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1. Mediterranean diet and the prevention of non-alcoholic fatty liver disease: results from a case-control study

Author

Giraldi, Luca, Miele, Luca, Aleksovska, K., Manca, F., Leoncini, Emanuele, Biolato, Marco, Arzani, D., Pirro, Maria Antonia, Marrone, Giuseppe, Cefalo, Chiara Maria Assunta, Racco, S., Liguori, Antonio, Rapaccini, Gian Ludovico, Miggiano, G. A., Gasbarrini, Antonio, Boccia, Stefania, and Grieco, Antonio

Subjects
Adult, Male, Epidemiology, Settore MED/12 - GASTROENTEROLOGIA, Rome, Feeding Behavior, Case-control, Middle Aged, Protective Factors, Diet, Mediterranean, Risk Assessment, Non-alcoholic Fatty Liver Disease, Risk Factors, Mediterranean diet, Prevalence, Humans, Female, Diet, Healthy, Risk Reduction Behavior, Aged, Retrospective Studies
Abstract

Few studies report that Mediterranean dietary (MD) pattern has a beneficial role in the progression of non-alcoholic fatty liver disease (NAFLD). Evidence on its potential effect on the onset of disease are, however, scanty. With our study, we evaluated whether MD affects the risk of NAFLD with a large case-control study performed in Italy.Three hundred and seventy-one cases of NAFLD and 444 controls were questioned on the demographic data and their dietary habits before diagnosis. Additionally, information about lifestyles and other related diseases, such as hypertension and diabetes mellitus were collected. The MD adherence was assessed using a pre-defined Mediterranean Diet Score (MDS). Odds ratios (OR) and 95% confidence intervals (CI) were obtained using a multiple logistic regression model.A high adherence to the MD is significantly associated with decreased risk of NAFLD (OR: 0.83 95% CI: 0.71-0.98). When the different MD components were examined separately, higher legumes consumption (OR: 0.62 95% CI: 0.38-0.99) and high fish consumption (OR 0.38 95% CI: 0.17-0.85) were reported to be protective against NAFLD.Our study shows that a high adherence to the MD decreases the risk of NAFLD.

Published
2020

2. Role of troponin in COVID-19 pandemic: A review of literature

Author

Piccioni, Andrea, Brigida, M., Loria, Valentina, Zanza, Christian, Longhitano, Y., Zaccaria, R., Racco, S., Gasbarrini, Antonio, Ojetti, Veronica, Franceschi, Francesco, Candelli, Marcello, Piccioni A., Loria V., Zanza C., Gasbarrini A. (ORCID:0000-0002-7278-4823), Ojetti V. (ORCID:0000-0002-8953-0707), Franceschi F. (ORCID:0000-0001-6266-445X), Candelli M. (ORCID:0000-0001-8443-7880), Piccioni, Andrea, Brigida, M., Loria, Valentina, Zanza, Christian, Longhitano, Y., Zaccaria, R., Racco, S., Gasbarrini, Antonio, Ojetti, Veronica, Franceschi, Francesco, Candelli, Marcello, Piccioni A., Loria V., Zanza C., Gasbarrini A. (ORCID:0000-0002-7278-4823), Ojetti V. (ORCID:0000-0002-8953-0707), Franceschi F. (ORCID:0000-0001-6266-445X), and Candelli M. (ORCID:0000-0001-8443-7880)

Abstract

Acute SARS-CoV-2 respiratory disease is an infectious respiratory disease caused by the virus SARS-CoV-2 belonging to the coronaviridae family. A pandemic is still present as of May 2020. In addition to causing pneumonia, SARS-CoV-2 may induce a direct damage to the heart, causing myocarditis, with significant impairment of cardiac contractility, and/or pericarditis. Elderly patients and those with cardiovascular risk factors, such as hypertension and diabetes mellitus, are at increased risk of heart complications from COVID-19. In this review, we focused on the correlation between COVID-19 infection and the high sensitivity troponin T and I, and their significance in the development of myocarditis. Data emerging from the studies so far conducted indicate that a high value of high-sensitivity troponin represents a negative prognostic indicator when associated with heart damage on an infectious-inflammatory basis (i.e. myopericarditis). We should identify a safe and clear diagnostic algorithm, possibly combining patient clinical history, troponin levels and cardiac ultrasound findings that could help us in the prediction of myopericarditis.

Published
2020

3. 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

4. Magnesium sulphate in the Emergency Department: an old, new friend

Author

Gilardi, E., Marsiliani, D., Nicolò, R., Petrucci, Martina, Torelli, Enrico, Racco, S., DI MAURIZIO, L., Saviano, Angela, Biscione, G., Giannuzzi, R., Covino, Marcello, Merra, Giuseppe, and Franceschi, Francesco

Subjects
Lung Diseases, Settore MED/09 - MEDICINA INTERNA, Atrial and ventricular arrhythmias, Magnesium sulphate, Arrhythmias, Cardiac, Acute asthma exacerbation, Asthma, Heart Arrest, Magnesium Sulfate, Cardiovascular Diseases, Pregnancy, Humans, migraine, Eclampsia, Female, Emergency Service, Hospital
Abstract

With our study, we searched the medical literature to find magnesium (Mg) correlation with Emergency situations or its use in Emergency Medicine. Our aim is to fill the gap that we find in our daily routine between Mg studies on its role in Emergency and the real conception that doctors have of it in medical practice. We searched the literature for terms as magnesium or magnesium sulphate, magnesium in emergency, eclampsia, arrhythmias, acute asthma exacerbation, magnesium, and pediatric population. After a thorough research, we divided our discoveries into chapters to sort out a large amount often discordant articles.

Published
2019

5. Role of troponin in COVID-19 pandemic: a review of literature.

Author

PICCIONI, A., BRIGIDA, M., LORIA, V., ZANZA, C., LONGHITANO, Y., ZACCARIA, R., RACCO, S., GASBARRINI, A., OJETTI, V., FRANCESCHI, F., and CANDELLI, M.

