Paolo Pazzi - Academia.edu (original) (raw)
Papers by Paolo Pazzi
Irish Journal of Medical Science, 1992
Gastroenterologie clinique et biologique, 1984
European Journal of Gastroenterology & Hepatology, 1997
European Journal of Cancer Prevention, 2001
The American journal of gastroenterology, 1994
To assess the efficacy of misoprostol for the treatment of chronic erosive gastritis and associat... more To assess the efficacy of misoprostol for the treatment of chronic erosive gastritis and associated symptoms. We performed a double-blind controlled trial, administering 200-micrograms misoprostol tablets or placebo twice daily for 2 months to 48 patients with symptomatic chronic erosive gastritis. Symptomatology was assessed by means of a standard questionnaire at the beginning and at the end of the study, as well as endoscopic and histologic changes of the gastric mucosa. At the end of the treatment period, a significant reduction in symptom score was observed in misoprostol-treated (from 86.6 +/- 66.2 to 17.6 +/- 18.2, p < 0.001) but not in placebo-treated patients. Endoscopic score was significantly reduced at the end of the treatment period in the misoprostol group, compared with that of the placebo group (p < 0.05). A significant reduction in the activity of histologic gastritis was observed only in patients on misoprostol. The prevalence of gastric colonization by Helic...
The Journal of nuclear medicine and allied sciences, 1989
Reumatismo, 1985
il lavoro analizza il comportamento degli acidi biliari in un gruppo di pazienti affetti da sscle... more il lavoro analizza il comportamento degli acidi biliari in un gruppo di pazienti affetti da ssclerodermia valutandone il significato clinico in relazione a possibili quadri di malassorbimento intestinal
Current Therapeutic Research-clinical and Experimental, 1985
Digestive and Liver Disease, 2016
Background and aims: Very little is known about the access to treatment for Chronic Hepatitis B i... more Background and aims: Very little is known about the access to treatment for Chronic Hepatitis B in the real clinical practice and the characteristics of the patients who do not receive antiviral therapy. Methods: HBV-RER is an observational multicenter network that collected data of patients with HBV infection during a 3 years observational period (2009-2012). Results: Among 2527 HBsAg positive patients, 1099 were never treated (NT); only 280 were included in the analysis due to different exclusion causes A minority was HBeAg-positive. The median age was 42. At liver biopsy most patients had Metavir score of F0-F1. Univariate analysis between 280 NT patients and the 290 naïve to treatment showed that NT patients were mostly female (P = 0.002), not Italian (P = 0.044), younger (P < 0.001). Metavir score was lower in NT (P0.002), such as the Fib4 score (P < 0.001). HBV DNA level was significantly higher in NT. At multivariate analysis, independent variables associated with notreatment were younger age, female gender, Metavir score F0-F1, Fib4 lower than 1.6 and lower blood level of HBV-DNA. Conclusions: There is a large number of patients eligible to treatment who do not receive it. A younger age and a less severe disease seem to be associated to deferral of treatment.
Presse Medicale, 1987
A partir de frottis perendoscopiques, seches a l'air, provenant du brossage des muqueuses gas... more A partir de frottis perendoscopiques, seches a l'air, provenant du brossage des muqueuses gastrique et duodenale et colores suivant la technique de May-Grunwald-Giemsa
Minerva medica, Jan 31, 1985
The pH values in 203 patients with various gastroduodenal pathologies were measured by means of a... more The pH values in 203 patients with various gastroduodenal pathologies were measured by means of a glass electrode inserted into the bioptic channel of the gastroscope. Analysis of the results confirms what we know of pH variations in gastric or duodenal ulcer cases and shows where perendoscopic pH measurements may be used beneficially. In particular it was found that mucous pH is not affected by H2 antagonists if these are taken more that 12 hours before the examination. Perendoscopic pH measurement appears to be a valuable tool in screening stomach lesions at risk in cases of chronic gastritis, since it facilitates the identification of atrophic or metaplastic lesions.
