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10. V.02.9 DOUBLE-SCOPE RECTAL ESD

Author

Spandre, M., primary, Arese, D., additional, Garripoli, A., additional, Giudici, G., additional, La Terra, A., additional, Sapone, N., additional, and Coppola, F., additional

Published
2023
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12. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas)

Author

Jais, B, Rebours, V, Malleo, G, Salvia, R, Fontana, M, Maggino, L, Bassi, C, Manfredi, R, Moran, R, Lennon, A M, Zaheer, A, Wolfgang, C, Hruban, R, Marchegiani, G, Fernández Del Castillo, C, Brugge, W, Ha, Y, Kim, M H, Oh, D, Hirai, I, Kimura, W, Jang, J Y, Kim, S W, Jung, W, Kang, H, Song, S Y, Kang, C M, Lee, W J, Crippa, S, Falconi, M, Gomatos, I, Neoptolemos, J, Milanetto, A C, Sperti, C, Ricci, C, Casadei, R, Bissolati, M, Balzano, G, Frigerio, I, Girelli, R, Delhaye, M, Bernier, B, Wang, H, Jang, K T, Song, D H, Huggett, M T, Oppong, K W, Pererva, L, Kopchak, K V, Del Chiaro, M, Segersvard, R, Lee, L S, Conwell, D, Osvaldt, A, Campos, V, Aguero Garcete, G, Napoleon, B, Matsumoto, I, Shinzeki, M, Bolado, F, Fernandez, J M Urman, Keane, M G, Pereira, S P, Acuna, I Araujo, Vaquero, E C, Angiolini, M R, Zerbi, A, Tang, J, Leong, R W, Faccinetto, A, Morana, G, Petrone, M C, Arcidiacono, P G, Moon, J H, Choi, H J, Gill, R S, Pavey, D, Ouaïssi, M, Sastre, B, Spandre, M, De Angelis, C G, Rios-Vives, M A, Concepcion-Martin, M, Ikeura, T, Okazaki, K, Frulloni, L, Messina, O, and Lévy, P

Published
2016
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21. Serous cystic neoplasm of the pancreas: A multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas)

Author

Jais, B., Rebours, V., Malleo, G., Salvia, R., Fontana, Tecla Maria, Maggino, L., Bassi, C., Manfredi, Riccardo, Moran, R., Lennon, A. M., Zaheer, A., Wolfgang, C., Hruban, R., Marchegiani, G., Fernandez Del Castillo, C., Brugge, W., Ha, Y., Kim, M. H., Oh, D., Hirai, I., Kimura, W., Jang, J. Y., Kim, S. W., Jung, W., Kang, H., Song, S. Y., Kang, C. M., Lee, W. J., Crippa, S., Falconi, M., Gomatos, I., Neoptolemos, J., Milanetto, A. C., Sperti, C., Ricci, C., Casadei, R., Bissolati, M., Balzano, G., Frigerio, I., Girelli, R., Delhaye, M., Bernier, B., Wang, H., Jang, K. T., Song, D. H., Huggett, M. T., Oppong, K. W., Pererva, L., Kopchak, K. V., Del Chiaro, M., Segersvard, R., Lee, L. S., Conwell, D., Osvaldt, A., Campos, V., Aguero Garcete, G., Napoleon, B., Matsumoto, I., Shinzeki, M., Bolado, F., Urman Fernandez, J. M., Keane, M. G., Pereira, S. P., Araujo Acuna, I., Vaquero, E. C., Angiolini, M. R., Zerbi, A., Tang, J., Leong, R. W., Faccinetto, A., Morana, G., Petrone, M. C., Arcidiacono, P. G., Moon, J. H., Choi, H. J., Gill, R. S., Pavey, D., Ouaissi, M., Sastre, B., Spandre, M., De Angelis, C. G., Rios-Vives, M. A., Concepcion-Martin, M., Ikeura, T., Okazaki, K., Frulloni, L., Messina, O., Levy, P., Fontana M., Manfredi R. (ORCID:0000-0002-4972-9500), Jais, B., Rebours, V., Malleo, G., Salvia, R., Fontana, Tecla Maria, Maggino, L., Bassi, C., Manfredi, Riccardo, Moran, R., Lennon, A. M., Zaheer, A., Wolfgang, C., Hruban, R., Marchegiani, G., Fernandez Del Castillo, C., Brugge, W., Ha, Y., Kim, M. H., Oh, D., Hirai, I., Kimura, W., Jang, J. Y., Kim, S. W., Jung, W., Kang, H., Song, S. Y., Kang, C. M., Lee, W. J., Crippa, S., Falconi, M., Gomatos, I., Neoptolemos, J., Milanetto, A. C., Sperti, C., Ricci, C., Casadei, R., Bissolati, M., Balzano, G., Frigerio, I., Girelli, R., Delhaye, M., Bernier, B., Wang, H., Jang, K. T., Song, D. H., Huggett, M. T., Oppong, K. W., Pererva, L., Kopchak, K. V., Del Chiaro, M., Segersvard, R., Lee, L. S., Conwell, D., Osvaldt, A., Campos, V., Aguero Garcete, G., Napoleon, B., Matsumoto, I., Shinzeki, M., Bolado, F., Urman Fernandez, J. M., Keane, M. G., Pereira, S. P., Araujo Acuna, I., Vaquero, E. C., Angiolini, M. R., Zerbi, A., Tang, J., Leong, R. W., Faccinetto, A., Morana, G., Petrone, M. C., Arcidiacono, P. G., Moon, J. H., Choi, H. J., Gill, R. S., Pavey, D., Ouaissi, M., Sastre, B., Spandre, M., De Angelis, C. G., Rios-Vives, M. A., Concepcion-Martin, M., Ikeura, T., Okazaki, K., Frulloni, L., Messina, O., Levy, P., Fontana M., and Manfredi R. (ORCID:0000-0002-4972-9500)

