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Hsu CT, Azzopardi N, Broad J. Prevalence and disease burden of gastroparesis in Asia. J Gastroenterol Hepatol 2024; 39:649-657. [PMID: 38224680 DOI: 10.1111/jgh.16474] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/26/2023] [Accepted: 12/18/2023] [Indexed: 01/17/2024]
Abstract
Gastroparesis is a gastrointestinal disorder characterized by significant prolongation of gastric emptying time caused by impaired motility of the stomach. Its estimated prevalence is 24.2 per 100 000 people. However, the prevalence of gastroparesis in Asian countries is unknown due to a limited number of epidemiological studies and significant phenotypic variability of the Asian population in these studies. Analysis of previous research on gastroparesis and functional bowel disorders reveals the possibility of an increased prevalence among Asian individuals. A comparison of ethnic constituents between the recent United Kingdom gastroparesis study and its mother database has demonstrated a higher prevalence of gastroparesis among British Asian patients when compared with British Caucasian patients. An estimated gastroparesis prevalence in the Asian population can be calculated by identifying the individuals who are likely to demonstrate a delayed gastric emptying from all diagnosed functional dyspepsia patients. We suggest that gastroparesis tends to be underdiagnosed in Asians due to a lack of studies on gastroparesis in the Asian continent, a lack of knowledge among practitioners, and poor availability of scintigraphy testing as well as limited therapeutic options for this disease. Given the high probability of Asian predominance in gastroparesis and its disease impact on quality of life, epidemiological research focusing on the Asian population is required.
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Affiliation(s)
- Ching-Tung Hsu
- North Middlesex University Hospital NHS Trust, London, UK
| | | | - John Broad
- Institute of Health Science Education, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
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2
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Gauci J, Azzopardi N, Cannataci C, Cortis K, Pisani D, Bozanic S, Bozanic S. The Sympathetic Ampulla. Turk J Gastroenterol 2023; 34:87-88. [PMID: 36656081 PMCID: PMC9984942 DOI: 10.5152/tjg.2020.18997] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- James Gauci
- Department of Gastroenterology, Mater Dei Hospital, Triq id-Donaturi tad-Demm, Msida, Malta,Corresponding author: James Gauci, e-mail:
| | - Neville Azzopardi
- Department of Gastroenterology, Mater Dei Hospital, Triq id-Donaturi tad-Demm, Msida, Malta
| | - Christine Cannataci
- Department of Radiology, Mater Dei Hospital, Triq id-Donaturi tad-Demm, Msida, Malta
| | - Kelvin Cortis
- Department of Radiology, Mater Dei Hospital, Triq id-Donaturi tad-Demm, Msida, Malta
| | - David Pisani
- Department of Radiology, Mater Dei Hospital, Triq id-Donaturi tad-Demm, Msida, Malta
| | - Snezana Bozanic
- Department of Pathology, Mater Dei Hospital, Triq id-Donaturi tad-Demm, Msida, Malta
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3
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Greenblatt DT, Pillay E, Snelson K, Saad R, Torres Pradilla M, Widhiati S, Diem A, Knight C, Thompson K, Azzopardi N, Werkentoft M, Moore Z, Patton D, Mayre-Chilton KM, Murrell DF, Mellerio JE. Recommendations on pregnancy, childbirth and aftercare in epidermolysis bullosa: a consensus-based guideline. Br J Dermatol 2021; 186:620-632. [PMID: 34687549 PMCID: PMC9298908 DOI: 10.1111/bjd.20809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 11/29/2022]
Abstract
Linked Comment:A.W. Lucky and E. Pope. Br J Dermatol 2022; 186:602–603. Plain language summary available online
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Affiliation(s)
- D T Greenblatt
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - E Pillay
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - K Snelson
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - R Saad
- Sydney Children's Hospital, Randwick, Sydney, NSW, Australia
| | - M Torres Pradilla
- Fundacion Universitaria de Ciencias de la Salud and Hospital de San Jose, Bogota, Colombia
| | - S Widhiati
- Pediatric Dermatology Division, Department of Dermatology and Venereology, Faculty of Medicine Universitas Sebelas Maret - Dr. Moewardi General Hospital, Surakarta, Indonesia
| | - A Diem
- EB House Austria, Outpatient Unit, Department of Dermatology and Allergology, University Hospital of the Paracelsus Medical University, Salzburg, Austria
| | - C Knight
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - K Thompson
- Royal Adelaide Hospital, Port Road, Adelaide, SA, Australia
| | | | | | - Z Moore
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - D Patton
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - K M Mayre-Chilton
