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Mandato C, Colucci A, Vajro P. Reasons why treatment of metabolic dysfunction-associated steatotic liver disease may benefit from targeting the gut-liver axis as well. United European Gastroenterol J 2024; 12:528-529. [PMID: 38544364 DOI: 10.1002/ueg2.12558] [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] [Indexed: 05/15/2024] Open
Affiliation(s)
- Claudia Mandato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, Baronissi (Salerno), Italy
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, Baronissi (Salerno), Italy
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, Baronissi (Salerno), Italy
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Mandato C, Colucci A, Vajro P. Letter to the editor in response to distinguishing autoimmune hepatitis from steatohepatitis in adolescents with obesity and positive screening alanine aminotransferase. JPGN Rep 2024; 5:238-239. [PMID: 38756137 PMCID: PMC11093892 DOI: 10.1002/jpr3.12050] [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] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/08/2023] [Indexed: 05/18/2024]
Affiliation(s)
- Claudia Mandato
- Section of Pediatrics, Department of MedicineSurgery and Dentistry “Scuola Medica Salernitana” University of SalernBaronissi (Salerno)Italy
| | - Angelo Colucci
- Section of Pediatrics, Department of MedicineSurgery and Dentistry “Scuola Medica Salernitana” University of SalernBaronissi (Salerno)Italy
| | - Pietro Vajro
- Section of Pediatrics, Department of MedicineSurgery and Dentistry “Scuola Medica Salernitana” University of SalernBaronissi (Salerno)Italy
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De Rosa R, Siano MA, Colucci A, De Anseris AGE, Siani P, Vajro P, Savarese G, Mandato C. Perceptions and Expectations of Youth Regarding the Respect for Their Rights in the Hospital. Children (Basel) 2024; 11:222. [PMID: 38397334 PMCID: PMC10887615 DOI: 10.3390/children11020222] [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] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 01/28/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Information obtained from children themselves regarding the characteristics of the ideal hospital that ensure well-being during a hospital stay is scarce. Here, we report the opinions, perceptions, and expectations of 700 children and adolescents about their experiences, assessed through a mixed-method research approach with age-appropriate questionnaires, three open-ended questions, and an analysis of optional pictorial and textual narratives. Most children indicated that, while they acknowledged the expertise of hospital staff, they also noted several shortcomings, e.g., insufficiently understandable medical information as well as emotional and cognitive support. The continuity of schooling and the right to suffer as little as possible were also critical issues. Adolescents valued in particular the quality of care and services provided, the hospital's adherence to equality and non-discrimination rights, and protection systems but negatively perceived several aspects related to play and participation. Significant differences in the co-occurrences of the most frequently used text terms with the keywords "hospital" and "child/adolescent" between age groups highlight variations in the way patients perceive and articulate their experiences within the hospital setting depending on the cognitive processes linked to age. In drawings, prevailing attention was placed on the physical context of the hospital room, with figures expressing mostly negative emotions. Specifically, in this regard, the main emotion in children was sadness, and, in adolescents, it was fear. Overall, these insights are pivotal in the context of our research objectives as they shed light on the nuanced preferences, needs, and perspectives of children and adolescents during their hospital stays. Recognizing the identified shortcomings, we propose recommendations emphasizing the improvement of medical communication clarity, enhancement of emotional and cognitive support, and the improvement of programs to avoid instructional gaps during hospital stays. Addressing these specific needs is critical for a more comprehensive approach to pediatric healthcare provision.
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Affiliation(s)
- Roberta De Rosa
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | - Maria Anna Siano
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | | | - Paolo Siani
- Pediatrics, AORN Santobono-Pausilipon Children’s Hospital, 80122 Naples, Italy;
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
| | - Giulia Savarese
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Psychology Section, University of Salerno, 84081 Salerno, Italy;
| | - Claudia Mandato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy; (R.D.R.); (M.A.S.); (A.C.); (P.V.)
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Luzi AM, Colucci A, Gallo P, De Mei B, Mastrobattista L, De Santis M, Pacifici R, Taruscio D, Gallo C. The Communicative-Relational Operating Model of the Italian National Institute of Health for an Effective Telephone Intervention in Public Health, Structured on Basic Counselling Skills. Ann Ig 2023; 35:379-402. [PMID: 37184351 DOI: 10.7416/ai.2023.2555] [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] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Introduction Communication has a crucial role in public health, because it becomes an essential component of prevention; it is also a proactive tool in health promotion. From a planning perspective, it is appropriate to use communication means that can help the bidirectional communication process, such as face-to-face communication and telephone communication. Materials and methods In relation to this, the Italian National Institute of Health has developed the "Modello Operativo Comunicativo-Relazionale" (the "Communicative-Relational Operating Model"). It is based on the fundamental skills of the counselling, this gives a protocol to the health professionals that is replicable and organized and it allows health professionals to carry out a telephone communication that is efficient with the user through technical-scientific and communication-relational skills. The goal is to answer in a customized way to the various users' health needs. The Operating Model was created by experts of the National AIDS and Sexually Transmitted Infections Helpline of the Operational Unit of Psycho-Socio-Behavioural Research, Communication, Training, of the Infectious Diseases Department. Later, the Operating Model was proposed to the experts of the Helplines in the National Centre on Addictions and Doping and the National Helpline of the National Centre for Rare Diseases in the National Institute of Health that integrated this method into their telephone approach. Results The Operating Model illustrated above was applied to several helplines of the National Institute of Health as an example of correct scientific information, updated and customized on sexual transmitted infections, addictions and rare diseases. Conclusions This article aims to illustrate the Operating Model, the theoretical prerequisites that subtend it and its possible application in the different public health structures that use the telephone for a profes-sional relationship with their users.
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Affiliation(s)
- A M Luzi
- Operational Unit of Psycho-Socio-Behavioural Research, Communication and Training, Infectious Diseases Department, National Institute of Health, Rome, Italy
| | - A Colucci
- Operational Unit of Psycho-Socio-Behavioural Research, Communication and Training, Infectious Diseases Department, National Institute of Health, Rome, Italy
| | - P Gallo
- Operational Unit of Psycho-Socio-Behavioural Research, Communication and Training, Infectious Diseases Department, National Institute of Health, Rome, Italy
| | - B De Mei
- National Centre for Disease Prevention and Health Promotion, Unit of Risk Factors Surveillance and Health Promotion Strategies, National Institute of Health, Rome, Italy
| | - L Mastrobattista
- Unit of Risk Factors Surveillance and Health Promotion Strategies, National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - M De Santis
- National Centre for Rare Diseases, National Institute of Health, Rome, Italy
| | - R Pacifici
- Unit of Risk Factors Surveillance and Health Promotion Strategies, National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - D Taruscio
- National Centre for Rare Diseases, National Institute of Health, Rome, Italy
| | - C Gallo
- Student of Communication, Technologies and Digital Culture, Faculty of Political Science, Sociology and Communication, Sapienza University of Rome, Rome, Italy
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Mandato C, Colucci A, Lanzillo R, Staiano A, Scarpato E, Schiavo L, Operto FF, Serra MR, Di Monaco C, Napoli JS, Massa G, Vajro P. Multiple Sclerosis-Related Dietary and Nutritional Issues: An Updated Scoping Review with a Focus on Pediatrics. Children (Basel) 2023; 10:1022. [PMID: 37371254 DOI: 10.3390/children10061022] [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] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/03/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE Lifestyle/dietetic habits play an important role in the development and progression of multiple sclerosis (MS) disease. Here, we examine the basic pathomechanisms underlying intestinal and brain barrier modifications in MS and consider diets and dietary supplementations proposed over time to complement pharmacological therapies for improving disease outcome both in adults and in children. METHODS Scoping literature search about evidence-based findings in MS-related gut-brain axis (GBA) pathophysiology and nutritional issues at all ages. FINDINGS Data show that (1) no universal best diet exists, (2) healthy/balanced diets are, however, necessary to safeguard the adequate intake of all essential nutrients, (3) diets with high intakes of fruits, vegetables, whole grains, and lean proteins that limit processed foods, sugar, and saturated fat appear beneficial for their antioxidant and anti-inflammatory properties and their ability to shape a gut microbiota that respects the gut and brain barriers, (4) obesity may trigger MS onset and/or its less favorable course, especially in pediatric-onset MS. Vitamin D and polyunsaturated fatty acids are the most studied supplements for reducing MS-associated inflammation. CONCLUSIONS Pending results from other and/or newer approaches targeting the GBA (e.g., pre- and probiotics, engineered probiotics, fecal-microbiota transplantation), accurate counseling in choosing adequate diet and maintaining physical activity remains recommended for MS prevention and management both in adults and children.
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Affiliation(s)
- Claudia Mandato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Roberta Lanzillo
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80138 Naples, Naples, Italy
| | - Annamaria Staiano
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80138 Naples, Naples, Italy
| | - Elena Scarpato
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80138 Naples, Naples, Italy
| | - Luigi Schiavo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Nutrition Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Francesca Felicia Operto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatric Psychiatry Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Maria Rosaria Serra
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, 80138 Naples, Naples, Italy
| | - Cristina Di Monaco
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80138 Naples, Naples, Italy
| | - Julia Sara Napoli
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Grazia Massa
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, 84081 Baronissi, Salerno, Italy
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, 84081 Baronissi, Salerno, Italy
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Mosca C, Colucci A, Savoia F, Calì C, Del Bene M, Ranucci G, Maglione A, Pepe A, Morelli A, Vajro P, Mandato C. Vitamin D Levels in the Pre- and Post-COVID-19 Pandemic Periods and Related Confinement at Pediatric Age. Nutrients 2023; 15:2089. [PMCID: PMC10181113 DOI: 10.3390/nu15092089] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 06/01/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) restrictions have been correlated with vitamin D deficiency in children, but some uncertainties remain. We retrospectively studied vitamin 25-(OH) D blood levels in 2182 Italian children/adolescents hospitalized for various chronic diseases in the year before (n = 1052) and after (n = 1130) the nationwide lockdown. The type of underlying disease, gender, and mean age (91 ± 55 and 91 ± 61 months, respectively) of patients included in the two periods were comparable. Although mean levels were the same (p = 0.24), deficiency status affected a significantly higher number of subjects during the lockdown period than in the pre-COVID period (p = 0.03), particularly in summer (p = 0.02), and there was also a smoothing of seasonal variations in vitamin D levels. Particularly at risk were males (OR = 1.22; p = 0.03), the 1–5 year age group (OR = 1.57; p < 0.01) and the 6–12 year age group (OR = 1.30; p = 0.04). Infants appeared not to be affected (p = 1.00). In the post-COVID period, the risk of vitamin D deficiency was unchanged in disease-specific groups. However, the proportion of deficiency or severe deficiency differed significantly in the subgroup with endocrinopathy (higher; Chi-square p = 0.04), and with respiratory problems and obesity (lower; Chi-square p = 0.01 and p < 0.01, respectively). Conflicting/opposite literature results advocate for further studies to clearly indicate the need for supplementation during possible future periods of confinement.
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Affiliation(s)
- Caterina Mosca
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, 80131 Naples, Italy
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Fabio Savoia
- Epidemiology, Biostatistic and Childhood Cancer Registry of Campania, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - Camilla Calì
- Epidemiology, Biostatistic and Childhood Cancer Registry of Campania, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - Margherita Del Bene
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, 80131 Naples, Italy
| | - Giusy Ranucci
- Pediatric Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), University of Pittsburgh Medical Center, 90127 Palermo, Italy
| | - Antonio Maglione
- Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - Angela Pepe
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Annalisa Morelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Claudia Mandato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
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Mandato C, Colucci A, Vajro P. Emerging, re-emerging and/or atypically behaving infectious diseases. Acta Paediatr 2023; 112:1145-1147. [PMID: 36944185 DOI: 10.1111/apa.16744] [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: 02/16/2023] [Revised: 02/21/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023]
Affiliation(s)
- Claudia Mandato
- Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Section of Pediatrics, Baronissi, Italy
| | - Angelo Colucci
- Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Section of Pediatrics, Baronissi, Italy
| | - Pietro Vajro
- Dipartimento di Medicina, Chirurgia e Odontoiatria "Scuola Medica Salernitana", Section of Pediatrics, Baronissi, Italy
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Luzi AM, Colucci A, Gallo P, De Mei B, Mastrobattista L, De Santis M, Pacifici R, Taruscio D, Gallo C. The Communicative-Relational Operating Model of the Italian National Institute of Health for an Effective Telephone Intervention in Public Health, Structured on Basic Counselling Skills. Ann Ig 2023. [PMID: 36753332 DOI: 10.7416/ai.2023.255] [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] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Introduction Communication has a crucial role in public health, because it becomes an essential component of prevention; it is also a proactive tool in health promotion. From a planning perspective, it is appropriate to use communication means that can help the bidirectional communication process, such as face-to-face communication and telephone communication. Materials and methods In relation to this, the Italian National Institute of Health has developed the "Modello Operativo Comunicativo-Relazionale" (the "Communicative-Relational Operating Model"). It is based on the fundamental skills of the counselling, this gives a protocol to the health professionals that is replicable and organized and it allows health professionals to carry out a telephone communication that is efficient with the user through technical-scientific and communication-relational skills. The goal is to answer in a customized way to the various users' health needs. The Operating Model was created by experts of the National AIDS and Sexually Transmitted Infections Helpline of the Operational Unit of Psycho-Socio-Behavioural Research, Communication, Training, of the Infectious Diseases Department. Later, the Operating Model was proposed to the experts of the Helplines in the National Centre on Addictions and Doping and the National Helpline of the National Centre for Rare Diseases in the National Institute of Health that integrated this method into their telephone approach. Results The Operating Model illustrated above was applied to several helplines of the National Institute of Health as an example of correct scientific information, updated and customized on sexual transmitted infections, addictions and rare diseases. Conclusions This article aims to illustrate the Operating Model, the theoretical prerequisites that subtend it and its possible application in the different public health structures that use the telephone for a professional relationship with their users.
