Publications by authors named "Amanda Vestito"

Chemotherapy can cause vascular and metabolic liver injury in patients with liver metastases, but scarce data are available. We aimed to (i) describe the prevalence of porto-sinusoidal vascular disorder (PSVD) among patients undergoing resection for liver metastases; and (ii) assess whether liver (LSM) and spleen stiffness measurements could diagnose PSVD and predict postoperative complications. This is a prospective single-center study enrolling consecutive patients undergoing hepatic resection for metastases at a tertiary center.

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Acute cholecystitis (AC), generally associated with the presence of gallstones, is a relatively frequent disease that can lead to serious complications. For these reasons, AC warrants prompt clinical diagnosis and management. There is general agreement in terms of considering early laparoscopic cholecystectomy (ELC) to be the best treatment for AC.

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Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the presence of atrophy in the oxyntic mucosa due to anti-parietal cell antibodies. This review provides a comprehensive and up-to-date overview of autoimmune atrophic gastritis, reporting recent evidence on epidemiology, pathogenesis, diagnosis, clinical presentation, risk of malignancies, and management. The prevalence of AAG has been estimated at between 0.

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  • - The study aimed to assess how effectively faecal calprotectin can differentiate between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), considering that their symptoms often overlap.
  • - Researchers reviewed data from 17 studies including nearly 2,000 patients, finding that faecal calprotectin had a sensitivity of 85.8% and specificity of 91.7%, indicating it can be a reliable diagnostic tool.
  • - The results showed that faecal calprotectin performed better in Western countries and at lower cut-off levels (≤50 μg/g), although most studies analyzed had a high risk of bias.
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Background And Aims: Porto-sinusoidal vascular disease (PSVD) has been described as the prominent pathology in liver explants of patients with cystic fibrosis (CF), but data outside the transplant setting are lacking. We aimed to investigate the prevalence of portal hypertension (PH) in CF-associated liver disease (CFLD) and develop an algorithm to classify liver involvement in CF patients.

Methods: This is a cross-sectional study of consecutive paediatric and adult patients in a tertiary centre between 2018 and 2019, who underwent ultrasound, liver (LSM) and spleen stiffness (SSM) measurement.

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  • Berardinelli-Seip congenital lipodystrophy (BSCL) poses severe metabolic challenges from an early age, and while diet is crucial for treatment, there is limited research on dietary interventions alone.
  • A case study of a 16-year-old BSCL patient who followed a strict low-fat diet since age one showed no need for medication or abnormalities in medical evaluations, highlighting the effectiveness of dietary management.
  • The findings suggest that a well-structured low-fat diet may serve as a standalone treatment for BSCL in certain patients, particularly those with high adherence and milder symptoms.
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Background: The role of sarcopenia in predicting decompensation other than hepatic encephalopathy is unclear. We aimed to evaluate the prognostic role of sarcopenia, assessed by computed tomography (CT), in the development of ascites and mortality in patients with advanced chronic liver disease (ACLD) outside the liver transplantation (LT) setting.

Material And Methods: We retrospectively evaluated ACLD patients with liver stiffness measurement (LSM) >10 kPa and an available CT scan within 6 months.

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Introduction: A noninvasive diagnosis of clinically significant portal hypertension (CSPH) has important prognostic and therapeutic implications for patients with compensated advanced chronic liver disease. We aimed to validate and improve the available algorithms for the CSPH diagnosis by evaluating spleen stiffness measurement (SSM) in patients with compensated advanced chronic liver disease.

Methods: This is a retrospective study including patients with liver stiffness measurement (LSM) ≥10 kPa, no previous decompensation, and available measurements of hepatic venous pressure gradient, LSM, and SSM by transient elastography referring to our center in Bologna.

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The burden of post-operative complications of patients undergoing liver resection for hepatocellular carcinoma (HCC) is a cause of morbidity and mortality. Recently, sarcopenia has been reported to influence the outcome of patients with cirrhosis. We aimed to assess factors associated with sarcopenia and its prognostic role in liver surgery candidates.

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In adult patients, acute lymphoblastic leukemia (ALL) is a rare hematological cancer with a cure rate below 50% and frequent relapses. With traditional therapies, patients with relapsed or refractory (R/R) ALL have a survival that may be measured in months; in these patients, inotuzumab ozogamicin (IO) is an effective therapy. IO was linked to increased risk of veno-occlusive disease/sinusoid obstruction syndrome (VOD/SOS), liver injury, and various grade of liver-related complications during clinical trials and real-life settings; however, hepatologic monitoring protocol is not established in this population.

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Purpose: The role of liver stiffness (LS) on ultrasound elastography in the prediction of hepatocellular carcinoma (HCC) recurrence after treatment with radiofrequency ablation (RFA) is still unclear. Our aim was to perform a systematic review and meta-analysis to assess whether LS can predict the recurrence of HCC after RFA.

Materials And Methods: Medline via PubMed, Embase, Scopus, and Cochrane Library databases, and abstracts of international conference proceedings were searched up to June 30, 2020.

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Portal hypertension is the main driver of complications in patients with advanced chronic liver disease (ACLD). In the last decade, many non-invasive tests, such us liver and spleen elastography, have been proposed and validated for the identification of patients with clinically significant portal hypertension (CSPH) and its complications, mainly hepatic decompensation and liver-related morbidity and mortality. Moreover, elastography accurately stratifies for the risk of HCC development, HCC recurrence and decompensation after liver surgery.

