Portal Vein Thrombosis Relevance on Liver Cirrhosis: Italian Venous Thrombotic Events Registry

Portal vein thrombosis may occur in cirrhosis; nevertheless, its prevalence, and predictors are still elusive. To investigate this issue, the Italian Society of Internal Medicine undertook the “Portal vein thrombosis Relevance On Liver cirrhosis: Italian Venous thrombotic Events Registry” (PRO-LIVER). This prospective multicenter study includes consecutive cirrhotic patients undergoing Doppler ultrasound examination of the portal area to evaluate the prevalence and incidence of portal vein thrombosis over a 2-year scheduled follow-up. Seven hundred and fifty-three (68 % men; 64 ± 12 years) patients were included in the present analysis. Fifty percent of the cases were cirrhotic outpatients.…

Intraperitoneal drain placement and outcomes after elective colorectal surgery: International matched, prospective, cohort study

Abstract Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and tim…

Real-life use of elbasvir/grazoprevir in adults and elderly patients: a prospective evaluation of comedications used in the PITER cohort.

Background In patients treated for HCV infection, potential drug–drug interactions (DDIs) can occur among direct-acting antiviral drugs (DAAs) and comedications used. The real-life effectiveness and safety of elbasvir/grazoprevir (ELB/GZR) among co-medicated HCV patients was evaluated. Methods We prospectively evaluated consecutive patients from 15 clinical centres participating in PITER who were treated with ELB/GZR and had been followed for at least 12 weeks after treatment. Data were prospectively collected on the use of comedications (including discontinuation, dose modification and addition of drugs) and potential DDIs with DAAs. Results Of the 356 patients with at least 12-week post-t…

COMEPA (COVID-19 Medicina Policlinico Palermo): a study in hospitalized patients

Coronavirus disease 2019 (COVID-19) has dramatically changed our lives. In the past months, hospitals were saturated of patients; therefore, it is still important to have simple and standardized prognostic factors and to evaluate the efficacy and safety of medications commonly used for COVID-19. We aimed to collect data of the patients hospitalized in Internal Medicine and Geriatrics Wards at the University Hospital (Policlinico) ‘P. Giaccone’ in Palermo, Italy (COMEPA, COVID-19 Medicina Policlinico Palermo), with the main purpose of finding prognostic tools that can be easily used in clinical practice in order to identify patients hospitalized for/with COVID-19 at higher risk of negative o…

The multifaceted spectrum of liver cirrhosis in older hospitalised patients: Analysis of the REPOSI registry

Abstract Background Knowledge on the main clinical and prognostic characteristics of older multimorbid subjects with liver cirrhosis (LC) admitted to acute medical wards is scarce. Objectives To estimate the prevalence of LC among older patients admitted to acute medical wards and to assess the main clinical characteristics of LC along with its association with major clinical outcomes and to explore the possibility that well-distinguished phenotypic profiles of LC have classificatory and prognostic properties. Methods A cohort of 6,193 older subjects hospitalised between 2010 and 2018 and included in the REPOSI registry was analysed. Results LC was diagnosed in 315 patients (5%). LC was ass…

Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register)

Purpose: To evaluate clinical features, treatments, and outcomes of osteoporotic patients admitted to internal medicine and geriatric wards compared with non-osteoporotic patients (REPOSI registry). Methods: We studied 4714 patients hospitalized between 2010 and 2016. We reported age, sex, educational level, living status, comorbidities and drugs taken, Cumulative Illness Rating Scale (CIRS), Barthel Index, Short-Blessed Test, 4-item Geriatric Depression Scale, serum hemoglobin, creatinine, and clinical outcomes. Osteoporosis was defined based on the diagnoses recorded at admission, according to the following ICD9: 733, 805-813, 820-823. Results: Twelve percent of the patients had a preadmi…

DRUG INDUCED LIVER INJURIES BY TICAGRELORSTATINS INTERACTION: A CASE REPORT

Background: The anti-aggregant therapy with aspirin and inhibitor of P2Y12 platelets receptor for ADP, such as ticagrelor, can be used to prevent atherothrombotic events in patients with coronaric acute syndrome. Statins are also recommended in these patients even if the safety profile is burdened by the risk of drug interaction (CYP 3A4 inhibition by ticagrelor). Here, we report a case of acute rabdomiolysis and hepatotoxicity in a woman with a recent myocardial infarction treated with ticagrelor 90 mg twice daily, aspirin 100 mg daily, atorvastatina 40 mg once daily. Methods: We report a case of 68 old Caucasian woman with a diagnosis of myocardial infarction and coronary percutaneous ste…

Clinical manifestations and outcome predictors of SARS-COV2 disease (COVID-19): experience of a single center.

PRESENTAZIONE ECOGRAFICA DELL’EPATOCARCINOMA: ESPERIENZA DI UN SINGOLO CENTRO NELL’ARCO DI TRE DECENNI

Valutare i cambiamenti della presentazione ecografica (US) degli epatocarcinomi (HCC) diagnosticati presso la nostra UO di Medicina Interna in tre periodi:1993-98, 2003-2008,2013-18. Il Gruppo 1 (G1) (1993-1998) comprendeva 174 HCC, il Gruppo 2 (G2) (2003-08) 96, il Gruppo 3 (G3) (2013-2018) 102. Sono stati registrati età, sesso, markers HBV, HCV, uso di alcol, alfafetoproteina (AFP), test di funzionalità epatica, autoanticorpi, ferritinemia. La diagnosi di HCC in G2 e G3 è stata posta secondo le linee guida EASL, in G1 con istologia o citologia nel 40%, nel resto con multiple tecniche di imaging concordanti (ecografia, TC, TC con lipiodol, angiografia), livelli sierici di AFP>200 ng/ml.…