Abstract

Objectives Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. Design Retrospective multinational study including SCN diagnosed between 1990 and 2014. Results 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16-99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2-200)), 9% had resection beyond 1 year of follow-up (3 years (1-20), size at diagnosis: 25 mm (4- 140)) and 39% had no surgery (3.6 years (1-23), 25.5 mm (1-200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/ year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN's related mortality was 0.1% (n=1).

Published
2016

26. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas)

Author

Jais, B, primary, Rebours, V, additional, Malleo, G, additional, Salvia, R, additional, Fontana, M, additional, Maggino, L, additional, Bassi, C, additional, Manfredi, R, additional, Moran, R, additional, Lennon, A M, additional, Zaheer, A, additional, Wolfgang, C, additional, Hruban, R, additional, Marchegiani, G, additional, Fernández Del Castillo, C, additional, Brugge, W, additional, Ha, Y, additional, Kim, M H, additional, Oh, D, additional, Hirai, I, additional, Kimura, W, additional, Jang, J Y, additional, Kim, S W, additional, Jung, W, additional, Kang, H, additional, Song, S Y, additional, Kang, C M, additional, Lee, W J, additional, Crippa, S, additional, Falconi, M, additional, Gomatos, I, additional, Neoptolemos, J, additional, Milanetto, A C, additional, Sperti, C, additional, Ricci, C, additional, Casadei, R, additional, Bissolati, M, additional, Balzano, G, additional, Frigerio, I, additional, Girelli, R, additional, Delhaye, M, additional, Bernier, B, additional, Wang, H, additional, Jang, K T, additional, Song, D H, additional, Huggett, M T, additional, Oppong, K W, additional, Pererva, L, additional, Kopchak, K V, additional, Del Chiaro, M, additional, Segersvard, R, additional, Lee, L S, additional, Conwell, D, additional, Osvaldt, A, additional, Campos, V, additional, Aguero Garcete, G, additional, Napoleon, B, additional, Matsumoto, I, additional, Shinzeki, M, additional, Bolado, F, additional, Fernandez, J M Urman, additional, Keane, M G, additional, Pereira, S P, additional, Acuna, I Araujo, additional, Vaquero, E C, additional, Angiolini, M R, additional, Zerbi, A, additional, Tang, J, additional, Leong, R W, additional, Faccinetto, A, additional, Morana, G, additional, Petrone, M C, additional, Arcidiacono, P G, additional, Moon, J H, additional, Choi, H J, additional, Gill, R S, additional, Pavey, D, additional, Ouaïssi, M, additional, Sastre, B, additional, Spandre, M, additional, De Angelis, C G, additional, Rios-Vives, M A, additional, Concepcion-Martin, M, additional, Ikeura, T, additional, Okazaki, K, additional, Frulloni, L, additional, Messina, O, additional, and Lévy, P, additional