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Affiliation(s)
- A M Luzi
- Operational Unit of Psycho-Socio-Behavioural Research, Communication and Training, Infectious Diseases Department, National Institute of Health, Rome, Italy
| | - A Colucci
- Operational Unit of Psycho-Socio-Behavioural Research, Communication and Training, Infectious Diseases Department, National Institute of Health, Rome, Italy
| | - P Gallo
- Operational Unit of Psycho-Socio-Behavioural Research, Communication and Training, Infectious Diseases Department, National Institute of Health, Rome, Italy
| | - B De Mei
- National Centre for Disease Prevention and Health Promotion, Unit of Risk Factors Surveillance and Health Promotion Strategies, National Institute of Health, Rome, Italy
| | - L Mastrobattista
- Unit of Risk Factors Surveillance and Health Promotion Strategies, National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - M De Santis
- National Centre for Rare Diseases, National Institute of Health, Rome, Italy
| | - R Pacifici
- Unit of Risk Factors Surveillance and Health Promotion Strategies, National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - D Taruscio
- National Centre for Rare Diseases, National Institute of Health, Rome, Italy
| | - C Gallo
- Student of Communication, Technologies and Digital Culture, Faculty of Political Science, Sociology and Communication, Sapienza University of Rome, Rome, Italy
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Pepe A, Colucci A, Carucci M, Nazzaro L, Bucci C, Ranucci G, Di Giorgio A, Vajro P, Mandato C. Case Report: Add-on treatment with odevixibat in a new subtype of progressive familial intrahepatic cholestasis broadens the therapeutic horizon of genetic cholestasis. Front Pediatr 2023; 11:1061535. [PMID: 36865697 PMCID: PMC9974160 DOI: 10.3389/fped.2023.1061535] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/13/2023] [Indexed: 02/16/2023] Open
Abstract
Odevixibat, an ileal bile acid transporter (IBAT) inhibitor, is effective for the treatment of pruritus in children diagnosed with progressive familial intrahepatic cholestasis (PFIC) type 1 and 2. There are no studies showing the efficacy of Odevixibat in children with different subtypes of PFIC. We describe the case of a 6-year-old girl with chronic cholestatic jaundice. In the last 12 months laboratory data showed high serum levels of bilirubin (total bilirubin x 2.5 ULN; direct bilirubin x 1.7 ULN) and bile acids (sBA x 70 ULN), elevated transaminases (x 3-4 ULN), and preserved synthetic liver function. Genetic testing showed homozygous mutation in ZFYVE19 gene, which is not included among the classic causative genes of PFIC and determined a new non-syndromic phenotype recently classified as PFIC9 (OMIM # 619849). Due to the persistent intensity of itching [score of 5 (very severe) at the Caregiver Global Impression of Severity (CaGIS)] and sleep disturbances not responsive to rifampicin and ursodeoxycholic acid (UDCA), Odevixibat treatment was started. After treatment with odevixibat we observed: (i) reduction in sBA from 458 to 71 μmol/L (absolute change from baseline: -387 μmol/L), (ii) reduction in CaGIS from 5 to 1, and (iii) resolution of sleep disturbances. The BMI z-score progressively increased from -0.98 to +0.56 after 3 months of treatment. No adverse drug events were recorded. Treatment with IBAT inhibitor was effective and safe in our patient suggesting that Odevixibat may be potentially considered for the treatment of cholestatic pruritus also in children with rare subtypes of PFIC. Further studies on a larger scale could lead to the increasing of patients eligible for this treatment.
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Affiliation(s)
- Angela Pepe
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, Baronissi (Salerno), Italy
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, Baronissi (Salerno), Italy
| | - Martina Carucci
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, Baronissi (Salerno), Italy
| | - Lucia Nazzaro
- Pediatric Unit, University Hospital "San Giovanni di Dio e Ruggi d"Aragona", Salerno, Italy
| | - Cristina Bucci
- Department of Gastroenterology, AORN Santobono- Pausilipon Children Hospital, Naples, Italy
| | - Giusy Ranucci
- Pediatric Department, AORN Santobono- Pausilipon Children Hospital, Naples, Italy
| | - Angelo Di Giorgio
- Department of Pediatric Gastroenterology Hepatology and Transplantation, Pediatric Hepatology, Gastroenterology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, Baronissi (Salerno), Italy
| | - Claudia Mandato
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Pediatrics Section, University of Salerno, Baronissi (Salerno), Italy
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Colucci A, Rocco MC, De Anseris AGE, Nazzaro L, Vajro P, Mandato C. Pediatric vs. adult NAFLD to MAFLD transition: a welcome but tangled path. Exploration of Medicine 2021. [DOI: 10.37349/emed.2021.00051] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The term non-alcoholic fatty liver disease (NAFLD) appears unfitting both in adults and in children. As obesity and metabolic syndrome play a relevant pathogenic role, an international group of adults’ liver disease experts has proposed to rename this condition metabolic (dysfunction)-associated fatty liver disease (MAFLD). While this new more appropriate and useful definition has mostly been met with good reactions in adults, it may present a tangled path in pediatrics. Here we further stress the recommendations of the North American and the European Societies for Pediatric Gastroenterology, Hepatology and Nutrition that a hyperechogenic liver in a child affected by obesity or overweight with chronically elevated liver enzymes should not be assumed to have NAFLD only. Especially in those patients who are not in the classic age range or who have particularly severe laboratory anomalies, other genetic, metabolic (inborn errors of metabolism, IEM), endocrine, intestinal and hepatic pediatric-onset conditions, should in fact be excluded, particularly when response to a weight loss trial is not available. The term pediatric fatty liver disease (PeFLD) with three subtypes (1. contextual diagnosis of an IEM; 2. Metabolic (dysfunction)-associated fatty liver; 3. unknown cause of fatty liver) has recently been proposed aiming to separate true MAFLD from IEM and/or the other above mentioned conditions, which may be rare when considered individually but represent a large group when considered collectively. Although the cost-effectiveness ratio of this attitude is still indeterminate, it is likely that the advantage of the early identification of a specifically treatable pediatric-onset liver disease associated to/mimicking MAFLD would be rewarding.
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Affiliation(s)
- Angelo Colucci
- Pediatrics Section, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi (Salerno), Italy
| | - Maria Chiara Rocco
- Pediatrics Section, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi (Salerno), Italy
| | | | - Lucia Nazzaro
- Pediatrics, AOU San Giovanni di Dio e Ruggi d’Aragona, 84131 Salerno, Italy
| | - Pietro Vajro
- Pediatrics Section, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84081 Baronissi (Salerno), Italy
| | - Claudia Mandato
- Department of Pediatrics, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
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Tessitore M, Sorrentino E, Schiano Di Cola G, Colucci A, Vajro P, Mandato C. Malnutrition in Pediatric Chronic Cholestatic Disease: An Up-to-Date Overview. Nutrients 2021; 13:2785. [PMID: 34444944 PMCID: PMC8400766 DOI: 10.3390/nu13082785] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 07/13/2021] [Revised: 08/08/2021] [Accepted: 08/11/2021] [Indexed: 12/16/2022] Open
Abstract
Despite recent advances, the causes of and effective therapies for pediatric chronic cholestatic diseases remain elusive, and many patients progress to liver failure and need liver transplantation. Malnutrition is a common complication in these patients and is a well-recognized, tremendous challenge for the clinician. We undertook a narrative review of both recent and relevant older literature, published during the last 20 years, for studies linking nutrition to pediatric chronic cholestasis. The collected data confirm that malnutrition and failure to thrive are associated with increased risks of morbidity and mortality, and they also affect the outcomes of liver transplantation, including long-term survival. Malnutrition in children with chronic liver disease is multifactorial and with multiple potential nutritional deficiencies. To improve life expectancy and the quality of life, patients require careful assessments and appropriate management of their nutritional statuses by multidisciplinary teams, which can identify and/or prevent specific deficiencies and initiate appropriate interventions. Solutions available for the clinical management of these children in general, as well as those directed to specific etiologies, are summarized. We particularly focus on fat-soluble vitamin deficiency and malnutrition due to fat malabsorption. Supplemental feeding, including medium-chain triglycerides, essential fatty acids, branched-chain amino acids, and the extra calories needed to overcome the consequences of anorexia and high energy requirements, is reviewed. Future studies should address the need for further improving commercially available and nutritionally complete infant milk formulae for the dietary management of this fragile category of patients. The aid of a specialist dietitian, educational training regarding nutritional guidelines for stakeholders, and improving family nutritional health literacy appear essential.
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Affiliation(s)
- Maria Tessitore
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Chair of Pediatrics and Residency Program of Pediatrics, Via S. Allende, University of Salerno, 84081 Baronissi, SA, Italy; (M.T.); (E.S.); (G.S.D.C.); (A.C.); (P.V.)
| | - Eduardo Sorrentino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Chair of Pediatrics and Residency Program of Pediatrics, Via S. Allende, University of Salerno, 84081 Baronissi, SA, Italy; (M.T.); (E.S.); (G.S.D.C.); (A.C.); (P.V.)
| | - Giuseppe Schiano Di Cola
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Chair of Pediatrics and Residency Program of Pediatrics, Via S. Allende, University of Salerno, 84081 Baronissi, SA, Italy; (M.T.); (E.S.); (G.S.D.C.); (A.C.); (P.V.)
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Chair of Pediatrics and Residency Program of Pediatrics, Via S. Allende, University of Salerno, 84081 Baronissi, SA, Italy; (M.T.); (E.S.); (G.S.D.C.); (A.C.); (P.V.)
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Chair of Pediatrics and Residency Program of Pediatrics, Via S. Allende, University of Salerno, 84081 Baronissi, SA, Italy; (M.T.); (E.S.); (G.S.D.C.); (A.C.); (P.V.)
| | - Claudia Mandato
- Department of Pediatrics, Santobono-Pausilipon Children’s Hospital Via M. Fiore, 80129 Naples, Italy
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12
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Franza F, Solomita B, Colucci A, Perito M, Pellegrino F, Buono GD, Tavormina G. Emotional blunting and cognitive profile in elderly depressed patients in treatment with vortioxetine. Eur Psychiatry 2021. [PMCID: PMC9471019 DOI: 10.1192/j.eurpsy.2021.875] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Introduction Antidepressants in older people have experienced their increase in medical prescriptions in recent decades whit comorbidity with other pathologies and drug polytherapies. With the use of antidepressants, can be observed side and unwanted effects (e.g. emotional blunting). Vortioxetine is a new antidepressant agent which promises fewer side effects. Objectives To evaluate the clinical efficacy, safety, side effects (e.g emotional blunting) and cognitive profile Methods 45 elderly patients affected by MDD (DSM-5) were recruited in our observational study. All patients were treated with vortioxetine for 12 months. Physiological and pathological parameters were collected at baseline (T0), after 3 months (T1), 6 months (T2); 12 months (T3). All patients were administered the following scales: GDS; MMSE; QLi; ODQ. The statistical data were processed with EZAnalyze. Results 33.33% of patients had a score in the “unlikely depression” GDS group. The ANOVA ODQ “Total” results indicate that at least two of the repeated measures differ significantly. Data of the “antidepressant as cause” dimension are interesting [T0 vs T3 (P-Unadjusted .000; P-Bonferroni .000; T-value 5.687. MMSE scores are indicative of one small but not significant difference. Mean QLIndex scores did not show statistically significant changes, but are indicative of positive changes from the baseline score Conclusions Vortioxetine resulted in partial reduction of depression. There was a moderate non-statistically significant increase in body weight, glycidic and lipid profiles. Overall data highlight the importance and role that vortioxetine can have in the management of depressive symptoms in elderly subjects. The handling, effectiveness and reduced side effects of the molecule are emphasized.