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,DEBRA International, Vienna, Austria
| | - D F Murrell
- Department of Dermatology at St. George Hospital, University of New South Wales, Sydney, NSW, Australia
| | - J E Mellerio
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Sparfel MA, Derolez S, Law-Wan J, Azzopardi N, Goupille P, Mulleman D, Bejan-Angoulvant T. POS0636 INFLUENCE OF DEMOGRAPHIC AND DISEASE RELATED FACTORS ON EFFICACY OF INFLIXIMAB OR GOLIMUMAB IN RHEUMATOID ARTHRITIS. A META-ANALYSIS ON RANDOMIZED PLACEBO- CONTROLLED TRIALS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:TNF inhibitors have changed the course of rheumatoid arthritis (RA). Yet, detailed analysis on factors influencing clinical response to TNF inhibitors in RA is lacking.Objectives:Herein we aimed at studying the impact of demographics and disease-related factors on therapeutic response to golimumab and infliximab in RA.Methods:Randomized clinical trials (RCTs) that evaluated golimumab and infliximab versus placebo or conventional therapy were sought. We selected the following factors: age, sex, ethnicity, body mass index (BMI), smoking status, physical activity, disease duration, disease activity at baseline, presence of auto-antibodies. We studied the impact of these factors on clinical response using firstly aggregate data in a Mantel-Haenszel random effects model, and secondly individual data in a multivariate regression model.Results:Individual data from 8 RCTs, 2 on infliximab (n=1477) and 6 on golimumab (total =3041) were obtained. In the aggregate model analysis, none of the selected factors had a significant impact on clinical response. In the multivariate analysis, male sex and physical activity were significantly associated with a lower DAS28-CRP after 6 months of treatment (regression coefficients -0.264 (p<0.001) and -0.193 (p=0.004) respectively), while a high initial DAS28-CRP was significantly associated with a higher DAS28-CRP (regression coefficient 0.579 (p<0.001)). The baseline disease activity was the only significant interaction factor with the effect of the treatment.Conclusion:Male gender and practicing physical activity are associated with lower disease activity 6 months after golimumab or infliximab initiation. High baseline disease activity significantly influences negatively the effect of the treatment on disease activity score.Acknowledgements:This study, carried out under YODA Project 2018-2931, used data obtained from the Yale University Open Data Access Project, which has an agreement with JANSSEN RESEARCH & DEVELOPMENT, L.L.C. The interpretation and reporting of research using this data are solely the responsibility of the authors and does not necessarily represent the official views of the Yale University Open Data Access Project or JANSSEN RESEARCH & DEVELOPMENT, L.L.C.Disclosure of Interests:Marc-Antoine SPARFEL: None declared, Sophie Derolez: None declared, Johan Law-Wan: None declared, Nicolas Azzopardi: None declared, Philippe Goupille Speakers bureau: Abbvie, Biogaran, BMS, Hospira, Janssen, MSD, Pfizer, Sanofi-Genzyme, UCB, Consultant of: Abbvie, Biogaran, BMS, Hospira, Janssen, MSD, Pfizer, Sanofi-Genzyme, UCB, Grant/research support from: Clinical trials sponsored by Abbvie, Roche, BMS, Boehringer, Lilly, Novartis, Pfizer, UCB, Janssen and MSD. Invitation to an international congresses by MSD, Roche, BMS and Abbvie, Denis Mulleman Speakers bureau: Pfizer and Novartis, Consultant of: Pfizer and Novartis, Grant/research support from: Invitation to an international congress by Janssen-Cilag, Theodora Bejan-Angoulvant: None declared
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Montebello A, Zahra Bianco E, Babic D, Delicata NP, Azzopardi N. Large cell neuroendocrine carcinoma arising from the anterior mediastinum. BMJ Case Rep 2021; 14:14/5/e240453. [PMID: 34035017 DOI: 10.1136/bcr-2020-240453] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Anterior mediastinal large cell neuroendocrine carcinomas (LCNECs) are extremely rare, extremely aggressive malignancies that carry a dismal prognosis. We discuss a woman aged 60 years who presented with a 2-month history of recurrent severe constant epigastric pain. Abdominal examination revealed massive hepatomegaly and a CT scan of the liver confirmed coarse liver lesions. Histology from a liver biopsy was consistent with a large cell (non-small cell) neuroendocrine carcinoma. A CT scan of the chest showed a large anterior mediastinal mass unrelated to the lung, suggesting that the anterior mediastinum was the primary origin of the tumour. The patient was planned to receive platinum/etoposide chemotherapy for a metastatic mediastinal large cell neuroendocrine carcinoma. Unfortunately, her health deteriorated, and she was unfit to undergo any further treatment. She was treated palliatively and died 2 months after the diagnosis.
