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Lazarus JV, Picchio CA, Colombo M. Hepatocellular Carcinoma Prevention in the Era of Hepatitis C Elimination. Int J Mol Sci 2023; 24:14404. [PMID: 37762706 PMCID: PMC10531569 DOI: 10.3390/ijms241814404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
The hepatitis C virus (HCV), a single-stranded RNA virus belonging to the Flaviviridae family, is a major cause of hepatocellular carcinoma (HCC) worldwide. Tumors caused by HCC have an increased mortality rate globally, which is more accentuated in Western countries. The carcinogenic potential of this virus is mediated through a wide range of mechanisms, spanning from the induction of chronic inflammation to oxidative stress and deregulation of cellular pathways by viral proteins. As the number of new infections continues unabated, HCC-related mortality should be prioritized through early detection, continued prevention of HCV transmission, and treatment of HCV with safe and efficacious direct antiviral agents (DAAs). People who inject drugs (PWID) are a significant reservoir of new HCV infections globally, and in order to eliminate hepatitis C as a global health threat, as set out by the World Health Organization, an integrated approach based on the optimization of care delivery and increased access to harm reduction and treatment for PWID is needed. Thanks to the development of safe and effective antiviral agents, eradication of the infection is now possible in almost all treated patients, leading to a significant reduction but not the elimination of the risk for HCC in cured patients. This is particularly relevant among aged populations who have cofactors of morbidity known to accelerate HCC progression, such as diabetes, obesity, and excessive alcohol consumption. Given the restless accumulation of individuals with cured HCV infection, the implementation of risk-stratified surveillance programs becomes impellent from a cost-effectiveness perspective, whereas the availability of a performant biomarker to predict HCC in cured patients remains an unmet clinical need.
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Affiliation(s)
- Jeffrey V. Lazarus
- HPAM, CUNY Graduate School of Public Health and Health Policy (CUNY SPH), New York, NY 10027, USA;
- Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
| | - Camila A. Picchio
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain;
| | - Massimo Colombo
- EASL International Liver Foundation, 1203 Geneva, Switzerland
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2
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Ratti F, Marino R, Pedica F, Gardini AC, Cipriani F, Rimini M, Della Corte A, Cascinu S, De Cobelli F, Colombo M, Aldrighetti L. Radial and longitudinal margins in surgery of perihilar cholangiocarcinoma: When R1 definition is associated with different prognosis. Surgery 2023; 174:447-456. [PMID: 37357095 DOI: 10.1016/j.surg.2023.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/15/2023] [Accepted: 05/24/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Infiltrated margins of resection (R1) and lymph node invasion are dominant negative predictors of survival in patients with a resectable perihilar cholangiocarcinoma. Less clear is whether survival predictors stratify differently between R0 (tumor-free margins) and R1 patients and whether the prognosis of the latter patients is influenced by the pattern of neoplastic infiltration (ie, radial versus longitudinal infiltration). We retrospectively evaluated a series of reported resected perihilar cholangiocarcinoma to obtain insights on the predictive power of these histologic features. METHODS The study includes 264 patients with perihilar cholangiocarcinoma treated between 2004 and 2019 in our center and followed up for >18 months. There were 176 patients with R0 (66.6%) and 88 patients with R1 (33.3%), 31 with radial infiltration only, 30 with longitudinal infiltration only, and 27 with both infiltration patterns. In all patients, the criteria for resection was the absence of metastatic involvement (ie, distant organ metastases, liver metastases, and lymph node metastases beyond the hepatoduodenal ligament). Histopathologic specimens of the resected tumors were centrally reviewed by a pathologist unaware of the clinical outcomes. RESULTS Three- and 5-year long-term survival were significantly better in R0 (respectively) compared to R1 patients (55% and 42% vs 42% and 18%, respectively, P < .05). In R1 patients with radial infiltration only and those with radial + longitudinal infiltration, both disease-free and overall survival were worse than those with longitudinal infiltration only (median disease-free survival of 18 and 23 months, respectively, P < .05, median overall survival of 33 and 39 months, respectively, P < .05). At multivariable analysis, nodal status, side of hepatectomy, grading, and presence of radial margin infiltration were associated with long-term outcome. CONCLUSION Radial infiltration of resection margins enhances the negative prognostic value of R1 margins in perihilar cholangiocarcinoma patients and should specifically be accounted for in the prediction of the outcome of adjuvant therapy.
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Affiliation(s)
- Francesca Ratti
- Hepatobiliary Surgery Division, Ospedale San Raffaele, Milan, Italy.
| | - Rebecca Marino
- Hepatobiliary Surgery Division, Ospedale San Raffaele, Milan, Italy
| | - Federica Pedica
- Department of Experimental Oncology, Pathology Unit, San Raffaele Hospital, Milan, Italy
| | | | | | - Margherita Rimini
- Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Stefano Cascinu
- Department of Medical Oncology, IRCCS San Raffaele Hospital, Milan, Italy
| | | | | | - Luca Aldrighetti
- Hepatobiliary Surgery Division, Ospedale San Raffaele, Milan, Italy
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3
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Barouki R, Samson M, Blanc EB, Colombo M, Zucman-Rossi J, Lazaridis KN, Miller GW, Coumoul X. The exposome and liver disease - how environmental factors affect liver health. J Hepatol 2023; 79:492-505. [PMID: 36889360 PMCID: PMC10448911 DOI: 10.1016/j.jhep.2023.02.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 03/10/2023]
Abstract
Since the initial development of the exposome concept, much effort has been devoted to the characterisation of the exposome through analytical, epidemiological, and toxicological/mechanistic studies. There is now an urgent need to link the exposome to human diseases and to include exposomics in the characterisation of environment-linked pathologies together with genomics and other omics. Liver diseases are particularly well suited for such studies since major functions of the liver include the detection, detoxification, and elimination of xenobiotics, as well as inflammatory responses. It is well known that several liver diseases are associated with i) addictive behaviours such as alcohol consumption, smoking, and to a certain extent dietary imbalance and obesity, ii) viral and parasitic infections, and iii) exposure to toxins and occupational chemicals. Recent studies indicate that environmental exposures are also significantly associated with liver diseases, and these include air pollution (particulate matter and volatile chemicals), contaminants such as polyaromatic hydrocarbons, bisphenol A and per-and poly-fluorinated substances, and physical stressors such as radiation. Furthermore, microbial metabolites and the "gut-liver" axis play a major role in liver diseases. Exposomics is poised to play a major role in the field of liver pathology. Methodological advances such as the exposomics-metabolomics framework, the determination of risk factors' genomic and epigenomic signatures, and cross-species biological pathway analysis should further delineate the impact of the exposome on the liver, opening the way for improved prevention, as well as the identification of new biomarkers of exposure and effects, and additional therapeutic targets.
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Affiliation(s)
| | - Michel Samson
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Rennes, France
| | | | - Massimo Colombo
- San Raffaele Hospital, Liver Center, Via Olgettina 60, 20132, Milan, Italy
| | - Jessica Zucman-Rossi
- Centre de Recherche des Cordeliers, Université Paris Cité, Sorbonne Université, Inserm, AP-HP, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, F-75006, Paris, France
| | | | - Gary W Miller
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, 10032, USA
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Colombo M, Aggujaro S, Lombardi N, Pedrocchi A, Molteni F, Guanziroli E. Motor and Cognitive Modulation of a Single Session of Transcutaneous Auricular Vagus Nerve Stimulation in Post Stroke Patients: A Pilot Study. IEEE Open J Eng Med Biol 2023; 4:292-299. [PMID: 38196973 PMCID: PMC10776103 DOI: 10.1109/ojemb.2023.3268011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/30/2023] [Accepted: 04/12/2023] [Indexed: 01/11/2024] Open
Abstract
Objective: The aim of the present study is to explore whether a single session of transcutaneous Vagus Nerve Stimulation (tVNS) can enhance the ipsilesional, and contralesional upper limb motor functions as well as cognitive functions in stroke patients. The effects of the stimulation were evaluated through two different tasks: the box and blocks test (BB), indexing manual dexterity, and the Go/No-go task, a visuomotor paradigm used to assess both motor readiness and response inhibition. Tests were administered without tVNS, during tVNS and during sham tVNS. Results: The BB showed a statistical difference for both contralesional side (p = 0.05) between Basal-Real condition (p = 0.042) and ipsilesional side (p = 0.001) between Basal-Real (p = 0.008) and for Real-Sham (p = 0.005). Any statistical difference was found for the mean latencies in the three conditions of the Go/No-go test. Conclusion: A single session of tVNS seems to improve upper limb motor functions but not cognitive functions in post-stroke patients, despite a positive trend was detected.
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Affiliation(s)
- M. Colombo
- Villa Beretta Rehabilitation Center Costa Masnaga – Lecco23845ComoItaly
| | - S. Aggujaro
- Villa Beretta Rehabilitation Center Costa Masnaga – Lecco23845ComoItaly
| | - N. Lombardi
- Villa Beretta Rehabilitation Center Costa Masnaga – Lecco23845ComoItaly
| | - A. Pedrocchi
- Nearlab, Department of Electronics, Informatics and BioengineeringPolitecnico di Milano20133MilanItaly
| | - F. Molteni
- Villa Beretta Rehabilitation Center Costa Masnaga – Lecco23845ComoItaly
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Pelusi S, Bianco C, Colombo M, Cologni G, Del Poggio P, Pugliese N, Prati D, Pigozzi MG, D'Ambrosio R, Lampertico P, Fagiuoli S, Valenti L. Metabolic dysfunction outperforms ultrasonographic steatosis to stratify hepatocellular carcinoma risk in patients with advanced hepatitis C cured with direct-acting antivirals. Liver Int 2023. [PMID: 37035867 DOI: 10.1111/liv.15577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/18/2023] [Accepted: 03/25/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND AND AIMS Metabolic dysfunction (MD)-associated fatty liver disease has been proposed to identify individuals at risk of liver events irrespectively of the contemporary presence of other liver diseases. The aim of this study was to examine the impact of MD in patients cured of chronic hepatis C (CHC). PATIENTS AND METHODS We analysed data from a real-life cohort of 2611 Italian patients cured of CHC with direct antiviral agents and advanced liver fibrosis, without HBV/HIV, transplantation and negative for hepatocellular carcinoma (HCC) history (age 61.4 ± 11.8 years, 63.9% males, median follow-up 34, 24-40 months). Information about ultrasonographic steatosis (US) after sustained virological response was available in 1978. RESULTS MD affected 58% of patients, diagnosed due to the presence of diabetes (MD-diabetes, 19%), overweight without diabetes (MD-overweight, 37%) or multiple metabolic abnormalities without overweight and diabetes (MD-metabolic, 2%). MD was more frequent than and not coincident with US (32% MD-only, 23% MD-US and 13% US-only). MD was associated with higher liver stiffness (p < 0.05), particularly in patients with MD-diabetes and MD-only subgroups, comprising older individuals with more advanced metabolic and liver disease (p < 0.05). At Cox proportional hazard multivariable analysis, MD was associated with increased risk of HCC (HR 1.97, 95% CI 1.27-3.04; p = 0.0023). Further classification according to diagnostic criteria improved risk stratification (p < 0.0001), with the highest risk observed in patients with MD-diabetes. Patients with MD-only appeared at highest risk since the sustained virological response achievement (p = 0.008), with a later catch-up of those with combined MD-US, whereas US-only was not associated with HCC. CONCLUSIONS MD is more prevalent than US in patients cured of CHC with advanced fibrosis and identifies more accurately individuals at risk of developing HCC.
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Affiliation(s)
- Serena Pelusi
- Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristiana Bianco
- Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Giuliana Cologni
- Department of Internal Medicine, Papa Giovanni Hospital, Bergamo, Italy
| | - Paolo Del Poggio
- Department of Gastroenterology and Hepatology, Papa Giovanni Hospital, Zingonia, Italy
| | - Nicola Pugliese
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Daniele Prati
- Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Roberta D'Ambrosio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Gastroenterology and Hepatology, Milan, Italy
| | - Pietro Lampertico
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Gastroenterology and Hepatology, Milan, Italy
- Department of Pathophysiology and Transplantation, CRC 'A. M. and A. Migliavacca' Center for Liver Disease, University of Milan, Milan, Italy
| | - Stefano Fagiuoli
- Gastroenterology, Hepatology and Transplantation Unit, Department of Specialty and Transplant Medicine, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Luca Valenti
- Department of Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Precision Medicine Lab, Biological Resource Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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6
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Wedemeyer H, Tergast TL, Lazarus JV, Razavi H, Bakoyannis K, Baptista-Leite R, Bartoli M, Bruggmann P, Buşoi CS, Buti M, Carballo M, Castera L, Colombo M, Coutinho RS, Dadon Y, Esmat G, Esteban R, Farran JC, Gillyon-Powell M, Goldberg D, Hutchinson S, Janssen HLA, Kalamitsis G, Kondili LA, Lambert JS, Marinho RT, Maticic M, Patricello A, Peck-Radosavljevic M, Pol S, Poljak M, Pop C, Sokol T, Sypsa V, Tözün N, Younossi Z, Aghemo A, Papatheodoridis GV, Hatzakis A. Securing wider EU commitment to the elimination of hepatitis C virus. Liver Int 2023; 43:276-291. [PMID: 36196744 DOI: 10.1111/liv.15446] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 09/04/2022] [Accepted: 09/29/2022] [Indexed: 01/25/2023]
Abstract
In 2016, the Hepatitis B and C Public Policy Association (HepBCPPA), gathered all the main stakeholders in the field of hepatitis C virus (HCV) to launch the now landmark HCV Elimination Manifesto, calling for the elimination of HCV in the EU by 2030. Since then, many European countries have made progress towards HCV elimination. Multiple programmes-from the municipality level to the EU level-were launched, resulting in an overall decrease in viremic HCV infections and liver-related mortality. However, as of 2021, most countries are not on track to reach the 2030 HCV elimination targets set by the WHO. Moreover, the COVID-19 pandemic has resulted in a decrease in HCV diagnoses and fewer direct-acting antiviral treatment initiations in 2020. Diagnostic and therapeutic tools to easily diagnose and treat chronic HCV infection are now well established. Treating all patients with chronic HCV infection is more cost-saving than treating and caring for patients with liver-related complications, decompensated cirrhosis or hepatocellular carcinoma. It is more important than ever to reinforce and scale-up action towards HCV elimination. Yet, efforts urgently need the dedicated commitment of policymakers at all governmental and policy levels. Therefore, the third EU Policy Summit, held in March 2021, featured EU parliamentarians and other key decision makers to promote dialogue and take strides towards securing wider EU commitment to advance and achieve HCV elimination by 2030. We have summarized the key action points and reported the 'Call-to-Action' statement supported by all the major relevant European associations in the field.