Abstract

Acute SARS-CoV-2 respiratory disease is an infectious respiratory disease caused by the virus SARS-CoV-2 belonging to the coronaviridae family. A pandemic is still present as of May 2020. In addition to causing pneumonia, SARS-CoV-2 may induce a direct damage to the heart, causing myocarditis, with significant impairment of cardiac contractility, and/or pericarditis. Elderly patients and those with cardiovascular risk factors, such as hypertension and diabetes mellitus, are at increased risk of heart complications from COVID-19. In this review, we focused on the correlation between COVID-19 infection and the high sensitivity troponin T and I, and their significance in the development of myocarditis. Data emerging from the studies so far conducted indicate that a high value of high-sensitivity troponin represents a negative prognostic indicator when associated with heart damage on an infectious-inflammatory basis (i.e. myopericarditis). We should identify a safe and clear diagnostic algorithm, possibly combining patient clinical history, troponin levels and cardiac ultrasound findings that could help us in the prediction of myopericarditis. [ABSTRACT FROM AUTHOR]

Published
2020

6. Field-practice study of sorafenib therapy for hepatocellular carcinoma: a prospective multicenter study in Italy

Author

Iavarone, M, Piscaglia, F, Zavaglia, C, Grieco, A, Villa, E, Colombo, M, Sangiovanni, A, Vavassori, S, Romeo, R, Borghi, A, Granito, A, Bolondi, L, Airoldi, A, Pinzello, G, Biolato, M, Racco, S, Pompili, M, Lei, B, De Maria, N., CABIBBO, Giuseppe, CAMMA', Calogero, DI MARCO, Vito, CRAXI, Antonio, Iavarone, M, Cabibbo, G, Piscaglia, F, Zavaglia, C, Grieco, A, Villa, E, Cammà, C, Colombo, M, Sangiovanni, A, Vavassori, S, Romeo, R, Di Marco, V, Craxì, A, Borghi, A, Granito, A, Bolondi, L, Airoldi, A, Pinzello, G, Biolato, M, Racco, S, Pompili, M, Lei, B, De Maria, N, Iavarone M, Cabibbo G, Piscaglia F, Zavaglia C, Grieco A, Villa E, Cammà C, Colombo M, Sangiovanni A, Vavassori S, Romeo R, di Marco V, Craxì A, Borghi A, Granito A, Bolondi L, Airoldi A, Pinzello G, Bidato M, Racco S, Pompili M, Lei B, and De Maria N.

Subjects
Sorafenib, Niacinamide, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Drug-Related Side Effects and Adverse Reactions, Pyridines, Antineoplastic Agents, EPATOCARCINOMA, law.invention, Randomized controlled trial, law, Drug Toxicity, Internal medicine, medicine, Humans, Prospective Studies, HCC, Prospective cohort study, Survival analysis, Aged, sorafenib, Hepatology, business.industry, Phenylurea Compounds, Benzenesulfonates, Liver Neoplasms, Carcinoma, Settore MED/09 - MEDICINA INTERNA, Hepatocellular, Middle Aged, medicine.disease, Survival Analysis, digestive system diseases, Surgery, Hepatocellular carcinoma, sorafenib, Regimen, TUMORI DEL FEGATO, Tolerability, Italy, Hepatocellular carcinoma, Disease Progression, Female, Liver cancer, business, medicine.drug
Abstract

A multicenter randomized controlled trial established sorafenib as a standard of care for patients with advanced hepatocellular carcinoma (HCC). Because the study was prematurely interrupted due to survival benefits in the sorafenib arm, we conducted an observational study to adequately assess risks and benefits of this regimen in field practice. Starting in 2008, all clinically compensated patients with advanced HCC and those with an intermediate HCC who were unfit or failed to respond to ablative therapies were consecutively evaluated in six liver centers in Italy, for tolerability as well as radiologic and survival response to 800-mg/d sorafenib therapy. Treatment was down-dosed or interrupted according to drug label. Two hundred ninety-six patients (88% Child-Pugh A, 75% Barcelona Clinic Liver Cancer [BCLC]-C, and 25% BCLC-B) received sorafenib for 3.8 months (95% CI 3.3-4.4). Two hundred sixty-nine (91%) patients experienced at least one adverse event (AE), whereas 161 (54%) had to reduce dosing. Treatment was interrupted in 103 (44%) for disease progression, in 95 (40%) for an AE, and in 38 (16%) for liver deterioration. The median survival was 10.5 months in the overall cohort, 8.4 months in BCLC-C versus 20.6 months in BCLC-B patients (P < 0.0001), and 21.6 months in the 77 patients treated for >70% of the time with a half dose versus 9.6 months in the 219 patients treated for >70% of the time with a full dose. At month 2 of treatment, the overall radiologic response was 8%. Eastern Cooperative Oncology Group performance status, macrovascular invasion, extrahepatic spread of the tumor, radiologic response at month 2, and sorafenib dosing were independent predictors of shortened survival. Conclusion: Overall, safety, effectiveness, and generalizability of sorafenib therapy in HCC was validated in field practice. The effectiveness of half-dosed sorafenib may have implications for tailored therapy.

Published
2011

9. Prospective Italian multicenter field-practice study with sorafenib for advanced hepatocellular carcinoma

Author

Iavarone M., Cabibbo G., Sangiovanni A., Camma C., Zavaglia C., Grieco A., Airoldi A., Biolato M., Di Marco V., Pinzello G. B., Racco S., Craxi A., Colombo M., BORGHI, ALBERTO, GRANITO, ALESSANDRO, PISCAGLIA, FABIO, BOLONDI, LUIGI, Iavarone M., Cabibbo G., Sangiovanni A., Camma C., Borghi A., Zavaglia C., Grieco A., Granito A., Airoldi A., Biolato M., Di Marco V., Piscaglia F., Pinzello G.B., Racco S., Bolondi L., Craxi A., and Colombo M.

Subjects
HEPATOCELLULAR CARCINOMA
Published
2011

10. Hepatocellular carcinoma treated by conventional transarterial chemoembolization in field-practice: Serum sodium predicts survival

Author

Biolato, M., Miele, L., Vero, V., Racco, S., Stasi, C. D., Iezzi, R., Zanche, A., Pompili, M., Rapaccini, G. L., LA TORRE, Giuseppe, Torre, G. L., Gasbarrini, A., and Grieco, A.

