, DI FEDE G, RINI GB, and CORROCHER R
Subjects: Adult, Male, Settore MED/09 - Medicina Interna, Chronic Idiopathic Urticaria, Genotype, Urticaria, human leucocyte antigen class I, Immunology, Genes, MHC Class II, Anti-Inflammatory Agents, Human leukocyte antigen, Lower risk, Drug Hypersensitivity, Research Communication, Antigen, Gene Frequency, Risk Factors, lcsh:Pathology, Medicine, Humans, Allele, Allele frequency, Alleles, Aspirin, business.industry, Anti-Inflammatory Agents, Non-Steroidal, Histocompatibility Antigens Class I, Case-control study, Cell Biology, HLA-DR Antigens, Middle Aged, NSAID, human leucocyte antigen class II, chronic idiopathic urticaria, aspirin, NSAIDs, hypersensitivity, MHC Class II, Phenotype, Genes, Case-Control Studies, Female, Non-Steroidal, business, lcsh:RB1-214, medicine.drug, HLA-DRB1 Chains
Abstract: Background. HLA genes play a role in the predisposition of several diseases. The aim was to analyze the prevalence of HLA class I phenotypes and HLA-DRB1*genotype in patients with CIU associated with ASA and NSAIDs hypersensitivity (AICU).Methods. 69 patients with AICU, and 200 healthy subjects.Results. Subjects with HLA-B44 and HLA-Cw5 antigens were more represented in patients with AICU than in control group. Subjects with HLA-A11, HLA-B13, HLACw4, and HLA-Cw7 antigen were more represented in control group than in patients with AICU. Multiple logistic regression demonstrated an association of HLA-Cw4 and HLA-Cw7 with a lower risk of AICU, whereas carriers of HLA-B44 phenotype had a higher risk of AICU. No differences were found between patients and controls as regards to HLA-DRB1*genotype.Conclusions. We observed an association between some HLA class-I antigens and AICU. To the best of our knowledge this is the first description of such association.
Published: 2006

50. Circulating levels of soluble adhesion molecules in patients with ANCA-associated vasculitis

Author: Gabriele, Di Lorenzo, Maria Luisa, Pacor, Pasquale, Mansueto, Claudia, Lo Bianco, Epifanio, Di Natale, Fabio, Rapisarda, Maria Esposito, Pellitteri, Vito, Ditta, Adriana, Gioè, Gaia, Giammarresi, Giovam Battista, Rini, and Maurizio, Li Vecchi
Subjects: Adult, Male, Vasculitis, Osmolar Concentration, Middle Aged, Intercellular Adhesion Molecule-1, Polycystic Kidney, Autosomal Dominant, Antibodies, Antineutrophil Cytoplasmic, Solubility, Case-Control Studies, Creatinine, Humans, Kidney Failure, Chronic, Female, E-Selectin, Aged, Peroxidase
Abstract: During inflammation, activated vascular endothelial cells and other cell types express various adhesion molecules, which facilitate the binding of circulating leukocytes and their extravasation in surrounding tissue (i.e. renal tissue). The serum concentration of circulating soluble adhesion molecules is supposed to reflect the degree of this activation.In the first part of the study, we determined if the serum levels of the soluble intercellular adhesion molecule (sICAM)-1 and the soluble endothelial cell-leukocyte adhesion molecule (sELAM)-1, in patients affected by microscopic polyangiitis (MPA), associated with myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibodies (ANCA), were related to the active and the inactive vasculitis phase. In the second part of the study, we examined the changes in circulating sICAM-1 and sELAM-1 levels and the clinical outcome of renal function in these patients.We examined 20 MPO-ANCA-positive MPA patients in an acute phase and in a remission phase, after 6 months of treatment, and 50 subjects as controls, 30 with autosomal dominant polycystic kidney disease (ADPKD) in stable chronic renal failure (CRF) and 20 healthy volunteers (HS) with normal renal function.Regarding serum creatinine (Cr) concentration, no significant differences were found comparing active and inactive phases in the MPA group and the CRF group. Mean serum adhesion molecule levels in the MPA group were higher in the active phase compared to the inactive phase and to the CRF and HS groups. In addition, considering the outcome of serum Cr concentrations in the MPA group, the serum adhesion molecule levels were higher and decreased more slowly in patients with final high serum Cr concentrations than in patients with final normal serum Cr concentrations.Our data suggest that in MPO-ANCA-positive MPA patients, higher sICAM-1 and sELAM-1 levels during the active phase and their slower decline during the treatment period, could be a prognostic risk factor for CRF development.
Published: 2004

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