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2. T.05.4: RENAL LITHOGENIC RISK IN PATIENTS WITH INFLAMMATORY BOWEL DISEASES CORRELATES WITH MICROBIOTA COMPOSITION, URINARY PROFILE AND DIETARY INTAKE

Author

Mignini, I., primary, Blasi, V., additional, Masucci, L., additional, De Maio, F., additional, Agrillo, C., additional, Monzo, F.R., additional, Laterza, L., additional, Settanni, C.R., additional, Scaldaferri, F., additional, Napolitano, D., additional, Schiavoni, E., additional, D'Amato, D., additional, De Ninno, G., additional, Baroni, S., additional, Garcovich, M., additional, Riccardi, L., additional, Grassi, F., additional, Cintoni, M., additional, Mele, M.C., additional, Gasbarrini, A., additional, Ferraro, P.M., additional, and Papa, A., additional

Published
2024
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3. P363 Multimodal dynamic ultrasound approach as predictor of response in patients with Crohn’s disease treated with ustekinumab

Author

Mignini, I, primary, Maresca, R, additional, Esposto, G, additional, Ainora, M E, additional, Liguori, A, additional, Cintoni, M, additional, Galasso, L, additional, Laterza, L, additional, Lopetuso, L R, additional, Garcovich, M, additional, Riccardi, L, additional, Gasbarrini, A, additional, Scaldaferri, F, additional, and Zocco, M A, additional

Published
2024
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4. P442 Renal lithogenic risk in patients with Inflammatory Bowel Diseases correlates with microbiota composition, urinary profile and dietary intake

Author

Mignini, I, primary, Blasi, V, additional, Masucci, L, additional, De Maio, F, additional, Agrillo, C, additional, Monzo, F R, additional, Laterza, L, additional, Scaldaferri, F, additional, Napolitano, D, additional, Schiavoni, E, additional, D' Amato, D, additional, De Ninno, G, additional, Baroni, S, additional, Mele, M C, additional, Grassi, F, additional, Cintoni, M, additional, Garcovich, M, additional, Riccardi, L, additional, Gasbarrini, A, additional, Ferraro, P M, additional, and Papa, A, additional

Published
2024
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5. Accurate liquid biopsy for the diagnosis of non-alcoholic steatohepatitis and liver fibrosis

Author

Angelini, Giulia, Panunzi, Simona, Castagneto-Gissey, L., Pellicano, F., De Gaetano, Anna Maria, Pompili, Maurizio, Riccardi, Laura, Garcovich, Matteo, Raffaelli, Marco, Ciccoritti, Luigi, Verrastro, Ornella, Russo, Maria Francesca, Vecchio, Fabio Maria, Casella, G., Casella-Mariolo, J., Papa, L., Marini, P. L., Rubino, F., Le Roux, C. W., Bornstein, S., Mingrone, Geltrude, Angelini G., Panunzi S., De Gaetano A. (ORCID:0000-0002-7493-9462), Pompili M. (ORCID:0000-0001-6699-7980), Riccardi L., Garcovich M., Raffaelli M. (ORCID:0000-0002-1259-2491), Ciccoritti L., Verrastro O., Russo M. F., Vecchio F. M. (ORCID:0000-0002-9197-2264), Mingrone G. (ORCID:0000-0003-2021-528X), Angelini, Giulia, Panunzi, Simona, Castagneto-Gissey, L., Pellicano, F., De Gaetano, Anna Maria, Pompili, Maurizio, Riccardi, Laura, Garcovich, Matteo, Raffaelli, Marco, Ciccoritti, Luigi, Verrastro, Ornella, Russo, Maria Francesca, Vecchio, Fabio Maria, Casella, G., Casella-Mariolo, J., Papa, L., Marini, P. L., Rubino, F., Le Roux, C. W., Bornstein, S., Mingrone, Geltrude, Angelini G., Panunzi S., De Gaetano A. (ORCID:0000-0002-7493-9462), Pompili M. (ORCID:0000-0001-6699-7980), Riccardi L., Garcovich M., Raffaelli M. (ORCID:0000-0002-1259-2491), Ciccoritti L., Verrastro O., Russo M. F., Vecchio F. M. (ORCID:0000-0002-9197-2264), and Mingrone G. (ORCID:0000-0003-2021-528X)

Abstract

Objective Clinical diagnosis and approval of new medications for non-alcoholic steatohepatitis (NASH) require invasive liver biopsies. The aim of our study was to identify non-invasive biomarkers of NASH and/or liver fibrosis. Design This multicentre study includes 250 patients (discovery cohort, n=100 subjects (Bariatric Surgery Versus Non-alcoholic Steato-hepatitis - BRAVES trial); validation cohort, n=150 (Liquid Biopsy for NASH and Liver Fibrosis - LIBRA trial)) with histologically proven non-alcoholic fatty liver (NAFL) or NASH with or without fibrosis. Proteomics was performed in monocytes and hepatic stellate cells (HSCs) with iTRAQ-nano- Liquid Chromatography - Mass Spectrometry/Mass Spectrometry (LC-MS/MS), while flow cytometry measured perilipin-2 (PLIN2) and RAB14 in peripheral blood CD14 + CD16 - monocytes. Neural network classifiers were used to predict presence/absence of NASH and NASH stages. Logistic bootstrap-based regression was used to measure the accuracy of predicting liver fibrosis. Results The algorithm for NASH using PLIN2 mean florescence intensity (MFI) combined with waist circumference, triglyceride, alanine aminotransferase (ALT) and presence/absence of diabetes as covariates had an accuracy of 93% in the discovery cohort and of 92% in the validation cohort. Sensitivity and specificity were 95% and 90% in the discovery cohort and 88% and 100% in the validation cohort, respectively. The area under the receiver operating characteristic (AUROC) for NAS level prediction ranged from 83.7% (CI 75.6% to 91.8%) in the discovery cohort to 97.8% (CI 95.8% to 99.8%) in the validation cohort. The algorithm including RAB14 MFI, age, waist circumference, high-density lipoprotein cholesterol, plasma glucose and ALT levels as covariates to predict the presence of liver fibrosis yielded an AUROC of 95.9% (CI 87.9% to 100%) in the discovery cohort and 99.3% (CI 98.1% to 100%) in the validation cohort, respectively. Accuracy was 99.25%, sensitivity 100% and

Published
2023

6. The Role of Transabdominal Ultrasound Elastography in Gastrointestinal Non-Liver Diseases: Current Application and Future Prospectives

Author

Paratore, Mattia, Garcovich, Matteo, Ainora, Maria Elena, Del Vecchio, Livio Enrico, Cuccia, Giuseppe, Riccardi, Laura, Pompili, Maurizio, Gasbarrini, Antonio, Zocco, Maria Assunta, Paratore M., Garcovich M., Ainora M. E., Del Vecchio L. E., Cuccia G., Riccardi L., Pompili M. (ORCID:0000-0001-6699-7980), Gasbarrini A. (ORCID:0000-0002-7278-4823), Zocco M. A. (ORCID:0000-0002-0814-9542), Paratore, Mattia, Garcovich, Matteo, Ainora, Maria Elena, Del Vecchio, Livio Enrico, Cuccia, Giuseppe, Riccardi, Laura, Pompili, Maurizio, Gasbarrini, Antonio, Zocco, Maria Assunta, Paratore M., Garcovich M., Ainora M. E., Del Vecchio L. E., Cuccia G., Riccardi L., Pompili M. (ORCID:0000-0001-6699-7980), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Zocco M. A. (ORCID:0000-0002-0814-9542)

Abstract

Ultrasound imaging is the first-line investigation for patients with abdominal symptoms, as it effectively depicts the gastrointestinal tract and enables the diagnosis of multiple pathological conditions. Among different recent ultrasound technological advancements, elastography enables the evaluation of various tissue characteristics, such as neoplastic transformation or fibroinflammatory status. In recent years, ultrasound elastography has been utilized extensively for the study of liver diseases and in numerous other clinical settings, including gastrointestinal diseases. Current guidelines suggest the use of transabdominal ultrasound elastography to characterize bowel wall lesions, to assess gastrointestinal contractility, to diagnose and grade chronic pancreatitis; however, no specific indications are provided. In the present paper, we summarize the evidence concerning the application of different ultrasound elastography modalities in gastrointestinal non-liver diseases.

Published
2023

8. Correlation Between QElaXto Techniques and Supersonic Imagine for Liver Stiffness Quantification in Chronic Liver Disease

Author

Garcovich, M., Faccia, M., Di Stasio, Enrico, Riccardi, Laura, Zocco, Maria Assunta, Ainora, Maria Elena, Vecchio, Fabio Maria, Mingrone, Geltrude, Gasbarrini, Antonio, Pompili, Maurizio, Di Stasio E. (ORCID:0000-0003-1047-4261), Riccardi L., Zocco M. A. (ORCID:0000-0002-0814-9542), Ainora M. E., Vecchio F. M. (ORCID:0000-0002-9197-2264), Mingrone G. (ORCID:0000-0003-2021-528X), Gasbarrini A. (ORCID:0000-0002-7278-4823), Pompili M. (ORCID:0000-0001-6699-7980), Garcovich, M., Faccia, M., Di Stasio, Enrico, Riccardi, Laura, Zocco, Maria Assunta, Ainora, Maria Elena, Vecchio, Fabio Maria, Mingrone, Geltrude, Gasbarrini, Antonio, Pompili, Maurizio, Di Stasio E. (ORCID:0000-0003-1047-4261), Riccardi L., Zocco M. A. (ORCID:0000-0002-0814-9542), Ainora M. E., Vecchio F. M. (ORCID:0000-0002-9197-2264), Mingrone G. (ORCID:0000-0003-2021-528X), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Pompili M. (ORCID:0000-0001-6699-7980)

Abstract

Objectives: Intersystem variability in liver stiffness (LS) quantification with ultrasound shear wave elastography (SWE) precludes direct comparison of results obtained with different equipment. The aim of this study was to investigate the agreement between point-SWE and 2-dimensional-SWE with Esaote-MyLab 9 (p-QElaXto and 2D-QElaXto, respectively) and 2D-SWE with SuperSonic Imagine (SSI) in order to assess specific LS thresholds for fibrosis staging with QElaXto techniques, using SSI as a reference standard. Methods: A total of 235 compensated chronic liver disease (CLD) patients without comorbidities potentially affecting LS were enrolled in the study. Among them, 101 patients underwent also liver biopsy. Agreement between the equipment was assessed with Pearson coefficient and Bland–Altman analysis, while cut-off values were calculated with receiver operating characteristics analysis. Results: Correlation between 2D-QElaXto and p-QElaXto with SSI resulted very good (r = 0.898 and r = 0.866), especially in precirrhotic stages, with a mean difference between LS values of −1.3 kPa for 2D-QElaXto and −0.6 kPa for p-QElaXto compared with SSI. Cut-off thresholds for diagnosing fibrosis ≥F2, ≥F3, and F4 in non-HBV-related CLD were, respectively, 5.5, 8.0, and 10.6 kPa for 2D-QElaXto and 6.1, 8.1, and 11.7 kPa for p-QElaXto. All three SWE techniques were effective in differentiating significant fibrosis ≥F2 from mild or absent fibrosis in the subgroup of patients submitted to biopsy and showed good feasibility. Conclusions: Correlation between QElaXto techniques and SSI in LS measurements is very good. Our study identifies for the first time cut-off thresholds for fibrosis staging in non-HBV-related CLD using two QElaXto techniques.

