Maria D'Armiento | Università degli Studi di Napoli "Federico II" (original) (raw)

Papers by Maria D'Armiento

Research paper thumbnail of Additional file 3 of Crohn disease-like enterocolitis remission after empagliflozin treatment in a child with glycogen storage disease type Ib: a case report

Additional file 3. Flash glucose monitoring data.

Research paper thumbnail of Crohn disease-like enterocolitis remission after empagliflozin treatment in a child with glycogen storage disease type Ib: a case report

Italian Journal of Pediatrics, 2021

Background Besides major clinical/biochemical features, neutropenia and inflammatory bowel diseas... more Background Besides major clinical/biochemical features, neutropenia and inflammatory bowel disease (IBD) constitute common complications of Glycogen storage disease type Ib (GSD Ib). However, their management is still challenging. Although previous reports have shown benefit of empagliflozin administration on neutropenia, no follow-up data on bowel (macro/microscopic) morphology are available. We herein present for the first time longitudinal assessment of bowel morphology in a GSD Ib child suffering from Crohn disease-like enterocolitis treated with empagliflozin. Case presentation A 14-year-old boy with GSD Ib and severe IBD was (off-label) treated with empagliflozin (20 mg/day) after informed oral and written consent was obtained from the patient’s parents. No adverse events were noted. Clinical symptoms and stool frequency improved within the first week of treatment. Pediatric Crohn disease activity index (PCDAI) normalised within the first month of treatment. Abdomen magnetic r...

Research paper thumbnail of Impact of Pre-Analytical Factors on MSI Test Accuracy in Mucinous Colorectal Adenocarcinoma: A Multi-Assay Concordance Study

Cells

Immunohistochemistry (IHC) and polymerase chain reaction (PCR) and fragment separation by capilla... more Immunohistochemistry (IHC) and polymerase chain reaction (PCR) and fragment separation by capillary electrophoresis represent the current clinical laboratory standard for the evaluation of microsatellite instability (MSI) status. The importance of reporting MSI status in colorectal cancer is based on its potential for guiding treatment and as a prognostic indicator. It is also used to identify patients for Lynch syndrome testing. Our aim was to evaluate pre-analytical factors, such as age of formalin-fixed and paraffin-embedded (FFPE) block, neoplastic cell percentage, mucinous component, and DNA integrity, that may influence the accuracy of MSI testing and assess the concordance between three different MSI evaluation approaches. We selected the mucinous colorectal cancer (CRC) histotype for this study as it may possibly represent an intrinsic diagnostic issue due to its low tumor cellularity. Seventy-five cases of mucinous CRC and corresponding normal colon tissue samples were retr...

Research paper thumbnail of Anti-HBc positivity was associated with histological cirrhosis in patients with chronic hepatitis C

INTRODUCTION. In patients with chronic hepatitis C it is still debated whether previous exposure ... more INTRODUCTION. In patients with chronic hepatitis C it is still debated whether previous exposure to the hepatitis B virus, diagnosed from the presence of the anti-HBc antibody, is linked to a greater risk of severe hepatitis. The aim of the study was to evaluate whether the presence of anti-HBc antibodies is associated with cirrhosis in patients with HBsAg-negative chronic hepatitis C. MATERIAL AND METHODS. Two hundred twenty-two consecutive HBsAg-negative patients with HCV-related chronic hepatitis were enrolled at their first liver biopsy. Ishak's scoring system was used to grade necroinflammation and fibrosis and the patients with stage 5 or 6 were considered as having histological cirrhosis. RESULTS. Patients with histological cirrhosis had a higher mean age, AST, ALT, a lower platelet count and prothrombin activity compared to those with milder fibrosis. The presence of anti-HBc was identified in 21 (63.6%) of the 33 patients with fibrosis score 5 or 6 and in 56 (29.6%; p < 0.001) of the 189 with score ≤ 4. Patients with cirrhosis had a significantly higher grading than those without cirrhosis (median = 8, IQR 6-11 vs. Median = 6, IQR = 4-8, respectively, p < 0.001). A multivariate logistic regression analysis showed that age, sex and anti-HBc positivity were independent predictors of histological cirrhosis. CONCLUSION. Our data support the idea that in patients with chronic hepatitis C the presence in serum of anti-HBc is associated with histological cirrhosis and is therefore a marker of clinical value.

Research paper thumbnail of Can only histological evaluation determine the allocation of ECD kidneys?

BMC nephrology, Jan 23, 2014

There is a recent debate on the "transplantability" of ECD (Expanded Criteria Donors) k... more There is a recent debate on the "transplantability" of ECD (Expanded Criteria Donors) kidneys and the selection criteria used to allocate them to single or double transplantation. Remuzzi et al. have defined a protocol incorporating pre-transplant donor biopsy to guide the use of older donor organs. They allocated organs as single or double transplants on the basis of histological findings. We aim to show the pros and cons of the only histological evaluation in the allocation of ECD kidneys, to compare the different experiences in United States and Europe and thus to discuss whether this tool should be used alone or included in a comprehensive clinical and histopathological evaluation. In the United States many Authors stated that the biopsy actually increases the percentage of kidney discarded and they raised questions about the importance of the biopsy in evaluating ECD kidneys for transplantation. On the other hand, the experiences of the majority of european transplant...

