Antonietta Gravina - Academia.edu (original) (raw)

Papers by Antonietta Gravina

Cell growth & differentiation: the molecular biology journal of the American Association for Cancer Research

Insulin-like growth factor II (IGF-II) is a polypeptide growth factor thought to be involved in f... more Insulin-like growth factor II (IGF-II) is a polypeptide growth factor thought to be involved in fetal tissue development. We previously showed an increased expression of IGF-II mRNA in human primary liver cancer. The present investigation was undertaken to characterize the ...

Acta gastro-enterologica Belgica

Background and Aim : percutaneous endoscopic gastrostomy (PEG) is an effective way of providing e... more Background and Aim : percutaneous endoscopic gastrostomy (PEG) is an effective way of providing enteral feeding to patients with functionally normal gastrointestinal tract who cannot meet their nutritional needs because of inadequate oral intake. This retrospective study evaluated the clinical outcome of critically ill patients with high assistance level undergoing PEG in a general ICU over a 12 year period.

Journal of gastrointestinal and liver diseases: JGLD

Angiodysplasia is a vascular lesion responsible for about 6% of lower gastrointestinal bleeding. ... more Angiodysplasia is a vascular lesion responsible for about 6% of lower gastrointestinal bleeding. It is generally located in the cecum and ascending colon of elderly patients. At colonoscopy, angiodysplasia appears as a bright red flat area with irregular borders as "coral bank" [1]. However, angiodysplasias with a pedunculated appearance have been reported . Histologically, colonic arteriovenous malformations are believed to be degenerative lesions, which are the result of intermittent, low-grade obstructions of the submucosal veins as they penetrate the muscular layers of the colon causing small arteriovenous communications .

Digestive and Liver Disease, 2015

Quality of bowel cleansing in hospitalized patients undergoing colonoscopy is often unsatisfactor... more Quality of bowel cleansing in hospitalized patients undergoing colonoscopy is often unsatisfactory. No study has investigated the inpatient or outpatient setting as cause of inadequate cleansing. To assess degree of bowel cleansing in inpatients and outpatients and to identify possible predictors of poor bowel preparation in the two populations. Prospective multicentre study on consecutive colonoscopies in 25 regional endoscopy units. Univariate and multivariate analysis with odds ratio estimation were performed. Data from 3276 colonoscopies were analyzed (2178 outpatients, 1098 inpatients). Incomplete colonoscopy due to inadequate cleansing was recorded in 369 patients (11.2%). There was no significant difference in bowel cleansing rates between in- and outpatients in both colonic segments. In the overall population, independent predictors of inadequate cleansing both at the level of right and left colon were: male gender (odds ratio, 1.20 [1.02-1.43] and 1.27 [1.05-1.53]), diabetes mellitus (odds ratio, 2.35 [1.68-3.29] and 2.12 [1.47-3.05]), chronic constipation (odds ratio, 1.60 [1.30-1.97] and 1.55 [1.23-1.94]), incomplete purge intake (odds ratio, 2.36 [1.90-2.94] and 2.11 [1.68-2.65]) and a runway time >12h (odds ratio, 3.36 [2.40-4.72] and 2.53 [1.74-3.67]). We found no difference in the rate of inadequate bowel preparation between hospitalized patients and outpatients.

Journal of gastrointestinal and liver diseases : JGLD, 2010

Acta gastro-enterologica Belgica, 2013

Superior mesenteric artery syndrome (SMAS) is a rare condition characterized by duodenal compress... more Superior mesenteric artery syndrome (SMAS) is a rare condition characterized by duodenal compression through aorto-mesenteric clamp, also known as the Wilkie's syndrome. In SMAS passage is blocked in the lower part of the duodenum by vascular compression. Precipitating factors include increased lordoses, loss of abdominal muscle tone, rapid weight loss (2), abdominal surgery, or intrabdominal inflammatory conditions that may compress the mesenteric vessels. Symptoms are usually non specific and intermittent and include postprandial epigastric fullness, bloating, nausea, vomiting, and abdominal pain that are usually relieved by the prone or knee-to-chest position (3). Diagnosis is based on imaging techniques that include X-ray passage series of the upper gastrointestinal tract and angiographical visualization of the superior mesenteric artery and determination of its angle of branching from the aorta. Retrocolic duodenojejunostomy has proven to be the most satisfactory surgical treatment for this lesion (4).