Published
2022

9. Hepatocellular carcinoma with portal vein tumor thrombus: a single-center retrospective analysis

Author

Pizzolante, F., primary, de Matthaeis, N., additional, Calvez, V., additional, Riccardi, L., additional, Cerrito, L., additional, Ponziani, F.R., additional, Santopaolo, F., additional, Genco, E., additional, Basso, M., additional, Contegiacomo, A., additional, Pafundi, P.C., additional, Garcovich, M., additional, Miele, L., additional, Grieco, A., additional, Giuliante, F., additional, Iezzi, R., additional, Manfredi, R., additional, Gasbarrini, A., additional, Pompili, M., additional, Armuzzi, A., additional, and Rapaccini, G.L., additional

Published
2022
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10. A machine-learning parsimonious multivariable predictive model of mortality risk in patients with Covid-19

Author

Murri, Rita, Lenkowicz, Jacopo, Masciocchi, Carlotta, Iacomini, C., Fantoni, Massimo, Damiani, Andrea, Marchetti, A., Sergi, P. D. A., Arcuri, G., Cesario, Alfredo, Patarnello, S., Antonelli, Massimo, Bellantone, Rocco Domenico Alfonso, Bernabei, Roberto, Boccia, Stefania, Calabresi, Paolo, Cambieri, Andrea, Cauda, Roberto, Colosimo, Cesare, Crea, Filippo, De Maria Marchiano, Ruggero, De Stefano, Valerio, Franceschi, Francesco, Gasbarrini, Antonio, Parolini, Ornella, Richeldi, Luca, Sanguinetti, Maurizio, Urbani, Andrea, Zega, Maurizio, Scambia, Giovanni, Valentini, Vincenzo, Armuzzi, Alessandro, Barba, Marta, Baroni, Silvia, Bellesi, Silvia, Bentivoglio, Anna Rita, Biasucci, Luigi Marzio, Biscetti, Federico, Candelli, Marcello, Capalbo, Gennaro, Cattani, P., Chiusolo, Patrizia, Cingolani, Antonella, Corbo, Giuseppe Maria, Covino, Marcello, Cozzolino, A. M., D'Alfonso, Maria Elena, De Angelis, G., De Pascale, Gennaro, Frisullo, Giovanni, Gabrielli, M., Gambassi, Giovanni, Garcovich, M., Gremese, Elisa, Grieco, D. L., Iaconelli, A., Iorio, Raffaele, Landi, Francesco, Larici, Anna Rita, Liuzzo, Giovanna, Maviglia, Riccardo, Miele, Luca, Montalto, Massimo, Natale, Luigi, Nicolotti, Nicola, Ojetti, Veronica, Pompili, Maurizio, Posteraro, Brunella, Rapaccini, Gian Ludovico, Rinaldi, R., Rossi, E., Santoliquido, Angelo, Sica, Simona, Tamburrini, Enrica, Teofili, Luciana, Testa, A., Tosoni, A., Trani, Carlo, Varone, Francesco, and Verme, L. Z. D.

Subjects
Male, medicine.medical_specialty, Multivariate analysis, Science, Youden's J statistic, Rome, Cross-validation, Article, Cohort Studies, Machine Learning, Models, Internal medicine, medicine, 80 and over, Humans, Hospital Mortality, Pandemics, Aged, Aged, 80 and over, Multidisciplinary, Framingham Risk Score, Models, Statistical, business.industry, SARS-CoV-2, COVID-19, Emergency department, Statistical, Middle Aged, Blood Cell Count, Oxygen, Quartile, Risk factors, ROC Curve, Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, Multivariate Analysis, Absolute neutrophil count, Medicine, Female, business, Blood Chemical Analysis, Cohort study
Abstract

The COVID-19 pandemic is impressively challenging the healthcare system. Several prognostic models have been validated but few of them are implemented in daily practice. The objective of the study was to validate a machine-learning risk prediction model using easy-to-obtain parameters to help to identify patients with COVID-19 who are at higher risk of death. The training cohort included all patients admitted to Fondazione Policlinico Gemelli with COVID-19 from March 5, 2020, to November 5, 2020. Afterward, the model was tested on all patients admitted to the same hospital with COVID-19 from November 6, 2020, to February 5, 2021. The primary outcome was in-hospital case-fatality risk. The out-of-sample performance of the model was estimated from the training set in terms of Area under the Receiving Operator Curve (AUROC) and classification matrix statistics by averaging the results of fivefold cross validation repeated 3-times and comparing the results with those obtained on the test set. An explanation analysis of the model, based on the SHapley Additive exPlanations (SHAP), is also presented. To assess the subsequent time evolution, the change in paO2/FiO2 (P/F) at 48 h after the baseline measurement was plotted against its baseline value. Among the 921 patients included in the training cohort, 120 died (13%). Variables selected for the model were age, platelet count, SpO2, blood urea nitrogen (BUN), hemoglobin, C-reactive protein, neutrophil count, and sodium. The results of the fivefold cross-validation repeated 3-times gave AUROC of 0.87, and statistics of the classification matrix to the Youden index as follows: sensitivity 0.840, specificity 0.774, negative predictive value 0.971. Then, the model was tested on a new population (n = 1463) in which the case-fatality rate was 22.6%. The test model showed AUROC 0.818, sensitivity 0.813, specificity 0.650, negative predictive value 0.922. Considering the first quartile of the predicted risk score (low-risk score group), the case-fatality rate was 1.6%, 17.8% in the second and third quartile (high-risk score group) and 53.5% in the fourth quartile (very high-risk score group). The three risk score groups showed good discrimination for the P/F value at admission, and a positive correlation was found for the low-risk class to P/F at 48 h after admission (adjusted R-squared = 0.48). We developed a predictive model of death for people with SARS-CoV-2 infection by including only easy-to-obtain variables (abnormal blood count, BUN, C-reactive protein, sodium and lower SpO2). It demonstrated good accuracy and high power of discrimination. The simplicity of the model makes the risk prediction applicable for patients in the Emergency Department, or during hospitalization. Although it is reasonable to assume that the model is also applicable in not-hospitalized persons, only appropriate studies can assess the accuracy of the model also for persons at home.

Published
2021

11. Prognostic role of ELF test compared to liver biopsy in patients with metabolic dysfunction-associated steatotic liver disease (MASLD)

Author

Liguori, A., D'Ambrosio, F., Viceconti, N., Termite, F., Petrucci, L., Beschi, R., Orienti, M., Galletti, S., Cardinali, S., Riccardi, L., Garcovich, M., Pizzolante, F., De Matthaeis, N., Zocco, M.A., Ainora, M.E., Giustiniani, M.C., Marrone, G., Biolato, M., C, Cefalo, Vecchio, F.M., Grieco, A., Urbani, A., Sanguinetti, M., Gasbarrini, A., and Miele, L.

Published
2024
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12. HepatoCATT Study Group for the Multidisciplinary Management of HCC. Interventional oncology treatments for unresectable early stage HCC in patients with a high risk for intraprocedural bleeding: Is a single-step combined therapy safe and feasible?

Author

Iezzi, R, Pompili, M, Posa, A, Carchesio, F, Siciliano, M, Annicchiarico, Be, Agnes, S, Giuliante, F, Garcovich, M, Cerrito, L, Ponziani, Fr, Basso, M, Cassano, A, Rapaccini, Gl, De Gaetano, Anna Maria, Gasbarrini, A, Manfredi, R, Iezzi R (ORCID:0000-0002-2791-481X), Pompili M (ORCID:0000-0001-6699-7980), Siciliano M, Agnes S (ORCID:0000-0002-3341-4221), Giuliante F (ORCID:0000-0001-9517-8220), Garcovich M (ORCID:0000-0001-8967-6688), Cerrito L, Ponziani FR (ORCID:0000-0002-5924-6238), Basso M, Cassano A (ORCID:0000-0002-3311-7163), De Gaetano AM (ORCID:0000-0002-7493-9462), Gasbarrini A (ORCID:0000-0002-7278-4823), Manfredi R (ORCID:0000-0002-4972-9500), Iezzi, R, Pompili, M, Posa, A, Carchesio, F, Siciliano, M, Annicchiarico, Be, Agnes, S, Giuliante, F, Garcovich, M, Cerrito, L, Ponziani, Fr, Basso, M, Cassano, A, Rapaccini, Gl, De Gaetano, Anna Maria, Gasbarrini, A, Manfredi, R, Iezzi R (ORCID:0000-0002-2791-481X), Pompili M (ORCID:0000-0001-6699-7980), Siciliano M, Agnes S (ORCID:0000-0002-3341-4221), Giuliante F (ORCID:0000-0001-9517-8220), Garcovich M (ORCID:0000-0001-8967-6688), Cerrito L, Ponziani FR (ORCID:0000-0002-5924-6238), Basso M, Cassano A (ORCID:0000-0002-3311-7163), De Gaetano AM (ORCID:0000-0002-7493-9462), Gasbarrini A (ORCID:0000-0002-7278-4823), and Manfredi R (ORCID:0000-0002-4972-9500)

Abstract

PURPOSE: This study was designed to assess the feasibility and safety of a single-step combined therapy using radiofrequency ablation and transarterial chemoembolization (RFA + TACE) in patients with hepatocellular carcinoma (HCC) and uncontrolled coagulopathy. The study also aimed to compare the effectiveness of this approach with TACE alone, performed in a control group. MATERIAL AND METHODS: One hundred and forty-three consecutive cirrhotic patients having a single HCC < 8 cm were enrolled in this observational prospective single-center study from January 2010 to June 2017 and were divided, according to coagulation tests, into three groups (A: low risk; B: intermediate risk and C: high risk of bleeding). The feasibility and safety of a single-step combined treatment (RFA followed by TACE) were evaluated in terms of technical success rate, periprocedural complications, and laboratory values variations. Tumor response obtained at 1-month CT follow-up for group C was compared with that of control group, composed by 16 matched patients with severe coagulopathy and single HCC < 8 cm, who underwent only TACE in a previous period, performed by the same operator. RESULTS: Technical success was achieved in all patients, without any major complications. Minor complications rate was significantly higher in group C after RFA; however, the patients were successfully treated with subsequent TACE therapy, without any differences between pre- and post-procedural laboratory values. One-month complete response rates were similar in all the three groups; however, the response rates of group C were significantly higher as compared to that of the control TACE Group (p < .001). CONCLUSION: The single-step RFA plus TACE therapy allows expansion of the indication for percutaneous thermal ablation, allowing to also include cases previously contraindicated due to the procedural high-risk of complications associated with bleeding, thus improving short-term patient outcome.

Published
2019

13. Performance of the model for end-stage liver disease score for mortality prediction and the potential role of etiology

Author

D'Amico, G, Maruzzelli, L, Airoldi, A, Petridis, I, Tosetti, G, Rampoldi, A, D'Amico, M, Miraglia, R, De Nicola, S, La Mura, V, Solcia, M, Volpes, R, Perricone, G, Sgrazzutti, C, Vanzulli, A, Primignani, M, Luca, A, Malizia, G, Federico, A, Dallio, M, Andriulli, A, Iacobellis, A, Addario, L, Garcovich, M, Gasbarrini, A, Chessa, L, Salerno, F, Gobbo, G, Merli, M, Ridola, L, Baroni, G, Tarantino, G, Caporaso, N, Morisco, F, Pozzoni, P, Colli, A, Belli, L, D'Amico, Gennaro, Maruzzelli, Luigi, Airoldi, Aldo, Petridis, Ioannis, Tosetti, Giulia, Rampoldi, Antonio, D'Amico, Mario, Miraglia, Roberto, De Nicola, Stella, La Mura, Vincenzo, Solcia, Marco, Volpes, Riccardo, Perricone, Giovanni, Sgrazzutti, Cristiano, Vanzulli, Angelo, Primignani, Massimo, Luca, Angelo, Malizia, Giuseppe, Federico, Alessandro, Dallio, Marcello, Andriulli, Angelo, Iacobellis, Angelo, Addario, Luigi, Garcovich, Matteo, Gasbarrini, Antonio, Chessa, Luchino, Salerno, Francesco, Gobbo, Giulia, Merli, Manuela, Ridola, Lorenzo, Baroni, Gianluca Svegliati, Tarantino, Giuseppe, Caporaso, Nicola, Morisco, Filomena, Pozzoni, Pietro, Colli, Agostino, Belli, Luca Saverio, D'Amico, G, Maruzzelli, L, Airoldi, A, Petridis, I, Tosetti, G, Rampoldi, A, D'Amico, M, Miraglia, R, De Nicola, S, La Mura, V, Solcia, M, Volpes, R, Perricone, G, Sgrazzutti, C, Vanzulli, A, Primignani, M, Luca, A, Malizia, G, Federico, A, Dallio, M, Andriulli, A, Iacobellis, A, Addario, L, Garcovich, M, Gasbarrini, A, Chessa, L, Salerno, F, Gobbo, G, Merli, M, Ridola, L, Baroni, G, Tarantino, G, Caporaso, N, Morisco, F, Pozzoni, P, Colli, A, Belli, L, D'Amico, Gennaro, Maruzzelli, Luigi, Airoldi, Aldo, Petridis, Ioannis, Tosetti, Giulia, Rampoldi, Antonio, D'Amico, Mario, Miraglia, Roberto, De Nicola, Stella, La Mura, Vincenzo, Solcia, Marco, Volpes, Riccardo, Perricone, Giovanni, Sgrazzutti, Cristiano, Vanzulli, Angelo, Primignani, Massimo, Luca, Angelo, Malizia, Giuseppe, Federico, Alessandro, Dallio, Marcello, Andriulli, Angelo, Iacobellis, Angelo, Addario, Luigi, Garcovich, Matteo, Gasbarrini, Antonio, Chessa, Luchino, Salerno, Francesco, Gobbo, Giulia, Merli, Manuela, Ridola, Lorenzo, Baroni, Gianluca Svegliati, Tarantino, Giuseppe, Caporaso, Nicola, Morisco, Filomena, Pozzoni, Pietro, Colli, Agostino, and Belli, Luca Saverio