Research paper thumbnail of Impact of hiatal hernia on pediatric dyspeptic symptoms

Journal of pediatric gastroenterology and nutrition, 2014

Hiatal hernia (HH) affects from 10% to 50% of adult population. The correlation between HH, gastr... more Hiatal hernia (HH) affects from 10% to 50% of adult population. The correlation between HH, gastroesophageal reflux disease, dyspeptic symptoms, and esophagitis has long been known in adults. The primary objective of our prospective observational study was to estimate the prevalence of HH in children undergoing esophagogastroduodenoscopy (EGD), irrespective of their symptoms. We prospectively enrolled 111 consecutive children (48 boys and 63 girls; mean age 94.9 ± 52.3 months) referred for EGD. In all of the patients a symptomatic score assessment based on the Rome III criteria was used to measure frequency, severity, and duration of gastrointestinal symptoms. HH presence was endoscopically defined; esophagitis presence was evaluated either endoscopically and histologically. Children were divided in 2 age-range groups: <48 months (group 1) and >48 months (group 2). Twenty-three patients of 111 (20.7%) had evidence of a sliding HH at EGD. In children from group 2, we found a st...

Research paper thumbnail of Anti-HBc positivity was associated with histological cirrhosis in patients with chronic hepatitis C

Annals of hepatology

INTRODUCTION. In patients with chronic hepatitis C it is still debated whether previous exposure ... more INTRODUCTION. In patients with chronic hepatitis C it is still debated whether previous exposure to the hepatitis B virus, diagnosed from the presence of the anti-HBc antibody, is linked to a greater risk of severe hepatitis. The aim of the study was to evaluate whether the presence of anti-HBc antibodies is associated with cirrhosis in patients with HBsAg-negative chronic hepatitis C. MATERIAL AND METHODS. Two hundred twenty-two consecutive HBsAg-negative patients with HCV-related chronic hepatitis were enrolled at their first liver biopsy. Ishak's scoring system was used to grade necroinflammation and fibrosis and the patients with stage 5 or 6 were considered as having histological cirrhosis. RESULTS. Patients with histological cirrhosis had a higher mean age, AST, ALT, a lower platelet count and prothrombin activity compared to those with milder fibrosis. The presence of anti-HBc was identified in 21 (63.6%) of the 33 patients with fibrosis score 5 or 6 and in 56 (29.6%; p &...

Research paper thumbnail of MDR1-P-glycoprotein behaves as an oncofetal protein that promotes cell survival in gastric cancer cells

Laboratory investigation; a journal of technical methods and pathology, 2012

P-glycoprotein (P-gp), traditionally linked to cancer poor prognosis and multidrug resistance, is... more P-glycoprotein (P-gp), traditionally linked to cancer poor prognosis and multidrug resistance, is undetectable in normal gastric mucosa and overexpressed in gastric cancer (GC). We propose that P-gp may be involved in Helicobacter pylori (Hp)-related gastric carcinogenesis by inhibiting apoptosis. Aim of the study was to evaluate the expression of P-gp in fetal stomach and in Hp-related gastric carcinogenesis, the epigenetic control of the multi-drug resistance-1 (MDR1) gene, the localization and interaction between P-gp and Bcl-x(L) and the effect of the selective silencing of P-gp on cell survival. P-gp and Bcl-xl expression was evaluated by immunohistochemistry on 28 spontaneously abortive human fetuses, 66 Hp-negative subjects, 138 Hp-positive chronic gastritis (CG) of whom 28 with intestinal metaplasia (IM) and 45 intestinal type GCs. P-gp/Bcl-x(L) colocalization was investigated by confocal immunofluorescence microscopy and protein-protein interaction by co-immunoprecipitation...

Research paper thumbnail of Age-Related Effects on Atherogenesis and Scavenger Enzymes of Intracranial and Extracranial Arteries in Men Without Classic Risk Factors for Atherosclerosis

Background and Purpose—Atherosclerosis occurs later and is less extensive in intracranial arterie... more Background and Purpose—Atherosclerosis occurs later and is less extensive in intracranial arteries than in extracranial arteries. However, the mechanisms responsible are poorly understood. A previous study has suggested a better antioxidant protection of intracranial arteries. Methods—To assess the influence of age on arterial activity of antioxidant enzymes and atherogenesis, we compared intracranial and extracranial arteries of humans of different ages

Research paper thumbnail of Lipomatosis of the parotid gland in a child

British Journal of Plastic Surgery, 2000

Lipomatosis of the parotid gland is a very rare tumour and its discovery in a child is exceptiona... more Lipomatosis of the parotid gland is a very rare tumour and its discovery in a child is exceptional. These tumours are not generally considered in the preoperative differential diagnosis of parotid region neoplasms because of their rarity. The treatment of choice is surgical excision, with a superficial or total parotidectomy, preserving the facial nerve. Long-term follow-up is advised due to possible microscopic infiltration. A case of lipomatosis of the parotid gland in a 4-month-old child is reported.

