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| 1 | New fecal test for non-invasive Helicobacter pylori detection:A diagnostic accuracy study显示文摘AIM To assess the diagnostic accuracy of a new fecal test for detecting Helicobacter pylori(H. pylori), using ^(13)Curea breath test as the reference standard, and explore bacterial antibiotic resistance. METHODS We conducted a prospective two-center diagnostic test accuracy study. We enrolled consecutive people≥ 18 years without previous diagnosis of H. pylori infection, referred for dyspepsia between February and October 2017. At enrollment, all participants underwent 13 C-urea breath test. Participants aged over 50 years were scheduled to undergo upper endoscopy with histology. Participants collected stool samples 1-3 d after enrollment for a new fecal investigation(THD fecal test). The detection of bacterial 23 S rRNA subunit gene indicated H. pylori infection. We also used the index diagnostic test to examine mutations conferring resistance to clarithromycin and levofloxacin. Independent investigators analyzed index test and reference test standard results blinded to the other test findings. We estimated sensitivity, specificity, positive(PPV) and negative(NPV) predictive value, diagnostic accuracy, positive and negative likelihood ratio(LR), together with 95% confidence intervals(CI).RESULTS We enrolled 294 consecutive participants(age: Median 37.0 years, IQR: 29.0-46.0 years; men: 39.8%). Ninetyfive(32.3%) participants had a positive ^(13)C-urea breath test. Twenty-three(7.8%) participants underwent upper endoscopy with histology, with a full concordance between ^(13)C-urea breath test and histology in detecting H. pylori infection. Four(1.4%) out of the 294 participants withdrew from the study after the enrollment visit and did not undergo THD fecal testing. In the 290 participants who completed the study, the THD fecal test sensitivity was 90.2%(CI: 84.2%-96.3%), specificity 98.5%(CI:96.8%-100%), PPV 96.5%(CI: 92.6%-100%), NPV 95.6%(CI: 92.8%-98.4%), accuracy 95.9%(CI: 93.6%-98.2%), positive LR 59.5(CI: 19.3-183.4), negative LR 0.10(CI: 0.05-0.18). Out of 83 infected participants identified with the THD fecal test, 34(41.0%) had bacterial genotypic changes consistent with antibiotic-resistant H. pylori infection. Of these, 27(32.5%) had bacterial strains resistant to clarithromycin, 3(3.6%) to levofloxacin, and 4(4.8%) to both antibiotics. CONCLUSION The THD fecal test has high performance for the non-invasive diagnosis of H. pylori infection while additionally enabling the assessment of bacterial antibiotic resistances. | Andrea Iannone Floriana Giorgio Francesco Russo Giuseppe Riezzo Bruna Girardi Maria Pricci Suetonia C Palmer Michele Barone Mariabeatrice Principi Giovanni FM Strippoli Alfredo Di Leo Enzo Ierardi | 2018 | World Journal of Gastroenterology2018，24，27： | 5 |
| 2 | HBsAg clearance by Peg-interferon addition to a long-term nucleos(t)ide analogues therapy显示文摘The ideal endpoint of hepatitis B virus(HBV)antiviral therapy is HBsAg loss,a difficult goal to obtain,especially in HBeAg negative patients.Herein,we report the results obtained by the addition of peg-interferonα-2a to a long-lasting nucleos(t)ide analogues therapy in a HBeAg negative,genotype D patient with steadily HBV-DNA negative/HBsAg positive values.In 2002,our Caucasian 44-year-old male patient received lamivudine and,4 years later,added adefovir because of a virological breakthrough.In 2011,considering his young age,liver stiffness(4.3 kPa)and HBsAg levels(3533IU/mL),we added Peg-interferonα-2a for six months(3in combination with nucleos(t)ide analogues followed by 3 mo of Peg-interferonα-2a monotherapy).A decrease of HBsAg levels was observed after 1 mo(1.21log)of Peg-interferon and 3 mo(1.88 log)after the discontinuation of all drugs.Later,a complete clearance of HBsAg was obtained with steadily undetectable HBVDNA serum levels(<9 IU/mL).HBsAg clearance by the addition of a short course of Peg-interferonα-2a represents an important result with clinical and pharmacoeconomic implications,considering that nucleos(t)ide analogues therapy in HBeAg negative chronic hepatitis B patients is considered a long-lasting/life-long treatment. | Michele Barone Andrea Iannone Alfredo Di Leo | 2014 | World Journal of Gastroenterology2014，20，26： | 5 |
| 3 | Noninvasive molecular analysis of Helicobacter pylori : Is it time for tailored first-line therapy?