Publications by authors named "Montalto M"

Context.—: Precise determination of biomarker status is necessary for clinical trial enrollment and endpoint analyses, as well as for optimal treatment determination in real-world practice. However, variabilities may be introduced into this process due to the processing of clinical specimens by different laboratories and assessment by distinct pathologists.

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  • Metabolic dysfunction-associated steatohepatitis (MASH) is a serious liver condition with limited treatment options and relies on manual biopsies for assessment, which often shows high variability among readers.
  • A new artificial intelligence (AI) system, AIM-MASH, has been developed and validated across multiple sites to assist pathologists in scoring liver biopsies related to MASH, showing high reliability and consistency compared to traditional methods.
  • AIM-MASH significantly improved the accuracy of assessing key factors like inflammation and MASH resolution when used by expert pathologists, suggesting it can reduce variability and enhance the evaluation of new treatments in MASH clinical trials.
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  • The study investigates the link between long COVID gastrointestinal symptoms and post-infection gut-brain interaction disorders, aiming to uncover the mechanisms behind these long-term issues.
  • Eighty-six individuals who recovered from SARS-CoV-2 infection were evaluated for GI symptoms, inflammation, and permeability, with specific questionnaires used to assess their conditions.
  • Results indicated that 43% of participants reported long-term GI symptoms, but those without symptoms had higher intestinal inflammation levels, suggesting local inflammatory mechanisms may not be the primary cause of GI complaints in long COVID.
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  • Acute diarrhea is a significant public health challenge, particularly in emergency departments (EDs), and managing these patients effectively is complex.
  • A study of over 20,000 patients revealed that factors like age over 65, prolonged symptoms, and certain health histories were linked to higher chances of returning to the ED after discharge.
  • Guidelines suggest a thorough evaluation of patient history and health conditions to tailor treatment, as the choice of antibiotics and other medications can affect readmission rates, especially in different age demographics.
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  • - The standard method for assessing metabolic dysfunction-associated steatosis in clinical trials is by evaluating liver biopsies on glass slides; however, shipping these slides poses logistical challenges and risks of damage.
  • - This study found that using digital images on the AISight whole slide image management system for assessing steatohepatitis offers comparable accuracy to traditional glass slide evaluations, with both methods verified against a consensus score from expert pathologists.
  • - The results showed that the agreement between digital scoring and the established "ground truth" was not inferior to that of glass scoring, indicating that digital assessments can reliably replace traditional methods in clinical trial settings for liver disease.
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Background: Hospital at home (HaH) delivers hospital-level care to acutely ill patients at home as a substitute for brick-and-mortar hospital care. The clinician and program characteristics of HaH programs worldwide are relatively unknown. We sought to describe the world's HaH clinicians and their programs' characteristics.

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  • - Clinical trials for metabolic dysfunction-associated steatohepatitis (MASH) need accurate histologic scoring to assess participants and outcomes, but varying interpretations have affected results.
  • - The AI-based tool AIM-MASH showed strong consistency and agreement with expert pathologists in scoring MASH histology, achieving accuracy comparable to that of average pathologists.
  • - AIM-MASH demonstrated a strong ability to predict patient outcomes, correlating well with pathologist scores and noninvasive biomarkers, indicating it could enhance the efficiency and reliability of clinical trials for MASH.
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Mild cognitive impairment (MCI) is a heterogeneous condition definable as the intermediate clinical state between normal aging and dementia. As a pre-dementia condition, there is a recent growing interest in the identification of non-invasive markers able to predict the progression from MCI to a more advanced stage of the disease. Previous evidence showed the close link between gut microbiota and neurodegenerative diseases, such as Alzheimer's (AD) and Parkinson's disease (PD).

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Platelets have a fundamental role in mediating hemostasis and thrombosis. However, more recently, a new idea is making headway, highlighting the importance of platelets as significant actors in modulating immune and inflammatory responses. In particular, platelets have an important role in the development of vascular amyloid-b-peptide(ab) deposits, known to play a relevant role in Alzheimer's disease (AD) through accumulation and deposition within the frontal cortex and hippocampus in the brain.