Research paper thumbnail of HEREDITARY LOCALIZED PRURITUS IN AFFECTED MEMBERS OF A KINDRED WITH MULTIPLE ENDOCRINE NEOPLASIA TYPE 2A (SIPPLE'S SYNDROME)

Clinical Endocrinology, 1989

We describe a kindred with medullary thyroid carcinoma and phaeochromocytoma (MEN 2A or Sipple&am... more We describe a kindred with medullary thyroid carcinoma and phaeochromocytoma (MEN 2A or Sipple&amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome) in which a cutaneous manifestation is only present in affected members. These members felt an intense itching in an area 5-10 cm in length and passing through the scapular region where, after long-term scratching, the skin appears hyperkeratotic and pigmented. Cutaneous biopsies proved negative for dermis nerve abnormality. This restricted itching strongly suggests dominant transmitted hereditary localized pruritus which was described many years ago in a family which was apparently free from inherited diseases. In the examined kindred this skin peculiarity was said to have appeared before the patients reached 10 years of age and, therefore, prior to the biochemical manifestation of the thyroid tumour. Three children of the last generation, aged 4 to 11 years, all of whom presented this cutaneous manifestation, were considered unaffected because of normal basal and stimulated calcitonin, but thyroid C-cell hyperplasia was recently proved in the eldest. In this MEN 2A kindred the presence of such a characteristic hereditary itch in affected members may be considered as a phenotypic marker giving advance warning of medullary thyroid carcinoma.

Research paper thumbnail of Basaloid Squamous Cell Carcinoma: A Rare Tumor at the Esophagogastric Junction and an Unexpected Durable Complete Response to FOLFOX-4

Oncology Research and Treatment, 2014

Basaloid squamous cell carcinoma (BSCC) is a high-grade variant of squamous cell carcinoma usuall... more Basaloid squamous cell carcinoma (BSCC) is a high-grade variant of squamous cell carcinoma usually localized in the aerodigestive tract, with a poor prognosis. Surgical resection is generally recommended, even if no standard treatment has been established yet. Here, we report the case history of a patient diagnosed with BSCC at the esophagogastric junction who was successfully treated with chemotherapy alone, leading to a durable complete response. The presented case illustrates the diagnostic challenges associated with BSCC of the esophagus and reports an unexpected chemosensitivity of this histotype to the combination of a platinum salt plus 5-fluorouracil, which could represent an optimal treatment strategy in unfit patients.

Research paper thumbnail of Large infratentorial subdural hemorrhage diagnosed by ultrasound and MRI in a second-trimester fetus

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2005

Research paper thumbnail of Prenatal diagnosis and hemodynamic evaluation of Klippel-Trenaunay-Weber syndrome

Ultrasound in Obstetrics and Gynecology, 1998

Klippel-Trenaunay-Weber syndrome is a rare congenital soft-tissue anomaly which is characterized ... more Klippel-Trenaunay-Weber syndrome is a rare congenital soft-tissue anomaly which is characterized by the presence of multiple hemangiomata, arteriovenous fistulas and limb hypertrophy. We report the ultrasound findings in two cases of early prenatal diagnosis at 17 and 18 weeks of gestation. The pathogenesis of the syndrome and involvement of the cardiovascular system are discussed.

Research paper thumbnail of Prenatal ultrasound diagnosis of Roberts syndrome in a family with negative history

Ultrasound in Obstetrics & Gynecology, 1996

Research paper thumbnail of Diagnosis of femoral hypoplasia–unusual facies syndrome in the fetus

Ultrasound in Obstetrics and Gynecology, 2007

is a rare condition characterized by a variable degree of unilateral or bilateral femoral hypopla... more is a rare condition characterized by a variable degree of unilateral or bilateral femoral hypoplasia associated with facial clefting and other minor malformations. The prenatal diagnosis of this condition is possible, but so far has been reported prospectively in only two cases. We review all cases of FHUFS reported in the literature and also describe three cases detected prenatally in the mid-trimester, underlining the variable expression of the syndrome. The reported association with maternal diabetes mellitus and differential diagnosis with other syndromes characterized by femoral hypoplasia are also discussed.

Research paper thumbnail of Age-Related Effects on Atherogenesis and Scavenger Enzymes of Intracranial and Extracranial Arteries in Men Without Classic Risk Factors for Atherosclerosis Editorial Comment

Stroke, 2001

Background and Purpose-Atherosclerosis occurs later and is less extensive in intracranial arterie... more Background and Purpose-Atherosclerosis occurs later and is less extensive in intracranial arteries than in extracranial arteries. However, the mechanisms responsible are poorly understood. A previous study has suggested a better antioxidant protection of intracranial arteries. Methods-To assess the influence of age on arterial activity of antioxidant enzymes and atherogenesis, we compared intracranial and extracranial arteries of humans of different ages who retrospectively lacked confounding classic risk factors (48 premature fetuses aged 6.4Ϯ0.8 months [meanϮSD], 58 children aged 7.9Ϯ3.8 years, 42 adults aged 42.5Ϯ5.1 years, and 40 elderly subjects aged 71.8Ϯ3.4 years; all males). Lesions were quantified by computer-assisted imaging analysis of sections of the middle cerebral and basilar arteries, the left anterior descending coronary artery, the common carotid artery, and the abdominal aorta. Macrophages, apolipoprotein B, oxidized LDL, and matrix metalloproteinase-9 in lesions were determined by immunocytochemistry. The effect of aging on atherogenesis was then compared with that on the activity of 4 antioxidant enzymes in the arterial wall. Results-Atherosclerosis was 6-to 19-fold greater (PϽ0.01) in extracranial arteries than in intracranial arteries, and it increased linearly with age. Intracranial arteries showed significantly greater antioxidant enzyme activities than did extracranial arteries. However, the antioxidant protection of intracranial arteries decreased significantly in older age, coinciding with a marked acceleration of atherogenesis. An increase in matrix metalloproteinase-9 protein expression and in gelatinolytic activity consistent with the degree of intracranial atherosclerosis was also observed. Conclusions-These results suggest that a greater activity of antioxidant enzymes in intracranial arteries may contribute to their greater resistance to atherogenesis and that with increasing age intracranial arteries respond with accelerated atherogenesis when their antioxidant protection decreases relatively more than that of extracranial arteries. (Stroke. 2001;32:2472-2480.)