Abstract

Although discrimination of the model for end stage liver disease (MELD) is generally considered acceptable, its calibration is still unclear. In a validation study, we assessed the discrimination and calibration performance of 3 versions of the model: original MELD-TIPS, used to predict survival after transjugular intra-hepatic portosystemic shunt (TIPS); classic MELD-Mayo; MELD-UNOS, used by United Network for Organ Sharing (UNOS). Recalibration and model updating were also explored.

Published
2021

14. Platelet count does not predict bleeding in cirrhotic patients: Results from the PRO-LIVER Study

Author

Basili, S. a, Raparelli, V. b., Napoleone, L. b., Talerico, G. a., Corazza, G. R. c., Perticone, F. d., Sacerdoti, D. e., Andriulli, A. f., Licata, A. g., Pietrangelo, A., Picardi, A. i., Raimondo, G. j., Violi, F., Palasciano, G., D’Alitto, F., Palmieri, V. O., Santovito, D., Michele, Di, Croce, D., Brocco, G., Fasolato, S., Cecchetto, S., Bombonato, L., Bertoni, G., Restuccia, M., Andreozzi, T., Liguori, P., Caroleo, M. L., Perticone, B., Staltari, M., Manfredini, O., Giorgi, De, Averna, A., Giammanco, M., Granito, A., Pettinari, A., Marinelli, I., Bolondi, S., Falsetti, L., Salvi, L., Durante-Mangoni, A., Cesaro, E., Farinaro, F., Ragone, V., Morana, E., Ippolito, I., Iacobellis, A., Niro, A., Merla, G., Maimone, A., Cacciola, S., Varvara, I., Drenaggi, D., Staffolani, D., Vespasiani-Gentilucci, S., Galati, U., Gallo, G., Davì, P., Schiavone, G., Santilli, C., Tana, F., Soresi, C., Bianchi, Giovanni, Carderi, B., Pinto, I., Tuttolomondo, A., Ferrari, A., Gresele, G., Fierro, P., Morelli, T., Laffi, O., Romanelli, G., Arena, R. G., Stasi, U., Gasbarrini, A., Garcovich, M., Zocco, M. A., Riccardi, L., Ainora, M. E., Capeci, W., Martino, Giuseppe, Nobili, P., Cavallo, L., Frugiuele, M., Greco, P., Ventura, P., Cuoghi, C., Marcacci, M., Serviddio, G., Vendemiale, G., Villani, R., Gargano, R., Vidili, G., Cesare, Di, Masala, V., Delitala, M., Invernizzi, G., Vincenzo, P., Minno, Di, Tufano, G., Purrello, A., Privitera, F., Forgione, G., Curigliano, A., Senzolo, V., Rodríguez-Castro, M., Giannelli, K. I., Serra, G., Neri, C., Pignataro, S., Rizzetto, P., Debernardi, M., Svegliati, V. W., Bergamaschi, B. G., Masotti, G., Costanzo, M., Antonio, F., Angelico, F., Del, Ben, Polimeni, M., Proietti, L., Cangemi, M., Romiti, R., Toriello, G. F., Sperduti, F., Santangelo, N., Visioli, G., Todisco, G., Vestri, Anna, Farcomeni, R., Corrao, A., Gobbi, S., Corradini, E., Costantino, G., Tripepi, G., Angelico, M., Bolondi, L., D’Amico, G., Franchis, De, Gatta, R., Tassone, A., Anzaldi, E. J., Barone, M., Bazzini, M., Bianchi, C., Boari, P. I., Bracco, B., Buonauro, C., Buttà, A., Buzzetti, E., Calabria, S., Caradio, F., Carleo, P., Carrabba, Maria, Castorani, D., Cecchetto, L., Cicco, L., Cimini, S., Colombo, C., B. M., Vuono, De, Denegri, S., Del, Corso, Giosia, Di, Donnarumma, P., Giorgini, E., Grassi, P., Grembiale, D., Hijazi, A., Iamele, D., Lorusso, L., Marchese, G., Marra, Alberto, Masala, M., Miceli, M., Montebianco, G., Murgia, A. L., Naccarato, G., Padula, P., Pattoneri, D., Perego, P., Pesce, F., Petramala, P., Piano, L., Pinto, S., Pinna, D., Pignataro, M., Pretti, F. S., Pucci, V., Salinaro, G., Salzano, F., Santarossa, A., Scarpini, C., Scicali, F., Sirico, R., Suppressa, D., Talia, P., Torres, M., Traversa, D., Vazzana, M., Vecchio, Claudia, Vettore, R., Vitale, E., Basili, S., Raparelli, V., Napoleone, L., Talerico, G., Corazza, G.R., Perticone, F., Sacerdoti, D., Andriulli, A., Licata, A., Pietrangelo, A., Picardi, A., Raimondo, G., Violi, F., Palasciano, Giuseppe, D’Alitto, Felicia, Palmieri, Vincenzo Ostilio, Santovito, Daniela, Di Michele, Dario, Croce, Giuseppe, Brocco, Silvia, Fasolato, Silvano, Cecchetto, Lara, Bombonato, Giancarlo, Bertoni, Michele, Restuccia, Tea, Andreozzi, Paola, Liguori, Maria Livia, Caroleo, Benedetto, Perticone, Maria, Staltari, Orietta, Manfredini, Roberto, De Giorgi, Alfredo, Averna, Maurizio, Giammanco, Antonina, Granito, Alessandro, Pettinari, Irene, Marinelli, Sara, Bolondi, Luigi, Falsetti, Lorenzo, Salvi, Aldo, Durante-Mangoni, Emanuele, Cesaro, Flavio, Farinaro, Vincenza, Ragone, Enrico, Morana, Ignazio, Ippolito, Antonio, Iacobellis, Angelo, Niro, Grazia, Merla, Antonio, Maimone, Sergio, Cacciola, Irene, Varvara, Doriana, Drenaggi, Davide, Staffolani, Silvia, Vespasiani-Gentilucci, Umberto, Galati, Giovanni, Gallo, Paolo, Davì, Giovanni, Schiavone, Cosima, Santilli, Francesca, Tana, Claudio, Soresi, Maurizio, Bianchi Giovanni, Battista, Carderi, Isabella, Pinto, Antonio, Tuttolomondo, Antonino, Ferrari, Giovanni, Gresele, Paolo, Fierro, Tiziana, Morelli, Olivia, Laffi, Giacomo, Romanelli, Roberto Giulio, Arena, Umberto, Stasi, Cristina, Gasbarrini, Antonio, Garcovich, Matteo, Zocco, Maria Assunta, Riccardi, Laura, Ainora, Maria Elena, Capeci, William, Martino Giuseppe, Pio, Nobili, Lorenzo, Cavallo, Maurizio, Frugiuele, Pierluigi, Greco, Antonio, Ventura, Paolo, Cuoghi, Chiara, Marcacci, Matteo, Serviddio, Gaetano, Vendemiale, Gianluigi, Villani, Rosanna, Gargano, Ruggiero, Vidili, Gianpaolo, Di Cesare, Valentina, Masala, Maristella, Delitala, Giuseppe, Invernizzi, Pietro, Vincenzo, Ronca, Di Minno, Giovanni, Tufano, Antonella, Purrello, Francesco, Privitera, Graziella, Forgione, Alessandra, Curigliano, Valentina, Senzolo, Marco, Rodríguez-Castro, Kryssia Isabel, Giannelli, Gianluigi, Serra, Carla, Neri, Sergio, Pignataro, Pietro, Rizzetto, Mario, Debernardi, Venon Wilma, Svegliati, Baroni Gianluca, Bergamaschi, Gaetano, Masotti, Michela, Costanzo, Filippo, Antonio, Figliomeni, Angelico, Francesco, Del Ben, Maria, Polimeni, Licia, Proietti, Marco, Cangemi, Roberto, Romiti Giulio, Francesco, Toriello, Filippo, Sperduti, Nicolò, Santangelo, Giuseppe, Visioli, Giacomo, Todisco, Tommaso, Vestri Anna, Rita, Farcomeni, Alessio, Corrao, Salvatore, Gobbi, Paolo, Corradini, Elena, Costantino, Giorgio, Tripepi, Giovanni, Angelico, Mario, D’Amico, Gennaro, De Franchis, Roberto, Gatta, Angelo, Tassone, Eliezer Joseph, Anzaldi, Massimiliano, Barone, Milena, Bazzini, Cristina, Bianchi, Paola Ilaria, Boari, Benedetta, Bracco, Christian, Buonauro, Agostino, Buttà, Carmelo, Buzzetti, Elena, Calabria, Stefano, Caradio, Federica, Carleo, Pietro, Carrabba Maria, Domenica, Castorani, Luigi, Cicco, Sebastiano, Cimini, Claudia, Colombo, Barbara Maria, De Vuono, Stefano, Denegri, Andrea, Del Corso, Lisette, Di Giosia, Paolo, Donnarumma, Emilia, Giorgini, Paolo, Grassi, Davide, Grembiale, Alessandro, Hijazi, Daniel, Iamele, Luigi, Lorusso, Giusi, Marchese, Alessandra, Marra Alberto, Maria, Miceli, Giuseppe, Montebianco, Abenavoli Ludovico, Murgia, Giuseppe, Naccarato, Paola, Padula, Donatella, Pattoneri, Paolo, Perego, Francesca, Pesce, Paola, Petramala, Luigi, Piano, Salvatore, Pinto, Daniela, Pinna, Miriam, Pignataro, Francesca Serena, Pretti, Vincenzo, Pucci, Giacomo, Salinaro, Francesco, Salzano, Andrea, Santarossa, Claudia, Scarpini, Francesca, Scicali, Roberto, Sirico, Domenico, Suppressa, Patrizia, Talia, Michela, Torres, Daniele, Traversa, Matteo, Vazzana, Natale, Vecchio Claudia, Rita, Vettore, Elia, Vitale, Francesco, Basili, S, Raparelli, V, Napoleone, L, Talerico, G, Corazza, G, Perticone, F, Sacerdoti, D, Andriulli, A, Licata, A, Pietrangelo, A, Picardi, A, Raimondo, G, Violi, F, Palasciano, G, D'Alitto, F, Palmieri, V, Santovito, D, Di Michele, D, Croce, G, Brocco, S, Fasolato, S, Cecchetto, L, Bombonato, G, Bertoni, M, Restuccia, T, Andreozzi, P, Liguori, M, Caroleo, B, Perticone, M, Staltari, O, Manfredini, R, De Giorgi, A, Averna, M, Giammanco, A, Granito, A, Pettinari, I, Marinelli, S, Bolondi, L, Falsetti, L, Salvi, A, Durante-Mangoni, E, Cesaro, F, Farinaro, V, Ragone, E, Morana, I, Ippolito, A, Iacobellis, A, Niro, G, Merla, A, Maimone, S, Cacciola, I, Varvara, D, Drenaggi, D, Staffolani, S, Vespasiani-Gentilucci, U, Galati, G, Gallo, P, Davi, G, Schiavone, C, Santilli, F, Tana, C, Soresi, M, Bianchi