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13
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Troisi J, Cavallo P, Richards S, Symes S, Colucci A, Sarno L, Landolfi A, Scala G, Adair D, Ciccone C, Maruotti GM, Martinelli P, Guida M. Noninvasive screening for congenital heart defects using a serum metabolomics approach. Prenat Diagn 2021; 41:743-753. [PMID: 33440021 DOI: 10.1002/pd.5893] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/11/2020] [Accepted: 12/20/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Heart anomalies represent nearly one-third of all congenital anomalies. They are currently diagnosed using ultrasound. However, there is a strong need for a more accurate and less operator-dependent screening method. Here we report a metabolomics characterization of maternal serum in order to describe a metabolomic fingerprint representative of heart congenital anomalies. METHODS Metabolomic profiles were obtained from serum of 350 mothers (280 controls and 70 cases). Nine classification models were built and optimized. An ensemble model was built based on the results from the individual models. RESULTS The ensemble machine learning model correctly classified all cases and controls. Malonic, 3-hydroxybutyric and methyl glutaric acid, urea, androstenedione, fructose, tocopherol, leucine, and putrescine were determined as the most relevant metabolites in class separation. CONCLUSION The metabolomic signature of second trimester maternal serum from pregnancies affected by a fetal heart anomaly is quantifiably different from that of a normal pregnancy. Maternal serum metabolomics is a promising tool for the accurate and sensitive screening of such congenital defects. Moreover, the revelation of the associated metabolites and their respective biochemical pathways allows a better understanding of the overall pathophysiology of affected pregnancies.
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Affiliation(s)
- Jacopo Troisi
- Department of Medicine and Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.,Metabolomics section, Theoreo Srl - Spin-off Company of the University of Salerno, Salerno, Italy.,Metabolomics section, European Biomedical Research Institute of Salerno (EBRIS), Salerno, Italy
| | - Pierpaolo Cavallo
- Department of Physics, University of Salerno, Salerno, Italy.,Istituto Sistemi Complessi, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy
| | - Sean Richards
- Department of Biology, Geology and Environmental Sciences, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA.,Department of Obstetrics and Gynecology, University of Tennessee College of Medicine, Chattanooga, TN, USA
| | - Steven Symes
- Department of Obstetrics and Gynecology, University of Tennessee College of Medicine, Chattanooga, TN, USA.,Department of Chemistry and Physics, University of Tennessee at Chattanooga, Chattanooga, Tennessee, USA
| | - Angelo Colucci
- Department of Medicine and Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Laura Sarno
- Department of Neurosciences and Reproductive and Dentistry Sciences, University of Naples Federico II, Naples, Italy
| | - Annamaria Landolfi
- Department of Medicine and Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Giovanni Scala
- Metabolomics section, Theoreo Srl - Spin-off Company of the University of Salerno, Salerno, Italy.,Hosmotic Srl, Naples, Italy
| | - David Adair
- Department of Obstetrics and Gynecology, University of Tennessee College of Medicine, Chattanooga, TN, USA
| | - Carla Ciccone
- Obstetrics and Gynecology clinic, G. Moscati Hospital, Avellino, Italy
| | - Giuseppe M Maruotti
- Department of Neurosciences and Reproductive and Dentistry Sciences, University of Naples Federico II, Naples, Italy
| | - Pasquale Martinelli
- Department of Neurosciences and Reproductive and Dentistry Sciences, University of Naples Federico II, Naples, Italy
| | - Maurizio Guida
- Department of Medicine and Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.,Metabolomics section, Theoreo Srl - Spin-off Company of the University of Salerno, Salerno, Italy.,Department of Neurosciences and Reproductive and Dentistry Sciences, University of Naples Federico II, Naples, Italy
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14
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Masarone M, Troisi J, Aglitti A, Torre P, Colucci A, Dallio M, Federico A, Balsano C, Persico M. Untargeted metabolomics as a diagnostic tool in NAFLD: discrimination of steatosis, steatohepatitis and cirrhosis. Metabolomics 2021; 17:12. [PMID: 33458794 DOI: 10.1007/s11306-020-01756-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 07/17/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Non-Alcoholic Fatty Liver Disease encompasses a spectrum of diseases ranging from simple steatosis to steatohepatitis (or NASH), up to cirrhosis and hepatocellular carcinoma (HCC). The challenge is to recognize the more severe and/or progressive pathology. A reliable non-invasive method does not exist. Untargeted metabolomics is a novel method to discover biomarkers and give insights on diseases pathophysiology. OBJECTIVES We applied metabolomics to understand if simple steatosis, steatohepatitis and cirrhosis in NAFLD patients have peculiar metabolites profiles that can differentiate them among each-others and from controls. METHODS Metabolomics signatures were obtained from 307 subjects from two separated enrollments. The first collected samples from 69 controls and 144 patients (78 steatosis, 23 NASH, 15 NASH-cirrhosis, 8 HCV-cirrhosis, 20 cryptogenic cirrhosis). The second, used as validation-set, enrolled 44 controls and 50 patients (34 steatosis, 10 NASH and 6 NASH-cirrhosis).The "Partial-Least-Square Discriminant-Analysis"(PLS-DA) was used to reveal class separation in metabolomics profiles between patients and controls and among each class of patients, and to reveal the metabolites contributing to class differentiation. RESULTS Several metabolites were selected as relevant, in particular:Glycocholic acid, Taurocholic acid, Phenylalanine, branched-chain amino-acids increased at the increase of the severity of the disease from steatosis to NASH, NASH-cirrhosis, while glutathione decreased (p < 0.001 for each). Moreover, an ensemble machine learning (EML) model was built (comprehending 10 different mathematical models) to verify diagnostic performance, showing an accuracy > 80% in NAFLD clinical stages prediction. CONCLUSIONS Metabolomics profiles of NAFLD patients could be a useful tool to non-invasively diagnose NAFLD and discriminate among the various stages of the disease, giving insights into its pathophysiology.
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Affiliation(s)
- Mario Masarone
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy
| | - Jacopo Troisi
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy
- Theoreo srl, Via degli Ulivi 3, 84090, Montecorvino Pugliano, SA, Italy
- European Biomedical Research Institute of Salerno (EBRIS), Via S. de Renzi, 3, 84125, Salerno, SA, Italy
- Hosmotic srl, Via R. Bosco 178, 80069, Vico Equense, NA, Italy
| | - Andrea Aglitti
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy
| | - Pietro Torre
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy
| | - Angelo Colucci
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy
- Theoreo srl, Via degli Ulivi 3, 84090, Montecorvino Pugliano, SA, Italy
| | - Marcello Dallio
- Hepatogastroenterology Division, University of Campania "Luigi Vanvitelli", Via S Pansini 5, 80131, Naples, Italy
| | - Alessandro Federico
- Hepatogastroenterology Division, University of Campania "Luigi Vanvitelli", Via S Pansini 5, 80131, Naples, Italy
| | - Clara Balsano
- MESVA Department, University of L'Aquila, Piazza S. Salvatore Tommasi 1, 67100, Coppito, L'Aquila, Italy
- F. Balsano Foundation, Via Giovanni Battista Martini 6, 00198, Rome, Italy
| | - Marcello Persico
- Internal Medicine and Hepatology Unit, Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Via Salvador Allende, 84081, Baronissi, SA, Italy.
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15
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Leonard MM, Karathia H, Pujolassos M, Troisi J, Valitutti F, Subramanian P, Camhi S, Kenyon V, Colucci A, Serena G, Cucchiara S, Montuori M, Malamisura B, Francavilla R, Elli L, Fanelli B, Colwell R, Hasan N, Zomorrodi AR, Fasano A. Multi-omics analysis reveals the influence of genetic and environmental risk factors on developing gut microbiota in infants at risk of celiac disease. Microbiome 2020; 8:130. [PMID: 32917289 PMCID: PMC7488762 DOI: 10.1186/s40168-020-00906-w] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 08/10/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Celiac disease (CD) is an autoimmune digestive disorder that occurs in genetically susceptible individuals in response to ingesting gluten, a protein found in wheat, rye, and barley. Research shows that genetic predisposition and exposure to gluten are necessary but not sufficient to trigger the development of CD. This suggests that exposure to other environmental stimuli early in life, e.g., cesarean section delivery and exposure to antibiotics or formula feeding, may also play a key role in CD pathogenesis through yet unknown mechanisms. Here, we use multi-omics analysis to investigate how genetic and early environmental risk factors alter the development of the gut microbiota in infants at risk of CD. RESULTS Toward this end, we selected 31 infants from a large-scale prospective birth cohort study of infants with a first-degree relative with CD. We then performed rigorous multivariate association, cross-sectional, and longitudinal analyses using metagenomic and metabolomic data collected at birth, 3 months and 6 months of age to explore the impact of genetic predisposition and environmental risk factors on the gut microbiota composition, function, and metabolome prior to the introduction of trigger (gluten). These analyses revealed several microbial species, functional pathways, and metabolites that are associated with each genetic and environmental risk factor or that are differentially abundant between environmentally exposed and non-exposed infants or between time points. Among our significant findings, we found that cesarean section delivery is associated with a decreased abundance of Bacteroides vulgatus and Bacteroides dorei and of folate biosynthesis pathway and with an increased abundance of hydroxyphenylacetic acid, alterations that are implicated in immune system dysfunction and inflammatory conditions. Additionally, longitudinal analysis revealed that, in infants not exposed to any environmental risk factor, the abundances of Bacteroides uniformis and of metabolite 3-3-hydroxyphenylproprionic acid increase over time, while those for lipoic acid and methane metabolism pathways decrease, patterns that are linked to beneficial immunomodulatory and anti-inflammatory effects. CONCLUSIONS Overall, our study provides unprecedented insights into major taxonomic and functional shifts in the developing gut microbiota of infants at risk of CD linking genetic and environmental risk factors to detrimental immunomodulatory and inflammatory effects. Video Abstract.
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Affiliation(s)
- Maureen M Leonard
- Division of Pediatric Gastroenterology and Nutrition, MassGeneral Hospital for Children, Harvard Medical School, Boston, MA, USA
- Mucosal Immunology and Biology Research Center, MassGeneral Hospital for Children, Boston, USA
- Harvard Medical School, Boston, MA, USA
- Celiac Research Program, Harvard Medical School, Boston, MA, USA
| | | | | | - Jacopo Troisi
- Theoreo srl, University of Salerno, Montecorvino Pugliano, Italy
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
- European Biomedical Research Institute of Salerno (EBRIS), Via S. De Renzi, 50, 84125, Salerno, Italy
| | - Francesco Valitutti
- European Biomedical Research Institute of Salerno (EBRIS), Via S. De Renzi, 50, 84125, Salerno, Italy
- Pediatric Unit, Maternal and Child Health Department, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | | | - Stephanie Camhi
- Mucosal Immunology and Biology Research Center, MassGeneral Hospital for Children, Boston, USA
- Celiac Research Program, Harvard Medical School, Boston, MA, USA
| | - Victoria Kenyon
- Mucosal Immunology and Biology Research Center, MassGeneral Hospital for Children, Boston, USA
- Celiac Research Program, Harvard Medical School, Boston, MA, USA
| | - Angelo Colucci
- Theoreo srl, University of Salerno, Montecorvino Pugliano, Italy
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Gloria Serena
- Division of Pediatric Gastroenterology and Nutrition, MassGeneral Hospital for Children, Harvard Medical School, Boston, MA, USA
- Mucosal Immunology and Biology Research Center, MassGeneral Hospital for Children, Boston, USA
- Harvard Medical School, Boston, MA, USA
- Celiac Research Program, Harvard Medical School, Boston, MA, USA
| | | | - Monica Montuori
- Pediatric Gastroenterology, Sapienza University of Rome, Rome, Italy
| | - Basilio Malamisura
- Pediatric Unit, Maternal and Child Health Department, AOU San Giovanni di Dio e Ruggi d'Aragona, Pole of Cava de' Tirreni, Salerno, Italy
| | | | - Luca Elli
- Center for Prevention and Diagnosis of Celiac Disease Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Rita Colwell
- CosmosID Inc., Rockville, MD, USA
- Center for Bioinformatics and Computational Biology, University of Maryland, College Park, MD, USA
| | | | - Ali R Zomorrodi
- Division of Pediatric Gastroenterology and Nutrition, MassGeneral Hospital for Children, Harvard Medical School, Boston, MA, USA.