Recenti progressi in medicina, Jun 1, 1998
Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society, Apr 1, 2016
The management of bloating is unclear and its relationship with patients' well-being and trea... more The management of bloating is unclear and its relationship with patients' well-being and treatment satisfaction independent of other abdominal symptoms is uncharacterized. We evaluated the association of bloating with patient-reported outcomes. Thirty-nine centers for functional gastrointestinal disorders joined the laxative inadequate relief survey. We enrolled 2203 consecutive outpatients with functional constipation (FC) or constipation-predominant irritable bowel syndrome (IBS-C) in two cross-sectional waves. Both wave 1 and 2 included the SF-12, the patient assessment of constipation-symptoms (PAC-SYM), and the treatment satisfaction questionnaire for medication (TSQM-2). Wave 2 only included a global rating of change (GRC) scale to assess patients' assessment of efficacy concerning treatment switches occurred in the 3 months prior to the interview. Bloating in the abdomen was defined on the basis of PAC-SYM item 3. The average age was 50.1 years (SD, 16.7) and 82.1% of...
The International Journal of Artificial Organs, 2002
Orthotopic liver transplantation (OLT) is the only effective therapeutic modality in severe acute... more Orthotopic liver transplantation (OLT) is the only effective therapeutic modality in severe acute hepatic failure (AHF). The scarcity of organs for transplantation leads to an urgent necessity for temporary liver support treatments in AHF patients. A hepatocyte-based bioartificial liver (BAL) is under investigation with the main purpose to serve as bridging treatment until a liver becomes available for OLT, or to promote spontaneous liver regeneration. We developed a novel radial-flow bioreactor (RFB) for three-dimensional, high-density hepatocyte culture and an integrated pumping apparatus in which, after plasmapheresis, the patient's plasma is recirculated through the hepatocyte-filled RFB. Two hundred thirty grams of freshly isolated porcine hepatocytes were loaded into the RFB for clinical liver support treatment. The BAL system was used 8 times in supporting 7 AHF patients in grade III-IV coma, all waiting for an urgent OLT. Three patients with no history of previous liver ...
Transplantation Proceedings, 2000
Annales de Chirurgie, 1994
A simple method for the assay of biliary lipids was used for routine determination of biliary cho... more A simple method for the assay of biliary lipids was used for routine determination of biliary cholesterol saturation index (CSI) in 17 healthy subjects, 40 untreated patients with radiolucent gallstones and 21 gallstone patients treated with ursodiol. The method is based on collection of bile with the Entero-Test, a device for easy sampling of gastrointestinal contents. The procedure was easy to perform and well accepted by the patients. Both CSI and the cholesterol content of bile were higher in untreated gallstone patients than in controls, and were significantly lower in treated than in untreated patients. Normal CSI was found in 35% of untreated gallstone patients, while 24% of healthy subjects had supersaturated bile. Supersaturated bile was still present in 14% of ursodeoxycholic acid treated patients, suggesting inefficacy of therapy. These results demonstrate the possibility of performing easy, routine determination of biliary lipid composition, which can yield useful inform...
The American journal of gastroenterology, 1989
Since the exact mechanisms of the pathogenicity of Campylobacter pylori are not known, we perform... more Since the exact mechanisms of the pathogenicity of Campylobacter pylori are not known, we performed an ultrastructural study with the aim of focusing on patterns of possible physical contact between C. pylori and gastric epithelium, and of considering them in relation to the bacterial pathogenicity. Among 20 random consecutive patients referred for routine gastroscopy, we studied ultrathin sections from the 11 patients with Campylobacter-like organisms, and recognized three patterns of physical contact between bacteria and epithelial cells. These patterns seem in accord with published data of C. pylori toxicity, and they could represent different evolutive stages of the infection.
European Journal of Gastroenterology & Hepatology, 1997
Membrane toxicity induced by hydrophobic bile salts may be important in liver diseases. Administr... more Membrane toxicity induced by hydrophobic bile salts may be important in liver diseases. Administration of ursodeoxycholate reduces serum liver enzymes in chronic liver diseases, but the nature of this effect is still unclear. We aimed at establishing a convenient in-vitro system for investigating the hepatotoxic properties of hydrophobic bile salts and the putative hepatoprotective effect of ursodeoxycholate. About 100 mg of freshly isolated rat hepatocytes were suspended on a resin column (Bio-Gel P4 fine) and perifused with different concentrations of bile salts. The effluent was collected at 5-min intervals and assayed for lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activity. Enzyme leakage induced by bile salts was compared with that induced by Triton X-100 (Union Carbide, Danbury, CT, USA) at different concentrations. After perifusion, hepatocytes were collected for electron microscopic observation. Cytotoxicity of individual bile salts, assessed by enzyme release, was time and concentration dependent and corresponded to their hydrophilic-hydrophobic balance. Perifusion with hydrophilic bile salts, cholate and ursodeoxycholate, did not result in a significant enzyme release in concentrations up to 5 mmol/l, whereas hydrophobic bile salts, chenodeoxycholate and deoxycholate, induced significant enzyme leakage even in low concentrations, 0.5 and 0.1 mmol/l, respectively. Addition of ursodeoxycholate significantly reduced the hepatotoxic effect of deoxycholate. This protective effect was evident within minutes. The ultrastructural appearance of hepatocytes exposed to hydrophobic bile salts was very similar to the non-specific cellular lysis observed after exposition to Triton X-100, suggesting that they act mainly in a detergent-like fashion. Perifused rat hepatocytes seem a convenient in-vitro system for investigating the hepatotoxic properties of bile salts and hepatoprotective effect of ursodeoxycholate, offering the opportunity to investigate the effects of bile salts under dynamic conditions, mimicking the in-vivo situation, and allowing continuous enzyme release monitoring. Hydrophobic bile salts seem to act mainly in a detergent-like fashion; ursodeoxycholate-related hepatoprotection could be due not only to a dilution effect of toxic bile salts, but also to a direct cytoprotective effect.