Giovanni, B, Carderi, I, Pinto, A, Tuttolomondo, A, Ferrari, G, Gresele, P, Fierro, T, Morelli, O, Laffi, G, Romanelli, R, Arena, U, Stasi, C, Gasbarrini, A, Garcovich, M, Zocco, M, Riccardi, L, Ainora, M, Capeci, W, Martino Giuseppe, P, Nobili, L, Cavallo, M, Frugiuele, P, Greco, A, Ventura, P, Cuoghi, C, Marcacci, M, Serviddio, G, Vendemiale, G, Villani, R, Gargano, R, Vidili, G, Di Cesare, V, Masala, M, Delitala, G, Invernizzi, P, Vincenzo, R, Di Minno, G, Tufano, A, Purrello, F, Privitera, G, Forgione, A, Curigliano, V, Senzolo, M, Rodriguez-Castro, K, Giannelli, G, Serra, C, Neri, S, Pignataro, P, Rizzetto, M, Debernardi, V, Svegliati, B, Bergamaschi, G, Masotti, M, Costanzo, F, Antonio, F, Angelico, F, Del Ben, M, Polimeni, L, Proietti, M, Cangemi, R, Romiti, G, Toriello, F, Sperduti, N, Santangelo, G, Visioli, G, Todisco, T, Vestri Anna, R, Farcomeni, A, Corrao, S, Gobbi, P, Corradini, E, Costantino, G, Tripepi, G, Angelico, M, D'Amico, G, De Franchis, R, Gatta, A, Tassone, E, Anzaldi, M, Barone, M, Bazzini, C, Bianchi, P, Boari, B, Bracco, C, Buonauro, A, Butta, C, Buzzetti, E, Calabria, S, Caradio, F, Carleo, P, Carrabba Maria, D, Castorani, L, Cicco, S, Cimini, C, Colombo, B, De Vuono, S, Denegri, A, Del Corso, L, Di Giosia, P, Donnarumma, E, Giorgini, P, Grassi, D, Grembiale, A, Hijazi, D, Iamele, L, Lorusso, G, Marchese, A, Marra, A, Miceli, G, Montebianco, A, Murgia, G, Naccarato, P, Padula, D, Pattoneri, P, Perego, F, Pesce, P, Petramala, L, Piano, S, Pinto, D, Pinna, M, Pignataro, F, Pretti, V, Pucci, G, Salinaro, F, Salzano, A, Santarossa, C, Scarpini, F, Scicali, R, Sirico, D, Suppressa, P, Talia, M, Torres, D, Traversa, M, Vazzana, N, Vecchio Claudia, R, Vettore, E, Vitale, F, S Basili, V Raparelli, L Napoleone, G Talerico, G Corazza, F Perticone, D Sacerdoti, A Andriulli, A Licata, A Pietrangelo, A Picardi, G Raimondo, F Violi, MD on behalf of PRO-LIVER Collaborator, Palasciano Giuseppe, D’Alitto Felicia, Palmieri Vincenzo Ostilio, Santovito Daniela, Di Michele Dario, Croce Giuseppe, Brocco Silvia, Fasolato Silvano, Cecchetto Lara, Bombonato Giancarlo, Bertoni Michele, Restuccia Tea, Andreozzi Paola, Liguori Maria Livia, Caroleo Benedetto, Perticone Maria, Staltari Orietta, Manfredini Roberto, De Giorgi Alfredo, Averna Maurizio, Giammanco Antonina, Granito Alessandro, Pettinari Irene, Marinelli Sara, Bolondi Luigi, Falsetti Lorenzo, Salvi Aldo, Durante-Mangoni Emanuele, Cesaro Flavio, Farinaro Vincenza, Ragone Enrico, Morana Ignazio, Ippolito Antonio, Iacobellis Angelo, Niro Grazia, Merla Antonio, Maimone Sergio, Cacciola Irene, Varvara Doriana, Drenaggi Davide, Staffolani Silvia, Vespasiani-Gentilucci Umberto, Galati Giovanni, Gallo Paolo, Davi Giovanni, Schiavone Cosima, Santilli Francesca, Tana Claudio, Soresi Maurizio, Bianchi Giovanni Battista, Carderi Isabella, Pinto Antonio, Tuttolomondo Antonino, Ferrari Giovanni, Gresele Paolo, Fierro Tiziana, Morelli Olivia, Laffi Giacomo, Romanelli Roberto Giulio, Arena Umberto, Stasi Cristina, Gasbarrini Antonio, Garcovich Matteo, Zocco Maria Assunta, Riccardi Laura, Ainora Maria Elena, Capeci William, Martino Giuseppe Pio, Nobili Lorenzo, Cavallo Maurizio, Frugiuele Pierluigi, Greco Antonio, Ventura Paolo, Cuoghi Chiara, Marcacci Matteo, Serviddio Gaetano, Vendemiale Gianluigi, Villani Rosanna, Gargano Ruggiero, Vidili Gianpaolo, Di Cesare Valentina, Masala Maristella, Delitala Giuseppe, Invernizzi Pietro, Vincenzo Ronca, Di Minno Giovanni, Tufano Antonella, Purrello Francesco, Privitera Graziella, Forgione Alessandra, Curigliano Valentina, Senzolo Marco, Rodríguez-Castro Kryssia Isabel, Giannelli Gianluigi, Serra Carla, Neri Sergio, Pignataro Pietro, Rizzetto Mario, Debernardi Venon Wilma, Svegliati Baroni Gianluca, Bergamaschi Gaetano, Masotti Michela, Costanzo Filippo, Antonio Figliomeni, Angelico Francesco, Del Ben Maria, Polimeni Licia, Proietti Marco, Cangemi Roberto, Romiti Giulio Francesco, Toriello Filippo, Sperduti Nicolò, Santangelo Giuseppe, Visioli Giacomo, Todisco Tommaso, Vestri Anna Rita, Farcomeni Alessio, Corrao Salvatore, Gobbi Paolo, Corradini Elena, Costantino Giorgio, Tripepi Giovanni, Angelico Mario, D’Amico Gennaro, de Franchis Roberto, Gatta Angelo, Tassone Eliezer Joseph, Anzaldi Massimiliano, Barone Milena, Bazzini Cristina, Bianchi Paola Ilaria, Boari Benedetta, Bracco Christian, Buonauro Agostino, Buttà Carmelo, Buzzetti Elena, Calabria Stefano, Caradio Federica, Carleo Pietro, Carrabba Maria Domenica, Castorani Luigi, Cicco Sebastiano, Cimini Claudia, Colombo Barbara Maria, De Vuono Stefano, Denegri Andrea, Del Corso Lisette, Di Giosia Paolo, Donnarumma Emilia, Giorgini Paolo, Grassi Davide, Grembiale Alessandro, Hijazi Daniel, Iamele Luigi, Lorusso Giusi, Marchese Alessandra, Marra Alberto Maria, Miceli Giuseppe, Montebianco Abenavoli Ludovico, Murgia Giuseppe, Naccarato Paola, Padula Donatella, Pattoneri Paolo, Perego Francesca, Pesce Paola, Petramala Luigi, Piano Salvatore, Pinto Daniela, Pinna Miriam, Pignataro Francesca Serena, Pretti Vincenzo, Pucci Giacomo, Salinaro Francesco, Salzano Andrea, Santarossa Claudia, Scarpini Francesca, Scicali Roberto, Sirico Domenico, Suppressa Patrizia, Talia Michela, Torres Daniele, Traversa Matteo, Vazzana Natale, Vecchio Claudia Rita, Vettore Elia, Vitale Francesco, Corazza, G. R., Guidacci, Raimondo, Palasciano, G., D'Alitto, F., Palmieri, V. O., Santovito, D., Di Michele, D., Croce, G., Brocco, S., Fasolato, S., Cecchetto, L., Bombonato, G., Bertoni, M., Restuccia, T., Andreozzi, P., Liguori, M. L., Caroleo, B., Perticone, M., Staltari, O., Manfredini, R., De Giorgi, A., Averna, M., Giammanco, A., Granito, A., Pettinari, I., Marinelli, S., Bolondi, L., Falsetti, L., Salvi, A., Durante-Mangoni, E., Cesaro, F., Farinaro, V., Ragone, E., Morana, I., Ippolito, A., Iacobellis, A., Niro, G., Merla, A., Maimone, S., Cacciola, I., Varvara, D., Drenaggi, D., Staffolani, S., Vespasiani-Gentilucci, U., Galati, G., Gallo, P., Davi, G., Schiavone, C., Santilli, F., Tana, C., Soresi, M., Bianchi Giovanni, B., Carderi, I., Pinto, A., Tuttolomondo, A., Ferrari, G., Gresele, P., Fierro, T., Morelli, O., Laffi, G., Romanelli, R. G., Arena, U., Stasi, C., Gasbarrini, A., Garcovich, M., Zocco, M. A., Riccardi, L., Ainora, M. E., Capeci, W., Martino Giuseppe, P., Nobili, L., Cavallo, M., Frugiuele, P., Greco, A., Ventura, P., Cuoghi, C., Marcacci, M., Serviddio, G., Vendemiale, G., Villani, R., Gargano, R., Vidili, G., Di Cesare, V., Masala, M., Delitala, G., Invernizzi, P., Vincenzo, R., Di Minno, G., Tufano, A., Purrello, F., Privitera, G., Forgione, A., Curigliano, V., Senzolo, M., Rodriguez-Castro, K. I., Giannelli, G., Serra, C., Neri, S., Pignataro, P., Rizzetto, M., Debernardi, V. W., Svegliati, B. G., Bergamaschi, G., Masotti, M., Costanzo, F., Antonio, F., Angelico, F., Del Ben, M., Polimeni, L., Proietti, M., Cangemi, R., Romiti, G. F., Toriello, F., Sperduti, N., Santangelo, G., Visioli, G., Todisco, T., Vestri Anna, R., Farcomeni, A., Corrao, S., Gobbi, P., Corradini, E., Costantino, G., Tripepi, G., Angelico, M., D'Amico, G., De Franchis, R., Gatta, A., Tassone, E. J., Anzaldi, M., Barone, M., Bazzini, C., Bianchi, P. I., Boari, B., Bracco, C., Buonauro, A., Butta, C., Buzzetti, E., Calabria, S., Caradio, F., Carleo, P., Carrabba Maria, D., Castorani, L., Cicco, S., Cimini, C., Colombo, B. M., De Vuono, S., Denegri, A., Del Corso, L., Di Giosia, P., Donnarumma, E., Giorgini, P., Grassi, D., Grembiale, A., Hijazi, D., Iamele, L., Lorusso, G., Marchese, A., Marra, A. M., Miceli, G., Montebianco, A. L., Murgia, G., Naccarato, P., Padula, D., Pattoneri, P., Perego, F., Pesce, P., Petramala, L., Piano, S., Pinto, D., Pinna, M., Pignataro, F. S., Pretti, V., Pucci, G., Salinaro, F., Salzano, A., Santarossa, C., Scarpini, F., Scicali, R., Sirico, D., Suppressa, P., Talia, M., Torres, D., Traversa, M., Vazzana, N., Vecchio Claudia, R., Vettore, E., and Vitale, F.