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Affiliation(s)
| | | | - Darko Babic
- Histopathology, Mater Dei Hospital, Msida, Malta
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Ma I, Angoulvant D, Azzopardi N, Ternant D, Ivanes F, Paintaud G, Bejan-Angoulvant T. LDL-cholesterol decrease by anti-PCSK9 monoclonal antibodies: systematic review, meta-analysis and meta-regression of randomized controlled trials. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
PCSK9 antibodies are novel potent and expansive lipid lowering agents that demonstrated clinical benefit in high risk patients. We hypothesized that optimization of dose and administration schedule, ideally adapted to the target population, could reduce costs while maintaining the clinical benefit.
Objective
To explore the relationship between LDL-Cholesterol (LDL-C) decrease by anti-PCSK9 monoclonal antibodies and several covariates such as drug dose, administration schedule, baseline LDL-C, population and statins.
Methods
We performed systematic review, meta-analysis and meta-regression of randomized controlled trials that compared alirocumab or evolocumab to placebo or no treatment and reported LDL-C decrease, with a minimum follow-up of 12 weeks and with a sample size of 30 patients or more. Electronic searches of MEDLINE, EMBASE, CENTRAL and ClinicalTrials.gov from inception to March 2019. We evaluated the quality of included studies and extracted aggregate data. We used random effect models and multivariate multilevel meta-regression to explore factors influencing LDL-C decrease. All analyses were performed with R.
Results
From 1479 references identified and screened on title/abstract, the full texts of 72 articles were screened. We included 32 studies (31 references.) Anti-PCSK9 mAbs decreased LDL-C by 53%, 95% CI (−56% to −50%), with no significant difference between the two drugs (p=0.07). In univariate meta-regressions, higher baseline LDL-C level, monthly administration, higher percentage of patients with high-dose statins were associated with a lower LDL-C decrease (p<0.0001, p=0.02 and p=0.006 respectively). Drug dose and population did not influence LDL-C decrease in univariate analysis, but with a significant statistical interaction between drug dose and administration schedule (p=0.03). In multivariate meta-regression, LDL-C decrease remained significantly and negatively influenced by baseline LDL-C level
(p<0.0001) and the percentage of patients with high-dose statins (p=0.0009), and was significantly and positively influenced by drug dose (p<0.0001).
Conclusion
Alirocumab and evolocumab showed substantial LDL-C reductions in clinical trials, without significant differences in their biological efficacies. A higher baseline LDL-C, higher intensity of statin co-treatment and a lower dose seemed to negatively influence LDL-C decrease.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- I Ma
- University Hospital of Tours, Tours, France
| | | | | | - D Ternant
- University Hospital of Tours, Tours, France
| | - F Ivanes
- University Hospital of Tours, Tours, France
| | - G Paintaud
- University Hospital of Tours, Tours, France
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7
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Rizzo K, Vella K, Zammit D, Gatt P, Grima C, Inguanez MB, Gerada J, Ellul P, Vassallo M, Azzopardi N, Pocock J, Gatt A. Fibrinogen measurement in liver disease: validation of the functional fibrinogen thromboelastography assay and a novel mathematical predictive model. Blood Transfus 2019; 17:237-246. [PMID: 30418134 PMCID: PMC6596371 DOI: 10.2450/2018.0105-18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Accepted: 10/09/2018] [Indexed: 04/14/2023]
Abstract
BACKGROUND Fibrinogen is produced in the liver and tends to be reduced in liver cirrhosis. Quantitative and qualitative tests exist to measure fibrinogen. We aimed to validate the functional fibrinogen thromboelastography assay (FF-TEG) and propose a new model to estimate fibrinogen levels via the Clauss method (Clauss) using data from a prothrombin time-derived fibrinogen assay (PT-Fg) in patients with liver cirrhosis. MATERIALS AND METHODS Clauss, PT-Fg, fibrinogen antigen (Fib-Ag) and FF-TEG were studied in 55 patients with liver cirrhosis (26 with Child-Turcotte-Pugh [CTP]-A disease, 14 with CTP-B and 15 CTP-C) and 20 healthy individuals. RESULTS The results of all four assays correlated strongly with each other, but gave significantly different mean levels in all cohorts. PT-Fg gave the highest levels whereas the Clauss gave the lowest levels. The FF-TEG performed well with results which were in between the Clauss and the PT-Fg. Significant differences were only observed between CTP-A and CTP-C for the Clauss, PT-Fg and Fib-Ag but not functional fibrinogen level. We devised a simple linear regression model in order to estimate Clauss from the PT-Fg. DISCUSSION The results of the FF-TEG correlate well with those of routine fibrinogen assays in patients with liver cirrhosis. However, the FF-TEG assay does not discriminate between early and late stages of disease, pointing to a preserved fibrin clot strength in cirrhosis. Through linear regression models, fibrinogen levels can be accurately estimated using the Clauss method based on fibrinogen levels obtained in the cheaper PT-Fg.
