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Individually administered or co-prescribed thiopurines and mesalamines for inflammatory bowel disease

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World Journal of Gastroenterology 2009年第12期15卷 1420-1426页

作者： Giovanni C Actis rinaldo pellicano Mario Rizzetto Muhammad Ayoubi Nicola Leone Gianfranco Tappero Paola Pazienza Floriano Rosina Division of Gastro-Hepatology Ospedale GradenigoTorino 10153Italy Division of Gastroenterology Ospedale MolinetteTorino 10153Italy

Data from both basic research and clinical experience continue to suggest that mesalamines and thioputines are effective and efficient for the maintenance of remission of inflammatory bowel diseases. Several decades following the formalization of their indications, attention on these two drugs has been fostered by recent achievements. Demonstration of the ability of mesalamine to activate a colonocyte differentiation factor has shed light on its chemopreventive effects on colorectal cancer; in addition to their anti-proliferative efficacy, thiopurines have been shown to be specific regulators of apoptosis. The two drugs are often coadministered in clinical practice. Recent advancements have shown that mesalamines exert a positive synergism in this context, insofar as they can inhibit sidemethylation of thiopurines and hasten the function of the main immunosuppressive pathways. Considering that up to 40% of patients cannot tolerate thiopurines, such renovated targets have stimulated efforts to improve compliance by research on the toxicity mechanisms. The definition of genetic polymorphisms in the enzymes of thiopurine metabolism, and the uncovering of synergistic drug interactions, such as that with allopurinol, are just two of the results of such efforts. Interaction between basic research and clinical practice has continued to inform indications and refine the prescriptions of mesalamines and thiopurines; these have not been restrained （they have been implemented in some cases） by the advent of the novel biological molecules with anti-cytokine activity.

关键词： Inflammatory bowel disease Mesalamine Thiopurines Azathioprine Remission Drug toxicity

Plasma erythropoietin levels in anaemic and non-anaemic patients with chronic liver diseases

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World Journal of Gastroenterology 2004年第9期10卷 1353-1356页

作者： Cosimo MarcelloBruno Sergio Neri ClaudioSciacca Gaetano Bertino Pietro DiPrima Danila Cilio Luciano Caruso Raffaello Cristaldi rinaldo pellicano Department of Internal Medicine and Sistemic Diseases University of CataniaItaly Department of Gastro-Hepatology Molinette HospitalTorinoItaly

AIM: To investigate the serum erythropoietin (Epo) levels in patients with chronic liver diseases and to compare to subjects with iron-deficiency anaemia and healthy ***: We examined 31 anaemic (ALC) and 22 non-anaemic (NALC) cirrhotic patients, 21 non-anaemic subjects with chronic active hepatitis (CAH), 24 patients with iron-deficiency anaemia (ID) and 15 healthy controls. Circulating Epo levels (ELISA; R&D Systems, Europe Ltd, Abingdon,UK) and haemoglobin (Hb) concentration were determined in all ***: Mean±SD of Epo values was 26.9±10.8 mU/mL in ALC patients, 12.5±8.0 mU/mL in NALC subjects,11.6±6.3 mU/mL in CAH patients, 56.4±12.7 mU/mL in the cases of ID and 9.3±2.6 mU/mL in controls. No significant difference (P>0.05) was found in Epo levels between controls, CAH and NALC patients. ALC individuals had higher Epo levels (P<0.01) than these groups whereas ID subjects had even higher levels (P<0.001) than patients suffering from ***: Increased Epo values in cirrhotics, are only detectable when haemoglobin was lesser than 12 g/***, this rise in value is lower than that observed in anaemic patients with iron-deficiency and appears blunted and inadequate in comparison to the degree of anaemia.