World journal of gastroenterology : WJG, Jan 21, 2014

Helicobacter pylori (H. pylori) is a well-known human pathogen that plays an essential role in th... more Helicobacter pylori (H. pylori) is a well-known human pathogen that plays an essential role in the pathogenesis of chronic gastritis, peptic ulcer disease, and gastric malignancies. Although H. pylori is susceptible to several antimicrobials, this infection has proven challenging to cure because of the increasing prevalence of bacterial strains that are resistant to the most commonly used antimicrobials, particularly clarithromycin. An effective (i.e., > 90%) first-line therapy is mandatory for avoiding supplementary treatments and testing, and more importantly for preventing the development of secondary resistance. This study reviews the recent literature on first-line therapies for H. pylori. The eradication rates following standard triple therapy (a proton pump inhibitor plus amoxicillin and clarithromycin) for H. pylori infection are declining worldwide. Several first-line strategies have been proposed to increase the eradication rate, including extending the treatment durati...

Acta gastro-enterologica Belgica, 2014

Alcohol consumption by adolescents and young adults is an issue of significant public concern. In... more Alcohol consumption by adolescents and young adults is an issue of significant public concern. Internet-based Social Networking sites, such as Facebook, are potential avenues to reach young people easily. to underline the innovation in proposing surveys to collect health-related information regarding young people alcohol consumption and other substances abuse by using Social Networking Websites, particularly Facebook. A questionnaire investigating modalities of alcohol consumption, drinking patterns' risk behaviors and other substances abuse was proposed through a "Facebook event" to young Italian Facebook users aged between 16 and 32. Each Facebook user invited to the event was free to participate, to answer to the questionnaire and to invite his "Facebook friends". During the 89 days of permanence on the Social Network, 1846 Facebook users participated the event and 732 of them decided spontaneously to answer the questionnaire. The frequency of answering wa...

Alimentary Pharmacology & Therapeutics, 2015

200 patients were included consecutively (mean age 47 years, 67% women, 13% ulcer). Previous fail... more 200 patients were included consecutively (mean age 47 years, 67% women, 13% ulcer). Previous failed therapy included: standard clarithromycin triple therapy (131 patients), sequential (32) and concomitant (37). A total of 96% took all medications correctly. Per-protocol and intention-to-treat eradication rates were 91.1% (95%CI = 87-95%) and 90% (95%CI = 86-94%). Cure rates were similar regardless of previous (failed) treatment or country of origin. Adverse effects were reported in 46% of patients, most commonly nausea (17%) and diarrhoea (16%); 3% were intense but none was serious.

Wireless Sensor Network, 2010

Wireless capsule endoscopy is a new endoscopic tool for the diagnosis and management of small bow... more Wireless capsule endoscopy is a new endoscopic tool for the diagnosis and management of small bowel diseases. The main indication at present is the evaluation of GI bleeding of obscure origin, Crohn's disease, coeliac disease and small bowel tumors. Studies suggest that capsule endoscopy is associated with few adverse events. Whether cardiac pacemaker may interfere with capsule endoscopy is still a controversial issue. We here report a case showing that there is a possibility of interference between the two procedures, cardiac pacemaker affecting the proper functioning of capsule endoscopy and that this is related to the distance between the pacemaker and the recorder.

United European Gastroenterology Journal, 2014

Recent studies suggest a potential relationship between rosacea and Helicobacter pylori (H. pylor... more Recent studies suggest a potential relationship between rosacea and Helicobacter pylori (H. pylori) infection or small intestinal bacterial overgrowth (SIBO), but there is no firm evidence of an association between rosacea and H. pylori infection or SIBO. We performed a prospective study to assess the prevalence of H. pylori infection and/or SIBO in patients with rosacea and evaluated the effect of H. pylori or SIBO eradication on rosacea. We enrolled 90 patients with rosacea from January 2012 to January 2013 and a control group consisting of 90 patients referred to us because of mapping of nevi during the same period. We used the (13)C Urea Breath Test and H. pylori stool antigen (HpSA) test to assess H. pylori infection and the glucose breath test to assess SIBO. Patients infected by H. pylori were treated with clarithromycin-containing sequential therapy. Patients positive for SIBO were treated with rifaximin. We found that 44/90 (48.9%) patients with rosacea and 24/90 (26.7%) control subjects were infected with H. pylori (p = 0.003). Moreover, 9/90 (10%) patients with rosacea and 7/90 (7.8%) subjects in the control group had SIBO (p = 0.6). Within 10 weeks from the end of antibiotic therapy, the skin lesions of rosacea disappeared or decreased markedly in 35/36 (97.2%) patients after eradication of H. pylori and in 3/8 (37.5%) patients who did not eradicate the infection (p < 0.0001). Rosacea skin lesions decreased markedly in 6/7 (85.7%) after eradication of SIBO whereas of the two patients who did not eradicate SIBO, one (50%) showed an improvement in rosacea (p = 0.284). Prevalence of H. pylori infection was significantly higher in patients with rosacea than control group, whereas SIBO prevalence was comparable between the two groups. Eradication of H. pylori infection led to a significant improvement of skin symptoms in rosacea patients.