Subjects
Sorafenib, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Time Factors, Settore MED/12 - GASTROENTEROLOGIA, Kaplan-Meier Estimate, Gastroenterology, Tertiary Care Centers, Risk Factors, Internal medicine, medicine, Retrospective Cohort Study, Humans, Chemoembolization, Therapeutic, Aged, Proportional Hazards Models, Retrospective Studies, business.industry, Proportional hazards model, Liver Neoplasms, Sodium, Retrospective cohort study, Model for end-stage liver disease sodium, General Medicine, Hepatitis B, Middle Aged, medicine.disease, Alkaline Phosphatase, digestive system diseases, Surgery, Portal vein thrombosis, sorafenib, chemoembolization, liver cancer, model for end-stage liver disease sodium, hyponatremia, Treatment Outcome, Hepatocellular carcinoma, Multivariate Analysis, Chemoembolization, Female, alpha-Fetoproteins, Hyponatremia, Liver cancer, business, medicine.drug
Abstract

AIM: To assess the prognostic role of baseline clinical, biochemical and radiological characteristics of patients with hepatocellular carcinoma (HCC) treated with the first transarterial chemoembolization (TACE) procedure. METHODS: Patients with HCC treated with conventional TACE in a tertiary care setting from 1997 to 2008 were retrospectively reviewed. Predictors of survival were identified using the Cox proportional regression model. RESULTS: Two hundred and seventy patients were included. Median age was 66 years, 81% were male, 58% were HCV-positive, 18% hepatitis B surface antigen-positive, 64% had a Child A status, 40% patients had a largest nodule diameter ≥ 5 cm and 32% had more than 3 tumor nodules. Median overall survival of the whole cohort was 25 mo (95%CI: 21.8-28.2) and the 1-, 2- and 3-year probability of survival was 80%, 50% and 31%, respectively. Non-tumor segmental portal vein thrombosis (HR = 1.76, 95%CI: 1.22-2.54), serum sodium (HR = 1.65, 95%CI: 1.25-2.18), diameter of largest nodule (HR = 1.59, 95%CI: 1.22-2.091), number of nodules (HR = 1.41, 95%CI: 1.06-1.88), alpha-fetoprotein (HR = 1.35, 95%CI: 1.03-1.76) and alkaline phosphatase (HR = 1.33, 95%CI: 1.01-1.74) were independent prognostic factors for overall survival on multivariate analysis. CONCLUSION: The inclusion of serum sodium alongside the already known prognostic factors may allow a better prognostic definition of patients with HCC as candidates for conventional TACE.

Published
2014

11. Prognostic Validation of Proposed BCLC-B Substaging System in Hepatocellular Carcinoma Patients Treated by Transarterial Chemoembolization

Author

Biolato, M., primary, Gallusi, G., additional, Iavarone, M., additional, Cabibbo, G., additional, Racco, S., additional, Santis, A.D., additional, Della Corte, C., additional, Maida, M., additional, Attili, A.F., additional, Sangiovanni, A., additional, Cammà, C., additional, La Torre, G., additional, Gasbarrini, A., additional, and Grieco, A., additional

Published
2016
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14. Cardiovascular risk and inflammation in nonalcoholic fatty liver disease: The upregulation of inflammatory platelet transcripts suggest a role for platelets in the “inflammatory network” of NAFLD

Author

Alberelli, M.A., primary, Miele, L., additional, Racco, S., additional, Biolato, M., additional, Marrone, G., additional, Cefalo, C., additional, Landolfi, R., additional, Gasbarrini, A., additional, De Candia, E., additional, and Grieco, A., additional

Published
2015
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15. Heparanase in NASH: Is it an useful marker of fibrogenesis?

Author

Marrone, G., primary, Miele, L., additional, Racco, S., additional, Cefalo, C., additional, Masola, V., additional, Onisto, M., additional, Vecchio, F.M., additional, Pompili, M., additional, Rapaccini, G.L., additional, Biolato, M., additional, Gasbarrini, A., additional, Gambaro, G., additional, and Grieco, A., additional

Published
2015
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16. ELF TEST IS A RELIABLE TOOL FOR NON-INVASIVE DIAGNOSIS OF LIVER FIBROSIS IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE

Author

Miele, L., primary, Isgrò, M.A., additional, De Michele, T., additional, Marrone, G., additional, Cefalo, C., additional, Racco, S., additional, Viti, L., additional, Giannace, A., additional, Morlacchi, C., additional, Rapaccini, G.L., additional, Gasbarrini, A., additional, Zuppi, C., additional, and Grieco, A., additional

Published
2015
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19. PREVALENCE OF LIVER STEATOSIS AND METABOLIC SYNDROME IN PATIENTS WITH PSORIASIS

Author

Miele, Luca, De Simone, Clara, Cefalo, Chiara Maria Assunta, Vallone, S, Gabrieli, Ml, Forgione, Alessandra, D'Agostino, Maria Antonietta, Bussoletti, C, Capizzi, Rodolfo, Racco, S, Pompilil, M, Gasbarrini, Giovanni Battista, Amerio, P, Rapaccini, Gian Ludovico, and Grieco, A

Subjects
N/A, Settore MED/12 - GASTROENTEROLOGIA
Published
2008

21. Pilot Study on the Role of Multidisciplinary Approach in Risk Reduction of Risk of Non- alcoholic Fatty Liver in Subjects with Eating Disorders

Author

Cefalo, C, Strangio, A, Miele, L, Rinaldi, L, Marrone, G, Racco, S, Zanche, A, Rapaccini, Gl, Bria, P, Gasbarrini, A, Grieco, A, Miele, L (ORCID:0000-0003-3464-0068), Rapaccini, GL (ORCID:0000-0002-6467-857X), Gasbarrini, A (ORCID:0000-0002-7278-4823), Cefalo, C, Strangio, A, Miele, L, Rinaldi, L, Marrone, G, Racco, S, Zanche, A, Rapaccini, Gl, Bria, P, Gasbarrini, A, Grieco, A, Miele, L (ORCID:0000-0003-3464-0068), Rapaccini, GL (ORCID:0000-0002-6467-857X), and Gasbarrini, A (ORCID:0000-0002-7278-4823)

