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1. Final Results from the First European Real-World Experience on Lusutrombopag Treatment in Cirrhotic Patients with Severe Thrombocytopenia: Insights from the REAl-World Lusutrombopag Treatment in ITalY Study

Author

Paolo Gallo, Antonio De Vincentis, Francesca Terracciani, Andrea Falcomatà, Valeria Pace Palitti, Maurizio Russello, Anthony Vignone, Domenico Alvaro, Raffaella Tortora, Marco Biolato, Maurizio Pompili, Vincenza Calvaruso, Veneziano Marzia, Marco Tizzani, Alessandro Caneglias, Francesco Frigo, Marcantonio Gesualdo, Alfredo Marzano, Valerio Rosato, Ernesto Claar, Rosanna Villani, Antonio Izzi, Raffaele Cozzolongo, Antonio Cozzolino, Aldo Airoldi, Chiara Mazzarelli, Marco Distefano, Claudia Iegri, Stefano Fagiuoli, Vincenzo Messina, Enrico Ragone, Rodolfo Sacco, Pierluigi Cacciatore, Flora Masutti, Saveria Lory Crocé, Alessandra Moretti, Valentina Flagiello, Giulia Di Pasquale, Antonio Picardi, and Umberto Vespasiani-Gentilucci

Subjects
severe thrombocytopenia, thrombopoietin receptor agonists (TPO-RA), lusutrombopag, portal vein thrombosis (PVT), Medicine
Abstract

Background and aims: Management of severe thrombocytopenia poses significant challenges in patients with chronic liver disease. Here, we aimed to evaluate the first real-world European post-marketing cohort of cirrhotic patients treated with lusutrombopag, a thrombopoietin receptor agonist, verifying the efficacy and safety of the drug. Methods: In the REAl-world Lusutrombopag treatment in ITalY (REALITY) study, we collected data from consecutive cirrhotic patients treated with lusutrombopag in 19 Italian hepatology centers, mostly joined to the “Club Epatologi Ospedalieri” (CLEO). Primary and secondary efficacy endpoints were the ability of lusutrombopag to avoid platelet transfusions and to raise the platelet count to ≥50,000/μL, respectively. Treatment-associated adverse events were also collected. Results: A total of 66 patients and 73 cycles of treatment were included in the study, since 5 patients received multiple doses of lusutrombopag over time for different invasive procedures. Fourteen patients (19%) had a history of portal vein thrombosis (PVT). Lusutrombopag determined a significant increase in platelet count [from 37,000 (33,000–44,000/μL) to 58,000 (49,000–82,000), p < 0.001]. The primary endpoint was met in 84% of patients and the secondary endpoint in 74% of patients. Baseline platelet count was the only independent factor associated with response in multivariate logistic regression analysis (OR for any 1000 uL of 1.13, CI95% 1.04–1.26, p 0.01), with a good discrimination power (AUROC: 0.78). Notably, a baseline platelet count ≤ 29,000/μL was identified as the threshold for identifying patients unlikely to respond to the drug (sensitivity of 91%). Finally, de novo PVT was observed in four patients (5%), none of whom had undergone repeated treatment, and no other safety or hemorrhagic events were recorded in the entire population analyzed. Conclusions: In this first European real-world series, lusutrombopag demonstrated efficacy and safety consistent with the results of registrational studies. According to our results, patients with baseline platelet counts ≤29,000/μL are unlikely to respond to the drug.

Published
2024
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2. Efficacy and safety of lenvatinib in patients with recurrent hepatocellular carcinoma after liver transplantation

Author

Kyunghye Bang, Andrea Casadei‐Gardini, Changhoon Yoo, Massimo Iavarone, Min‐Hee Ryu, Sook Ryun Park, Hyung‐Don Kim, Young‐In Yoon, Dong‐Hwan Jung, Gil‐Chun Park, Chul‐Soo Ahn, Deok‐Bog Moon, Shin Hwang, Ki‐Hun Kim, Gi‐Won Song, Chiara Mazzarelli, Eleonora Alimenti, Stephen L. Chan, Massimo De Giorgio, Baek‐Yeol Ryoo, and Sung‐Gyu Lee

Subjects
Albumin–bilirubin grade, chemotherapy, hepatocellular carcinoma, lenvatinib, liver transplantation, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Introduction Lenvatinib is approved for the treatment of patients with metastatic or recurrent hepatocellular carcinoma (HCC); however, clinical outcomes of lenvatinib therapy in patients with post‐liver transplantation (LT) HCC recurrence remain unclear. We investigated the efficacy and safety of lenvatinib in patients with post‐LT HCC recurrence. Methods This multinational, multicenter, retrospective study included 45 patients with recurrent HCC after LT who received lenvatinib at six institutions in three countries (Korea, Italy, and Hong Kong) from June 2017 to October 2021. Results At the time of lenvatinib initiation, 95.6% (n = 43) of patients had Child–Pugh A status, and 35 (77.8%) and 10 (22.2%) participants were classified as having albumin–bilirubin (ALBI) grades 1 and 2, respectively. The objective response rate was 20.0%. With a median follow‐up duration of 12.9 months (95% confidence interval [CI]: 11.2–14.7), the median progression‐free survival and overall survival (OS) were 7.6 (95% CI: 5.3–9.8) months, and 14.5 (95% CI: 0.8–28.2) months, respectively. Patients with ALBI grade 1 showed significantly better OS (52.3 months, [95% CI: not assessable]) than patients with ALBI grade 2 (11.1 months [95% CI: 0.0–30.4 months], p = 0.003). The most common adverse events were hypertension (n = 25, 55.6%), fatigue (n = 17, 37.8%), and anorexia (n = 14, 31.1%). Conclusion Lenvatinib showed consistent efficacy and toxicity profiles in patients with post‐LT HCC recurrence that were comparable to those reported from previous studies among non‐LT HCC patients. The baseline ALBI grade correlated with better OS in post‐LT lenvatinib‐treated patients.

Published
2023
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3. Impact of SARS-CoV-2 Pandemic on the Management of Patients with Hepatocellular Carcinoma

Author

Maria Guarino, Valentina Cossiga, Mario Capasso, Chiara Mazzarelli, Filippo Pelizzaro, Rodolfo Sacco, Francesco Paolo Russo, Alessandro Vitale, Franco Trevisani, Giuseppe Cabibbo, and on behalf of the Associazione Italiana per lo Studio del Fegato (AISF) HCC Special Interest Group

Subjects
hepatocellular carcinoma, COVID-19, SARS-CoV-2, liver cancer, Medicine
Abstract

Worldwide, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) significantly increases mortality and morbidity. The Coronavirus Disease 2019 (COVID-19) outbreak has had a considerable impact on healthcare systems all around the world, having a significant effect on planned patient activity and established care pathways, in order to meet the difficult task of the global pandemic. Patients with hepatocellular carcinoma (HCC) are considered a particularly susceptible population and conceivably at increased risk for severe COVID-19 because of two combined risk factors: chronic advanced liver disease and HCC itself. In these challenging times, it is mandatory to reshape clinical practice in a prompt way to preserve the highest standards of patient care and safety. However, due to the stay-at-home measures instituted to stop the spread of COVID-19, HCC surveillance has incurred a dramatic drop, and care for HCC patients has been rearranged by refining the algorithm for HCC treatment to the COVID-19 pandemic, permitting these patients to be safely managed by identifying those most at risk of neoplastic disease progression.

Published
2022
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4. Similar survival but higher and delayed hepatocellular carcinoma recurrence in HIV-positive compared to negative cirrhotics undergoing liver transplantation

Author

Roberto Rossotti, Marco Merli, Chiara Mazzarelli, Riccardo Maria De Carlis, Giovanna Travi, Marta Vecchi, Raffaella Viganò, Andrea Lauterio, Alessandro Raimondi, Luca Saverio Belli, Luciano Gregorio De Carlis, Massimo Puoti, Rossotti, R, Merli, M, Mazzarelli, C, De Carlis, R, Travi, G, Vecchi, M, Vigano, R, Lauterio, A, Raimondi, A, Belli, L, De Carlis, L, and Puoti, M

Subjects
Liver transplantation, HCC recurrence, Hepatology, HCV, Gastroenterology, HIV, DAA
Abstract

Background: Liver transplantation (LT) represents the best therapeutic option for hepatocellular carcinoma (HCC) and end-stage liver disease (ESLD). Although HIV infection does not seem to lower survival rates, HCV and HCC recurrence appear more harmful. Aims: To compare the overall survival after LT; evaluate the impact of anti-HCV direct-acting agents (DAA); assess the rate of HCC recurrence in HIV-positive and negative patients. Methods: Subjects with HCV/HBV infection who underwent LT for HCC or ESLD from 2012 to 2019 were retrospectively evaluated. Results: Study population included 299 individuals, 31 (10.4%) were HIV-positive. Overall mortality was similar (16.1% versus 19.0%, p = 0.695). HCC recurrence was observed in 6 HIV-positive (19.4%) and in 17 negative subjects (6.3%, p = 0.022). Time to relapse was 831 days in HIV-positive and 315 days in negative patients (p = 0.046). Cox model found a significant role for HIV in univariate analysis but, after adjusting for variables, extra-hepatic tumor was the only factor associated to recurrence (aHR 56.379, p < 0.001). Conclusions: Post-LT survival improved after DAA availability and HIV has no impact on mortality. A higher and delayed rate of HCC recurrence was observed in co-infected individuals: surveillance protocols should be strengthened along time in this population.

Published
2023

5. Efficacy and safety of lenvatinib in patients with recurrent hepatocellular carcinoma after liver transplantation

Author

Kyunghye Bang, Andrea Casadei-Gardini, Changhoon Yoo, Massimo Iavarone, Min-Hee Ryu, Sook Ryun Park, Hyung-Don Kim, Young-In Yoon, Dong-Hwan Jung, Gil-Chun Park, Chul-Soo Ahn, Deok-Bog Moon, Shin Hwang, Ki-Hun Kim, Gi-Won Song, Chiara Mazzarelli, Eleonora Alimenti, Stephen L. Chan, Massimo De Giorgio, Baek-Yeol Ryoo, and Sung-Gyu Lee

Subjects
Cancer Research, Oncology, Radiology, Nuclear Medicine and imaging
Abstract

Background: Lenvatinib is approved for patients with metastatic or recurrent hepatocellular carcinoma (HCC); however, its clinical outcomes in patients experiencing HCC recurrence after liver transplantation (LT) remain unclear. Thus, we investigated the efficacy and safety of lenvatinib in patients with recurrent HCC after LT.Methods: This multinational, multicenter, retrospective study included 45 patients with recurrent HCC after LT who received lenvatinib at six institutions in three countries (Korea, Italy, and Hong Kong) from June 2017 to October 2021.Results: At the time of lenvatinib initiation, 95.6% (n = 43) of patients were Child–Pugh A, with 35 (77.8%) and 10 (22.2%) patients classified as albumin-bilirubin (ALBI) grades 1 and 2, respectively. The objective response rate was 20.0%. With a median follow-up duration of 12.9 months (95% confidence interval [CI]: 11.2–14.7), median progression-free survival and overall survival (OS) were 7.6 (95% CI: 5.3–9.8) months, and 14.5 (95% CI: 0.8–28.2) months, respectively. Patients with ALBI grade 1 showed significantly better OS (52.3 months, [95% CI: not assessable]) than patients with ALBI grade 2 (11.1 months [95% CI: 0.0–30.4 months], p = 0.003). The most common adverse events were hypertension (n = 25, 55.6%), fatigue (n = 17, 37.8%), and anorexia (n = 14, 31.1%).Conclusion: Lenvatinib showed consistent efficacy and toxicity profiles in patients with recurrent HCC after LT compared to the results of previous studies of non-LT HCC patients. The baseline ALBI grade was correlated with better OS in lenvatinib-treated patients with LT.

