Relazione tra linfoadenopatia del legamento epatoduodenale e risposta alla terapia anti-virale in pazienti con epatite cronica HCV-correlata

Platelet changes in patients with hepatitis C virus-related liver cirrhosis after directly acting antiviral therapy

Background and Purpose of the study:Thrombocytopenia is the most common haematological abnormality in patients with Liver Cirrhosis and it is caused by multiple factors. This study evaluated platelets (PLT) count changes in patients with HCV related LC after DAAs therapy. Materials and Methods: We enrolled 83 patients with LC. In all patients were evaluated liver function tests and PLT count at baseline (BL), at end of therapy (ET) and three months post treatment (PostT), Elastography and ultrasound (US) at BL, and US at PostT. LC diagnosis was histological in 13 patients, in 71 with liver stiffness >12 kPa. All patients were SVR (58 patients had DAAs therapy without, 25 with Ribavirin).…

Steatosi epatica (SE) e rischio cardiovascolare in una popolazione di pazienti HIV-positivi

Ruolo dell’ecografia nella diagnosi differenziale delle malattie correlarte al glutine

Obiettivi dello studio: È noto che la Malattia Celiaca (MC) ha dei segni ecografici che frequentemente si associano ad essa. Visto la limitatezza dei presidi per la diagnosi di Non Celiac Gluten Sensitivity (NCGS) noi abbiamo valutato in una popolazione di pazienti con NCGS l’aspetto ecografico delle anse intestinali, della milza e della vena porta e di confrontarlo con quello dei pazienti celiaci. Materiali: Sono stati inclusi 45 pazienti (11M, 24F, età media 35.7± 11.5), nei quali era posta diagnosi di NCGS in accordo con i criteri proposti da Sapone. Tutti i pazienti avevano i seguenti criteri aggiuntivi. 1) risoluzione dei sintomi gastrointestinali con una dieta di eliminazione standard…

Esiste un pattern ecografico associato alla steatosi capace di facilitare il suo riconoscimento etiologico?

Effects of Steatosis on Hepatic Hemodynamics in Patients with Metabolic Syndrome

The aim of our study was to assess the hemodynamic changes in hepatic and splenic circulation using B-mode ultrasonography and color Doppler ultrasonography, in a population of patients with metabolic syndrome divided with respect to the presence or absence of steatosis diagnosed by ultrasonography. One hundred forty-one patients were included in the study. The severity of non-alcoholic fatty liver disease was classified as mild, moderate or severe. Visceral fat thickness, longitudinal diameter of the spleen, diameter of the portal vein, mean maximum portal vein flow velocity, hepatic artery and splenic artery resistivity indexes and hepatic vein flow phasicity were measured. Non-alcoholic …

Un caso di Leishmaniosi viscerale progressiva: ruolo del color Doppler nella diagnosi

Hemophagocytic syndrome in a patient with disseminated tuberculosis: a case report

Hemophagocytic syndrome (HS) is a rare disorder of the immune system. It is characterized by fever, lymphadenopathy, hepatosplenomegaly, cytopenia and hyperferritinemia. The cause differs in each country suggesting a specific genetic background and epidemiology of infections, and it can be associated with malignant diseases. A rare cause of HS is tuberculosis (TB), we describe a case of HS associated with disseminated Mycobacterium tuberculosis (MT) infection in a patient from Sudan. He presented diarrhea, fever, pancytopenia, thickened and dilated bowel loops and lymph nodes enlargement at ultrasound and computed tomography scan. A bone marrow biopsy performed to rule out a lymphoma reveal…

PREVALENCE OF LIVER STEATOSIS AND FIBROSIS AND RELIABILITY OF ULTRASOUND IN DETECTING NAFLD IN OBESE PATIENTS

Background: Non-alcoholic fatty liver disease (NAFLD) is the most frequent chronic liver disease in Western countries, and in particular in obese patients the prevalence is higher than in general population. It has a large clinical spectrum, ranging from simple steatosis to steatohepatitis (NASH) and cirrhosis. Aim of the study: To evaluate in obese patients who underwent bariatric surgery in the last 3 years: 1) the histological prevalence and severity of liver steatosis (LS) and fibrosis; 2) the reliability of ultrasound (US) in diagnosing steatosis. Patients and methods: We reviewed preoperative liver US and intraoperative liver biopsy results in 57 bariatric surgery patients (age 42 ± 1…

Ruolo dei pattern ecografici nella sorveglianza per la diagnosi precoce dell'HCC

Long-term follow-up of hepatitis C virus-positive patients with persistently normal serum transaminases

Material and methods. This study prospectively evaluated the progression of liver disease in a group of anti-HCV-positive patients with persistently normal ALT levels (PNALT) who were HCV-RNA positive. Patients selected for this study were those who presented with PNALT according to the Italian Association for the Study of the Liver (AISF) criteria in the year 1995/96 and underwent liver biopsy. They were divided into two groups according to their ALT evolution. Forty-five patients were included in this study. Results. After a median follow-up time of 180 months twenty-five of them maintained PNALT, but two of these developed liver cirrhosis (LC) in a mean time of 174 and 202 months, respec…