Abstract

N/A

Published
2013

23. SERUM SODIUM IS A PREDICTOR OF SURVIVAL FOR 'INTERMEDIATE HCC' TREATED WITH TRANSARTERIAL CHEMIOEMBOLIZATION (TACE)

Author

Vero, V, Racco, S, Gabrieli, Ml, Pompili, M, Marrone, G, Forgione, A, Biolato, M, Cefalo, C, Di Stasi, C, Miele, L, Rapaccini, Gl, Grieco, A, Pompili, M (ORCID:0000-0001-6699-7980), Di Stasi, C (ORCID:0000-0002-6822-3599), Miele, L (ORCID:0000-0003-3464-0068), Rapaccini, GL (ORCID:0000-0002-6467-857X), Vero, V, Racco, S, Gabrieli, Ml, Pompili, M, Marrone, G, Forgione, A, Biolato, M, Cefalo, C, Di Stasi, C, Miele, L, Rapaccini, Gl, Grieco, A, Pompili, M (ORCID:0000-0001-6699-7980), Di Stasi, C (ORCID:0000-0002-6822-3599), Miele, L (ORCID:0000-0003-3464-0068), and Rapaccini, GL (ORCID:0000-0002-6467-857X)

Abstract

N/A

Published
2009

24. THE 15 AND 30 MINUTES SAMPLING OF 13C-BREATH TESTING ARE ABLE TO PREDICT SEVERE HEPATIC FIBROSIS AND SEVERITY OF LIVER DISEASE

Author

Miele, L, Candelli, M, Marrone, G, Zocco, Ma, Biolato, M, Gigante, G, Racco, S, Cefalo, C, Pompili, M, Rapaccini, Gl, Grieco, A, Gasbarrini, A, Miele, L (ORCID:0000-0003-3464-0068), Candelli, M (ORCID:0000-0001-8443-7880), Zocco, MA (ORCID:0000-0002-0814-9542), Pompili, M (ORCID:0000-0001-6699-7980), Rapaccini, GL (ORCID:0000-0002-6467-857X), Gasbarrini, A (ORCID:0000-0002-7278-4823), Miele, L, Candelli, M, Marrone, G, Zocco, Ma, Biolato, M, Gigante, G, Racco, S, Cefalo, C, Pompili, M, Rapaccini, Gl, Grieco, A, Gasbarrini, A, Miele, L (ORCID:0000-0003-3464-0068), Candelli, M (ORCID:0000-0001-8443-7880), Zocco, MA (ORCID:0000-0002-0814-9542), Pompili, M (ORCID:0000-0001-6699-7980), Rapaccini, GL (ORCID:0000-0002-6467-857X), and Gasbarrini, A (ORCID:0000-0002-7278-4823)

Abstract

N/A

Published
2009

25. Abdominal angina due to recurrence of cancer of the papilla of vater: a case report.

Author

Biolato, Marco, Gabrieli, Maria Letizia, Parente, Antonio, Racco, S., Costantini, Melania, Bonomo, Lorenzo, Rapaccini, Gian Ludovico, Gasbarrini, Giovanni Battista, Grieco, Antonio, Bonomo, Lorenzo (ORCID:0000-0001-5101-9367), Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), Grieco, Antonio (ORCID:0000-0002-0544-8993), Biolato, Marco, Gabrieli, Maria Letizia, Parente, Antonio, Racco, S., Costantini, Melania, Bonomo, Lorenzo, Rapaccini, Gian Ludovico, Gasbarrini, Giovanni Battista, Grieco, Antonio, Bonomo, Lorenzo (ORCID:0000-0001-5101-9367), Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), and Grieco, Antonio (ORCID:0000-0002-0544-8993)

Abstract

Abdominal angina is usually caused by atherosclerotic disease, and other causes are considered uncommon. This is the first report of a case of abdominal angina secondary to neoplastic vascular stenosis caused by local recurrence of an adenocarcinoma of the papilla of Vater. CASE PRESENTATION: An 80-year-old woman of Caucasian origin presented with abdominal pain and diarrhea. She had undergone a pancreaticoduodenectomy for adenocarcinoma of the papilla of Vater four years earlier. Computed tomography revealed a mass surrounding her celiac trunk and superior mesenteric artery. Her abdominal pain responded poorly to analgesic drugs, but disappeared when oral feedings were withheld. A duplex ultrasonography of the patient's splanchnic vessels was consistent with vascular stenosis. Parenteral nutrition was started and the patient remained pain free until her death. CONCLUSION: Pain relief is an important therapeutic target in patients with cancer. In this case, abdominal pain was successfully managed only after the ischemic cause had been identified. The conventional analgesic therapy algorithm based on nonsteroidal anti-inflammatory drugs and opioids had been costly and pointless, whereas the simple withdrawal of oral feeding spared the patient of the discomfort of additional invasive procedures and allowed her to spend her remaining days in a completely pain-free state.

Published
2009

26. P.13.8 THE IMPACT OF BASELINE CHARACTERISTICS ON THE SURVIVAL IN A COHORT OF 270 PATIENTS WITH HEPATOCELLULAR CARCINOMA TREATED WITH TRANSARTERIAL CHEMOEMBOLIZATION: A SINGLE CENTER STUDY

Author

Biolato, M., primary, Vero, V., additional, Racco, S., additional, Di Stasi, C., additional, Zanché, A., additional, Miele, L., additional, Pompili, M., additional, Rapaccini, G.L., additional, Siciliano, M., additional, Gasbarrini, A., additional, and Grieco, A., additional

Published
2013
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27. F-40 The impact of baseline characteristics on the survival in a cohort of 270 patients with hepatocellular carcinoma treated with transarterial chemoembolization: a single center study

Author

Biolato, M., primary, Vero, V., additional, Racco, S., additional, Di Stasi, C., additional, Villani, R., additional, Zanché, A., additional, Miele, L., additional, Pompili, M., additional, Rapaccini, G.L., additional, Siciliano, M., additional, Gasbarrini, A., additional, and Grieco, A., additional