Published
2022

6. Liver transplantation for severe alcoholic hepatitis: A multicenter Italian study

Author

Giacomo Germani, Debora Angrisani, Giovanni Addolorato, Manuela Merli, Chiara Mazzarelli, Claudia Tarli, Barbara Lattanzi, Adelaide Panariello, Paola Prandoni, Lucia Craxì, Giovanni Forza, Alessandra Feltrin, Andrea Ronzan, Paolo Feltracco, Antonio Grieco, Salvatore Agnes, Antonio Gasbarrini, Massimo Rossi, Luciano De Carlis, Francesco D’Amico, Umberto Cillo, Luca S. Belli, Patrizia Burra, Germani Giacomo, Belli Luca Saverio, Addolorato Giovanni, Merli Manuela, Mazzelli Chiara, Tarli Claudia, Lattanzi Barbara, Angrisani Debora, Panariello Adelaide, Craxì Lucia, Forza Giovanni, Feltrin Alessandra, Ronza Andrea, Feltracco Paolo, Cillo Umberto, Burra Patrizia, Germani, G, Angrisani, D, Addolorato, G, Merli, M, Mazzarelli, C, Tarli, C, Lattanzi, B, Panariello, A, Prandoni, P, Craxi, L, Forza, G, Feltrin, A, Ronzan, A, Feltracco, P, Grieco, A, Agnes, S, Gasbarrini, A, Rossi, M, De Carlis, L, Francesco, D, Cillo, U, Belli, L, and Burra, P

Subjects
Male, clinical decision-making, Transplantation, Waiting Lists, alcoholism and substance abuse, Hepatitis, Alcoholic, Patient Selection, alllocation, Settore MED/09 - MEDICINA INTERNA, clinical research/practice, liver transplantation/hepatology, alcoholic hepatiti, Middle Aged, Liver Transplantation, Recurrence, MED/18 - CHIRURGIA GENERALE, Humans, Immunology and Allergy, Female, ethic, Pharmacology (medical), Liver transplant
Abstract

There is increasing evidence that early liver transplantation (eLT), performed within standardized protocols can improve survival in severe alcoholic hepatitis (sAH). The aim of the study was to assess outcomes after eLT for sAH in four Italian LT centers and to compare them with non-responders to medical therapy excluded from eLT. Patients admitted for sAH (2013–2019), according to NIAAA criteria, were included. Patients not responding to medical therapy were placed on the waiting list for eLT after a strict selection. Histological features of explanted livers were evaluated. Posttransplant survival and alcohol relapse were evaluated. Ninety-three patients with severe AH were evaluated (65.6% male, median [IQR] age: 47 [42–56] years). Forty-five of 93 patients received corticosteroids, 52 of 93 were non-responders and among these, 20 patients were waitlisted. Sixteen patients underwent LT. Overall, 6-, 12-, and 24-month survival rates were 100% significantly higher compared with non-responders to medical therapy who were denied LT (45%, 45%, and 36%; p&nbsp

Published
2022

7. Personalised management of patients with hepatocellular carcinoma: a multiparametric therapeutic hierarchy concept

Author

Vitale, Alessandro, Cabibbo, Giuseppe, Iavarone, Massimo, Viganò, Luca, Pinato, David J, Ponziani, Francesca Romana, Lai, Quirino, Casadei-Gardini, Andrea, Celsa, Ciro, Galati, Giovanni, Gambato, Martina, Crocetti, Laura, Renzulli, Matteo, Giannini, Edoardo G, Farinati, Fabio, Trevisani, Franco, Cillo, Umberto Umberto Baccarani, Giuseppina, Brancaccio, Raffaele, Cozzolongo, Alessandro, Cucchetti, Nicoletta De Matthaeis, Stefano Di Sandro, Simone, Famularo, Michele, Finotti, Francesco, G Foschi, Davide, Ghinolfi, Marco, Guarracino, Gruttadauria, Salvatore Giovanni, Guarino, FRANCESCA MARIA, Alba, Kostandini, Ilaria, Lenci, Giovanni, B Levi Sandri, Tommaso, M Manzia, Giovanni, Marasco, Mario, Masarone, Chiara, Mazzarelli, Fabio, Melandro, Luca, Miele, Filomena, Morisco, Daniele, Nicolini, Duilio, Pagano, Filippo, Pelizzaro, Giulia, Pieri, Fabio, Piscaglia, Maria Corina Plaz Torres, Riccardo, Pravisani, Maria, Rendina, Romano, Fabrizio, Francesco, P Russo, Rodolfo, Sacco, Angelo, Sangiovanni, Carlo, Sposito, Raffaella, Tortora, Francesco, Tovoli, Mauro, Viganò, and Paola, Violi

Published
2023

8. A Very Short Course of HBIg+NA Followed by Entecavir or Tenofovir Monotherapy Prevents HBV Recurrence in Low-Risk Liver Transplant Recipients

Author

Matteo Angelo Manini, Aisling Considine, Abid Suddle, Matthew Bruce, Chiara Mazzarelli, Nigel Heaton, Gavin Whitehouse, Stefano Fagiuoli, Kosh Agarwal, Michael A. Heneghan, Manini, M, Bruce, M, Whitehouse, G, Mazzarelli, C, Considine, A, Agarwal, K, Suddle, A, Fagiuoli, S, Heaton, N, and Heneghan, M

Subjects
Adult, Male, Hepatitis B virus, medicine.medical_specialty, HBsAg, Guanine, Tenofovir, medicine.medical_treatment, Immunoglobulins, Liver transplantation, medicine.disease_cause, Antiviral Agents, Gastroenterology, Interquartile range, Internal medicine, medicine, Humans, Transplantation, biology, Drug Substitution, business.industry, Entecavir, Middle Aged, Hepatitis B, Liver Transplantation, Treatment Outcome, Reinfection, biology.protein, Female, Surgery, Antibody, business, Follow-Up Studies, medicine.drug
Abstract

Background: Monoprophylaxis with third-generation nucleos(t)ide analogues (NAs) can be safely adopted in hepatitis B virus (HBV)-positive, liver transplantation (LT) patients after at least 6 months of HBV immunoglobulin (HBIg)+NA. We investigated the efficacy of earlier initiation of post-LT entecavir (ETV) or tenofovir (TDF) monoprophylaxis. Methods: Between September 2011 and January 2017, all consecutive hepatitis B surface antigen (HBsAg)-positive transplanted patients were scheduled to receive HBIg with ETV or TDF for a period related to the risk for HBV reinfection: 1. low-risk patients (HBeAg-negative and HBV DNA < 12 IU/mL before LT) were due to withdraw from HBIg once HBsAg had become negative after a minimum of 7 days of HBIg+NA; 2. high-risk patients were due to receive HBIg for at least 6 months, after which they continued with third-generation NA monotherapy, only. Results: Twenty patients with a median interquartile range (IQR) follow-up of 46 (64-39) months were enrolled in the study (40% receiving ETV, 60% receiving TDF). Two low-risk patients refused early HBIg withdrawal and were therefore treated and analyzed along with the high-risk group. Eventually, there were 2 groups: group A, which included 12 low-risk patients, and group B, which included 8 patients (six high-risk, 2 low-risk). After transplantation, group A and B patients received HBIg+NA for a median (IQR) time of 7 (9-7) days and 9 (13-5) months, respectively. All 20 recipients demonstrated HBV DNA < 12 IU/mL and stable graft function during follow-up. Two patients (10%), 1 from each group, had HBsAg relapse. Notably, both patients who relapsed had hepatocellular carcinoma (HCC) diagnosed before LT and showed very low levels (< 0.25 IU/mL) of HBsAg after recurrence. Conclusion: In low-risk HBsAg-positive recipients, HBIg may be safely discontinued within 2 weeks of LT and replaced by ETV or TDF monotherapy.

Published
2021

9. Impact of SARS-CoV-2 Pandemic on the Management of Patients with Hepatocellular Carcinoma

Author

Maria, Guarino, Valentina, Cossiga, Mario, Capasso, Chiara, Mazzarelli, Filippo, Pelizzaro, Rodolfo, Sacco, Francesco Paolo, Russo, Alessandro, Vitale, Franco, Trevisani, Giuseppe, Cabibbo, Baccarani, Umberto, Bhoori, Sherrie, Borzio, Mauro, Brancaccio, Giuseppina, Burra, Patrizia, Casadei Gardini, Andrea, Carrai, Paola, Centonze, Leonardo, Cescon, Matteo, Cillo, Umberto, Cozzolongo, Raffaele, Cucchetti, Alessandro, De Matthaeis, Nicoletta, Di Costanzo, Giovan Giuseppe, Di Sandro, Stefano, Famularo, Simone, Farinati, Fabio, Finotti, Michele, Giuseppe Foschi, Francesco, Galati, Giovanni, Gambato, Martina, Giovanni Giannini, Edoardo, Giuliante, Felice, Ghinolfi, Davide, Gruttaduria, Salvatore, Iavarone, Massimo, Kostandini, Alba, Lai, Quirino, Lenci, Ilaria, Giovanni Lupo, Luigi, Manzia, Tommaso, Marasco, Giovanni, Marenco, Simona, Masarone, Mario, Mazzocato, Susanna, Melandro, Fabio, Mescoli, Claudia, Miele, Luca, Morisco, Filomena, Nicolini, Daniele, Pagano, Duilio, Persico, Marcello, Platz Torres, Maria Corina, Ponziani, Francesca Romana, Pravisani, Riccardo, Rendina, Maria, Renzulli, Matteo, Ricci, Lilia, Romano, Fabrizio, Battista Levi Sandri, Giovanni, Sangiovanni, Angelo, Sposito, Carlo, Tortora, Raffaella, Viganò, Luca, Viganò, Mauro, Vincenzi, Valter, Violi, Pola, Nicoletta, De Matthaeis, Felice, Giuliante (ORCID:0000-0001-9517-8220), Luca, Miele (ORCID:0000-0003-3464-0068), Francesca Romana, Ponziani (ORCID:0000-0002-5924-6238), Maria, Guarino, Valentina, Cossiga, Mario, Capasso, Chiara, Mazzarelli, Filippo, Pelizzaro, Rodolfo, Sacco, Francesco Paolo, Russo, Alessandro, Vitale, Franco, Trevisani, Giuseppe, Cabibbo, Baccarani, Umberto, Bhoori, Sherrie, Borzio, Mauro, Brancaccio, Giuseppina, Burra, Patrizia, Casadei Gardini, Andrea, Carrai, Paola, Centonze, Leonardo, Cescon, Matteo, Cillo, Umberto, Cozzolongo, Raffaele, Cucchetti, Alessandro, De Matthaeis, Nicoletta, Di Costanzo, Giovan Giuseppe, Di Sandro, Stefano, Famularo, Simone, Farinati, Fabio, Finotti, Michele, Giuseppe Foschi, Francesco, Galati, Giovanni, Gambato, Martina, Giovanni Giannini, Edoardo, Giuliante, Felice, Ghinolfi, Davide, Gruttaduria, Salvatore, Iavarone, Massimo, Kostandini, Alba, Lai, Quirino, Lenci, Ilaria, Giovanni Lupo, Luigi, Manzia, Tommaso, Marasco, Giovanni, Marenco, Simona, Masarone, Mario, Mazzocato, Susanna, Melandro, Fabio, Mescoli, Claudia, Miele, Luca, Morisco, Filomena, Nicolini, Daniele, Pagano, Duilio, Persico, Marcello, Platz Torres, Maria Corina, Ponziani, Francesca Romana, Pravisani, Riccardo, Rendina, Maria, Renzulli, Matteo, Ricci, Lilia, Romano, Fabrizio, Battista Levi Sandri, Giovanni, Sangiovanni, Angelo, Sposito, Carlo, Tortora, Raffaella, Viganò, Luca, Viganò, Mauro, Vincenzi, Valter, Violi, Pola, Nicoletta, De Matthaeis, Felice, Giuliante (ORCID:0000-0001-9517-8220), Luca, Miele (ORCID:0000-0003-3464-0068), and Francesca Romana, Ponziani (ORCID:0000-0002-5924-6238)

