Protective Effect of Caffeine and Chlorogenic Acids of Coffee in Liver Disease.

Coffee is one of the most widely consumed beverages in the world due to its unique aroma and psychostimulant effects, mainly due to the presence of caffeine. In recent years, experimental evidence has shown that the moderate consumption of coffee (3/4 cups per day) is safe and beneficial to human health, revealing protective effects against numerous chronic metabolic diseases such as diabetes, cardiovascular, neurodegenerative, and hepatic diseases. This review focuses on two of coffee's main bioactive compounds, i.

Final Results from the First European Real-World Experience on Lusutrombopag Treatment in Cirrhotic Patients with Severe Thrombocytopenia: Insights from the REAl-World Lusutrombopag Treatment in ITalY Study.

Management of severe thrombocytopenia poses significant challenges in patients with chronic liver disease. Here, we aimed to evaluate the first real-world European post-marketing cohort of cirrhotic patients treated with lusutrombopag, a thrombopoietin receptor agonist, verifying the efficacy and safety of the drug. In the REAl-world Lusutrombopag treatment in ITalY (REALITY) study, we collected data from consecutive cirrhotic patients treated with lusutrombopag in 19 Italian hepatology centers, mostly joined to the "Club Epatologi Ospedalieri" (CLEO).

Factors Enhancing Treatment of Hepatitis C Virus-Infected Italian People Who Use Drugs: The CLEO-GRECAS Experience.

Introduction: We assessed the performance of direct-acting antivirals (DAAs) in hepatitis C virus (HCV)-infected people who use drugs (PWUDs) in terms of sustained virological response (SVR) and adherence rates in comparison to a location-matched cohort of non-PWUD HCV patients.

Methods: All consecutive HCV RNA-positive PWUDs were enrolled between 2015 and 2019. All subjects underwent DAA treatment according to international guidelines and then followed, at least, up to 12 weeks after the end of treatment (SVR12).

Rate of non-response to ursodeoxycholic acid in a large real-world cohort of primary biliary cholangitis patients in Italy.

Response to ursodeoxycholic acid (UDCA) is crucial for the prediction of primary biliary cholangitis (PBC) prognosis, and different response criteria were validated and proposed by reference centers for PBC. To date, rates of non-response to UDCA from real-world series are lacking. Hepatology/Gastroenterology centers belonging to 'Club Epatologi Ospedalieri' (CLEO) and 'Associazione Italiana Gastroenterologi Ospedalieri' (AIGO) were invited to participate in the study, and asked to extract all patients followed for PBC, without any selection or exclusion, and fill in the database provided.

Optimal cure rate by personalized HCV regimens in real-life: a proof-of-concept study.

Background: Pretreatment evaluation of HCV-infected patients is a complex interplay between multiple clinical and viral parameters, leading to a tailored approach that may bring real-life sustained virological response (SVR) rates close to 98%-99%.

Objectives: As proof-of-concept, we evaluated the efficacy of all-oral direct-acting antiviral (DAA) regimens in patients whose personalization included pre-therapy evaluation of natural resistance-associated substitutions (RASs), in addition to international guideline recommendations.

Methods: One hundred and thirty-one patients who started a first-line all-oral DAA regimen between April 2015 and December 2016 were tested for baseline NS3 and NS5A RASs by Sanger sequencing.

Multiclass HCV resistance to direct-acting antiviral failure in real-life patients advocates for tailored second-line therapies.

Background & Aims: Despite the excellent efficacy of direct-acting antivirals (DAA) reported in clinical trials, virological failures can occur, often associated with the development of resistance-associated substitutions (RASs). This study aimed to characterize the presence of clinically relevant RASs to all classes in real-life DAA failures.

Methods: Of the 200 virological failures that were analyzed in 197 DAA-treated patients, 89 with pegylated-interferon+ribavirin (PegIFN+RBV) and 111 without (HCV-1a/1b/1g/2/3/4=58/83/1/6/24/25; 56.

Efficacy and safety of sofosbuvir/simeprevir plus flat dose ribavirin in genotype 1 elderly cirrhotic patients: A real-life study.

Background & Aims: The proportion of HCV-infected patients over age 65 years in Western countries is increasing. This growth and the advent of new antiviral therapy bring into the question the real-world efficacy and safety of the combination of sofosbuvir (SOF) and simeprevir (SMV) plus a flat dose of 800 mg/d ribavirin (RBV) in elderly patients with cirrhosis compared to younger patients.

Methods: Retrospective observational multicentre real-life investigation study of SOF/SMV/RBV for a duration of 12 weeks in HCV genotype 1-infected patients with cirrhosis.

Non insulin-dependent diabetes mellitus (type 2) secondary failure. Metformin-glibenclamide treatment.

The goal of sulphonylurea (S) treatment in Non-Insulin-Dependent Diabetes Mellitus (NIDDM - type 2 diabetes) subjects should be to obtain a satisfactory glycemic control (fasting glycemic levels < 140 mg%). The loss of an adequate blood glucose control after an initial variable period of S is known as secondary failure (SF). The number of SF are extremely variable among different trials for many reasons, some of which are patient-related: increased food intake, weight gain, non-compliance, poor physical activity, stress, diseases and÷or impaired pancreatic beta cell function, desensitization after S chronic therapy, reduced absorption, concomitant therapies.

Zafirlukast versus budesonide on bronchial reactivity in subjects with mild-persistent asthma.