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  • The study focuses on creating a deep learning digital pathology tool for accurately detecting, segmenting, and classifying nuclei in cancer tissues, addressing challenges in quantifying nuclear morphology in histologic images.
  • This tool was trained on nucleus annotations to analyze H&E-stained slides from various cancer cohorts (BRCA, LUAD, PRAD), revealing significant differences in nuclear features like shape and size linked to genomic instability and cancer prognosis.
  • Results highlighted that certain nuclear characteristics, particularly in fibroblasts, were associated with patient survival outcomes and gene expression related to tumor biology, paving the way for better understanding of cancer biomarkers.
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Purpose Of Review: Lactose malabsorption and intolerance are very common conditions. However, their optimal approach, including the diagnostic assessment, remains a matter of debate, especially in advanced age. In this brief review, we focused on current knowledge, concerns, and impact in clinical practice of lactose malabsorption and intolerance in elderly.

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Fecal calprotectin (FC) has been largely recognized as a surrogate marker of intestinal neutrophilic inflammation, very reliable in distinguishing between inflammatory bowel diseases and functional gastrointestinal (GI) disorders. Aging has been suggested to influence FC results and their diagnostic accuracy; however, no studies are specifically targeted on this focus. In a retrospective study, we evaluated the eventual age-differences of the diagnostic accuracy of FC in discriminating between organic-inflammatory GI diseases and functional GI disorders.

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Purpose: Heart failure (HF) is a major health problem affecting millions of people worldwide. In the latest years, many efforts have been made to identify predictors of poor prognosis in these patients. The aim of this systematic review and meta-analysis was to enlighten the correlation between liver stiffness (LS), assessed by Shear Wave Elastography techniques, and HF, particularly focusing on the prognostic value of LS on cardiovascular outcomes.

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Diseases of the pericardium encompass a spectrum of conditions, including acute and recurrent pericarditis, where inflammation plays a pivotal role in the pathogenesis and clinical manifestations. Anti-inflammatory therapy indeed forms the cornerstone of treating these conditions: NSAIDs, colchicine, and corticosteroids (as a second-line treatment) are recommended by current guidelines. However, these medications come with several contraindications and are not devoid of adverse effects.

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: Heart failure (HF) represents a major health burden. Although several treatment regimens are available, their effectiveness is often unsatisfactory. Growing evidence suggests a pivotal role of the gut in HF.

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Introduction: Recently, medical interest has been growing in SARS-CoV-2 infection and its multiorgan involvement, including the liver. Up until now, a few reports have described autoimmune hepatitis (AIH) triggered by SARS-CoV-2 infection, but no data are available about the specific liver inflammatory infiltrate and cluster of differentiation. We report a case of AIH triggered by SARS-CoV-2 infection, with a particular focus on its histological and mainly immunohistochemical features.

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  • * While many with lactase deficiency don't experience symptoms, about one-third do suffer from lactose intolerance.
  • * Excluding dairy from diets might seem like a solution, but it can lead to nutritional deficiencies, especially in older adults, who rely on dairy for essential nutrients that support bone and muscle health.
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The long-term impact of COVID-19 disease is becoming a major global concern. In this retrospective monocentric analysis, we included consecutive subjects admitted to our COVID-19 Post-Acute Care Service for a SARS-CoV-2 infection that occurred between three and twelve months before. A home medication list relative to the period before SARS-CoV-2 infection (baseline) was recorded and compared with that one relative to the time of outpatient visit (follow-up).

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Background: Older age is a well-known risk factor for recurrent and severe Clostridioides difficile infection (CDI). Fecal microbiota transplantation (FMT) is widely recognized as an effective and safe therapeutic option for the treatment of recurrent CDI (rCDI). However, the efficacy and safety of FMT for rCDI in very old patients are uncertain.

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  • Clinical trials for nonalcoholic steatohepatitis (NASH) rely on consistent histologic scoring, but variability in these interpretations has affected trial results.* -
  • An AI tool called AIM-NASH was developed to provide standardized scoring for NASH histology, showing strong correlation with expert consensus scores and improving predictive accuracy for patient outcomes.* -
  • In a retrospective analysis, AIM-NASH helped meet previously unmet pathological endpoints in the ATLAS trial, suggesting it could reduce variability in scoring and enhance the assessment of treatment responses in clinical trials.*
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