Abstract

Worldwide, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) significantly increases mortality and morbidity. The Coronavirus Disease 2019 (COVID-19) outbreak has had a considerable impact on healthcare systems all around the world, having a significant effect on planned patient activity and established care pathways, in order to meet the difficult task of the global pandemic. Patients with hepatocellular carcinoma (HCC) are considered a particularly susceptible population and conceivably at increased risk for severe COVID-19 because of two combined risk factors: chronic advanced liver disease and HCC itself. In these challenging times, it is mandatory to reshape clinical practice in a prompt way to preserve the highest standards of patient care and safety. However, due to the stay-at-home measures instituted to stop the spread of COVID-19, HCC surveillance has incurred a dramatic drop, and care for HCC patients has been rearranged by refining the algorithm for HCC treatment to the COVID-19 pandemic, permitting these patients to be safely managed by identifying those most at risk of neoplastic disease progression.

Published
2022

10. Implementation of the frailty assessment to improve liver transplant outcomes

Author

Mattia Corradi, Chiara Mazzarelli, Matteo Cesari, Raffaella Viganò, and Luca Saverio Belli

Subjects
Aging, Settore MED/09 - Medicina Interna, frailty index, Frailty, long term survivors, Frail Elderly, Middle Aged, Liver Transplantation, Treatment Outcome, Humans, Geriatrics and Gerontology, frailty, improving outcomes, liver transplantation, Geriatric Assessment, Aged
Abstract

The majority of patients undergoing Orthotopic Liver Transplantation (OLT) have increased in age, therefore chronological age may have become an unreliable parameter for supporting clinical decisions. The age-related deficit accumulation model measuring frailty proposed by Rockwood et al., may propose an alternative in providing an estimate of an individual’s biological age. No Frailty Index (FI) tailored specifically for OLT patients exists to date. Forty-three consecutive OLT patients with ≥ 20 years of survival with a functioning graft were included in our study. The FI was computed taking to account 39 items (FI-39), meeting the standard criteria for internal validation. Endpoints were polypharmacy, and recent Emergency Room admission. The mean age of our population was 69 (sd 9) years. The mean FI-39 was 0.23 (sd 0.1). The FI-39 was associated with polypharmacy [odds ratio (OR) 1.13; Confidence interval (95%CI) 1.03–1.24; p = 0.01], and recent Emergency Room admission [beta coefficient + 1.98; 95%CI + 0.26, + 3.70; p = 0.03], independent for age and sex. This study demonstrates that an FI can be derived from data collected during routine clinical follow-up and allows for improved differentiation related to the OLT clinical complexity in OLT patients, independent of chronological age. This may lead to the adoption of FI-39 to improve personalized OLT patient care.

Published
2021

12. Patients with chronic HCV and decompensated cirrhosis are at risk for MELD purgatory

Author

Lisette Krassenburg, Grishma Hirode, Hooman Farhang Zangneh, Raoel Maan, Alnoor Ramji, Michael P. Manns, Heiner Wedemeyer, Markus Cornberg, Robert De Knegt, Kosh Agarwal, Zillah Cargill, Gonzalo Crespo, Giuseppina Brancaccio, Maria Cristina Morelli, Ilaria Lenci, Chiara Mazzarelli, Paolo Angeli, Patrizia Burra, Gabriella Verucchi, Maria Francesca Donato, Paola Carrai, Silvia Martini, Paolo Caraceni, Francesco Paolo Russo, Robert De Man, Harry Janssen, Bettina Hansen, Adriaan Van der Meer, and Jordan Feld

Subjects
Hepatology
Published
2022

13. Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: Results of the ELITA/EF-CLIF collaborative study (ECLIS)

Author

Luca S. Belli, Christophe Duvoux, Thierry Artzner, William Bernal, Sara Conti, Paolo A. Cortesi, Sophie-Caroline Sacleux, George-Philippe Pageaux, Sylvie Radenne, Jonel Trebicka, Javier Fernandez, Giovanni Perricone, Salvatore Piano, Silvio Nadalin, Maria C. Morelli, Silvia Martini, Wojciech G. Polak, Krzysztof Zieniewicz, Christian Toso, Marina Berenguer, Claudia Iegri, Federica Invernizzi, Riccardo Volpes, Vincent Karam, René Adam, François Faitot, Liane Rabinovich, Faouzi Saliba, Lucy Meunier, Mickael Lesurtel, Frank E. Uschner, Costantino Fondevila, Baptiste Michard, Audrey Coilly, Magdalena Meszaros, Domitille Poinsot, Andreas Schnitzbauer, Luciano G. De Carlis, Roberto Fumagalli, Paolo Angeli, Vincente Arroyo, Rajiv Jalan, Raffaella Viganò, Chiara Mazzarelli, Andrea Lauterio, Alessandro Giacomoni, Francesca Donato, Pietro Lampertico, Luisa Pasulo, Stefano Fagiuoli, Michele Colledan, Maria Cristina Morelli, Giovanni Vitale, Damiano Patrono, Renato Romagnoli, Antonio Ottobrelli, Ioannis Petridis, Umberto Cillo, Giacomo Germani, Patrizia Burra, Philippe Bachellier, Pietro Addeo, Camille Besch, Francoise Faitot, Sophie Caroline Sacleux, Saliba Faouzi, Rene Adam, Didier Samuel, Celine Guichon, Stéfanie Faure, Josè Ursic-Bedoya, Jorde Colmenero, David Toapanta, María Hernández-Tejero, Carmen Vinaixa, Caroline den Hoed, Jubi E. de Haan, Andrea Della Penna, Frank Erhard Uschner, Martin Welker, Stefan Zeuzem, Wolf Bechstein, Nicolas Goossens, Joanna Raszeja-Wyszomirska, Dev Katarey, Banwari Agarwal, Surgery, Internal Medicine, Gastroenterology & Hepatology, Intensive Care, ASST Great Metropolitan Niguarda / ASST Grande Ospedale Metropolitano Niguarda [Milan, Italia], Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital de Hautepierre [Strasbourg], King‘s College London, Ospedale Multimedica Sesto San Giovanni, Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Centre Hépato-Biliaire [Hôpital Paul Brousse] (CHB), Hôpital Paul Brousse-Assistance Publique - Hôpitaux de Paris, Physiopathologie et traitement des maladies du foie, Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi], Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), Service d'Hépatologie [Hôpital de la Croix-Rousse - HCL], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Goethe-University Frankfurt am Main, European Foundation for Study of Chronic Liver Failure [Barcelona] (EF CLIF), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBERehd), Liver Unit, Clínica Universitaria, CIBER-EHD, Azienda Ospedale Università di Padova = Hospital-University of Padua (AOUP), Universitätsklinikum Tübingen - University Hospital of Tübingen, Eberhard Karls Universität Tübingen = Eberhard Karls University of Tuebingen, Azienda Ospedaliero-Universitaria di Bologna, Azienda Ospedalerio - Universitaria Città della Salute e della Scienza di Torino = University Hospital Città della Salute e della Scienza di Torino, Erasmus University Medical Center [Rotterdam] (Erasmus MC), Medical University of Warsaw - Poland, Geneva University Hospitals and Geneva University, Hospital Universitari i Politècnic La Fe = University and Polytechnic Hospital La Fe, Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), Pôle des Pathologies Digestives Hépatiques et Transplantation [Hôpital Hautepierre-Strasbourg], Department of Physiopatology and Transplantation, University of Milan (DEPT), Università degli Studi di Milano = University of Milan (UNIMI), Ospedale S. Giovanni Battista-Molinette, Azienda Ospedaliera di Padova, Università degli Studi di Padova = University of Padua (Unipd), Hospital Clinic i Provincial de Barcelona (SCReN), University College London Hospitals (UCLH), Belli, L, Duvoux, C, Artzner, T, Bernal, W, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinovich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Fondevila, C, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Jalan, R, Fagiuoli, S, Goossens, Nicolas, and Salvy-Córdoba, Nathalie

Subjects
Male, 0301 basic medicine, Multi-drug resistant organisms, medicine.medical_treatment, Waiting list, Salvage therapy, Liver transplantation, Severity of Illness Index, MESH: Proportional Hazards Models, Cohort Studies, 0302 clinical medicine, MESH: Risk Factors, Risk Factors, Medicine, MESH: Cohort Studies, Acute-on-Chronic Liver Failure, MESH: Aged, High rate, MESH: Middle Aged, ddc:617, Hazard ratio, MESH: Acute-On-Chronic Liver Failure, Middle Aged, Prognosis, Predictive factors, Italy, Female, 030211 gastroenterology & hepatology, Adult, MESH: Liver Transplantation, medicine.medical_specialty, MESH: Prognosis, 03 medical and health sciences, MESH: Severity of Illness Index, Internal medicine, Humans, Acute on chronic liver failure, Renal replacement therapy, Aged, Proportional Hazards Models, Retrospective Studies, MESH: Humans, Hepatology, business.industry, MESH: Italy, MESH: Adult, MESH: Retrospective Studies, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Retrospective cohort study, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Multi-drug resistant organism, MESH: Male, 030104 developmental biology, Predictive factor, business, MESH: Female
Abstract

Background & Aims: Liver transplantation (LT) has been proposed as an effective salvage therapy even for the sickest patients with acute-on-chronic liver failure (ACLF). This large collaborative study was designed to assess the current clinical practice and outcomes of patients with ACLF who are wait-listed for LT in Europe. Methods: This was a retrospective study including 308 consecutive patients with ACLF, listed in 20 centres across 8 European countries, from January 2018 to June 2019. Results: A total of 2,677 patients received a LT: 1,216 (45.4%) for decompensated cirrhosis. Of these, 234 (19.2%) had ACLF at LT: 58 (4.8%) had ACLF-1, 78 (6.4%) had ACLF-2, and 98 (8.1%) had ACLF-3. Wide variations were observed amongst countries: France and Germany had high rates of ACLF-2/3 (27-41%); Italy, Switzerland, Poland and the Netherlands had medium rates (9-15%); and the United Kingdom and Spain had low rates (3-5%) (p 4 mmol/L (hazard ratio [HR] 3.14; 95% CI 1.37-7.19), recent infection from multidrug resistant organisms (HR 3.67; 95% CI 1.63-8.28), and renal replacement therapy (HR 2.74; 95% CI 1.37-5.51) were independent predictors of post-LT mortality. During the same period, 74 patients with ACLF died on the waiting list. In an intention-to-treat analysis, 1-year survival of patients with ACLF on the LT waiting list was 73% for ACLF-1 or-2 and 50% for ACLF-3. Conclusion: The results reveal wide variations in the listing of patients with ACLF in Europe despite favourable post-LT survival. Risk factors for mortality were identified, enabling a more pre-cise prognostic assessment of patients with ACLF. Lay summary: Acute-on-chronic liver failure (ACLF) is a severe clinical condition for which liver transplantation is an effective therapeutic option. This study has demonstrated that in Europe, referral and access to liver transplantation (LT) for patients with ACLF needs to be harmonised to avoid inequities. Post-LT survival for patients with ACLF was >80% after 1 year and some factors have been identified to help select patients with favourable outcomes. (C) 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All reserved.