Published
2013
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28. OC-1 Prospective Italian multicenter field-practice study with sorafenib for advanced hepatocellular carcinoma

Author

Iavarone, M., primary, Cabibbo, G., additional, Sangiovanni, A., additional, Cammà, C., additional, Borghi, A., additional, Zavaglia, C., additional, Grieco, A., additional, Granito, A., additional, Airoldi, A., additional, Biolato, M., additional, Di Marco, V., additional, Piscaglia, F., additional, Pinzello, G.B., additional, Racco, S., additional, Bolondi, L., additional, Craxì, A., additional, and Colombo, M., additional

Published
2011
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32. PA.92 A PROPOSAL MODEL FOR THE NON-INVASIVE ASSESSMENT OF HISTOLOGICAL INFLAMMATION IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD)

Author

Forgione, A., primary, Miele, L., additional, Cefalo, C., additional, Caprodossi, A., additional, Vellone, V., additional, Racco, S., additional, Gabrieli, M.L., additional, Vero, V., additional, Biolato, M., additional, Vecchio, F.M., additional, Gasbarrini, G., additional, and Grieco, A., additional

Published
2008
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33. PA.93 EFFECT OF 6 MONTHS METFORMIN THERAPY ON LIVER FUNCTION TEST IN PATIENTS WITH POLYCYSTIC OVARY SYNDROME (PCOS)

Author

Miele, L., primary, Cefalo, C., additional, Martinez, D., additional, Forgione, A., additional, Pompili, M., additional, Sagnella, F., additional, Racco, S., additional, Vero, V., additional, Gabrieli, M.L., additional, Biolato, M., additional, Lanzone, A., additional, Apa, R., additional, Gasbarrini, G., additional, and Grieco, A., additional

Published
2008
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34. Transarterial chemoembolization (TACE) for unresectable HCC: A new life begins?

Author

BIOLATO, M., MARRONE, G., RACCO, S., DI STASI, C., MIELE, L., GASBARRINI, G., LANDOLFI, R., and GRIECO, A.

Abstract

Background and Objectives: to provide an overview on the loco-regional therapy performed by transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC), either as sole, either as neoadjuvant to surgery or bridge therapy to orthotopic liver transplantation (OLT). Evidence and Information Sources: The current review is based on an analysis of the current literature and the caseload experience of the Authors on this topic. State of the Art: Chemoembolization combines de-arterialization of the tumor and selective delivery of chemotherapeutic agents into tumor's feeding vessels during angiography. Tumor ischemia raises the drug concentration compared to infusion alone and extends the retention of the chemotherapeutic drug. As locoregional therapy, TACE allows a complete local tumor control of 25-35% and permits an increase of survival in patients with intermediate HCC according to Barcelona-Clinic Liver Cancer (BCLC) classification. Excellent results were also achieved by combined therapies, such as with percutaneous ethanol injection or radio-frequency ablation, as neoadjuvant therapy prior to liver resection and in some circumstances as a bridging tool before liver transplantation. Perspectives: Drug eluting beads are microspheres that can be loaded with doxorubicin and induce toxic and ischemic necrosis with the same device; that allows an increase of drug selectively exposed to tumor cells and simultaneously a reduction of systemic toxicity. Tumor embolization induces a neoangiogenic reaction with a significant growth of adiacent satellites, so the association with sorafenib has a strong rationale for a combined therapy and is currently under investigation. Conclusions: today TACE is the standard of care for treatment of intermediate hepatocellular carcinoma. To get the best performance it should be tailored according to the individual patient's condition. [ABSTRACT FROM AUTHOR]

Published
2010

37. Transarterial chemoembolization (TACE) for unresectable HCC: A new life begins?

Author

Biolato M, Marrone G, Racco S, Di Stasi C, Luca Miele, Gasbarrini G, Landolfi R, and Grieco A

Subjects
Settore MED/06 - ONCOLOGIA MEDICA, Carcinoma, Hepatocellular, Hepatocellular carcinoma, Settore MED/09 - MEDICINA INTERNA, Liver Neoplasms, Angiogenesis Inhibitors, Sorafenib, Drug eluting beads, Combined Modality Therapy, Humans, Chemoembolization, Chemoembolization, Therapeutic, Liver cancer, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA
Abstract

To provide an overview on the loco-regional therapy performed by transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC), either as sole, either as neoadjuvant to surgery or bridge therapy to orthotopic liver transplantation (OLT).The current review is based on an analysis of the current literature and the caseload experience of the Authors on this topic.Chemoembolization combines de-arterialization of the tumor and selective delivery of chemotherapeutic agents into tumor's feeding vessels during angiography. Tumor ischemia raises the drug concentration compared to infusion alone and extends the retention of the chemotherapeutic drug. As locoregional therapy, TACE allows a complete local tumor control of 25-35% and permits an increase of survival in patients with intermediate HCC according to Barcelona-Clinic Liver Cancer (BCLC) classification. Excellent results were also achieved by combined therapies, such as with percutaneous ethanol injection or radiofrequency ablation, as neoadjuvant therapy prior to liver resection and in some circumstances as a bridging tool before liver transplantation.Drug eluting beads are microspheres that can be loaded with doxorubicin and induce toxic and ischemic necrosis with the same device; that allows an increase of drug selectively exposed to tumor cells and simultaneously a reduction of systemic toxicity. Tumor embolization induces a neoangiogenic reaction with a significant growth of adiacent satellites, so the association with sorafenib has a strong rationale for a combined therapy and is currently under investigation.Today TACE is the standard of care for treatment of intermediate hepatocellular carcinoma. To get the best performance it should be tailored according to the individual patient's condition.