Published
2015
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28. P1028 NON-INVASIVE SCORE SYSTEM FOR FIBROSIS (NISF) IN CHRONIC LIVER DISEASE: A NEW MODEL COMBINING BIOCHEMICAL, ELASTOGRAPHIC AND ULTRASOUND DATA

Author

Gaia, S., primary, Campion, D., additional, Spandre, M., additional, Cantamessa, A., additional, Brunello, F., additional, Evangelista, A., additional, Cosso, L., additional, Carucci, P., additional, Rolle, E., additional, Ciccone, G., additional, Bugianesi, E., additional, Carenzi, S., additional, and Rizzetto, M., additional

Published
2014
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29. Non-Invasive Score system for Fibrosis (NISF): A new staging model combining biochemical, elastographic and ultrasound data in chronic liver disease

Author

Campion, D., primary, Gaia, S., additional, Spandre, M., additional, Cantamessa, A., additional, Brunello, F., additional, Evangelista, A., additional, Cosso, L., additional, Carucci, P., additional, Rolle, E., additional, Ciccone, G., additional, Bugianesi, E., additional, Carenzi, S., additional, and Rizzetto, M., additional

Published
2014
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30. T-28 Hypothalamic-pituitary-adrenal axis and adrenal dysfunction in non-septic cirrhotic patients with ascites: a pathophysiological and clinical evaluation

Author

Risso, A., primary, Di Luigi, P., additional, Alessandria, C., additional, Mezzabotta, L., additional, Elia, C., additional, Andrealli, A., additional, Spandre, M., additional, Giordano, R., additional, Morgando, A., additional, Marzano, A., additional, Arvat, E., additional, Ghigo, E., additional, and Rizzetto, M., additional

Published
2013
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31. T-27 Study of new algorithms for non-invasive staging of liver fibrosis in chronic viral hepatitis (CH) and non-alcoholic fatty liver disease (NAFLD)

Author

Campion, D., primary, Gaia, S., additional, Spandre, M., additional, Brunello, F., additional, Evangelista, A., additional, Cosso, L., additional, Bugianesi, E., additional, Carenzi, S., additional, Carucci, P., additional, Cantamessa, A., additional, Ciccone, G., additional, and Rizzetto, M., additional

Published
2013
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40. Small rectosigmoid polyps

Author

Pennazio, M, primary, Arrigoni, A, additional, Spandre, M, additional, Cavellero, M, additional, Bertone, A, additional, Gemme, C, additional, Risio, M, additional, and Rossini, F P, additional

Published
1993
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42. Clinico--Pathological Features of Collagenous Colitis: Case Report and Literature Review.

Author

Coverlizza, S., Ferrari, A., Scevola, F., Gemme, C., Cavallero, M., Spandre, M., Risio, M., and Rossini, F. P.

Subjects
COLITIS, DIARRHEA, ABDOMINAL pain, COLLAGEN, GASTROINTESTINAL mucosa, DISEASE relapse
Abstract

Collagenous colitis is a newly identified condition, with clinical features of chronic watery diarrhea and abdominal pain. Histologically the main characteristic is the presence of a thick collagen band below the surface epithelium. Collagenous colitis occurs in adults, especially women. Endoscopy reveals no particular changes in the intestinal mucosa. Symptoms may persist for years with periods of remission and recurring acute attacks. The cause of this condition is still unknown, and because of no real knowledge only symptoms can be treated, usually with little success. [ABSTRACT FROM AUTHOR]

