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| 1 | Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice显示文摘AIM: To verify the validity of the International Ascites Club guidelines for treatment of spontaneous bacterial peritonitis (SBP) in clinical practice. METHODS: All SBP episodes occurring in a group of consecutive cirrhotics were managed accordingly and included in the study. SBP was diagnosed when the ascitic fluid polymorphonuclear (PMN) cell count was > 250 cells/mm3, and empirically treated with cefotaxime. RESULTS: Thirty-eight SBP episodes occurred in 32 cirrhotics (22 men/10 women; mean age: 58.6 ± 11.2 years). Prevalence of SBP, in our population, was 17%. Ascitic fluid culture was positive in nine (24%) cases only. Eleven episodes were nosocomial and 71% community-acquired. Treatment with cefotaxime was successful in 59% of cases, while 41% of episodes required a modification of the initial antibiotic therapy because of a less-than 25% decrease in ascitic PMN count at 48 h. Change of antibiotic therapy led to the resolution of infection in 87% of episodes. Among the cases with positive culture, the initial antibiotic therapy with cefotaxime failed at a percentage (44%) similar to that of the whole series. In these cases, the isolated organisms were either resistant or with an inherent insufficient susceptibility to cefotaxime. CONCLUSION: In clinical practice, ascitic PMN count is a valid tool for starting a prompt antibiotic treatment andevaluating its efficacy. The initial treatment with cefotaxime failed more frequently than expected. An increase in healthcare-related infections with antibiotic-resistant pathogens may explain this finding. A different first-line antibiotic treatment should be investigated. | Stefania Angeloni Cinzia Leboffe Antonella Parente Mario Venditti Alessandra Giordano Manuela Merli Oliviero Riggio | 2008 | World Journal of Gastroenterology2008，14，17： | 42 |
| 2 | Ascitic fluid analysis for diagnosis and monitoring of spontaneous bacterial peritonitis显示文摘Polymorphonuclear (PMN) cell count in the ascitic fluid is essential for the diagnosis and management of spontaneous bacterial peritonitis (SBP). To date, PMN cell count is routinely performed by traditional manual counting. However, this method is time-consuming, costly, and not always timely available. Therefore, considerable efforts have been made in recent years to develop an alternative test for a more rapid diagnosis and monitoring of SBP. The use of urinary reagent strips was proposed to achieve an 'instant' bedside diagnosis of SBP. A series of reports evaluated the urine strip test for SBP diagnosis and reported promising results. However, a recent large multicenter study revealed a surprising lack of diagnostic effi cacy of the urine screening test for SBP diagnosis. Another method, more recently proposed as an alternative to the manual PMN count, is the measurement of lactoferrin in ascitic fluid, but the data available on the diagnostic value of this test are limited to a single study. However, both urinary reagent strips and ascitic lactoferrin tests are qualitative methods and need, therefore, to be further confirmed by standard cytology of the ascitic fluid. To date, the only quantitative method proposed as a valid alternative to manual PMN counting is automated blood cell counters, commonly used in all laboratories for blood cell counting. Data available in the literature on the diagnostic performance of this method are limited but very promising, and this tool seems to have the potential to replace the manual counting method. | Oliviero Riggio Stefania Angeloni | 2009 | World Journal of Gastroenterology2009，15，31： | 33 |
| 3 | Quality of life in patients with minimal hepatic encephalopathy显示文摘Minimal hepatic encephalopathy(MHE) represents the mildest type of hepatic encephalopathy(HE). This condition alters the performance of psychometric tests by impairing attention, working memory, psychomotor speed, and visuospatial ability, as well as electrophysiological and other functional brain measures. MHE is a frequent complication of liver disease, affecting up to 80% of tested patients, depending of the diagnostic tools used for the diagnosis. MHE is related to falls, to an impairment in fitness to drive and the development of overt HE, MHE severely affects the lives of patients and caregivers by altering their quality of life(QoL) and their socioeconomic