World Journal of Clinical Cases, 2013

Obesity is considered an emerging epidemic that is often associated with non-alcoholic fatty live... more Obesity is considered an emerging epidemic that is often associated with non-alcoholic fatty liver disease. Among the therapeutic options for morbid obesity, bariatric surgery plays an important role when conventional therapies fail. The effects of bariatric surgery on liver function and morphology are controversial in the literature. Liver failure has been reported after jejunoileal bypass (JIB), biliopancreatic diversion and gastric bypass. Biliointestinal bypass (BIB) is considered an effective procedure among recently introduced bariatric surgery techniques. It is a clinically safe, purely malabsorptive operation in which the blind intestinal loop of the JIB is anastomosed to the gallbladder, allowing a portion of bile to transit into excluded intestinal tract. BIB is the only procedure, to our knowledge, to have no liver side effects reported in the literature. We report the case of a young obese woman who developed liver failure 8 mo after BIB. She had a rapid weight loss (70 kg) with a reduction in body mass index of 41% from January to September 2012. Because of a severe hepatic decompensation, she was referred to a transplantation centre. We strongly believe that the most important pathogenetic mechanism involved in the development of liver injury is the rapid weight loss that produced a significant fatty liver infiltration.

Hepatitis Monthly, 2014

Dermatological adverse events are an existing concern during treatment of hepatitis C virus infec... more Dermatological adverse events are an existing concern during treatment of hepatitis C virus infection. Peginterferon/ ribavirin treatment is associated with well-characterized dermatological lesions tending towards a uniform entity of dermatitis. New telaprevir-or boceprevir-based triple-therapy has led to significant improvements in sustained virological response rates, although associated with an increase in cutaneous adverse events compared peginterferon/ribavirin alone. Case Presentation: We report a case of a patient who discontinued telaprevir because of severe skin eruptions and who, during ribavirin and interferon treatment, after a period free of skin lesions, developed new dermatological lesions different than those experienced during telaprevir treatment. Conclusions: Several adverse effects are associated to anti-HCV drugs, hence appropriate skin care management and follow-up are very important. A careful anamnesis before the initiation of triple therapy is necessary to identify previous dermatological diseases that could increase skin adverse effects incidence.

Digestive and Liver Disease, 2015

Aim was to evaluate the efficacy and tolerability of a moxifloxacin-containing second-line triple... more Aim was to evaluate the efficacy and tolerability of a moxifloxacin-containing second-line triple regimen in patients whose previous Helicobacter pylori eradication treatment failed. Prospective multicentre study including patients in whom a triple therapy or a non-bismuth-quadruple-therapy failed. Moxifloxacin (400mg qd), amoxicillin (1g bid), and esomeprazole (40mg bid) were prescribed for 14 days. Eradication was confirmed by (13)C-urea-breath-test. Compliance was determined through questioning and recovery of empty medication envelopes. 250 patients were consecutively included (mean age 48±15 years, 11% with ulcer). Previous (failed) therapy included: standard triple (n=179), sequential (n=27), and concomitant (n=44); 97% of patients took all medications, 4 were lost to follow-up. Intention-to-treat and per-protocol eradication rates were 82.4% (95% CI, 77-87%) and 85.7% (95% CI, 81-90%). Cure rates were similar independently of diagnosis (ulcer, 77%; dyspepsia, 82%) and previous treatment (standard triple, 83%; sequential, 89%; concomitant, 77%). At multivariate analysis, only age was associated with eradication (OR=0.957; 95% CI, 0.933-0.981). Adverse events were reported in 25.2% of patients: diarrhoea (9.6%), abdominal pain (9.6%), and nausea (9.2%). 14-day moxifloxacin-containing triple therapy is an effective and safe second-line strategy in patients whose previous standard triple therapy or non-bismuth quadruple (sequential or concomitant) therapy has failed, providing a simple alternative to bismuth quadruple regimen.