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Affiliation(s)
- Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Tammo L Tergast
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Homie Razavi
- Center for Disease Analysis Foundation, Lafayette, Colorado, USA
| | | | - Ricardo Baptista-Leite
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.,Institute of Health Sciences, Católica University of Portugal, Lisbon, Portugal
| | | | | | | | - Maria Buti
- Liver Unit, Hospital Universitari Vall d'Hebron and CIBERHED del Instituto Carlos III, Barcelona, Spain
| | - Manuel Carballo
- International Centre for Migration, Health and Development, Geneva, Switzerland
| | - Laurent Castera
- Department of Hepatology, Hôpital Beaujon AP-HP-University of Paris-VII, Clichy, France
| | | | | | | | - Gamal Esmat
- Endemic Medicine and Department of HepatoGastroenterology Faculty of Medicine, Cairo University Hospital, Cairo, Egypt
| | - Rafael Esteban
- Liver Unit, Hospital Universitari Vall d'Hebron and CIBERHED del Instituto Carlos III, Barcelona, Spain
| | | | | | | | - Sharon Hutchinson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Harry L A Janssen
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | | | | | - John S Lambert
- Mater Misericordiae University Hospital, and UCD School of Medicine, Dublin, Ireland
| | - Rui Tato Marinho
- Serviço de Gastrenterologia e Hepatologia, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte EPE, Lisbon, Portugal
| | - Mojca Maticic
- Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Markus Peck-Radosavljevic
- Department of Internal Medicine and Gastroenterology (IMuG) Hepatology, Endocrinology, Rheumatology and Nephrology with Centralized Emergency Department (ZAE), Klagenfurt, Austria
| | - Stanislas Pol
- Department of Hepatology, Université de Paris, APHP, Hopital Cochin, Paris, France
| | - Mario Poljak
- Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
| | - Cora Pop
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | | | - Vana Sypsa
- Epidemiology and Preventive Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Nurdan Tözün
- Department of Gastroenterology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
| | - Zobair Younossi
- Department of Medicine, Inova Health Fairfax Medical Campus, Fairfax, Virginia, USA
| | - Alessio Aghemo
- Division of Internal Medicine and Hepatology, Department of Gastroenterology, IRCCS Humanitas Clinical and Research Hospital, Milan, Italy
| | - George V Papatheodoridis
- Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, Athens, Greece
| | - Angelos Hatzakis
- Epidemiology and Preventive Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece
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De Cillis S, De Luca S, Amparore D, Checcucci E, Piramide F, Piana A, Volpi G, Sica M, Verri P, Meziere J, Zamengo D, Quarà A, Cisero E, Busacca G, Colombo M, Cidda D, Gatti C, Sterrantino A, Ortenzi M, Manfredi M, Fiori C, Porpiglia F. Lower Urinary Tract Symptoms (LUTS) after Aquablation for the treatment of Benign Prostatic Hyperplasia (BPH): Evaluation of symptoms category (filling versus voiding phase) prevalence rates. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00077-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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8
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Amparore D, Piramide F, Checcucci E, Piana A, Volpi G, De Cillis S, Verri P, Granato S, Sica M, Quarà A, Busacca G, Colombo M, Bellin A, Manfredi M, Fiori C, Porpiglia F. 3D Augmented reality for neoplastic venous thrombus identification during robotic radical nephrectomy for RCC: A new tool for intraoperative guidance. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01404-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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9
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Jaffe A, Taddei TH, Giannini EG, Ilagan-Ying YC, Colombo M, Strazzabosco M. Alternative HCC prognostic biomarkers and use of artificial intelligence in the management of HCC. Liver Int 2023; 43:258-259. [PMID: 36426717 DOI: 10.1111/liv.15482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Ariel Jaffe
- Liver Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.,Smilow Cancer Hospital and Liver Cancer Program, New Haven, Connecticut, USA
| | - Tamar H Taddei
- Liver Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Edoardo G Giannini
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ysabel C Ilagan-Ying
- Liver Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | - Mario Strazzabosco
- Liver Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.,Smilow Cancer Hospital and Liver Cancer Program, New Haven, Connecticut, USA
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10
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Willacker L, Raiser TM, Bassi M, Bender A, Comanducci A, Rosanova M, Sobel N, Arzi A, Belloli L, Casarotto S, Colombo M, Derchi CC, Fló Rama E, Grill E, Hohl M, Kuehlmeyer K, Manasova D, Rosenfelder MJ, Valota C, Sitt JD. PerBrain: a multimodal approach to personalized tracking of evolving state-of-consciousness in brain-injured patients: protocol of an international, multicentric, observational study. BMC Neurol 2022; 22:468. [PMID: 36494776 PMCID: PMC9733076 DOI: 10.1186/s12883-022-02958-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/01/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Disorders of consciousness (DoC) are severe neurological conditions in which consciousness is impaired to various degrees. They are caused by injury or malfunction of neural systems regulating arousal and awareness. Over the last decades, major efforts in improving and individualizing diagnostic and prognostic accuracy for patients affected by DoC have been made, mainly focusing on introducing multimodal assessments to complement behavioral examination. The present EU-funded multicentric research project "PerBrain" is aimed at developing an individualized diagnostic hierarchical pathway guided by both behavior and multimodal neurodiagnostics for DoC patients. METHODS In this project, each enrolled patient undergoes repetitive behavioral, clinical, and neurodiagnostic assessments according to a patient-tailored multi-layer workflow. Multimodal diagnostic acquisitions using state-of-the-art techniques at different stages of the patients' clinical evolution are performed. The techniques applied comprise well-established behavioral scales, innovative neurophysiological techniques (such as quantitative electroencephalography and transcranial magnetic stimulation combined with electroencephalography), structural and resting-state functional magnetic resonance imaging, and measurements of physiological activity (i.e. nasal airflow respiration). In addition, the well-being and treatment decision attitudes of patients' informal caregivers (primarily family members) are investigated. Patient and caregiver assessments are performed at multiple time points within one year after acquired brain injury, starting at the acute disease phase. DISCUSSION Accurate classification and outcome prediction of DoC are of crucial importance for affected patients as well as their caregivers, as individual rehabilitation strategies and treatment decisions are critically dependent on the latter. The PerBrain project aims at optimizing individual DoC diagnosis and accuracy of outcome prediction by integrating data from the suggested multimodal examination methods into a personalized hierarchical diagnosis and prognosis procedure. Using the parallel tracking of both patients' neurological status and their caregivers' mental situation, well-being, and treatment decision attitudes from the acute to the chronic phase of the disease and across different countries, this project aims at significantly contributing to the current clinical routine of DoC patients and their family members. TRIAL REGISTRATION ClinicalTrials.gov, NCT04798456 . Registered 15 March 2021 - Retrospectively registered.
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Affiliation(s)
- L. Willacker
- grid.5252.00000 0004 1936 973XDepartment of Neurology, University Hospital of the Ludwig-Maximilians-Universität München, Marchioninistr. 15, Munich, Germany
| | - T. M. Raiser
- grid.5252.00000 0004 1936 973XDepartment of Neurology, University Hospital of the Ludwig-Maximilians-Universität München, Marchioninistr. 15, Munich, Germany
| | - M. Bassi
- grid.4708.b0000 0004 1757 2822Department of Biomedical and Clinical Sciences, University of Milano, Milan, Italy
| | - A. Bender
- grid.5252.00000 0004 1936 973XDepartment of Neurology, University Hospital of the Ludwig-Maximilians-Universität München, Marchioninistr. 15, Munich, Germany ,grid.478057.90000 0004 0381 347XTherapiezentrum Burgau, Hospital for Neurological Rehabilitation, Burgau, Germany
| | - A. Comanducci
- grid.418563.d0000 0001 1090 9021IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - M. Rosanova
- grid.4708.b0000 0004 1757 2822Department of Biomedical and Clinical Sciences, University of Milano, Milan, Italy
| | - N. Sobel
- grid.13992.300000 0004 0604 7563Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel
| | - A. Arzi
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, 75013 Paris, France ,grid.9619.70000 0004 1937 0538Department of Medical Neurobiology and Department of Cognitive and Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - L. Belloli
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, 75013 Paris, France ,grid.7345.50000 0001 0056 1981Laboratorio de Inteligencia Artificial Aplicada, Instituto de Ciencias de la Computación, Universidad de Buenos Aires, Buenos Aires, Argentina ,grid.423606.50000 0001 1945 2152Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ministry of Science, Technology and Innovation, Buenos Aires, Argentina
| | - S. Casarotto
- grid.4708.b0000 0004 1757 2822Department of Biomedical and Clinical Sciences, University of Milano, Milan, Italy ,grid.418563.d0000 0001 1090 9021IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - M. Colombo
- grid.4708.b0000 0004 1757 2822Department of Biomedical and Clinical Sciences, University of Milano, Milan, Italy
| | - C. C. Derchi
- grid.418563.d0000 0001 1090 9021IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - E. Fló Rama
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, 75013 Paris, France
| | - E. Grill
- grid.5252.00000 0004 1936 973XInstitute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany ,grid.411095.80000 0004 0477 2585German Center for Vertigo and Balance Disorders, Klinikum der Universität München, Munich, Germany
| | - M. Hohl
- grid.5252.00000 0004 1936 973XDepartment of Neurology, University Hospital of the Ludwig-Maximilians-Universität München, Marchioninistr. 15, Munich, Germany
| | - K. Kuehlmeyer
- grid.5252.00000 0004 1936 973XInstitute of Ethics, History and Theory of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - D. Manasova
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, 75013 Paris, France ,grid.508487.60000 0004 7885 7602Université Paris Cité, Paris, France
| | - M. J. Rosenfelder
- grid.478057.90000 0004 0381 347XTherapiezentrum Burgau, Hospital for Neurological Rehabilitation, Burgau, Germany ,grid.6582.90000 0004 1936 9748Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - C. Valota
- grid.4708.b0000 0004 1757 2822Department of Biomedical and Clinical Sciences, University of Milano, Milan, Italy ,grid.418563.d0000 0001 1090 9021IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
| | - J. D. Sitt
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, 75013 Paris, France
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11
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Jaffe A, Taddei TH, Giannini EG, Ilagan-Ying YC, Colombo M, Strazzabosco M. Holistic management of hepatocellular carcinoma: The hepatologist's comprehensive playbook. Liver Int 2022; 42:2607-2619. [PMID: 36161463 PMCID: PMC10878125 DOI: 10.1111/liv.15432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/26/2022] [Accepted: 09/21/2022] [Indexed: 12/12/2022]
Abstract
Hepatocellular carcinoma (HCC) is a common complication in patients with chronic liver disease and leads to significant morbidity and mortality. Liver disease and liver cancer are preventable by mitigating and managing common risk factors, including chronic hepatitis B and C infection, alcohol use, diabetes, obesity and other components of the metabolic syndrome. The management of patients with HCC requires treatment of the malignancy and adequate control of the underlying liver disease, as preserving liver function is critical for successful cancer treatment and may have a relevant prognostic role independent of HCC management. Hepatologists are the ideal providers to guide the care of patients with HCC as they are trained to identify patients at risk, apply appropriate surveillance strategies, assess and improve residual liver function, evaluate candidacy for transplant, provide longitudinal care to optimize and preserve liver function during and after HCC treatment, survey for cancer recurrence and manage its risk factors, and prevent and treat decompensating events. We highlight the need for a team-based holistic approach to the patient with liver disease and HCC and identify necessary gaps in current care and knowledge.