status. MHE is detected in clinically asymptomatic patients through appropriate psychometric tests and neurophysiological methods which highlight neuropsychological alterations such as video-spatial orientation deficits, attention disorders, memory, reaction times, electroencephalogram slowing, prolongation of latency evoked cognitive potentials and reduction in the critical flicker frequency. Several treatments have been proposed for MHE treatment such as non-absorbable disaccharides, poorly absorbable antibiotics such rifaximin, probiotics and branched chain amino acids. However, because of the multiple diagnosis methods, the various endpoints of treatment trials and the variety of agents used in trials, to date the treatment of MHE is not routinely recommended apart from on a case-by-case basis. Aim of this review is analyze the burden of MHE on QoL of patients and provide a brief summary of therapeutic approaches. | Lorenzo Ridola Silvia Nardelli Stefania Gioia Oliviero Riggio | 2018 | World Journal of Gastroenterology2018，24，48： | 14 |
| 4 | Spontaneous porto-systemic shunts in liver cirrhosis:Clinical and therapeutical aspects显示文摘Spontaneous porto-systemic shunts(SPSS)are frequent in liver cirrhosis and their prevalence increases as liver function deteriorates,probably as a consequence of worsening portal hypertension,but without achieving an effective protection against cirrhosis'complications.Several types of SPSS have been described in the literature,each one associated with different clinical manifestations.In particular,recurrent or persistent hepatic encephalopathy is more frequent in patients with splenorenal shunt,while the presence of gastric varices and consequently the incidence of variceal bleeding is more common in gastrorenal shunt.In the advanced stage,the presence of large SPSS can lead to the so called“portosystemic shunt syndrome”,characterized by a progressive deterioration of hepatic function,hepatic encephalopathy and,sometimes,portal vein thrombosis.The detection of SPSS in patients with liver cirrhosis is recommended in order to prevent or treat recurrent hepatic encephalopathy or variceal bleeding. | Silvia Nardelli Oliviero Riggio Stefania Gioia Marta Puzzono Giuseppe Pelle Lorenzo Ridola | 2020 | World Journal of Gastroenterology2020，26，15： | 11 |
| 5 | Accuracy of the automated cell counters for management of spontaneous bacterial peritonitis显示文摘AIM: To evaluate the accuracy of automated blood cell counters for ascitic polymorphonuclear (PMN) determination for: (1) diagnosis, (2) efficacy of the ongoing antibiotic therapy, and (3) resolution of spontaneous bacterial peritonitis (SBP). METHODS: One hundred and twelve ascitic fluid samples were collected from 52 consecutive cirrhotic patients, 16 of them with SBP. The agreement between the manual and the automated method for PMN count was assessed. The sensitivity/specificity and the positive/negative predictive value of the automated blood cell counter were also calculated by considering the manual method as the 'gold standard' . RESULTS: The mean ± SD of the difference between manual and automated measurements was 7.8 ± 58 cells/mm3, while the limits of agreement were +124 cells/mm3 [95% confidence interval (CI): +145 to +103] and -108 cells/mm3 (95% CI: -87 to -129). The automated cell counter had a sensitivity of 100% and a specificity of 97.7% in diagnosing SBP, and a sensitivity of 91% and a specificity of 100% for the efficacy of the ongoing antibiotic therapy. The two methods showed a complete agreement for the resolution of infection. CONCLUSION: Automated cell counters not only have a good diagnostic accuracy, but are also very effective in monitoring the antibiotic treatment in patients with SBP. Because of their quicker performance, they should replace the manual counting for PMN determination in the ascitic fluid of patients with SBP. | Oliviero Riggio Stefania Angeloni Antonella Parente Cinzia Leboffe Giorgio Pinto Teresa Aronne Manuela Merli | 2008 | World Journal of Gastroenterology2008，14，37： | 6 |
| 6 | Incidence and natural history of small esophageal varices in cirrhotic patients显示文摘 | Manuela Merli Giorgia Nicolini Stefania Angeloni Vittorio Rinaldi Adriano De Santis Carlo Merkel Adolfo Francesco Attili Oliviero Riggio | 2002 | Journal of Hepatology2002，，3： | 4 |