Published
1986

45. Characteristics of liver diseases in the elderly: a review

Author

Premoli, A., Pascheyfa, E., Hvalryg, M., Spandre, M., Bo, S., and Marilena DURAZZO

Subjects
Liver Cirrhosis, Biliary, Liver Diseases, Humans, Aged
Abstract

Chronic liver diseases are becoming more commonly diagnosed in the elderly, although they are not age-related. Most liver functions in advanced age appear to be well preserved, but some changes in liver morphology and physiology with aging may lead to several differences in clinical course and management of liver diseases in older patients compared to younger. A cautious individual evaluation is therefore required in aged patients, especially concerning reduced hepatic drug clearance and comorbidity. Many chronic liver diseases are characterized by a slow and indolent course with non-specific clinical presentation and this may lead a later diagnosis in the elderly. The presence of an advanced liver disease or cirrhosis is more frequent in old patients as the first clinical presentation. No significant differences in diagnostic investigations or treatment options occur between the elderly and the young. Hepatocellular carcinoma is an affliction of the old patients (mean age 65 age) and follow up with ultrasonography and alpha-fetoprotein is mandatory. Advanced age is not considered a contraindication to liver transplantation, but recipients older than 60 years with poor hepatic synthetic function and comorbidity show a worse prognosis with lower survival rates. This review focuses on new emerging conditions, clinical features and updated therapeutic approaches of the most common chronic liver diseases among the elderly.

47. Serous cystic neoplasm of the pancreas: a multinational study of 2622 patients under the auspices of the International Association of Pancreatology and European Pancreatic Club (European Study Group on Cystic Tumors of the Pancreas)

Author

Luca Frulloni, I Gomatos, O Messina, Raghubinder S. Gill, Paolo Giorgio Arcidiacono, Vinicius Jardim Campos, Myriam Delhaye, W J Lee, Roberto Girelli, J M Urman Fernandez, Isabella Frigerio, Massimiliano Bissolati, Wataru Kimura, M Concepcion-Martin, T Ikeura, Jong Ho Moon, J Y Jang, Alessandro Bersch Osvaldt, Darwin L. Conwell, Riccardo Manfredi, Claudio Bassi, Maria Rachele Angiolini, Bertrand Napoleon, M Del Chiaro, B Jais, Riccardo Casadei, L S Lee, Atif Zaheer, Woohyun Jung, Ralph H. Hruban, F Bolado, D Oh, Ralf Segersvärd, Martina Fontana, Laura Maggino, Eva C. Vaquero, B Sastre, M A Rios-Vives, S Y Song, Rupert W. Leong, Anna Caterina Milanetto, Stephen P. Pereira, Margaret G. Keane, Giuseppe Malleo, Kazuichi Okazaki, Anne Marie Lennon, D H Song, I Araujo Acuna, Robert A. Moran, G Aguero Garcete, Hua Wang, Philippe Lévy, Stefano Crippa, Kofi Oppong, Giovanni Marchegiani, Vinciane Rebours, Myung-Hwan Kim, K V Kopchak, Darren Pavey, Chang Moo Kang, Matthew T. Huggett, Roberto Salvia, Claudio Ricci, Giovanni Morana, B Bernier, Alessandro Zerbi, C. De Angelis, Christopher L. Wolfgang, C. Fernandez del Castillo, M Shinzeki, Cosimo Sperti, Alex Faccinetto, Gianpaolo Balzano, Ichiro Hirai, Mehdi Ouaissi, Massimo Falconi, Y Ha, M Spandre, K T Jang, William R. Brugge, John P. Neoptolemos, M C Petrone, H J Choi, Huapyong Kang, I Matsumoto, J Tang, S W Kim, L Pererva, Jais, B, Rebours, V, Malleo, G, Salvia, R, Fontana, M, Maggino, L, Bassi, C, Manfredi, R, Moran, R, Lennon, A M, Zaheer, A, Wolfgang, C, Hruban, R, Marchegiani, G, Fernández Del Castillo, C, Brugge, W, Ha, Y, Kim, M H, Oh, D, Hirai, I, Kimura, W, Jang, J Y, Kim, S W, Jung, W, Kang, H, Song, S Y, Kang, C M, Lee, W J, Crippa, S, Falconi, M, Gomatos, I, Neoptolemos, J, Milanetto, A C, Sperti, C, Ricci, C, Casadei, R, Bissolati, M, Balzano, G, Frigerio, I, Girelli, R, Delhaye, M, Bernier, B, Wang, H, Jang, K T, Song, D H, Huggett, M T, Oppong, K W, Pererva, L, Kopchak, K V, Del Chiaro, M, Segersvard, R, Lee, L S, Conwell, D, Osvaldt, A, Campos, V, Aguero Garcete, G, Napoleon, B, Matsumoto, I, Shinzeki, M, Bolado, F, Fernandez, J M Urman, Keane, M G, Pereira, S P, Acuna, I Araujo, Vaquero, E C, Angiolini, M R, Zerbi, A, Tang, J, Leong, R W, Faccinetto, A, Morana, G, Petrone, M C, Arcidiacono, P G, Moon, J H, Choi, H J, Gill, R S, Pavey, D, Ouaïssi, M, Sastre, B, Spandre, M, De Angelis, C G, Rios-Vives, M A, Concepcion-Martin, M, Ikeura, T, Okazaki, K, Frulloni, L, Messina, O, Lévy, P, Lennon, Am, Kim, Mh, Jang, Jy, Kim, Sw, Song, Sy, Kang, Cm, Lee, Wj, Milanetto, Ac, Jang, Kt, Song, Dh, Huggett, Mt, Oppong, Kw, Kopchak, Kv, Lee, L, Fernandez, Jm, Keane, Mg, Pereira, Sp, Acuna, Ia, Vaquero, Ec, Angiolini, Mr, Leong, Rw, Petrone, Mc, Arcidiacono, P. G., Moon, Jh, Choi, Hj, Gill, R, De Angelis, Cg, Rios-Vives, Ma, and Lévy, P.

