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| 1 | Spontaneous fungal peritonitis: Epidemiology, current evidence and future prospective显示文摘Spontaneous bacterial peritonitis is a complication of ascitic patients with end-stage liver disease(ESLD); spontaneous fungal peritonitis(SFP) is a complication of ESLD less known and described. ESLD is associated to immunodepression and the resulting increased susceptibility to infections. Recent perspectives of the management of the critically ill patient with ESLD do not specify the rate of isolation of fungi in critically ill patients,not even the antifungals used for the prophylaxis,neither optimal treatment. We reviewed,in order to focus the epidemiology,characteristics,and,considering the high mortality rate of SFP,the use of optimal empirical antifungal therapy the current literature. | Marco Fiore Sebastiano Leone | 2016 | World Journal of Gastroenterology2016，22，34： | 19 |
| 2 | Current concepts and future strategies in the antimicrobial therapy of emerging Gram-positive spontaneous bacterial peritonitis显示文摘Spontaneous bacterial peritonitis(SBP) is the most common infection in end-stage liver disease patients.SBP is defined as an ascitic fluid infection with a polymorphonuclear leucocyte count ≥ 250/mm^3 without an evident intra-abdominal surgically treatable source.Several mechanisms contribute to SBP occurrence,including translocation of gut bacteria and their products,reduced intestinal motility provoking bacterial overgrowth,alteration of the gut's barrier function and local immune responses.Historically,Gram-negative enteric bacteria have been the main causative agents of SBP,thereby guiding the empirical therapeutic choice.However,over the last decade,a worryingly increasing prevalence of Gram-positive and multi-drug resistant(MDR) SBP has been seen.Recently,the microbiological spectrum of SBP seems to have changed in Europe due to a high prevalence of Gram-positive bacteria(48%-62%).The overall proportion of MDR bacteria is up to 22%-73% of cases.Consequently,empirical therapy based on thirdgeneration cephalosporins or amoxicillin/clavulanic acid,can no longer be considered the standard of care,as these drugs are associated with poor outcomes.Theaim of this review is to describe,with an epidemiological focus,the evidence behind this rise in Gram-positive and MDR SBP from 2000 to present,and illustrate potential targeted therapeutic strategies.An appropriate treatment protocol should include daptomycin plus ceftaroline and meropenem,with prompt stepdown to a narrower spectrum when cultures and sensitivity data are available in order to reduce both cost and potential antibiotic resistance development. | Marco Fiore Alberto Enrico Maraolo Ivan Gentile Guglielmo Borgia Sebastiano Leone Pasquale Sansone Maria Beatrice Passavanti Caterina Aurilio Maria Caterina Pace | 2017 | World Journal of Hepatology2017，9，30： | 13 |
| 3 | Nosocomial spontaneous bacterial peritonitis antibiotic treatment in the era of multi-drug resistance pathogens: A systematic review显示文摘AIM To systematically review literature upon aetiology of nosocomial spontaneous bacterial peritonitis(N-SBP) given the rising importance of multidrug-resistant(MDR) bacteria.METHODS A literature search was performed on MEDLINE and Google Scholar databases from 2000 to 15 th of November 2016, using the following search strategy: 'spontaneous' AND 'peritonitis'.RESULTS The initial search through electronic databases retrieved 2556 records. After removing duplicates, 1958 records remained. One thousand seven hundred and thirty-five of them were excluded on the basis of the screening of titles and abstract, and the ensuing number of remaining articles was 223. Of these records, after careful evaluation, only 9 were included in the qualitative analysis. The overall proportion of MDR bacteria turned out to be from 22% to 73% of cases across the studies.CONCLUSION N-SBP is caused, in a remarkable proportion, by MDR pathogens. This should prompt a careful re-assessment of guidelines addressing the treatment of this clinical entity. | Marco Fiore Alberto Enrico Maraolo Ivan Gentile Guglielmo Borgia Sebastiano Leone Pasquale Sansone Maria Beatrice Passavanti Caterina Aurilio Maria Caterina Pace | 2017 | World Journal of Gastroenterology2017，23，25： | 9 |