- Mucosal Immunology and Biology Research Center, MassGeneral Hospital for Children, Boston, USA.
- Harvard Medical School, Boston, MA, USA.
- Celiac Research Program, Harvard Medical School, Boston, MA, USA.
| | - Alessio Fasano
- Division of Pediatric Gastroenterology and Nutrition, MassGeneral Hospital for Children, Harvard Medical School, Boston, MA, USA.
- Mucosal Immunology and Biology Research Center, MassGeneral Hospital for Children, Boston, USA.
- Harvard Medical School, Boston, MA, USA.
- Celiac Research Program, Harvard Medical School, Boston, MA, USA.
- European Biomedical Research Institute of Salerno (EBRIS), Via S. De Renzi, 50, 84125, Salerno, Italy.
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16
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Troisi J, Giugliano L, Sarno L, Landolfi A, Richards S, Symes S, Colucci A, Maruotti G, Adair D, Guida M, Martinelli P, Guida M. Serum metallome in pregnant women and the relationship with congenital malformations of the central nervous system: a case-control study. BMC Pregnancy Childbirth 2019; 19:471. [PMID: 31805895 PMCID: PMC6896487 DOI: 10.1186/s12884-019-2636-5] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 11/26/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Congenital malformations of the central nervous system (CNS) consist of a wide range of birth defects of multifactorial origin. METHODS Concentrations of 44 metals were determined by Inductively Coupled Plasma Mass Spectrometry in serum of 111 mothers in the second trimester of pregnancy who carried a malformed fetus and compared them with serum concentrations of the same metals in 90 mothers with a normally developed fetus at the same week of pregnancy. Data are reported as means ± standard deviations. RESULTS We found a direct relationship between congenital defects of the CNS and maternal serum concentration of aluminum: it was statistically higher in women carrying a fetus with this class of malformation, compared both to mothers carrying a fetus with another class of malformation (6.45 ± 15.15 μg/L Vs 1.44 ± 4.21 μg/L, p < 0.0006) and to Controls (i.e. mothers carrying a normally-developed fetus) (6.45 ± 15.15 μg/L Vs 0.11 ± 0.51 μg/L, p < 0.0006). Moreover, Aluminum abundances were below the limit of detection in the majority of control samples. CONCLUSION CAluminum may play a role in the onset of central nervous system malformations, although the exact Aluminum species and related specific type of malformation needs further elucidation.
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Affiliation(s)
- Jacopo Troisi
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.,THEOREO Srl Spin-off Company of the University of Salerno, Salerno, Italy
| | - Luigi Giugliano
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Laura Sarno
- Department of Neurosciences, Dentistry and Reproductive Sciences, University of Naples "Federico II", Naples, Italy.
| | - Annamaria Landolfi
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Sean Richards
- Department of Biology, Geology and Environmental Sciences, University of Tennessee at Chattanooga, 615 McCallie Ave, Chattanooga, TN, 37403, USA.,Department of Obstetrics and Gynecology, University of Tennessee College of Medicine, Chattanooga, TN, USA
| | - Steven Symes
- Department of Chemistry and Physics, University of Tennessee at Chattanooga, 615 McCallie Ave, Chattanooga, TN, 37403, USA.,Department of Obstetrics and Gynecology, University of Tennessee College of Medicine, Chattanooga, TN, USA
| | - Angelo Colucci
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.,THEOREO Srl Spin-off Company of the University of Salerno, Salerno, Italy
| | - Giuseppe Maruotti
- Department of Neurosciences, Dentistry and Reproductive Sciences, University of Naples "Federico II", Naples, Italy
| | - David Adair
- Department of Chemistry and Physics, University of Tennessee at Chattanooga, 615 McCallie Ave, Chattanooga, TN, 37403, USA
| | - Marco Guida
- Department of Biology, University of Naples "Federico II", Naples, Italy
| | - Pasquale Martinelli
- Department of Neurosciences, Dentistry and Reproductive Sciences, University of Naples "Federico II", Naples, Italy
| | - Maurizio Guida
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.,THEOREO Srl Spin-off Company of the University of Salerno, Salerno, Italy
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Abstract
Metabolomics is an intriguing field of study providing a new readout of the biochemical activities taking place at the moment of sampling within a subject's biofluid or tissue. Metabolite concentrations are influenced by several factors including disease, environment, drugs, diet and, importantly, genetics. Metabolomics signatures, which describe a subject's phenotype, are useful for disease diagnosis and prognosis, as well as for predicting and monitoring the effectiveness of treatments. Metabolomics is conventionally divided into targeted (i.e., the quantitative analysis of a predetermined group of metabolites) and untargeted studies (i.e., analysis of the complete set of small-molecule metabolites contained in a biofluid without a pre-imposed metabolites-selection). Both approaches have demonstrated high value in the investigation and understanding of several monogenic and multigenic conditions. Due to low costs per sample and relatively short analysis times, metabolomics can be a useful and robust complement to genetic sequencing.
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Affiliation(s)
- Jacopo Troisi
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy; Theoreo srl, Montecorvino Pugliano, Italy; European Biomedical Research Institute of Salerno (EBRIS), Salerno, Italy.
| | - Pierpaolo Cavallo
- Department of Physics, University of Salerno, Fisciano, Italy; Istituto Sistemi Complessi del Consiglio Nazionale delle Ricerche (ISC-CNR), Roma, Italy
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, Italy
| | - Luca Pierri
- Department of Translational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | | | - Steven Symes
- Department of Chemistry and Physics, University of Tennessee at Chattanooga, Chattanooga, TN, United States; Department of Obstetrics and Gynecology, University of Tennessee College of Medicine, Chattanooga, TN, United States
| | - Carter Jones
- Department of Biology, Geology and Environmental Sciences, University of Tennessee at Chattanooga, Chattanooga, TN, United States
| | - Sean Richards
- Department of Obstetrics and Gynecology, University of Tennessee College of Medicine, Chattanooga, TN, United States; Department of Biology, Geology and Environmental Sciences, University of Tennessee at Chattanooga, Chattanooga, TN, United States
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18
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Bollegala N, Lomonaco J, Colucci A, Bannerman H, Griffiths A, Sherlock M, Marshall J, Nguyen GC. A85 IMPROVING OUTCOMES IN THE PEDIATRIC TO ADULT CARE TRANSITION IN IBD (IMPACT IBD). J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.084] [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: 11/13/2022] Open
Affiliation(s)
- N Bollegala
- GI, Women’s College Hospital, Toronto, ON, Canada
| | - J Lomonaco
- GI, Women’s College Hospital, Toronto, ON, Canada
| | - A Colucci
- Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
| | - H Bannerman
- McMaster University Medical Centre, Hamilton, ON, Canada
| | - A Griffiths
- Hospital for Sick Children, Toronto, ON, Canada
| | - M Sherlock
- McMaster University Medical Centre, Hamilton, ON, Canada
| | - J Marshall
- McMaster University Medical Centre, Hamilton, ON, Canada
| | - G C Nguyen
- Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada
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Troisi J, Belmonte F, Bisogno A, Pierri L, Colucci A, Scala G, Cavallo P, Mandato C, Di Nuzzi A, Di Michele L, Delli Bovi AP, Guercio Nuzio S, Vajro P. Metabolomic Salivary Signature of Pediatric Obesity Related Liver Disease and Metabolic Syndrome. Nutrients 2019; 11:nu11020274. [PMID: 30691143 PMCID: PMC6412994 DOI: 10.3390/nu11020274] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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: 12/24/2018] [Revised: 01/16/2019] [Accepted: 01/21/2019] [Indexed: 12/11/2022] Open
Abstract
Pediatric obesity-related metabolic syndrome (MetS) and nonalcoholic fatty liver disease (NAFLD) are increasingly frequent conditions with a still-elusive diagnosis and low-efficacy treatment and monitoring options. In this study, we investigated the salivary metabolomic signature, which has been uncharacterized to date. In this pilot-nested case-control study over a transversal design, 41 subjects (23 obese patients and 18 normal weight (NW) healthy controls), characterized based on medical history, clinical, anthropometric, and laboratory data, were recruited. Liver involvement, defined according to ultrasonographic liver brightness, allowed for the allocation of the patients into four groups: obese with hepatic steatosis ([St+], n = 15) and without hepatic steatosis ([St–], n = 8), and with (n = 10) and without (n = 13) MetS. A partial least squares discriminant analysis (PLS-DA) model was devised to classify the patients’ classes based on their salivary metabolomic signature. Pediatric obesity and its related liver disease and metabolic syndrome appear to have distinct salivary metabolomic signatures. The difference is notable in metabolites involved in energy, amino and organic acid metabolism, as well as in intestinal bacteria metabolism, possibly reflecting diet, fatty acid synthase pathways, and the strict interaction between microbiota and intestinal mucins. This information expands the current understanding of NAFLD pathogenesis, potentially translating into better targeted monitoring and/or treatment strategies in the future.
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Affiliation(s)
- Jacopo Troisi
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
- Theoreo srl, Via degli Ulivi 3, 84090 Montecorvino Pugliano (SA), Italy.
- European Biomedical Research Institute of Salerno (EBRIS), Via S. de Renzi, 3, 84125 Salerno, Italy.
- Hosmotic srl, Via R. Bosco 178, 80069 Vico Equense (NA), Italy.
| | - Federica Belmonte
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Antonella Bisogno
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Luca Pierri
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Angelo Colucci
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
- Theoreo srl, Via degli Ulivi 3, 84090 Montecorvino Pugliano (SA), Italy.
| | - Giovanni Scala
- Hosmotic srl, Via R. Bosco 178, 80069 Vico Equense (NA), Italy.
| | - Pierpaolo Cavallo
- Department of Physics, University of Salerno, 84084 Fisciano (Salerno), Italy.
| | - Claudia Mandato
- Department of Pediatrics, Children's Hospital Santobono-Pausilipon, 80129 Naples, Italy.
| | - Antonella Di Nuzzi
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Laura Di Michele
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Anna Pia Delli Bovi
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Salvatore Guercio Nuzio
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Pietro Vajro
- Department of Medicine and Surgery and Dentistry, "Scuola Medica Salernitana", Pediatrics Section University of Salerno, 84081 Baronissi (Salerno), Italy.
- European Laboratory of Food Induced Intestinal Disease (ELFID), University of Naples Federico II, 80100 Naples, Italy.
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20
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Burrello C, Garavaglia F, Cribiù FM, Ercoli G, Lopez G, Troisi J, Colucci A, Guglietta S, Carloni S, Guglielmetti S, Taverniti V, Nizzoli G, Bosari S, Caprioli F, Rescigno M, Facciotti F. Therapeutic faecal microbiota transplantation controls intestinal inflammation through IL10 secretion by immune cells. Nat Commun 2018; 9:5184. [PMID: 30518790 PMCID: PMC6281577 DOI: 10.1038/s41467-018-07359-8] [Citation(s) in RCA: 173] [Impact Index Per Article: 28.8] [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] [Received: 01/04/2018] [Accepted: 10/25/2018] [Indexed: 12/12/2022] Open
Abstract
Alteration of the gut microbiota has been associated with different gastrointestinal disorders. Normobiosis restoration by faecal microbiota transplantation (FMT) is considered a promising therapeutic approach, even if the mechanisms underlying its efficacy are at present largely unknown. Here we sought to elucidate the functional effects of therapeutic FMT administration during experimental colitis on innate and adaptive immune responses in the intestinal mucosa. We show that therapeutic FMT reduces colonic inflammation and initiates the restoration of intestinal homeostasis through the simultaneous activation of different immune-mediated pathways, ultimately leading to IL-10 production by innate and adaptive immune cells, including CD4+ T cells, iNKT cells and Antigen Presenting Cells (APC), and reduces the ability of dendritic cells, monocytes and macrophages to present MHCII-dependent bacterial antigens to colonic T cells. These results demonstrate the capability of FMT to therapeutically control intestinal experimental colitis and poses FMT as a valuable therapeutic option in immune-related pathologies.