Research paper thumbnail of Prenatal 2D and 3D ultrasound diagnosis of diprosopus: case report with post-mortem magnetic resonance images (MRI) and review of the literature

Prenatal Diagnosis, 2009

... Giuseppe Maria Maruotti 1 ,; Dario Paladini 1 ,; Raffaele Napolitano 1 ,; Laura Letizia Mazza... more ... Giuseppe Maria Maruotti 1 ,; Dario Paladini 1 ,; Raffaele Napolitano 1 ,; Laura Letizia Mazzarelli 1 ,; Tiziana Russo 1 ,; Mario Quarantelli 2 ,; Maria Rosaria D&amp;amp;#x27;Armiento 3 ,; Pasquale Martinelli 1,*. Article first published online: 29 JUN 2009. DOI: 10.1002/pd.2321. ...

Research paper thumbnail of Evidence of Bacteroides fragilis Protection from Bartonella henselae-Induced Damage

PLoS ONE, 2012

Bartonella henselae is able to internalize endothelial progenitor cells (EPCs), which are resista... more Bartonella henselae is able to internalize endothelial progenitor cells (EPCs), which are resistant to the infection of other common pathogens. Bacteroides fragilis is a gram-negative anaerobe belonging to the gut microflora. It protects from experimental colitis induced by Helicobacter hepaticus through the polysaccharide A (PSA). The aim of our study was to establish: 1) whether B. fragilis colonization could protect from B. henselae infection; if this event may have beneficial effects on EPCs, vascular system and tissues. Our in vitro results establish for the first time that B. fragilis can internalize EPCs and competes with B. henselae during coinfection. We observed a marked activation of the inflammatory response by Real-time PCR and ELISA in coinfected cells compared to B. henselae-infected cells (63 vs 23 up-regulated genes), and after EPCs infection with mutant B. fragilis DPSA (>90% up-regulated genes) compared to B. fragilis. Interestingly, in a mouse model of coinfection, morphological and ultrastructural analyses by hematoxylin-eosin staining and electron microscopy on murine tissues revealed that damages induced by B. henselae can be prevented in the coinfection with B. fragilis but not with its mutant B. fragilis DPSA. Moreover, immunohistochemistry analysis with anti-Bartonella showed that the number of positive cells per field decreased of at least 50% in the liver (2064 vs 5068), aorta (561 vs 1062) and spleen (2563 vs 4066) sections of mice coinfected compared to mice infected only with B. henselae. This decrease was less evident in the coinfection with DPSA strain (3566 in the liver, 561 in the aorta and 3065 in the spleen). Finally, B. fragilis colonization was also able to restore the EPC decrease observed in mice infected with B. henselae (0.65 vs 0.06 media). Thus, our data establish that B. fragilis colonization is able to prevent B. henselae damages through PSA. Citation: Sommese L, Pagliuca C, Avallone B, Ippolito R, Casamassimi A, et al. (2012) Evidence of Bacteroides fragilis Protection from Bartonella henselae-Induced Damage. PLoS ONE 7(11): e49653.

Research paper thumbnail of Predictive Factors of Complete Response to Neoadjuvant Chemoradiotherapy in Patients with Rectal Cancer

Oncology, 2010

Pathological complete response (pCR) after neoadjuvant chemoradiotherapy is a favorable prognosti... more Pathological complete response (pCR) after neoadjuvant chemoradiotherapy is a favorable prognosticator in rectal cancer patients. We investigated whether the biological features of the primary tumor affect pCR. Forty-six patients treated with capecitabine-oxaliplatin and pelvic conformal radiotherapy were considered. Forty-three patients underwent surgery, and the pathologic response was scored according to the tumor regression grade (TRG) scale. Epidermal growth factor receptor (EGFR), vascular endothelial growth factor, poly(adenosine diphosphate-ribose) polymerase-1, X-ray cross-complimenting, thymidylate synthase (TS) and Ki67 expression were evaluated by immunohistochemistry on rectal biopsies obtained before chemoradiotherapy, and scored as the percentage of positive cells. Cutoffs were selected based on ROC analysis. The correlation between the biological factors and the TRG coded as TRG1 (pCR) versus TRG ≥2 (no pCR) was assessed by the χ(2) test and logistic regression analysis. Low EGFR (p = 0.007), high TS (p = 0.002), and high Ki67 (p = 0.05) were strongly associated with pCR. Upon univariate analysis, TRG significantly affected disease-free survival (p = 0.03). pCR was significantly associated with high TS, high Ki67 and low EGFR expression. Patients with pCR have a significantly lower incidence of relapse.