Subjects
Male, Abdominal pain, Internationality, PANCREATIC SURGERY, PANCREATIC TUMOURS, Cystadenoma, Gastroenterology, 0302 clinical medicine, 80 and over, Medicine, Societies, Medical, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, Aged, 80 and over, Cystadenoma, Serous, Middle Aged, Europe, Serous fluid, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, medicine.symptom, hormones, hormone substitutes, and hormone antagonists, Adult, medicine.medical_specialty, endocrine system, Adolescent, Pancreatic serous cystadenoma, Malignancy, Asymptomatic, Aged, Humans, Retrospective Studies, Young Adult, Pancreatic Neoplasms, 03 medical and health sciences, Internal medicine, Medical, business.industry, Serous, Retrospective cohort study, medicine.disease, Cystic Neoplasm, Surgery, stomatognathic diseases, nervous system, sense organs, business, Societies
Abstract

Objectives Serous cystic neoplasm (SCN) is a cystic neoplasm of the pancreas whose natural history is poorly known. The purpose of the study was to attempt to describe the natural history of SCN, including the specific mortality. Design Retrospective multinational study including SCN diagnosed between 1990 and 2014. Results 2622 patients were included. Seventy-four per cent were women, and median age at diagnosis was 58 years (16–99). Patients presented with non-specific abdominal pain (27%), pancreaticobiliary symptoms (9%), diabetes mellitus (5%), other symptoms (4%) and/or were asymptomatic (61%). Fifty-two per cent of patients were operated on during the first year after diagnosis (median size: 40 mm (2–200)), 9% had resection beyond 1 year of follow-up (3 years (1–20), size at diagnosis: 25 mm (4–140)) and 39% had no surgery (3.6 years (1–23), 25.5 mm (1–200)). Surgical indications were (not exclusive) uncertain diagnosis (60%), symptoms (23%), size increase (12%), large size (6%) and adjacent organ compression (5%). In patients followed beyond 1 year (n=1271), size increased in 37% (growth rate: 4 mm/year), was stable in 57% and decreased in 6%. Three serous cystadenocarcinomas were recorded. Postoperative mortality was 0.6% (n=10), and SCN9s related mortality was 0.1% (n=1). Conclusions After a 3-year follow-up, clinical relevant symptoms occurred in a very small proportion of patients and size slowly increased in less than half. Surgical treatment should be proposed only for diagnosis remaining uncertain after complete workup, significant and related symptoms or exceptionally when exists concern with malignancy. This study supports an initial conservative management in the majority of patients with SCN. Trial registration number IRB 00006477.