38. [The treatment of hepatocellular carcinoma: an update]

Author

Vero V, Racco S, Biolato M, Pompili M, Gasbarrini G, Luca Miele, and Grieco A

Subjects
Carcinoma, Hepatocellular, Settore MED/12 - GASTROENTEROLOGIA, Brachytherapy, Liver Neoplasms, Carcinoma, Settore MED/09 - MEDICINA INTERNA, Antineoplastic Agents, Hepatocellular, Prognosis, Embolization, Therapeutic, Liver Transplantation, Embolization, Hepatectomy, Humans, Therapeutic, Neoplasm Staging
Abstract

Hepatocellular carcinoma (HCC) is the third most frequent cause of death from cancer with an increasing incidence in the world. Hepatic cirrhosis is the main risk factor for the development of this tumor, present in more than 80% of cases. The prognosis of this tumor is still poor and appears to be strictly related to liver residual function and tumor extension. A regular surveillance program was defined to increase early detection of tumor in cirrhotic patients when curative treatment could be applied. Liver transplantation and liver resection offer a high rate of positive response when applied in a early stage of the disease; locoregional therapies are effective, palliative options for patients with unresectable HCC: transarterial chemoembolisation being the only with a proven positive impact on survival. Several prognostic systems are proposed in the last years to stratify patients in different risk groups and to identify those who could achieve the best survival benefit from different therapeutic strategies: the Okuda system, the Cancer of the Liver Italian Program and the Barcelona Clínic Liver Cancer are the most widely used, but there is no consensus to which is the best in predicting outcome most accurately.

39. Intestinal permeability after Mediterranean diet and low-fat diet in non-alcoholic fatty liver disease.

Author

Biolato M, Manca F, Marrone G, Cefalo C, Racco S, Miggiano GA, Valenza V, Gasbarrini A, Miele L, and Grieco A

Subjects
Adult, Body Mass Index, Body Weight, Chromium Radioisotopes chemistry, Chromium Radioisotopes pharmacokinetics, Cross-Over Studies, Edetic Acid chemistry, Edetic Acid pharmacokinetics, Female, Humans, Male, Non-alcoholic Fatty Liver Disease metabolism, Overweight metabolism, Permeability, Prospective Studies, Treatment Outcome, Waist Circumference, Diet, Fat-Restricted, Diet, Mediterranean, Intestinal Mucosa metabolism, Non-alcoholic Fatty Liver Disease diet therapy, Overweight diet therapy
Abstract

Background: In non-alcoholic fatty liver disease (NAFLD), a high-fat or high-fructose diet increases intestinal permeability and promotes derangement of the gut-liver axis. We hypothesize that, diet could be able to modulate intestinal permeability in patients with NAFLD., Aim: To detect diet-induced modification of intestinal permeability in patients with NAFLD undergoing a Mediterranean diet or a low-fat diet., Methods: The current study was a dietary intervention for non-diabetic, patients with biopsy-verified NAFLD and increased transaminases. A crossover design was employed: participants underwent 16 weeks of Mediterranean diet, 16 wk of free wash-out, and 16 weeks of low-fat diet. Both diets were hypocaloric and no consumption of supplements was allowed. All patients were followed bimonthly by a dietitian. Evaluations of clinical and metabolic parameters were completed at baseline and at the end of each dietary period. Intestinal permeability was assessed by chromium-51 ethylene diamine tetraacetate excretion testing (51Cr-EDTA)., Results: Twenty Caucasian patients, 90% male, median age 43 years, body mass index (BMI) 30.9, with biopsy-verified NAFLD were enrolled. At the end of 16 weeks of a Mediterranean diet, a significant reduction in mean body weight (-5.3 ± 4.1 kg, P = 0.003), mean waist circumference (-7.9 ± 4.9 cm, P = 0.001), and mean transaminase levels [alanine aminotransferase (ALT) -28.3 ± 11.9 IU/L, P = 0.0001; aspartate aminotransferase (AST) -6.4 ± 56.3 IU/L, P = 0.01] were observed. These benefits were maintained after 16 wk of wash-out and also after 16 wk of low-fat diet, without further improvements. Fourteen of the 20 patients had intestinal permeability alteration at baseline (mean percentage retention of 51Cr-EDTA = 5.4%), but no significant changes in intestinal permeability were observed at the end of the 16 wk of the Mediterranean diet or 16 wk of the low-fat diet., Conclusion: Mediterranean diet is an effective strategy for treating overweight, visceral obesity and serum transaminase in patients with NAFLD. If the Mediterranean diet can improve intestinal permeability in patients with NAFLD, it deserves further investigation., Competing Interests: Conflict-of-interest statement: There are no conflicts of interest to report.

Published
2019
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40. Prognostic ability of BCLC-B Subclassification in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization.

Author

Biolato M, Gallusi G, Iavarone M, Cabibbo G, Racco S, De Santis A, Corte CD, Maida M, Attili AF, Sangiovanni A, Cammà C, La Torre G, Gasbarrini A, and Grieco A

Subjects
Aged, Aged, 80 and over, Carcinoma, Hepatocellular mortality, Carcinoma, Hepatocellular pathology, Female, Humans, Italy, Kaplan-Meier Estimate, Liver Neoplasms mortality, Liver Neoplasms pathology, Male, Middle Aged, Multivariate Analysis, Predictive Value of Tests, Proportional Hazards Models, Retrospective Studies, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Carcinoma, Hepatocellular therapy, Chemoembolization, Therapeutic adverse effects, Chemoembolization, Therapeutic mortality, Decision Support Techniques, Liver Neoplasms therapy, Neoplasm Staging methods
Abstract

Prognostic ability of BCLC-B Subclassification in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization Background and aims. A subclassification system for intermediate hepatocellular carcinoma (HCC) was recently proposed to optimize treatment allocation. The aim of this study was to assess the prognostic ability of that substaging proposal., Patients and Methods: This is a retrospective multicenter cohort study including patients with intermediate HCC treated with transarterial chemoembolization (TACE). Predictors of survival were identified using the Cox proportional regression model., Results: 289 Barcelona Clinic Liver Cancer (BCLC) B patients were included. Median overall survival of the whole cohort was 23 months (C.I. 95% 20.2- 25.8). Child A status (H.R. 1.35, C.I. 95% 1.02-1.78) and tumour burden beyond the up-to-seven criterion (H.R. 1.39, C.I. 95% 1.07- 1.80) were independent prognostic factors for overall survival on multivariate analysis. Analysis of the substages showed that median survival was 33.0 months for B1 stage (n = 81), 20.8 months for B2 stage (n = 106), 16.1 months for B3 stage (n = 24), 22.2 months for B4 stage (n = 42) and 15.0 months for quasi-C stage (n = 36). Regarding the discriminatory ability of the substaging proposal, the log rank test showed a significant survival difference for B1vs. B4 (p = 0.003) and B1 vs. Quasi-C (p = 0.039) and a trend for B1 vs. B2 (p = 0.05) and B1 vs. B3 (p = 0.05)., Conclusions: Apart from substage B1, BCLC-B subclassification does not discriminate perfectly patients treated with TACE. Also some patients in substage B4 can benefit from TACE.