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Affiliation(s)
- Kirsty Rizzo
- Faculty of Health Sciences, University of Malta, Tal-Qroqq, Msida, Malta
| | - Kevin Vella
- Coagulation Laboratory, Department of Pathology, “Mater Dei” Hospital, Msida, Malta
| | - Daniel Zammit
- Coagulation Laboratory, Department of Pathology, “Mater Dei” Hospital, Msida, Malta
| | - Peter Gatt
- Clinical Perfusion Services, Department of Cardiac Surgery, “Mater Dei” Hospital, Msida, Malta
| | - Charlie Grima
- Clinical Perfusion Services, Department of Cardiac Surgery, “Mater Dei” Hospital, Msida, Malta
| | - Monique Borg Inguanez
- Department of Statistics and Operations Research, University of Malta, Tal-Qroqq, Msida, Malta
| | - Jurgen Gerada
- Division of Gastroenterology, “Mater Dei” Hospital, Msida, Malta
| | - Pierre Ellul
- Division of Gastroenterology, “Mater Dei” Hospital, Msida, Malta
| | - Mario Vassallo
- Division of Gastroenterology, “Mater Dei” Hospital, Msida, Malta
| | | | - James Pocock
- Division of Gastroenterology, “Mater Dei” Hospital, Msida, Malta
| | - Alex Gatt
- Coagulation Laboratory, Department of Pathology, “Mater Dei” Hospital, Msida, Malta
- Department of Pathology, University of Malta, Tal-Qroqq, Msida, Malta
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Pointreau Y, Azzopardi N, Ternant D, Calais G, Paintaud G. Association radiothérapie cétuximab dans les cancers ORL : impact sur la survie globale du grade de radiodermite et de la clairance globale. Cancer Radiother 2016. [DOI: 10.1016/j.canrad.2016.08.016] [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: 11/27/2022]
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Ellul P, Schembri J, Torpiano P, Borg J, Azzopardi N. Letter: abnormal bone densitometry in patients with coeliac disease -beyond malabsorption and sunlight exposure. Aliment Pharmacol Ther 2016; 43:658-9. [PMID: 26843349 DOI: 10.1111/apt.13512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/11/2022]
Affiliation(s)
- P Ellul
- Gastroenterology, Mater Dei Hospital, Tal Qroqq, Malta.
| | - J Schembri
- Gastroenterology, Mater Dei Hospital, Tal Qroqq, Malta
| | - P Torpiano
- Gastroenterology, Mater Dei Hospital, Tal Qroqq, Malta
| | - J Borg
- Gastroenterology, Mater Dei Hospital, Tal Qroqq, Malta
| | - N Azzopardi
- Gastroenterology, Mater Dei Hospital, Tal Qroqq, Malta
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Granata A, Curcio G, Azzopardi N, Tarantino I, Barresi L, Miraglia R, Traina M. Migration of embolization coils placed to stop a severe iatrogenic bleed following endoscopic ultrasound-guided cystogastrostomy. Endoscopy 2015; 46 Suppl 1 UCTN:E306-7. [PMID: 25058825 DOI: 10.1055/s-0034-1377212] [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: 12/10/2022]
Affiliation(s)
- Antonino Granata
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Gabriele Curcio
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Neville Azzopardi
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Ilaria Tarantino
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Luca Barresi
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Roberto Miraglia
- Radiology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Mario Traina
- Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
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Herve V, Rabbe N, Guilleminault L, Paul F, Schlick L, Azzopardi N, Duruisseaux M, Fouquenet D, Montharu J, Redini F, Paintaud G, Lemarié E, Cadranel J, Wislez M, Heuzé-Vourc’h N. Aérosolthérapie anti-VEGF dans les adénocarcinomes pulmonaires primitifs mutés pour K-ras. Rev Mal Respir 2015. [DOI: 10.1016/j.rmr.2015.02.044] [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: 12/01/2022]
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Guilleminault L, Azzopardi N, Arnoult C, Sobilo J, Hervé V, Montharu J, Guillon A, Andres C, Herault O, Le Pape A, Diot P, Lemarié E, Paintaud G, Gouilleux-Gruart V, Heuzé-Vourc'h N. Fate of inhaled monoclonal antibodies after the deposition of aerosolized particles in the respiratory system. J Control Release 2014; 196:344-54. [DOI: 10.1016/j.jconrel.2014.10.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 09/30/2014] [Accepted: 10/02/2014] [Indexed: 12/18/2022]
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Affiliation(s)
| | - Pierre Ellul
- Gastroenterology Department, Mater dei Hospital, Malta.
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14
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Affiliation(s)
| | - Pierre Ellul
- Gastroenterology Department, Mater dei Hospital, Malta.
