Publications by authors named "Ludovico Abenavoli"

Liver cirrhosis is a chronic, progressive condition characterized by fibrosis and architectural distortion of the liver, leading to impaired liver function and severe complications. Accurately predicting these complications is crucial to the improvement of patient outcomes. Therefore, this study aimed to evaluate the accuracy of various non-invasive biomarkers and clinical scores in assessing the risk of complications among cirrhotic patients.

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The gut microbiota constitutes a complex microorganism community that harbors bacteria, viruses, fungi, protozoa, and archaea. The human gut bacterial microbiota has been extensively proven to participate in human metabolism, immunity, and nutrient absorption. Its imbalance, namely "dysbiosis", has been linked to disordered metabolism.

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  • Inflammatory bowel disease (IBD) is linked to metabolic dysfunction, particularly metabolic dysfunction-associated steatotic liver disease (MASLD), which affects its patients due to common risk factors.* -
  • A study of 272 IBD patients revealed that 18% had MASLD, with those affected being older, having higher BMI and triglyceride levels, and more likely to suffer from type 2 diabetes and hypertension compared to those with non-alcoholic fatty liver disease (NAFLD).* -
  • The findings emphasize the need for early detection of MASLD in IBD patients and suggest a multidisciplinary approach to manage the associated cardiometabolic risks effectively.*
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Metabolic-Associated Fatty Liver Disease (MAFLD) is a clinical-pathological scenario that occurs due to the accumulation of triglycerides in hepatocytes which is considered a significant cause of liver conditions and contributes to an increased risk of death worldwide. Even though the possible causes of MAFLD can involve the interaction of genetics, hormones, and nutrition, lifestyle (diet and sedentary lifestyle) is the most influential factor in developing this condition. Polyphenols comprise many natural chemical compounds that can be helpful in managing metabolic diseases.

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Background: Pneumomediastinum (PNM) is a severe complication in COVID-19 patients, potentially exacerbating morbidity and requiring heightened clinical attention. This study aims to identify risk factors, clinical characteristics, and outcomes associated with PNM in COVID-19 patients hospitalized for respiratory failure in our institution.

Methods: Among 4513 patients admitted in our institution and testing positive for COVID-19 infection during the peak of the COVID-19 pandemic in Italy (1 March 2020 to 31 July 2020), we conducted a single-center, retrospective case-control study focusing our analysis on those with severe disease (respiratory failure).

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  • The study of gut microbiota, especially its bacterial components, is important for understanding health and disease, but the role of gut viruses is becoming increasingly recognized for their impact on gut health and the immune system.
  • Environmental stressors significantly affect both the host's immune response and the composition of the gut virome, which can disrupt gut-brain communication and influence neurological functions.
  • This literature review aims to investigate how stress and gut virome interactions, along with immune system changes, can lead to the development of various diseases.
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Superior mesenteric artery (SMA) syndrome or Wilkie's syndrome is a vascular compression disorder that causes the abnormal compression of the third portion of the duodenum by the SMA. It has a low incidence rate, which is higher in young women, and is rarely associated with the Nutcracker phenomenon: a condition of the compression of the left renal vein between the SMA and the aorta, which manifests as pain in the left flank and pelvis. Here, we report on the case of a 54-year-old woman with a history of repeated episodes of abdominal pain caused by the Nutcracker syndrome and Wilkie's syndrome.

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Background: Liver cancer, particularly hepatocellular carcinoma (HCC), is a significant gastrointestinal disease with a mortality rate as high as nearly 80% within five years. The disease's pathophysiology involves deranged immune responses and bile acid metabolism, with the gut microbiota (GM) playing a crucial role. Recent research highlights the potential of GM in influencing HCC treatment outcomes, especially regarding immune checkpoint inhibitors (ICIs).

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Background: infection (CDI) is a significant cause of mortality, especially in healthcare environments. Reliable biomarkers that can accurately predict mortality in CDI patients are yet to be evaluated. Our study aims to evaluate the accuracy of several inflammatory biomarkers and hemogram-derived ratios in predicting mortality in CDI patients, such as the neutrophil-to-lymphocyte ratio (NLR), the systemic immune-inflammation index (SII), the platelet-to-neutrophil ratio (PNR), the derived neutrophil-to-lymphocyte ratio (dNLR), C-reactive protein (CRP), the platelet-to-lymphocyte ratio (PLR), and procalcitonin (PCT).

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Recent efforts to reclassify non-alcoholic fatty liver disease (NAFLD) as metabolic dysfunction-associated fatty liver disease (MAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) are intended to divert attention to the metabolic basis of the disease rather than to alcohol consumption. This reclassification recognizes the role of obesity, sedentary lifestyles and poor dietary habits in the development of the disease, leading to a better understanding of its etiology. Nevertheless, the transition has posed its own challenges, particularly with regard to communication between patient and healthcare professional.

