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Efficacy of a therapeutic strategy for eradication of Helicobacter pylori infection

World Journal of Gastroenterology 2012年第33期18卷 4542-4548页

作者： Giuliana Sereni Francesco Azzolini Lorenzo Camellini Debora Formisano Francesco Decembrino Veronica Iori Cristiana Tioli Maurizio Cavina Francesco Di Mario giuliano bedogni Romano Sassatelli Unit of Gastroenterology and Digestive Endoscopy Arcispedale Santa Maria Nuova Istituto di Ricovero e Cura a Carattere Scientifico 42123 Reggio Emilia Italy Statistics and Clinical Epidemiology Unit Arcispedale Santa Maria Nuova Istituto di Ricovero e Cura a Carattere Scientifico 42123 Reggio Emilia Italy Unit of Gastroenterology Ospedale S. Maria di Ca' Foncello 31100 Treviso Italy

AIM: To determine the efficacy of our therapeutic strategy for Helicobacter pylori (H. pylori) eradication and to identify predictive factors for successful eradication. METHODS: From April 2006 to June 2010, we retrospectively assessed 2428 consecutive patients (1025 men, 1403 women; mean age 55 years, age range 18-92 years) with gastric histology positive for H. pylori infection referred to our unit for 13-C urea breath test(UBT), after first-line therapy with proton pump inhibitor (PPI) b.i.d. + amoxicillin 1 g b.i.d. + clarithromycin 500 mg b.i.d. for 7 d. Patients who were still positive to UBT were recommended a second-line therapy (PPI b.i.d. + amoxicillin 1 g b.i.d. + tinidazole 500 mg b.i.d. for 14 d). Third choice treatment was empirical with PPI b.i.d. + amoxicillin 1 g b.i.d. + levofloxacin 250 mg b.i.d. for 14 d. RESULTS: Out of 614 patients, still H. pylori-positive after first-line therapy, only 326 and 19 patients respectively rechecked their H. pylori status by UBT after the suggested second and third-line regimens. "Per protocol" eradication rates for first, second and thirdline therapy were 74.7% (95% CI: 72.7%-76.4%), 85.3% (95% CI: 81.1%-89.1%) and 89.5% (95% CI: 74.9%-103%) respectively. The overall percentage of patients with H. pylori eradicated after two treatments was 97.8% (95% CI: 97.1%-98.4%), vs 99.9% (95% CI: 99.8%-100%) after three treatments. The study found that eradication therapy was most effective in patients with ulcer disease (P < 0.05, P = 0.028), especially in those with duodenal ulcer. Smoking habits did not significantly affect the eradication rate. CONCLUSION: First-line therapy with amoxicillin and clarithromycin produces an H. pylori eradication rate comparable or superior to other studies and secondline treatment can still be triple therapy with amoxicillin and tinidazole.

关键词： Helicobacter pylori Eradication treatment Rescue therapy Eradication rate Triple therapy Firstline therapy Second-line therapy

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Epidemiology of fatty liver: An update

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World Journal of Gastroenterology 2014年第27期20卷 9050-9054页

作者： Giorgio bedogni Valerio Nobili Claudio Tiribelli Liver Research Center Fondazione Italiana Fegato-ONLUS 34013 Trieste Italy International Center for the Assessment of Nutritional Status University of Milan 20126 Milan Italy Liver Research Unit Bambino Gesù Children’s Hospital IRCCS 00149 Rome Italy Department of Medical Sciences University of Trieste 34013 Trieste Italy

We provide a concise review of the main epidemiological literature on fatty liver(FL) published between January 2011 and October 2013. The findings from the literature will be considered in light of the already available knowledge. We discuss the limitations inherent in the categorization of FL into non-alcoholic and alcoholic FL, the potential relevance of FL as an independent predictor of cardiometabolic disease, and recent research addressing the role of FL as an independent predictor of mortality. This review is organized as a series of answers to relevant questions about the epidemiology of FL.

关键词： Fatty liver Epidemiology

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Impact of severe left ventricular dysfunction on mid-term mortality in elderly patients undergoing transcatheter aortic valve implantation

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Journal of Geriatric Cardiology 2016年第4期13卷 290-298页

作者： Giuseppe Ferrante Patrizia Presbitero Paolo Pagnotta Anna Sonia Petronio Nedy Brambilla Federico De Marco Claudia Fiorina Cristina Giannini Fabrizio D'Ascenzo Silvio Klugmann Marco L Rossi Federica Ettori Francesco bedogni Luca Testa Department of Cardiovascular Medicine Humanitas Research Hospital Rozzano Italy Cardiothoracic and Vascular Department Azienda Ospedaliero-Universitaria Pisana Pisa Italy Department of Cardiology IRCCS Pol. S. Donato S. Donato Milanese Milan Italy Department of lnterventional Cardiology Niguarda Ca' Granda Hospital Milan Italy Cardiothoracic Department Spedali Civili di Brescia Brescia Italy Cardiothoracic Department Ospedale Molinette Torino Italy