| 4 | Current controversies and future perspectives on treatment of intensive care unit delirium in adults显示文摘Delirium is the most frequent manifestation of acute brain dysfunction in intensive care unit(ICU).Although antipsychotics are widely used to treat this serious complication,recent evidence has emphasized that these agents did not reduce ICU delirium(ICU-D)prevalence and did not improve survival,length of ICU or hospital stay after its occurrence.Of note,no pharmacological strategy to prevent or treat delirium has been identified,so far.In this scenario,new scientific evidences are urgently needed.Investigations on specific ICU-D subgroups,or focused on different clinical settings,and studies on medications other than antipsychotics,such as dexmedetomidine or melatonin,may represent interesting fields of research.In the meantime,because there is some evidence that ICU-D can be effectively prevented,the literature suggests strengthening all the strategies aimed at prevention through no-pharmacological approaches mostly focused on the correction of risk factors.The more appropriate strategy useful to treat established delirium remains the use of antipsychotics managed by choosing the right doses after a careful case-by-case analysis.While the evidence regarding the use of dexmedetomidine is still conflicting and sparse,this drug offers interesting perspectives for both ICU-D prevention and treatment.This paper aims to provide an overview of current pharmacological approaches of evidence-based medicine practice.The state of the art of the on-going clinical research on the topic and perspectives for future research are also addressed. | Marco Cascella Marco Fiore Sebastiano Leone Domenico Carbone Raffaela Di Napoli | 2019 | World Journal of Critical Care Medicine2019，8，3： | 2 |
| 5 | Outcomes assessment of hepatitis C virus-positive psoriatic patients treated using pegylated interferon in combination with ribavirin compared to new Direct-Acting Antiviral agents显示文摘AIM To evaluate the outcomes in biological treatment and quality of life of psoriatic patients with chronic hepatitis C(CHC) treated with new Direct-Acting Antiviral agents(DAAs) compared to pegylated interferon-2α plus ribavirin(P/R) therapy.METHODS This is a retrospective study involving psoriatic patients in biological therapy who underwent anti-hepatitis C virus(HCV) treatment at the Department of Dermatology Galeazzi Orthopaedic Institute Milan, Italy from January 2010 to November 2017. The patients were divided into two groups: patients that underwent therapy with DAAs and patients that underwent HCV treatment with P/R. Patients were assessed by a dermatologist for psoriasis symptoms, collecting Psoriasis Area Severity Index(PASI) scores and the Dermatology Quality of Life Index(DLQI). PASI and DLQI scores were evaluated 24 wk after the end of HCV treatment and were assumed as an outcome of the progression of psoriasis. Switching to a different b DMARD was considered as an inadequate response to biological therapy. The dropout of HCV therapy and sustained virological response(SVR) were considered as outcomes of HCV therapy.RESULTS Fifty-nine psoriatic patients in biological therapy underwent antiviral therapy for CHC. Of this, 27 patients were treated with DAAs and 32 with P/R. After 24 wk post treatment, the DLQI and the PASI scores were significantly lower(P < 0.001 and P < 0.005, respectively) in the DAAs group compared with P/R group. None of the patients in the DAAs group(0/27) compared to 8 patients of the P/R group(8/32) needed a shift in biological treatment.CONCLUSION DAAs seem to be more effective and safe than P/R in HCV-positive psoriatic patients on biological treatment. Fewer dermatological adverse events may be due to interferon-free therapy. | Giovanni Damiani Chiara Franchi Paolo Pigatto Andrea Altomare Alessia Pacifico Stephen Petrou Sebastiano Leone Maria Caterina Pace Marco Fiore | 2018 | World Journal of Hepatology2018，10，2： | 1 |
| 6 | Use of anti-fungals in critically ill cirrhotic patients with spontaneous peritonitis显示文摘 | Marco Fiore Sebastiano Leone | 2015 | Journal of Hepatology2015，，： | 1 |
| 7 | Comment on “Management of infections in cirrhotic patients: report of a consensus conference”显示文摘 | Sebastiano Leone Luca Bisi Marianna Rossi Andrea Gori | 2014 | Digestive and Liver Disease2014，，： | 1 |
| 8 | Intra-abdominal infections: model of antibiotic stewardship in an era with limited antimicrobial options显示文摘 | Sebastiano Leone | 2011 | International Journal of Antimicrobial Agents2011，，3： | 1 |
| 9 | Spontaneous bacterial peritonitis due to carbapenemase-producing Enterobacteriaceae:Etiology and antibiotic treatment显示文摘Carbapenem antibiotics were first introduced in the 1980s and have long been considered the most active agents for the treatment of multidrug-resistant gramnegative bacteria.Over the last decade,carbapenem-resistant Enterobacteriaceae(CRE)have emerged as organisms causing spontaneous bacterial peritonitis.Infections caused by CRE have shown a higher mortality rate than those caused by bacteria sensitive to carbapenem antibiotics.Current antibiotic guidelines for the treatment of spontaneous bacterial peritonitis are insufficient,and rapid deescalation of empiric antibiotic treatment is not widely recognized.This review summarizes the molecular characteristics,epidemiology and possible treatment of spontaneous bacterial peritonitis caused by CRE. | Marco Fiore Sveva Di Franco Aniello Alfieri Maria Beatrice Passavanti Maria Caterina Pace Stephen Petrou Francesca Martora Sebastiano Leone | 2020 | World Journal of Hepatology2020，12，12： | 1 |