Published
2021

14. Daclatasvir-based regimens in HCV cirrhosis: experience from the Italian early access program

Author

Stefano Fagiuoli, Mario Angelico, Paola Carrai, Marzia Montalbano, Marco Biolato, Teresa Santantonio, Luisa Pasulo, Luca S. Belli, Gabriella Verucchi, Gianpiero D'Offizi, Lorenzo Badia, Elena Angeli, Erica Villa, Marcello Persico, Chiara Mazzarelli, Guido Piai, Raffaella Lionetti, Giovanni Guaraldi, Vanni Borghi, Vincenza Calvaruso, Laura Milazzo, Martina Felder, Antonio Grieco, Massimo Puoti, Antonio Craxì, Alfredo Alberti, Rossella Letizia Mancusi, Calvaruso, Vincenza, Mazzarelli, Chiara, Milazzo, Laura, Badia, Lorenzo, Pasulo, Luisa, Guaraldi, Giovanni, Lionetti, Raffaella, Villa, Erica, Borghi, Vanni, Carrai, Paola, Alberti, Alfredo, Biolato, Marco, Piai, Guido, Persico, Marcello, Santantonio, Teresa, Felder, Martina, Angelico, Mario, Montalbano, Marzia, Mancusi, Rossella Letizia, Grieco, Antonio, Angeli, Elena, D'Offizi, Gianpiero, Fagiuoli, Stefano, Belli, Luca, Verucchi, Gabriella, Puoti, Massimo, Craxì, Antonio, Calvaruso V, Mazzarelli C, Milazzo L, Badia L, Pasulo L, Guaraldi G, Lionetti R, Villa E, Borghi V, Carrai P, Alberti A, Biolato M, Piai G, Persico M, Santantonio T, Felder M, Angelico M, Montalbano M, Mancusi RL, Grieco A, Angeli E, D'Offizi G, Fagiuoli S, Belli L, Verucchi G, Puoti M, Craxì A., Calvaruso, V, Mazzarelli, C, Milazzo, L, Badia, L, Pasulo, L, Guaraldi, G, Lionetti, R, Villa, E, Borghi, V, Carrai, P, Alberti, A, Biolato, M, Piai, G, Persico, M, Santantonio, T, Felder, M, Angelico, M, Montalbano, M, Mancusi, R, Grieco, A, Angeli, E, D'Offizi, G, Fagiuoli, S, Belli, L, Verucchi, G, Puoti, M, and Craxi, A

Subjects
0301 basic medicine, Simeprevir, Liver Cirrhosis, Male, Pyrrolidines, Sofosbuvir, Sustained Virologic Response, lcsh:Medicine, Settore MED/05, Gastroenterology, chemistry.chemical_compound, 0302 clinical medicine, Liver Function Tests, INFECTION, Medicine, PLUS SOFOSBUVIR, lcsh:Science, Sulfonamides, Multidisciplinary, Imidazoles, Valine, Hepatitis C, Middle Aged, Treatment Outcome, Italy, SAFETY, HCV, SUSTAINED VIROLOGICAL RESPONSE, Drug Therapy, Combination, Female, RIBAVIRIN, Settore BIO/19 - MICROBIOLOGIA GENERALE, CHRONIC HEPATITIS-C, medicine.drug, Adult, medicine.medical_specialty, Daclatasvir, Drug-Related Side Effects and Adverse Reactions, Antiviral Agents, Article, 03 medical and health sciences, Internal medicine, Humans, Aged, ADVANCED LIVER-DISEASE, business.industry, Ribavirin, VIRUS GENOTYPE 3, lcsh:R, Hepatitis C, Chronic, HCV HIV Daclatasvir, medicine.disease, Isoquinolines, EFFICACY, Regimen, 030104 developmental biology, chemistry, Asunaprevir, lcsh:Q, Liver function, Carbamates, business, 030217 neurology & neurosurgery
Abstract

We reported the efficacy and safety data for daclatasvir (DCV)-based all-oral antiviral therapy in patients treated in the Italian compassionate-use program. 275 patients were included (202 male-73.5%, mean age: 57.4 years, 62 HIV-coinfected, 94 with recurrence of hepatitis C post-OLT). Forty-nine patients (17.8%) had Child-Pugh B, Genotype(G) distribution was: G1a:72 patients (26.2%), G1b:137 (49.8%); G3:40 (14.5%) and G4:26 (9.5%). Patients received DCV with sofosbuvir(SOF) (n = 221, 129 with ribavirin(RBV) or with simeprevir (SMV) or asunaprevir (ASU) (n = 54, 19 with RBV) for up to 24 weeks. Logistic regression was used to identify baseline characteristics associated with sustained virological response at week 12 post-treatment (SVR12). Liver function changes between baseline and follow up were assessed in 228 patients. 240 patients achieved SVR12 (87.3%), post transplant and HIV co-infected patients were equally distributed among SVR and no SVR (35% vs 34.3%; p = 0.56 and 24.2% vs 11.4%, p = 0.13, respectively). SVR rate was significantly higher with the combination DCV + SOF compared with DCV + SIM or ASU (93.2% vs 63.0%, p

Published
2019

15. On-treatment serum albumin level can guide long-term treatment in patients with cirrhosis and uncomplicated ascites

Author

Alessandro Federico, M. Colpani, Paolo Caraceni, Marco Domenicali, Manuel Tufoni, L. Simone, A Alberti, Giovanni Raimondo, A. Risso, Antonietta Sticca, Salvatore Piano, Anna Visani, Francesco Salerno, Giacomo Laffi, Piera Rossi, Paolo Angeli, F. Fidone, Pierluigi Toniutto, Vincenza Calvaruso, Silvia Nardelli, Aldo Airoldi, Sara Massironi, Stefania Gioia, A. Roncadori, Marco Marzioni, Nicola Caporaso, N.M. Castellaneta, Stefano Fagiuoli, Francesco Giuseppe Foschi, Raffaele Cozzolongo, Maria Rendina, Irene Cacciola, Oliviero Riggio, Sergio Neri, Raffaella Viganò, Ferdinando Giannone, Chiara Mazzarelli, Maria Marsico, Giovanni Parrella, Riccardo Guarisco, Chiara Elia, F. Levantesi, M. Cavallin, Alida Andrealli, A. Pecchioli, Loredana Prestianni, Rosanna De Marco, T Gabbani, Elga Neri, S. Boccia, Arianna Lanzi, Giacomo Zaccherini, Marcello Dallio, Giovanni Perricone, Giorgio Ballardini Natascia Celli, Francesco Auriemma, Federica Mirici Cappa, Agnese Antognoli, Annalisa Tortora, Gianfranco Elia, R. Bringiotti, Francesco De Leonardis, Marcello Vangeli, Agostino Rizzotto, Dario Conte, Manuela Merli, Francesca Capretti, Mauro Bernardi, Chiara Pasquale, Pietro Leo, D. Maiorca, M. Zappimbulso, Filomena Morisco, Vincenzo Sangiovanni, Maurizio Baldassarre, Lucia Cesarini, Gianluca Svegliati-Baroni, Maria Guarino, Carmelina Loguercio, Alessandra Galioto, Antonio Mastroianni, Giorgio Maria Saracco, Antonio Gasbarrini, G. Magini, Alba Kostandini, Carlo Alessandria, Josè Petruzzi, Vito Di Marco, Silvano Fasolato, Elisa Negri, Fabio Pugliese, Mario Angelico, Daniela Campion, Caraceni P., Tufoni M., Zaccherini G., Riggio O., Angeli P., Alessandria C., Neri S., Foschi F.G., Levantesi F., Airoldi A., Simone L., Svegliati-Baroni G., Fagiuoli S., Laffi G., Cozzolongo R., Di Marco V., Sangiovanni V., Morisco F., Toniutto P., Gasbarrini A., De Marco R., Piano S., Nardelli S., Elia C., Roncadori A., Baldassarre M., Bernardi M., Domenicali M., Giannone F.A., Antognoli A., Merli M., Pasquale C., Gioia S., Fasolato S., Sticca A., Campion D., Risso A., Saracco G.M., Prestianni L., Fidone F., Maiorca D., Rizzotto A., Cappa F.M., Lanzi A., Neri E., Visani A., Mastroianni A., Perricone G., Alberti A.B., Cesarini L., Mazzarelli C., Vangeli M., Vigano R., Marzioni M., Capretti F., Kostandini A., Magini G., Colpani M., Gabbani T., Marsico M., Zappimbulso M., Petruzzi J., Calvaruso V., Parrella G., Caporaso N., Auriemma F., Guarino M., Pugliese F., Tortora A., Leo P., Angelico M., De Leonardis F., Pecchioli A., Rossi P., Raimondo G., Cacciola I., Elia G., Negri E., Dallio M., Loguercio C., Federico A., Conte D., Massironi S., Natascia Celli G.B., Rendina M., Bringiotti R., Castellaneta N.M., Salerno F., Boccia S., Guarisco R., Galioto A., Cavallin M., Andrealli A., Caraceni, P., Tufoni, M., Zaccherini, G., Riggio, O., Angeli, P., Alessandria, C., Neri, S., Foschi, F. G., Levantesi, F., Airoldi, A., Simone, L., Svegliati-Baroni, G., Fagiuoli, S., Laffi, G., Cozzolongo, R., Di Marco, V., Sangiovanni, V., Morisco, F., Toniutto, P., Gasbarrini, A., De Marco, R., Piano, S., Nardelli, S., Elia, C., Roncadori, A., Baldassarre, M., Bernardi, M., Domenicali, M., Giannone, F. A., Antognoli, A., Merli, M., Pasquale, C., Gioia, S., Fasolato, S., Sticca, A., Campion, D., Risso, A., Saracco, G. M., Prestianni, L., Fidone, F., Maiorca, D., Rizzotto, A., Cappa, F. M., Lanzi, A., Neri, E., Visani, A., Mastroianni, A., Perricone, G., Alberti, A. B., Cesarini, L., Mazzarelli, C., Vangeli, M., Vigano, R., Marzioni, M., Capretti, F., Kostandini, A., Magini, G., Colpani, M., Gabbani, T., Marsico, M., Zappimbulso, M., Petruzzi, J., Calvaruso, V., Parrella, G., Caporaso, N., Auriemma, F., Guarino, M., Pugliese, F., Tortora, A., Leo, P., Angelico, M., De Leonardis, F., Pecchioli, A., Rossi, P., Raimondo, G., Cacciola, I., Elia, G., Negri, E., Dallio, M., Loguercio, C., Federico, A., Conte, D., Massironi, S., Natascia Celli, G. B., Rendina, M., Bringiotti, R., Castellaneta, N. M., Salerno, F., Boccia, S., Guarisco, R., Galioto, A., Cavallin, M., Andrealli, A., Caraceni, P, Tufoni, M, Zaccherini, G, Riggio, O, Angeli, P, Alessandria, C, Neri, S, Foschi, F, Levantesi, F, Airoldi, A, Simone, L, Svegliati-Baroni, G, Fagiuoli, S, Laffi, G, Cozzolongo, R, Di Marco, V, Sangiovanni, V, Morisco, F, Toniutto, P, Gasbarrini, A, De Marco, R, Piano, S, Nardelli, S, Elia, C, Roncadori, A, Baldassarre, M, Bernardi, M, Domenicali, M, Giannone, F, Antognoli, A, Merli, M, Pasquale, C, Gioia, S, Fasolato, S, Sticca, A, Campion, D, Risso, A, Saracco, G, Prestianni, L, Fidone, F, Maiorca, D, Rizzotto, A, Cappa, F, Lanzi, A, Neri, E, Visani, A, Mastroianni, A, Perricone, G, Alberti, A, Cesarini, L, Mazzarelli, C, Vangeli, M, Vigano, R, Marzioni, M, Capretti, F, Kostandini, A, Magini, G, Colpani, M, Gabbani, T, Marsico, M, Zappimbulso, M, Petruzzi, J, Calvaruso, V, Parrella, G, Caporaso, N, Auriemma, F, Guarino, M, Pugliese, F, Tortora, A, Leo, P, Angelico, M, De Leonardis, F, Pecchioli, A, Rossi, P, Raimondo, G, Cacciola, I, Elia, G, Negri, E, Dallio, M, Loguercio, C, Federico, A, Conte, D, Massironi, S, Natascia Celli, G, Rendina, M, Bringiotti, R, Castellaneta, N, Salerno, F, Boccia, S, Guarisco, R, Galioto, A, Cavallin, M, and Andrealli, A