World Journal of Gastroenterology, 2010

Obesity is increasingly being recognized as a risk factor for a number of benign and malignant ga... more Obesity is increasingly being recognized as a risk factor for a number of benign and malignant gastrointestinal conditions. However, literature on the underlying pathophysiological mechanisms is sparse and ambiguous. There is compelling evidence that both overnutrition and undernutrition negatively interfere with the immune system. Overnutrition has been found to increase susceptibility to the development of inflammatory diseases, autoimmune diseases and cancer. In the regulation of immune and inflammatory processes, white adipose tissue plays a critical role, not only as an energy store but also as an important endocrine organ. The obese state is characterised by a low-grade systemic inflammation, mainly as a result of increased adipocytes as well as fat resident-and recruited-macrophage activity. In the past few years, various products of adipose tissue including adipokines and cytokines have been characterised and a number of path-ways linking adipose tissue metabolism with the immune system have been identified. Activation of the innate immune system plays a major role in hepatic steatosis. Non-alcoholic fatty liver disease includes a wide spectrum of diseases, from pure steatosis to non-alcoholic steatohepatitis in the absence of significant alcohol consumption. Although steatosis is considered a non-progressive disease, non-alcoholic steatohepatitis may deteriorate in advanced chronic liver diseases, cirrhosis, and hepatocellular carcinoma. An important parallel between obesityrelated pathology of adipose tissue and liver pertains to the emerging role of macrophages, and growing evidence suggests that Kupffer cells critically contribute to progression of non-alcoholic fatty liver disease. Moreover, a close link between specific immune activation and atherosclerosis has been well established, suggesting that fat can directly trigger immune responses. This review discusses the role of fat as "a matter of disturbance for the immune system" with a focus on hepatic steatosis.

British Journal of Nutrition, 2008

Aspirin causes gastroduodenal ulcers and complications. Food bioactive compounds could exert bene... more Aspirin causes gastroduodenal ulcers and complications. Food bioactive compounds could exert beneficial effects in the gastrointestinal tract. We evaluated whether apple polyphenol extract (APE) reduced aspirin-induced injury to the rat gastric mucosa. Rats were treated with APE (10 24 M catechin equivalent) before oral aspirin (200 mg/kg). Cyclo-oxygenase-2 (COX-2), transforming growth factor-a (TGFa) and heparinbinding epidermal-growth-factor-like growth factor (HB-EGF) mRNA and protein expression were assessed by RT-PCR and Western blot analysis, respectively; malondialdehyde (MDA) was determined by HPLC; gastric secretion was evaluated in pylorus-ligated rats. APE decreased acute and chronic aspirin injury both macroscopically and microscopically (approximately 50 % decrease in lesion score; P,0·05). Aspirin up-regulated mRNA and protein expression of COX-2 and HB-EGF, but not of TGFa; APE reduced aspirin-induced mRNA and protein overexpression of COX-2 and HB-EGF; aspirin significantly increased gastric MDA and this effect was counteracted by APE pre-treatment. APE did not significantly affect gastric acid secretion. In conclusion, APE reduces aspirin-induced gastric injury independently of acid inhibition. We speculate that APE might be of therapeutic use in the prophylaxis of aspirin-related gastropathy.

We have studied the expression of insulin-like growth fador type II (IGF-ll) and its autocrine ro... more We have studied the expression of insulin-like growth fador type II (IGF-ll) and its autocrine role during the proliferation and differentiation of the CaCo-2 colon carcinoma cell line. ICE-Il RNA levels were high in proliferating cells and decreased by more than 10-fold when cells ceased to proliferate and differentiated. Immunoreadive ICE-Il protein was high in the conditioned media of proliferating cells and decreased 20-fold in the media of differentiated cells. Reduced ICE-Il expression was associated with a decrease in ICE-I receptor number that was high in proliferating cells (approximately 80,000 binding sites/cell) and reduced by 4-fold in differentiated cells. Exogenously added ICE-Il was able to stimulate proliferation of serum-deprived cells in a dose-dependent fashion. ICE-Il aded through the ICE-I receptor, since both basal and ICE-Il-stimulated cell proliferation was inhibited by the monoclonal antibody a-lR3, which blocks the binding sites of the ICE-I receptor. The ...

Journal of the European Academy of Dermatology and Venereology, 2009

Pyoderma gangrenosum is a rare, ulcerative, cutaneous condition. First described in 1930, the pat... more Pyoderma gangrenosum is a rare, ulcerative, cutaneous condition. First described in 1930, the pathogenesis of pyoderma gangrenosum remains unknown, but it is probably related to a hyperergic reaction. There are various clinical and histological variants of this disorder. Pyoderma gangrenosum often occurs in association with a systemic disease such as inflammatory bowel disease, rheumatologic disease, paraproteinaemia, or haematological malignancy. The diagnosis, mainly based on the clinical presentation and course, is confirmed through a process of elimination of other causes of cutaneous ulcers. Local treatment may be sufficient for mild disease, while for severe cases, systemic immunosuppressants are the mainstay. Long-term treatment with these agents is often required, but this can expose patients to adverse side-effects.

The Journal of Pathology, 2005

mucosa than in the non-infected mucosa. The increase in VEGF expression was associated with a sig... more mucosa than in the non-infected mucosa. The increase in VEGF expression was associated with a significant increase in neo-angiogenesis as assessed by determination of CD34-positive microvessels. H. pylori gastritis is therefore associated with up-regulation of VEGF expression, which parallels the increased formation of blood vessels in the gastric mucosa. It is postulated that increased VEGF expression and neo-angiogenesis may contribute to H. pylori-related gastric carcinogenesis.

