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Antonio Grieco

Publications and source records attributed to Antonio Grieco.

16 recordsLinked to original sources
PubMed2006

Eighteen needles to forget...an unnamed past.

Lasthénie de Ferjol syndrome is a very rare psychiatric illness that occurs mainly in women. It is characterized by severe recurrent iron-deficiency anemia caused be repeated episodes self-induced blood-letting. We report the case of a young homosexual male repeatedly admitted to various hospitals for severe hypochromic anemia. We discovered that the anemia was indeed due to psychotic self-provoked hemorrhages. Based on this experience and a review of the few cases reported in the literature, we discuss issues of early diagnosis, management and treatment of Lasthénie de Ferjol patients.

Adult↗
PubMed2006

Correlates of HCV seropositivity among familial contacts of HCV positive patients.

BACKGROUND: Determinants of intrafamilial HCV transmission are still being debated. The aim of this study is to investigate the correlates of HCV seropositivity among familial contacts of HCV positive patients in Italy. METHODS: A cross-sectional study was conducted with 175 HCV positive patients (index cases), recruited from Policlinico Gemelli in Rome as well as other hospitals in Central Italy between 1995 and 2000 (40% female, mean age 57 +/- 15.2 years), and 259 familial contacts. Differences in proportions of qualitative variables were tested with non-parametric tests (chi2, Yates correction, Fisher exact test), and a p value < 0.05 was considered significant. A multivariate analysis was conducted using logistic regression in order to verify which variables statistically have an influence on HCV positivity in contact individuals. RESULTS: Seropositivity for HCV was found in 8.9% of the contacts. From the univariate analysis, risk factors significantly associated to HCV positivity in the contacts were: intravenous drug addiction (p = 0.004) and intercourse with drug addicts (p = 0.005). The only variables associated significantly and independently to HCV seropositivity in patients' contacts were intercourse with drug addicts (OR = 19.28; 95% CI: 2.01 - 184.94), the retirement status from work (OR = 3.76; 95% CI: 1.17 - 11.98), the time of the relationship (OR = 1.06; 95% CI: 1.00 - 1.11) and tattoos (OR = 7.68; 95% CI: 1.00 - 60.20). CONCLUSION: The present study confirms that having intercourse with a drug addict is the most significant risk factor for intrafamilial HCV transmission. The association with retirement status from work could be related to both a long-term relationship with an index case and past exposure to common risk factors.

Adult↗
PubMed2006

Correlation between Legionella contamination in water and surrounding air.

We evaluated Legionella pneumophila contamination of water and surrounding air in a burn care department equipped with bathtubs. In water, the bacterium always aerosolized, but in surrounding air, it diluted itself to such a point that it became undetectable at 1 m or more from the source of emission, which indicated that patients were at low risk of inhaling a dangerous quantity of the microbe.

Air Microbiology↗
PubMed2006

[Oxidative stress in metabolic syndrome and nonalcoholic steatohepatitis. Is it possible a role for vitamins in clinical practice?].

Metabolic syndrome (MS) is a worldwide medical problem characterized by a cluster of cardiovascular risk factors and metabolic modifications involving peripheral insulin resistance. Nonalcoholic steatohepatitis (NASH) represents the liver expression of this pathological condition. Both MS and NASH are characterized by proinflammatory status and increased oxidative stress. According this, we aimed to review the literature for considering a possible role for vitamins as therapeutical support in MS and NASH.

Adult↗
PubMed2004

Recurrent acute hepatitis associated with use of cetirizine.

OBJECTIVE: To describe a case of recurrent acute hepatitis related to the use of cetirizine, a selective histamine(1)-receptor antagonist approved for the treatment of common allergic diseases. CASE SUMMARY: A 26-year-old man was hospitalized with a week-long history of weakness, nausea, anorexia, and hyperchromic urine, which had developed after 6 days of therapy with oral cetirizine 10 mg/day for allergic rhinitis. Admission laboratory testing revealed evidence of acute hepatitis and seropositivity for liver-kidney microsome antibodies. Liver biopsy findings of diffuse portal tract and lobular inflammation with a prominent eosinophilic infiltrate were consistent with drug-related hepatitis. The patient was discharged after one week of treatment with tocopherol and glutathione. Three months after discharge, transaminase levels were normal. At 6 months, seropositivity for liver-kidney microsome antibodies was still present, but considerably less intense. The patient had suffered 2 previous episodes of "acute hepatitis of unknown origin," and both had occurred after cetirizine use. DISCUSSION: Use of the Naranjo probability scale indicated cetirizine as the probable cause of acute hepatitis, and the positivity for liver-kidney microsome antibodies is suggestive of an autoimmune mechanism for liver damage. As of September 13, 2004, ours is the fourth reported case of acute hepatitis associated with cetirizine and the second in which liver-kidney microsome antibodies have been documented. CONCLUSIONS: Although cetirizine is considered to have low potential for severe hepatic toxicity, the possibility that it can provoke autoimmune-mediated hepatotoxicity should be considered.