Subjects
Male, 0301 basic medicine, Cirrhosis, ascites, complications, liver cirrhosis, serum albumin, survival, Serum albumin, Survival, Logistic regression, Gastroenterology, Biomarkers, Pharmacological, Ascites, Complications, 0302 clinical medicine, Medicine, biology, Middle Aged, Intention to Treat Analysis, Treatment Outcome, Ascite, Female, 030211 gastroenterology & hepatology, Drug Monitoring, medicine.symptom, medicine.medical_specialty, Settore MED/12 - GASTROENTEROLOGIA, Serum Albumin, Human, 03 medical and health sciences, Serum albumin level, Predictive Value of Tests, Internal medicine, Post-hoc analysis, Humans, In patient, Biological Products, Cirrhosi, Hepatology, business.industry, Albumin, medicine.disease, Long-Term Care, Survival Analysis, 030104 developmental biology, biology.protein, business, Complication
Abstract

Background & Aims: The ANSWER study reported that long-term albumin administration in patients with cirrhosis and uncomplicated ascites improves survival. During treatment, serum albumin increased within a month and remained stable thereafter. In this post hoc analysis, we aimed to determine whether on-treatment serum albumin levels could guide therapy. Methods: Logistic regression was used to assess the association between baseline serum albumin and mortality, as well as to determine on-treatment factors associated with mortality and to predict the achievement of a given on-treatment serum albumin level. Survival was assessed by Kaplan-Meier estimates and second-order polynomial regression. Patients whose on-treatment serum albumin remained below normal were compared with a subset of patients from the control arm matched by principal score. Results: Baseline serum albumin was closely associated with 18-month mortality in untreated patients; albumin treatment almost effaced this relationship. On-treatment serum albumin and MELD-Na at month 1 were the sole independent variables associated with mortality. Second-order polynomial regression revealed that survival improved in parallel with increased 1-month on-treatment serum albumin. Kaplan-Meier estimations showed that any value of 1-month on-treatment serum albumin (0.1 g/dl intervals) in the range 2.5–4.5 g/dl discriminated patient survival. In the normal range of serum albumin, the best discriminant value was 4.0 g/dl. Compared to untreated patients, survival even improved in patients whose on-treatment serum albumin remained below normal. Conclusion: Baseline serum albumin per se should not guide the decision to start albumin therapy. Conversely, 1-month on-treatment serum albumin levels are strongly associated with outcomes and could guide the use of albumin – 4.0 g/dl being the target threshold. However, even patients whose serum albumin remains below normal benefit from long-term albumin administration. Lay summary: The ANSWER study has shown that long-term albumin administration improves survival and prevents the occurrence of major complications in patients with cirrhosis and ascites. This study shows that the achievement of these beneficial effects is related to a significant increase in serum albumin concentration. Even though the best results follow the achievement of a serum albumin concentration of 4 g/dl, a survival benefit is also achieved in patients who fail to normalise serum albumin.

Published
2020

16. Palliative care in end‐stage liver disease: Time to do better?

Author

Luca S. Belli, Michael A. Heneghan, Mary Cannon, Chiara Mazzarelli, Wendy Prentice, and Kosh Agarwal

Subjects
Liver Cirrhosis, medicine.medical_specialty, Palliative care, medicine.medical_treatment, MEDLINE, Liver transplantation, Severity of Illness Index, End Stage Liver Disease, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Quality of life (healthcare), Severity of illness, Humans, Medicine, 030212 general & internal medicine, Intensive care medicine, Transplantation, Evidence-Based Medicine, Hepatology, Delivery of Health Care, Integrated, business.industry, Palliative Care, End stage liver disease, medicine.disease, Liver Transplantation, Treatment Outcome, Quality of Life, 030211 gastroenterology & hepatology, Surgery, business, Psychosocial
Abstract

Optimal involvement of palliative care (PC) services in the management of patients with decompensated cirrhosis and end-stage liver disease (ESLD) is limited. This may result from both ignorance and the failure to recognize the spectrum and unpredictability of the underlying liver condition. Palliative care is a branch of medicine that focuses on quality of life (QoL) by optimizing symptom management and providing psychosocial, spiritual, and practical support for both patients and their caregivers. Historically, palliative care has been underutilized for patients with decompensated liver disease. This review provides an evidence-based analysis of the benefits of the integration of palliative care into the management of patients with ESLD. Liver Transplantation 24 961-968 2018 AASLD.

Published
2018

17. Efficacy and Tolerability of Direct‐Acting Antivirals for Hepatitis C in Older Adults

Author

Abid Suddle, Matteo Angelo Manini, Geoffrey Dusheiko, Kate Childs, Ivana Carey, Mary Cannon, Aisling Considine, Chiara Mazzarelli, and Kosh Agarwal

Subjects
Male, medicine.medical_specialty, Anemia, Hepatitis C virus, medicine.disease_cause, Antiviral Agents, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, Ribavirin, medicine, Humans, Outpatient clinic, 030212 general & internal medicine, Adverse effect, Fatigue, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Headache, Hepatitis C, Hepatitis C, Chronic, Middle Aged, Viral Load, medicine.disease, Treatment Outcome, Tolerability, chemistry, Female, 030211 gastroenterology & hepatology, Geriatrics and Gerontology, Viral hepatitis, business
Abstract

Objectives To evaluate the efficacy and tolerability of direct‐acting antiviral (DAA) therapy in individuals aged 65 and older. Design Retrospective review between June 2014 and January 2017. Setting Viral hepatitis outpatient clinic. Participants Individuals aged 65 and older treated with DAA therapy for hepatitis C virus (HCV) during the study period (N=113) divided into 2 cohorts: aged 65 to 74 (n=88) and aged 75 and older (n=25). Measurements Drug‐drug interactions (DDIs), adverse events (AEs), and rates of sustained virologic response with DAA therapy were assessed. Results Sustained virologic response rate was 97.7% in individuals aged 65 to 74 and 95.8% in those aged 75 and older. Individuals aged 75 and older were more likely to be taking more than 2 medications per day for chronic conditions (84% vs 62%, p=.02) and more likely to have clinically significant DDIs necessitating cessation or adjustment of medications before commencement of DAA therapy (80% vs 36%, p=.001). Moreover, individuals aged 75 and older were more likely to experience an AE during therapy (50% vs 26%, p=.03) and were more susceptible to developing anemia secondary to ribavirin (60% vs 20%, p=.02). Conclusion DAA therapy is highly efficacious for the treatment of HCV in older adults, but those aged 75 and older are more likely to have clinically significant pretreatment DDIs and experience AEs, including ribavirin‐induced anemia, during therapy.

Published
2018

18. Hepatocellular Carcinoma as a Complication of Vascular Disease of the Liver After Fontan Procedure

Author

Mark Hudson, Abid Suddle, Chiara Mazzarelli, Debashis Sarker, Pauline Kane, Nigel Heaton, Alberto Quaglia, and Mary Cannon

Subjects
Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.medical_treatment, 030204 cardiovascular system & hematology, Fontan Procedure, Fontan procedure, Young Adult, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, medicine, Humans, Vascular Diseases, Hepatology, Vascular disease, business.industry, Liver Neoplasms, medicine.disease, Surgery, Hepatocellular carcinoma, Female, 030211 gastroenterology & hepatology, Complication, business
Published
2018

19. An atypical presentation of biliary cast syndrome (BCS)

Author

Angelo Vanzulli, Marcello Vangeli, Raffaella Viganò, and Chiara Mazzarelli

Subjects
Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Hepatology, business.industry, Biliary Tract Diseases, Gastroenterology, Syndrome, Magnetic Resonance Imaging, Dermatology, Liver Transplantation, Diagnosis, Differential, Postoperative Complications, Replantation, Medical Illustration, Humans, Medicine, Presentation (obstetrics), Biliary Tract, business, Cast Syndrome
Published
2021

22. Liver transplantation in patients with ACLF. Preliminary experience of 6 Italian centres

Author

Stefano Fagiuoli, C. Morelli, Salvatore Piano, Luca S. Belli, Paolo Caraceni, Silvia Martini, Riccardo Volpes, P. Angeli, C. Ieri, Chiara Mazzarelli, Giovanni Perricone, Ioannis Petridis, and S. Ottobrelli

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, medicine.medical_treatment, Gastroenterology, Medicine, In patient, Liver transplantation, business
Published
2020