Published
2016

48. Gastroenterology today: between certainties and news.

Author

Pellicano R, Ribaldone DG, Astegiano M, Dughera L, Battaglia E, Morgando A, Arrigoni A, Spandre M, Grassini M, Saracco GM, and Mégraud F

Subjects
Dysbiosis drug therapy, Dysbiosis microbiology, Gastrointestinal Diseases drug therapy, Helicobacter Infections drug therapy, Helicobacter Infections microbiology, Humans, Irritable Bowel Syndrome drug therapy, Irritable Bowel Syndrome microbiology, Gastrointestinal Diseases microbiology, Gastrointestinal Microbiome
Abstract

This special article reports on two crucial issues discussed during a meeting. The first was the updated management of Helicobacter pylori (H. pylori) infection. This was approached taking into account the recent European Guidelines, with a focus on novelties in treatment. In particular, considering the increasing H. pylori antibiotic resistance to clarithromycin, in countries with a high clarithromycin resistance rate, the bismuth-containing quadruple therapies should be preferred. The new formulation, with bismuth, metronidazole, and tetracycline contained in a single capsule (three-in-one), has shown exciting results both in naive and in non-responder patients. Levofloxacin- and rifabutin-containing triple therapies should be proposed to patients who experienced H. pylori treatment failures. Another key message on H. pylori management was that, after one or more failures, standard antimicrobial susceptibility testing should be considered before prescribing a further treatment. The second issue concerned the novelties on dysbiosis of intestinal microbiota and its clinical consequences. Among the latter, the focus was on both constipation-predominant irritable bowel syndrome (IBS-C) and microscopic colitis. Since the number of microorganisms inhabiting the gastrointestinal (GI) tract is estimated to be about 10 times higher than that of human cells, it is not surprising to foresee the clinical consequences of dysbiosis. However, to date the role of dysbiosis in IBS-C and in microscopic colitis is poorly known and major efforts are needed to understand if manipulating microbiota could improve the treatment of these and other diseases both within and outside the GI tract. At a meeting held in Turin, Italy, on May 27, 2017 two crucial issues of modern gastroenterology were discussed: the updated management of Helicobacter pylori (H. pylori) infection and the novelties regarding the dysbiosis of intestinal microbiota and its clinical consequences. Among the latter, a focus was made on both constipation-predominant irritable bowel syndrome (IBS-C) and microscopic colitis. In this special article we report the most recent salient advances discussed during this meeting.

Published
2018
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49. Non-invasive score system for fibrosis in chronic hepatitis: proposal for a model based on biochemical, FibroScan and ultrasound data.

Author

Gaia S, Campion D, Evangelista A, Spandre M, Cosso L, Brunello F, Ciccone G, Bugianesi E, and Rizzetto M

Subjects
Adult, Biopsy, Needle, Cohort Studies, Elasticity Imaging Techniques methods, Female, Hepatitis B, Chronic diagnostic imaging, Hepatitis B, Chronic pathology, Hepatitis C, Chronic diagnostic imaging, Hepatitis C, Chronic pathology, Humans, Immunohistochemistry, Liver Cirrhosis diagnostic imaging, Liver Cirrhosis pathology, Male, Middle Aged, Predictive Value of Tests, ROC Curve, Sensitivity and Specificity, Severity of Illness Index, Ultrasonography, Doppler, Hepatitis, Viral, Human diagnostic imaging, Hepatitis, Viral, Human pathology, Non-alcoholic Fatty Liver Disease diagnostic imaging, Non-alcoholic Fatty Liver Disease pathology
Abstract