Subjects
Liver Cirrhosis, Male, Settore MED/09 - Medicina Interna, 030204 cardiovascular system & hematology, Gastroenterology, Severity of Illness Index, cjirrhosis, ACTIVATION, 0302 clinical medicine, Risk Factors, Medicine, Platelet, Prospective Studies, Prospective cohort study, RISK, Aged, 80 and over, medicine.diagnostic_test, PRO-LIVER, Platelet, cirrhosis, gastrointestinal bleeding, ASSOCIATION, Middle Aged, Prognosis, Italy, 030211 gastroenterology & hepatology, Female, Gastrointestinal Hemorrhage, Human, Adult, Platelets, medicine.medical_specialty, Prognosi, Liver Cirrhosi, MEDLINE, COAGULATION, gastrointestinal bleeding, Socio-culturale, Hemorrhage, Hepatology, Follow-Up Studie, 03 medical and health sciences, Text mining, Internal medicine, Severity of illness, ENDOTOXEMIA, Pro-Liver Study, Humans, HEMOSTASIS, International Normalized Ratio, Aged, Proportional Hazards Models, Prothrombin time, Cirrhosi, Platelet Count, Bleeding, Liver Cirrhosis, business.industry, Proportional hazards model, Platelet Count, Risk Factor, cirrhosis, bleeding, Thrombocytopenia, Prospective Studie, THROMBOSIS, Platelets, cjirrhosis, bleeding, PRO-LIVER, Proportional Hazards Model, Prothrombin Time, business, DECOMPENSATED CIRRHOSIS, Follow-Up Studies
Abstract

OBJECTIVES: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear. METHODS: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of ∼4 years. RESULTS: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64±37 years; 47% Child–Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800–1,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.89%/year for major and minor bleeding, respectively). Fifty-two (18.6%) patients experienced a major (n=34) or minor (n=18) bleeding event, predominantly from gastrointestinal origin. Platelet counts progressively decreased with the worsening of liver disease and were similar in patients with or without major or minor bleeding: a platelet count ≤50×103/μl was detected in 3 (6%) patients with and in 20 (9%) patients without any bleeding event. Conversely, prothrombin time-international normalized ratio was slightly higher in patients with overall or major bleeding. On Cox proportional hazard analysis, only a previous gastrointestinal bleeding (hazard ratio (HR): 1.96; 95% confidence interval: 1.11–3.47; P=0.020) and encephalopathy (HR: 2.05; 95% confidence interval: 1.16–3.62; P=0.013) independently predicted overall bleeding events. CONCLUSIONS: Platelet count does not predict unprovoked major or minor bleeding in cirrhotic patients.

Published
2018

16. A new ultrasound score for the assessment and follow-up of chronic pancreatitis: The ‘Gemelli USCP score’

Author

Pagliari, D., Ainora, Maria Elena, Brizi, Maria Gabriella, Cintoni, M., Rinninella, Emanuele, Attili, Fabia, Mancarella, Francesco Antonio, Garcovich, M., Riccardi, Laura, Pompili, Maurizio, Gasbarrini, Antonio, Manfredi, Riccardo, Zocco, Maria Assunta, Ainora M. E., Brizi M. G. (ORCID:0000-0002-3704-6796), Rinninella E. (ORCID:0000-0002-9165-2367), Attili F., Mancarella F. A., Riccardi L., Pompili M. (ORCID:0000-0001-6699-7980), Gasbarrini A. (ORCID:0000-0002-7278-4823), Manfredi R. (ORCID:0000-0002-4972-9500), Zocco M. A. (ORCID:0000-0002-0814-9542), Pagliari, D., Ainora, Maria Elena, Brizi, Maria Gabriella, Cintoni, M., Rinninella, Emanuele, Attili, Fabia, Mancarella, Francesco Antonio, Garcovich, M., Riccardi, Laura, Pompili, Maurizio, Gasbarrini, Antonio, Manfredi, Riccardo, Zocco, Maria Assunta, Ainora M. E., Brizi M. G. (ORCID:0000-0002-3704-6796), Rinninella E. (ORCID:0000-0002-9165-2367), Attili F., Mancarella F. A., Riccardi L., Pompili M. (ORCID:0000-0001-6699-7980), Gasbarrini A. (ORCID:0000-0002-7278-4823), Manfredi R. (ORCID:0000-0002-4972-9500), and Zocco M. A. (ORCID:0000-0002-0814-9542)

Abstract

Background: : Ultrasound (US) is frequently the first line imaging technique used in patients with abdominal pain and clinical suspicion of chronic pancreatitis (CP), but its role in the diagnosis and follow-up of CP is still controversial. Aims: : We aimed to develop a dedicated score for the US staging of CP and to evaluate the agreement of this score with standard imaging techniques. Methods: : Ninety consecutive patients with a diagnosis of CP referred to the pancreatic outpatient clinic of A. Gemelli Hospital between June and September 2018 were recruited in the study. Patients underwent pancreatic US to evaluate different morphological parameters to develop an US based score system, called the Gemelli UltraSound Chronic Pancreatitis (USCP) score. Results: : The Gemelli USCP score significantly increased according to the Cambridge score for both mean value (p<0.0001) and each parameter evaluated (p<0.0001). Moreover, we found a significant correlation between the score and laboratory parameters related to pancreatic exocrine insufficiency such as vitamin D, B9, and B12 deficiency and fecal elastase values (p<0.0001). Conclusions: : The development of a dedicated US score could be useful in the follow up of patients with CP as alternative non-invasive technique to standard radiological imaging.

Published
2020

17. Sarilumab use in severe SARS-CoV-2 pneumonia

Author

Gremese, Elisa, Cingolani, Antonella, Bosello, Silvia Laura, Alivernini, Stefano, Tolusso, Barbara, Perniola, S., Landi, Francesco, Pompili, Maurizio, Murri, Rita, Santoliquido, Angelo, Garcovich, M., Sali, Michela, De Pascale, Gennaro, Gabrielli, Maurizio, Biscetti, Federico, Montalto, Massimo, Tosoni, Alessio, Gambassi, Giovanni, Rapaccini, Gian Ludovico, Iaconelli, Amerigo, Zileri Del Verme, L., Petricca, L., Fedele, A. L., Lizzio, Marco Maria, Tamburrini, Enrica, Natalello, Gerlando, Gigante, Laura, Bruno, D., Verardi, Lucrezia, Taddei, Eleonora, Calabrese, Anna Chiara, Lombardi, Francesca, Bernabei, Roberto, Cauda, Roberto, Franceschi, Francesco, Landolfi, Raffaele, Richeldi, Luca, Sanguinetti, Maurizio, Fantoni, Massimo, Antonelli, Massimo, Gasbarrini, Antonio, Gremese E. (ORCID:0000-0002-2248-1058), Cingolani A. (ORCID:0000-0002-3793-2755), Bosello S. L. (ORCID:0000-0002-4837-447X), Alivernini S. (ORCID:0000-0002-7383-4212), Tolusso B. (ORCID:0000-0002-9108-6609), Landi F. (ORCID:0000-0002-3472-1389), Pompili M. (ORCID:0000-0001-6699-7980), Murri R. (ORCID:0000-0003-4263-7854), Santoliquido A. (ORCID:0000-0003-1539-4017), Sali M. (ORCID:0000-0003-3609-2990), De Pascale G. (ORCID:0000-0002-8255-0676), Gabrielli M., Biscetti F. (ORCID:0000-0001-7449-657X), Montalto M. (ORCID:0000-0001-8819-3684), Tosoni A., Gambassi G. (ORCID:0000-0002-7030-9359), Rapaccini G. L. (ORCID:0000-0002-6467-857X), Iaconelli A., Lizzio M. M., Tamburrini E. (ORCID:0000-0003-4930-426X), Natalello G., Gigante L., Verardi L., Taddei E., Calabrese A., Lombardi F. (ORCID:0000-0001-5757-8346), Bernabei R. (ORCID:0000-0002-9197-004X), Cauda R. (ORCID:0000-0002-1498-4229), Franceschi F. (ORCID:0000-0001-6266-445X), Landolfi R. (ORCID:0000-0002-7913-8576), Richeldi L. (ORCID:0000-0001-8594-1448), Sanguinetti M. (ORCID:0000-0002-9780-7059), Fantoni M. (ORCID:0000-0001-6913-8460), Antonelli M. (ORCID:0000-0003-3007-1670), Gasbarrini A. (ORCID:0000-0002-7278-4823), Gremese, Elisa, Cingolani, Antonella, Bosello, Silvia Laura, Alivernini, Stefano, Tolusso, Barbara, Perniola, S., Landi, Francesco, Pompili, Maurizio, Murri, Rita, Santoliquido, Angelo, Garcovich, M., Sali, Michela, De Pascale, Gennaro, Gabrielli, Maurizio, Biscetti, Federico, Montalto, Massimo, Tosoni, Alessio, Gambassi, Giovanni, Rapaccini, Gian Ludovico, Iaconelli, Amerigo, Zileri Del Verme, L., Petricca, L., Fedele, A. L., Lizzio, Marco Maria, Tamburrini, Enrica, Natalello, Gerlando, Gigante, Laura, Bruno, D., Verardi, Lucrezia, Taddei, Eleonora, Calabrese, Anna Chiara, Lombardi, Francesca, Bernabei, Roberto, Cauda, Roberto, Franceschi, Francesco, Landolfi, Raffaele, Richeldi, Luca, Sanguinetti, Maurizio, Fantoni, Massimo, Antonelli, Massimo, Gasbarrini, Antonio, Gremese E. (ORCID:0000-0002-2248-1058), Cingolani A. (ORCID:0000-0002-3793-2755), Bosello S. L. (ORCID:0000-0002-4837-447X), Alivernini S. (ORCID:0000-0002-7383-4212), Tolusso B. (ORCID:0000-0002-9108-6609), Landi F. (ORCID:0000-0002-3472-1389), Pompili M. (ORCID:0000-0001-6699-7980), Murri R. (ORCID:0000-0003-4263-7854), Santoliquido A. (ORCID:0000-0003-1539-4017), Sali M. (ORCID:0000-0003-3609-2990), De Pascale G. (ORCID:0000-0002-8255-0676), Gabrielli M., Biscetti F. (ORCID:0000-0001-7449-657X), Montalto M. (ORCID:0000-0001-8819-3684), Tosoni A., Gambassi G. (ORCID:0000-0002-7030-9359), Rapaccini G. L. (ORCID:0000-0002-6467-857X), Iaconelli A., Lizzio M. M., Tamburrini E. (ORCID:0000-0003-4930-426X), Natalello G., Gigante L., Verardi L., Taddei E., Calabrese A., Lombardi F. (ORCID:0000-0001-5757-8346), Bernabei R. (ORCID:0000-0002-9197-004X), Cauda R. (ORCID:0000-0002-1498-4229), Franceschi F. (ORCID:0000-0001-6266-445X), Landolfi R. (ORCID:0000-0002-7913-8576), Richeldi L. (ORCID:0000-0001-8594-1448), Sanguinetti M. (ORCID:0000-0002-9780-7059), Fantoni M. (ORCID:0000-0001-6913-8460), Antonelli M. (ORCID:0000-0003-3007-1670), and Gasbarrini A. (ORCID:0000-0002-7278-4823)

Abstract

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

Published
2020

18. Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line

Author

Ciccullo, A., Borghetti, Alberto, Zileri Dal Verme, Lorenzo, Tosoni, Alessio, Lombardi, Francesca, Garcovich, M., Biscetti, Federico, Montalto, Massimo, Cauda, Roberto, Di Giambenedetto, Simona, Borghetti A., Zileri Dal Verme L., Tosoni A., Lombardi F. (ORCID:0000-0001-5757-8346), Biscetti F. (ORCID:0000-0001-7449-657X), Montalto M. (ORCID:0000-0001-8819-3684), Cauda R. (ORCID:0000-0002-1498-4229), Di Giambenedetto S. (ORCID:0000-0001-6990-5076), Ciccullo, A., Borghetti, Alberto, Zileri Dal Verme, Lorenzo, Tosoni, Alessio, Lombardi, Francesca, Garcovich, M., Biscetti, Federico, Montalto, Massimo, Cauda, Roberto, Di Giambenedetto, Simona, Borghetti A., Zileri Dal Verme L., Tosoni A., Lombardi F. (ORCID:0000-0001-5757-8346), Biscetti F. (ORCID:0000-0001-7449-657X), Montalto M. (ORCID:0000-0001-8819-3684), Cauda R. (ORCID:0000-0002-1498-4229), and Di Giambenedetto S. (ORCID:0000-0001-6990-5076)