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Affiliation(s)
- Ariel Jaffe
- Liver Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
- Smilow Cancer Hospital and Liver Cancer Program, New Haven, CT, USA
| | - Tamar H. Taddei
- Liver Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Edoardo G. Giannini
- Gastroenterology Unit, Department of Internal Medicine, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ysabel C. Ilagan-Ying
- Liver Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | | | - Mario Strazzabosco
- Liver Center, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
- Smilow Cancer Hospital and Liver Cancer Program, New Haven, CT, USA
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12
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Pecoraro A, Amparore D, Piramide F, Verri P, Checcucci E, De Cillis S, Piana A, Sica M, Piscitello S, Burgio M, Meziere J, Zamengo D, Quarà A, Della Corte M, Busacca G, Colombo M, Mandaletti M, Manfredi M, Fiori C, Porpiglia F. 3D virtual models assistance predicts higher rates of “successful” minimally-invasive partial nephrectomy: an institutional analysis across the available trifecta definitions. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01181-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Amparore D, Piramide F, Checcucci E, De Cillis S, Piana A, Volpi G, Verri P, Granato S, Sica M, Meziere J, Busacca G, Cisero E, Colombo M, Mandaletti M, Ortenzi M, Cidda D, Bellin A, Cattaneo G, Manfredi M, Fiori C, Porpiglia F. Identification of renal perfusion areas with a mathematical algorithm to increase the precision of selective clamping during robot-assisted partial nephrectomy. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02236-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Amparore D, Piramide F, Checcucci E, De Cillis S, Piana A, Volpi G, Sica M, Verri P, Granato S, Burgio M, Ola L, Zamengo D, Della Corte M, Busacca G, Colombo M, Mandaletti M, Cossu M, Mesterca A, Manfredi M, Fiori C, Porpiglia F. A new technology to optimize selective clamping during 3D guided robotic partial nephrectomy: Is it feasible to precisely establish the perfusion areas of the organ? EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02165-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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15
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Piramide F, De Luca S, Checcucci E, Amparore D, Volpi G, De Cillis S, Piana A, Verri P, Piscitello S, Zamengo D, Meziere J, Busacca G, Colombo M, Pini F, Sterrantino A, Ortenzi M, Giordano A, Manfredi M, Fiori C, Porpiglia F. Results from our prospective comparative and functional analysis after different ablative techniques for MRI/real-time ultrasound image fusion guided high intensity focused ultrasound (HIFU). EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01245-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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16
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Checcucci E, Piazzolla P, Manfredi M, Amparore D, Piana A, De Cillis S, Piramide F, Volpi G, Sica M, Granato S, Burgio M, Ola L, Meziere J, Della Corte M, Cisero E, Colombo M, Gatti C, Fiori C, Porpiglia F. Artificial intelligence based system to alert the surgeon of active bleeding during robotic prostatectomy: a feasibility preliminary study. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01168-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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17
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Lazarus JV, Castera L, Mark HE, Allen AM, Adams LA, Anstee QM, Arrese M, Alqahtani SA, Bugianesi E, Colombo M, Cusi K, Hagström H, Loomba R, Romero-Gómez M, Schattenberg JM, Thiele M, Valenti L, Wong VWS, Yilmaz Y, Younossi ZM, Francque SM, Tsochatzis EA. Real-world evidence on non-invasive tests and associated cut-offs used to assess fibrosis in routine clinical practice. JHEP Rep 2022; 5:100596. [PMID: 36644239 PMCID: PMC9832273 DOI: 10.1016/j.jhepr.2022.100596] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/05/2022] [Accepted: 09/12/2022] [Indexed: 01/18/2023] Open
Abstract
Background & Aims Non-invasive tests (NITs) offer a practical solution for advanced fibrosis identification in non-alcoholic fatty liver disease (NAFLD). Despite increasing implementation, their use is not standardised, which can lead to inconsistent interpretation and risk stratification. We aimed to assess the types of NITs and the corresponding cut-offs used in a range of healthcare settings. Methods A survey was distributed to a convenience sample of liver health experts who participated in a global NAFLD consensus statement. Respondents provided information on the NITs used in their clinic with the corresponding cut-offs and those used in established care pathways in their areas. Results There were 35 respondents from 24 countries, 89% of whom practised in tertiary level settings. A total of 14 different NITs were used, and each respondent reported using at least one (median = 3). Of the respondents, 80% reported using FIB-4 and liver stiffness by vibration-controlled transient elastography (Fibroscan®), followed by the NAFLD fibrosis score (49%). For FIB-4, 71% of respondents used a low cut-off of <1.3 (range <1.0 to <1.45) and 21% reported using age-specific cut-offs. For Fibroscan®, 21% of respondents used a single liver stiffness cut-off: 8 kPa in 50%, while the rest used 7.2 kPa, 7.8 kPa and 8.7 kPa. Among the 63% of respondents who used lower and upper liver stiffness cut-offs, there were variations in both values (<5 to <10 kPa and >7.5 to >20 kPa, respectively). Conclusions The cut-offs used for the same NITs for NAFLD risk stratification vary between clinicians. As cut-offs impact test performance, these findings underscore the heterogeneity in risk-assessment and support the importance of establishing consistent guidelines on the standardised use of NITs in NAFLD management. Lay summary Owing to the high prevalence of non-alcoholic fatty liver disease (NAFLD) in the general population it is important to identify those who have more advanced stages of liver fibrosis, so that they can be properly treated. Non-invasive tests (NITs) provide a practical way to assess fibrosis risk in patients. However, we found that the cut-offs used for the same NITs vary between clinicians. As cut-offs impact test performance, these findings highlight the importance of establishing consistent guidelines on the standardised use of NITs to optimise clinical management of NAFLD.
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Affiliation(s)
- Jeffrey V. Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Corresponding author. Address: Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Calle del Rosselló 171, ENT-2, ES-08036 Barcelona, Spain. Tel.: +34 608 703 573.
| | - Laurent Castera
- Université de Paris, UMR1149 (CRI), Inserm, Paris, France & Service d’Hépatologie, AP-HP, Hôpital Beaujon, Clichy, France
| | - Henry E. Mark
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Alina M. Allen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Leon A. Adams
- Department of Hepatology and Liver Transplant Unit, Sir Charles Gairdner Hospital, Medical School, University of Western Australia, Perth, Australia
| | - Quentin M. Anstee
- Translational & Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Newcastle NIHR Biomedical Research Centre, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle Upon Tyne, UK
| | - Marco Arrese
- Department of Gastroenterology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Centro de Envejecimiento y Regeneración (CARE), Departamento de Biología Celular y Molecular, Facultad de Ciencias Biologicas, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Saleh A. Alqahtani
- Division of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, USA
- Organ Transplant Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Elisabetta Bugianesi
- Department of Medical Sciences, Division of Gastroenterology and Hepatology, A.O. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | | | - Kenneth Cusi
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA
| | - Hannes Hagström
- Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Rohit Loomba
- Department of Medicine, NAFLD Research Center, La Jolla, CA, USA
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Manuel Romero-Gómez
- Virgen del Rocio University Hospital, Institute of Biomedicine of Seville (HUVR/CSIC/US), CIBEREHD, University of Seville, Seville, Spain
| | - Jörn M. Schattenberg
- Metabolic Liver Research Program, I. Department of Medicine, University Medical Centre Mainz, Mainz, Germany
| | - Maja Thiele
- Liver Research Center, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Precision Medicine, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Vincent Wai-Sun Wong
- Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Yusuf Yilmaz
- Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
- Liver Research Unit, Institute of Gastroenterology, Marmara University, Istanbul, Turkey
| | | | - Sven M. Francque
- Department of Gastroenterology Hepatology, University Hospital Antwerp & Translational Sciences in Inflammation and Immunology TWI2N, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Emmanuel A. Tsochatzis
- University College London Institute for Liver and Digestive Health, Royal Free Hospital, London, United Kingdom
- Sheila Sherlock Liver Centre, Royal Free Hospital, London, United Kingdom
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18
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Guidotti LG, La Vecchia C, Colombo M. Low-dose aspirin reduces the risk of HBV-associated HCC even when administered short-term: Too good to be true? Hepatology 2022; 76:300-302. [PMID: 35254662 DOI: 10.1002/hep.32445] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 02/28/2022] [Indexed: 12/08/2022]
Affiliation(s)
- Luca G Guidotti
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Massimo Colombo
- Liver Center & General Medicine, IRCCS San Raffaele Hospital, Milan, Italy
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19
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Strazzabosco M, Cabibbo G, Colombo M. Adjusting Barcelona Clinic Liver Cancer Staging System to the Evolving Landscape of Hepatocellular Carcinoma: A Look to the Future. Gastroenterology 2022; 162:2106-2108. [PMID: 35122767 DOI: 10.1053/j.gastro.2022.01.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Indexed: 12/02/2022]
Affiliation(s)
- Mario Strazzabosco
- Liver Center, Department of Internal Medicine, Yale University School of Medicine and, Smilow Cancer Hospital and Liver Cancer Program, New Haven, Connecticut
| | - Giuseppe Cabibbo
- Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Massimo Colombo
- Liver Center, Iceberg General Medicine 8, Ospedale San Raffaele, Milan, Italy
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20
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Izzotti A, Grasselli E, Barbaresi M, Bixio M, Colombo M, Pfeffer U, Pulliero A, Sossai D, Borneto A, Boccaccio A, Manfredi V, Bassetti M, Nicosia E, Tiso M. Development of an integrated environmental monitoring protocol for SARS-CoV-2 contamination. Applications at the IRCSS San Martino Polyclinic Hospital in Genoa, Italy. Environ Res 2022; 209:112790. [PMID: 35104484 PMCID: PMC8800503 DOI: 10.1016/j.envres.2022.112790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/06/2022] [Accepted: 01/20/2022] [Indexed: 06/14/2023]
Abstract
SCIENTIFIC BACKGROUND Environmental sampling of SARS-CoV-2 is a fundamental tool for evaluating the effectiveness of non-specific prophylaxis measures in counteracting virus spread. The purpose of our work was to evaluate the effectiveness of the different sampling methods in the hospital setting to assess their correlation with the structural, functional, and operational situation of the monitored departments and to define the dynamics of the spread of the virus in indoor environments. METHODS The monitoring (air bubbling sampling, surface wipe test) was carried out at the San Martino Polyclinic Hospital (Genoa, Italy) in the period since April 2020 to June 2021. The presence of viral RNA in the collected samples was evaluated by qPCR. The infection capacity of the samples collected was also evaluated by an in vitro challenge test on cells sensitive to SARS-CoV-2 infection. RESULTS The percentage of positivity with respect to the number of tests performed (sensitivity) were air bubbler 50%, wipe test 17%, and challenge test 11%. Only 20% of the samples tested positive in the wipe test and 43% of the samples tested positive in the bubbler sampling were also positive in the challenge test. All the positivity obtained was detected at a distance of less than 2 m and height of less than 1.5 from COVID-19 patients. CONCLUSIONS Environmental contamination from SARS-CoV-2 detected at the San Martino Polyclinic Hospital is found lower than similar assessments performed in other hospitals both in Italy and abroad. Our study predicted that environmental monitoring of SARS-CoV-2 must be carried out in an integrated way by not using a single sampling method, as each individual test has a different biological significance and performance. However, the virus detected by wipe test only is often a degraded viral fragment and not an intact infecting virion.
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Affiliation(s)
- A Izzotti
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Experimental Medicine, University of Genoa, Italy.
| | - E Grasselli
- Life Sciences Department, University of Genoa, Italy.
| | - M Barbaresi
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - M Bixio
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - M Colombo
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - U Pfeffer
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - A Pulliero
- Department of Health Sciences, University of Genoa, Italy.
| | - D Sossai
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | - A Borneto
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
| | | | | | - M Bassetti
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Health Sciences, University of Genoa, Italy.
| | - E Nicosia
- Environmental Department, Ligurian Region, Italy.
| | - M Tiso
- Life Sciences Department, University of Genoa, Italy; MICAMO Environmental and Molecular Microbiology - Spin-Off University of Genoa, Italy.
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21
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D’Ambrosio R, Rizzardini G, Puoti M, Fagiuoli S, Anolli MP, Gabiati C, D’Amico F, Pasulo L, Restelli U, Colombo M, Lampertico P. Implementation of HCV screening in the 1969-1989 birth-cohort undergoing COVID-19 vaccination. Liver Int 2022; 42:1012-1016. [PMID: 35220667 PMCID: PMC9115160 DOI: 10.1111/liv.15216] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/09/2021] [Accepted: 01/26/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIM The World Health Organization (WHO) goal of hepatitis C virus (HCV) elimination by 2030 relies on the scaling-up of both identification and linkage to care of the infected population, worldwide. In Italy, the estimated burden of HCV carriers who are unaware of their infection amounts to 200 000 persons, a projection that reinforces the need for broadening population access to effective screening programmes. METHODS A pivotal screening programme targeting subjects born between 1969 and 1989 has been conducted in Lombardy, Northern Italy, where point-of-care (POC) testing was offered for free concomitantly to COVID-19 vaccination. RESULTS Amongst 7219 subjects born between 1969 and 1989 who underwent HCV screening through POC, 7 (0.10%) subjects tested anti-HCV positive: 5 (0.07%) had confirmed anti-HCV positivity (Table 1) and 4 of them (0.05%) were HCV-RNA positive by standard confirmation tests. CONCLUSIONS This pivotal study demonstrated the feasibility of a POC-based anti-HCV screening programme in young adults undergoing COVID-19 vaccination. The prevalence of HCV infection in subjects born in the 1969-1989 cohort in Italy seems to be lower than previously estimated. Whether the extension of this programme to subjects born before 1969 could lead to improved screening effectiveness should be a matter of debate.