Background Whether patients with reduced left ventricular function present worse outcome after transcatheter aortic valve implantation （TAVI） is controversial. The aim of this study was to assess the impact of baseline severe impairment of left ventricular ejection fraction （LVEF） on mortality after TAVI. Methods Six-hundred-forty-nine patients with aortic stenosis underwent TAVI with the CoreValve system （92.8%） or the Edwards SAPIEN valve system （7.2%）. Baseline LVEF was measured by the echocardiographic Simpson method. The impact of LVEF 〈 30% on mortality was assessed by Cox regression. Results Patients with LVEF 〈 30% （n = 63）, as compared to those with LVEF 〉 30% （n = 586）, had a higher prevalence of NHYA class 〉 2 （P 〈 0.001） and presented with a higher Euroscore （P 〈 0.001）. Procedural success was similar in both groups （98.4% vs. 97.2%, P = 1）. After a median follow-up of 436 days （25^-75th percentile, 357-737 days）, all-cause mortality [23.8% vs. 23.7%, P = 0.87, hazard ratios （HR）： 0.96, 95% confidence intervals （CI）： 0.56-1.63] and cardiac mortality （19.1% vs. 17.6%, P = 0.89, HR： 1.04, 95% CI： 0.57-1.90） were similar in patients with LVEF 〈 30% as compared to those with LVEF 〉 30%. Thirty-day all-cause mortality was not significantly different between the two groups （11.1% vs. 6.3%, P = 0.14, HR： 1.81, 95% CI： 0.814.06）. Patients with LVEF 〈 30% had a trend toward higher risk of 30-day cardiac mortality （11.1% vs. 5.3%; P = 0.06, HR： 2.16, 95% CI： 0.95-4.90）, which disappeared after multivariable adjustment （P = 0.22）. Conclusions Baseline severe impairment of LVEF is not a predictor of increased short-term and mid-term mortality after TAVI. Selected patients with severe impairment of left ventricular function should not be denied TAVI.

关键词： Left ventricular ejection fraction Mortality Transcatheter aortic valve implantation

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非酒精性脂肪肝的发病率及危险因素:饮酒与肝脏的研究

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世界核心医学期刊文摘（胃肠病学分册） 2005年第10期1卷 37-38页

作者： bedogni G. Miglioli L. Masutti F. S. Bellentani 李翔 Fonda Studio Malattie Fegato-ONLUS Sezione di Campogalliano Via R. Luxemburg 29/N 41011Ca-mpogalliano (MO) Italy

The prevalence of and the risk factors for fatty liver have not undergone a formal evaluation in a representative sample of the general population. We therefore performed a cross-sectional study in the town of Campogalliano (Modena, Italy), within the context of the Dionysos Project. Of 5,780 eligible persons aged 18 to 75 years, 3,345 (58%) agreed to participate in the study. Subjects with suspected liver disease (SLD), defined on the basis of elevated serum alanine aminotransferase (ALT)-and γ-glutamyl-transferase (GGT) activity, hepatitis B surface antigen (HBsAg), or hepatitis C virus (HCV)-RNA positivity, were matched with randomly selected subjects of the same age and sex without SLD. A total of 311 subjects with and 287 without SLD underwent a detailed clinical, laboratory, and anthropometrical evaluation. Fatty liver was diagnosed by ultrasonography, and alcohol intakewas assessed by using a 7-day diary. Multinomial logistic regression was used to detect risk factors for normal liver versus nonalcoholic fatty liver disease (NAFLD) and for alcoholic fatty liver (AFLD) versus NAFLD. The prevalence of NAFLD was similar in subjects with and without SLD (25 vs. 20%, P = .203). At multivariable analysis, normal liver was more likely than NAFLD in older subjects and less likely in the presence of obesity, hyperglycemia, hyperinsulinemia, hypertriglyceridemia, and systolic hypertension; AFLD was more likely than NAFLD in older subjects, males, and in the presence of elevated GGT and hypertriglyceridemia, and less likely in the presence of obesity and hyperglycemia. In conclusion, NAFLD is highly prevalent in the general population, is not associated with SLD, but is associated with many features of the metabolic syndrome.

关键词：酒精性脂肪肝高血糖症收缩期高血压高胰岛素血症高甘油三酯血症典型脂肪肝丙型肝炎病毒代谢综合征计划内容摩德纳

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