Research paper thumbnail of Additional file 3 of Crohn disease-like enterocolitis remission after empagliflozin treatment in a child with glycogen storage disease type Ib: a case report

Additional file 3. Flash glucose monitoring data.

Research paper thumbnail of Crohn disease-like enterocolitis remission after empagliflozin treatment in a child with glycogen storage disease type Ib: a case report

Italian Journal of Pediatrics, 2021

Background Besides major clinical/biochemical features, neutropenia and inflammatory bowel diseas... more Background Besides major clinical/biochemical features, neutropenia and inflammatory bowel disease (IBD) constitute common complications of Glycogen storage disease type Ib (GSD Ib). However, their management is still challenging. Although previous reports have shown benefit of empagliflozin administration on neutropenia, no follow-up data on bowel (macro/microscopic) morphology are available. We herein present for the first time longitudinal assessment of bowel morphology in a GSD Ib child suffering from Crohn disease-like enterocolitis treated with empagliflozin. Case presentation A 14-year-old boy with GSD Ib and severe IBD was (off-label) treated with empagliflozin (20 mg/day) after informed oral and written consent was obtained from the patient’s parents. No adverse events were noted. Clinical symptoms and stool frequency improved within the first week of treatment. Pediatric Crohn disease activity index (PCDAI) normalised within the first month of treatment. Abdomen magnetic r...

Research paper thumbnail of Impact of Pre-Analytical Factors on MSI Test Accuracy in Mucinous Colorectal Adenocarcinoma: A Multi-Assay Concordance Study

Cells

Immunohistochemistry (IHC) and polymerase chain reaction (PCR) and fragment separation by capilla... more Immunohistochemistry (IHC) and polymerase chain reaction (PCR) and fragment separation by capillary electrophoresis represent the current clinical laboratory standard for the evaluation of microsatellite instability (MSI) status. The importance of reporting MSI status in colorectal cancer is based on its potential for guiding treatment and as a prognostic indicator. It is also used to identify patients for Lynch syndrome testing. Our aim was to evaluate pre-analytical factors, such as age of formalin-fixed and paraffin-embedded (FFPE) block, neoplastic cell percentage, mucinous component, and DNA integrity, that may influence the accuracy of MSI testing and assess the concordance between three different MSI evaluation approaches. We selected the mucinous colorectal cancer (CRC) histotype for this study as it may possibly represent an intrinsic diagnostic issue due to its low tumor cellularity. Seventy-five cases of mucinous CRC and corresponding normal colon tissue samples were retr...

Research paper thumbnail of Anti-HBc positivity was associated with histological cirrhosis in patients with chronic hepatitis C

INTRODUCTION. In patients with chronic hepatitis C it is still debated whether previous exposure ... more INTRODUCTION. In patients with chronic hepatitis C it is still debated whether previous exposure to the hepatitis B virus, diagnosed from the presence of the anti-HBc antibody, is linked to a greater risk of severe hepatitis. The aim of the study was to evaluate whether the presence of anti-HBc antibodies is associated with cirrhosis in patients with HBsAg-negative chronic hepatitis C. MATERIAL AND METHODS. Two hundred twenty-two consecutive HBsAg-negative patients with HCV-related chronic hepatitis were enrolled at their first liver biopsy. Ishak&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s scoring system was used to grade necroinflammation and fibrosis and the patients with stage 5 or 6 were considered as having histological cirrhosis. RESULTS. Patients with histological cirrhosis had a higher mean age, AST, ALT, a lower platelet count and prothrombin activity compared to those with milder fibrosis. The presence of anti-HBc was identified in 21 (63.6%) of the 33 patients with fibrosis score 5 or 6 and in 56 (29.6%; p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001) of the 189 with score ≤ 4. Patients with cirrhosis had a significantly higher grading than those without cirrhosis (median = 8, IQR 6-11 vs. Median = 6, IQR = 4-8, respectively, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). A multivariate logistic regression analysis showed that age, sex and anti-HBc positivity were independent predictors of histological cirrhosis. CONCLUSION. Our data support the idea that in patients with chronic hepatitis C the presence in serum of anti-HBc is associated with histological cirrhosis and is therefore a marker of clinical value.

Research paper thumbnail of Can only histological evaluation determine the allocation of ECD kidneys?

BMC nephrology, Jan 23, 2014

There is a recent debate on the "transplantability" of ECD (Expanded Criteria Donors) k... more There is a recent debate on the "transplantability" of ECD (Expanded Criteria Donors) kidneys and the selection criteria used to allocate them to single or double transplantation. Remuzzi et al. have defined a protocol incorporating pre-transplant donor biopsy to guide the use of older donor organs. They allocated organs as single or double transplants on the basis of histological findings. We aim to show the pros and cons of the only histological evaluation in the allocation of ECD kidneys, to compare the different experiences in United States and Europe and thus to discuss whether this tool should be used alone or included in a comprehensive clinical and histopathological evaluation. In the United States many Authors stated that the biopsy actually increases the percentage of kidney discarded and they raised questions about the importance of the biopsy in evaluating ECD kidneys for transplantation. On the other hand, the experiences of the majority of european transplant...