关键词： Aged Anemia, Iron-Deficiency Erythropoietin Female Hemoglobins Hepatitis, Chronic Humans Liver Cirrhosis Male Middle Aged Regression Analysis

Lack of association between seroprevalence of Helicobacterpylori infection and primary biliary cirrhosis

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World Journal of Gastroenterology 2004年第21期10卷 3179-3181页

作者： Marilena Durazzo Floriano Rosina Alberto Premoli Enrico Morello Sharmila Fagoonee Rosaria Innarella Enrico Solerio rinaldo pellicano Mario Rizzetto Department of Internal Medicine Unitersity of TurinTurinItaly Department of Gastroenterology Gradenigo HospitalTurinltaly Department of Biology Biochemistry and GeneticsUniversity of TurinTurinltaly Department of Gastroenterology Molinette HospitalTurinltaly

AIM:To determine the association between seroprevalence of Helicobacter pylori(H pylori)infection and primary biliary cirrhosis(PBC). METHODS:In this case-control study,149 consecutive patients(10 males,139 females,mean age 58.2±11 years, range 26-82 years)suffering from PBC and 619 consecutive healthy volunteer blood donors(523 males,96 females, mean age 47±5.3 years,range 18-65 years)attending the Hospital Blood Bank and residing in the same area were recruited.A commercial enzyme linked immunosorbent assay was used to detect anti-H pylori(IgG)antibodies in serum. RESULTS:AnUbodies to Hpyloriwere present in 78(52.3%) out of 149 PBC-patients and in 291(47%)out of 619 volunteers(P=0.24,OR 1.24,95% CI 0.85-1.80).In the subjects less than 60 years old,the prevalence of H pylori infection among PBC-patients(40/79)was slightly higher than in controls(50.6% vs 46.2%)P=0.46,OR=1.19,95% CI:0.72-1.95).In those over 60 years,the prevalence of Hpylori infection was similar between PBC-patients and controls(54.2% vs57.8%,P=0.7,OR 0.86,95% CI 0.36- 2.07). CONCLUSION:There is no association between seroprevalence of H pylori in fection and primary biliary cirrhosis.

关键词： Adult Aged Aged, 80 and over Antibodies, Bacterial Case-Control Studies Female Helicobacter Infections Helicobacter pylori purification Humans Liver Cirrhosis, Biliary Male Middle Aged Research Support, Non-U.S. Gov't Seroepidemiologic Studies

Inflammatory bowel disease:Efficient remission maintenance is crucial for cost containment

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2017年第2期8卷 114-119页

作者： Giovanni C Actis rinaldo pellicano the Medical Center Practice Office Hepatogastroenterology Division Ospedale Gradenigo Unit of Gastroenterology Ospedale Molinette

The inflammatory bowel diseases(IBD) are chronicincurable inflammatory disorders of the gut. Some 10% run a downhill course, requiring emergency medical support and often surgery; another small subset are monogenic, and, threatening pediatric patients, are the challenge of these days. The majority of the IBDs, however, are polygenic low-penetrance diseases, running a lifetime waxing-and-waning course. The prevalent trend is towards a slow worsening and steady cost increase. Each and all drugs of the available arsenal exhibit strengths and weaknesses: Mesalamines are chiefly effectively for mildmoderate colitis, and do not work in Crohn's; steroids do not control some 40% of the ulcerative colitis cases, and are not indicated for Crohn's; thiopurines are effective in the maintenance of the IBDs but do not prevent relapses on withdrawal; biologics are still being used empirically(not monitored) causing further increase of their cost over that of hospitalization. Against all these caveats, two simple rules still hold true: Strict adherence maintenance and avoidance of colitogenic drugs. This matter is expanded in this minireview.