Acute Disease↗
PubMed2004

[Gastroesophageal reflux disease: facts and uncertainties].

In these years the increasing interest regarding clinical presentation of Gastro-Esophageal Reflux Disease (GERD) is certainly due to the complex pathogenic mechanism and the poor correlations between symptoms, clinical picture and endoscopic findings. In this paper we review clinical, pathological and therapeutical features of GERD focusing on controversial findings in clinical practice.

Barrett Esophagus↗
PubMed2003

Evaluation of the albumin-gamma-glutamyltransferase isoenzyme as a diagnostic marker of hepatocellular carcinoma-complicating liver cirrhosis.

AIM: The present study aimed to evaluate the usefulness of albumin-gamma-glutamyltransferase isoenzyme in the diagnosis of hepatocellular carcinoma. METHODS: Electrophoretic assays of gamma-glutamyltransferase isoenzymes were performed on sera from 190 cirrhotics with (n = 131) or without (n = 59) hepatocellular carcinoma, 36 patients with chronic active hepatitis, 17 patients with liver metastases, and 16 control subjects. In the group of cirrhotic patients, the serum level of alpha-fetoprotein was also assessed. RESULTS: Albumin-gamma-glutamyltransferase was found in 88 of 131 cirrhotics with hepatocellular carcinoma, 14 of 59 cirrhotics without hepatocellular carcinoma, nine of 17 patients with liver metastases, and in none of the chronic active hepatitis or control patients. Within the cirrhotic subgroup, albumin-gamma-glutamyltransferase was effective in detecting hepatocellular carcinoma in general (sensitivity: 67%; specificity: 76%; diagnostic accuracy: 70%), and small hepatocellular carcinoma (< 3 cm; corresponding figures: 58, 76, and 69%). The best alpha-fetoprotein value discriminating between hepatocellular carcinoma and non-hepatocellular carcinoma cirrhotics was 20 ng/mL (sensitivity: 54%; specificity 85%; accuracy: 64%). The combined use of albumin-gamma-glutamyltransferase and alpha-fetoprotein, > 20 ng/mL, was associated with greater sensitivity and accuracy (84 and 74%, respectively) than those observed with either of the two markers considered alone. CONCLUSIONS: Albumin-gamma-glutamyltransferase appears to be a sensitive diagnostic marker of both advanced and small hepatocellular carcinoma-complicating liver cirrhosis.

Adolescent↗
PubMed2002

Acute cholestatic hepatitis associated with celecoxib.

OBJECTIVE: To report a case of acute cholestatic hepatitis associated with the selective cyclooxygenase-2 inhibitor celecoxib. CASE SUMMARY: A 41-year-old white man was hospitalized for jaundice after 2 doses of celecoxib 200 mg for pain associated with right-knee trauma. Laboratory workup showed hyperbilirubinemia, mildly elevated serum transaminase concentrations, and cholestasis. Abdominal imaging showed no dilation of the biliary tree. Histology showed cholestasis, with bile plugs in dilated bile canaliculi and a mild portal infiltrate that are highly suggestive of drug-induced cholestasis. DISCUSSION: This is the fourth report in the English-language literature describing cholestatic hepatitis temporally related to celecoxib use, the second supported by histologic findings typical of drug-induced cholestasis, and the first in a patient who denied use of alcoholic beverages and was taking no other drugs or herbal products at the time of the reaction. The Naranjo probability scale indicated that celecoxib was a probable cause of acute cholestatic hepatitis in this patient. CONCLUSIONS: Cholestatic hepatitis is a well-recognized adverse effect of several drugs. Although celecoxib is considered to have a very low potential for hepatic toxicity, well-documented reports of adverse reactions can contribute significantly to the definition of more accurate safety profiles for new drugs introduced into clinical practice.

Acute Disease↗
PubMed2002

Propafenone-related cholestatic hepatitis in an elderly patient.

Hepatic toxicity caused by propafenone is extremely rare. We here describe a case of acute cholestasis secondary to propafenone treatment in an elderly male with no history of preexistent liver disease. The clinical picture and time course of the symptoms seem to be compatible with a direct toxic reaction. Age-related delays in hepatic drug metabolism should explain the hazardous increase in the bioavailability of this drug. Despite the rarity of this complication, propafenone should be considered as a potential cause of drug-induced cholestasis in elderly patients. The literature on the hepatotoxicity of propafenone is also reviewed.