Abstract

Not available

Published
2020

19. Assessment of neurological manifestations in hospitalized patients with COVID-19

Author

Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), Scaldaferri F. (ORCID:0000-0001-8334-7541), Luigetti, Marco, Iorio, Raffaele, Bentivoglio, Anna Rita, Tricoli, Luca, Riso, Vittorio, Marotta, Jessica, Piano, Carla, Primiano, Guido Alessandro, Zileri Del Verme, L., Lo Monaco, Maria Rita, Calabresi, Paolo, Abbate, V., Acampora, N., Addolorato, G., Agostini, F., Ainora, M. E., Akacha, K., Amato, E., Andreani, F., Andriollo, G., Annetta, Maria Giuseppina, Annicchiarico, B. E., Antonelli, Massimo, Antonucci, G., Anzellotti, G. M., Armuzzi, A., Baldi, F., Barattucci, I., Barillaro, C., Barone, F., Bellantone, R. D. A., Bellieni, A., Bello, G., Benicchi, A., Benvenuto, F., Berardini, L., Berloco, F., Bernabei, R., Bianchi, A., Biasucci, D. G., Biasucci, L. M., Bibbo, S., Bini, A., Bisanti, A., Biscetti, F., Bocci, M. G., Bonadia, N., Bongiovanni, F., Borghetti, A., Bosco, G., Bosello, Silvia Laura, Bove, V., Bramato, G., Brandi, V., Bruni, T., Bruno, C., Bruno, D., Bungaro, M. C., Buonomo, A., Burzo, L., Calabrese, A., Calvello, M. R., Cambieri, A., Cambise, C., Camma, G., Candelli, M., Canistro, G., Cantanale, A., Capalbo, G., Capaldi, L., Capone, E., Capristo, E., Carbone, L., Cardone, S., Carelli, S., Carfi, A., Carnicelli, A., Caruso, C., Casciaro, F. A., Catalano, L., Cauda, R., Cecchini, A. L., Cerrito, L., Cesarano, M., Chiarito, A., Cianci, Rossella, Cicchinelli, S., Ciccullo, A., Cicetti, M., Ciciarello, F., Cingolani, A., Cipriani, M. C., Consalvo, M. L., Coppola, G., Corbo, G. M., Corsello, A., Costante, F., Costanzi, M., Covino, M., Crupi, D., Cutuli, S. L., D'Addio, S., D'Alessandro, A., D'Alfonso, M. E., D'Angelo, E., D'Aversa, F., Damiano, F., De Berardinis, G. M., De Cunzo, T., De Gaetano, D. K., De Luca, G., De Matteis, G., De Pascale, G., De Santis, P., De Siena, M., De Vito, F., Del Gatto, V., Del Giacomo, P., Del Zompo, F., Dell'Anna, A. M., Della, P. D., Di Gialleonardo, L., Di Giambenedetto, S., Di Luca, R., Di Maurizio, L., Di Muro, M., Dusina, A., Eleuteri, D., Esperide, A., Fachechi, D., Faliero, D., Falsiroli, C., Fantoni, M., Fedele, A., Feliciani, D., Ferrante, C., Ferrone, G., Festa, R., Fiore, M. C., Flex, A., Forte, E., Franceschi, Francesco, Francesconi, A., Franza, L., Funaro, B., Fuorlo, M., Fusco, D., Gabrielli, M., Gaetani, E., Galletta, C., Gallo, A., Gambassi, G., Garcovich, M., Gasbarrini, A., Gasparrini, I., Gelli, S., Giampietro, A., Gigante, L., Giuliano, G., Giupponi, B., Gremese, E., Grieco, Domenico Luca, Guerrera, M., Guglielmi, V., Guidone, C., Gulli, A., Iaconelli, A., Iafrati, A., Ianiro, Gianluca, Iaquinta, A., Impagnatiello, M., Inchingolo, R., Intini, E., Iorio, R., Izzi, I. M., Jovanovic, T., Kadhim, C., La Macchia, R., La Milia, D. I., Landi, F., Landi, G., Landi, R., Landolfi, R., Leo, M., Leone, P. M., Levantesi, L., Liguori, A., Liperoti, R., Lizzio, M. M., Lo Monaco Maria, R., Locantore, P., Lombardi, F., Lombardi, G., Lopetuso, L., Loria, V., Losito, A. R., Lucia, M. B. P., Macagno, F., Macerola, N., Maggi, G., Maiuro, G., Mancarella, F., Mangiola, F., Manno, A., Marchesini, D., Maresca, G. M., Marrone, G., Martis, I., Martone, A. M., Marzetti, Emanuele, Mattana, C., Matteo, M. V., Maviglia, R., Mazzarella, A., Memoli, C., Miele, Luca, Migneco, A., Mignini, I., Milani, A., Milardi, D., Montalto, M., Montemurro, G., Monti, F., Montini, Luca, Morena, T. C., Morra, V., Morretta, C., Moschese, D., Murace, C. A., Murdolo, M., Murri, Rita, Napoli, M., Nardella, E., Natalello, G., Natalini, D., Navarra, S. M., Nesci, A., Nicoletti, A., Nicoletti, R., Nicoletti, T. F., Nicolo, R., Nicolotti, N., Nista, E. C., Nuzzo, E., Oggiano, M., Ojetti, V., Pagano, F. C., Paiano, G., Pais, C., Pallavicini, F., Palombo, A., Paolillo, F., Papa, Alfredo, Papanice, D., Papparella, L. G., Paratore, M., Parrinello, G., Pasciuto, G., Pasculli, P., Pecorini, G., Perniola, S., Pero, E., Petricca, L., Petrucci, M., Picarelli, C., Piccioni, A., Piccolo, A., Piervincenzi, E., Pignataro, G., Pignataro, R., Pintaudi, G., Pisapia, L., Pizzoferrato, M., Pizzolante, F., Pola, R., Policola, C., Pompili, M., Pontecorvi, F., Pontecorvi, V., Ponziani, F., Popolla, V., Porceddu, E., Porfidia, A., Porro, L. M., Potenza, A., Pozzana, F., Privitera, G., Pugliese, D., Pulcini, G., Racco, S., Raffaelli, F., Ramunno, V., Rapaccini, G. L., Richeldi, Luca, Rinninella, Emanuele, Rocchi, S., Romano, B., Romano, S., Rosa, F., Rossi, L., Rossi, R., Rossini, E., Rota, E., Rovedi, F., Rubino, C., Rumi, G., Russo, A., Sabia, L., Salerno, A., Salini, S., Salvatore, L., Samori, D., Sandroni, Claudio, Sanguinetti, M., Santarelli, L., Santini, P., Santolamazza, D., Santoliquido, A., Santopaolo, F., Santoro, M. C., Sardeo, F., Sarnari, C., Saviano, A., Saviano, L., Scaldaferri, Franco, Scarascia, R., Schepis, T., Schiavello, F., Scoppettuolo, G., Sedda, D., Sessa, F., Sestito, L., Settanni, C., Siciliano, M., Siciliano, V., Sicuranza, R., Simeoni, B., Simonetti, J., Smargiassi, A., Soave, P. M., Sonnino, C., Staiti, D., Stella, C., Stella, L., Stival, E., Taddei, E., Talerico, R., Tamburello, E., Tamburrini, E., Tanzarella, E. S., Tarascio, E., Tarli, C., Tersali, A., Tilli, P., Timpano, J., Torelli, E., Torrini, F., Tosato, M., Tosoni, A., Tricoli, L., Tritto, M., Tumbarello, M., Tummolo, A. M., Vallecoccia, M. S., Valletta, F., Varone, F., Vassalli, F., Ventura, G., Verardi, L., Vetrone, L., Vetrugno, G., Visconti, E., Visconti, F., Viviani, A., Zaccaria, R., Zaccone, C., Zelano, L., Zileri Dal Verme, L., Zuccala, G., Luigetti M. (ORCID:0000-0001-7539-505X), Iorio R. (ORCID:0000-0002-6270-0956), Bentivoglio A. R. (ORCID:0000-0002-9663-095X), Tricoli L., Riso V., Marotta J., Piano C., Primiano G., Lo Monaco M. R. (ORCID:0000-0002-1457-7981), Calabresi P. (ORCID:0000-0003-0326-5509), Annetta M. G. (ORCID:0000-0001-7574-1311), Antonelli M. (ORCID:0000-0003-3007-1670), Bosello S. (ORCID:0000-0002-4837-447X), Cianci R. (ORCID:0000-0001-5378-8442), Franceschi F. (ORCID:0000-0001-6266-445X), Grieco D. L. (ORCID:0000-0002-4557-6308), Ianiro G. (ORCID:0000-0002-8318-0515), Marzetti E. (ORCID:0000-0001-9567-6983), Miele L. (ORCID:0000-0003-3464-0068), Montini L. (ORCID:0000-0003-4602-5134), Murri R. (ORCID:0000-0003-4263-7854), Papa A. (ORCID:0000-0002-4186-7298), Richeldi L. (ORCID:0000-0001-8594-1448), Rinninella E. (ORCID:0000-0002-9165-2367), Sandroni C. (ORCID:0000-0002-8878-2611), and Scaldaferri F. (ORCID:0000-0001-8334-7541)

Abstract

Background and purpose: The objective of this study was to assess the neurological manifestations in a series of consecutive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients, comparing their frequency with a population hospitalized in the same period for flu/respiratory symptoms, finally not related to SARS-CoV-2. Methods: Patients with flu/respiratory symptoms admitted to Fondazione Policlinico Gemelli hospital from 14 March 2020 to 20 April 2020 were retrospectively enrolled. The frequency of neurological manifestations of patients with SARS-CoV-2 infection was compared with a control group. Results: In all, 213 patients were found to be positive for SARS-CoV-2, after reverse transcriptase polymerase chain reaction on nasal or throat swabs, whilst 218 patients were found to be negative and were used as a control group. Regarding central nervous system manifestations, in SARS-CoV-2-positive patients a higher frequency of headache, hyposmia and encephalopathy always related to systemic conditions (fever or hypoxia) was observed. Furthermore, muscular involvement was more frequent in SARS-CoV-2 infection. Conclusions: Patients with COVID-19 commonly have neurological manifestations but only hyposmia and muscle involvement seem more frequent compared with other flu diseases.

Published
2020

20. Madelung's disease and acute alcoholic hepatitis: case report and review of literature

Author

Vassallo, G A, Mirijello, Antonio, Tarli, Claudia, Rando, Maria Margherita, Antonelli, Massimo, Garcovich, Simone, Zocco, Maria Assunta, Sestito, L, Mosoni, Carolina, Dionisi, T, D'Addio, Stefano, Tosoni, A, Gasbarrini, Antonio, Addolorato, Giovanni, Mirijello, A, Tarli, C, Rando, M M, Antonelli, M (ORCID:0000-0003-3007-1670), Garcovich, M (ORCID:0000-0001-8967-6688), Zocco, M A (ORCID:0000-0002-0814-9542), Mosoni, C, D'Addio, S, Gasbarrini, A (ORCID:0000-0002-7278-4823), Addolorato, G (ORCID:0000-0002-1522-9946), Vassallo, G A, Mirijello, Antonio, Tarli, Claudia, Rando, Maria Margherita, Antonelli, Massimo, Garcovich, Simone, Zocco, Maria Assunta, Sestito, L, Mosoni, Carolina, Dionisi, T, D'Addio, Stefano, Tosoni, A, Gasbarrini, Antonio, Addolorato, Giovanni, Mirijello, A, Tarli, C, Rando, M M, Antonelli, M (ORCID:0000-0003-3007-1670), Garcovich, M (ORCID:0000-0001-8967-6688), Zocco, M A (ORCID:0000-0002-0814-9542), Mosoni, C, D'Addio, S, Gasbarrini, A (ORCID:0000-0002-7278-4823), and Addolorato, G (ORCID:0000-0002-1522-9946)

Abstract

N/A

Published
2019

21. Interventional oncology treatment for unresecable early stage HCC in patient with high risk for intraprocedural bleeding: is a single step combined therapy safe and feasible?