Background & Aims: We elaborate a non-invasive score system for liver fibrosis (NISF), exploring its diagnostic performance and comparing its accuracy to FibroScan in patients with chronic viral hepatitis (CH) and non-alcoholic fatty liver disease (NAFLD)., Methods: Clinical, biochemical, elastographic and ultrasound parameters derived from patients with CH (n = 83) or NAFLD (n = 58), undergoing liver biopsy for fibrosis assessment, were prospectively collected as potential predictors of fibrosis. Each parameter was evaluated for its correlation with the liver biopsy (Gold Standard). Candidate predictors with good interobserver agreement and correlation with histological stages were combined into two algorithms (NISF) to predict fibrosis in chronic viral hepatitis and NAFLD., Results: The CH-NISF included six parameters: bluntness of liver edges, irregularity of left lobe surface, diameter of segment 4, liver stiffness measurement, platelet count and ALT values. The ability of the model to discriminate F3-F4 vs F0-F1 stages and F2 vs F0-F1 was high (AUROC of 0.95 and 0.83 respectively) and better than FibroScan alone, especially in intermediate stages (F2 vs F0-F1), AUROC 0.83 vs 0.57 (P = 0.003). The resulting algorithm is available as mathematical formula, nomogram or free online link. [http://health.mafservizi.it/NISF_Calculator/liver.htm] The NAFLD-NISF included liver stiffness, platelet count and AST levels, had good ability to discriminate F0-F1 vs F2-F3-F4 stages (AUROC 0.86), however, not significantly higher than FibroScan., Conclusions: CH-NISF can be proposed as preliminary and easily available staging tool, superior to FibroScan alone in predicting histological fibrosis, especially in intermediate stages. Further validations are needed to improve NISF accuracy in NAFLD., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Published
2015
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50. Adrenal function and microbial DNA in noninfected cirrhotic patients with ascites: Relationship and effect on survival.

Author

Risso A, Alessandria C, Mezzabotta L, Elia C, Andrealli A, Spandre M, Di Luigi P, Barbui A, Evangelista A, Morgando A, Serra R, Ciccone G, Marzano A, and Rizzetto M

Subjects
Adrenal Insufficiency complications, Aged, Ascites etiology, Ascites metabolism, Ascites microbiology, DNA, Bacterial metabolism, DNA, Fungal metabolism, End Stage Liver Disease etiology, Female, Humans, Liver Cirrhosis blood, Liver Cirrhosis complications, Liver Transplantation, Male, Middle Aged, Survival Rate, Adrenal Insufficiency blood, DNA, Bacterial blood, DNA, Fungal blood, End Stage Liver Disease blood, Hydrocortisone blood, Liver Cirrhosis mortality
Abstract

Background: There are few data on clinical relevance of adrenal dysfunction and its relationship with occult microbial DNA in noninfected haemodynamically stable cirrhotic patients with ascites., Aims: The aim of this study was to evaluate prognostic role of adrenal dysfunction, microbial DNA, and their relationship., Methods: Adrenal function was assessed in 93 consecutive patients following a corticotropin stimulation test. Adrenal dysfunction was defined as: basal cortisol <10 μg/dl, delta cortisol <9 μg/dl, or peak cortisol <18 μg/dl. Microbial DNA was assessed in blood and ascites of 54 consecutive patients. Patients were followed up until liver transplantation or death., Results: Adrenal dysfunction was not significantly associated with mortality, while the risk of death rose significantly with an increase in basal cortisol values (HR 1.13 per 1-μl/dl increase; 95% CI 1.01-1.26). Microbial DNA was independently associated with reduced survival (HR 8.05, 95% CI 1.57-41.2). In microbial DNA-positive patients a significant correlation was found between Model for End-Stage Liver Disease (MELD) score and basal cortisol values (Pearson's r=0.5107; p=0.018)., Conclusions: Microbial DNA and MELD score, but not adrenal function, were the best independent predictors of mortality in noninfected cirrhotic patients with ascites. High serum cortisol levels may be a systemic reaction to microbial translocation, increasing in parallel with deterioration of liver function., (Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2015
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