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Affiliation(s)
- Claudia Burrello
- Department of Experimental Oncology, European Institute of Oncology IRCCS, via Adamello 16, Milan, 20139, Italy.,Department of Oncology and Hemato-oncology, Università degli Studi di Milano, via F. Sforza 28, Milan, 20122, Italy
| | - Federica Garavaglia
- Department of Experimental Oncology, European Institute of Oncology IRCCS, via Adamello 16, Milan, 20139, Italy
| | - Fulvia Milena Cribiù
- Pathology Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, via F. Sforza 35, Milan, 20135, Italy
| | - Giulia Ercoli
- Pathology Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, via F. Sforza 35, Milan, 20135, Italy
| | - Gianluca Lopez
- Pathology Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, via F. Sforza 35, Milan, 20135, Italy
| | - Jacopo Troisi
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, 84081, SA, Italy.,Theoreo srl, Spin-off company of the University of Salerno, Via degli Ulivi 3, 84090, Montecorvino Pugliano, SA, Italy.,European Biomedical Research Institute of Salerno (EBRIS), Via S. de Renzi, 3, 84125, Salerno, SA, Italy
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Baronissi, 84081, SA, Italy.,Theoreo srl, Spin-off company of the University of Salerno, Via degli Ulivi 3, 84090, Montecorvino Pugliano, SA, Italy
| | - Silvia Guglietta
- Department of Experimental Oncology, European Institute of Oncology IRCCS, via Adamello 16, Milan, 20139, Italy
| | - Sara Carloni
- Laboratory of Mucosal Immunology and Microbiota, Humanitas Clinical and Research Center, Via Manzoni 56, Milan, 20089, Italy
| | - Simone Guglielmetti
- Department of Food Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, Milan, 20133, via Celoria 2, Italy
| | - Valentina Taverniti
- Department of Food Environmental and Nutritional Sciences (DeFENS), Università degli Studi di Milano, Milan, 20133, via Celoria 2, Italy
| | - Giulia Nizzoli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, via F. Sforza 35, Milan, 20135, Italy
| | - Silvano Bosari
- Pathology Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, via F. Sforza 35, Milan, 20135, Italy
| | - Flavio Caprioli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, via F. Sforza 35, Milan, 20135, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, via F. Sforza 28, Milan, 20135, Italy
| | - Maria Rescigno
- Laboratory of Mucosal Immunology and Microbiota, Humanitas Clinical and Research Center, Via Manzoni 56, Milan, 20089, Italy
| | - Federica Facciotti
- Department of Experimental Oncology, European Institute of Oncology IRCCS, via Adamello 16, Milan, 20139, Italy.
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Troisi J, Symes S, Adair D, Colucci A, Prisco SE, Aquino CI, Vivone I, Guida M, Richards S. Placental tissue metabolome analysis by GC-MS: Oven-drying is a viable sample preparation method. Prep Biochem Biotechnol 2018; 48:474-482. [PMID: 29932806 DOI: 10.1080/10826068.2018.1466151] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Analysis of the human placenta metabolome has great potential to advance the understanding of complicated pregnancies and deleterious fetal outcomes in remote populations, but samples preparation can present unique challenges. Herein, we introduce oven-drying as a simple and widely available method of sample preparation that will facilitate investigations of the placental metabolome from remote and under-studied populations. Placentae from complicated and uncomplicated pregnancies were prepared in three ways (oven-dried at 60 °C, fresh, lyophilized) for metabolome analysis via gas chromatography-mass spectrometry (GC-MS). Multiple computer models (e.g. PLS-DA, ANN) were employed to classify and determine if there was a difference in placentae metabolome and a group of metabolites with high variable importance in projection scores across the three preparations and by complicated vs. control groups. The analyses used herein were shown to be thorough and sensitive. Indeed, significant differences were detected in metabolomes of complicated vs. uncomplicated pregnancies; however, there were no statistical differences in the metabolome of placentae prepared by oven-drying vs. lyophilization vs. fresh placentae. Oven-drying is a viable sample preparation method for placentae intended for use in metabolite analysis via GC-MS. These results open many possibilities for researching metabolome patterns associated with fetal outcomes in remote and resource-poor communities worldwide.
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Affiliation(s)
- Jacopo Troisi
- a Department of Medicine and Surgery and Dentistry , "Scuola Medica Salernitana", University of Salerno , Baronissi, Italy.,b Theoreo Srl - Spin-off Company of the University of Salerno , Montecorvino Pugliano , Italy
| | - Steven Symes
- c Department of Chemistry and Physics , University of Tennessee at Chattanooga , Chattanooga , TN , USA
| | - David Adair
- d Department of Obstetrics and Gynecology , University of Tennessee College of Medicine , Chattanooga , TN , USA
| | - Angelo Colucci
- a Department of Medicine and Surgery and Dentistry , "Scuola Medica Salernitana", University of Salerno , Baronissi, Italy
| | - Sonia Elisa Prisco
- a Department of Medicine and Surgery and Dentistry , "Scuola Medica Salernitana", University of Salerno , Baronissi, Italy
| | - Carmen Imma Aquino
- a Department of Medicine and Surgery and Dentistry , "Scuola Medica Salernitana", University of Salerno , Baronissi, Italy
| | - Immacolata Vivone
- a Department of Medicine and Surgery and Dentistry , "Scuola Medica Salernitana", University of Salerno , Baronissi, Italy
| | - Maurizio Guida
- a Department of Medicine and Surgery and Dentistry , "Scuola Medica Salernitana", University of Salerno , Baronissi, Italy
| | - Sean Richards
- e Department of Biology, Geology and Environmental Sciences , University of Tennessee at Chattanooga , Chattanooga , TN , USA
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Olivani P, Codecasa L, Colucci A, Della Valle S, Mai L, Marceca M, Panizzut D, Sachsel E. The tubercular disease in immigrants without documents: new diagnostic settings adopted in Milan, Italy. Ann Ig 2014; 25:493-500. [PMID: 24284535 DOI: 10.7416/ai.2013.1949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The tubercular disease (TB) is "the disease of poverty and people in need", spread in the poorest countries and among the less wealthy people of the western world (immigrants). In Italy the health authority has recently defined precise diagnostic and therapeutic patterns for TB. The social and health Association Naga in Milan with the Regional Reference Centre for TB, designed a screening system. In Naga's surgery all the undocumented immigrants, coming to Italy from countries with high TB incidence (> 100/100000) and high immigration rates, are screened by a questionnaire created by the Swiss Lung League; the suspect cases are sent to a designed centre for a second level of investigation. The use of this form allows to set a first selection based on the patients' anamnestic history, thus avoiding the intradermal reaction that, due to its low selectivity, could cause a 4 times higher crowding of the designed secondary centers.
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23
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Duffy P, III, Colucci A, Faintuch S, Brennan I, Collares F, Ahmed M. Lower GI bleeding: does initial diagnostic imaging improve positivity rates of mesenteric angiography? J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.532] [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: 10/25/2022] Open
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24
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Colucci A, Bianco A, Pomara F, Petrucci M, Grosso F, De Vita A, Adamo V, Palma A. Disease management of type 2 diabetes: a follow-up analysis in a sanitary district of Sicily. MINERVA GASTROENTERO 2011; 57:241-246. [PMID: 21769074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM The aim of this paper was to analyze the Disease management of type 2 diabetes in a sanitary district of the Sicily Region (Italy). METHODS In a population of 9 698 subjects, we selected patients with known type 2 diabetes: a cohort of 385 subjects, (206 women and 179 men) following up for one year. Prevalence of type 2 diabetes in the analyzed population was 3.97%. A great lot of cohort was on a diet. RESULTS After one year, a per cent reduction of obese and overweight subjects was observed. No differences were observed for Body Mass Index (BMI) at the beginning and at the end of the study. After one year, through educational meetings with the doctor, a significant increase of knowledge on the patient's conditions and on the diabetes complications was verified, but our data showed persistent poor attention by doctors. The poor knowledge of patients led to a difficult disease management. After one year, a great lot of cohort used antistroke and cardiovascular disease therapy, reducing significantly the cardiovascular disease risk. However, our study also highlights a gap between the therapeutic guidelines and the actual treatment, with wide variability in the delivery of secondary prevention. CONCLUSION. Our study showed that a persevering warning and a constant adjournment of doctors improves the disease management, reducing complications risk in type 2 diabetes patients.
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Affiliation(s)
- A Colucci
- Assessorato Regionale della Sanità, Palermo, Italy
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25
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Pham QH, Von Lueder TG, Namtvedt SK, Rosjo H, Omland T, Steine K, Timoteo AT, Mota Carmo M, Simoes M, Branco LM, Ferreira RC, Kato R, Ito J, Tahara T, Yokoyama Y, Ashikaga T, Satoh Y, Na JO, Hong HE, Kim MN, Shin SY, Choi CU, Kim EJ, Rha SW, Park CG, Seo HS, Oh DJ, Ticulescu R, Brigido S, Vriz O, Sparacino L, Popescu BA, Ginghina C, Carerj S, Nicolosi GL, Antonini-Canterin F, Onaindia Gandarias JJ, Romero A, Laraudogoitia E, Velasco S, Quintana O, Cacicedo A, Rodriguez I, Alarcon JA, Gonzalez J, Lekuona I, Onaindia Gandarias JJ, Laraudogoitia E, Romero A, Velasco S, Cacicedo A, Quintana O, Subinas A, Gonzalez J, Alarcon JA, Lekuona I, Abdula G, Lund LH, Winter R, Brodin L, Sahlen A, Masaki M, Cha YM, Yuasa T, Dong K, Dong YX, Mankad SV, Oh JK, Vallet F, Lequeux B, Diakov C, Sosner P, Christiaens L, Coisne D, Kihara C, Murata K, Wada Y, Uchida K, Ueyama T, Okuda S, Susa T, Matsuzaki M, Cho EJ, Choi KY, Kwon BJ, Kim DB, Jang SW, Cho JS, Jung HO, Jeon HK, Youn HJ, Kim JH, Cikes M, Bijnens B, Velagic V, Kopjar T, Milicic D, Biocina B, Gasparovic H, Almuntaser I, Brown A, Foley B, Mulvihill N, Crean P, King G, Murphy R, Takata Y, Taniguchi M, Nobusada S, Sugawara M, Toh N, Kusano K, Itoh H, Wellnhofer E, Kriatselis C, Nedios S, Gerds-Li JH, Fleck E, Poulsen MK, Henriksen JE, Dahl J, Johansen A, Haghfelt T, Hoilund-Carlsen PF, Beck-Nielsen H, Moller JE, Dankowski R, Wierzchowiecki M, Michalski M, Nowicka A, Szymanowska K, Pajak A, Poprawski K, Szyszka A, Kasner M, Westermann D, Schultheiss HP, Tschoepe C, Watanabe T, Iwai-Takano M, Kobayashi A, Machii H, Takeishi Y, Paelinck BP, Van Herck PL, Bosmans JM, Vrints CJ, Lamb HJ, Doltra A, Vidal B, Silva E, Poyatos S, Mont L, Berruezo A, Castel A, Tolosana JM, Brugada J, Sitges M, Dencker M, Bjorgell O, Hlebowicz J, Szelenyi ZS, Szenasi G, Kiss M, Prohaszka Z, Patocs A, Karadi I, Vereckei A, Saha SK, Anderson PL, Govind S, Govindan M, Moggridge JC, Kiotsekoglou A, Gopal AS, Loegstrup BB, Christophersen TB, Hoefsten DE, Moeller JE, Boetker HE, Egstrup K, Wellnhofer E, Kriatselis C, Nedios S, Gerds-Li JH, Fleck E, Graefe M, Huang FQ, Zhang RS, Le TT, Tan RS, Sattarzadeh Badkoubeh R, Tavoosi A, Elahian AR, Drapkina