| 10 | Gut microbiota and nutrient interactions with skin in psoriasis:A comprehensive review of animal and human studies显示文摘The intestinal tract(i.e.,the gut),is where the body’s nutrients are absorbed,and is simultaneously inhabited by numerous microbes.An increasing body of literature suggests a crucial role for the gut microbiome in modulating systemic inflammatory disease.Psoriasis is a chronic systemic inflammatory disease and its pathogenesis is related to the interaction between genetic susceptibility,immune response and environmental triggers.The omics era has allowed physicians to assess different aspects of psoriasis pathogenesis such as the microbiome,infectome,and autoinfectome.Furthermore,diet appears to play an important role in modulating disease activity,perhaps by influencing gut microbes.Given these observations,we aimed to summarize the current knowledge regarding skin-microbiome-gut-nutrients and psoriasis. | Giovanni Damiani Nicola Luigi Bragazzi Thomas S McCormick Paolo Daniele Maria Pigatto Sebastiano Leone Alessia Pacifico Danica Tiodorovic Sveva Di Franco Aniello Alfieri Marco Fiore | 2020 | World Journal of Clinical Cases2020，8，6： | 1 |
| 11 | Antimicrobial approach of abdominal post-surgical infections显示文摘Abdominal surgical site infections(SSIs)are infections that occur after abdominal surgery.They can be superficial,involving the skin tissue only,or more profound,involving deeper skin tissues including organs and implanted materials.Currently,SSIs are large global health problem with an incidence that varies significantly depending on the United Nations’Human Development Index.The purpose of this review is to provide a practical update on the latest available literature on SSIs,focusing on causative pathogens and treatment with an overview of the ongoing studies of new therapeutic strategies. | Marco Fiore Antonio Corrente Sveva Di Franco Aniello Alfieri Maria Caterina Pace Francesca Martora Stephen Petrou Claudio Mauriello Sebastiano Leone | 2023 | World Journal of Gastrointestinal Surgery2023，15，12： | 0 |
| 12 | Burden of severe infections due to carbapenem-resistant pathogens in intensive care unit显示文摘Intensive care units(ICU)for various reasons,including the increasing age of admitted patients,comorbidities,and increasingly complex surgical procedures(e.g.,transplants),have become'the epicenter'of nosocomial infections,these are characterized by the presence of multidrug-resistant organisms(MDROs)as the cause of infection.Therefore,the perfect match of fragile patients and MDROs,as the cause of infection,makes ICU mortality very high.Furthermore,carbapenems were considered for years as last-resort antibiotics for the treatment of infections caused by MDROs;unfortunately,nowadays carbapenem resistance,mainly among Gram-negative pathogens,is a matter of the highest concern for worldwide public health.This comprehensive review aims to outline the problem from the intensivist's perspective,focusing on the new definition and epidemiology of the most common carbapenem-resistant MDROs(Acinetobacter baumannii,Pseudomonas aeruginosa and Enterobacterales)to emphasize the importance of the problem that must be permeating clinicians dealing with these diseases. | Maria Caterina Pace Antonio Corrente Maria Beatrice Passavanti Pasquale Sansone Stephen Petrou Sebastiano Leone Marco Fiore | 2023 | World Journal of Clinical Cases2023，11，13： | 0 |
| 13 | Current status of COVID-19 treatment:An opinion review显示文摘The pandemic severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has garnered the attention of scientists worldwide in the search for an effective treatment while also focusing on vaccine development.Several drugs have been used for the management of coronavirus disease 2019(COVID-19),which has affected many hospitals and health centers worldwide.Statistically significant results are lacking on the effectiveness of the experimented drugs in reducing COVID-19 morbidity or mortality,as there are very few published randomized clinical trials.Despite this,the literature offers some material for study and reflection.This opinion review attempts to address three burning questions on COVID-19 treatment options.(1)What kind of studies are currently published or ongoing in the treatment of patients with COVID-19?(2)What drugs are currently described in the literature as options of treatment for patients affected by the infection?And(3)Are there specific clinical manifestations related to COVID-19 that can be treated with a customized and targeted therapy?By answering these questions,we wish to create a summary of current COVID-19 treatments and the anti-COVID-19 treatments proposed in the recent clinical trials developed in the last 3 mo,and to describe examples of clinical manifestations of the SARS-CoV-2 infection with a cause-related treatment. | Sveva Di Franco Aniello Alfieri Stephen Petrou Giovanni Damiani Maria Beatrice Passavanti Maria Caterina Pace Sebastiano Leone Marco Fiore | 2020 | World Journal of Virology2020，9，3： | 0 |