Published
2018
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41. Hepatocellular carcinoma treated by conventional transarterial chemoembolization in field-practice: serum sodium predicts survival.

Author

Biolato M, Miele L, Vero V, Racco S, Di Stasi C, Iezzi R, Zanché A, Pompili M, Rapaccini GL, La Torre G, Gasbarrini A, and Grieco A

Subjects
Aged, Alkaline Phosphatase blood, Carcinoma, Hepatocellular blood, Carcinoma, Hepatocellular mortality, Female, Humans, Kaplan-Meier Estimate, Liver Neoplasms blood, Liver Neoplasms mortality, Male, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Retrospective Studies, Risk Factors, Tertiary Care Centers, Time Factors, Treatment Outcome, alpha-Fetoproteins analysis, Carcinoma, Hepatocellular therapy, Chemoembolization, Therapeutic adverse effects, Chemoembolization, Therapeutic mortality, Liver Neoplasms therapy, Sodium blood
Abstract

Aim: To assess the prognostic role of baseline clinical, biochemical and radiological characteristics of patients with hepatocellular carcinoma (HCC) treated with the first transarterial chemoembolization (TACE) procedure., Methods: Patients with HCC treated with conventional TACE in a tertiary care setting from 1997 to 2008 were retrospectively reviewed. Predictors of survival were identified using the Cox proportional regression model., Results: Two hundred and seventy patients were included. Median age was 66 years, 81% were male, 58% were HCV-positive, 18% hepatitis B surface antigen-positive, 64% had a Child A status, 40% patients had a largest nodule diameter ≥ 5 cm and 32% had more than 3 tumor nodules. Median overall survival of the whole cohort was 25 mo (95%CI: 21.8-28.2) and the 1-, 2- and 3-year probability of survival was 80%, 50% and 31%, respectively. Non-tumor segmental portal vein thrombosis (HR = 1.76, 95%CI: 1.22-2.54), serum sodium (HR = 1.65, 95%CI: 1.25-2.18), diameter of largest nodule (HR = 1.59, 95%CI: 1.22-2.091), number of nodules (HR = 1.41, 95%CI: 1.06-1.88), alpha-fetoprotein (HR = 1.35, 95%CI: 1.03-1.76) and alkaline phosphatase (HR = 1.33, 95%CI: 1.01-1.74) were independent prognostic factors for overall survival on multivariate analysis., Conclusion: The inclusion of serum sodium alongside the already known prognostic factors may allow a better prognostic definition of patients with HCC as candidates for conventional TACE.

Published
2014
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42. Non-alcoholic fatty liver disease is associated with high prevalence of gastro-oesophageal reflux symptoms.

Author

Miele L, Cammarota G, Vero V, Racco S, Cefalo C, Marrone G, Pompili M, Rapaccini G, Bianco A, Landolfi R, Gasbarrini A, and Grieco A

Subjects
Adult, Case-Control Studies, Cross-Sectional Studies, Female, Gastroesophageal Reflux diagnosis, Gastroesophageal Reflux epidemiology, Health Surveys, Humans, Logistic Models, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Odds Ratio, Prevalence, Risk Factors, Surveys and Questionnaires, Fatty Liver complications, Gastroesophageal Reflux etiology
Abstract

Background: Gastro-oesophageal reflux symptoms are usually reported by patients with obesity and metabolic syndrome. Aim of this study was to assess the prevalence and clinical characteristics of gastro-oesophageal reflux symptoms in subjects with non-alcoholic fatty liver disease., Methods: Cross-sectional, case-control study of 185 consecutive patients with non-alcoholic fatty liver disease and an age- and sex-matched control group of 112 healthy volunteers. Participants were interviewed with the aid of a previously validated questionnaire to assess lifestyle and reflux symptoms in the 3 months preceding enrolment. Odds ratios were determined before and after adjustment for body mass index, increased waist circumference, physical activity, metabolic syndrome and proton pump inhibitors and/or antiacid medication., Results: The prevalence of heartburn and/or regurgitation and of at least one of gastro-oesophageal reflux symptoms was significantly higher in the non-alcoholic fatty liver disease group. Non-alcoholic fatty liver disease subjects were associated to higher prevalence of heartburn (adjusted odds ratios: 2.17, 95% confidence intervals: 1.16-4.04), regurgitation (adjusted odds ratios: 2.61, 95% confidence intervals: 1.24-5.48) and belching (adjusted odds ratios: 2.01, 95% confidence intervals: 1.12-3.59) and had higher prevalence of at least one GER symptom (adjusted odds ratios: 3.34, 95% confidence intervals: 1.76-6.36)., Conclusion: Non-alcoholic fatty liver disease is associated with a higher prevalence of gastro-oesophageal reflux symptoms., (Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2012
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43. [Helicobacter pylori infection: from gastric to systemic disease].

Author

Gasbarrini G, Racco S, Franceschi F, Miele L, Cammarota G, Grieco A, and Gasbarrini A

Subjects
Adenocarcinoma microbiology, Anemia, Iron-Deficiency microbiology, Atherosclerosis microbiology, Duodenal Diseases microbiology, Female, Helicobacter Infections drug therapy, Hepatic Encephalopathy microbiology, Humans, Lymphoma, B-Cell, Marginal Zone microbiology, Migraine Disorders microbiology, Practice Guidelines as Topic, Pre-Eclampsia microbiology, Pregnancy, Purpura, Thrombocytopenic, Idiopathic microbiology, Randomized Controlled Trials as Topic, Raynaud Disease microbiology, Stomach Neoplasms microbiology, Thyroiditis, Autoimmune microbiology, Helicobacter Infections complications, Helicobacter pylori, Stomach Diseases microbiology
Abstract

H. pylori infection, through a chronic stimulation of the immune system and the occurrence of molecular mimicry mechanisms, is responsible for the majority of the gastroduodenal diseases and also for some extragastric disorders, including sideropenic anemia and idiopathic thrombocytopenic purpura; other diseases are under investigation.