Acute Disease↗
PubMed1994

Antipyrine Metabolism during Chemotherapy with 5-Fluorouracil Plus Folinic Acid in Patients with Liver Metastases from Primary Colorectal Cancer.

Current evidence suggests that the drug-metabolizing capacity of the liver can be altered by neoplastic lesions and by the chemotherapeutic agents used to treat them. Antipyrine metabolism is a widely used dynamic test for assessing mixed hepatic oxidase system activity in humans. This study was conducted to determine the effects of 5-fluorouracil-folinic acid chemotherapy on hepatic drug metabolization in patients with diffuse liver metastases from colorectal tumors using antipyrine metabolism as an index. Twenty-three patients, all with diffuse liver metastases from primary colorectal tumors and normal liver function tests, were treated with 5-day cycles of 5-fluorouracil (5-FU) (370 mg m(minus sign2) day(minus sign1) I.V.) and folinic acid (200 mg m(minus sign2) day(minus sign1) I.V.) administered every 28 days. Antipyrine metabolism was assessed before initiation of therapy and after each 5-day cycle to determine the effects of this chemotherapeutic protocol on the mixed-hepatic oxidase system. Response to treatment was assessed after 4 months. None of the patients displayed any change in antipyrine metabolism following treatment. There was no correlation between the ability to metabolize antipyrine and the response to chemotherapy. 5FU has been found to decrease antipyrine metabolism in rats with no liver disease. The absence of such an effect in our patients is thought to be due to inductive effects exerted by the metastases on the mixed hepatic oxidase system and modification of 5-FU metabolism by folinic acid. The liver appears to have an enormous functional reserve, even when there is massive tumor involvement.

Journal Article↗
PubMedDate not supplied

Transarterial chemoembolization (TACE) for unresectable hepatocellular carcinoma in cirrhotics: functional hepatic reserve and survival.

BACKGROUND/AIMS: Transarterial chemoembolization is widely used for palliative treatment of hepatocellular carcinoma, but patient's characteristics associated with maximal benefit are still undefined. METHODOLOGY: In 81 cirrhotic patients with unresectable hepatocellular carcinoma, who underwent transarterial chemoembolization, variables correlated with survival were studied. In 46/81, the antipyrine metabolism test has been performed before and 72 hours after first transarterial chemoembolization. RESULTS: Mean overall survival of whole population was 22 months. One-, two-, and three-year survival rates were respectively 85%, 38.6%, and 18.1%. Better survival was observed in those patients who received more than one treatment (p = 0.016), while no relationship was found with treatment response, drug used, or number of lobes involved. Univariate analysis of the subgroup with antipyrine pharmacokinetic data revealed a significant relation between survival and baseline albumin (p = 0.039), total cholesterol (p = 0.036), AST (p = 0.017), log of total bilirubin (p = 0.017), and Child-Pugh class (p = 0.029), but not with parameters of antipyrine metabolism. Antipyrine metabolism was not significantly modified by transarterial chemoembolization in the subgroup tested before and after the first treatment. Using Cox regression analysis and selecting AST and log of total bilirubin, a prognostic index was defined: prognostic index 0.006 (AST-83.044) + 0.638 [log of total bilirubin-0.1175]. One-, two-, and three-year survival rates were respectively 92%, 59.2%, and 29.6% for the patient group with prognostic index < 0, and 76%, 14.3%, and 4.8% for the group with prognostic index > 0 (p < 0.01). CONCLUSIONS: Transarterial chemoembolization is a safe procedure and appears beneficial for those patients with a good functional hepatic reserve. The antipyrine metabolism test does not provide any additional prognostic information.

Adult↗
PubMedDate not supplied

[Drug-induced hepatitis].

Explore the source record for details and available documents.

Chemical and Drug Induced Liver Injury↗
PubMedDate not supplied

A "progressive" visual loss.

An unusual cause of acute-onset and progressively worsening visual loss is presented. A 60-year-old woman was referred for left homonymous hemianopsia to our Emergency Medicine Department because of a suspected vascular accident. Ten years earlier she had been diagnosed as having chronic lymphocytic leukemia. Brain computed tomography and magnetic resonance imaging revealed "bilateral foci of white matter abnormalities in the occipital regions, compatible with a diagnosis of progressive multifocal leukoencephalopathy". Her cerebrospinal fluid was positive for papovavirus JC. Progressive multifocal leukoencephalopathy due to papovavirus JC, a typical complication in AIDS patients, is a rare complication in patients with other immunosuppressive conditions, such as chronic lymphocytic leukemia.

Acquired Immunodeficiency Syndrome↗