O, Ivashkin VI, Vereckei A, Szelenyi ZS, Fazakas A, Pepo L, Janosi O, Karadi I, Kopitovic I, Goncalves A, Marcos-Alberca P, Almeria C, Feltes G, Rodriguez E, Garcia E, Hernandez-Antolin R, Macaya C, Silva Cardoso J, Zamorano JL, Navarro MS, Valentin M, Banes CM, Rigo F, Grolla E, Tona F, Cuaia V, Moreo A, Badano L, Raviele A, Iliceto S, Tarzia P, Sestito A, Nerla R, Di Monaco A, Infusino F, Matera D, Greco F, Tacchino RM, Lanza GA, Crea F, Nemes A, Balazs E, Pinter KS, Egyed A, Csanady M, Forster T, Loegstrup BB, Christophersen TB, Hoefsten DE, Moeller JE, Boetker HE, Egstrup K, Holte E, Vegsundvag J, Hole T, Hegbom K, Wiseth R, Nemes A, Balazs E, Pinter KS, Egyed A, Csanady M, Forster T, Sharif D, Sharif-Rasslan A, Shahla C, Khalil A, Rosenschein U, Zagatina A, Zhuravskaya N, Tyurina TV, Tagliamonte E, Cirillo T, Coppola A, Marinelli U, Romano C, Riccio G, Citro R, Astarita C, Capuano N, Tagliamonte E, Cirillo T, Marinelli U, Quaranta G, Desiderio A, Riccio G, Romano C, Capuano N, Frattini S, Faggiano P, Zilioli V, Locantore E, Longhi S, Bellandi F, Faden G, Triggiani M, Dei Cas L, Dalsgaard M, Kjaergaard J, Iversen K, Hassager C, Dinh W, Nickl WN, Smettan JS, Koehler TK, Scheffold TD, Coll Barroso MCB, Guelker JG, Fueth RF, Kamperidis V, Hadjimiltiades S, Sianos G, Efthimiadis G, Karvounis H, Parcharidis G, Styliadis IH, Velasco Del Castillo MS, Cacicedo A, Onaindia JJ, Quintana O, Alarcon JA, Rodriguez I, Telleria M, Subinas A, Lekuona I, Laraudogoitia E, Carstensen HG, Nordenberg C, Sogaard P, Fritz-Hansen T, Bech J, Galatius S, Jensen JS, Mogelvang R, Bartko PE, Graf S, Rosenhek R, Burwash IG, Bergler-Klein J, Clavel MA, Baumgartner H, Pibarot P, Mundigler G, Kirilmaz B, Eser I, Tuzun N, Komur B, Dogan H, Taskiran Comez A, Ercan E, Cusma-Piccione M, Zito C, Oreto G, Piluso S, Tripepi S, Oreto L, Longordo C, Ciraci L, Di Bella G, Carerj S, Piatkowski R, Kochanowski J, Scislo P, Grabowski M, Marchel M, Roik M, Kosior D, Opolski G, Sknouril L, Dorda M, Holek B, Gajdusek L, Chovancik J, Branny M, Fiala M, Szymanski P, Lipczynska M, Klisiewicz A, Hoffman P, Jander N, Minners J, Martin G, Zeh W, Allgeier M, Gohlke-Baewolf C, Gohlke H, Nistri S, Porciani MC, Attanasio M, Abbate R, Gensini GF, Pepe G, Duncan RF, Piantadosi C, Nelson AJ, Wittert G, Dundon B, Worthley MI, Worthley SG, Jung P, Berlinger K, Rieber J, Sohn HZ, Schneider P, Leibig M, Koenig A, Klauss V, Tomkiewicz-Pajak L, Kolcz J, Olszowska M, Pieculewicz M, Podolec P, Pieculewicz M, Przewlocki T, Tomkiewicz-Pajak L, Suchon E, Sobien B, Podolec P, Pieculewicz M, Przewlocki T, Wilkolek P, Tomkiewicz-Pajak L, Ziembicka A, Podolec P, Pieculewicz M, Przewlocki T, Tomkiewicz-Pajak L, Hlawaty M, Wilkolek P, Sobien B, Suchon E, Podolec P, Van De Bruaene A, Hermans H, Buys R, Vanhees L, Delcroix M, Voigt JU, Budts W, De Cillis E, Acquaviva T, Basile D, Bortone AS, Kalimanovska-Ostric D, Nastasovic T, Vujisic-Tesic B, Jovanovic I, Milakovic B, Dostanic M, Stosic M, Frogoudaki A, Andreou K, Parisis J, Triantafyllidi E, Gaitani S, Paraskevaidis J, Anastasiou-Nana M, Pieculewicz M, Przewlocki T, Tomkiewicz-Pajak L, Sobien B, Hlawaty M, Podolec P, De Pasquale G, Kuehn A, Petzuch K, Mueller J, Meierhofer C, Fratz S, Hager A, Hess J, Vogt M, Attenhofer Jost CH, Dearani JA, Scott CG, Burkhart HM, Connolly HM, Vitarelli A, Battaglia D, Caranci F, Padella V, Continanza G, Dettori O, Capotosto L, Vitarelli M, De Cicco V, Cortez Morichetti M, Mohanan Nair KK, Sasidaharan B, Thajudeen A, Tharakan JM, Mertens L, Ahmad N, Kantor PK, Grosse-Wortmann L, Friedberg MK, Bernard YF, Morel MA, Descotes-Genon V, Jehl J, Meneveau N, Schiele F, Kaldararova M, Simkova I, Tittel P, Masura J, Trojnarska O, Szczepaniak L, Mizia -Stec K, Cieplucha A, Bartczak A, Grajek S, Tykarski A, Gasior Z, Attenhofer Jost CH, Babovicvuksanovic D, Scott CG, Bonnichsen CR, Burkhart HM, Connolly HM, Morgan GJ, Slorach C, Hui W, Sarkola T, Lee KJ, Chaturvedi R, Benson L, Mertens L, Bradley T, Iancu ME, Ghiorghiu I, Serban M, Craciunescu I, Hodo A, Popescu BA, Ginghina C, Morgan J, Morgan GJ, Slorach C, Hui W, Roche L, Lee K, Chaturvedi R, Benson L, Bradley T, Mertens L, Morgan J, Morgan GJ, Slorach C, Hui W, Sarkola T, Lee K, Chaturvedi R, Benson L, Bradley T, Mertens L, Milanesi O, Favero V, Padalino M, Biffanti R, Cerutti A, Maschietto N, Reffo E, Vida V, Stellin G, Irtyuga O, Gamazin D, Voronkina I, Tsoyi N, Gudkova E, Moiseeva O, Aggeli C, Kazazaki C, Felekos I, Lagoudakou S, Roussakis G, Skoumas J, Pitsavos C, Stefanadis C, Cueff C, Keenan N, Steg PG, Cimadevilla C, Ducrocq G, Vahanian A, Messika-Zeitoun D, Petrella L, Mazzola AM, Villani CV, Giancola RG, Ciocca MC, Di Eusanio DEM, Nolan S, Ionescu A, Skaug TR, Amundsen BH, Hergum T, Torp H, Haugen BO, Lopez Aguilera J, Mesa Rubio D, Ruiz Ortiz M, Delgado Ortega M, Villanueva Fernandez E, Cejudo Diaz Del Campo L, Toledano Delgado F, Leon Del Pino M, Romo Pena E, Suarez De Lezo Cruz-Conde J, De Marco E, Colucci A, Comerci G, Gabrielli FA, Natali R, Garramone B, Savino M, Lotrionte M, Sonaglioni A, Loperfido F, Zdravkovic M, Perunicic J, Krotin M, Ristic M, Vukomanovic V, Zaja M, Radovanovic S, Saric J, Zdravkovic D, Cotrim C, Almeida AR, Miranda R, Almeida AG, Picano E, Carrageta M, D'andrea A, Cocchia R, Riegler L, Golia E, Scarafile R, Citro R, Caso P, Russo MG, Bossone E, Calabro' R, Noman H, Adel A, Elfaramawy AMR, Abdelraouf M, Elnaggar WAEL, Baligh E, Sargento L, Silva D, Goncalves S, Ribeiro S, Vinhas Sousa G, Almeida A, Lopes M, Rodriguez-Manero M, Aguado Gil L, Azcarate P, Lloret Luna P, Macias Gallego A, Castano SARA, Garcia M, Pujol Salvador C, Barba J, Redondo P, Tomasoni L, Sitia S, Atzeni F, Gianturco L, Ricci C, Sarzi-Puttini P, Turiel M, Sitia S, Tomasoni L, Atzeni F, De Gennaro Colonna V, Sarzi-Puttini P, Turiel M, Uejima T, Jaroch J, Antonini-Canterin F, Polombo C, Carerj S, Hughes A, Vinereanu D, Evanvelista A, Leftheriotis G, Fraser AG, Lewczuk A, Sobkowicz B, Tomaszuk-Kazberuk A, Sawicki R, Hirnle T, Michalski BW, Filipiak D, Kasprzak JD, Lipiec P, Dalen H, Haugen BO, Mjolstad OC, Klykken BE, Graven T, Martensson M, Olsson M, Brodin LA, Antonini-Canterin F, Ticulescu R, Vriz O, Enache R, Leiballi E, Popescu BA, Ginghina C, Nicolosi GL, Penhall A, Perry R, Altman M, Sinhal A, Bennetts J, Chew DP, Joseph MX, Larsen LH, Kjaergaard J, Kristensen T, Kober LV, Kofoed KF, Hassager C, Moscoso Costa F, Ribeiras R, Brito J, Boshoff S, Neves J, Teles R, Canada M, Andrade MJ, Gouveia R, Silva A, Miskovic A, Poerner TP, Stiller CS, Goebel BG, Moritz AM, Stefani L, Galanti GG, Moraldo M, Bergamini C, Pabari PA, Dhutia NM, Malaweera ASN, Willson K, Davies J, Hughes AD, Xu XY, Francis DP, Jasaityte R, Amundsen B, Barbosa D, Loeckx D, Kiss G, Orderud F, Robesyn V, Claus P, Torp H, D'hooge J, Kihara C, Murata K, Wada Y, Uchida K, Nao T, Okuda S, Susa T, Miura T, Matsuzaki M, Shams K, Samir S, Samir R, El-Sayed M, Anwar AM, Nosir Y, Galal A, Chamsi-Pasha H, Ciobanu A, Dulgheru R, Bennett S, Vinereanu D, De Luca A, Toncelli L, Cappelli F, Stefani L, Cappelli B, Vono MCR, Galanti G, Zorman Y, Yilmazer MS, Akyildiz M, Gurol T, Aydin A, Dagdeviren B, Kalangos A. Poster session V * Saturday 11 December 2010, 08:30-12:30. European Journal of Echocardiography 2010. [DOI: 10.1093/ejechocard/jeq148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Soncini M, Russo A, Campi E, Lanzi P, Colombo A, Pometta R, Colucci A, Gasparini P. Capsule endoscopy of the small bowel in the clinical practice: outpatient management is feasible and cheaper. MINERVA GASTROENTERO 2010; 56:383-387. [PMID: 21139537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM Four Italian regions have cost coding for outpatient capsule-endoscopy. Elsewhere it is performed in ordinary hospital admission. To identify, in a cohort of patients of a Gastroenterology Unit, those feasible for outpatient versus inpatient treatment; to analyze costs distribution in both management areas. METHODS We retrospectively analysed 100 clinical records of admissions to A.O. San-Carlo-Borromeo, Milan between 2005-2008. Hospitalization criteria (at least 3): 1) occult/obscure gastrointestinal bleeding; 2) hemoglobin ≤ 8 gr/dL; 3) indication for blood transfusions; 4) urgent hospital admission. RESULTS A total of 62 patients had urgent admission, 60 blood transfusions, 81 underwent EGD and colonoscopy, 8 enteroscopy and 5 surgery. Mean haemoglobin value was 8.67 g/dL. Capsule-endoscopy was positive in 70, uncertain in 8, negative in 22. Positive cases: 33 angiodyplasia, 18 ulcers/erosions, 13 polyps/masses, 5 overt bleeding, 1 celiac disease. 47/100 were appropriate as outpatient, saving 432 days of hospital stays. Admission coding was grouped into 7 DRGs (overall expense: 98,366 Euros). Considering EGD/colonoscopy outpatient costs and 1.100 euros as estimated value for capsule-endoscopy, the total expense could be 53.919. CONCLUSION Outpatient capsule-endoscopy small bowel examination is feasible in half of the cases. It is cost saving, (about 45.000 Euros/100 patients), reducing inappropriate hospital stays.
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Affiliation(s)
- M Soncini
- San Carlo Borromeo Hospital Milan, Milan, Italy.
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Toti L, Stacchini P, Masella R, Barbini DA, Busani L, Colucci A, Fiore A, Gattuso A, Macri A. The role of Italy's National Focal Point. J Biotechnol 2010. [DOI: 10.1016/j.jbiotec.2010.08.036] [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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Pettenò A, Dotti P, Colucci A, Dallavalle F, Gentilini C, Tralce L. [Renal artery thrombosis]. Urologia 2009; 76 Suppl 15:47-50. [PMID: 21104685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Colucci A, Magliocco A, Aiala MR, Bua A, Allegra G, Pomara F, Mira A. [Analysis of type 2 diabetes disease management: cross-study of a sanitary district]. Minerva Med 2007; 98:167-73. [PMID: 17592438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
AIM We studied type 2 diabetes prevalence in the Sicilian country, and the disease management, trough the analysis of some indicators. METHODS A cohort of 385 subjects with type 2 diabetes was selected in a sanitary district. Anamnestic, anthropometric, pharmacological data were recorded by a self-controlled software (Gipac-2). We used Student's t-test for statistical data analysis. RESULTS The cohort of diabetic people represents 3.97% of the studied population in toto, 206 women and 179 men: only 2/3 of the studied people followed the therapeutic indications, using prevalently oral hypoglycemic therapy, with poor agreement to specialised centres for diabetes. Hypertension was present in 52.51% of men, in 68.21% of women; most of 50% of people, men and women, showed an obesity/overweight condition. The observations of eventual diabetes complications (eye, foot etc.) was poor by doctors: a 1/3 of patients had diabetes complications undefined. The disease management analysis showed the use of antiplatelet-adhesion drugs involved a half of the studied people; 55-60% of people agreed to diet restriction, no sex-related; the self-control of glucose blood value was present in 65-70% of subjects. The indicators analysis showed that only 40% of men and women performed a HbA1C measurement; 40-50% of people did not control blood pressure in 90 days, 65% did not perform a LDL measurement in one year, more than 70% did not perform a fundus oculi check up. CONCLUSION The study confirms the incidence of diabetes similar to national and European standards. The disease management appears lacunose in half of the population, the use of indicators is limited; guidelines on chronic disease management and on prevention of complications are partially applied. The use of sensitization strategies of sanitary operators, trough formation periods, is very important in order to implement the chronic disease management.