Published
2010

44. Abdominal angina due to recurrence of cancer of the papilla of Vater: a case report.

Author

Biolato M, Gabrieli ML, Parente A, Racco S, Costantini M, Bonomo L, Rapaccini GL, Gasbarrini G, and Grieco A

Abstract

Introduction: Abdominal angina is usually caused by atherosclerotic disease, and other causes are considered uncommon. This is the first report of a case of abdominal angina secondary to neoplastic vascular stenosis caused by local recurrence of an adenocarcinoma of the papilla of Vater., Case Presentation: An 80-year-old woman of Caucasian origin presented with abdominal pain and diarrhea. She had undergone a pancreaticoduodenectomy for adenocarcinoma of the papilla of Vater four years earlier. Computed tomography revealed a mass surrounding her celiac trunk and superior mesenteric artery. Her abdominal pain responded poorly to analgesic drugs, but disappeared when oral feedings were withheld. A duplex ultrasonography of the patient's splanchnic vessels was consistent with vascular stenosis. Parenteral nutrition was started and the patient remained pain free until her death., Conclusion: Pain relief is an important therapeutic target in patients with cancer. In this case, abdominal pain was successfully managed only after the ischemic cause had been identified. The conventional analgesic therapy algorithm based on nonsteroidal anti-inflammatory drugs and opioids had been costly and pointless, whereas the simple withdrawal of oral feeding spared the patient of the discomfort of additional invasive procedures and allowed her to spend her remaining days in a completely pain-free state.

Published
2009
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45. Serum levels of hyaluronic acid and tissue metalloproteinase inhibitor-1 combined with age predict the presence of nonalcoholic steatohepatitis in a pilot cohort of subjects with nonalcoholic fatty liver disease.

Author

Miele L, Forgione A, La Torre G, Vero V, Cefalo C, Racco S, Vellone VG, Vecchio FM, Gasbarrini G, Rapaccini GL, Neuman MG, and Grieco A

Subjects
Adolescent, Adult, Age Factors, Cohort Studies, Fatty Liver diagnosis, Female, Humans, Liver Function Tests, Male, Matrix Metalloproteinase 1 blood, Matrix Metalloproteinase 2 blood, Middle Aged, Pilot Projects, Regression Analysis, Sensitivity and Specificity, Young Adult, Fatty Liver blood, Hyaluronic Acid blood, Tissue Inhibitor of Metalloproteinase-1 blood
Abstract

Hyaluronic acid (HA) and tissue inhibitor of metalloproteinase 1 (TIMP-1) are reliable markers of liver fibrosis and are closely linked to the proinflammatory status. In this pilot cohort study, we attempted to identify a clinical score that would predict the severity of nonalcoholic fatty liver disease (NAFLD) based on clinical variables and serum markers of fibrosis and inflammation. The cohort included 46 patients with histologically confirmed NAFLD (76.1% male; mean age, 43+/-13 years; mean body mass index [BMI], 27.8+/-3.5). Serum transforming growth factor beta (TGF-beta), HA, TIMP, and matrix metalloproteinase (MMP) levels were measured with commercial enzyme-linked immunoassay (ELISA) kits. Demographic features and clinical and laboratory findings were subjected to univariate and multivariate binary logistic regression analysis to construct the mathematical model. Receiver operating characteristic curve (ROC) analysis was used to identify a threshold value for diagnosis of NASH and to assess its sensitivity and specificity. Serum levels of HA and TIMP-1 were statistically different in patients with nonalcoholic steatohepatitis (NASH) (P<0.05). Logistic regression analysis of several clinical variables indicated patient age as the only independent predictor of NASH (odds ratio [OR], 1.129, 95% confidence interval [CI], 1.019-1.251, P=0.020). The mathematical model constructed on the basis of these results included age, TIMP-1, and HA levels. A value of 148.27 or more identified patients with NASH with 85.7% sensitivity, 87.1% specificity, and negative and positive predictive values of 96.4% and 60%, respectively. This model seems to represent a reliable noninvasive tool for excluding the presence of NASH. If validated in larger prospective cohort studies, it might be useful for determining when a liver biopsy is actually warranted in patients with NAFLD.

Published
2009
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46. [The treatment of hepatocellular carcinoma: an update].

Author

Vero V, Racco S, Biolato M, Pompili M, Gasbarrini G, Miele L, and Grieco A

Subjects
Antineoplastic Agents therapeutic use, Brachytherapy methods, Carcinoma, Hepatocellular diagnosis, Embolization, Therapeutic methods, Hepatectomy, Humans, Liver Neoplasms diagnosis, Liver Transplantation, Neoplasm Staging methods, Prognosis, Carcinoma, Hepatocellular therapy, Liver Neoplasms therapy
Abstract

Hepatocellular carcinoma (HCC) is the third most frequent cause of death from cancer with an increasing incidence in the world. Hepatic cirrhosis is the main risk factor for the development of this tumor, present in more than 80% of cases. The prognosis of this tumor is still poor and appears to be strictly related to liver residual function and tumor extension. A regular surveillance program was defined to increase early detection of tumor in cirrhotic patients when curative treatment could be applied. Liver transplantation and liver resection offer a high rate of positive response when applied in a early stage of the disease; locoregional therapies are effective, palliative options for patients with unresectable HCC: transarterial chemoembolisation being the only with a proven positive impact on survival. Several prognostic systems are proposed in the last years to stratify patients in different risk groups and to identify those who could achieve the best survival benefit from different therapeutic strategies: the Okuda system, the Cancer of the Liver Italian Program and the Barcelona Clínic Liver Cancer are the most widely used, but there is no consensus to which is the best in predicting outcome most accurately.

Published
2009

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