Affidabilità del bright liver nella diagnosi di steatosi epatica in pazienti con infezione da virus dell'immunodeficienza acquisita (HIV), da virus dell'epatite C (HCV) e coinfezione HCV/HIV: dati preliminari

Abdominal Ultrasound Does Not Reveal Significant Alterations in Patients With Nonceliac Wheat Sensitivity

Abstract GOALS: The goal of this study was (A) to evaluate abdominal ultrasound signs in nonceliac wheat sensitivity (NCWS) patients for features useful in diagnosis and (B) to compare these aspects with those of celiac patients to assess whether ultrasound can be useful in the differential diagnosis between NCWS and celiac disease (CD). BACKGROUND: NCWS diagnosis is difficult as no biomarkers of this condition have as yet been identified. In CD ultrasound aspects have been identified that have a good diagnostic accuracy. STUDY: We prospectively recruited 45 NCWS patients (11 males, 34 females; mean age 35.7 y). Three control groups were included: (A) 99 age-matched CD patients; (B) 18 pati…

Median arcuate ligament syndrome, a rare case of chronic abdominal pain

The median arcuate ligament syndrome (MALS) is a rare disease characterized by abdominal pain caused by the external compression of the celiac artery by the median arcuate ligament. Surgical treatment is indicated, but given the non-specific symptoms, these patients are often hospitalized in the Departments of Internal Medicine where the diagnosis may be unknown. We present a case of MALS admitted to our Internal Medicine Division. An abdominal ultrasound in a woman with longstanding abdominal pain showed elevated celiac artery velocities during forced expiration. Computed tomography angiography (CTA) of the abdomen showed stenosis of the origin of the celiac artery and confirmed the diagno…

The Prevalence of NAFLD and Fibrosis in Bariatric Surgery Patients and the Reliability of Noninvasive Diagnostic Methods

Background. Bariatric surgery patients have a higher prevalence of nonalcoholic fatty liver (NAFL) than the general population; however, its assessment and the accurate staging of fibrosis are often complicated because noninvasive tests are not very accurate in patients with morbid obesity, and liver biopsy cannot be performed as a routine exam. The aim of this study was to evaluate (A) the histological prevalence of NAFL, nonalcoholic steatohepatitis (NASH), and fibrosis in patients undergoing bariatric surgery; (B) the reliability of ultrasound (US) in diagnosing NAFL; and (C) the reliability of various fibrosis scoring systems for defining fibrosis. Methods. US and intraoperative liver b…

Surveillance Program for Diagnosis of HCC in Liver Cirrhosis: Role of Ultrasound Echo Patterns

International guidelines suggest ultrasound surveillance for hepatocellular carcinoma (HCC) early diagnosis in liver cirrhosis (LC) patients, but 40% of nodules <2 cm escape detection. We investigated the existence of an ultrasound pattern indicating a higher risk of developing HCC in patients under surveillance. 359 patients with LC (Child-Pugh A-B8) underwent ultrasound screening (median follow-up 54 months, range 12–90 months), liver function tests, alpha-fetoprotein assay, and portal hypertension evaluation. Echo patterns were homogeneous, bright liver, coarse, coarse small nodular pattern, and coarse large nodular pattern. During follow-up 13.9% developed HCC. At multivariate analys…

Prospective evaluation of hepatic steatosis in HIV-infected patients with or without hepatitis C virus co-infection

Background: Limited data are available on hepatic steatosis (HS) in HIV patients who are not infected with hepatitis C virus (HCV). The aims of this study were to assess the prevalence of HS and its risk factors in HIV patients with and without HCV infection, and to evaluate whether HS correlates with advanced liver fibrosis and/or cardiovascular disease risk. Methods: Fifty-seven HIV mono-infected and 61 HIV/HCV co-infected patients were enrolled consecutively. All patients underwent liver ultrasound and transient elastography. The main parameters of liver function, HIV and HCV viral loads, CD4+ cell counts, and data on highly active antiretroviral therapy (HAART) were recorded. Cardiovasc…

Daily Use of Extra Virgin Olive Oil with High Oleocanthal Concentration Reduced Body Weight, Waist Circumference, Alanine Transaminase, Inflammatory Cytokines and Hepatic Steatosis in Subjects with the Metabolic Syndrome: A 2-Month Intervention Study

Extra virgin olive oil (EVOO) intake is associated with reduced cardiovascular risk, and its phenolic compound oleocanthal (OC) has anti-oxidant and anti-inflammatory properties. The cardiometabolic effects of EVOO with a high OC concentration have not been fully elucidated. We administered EVOO with a high OC concentration daily to 23 subjects with the metabolic syndrome (MetS) and hepatic steatosis (15 men and 8 women, age: 60 &plusmn