165 results on '"Lorenzo Ridola"'
Search Results
152. Eradication Therapy in Helicobacter pylori-negative, Gastric Low-grade Mucosa-associated Lymphoid Tissue Lymphoma Patients A Systematic Review
- Author
-
Robert M. Genta, Luigi Rossi, Cesare Hassan, Lorenzo Ridola, Vincenzo De Francesco, Dino Vaira, Silverio Tomao, Angelo Zullo, Angelo Zullo, Cesare Hassan, Lorenzo Ridola, Vincenzo De Francesco, Luigi Rossi, Silverio Tomao, Dino Vaira, and Robert M. Genta
- Subjects
medicine.medical_specialty ,therapeutic use ,eradication therapy ,drug therapy/microbiology/pathology ,helicobacter infections ,remission induction ,stomach neoplasms ,anti-bacterial agents ,treatment outcome ,humans ,marginal zone ,isolation /&/ purification ,drug therapy/pathology ,gastric malt lymphoma ,b-cell ,h. pylori ,helicobacter pylori ,lymphoma ,Mucosa-Associated Lymphoid Tissue Lymphoma ,Gastroenterology ,Helicobacter Infections ,Stomach Neoplasms ,Internal medicine ,h.pylori ,medicine ,Humans ,Helicobacter ,B cell ,biology ,Helicobacter pylori ,business.industry ,Remission Induction ,Lymphoma, B-Cell, Marginal Zone ,medicine.disease ,biology.organism_classification ,Confidence interval ,Lymphoma ,Anti-Bacterial Agents ,malt lymphoma ,medicine.anatomical_structure ,Pooled analysis ,Lymphatic system ,Treatment Outcome ,business - Abstract
Aim To assess the remission rate of gastric low-grade B-cell mucosa-associated lymphoid tissue lymphoma after an eradication therapy in Helicobacter pylori-negative patients. Methods We performed a systematic review with pooled analysis of published studies. Data were analyzed according to: (1) number of H. pylori-negative patients treated with only eradication therapy; (2) number of patients in whom the complete lymphoma remission was achieved; and (3) the method used to exclude H. pylori infection. Results Overall, 11 studies with 110 patients met the inclusion criteria for this pooled analysis. H. pylori infection was excluded in all studies with at least 3 different diagnostic tests. Eradication therapy achieved a complete lymphoma regression in 17 (15.5%; 95% confidence interval, 8.7-22.2) patients. Conclusions Eradication therapy is successful in a small but distinct subgroup of H. pylori-negative patients with low-grade mucosa-associated lymphoid tissue lymphoma. On the basis of the generally indolent behavior of this neoplasia, before resorting to aggressive, costly, and potentially more toxic oncologic therapies, it would seem reasonable to attempt eradication therapy in all patients, irrespective of their H. pylori status.
153. Physiopatogenic, clinical and practical aspects of hepatic encephalopathy
- Author
-
Manuela Merli and Lorenzo Ridola
154. Two-week Triple Therapy with either Standard or High-dose Esomeprazole for First-line H. pylori Eradication
- Author
-
Vincenzo De Francesco, Cesare Hassan, Angelo Zullo, Annamaria Bellesia, Domenico Alvaro, Lorenzo Ridola, Dino Vaira, De Francesco, Vincenzo, Ridola, Lorenzo, Hassan, Cesare, Bellesia, Annamaria, Alvaro, Domenico, Vaira, Dino, and Zullo, Angelo
- Subjects
Male ,Proton Pump Inhibitor ,Time Factors ,Intention to Treat Analysi ,Levofloxacin ,Adult ,Aged ,Amoxicillin ,Clarithromycin ,Drug Administration Schedule ,Drug Therapy, Combination ,Esomeprazole ,Female ,Helicobacter Infections ,Helicobacter pylori ,Humans ,Intention to Treat Analysis ,Italy ,Middle Aged ,Prospective Studies ,Proton Pump Inhibitors ,Remission Induction ,Treatment Outcome ,Gastroenterology ,0302 clinical medicine ,medicine.diagnostic_test ,biology ,030220 oncology & carcinogenesis ,Combination ,030211 gastroenterology & hepatology ,Human ,medicine.drug ,medicine.medical_specialty ,Time Factor ,medicine.drug_class ,Urea breath test ,Proton-pump inhibitor ,03 medical and health sciences ,Pharmacotherapy ,Drug Therapy ,Internal medicine ,medicine ,Intention-to-treat analysis ,business.industry ,biology.organism_classification ,Prospective Studie ,Regimen ,business ,Helicobacter Infection - Abstract
