11 research outputs found

    Corneal Involvement In Primary Biliary Cirrhosis : An In Vivo Confocal Microscopy Study

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    Purpose:To investigate the corneal involvement in Primary Biliary Cirrhosis (PBC), a slowly progressive cholestatic liver disease of autoimmune etiology. Methods:Seven female patients affected by PBC underwent a slit-lamp biomicroscopy of the anterior segment with and without Goldmann's three-mirror contact lens, and laser scanning confocal microscopy (LSCM, Heidelberg Engineering Germany). LSCM images were acquired and analyzed for all layers of central and peripheral cornea (four quadrants). Results:All patients had normal findings both at slit-lamp biomicroscopy and at gonioscopy. Peculiar findings were shown at LSCM: all patients showed keratocytes activation (Figure 1); sub-basal nerve fibers with beadlike structure (Figure 2) were found in six patients (86%); four subjects (57%) had hyper-reflective stromal macro-deposits (Figure 2). No deposits suggestive for copper deposition were detected at the level of Descemet\u2019s membrane. Conclusions:To the best of our knowledge this is the first confocal microscopy study on PBC patients. LSCM could show that subclinical corneal inflammation is a very common finding also in ophthalmoscopically normal patients affected by this autoimmune disease

    Correction to: Anemia in patients with Covid-19: pathogenesis and clinical significance (Clinical and Experimental Medicine, (2021), 10.1007/s10238-020-00679-4)

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    The original version of this article unfortunately contained a mistake. The correct information is given below. The co-authorship of the members of ‘‘Internal Medicine Covid-19 Collaborators” was inadvertently not clearly indicated. The names of these members should have been clearly linked to the author line of the article, to ensure that the article can be found under each of their names in PubMed and other databases. In order to rectify this situation, this erratum provides a corrected author line, found above, that includes the names of the members of ‘‘Internal Medicine Covid-19 Collaborators”. The given name and family name of the second author was incorrectly tagged in the xml data, therefore it is abbreviated wrongly as ‘‘de Andreis FB’’. The correct given name is Federica and family name is Borrelli de Andreis. The original article has been corrected

    Anemia in patients with Covid-19: pathogenesis and clinical significance

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    COVID-19 patients typically present with lower airway disease, although involvement of other organ systems is usually the rule. Hematological manifestations such as thrombocytopenia and reduced lymphocyte and eosinophil numbers are highly prevalent in COVID-19 and have prognostic significance. Few data, however, are available about the prevalence and significance of anemia in COVID-19. In an observational study, we investigated the prevalence, pathogenesis and clinical significance of anemia among 206 patients with COVID-19 at the time of their hospitalization in an Internal Medicine unit. The prevalence of anemia was 61% in COVID-19, compared with 45% in a control group of 71 patients with clinical and laboratory findings suggestive of COVID-19, but nasopharyngeal swab tests negative for SARS-CoV-2 RNA (p = 0.022). Mortality was higher in SARS-CoV-2 positive patients. In COVID-19, females had lower hemoglobin concentration than males and a higher prevalence of moderate/severe anemia (25% versus 13%, p = 0.032). In most cases, anemia was mild and due to inflammation, sometimes associated with iron and/or vitamin deficiencies. Determinants of hemoglobin concentration included: erythrocyte sedimentation rate, serum cholinesterase, ferritin and protein concentrations and number of chronic diseases affecting each patient. Hemoglobin concentration was not related to overall survival that was, on the contrary, influenced by red blood cell distribution width, age, lactate dehydrogenase and the ratio of arterial partial oxygen pressure to inspired oxygen fraction. In conclusion, our results highlight anemia as a common manifestation in COVID-19. Although anemia does not directly influence mortality, it usually affects elderly, frail patients and can negatively influence their quality of life

    Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy

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    Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25–97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07–5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome

    Undetectable HCV-RNA at treatment-week 8 results in high-sustained virological response in HCV G1 treatment-experienced patients with advanced liver disease: The International Italian/Spanish Boceprevir/Peginterferon/Ribavirin Name Patients Program

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    In many countries, first-generation protease inhibitors (PIs)/peginterferon/ribavirin (P/R) still represent the only treatment option for HCV-infected patients. Subjects with advanced disease and previous failure to P/R urgently need therapy, but they are under-represented in clinical trials. All treatment-experienced F3/4 Metavir patients who received boceprevir (BOC)+P/R in the Italian-Spanish Name Patient Program have been included in this study. Multivariate logistic regression analysis (MLR) was used to identify baseline and on-treatment predictors of SVR and adverse events (AEs). Four hundred and sixteen patients, mean age 57.7 (range 25-78 years), 70% males, 69.5% (289/416) F4, 14% (41/289) Child-Pugh class A6, 24% (70/289) with varices and 42% (173/416) prior null responders to P/R, were analysed. Overall, SVR rate (all 381 patients who received one dose of BOC) was 49%, (58% in F3, 45% in F4, 61% in relapsers, 51% in partial, 38% in null responders, and 72% in subjects with undetectable HCV-RNA at treatment-week (TW)8. Among patients with TW8 HCV-RNA 65 1000 IU/L, SVR was 8% (negative predictive value = 92%). Death occurred in 3 (0.8%) patients, while decompensation and infections were observed in 2.9% and 11%, respectively. At MLR, SVR predictors were TW4 HCV-RNA 65 1log10-decline from baseline, undetectable TW8 HCV-RNA, prior relapse, albumin levels 653.5 g/dL and platelet counts 65100 000/lL. Metavir F4, Child-Pugh A6, albumin, platelets, age and female gender were associated with serious and haematological AEs. Among treatment-experienced patients with advanced liver disease eligible for IFN-based therapy, TW8 HCV-RNA characterised the subset with either high or poor likelihood of achieving SVR. Using TW8 HCV-RNA as a futility rule, BOC/P/R appears to have a favourable benefit-risk profile

    Correction to: Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial (Journal of Translational Medicine, (2020), 18, 1, (405), 10.1186/s12967-020-02573-9)

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    Correction to: Tocilizumab for patients with COVID-19 pneumonia. The single-arm TOCIVID-19 prospective trial (Journal of Translational Medicine, (2020), 18, 1, (405), 10.1186/s12967-020-02573-9)

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    Following publication of the original article [1] the authors identified that the collaborators of the TOCIVID-19 investigators, Italy were only available in the supplementary file. The original article has been updated so that the collaborators are correctly acknowledged. For clarity, all collaborators are listed in this correction article
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