23. Early liver transplantation in active drinkers with and without alcoholic hepatitis: a monocentric case series

Author

Raffaella Viganò, D. Angrisani, Chiara Mazzarelli, A. Panariello, R. Stigliano, P. Prandoni, Luca S. Belli, S. De Nicola, Andrea Airoldi, M. Vangeli, M. Percudani, and Giovanni Perricone

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, medicine.medical_treatment, Gastroenterology, medicine, Alcoholic hepatitis, Liver transplantation, medicine.disease, business
Published
2020

24. Harmful and Beneficial Effects of Anticoagulants in Patients With Cirrhosis and Portal Vein Thrombosis

Author

Marcello Vangeli, Chiara Mazzarelli, and Aldo Airoldi

Subjects
Liver Cirrhosis, Venous Thrombosis, medicine.medical_specialty, Cirrhosis, Hepatology, business.industry, Portal Vein, Liver Diseases, Gastroenterology, Portal vein, MEDLINE, Anticoagulants, medicine.disease, Portal vein thrombosis, Venous thrombosis, Internal medicine, medicine, Humans, In patient, business, Beneficial effects
Published
2018

25. AISF position paper on HCV in immunocompromised patients

Author

Gabriele Missale, Mauro Viganò, Marco Astegiano, Mauro Salizzoni, C. Chialà, Angelo Pera, Patrizia Racca, Massimo Di Maio, Mario Salomone, M. Puoti, Simone Parisi, Paolo Bironzo, M. Rendina, Carla Pasquina, Clodoveo Ferri, Luisa Pasulo, Rita Tozzi, A. Tucci, Pietro Lampertico, Emanuele Angelucci, Bruno Daniele, Patrizia Burra, Franco Riccardini, Marco Lagget, Fabio Salvatore Macaluso, Davide Giuseppe Ribaldone, Luca Miele, Clara Lisa Peroni, Raffaele Bruno, Anna Linda Zignego, Ambrogio Orlando, Giovanni Battista Gaeta, Giuseppe Montrucchio, Daniela Libertucci, Massimo Marignani, Agostino Colli, Enrico Fusaro, Antonio Craxì, Giorgio Maria Saracco, Barbara Imperatrice, Paolo Caraceni, Luisa Giaccone, Chiara Baratelli, Giuliano Torre, Luigi Biancone, Elisabetta De Gasperi, Mario Rizzetto, Maria Grazia Clemente, Francesco Paolo Russo, Aldo Giacardi, Riccardo Volpes, Edoardo G. Giannini, Daniele Curci, Rossella Della Valle, Salvatore Petta, Pierluigi Toniutto, Alessandro Busca, Pietro Vajro, Giorgio Verme, Chiara Mazzarelli, Paolo Grossi, Maria Chiara Ditto, Lorella Orsucci, Umberto Vitolo, Alberto Mella, Salvatore Madonia, Federica Cavallo, Maria Giuseppina Cabras, Stefano Bonora, Massimiliano Conforti, Vito Di Marco, Mario Pirisi, Giuseppe Cariti, Marta Coscia, Giuseppina Brancaccio, L. Scaglione, Stefano Fagiuoli, Alfredo Marzano, Stefano Cusinato, Roberto Minutolo, Giuseppe Rossi, Enrico Brignardello, Maurizia Rossana Brunetto, Marzano A., Angelucci E., Astegiano M., Baratelli C., Biancone L., Bironzo P., Brancaccio G., Brunetto M.R., Bruno R., Burra P., Cabras M.G., Caraceni P., Chiala C., Clemente M.G., Colli A., Daniele B., De Gasperi E., Di Marco V., Ditto M.C., Fagiuoli S., Ferri C., Gaeta G.B., Grossi P.A., Imperatrice B., Lampertico P., Macaluso F.S., Madonia S., Marignani M., Mazzarelli C., Mella A., Missale G., Parisi S., Pasulo L., Puoti M., Rendina M., Ribaldone D., Rossi G., Toniutto P., Tucci A., Vajro P., Vigano M., Volpes R., Zignego A.L., Giannini E.G., Miele L., Russo F.P., Petta S., Bonora S., Brignardello E., Busca A., Cariti G., Cavallo F., Conforti M., Coscia M., Craxi A., Curci D., Cusinato S., Di Maio M., Valle R.D., Fusaro E., Giacardi A., Giaccone L., Lagget M., Libertucci D., Minutolo R., Montrucchio G., Orlando A., Orsucci L., Pasquina C., Pera A., Peroni C.L., Pirisi M., Racca P., Riccardini F., Rizzetto M., Salizzoni M., Salomone M., Saracco G.M., Scaglione L., Torre G., Tozzi R., Vitolo U., Verme G., Angelucci, E, Astegiano, M, Baratelli, C, Biancone, L, Bironzo, P, Brancaccio, G, Brunetto, M, Bruno, R, Burra, P, Cabras, M, l Caraceni, P, Chialà, C, Clemente, M, Colli, A, Daniele, B, De Gasperi, E, Di Marco, V, Ditto, M, Fagiuoli, S, Ferri, C, Gaeta, G, Grossi, P, Imperatrice, B, Lampertico, P, Macaluso, F, Madonia, S, Marignani, M, Mazzarelli, C, Mella, A, Missale, G, Parisi, S, Pasulo, L, Puoti, M, Rendina, M, Ribaldone, D, Rossi, G, Toniutto, P, Tucci, A, Vajro, P, Viganò, M, Volpes, R, Zignego, A, Giannini, E, Miele, L, Russo, F, Petta, S, Bonora, S, Brignardello, E, Busca, A, Cariti, G, Cavallo, F, Conforti, M, Coscia, M, Craxì, A, Curci, D, Cusinato, S, Di Maio, M, Valle, R, Fusaro, E, Giacardi, A, Giaccone, L, Lagget, M, Libertucci, D, Minutolo, R, Montrucchio, G, Orlando, A, Orsucci, L, Pasquina, C, Pera, A, Peroni, C, Pirisi, M, Racca, P, Riccardini, F, Rizzetto, M, Salizzoni, M, Salomone, M, Saracco, G, Scaglione, L, Torre, G, Tozzi, R, Vitolo, U, Verme, G, Marzano, Alfredo, Angelucci, Emanuele, Astegiano, Marco, Baratelli, Chiara, Biancone, Luigi, Bironzo, Paolo, Brancaccio, Giuseppina, Brunetto, Maurizia Rossana, Bruno, Raffaele, Burra, Patrizia, Cabras, Maria Giuseppina, Caraceni, Paolo, Chialà, Claudia, Clemente, Maria Grazia, Colli, Agostino, Daniele, Bruno, De Gasperi, Elisabetta, Di Marco, Vito, Ditto, Maria Chiara, Fagiuoli, Stefano, Ferri, Clodoveo, Gaeta, Giovanni Battista, Grossi, Paolo Antonio, Imperatrice, Barbara, Lampertico, Pietro, Macaluso, Fabio Salvatore, Madonia, Salvatore, Marignani, Massimo, Mazzarelli, Chiara, Mella, Alberto, Missale, Gabriele, Parisi, Simone, Pasulo, Luisa, Puoti, Massimo, Rendina, Maria, Ribaldone, Davide, Rossi, Giuseppe, Toniutto, Pierluigi, Tucci, Alessandra, Vajro, Pietro, Viganò, Mauro, Volpes, Riccardo, Zignego, Anna Linda, Giannini, Edoardo G., Miele, Luca, Russo, Francesco Paolo, Petta, Salvatore, Bonora, Stefano, Brignardello, Enrico, Busca, Alessandro, Cariti, Giuseppe, Cavallo, Federica, Conforti, Massimiliano, Coscia, Marta, Craxì, Antonio, Curci, Daniele, Cusinato, Stefano, Di Maio, Massimo, Valle, Rossella Della, Fusaro, Enrico, Giacardi, Aldo, Giaccone, Luisa, Lagget, Marco, Libertucci, Daniela, Minutolo, Roberto, Montrucchio, Giuseppe, Orlando, Ambrogio, Orsucci, Lorella, Pasquina, Carla, Pera, Angelo, Peroni, Clara Lisa, Pirisi, Mario, Racca, Patrizia, Riccardini, Franco, Rizzetto, Mario, Salizzoni, Mauro, Salomone, Mario, Saracco, Giorgio Maria, Scaglione, Luca, Torre, Giuliano, Tozzi, Rita, Vitolo, Umberto, Verme, Giorgio, and Ditto, MARIA CHIARA

Subjects
medicine.medical_specialty, Transplant Recipient, Comorbidity, Antiviral Agents, Organ transplantation, 03 medical and health sciences, Immunocompromised Host, 0302 clinical medicine, Internal medicine, Neoplasms, medicine, Immunocompromised patient, Humans, Chronic, Intensive care medicine, Antiviral Agent, Hepatology, business.industry, Gastroenterology, Hepatitis C, Chronic, medicine.disease, Hepatitis C, Organ transplant, HCV, Immunocompromised patients, Transplant Recipients, Immunocompetence, Italy, 030220 oncology & carcinogenesis, HCV, Immunocompromised patients, Organ transplant, Position paper, Neoplasm, 030211 gastroenterology & hepatology, business, Direct acting, Human
Abstract

This report summarizes the clinical features and the indications for treating HCV infection in immunocompromised and transplanted patients in the Direct Acting Antiviral drugs era.

Published
2018

26. Sofosbuvir plus daclatasvir with or without ribavirin is safe and effective for post-transplant hepatitis C recurrence and severe fibrosis and cirrhosis: A prospective study

Author

Vincenza Calvaruso, Marzia Montalbano, Laura Loiacono, Chiara Mazzarelli, Raffaella Lionetti, Giovanni Guaraldi, Ilaria Lenci, Paola Piccolo, Martina Milana, Ubaldo Visco-Comandini, Gianpiero D'Offizi, Giovanna Valente, Stefano Fagiuoli, Antonio Craxì, Paola Carrai, Rossella Letizia Mancusi, Marco Biolato, Mario Angelico, Lionetti R, Calvaruso V, Piccolo P, Mancusi RL, Mazzarelli C, Fagiuoli S, Montalbano M, Lenci I, Carrai P, Guaraldi G, Visco-Comandini U, Milana M, Biolato M, Loiacono L, Valente G, Craxì A, Angelico M, D'offizi G, Lionetti, R, Calvaruso, V, Piccolo, P, Mancusi, R, Mazzarelli, C, Fagiuoli, S, Montalbano, M, Lenci, I, Carrai, P, Guaraldi, G, Visco-Comandini, U, Milana, M, Biolato, M, Loiacono, L, Valente, G, Craxi, A, Angelico, M, and D'Offizi, G

Subjects
Liver Cirrhosis, Male, hepatitis C virus, Pyrrolidines, Cirrhosis, Sofosbuvir, medicine.medical_treatment, antiviral treatment, Hepacivirus, 030230 surgery, Liver transplantation, medicine.disease_cause, Gastroenterology, chemistry.chemical_compound, 0302 clinical medicine, Recurrence, hepatitis C viru, Prospective Studies, Prospective cohort study, Settore MED/12 - Gastroenterologia, liver transplantation, direct antiviral agents, Imidazoles, Valine, Hepatitis C, Middle Aged, Prognosis, Italy, HCV, Drug Therapy, Combination, Female, 030211 gastroenterology & hepatology, medicine.drug, medicine.medical_specialty, Daclatasvir, Hepatitis C virus, Antiviral Agents, cirrhosis, 03 medical and health sciences, Internal medicine, Ribavirin, medicine, Humans, Transplantation, direct antiviral agent, business.industry, medicine.disease, chemistry, Carbamates, business, Follow-Up Studies, cirrhosi
Abstract