Background & Aims: The updated Italian guidelines advise a standard 14-day triple therapy for first-line H. pylori eradication. This prospective study evaluated the cure rate following a 14-day triple therapy with either a standard or double-dose proton pump inhibitor (PPI). Methods. A total of 145 consecutive patients with H. pylori infection were randomized to receive a 14-day, first-line triple therapy with clarithromycin 500 mg, amoxicillin 1 g and esomeprazole at either 20 mg (standard therapy) or 40 mg (double-dose therapy), each given twice daily. Results. At intention-to-treat analysis, H. pylori infection was cured in 73.9% (95% CI: 63.9−84) and 81.9% (95% CI: 73−90.8) following standard and double-dose therapy, respectively, and in 78.2% (95% CI: 68.5−87.9) and 85.5% (95% CI: 77.2−93.8) at per-protocol analysis. No statistically significant difference occurred. Overall, 16.4% and 19.4% patients in the standard and double-dose therapy regimen complained of side effects. Conclusion. The success rate of both standard and double-dose 14-day triple therapies for first-line H. pylori treatment was unsatisfactory. A prolonged 14-day levofloxacin-based triple therapy for second-line H. pylori eradication seems to be promising. Abbrevations: ITT: Intention To Treat; NUD: non ulcer dyspepsia; PP: PerAdd Contributor Protocol; PPI: proton pump inhibitors; PUD: peptic ulcer disease; UBT: urea breath test.
155. Helicobacter pylori Eradication for Hepatic Encephalopathy Treatment The Ideal Study Is Still Lacking!
- Author
-
Angelo Zullo, Lorenzo Ridola, Vincenzo De Francesco, and Cesare Hassan
- Subjects
medicine.medical_specialty ,cirrotics ,Ideal (set theory) ,biology ,business.industry ,Gastroenterology ,MEDLINE ,Helicobacter pylori ,biology.organism_classification ,medicine.disease ,Helicobacter Infections ,helicobacter pylori, hepatic encephalopathy, cirrotics ,Internal medicine ,Hepatic Encephalopathy ,helicobacter pylori ,Medicine ,Humans ,Hyperammonemia ,business ,Hepatic encephalopathy
156. High prevalence of vitamin D deficiency and insufficiency in patients with rheumatic diseases
- Author
-
Bruzzese, V., Zullo, A., Andrea Picchianti-Diamanti, Hassan, C., Lorenzetti, R., Lorenzo Ridola, Severino, M. L., Lulli, Patrizia, Scolieri, P., Marrese, C., and Bruno Lagana
157. High prevalence of primary antibiotic resistance in Helicobacter pylori isolates in Italy
- Author
-
Saracino, I. M., Zullo, A., Holton, J., Castelli, V., Fiorini, G., Zaccaro, C., Ridola, L., Ricci, C., Luigi Gatta, Vaira, D., Ilaria M Saracino, Angelo Zullo, John Holton, Valentina Castelli, Giulia Fiorini, Cristina Zaccaro, Lorenzo Ridola, Chiara Ricci, Luigi Gatta, and Dino Vaira
- Subjects
Adult ,Aged, 80 and over ,Male ,Helicobacter pylori ,Antibiotic resistance ,Clarithromycin ,Dyspepsia ,Levofoxacin ,Metronidazole ,Levofloxacin ,Microbial Sensitivity Tests ,Middle Aged ,Anti-Bacterial Agents ,Helicobacter Infections ,Young Adult ,Italy ,Drug Resistance, Multiple, Bacterial ,Drug Resistance, Bacterial ,dyspepsia ,Humans ,Female ,Aged - Abstract
Background & Aims: H. pylori eradication with standard therapies is decreasing worldwide, mainly because of increased primary antibiotic resistance rates. We aimed to assess primary resistance in H. pylori isolates towards the most used antibiotics in clinical practice. methods: The study enrolled consecutive, dyspeptic, adult patients, never treated for H. pylori, who had underwent upper endoscopy. Gastric biopsies were taken for standard histology, and two further antral biopsies were used for H. pylori culture. Minimal inhibitory concentrations (MIC) ≥1, ≥8 and ≥1 mg/L were used as break point for clarithromycin, metronidazole, and levofloxacin resistance, respectively. Results: Bacterial culture was successful in 145 (94%) out of 154 infected patients. Resistance towards at least one antibiotic was detected in 111 (76.6%) isolated, and multiple antibiotic resistance in 35.2% of cases. Primary resistance towards clarithromycin, metronidazole, and levofloxacin was detected in 51 (35.2%), 86 (59.3%), and in 32 isolated (22.1%), respectively. Levofloxacin resistance was significantly associated with the male sex (OR: 11.3, 95% CI = 1.2-103; P = 0.03), whilst females were at a higher risk of being infected with bacterial strains harbouring a double clarithromycin and metronidazole resistance (OR: 4.9, 95% CI = 1.2-19.8, P = 0.02). Conclusion: Our data indicate a very high primary resistance rate towards the most used antibiotics in H. pylori isolates. The efficacy of standard eradication therapies is expected to further decrease
158. The burden of minimal hepatic encephalopathy: from diagnosis to therapeutic strategies.
- Author
-
Ridola L, Cardinale V, and Riggio O
- Abstract
Minimal hepatic encephalopathy (MHE) is the mildest form of hepatic encephalopathy (HE). It affects the performance of psychometric tests focused on attention, working memory, psychomotor speed, and visuospatial ability, as well as electrophysiological and other functional brain measures. MHE is a frequent complication of liver disease, affecting up to 80% of tested patients. By being related to falls, an impairment in fitness to drive and the development of overt HE, MHE severely affects the lives of patients and caregivers by altering their quality of life and their socioeconomic status. MHE is detected in clinically asymptomatic patients using appropriate psychometric tests and neurophysiological methods that highlight neuropsychological alterations, such as video-spatial orientation deficits, attention disorders, memory, reaction times, electroencephalogram slowing, prolongation of latency-evoked cognitive potentials, and reduction in the critical flicker frequency. Several treatments have been proposed for MHE treatment, including non-absorbable disaccharides, poorly absorbable antibiotics such as rifaximin, probiotics and branched-chain amino acids. However, because of the multiple diagnosis methods, the various endpoints of treatment trials and the variety of agents used in trials, the treatment of MHE is not currently recommended as routine, but only on a case-by-case basis., Competing Interests: Conflict of Interest: None
- Published
- 2018
- Full Text
- View/download PDF
159. First-line therapies for Helicobacter pylori eradication: a critical reappraisal of updated guidelines.
- Author
-
De Francesco V, Bellesia A, Ridola L, Manta R, and Zullo A
- Abstract
Helicobacter pylori (H. pylori) treatment remains a challenge for the clinician, as no available therapy is able to cure the infection in all treated patients. In the last two decades, several antibiotic combinations have been proposed, including triple therapies, bismuth-free therapies (sequential, concomitant, hybrid regimens), and bismuth-based quadruple therapy. Some national and international guidelines on H. pylori management have recently been updated, recommending or discouraging the use of each of these therapeutic approaches, based mainly on the presumed pattern of primary antibiotic resistance in different geographic areas. We examined the recommendations on first-line therapies in the most recently updated guidelines worldwide, taking into account other data affecting the efficacy of a therapy regimen beyond the primary resistance pattern. Although several guidelines highlighted that the results achieved by an eradication therapy are population-specific and not directly transferable, it emerged that some therapy regimens are recommended or discouraged with no mention of the vital need for national data., Competing Interests: Conflict of Interest: None