Research paper thumbnail of Impact of hiatal hernia on pediatric dyspeptic symptoms

Journal of pediatric gastroenterology and nutrition, 2014

Hiatal hernia (HH) affects from 10% to 50% of adult population. The correlation between HH, gastr... more Hiatal hernia (HH) affects from 10% to 50% of adult population. The correlation between HH, gastroesophageal reflux disease, dyspeptic symptoms, and esophagitis has long been known in adults. The primary objective of our prospective observational study was to estimate the prevalence of HH in children undergoing esophagogastroduodenoscopy (EGD), irrespective of their symptoms. We prospectively enrolled 111 consecutive children (48 boys and 63 girls; mean age 94.9 ± 52.3 months) referred for EGD. In all of the patients a symptomatic score assessment based on the Rome III criteria was used to measure frequency, severity, and duration of gastrointestinal symptoms. HH presence was endoscopically defined; esophagitis presence was evaluated either endoscopically and histologically. Children were divided in 2 age-range groups: <48 months (group 1) and >48 months (group 2). Twenty-three patients of 111 (20.7%) had evidence of a sliding HH at EGD. In children from group 2, we found a st...

Research paper thumbnail of Anti-HBc positivity was associated with histological cirrhosis in patients with chronic hepatitis C

Annals of hepatology

INTRODUCTION. In patients with chronic hepatitis C it is still debated whether previous exposure ... more INTRODUCTION. In patients with chronic hepatitis C it is still debated whether previous exposure to the hepatitis B virus, diagnosed from the presence of the anti-HBc antibody, is linked to a greater risk of severe hepatitis. The aim of the study was to evaluate whether the presence of anti-HBc antibodies is associated with cirrhosis in patients with HBsAg-negative chronic hepatitis C. MATERIAL AND METHODS. Two hundred twenty-two consecutive HBsAg-negative patients with HCV-related chronic hepatitis were enrolled at their first liver biopsy. Ishak's scoring system was used to grade necroinflammation and fibrosis and the patients with stage 5 or 6 were considered as having histological cirrhosis. RESULTS. Patients with histological cirrhosis had a higher mean age, AST, ALT, a lower platelet count and prothrombin activity compared to those with milder fibrosis. The presence of anti-HBc was identified in 21 (63.6%) of the 33 patients with fibrosis score 5 or 6 and in 56 (29.6%; p &...

Research paper thumbnail of MDR1-P-glycoprotein behaves as an oncofetal protein that promotes cell survival in gastric cancer cells

Laboratory investigation; a journal of technical methods and pathology, 2012

P-glycoprotein (P-gp), traditionally linked to cancer poor prognosis and multidrug resistance, is... more P-glycoprotein (P-gp), traditionally linked to cancer poor prognosis and multidrug resistance, is undetectable in normal gastric mucosa and overexpressed in gastric cancer (GC). We propose that P-gp may be involved in Helicobacter pylori (Hp)-related gastric carcinogenesis by inhibiting apoptosis. Aim of the study was to evaluate the expression of P-gp in fetal stomach and in Hp-related gastric carcinogenesis, the epigenetic control of the multi-drug resistance-1 (MDR1) gene, the localization and interaction between P-gp and Bcl-x(L) and the effect of the selective silencing of P-gp on cell survival. P-gp and Bcl-xl expression was evaluated by immunohistochemistry on 28 spontaneously abortive human fetuses, 66 Hp-negative subjects, 138 Hp-positive chronic gastritis (CG) of whom 28 with intestinal metaplasia (IM) and 45 intestinal type GCs. P-gp/Bcl-x(L) colocalization was investigated by confocal immunofluorescence microscopy and protein-protein interaction by co-immunoprecipitation...

Research paper thumbnail of Age-Related Effects on Atherogenesis and Scavenger Enzymes of Intracranial and Extracranial Arteries in Men Without Classic Risk Factors for Atherosclerosis

Background and Purpose—Atherosclerosis occurs later and is less extensive in intracranial arterie... more Background and Purpose—Atherosclerosis occurs later and is less extensive in intracranial arteries than in extracranial arteries. However, the mechanisms responsible are poorly understood. A previous study has suggested a better antioxidant protection of intracranial arteries. Methods—To assess the influence of age on arterial activity of antioxidant enzymes and atherogenesis, we compared intracranial and extracranial arteries of humans of different ages

Research paper thumbnail of Lipomatosis of the parotid gland in a child

British Journal of Plastic Surgery, 2000

Lipomatosis of the parotid gland is a very rare tumour and its discovery in a child is exceptiona... more Lipomatosis of the parotid gland is a very rare tumour and its discovery in a child is exceptional. These tumours are not generally considered in the preoperative differential diagnosis of parotid region neoplasms because of their rarity. The treatment of choice is surgical excision, with a superficial or total parotidectomy, preserving the facial nerve. Long-term follow-up is advised due to possible microscopic infiltration. A case of lipomatosis of the parotid gland in a 4-month-old child is reported.