Cell growth & differentiation: the molecular biology journal of the American Association for Cancer Research

Insulin-like growth factor II (IGF-II) is a polypeptide growth factor thought to be involved in f... more Insulin-like growth factor II (IGF-II) is a polypeptide growth factor thought to be involved in fetal tissue development. We previously showed an increased expression of IGF-II mRNA in human primary liver cancer. The present investigation was undertaken to characterize the ...

Acta gastro-enterologica Belgica

Background and Aim : percutaneous endoscopic gastrostomy (PEG) is an effective way of providing e... more Background and Aim : percutaneous endoscopic gastrostomy (PEG) is an effective way of providing enteral feeding to patients with functionally normal gastrointestinal tract who cannot meet their nutritional needs because of inadequate oral intake. This retrospective study evaluated the clinical outcome of critically ill patients with high assistance level undergoing PEG in a general ICU over a 12 year period.

Journal of gastrointestinal and liver diseases: JGLD

Angiodysplasia is a vascular lesion responsible for about 6% of lower gastrointestinal bleeding. ... more Angiodysplasia is a vascular lesion responsible for about 6% of lower gastrointestinal bleeding. It is generally located in the cecum and ascending colon of elderly patients. At colonoscopy, angiodysplasia appears as a bright red flat area with irregular borders as "coral bank" [1]. However, angiodysplasias with a pedunculated appearance have been reported . Histologically, colonic arteriovenous malformations are believed to be degenerative lesions, which are the result of intermittent, low-grade obstructions of the submucosal veins as they penetrate the muscular layers of the colon causing small arteriovenous communications .

Digestive and Liver Disease, 2015

Quality of bowel cleansing in hospitalized patients undergoing colonoscopy is often unsatisfactor... more Quality of bowel cleansing in hospitalized patients undergoing colonoscopy is often unsatisfactory. No study has investigated the inpatient or outpatient setting as cause of inadequate cleansing. To assess degree of bowel cleansing in inpatients and outpatients and to identify possible predictors of poor bowel preparation in the two populations. Prospective multicentre study on consecutive colonoscopies in 25 regional endoscopy units. Univariate and multivariate analysis with odds ratio estimation were performed. Data from 3276 colonoscopies were analyzed (2178 outpatients, 1098 inpatients). Incomplete colonoscopy due to inadequate cleansing was recorded in 369 patients (11.2%). There was no significant difference in bowel cleansing rates between in- and outpatients in both colonic segments. In the overall population, independent predictors of inadequate cleansing both at the level of right and left colon were: male gender (odds ratio, 1.20 [1.02-1.43] and 1.27 [1.05-1.53]), diabetes mellitus (odds ratio, 2.35 [1.68-3.29] and 2.12 [1.47-3.05]), chronic constipation (odds ratio, 1.60 [1.30-1.97] and 1.55 [1.23-1.94]), incomplete purge intake (odds ratio, 2.36 [1.90-2.94] and 2.11 [1.68-2.65]) and a runway time >12h (odds ratio, 3.36 [2.40-4.72] and 2.53 [1.74-3.67]). We found no difference in the rate of inadequate bowel preparation between hospitalized patients and outpatients.

Journal of gastrointestinal and liver diseases : JGLD, 2010

Acta gastro-enterologica Belgica, 2013

Superior mesenteric artery syndrome (SMAS) is a rare condition characterized by duodenal compress... more Superior mesenteric artery syndrome (SMAS) is a rare condition characterized by duodenal compression through aorto-mesenteric clamp, also known as the Wilkie's syndrome. In SMAS passage is blocked in the lower part of the duodenum by vascular compression. Precipitating factors include increased lordoses, loss of abdominal muscle tone, rapid weight loss (2), abdominal surgery, or intrabdominal inflammatory conditions that may compress the mesenteric vessels. Symptoms are usually non specific and intermittent and include postprandial epigastric fullness, bloating, nausea, vomiting, and abdominal pain that are usually relieved by the prone or knee-to-chest position (3). Diagnosis is based on imaging techniques that include X-ray passage series of the upper gastrointestinal tract and angiographical visualization of the superior mesenteric artery and determination of its angle of branching from the aorta. Retrocolic duodenojejunostomy has proven to be the most satisfactory surgical treatment for this lesion (4).