- Published
- 2017
- Full Text
- View/download PDF
160. Inflammatory bowel disease nurse specialists for patients on biological therapies: a nationwide Italian survey.
- Author
-
Guarini A, Marinis F, Kohn A, Orzes N, D'Incà R, Iannone T, Giaquinto A, Rivara C, Ridola L, Lorenzetti R, and Zullo A
- Abstract
Background: Management of inflammatory bowel disease (IBD) patients requires a multidisciplinary approach. Among the working team, the role of IBD nurse is expected to be particularly relevant when managing patients receiving biological therapies. We performed a survey to assess the presence of IBD nurse in centers where patients were receiving biologics., Methods: For this Italian nationwide survey a specific questionnaire was prepared. IBD nurse was defined as a nurse directly involved in all phases of biological therapy, from pre-therapy screening, administration and monitoring during therapy, to follow up performed by a dedicated helpline, completed a specific training on biological therapy therapy, and observed international guidelines., Results: A total of 53 Italian IBD centers participated in the survey, and 91 valid questionnaires were collected. Overall, 34 (37.4%) nurses could be classified as IBD specialists. IBD nurses had a significantly higher educational level than other nurses, they were more frequently operating in Central or Southern than in Northern Italy, they were working in an Academic center rather than in a General hospital, and in IBD centers with >25 patients on biological therapy. On the contrary, mean age, gender distribution, years of nursing, and years working in the IBD unit did not significantly differ between IBD and other nurses., Conclusions: Our nationwide survey showed that the presence of an IBD nurse is still lacking in the majority of Italian IBD centers where patients receive biological therapies, suggesting a prompt implementation., Competing Interests: None
- Published
- 2016
- Full Text
- View/download PDF
161. High-dose esomeprazole and amoxicillin dual therapy for first-line Helicobacter pylori eradication: a proof of concept study.
- Author
-
Zullo A, Ridola L, Francesco VD, Gatta L, Hassan C, Alvaro D, Bellesia A, de Nucci G, and Manes G
- Abstract
Background: The prevalence of resistance to clarithromycin and metronidazole has considerably increased, with a corresponding decrease in the eradication rate for Helicobacter pylori (H. pylori) infection. Primary resistance to amoxicillin is extremely low, and esomeprazole was found to exert a noteworthy antimicrobial activity in vitro against H. pylori. A dual therapy with high-dose of esomeprazole coupled with high-dose amoxicillin might be therefore an ideal first-line treatment for H. pylori eradication. We aimed to assess the efficacy of a first-line 10-day, high-dose dual therapy consisting of amoxicillin and esomeprazole to eradicate H. pylori infection., Methods: Consecutive naïve H. pylori-infected patients, who underwent an upper endoscopy in 4 Italian hospitals due to dyspeptic symptoms and found to be infected at routine histological assessment, were invited to participate. Patients enrolled received a 10-day, high-dose dual therapy comprising esomeprazole (40 mg t.i.d) and amoxicillin (1 g t.i.d.). At least 4 weeks after the end of the treatment a (13)C-urea breath test was performed to evaluate the eradication., Results: A total of 56 patients agreed to participate in the study and were all followed-up. The overall eradication was 87.5% (95% CI=78.8•96.2), without a statistically significant difference among centres. Overall, 5 (8.9%; 1.5•16.4%) patients complained of side-effects., Conclusions: The 10-day, high-dose dual therapy with esomeprazole and amoxicillin might be an effective and safe first-line regimen. The efficacy of a longer 14-day regimen should be tested.