| 7 | Sarcopenia and cognitive impairment in liver cirrhosis: A viewpoint on the clinical impact of minimal hepatic encephalopathy显示文摘Minimal hepatic encephalopathy (MHE) represents the mildest type of hepatic encephalopathy (HE). MHE is considered as a preclinical stage of HE and is part of a wide spectrum of typical neurocognitive alterations characteristic of patients with liver cirrhosis, particularly involving the areas of attention, alertness, response inhibition, and executive functions. MHE can be detected by testing the patients’ psychometric performance, attention, working memory, psychomotor speed, and visuospatial ability, as well as by means of electrophysiological and other functional brain measures. MHE is very frequent, affecting from 20% up to 80% of patients tested, depending of the diagnostic tools used. Although subclinical, MHE is considered to be clinically relevant. In fact, MHE has been related to the patients’ falls, fitness to drive, and working ability. As a consequence, MHE affects the patients and caregivers lives by altering their quality of life and even their socioeconomic status. Recently sarcopenia, a very common condition in patients with advanced liver disease, has been shown to be strictly related to both minimal and overt HE. Aim of this review is to summarize the most recently published evidences about the emerging relationship between sarcopenia and cognitive impairment in cirrhotic patients and provide suggestions for future research. | Silvia Nardelli Stefania Gioia Jessica Faccioli Oliviero Riggio Lorenzo Ridola | 2019 | World Journal of Gastroenterology2019，25，35： | 4 |
| 8 | ESPEN Guidelines on Enteral Nutrition: Liver disease显示文摘 | M. Plauth E. Cabré O. Riggio M. Assis-Camilo M. Pirlich J. Kondrup P. Ferenci E. Holm S. vom Dahl M.J. Müller W. Nolte | 2006 | Clinical Nutrition2006，，2： | 3 |
| 9 | Cirrhotic Patients Are at Risk for Health Care–Associated Bacterial Infections显示文摘 | Manuela Merli Cristina Lucidi Valerio Giannelli Michela Giusto Oliviero Riggio Marco Falcone Lorenzo Ridola Adolfo Francesco Attili Mario Venditti | 2010 | Clinical Gastroenterology and Hepatology2010，，11： | 3 |
| 10 | MELD score is better than Child–Pugh score in predicting 3-month survival of patients undergoing transjugular intrahepatic portosystemic shunt显示文摘 | Francesco Salerno Manuela Merli Massimo Cazzaniga Valentina Valeriano Plinio Rossi Andrea Lovaria Daniele Meregaglia Antonio Nicolini Lorenzo Lubatti Oliviero Riggio | 2002 | Journal of Hepatology2002，，4： | 2 |
| 11 | Hepatic encephalopathy therapy:An overview显示文摘Type-C hepatic encephalopathy(HE) is a severe complication of cirrhosis,which seriously affects quality of life and is strongly related to patient survival.Treatment based on a classical pharmacological approach that is aimed at reducing the production of gut-derived toxins,such as ammonia,is still under debate.Currently,results obtained from clinical trials do not support any specific treatment for HE and our competence in testing old and new treatment modalities by randomized controlled trials with appropriate clinically relevant end-points urgently needs to be improved.On the other hand,patients who are at risk for HE are now identifiable,based on studies on the natural history of the disease.Today,very few studies that are specifically aimed at establishing whether HE may be prevented are available or in progress.Recent studies have looked at non absorbable disaccharides or antibiotics and other treatment modalities,such as the modulation of intestinal flora.In the treatment of severe stage HE,artificial liver supports have been tested with initial positive results but more studies are needed. | Oliviero Riggio Lorenzo Ridola Chiara Pasquale | 2010 | World Journal of Gastrointestinal Pharmacology and Therapeutics2010，1，2： | 2 |
| 12 | Presidential leadership and charisma: The effects of metaphor显示文摘 | Jeffery Scott Mio Ronald E. Riggio Shana Levin Renford Reese | 2005 | The Leadership Quarterly2005，，2： | 2 |