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Affiliation(s)
- Roberta D’Ambrosio
- Division of Gastroenterology and HepatologyFoundation IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Giuliano Rizzardini
- ASST Fatebenefratelli‐Sacco, First Division of Infectious DiseasesMilanItaly
| | - Massimo Puoti
- ASST Grande Ospedale Metropolitano Niguarda, Division of Infectious DiseasesMilanItaly
| | - Stefano Fagiuoli
- AAST Papa Giovanni XXIII, Gastroenterology, Hepatology and TransplantationBergamoItaly
| | - Maria Paola Anolli
- Division of Gastroenterology and HepatologyFoundation IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Claudia Gabiati
- ASST Fatebenefratelli‐Sacco, Division of Internal MedicineMilanItaly
| | - Federico D’Amico
- ASST Grande Ospedale Metropolitano Niguarda, Division of Infectious DiseasesMilanItaly
| | - Luisa Pasulo
- AAST Papa Giovanni XXIII, Gastroenterology, Hepatology and TransplantationBergamoItaly
| | - Umberto Restelli
- LIUC Cattaneo UniversityCastellanza (VA)Italy
- Faculty of Health SciencesSchool of Public HealthUniversity of the WitwatersrandJohannesburgSouth Africa
| | | | - Pietro Lampertico
- Division of Gastroenterology and HepatologyFoundation IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
- CRC “A. M. and A. Migliavacca” Center for Liver Diseases, Department of Pathophysiology and TransplantationUniversity of MilanMilanItaly
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22
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Lazarus JV, Picchio CA, Byrne CJ, Crespo J, Colombo M, Cooke GS, Dore GJ, Grebely J, Ward JW, Dillon JF. A Global Systematic Review of Hepatitis C Elimination Efforts through Micro-Elimination. Semin Liver Dis 2022; 42:159-172. [PMID: 35189667 DOI: 10.1055/a-1777-6112] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Microelimination targets specific subpopulations and/or geographic settings for hepatitis C virus (HCV) elimination. This review reports on global HCV microelimination literature published from 2013 to 2020. Data were extracted from publications to report a score based on the four key components defining microelimination. Sustained virologic response (SVR) and treatment initiation proportions were calculated for each manuscript and grouped means of these estimates were compared depending on microelimination score and care setting. A total of 83% of the studies were from high-income settings and mainly included people who use drugs or those incarcerated. Among manuscripts, 18 had "low" microelimination scores, 11 had "high" scores, and the differences in mean proportion who initiated treatment and achieved SVR between low and high score groups were statistically significant. Microelimination can be a useful complementary strategy for driving engagement in HCV treatment and cure. Our analysis suggests that adhering to more of the core microelimination components can improve outcomes. This study is registered with Prospero, registration identification: CRD42020175211.
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Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic de Barcelona, Spain
- Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Camila A Picchio
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic de Barcelona, Spain
| | - Christopher J Byrne
- Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Ninewells Hospital, Dundee, United Kingdom
| | - Javier Crespo
- Department of Gastroenterology and Hepatology, University Hospital Marques de Valdecilla. Research Institute Valdecilla-IDIVAL, Santander, Spain
| | - Massimo Colombo
- General Medicine & Liver Center, San Raffaele Hospital, Milan, Italy
| | - Graham S Cooke
- Division of Infectious Diseases, Faculty of Medicine, Imperial College London, United Kingdom
| | | | | | - John W Ward
- Coalition for Global Hepatitis Elimination, The Task Force for Global Health, Atlanta, United States
| | - John F Dillon
- Division of Molecular and Clinical Medicine, University of Dundee School of Medicine, Ninewells Hospital, Dundee, United Kingdom
- Department of Gastroenterology, Ninewells Hospital & Medical School, Dundee, United Kingdom
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Sulkowski M, Telep LE, Colombo M, Durand F, Reddy KR, Lawitz E, Bourlière M, Cheinquer N, Scherbakovsky S, Ni L, Force L, Ramroth H, Gaggar A, Chokkalingam AP, Sise ME. Sofosbuvir and risk of estimated glomerular filtration rate decline or end-stage renal disease in patients with renal impairment. Aliment Pharmacol Ther 2022; 55:1169-1178. [PMID: 35235245 PMCID: PMC9313579 DOI: 10.1111/apt.16830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/21/2021] [Accepted: 02/04/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sofosbuvir, a prodrug nucleoside inhibitor of hepatitis C virus, has a predominant circulating metabolite that is renally eliminated. Whether sofosbuvir is associated with chronic kidney disease (CKD) progression is not well understood. METHODS We performed a retrospective analysis of patients with estimated glomerular filtration rate (eGFR) 30-89 mL/min/1.73 m2 treated with sofosbuvir in 76 Phase 2/3 registrational trials. We evaluated eGFR at each study visit. Separately, we performed a retrospective analysis of an administrative claims database (IQVIA PharMetrics Plus™) to compare the risk of incident end-stage renal disease (ESRD) associated with the use of sofosbuvir or non-sofosbuvir regimens among patients with CKD using propensity score methods. Exposure, CKD status and outcomes were determined using diagnosis and medication claim codes. Cox proportional hazards methods were used to estimate ESRD risk. RESULTS Among 4642 trial participants with baseline stage 2 CKD (eGFR 60-89 ml/min/1.73 m2 ) and 682 trial participants with stage 3 CKD (eGFR 30-59 ml/min/1.73 m2 ) mean (SD) eGFR improved from baseline to 4 weeks post-treatment (+0.7 [9.3] and +2.6 [8.8] ml/min/1.73 m2 , respectively; p < 0.001 each). In the second analysis, among 2042 patients with CKD receiving sofosbuvir-based regimens compared to 431 receiving non-sofosbuvir-based regimens, after adjusting for baseline covariates and weighting based on treatment propensity scores, there was no significant difference in risk of ESRD (adjusted HR = 0.85, 95% CI: 0.51-1.42). CONCLUSIONS Clinical trial participants with CKD did not experience worsening eGFR during sofosbuvir-based treatment, and sofosbuvir was not associated with an increased risk of ESRD in patients with CKD in a nationally-representative administrative claims database.
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Affiliation(s)
- Mark Sulkowski
- Johns Hopkins University School of MedicineBaltimoreMarylandUSA
| | | | | | | | - K. Rajender Reddy
- Department of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Eric Lawitz
- Texas Liver InstituteUniversity of Texas Health Science CenterSan AntonioTexasUSA
| | - Marc Bourlière
- Hépato‐Gastro‐EntérologieHôpital Saint JosephMarseilleFrance
- INSERM 1252, IRD, Sciences Economiques & Sociales de la Santé & Traitement de l’Information MédicaleAix‐Marseille UniversityMarseilleFrance
| | | | | | - Liyun Ni
- Gilead Sciences, Inc.Foster CityCaliforniaUSA
| | | | | | - Anuj Gaggar
- Gilead Sciences, Inc.Foster CityCaliforniaUSA
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Forner A, Colombo M. The Maze of Systemic Therapy for Hepatocellular Carcinoma: Did We Find the Compass? Gastroenterology 2022; 162:1770-1772. [PMID: 34954224 DOI: 10.1053/j.gastro.2021.12.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Alejandro Forner
- Liver Unit, Barcelona Clinic Liver Cancer (BCLC) group, ICMDM, Hospital Clinic Barcelona, IDIBAPS, University of Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Massimo Colombo
- Liver Center, General Medicine 8, IRCCS Ospedale San Raffaele, Milan, Italy
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Sidoli C, Zambon A, Tassistro E, Rossi E, Mossello E, Inzitari M, Cherubini A, Marengoni A, Morandi A, Bellelli G, Tarasconi A, Sella M, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Porcella L, Nardiello I, Chimenti E, Zeni M, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, Pietrogrande L, Mosca M, Corazzin I, Rossi P, Nunziata V, D’Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell’Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Borghi C, Bianchetti A, Crucitti A, DiFrancesco V, Fontana G, Geriatria A, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cassadonte F, Vatrano M, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Seneci F, Fimognari F, Bambar V, Saitta A, Corica F, Braga M, Servi, Ettorre E, Camellini Bellelli CG, Annoni G, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Formilan M, Patrizia G, Santuar L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl’Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Alessandro M, Calogero P, Corvalli G, Di F, Pezzoni D, Platto C, D’Ambrosio V, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Bonetto M, Grasso M, Troisi E, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Faraci B, Bertoletti E, Vannucci M, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D’Amico F, Grippa A, Mazzone A, Cottino M, Vezzadini G, Avanzi S, Brambilla C, Orini S, Sgrilli F, Mello A, Lombardi Muti LE, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D’Amico F, D’Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Cortegiani A, Pistidda L, D’Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. Prevalence and features of delirium in older patients admitted to rehabilitation facilities: a multicenter study. Aging Clin Exp Res 2022; 34:1827-1835. [PMID: 35396698 DOI: 10.1007/s40520-022-02099-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/16/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Delirium is thought to be common across various settings of care; however, still little research has been conducted in rehabilitation. AIM We investigated the prevalence of delirium, its features and motor subtypes in older patients admitted to rehabilitation facilities during the three editions of the "Delirium Day project". METHODS We conducted a cross-sectional study in which 1237 older patients (age ≥ 65 years old) admitted to 50 Italian rehabilitation wards during the three editions of the "Delirium Day project" (2015 to 2017) were included. Delirium was evaluated through the 4AT and its motor subtype with the Delirium Motor Subtype Scale. RESULTS Delirium was detected in 226 patients (18%), and the most recurrent motor subtype was mixed (37%), followed by hypoactive (26%), hyperactive (21%) and non-motor one (16%). In a multivariate Poisson regression model with robust variance, factors associated with delirium were: disability in basic (PR 1.48, 95%CI: 1.17-1.9, p value 0.001) and instrumental activities of daily living (PR 1.58, 95%CI: 1.08-2.32, p value 0.018), dementia (PR 2.10, 95%CI: 1.62-2.73, p value < 0.0001), typical antipsychotics (PR 1.47, 95%CI: 1.10-1.95, p value 0.008), antidepressants other than selective serotonin reuptake inhibitors (PR 1.3, 95%CI: 1.02-1.66, p value 0.035), and physical restraints (PR 2.37, 95%CI: 1.68-3.36, p value < 0.0001). CONCLUSION This multicenter study reports that 2 out 10 patients admitted to rehabilitations had delirium on the index day. Mixed delirium was the most prevalent subtype. Delirium was associated with unmodifiable (dementia, disability) and modifiable (physical restraints, medications) factors. Identification of these factors should prompt specific interventions aimed to prevent or mitigate delirium.
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La Mura V, Gagliano N, Arnaboldi F, Sartori P, Procacci P, Denti L, Liguori E, Bitto N, Ristagno G, Latini R, Dondossola D, Salerno F, Tripodi A, Colombo M, Peyvandi F. Simvastatin Prevents Liver Microthrombosis and Sepsis Induced Coagulopathy in a Rat Model of Endotoxemia. Cells 2022; 11:cells11071148. [PMID: 35406712 PMCID: PMC8997834 DOI: 10.3390/cells11071148] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/19/2022] [Accepted: 03/22/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Endotoxemia causes endothelial dysfunction and microthrombosis, which are pathogenic mechanisms of coagulopathy and organ failure during sepsis. Simvastatin has potential anti-thrombotic effects on liver endothelial cells. We investigated the hemostatic changes induced by lipopolysaccharide (LPS) and explored the protective effects of simvastatin against liver vascular microthrombosis. Methods and results: We compared male Wistar rats exposed to LPS (5 mg/kg one i.p. dose) or saline in two experimental protocols—placebo (vehicle) and simvastatin (25 mg/kg die, orally, for 3 days before LPS). Morphological studies were performed by light- and electron-microscopy analyses to show intravascular fibrin deposition, vascular endothelial structure and liver damage. Peripheral- and organ-hemostatic profiles were analyzed using whole blood viscoelastometry by ROTEM, liver biopsy and western-blot/immunohistochemistry of thrombomodulin (TM), as well as immunohistochemistry of the von Willebrand factor (VWF). LPS-induced fibrin deposition and liver vascular microthrombosis were combined with a loss of sinusoidal endothelial TM expression and VWF-release. These changes were associated with parenchymal eosinophilia and necrosis. ROTEM analyses displayed hypo-coagulability in the peripheral blood that correlated with the degree of intrahepatic fibrin deposition (p < 0.05). Simvastatin prevented LPS-induced fibrin deposition by preserving TM expression in sinusoidal cells and completely reverted the peripheral hypo-coagulability caused by endotoxemia. These changes were associated with a significant reduction of liver cell necrosis without any effect on eosinophilia. Conclusions: Simvastatin preserves the antithrombotic properties of sinusoidal endothelial cells disrupted by LPS, deserving pharmacological properties to contrast sepsis-associated coagulopathy and hepatic failure elicited by endotoxemia
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Affiliation(s)
- Vincenzo La Mura
- Fondazione I.R.C.C.S. Ca’ Granda, Ospedale Maggiore Policlinico, U.O.C. Medicina Generale Emostasi e Trombosi, 20122 Milan, Italy; (N.B.); (A.T.); (F.P.)
- CRC “A.M. e A. Migliavacca” per lo Studio e la Cura delle Malattie del Fegato, Università degli Studi di Milano, 20122 Milan, Italy
- Dipartimento di Fisiopatologia dei Trapianti, Università degli Studi di Milano, 20132 Milan, Italy; (E.L.); (G.R.); (D.D.)
- Correspondence:
| | - Nicoletta Gagliano
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milan, Italy; (N.G.); (F.A.); (P.S.); (P.P.); (L.D.); (F.S.)
| | - Francesca Arnaboldi
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milan, Italy; (N.G.); (F.A.); (P.S.); (P.P.); (L.D.); (F.S.)
| | - Patrizia Sartori
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milan, Italy; (N.G.); (F.A.); (P.S.); (P.P.); (L.D.); (F.S.)
| | - Patrizia Procacci
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milan, Italy; (N.G.); (F.A.); (P.S.); (P.P.); (L.D.); (F.S.)
| | - Luca Denti
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milan, Italy; (N.G.); (F.A.); (P.S.); (P.P.); (L.D.); (F.S.)
| | - Eleonora Liguori
- Dipartimento di Fisiopatologia dei Trapianti, Università degli Studi di Milano, 20132 Milan, Italy; (E.L.); (G.R.); (D.D.)
| | - Niccolò Bitto
- Fondazione I.R.C.C.S. Ca’ Granda, Ospedale Maggiore Policlinico, U.O.C. Medicina Generale Emostasi e Trombosi, 20122 Milan, Italy; (N.B.); (A.T.); (F.P.)
| | - Giuseppe Ristagno
- Dipartimento di Fisiopatologia dei Trapianti, Università degli Studi di Milano, 20132 Milan, Italy; (E.L.); (G.R.); (D.D.)