- Published
- 2015
162. Helicobacter pylori and portal hypertensive gastropathy: any new information?
- Author
-
Zullo A, Hassan C, Ridola L, and Francesco VD
- Published
- 2014
163. Gastric MALT lymphoma: old and new insights.
- Author
-
Zullo A, Hassan C, Ridola L, Repici A, Manta R, and Andriani A
- Abstract
The stomach is the most frequent site of extranodal lymphoma. Gastric lymphoma originating from mucosa-associated lymphoid tissue (MALT) is typically a low-grade, B-cell neoplasia strongly associated with Helicobacter pylori ( H. pylori ) infection. Only certain H. pylori strains in some predisposed patients determine lymphoma development in the stomach, according to a strain-host-organ specific process. The clinical presentation is poorly specific, symptoms ranging from vague dyspepsia to alarm symptoms. Similarly, different endoscopy patterns have been described for gastric lymphoma. H. pylori eradication is advised as first-line therapy in early stage disease, and complete lymphoma remission is achieved in 75% of cases. Neoplasia stage, depth of infiltration in the gastric wall, presence of the API2-MALT1 translocation, localization in the stomach, and patient ethnicity have been identified as predictors of remission. Recent data suggests that H. pylori eradication therapy may be successful for gastric lymphoma treatment also in a small subgroup (15%) of H. pylori -negative patients. The overall 5-year survival and disease-free survival rates are as high as 90% and 75%, respectively. Management of patients who failed to achieve lymphoma remission following H. pylori eradication include radiotherapy, chemotherapy and, in selected cases, surgery.
- Published
- 2014
164. First- and second-line Helicobacter pylori eradication with modified sequential therapy and modified levofloxacin-amoxicillin-based triple therapy.
- Author
-
Zullo A, Ridola L, Efrati C, Giorgio F, Nicolini G, Cannaviello C, Alvaro D, Hassan C, Gatta L, and Francesco VD
- Abstract
Background: Helicobacter pylori ( H. pylori ) treatment remains a challenge for physicians. Although highly effective, the standard sequential therapy fails in a certain number of patients. Moreover, the cure rate following a levofloxacin-amoxicillin second-line triple therapy seems to be decreasing. We tested the efficacy of modified 10-day sequential therapy, and an intensified levofloxacin-amoxicillin regimen as first- and second-line therapy respectively., Methods: In this prospective, open label, multicenter, pilot study H. pylori -infected patients received a first-line modified 10-day sequential therapy regimen including rabeprazole 20 mg, and amoxicillin 1 g for the first 3 days, followed by rabeprazole 20 mg, clarithromycin 250 mg, and metronidazole 250 mg, for the remaining 7 days, all drugs given thrice daily. An 8-day therapy regimen with rabeprazole 20 mg, levofloxacin 250 mg, and amoxicillin 1 g, all thrice daily, was administered a second-line therapy., Results: A total of 99 and 15 patients were enrolled for first- and second-line therapy. The eradication rates were 85.9% (95% CI 80-93) and 93.4% (95% CI 88-98) according to ITT and PP analyses following modified sequential therapy, and 60% (95% CI 35-86) and 64.3% (95% CI 39-89) following the intensified second-line therapy., Conclusion: A modified sequential 3- plus 7-day regimen with thrice daily drug administration failed to achieve very high eradication rate at ITT analysis. The intensified second-line regimen achieved disappointingly low eradication rate. Novel levofloxacin-free second-line therapies are urged in Italy.
- Published
- 2014
165. Hepatic encephalopathy therapy: An overview.
- Author
-
Riggio O, Ridola L, and Pasquale C
- Abstract
Type-C hepatic encephalopathy (HE) is a severe complication of cirrhosis, which seriously affects quality of life and is strongly related to patient survival. Treatment based on a classical pharmacological approach that is aimed at reducing the production of gut-derived toxins, such as ammonia, is still under debate. Currently, results obtained from clinical trials do not support any specific treatment for HE and our competence in testing old and new treatment modalities by randomized controlled trials with appropriate clinically relevant end-points urgently needs to be improved. On the other hand, patients who are at risk for HE are now identifiable, based on studies on the natural history of the disease. Today, very few studies that are specifically aimed at establishing whether HE may be prevented are available or in progress. Recent studies have looked at non absorbable disaccharides or antibiotics and other treatment modalities, such as the modulation of intestinal flora. In the treatment of severe stage HE, artificial liver supports have been tested with initial positive results but more studies are needed.
- Published
- 2010
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.