关键词： Inflammatory bowel disease Therapy Cost containment Budget Treatment adherence Inflammatory bowel disease managed care

IL28B polymorphism genotyping as predictor of rapid virologic response during interferon plus ribavirin treatment in hepatitis C virus genotype 1 patients

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World Journal of Gastroenterology 2014年第36期20卷 13146-13152页

作者： Chiara Rosso Maria Lorena Abate Alessia Ciancio Silvia Strona Gian Paolo Caviglia Antonella Olivero Giovanni Antonio Touscoz Mario Rizzetto rinaldo pellicano Antonina Smedile Department of Medical Science University of Turin 10123 Turin Italy Department of Gastroenterology and Hepatology Molinette Hospital 10126 Turin Italy

AIM: To clarify the association of interleukin-28B (IL28B) single nucleotide polymorphisms (SNPs) with hepatitis C virus (HCV) viremia changes for assessment of interferon (IFN) response.

关键词： Hepatitis C virus-G1 Interleukin-28B rs12979860 Interleukin-28B rs8099917 Interferon sensitivity Triple therapy

Interferon β-1a alone or in combination with ribavirin: A randomized trial to compare efficacy and safety in chronic hepatitis C

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World Journal of Gastroenterology 2005年第29期11卷 4484-4489页

作者： rinaldo pellicano Antonio Craxì Piero Luigi Almasio Mario Valenza Giovanna Venezia Alfredo Alberti Silvia Boccato Luigi Demelia Orazio Sorbello Antonino Picciotto Francesco Torre Gaetano Ideo Carlo Cattaneo Mara Berrutti Mario Rizzetto U.O.A.D.U. Gastro-Hepatology S. Giovanni Battista (Molinette) Hospital Turin Italy Venezia Department of Gastroenterology and Hepatology University of Palermo Italy Department of Internal Medicine University of Padua Italy Institute of Clinical Medicine University of Cagliari Italy Department of Internal Medicine University of Genoa Italy Department of Hepatology San Giuseppe Hospital Milan Italy U.O.A.D.U. Gastro-Hepatoiogy S. Giovanni Battista (Molinette) Hospital Turin Italy

AIM： To compare the efficacy and safety of recombinant human IFN β-la alone or in combination with ribavirin in treatment-naive subjects with chronic hepatitis C. METHODS： Open, randomized trial was performed in 6 Italian tertiary centers： 102 of the 108 patients screened were randomized to receive 6 MIU of recombinant human IFN β-la subcutaneously daily for 24 wk, alone （Group 1, n = 51） or in combination with ribavirin 1 000 to 1 200 mg/d （Group 2, n = 51）. RESULTS： The end-of-treatment virologic response rate was 29.4% in Group 1 and 41.2% in Group 2 （nonsignificant）. Twenty-four weeks after stopping therapy, sustained virologic response rate was 21.6% in Group 1 and 27.4% in Group 2 （non-significant）. All subjects in Group 1 completed treatment, while two subjects in Group 2 stopped therapy due to treatment-related adverse events. CONCLUSION： Recombinant human IFN β-la, alone or in combination with ribavirin, has an excellent safety profile and, may represent an alternative for chronic hepatitis C patients who are unable to tolerate pegylated α-interferon.

关键词： Chronic hepatitis C IFN β-1a Ribavirin

Endoscopic ultrasound in common bile duct dilatation with normal liver enzymes

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World Journal of Gastrointestinal Endoscopy 2015年第8期7卷 799-805页

作者： Claudio De Angelis Milena Marietti Mauro Bruno rinaldo pellicano Mario Rizzetto Department of Gastroenterology and Digestive Endoscopy "Città della Salute e della Scienza"University of Turin