| 13 | Is porto sinusoidal vascular disease to be actively searched in patients with portal vein thrombosis?显示文摘Porto sinusoidal vascular liver disease (PSVD) and portal vein thrombosis (PVT) are distinct vascular liver diseases characterized, respectively, by an intrahepatic and a prehepatic obstacle to the flow in the liver portal system. PVT may also occur as a complication of the natural history of PSVD, especially if a prothrombotic condition coexists. In other cases, it is associated to local and systemic pro-thrombotic conditions, even if its cause remains unknown in up to 25% despite an active search. In our opinion, the presence of PSVD should be suspected in patients with PVT especially in those with PVT “sine causa” and the active search of this condition should be included in their diagnostic work-out. However, sometimes the diagnosis of pre-existing PSVD is very hard. Biopsy cannot be fully discriminant as similar histological data have been described in both conditions. Liver stiffness may help as it has been shown to be higher in PSVD than in “pure” PVT, due to the presence of sclerosis in the portal venous radicles observable in PSVD patients. Nevertheless, comparing liver stiffness between PVT and PSVD has until now been restricted to very limited series of patients. In conclusion, even if it is still totally hypothetical, our point of view may have clinical consequences, especially when deciding to perform a liver biopsy in patients with a higher liver stiffness and suspending the anticoagulation in patients with PVT and no detectable prothrombotic factors. | Stefania Gioia Silvia Nardelli Lorenzo Ridola Giulia d’Amati Oliviero Riggio | 2019 | World Journal of Hepatology2019，11，8： | 2 |
| 14 | 妊娠期癫痫发作的应急处理显示文摘妊娠期癫痫应用抗癫痫药物有某些致畸作用,癫痫发作未控制对胎儿的危险较之使用抗癫痫药物更大。癫痫持续状态的处理需用静脉苯酰安定、苯妥英钠或苯巴比妥。胎儿的良好预后取决于对发作的迅速控制。对子痫的处理尚有争议。目前,处理子痫发作可采用处理癫痫持续状态的方法。 | Jagoda A Riggio S 崔书章 柴艳芬 | 1992 | 国外医学(妇产科学分册)1992，19，3： | 2 |
| 15 | Rifaximin therapy and hepatic encephalopathy:Pros and cons显示文摘Hepatic encephalopathy(HE) is the second most common major complication in cirrhotics and it significantly impacts quality of life.Therapeutic approaches for HE treatment and prevention mainly continue to rely on ammonia-lowering strategies and non-absorbable disaccharides are currently considered the cornerstone therapy.Non-absorbable antibiotics,such as neomycin and paramomycin,are effective in treatment of acute HE episodes but their prolonged use for recurrence prevention is hampered by possible side-effects.To overcome these limitations,rifaximin use has been proposed.Rifaximin has been shown to be not superior to non-absorbable disaccharides for either HE treatment or prevention,with a similar incidence of side-effects.Cirrhosis significantly increases rifaximin absorption and this could be a cause for concern.Following long-term rifaximin therapy,Clostridium difficile colitis has been observed and Candida albicans has been isolated from 20% of patients.In addition,selection of resistant mutants of both Gram-negative and-positive bacteria in the gastrointestinal tract cannot be definitely ruled out.Electrolyte alterations(sodium and potassium) have been reported during rifaximin therapy,a warning for its long-term use in cirrhotics.Moreover,a potential interference with vitamin K production should be considered which could further impair the already altered clotting status of these patients.The therapeutic cost of rifaximin is markedly higher than non-absorbable disaccharides.While waiting for further safety data,caution should be used to limit the use of rifaximin therapy for a very short-term period in selected HE cirrhotics not responding to nonabsorbable disaccharides. | Angelo Zullo Cesare Hassan Lorenzo Ridola Roberto Lorenzetti Salvatore MA Campo Oliviero Riggio | 2012 | World Journal of Gastrointestinal Pharmacology and Therapeutics2012，3，4： | 2 |
| 16 | Microbiological culture analysis of the tongue anaerobic microflora in subjects with and without halitosis显示文摘 | Donaldson AC Kenzie DM Riggio MP | 2005 | Oral Diseases2005，11，： | 1 |
| 17 | Comparison of polymerase chain reaction and culture methods for detection of Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis in subgingival plaque samples显示文摘 | Riggio MP Macfarlane TW Mackenzie D | 1996 | J Periodontal Res1996，31，7： | 1 |
| 18 | Molecular identification of bacteria on the tongue dorsum of subjects with and without halitosis显示文摘 | Riggio MP Lennon A Rolph HJ | 2008 | Oral Diseases2008，14，3： | 1 |
| 19 | G-quadruplex ligand RHPS4 potentiates the antitumor activity of camp- tothecins in preclinical models of solid tumors显示文摘 | Leonetti C Scarsella M Riggio G | 2008 | Clin Cancer Res2008，14，22： | 1 |
| 20 | The Relationship Between Central Cues and Peripheral Cues in Covert Visual Orientation显示文摘 | Riggio L Kirsner K | 1997 | Perception and Psychophysics[J]1997，59，6： | 1 |
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