Research paper thumbnail of HEREDITARY LOCALIZED PRURITUS IN AFFECTED MEMBERS OF A KINDRED WITH MULTIPLE ENDOCRINE NEOPLASIA TYPE 2A (SIPPLE'S SYNDROME)

Clinical Endocrinology, 1989

We describe a kindred with medullary thyroid carcinoma and phaeochromocytoma (MEN 2A or Sipple&am... more We describe a kindred with medullary thyroid carcinoma and phaeochromocytoma (MEN 2A or Sipple&amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome) in which a cutaneous manifestation is only present in affected members. These members felt an intense itching in an area 5-10 cm in length and passing through the scapular region where, after long-term scratching, the skin appears hyperkeratotic and pigmented. Cutaneous biopsies proved negative for dermis nerve abnormality. This restricted itching strongly suggests dominant transmitted hereditary localized pruritus which was described many years ago in a family which was apparently free from inherited diseases. In the examined kindred this skin peculiarity was said to have appeared before the patients reached 10 years of age and, therefore, prior to the biochemical manifestation of the thyroid tumour. Three children of the last generation, aged 4 to 11 years, all of whom presented this cutaneous manifestation, were considered unaffected because of normal basal and stimulated calcitonin, but thyroid C-cell hyperplasia was recently proved in the eldest. In this MEN 2A kindred the presence of such a characteristic hereditary itch in affected members may be considered as a phenotypic marker giving advance warning of medullary thyroid carcinoma.

Research paper thumbnail of Basaloid Squamous Cell Carcinoma: A Rare Tumor at the Esophagogastric Junction and an Unexpected Durable Complete Response to FOLFOX-4

Oncology Research and Treatment, 2014

Basaloid squamous cell carcinoma (BSCC) is a high-grade variant of squamous cell carcinoma usuall... more Basaloid squamous cell carcinoma (BSCC) is a high-grade variant of squamous cell carcinoma usually localized in the aerodigestive tract, with a poor prognosis. Surgical resection is generally recommended, even if no standard treatment has been established yet. Here, we report the case history of a patient diagnosed with BSCC at the esophagogastric junction who was successfully treated with chemotherapy alone, leading to a durable complete response. The presented case illustrates the diagnostic challenges associated with BSCC of the esophagus and reports an unexpected chemosensitivity of this histotype to the combination of a platinum salt plus 5-fluorouracil, which could represent an optimal treatment strategy in unfit patients.

Research paper thumbnail of Large infratentorial subdural hemorrhage diagnosed by ultrasound and MRI in a second-trimester fetus

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, 2005

Research paper thumbnail of Prenatal diagnosis and hemodynamic evaluation of Klippel-Trenaunay-Weber syndrome

Ultrasound in Obstetrics and Gynecology, 1998

Klippel-Trenaunay-Weber syndrome is a rare congenital soft-tissue anomaly which is characterized ... more Klippel-Trenaunay-Weber syndrome is a rare congenital soft-tissue anomaly which is characterized by the presence of multiple hemangiomata, arteriovenous fistulas and limb hypertrophy. We report the ultrasound findings in two cases of early prenatal diagnosis at 17 and 18 weeks of gestation. The pathogenesis of the syndrome and involvement of the cardiovascular system are discussed.

Research paper thumbnail of Prenatal ultrasound diagnosis of Roberts syndrome in a family with negative history

Ultrasound in Obstetrics & Gynecology, 1996

Research paper thumbnail of Diagnosis of femoral hypoplasia–unusual facies syndrome in the fetus

Ultrasound in Obstetrics and Gynecology, 2007

is a rare condition characterized by a variable degree of unilateral or bilateral femoral hypopla... more is a rare condition characterized by a variable degree of unilateral or bilateral femoral hypoplasia associated with facial clefting and other minor malformations. The prenatal diagnosis of this condition is possible, but so far has been reported prospectively in only two cases. We review all cases of FHUFS reported in the literature and also describe three cases detected prenatally in the mid-trimester, underlining the variable expression of the syndrome. The reported association with maternal diabetes mellitus and differential diagnosis with other syndromes characterized by femoral hypoplasia are also discussed.

Research paper thumbnail of Age-Related Effects on Atherogenesis and Scavenger Enzymes of Intracranial and Extracranial Arteries in Men Without Classic Risk Factors for Atherosclerosis Editorial Comment

Stroke, 2001

Background and Purpose-Atherosclerosis occurs later and is less extensive in intracranial arterie... more Background and Purpose-Atherosclerosis occurs later and is less extensive in intracranial arteries than in extracranial arteries. However, the mechanisms responsible are poorly understood. A previous study has suggested a better antioxidant protection of intracranial arteries. Methods-To assess the influence of age on arterial activity of antioxidant enzymes and atherogenesis, we compared intracranial and extracranial arteries of humans of different ages who retrospectively lacked confounding classic risk factors (48 premature fetuses aged 6.4Ϯ0.8 months [meanϮSD], 58 children aged 7.9Ϯ3.8 years, 42 adults aged 42.5Ϯ5.1 years, and 40 elderly subjects aged 71.8Ϯ3.4 years; all males). Lesions were quantified by computer-assisted imaging analysis of sections of the middle cerebral and basilar arteries, the left anterior descending coronary artery, the common carotid artery, and the abdominal aorta. Macrophages, apolipoprotein B, oxidized LDL, and matrix metalloproteinase-9 in lesions were determined by immunocytochemistry. The effect of aging on atherogenesis was then compared with that on the activity of 4 antioxidant enzymes in the arterial wall. Results-Atherosclerosis was 6-to 19-fold greater (PϽ0.01) in extracranial arteries than in intracranial arteries, and it increased linearly with age. Intracranial arteries showed significantly greater antioxidant enzyme activities than did extracranial arteries. However, the antioxidant protection of intracranial arteries decreased significantly in older age, coinciding with a marked acceleration of atherogenesis. An increase in matrix metalloproteinase-9 protein expression and in gelatinolytic activity consistent with the degree of intracranial atherosclerosis was also observed. Conclusions-These results suggest that a greater activity of antioxidant enzymes in intracranial arteries may contribute to their greater resistance to atherogenesis and that with increasing age intracranial arteries respond with accelerated atherogenesis when their antioxidant protection decreases relatively more than that of extracranial arteries. (Stroke. 2001;32:2472-2480.)