Author

Iezzi, Roberto, Pompili, Maurizio, Posa, A, Cachesio, F, Siciliano, Massimo, Annicchiarico, Brigida Eleonora, Agnes, Salvatore, Giuliante, Felice, Garcovich, M, Cerrito, L, Ponziani, Francesca Romana, Basso, Michele, Cassano, Alessandra, Rapaccini, Gian Ludovico, De Gaetano, Anna Maria, Gasbarrini, Antonio, Manfredi, Riccardo, Iezzi R (ORCID:0000-0002-2791-481X), Pompili M (ORCID:0000-0001-6699-7980), Siciliano M, Annicchiarico B, Agnes S (ORCID:0000-0002-3341-4221), Giuliante F (ORCID:0000-0001-9517-8220), ponziani fr (ORCID:0000-0002-5924-6238), Basso M, Cassano A (ORCID:0000-0002-3311-7163), Rapaccini G (ORCID:0000-0002-6467-857X), De Gaetano AM (ORCID:0000-0002-7493-9462), Gasbarrini A (ORCID:0000-0002-7278-4823), Manfredi R (ORCID:0000-0002-4972-9500), Iezzi, Roberto, Pompili, Maurizio, Posa, A, Cachesio, F, Siciliano, Massimo, Annicchiarico, Brigida Eleonora, Agnes, Salvatore, Giuliante, Felice, Garcovich, M, Cerrito, L, Ponziani, Francesca Romana, Basso, Michele, Cassano, Alessandra, Rapaccini, Gian Ludovico, De Gaetano, Anna Maria, Gasbarrini, Antonio, Manfredi, Riccardo, Iezzi R (ORCID:0000-0002-2791-481X), Pompili M (ORCID:0000-0001-6699-7980), Siciliano M, Annicchiarico B, Agnes S (ORCID:0000-0002-3341-4221), Giuliante F (ORCID:0000-0001-9517-8220), ponziani fr (ORCID:0000-0002-5924-6238), Basso M, Cassano A (ORCID:0000-0002-3311-7163), Rapaccini G (ORCID:0000-0002-6467-857X), De Gaetano AM (ORCID:0000-0002-7493-9462), Gasbarrini A (ORCID:0000-0002-7278-4823), and Manfredi R (ORCID:0000-0002-4972-9500)

Published
2019

23. Usefulness of contrast-enhanced ultrasound (CEUS) in Inflammatory Bowel Disease (IBD)

Author

Pecere, Silvia, Holleran, G., Ainora, Maria Elena, Garcovich, M., Scaldaferri, Franco, Gasbarrini, Antonio, Zocco, Maria Assunta, Pecere S., Ainora M. E., Scaldaferri F. (ORCID:0000-0001-8334-7541), Gasbarrini A. (ORCID:0000-0002-7278-4823), Zocco M. A. (ORCID:0000-0002-0814-9542), Pecere, Silvia, Holleran, G., Ainora, Maria Elena, Garcovich, M., Scaldaferri, Franco, Gasbarrini, Antonio, Zocco, Maria Assunta, Pecere S., Ainora M. E., Scaldaferri F. (ORCID:0000-0001-8334-7541), Gasbarrini A. (ORCID:0000-0002-7278-4823), and Zocco M. A. (ORCID:0000-0002-0814-9542)

Abstract

Intestinal ultrasonography has emerged as a cheap, non-invasive and readily accessible modality for the assessment of a number of gastroenterological diseases. Over the last decade, particularly due to the widespread use of biological agents in Inflammatory Bowel Disease (IBD), guidelines regarding management and follow-up advise more regular disease assessment and surveillance in order to guide treatment adjustments, and provide more personalised care. Given the young age of the majority of patients with IBD the availability of an alternative modality to harmful radiation or the risks of endoscopy for this indication offers an appealing advantage. Intestinal ultrasonography has been shown to be as sensitive and specific for detecting IBD as both computed tomography and magnetic resonance enterography, and endoscopic evaluation. More recent developments in the technology of ultrasonography equipment and the use of intravenous contrast agents (contrast enhanced ultrasonography, known as CEUS), have significantly increased the ability to both detect disease location, determine the disease activity and also potentially the difference between fibrotic and inflammatory segments. This review focusses specifically on the value of CEUS for the diagnosis of both Crohn's disease and Ulcerative Colitis, in determining disease activity, extraintestinal complications, determination of fibrosis as well as its more recent use in assessing and predicting response to biological and immunosuppressive therapies.

Published
2018

27. P.09.10 CIRRHOTIC PATIENTS WITH MINIMAL HEPATIC ENCEPHALOPATHY PRESENT INCREASED CEREBRAL VASCULAR RESISTANCE, WHICH REMAINS UNCHANGED AFTER MEDICAL TREATMENT

Author

Ponziani, F.R., primary, Funaro, B., additional, Ainora, M.E., additional, Lupascu, A., additional, Riccardi, L., additional, Annicchiarico, B.E., additional, Garcovich, M., additional, Quadarella, A., additional, Siciliano, M., additional, Tondi, P., additional, Gasbarrini, G.B., additional, Gasbarrini, A., additional, Pompili, M., additional, and Zocco, M.A., additional

Published
2018
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28. P.09.30 NEW DIRECT-ACTING ANTIVIRAL (DAA) THERAPY IMPACTS LIVER STIFFNESS MEASUREMENTS IN PATIENTS WITH CHRONIC HEPATITIS C VIRUS (HCV) INFECTION

Author

Gibiino, G., primary, Ainora, M.E., additional, Garcovich, M., additional, Lembo, T., additional, Ponziani, F., additional, Funaro, B., additional, Tortora, A., additional, Riccardi, L., additional, Siciliano, M., additional, Pompili, M., additional, Gasbarrini, G.B., additional, Gasbarrini, A., additional, and Zocco, M.A., additional

Published
2018
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29. Diffuse liver infiltration by lobular breast carcinoma: Shear wave elastography as gold standard imaging study.

Author

Orlandi, Armando, Garcovich, Matteo, di Salvatore, M, Riccardi, Laura, Arena, Vincenzo, Calegari, Maria Alessandra, Pompili, Maurizio, Barone, C., Orlandi A (ORCID:0000-0001-5253-4678), Garcovich M, Riccardi L, Arena V (ORCID:0000-0002-7562-223X), Calegari MA, Pompili M (ORCID:0000-0001-6699-7980), Orlandi, Armando, Garcovich, Matteo, di Salvatore, M, Riccardi, Laura, Arena, Vincenzo, Calegari, Maria Alessandra, Pompili, Maurizio, Barone, C., Orlandi A (ORCID:0000-0001-5253-4678), Garcovich M, Riccardi L, Arena V (ORCID:0000-0002-7562-223X), Calegari MA, and Pompili M (ORCID:0000-0001-6699-7980)

Abstract

No abstract

Published
2017

30. Madelung's disease and acute alcoholic hepatitis: case report and review of literature.

Author

VASSALLO, G. A., MIRIJELLO, A., TARLI, C., RANDO, M. M., ANTONELLI, M., GARCOVICH, M., ZOCCO, M. A., SESTITO, L., MOSONI, C., DIONISI, T., D'ADDIO, S., TOSONI, A., GASBARRINI, A., and ADDOLORATO, G.

Abstract

Madelung's disease is a rare condition characterized by symmetric growth of fatty tumors (lipomas) around the neck, shoulders, upper arms, and trunk. It often affects men with a history of alcohol abuse. Here we report a review of the literature about this disease together with the description of a patient affected by Madelung's disease and acute alcoholic hepatitis. [ABSTRACT FROM AUTHOR]

Published
2019

31. Spleen ultrasound elastography: state of the art and future directions - a systematic review.

Author

GIBIINO, G., GARCOVICH, M., AINORA, M. E., and ZOCCO, M. A.

Abstract

OBJECTIVE: An early and accurate diagnosis of clinically significant portal hypertension is mandatory for a correct prediction and management of the complications usually observed in patients affected by chronic liver disease (CLD). Spleen stiffness measurement is arising as a promising non-invasive technique, giving a reliable measure of haemodynamic changes occurring during cirrhosis progression, but contrasting data are available to date. MATERIALS AND METHODS: A systematic review was performed including the several studies dealing with the spleen stiffness measurement in the evaluation of portal hypertension in adult patients affected by hepatic or extra-hepatic portal hypertension (PH). Results were organized in technical classification from the first one-dimensional device (TE) to the latest ultrasound elastographic techniques (pSWE and 2D-SWE). RESULTS: We evaluated a total of nearly twenty studies dealing with all available elastographic techniques that were usually compared with HVPG, which is the gold standard for diagnosing the presence of PH. Spleen stiffness showed overall a good diagnostic accuracy to diagnose clinically significant PH in CLD, in some cases even with reliable cut-off values for severe PH. CONCLUSIONS: Spleen ultrasound elastography could be an accurate non-invasive tool for assessing the presence of portal hypertension. However, the different techniques available to date and the various cut-off values suggested might still limit the impact on clinical practice. [ABSTRACT FROM AUTHOR]

Published
2019

35. Cutaneous manifestations of hepatitis C in the era of new antiviral agents

Author

Garcovich, Simone, Garcovich, M, Capizzi, Rodolfo, Gasbarrini, Antonio, Zocco, Ma, Garcovich, S (ORCID:0000-0001-8967-6688), Capizzi, Rodolfo (ORCID:0000-0001-6149-9237), Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Garcovich, Simone, Garcovich, M, Capizzi, Rodolfo, Gasbarrini, Antonio, Zocco, Ma, Garcovich, S (ORCID:0000-0001-8967-6688), Capizzi, Rodolfo (ORCID:0000-0001-6149-9237), and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)

Abstract

The association of chronic hepatitis C virus (HCV) infection with a wide spectrum of cutaneous manifestations has been widely reported in the literature, with varying strength of epidemiological association. Skin diseases which are certainly related with chronic HCV infection due to a strong epidemiological and pathogenetic association are mixed cryoglobulinemia, lichen planus and porphyria cutanea tarda. Chronic pruritus and necrolytic acral erythema are conditions that may share a possible association with HCV infection, while several immune-mediated inflammatory skin conditions, such as psoriasis, chronic urticaria and vitiligo, have been only anecdotally reported in the setting of chronic HCV infection. Traditional interferon-based treatment regimens for HCV infection are associated with substantial toxicity and a high-risk of immune-related adverse events, while the advent of new direct-acting antivirals with sustained virological response and improved tolerability will open the door for all-oral, interferon-free regimens. In the new era of these direct acting antivirals there will be hopefully a renewed interest in extra-hepatic manifestations of HCV infection. The aim of the present paper is to review the main cutaneous HCV-related disorders - mixed cryoglobulinemia, lichen planus, porphyria cutanea tarda and chronic pruritus - and to discuss the potential impact of new antiviral treatments on the course of these extra-hepatic manifestations of chronic HCV infection.

Published
2015

38. Liver transplantation in alcoholic patients: impact of an alcohol addiction unit within a liver transplant center

Author

Abbate V, Abenavoli L, Antonelli M, Annicchiarico E, Avolio AW, Biolato M, Campanale C, Capristo E, Caputo F, Cesario V, Castagneto M, de Matthaeis N, Favale C, Ferrarese D, Garcovich M, Frongillo F, Grieco A, Malandrino N, Miele L, Milani A, Nesci A, Nure E, Pelecca G, Pepe G, Pietrogiacomi P, Pizzolante F, Pompili M, Ponziani FR, Rapaccini G, Riccardi L, Rinninella E, Santoro MC, Sganga G, Siciliano M, Vero V, and Vonghia L.

