Publications by authors named "Pizzol Antonio"

: Over the past decade, TNF inhibitors such as Infliximab and Adalimumab have become central to Inflammatory Bowel Diseases treatment, greatly enhancing patient outcomes. However, immunogenicity-where anti-drug antibodies diminish effectiveness-remains an issue, often requiring dose changes or combination therapies. Pharmacogenomics is increasingly applied in IBD to personalise treatment, especially since genetic factors like the HLA-DQA1*05 variant heighten the immunogenicity risk with IFX.

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Menetrier's disease (MD) is a protein-losing gastropathy characterized by acute generalized edema due to hypoalbuminemia. MD is rare in childhood, and it is commonly associated with cytomegalovirus infection. We reported two children, who presented with a history of generalized edema after some days of abdominal pain and diarrhea.

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  • The study investigates foreign body ingestion (FBI) in children under 18 in Italy, highlighting the prevalence and trends from 2015 to 2020.
  • A total of 5,771 cases were analyzed, with the majority occurring at home, mostly involving children under 6, and commonly featuring blunt objects.
  • The results indicate stable rates of FBI over time, urging the importance of preventive strategies to protect young children, especially those 5 and under, from such incidents.
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Background And Aims: Upper endoscopy (UE) procedures (EGD and ERCP) are an established standard of care in pediatric gastroenterology. The Pediatric Endoscopy Quality Improvement Network (PEnQuIN) recently published its pediatric-specific endoscopy quality guidelines. This study, initiated by the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition, aims to evaluate the adherence of Italian pediatric endoscopy centers (PECs) to these established quality standards.

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Jansen-de Vries syndrome (JdVS) is a neurodevelopmental condition attributed to pathogenic variants in Exons 5 and 6 of PPM1D. As the full phenotypic spectrum and natural history remain to be defined, we describe a large cohort of children and adults with JdVS. This is a retrospective cohort study of 37 individuals from 34 families with disease-causing variants in PPM1D leading to JdVS.

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Background: Aim of the present report was to investigate the repercussions of COVID-19 pandemic on the procedural volumes and on the main indications of pediatric digestive endoscopy in Italy.

Methods: An online survey was distributed at the beginning of December 2020 to Italian digestive endoscopy centers. Data were collected comparing two selected time intervals: the first from 1st of February 2019 to 30th June 2019 and the second from 1st February 2020 to 30th June 2020.

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Objectives: The incidence of choledocolithiasis is reported to be increasing in children. As for the adult population, several different therapeutic strategies have been described, however it is unclear which of those should be considered the gold standard. There is evidence-based literature in adults that supports a combined "rendez-vous" endoscopic retrograde cholangiopancreatography-laparoscopic cholecystectomy technique.

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BACKGROUND Intussusception is the most common cause of intestinal obstruction in children, with a peak incidence usually before the second year of age, while in neonates it is a rare entity. We describe a delayed and incidental diagnosis of neonatal intussusception secondary to Meckel's diverticulum in a neonate with shaken baby syndrome (SBS). This is, to the best of our knowledge, the first reported case of a neonatal intussusception with a Meckel's diverticulum as a lead point in a neurologically impaired child.

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Human endogenous retroviruses (HERVs) represent 8% of our genome. Although no longer infectious, they can regulate transcription of adjacent cellular genes, produce retroviral RNAs, and encode viral proteins that can modulate both innate and adaptive immune responses. Based on this, HERVs have been studied and proposed as contributing factors in various autoimmune disorders.

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Background: The impact of graft fibrosis and inflammation on the natural history of pediatric liver transplants is still debated. Our objectives were to evaluate the evolution of posttransplant fibrosis and inflammation over time at protocol liver biopsies (PLBs), risk factors for fibrosis, presence of donor-specific antibodies (DSAs), and/or their correlation with graft and recipient factors.

Methods: A single-center, retrospective (2000-2019) cross-sectional study on pediatric liver transplant recipients who had at least 1 PLB, followed by a longitudinal evaluation in those who had at least 2 PLBs, was conducted.

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  • Tacrolimus pharmacokinetics in pediatric liver transplant recipients are affected by the donor's CYP3A5 genotype and the recipient's age, suggesting a need for a genotype-based dosing algorithm.
  • GRWR is a significant factor influencing TAC dosing, with younger children receiving grafts with a higher GRWR compared to older children.
  • In the study, higher GRWR was linked to lower TAC concentration relative to weight and increased risk of acute rejection, highlighting the importance of adjusting TAC doses based on donor genetics and graft characteristics.
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Objectives: The aims of the study was to expand the pediatric experience on hepatitis-B virus (HBV) reactivation, a known complication in patients with hematologic malignancies or on immunosuppression.