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Affiliation(s)
- A Colucci
- Dipartimento Osservatorio Epidemiologico, Assessorato della Sanità Regione Siciliana, Palermo, Italy
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Abstract
BACKGROUND Benign liver tumours (haemangioma, focal nodular hyperplasia, and hepatic adenoma) have different prevalence and prognosis. Spontaneous rupture and malignant transformation can complicate hepatic adenoma. Elective surgery is controversial, and indications are represented by uncertain diagnosis, presence of symptoms, and prevention of major complications. OBJECTIVES To assess the beneficial and harmful effects of elective surgery of benign liver tumours. We identified 31 cases series. These were small (with less than 60 participants) and the types of tumours mixed. These studies reported no significant mortality, but in the six studies with mortality it ranged from 1% to 17%. SEARCH STRATEGY The Cochrane Hepato-Biliary Group Controlled Trials Register and the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (searches in Issue 1, 2006), MEDLINE, EMBASE, CancerLit, and Science Citation Index Expanded (SCI-EXPANDED) (searched December 2005). A further search included the proceedings of major hepatological and surgical congresses (Annual Meetings of the American Association for the Study of the Liver (AASLD) and European Association for the Study of the Liver (EASL)), and examination of the references of relevant papers and reference lists of the identified studies. SELECTION CRITERIA Randomised clinical trials in adult patients with benign liver tumours without indications for emergency surgery in which elective surgery (resection) versus no intervention or sham operation are compared. DATA COLLECTION AND ANALYSIS All trials identified through searches were evaluated for eligibility for inclusion. We intended to extract relevant data in order to analyse the outcomes as per our published protocol using intention-to-treat analysis. MAIN RESULTS We could not identify any randomised clinical trials. AUTHORS' CONCLUSIONS We were unable to find evidence supporting or refuting elective surgery for patients with benign liver tumours. We need large, long-term randomised clinical trials with adequate methodology to assess the benefits and harms of elective surgery.
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Affiliation(s)
- A Colli
- Ospedale "A Manzoni" Lecco, Department of Internal Medicine, Via dell'Eremo, 9/11, Lecco, Italy, 23900.
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Abstract
We reviewed data on gallbladder motility in obesity, diabetes and coeliac disease. In obesity, a condition characterised by increased risk of gallstone(s), decreased gallbladder motility has heterogeneously been reported as a consequence of the different type of meals used to induce gallbladder contraction, characteristics of the population studied, technique used, and proportion of patients with hyperinsulinaemia. Moreover, recent studies have evaluated the effect of dietary restriction on gallbladder motility in obese patients. A two- to three-fold increase in the risk of cholesterol gallstone(s) has been reported in diabetic patients, mainly in relation to obesity and hypertriglyceridaemia. Furthermore, decreased gallbladder motility has been described and attributed to other factors, including underlying autonomic neuropathy, reduced gallbladder sensitivity to cholecystokinin and/or reduced number of cholecystokinin receptors on the gallbladder wall. Impaired gallbladder motility has been reported also in patients with coeliac disease in relation to reduced secretion of enteric hormones and/or decreased gallbladder sensitivity to them. In particular, untreated coeliacs, when compared to controls, showed low postprandial cholecystokinin and increased fasting somatostatin levels. Interestingly, the correlation between fasting somatostatin levels and gallbladder size has clearly been confirmed in patients affected by somatostatinoma or treated with somatostatin or its analogues. Gallbladder motility can be affected by various clinical conditions, such as obesity, diabetes mellitus and coeliac disease.
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Conte D, Colucci A, Minola E, Fraquelli M, Prati D. Clinical course of pregnant women with chronic hepatitis C virus infection and risk of mother-to-child hepatitis C virus transmission. Dig Liver Dis 2001; 33:366-71. [PMID: 11432518 DOI: 10.1016/s1590-8658(01)80094-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [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: 02/08/2023]
Abstract
As far as concerns chronic hepatitis C virus infection in pregnant women, different points remain to be elucidated, such as the clinical course, the rate of mother-to-child hepatitis C virus transmission and, in particular, its route and the possible risk factors. This review aimed to analyse current data on the prevalence of chronic hepatitis C virus infection in pregnant women and its relationship with risk factors, the rate of mother-to-child hepatitis C virus transmission and the factors possibly involved, particularly the maternal hepatitis C virus viral load and the human immunodeficiency virus coinfection, and the type of delivery and feeding. Finally, the appropriate timing for HCV-RNA testing in newborns has been reviewed.
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Affiliation(s)
- D Conte
- Chair of Gastroenterology, IRCCS Maggiore Hospital, Milan, Italy.
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Conte D, Fraquelli M, Prati D, Colucci A, Minola E. Prevalence and clinical course of chronic hepatitis C virus (HCV) infection and rate of HCV vertical transmission in a cohort of 15,250 pregnant women. Hepatology 2000; 31:751-5. [PMID: 10706568 DOI: 10.1002/hep.510310328] [Citation(s) in RCA: 272] [Impact Index Per Article: 11.3] [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: 12/13/2022]
Abstract
The prevalence and natural course of chronic hepatitis C virus (HCV) infection was evaluated in 15,250 consecutive pregnant women. The rate of HCV vertical and perinatal transmission was also assessed. The presence of anti-HCV was tested by means of EIA III and confirmed by recombinant immunoblot assay III. Alanine transaminase (ALT), anti-human immunodeficiency virus (HIV), and HCV-RNA were tested during the first month and third trimester of pregnancy, and 6 months after delivery; the same tests were made in all of the newborns of anti-HCV-positive mothers at birth (on cord blood samples) and then at 4-month intervals. Anti-HCV positivity was found in 370 cases (2.4%), 72% of whom were also HCV-RNA-positive. The proportion of women with hypertransaminases decreased from 56.4% at the first examination during the first month of pregnancy to 7.4% in the last trimester, and then increased again after delivery (54. 5%), without any concomitant changes in the proportion of those with viremia. The proportion of anti-HCV- and HCV-RNA-positive newborns was 5.1% after 1 year (8 of 155), all of whom had the same genotype as their mother. The rate of HCV transmission was not affected by the type of delivery or feeding, or the HIV status of the mother. The results of this large-scale study confirm previous data in smaller series concerning the prevalence of HCV infection in pregnant women, and strongly support the hypothesis of a favorable (possibly immunomediated) effect of pregnancy on liver cell necrosis in anti-HCV-positive women.
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MESH Headings
- Adult
- Alanine Transaminase/blood
- Antibodies, Viral/blood
- Cohort Studies
- Female
- Hepacivirus/genetics
- Hepatitis C, Chronic/complications
- Hepatitis C, Chronic/epidemiology
- Hepatitis C, Chronic/pathology
- Humans
- Infant, Newborn
- Infectious Disease Transmission, Vertical
- Italy/epidemiology
- Male
- Neonatal Screening
- Pregnancy
- Pregnancy Complications, Infectious/blood
- Pregnancy Complications, Infectious/epidemiology
- Pregnancy Complications, Infectious/pathology
- Pregnancy Trimesters
- Prevalence
- RNA, Viral/blood
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Affiliation(s)
- D Conte
- Cattedra di Gastroenterologia, IRCCS Ospedale Maggiore, Milan, Italy.
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Camoni L, Colucci A, Covre P, D'Agostini A, Frati AR, Gallo P, Geraci S, Latini O, Luzi AM, Mayer R, Morrone A, Petrosillo N, Pino D, Rezza G, Rosa E, Spizzichino L, Volpicelli S, Schinaia N. Immigration and health: the Italian National Focal Point experience. Ann Ist Super Sanita 2000; 36:479-90. [PMID: 11372072] [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: 04/16/2023]
Abstract
This report is a description of the situation of migrant populations in Italy. It was written by a committed team of experts from public institutions, non-governmental organisations (NGO) and volunteer associations that for three years have been part of the Italian National Focal Point (NFP) within the European Project "AIDS & Mobility", which is being co-ordinated by the Netherlands Institute for Health Promotion and Disease Prevention (the Netherlands) and financed by the European Commission DG/V. This year the Italian National Focal Point, co-ordinated by the Telefono Verde AIDS of the Istituto Superiore di Sanità, has produced a second report (the first one was published in 1998) on health issues related to migrant populations. Besides providing an updated picture on the presence of foreigners in Italy, such report illustrates the present legislative situation within the sanitary area and some interventions regarding prevention, treatment and rehabilitation provided by each structure in the Italian NFP to foreign citizens. The initiatives carried out during the year 1999 by public institutions, NGO and volunteer associations are also reported in order to detect the psycho-social-sanitary needs of immigrants and target prevention programmes to their particular and specific needs.
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Trovato C, Pometta R, Colucci A, Bardella MT, Conte D. Severe hypopharyngeal dysphagia in a patient on chronic steroid treatment. Ital J Gastroenterol Hepatol 1999; 31:613-5. [PMID: 10604105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
A 44-year-old Caucasian male who had been on long-term steroid treatment for an unspecified collagen disease was referred to our Unit because of fever, severe hypopharyngeal dysphagia, night sweats and evidence of marked superior vena cava compression. Extrapulmonary disseminated tuberculosis also involving bone and liver was eventually diagnosed and proven by means of specific polymerase chain reaction assay. Antimycobacterial treatment, which led to a dramatic improvement within two months, was protracted for 18 months until the complete return to normal of both clinical and laboratory findings.
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Affiliation(s)
- C Trovato
- Chair of Gastroenterology, IRCCS Ospedale Maggiore, Milan, Italy
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Colucci A, Covre P, D'Agostini A, Gallo P, Geraci S, Kanieff M, Luzi AM, Mayer R, Morrone A, Morte Karag MR, Petrosillo N, Spizzichino L, Claver PT, Volpicelli S. Immigration and health: the Italian situation. Italian National Focal Point (NFP) of the AIDS & Mobility Project. Ann Ist Super Sanita 1999; 34:473-87. [PMID: 10234879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
This report is a description of the situation of migrant populations in Italy. It was written as part of the European project "AIDS & Mobility", which is being co-ordinated by the Netherlands Institute for Health Promotion and Disease Prevention and financed by the European Union (EU). The report was written by the Italian National Focal Point (NFP) of the AIDS & Mobility Project, which consists of a committed team of experts from public institutions, non-governmental organizations, volunteer associations, and researchers from the Telefono Verde AIDS (National AIDS Help-line of Italy) of the Centro Operativo AIDS (COA, National AIDS Unit of Italy) of the Istituto Superiore di Sanità. The report illustrates the phenomenon of immigration in Italy, with demographic data (updated at 31 December 1997) on the presence of non-Italians and a review of the current laws pertinent to this phenomenon, with particular reference to health care laws. Moreover, epidemiological data on HIV/AIDS and on sexually transmitted diseases are provided, particularly as they relate to drug addiction and prostitution. Finally, following an accurate analysis of the situation and in light of the experience gained, the report includes proposals for identifying needs, objectives to pursue, and strategies to adopt, with respect to confronting the issue of immigration.