Background: In 2012, an Italian Named Patient Program began for hepatitis C virus (HCV)-infected liver transplant (LT) recipients with advanced fibrosis, before approval of direct antiviral agents (DAA), to benefit severely ill patients. The aim of this “real-life” study was to assess treatment efficacy and safety with an extended course of daclatasvir (DCV) plus sofosbuvir (SOF) with or without ribavirin (RBV). Methods: All HCV LT recipients with severe fibrosis in 15 Italian transplant centers were treated with DCV+SOF±RBV for 24weeks; sustained virological response was assessed at 12weeks post-treatment (SVR12). Results: Eighty-seven patients were enrolled (75.9% males, mean age 58.4±7.2years, 83.9% genotype 1, 81.6% cirrhosis); 52 (59.8%) received RBV. Overall, 79 obtained SVR12 (90.8%): 100% in F3 and 88.7% in cirrhotics (91.5% in Child-Pugh A, 83.3% in Child-Pugh B and C). According to the treatment group, SVR was 80% in DCV+SOF group and 98.1% in SOF+DCV+RBV. Two virological relapses occurred during follow-up in cirrhotic patients who received DCV+SOF. Four cirrhotic patients in DCV+SOF group and 1 in DCV+SOF+RBV group died on treatment. Conclusion: An extended course of SOF plus DCV for 24weeks, with or without RBV, is effective and well tolerated for the treatment of post-LT HCV recurrence with severe fibrosis.

Published
2018

27. Autoimmunity after liver transplantation: a frequent event but a rare clinical problem

Author

Marcello Vangeli, Giovanni Perricone, Luca S. Belli, Claudio Zavaglia, Raffaella Viganò, Chiara Mazzarelli, Diana Fanti, and Antonella Foschi

Subjects
Male, medicine.medical_treatment, Autoimmunity, Autoimmune hepatitis, Liver transplantation, medicine.disease_cause, Autoimmune Diseases, Postoperative Complications, Risk Factors, Prevalence, medicine, Humans, Autoantibodies, Retrospective Studies, Liver injury, Transplantation, business.industry, Autoantibody, Middle Aged, medicine.disease, Tacrolimus, Liver Transplantation, Titer, Italy, Immunology, Etiology, Female, business, Follow-Up Studies
Abstract

Autoantibodies are frequently detected after liver transplantation (LT), but their role is unclear. This study was designed to address three points: autoantibody prevalence pre-LT and over time up to five yr after LT, identification of possible predictors of autoantibody formation, and correlation between autoantibodies and graft dysfunction. To these aims, we retrospectively evaluated 92 consecutive LT recipients for whom prospectively stored frozen sera were available for autoantibodies assessment by immunofluorescence. The overall autoantibody prevalence resulted significantly higher after LT than before LT (64% vs. 27%, p < 0.001 and 35.9% vs. 8.7%, p < 0.001 considering cutoff titer of ≥ 1:80 and ≥ 1:160, respectively). Recipient gender, donor age and gender, and indication for LT and main immunosuppressant (cyclosporine vs. tacrolimus) were not associated with the presence of autoantibodies. Patients with graft dysfunction had a significantly higher autoantibody prevalence irrespective of the etiology of liver injury as compared to those patients with persistently normal liver biochemistry, but only for cutoff titers ≥ 1:160 (p = 0.004). No cases of de novo autoimmune hepatitis were observed. In conclusion, autoantibodies are very frequently detected after LT also at high titers and their association with graft dysfunction likely represents an aspecific indicator of liver injury.

Published
2015

28. 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

30. The optimal timing of hepatitis C therapy in liver transplant-eligible patients: Cost-effectiveness analysis of new opportunities

Author

S. De Nicola, Lorenzo G. Mantovani, Mario Strazzabosco, Luca S. Belli, Christophe Duvoux, Paolo Cortesi, Giancarlo Cesana, Chiara Mazzarelli, Giovanni Perricone, Rita Facchetti, Cortesi, P, Belli, L, Facchetti, R, Mazzarelli, C, Perricone, G, De Nicola, S, Cesana, G, Duvoux, C, Mantovani, L, and Strazzabosco, M

Subjects
Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Time Factors, Direct-acting antiviral agent, Cost effectiveness, medicine.medical_treatment, Cost-Benefit Analysis, Population, Infectious Disease, Liver transplantation, Antiviral Agents, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Virology, medicine, Humans, education, Aged, education.field_of_study, Hepatology, business.industry, Hepatitis C, Cost-effectiveness analysis, Hepatitis C, Chronic, Middle Aged, medicine.disease, Liver Transplantation, Transplantation, Regimen, Infectious Diseases, Cost-effectivene, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, Female, business
Abstract

Different strategies of DAAs treatment are currently possible both pre- and postliver transplantation (LT). Clinical and economic consequences of these strategies still need to be adequately investigated; this study aims at assessing their cost-effectiveness. A decision analytical model was created to simulate the progression of HCV-infected patients listed for decompensated cirrhosis (DCC) or for hepatocellular carcinoma (HCC). Three DAAs treatment strategies were compared: (i) a 12-week course of DAAs prior to transplantation (PRE-LT), (ii) a 4-week course of DAAs starting at the time of transplantation (PERI-LT) and (iii) a 12-week course of DAAs administered at disease recurrence (POST-LT). The population was substratified according to HCC presence and, in those without HCC, according to the MELD score at listing. Data on DAAs effectiveness were estimated using a cohort of patients still followed by 11 transplant centres of the European Liver and Intestine Transplant Association and by data available in the literature. In this study, PRE-LT treatment strategy was dominant for DCC patients with MELD20 and for those with HCC. Sensitivity analyses confirmed PRE-LT as the cost-effective strategy for patients with MELD≤20. In conclusion, PRE-LT treatment is cost-effective for patients with MELD≤20 without HCC, while treatments after LT are cost-effective in cirrhotic patients with MELD>20 and in those with HCC. It is worth reminding, though, that the final choice of a specific regimen at the patient level will have to be personalized based on clinical, social and transplant-related factors

Published
2017

31. Change of liver transplantation list composition: Pre versus post direct-acting antivirals era. The Niguarda Hospital experience

Author

Giovanni Perricone, Chiara Mazzarelli, Raffaella Viganò, and A Alberti

Subjects
medicine.medical_specialty, Hepatology, Waiting Lists, business.industry, medicine.medical_treatment, Gastroenterology, Liver transplantation, DIRECT ACTING ANTIVIRALS, Hospital experience, Antiviral Agents, Hepatitis C, Hospitals, Surgery, Liver Transplantation, 03 medical and health sciences, 0302 clinical medicine, Italy, 030220 oncology & carcinogenesis, medicine, Humans, 030211 gastroenterology & hepatology, Intensive care medicine, business
Published
2017

32. 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 Società 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 ≥10 (indicative of dementia), 12% had an SBT score of 5-9 (indicative of questionable dementia); and 17% had an SBT score

Published
2017

33. Hepatic toll-like receptor 4 expression is associated with portal inflammation and fibrosis in patients with NAFLD

Author

Giovanni Galati, Umberto Vespasiani-Gentilucci, Antonio Picardi, Sergio Morini, Andrea Onetti-Muda, Giuseppe Perrone, Simone Carotti, and Chiara Mazzarelli

Subjects
Liver Cirrhosis, medicine.medical_specialty, Pathology, Biopsy, Fluorescent Antibody Technique, Inflammation, Biology, Gastroenterology, Statistics, Nonparametric, Pathogenesis, Non-alcoholic Fatty Liver Disease, Fibrosis, Internal medicine, Hepatic Stellate Cells, medicine, Humans, Progenitor cell, Myofibroblasts, Membrane Glycoproteins, Hepatology, CD68, Histological Techniques, Keratin-7, medicine.disease, Immunohistochemistry, Actins, Toll-Like Receptor 4, Portal System, Italy, Liver, Hepatic stellate cell, TLR4, medicine.symptom, Carrier Proteins, Acute-Phase Proteins
Abstract

Background & Aims Notwithstanding evidences implicating the lipopolysaccharides (LPS)/toll-like receptor-4 (TLR4) axis in the pathogenesis of NAFLD, there are no studies aimed to characterize hepatic TLR4 expression in NAFLD patients. We aimed to analyse hepatic TLR4 expression and to verify its relationship with disease activity/evolution in NAFLD patients. Methods Liver tissue from 74 patients with NAFLD and 12 controls was analysed by immunohistochemistry (IHC) for TLR4, α–smooth muscle actin (α–SMA) and cytokeratin-7. IHC for α–SMA was used to evaluate activation of fibrogenic cells (hepatic stellate cells and portal/septal myofibroblasts), that for cytokeratin-7 to count hepatic progenitor cells and bile ducts/ductules, and that for CD68, in a subgroup of 27 patients, for detecting macrophages. Serum LPS-binding protein (LBP), a sensitive marker of LPS activity, was determined in 36 patients and 32 controls. Results As confirmed by double-labelling experiments, the highest level of TLR4 expression was observed in hepatic progenitor cells, biliary cells and portal/septal macrophages. TLR4-positive hepatic progenitor cells and bile ducts/ductules correlated with portal/interface inflammation, activity of fibrogenic cells and fibrosis (P

Published
2014

34. Prognostic factors of hepatic decompensation and hepatocellular carcinoma in patients with transfusion-acquired HCV infection

Author

Carmine Tinelli, Chiara Mazzarelli, Antonella Foschi, Alessandra Mangia, Valeria Piazzolla, Claudio Zavaglia, Aldo Airoldi, Enrico Maria Silini, Rosa Stigliano, and Marcello Vangeli

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Carcinoma, Hepatocellular, Blood transfusion, medicine.medical_treatment, Gastroenterology, Liver disease, Sex Factors, Internal medicine, Humans, Medicine, Decompensation, Cumulative incidence, Retrospective Studies, Univariate analysis, Hepatology, business.industry, Incidence, Incidence (epidemiology), Liver Neoplasms, Age Factors, Transfusion Reaction, Hepatitis C, Chronic, Middle Aged, Prognosis, medicine.disease, Hepatocellular carcinoma, Multivariate Analysis, Cohort, Female, business, Liver Failure
Abstract

Aim of this study was to assess if host (immunogenetic traits, age, sex), exogenous (alcohol) or viral factors (viral type, past HBV infection) might affect the progression of chronic hepatitis C to liver decompensation or the development of HCC in a cohort of patients exposed to a single blood transfusion prior to the introduction of anti-HCV screening.Two hundred and forty-eight patients with a history of a single exposure to blood or blood products prior to 1990 were retrospectively considered. Patients were devoid of other risk factors of liver disease or immunosuppression and naïve to antiviral therapies. Eight baseline variables were assessed: age at transfusion, sex, HBV core antibody, immunogenetic profile (DRB1*11, DRB1*1104, DRB1*07), HCV genotype and alcohol consumption.The follow-up was 22 (SD: 11) years. Sixty-eight patients (27%) progressed to hepatic decompensation over a median period of 22.5 years (IQR: 14-30) and 41 patients (16%) developed HCC over a median period of 31 years (IQR: 24-38). The cumulative incidence of liver failure was 0.4% (95% CI: 0.1-3.1), 4.9% (95% CI: 2.6-9.3) and 16.2% (95% CI: 10.4-24.7) at 10, 20 and 30 years after blood transfusion respectively. By univariate analysis, only age at transfusion was correlated with the risk of decompensation. Stratifying the age of transfusion by tertiles, the incidence of hepatic decompensation was 0.7% per year in patients transfused at ≤24 years of age as compared to 1.2% and 1.9% per year in those transfused at 25-35 and36 years of age respectively (HR: 5.5, 95% CI: 2.78-10.7, P0.001). The risk of HCC development was correlated by univariate analysis with age at transfusion (as continuous variable, HR: 1.12, 95% CI: 1.08-1.16 per year of age, P0.001,36 compared to ≤24 years, HR: 10.3, 95% CI: 3.9-26.9, P0.001) and male sex (HR: 4.2, 95% CI: 1.7-10, P=0.001). Multivariate analysis confirmed age at transfusion and male sex as independent predictors of HCC development [HR: 1.12 per year (95% CI: 1.08-1.16), P0.001 and HR: 5.4 (95% CI: 2.2-13.2), P0.001 respectively].In patients with transfusion-acquired HCV infection, age at transfusion affects the risk for hepatic decompensation. Age at transfusion and male sex are independent risk factors for HCC development.