Methods: Retrospective appraisal of HBV therapy/prophylaxis in immunocompromised children, studied from April 2006 to March 2020.

Results: Eighteen HBV-positive patients, 5 girls, median age 11.

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In February 2020, the COVID-19 pandemic overwhelmed Italy. We retrospectively reviewed all attendances and emergency (A&E) admissions due to foreign-body ingestions (FBIs) to an Italian pediatric referral hospital, from February 24 to April 24, 2020, COVID-19 lockdown and compared them with the same period in the previous 4 years. A total of 101 cases were recorded.

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  • Calprotectin is a protein made from S100A8 and S100A9 that plays a key role in indicating inflammation in the gastrointestinal (GI) tract by correlating with neutrophil movement.
  • Fecal calprotectin (FC) is a valuable diagnostic marker for distinguishing between inflammatory and non-inflammatory GI conditions and is associated with various diseases such as gastroenteritis and cancer.
  • The review focuses on the effectiveness of measuring FC in pediatric patients, emphasizing the need for better guidelines to prevent overlooking serious conditions and minimize the necessity for invasive diagnostics like colonoscopy.
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Background: paucity of interlobular bile ducts is an important observation at liver biopsy in the diagnostic work-up of neonatal cholestasis. To date, other than in the Alagille syndrome, syndromic paucity of interlobular bile ducts has been documented in four cholestatic neonates with HFN1β mutations. A syndromic phenotype, known as renal cysts and diabetes syndrome (RCAD), has been identified.

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Although about 35 years have elapsed since the discovery of the Helicobacter pylori, its diagnosis and the choice of optimal eradication therapy are still to be defined. Over time, there has been an increase in interest, publications, recommendations and guidelines. Moreover, management of the disease in pediatric subjects differs somewhat to that of adults and requires a more delicate approach leading to alternative strategies for both diagnosis and treatment.

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  • Liver biopsies in pediatric HSCT patients are equally effective when done at bedside in the BMTU compared to the DSU, with lower emotional stress for the children.
  • In a study of 45 children, those biopsied in the BMTU had significantly less agitation (16.1%) compared to those in the DSU (58.3%), indicating better patient compliance.
  • Complication rates were similar between the two locations, with minor complications occurring more in the DSU (25%) than the BMTU (16%), suggesting that bedside procedures are just as safe.
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  • Acquired torticollis is a frequent finding in children in emergency care and can indicate various medical issues like trauma, infections, or tumors.
  • Spondylodiscitis, a rare low-grade bacterial infection affecting the cervical spine, can be a potential cause of torticollis in children.
  • A case of a 4-year-old with painful torticollis revealed high inflammation markers and MRI findings consistent with cervical spondylodiscitis, which improved with antibiotic treatment, suggesting MRI should be considered for unexplained torticollis cases.
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  • BK polyomavirus commonly infects people, but serious symptoms primarily occur in those with weakened immune systems, like transplant patients.
  • A 15-year-old girl with leukemia had a hematopoietic stem cell transplant and experienced a reactivation of the virus leading to severe urinary and kidney issues.
  • This case highlights an unusual immune response (polyclonal gammopathy) linked to kidney damage caused by the BK virus, confirmed through detailed medical tests.
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  • Defibrotide (DFT) is studied as a potential treatment for veno-occlusive disease (VOD) and its impact on neutrophil engraftment in pediatric hematopoietic stem cell transplantation (HSCT) patients.
  • A retrospective analysis of 44 pediatric patients revealed significant differences in the time to neutrophil and white blood cell engraftment between those receiving DFT prophylaxis and those who did not.
  • The findings suggest that DFT prophylaxis may delay the engraftment of polymorphonuclear neutrophils in children undergoing HSCT.
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Background: Torquetenovirus (TTV) represents a commensal human virus producing life-long viremia in approximately 80% of healthy individuals of all ages. A potential pathogenic role for TTV has been suggested in immunocompromised patients with hepatitis of unknown etiology sustained by strong proinflammatory cytokines.

Objectives: The aim of this study was to investigate the sera immunological profile linked to TTV infection in bone marrow transplant (BMT) children with liver injury.

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