显示文摘The main problem of Helicobacter pylori(H. pylori) infection management is linked to antibiotic resistances. This phenomenon has grown in the last decade, inducing a dramatic decline in conventional regimen effectiveness. The causes of resistance are point mutations in bacterial DNA, which interfere with antibiotic mechanism of action, especially clarithromycin and levofloxacin. Therefore, international guidelines have recently discouraged their use in areas with a relevant resistance percentage, suggesting first-line schedules with expected high eradication rates, i.e., bismuth containing or non-bismuth quadruple therapies. These regimens require the daily assumption of a large number of tablets. Consequently, a complete adherence is expected only in subjects who may be motivated by the presence of major disorders. However, an incomplete adherence to antibiotic therapies may lead to resistance onset, since sub-inhibitory concentrations could stimulate the selection of resistant mutants. Of note, a recent meta-analysis suggests that susceptibility tests may be more useful for the choice of first than second-line or rescue treatment. Additionally, susceptibility guided therapy has been demonstrated to be highly effective and superior to empiric treatments by both meta-analyses and recent clinical studies. Conventional susceptibility test is represented by culture and antibiogram. However, the method is not available everywhere mainly for methodology-related factors and fails to detect hetero-resistances. Polymerase chain reaction(PCR)-based, culture-free techniques on gastric biopsy samples are accurate in finding even minimal traces of genotypic resistant strains and hetero-resistant status by the identification of specific point mutations. The need for an invasive endoscopic procedure has been the most important limit to their spread. A further step has, moreover, been the detection of point mutations in bacterial DNA fecal samples. Few studies on clarithromycin susceptibility have shown an overall high sensitivity and specificity when compared with culture or PCR on gastric biopsies. On these bases, two commercial tests are now available although they have shown some controversial findings. A novel PCR method showed a full concordance between tissue and stool results in a preliminary experience. In conclusion, despite poor validation, there is increasing evidence of a potential availability of noninvasive investigations able to detect H. pylori resistances to antibiotics. These kinds of analysis are currently at a very early phase of development and caution should be paid about their clinical application. Only further studies aimed to evaluate their sensitivity and specificity will afford novel data for solid considerations. Nevertheless, noninvasive molecular tests may improve patient compliance, time/cost of infection management and therapeutic outcome. Moreover, the potential risk of a future increase of resistance to quadruple regimens as a consequence of their use on large scale and incomplete patient adherence could be avoided. | Enzo Ierardi Floriana Giorgio Andrea Iannone Giuseppe Losurdo Mariabeatrice Principi Michele Barone Antonio Pisani Alfredo Di Leo | 2017 | World Journal of Gastroenterology2017，23，14： | 3 |
| 4 | Novel frontiers of agents for bowel cleansing for colonoscopy显示文摘The incidence of colorectal cancer(CRC)is characterized by rapid declines in the wake of widespread screening.Colonoscopy is the gold standard for CRC screening,but its accuracy is related to high quality of bowel preparation(BP).In this review,we aimed to summarized the current strategy to increase bowel cleansing before colonoscopy.Newly bowel cleansing agents were developed with the same efficacy of previous agent but requiring less amount of liquid to improve patients’acceptability.The role of the diet before colonoscopy was also changed,as well the contribution of educational intervention and the use of adjunctive drugs to improve patients’tolerance and/or quality of BP.The review also described BP in special situations,as lower gastrointestinal bleeding,elderly people,patients with chronic kidney disease,patients with inflammatory bowel disease,patients with congestive heart failure,inpatient,patient with previous bowel resection,pregnant/lactating patients.The review underlined the quality of BP should be described using a validate scale in colonoscopy report and it explored the available scales.Finally,the review explored the possible contribution of bowel cleansing in post-colonoscopy syndrome that can be related by a transient alteration of gut microbiota.Moreover,the study underlined several points needed to further investigations. | Milena Di Leo Andrea Iannone Monica Arena Giuseppe Losurdo Maria Angela Palamara Giuseppe Iabichino Pierluigi Consolo Maria Rendina Carmelo Luigiano Alfredo Di Leo | 2021 | World Journal of Gastroenterology2021，27，45： | 2 |
| 5 | Extra-intestinal manifestations of non-celiac gluten sensitivity: an expanding paradigm显示文摘Non celiac gluten sensitivity(NCGS) is a syndrome characterized by a cohort of symptoms related to the ingestion of gluten-containing food in subjects who are not affected by celiac disease(CD) or wheat allergy. The possibility of systemic manifestations in this condition has been suggested by some reports. In most cases they are characterized by vague symptoms such as ‘foggy mind', headache, fatigue, joint and muscle pain, leg or arm numbness even if more specific complaints have been described. NCGS has an immune-related background. Indeed there is a strong evidence that a selective activation of innate immunity may be the trigger for NCGS inflammatory response. The most commonly autoimmune disorders associated to NCGS are Hashimoto thyroiditis, dermatitis herpetiformis, psoriasis and