- Fondazione I.R.C.C.S. Ca’ Granda, Ospedale Maggiore Policlinico, U.O.C. Anestesia e Rianimazione, 20122 Milan, Italy
| | - Roberto Latini
- Dipartimento di Ricerca Cardiovascolare, Istituto di Ricerche Farmacologiche Mario Negri I.R.C.C.S., 20156 Milan, Italy;
| | - Daniele Dondossola
- Dipartimento di Fisiopatologia dei Trapianti, Università degli Studi di Milano, 20132 Milan, Italy; (E.L.); (G.R.); (D.D.)
- U.O. Chirurgia Generale e dei Trapianti di Fegato, Fondazione IRCCS Ca′ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Francesco Salerno
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, 20133 Milan, Italy; (N.G.); (F.A.); (P.S.); (P.P.); (L.D.); (F.S.)
| | - Armando Tripodi
- Fondazione I.R.C.C.S. Ca’ Granda, Ospedale Maggiore Policlinico, U.O.C. Medicina Generale Emostasi e Trombosi, 20122 Milan, Italy; (N.B.); (A.T.); (F.P.)
| | - Massimo Colombo
- Liver Center IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | - Flora Peyvandi
- Fondazione I.R.C.C.S. Ca’ Granda, Ospedale Maggiore Policlinico, U.O.C. Medicina Generale Emostasi e Trombosi, 20122 Milan, Italy; (N.B.); (A.T.); (F.P.)
- Dipartimento di Fisiopatologia dei Trapianti, Università degli Studi di Milano, 20132 Milan, Italy; (E.L.); (G.R.); (D.D.)
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Colucci G, Uceda Renteria S, Lunghi G, Ceriotti F, Sguazzini E, Spalenza S, Regazzo C, Lampertico P, Colombo M. Italian migrants study: An HCV and HBV micro-elimination pilot project. Clin Res Hepatol Gastroenterol 2022; 46:101852. [PMID: 34923181 DOI: 10.1016/j.clinre.2021.101852] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/09/2021] [Accepted: 12/03/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Migrants represent a key target population for viral hepatitis micro-elimination programs and are important targets for specific prevention, screening and treatment programs. AIMS To raise awareness on viral hepatitis among migrants and key stakeholders, assess the prevalence of HBV and HCV among migrants, and determine an optimal and scalable viral hepatitis screening and treatment protocol. MATERIAL AND METHODS Unselected, consecutive migrants reaching the costs of Italy were screened for HBV, HCV, HDV and HIV markers. Anagraphic and anamnestic information were used to identify viral hepatitis endemic hotspots in the countries of birth or transit. Personal data, including migration route, test results and treatment, were collected and stored in a dedicated database RESULTS: 362 patients were recruited in 2019; median age was 28 years, 71% were male. Most of the patients were African (54%) or Asian (40%). 49% positive for at least one HBV marker: 2.2% HBsAg (asymptomatic carriers with low viremia); 10.6% anti-HBs; 28.5% anti-HBs and anti-HBc, 1.7% anti-HCV, 0.6% anti-HIV, with low or undetectable viral load. Libya was the nexus shared by most of the positive, reactive cases. HCV and HIV markers were only found in migrants already resident in Italy for more than 6-12 months. CONCLUSION Low to moderate prevalence of hepatitis B markers were observed in African and Asian first arrival migrants. Migrants positive for HCV and HIV likely acquired the infection after arrival in Italy, suggesting migrants are at risk of contracting viral infections once in Italy, highlighting the importance of ensuring access to prevention for migrant communities.
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Affiliation(s)
- Giuseppe Colucci
- Division of Gastroenterology and Hepatology, University of Milan, Milan, Italy.
| | - Sara Uceda Renteria
- Department of Laboratory Medicine, Virology Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Giovanna Lunghi
- Department of Laboratory Medicine, Virology Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Ferruccio Ceriotti
- Department of Laboratory Medicine, Virology Unit, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Enrico Sguazzini
- Department of Medical Biotechnology, Università degli Studi di Milano, Milan, Italy
| | | | | | - Pietro Lampertico
- Division of Gastroenterology and Hepatology, University of Milan, Milan, Italy
| | - Massimo Colombo
- EASL International Liver Foundation (EILF), Geneve, Switzerland
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Colombo M, Barouki R. Expanding the liver exposome: Should hepatologists care about air pollution? J Hepatol 2022; 76:495-497. [PMID: 34883156 DOI: 10.1016/j.jhep.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 12/04/2022]
Affiliation(s)
- Massimo Colombo
- San Raffaele Hospital, Liver Center, Via Olgettina 60, 20132 Milan, Italy.
| | - Robert Barouki
- Université de Paris, Inserm, unit 1124, T3S, 45 rue des Saints Pères, 75006 Paris, France.
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Colombo M, Maniscalco P. Impact of CIO on evolution of trauma care in Italy. Injury 2022; 53 Suppl 1:S1. [PMID: 35307081 DOI: 10.1016/j.injury.2022.01.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- M Colombo
- UOC Ortopedia e Traumatologia 3 ASST Pini CTO Milan, Italy.
| | - P Maniscalco
- Struttura Complessa di Ortopedia e Traumatologia AUSL Piacenza, Italy
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Younossi ZM, Racila A, Muir A, Bourliere M, Mangia A, Esteban R, Zeuzem S, Colombo M, Manns M, Papatheodoridis GV, Buti M, Chokkalingam A, Gaggar A, Nader F, Younossi I, Henry L, Stepanova M. Long-term Patient-Centered Outcomes in Cirrhotic Patients With Chronic Hepatitis C After Achieving Sustained Virologic Response. Clin Gastroenterol Hepatol 2022; 20:438-446. [PMID: 33493697 DOI: 10.1016/j.cgh.2021.01.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/04/2021] [Accepted: 01/18/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND & AIMS Achieving sustained virologic response (SVR) among patients with hepatitis C virus (HCV) leads to patient reported outcome (PRO) improvement. We aimed to assess the long-term post-SVR PRO trends in HCV patients with cirrhosis. METHODS Patients with HCV and cirrhosis treated in clinical trials with direct acting antiviral agents (DAAs) who achieved SVR-12 were prospectively enrolled in a long-term registry (clinicaltrials.gov #NCT02292706). PROs were collected every 24 weeks using the Short Form-36v2 (SF-36), CLDQ-HCV, and WPAI-HCV. RESULTS Pre-treatment baseline data were available for 854 cirrhotic patients who achieved SVR after DAAs. Of these, 730 had compensated (CC) and 124 had decompensated cirrhosis (DCC) before treatment- patients with DCC reported severe impairment in their PROs in comparison to CC patients (by mean -5% to -16% of a PRO range size; p < .05 for 16 out of 20 studied PROs]. After achieving SVR and registry enrollment, significant PRO improvements were noted from pre-treatment levels in 11/20 domains for those with DCC (+4% to +21%) and 19/20 PRO domains in patients with CC (+3% to +17%). Patients with baseline DCC had higher rates of hepatocellular carcinoma and mortality (P < .05). In patients with CC, the PRO gains persisted up to 168 weeks (3.5 years) of registry follow-up. In patients with DCC, the improvements lasted for at least 96 weeks but a declining trend after year 2. CONCLUSIONS Patients with HCV cirrhosis experience severe PRO impairment at baseline with sustainable improvement after SVR. Though those with DCC experience improvement, there is a decline after 2 years.
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Affiliation(s)
- Zobair M Younossi
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia; Inova Medicine, Inova Health System, Falls Church, Virginia; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia.
| | - Andrei Racila
- Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia; Inova Medicine, Inova Health System, Falls Church, Virginia
| | - Andrew Muir
- Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Marc Bourliere
- Department of Hepato- Gastroenterology, Hospital Saint Joseph, Marseille, France
| | - Alessandra Mangia
- IRCCS Casa Sollievo della Sofferenza Hospital, Liver Unit, Medical Sciences, San Giovanni Rotondo, Italy
| | - Rafael Esteban
- Liver Unit, Hospital Universitari Vall d'Hebron and Ciberehd del Instituto Carlos III, Barcelona, Spain
| | - Stefan Zeuzem
- Department of Medicine I at the Goethe University Hospital, Frankfurt, Germany
| | - Massimo Colombo
- Liver Center for Translational Research, IRCCS Humanitas, Milan, Italy
| | | | | | - Maria Buti
- Liver Unit, Hospital Universitari Vall d'Hebron and Ciberehd del Instituto Carlos III, Barcelona, Spain
| | | | | | - Fatema Nader
- Center for Outcomes Research in Liver Disease, Washington, District of Columbia
| | - Issah Younossi
- Center for Outcomes Research in Liver Disease, Washington, District of Columbia
| | - Linda Henry
- Center for Outcomes Research in Liver Disease, Washington, District of Columbia
| | - Maria Stepanova
- Center for Outcomes Research in Liver Disease, Washington, District of Columbia
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31
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Valenti L, Pedica F, Colombo M. Distinctive features of hepatocellular carcinoma in non-alcoholic fatty liver disease. Dig Liver Dis 2022; 54:154-163. [PMID: 34294580 DOI: 10.1016/j.dld.2021.06.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/31/2021] [Accepted: 06/22/2021] [Indexed: 02/07/2023]
Abstract
Hepatocellular carcinoma (HCC) is on the rise globally, causing more than 800 thousand deaths annually, with an estimated annual percent change of 0.51 for causes other than viral hepatitis, including nonalcoholic fatty liver disease (NAFLD). The incidence of NAFLD-related HCC is peaking in several Far East regions (6-12% vs. 2-3% in Western Europe and USA), HCC risk being mainly driven by the epidemic of obesity and diabetes, both favored by an unhealthy diet and sedentary lifestyle. Under inherited susceptibility outlined by such genetic markers as variants in PNPLA3, TM6SF2 and MBOAT7, neoplastic transformation of NAFLD is driven by sublethal lipotoxicity consequent to hepatocyte lipid overload, whereas a myriad of factors spanning from subverted circadian homeostasis and gut dysbiosis to alcohol abuse and tobacco may interact as risk modifiers. At variance with viral HCC, NAFLD-HCC shows a frequent association with cardiovascular co-morbidities, absence of cirrhosis in up to half of patients and an association with persistently normal transaminase values. All these misleading features of NAFLD-related HCC account for the low uptake of surveillance and linkage to curative treatments that has been reported in patients with this cancer, a downside that could be attenuated when scores for cost-effective risk stratification become available.