| 14 | Antibiotic treatment in cirrhotic patients显示文摘In this editorial,we comment on the article by Liakina V:“Antibiotic resistance in patients with liver cirrhosis:Prevalence and current approach to tackle”(World J Clin Cases 2023,11:7530-7542).In this excellent review,Liakina presents current data on bacterial complications in patients with cirrhosis.Bacterial infections are the most common complication in patients with liver cirrhosis.We focus specifically on spontaneous bacterial peritonitis(SBP)which is the most repres-entative infectious complication.Liakina V suggested starting empirically,in all patients with suspected SBP,third-generation cephalosporins when the number of polymorphonuclear leukocytes(PMNs)in ascites is greater than 250/mm^(3).This statement creates some doubts in our clinical practice so we discuss on the unsolved pitfalls of diagnosis and treatment that are often encountered in patients with ascitic fluid infections,especially on bacterascites that is defined as ascitic bacterial growth with PMNs below 250/mm^(3).The severity of liver disease and overall prognosis are highly comparable for patients with bacterascites and SBP in some recent well-conducted studies.Furthermore,we present a brief analysis of the prevalence of antibiotic-resistant isolates with an introduction of currently approved antibiotic drug options to treat ascitic fluid infections avoiding antibiotic resistance.In light of the most recent epidemiological data,third-generation cephalosporins should not be considered as an empirical antibiotic treatment of choice for ascitic fluid infections. | Marco Fiore Sebastiano Leone | 2023 | World Journal of Clinical Cases2023，11，35： | 0 |
| 15 | Nonalcoholic fatty liver disease prevalence in an Italian cohort of patients with hidradenitis suppurativa: A multi-center retrospective analysis显示文摘BACKGROUND Nonalcoholic fatty liver disease(NAFLD) includes two distinct conditions, with different histologic features and prognosis: non-alcoholic fatty liver(NAFL) and non-alcoholic steatohepatitis(NASH). Furthermore, NASH is the more aggressive necro-inflammatory form, which may accumulate fibrosis and result in End stage liver disease(ESLD). NAFLD is also linked to systemic inflammatory conditions such as psoriasis. NAFLD is currently the most common cause of ESLD in Western countries, becoming a serious public health concern.Hidradenitis suppurativa(HS) is a systemic inflammatory/autoinflammatory disease of the terminal follicular epithelium of the apocrine gland with a prevalence of 0.05% to 4.10%. Due to its systemic inflammatory behavior several comorbidities were recently associated, however liver ones were scarcely assessed.AIM To evaluate the prevalence and characteristics of NASH/NAFL in HS patients.METHODS This retrospective study is a sub-analysis of a larger study carried out in 4 Italian dermatological centers. In this cohort, there were 83 patients: 51 patients with HS only, 20 patients with HS/NAFL and 12 with HS/NASH.RESULTS Inflammatory comorbidities were present in 3.9% of HS only patients, 25% of HS/NAFL patients and 58.3% of HS/NASH patients(P < 0.001). Similarly, mean Autoinflammatory Disease Damage Index(ADDI) was significantly higher among patients with HS/NASH(5.3 ± 2.2, P < 0.001) compared to patients with HS/NAFL or HS only(2.8 ± 1.6 and 2.6 ± 1.4 respectively). Furthermore, ADDI correlates with IHS4 in HS, HS/NAFL and HS/NASH. Diabetic patients have higher Hurley score than not diabetic ones. Ultrasound examination was significantly different in the three groups.CONCLUSION HS patients displayed a high prevalence of NASH/NAFLD and ultrasound examination should be particularly addressed to patients that display high ADDI scores. | Giovanni Damiani Sebastiano Leone Kristen Fajgenbaum Nicola L Bragazzi Alessia Pacifico Rosalynn RZ Conic Paolo DM Pigatto Carlo Maiorana Pierpaolo Poli Emilio Berti Maria C Pace Piergiorgio Malagoli Vincenzo Bettoli Marco Fiore | 2019 | World Journal of Hepatology2019，11，4： | 0 |
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