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15
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Curcio G, Granata A, Azzopardi N, Sanna P, Barresi L, Tarantino I, Traina M. ClearPath-assisted underwater endoscopic mucosal resection of a laterally spreading tumor of the colon. Endoscopy 2014; 46 Suppl 1 UCTN:E40-1. [PMID: 24523173 DOI: 10.1055/s-0033-1359127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/10/2022]
Affiliation(s)
- Gabriele Curcio
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Antonino Granata
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Neville Azzopardi
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Patrizia Sanna
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Luca Barresi
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Ilaria Tarantino
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Mario Traina
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
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16
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Curcio G, Granata A, Azzopardi N, Sanna P, Barresi L, Tarantino I, Miraglia R, Traina M. "Brush recanalization" of a challenging biliary stricture after liver transplantation: a novel application for an old device. Endoscopy 2014; 46 Suppl 1 UCTN:E34-5. [PMID: 24523170 DOI: 10.1055/s-0033-1359131] [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: 12/10/2022]
Affiliation(s)
- Gabriele Curcio
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Antonino Granata
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Neville Azzopardi
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Patrizia Sanna
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Luca Barresi
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Ilaria Tarantino
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Roberto Miraglia
- Department of Radiology, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
| | - Mario Traina
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy
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Granata A, Curcio G, Azzopardi N, Barresi L, Tarantino I, Traina M. ClearPath: a new method for fast and simple drainage of a perianastomotic abscess. Endoscopy 2014; 46 Suppl 1 UCTN:E289. [PMID: 24906105 DOI: 10.1055/s-0034-1377188] [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: 12/10/2022]
Affiliation(s)
- Antonino Granata
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT-UPMC), Palermo, Italy
| | - Gabriele Curcio
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT-UPMC), Palermo, Italy
| | - Neville Azzopardi
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT-UPMC), Palermo, Italy
| | - Luca Barresi
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT-UPMC), Palermo, Italy
| | - Ilaria Tarantino
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT-UPMC), Palermo, Italy
| | - Mario Traina
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT-UPMC), Palermo, Italy
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Abstract
BACKGROUND Klebsiella pneumoniae bacteraemia (KPB) has been associated with multiple risk factors. However association of these risk factors with mortality secondary to KPB has been poorly documented. OBJECTIVES To assess underlying co-morbidities in patients with KPB and any associated presentations. These findings were then used to devise a score to estimate the risk of in-hospital mortality in patients with underlying KPB. METHODS A retrospective analysis of all patients diagnosed with KPB between November 2007 and March 2012 at Mater Dei hospital in Malta was carried out. Using the odds ratios of risk factors for mortality associated with KPB, a mortality risk score was then prepared. RESULTS 186 patients (mean age 62 years; mean hospital stay 22.6 days) were included. 51 patients died as inpatients. Being admitted to intensive care (Overall risk (OR): 9, p<0.0001), having a solid organ tumour (OR 3, p<0.005), and having an underlying pneumonia (OR 3, p<0.021) were statistically significant risk factors associated with mortality. There were 0% mortality in patients with a score of 0, and progressively increasing mortalities with increasing scores up to a 100% mortality in patients with scores of >15. This translated into a validated risk score where an increasing score reflected an increasing mortality. CONCLUSIONS Klebsiella pneumoniae bacteraemia is associated with high in-patient mortality. ICU admission, underlying solid tumours, and co-existent pneumonias are among the factors used in our mortality risk score. This needs to be further validated in larger populations.
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Affiliation(s)
| | - N Azzopardi
- Department of Medicine, Mater Dei Hospital, Msida MSD 2090, Malta
| | - J Sant
- Department of Medicine, Mater Dei Hospital, Msida MSD 2090, Malta
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Tarantino I, Barresi L, Granata A, Azzopardi N, Curcio G, Traina M. Endoscopic treatment of an infected retroperitoneal hematoma following endoscopic ultrasound-guided pseudocyst drainage. Endoscopy 2014; 45 Suppl 2 UCTN:E395-6. [PMID: 24285067 DOI: 10.1055/s-0033-1344869] [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: 12/10/2022]
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Abstract
BACKGROUND Streptococcus gallolyticus bacteraemia has been associated with several pathologies, including bacterial endocarditis and colorectal cancer. AIMS In this study, we have analysed whether Streptococcus gallolyticus bacteraemia is associated with an increased risk of hepatobiliary and colonic pathology. The association with other pathologies and the antibiotic sensitivities of Streptococcus gallolyticus were also analysed. DESIGN Observational retrospective study. METHODS The case notes of patients with documented Streptococcus gallolyticus bacteraemia between 2007 and 2012 at Mater Dei hospital (Malta) were reviewed. Demographic and clinical data, including co-morbidities, clinical investigations, antibiotic sensitivities and mortality were analysed. RESULTS A total of 42 patients (33 males, 9 females) were recruited. Two patients were pre-term infants and were therefore excluded from the study. Mean age of the cohort population studied was 72 years (SD ± 14). One-year survival rate was 62%. Gastrointestinal (colonic and hepatobiliary-pancreatic) pathologies were present in 59.5% of patients with 16% of this group having more than one gastrointestinal pathology. High incidence rates of underlying diabetes mellitus (28.6%), valvular heart disease (21.4%) and malignancies (21.4%) were noted in this study. Furthermore, we observed that 14.3% of patients had an underlying respiratory pathology. Streptococcus gallolyticus was 100% sensitive to cefotaxime and vancomycin but was highly resistant to clindamycin, erythromycin and tetracycline. CONCLUSION Streptococcus gallolyticus bacteraemia is commoner in the elderly and in those with multiple underlying co-morbidities. The high incidence of gastrointestinal pathologies among patients with Streptococcus gallolyticus bacteraemia (59.5%) suggests that a thorough work-up for colonic and hepatobiliary/pancreatic pathology should be carried out in these patients.