Published
2013

39. Treatment of Portal Vein Tumor Thrombosis (PVTT) Can Impact Survival of Patients With Advanced HCC?

Author

Cesario, Valentina, Rinninella, Emanuele, Ponziani, Francesca Romana, Garcovich, M, Roccarina, D, Campanale, Mariachiara, Di Rienzo, Ta, Barbaro, Federico, Siciliano, M, Annicchiarico, Brigida Eleonora, Pompili, Maurizio, Rapaccini, Gian Ludovico, Riccardi, Laura, Grieco, A, Miele, Luca, Iezzi, Roberto, De Gaetano, Anna Maria, Di Stasio, Enrico, Gasbarrini, Giovanni Battista, Bonomo, Lorenzo, Zocco, Maria Assunta, and Gasbarrini, Antonio

Subjects
n/a, Settore MED/12 - GASTROENTEROLOGIA
Published
2013

45. Toxicity and risks from drug-to-drug interactions of new antivirals for chronic hepatitis C.

Author

BINDA, C., TORTORA, A., GARCOVICH, M., ANNICCHIARICO, B. E., and SICILIANO, M.

Abstract

The new direct acting antivirals (DAAs), defined as those drugs that are effective in combinations without interferon, have totally changed HCV treatment and probably in few years will also totally change global landscape of advanced liver diseases. The advantage of DAAs is a low-risk/high-benefit ratio. Although overall adverse events during DAAs treatment are limited in frequency and severity, some toxicity issues emerged during the first years of real-life experience with these drugs. Another peculiar characteristic of present DAAs is a high probability of interaction with other “common- use” drugs, such as anti-hypertensive, anti- platelet, antiarrhythmic and cholesterol lowering agents. Above all, special attention should be paid in older patients and in those belonging to special populations, who more frequently require the concomitant use of polytherapy. [ABSTRACT FROM AUTHOR]

Published
2017

46. P1023 OUR PRELIMINARY EXPERIENCE WITH ElastPQ SHEAR WAVE ELASTOGRAPHY TECHNIQUE AND DOPPLER INDICES IN THE NON-INVASIVE ASSESSMENT OF LIVER FIBROSIS

Author

Garcovich, M., primary, Zocco, M.A., additional, Riccardi, L., additional, Annicchiarico, E.B., additional, Ainora, M.E., additional, Roccarina, D., additional, Caracciolo, G., additional, Grieco, A., additional, Rapaccini, G.L., additional, Siciliano, M., additional, Pompili, M., additional, and Gasbarrini, A., additional

Published
2014
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47. P.16.9 SHORT TREATMENT WITH RIFAXIMIN IMPROVES BLOOD CEREBRAL FLOW AT TRANSCRANIAL DOPPLER AND PSYCHOMETRIC TESTS IN CIRRHOTIC PATIENTS WITH MINIMAL HEPATIC ENCEPHALOPATHY

Author

Caracciolo, G., primary, Zocco, M.A., additional, Lupascu, A., additional, Annicchiarico, B.E., additional, Garcovich, M., additional, Ainora, M.E., additional, Roccarina, D., additional, D'Aversa, F., additional, Ferrarese, D., additional, Siciliano, M., additional, Tondi, P., additional, and Gasbarrini, A., additional

Published
2014
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48. P.16.15 FEASIBILITY AND ACCURACY OF ELASTPQ® SHEAR WAVE ELASTOGRAPHY TECHNIQUE AND DOPPLER INDICES IN THE NON-INVASIVE ASSESSEMENT OF LIVER FIBROSIS: A PRELIMINARY EXPERIENCE

Author

Garcovich, M., primary, Zocco, M.A., additional, Riccardi, L., additional, Roccarina, D., additional, Annicchiarico, B.E., additional, Ainora, M.E., additional, Caracciolo, G., additional, Ponziani, F.R., additional, Grieco, A., additional, Siciliano, M., additional, Pompili, M., additional, and Gasbarrini, A., additional

Published
2014
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49. Treatment of Portal Vein Tumor Thrombosis (PVTT) Can Impact Survival of Patients With Advanced HCC?

Author

Cesario, V, Rinninella, E, Ponziani, Fr, Garcovich, M, Roccarina, D, Campanale, M, Di Rienzo, Ta, Barbaro, F, Siciliano, M, Annicchiarico, Be, Pompili, M, Rapaccini, Gl, Riccardi, L, Grieco, A, Miele, L, Iezzi, R, De Gaetano, Am, Di Stasio, E, Gasbarrini, Gb, Bonomo, L, Zocco, Ma, Gasbarrini, A, Rinninella, E (ORCID:0000-0002-9165-2367), Ponziani, FR (ORCID:0000-0002-5924-6238), Annicchiarico, BE, Pompili, M (ORCID:0000-0001-6699-7980), Rapaccini, GL (ORCID:0000-0002-6467-857X), Miele, L (ORCID:0000-0003-3464-0068), Iezzi, R (ORCID:0000-0002-2791-481X), De Gaetano, AM (ORCID:0000-0002-7493-9462), Di Stasio, E (ORCID:0000-0003-1047-4261), Gasbarrini, GB, Bonomo, L (ORCID:0000-0001-5101-9367), Zocco, MA (ORCID:0000-0002-0814-9542), Gasbarrini, A (ORCID:0000-0002-7278-4823), Cesario, V, Rinninella, E, Ponziani, Fr, Garcovich, M, Roccarina, D, Campanale, M, Di Rienzo, Ta, Barbaro, F, Siciliano, M, Annicchiarico, Be, Pompili, M, Rapaccini, Gl, Riccardi, L, Grieco, A, Miele, L, Iezzi, R, De Gaetano, Am, Di Stasio, E, Gasbarrini, Gb, Bonomo, L, Zocco, Ma, Gasbarrini, A, Rinninella, E (ORCID:0000-0002-9165-2367), Ponziani, FR (ORCID:0000-0002-5924-6238), Annicchiarico, BE, Pompili, M (ORCID:0000-0001-6699-7980), Rapaccini, GL (ORCID:0000-0002-6467-857X), Miele, L (ORCID:0000-0003-3464-0068), Iezzi, R (ORCID:0000-0002-2791-481X), De Gaetano, AM (ORCID:0000-0002-7493-9462), Di Stasio, E (ORCID:0000-0003-1047-4261), Gasbarrini, GB, Bonomo, L (ORCID:0000-0001-5101-9367), Zocco, MA (ORCID:0000-0002-0814-9542), and Gasbarrini, A (ORCID:0000-0002-7278-4823)

Abstract

N/A

Published
2013

50. Liver transplantation in alcoholic patients: Impact of an alcohol addiction unit within a liver transplant center

Author

Addolorato, G., Mirijello, A., Leggio, L., Ferrulli, A., D'Angelo, C., Vassallo, G., Cossari, A., Gasbarrini, G., Landolfi, R., Agnes, S., Gasbarrini, A., Abbate, V., Abenavoli, L., Antonelli, M., Annicchiarico, E., Avolio, A. W., Biolato, M., Campanale, C., Capristo, E., Caputo, F., Cesario, V., Castagneto, M., Dematthaeis, N., Favale, C., Ferrarese, D., Garcovich, M., Frongillo, F., Grieco, A., Malandrino, N., Miele, L., Milani, A., Nesci, A., Nure, E., Pelecca, G., Pepe, G., Pietrogiacomi, P., Pizzolante, F., Pompili, M., Romana Ponziani, F., Rapaccini, G., Riccardi, L., Rinninella, E., Santoro, M. C., Sganga, G., Siciliano, M., Vero, V., Vonghia, L., Addolorato G. (ORCID:0000-0002-1522-9946), Mirijello A., D'Angelo C., Gasbarrini G., Landolfi R. (ORCID:0000-0002-7913-8576), Agnes S. (ORCID:0000-0002-3341-4221), Gasbarrini A. (ORCID:0000-0002-7278-4823), Antonelli M. (ORCID:0000-0003-3007-1670), Annicchiarico E., Avolio A. W. (ORCID:0000-0003-2491-7625), Capristo E. (ORCID:0000-0002-5753-3495), Caputo F., Cesario V., Frongillo F., Grieco A. (ORCID:0000-0002-0544-8993), Miele L. (ORCID:0000-0003-3464-0068), Milani A. (ORCID:0000-0003-1303-7737), Nesci A. (ORCID:0000-0001-9466-1755), Nure E., Pizzolante F., Pompili M. (ORCID:0000-0001-6699-7980), Rapaccini G. (ORCID:0000-0002-6467-857X), Riccardi L., Rinninella E. (ORCID:0000-0002-9165-2367), Sganga G. (ORCID:0000-0001-5079-0395), Siciliano M., Vero V., Vonghia L., Addolorato, G., Mirijello, A., Leggio, L., Ferrulli, A., D'Angelo, C., Vassallo, G., Cossari, A., Gasbarrini, G., Landolfi, R., Agnes, S., Gasbarrini, A., Abbate, V., Abenavoli, L., Antonelli, M., Annicchiarico, E., Avolio, A. W., Biolato, M., Campanale, C., Capristo, E., Caputo, F., Cesario, V., Castagneto, M., Dematthaeis, N., Favale, C., Ferrarese, D., Garcovich, M., Frongillo, F., Grieco, A., Malandrino, N., Miele, L., Milani, A., Nesci, A., Nure, E., Pelecca, G., Pepe, G., Pietrogiacomi, P., Pizzolante, F., Pompili, M., Romana Ponziani, F., Rapaccini, G., Riccardi, L., Rinninella, E., Santoro, M. C., Sganga, G., Siciliano, M., Vero, V., Vonghia, L., Addolorato G. (ORCID:0000-0002-1522-9946), Mirijello A., D'Angelo C., Gasbarrini G., Landolfi R. (ORCID:0000-0002-7913-8576), Agnes S. (ORCID:0000-0002-3341-4221), Gasbarrini A. (ORCID:0000-0002-7278-4823), Antonelli M. (ORCID:0000-0003-3007-1670), Annicchiarico E., Avolio A. W. (ORCID:0000-0003-2491-7625), Capristo E. (ORCID:0000-0002-5753-3495), Caputo F., Cesario V., Frongillo F., Grieco A. (ORCID:0000-0002-0544-8993), Miele L. (ORCID:0000-0003-3464-0068), Milani A. (ORCID:0000-0003-1303-7737), Nesci A. (ORCID:0000-0001-9466-1755), Nure E., Pizzolante F., Pompili M. (ORCID:0000-0001-6699-7980), Rapaccini G. (ORCID:0000-0002-6467-857X), Riccardi L., Rinninella E. (ORCID:0000-0002-9165-2367), Sganga G. (ORCID:0000-0001-5079-0395), Siciliano M., Vero V., and Vonghia L.

Abstract

Background: Many concerns about liver transplantation in alcoholic patients are related to the risk of alcohol recidivism. Starting from 2002, an Alcohol Addiction Unit (AAU) was formed within the liver transplant center for the management of alcoholic patients affected by end-stage liver disease and included in the waiting list for transplantation. We evaluated retrospectively the impact of the AAU on alcohol recidivism after transplantation. The relationship between alcohol recidivism and the duration of alcohol abstinence before transplant was evaluated as well. Methods: Between 1995 and 2010, 92 cirrhotic alcoholic patients underwent liver transplantation. Clinical evaluation and management of alcohol use in these patients was provided by psychiatrists with expertise in addiction medicine not affiliated to the liver transplant center before 2002 (n = 37; group A), or by the clinical staff of the AAU within the liver transplant center starting from 2002 (n = 55; group B). Results: Group B, as compared with group A, showed a significantly lower prevalence of alcohol recidivism (16.4 vs. 35.1%; p = 0.038) and a significantly lower mortality (14.5 vs. 37.8%; p = 0.01). Furthermore, an analysis of group B patients with either ≥6 or <6 months of alcohol abstinence before transplantation showed no difference in the rate of alcohol recidivism (21.1 vs. 15.4%; p = ns). Conclusions: The presence of an AAU within a liver transplant center reduces the risk of alcohol recidivism after transplantation. A pretransplant abstinence period <6 months might be considered, at least in selected patients managed by an AAU. © 2013 by the Research Society on Alcoholism.

Published
2013

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