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Affiliation(s)
- Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Italy; Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Pedica
- Department of Experimental Oncology, Pathology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Colombo
- Liver Center, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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32
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Zucchelli A, Manzoni F, Morandi A, Di Santo S, Rossi E, Valsecchi MG, Inzitari M, Cherubini A, Bo M, Mossello E, Marengoni A, Bellelli G, Tarasconi A, Sella M, Auriemma S, Paternò G, Faggian G, Lucarelli C, De Grazia N, Alberto C, Margola A, Porcella L, Nardiello I, Chimenti E, Zeni M, Giani A, Famularo S, Romairone E, Minaglia C, Ceccotti C, Guerra G, Mantovani G, Monacelli F, Minaglia C, Candiani T, Ballestrero A, Minaglia C, Santolini F, Minaglia C, Rosso M, Bono V, Sibilla S, Dal Santo P, Ceci M, Barone P, Schirinzi T, Formenti A, Nastasi G, Isaia G, Gonella D, Battuello A, Casson S, Calvani D, Boni F, Ciaccio A, Rosa R, Sanna G, Manfredini S, Cortese L, Rizzo M, Prestano R, Greco A, Lauriola M, Gelosa G, Piras V, Arena M, Cosenza D, Bellomo A, LaMontagna M, Gabbani L, Lambertucci L, Perego S, Parati G, Basile G, Gallina V, Pilone G, Giudice C, De F, Pietrogrande L, De B, Mosca M, Corazzin I, Rossi P, Nunziata V, D‘Amico F, Grippa A, Giardini S, Barucci R, Cossu A, Fiorin L, Arena M, Distefano M, Lunardelli M, Brunori M, Ruffini I, Abraham E, Varutti A, Fabbro E, Catalano A, Martino G, Leotta D, Marchet A, Dell‘Aquila G, Scrimieri A, Davoli M, Casella M, Cartei A, Polidori G, Basile G, Brischetto D, Motta S, Saponara R, Perrone P, Russo G, Del D, Car C, Pirina T, Franzoni S, Cotroneo A, Ghiggia F, Volpi G, Menichetti C, Bo M, Panico A, Calogero P, Corvalli G, Mauri M, Lupia E, Manfredini R, Fabbian F, March A, Pedrotti M, Veronesi M, Strocchi E, Bianchetti A, Crucitti A, Di Francesco V, Fontana G, Bonanni L, Barbone F, Serrati C, Ballardini G, Simoncelli M, Ceschia G, Scarpa C, Brugiolo R, Fusco S, Ciarambino T, Biagini C, Tonon E, Porta M, Venuti D, DelSette M, Poeta M, Barbagallo G, Trovato G, Delitala A, Arosio P, Reggiani F, Zuliani G, Ortolani B, Mussio E, Girardi A, Coin A, Ruotolo G, Castagna A, Masina M, Cimino R, Pinciaroli A, Tripodi G, Cannistrà U, Cassadonte F, Vatrano M, Cassandonte F, Scaglione L, Fogliacco P, Muzzuilini C, Romano F, Padovani A, Rozzini L, Cagnin A, Fragiacomo F, Desideri G, Liberatore E, Bruni A, Orsitto G, Franco M, Bonfrate L, Bonetto M, Pizio N, Magnani G, Cecchetti G, Longo A, Bubba V, Marinan L, Cotelli M, Turla M, Brunori M, Sessa M, Abruzzi L, Castoldi G, LoVetere D, Musacchio C, Novello M, Cavarape A, Bini A, Leonardi A, Seneci F, Grimaldi W, Fimognari F, Bambara V, Saitta A, Corica F, Braga M, Ettorre E, Camellini C, Marengoni A, Bruni A, Crescenzo A, Noro G, Turco R, Ponzetto M, Giuseppe L, Mazzei B, Maiuri G, Costaggiu D, Damato R, Fabbro E, Patrizia G, Santuari L, Gallucci M, Minaglia C, Paragona M, Bini P, Modica D, Abati C, Clerici M, Barbera I, NigroImperiale F, Manni A, Votino C, Castiglioni C, Di M, Degl‘Innocenti M, Moscatelli G, Guerini S, Casini C, Dini D, DeNotariis S, Bonometti F, Paolillo C, Riccardi A, Tiozzo A, SamySalamaFahmy A, Riccardi A, Paolillo C, DiBari M, Vanni S, Scarpa A, Zara D, Ranieri P, Calogero P, Corvalli G, Pezzoni D, Gentile S, Morandi A, Platto C, D‘Ambrosio V, Faraci B, Ivaldi C, Milia P, DeSalvo F, Solaro C, Strazzacappa M, Bo M, Panico A, Cazzadori M, Confente S, Bonetto M, Magnani G, Cecchetti G, Guerini V, Bernardini B, Corsini C, Boffelli S, Filippi A, Delpin K, Bertoletti E, Vannucci M, Tesi F, Crippa P, Malighetti A, Caltagirone C, DiSant S, Bettini D, Maltese F, Formilan M, Abruzzese G, Minaglia C, Cosimo D, Azzini M, Cazzadori M, Colombo M, Procino G, Fascendini S, Barocco F, Del P, D‘Amico F, Grippa A, Mazzone A, Riva E, Dell‘Acqua D, Cottino M, Vezzadini G, Avanzi S, Orini S, Sgrilli F, Mello A, Lombardi L, Muti E, Dijk B, Fenu S, Pes C, Gareri P, Castagna A, Passamonte M, De F, Rigo R, Locusta L, Caser L, Rosso G, Cesarini S, Cozzi R, Santini C, Carbone P, Cazzaniga I, Lovati R, Cantoni A, Ranzani P, Barra D, Pompilio G, Dimori S, Cernesi S, Riccò C, Piazzolla F, Capittini E, Rota C, Gottardi F, Merla L, Barelli A, Millul A, De G, Morrone G, Bigolari M, Minaglia C, Macchi M, Zambon F, D‘Amico F, D‘Amico F, Pizzorni C, DiCasaleto G, Menculini G, Marcacci M, Catanese G, Sprini D, DiCasalet T, Bocci M, Borga S, Caironi P, Cat C, Cingolani E, Avalli L, Greco G, Citerio G, Gandini L, Cornara G, Lerda R, Brazzi L, Simeone F, Caciorgna M, Alampi D, Francesconi S, Beck E, Antonini B, Vettoretto K, Meggiolaro M, Garofalo E, Bruni A, Notaro S, Varutti R, Bassi F, Mistraletti G, Marino A, Rona R, Rondelli E, Riva I, Scapigliati A, Cortegiani A, Vitale F, Pistidda L, D‘Andrea R, Querci L, Gnesin P, Todeschini M, Lugano M, Castelli G, Ortolani M, Cotoia A, Maggiore S, DiTizio L, Graziani R, Testa I, Ferretti E, Castioni C, Lombardi F, Caserta R, Pasqua M, Simoncini S, Baccarini F, Rispoli M, Grossi F, Cancelliere L, Carnelli M, Puccini F, Biancofiore G, Siniscalchi A, Laici C, Mossello E, Torrini M, Pasetti G, Palmese S, Oggioni R, Mangani V, Pini S, Martelli M, Rigo E, Zuccalà F, Cherri A, Spina R, Calamai I, Petrucci N, Caicedo A, Ferri F, Gritti P, Brienza N, Fonnesu R, Dessena M, Fullin G, Saggioro D. The association between low skeletal muscle mass and delirium: results from the nationwide multi-centre Italian Delirium Day 2017. Aging Clin Exp Res 2022; 34:349-357. [PMID: 34417734 PMCID: PMC8847195 DOI: 10.1007/s40520-021-01950-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/31/2021] [Indexed: 01/22/2023]
Abstract
Introduction Delirium and sarcopenia are common, although underdiagnosed, geriatric
syndromes. Several pathological mechanisms can link delirium and low skeletal muscle mass, but few studies have investigated their association. We aimed to investigate (1) the association between delirium and low skeletal muscle mass and (2) the possible role of calf circumference mass in finding cases with delirium. Methods The analyses were conducted employing the cross-sectional “Delirium Day” initiative, on patient 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes and hospices in Italy in 2017. Delirium was diagnosed as a 4 + score at the 4-AT scale. Low skeletal muscle mass was operationally defined as calf circumference ≤ 34 cm in males and ≤ 33 cm in females. Logistic regression models were used to investigate the association between low skeletal muscle mass and delirium. The discriminative ability of calf circumference was evaluated using non-parametric ROC analyses. Results A sample of 1675 patients was analyzed. In total, 73.6% of participants had low skeletal muscle mass and 24.1% exhibited delirium. Low skeletal muscle mass and delirium showed an independent association (OR: 1.50; 95% CI 1.09–2.08). In the subsample of patients without a diagnosis of dementia, the inclusion of calf circumference in a model based on age and sex significantly improved its discriminative accuracy [area under the curve (AUC) 0.69 vs 0.57, p < 0.001]. Discussion and conclusion Low muscle mass is independently associated with delirium. In patients without a previous diagnosis of dementia, calf circumference may help to better identify those who develop delirium. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-021-01950-8.
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Lazarus JV, Mark HE, Rinella ME, Colombo M. Editorial: global liver fat accumulation and global health-towards a sustainable development goal. Authors' reply. Aliment Pharmacol Ther 2022; 55:489-490. [PMID: 35092059 DOI: 10.1111/apt.16768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain.,EASL International Liver Foundation, Geneva, Switzerland
| | - Henry E Mark
- EASL International Liver Foundation, Geneva, Switzerland
| | - Mary E Rinella
- Department of Medicine, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
| | - Massimo Colombo
- EASL International Liver Foundation, Geneva, Switzerland.,Liver Center, IRCCS San Raffaele Hospital, Milan, Italy
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34
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Burgio V, Iavarone M, Di Costanzo GG, Marra F, Lonardi S, Tamburini E, Piscaglia F, Masi G, Celsa C, Foschi FG, Silletta M, Amoruso DC, Rimini M, Bruccoleri M, Tortora R, Campani C, Soldà C, Viola MG, Forgione A, Conti F, Salani F, Catanese S, Giacchetto CM, Fulgenzi C, Coppola C, Lampertico P, Pellino A, Rancatore G, Cabibbo G, Ratti F, Pedica F, Della Corte A, Colombo M, De Cobelli F, Aldrighetti L, Cascinu S, Casadei-Gardini A. Real-Life Clinical Data of Lenvatinib versus Sorafenib for Unresectable Hepatocellular Carcinoma in Italy. Cancer Manag Res 2022; 13:9379-9389. [PMID: 34992463 PMCID: PMC8713715 DOI: 10.2147/cmar.s330195] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022] Open
Abstract
Background Lenvatinib has been approved in Italy since October 2019 as a first-line therapy for advanced hepatocellular carcinoma (HCC) and to date data on effectiveness and safety of lenvatinib are not available in our region. To fill this gap, we performed a multicentric analysis of the real-world treatment outcomes with the propensity score matching in a cohort of Italian patients with unresectable HCC who were treated with either sorafenib or lenvatinib. Aims and Methods To evaluate the effectiveness of sorafenib and lenvatinib as primary treatment of advanced HCC in clinical practice we performed a multicentric analysis of the treatment outcomes of 288 such patients recruited in 11 centers in Italy. A propensity score was used to mitigate confounding due to referral biases in the assessment of mortality and progression-free survival. Results Over a follow-up period of 11 months the Cox regression model showed 48% reduction of death risk for patients treated with lenvatinib (95% CI: 0.34-0.81; p = 0.0034), compared with those treated with sorafenib. The median PFS was 9.0 and 4.9 months for lenvatinib and sorafenib arm, respectively. Patients treated with lenvatinib showed a higher percentage of response rate (29.4% vs 2.8%; p < 0.00001) compared with patients treated with sorafenib. Sorafenib was shown to be correlated with more HFSR, diarrhea and fatigue, while lenvatinib with more hypertension and fatigue. Conclusion Our study highlighted for the first time the efficacy and safety of lenvatinib in an Italian cohort of patients.
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Affiliation(s)
- Valentina Burgio
- Department of Medical Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy
| | - Massimo Iavarone
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, Milan, Italy
| | | | - Fabio Marra
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Firenze, Italy
| | - Sara Lonardi
- Early Phase Clinical Trial Unit, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.,Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Emiliano Tamburini
- Department of Oncology and Palliative Care, Cardinale Hospital, Naples, Italy
| | - Fabio Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Disease, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gianluca Masi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.,Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Ciro Celsa
- Department of Surgical, Oncological and Oral Sciences (Di.Chir.On.S.), University of Palermo, Palermo, 90127, Italy
| | | | | | | | - Margherita Rimini
- Department of Oncology and Hematology, Division of Oncology, University of Modena and Reggio Emilia, Modena, 4121, Italy
| | - Mariangela Bruccoleri
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, Milan, Italy
| | | | - Claudia Campani
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Firenze, Italy
| | - Caterina Soldà
- Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | | | - Antonella Forgione
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Disease, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Fabio Conti
- Internal Medicine, Infermi Hospital, Faenza (AUSL ROMAGNA), Ravenna, Italy
| | - Francesca Salani
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.,Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Silvia Catanese
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.,Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Carmelo Marco Giacchetto
- Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, 90127, Italy
| | | | - Carmine Coppola
- Hepatology Unit, Internal Medicine, Area Stabiese Hospital, Naples, Italy
| | - Pietro Lampertico
- Liver Center, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy
| | - Antonio Pellino
- Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.,Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Gabriele Rancatore
- Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, 90127, Italy
| | - Giuseppe Cabibbo
- Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, 90127, Italy
| | - Francesca Ratti
- Hepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy
| | - Federica Pedica
- Department of Experimental Oncology, Pathology Unit, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy
| | - Angelo Della Corte
- Department of Radiology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy
| | - Massimo Colombo
- Liver Center, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy
| | | | - Luca Aldrighetti
- Hepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy
| | - Stefano Cascinu
- Department of Medical Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, 20132, Italy
| | - Andrea Casadei-Gardini
- Department of Medical Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, 20132, Italy.,School of Medicine, Vita-Salute San Raffaele University, Milan, 20132, Italy
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Lazarus JV, Mark HE, Colombo M, Demaio S, Dillon JF, George J, Hagström H, Hocking S, Lee N, Nieuwenhuijsen MJ, Rinella ME, Romero-Gomez M, Soriano JB, Schattenberg JM, Tacke F, Tsochatzis EA, Valenti L, Zelber-Sagi S, Ashworth Dirac M, Huang TTK. A sustainable development goal framework to guide multisectoral action on NAFLD through a societal approach. Aliment Pharmacol Ther 2022; 55:234-243. [PMID: 34866201 DOI: 10.1111/apt.16720] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/07/2021] [Accepted: 11/18/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent condition that requires a comprehensive and coordinated response across sectors and disciplines. AIMS In the absence of a multisectoral framework to tackle this condition, we developed one using the sustainable development goals (SDGs) as the basis for converging thinking about the design and delivery of public health responses. METHODS A multidisciplinary group identified the SDG targets and indicators for inclusion in the new framework through a two-stage process. Firstly, a core team of three researchers independently reviewed the 169 targets and 231 indicators of the SDGs to select a shortlist. Over two Delphi rounds, a multidisciplinary group of 12 experts selected which of the shortlisted targets and indicators to include. Respondents also provided written feedback on their selection. Targets and indicators with 75% or greater agreement were included in the final framework. RESULTS The final framework comprises 16 targets-representing 9% of all targets and 62% (16/26) of the shortlisted targets-and seven indicators, accounting for 50% (7/14) of the shortlisted indicators and 3% of all indicators. The selected targets and indicators cover a broad range of factors, from health, food and nutrition to education, the economy, and the built environment. CONCLUSIONS Addressing the challenge of NAFLD will require a re-envisioning of the liver health landscape, with greater focus on joined-up systems thinking and action. This new framework can help guide this process, including by outlining the stakeholders with whom the liver health community needs to engage.
