25 research outputs found

    Progetto per il concorso internazionale per il waterfront di La Spezia.

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    Progetto per il concorso internazionale per il waterfront di La Spezia. Progetto: Jose Maria Tomas Llavador, Studio Schiattarella, Aldo Mazzanobile Consulenti: Mario Manfroni (progetto urbano) Christian Rocchi (progetto urbano) Valeria Caramagno (verde) Maria Emanuela Lo Monaco (pr.financing) Exa Engineering (strutture e op.marittime) Patrizia Burlando (paesaggio) Collaboratori: Pilar Martì Rodrigo, Paola Schiattarella, Fabrizio Battistelli, Daniela Biavati, Gianluca Bilotta, Gabriele Cossetto, Emidio Di Nicola, Alberto Greti, Ernesto Iacangelo, Sabrina Leone, Carla Maresca, Angela Pizzuti, Alessandra Rapaccini, Alberto Riccioni, Giacomo Sanna, Giorgia Semprini, Vicenç Ferrer

    Serum levels of hyaluronic acid and tissue metalloproteinase inhibitor-1 combined with age predict the presence of nonalcoholic steatohepatitis in a pilot cohort of subjects with nonalcoholic fatty liver disease

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    Hyaluronic acid (HA) and tissue inhibitor of metalloproteinase 1 (TIMP-1) are reliable markers of liver fibrosis and are closely linked to the proinflammatory status. In this pilot cohort study, we attempted to identify a clinical score that would predict the severity of nonalcoholic fatty liver disease (NAFLD) based on clinical variables and serum markers of fibrosis and inflammation. The cohort included 46 patients with histologically confirmed WILD (76.1% male; mean age, 43 +/- 13 years; mean body mass index (BMI), 27.8 +/- 3.5). Serum transforming growth factor beta (TGF-beta), HA, TIMP, and matrix metalloproteinase (MMP) levels were measured with commercial enzyme-linked immunoassay (ELISA) kits. Demographic features and clinical and laboratory findings were subjected to univariate and multivariate binary logistic regression analysis to construct the mathematical model. Receiver operating characteristic curve (ROC) analysis was used to identify a threshold value for diagnosis of NASH and to assess its sensitivity and specificity. Serum levels of HA and TIMP-1 were statistically different in patients with nonalcoholic steatohepatitis (NASH) (P < 0.05). Logistic regression analysis of several clinical variables indicated patient age as the only independent predictor of NASH (odds ratio (OR), 1.129, 95% confidence interval (0), 1.019-1.251, P = 0.020). The mathematical model constructed on the basis of these results included age, TIMP-1, and HA levels. A value of 148.27 or more identified patients with NASH with 85.7% sensitivity, 87.1% specificity, and negative and positive predictive values of 96.4% and 60%, respectively. This model seems to represent a reliable noninvasive tool for excluding the presence of NASH. If validated in larger prospective cohort studies, it might be useful for determining when a liver biopsy is actually warranted in patients with NAFLD. (Translational Research 2009; 154:194-201

    A modern multidisciplinary approach to the treatment of enterocutaneous fistulas in Crohn’s disease patients

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    Introduction: Enterocutaneous fistulas (ECFs) is a manifestation of penetrating Crohn’s disease (CD) that is challenging to treat and has considerable morbidity and mortality rates. Areas covered: This review aims to explore the practical and updated principles for the optimal treatment of ECFs in CD patients. Expert Opinion: Optimal ECF management requires a multidisciplinary approach. Treatment first includes fluid resuscitation and electrolyte rebalancing with control of sepsis by means of antibiotics and, when indicated, drainage of infected collections. Subsequent therapeutic steps include nutritional support, control of the fistula output and treatment of peristomal skin. Anti-TNF-α therapy seems to have limited utility only after sepsis is resolved and intestinal stenosis excluded. However, ECFs heal in only approximately one-third of cases without surgical intervention. Thus, correct surgical timing combined with adequate nutritional support, sepsis resolution and skin care is considered the appropriate preoperative setting

    Rapid regression of psoriasis in a coeliac patient after gluten-free diet. A case report and review of the literature

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    Several skin disorders are present in patients affected by coeliac disease (CD) - among them, psoriasis has been described. However, at present the relationship between CD and psoriasis remains controversial since there are few and contrasting data on this topic
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