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  • The study investigates how atrophic gastritis, especially autoimmune types and advanced cases, affects serum ghrelin levels and body mass index (BMI).
  • It involved 63 patients categorized based on the type of gastritis they had, with tests including endoscopy and multiple gastric biopsies to diagnose and stage the condition.
  • Results indicated that advanced atrophic gastritis was linked to lower ghrelin levels and decreased BMI, while a positive correlation was found between ghrelin levels and BMI in non-obese patients.
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  • - Imaging is crucial for diagnosing non-traumatic acute abdominal pain (AAP) in emergency departments, with a study conducted in Bologna, Italy, analyzing 578 patients to assess the effectiveness of various imaging techniques.
  • - Among the patients, 433 (74.9%) had abdominal imaging, primarily using plain radiography and ultrasonography, while computed tomography (CT) was also utilized; however, plain radiography showed relatively low sensitivity compared to ultrasound and CT.
  • - The findings suggest that plain radiography is frequently overused despite its limited effectiveness, and both ultrasonography and CT are more accurate options that should be prioritized for diagnosing AAP in emergency settings.
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Veno-occlusive-disease (VOD), known also as sinusoidal-obstruction-syndrome (SOS), is one of the main complications of haematopoietic stem cell transplantation and is related to the treatment with pyrrolizidine alkaloids or other toxic agents (chemotherapy for liver-metastasis). Clinical diagnosis using the recent criteria from the European Society for Blood and Marrow Transplantation, is the reference for VOD/SOS diagnosis. However, increasing evidence suggests the emerging role of several imaging methods that could help the clinician in VOD/SOS assessment.

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Purpose:  To perform a systematic review with meta-analysis to assess whether ultrasound elastography can have a diagnostic role in detecting fibrotic bowel strictures in patients with Crohn's disease.

Materials And Methods:  MEDLINE via the PubMed, Ovid Embase, Scopus and Cochrane Library databases, and abstracts of international conference proceedings were searched up to March 31, 2018. Studies were included if they assessed the performance of abdominal ultrasound elastography in detecting fibrotic bowel strictures in patients with Crohn's disease using histology or the need for surgery after medical treatment as a reference standard.

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Aims: Budd-Chiari Syndrome (BCS) is a rare vascular disease of the liver caused by the obstruction of the hepatic venous outflow located from the small hepatic venules up to the entrance of the inferior vena cava (IVC) into the right atrium. Current prognostic indexes are suboptimal for an individual prognostic assessment and subsequent management of patients with BCS. Liver (LSM) and spleen (SSM) stiffness measurements are widely validated prognostic tools in hepatology, but the evidence in patients with BCS is limited.

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Veno-occlusive disease (VOD), also known as sinusoidal obstruction syndrome (SOS), is a life-threatening complication affecting patients undergoing hematopoietic stem cell transplantation (HSCT). The survival rate is higher when specific therapy is initiated early; thus, improving early, noninvasive diagnosis of VOD/SOS is an important need. In an adult population undergoing HSCT, we aimed to assess the role of liver stiffness measurement (LSM), evaluated by transient elastography (TE), for diagnosing VOD/SOS.

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  • A systematic review evaluated the prevalence of upper gastrointestinal endoscopic findings like esophagitis and peptic ulcers in community settings.
  • Data from 12 studies indicated that the prevalence of these findings varied significantly across different regions, ranging from 24.9% to 68.9%.
  • The study concluded that at least 25% of individuals have upper gastrointestinal issues, with the prevalence of H. pylori negatively correlating with reflux-related esophageal conditions.
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A non-invasive test for oro-ileal transit time (OITT) evaluation was developed, based on the measurement of tauroursodeoxycholic acid (TUDCA) oral fluid concentration profile after its oral administration. Exploiting the fact that TUDCA is actively absorbed only in the ileum, OITT is measured as the time corresponding to TUDCA maximum oral fluid concentration (tmax). To measure oral fluid TUDCA concentration in a point-of-care setting, an ultrasensitive portable immunosensor was developed, based on a competitive chemiluminescent enzyme immunoassay (CL-EIA), using immobilized anti-TUDCA antibody and an ursodeoxycholic acid (UDCA)-peroxidase conjugate as tracer, detected by enhanced chemiluminescence employing a portable charge-coupled device (CCD)-based device.

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Background: After a Kasai procedure, 70% of patients with biliary atresia develop chronic liver disease with portal hypertension and oesophageal varices.

Aims: To investigate the role of new non-invasive parameters in predicting the presence of varices in patients with biliary atresia after a Kasai procedure and to identify the cut-off values of these parameters in predicting the presence of varices.

Methods: 31 patients with biliary atresia who had undergone a Kasai portoenterostomy were studied.

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  • * Researchers analyzed 81 cirrhotic patients with solitary HCC who underwent NCB before liver surgery, finding that NCB accurately identified tumour grade in 91.4% of cases, with no major complications reported.
  • * The results indicated that while NCB had a sensitivity of 65% and a specificity of 98.1%, the overall survival rates dropped over five years, and recurrence rates were significantly higher for poorly differentiated (high grade) tumours compared to low grade.
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While lifestyle modifications are currently used as first-line treatment for subjects with gastroesophageal reflux disease (GERD), the pathogenetic role of lifestyle factors and consequently, the efficacy of lifestyle measures is controversial. Our aim was to systematically review the pathogenetic link between overweight/obesity, dietary habits, physical activity and GERD, and the beneficial effect of specific recommended changes, by means of the available literature from the 1999 to the present. Obesity, in particular, abdominal obesity, plays a key role in determining GERD symptoms and complications through mechanical and metabolic effects.

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