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Pasquale L, Najafishirtari S, Brescia R, Scarpellini A, Demirci C, Colombo M, Manna L. Atmosphere-Induced Transient Structural Transformations of Pd-Cu and Pt-Cu Alloy Nanocrystals. Chem Mater 2021; 33:8635-8648. [PMID: 34853491 PMCID: PMC8619592 DOI: 10.1021/acs.chemmater.1c02377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/29/2021] [Indexed: 06/13/2023]
Abstract
We have investigated the transformations of colloidal Pd-Cu and Pt-Cu bimetallic alloy nanocrystals (NCs) supported on γ-Al2O3 when exposed to a sequence of oxidizing and then reducing atmospheres, in both cases at high temperature (350 °C). A combination of in situ diffuse reflectance infrared Fourier transform spectroscopy and X-ray absorption spectroscopy was employed to probe the NC surface chemistry and structural/compositional variations in response to the different test conditions. Depending on the type of noble metal in the bimetallic NCs (whether Pd or Pt), different outcomes were observed. The oxidizing treatment on Pd-Cu NCs led to the formation of a PdCuO mixed oxide and PdO along with a minor fraction of CuO x species on the support. The same treatment on Pt-Cu NCs caused a complete dealloying between Pt and Cu, forming separate Pt NCs with a minor fraction of PtO NCs and CuO x species, the latter finely dispersed on the support. The reducing treatment that followed the oxidizing treatment largely restored the Pd-Cu alloy NCs, although with a residual fraction of CuO x species remaining. Similarly, Pt-Cu NCs were partially restored but with a large fraction of CuO x species still located on the support. Our results indicate that the noble metal present in the bimetallic Cu-based alloy NCs has a strong influence on the dealloying/migrations/realloying processes occurring under typical heterogeneous catalytic reactions, elucidating the structural/compositional variations of these NCs depending on the atmospheres to which they are exposed.
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Affiliation(s)
- Lea Pasquale
- Department
of Nanochemistry, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy
- Dipartimento
di Chimica e Chimica Industriale, Università
degli Studi di Genova, Via Dodecaneso 31, 16146 Genova, Italy
| | - Sharif Najafishirtari
- Department
of Nanochemistry, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy
| | - Rosaria Brescia
- Electron
Microscopy Facility, Istituto Italiano di
Tecnologia, Via Morego 30 16163, Genova, Italy
| | - Alice Scarpellini
- Electron
Microscopy Facility, Istituto Italiano di
Tecnologia, Via Morego 30 16163, Genova, Italy
| | - Cansunur Demirci
- Department
of Nanochemistry, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy
- Dipartimento
di Chimica e Chimica Industriale, Università
degli Studi di Genova, Via Dodecaneso 31, 16146 Genova, Italy
| | - Massimo Colombo
- Department
of Nanochemistry, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy
| | - Liberato Manna
- Department
of Nanochemistry, Istituto Italiano di Tecnologia, Via Morego 30, 16163 Genova, Italy
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Valenti L, Pelusi S, Aghemo A, Gritti S, Pasulo L, Bianco C, Iegri C, Cologni G, Degasperi E, D'Ambrosio R, Del Poggio P, Soria A, Puoti M, Carderi I, Pigozzi MG, Carriero C, Spinetti A, Zuccaro V, Memoli M, Giorgini A, Viganò M, Rumi MG, Re T, Spinelli O, Colombo MC, Quirino T, Menzaghi B, Lorini G, Pan A, D'Arminio Monforte A, Buscarini E, Autolitano A, Bonfanti P, Terreni N, Aimo G, Mendeni M, Prati D, Lampertico P, Colombo M, Fagiuoli S. Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real-Life Cohort Study. Hepatol Commun 2021; 6:867-877. [PMID: 34811949 PMCID: PMC8948549 DOI: 10.1002/hep4.1851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 12/14/2022] Open
Abstract
The aim of this study was to examine the impact of features of dysmetabolism on liver disease severity, evolution, and clinical outcomes in a real‐life cohort of patients treated with direct acting antivirals for chronic hepatitis C virus (HCV) infection. To this end, we considered 7,007 patients treated between 2014 and 2018, 65.3% with advanced fibrosis, of whom 97.7% achieved viral eradication (NAVIGATORE‐Lombardia registry). In a subset (n = 748), liver stiffness measurement (LSM) was available at baseline and follow‐up. Higher body mass index (BMI; odds ratio [OR] 1.06 per kg/m2, 1.03‐1.09) and diabetes (OR 2.01 [1.65‐2.46]) were independently associated with advanced fibrosis at baseline, whereas statin use was protective (OR 0.46 [0.35‐0.60]; P < 0.0001 for all). The impact of BMI was greater in those without diabetes (P = 0.003). Diabetes was independently associated with less pronounced LSM improvement after viral eradication (P = 0.001) and in patients with advanced fibrosis was an independent predictor of the most frequent clinical events, namely de novo hepatocellular carcinoma (HCC; hazard ratio [HR] 2.09 [1.20‐3.63]; P = 0.009) and cardiovascular events (HR 2.73 [1.16‐6.43]; P = 0.021). Metformin showed a protective association against HCC (HR 0.32 [0.11‐0.96]; P = 0.043), which was confirmed after adjustment for propensity score (P = 0.038). Diabetes diagnosis further refined HCC prediction in patients with compensated advanced chronic liver disease at high baseline risk (P = 0.024). Conclusion: Metabolic comorbidities were associated with advanced liver fibrosis at baseline, whereas statins were protective. In patients with advanced fibrosis, diabetes increased the risk of de novo HCC and of cardiovascular events. Optimization of metabolic comorbidities treatment by a multi‐disciplinary management approach may improve cardiovascular and possibly liver‐related outcomes.
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Affiliation(s)
- Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy.,Precision Medicine Lab, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Serena Pelusi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy.,Precision Medicine Lab, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Alessio Aghemo
- Department of Internal Medicine and Hepatology, Humanitas University and Research Hospital, Rozzano, Italy
| | - Sara Gritti
- Fondazione Ricerca Ospedale di Bergamo, Papa Giovanni Hospital, Bergamo, Italy
| | - Luisa Pasulo
- Department of Gastroenterology and Hepatology, Papa Giovanni Hospital, Bergamo, Italy
| | - Cristiana Bianco
- Precision Medicine Lab, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Claudia Iegri
- Department of Gastroenterology and Hepatology, Papa Giovanni Hospital, Bergamo, Italy
| | - Giuliana Cologni
- Department of Internal Medicine, Papa Giovanni Hospital, Bergamo, Italy
| | - Elisabetta Degasperi
- Division of Gastroenterology & Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Roberta D'Ambrosio
- Division of Gastroenterology & Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Paolo Del Poggio
- Department of Gastroenterology and Hepatology, Papa Giovanni Hospital, Bergamo, Zingonia, Italy
| | - Alessandro Soria
- Division of Infectious Diseases, San Gerardo Hospital-ASST Monza, Monza, Italy
| | - Massimo Puoti
- Department of Infectious Diseases, Hepatitis Center, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy
| | | | | | - Canio Carriero
- Department of Infectious Diseases, Spedali Civili Hospital-ASST Brescia, Brescia, Italy
| | - Angiola Spinetti
- Department of Infectious Diseases, Spedali Civili Hospital-ASST Brescia, Brescia, Italy
| | - Valentina Zuccaro
- Department of Infectious Diseases, Fondazione IRCCS Policlinico San Matteo di Pavia, Pavia, Italy
| | - Massimo Memoli
- Liver Center, San Raffaele Scientific Institute IRCCS, Milano, Italy
| | - Alessia Giorgini
- Department of Gastroenterology and Hepatology, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Mauro Viganò
- Department of Gastroenterology and Hepatology, San Giuseppe Hospital, Milan, Italy
| | - Maria Grazia Rumi
- Department of Gastroenterology and Hepatology, San Giuseppe Hospital, Milan, Italy
| | - Tiziana Re
- Department of Gastroenterology and Hepatology, Legnano Hospital-ASST Milano Ovest, Milan, Italy
| | - Ombretta Spinelli
- Department of Gastroenterology and Hepatology, Lariana Como Hospital, Milan, Italy
| | - Maria Chiara Colombo
- Department of Gastroenterology and Hepatology, Lariana Como Hospital, Milan, Italy
| | - Tiziana Quirino
- Department of Gastroenterology and Hepatology, Busto Arsizio Hospital ASST Valle Olona, Milan, Italy
| | - Barbara Menzaghi
- Department of Gastroenterology and Hepatology, Busto Arsizio Hospital ASST Valle Olona, Milan, Italy
| | - Gianpaolo Lorini
- Department of Gastroenterology and Hepatology, ASST Franciacorta, Milan, Italy
| | - Angelo Pan
- Department of Internal Medicine, Ospedale di Cremona, Cremona, Italy
| | | | | | | | - Paolo Bonfanti
- Division of Infectious Diseases, ASST Lecco, Lecco, Italy
| | | | | | | | - Daniele Prati
- Precision Medicine Lab, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
| | - Pietro Lampertico
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy.,Division of Gastroenterology & Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milano, Italy.,CRC "AM. and A. Migliavacca" Center for Liver Disease, Università degli Studi di Milano, Milano, Italy
| | - Massimo Colombo
- Liver Center, San Raffaele Scientific Institute IRCCS, Milano, Italy
| | - Stefano Fagiuoli
- Department of Gastroenterology and Hepatology, Papa Giovanni Hospital, Bergamo, Italy
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Alqahtani SA, Colombo M. Treatment for Viral Hepatitis as Secondary Prevention for Hepatocellular Carcinoma. Cells 2021; 10:3091. [PMID: 34831314 PMCID: PMC8619578 DOI: 10.3390/cells10113091] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/05/2021] [Accepted: 11/07/2021] [Indexed: 02/06/2023] Open
Abstract
Chronic infections with either hepatitis B or C virus (HBV or HCV) are among the most common risk factors for developing hepatocellular carcinoma (HCC). The hepatocarcinogenic potential of these viruses is mediated through a wide range of mechanisms, including the induction of chronic inflammation and oxidative stress and the deregulation of cellular pathways by viral proteins. Over the last decade, effective anti-viral agents have made sustained viral suppression or cure a feasible treatment objective for most chronic HBV/HCV patients. Given the tumorigenic potential of HBV/HCV, it is no surprise that obtaining sustained viral suppression or eradication proves to be effective in preventing HCC. This review summarizes the mechanisms by which HCV and HBV exert their hepatocarcinogenic activity and describes in detail the efficacy of anti-HBV and anti-HCV therapies in terms of HCC prevention. Although these treatments significantly reduce the risk for HCC in patients with chronic viral hepatitis, this risk is not eliminated. Therefore, we evaluate potential strategies to improve these outcomes further and address some of the remaining controversies.
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Affiliation(s)
- Saleh A. Alqahtani
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, USA
- Liver Transplant Center, and Biostatistics, Epidemiology, and Scientific Computing Department, King Faisal Specialist Hospital & Research Center, Riyadh 11564, Saudi Arabia
| | - Massimo Colombo
- Liver Center, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
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39
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Valenti L, Pelusi S, Bianco C, Ceriotti F, Berzuini A, Iogna Prat L, Trotti R, Malvestiti F, D'Ambrosio R, Lampertico P, Colli A, Colombo M, Tsochatzis EA, Fraquelli M, Prati D. Definition of Healthy Ranges for Alanine Aminotransferase Levels: A 2021 Update. Hepatol Commun 2021; 5:1824-1832. [PMID: 34520121 PMCID: PMC8557310 DOI: 10.1002/hep4.1794] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/22/2021] [Accepted: 07/02/2021] [Indexed: 12/12/2022] Open
Abstract
The changing epidemiology of liver disease, and modifications in the recommended analytical methodology call for a re-evaluation of the upper reference limits (URLs) of alanine aminotransferase (ALT) levels. Using the same approach consolidated 20 years ago to define the healthy population, we defined the URL for the newly recommended International Federation of Clinical Chemistry (IFCC) standardized test. In a cross-sectional study, we examined 21,296 apparently healthy blood donors (age 18-65 years) and calculated the sex-specific URL by the 95th percentile in individuals without risk factors for liver disease. These were tested for the ability to predict liver damage in a subset of 745 participants with dysmetabolism, in an independent cohort of 977 unselected donors, and in 899 patients with chronic liver disease. ALT levels were measured by the IFCC test. Male sex, body mass index, glucose, lipids, ferritin, hypertension, and younger age were independent ALT predictors (P < 0.001). Updated URLs were identified at 42/30 U/L in males/females, approximately 30% lower than those currently recommended by the IFCC. Due to improved sensitivity, they conferred the ability to detect steatosis and significant fibrosis in individuals with dysmetabolism (odds ratio [OR] = 2.31, range 1.40-3.80, P = 0.001; and OR = 3.35, range 1.19-9.42, P = 0.021; respectively), although with a limited accuracy, and significant fibrosis in unselected donors (OR = 2.32, 1.02-5.31, P = 0.045). Updated URLs had a moderate to high accuracy to discriminate liver conditions (area under the receiver operating characteristic curve = 0.81, range 0.78-0.91). Conclusion: Updated URLs by the IFCC method were lower than those calculated in initial studies, but higher than those in use with the recommended old, nonstandardized method, and were able to better predict liver disease. The limited awareness that different techniques are still in use should be regarded as a possible source of medical errors.