Artificial Organs, 2001
To overcome the limitations of standard hollowfiber module in ensuring efficient cell perfusion a... more To overcome the limitations of standard hollowfiber module in ensuring efficient cell perfusion and long-term expression of highly differentiated hepatocyte functions, we developed a novel bioreactor in which a three-dimensional hepatocyte culture system was perfused in radial-flow geometry. Isolated porcine hepatocytes were cultured for 2 weeks in recirculating serum-free tissue culture medium, in which NH 4 Cl and lidocaine were repeatedly added, and ammonia removal, urea synthesis, monoethylglycinexylide (MEGX) production, albumin secretion, PO 2 , PCO 2 , O 2 consumption, and pH were measured thereafter. During the whole duration of the study, ammonia removal was paralleled by urea production, while MEGX concentration was constantly increased. Our results indicated that hepatocytes remained differentiated and metabolically active throughout the duration of the study. The radial-flow bioreactor allowed physiological contact between recirculating fluid and cells by equalizing the concentration of the perfusing components, including O 2 , throughout the module, suggesting a potential use of this configuration for extracorporeal liver support.
Irish Journal of Medical Science, 1992
Gastroenterologie clinique et biologique, 1984
European Journal of Gastroenterology & Hepatology, 1997
European Journal of Cancer Prevention, 2001
The American journal of gastroenterology, 1994
To assess the efficacy of misoprostol for the treatment of chronic erosive gastritis and associat... more To assess the efficacy of misoprostol for the treatment of chronic erosive gastritis and associated symptoms. We performed a double-blind controlled trial, administering 200-micrograms misoprostol tablets or placebo twice daily for 2 months to 48 patients with symptomatic chronic erosive gastritis. Symptomatology was assessed by means of a standard questionnaire at the beginning and at the end of the study, as well as endoscopic and histologic changes of the gastric mucosa. At the end of the treatment period, a significant reduction in symptom score was observed in misoprostol-treated (from 86.6 +/- 66.2 to 17.6 +/- 18.2, p < 0.001) but not in placebo-treated patients. Endoscopic score was significantly reduced at the end of the treatment period in the misoprostol group, compared with that of the placebo group (p < 0.05). A significant reduction in the activity of histologic gastritis was observed only in patients on misoprostol. The prevalence of gastric colonization by Helic...
The Journal of nuclear medicine and allied sciences, 1989
Reumatismo, 1985
il lavoro analizza il comportamento degli acidi biliari in un gruppo di pazienti affetti da sscle... more il lavoro analizza il comportamento degli acidi biliari in un gruppo di pazienti affetti da ssclerodermia valutandone il significato clinico in relazione a possibili quadri di malassorbimento intestinal
Current Therapeutic Research-clinical and Experimental, 1985
Digestive and Liver Disease, 2016
Background and aims: Very little is known about the access to treatment for Chronic Hepatitis B i... more Background and aims: Very little is known about the access to treatment for Chronic Hepatitis B in the real clinical practice and the characteristics of the patients who do not receive antiviral therapy. Methods: HBV-RER is an observational multicenter network that collected data of patients with HBV infection during a 3 years observational period (2009-2012). Results: Among 2527 HBsAg positive patients, 1099 were never treated (NT); only 280 were included in the analysis due to different exclusion causes A minority was HBeAg-positive. The median age was 42. At liver biopsy most patients had Metavir score of F0-F1. Univariate analysis between 280 NT patients and the 290 naïve to treatment showed that NT patients were mostly female (P = 0.002), not Italian (P = 0.044), younger (P < 0.001). Metavir score was lower in NT (P0.002), such as the Fib4 score (P < 0.001). HBV DNA level was significantly higher in NT. At multivariate analysis, independent variables associated with notreatment were younger age, female gender, Metavir score F0-F1, Fib4 lower than 1.6 and lower blood level of HBV-DNA. Conclusions: There is a large number of patients eligible to treatment who do not receive it. A younger age and a less severe disease seem to be associated to deferral of treatment.