Published
2014

36. Direct-acting antiviral therapy in patients with hepatocellular cancer: The timing of treatment is everything

Author

Kosh Agarwal, Luca S. Belli, Chiara Mazzarelli, and Mary Cannon

Subjects
0301 basic medicine, Oncology, medicine.medical_specialty, Hepatocellular cancer, Hepatology, business.industry, Antiviral therapy, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Text mining, Internal medicine, medicine, 030211 gastroenterology & hepatology, In patient, business, Direct acting
Published
2018

37. 03:18 PM Abstract No. 75 Portal cavernoma revascularization through splenic access in symptomatic portal hypertension: a paradigm shift in interventional radiology

Author

Chiara Mazzarelli, Michele Nichelatti, Antonio Rampoldi, Marco Solcia, Ruggero Vercelli, S. Di Sandro, C. Migliorisi, Andrea Airoldi, Lino Belli, S. De Nicola, F. Barbosa, A. De Gasperi, and L. De Carlis

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Medicine, Portal hypertension, Radiology, Nuclear Medicine and imaging, Interventional radiology, Radiology, Cardiology and Cardiovascular Medicine, business, medicine.disease, Revascularization
Published
2019

38. LIVER TRANSPLANTATION IN HIV-POSITIVE PATIENTS: THE INITIAL EXPERIENCE

Author

L. De Carlis, Michele Colledan, Stefano Fagiuoli, Chiara Mazzarelli, A. De Gasperi, E. Mazza, Iacopo Mangoni, C. Iegri, Giovanna Travi, Giuliana Cologni, Lino Belli, Luisa Pasulo, C. Moioli, F. Mangiola, C. Di Benedetto, A. Corti, M. Marchesi, M. Puoti, Di Benedetto, C, Iegri, C, Pasulo, L, Travi, G, Moioli, C, Colledan, M, De Carlis, L, Mazzarelli, C, Cologni, G, Corti, A, Mazza, E, Marchesi, M, De Gasperi, A, Mangoni, I, Mangiola, F, Belli, L, Fagiuoli, S, and Puoti, M

Subjects
medicine.medical_specialty, Liver transplantation, Hepatology, business.industry, Internal medicine, medicine.medical_treatment, Gastroenterology, Human immunodeficiency virus (HIV), medicine, medicine.disease_cause, business
Published
2016

39. Interleukin-28B (IL-28B) single-nucleotide polymorphisms and interferon plus ribavirin treatment outcome in Italian chronically HCV-infected patients

Author

Gianluigi Giannelli, Carolina Scagnolari, Chiara Mazzarelli, Eligio Pizzigallo, Guido Antonelli, Katia Monteleone, Bruno Vincenzi, A. Carducci, Salvatore Antonaci, Elisabetta Riva, Antonio Picardi, and Carla Selvaggi

Subjects
Hepatology, business.industry, Ribavirin, Treatment outcome, HCV genotypes, virus diseases, Single-nucleotide polymorphism, digestive system diseases, chemistry.chemical_compound, Infectious Diseases, Interleukin 28B, chemistry, Interferon, Virology, Immunology, Genotype, Medicine, In patient, business, medicine.drug
Abstract

To determine the single or combined effect ofboth rs12979860 and rs8099917 SNPs on HCV treatmentresponse, these variants were genotyped in samples from acohort of 170 patients infected with different HCV genotypes(HCVGT). The favourable rs12979860 CC genotype wasfound only in patients with sustained or rapid virologicalresponses (SVR/RVR) and at significantly high proportionsin HCVGT1/4 SVR patients. A significant association wasalso found between the rs8099917 TT genotype and SVR inboth HCVGT1/4 and HCVGT2/3 groups of patients. Incontrast, we found that there was significantly more of thers8099917 GG genotype in nonresponders (NR) than in SVRpatients which suggests a good association of the minorhomozygote GG with the lack of treatment response. Thecombination of rs12979860/rs8099917 CC/TT favourablegenotypes was found only in SVR patients and matched thefrequency observed for their rs12979860 CC genotypesalone. By contrast, the inverse unfavourable correlaters12979860/rs8099917 TT/GG genotype was seen more inNR than in SVR patients as observed for the single GGgenotype. This study confirms the impact of bothrs12979860 and/or rs8099917 IL-28B SNPs on treatment-induced clearance of HCV-RNA and demonstrates that thers12979860 CC genotype is stronger than rs8099917 TTgenotype in predicting a positive treatment response inHCVGT1/4 patients. The unfavourable rs8099917 GGgenotype seems to be more important in predicting the fail-ure of treatment response independently from HCV geno-type.Keywords: HCV, IFN, IL-28B, RBV, SVR.

Published
2012

41. Delisting of Liver Transplant Candidates with Chronic HCV Infection after Viral Erradication

Author

Mario Strazzabosco, Stella Di Nicola, Carmen Vinaixa, Audrey Coilly, C. Morelli, Susanne-Rasoul Rockenschaub, Gabriela A. Berlakovich, Marina Berenguer, Luisa Pasulo, Francesca Donato, Christophe Duvuox, Chiara Mazzarelli, Luca S. Belli, Georges-Philippe Pageaux, Ricardo Volpes, Silvia Martini, Giovanni Perricone, Rita Faccheti, and Pablo Cortesi

Subjects
Transplantation, medicine.medical_specialty, business.industry, Internal medicine, medicine, business, Outcome (game theory)
Published
2018

42. Direct fibrosis markers kinetic in patients undergoing antiviral treatment with DAA for chronic hepatitis C

Author

G. Dusheiko, Mary Cannon, Chiara Mazzarelli, Matthew Bruce, Ivana Carey, S. Imbert, and Kosh Agarwal

Subjects
0301 basic medicine, medicine.medical_specialty, Hepatology, business.industry, medicine.disease, Gastroenterology, 03 medical and health sciences, 030104 developmental biology, Chronic hepatitis, Fibrosis, Internal medicine, Medicine, In patient, Antiviral treatment, business
Published
2018

43. 'How do you feel about your diagnosis of Hepatitis C today?': The emotional benefits of direct-acting antiviral therapy

Author

G. Dusheiko, Kosh Agarwal, Mary Cannon, T. Ow, L. Smith, S. Montague, Kate Childs, and Chiara Mazzarelli

Subjects
03 medical and health sciences, 0302 clinical medicine, Hepatology, business.industry, Antiviral therapy, Medicine, 030211 gastroenterology & hepatology, 030212 general & internal medicine, Hepatitis C, business, Bioinformatics, medicine.disease, Direct acting
Published
2018

44. The percentage of patients with HCV infection in need of a liver transplant is rapidly declining while their survival after transplantation is improving: A study based on European liver transplant registry

Author

Raffaella Viganò, Chiara Mazzarelli, Rita Facchetti, Christophe Duvoux, M. Strazzabosco, M. Vangeli, Giovanni Perricone, Paolo Cortesi, Luca S. Belli, René Adam, and V. Karam

Subjects
Transplantation, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Hepatology, business.industry, Internal medicine, medicine, 030211 gastroenterology & hepatology, 030230 surgery, business
Published
2018

45. Predictors of clinical improvement among HCV patients with advanced liver disease treated with DAA: a single center experience

Author

Ivana Carey, Kate Childs, Matteo Angelo Manini, G. Dusheiko, Kosh Agarwal, Chiara Mazzarelli, Abid Suddle, and Mary Cannon

Subjects
0301 basic medicine, 03 medical and health sciences, Liver disease, medicine.medical_specialty, Hepatology, business.industry, Internal medicine, 030106 microbiology, medicine, medicine.disease, Single Center, business
Published
2018

49. Heart failure and chronic kidney disease in a registry of internal medicine wards

Author

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

Subjects
medicine.medical_specialty, Chronic kidney disease, Elderly, Heart failure, REPOSI, Gerontology, Geriatrics and Gerontology, Humans, Sleep Apnea Syndromes, Noninvasive Ventilation, Renal function, chronic kidney disease, elderly, registry, Tertiary care, Sleep Apnea Syndrome, Internal medicine, Epidemiology, medicine, business.industry, medicine.disease, Heart failure, Elderly, Chronic kidney disease, REPOSI, Icd codes, business, Clinical record, Body mass index, Kidney disease, Human
Abstract

Background: The aim of the present study was to evaluate the association between heart failure (HF) and chronic kidney disease (CKD) in tertiary care centers using the clinical records of patients enrolled in internal medicine departments.Patients and methods: We used the clinical records of 1380 elderly patients to identify patients with a history of HF and CKD using admission ICD codes and glomerular filtration rate (GFR) formulas. Magnitude and strength of such associations were investigated by univariable and multivariable analysis.Results: Of the 1380 patients enrolled, 27.9% had HF (age 80 ± 7, BMI 27 ± 6 kg/m2) and 17.4% CKD (age 81 ± 7, BMI 26.8 ± 6 kg/m2). Both groups were significantly older (P

Published
2014

50. Lower schooling, higher hepatitis C virus prevalence in Italy: An association dependent on age

Author

Federica Bambacioni, Elisabetta Riva, Umberto Vespasiani Gentilucci, Antonio Picardi, Enrica Fiori, Chiara Mazzarelli, D. D'Avola, Sandro Spataro, and Giovanni Galati

Subjects
Adult, Male, medicine.medical_specialty, Pediatrics, Adolescent, Hepatitis C virus, Hepacivirus, medicine.disease_cause, Education, Virology, Epidemiology, Prevalence, medicine, Humans, Child, Socioeconomic status, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Age Factors, Middle Aged, Hepatitis C, Infectious Diseases, Italy, Socioeconomic Factors, Child, Preschool, Regression Analysis, Female, business, Demography
Published
2007

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