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Affiliation(s)
- Luca Valenti
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly.,Department of Transfusion Medicine and HaematologyFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Serena Pelusi
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly.,Department of Transfusion Medicine and HaematologyFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Cristiana Bianco
- Department of Transfusion Medicine and HaematologyFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly.,Department of MedicineUdine HospitalUdineItaly
| | - Ferruccio Ceriotti
- Clinical LaboratoryFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico MilanMilanItaly
| | - Alessandra Berzuini
- Department of Transfusion Medicine and HaematologyFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Laura Iogna Prat
- UCL Institute for Liver and Digestive HealthRoyal Free Hospital and UCLLondonUnited Kingdom
| | - Roberta Trotti
- Department of Transfusion Medicine and HaematologyFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Francesco Malvestiti
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly.,Department of Transfusion Medicine and HaematologyFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Roberta D'Ambrosio
- Division of Gastroenterology and HepatologyFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico MilanMilanItaly
| | - Pietro Lampertico
- Division of Gastroenterology and HepatologyFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico MilanMilanItaly.,CRC "A. M. and A. Migliavacca" Center for Liver DiseaseDepartment of Pathophysiology and TransplantationUniversity of MilanMilanItaly
| | - Agostino Colli
- Department of Transfusion Medicine and HaematologyFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly
| | | | - Emmanuel A Tsochatzis
- UCL Institute for Liver and Digestive HealthRoyal Free Hospital and UCLLondonUnited Kingdom
| | - Mirella Fraquelli
- Department of Gastroenterology and EndoscopyFondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico MilanMilanItaly
| | - Daniele Prati
- Department of Transfusion Medicine and HaematologyFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoMilanItaly
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40
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Affiliation(s)
- Luca Valenti
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano and, Precision Medicine, Department of Transfusion Medicine and Hematology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Mario U Mondelli
- Division of Infectious Diseases II and Immunology, Department of Medical Sciences and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo and, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
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41
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Goker F, Alicchio S, Colombo M, Bordin M, Tosi M, Colombelli F, Rovati M, Giacomello MS, Mortellaro C, Greco Lucchina A, Del Fabbro M. Long-term clinical outcome of dental implants: A retrospective clinical study with a minimum follow-up between 9.5 and 17.7 years. J BIOL REG HOMEOS AG 2021; 35:37-51. [PMID: 34281301 DOI: 10.23812/21-2supp1-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this retrospective case series was to evaluate the clinical and radiographic outcomes of the patients that underwent implant surgery in all indication classes, with a follow-up of at least 9 years. 121 healthy patients in need for oral rehabilitation with dental implants were included in this study. 196 implants (160 conical, 73 cylindric design implants) were inserted. The implant survival rate was the primary outcome. Intra- and postoperative complications were additional criteria for success. The mean follow-up of the patients was 12.29 years (SD 1.39). Mean age of the study population was 51.0 years (SD 12.7). The mean bone loss around implants after at least 9 years of loading was measured as 2.0 mm (SD 0.73 mm). Intra-operative complications were seen in 5 patients. Post-operative complications included: 5 mucositis,1 dehiscence, 2 screw loosening, 1 infection at site and 1 nonintegrated implant. Two implants were lost in two patients. The overall implant survival rate was 99.1%. As a conclusion, oral rehabilitation with dental implant-supported prostheses can be accepted as a safe procedure with relevantly high survival rates of oral implants and successful aesthetic and functional outcomes.
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Affiliation(s)
- F Goker
- University of Milano, Department of Biomedical, Surgical and Dental Sciences, Milan, Italy
| | | | - M Colombo
- Private practice, Meda, Monza-Brianza, Italy
| | - M Bordin
- Private practice, Terrazzo, Verona, Italy
| | - M Tosi
- Private practice, Nova Milanese, Monza-Brianza, Italy
| | - F Colombelli
- Private practice, Casirate d'Adda, Bergamo, Italy
| | - M Rovati
- University of Milano, Department of Biomedical, Surgical and Dental Sciences, Milan, Italy
| | - M S Giacomello
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - C Mortellaro
- Research Laboratory in Regenerative Medicine and Tissue Engineering, Saint Camillus International University of Health Sciences, Rome, Italy
| | - A Greco Lucchina
- Research Laboratory in Regenerative Medicine and Tissue Engineering, Saint Camillus International University of Health Sciences, Rome, Italy
| | - M Del Fabbro
- University of Milano, Department of Biomedical, Surgical and Dental Sciences, Milan, Italy.,IRCCS Orthopedic Institute Galeazzi, Dental Clinic, Milan, Italy
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42
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Battistini A, Cammi A, Lorenzi S, Colombo M, Fairweather M. Development of a CFD – LES model for the dynamic analysis of the DYNASTY natural circulation loop. Chem Eng Sci 2021. [DOI: 10.1016/j.ces.2021.116520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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43
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Aldrighetti L, De Cobelli F, Colombo M. Climbing the Everest of Lymph Nodes Staging in Cholangiocarcinoma: Close to the Peak? Gastroenterology 2021; 160:2186-2188. [PMID: 33548232 DOI: 10.1053/j.gastro.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Luca Aldrighetti
- Division of Hepatobiliary Surgery, IRCCS San Raffaele Hospital, Vita-Salute University, Milan, Italy
| | - Francesco De Cobelli
- Department of Radiology, IRCCS San Raffaele Hospital, Vita - Salute University, Milan, Italy
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44
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Fouad Y, Lazarus JV, Negro F, Peck-Radosavljevic M, Sarin SK, Ferenci P, Esmat G, Ghazinian H, Nakajima A, Silva M, Lee S, Colombo M. MAFLD considerations as a part of the global hepatitis C elimination effort: an international perspective. Aliment Pharmacol Ther 2021; 53:1080-1089. [PMID: 33751604 DOI: 10.1111/apt.16346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/17/2021] [Accepted: 03/09/2021] [Indexed: 12/09/2022]
Abstract
BACKGROUND The World Health Organization (WHO) set a goal to eliminate hepatitis C (HCV) infection globally by 2030, with specific targets to reduce new viral hepatitis infections by 80% and reduce related deaths by 65%. However, an overlooked aspect that may hinder these efforts is the impact other liver diseases could have by continuing to drive liver disease progression and offset the beneficial impact of DAAs on end-stage liver disease and hepatocellular carcinoma (HCC). In particular, the decrease in HCV prevalence has been countered by a marked increase in the prevalence of metabolic-associated fatty liver disease (MAFLD). AIMS To review the potential interaction of HCV and MAFLD. METHODS We have reviewed the literature relating to an arrange of interaction of HCV, metabolic dysfunction and MAFLD. RESULTS In this viewpoint, international experts suggest a holistic and multidisciplinary approach for the management of the growing number of treated HCV patients who achieved SVR, taking into consideration the overlooked impact of MAFLD for reducing morbidity and mortality in people who have had HCV. CONCLUSIONS This will strengthen and improve the continuum of care cascade for patients with liver disease(s) and holds the potential to alleviate the cost burden of disease; and increase quality of life for patients following DAAs treatment.
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Abstract
Surveillance is the only pragmatic approach to improve treatment of hepatocellular carcinoma (HCC) owing to the fact that it allows detection of the tumor at an early and better curable stage. International liver societies recommend surveillance with biannual abdominal ultrasound (US) for patients with cirrhosis of any etiology because of their high risk of developing HCC. This strategy is considered cost-effective, as surveillance requires an articulated and costly set of interventions, including linkage to care of patients with an early detected tumor. However, as transition to HCC is increasingly being observed in noncirrhotic patients, the majority of which does not reach the threshold of cost effectiveness for screening. The European and Japanese liver societies elected to confine recommendations for HCC screening to noncirrhotic patients with advanced fibrosis due to hepatitis C or hepatitis B only. These latter recommendations, however, are challenged by the increasing number of patients with viral hepatitis in whom HCC risk has been attenuated but not eradicated by successful antiviral therapy. In this set of patients, entry criteria of surveillance need to be refined in the light of the suboptimal diagnostic accuracy of non invasive tests that are employed to identify the ideal candidates for surveillance.
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Affiliation(s)
- Angelo Sangiovanni
- IRCCS Ca' Granda Ospedale Maggiore Policlinico, Division of Gastroenterology and Hepatology, CRC “A. M. and A. Migliavacca” Center for Liver Disease, Milan, Italy
| | - Massimo Colombo
- Liver Center, IRCCS San Raffaele Hospital, Milan, Italy,Address for correspondence: Prof. Massimo Colombo, Liver Center, IRCCS, Ospedale San Raffaele Hospital, Via Olgettina, 60 Milan, Italy. E-mail:
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46
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Cabrera R, Singal AG, Colombo M, Kelley R, Lee H, Mospan AR, Meyer T, Newell P, Parikh ND, Sangro B, Reddy KR, Watkins S, Zink RC, Di Bisceglie AM. A Real-World Observational Cohort of Patients with Hepatocellular Carcinoma: Design and Rationale for TARGET-HCC. Hepatol Commun 2021; 5:538-547. [PMID: 33681685 PMCID: PMC7917285 DOI: 10.1002/hep4.1652] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/20/2020] [Accepted: 11/05/2020] [Indexed: 12/30/2022] Open
Abstract
This study describes the design of the TARGET-hepatocellular carcinoma (HCC) cohort and descriptive characteristics of the patient population at diagnosis among those who were enrolled in the cohort across academic and community clinical centers. TARGET-HCC is a 5-year, longitudinal, observational cohort of patients with HCC receiving care in usual clinical practice. Redacted clinical information, obtained from medical records, captures the natural history and management of the disease, including the safety and efficacy of treatment interventions used in usual clinical practice. Patients can complete patient-reported outcome measures and provide biological specimens for future translational studies. The TARGET-HCC study includes adults with histologic, cytologic, or radiologic diagnosis of HCC from academic and community centers in both the United States and Europe. A total of 1,841 participants were enrolled between January 9, 2017, and July 23, 2019, at 67 sites in the United States and Europe. To date, the most common liver disease etiology in the cohort continues to be hepatitis C, although nearly half had a nonviral etiology, including alcohol-related liver disease or nonalcoholic steatohepatitis. Most included patients were diagnosed at an early stage (Barcelona Clinic Liver Cancer Stage [BCLC] 0/A), but only approximately one third underwent curative treatment. Systemic therapy has been used in 7.3% of enrolled patients, including 45.7% of those with BCLC stage C tumors. Conclusion: Overall, the TARGET-HCC cohort allows for the assessment of patient characteristics and investigation of new treatment paradigms and sequencing with existing agents as well as novel regimens for HCC.
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Affiliation(s)
| | - Amit G. Singal
- University of Texas Southwestern Medical CenterDallasTXUSA
| | - Massimo Colombo
- Center for Translational Research in Liver DiseaseHumanitas HospitalRozzanoItaly
| | - R. Kate Kelley
- University of California San FranciscoSan FranciscoCAUSA
| | - Hannah Lee
- Division of Gastroenterology, Hepatology and NutritionVirginia Commonwealth UniversityRichmondVAUSA
| | | | - Tim Meyer
- Royal Free Hospital and University College London Cancer InstituteUniversity College LondonLondonUnited Kingdom
| | | | - Neehar D. Parikh
- Division of Internal MedicineUniversity of MichiganAnn ArborMIUSA
| | - Bruno Sangro
- Department of Internal MedicineClinica Universidad de NavarraMadridSpain
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47
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Casadei-Gardini A, Cascinu S, Colombo M. Atezolizumab and Bevacizumab in Advanced Hepatocellular Carcinoma: Ready for Prime Time? Gastroenterology 2021; 160:1423-1424. [PMID: 33310087 DOI: 10.1053/j.gastro.2020.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Indexed: 12/02/2022]
Affiliation(s)
- Andrea Casadei-Gardini
- School of Medicine, Vita-Salute San Raffaele University and, Unit of Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stefano Cascinu
- School of Medicine, Vita-Salute San Raffaele University and, Unit of Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Colombo
- Liver Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
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48
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Signorelli D, Fortunato O, Pontis F, Capizzuto V, Ferri R, Brambilla M, Ferrara R, Proto C, Lo Russo G, Prelaj A, Galli G, De Toma A, Viscardi G, Lobefaro R, Nichetti F, Ganzinelli M, Zilembo N, Colombo M, Sozzi G, Garassino M, Jachetti E. P33.01 Circulating Extracellular Vesicles as Biomarkers for Immune-Checkpoint Inhibitors in Advanced NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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49
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Guidotti LG, La Vecchia C, Colombo M. Is It Time to Recommend Low-Dose Aspirin Treatment for the Prevention of Hepatocellular Carcinoma? Gastroenterology 2020; 159:1988-1990. [PMID: 32918913 DOI: 10.1053/j.gastro.2020.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Indexed: 12/02/2022]
Affiliation(s)
- Luca G Guidotti
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute; Vita-Salute San Raffaele University, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Lazarus JV, Negro F, El‐Sayed M, Colombo M. A letter of solidarity during the COVID-19 pandemic. Liver Int 2020; 40:2877-2878. [PMID: 32526075 PMCID: PMC7307127 DOI: 10.1111/liv.14570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- Jeffrey V. Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital ClínicUniversity of BarcelonaBarcelonaSpain,EASL International Liver FoundationGenevaSwitzerland
| | - Francesco Negro
- EASL International Liver FoundationGenevaSwitzerland,Department of Medicine and Department of Pathology and ImmunologyUniversity Hospitals of GenevaGenevaSwitzerland
| | - Manal El‐Sayed
- EASL International Liver FoundationGenevaSwitzerland,Ain Shams UniversityCairoEgypt
| | - Massimo Colombo
- EASL International Liver FoundationGenevaSwitzerland,Department of MedicineHumanitas HospitalRozzanoItaly
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