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Curcio G, Granata A, Azzopardi N, Barresi L, Tarantino I, Traina M. Argon plasma coagulation before mechanical fragmentation of a large gastric persimmon bezoar: the woodworm technique. Endoscopy 2014; 45 Suppl 2 UCTN:E227-8. [PMID: 23945922 DOI: 10.1055/s-0033-1344220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/10/2022]
Affiliation(s)
- G Curcio
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies, Palermo, Italy.
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Curcio G, Azzopardi N, Granata A, Barresi L, Tarantino I, Traina M. Endoscopic guide wire gallbladder decompression in a critically ill, septic patient. Endoscopy 2014; 45 Suppl 2 UCTN:E248-9. [PMID: 24008449 DOI: 10.1055/s-0033-1344420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 12/10/2022]
Affiliation(s)
- G Curcio
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies, ISMETT, Palermo, Italy.
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Curcio G, Granata A, Azzopardi N, Pagano D, Barresi L, Tarantino I, Spada M, Traina M. The 'clip-band closure' technique: a new endoscopic traction method for closure of a large ulcer. Endoscopy 2014; 45 Suppl 2 UCTN:E171-2. [PMID: 23801287 DOI: 10.1055/s-0032-1326499] [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: 12/10/2022]
Affiliation(s)
- G Curcio
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
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Barresi L, Tarantino I, Traina M, Granata A, Curcio G, Azzopardi N, Baccarini P, Liotta R, Fornelli A, Maimone A, Jovine E, Cennamo V, Fabbri C. Endoscopic ultrasound-guided fine needle aspiration and biopsy using a 22-gauge needle with side fenestration in pancreatic cystic lesions. Dig Liver Dis 2014; 46:45-50. [PMID: 23916241 DOI: 10.1016/j.dld.2013.06.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [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: 02/08/2013] [Revised: 06/21/2013] [Accepted: 06/28/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cytologic diagnosis by endoscopic ultrasound-guided fine needle aspiration is associated with low sensitivity and adequacy. A newly designed endoscopic ultrasound-guided fine needle biopsy device, endowed with a side fenestration, is now available. AIMS We carried out a study with the aim of evaluating the feasibility, safety, and diagnostic yield of the 22-gauge needle with side fenestration for endoscopic ultrasound fine needle aspiration and biopsy of pancreatic cystic lesions. METHODS 58 patients with 60 pancreatic cystic lesions consecutively referred for endoscopic ultrasound guided-fine needle aspiration were enrolled in a prospective, dual centre study, and underwent fine needle aspiration and biopsy with the 22-gauge needle with side fenestration. RESULTS Fine needle aspiration and biopsy was technically feasible in all cases. In 39/60 (65%) pancreatic cystic lesions, the specimens were adequate for cyto-histologic assessment. In lesions with solid components, and in malignant lesions, adequacy was 94.4% (p = 0.0149) and 100% (p = 0.0069), respectively. Samples were adequate for histologic evaluation in 18/39 (46.1%) cases. There were only 2 (3.3%) mild complications. CONCLUSIONS Fine needle aspiration and biopsy with the 22-gauge needle with side fenestration is feasible, and superior to conventional endoscopic ultrasound-guided fine needle aspiration cytology from cystic fluid, particularly in pancreatic cystic lesions with solid component or malignancy, with a higher diagnostic yield and with no increase in complication rate.