Research paper thumbnail of Prenatal 2D and 3D ultrasound diagnosis of diprosopus: case report with post-mortem magnetic resonance images (MRI) and review of the literature

Prenatal Diagnosis, 2009

... Giuseppe Maria Maruotti 1 ,; Dario Paladini 1 ,; Raffaele Napolitano 1 ,; Laura Letizia Mazza... more ... Giuseppe Maria Maruotti 1 ,; Dario Paladini 1 ,; Raffaele Napolitano 1 ,; Laura Letizia Mazzarelli 1 ,; Tiziana Russo 1 ,; Mario Quarantelli 2 ,; Maria Rosaria D&amp;amp;#x27;Armiento 3 ,; Pasquale Martinelli 1,*. Article first published online: 29 JUN 2009. DOI: 10.1002/pd.2321. ...

Research paper thumbnail of Evidence of Bacteroides fragilis Protection from Bartonella henselae-Induced Damage

PLoS ONE, 2012

Bartonella henselae is able to internalize endothelial progenitor cells (EPCs), which are resista... more Bartonella henselae is able to internalize endothelial progenitor cells (EPCs), which are resistant to the infection of other common pathogens. Bacteroides fragilis is a gram-negative anaerobe belonging to the gut microflora. It protects from experimental colitis induced by Helicobacter hepaticus through the polysaccharide A (PSA). The aim of our study was to establish: 1) whether B. fragilis colonization could protect from B. henselae infection; if this event may have beneficial effects on EPCs, vascular system and tissues. Our in vitro results establish for the first time that B. fragilis can internalize EPCs and competes with B. henselae during coinfection. We observed a marked activation of the inflammatory response by Real-time PCR and ELISA in coinfected cells compared to B. henselae-infected cells (63 vs 23 up-regulated genes), and after EPCs infection with mutant B. fragilis DPSA (>90% up-regulated genes) compared to B. fragilis. Interestingly, in a mouse model of coinfection, morphological and ultrastructural analyses by hematoxylin-eosin staining and electron microscopy on murine tissues revealed that damages induced by B. henselae can be prevented in the coinfection with B. fragilis but not with its mutant B. fragilis DPSA. Moreover, immunohistochemistry analysis with anti-Bartonella showed that the number of positive cells per field decreased of at least 50% in the liver (2064 vs 5068), aorta (561 vs 1062) and spleen (2563 vs 4066) sections of mice coinfected compared to mice infected only with B. henselae. This decrease was less evident in the coinfection with DPSA strain (3566 in the liver, 561 in the aorta and 3065 in the spleen). Finally, B. fragilis colonization was also able to restore the EPC decrease observed in mice infected with B. henselae (0.65 vs 0.06 media). Thus, our data establish that B. fragilis colonization is able to prevent B. henselae damages through PSA. Citation: Sommese L, Pagliuca C, Avallone B, Ippolito R, Casamassimi A, et al. (2012) Evidence of Bacteroides fragilis Protection from Bartonella henselae-Induced Damage. PLoS ONE 7(11): e49653.

Research paper thumbnail of Predictive Factors of Complete Response to Neoadjuvant Chemoradiotherapy in Patients with Rectal Cancer

Oncology, 2010

Pathological complete response (pCR) after neoadjuvant chemoradiotherapy is a favorable prognosti... more Pathological complete response (pCR) after neoadjuvant chemoradiotherapy is a favorable prognosticator in rectal cancer patients. We investigated whether the biological features of the primary tumor affect pCR. Forty-six patients treated with capecitabine-oxaliplatin and pelvic conformal radiotherapy were considered. Forty-three patients underwent surgery, and the pathologic response was scored according to the tumor regression grade (TRG) scale. Epidermal growth factor receptor (EGFR), vascular endothelial growth factor, poly(adenosine diphosphate-ribose) polymerase-1, X-ray cross-complimenting, thymidylate synthase (TS) and Ki67 expression were evaluated by immunohistochemistry on rectal biopsies obtained before chemoradiotherapy, and scored as the percentage of positive cells. Cutoffs were selected based on ROC analysis. The correlation between the biological factors and the TRG coded as TRG1 (pCR) versus TRG ≥2 (no pCR) was assessed by the χ(2) test and logistic regression analysis. Low EGFR (p = 0.007), high TS (p = 0.002), and high Ki67 (p = 0.05) were strongly associated with pCR. Upon univariate analysis, TRG significantly affected disease-free survival (p = 0.03). pCR was significantly associated with high TS, high Ki67 and low EGFR expression. Patients with pCR have a significantly lower incidence of relapse.