World journal of gastroenterology : WJG, Jan 21, 2014

Helicobacter pylori (H. pylori) is a well-known human pathogen that plays an essential role in th... more Helicobacter pylori (H. pylori) is a well-known human pathogen that plays an essential role in the pathogenesis of chronic gastritis, peptic ulcer disease, and gastric malignancies. Although H. pylori is susceptible to several antimicrobials, this infection has proven challenging to cure because of the increasing prevalence of bacterial strains that are resistant to the most commonly used antimicrobials, particularly clarithromycin. An effective (i.e., > 90%) first-line therapy is mandatory for avoiding supplementary treatments and testing, and more importantly for preventing the development of secondary resistance. This study reviews the recent literature on first-line therapies for H. pylori. The eradication rates following standard triple therapy (a proton pump inhibitor plus amoxicillin and clarithromycin) for H. pylori infection are declining worldwide. Several first-line strategies have been proposed to increase the eradication rate, including extending the treatment durati...

Acta gastro-enterologica Belgica, 2014

Alcohol consumption by adolescents and young adults is an issue of significant public concern. In... more Alcohol consumption by adolescents and young adults is an issue of significant public concern. Internet-based Social Networking sites, such as Facebook, are potential avenues to reach young people easily. to underline the innovation in proposing surveys to collect health-related information regarding young people alcohol consumption and other substances abuse by using Social Networking Websites, particularly Facebook. A questionnaire investigating modalities of alcohol consumption, drinking patterns' risk behaviors and other substances abuse was proposed through a "Facebook event" to young Italian Facebook users aged between 16 and 32. Each Facebook user invited to the event was free to participate, to answer to the questionnaire and to invite his "Facebook friends". During the 89 days of permanence on the Social Network, 1846 Facebook users participated the event and 732 of them decided spontaneously to answer the questionnaire. The frequency of answering wa...

Alimentary Pharmacology & Therapeutics, 2015

200 patients were included consecutively (mean age 47 years, 67% women, 13% ulcer). Previous fail... more 200 patients were included consecutively (mean age 47 years, 67% women, 13% ulcer). Previous failed therapy included: standard clarithromycin triple therapy (131 patients), sequential (32) and concomitant (37). A total of 96% took all medications correctly. Per-protocol and intention-to-treat eradication rates were 91.1% (95%CI = 87-95%) and 90% (95%CI = 86-94%). Cure rates were similar regardless of previous (failed) treatment or country of origin. Adverse effects were reported in 46% of patients, most commonly nausea (17%) and diarrhoea (16%); 3% were intense but none was serious.

Wireless Sensor Network, 2010

Wireless capsule endoscopy is a new endoscopic tool for the diagnosis and management of small bow... more Wireless capsule endoscopy is a new endoscopic tool for the diagnosis and management of small bowel diseases. The main indication at present is the evaluation of GI bleeding of obscure origin, Crohn's disease, coeliac disease and small bowel tumors. Studies suggest that capsule endoscopy is associated with few adverse events. Whether cardiac pacemaker may interfere with capsule endoscopy is still a controversial issue. We here report a case showing that there is a possibility of interference between the two procedures, cardiac pacemaker affecting the proper functioning of capsule endoscopy and that this is related to the distance between the pacemaker and the recorder.

United European Gastroenterology Journal, 2014

Recent studies suggest a potential relationship between rosacea and Helicobacter pylori (H. pylor... more Recent studies suggest a potential relationship between rosacea and Helicobacter pylori (H. pylori) infection or small intestinal bacterial overgrowth (SIBO), but there is no firm evidence of an association between rosacea and H. pylori infection or SIBO. We performed a prospective study to assess the prevalence of H. pylori infection and/or SIBO in patients with rosacea and evaluated the effect of H. pylori or SIBO eradication on rosacea. We enrolled 90 patients with rosacea from January 2012 to January 2013 and a control group consisting of 90 patients referred to us because of mapping of nevi during the same period. We used the (13)C Urea Breath Test and H. pylori stool antigen (HpSA) test to assess H. pylori infection and the glucose breath test to assess SIBO. Patients infected by H. pylori were treated with clarithromycin-containing sequential therapy. Patients positive for SIBO were treated with rifaximin. We found that 44/90 (48.9%) patients with rosacea and 24/90 (26.7%) control subjects were infected with H. pylori (p = 0.003). Moreover, 9/90 (10%) patients with rosacea and 7/90 (7.8%) subjects in the control group had SIBO (p = 0.6). Within 10 weeks from the end of antibiotic therapy, the skin lesions of rosacea disappeared or decreased markedly in 35/36 (97.2%) patients after eradication of H. pylori and in 3/8 (37.5%) patients who did not eradicate the infection (p < 0.0001). Rosacea skin lesions decreased markedly in 6/7 (85.7%) after eradication of SIBO whereas of the two patients who did not eradicate SIBO, one (50%) showed an improvement in rosacea (p = 0.284). Prevalence of H. pylori infection was significantly higher in patients with rosacea than control group, whereas SIBO prevalence was comparable between the two groups. Eradication of H. pylori infection led to a significant improvement of skin symptoms in rosacea patients.