rheumatologic diseases. The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported; it could be a characteristic feature that could help the diagnosis and be simultaneously managed. A possible neurological involvement has been underlined by NCGS association with gluten ataxia, gluten neuropathy and gluten encephalopathy. NCGS patients may show even psychiatric diseases such as depression, anxiety and psychosis. Finally, a link with functional disorders(irritable bowel syndrome and fibromyalgia) is a topic under discussion. In conclusion, the novelty of this matter has generated an expansion of literature data with the unavoidable consequence that some reports are often based on low levels of evidence. Therefore, only studies performed on large samples with the inclusion of control groups will be able to clearly establish whether the large information from the literature regarding extra-intestinal NCGS manifestations could be supported by evidence-based agreements. | Giuseppe Losurdo Mariabeatrice Principi Andrea Iannone Annacinzia Amoruso Enzo Ierardi Alfredo Di Leo Michele Barone | 2018 | World Journal of Gastroenterology2018，24，14： | 2 |
| 6 | Metastatic tumors to the stomach: Clinical and endoscopicfeatures显示文摘AIM: To evaluate the clinical and endoscopic patterns in a large series of patients with metastatic tumors in the stomach. METHODS: A total of 64 patients with gastric meta- stases from solid malignant tumors were retros- pectively examined between 1990 and 2005. The clinicopathological findings were reviewed along with tumor characteristics such as endoscopic pattern, location, size and origin of the primary sites. RESULTS: Common indications for endoscopy were anemia, bleeding and epigastric pain. Metastases presented as solitary (62.5%) or multiple (37.5%) tumors were mainly located in the middle or upper third of stomach. The main primary metastatic tumors were from breast and lung cancer and malignant melanoma. CONCLUSION: As the prognosis of cancer patients has been improving gradually, gastrointestinal (GI) metastases will be encountered more often. Endoscopic examinations should be conducted carefully in patients with malignancies, and endoscopic biopsies and information on the patient’s clinical history are useful for correct diagnosis of gastric metastases. | Giovanni D De Palma Stefania Masone Maria Rega Immacolata Simeoli Mario Donisi Pietro Addeo Loredana Iannone Vincenzo Pilone Giovanni Persico | 2006 | World Journal of Gastroenterology2006，12，45： | 2 |
| 7 | Multiplexed microsphere-based fiow cytometric assays显示文摘 | Kellar KL Iannone MA | 2002 | Exp Hemat2002，30，1： | 1 |
| 8 | Engineered mu-bimodal poly(epsilon-caprolactone)porous scaffold for enhanced hMSC colonization and proliferation显示文摘 | Salerno A Guarnieri D Iannone M | | 0，，04： | 1 |
| 9 | The pathophysiology of osteoarthritis显示文摘 | Iannone F Lapadula G | 2003 | Aging Clin Exp Res2003，15，5： | 1 |
| 10 | MMP-2,MMP-9,TIMP-1 and TIMP-2 levels in patients with rheumatoid arthritis and psoriatic arthritis显示文摘 | Giannelli G Erriquez R Iannone F | 2004 | Clin Exp Rheumatol2004，22，3： | 1 |
| 11 | Polarization modulated direct detection optical transmission systems 显示文摘 | Betti S Marchis G D Iannone E | 1992 | Journal of Lightwave Technology1992，10，1： | 1 |
| 12 | Comparison of surgical treatments for knee dislocation显示文摘 | Mariani PP Santoriello P Iannone S | 1999 | J Knee Surg (Am)1999，12，4： | 1 |
| 13 | Maximal endothelial tis- sue plasminogen activator release is not impaired in patients with acute coronary syndromes before heparin treatment显示文摘 | Otivotti L Spallarossa PA Iannone A | 2001 | Blood Coagul Fibrin- ol2001，12，4： | 1 |
| 14 | A coherency recognition based on structural decomposition procedure显示文摘 | Enrico De Tuglie Silvio Marcello Iannone Francesco Torelli | 2008 | IEEE Transactions on Power Systems2008，23，2： | 1 |
| 15 | Acute promyelocytic leukemia:morphological and clinical features显示文摘 | Invernizzi R Iannone AM Bernuzzi S | 1993 | Haematologica1993，78，3： | 1 |
| 16 | The role of oxidative stress in paraquat-induced neurotoxicity in rats:protection by non peptidyl superoxide dismutase mimetic显示文摘 | Vincenzo Mollace Michelangelo Iannone Carolina Muscoli | 2003 | Neurosci Lett2003，335，3： | 1 |
| 17 | Repeatable battery for the assessment of neuropsyehologieal status as a screening test in schizophrenia Ⅰ: sensitivity, reliability, and validity 显示文摘 | Gold JM Queern C Iannone VN et at | 1999 | Am J Psychiatry1999，156，12： | 1 |
| 18 | MMP-2, MMP-9,TIMP-1 and TIMP-2 levels in patients with rheumatoid arthritis and psoriatic arthritis显示文摘 | Giannelli G Erriquez R Iannone F | 2004 | Clin Exp Rheumatol2004，22，3： | 1 |
| 19 | Repeatable batteryfor the assessment of neuropsychological status as ascreening test in schizophrenia I : sensitivity, reliability, andvalidity 显示文摘 | Gold JM Queem C Iannone VN | 1999 | Am J Psychiatry1999，156，12： | 1 |
| 20 | A coherency recog- nition based on structural decomposition procedure显示文摘 | de TUGLIE E IANNONE S M TORELLI F | 2008 | IEEE Transactions on Power Systems2008，23，2： | 1 |
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