Asthma is one of the most common chronic diseases in children and adults. Recent studies have shown that in asthmatic patients treated with inhaled corticosteroids there is a better disease’s control when adding a second drug, than increasing the corticosteroid’s dose. The aim of this study has been to evaluate the effectiveness and tolerance of zafirlukast, a leukotriene receptor antagonist, versus budesonide in clinically steady patients with mild persistent bronchial asthma.

Ureaplasma urealyticum as a possible cause of reflex sympathetic dystrophy syndrome.

We describe the cases of two patients with clinical and radiological findings of the reflex sympathetic dystrophy syndrome (RSDS) in whom the history of a previous genito-urinary inflammation and high levels of ESR lead us to suspect a hidden reactive arthritis. However, instrumental examinations showed a characteristic picture of RSDS without evident signs of arthritis. In both patients we decided a treatment with quinolones because of detection of an ureaplasma urealyticum genito-urinary infection.

New medical licensing examination using computer-based case simulations and standardized patients.

Purpose: To evaluate a new method, used for the first time in Italy, of administering the Medical Licensing Examination (MLE).

Method: Eighty medical school graduates taking the MLE were studied. The MLE was based on the Multimedia Integrated Pilot Project (MIPP), a single two-step examination that combines computer-based case simulations (step 1) and clinical encounters using standardized patients (step 2).

Clinical nutrition: inadequate teaching in medical schools.

Background And Aim: The teaching of Clinical Nutrition (CN) is frequently neglected in Medical Schools, though many official institutions strongly recommend its incorporation in their curricula. This work aimed to assess CN knowledge among final-year medical students and final-year dietology diploma students.

Methods And Results: We compared the performances of final-year Medical School students who did and who did not take the CN course and final-year dietology students in a computer-based multiple choice question examination related to core CN competencies that primary-care physicians and dieticians should know and be able to put into practice.

[Professional licensing examination. Innovative experience: the Integrated Multimedia Pilot Project of the Chieti University].

The Medical Licensing Examination (MLE) is governed, in Italy, by a law enacted in 1956. An ideal clinical competence assessment tool should effectively, reliably and objectively measure all the components of clinical competence: basic knowledge and clinical skills as history-taking, performing a physical examination, formulating the most likely diagnosis, establishing a management plan, communication and interpersonal relations. Since 1998 first session of the MLE, Chieti University implemented computer-based case simulations and standardized patients in the Multimedia Integrated Pilot Project (MIPP) administration.

Does holiday hypoglycaemia exist?

Background: To determine whether an excessive, prolonged and, above all, unusual physical exertion could be associated with episodes of mild hypoglycaemia in non-insulin-dependent diabetes mellitus (NIDDM) patients treated with glibenclamide.

Experimental Design: 11 months of observation with retrospective analysis of patient personal diaries to determine the hypoglycaemic risk.

Setting: Diabetic Unit-Department of Medicine and Aging-Chieti University School of Medicine.

Risk factors for hypertension in obese women. The role of weight cycling.

Objective: To study significant factors associated with the risk of hypertension among obese women, with and without a history of weight cycling (WC).

Design: Case-control study.

Setting: Obesity Clinic of Chieti University, Italy.

Impact of different scoring methods on the clinical skills assessment of internal medicine students.

The aim of this study was to determine how different scoring methods could influence the results achieved in clinical competence assessment examinations at the end of the medical school curriculum. Fifty-six final-year medical school students were examined using a programme of multimedia computer-based simulated cases (Procuste programme). For generating results, the following scoring methods were applied: (1) the method used for the Internal Medicine official certification examination which includes both weighted and unweighted items; (2) a method with only unweighted items;(3) a method which includes single-item analysis.

Weight fluctuations could increase blood pressure in android obese women.

Recent studies have documented a relationship between increased morbidity and mortality from cardiovascular diseases and a history of weight cycling (WC) in obese subjects. We performed a cross-sectional analysis in 96 weight-cycling android obese women, matched with 96 non-weight-cycling android obese women by age, body mass index (BMI) and waist-to-hip ratio (WHR), to evaluate any increase in blood pressure (BP) levels in association with WC. The patients were all between 20 and 45 years old, were non-menopausal, did not smoke, did not take any medication, had normal glucose tolerance and were otherwise healthy.

[Assessment of clinical competence of medical school graduates in Italy with standardized patients. The opinion of the examinees].

An international collaborative project for the evaluation of clinical competence at the end of the Medical School curriculum using the ECFMG-CSA (Educational Commission for Foreign Medical Graduates--Clinical Skills Assessment) prototype was started in Italy in April 1996. Faculty representatives from Italian Medical Schools and experts from the ECFMG in Philadelphia participated in the Project. The CSA consists of integrated clinical encounters with 10 standardized patients during which the examinee is asked to obtain a focused history, perform a relevant physical examination and communicate initial diagnoses and management plan to the Standardized Patient (SP).

Association between anthropometric and ultrasound measurements of fatness with ambulatory blood pressure monitoring in obese women.

Objective: An association between body fat distribution indices and the amount of visceral adipose tissue (AT) with blood pressure (BP) has been documented. However, most studies used casual morning BP values as the dependent variable. The aim of our study was to identify which of the obesity indices (the body mass index (BMI), waist-to-hip ratio (WHR), sagittal diameter or visceral (AT) measured by ultrasonography (US)) better correlated with BP determined by 24 h ambulatory monitoring.