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Pometta R, Trovato C, Colucci A, Bardella MT, Fraquelli M, Conte D. Melena: an unusual manifestation of Whipple's disease. Ital J Gastroenterol Hepatol 1998; 30:664-5. [PMID: 10076794] [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: 02/11/2023]
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Patterson RB, Pinto B, Marcus B, Colucci A, Braun T, Roberts M. Value of a supervised exercise program for the therapy of arterial claudication. J Vasc Surg 1997; 25:312-8; discussion 318-9. [PMID: 9052565 DOI: 10.1016/s0741-5214(97)70352-5] [Citation(s) in RCA: 165] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE This study was performed to test the effectiveness of a formal supervised exercise program against a home-based exercise program for both walking ability and quality of life endpoints. METHODS Patients with arterial claudication were randomized to either a 12-week supervised exercise program (SUPEX) with weekly lectures relating to peripheral vascular disease or to a home exercise group (HOMEX) who attended an identical lecture program and received weekly exercise instruction. The study population included 29 men and 26 women, with a mean age of 69.1 +/- 8.1 years. Forty-seven patients completed the 12-week program, 46 were available for testing at completion, and 38 for 6-month testing. Claudication pain time (CPT) and maximum walking time (MWT) on a progressive treadmill exercise test were assessed at baseline, program completion, and 6 months. The Medical Outcomes Study Short Form-36 (SF-36) was administered at these intervals to assess effects on quality of life. RESULTS Each group improved (p < 0.001) in both CPT and MWT at the completion of the 12-week program, which was sustained at the 6-month follow-up. Increase in HOMEX CPT from baseline (3.6 +/- 2.73 minutes) to 6-month follow-up (6.6 +/- 3.17 minutes) was less than for the SUPEX group (3.8 +/- 2.74 to 11.2 +/- 4.02 minutes, respectively); similar results were obtained for MWT. At both completion and 6 months, there was a significant intergroup difference for CPT and MWT (p < 0.004) favoring SUPEX. For both groups, measures of health perception based on the SF-36 demonstrated improvement (p < 0.002) in Physical Function Subscale, Bodily Pain Subscale, and Physical Composite Score. There were no between-group differences on the subsets of the SF-36 at the three assessment intervals. CONCLUSIONS Supervised exercise programs provide superior increased walking ability in the noninterventional therapy of arterial claudication, and both supervised and home based exercise therapy result in improved SF-36 functional measures. The lack of intergroup differences in these measures may be a result of the high degree of interaction with healthcare providers in the HOMEX group. Although a supervised program results in optimal walking benefits, a highly structured home-based program provides similar functional improvement and may be a satisfactory alternative for patients with lesser walking requirements.
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Affiliation(s)
- R B Patterson
- Department of Surgery, Brown University School of Medicine, Providence, RI 02906, USA
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Liso V, Specchia G, Pansini N, Iacobazzi A, Colucci A, Mininni D, Mestice A, Palumbo G. [The MDR phenotype in acute nonlymphoid leukemia]. Haematologica 1991; 76 Suppl 3:154-7. [PMID: 1684339] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1
- Antibody Specificity
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/immunology
- Drug Resistance
- Flow Cytometry
- Humans
- Immunoenzyme Techniques
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/enzymology
- Leukemia, Myeloid, Acute/genetics
- Membrane Glycoproteins/analysis
- Membrane Glycoproteins/immunology
- Neoplasm Proteins/analysis
- Neoplasm Proteins/immunology
- Phenotype
- Remission Induction
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Affiliation(s)
- V Liso
- Università degli Studi, Bari
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Bardeschi A, Colucci A, Gianelle V, Gnagnetti M, Tamponi M, Tebaldi G. Analysis of the impact on air quality of motor vehicle traffic in the Milan urban area. ACTA ACUST UNITED AC 1991. [DOI: 10.1016/0957-1272(91)90013-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [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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Filippelli A, Marrazzo R, Susanna V, Losasso C, De Santis D, de Novellis V, Marmo M, Servodio R, Colucci A. Opiate peptidergic neurotransmission and cardiovascular and respiratory apparatus: Experimental research with β-endorphin (E) and dermorphin (D) on normotensive and hypertensive rats. Pharmacol Res 1990. [DOI: 10.1016/s1043-6618(09)80240-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Procaccia S, Bianchi Porro G, Colucci A, Villa P, Blasio R, Ardizzone S, Bonacina CA, Zanussi C. Detection of rheumatoid factors of different isotypes and of circulating immune complexes in patients with inflammatory bowel disease. Boll Ist Sieroter Milan 1990; 69:413-21. [PMID: 2152301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The behaviour of some serological aspects of autoimmunity was studied in patients with inflammatory bowel disease (IBD) by determining the incidence and levels of serum IgM, IgG and IgA rheumatoid factors (RF) and of circulating immune-complexes (IC) in 67 patients suffering from ulcerative colitis (UC) and 53 from Crohn's disease (CD). Sera from 40 young healthy subjects were included as controls. RF were detected by an enzyme linked immuno-assay (ELISA) and IC by the CIC-conglutinin and the CIC-C1q assays. ELISA detected a higher incidence of IgM RF in both UC and CD groups than the routine agglutination tests, although the mean levels were non significantly higher than in controls. Mean IgG RF levels were significantly above normal in UC and CD patients, the latter showing a greater incidence of elevated values and higher mean levels. IgA RF were significantly elevated only in CD patients; mean values for the UC group were within the normal range. The CIC-conglutinin test did not detect a significant incidence or high mean levels of IC and the CIC-C1q assay turned up a sizeable number of positive samples only in the CD group. Although still only preliminary, these overall findings suggest that RF activity is somehow present in patients with IBD. The greater prevalence of IC in CD patients, together with the patterns of IgG and IgA RF support the concept that this disease possibly involves autoimmune phenomena more than ulcerative colitis.
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Affiliation(s)
- S Procaccia
- Istituto di Clinica Medica I, University of Milan, Italy
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Gebbia V, Miserendino V, Miceli S, Colucci A, Reyes MT, Rausa L, Di Marco P, Citarrella P. Analysis of human dysplastic haematopoiesis in long-term bone marrow culture. Blut 1989; 59:442-8. [PMID: 2819250 DOI: 10.1007/bf00349065] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
In this paper we have analysed the behaviour of myelodysplastic marrow in a long-term bone marrow liquid culture system (LTBMC) from eleven patients with myelodysplastic syndromes with regard to cellularity, day-7 and day-14 CFU-GM growth, cluster formation, adherent cells and CFU-F formation. An altered CFU-GM pattern was found in 64% of cases at diagnosis, while normal growth was seen in the remaining cases, all of which were affected by refractory anaemia. The levels of CFU-GM, as well as cellularity, were reduced in myelodysplastic marrows compared to normal controls over the whole duration of LTBMCs. Cases with a normal CFU-GM level at diagnosis also showed pathological behaviour when examined in LTBMC. The duration of dysplastic haematopoiesis was significantly shorter than that of controls. The proliferative ability of CFU-F was reduced in 50% of cases as shown by replating experiments. In conclusion, myelodysplastic marrow shows an abnormal behaviour in LTBMC, even in those cases which present normal CFU-GM growth at diagnosis.
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Affiliation(s)
- V Gebbia
- Cattedra di Ematologia, Istituto di Clinica Medica I, Universitá di Palermo, Italia
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Tambone Reyes M, Gebbia V, Teresi M, Bonaccorso R, Colucci A, Quartararo L, Di Marco P, Citarrella P, Mansueto S. Alpha interferon in the treatment of hairy cell leukemia. J Chemother 1989; 1:1264-5. [PMID: 16312859] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- M Tambone Reyes
- Chair of Hematology and Chair of Medical Pathology, Institute of Clinical Medicine, University of Palermo, Italy
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Liso V, Specchia G, Pavone V, Pansini N, Capalbo S, Ostuni A, Mastria A, Colucci A, Costantino G. Prophylactic administration of oral norfloxacin for prevention of gram-negative bacterial infections in patients with acute leukemias. J Chemother 1989; 1:1297-9. [PMID: 16312873] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- V Liso
- Haematology Service - University of Bari, Bari, Italy
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Gebbia V, Colucci A, Citarrella P, Di Marco P, Miserendino V, Tambone Reyes M, Teresi M, Bonaccorso R, Rausa L, Mansueto S. The multipotential hematopoietic growth factors, bryostatins, inhibit human leukemia cell lines in vitro. J Chemother 1989; 1:1161-3. [PMID: 16312816] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- V Gebbia
- Section of Clinical Oncology, Institute of Pharmacology, University of Palermo, Italy
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Liso V, Specchia G, Pansini N, Colucci A. Acute mixed lineage leukemias. Bone Marrow Transplant 1989; 4 Suppl 1:73-5. [PMID: 2713564] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- V Liso
- Servizio di Ematologia, University of Bari, Italy
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Pavone V, Specchia G, Guarini A, Coniglio M, Iaculli L, Girardi F, Colucci A, Liso V. Piperacillin plus amikacin versus cefotaxime plus amikacin in neutropenic and feverish patients with malignant hemopathies. Chemioterapia 1988; 7:330-5. [PMID: 3224402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Seventy-one neutropenic patients under cytostatic treatment for malignant hemopathies (neutrophil granulocytes less than or equal to/mm3 with feverish episodes in progress (T greater than or equal to 38.5 degrees C) which were probably of an infectious nature were treated according to two antibiotic protocols (piperacillin + amikacin [P + A] or cefotaxime + amikacin [C + A] in a randomized, comparative, prospective study. Of the 71 patients enrolled, 65 could in the end be evaluated for the purposes of this study (36 treated according to the P + A protocol, 29 according to the C + A protocol). In 16 patients the infection was documented bacteriologically. In these cases the percentages of response were, respectively, 77.7% with the P + A and 71.4% with the C + A protocol. The positive clinical results of the two protocols being studied were, considering the entire survey (bacteriologically documented, clinically documented and FUO infections), respectively, 69.4% in the patients treated with P + A and 62.0% in those treated with C + A. The results of the study seem to indicate that the severity of the neutropenia (N.G. less than 500 or greater than 500) does not affect the response to the antibiotic therapy. Modest and transient side effects (hypokalemia and increase of the ClCr) were noted above all in the patients subjected to the therapy with C + A. The results of this study show, therefore, a superimposable effectiveness of the two therapeutic protocols (P + A and C + A) in the empirical treatment of infections in neutropenic patients with malignant hemopathies.
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Affiliation(s)
- V Pavone
- Department of Hematology, University of Bari, Italy
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Procaccia S, Lanzanova D, Caputo D, Ferrante P, Papini E, Gasparini A, Colucci A, Bianchi M, Villa P, Blasio R. Circulating immune complexes in serum and in cerebrospinal fluid of patients with multiple sclerosis. Characterization and correlation with the clinical course. Acta Neurol Scand 1988; 77:373-81. [PMID: 3046225 DOI: 10.1111/j.1600-0404.1988.tb05922.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We studied circulating immune complexes (IC) in the serum and cerebrospinal fluid (CSF) of patients with clinically defined multiple sclerosis (MS), in order to establish a correlation with the clinical course of the disease and to investigate the molecular composition of the IC isolated from patients in active phase of the disease. Serum IC levels were found to be significantly increased in patients from the progressive and active relapsing-remittent subgroups with both the CIC-conglutinin and C1q-binding methods. High levels of IC in CSF were detected only in the subgroup consisting of the relapsing-remittent patients in disease exacerbation when IC were determined by the C1q-binding test. No significant increase in serum or in CSF were found using the mRF-I test. The preliminary results of a qualitative investigation on serum IC in MS indicated that they are heterogeneous in nature, their size is mainly of the intermediate type, and they contain IgG, IgM, complement components and beta 2-microglobulins, the latter presenting an observation both new and interesting for studies on serum IC in MS patients.
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Affiliation(s)
- S Procaccia
- Institute of Medicine, University of Milan Medical School, Italy
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Procaccia S, Gasparini A, Colucci A, Lanzanova D, Bianchi M, Forcellini P, Villa P, Blasio R, Zanussi C. ELISA determined IgM, IgG and IgA rheumatoid factors in rheumatoid arthritis and in other connective tissue diseases. Clin Exp Rheumatol 1987; 5:335-42. [PMID: 3440330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We used an adaptation of an enzyme-linked immunoadsorbent assay (ELISA) to determine serum levels of IgM, IgG and IgA rheumatoid factors (RF) in 50 patients with classic or definite rheumatoid arthritis (RA) according to the ARA criteria, balanced for positive or negative-routine Latex-RF reaction. A control group of 50 young normal subjects and a reference group of 44 patients with other connective tissue diseases (OCTD) were also studied. We confirmed the high sensibility of the method, together with its good specificity and reproducibility. For the IgM RF a very significant correlation was found between ELISA results and Latex-RF titration (p less than 0.001). Many Latex-RF negative RA patients had high ELISA levels of IgM RF, suggesting that this assay reveals, at least in part, hidden or non-agglutinating IgM RF. Among the OCTD group only some SLE cases, mainly Latex-RF positive, had enhanced IgM RF on ELISA. Considered quantitatively, IgG RF did not play a significant diagnostic role for RA (p greater than 0.05), because they were also found, with widely dispersed values, in normal subjects, and because the mean increase in RA patients was relatively small. Interestingly, IgA RF were above the normal range in many RA patients, both Latex-RF positive or negative. The mean values differed significantly from those of controls (p less than 0.005), and a correlation was observed between IgA RF levels and IgA containing immune-complexes. Normal IgA RF values were observed in SLE patients, even if Latex-RF positive, suggesting that their increase in RA patients is not the mere expression of a polyclonal B cell activation.
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Affiliation(s)
- S Procaccia
- Clinica Medica II, University of Milan, Italy
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