In recent years,the description of isolated bile duct dilatation has been increasingly observed in subjects with normal liver function tests and nonspecific abdominal symptoms,probably due to the widespread use of high-resolution imaging ***,there is scant literature about the evolution of this condition and the impact of endoscopic ultrasound(EUS)in the diagnostic work *** noninvasive imaging tests(transabdominal ultrasound,computed tomography or magnetic resonance cholangiopancreatography)fail to identify the cause of dilatation and clinical or biochemical alarm signs are absent,the probability of having biliary disease is considered *** this setting,using EUS,the presence of pathologic findings(choledocholithiasis,strictures,chronic pancreatitis,ampullary or pancreatic tumors,cholangiocarcinoma),not always with a benign course,has been *** aim of this review has been to evaluate the prevalence of disease among nonjaundiced patients without signs of cytolysis and/or cholestasis and the assessment of EUS *** point out to a promising role of EUS in the identification of a potential biliary *** is a low invasive technique,with high accuracy,that could play a double cost-effective role:identifying pathologic conditions with dismal prognosis,in asymptomatic patients with negative prior imaging tests,and excluding pathologic conditions and further follow-up in healthy subjects.

关键词： Unexplained common bile duct dilatation Endoscopic ultrasound Normal liver enzymes

Erythropoietin in liver cirrhosis: Two questions without answers

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World Journal of Gastroenterology 2005年第23期11卷 3649-3649页

作者： Cosimo Marcello Bruno Claudio Sciacca Danila Cilio Gaetano Bertino rinaldo pellicano Department of Internal Medicine and Systemic Diseases Department of Gastro-Hepatology

TO THE EDITORIn a recent paper[1], and in a subsequent letter[2], Tacke et al. reported the investigation of plasma erythropoietin (Epo) levels in patients affected by chronic liver disease of various aetiologies. The authors also compared[2] their data to our previous work[3]. The results show a substantial agreement but also some important differences between the two works. We would like to highlight, from our point of view, this issue. Both the papers demonstrated increased Epo values in anaemic cirrhotic subjects when compared to healthy controls and non-anemic patients with liver disease.

关键词： Erythropoietin Liver cirrhosis

Helicobacter pylori infection and asthma:Is there a direct or an inverse association?A meta-analysis

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World Journal of Meta-Analysis 2016年第3期4卷 63-68页

作者： Davide Giuseppe Ribaldone Sharmila Fagoonee Jacopo Colombini Giorgio Saracco Marco Astegiano rinaldo pellicano Gastroen--terology-U Department of General and Specialist MedicineCittà della Salute e della Scienza of Turin Institute for Biostructures and Bioimages- CNR c/o Molecular Biotechnology Center University of Turin Otorhinolaryngoiatry-2 Department of General and Specialist SurgicalCittà della Salute e della Scienza of Turin Department of Oncology San Luigi Hospital Department of Gastroenterology and Hepato-logy Molinette Hospital

AIM:To analyze the consistency of a potential involvement of the bacterium infection in the asthma disease. METHODS:A systematic literature search of the terms "Helicobacter pylori "(H. pylori) associated to "asthma" using PubM ed,Scopus and the Cochrane Library Central was performed. Reference lists from published articles were also employed. Titles of these publications and their abstracts were scanned in order to eliminate duplicates and irrelevant articles. The criteria of inclusion of the studies were:Original studies; the H. pylori diagnostic method has been declared; all ranges of age have been included in our study; a definitive diagnosis of asthma has been ***:We selected 14 articles in which the association between the two conditions was addressed. In 7 studies the prevalence of H. pylori infection in the asthma population and in the control population was made explicit. There was heterogeneity between the studies(Cohran's Q = 0.02). The H. pylori infection in the asthma population resulted 33.6%(518 of 1542),while in the control population resulted 37.6%(2746 of 7310)(relative risk of H. pylori infection in the asthma population = 0.87,95%CI:0.72-1.05,P = 0.015,random effects model). Instead,considering the morevirulent strains,the majority of studies showed an inverse relationship between the prevalence of H. pylori infection and ***:In our meta-analysis the prevalence of H. pylori infection in the asthma population resulted not statistically significant lower than in control population(P = 0.15). Instead,considering the more virulent strains,the majority of studies showed an inverse relationship between the prevalence of H. pylori infection and asthma.

关键词： Allergic diseases Asthma Extragastric manifestations Helicobacter pylori Hygiene