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Affiliation(s)
- Luca Barresi
- Gastroenterology and Endoscopy Unit, ISMETT, Palermo, Italy.
| | | | - Mario Traina
- Gastroenterology and Endoscopy Unit, ISMETT, Palermo, Italy
| | | | | | | | - Paola Baccarini
- Pathology Unit, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | | | - Adele Fornelli
- Pathology Unit, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | - Antonella Maimone
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | - Elio Jovine
- Department of General Surgery, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | - Vincenzo Cennamo
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | - Carlo Fabbri
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
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Granata A, Azzopardi N, Barresi L, Traina M. Biliary tree under a starry sky following an abdominal gun shot wound. Dig Liver Dis 2013; 45:961. [PMID: 23845788 DOI: 10.1016/j.dld.2013.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Revised: 05/22/2013] [Accepted: 05/27/2013] [Indexed: 12/11/2022]
Affiliation(s)
- Antonino Granata
- Gastroenterology and Endoscopy Department, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, Palermo, Italy.
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Curcio G, Traina M, Azzopardi N, Barresi L, Tarantino I, Granata A. Endoloop/clip technique for gastrointestinal hemorrhage: rescue or first-line line therapy? Endoscopy 2013; 45:855. [PMID: 24068593 DOI: 10.1055/s-0033-1344391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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Granata A, Curcio G, Azzopardi N, Barresi L, Tarantino I, Traina M. Hemostatic powder as rescue therapy in a patient with H1N1 influenza with uncontrolled colon bleeding. Gastrointest Endosc 2013; 78:451. [PMID: 23948196 DOI: 10.1016/j.gie.2013.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 06/03/2013] [Accepted: 07/08/2013] [Indexed: 01/13/2023]
Affiliation(s)
- Antonino Granata
- Gastroenterology and Endoscopy Unit, Mediterranean Institute for Transplantation and Advanced Specialized Therapies, Palermo, Italy
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Curcio G, Granata A, Azzopardi N, Barresi L, Tarantino I, Traina M. Endoscopic gastrointestinal lavage (EGIL): a new sampling technique for the untouchable patient. J Gastrointestin Liver Dis 2013; 22:235. [PMID: 23799227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Abstract
BACKGROUND We analyzed the characteristics associated with increased risk of osteoporosis in patients with Crohn's disease in Malta. METHOD Eighty-three patients with histologically and endoscopically confirmed Crohn's disease underwent a DEXA bone density scan and their phenotypic characteristics were analyzed. RESULTS There was a significant association between body mass index and bone mineral density (P = 0.004) and a significant difference in the T scores of patients according to age at diagnosis (Montreal Classification: P = 0.0006) with patients diagnosed <17 years (n = 13) having lower T scores than those diagnosed at older age groups (n = 70). There was a significant difference between the T scores of patients on infliximab (n = 33) and those not on biological therapy (n = 50, P = 0.0058). Patients with high cumulative corticosteroid doses (>10 mg/d for >3 mo, n = 18) had lower bone mineral densities than patients who received smaller corticosteroid doses (P = 0.013). There was however no significant difference in the T scores of patients according to disease location (P = 0.18), disease type (P = 0.64), gender (P = 0.30), and history of ileal resection (P = 0.68). There was also no significant correlation between disease duration and T scores (hip) (P = 0.61). CONCLUSIONS Low body mass index, early disease onset, high corticosteroid doses and, anti-tumor necrosis factor α therapy are associated with increased risk of osteoporosis. Lower T scores in patients on infliximab occur as patients receiving this therapy have more severe inflammation, which is associated with elevated osteoclastogenic factors, rather than as a side-effect of the anti-tumor necrosis factor-α therapy.
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Affiliation(s)
- Neville Azzopardi
- Division of Gastroenterology, Mater Dei Hospital (Malta), Mellieha, Malta.
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Ellul P, Fenech VA, Azzopardi C, Callus L, Delicata N, Muscat J, Azzopardi N, Vassallo M. Diarrhoeal episodes in travellers suffering from IBD. Frontline Gastroenterol 2013; 4:120-124. [PMID: 28839712 PMCID: PMC5369812 DOI: 10.1136/flgastro-2012-100265] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 10/06/2012] [Revised: 11/12/2012] [Accepted: 11/12/2012] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND AND AIMS There is limited data on the risk of developing diarrhoea in travelling patients with inflammatory bowel disease (IBD). We analysed the rate of developing diarrhoea among travellers suffering from IBD and their healthy controls. METHODS We performed a retrospective case-controlled study among 78 patients with IBD and their healthy travelling companion controls, thus matching both groups to the same environmental conditions. Data was retrieved through a structured questionnaire, interview and clinical case notes review. RESULTS Sixteen (20.5%) patients with IBD developed diarrhoea while abroad (p -0.0001) Statistical analysis using a χ2 test for independence (with Yates Continuity Correction). Prior to travelling, they were in clinical remission. Only one healthy control (1.3%) developed diarrhoea while abroad. In 11 patients (14.1%), the duration of diarrhoea was 3 days or less, and resolved on its own without antibiotics, any increase in their IBD medications and without a medical consultation. The other five patients had a flare-up of their disease and needed medications to put them back into remission. There was no statistically significant difference between patients having immunomodulator medications versus those having aminosalicylates only in developing diarrhoea when abroad. CONCLUSIONS Patients with IBD have a higher rate of developing diarrhoea compared with controls when travelling. Thus, such patients must always seek a pretravel medical consultation.