Presse Medicale, 1987
A partir de frottis perendoscopiques, seches a l'air, provenant du brossage des muqueuses gas... more A partir de frottis perendoscopiques, seches a l'air, provenant du brossage des muqueuses gastrique et duodenale et colores suivant la technique de May-Grunwald-Giemsa
Minerva medica, Jan 31, 1985
The pH values in 203 patients with various gastroduodenal pathologies were measured by means of a... more The pH values in 203 patients with various gastroduodenal pathologies were measured by means of a glass electrode inserted into the bioptic channel of the gastroscope. Analysis of the results confirms what we know of pH variations in gastric or duodenal ulcer cases and shows where perendoscopic pH measurements may be used beneficially. In particular it was found that mucous pH is not affected by H2 antagonists if these are taken more that 12 hours before the examination. Perendoscopic pH measurement appears to be a valuable tool in screening stomach lesions at risk in cases of chronic gastritis, since it facilitates the identification of atrophic or metaplastic lesions.
Recenti progressi in medicina, Jun 1, 1998
Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society, Apr 1, 2016
The management of bloating is unclear and its relationship with patients' well-being and trea... more The management of bloating is unclear and its relationship with patients' well-being and treatment satisfaction independent of other abdominal symptoms is uncharacterized. We evaluated the association of bloating with patient-reported outcomes. Thirty-nine centers for functional gastrointestinal disorders joined the laxative inadequate relief survey. We enrolled 2203 consecutive outpatients with functional constipation (FC) or constipation-predominant irritable bowel syndrome (IBS-C) in two cross-sectional waves. Both wave 1 and 2 included the SF-12, the patient assessment of constipation-symptoms (PAC-SYM), and the treatment satisfaction questionnaire for medication (TSQM-2). Wave 2 only included a global rating of change (GRC) scale to assess patients' assessment of efficacy concerning treatment switches occurred in the 3 months prior to the interview. Bloating in the abdomen was defined on the basis of PAC-SYM item 3. The average age was 50.1 years (SD, 16.7) and 82.1% of...
The International Journal of Artificial Organs, 2002
Orthotopic liver transplantation (OLT) is the only effective therapeutic modality in severe acute... more Orthotopic liver transplantation (OLT) is the only effective therapeutic modality in severe acute hepatic failure (AHF). The scarcity of organs for transplantation leads to an urgent necessity for temporary liver support treatments in AHF patients. A hepatocyte-based bioartificial liver (BAL) is under investigation with the main purpose to serve as bridging treatment until a liver becomes available for OLT, or to promote spontaneous liver regeneration. We developed a novel radial-flow bioreactor (RFB) for three-dimensional, high-density hepatocyte culture and an integrated pumping apparatus in which, after plasmapheresis, the patient's plasma is recirculated through the hepatocyte-filled RFB. Two hundred thirty grams of freshly isolated porcine hepatocytes were loaded into the RFB for clinical liver support treatment. The BAL system was used 8 times in supporting 7 AHF patients in grade III-IV coma, all waiting for an urgent OLT. Three patients with no history of previous liver ...
Transplantation Proceedings, 2000
Annales de Chirurgie, 1994
A simple method for the assay of biliary lipids was used for routine determination of biliary cho... more A simple method for the assay of biliary lipids was used for routine determination of biliary cholesterol saturation index (CSI) in 17 healthy subjects, 40 untreated patients with radiolucent gallstones and 21 gallstone patients treated with ursodiol. The method is based on collection of bile with the Entero-Test, a device for easy sampling of gastrointestinal contents. The procedure was easy to perform and well accepted by the patients. Both CSI and the cholesterol content of bile were higher in untreated gallstone patients than in controls, and were significantly lower in treated than in untreated patients. Normal CSI was found in 35% of untreated gallstone patients, while 24% of healthy subjects had supersaturated bile. Supersaturated bile was still present in 14% of ursodeoxycholic acid treated patients, suggesting inefficacy of therapy. These results demonstrate the possibility of performing easy, routine determination of biliary lipid composition, which can yield useful inform...