World Journal of Clinical Cases, 2013

Obesity is considered an emerging epidemic that is often associated with non-alcoholic fatty live... more Obesity is considered an emerging epidemic that is often associated with non-alcoholic fatty liver disease. Among the therapeutic options for morbid obesity, bariatric surgery plays an important role when conventional therapies fail. The effects of bariatric surgery on liver function and morphology are controversial in the literature. Liver failure has been reported after jejunoileal bypass (JIB), biliopancreatic diversion and gastric bypass. Biliointestinal bypass (BIB) is considered an effective procedure among recently introduced bariatric surgery techniques. It is a clinically safe, purely malabsorptive operation in which the blind intestinal loop of the JIB is anastomosed to the gallbladder, allowing a portion of bile to transit into excluded intestinal tract. BIB is the only procedure, to our knowledge, to have no liver side effects reported in the literature. We report the case of a young obese woman who developed liver failure 8 mo after BIB. She had a rapid weight loss (70 kg) with a reduction in body mass index of 41% from January to September 2012. Because of a severe hepatic decompensation, she was referred to a transplantation centre. We strongly believe that the most important pathogenetic mechanism involved in the development of liver injury is the rapid weight loss that produced a significant fatty liver infiltration.

Hepatitis Monthly, 2014

Dermatological adverse events are an existing concern during treatment of hepatitis C virus infec... more Dermatological adverse events are an existing concern during treatment of hepatitis C virus infection. Peginterferon/ ribavirin treatment is associated with well-characterized dermatological lesions tending towards a uniform entity of dermatitis. New telaprevir-or boceprevir-based triple-therapy has led to significant improvements in sustained virological response rates, although associated with an increase in cutaneous adverse events compared peginterferon/ribavirin alone. Case Presentation: We report a case of a patient who discontinued telaprevir because of severe skin eruptions and who, during ribavirin and interferon treatment, after a period free of skin lesions, developed new dermatological lesions different than those experienced during telaprevir treatment. Conclusions: Several adverse effects are associated to anti-HCV drugs, hence appropriate skin care management and follow-up are very important. A careful anamnesis before the initiation of triple therapy is necessary to identify previous dermatological diseases that could increase skin adverse effects incidence.

Digestive and Liver Disease, 2015

Aim was to evaluate the efficacy and tolerability of a moxifloxacin-containing second-line triple... more Aim was to evaluate the efficacy and tolerability of a moxifloxacin-containing second-line triple regimen in patients whose previous Helicobacter pylori eradication treatment failed. Prospective multicentre study including patients in whom a triple therapy or a non-bismuth-quadruple-therapy failed. Moxifloxacin (400mg qd), amoxicillin (1g bid), and esomeprazole (40mg bid) were prescribed for 14 days. Eradication was confirmed by (13)C-urea-breath-test. Compliance was determined through questioning and recovery of empty medication envelopes. 250 patients were consecutively included (mean age 48±15 years, 11% with ulcer). Previous (failed) therapy included: standard triple (n=179), sequential (n=27), and concomitant (n=44); 97% of patients took all medications, 4 were lost to follow-up. Intention-to-treat and per-protocol eradication rates were 82.4% (95% CI, 77-87%) and 85.7% (95% CI, 81-90%). Cure rates were similar independently of diagnosis (ulcer, 77%; dyspepsia, 82%) and previous treatment (standard triple, 83%; sequential, 89%; concomitant, 77%). At multivariate analysis, only age was associated with eradication (OR=0.957; 95% CI, 0.933-0.981). Adverse events were reported in 25.2% of patients: diarrhoea (9.6%), abdominal pain (9.6%), and nausea (9.2%). 14-day moxifloxacin-containing triple therapy is an effective and safe second-line strategy in patients whose previous standard triple therapy or non-bismuth quadruple (sequential or concomitant) therapy has failed, providing a simple alternative to bismuth quadruple regimen.

World Journal of Gastroenterology, 2010

Obesity is increasingly being recognized as a risk factor for a number of benign and malignant ga... more Obesity is increasingly being recognized as a risk factor for a number of benign and malignant gastrointestinal conditions. However, literature on the underlying pathophysiological mechanisms is sparse and ambiguous. There is compelling evidence that both overnutrition and undernutrition negatively interfere with the immune system. Overnutrition has been found to increase susceptibility to the development of inflammatory diseases, autoimmune diseases and cancer. In the regulation of immune and inflammatory processes, white adipose tissue plays a critical role, not only as an energy store but also as an important endocrine organ. The obese state is characterised by a low-grade systemic inflammation, mainly as a result of increased adipocytes as well as fat resident-and recruited-macrophage activity. In the past few years, various products of adipose tissue including adipokines and cytokines have been characterised and a number of path-ways linking adipose tissue metabolism with the immune system have been identified. Activation of the innate immune system plays a major role in hepatic steatosis. Non-alcoholic fatty liver disease includes a wide spectrum of diseases, from pure steatosis to non-alcoholic steatohepatitis in the absence of significant alcohol consumption. Although steatosis is considered a non-progressive disease, non-alcoholic steatohepatitis may deteriorate in advanced chronic liver diseases, cirrhosis, and hepatocellular carcinoma. An important parallel between obesityrelated pathology of adipose tissue and liver pertains to the emerging role of macrophages, and growing evidence suggests that Kupffer cells critically contribute to progression of non-alcoholic fatty liver disease. Moreover, a close link between specific immune activation and atherosclerosis has been well established, suggesting that fat can directly trigger immune responses. This review discusses the role of fat as "a matter of disturbance for the immune system" with a focus on hepatic steatosis.