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Affiliation(s)
- Pierre Ellul
- Gastroenterology Division, Mater Dei Hospital, Msida, Malta
| | | | | | - Lara Callus
- Gastroenterology Division, Mater Dei Hospital, Msida, Malta
| | | | - Jeffrey Muscat
- Gastroenterology Division, Mater Dei Hospital, Msida, Malta
| | | | - Mario Vassallo
- Gastroenterology Division, Mater Dei Hospital, Msida, Malta
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Guilleminault L, Azzopardi N, Wyckmans M, Roseau G, De Monte M, Legrain B, Vourc’h P, Hérault O, Andres C, Paintaud G, Lemarié E, Heuzé-Vourc’h N. Étude de la pharmacocinétique du cetuximab administré par voie pulmonaire chez le primate non-humain. Rev Mal Respir 2013. [DOI: 10.1016/j.rmr.2012.10.077] [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: 11/25/2022]
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Azzopardi N, Chetcuti S, Sant J, Pocock J. Acute Liver Impairment in a Young, Healthy Athlete: Hypoxic Hepatitis and Rhabdomyolysis following Heat Stroke. Case Rep Gastroenterol 2012; 6:563-8. [PMID: 23012616 PMCID: PMC3457030 DOI: 10.1159/000338838] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Any process that substantially diminishes arterial blood flow or arterial oxygen content to the liver can result in hypoxic (ischaemic) hepatitis. 90% of hypoxic hepatitis occurs in unstable patients in intensive care units with haemodynamic failure secondary to heart failure, respiratory failure and toxic shock. The rate of in-hospital mortality in hypoxic hepatitis is very high with studies recording mortalities of 61.5%. It tends to be very uncommon in healthy, young patients with no underlying medical problems. We report here the case of a young healthy athlete who developed heat stroke associated with rhabdomyolysis and hypoxic hepatitis while he was running the final stages of a marathon. The patient required intensive care admission and inotropic support for a few hours after he was admitted with heat stroke. He underwent a rapid recovery after he was resuscitated with fluids. N-acetyl cysteine was also given during the acute stage of the hepatitis. This case highlights an uncommon case of hypoxic hepatitis in a young, healthy patient secondary to hypotension and heat stroke. Inotropic support might have precipitated the hypoxic hepatitis in this young patient.
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Azzopardi N. Endoscopic retrograde cholangiopancreatography stents: indications, risks and novel uses. Gastroenterol Insights 2012. [DOI: 10.4081/gi.2012.e12] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
High output ileostomies are important complications of stoma formation following bowel surgery. Adequate management of such stomas might prevent severe morbidity and mortality when this potentially fatal complication develops. In this case report, we describe a female patient with a recent ileostomy formation following panproctocolectomy for ulcerative colitis who presented with progressively increasing shortness of breath. The patient was found to have a hypochloraemic metabolic acidosis on arterial blood gases. She rapidly improved with adequate sodium and fluid replacement and with the use of a course of proton pump inhibitors. This case highlights the importance of recognising high output ileostomies early and important management issues in their regard.
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Azzopardi N, Ellul P, Attard T, Attard J, DeGaetano J, Vassallo M, Piscopo T. A difficult case of Crohn's disease? Case Reports 2011; 2011:2011/mar05_1/bcr1220103612. [DOI: 10.1136/bcr.12.2010.3612] [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: 11/04/2022] Open
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36
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Chu Miow Lin D, Mulleman D, Azzopardi N, Griffoul-Espitalier I, Valat JP, Paintaud G, Goupille P. Trough infliximab concentration may predict long-term maintenance of infliximab in ankylosing spondylitis. Scand J Rheumatol 2010; 39:97-8. [PMID: 20132079 DOI: 10.3109/03009740903177745] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Affiliation(s)
- N Azzopardi
- Department of Anaesthesia, Angau Hospital, Lae, Papua New Guinea
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Azzopardi N. Neonatal anesthesia in Malta. A 4-year study (1980-1983). Acta Anaesthesiol Belg 1985; 36:163-7. [PMID: 4061017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Out of 21,090 live births registered in the Maltese Archipelago between 1st January 1980 and 31st December, 1983 there were 31 cases of congenital abnormalities that needed emergency surgery in the first few hours of life. The final results obtained locally compare favourably to those registered in larger centres abroad.
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Azzopardi N. [First 100 cases treated at the Diabetological Clinic in Mosta]. Minerva Med 1973; 64:12-3. [PMID: 4686678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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