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A sedentary lifestyle associated with unregulated diets rich in high-calorie foods have contributed to the great prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) latterly, with up to 60% in the high-risk population and 25% in the general population. The absence of specific pharmacological strategies for this syndrome represents one of the major problems in the management of MASLD patients. Lifestyle interventions and adherence to a healthy diet are the main cornerstones of current therapies.

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The gastrointestinal tract is inhabited by the gut microbiota. The main phyla are Firmicutes and Bacteroidetes. In non-alcoholic fatty liver disease, now renamed metabolic dysfunction-associated fatty liver disease (MAFLD), an alteration in Firmicutes and Bacteroidetes abundance promotes its pathogenesis and evolution into non-alcoholic steatohepatitis, liver cirrhosis, and hepatocellular carcinoma.

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  • Alcoholic liver disease (ALD) is a significant chronic liver condition ranging from mild liver fat accumulation to severe inflammation and cirrhosis, primarily caused by alcohol consumption.
  • The disease's development is influenced by a complex interplay of factors, including direct damage from ethanol and imbalanced cytokine levels that promote inflammation.
  • Current treatments like corticosteroids help reduce mortality but there are no specific therapies for ALD yet; ongoing research is focusing on targeting pro-inflammatory cytokines to improve treatment outcomes.
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() infection is a prevalent global health issue, associated with several gastrointestinal disorders, including gastritis, peptic ulcers, and gastric cancer. The landscape of treatment has evolved over the years, with increasing challenges due to antibiotic resistance and treatment failure. Traditional diagnostic methods, such as the urea breath test, stool antigen test, and endoscopy with biopsy, are commonly used in clinical practice.

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The global health emergency caused by the Coronavirus disease-19 (COVID-19) pandemic officially ended on 11 May 2023 [...

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Background And Aim: Antimicrobial resistance (AMR) is a chronic issue of our Westernized society, mainly because of the uncontrolled and improper use of antimicrobials. The coronavirus disease 2019 (COVID-19) pandemic has triggered and expanded AMR diffusion all over the world, and its clinical and therapeutic features have changed. Thus, we aimed to review evidence from the literature on the definition and causative agents of AMR in the frame of the COVID-19 post-pandemic era.

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The BAP1 tumor suppressor gene encodes a deubiquitinase enzyme involved in several cellular activities, including DNA repair and apoptosis. Germline pathogenic variants in BAP1 have been associated with heritable conditions including BAP1 tumor predisposition syndrome 1 (BAP1-TPDS1) and a neurodevelopmental disorder known as Kury-Isidor syndrome (KURIS). Both these conditions are caused by monoallelic, dominant alterations of BAP1 but have never been reported in the same subject or family, suggesting a mutually exclusive genotype-phenotype correlation.

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  • - Malignant pleural mesothelioma (MPM) is a highly aggressive cancer linked primarily to asbestos exposure, but recent trends show a growing number of cases without clear asbestos links, suggesting genetic factors may also play a significant role in susceptibility.
  • - About 20% of MPM cases could be influenced by genetic predisposition, particularly involving the BAP1 gene, where those carrying specific variants tend to experience less aggressive forms of the disease and have different treatment needs.
  • - The review summarizes research on both genetic (germline) and non-genetic (asbestos-related) causes of MPM, highlighting the importance of genetic testing and surveillance for at-risk individuals.
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We read with great interest the recent article by Meneghini et al. on the assessment of the effects of different alimentary regimens, included Mediterranean diet (MD), on polycystic ovary syndrome (PCOS) patients prior to in vitro fertilization cycles [..

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  • Primary biliary cholangitis (PBC) is an autoimmune disease mainly affecting women aged 40-60, leading to bile duct destruction and associated with antimitochondrial antibodies (AMA) found in 95% of patients.
  • The standard treatment for PBC is Ursodeoxycholic acid (UDCA), which helps protect bile ducts, but not all patients respond effectively to this therapy.
  • There is increasing interest in the role of gut microbiota in PBC, particularly how its composition changes before and after UDCA treatment, though research on this topic is still limited.
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  • Inflammatory bowel disease (IBD) includes Crohn's disease and ulcerative colitis, and is linked to extraintestinal issues like nonalcoholic fatty liver disease (NAFLD).
  • A study involving 143 IBD patients indicated a 23% prevalence of NAFLD, with higher rates in males and those with longer disease duration and other metabolic issues.
  • The findings suggest that routine liver ultrasounds should be conducted for IBD patients to catch NAFLD early, and further research is needed with larger groups for validation.
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