The American journal of gastroenterology, 1989
Since the exact mechanisms of the pathogenicity of Campylobacter pylori are not known, we perform... more Since the exact mechanisms of the pathogenicity of Campylobacter pylori are not known, we performed an ultrastructural study with the aim of focusing on patterns of possible physical contact between C. pylori and gastric epithelium, and of considering them in relation to the bacterial pathogenicity. Among 20 random consecutive patients referred for routine gastroscopy, we studied ultrathin sections from the 11 patients with Campylobacter-like organisms, and recognized three patterns of physical contact between bacteria and epithelial cells. These patterns seem in accord with published data of C. pylori toxicity, and they could represent different evolutive stages of the infection.
European Journal of Gastroenterology & Hepatology, 1997
Membrane toxicity induced by hydrophobic bile salts may be important in liver diseases. Administr... more Membrane toxicity induced by hydrophobic bile salts may be important in liver diseases. Administration of ursodeoxycholate reduces serum liver enzymes in chronic liver diseases, but the nature of this effect is still unclear. We aimed at establishing a convenient in-vitro system for investigating the hepatotoxic properties of hydrophobic bile salts and the putative hepatoprotective effect of ursodeoxycholate. About 100 mg of freshly isolated rat hepatocytes were suspended on a resin column (Bio-Gel P4 fine) and perifused with different concentrations of bile salts. The effluent was collected at 5-min intervals and assayed for lactate dehydrogenase (LDH), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activity. Enzyme leakage induced by bile salts was compared with that induced by Triton X-100 (Union Carbide, Danbury, CT, USA) at different concentrations. After perifusion, hepatocytes were collected for electron microscopic observation. Cytotoxicity of individual bile salts, assessed by enzyme release, was time and concentration dependent and corresponded to their hydrophilic-hydrophobic balance. Perifusion with hydrophilic bile salts, cholate and ursodeoxycholate, did not result in a significant enzyme release in concentrations up to 5 mmol/l, whereas hydrophobic bile salts, chenodeoxycholate and deoxycholate, induced significant enzyme leakage even in low concentrations, 0.5 and 0.1 mmol/l, respectively. Addition of ursodeoxycholate significantly reduced the hepatotoxic effect of deoxycholate. This protective effect was evident within minutes. The ultrastructural appearance of hepatocytes exposed to hydrophobic bile salts was very similar to the non-specific cellular lysis observed after exposition to Triton X-100, suggesting that they act mainly in a detergent-like fashion. Perifused rat hepatocytes seem a convenient in-vitro system for investigating the hepatotoxic properties of bile salts and hepatoprotective effect of ursodeoxycholate, offering the opportunity to investigate the effects of bile salts under dynamic conditions, mimicking the in-vivo situation, and allowing continuous enzyme release monitoring. Hydrophobic bile salts seem to act mainly in a detergent-like fashion; ursodeoxycholate-related hepatoprotection could be due not only to a dilution effect of toxic bile salts, but also to a direct cytoprotective effect.
Artificial Organs, 2001
To overcome the limitations of standard hollowfiber module in ensuring efficient cell perfusion a... more To overcome the limitations of standard hollowfiber module in ensuring efficient cell perfusion and long-term expression of highly differentiated hepatocyte functions, we developed a novel bioreactor in which a three-dimensional hepatocyte culture system was perfused in radial-flow geometry. Isolated porcine hepatocytes were cultured for 2 weeks in recirculating serum-free tissue culture medium, in which NH 4 Cl and lidocaine were repeatedly added, and ammonia removal, urea synthesis, monoethylglycinexylide (MEGX) production, albumin secretion, PO 2 , PCO 2 , O 2 consumption, and pH were measured thereafter. During the whole duration of the study, ammonia removal was paralleled by urea production, while MEGX concentration was constantly increased. Our results indicated that hepatocytes remained differentiated and metabolically active throughout the duration of the study. The radial-flow bioreactor allowed physiological contact between recirculating fluid and cells by equalizing the concentration of the perfusing components, including O 2 , throughout the module, suggesting a potential use of this configuration for extracorporeal liver support.