British Journal of Nutrition, 2008

Aspirin causes gastroduodenal ulcers and complications. Food bioactive compounds could exert bene... more Aspirin causes gastroduodenal ulcers and complications. Food bioactive compounds could exert beneficial effects in the gastrointestinal tract. We evaluated whether apple polyphenol extract (APE) reduced aspirin-induced injury to the rat gastric mucosa. Rats were treated with APE (10 24 M catechin equivalent) before oral aspirin (200 mg/kg). Cyclo-oxygenase-2 (COX-2), transforming growth factor-a (TGFa) and heparinbinding epidermal-growth-factor-like growth factor (HB-EGF) mRNA and protein expression were assessed by RT-PCR and Western blot analysis, respectively; malondialdehyde (MDA) was determined by HPLC; gastric secretion was evaluated in pylorus-ligated rats. APE decreased acute and chronic aspirin injury both macroscopically and microscopically (approximately 50 % decrease in lesion score; P,0·05). Aspirin up-regulated mRNA and protein expression of COX-2 and HB-EGF, but not of TGFa; APE reduced aspirin-induced mRNA and protein overexpression of COX-2 and HB-EGF; aspirin significantly increased gastric MDA and this effect was counteracted by APE pre-treatment. APE did not significantly affect gastric acid secretion. In conclusion, APE reduces aspirin-induced gastric injury independently of acid inhibition. We speculate that APE might be of therapeutic use in the prophylaxis of aspirin-related gastropathy.

We have studied the expression of insulin-like growth fador type II (IGF-ll) and its autocrine ro... more We have studied the expression of insulin-like growth fador type II (IGF-ll) and its autocrine role during the proliferation and differentiation of the CaCo-2 colon carcinoma cell line. ICE-Il RNA levels were high in proliferating cells and decreased by more than 10-fold when cells ceased to proliferate and differentiated. Immunoreadive ICE-Il protein was high in the conditioned media of proliferating cells and decreased 20-fold in the media of differentiated cells. Reduced ICE-Il expression was associated with a decrease in ICE-I receptor number that was high in proliferating cells (approximately 80,000 binding sites/cell) and reduced by 4-fold in differentiated cells. Exogenously added ICE-Il was able to stimulate proliferation of serum-deprived cells in a dose-dependent fashion. ICE-Il aded through the ICE-I receptor, since both basal and ICE-Il-stimulated cell proliferation was inhibited by the monoclonal antibody a-lR3, which blocks the binding sites of the ICE-I receptor. The ...

Journal of the European Academy of Dermatology and Venereology, 2009

Pyoderma gangrenosum is a rare, ulcerative, cutaneous condition. First described in 1930, the pat... more Pyoderma gangrenosum is a rare, ulcerative, cutaneous condition. First described in 1930, the pathogenesis of pyoderma gangrenosum remains unknown, but it is probably related to a hyperergic reaction. There are various clinical and histological variants of this disorder. Pyoderma gangrenosum often occurs in association with a systemic disease such as inflammatory bowel disease, rheumatologic disease, paraproteinaemia, or haematological malignancy. The diagnosis, mainly based on the clinical presentation and course, is confirmed through a process of elimination of other causes of cutaneous ulcers. Local treatment may be sufficient for mild disease, while for severe cases, systemic immunosuppressants are the mainstay. Long-term treatment with these agents is often required, but this can expose patients to adverse side-effects.

The Journal of Pathology, 2005

mucosa than in the non-infected mucosa. The increase in VEGF expression was associated with a sig... more mucosa than in the non-infected mucosa. The increase in VEGF expression was associated with a significant increase in neo-angiogenesis as assessed by determination of CD34-positive microvessels. H. pylori gastritis is therefore associated with up-regulation of VEGF expression, which parallels the increased formation of blood vessels in the gastric mucosa. It is postulated that increased VEGF expression and neo-angiogenesis may contribute to H. pylori-related gastric carcinogenesis.