Piergiorgio Duca

University of Milan | UNIMI · Department of Biomedical and Clinical Sciences "Luigi Sacco"

Purpose The diagnostic accuracy of Narrow Band Imaging (NBI) in the endoscopic surveillance of ulcerative colitis (UC) has been disappointing in most trials which used the Kudo classification. We aim to compare the performance of NBI in the lesion characterization of UC, when applied according to three different classifications (NICE, Kudo, Kudo-IB...

[This corrects the article DOI: 10.1371/journal.pone.0228725.].

Background and aims There is uncertainty regarding the optimal duration of treatment with azathioprine (AZA) in ulcerative colitis (UC) and Crohn’s disease (CD). We analyzed the clinical course and predictors of relapse after AZA withdrawal in patients in sustained deep remission. Methods A prospective study was performed on patients who stopped t...

Background and study aims Virtual chromoendoscopy with Fuji Intelligent Color Enhancement (FICE) has never been studied in prospective trials of endoscopic surveillance for ulcerative colitis (UC). We compared FICE and white light endoscopy (WLE) in differentiation of visible lesions in UC. Patients and methods In a prospective parallel study, we c...

The article compares two of the most followed indices in the monitoring of COVID-19 epidemic cases: the Rt and the RDt indices. The first was disseminated by the Italian National Institute of Health (ISS) and the second, which is more usable due to the lower difficulty of calculation and the availability of data, was adopted by various regional and...

Le linee guida 2019 delle Società europee di cardiologia e dell'aterosclerosi sulla gestione delle dislipidemie hanno aumentato l'aggressività diagnostico-terapeutica e non distinguono prevenzione primaria e secondaria, con parziale eccezione per gli ultra75enni. Raccomandano nuovi target di cLDL: per pazienti a rischio molto alto si raccomanda una...

La pandemia di COVID-19 ha indotto il Governo a estendere e rafforzare la raccomandazione di vaccinazione antinfluenzale, e varie Regioni ne hanno ordinato l’obbligo per anziani e personale sanitario. Ad oggi, però, le ricerche più valide su anziani hanno dimostrato la sua utilità solo in cardiopatici in fase attiva, mentre per non cardiopatici le...

Oocyte donations (OD) represent 4.5% of all in vitro fertilization (IVF) cycles. While OD pregnancies face increased risks of obstetrical complications, especially pregnancy-induced hypertension and pre-eclampsia (PE), little is known about the physiology and the physiopathology of placentation. We performed a prospective case-control study to anal...

Background Risk stratification is challenging in conditions, such as chest pain, shortness of breath and syncope, which can be the manifestation of many possible underlying diseases. In these cases, decision tools are unlikely to accurately identify all the different adverse events related to the possible etiologies. Attribute matching is a predict...

Background In ulcerative colitis (UC), the diagnostic accuracy of virtual chromoendoscopy with non-magnified Narrow Band Imaging (NBI) was disappointing in the detection and differential diagnosis of neoplastic lesions in most trials performed according to unclear diagnostic criteria. The Kudo and NICE criteria are validated in the general populati...

Background HIV-1 infected patients show impaired semen parameters. Currently, it is not clear whether HIV-1 infection itself or antiretroviral therapy have an effect on semen parameters. We aim evaluate semen quality in a large cohort of fertile HIV-1 infected men under stable highly active antiretroviral therapy (HAART) and to assess the effect of...

Semen parameters among subgroups of HAART type according to HAART duration. HAART type was defined as: 1, NRTI; 2: NRTI+IP; 3: NRTI+ NNRTI. HAART duration subgroups were defined according to the median duration for each HAART type group. The comparison between HAART duration subgroups was performed using Kruskall-Wallis test. N.s.: not significant....

Results from the general linear model on semen parameters in a subgroup of 413 aviremic patients. Values are regression coefficients (95% confidence interval) from the general linear model that reflect differences in semen parameters per standard-deviation scores change in age, HAART duration, viral load and CD4 count and per unit of change in HAAR...

Objectives The purpose of this study was to compare the performance of gadobenate dimeglumine–enhanced MRI and gadoxetic acid–enhanced MRI in the hepatobiliary phase (HBP) in cirrhotic patients with different degrees of liver dysfunction. Methods In this retrospective cross-sectional study, we analyzed the unenhanced phase and the HBP of 131 gadob...

HIV-1-affected couples’ desire to have children and free sexual intercourses with the use of pre-exposure prophylaxis for the negative partner has emerged as an alternative option to assisted reproduction in aviremic patients under highly active antiretroviral therapy (HAART). It is already known that sperm quality may be impaired in HIV-infected m...

Background Pregnancy hormonal milieu represents a crucial determinant of fetal outcome. We aim to determine 17β-estradiol (E2) and progesterone (PGT) concentrations in spontaneous pregnancies during the first trimester. In addition, we aim to determine E2 concentrations as a function of gestational age (GA) and PGT. Methods Between November 2015 a...

Goals: The aim of this study was to analyze the performance of Fuji Intelligent Color Enhancement (FICE) using the classification of Kudo in the differentiation of neoplastic and non-neoplastic raised lesions in ulcerative colitis (UC). Background: The Kudo classification of mucosal pit patterns is an aid for the differential diagnosis of colore...

Background: People with abdominal aortic aneurysm who receive endovascular aneurysm repair (EVAR) need lifetime surveillance to detect potential endoleaks. Endoleak is defined as persistent blood flow within the aneurysm sac following EVAR. Computed tomography (CT) angiography is considered the reference standard for endoleak surveillance. Colour...

The optimal emergency department (ED) evaluation of syncope is uncertain. Research reports from multiple countries suggest extensive practice variation, high costs, and questionable benefit associated with current approaches.1–5 Moreover, only a few of the recommendations from international syncope guidelines deal with ED management.6–8 For example...

This study investigates the hypothesis that placenta works differently in oocyte donation (OD) compared to spontaneous pregnancies. To verify this hypothesis we examine the first trimester maternal serum levels of free β-hCG and pregnancy-associated plasma protein-A (PAPP-A). Then we evaluated for potential differences of Down syndrome screening be...

Health research based on administrative data and the availability of regional or national administrative databases has been increasing in recent years. We will discuss the general characteristics of administrative data and specific aspects of their use for health research purposes, indicating their advantages and disadvantages. Some fields of appli...

Osteoporosis treatment has low adherence and persistence. This study evaluated if greater patient involvement could improve them. At 12 months, only 114 out of 344 participants were "fully adherent and persistent" (all drug doses taken throughout the study). Only frequency of drug administration had a significant influence on adherence. Osteoporosi...

Objective: To evaluate accuracy and cost of non-invasive diagnostic strategies including magnetic resonance imaging, intestinal ultrasonography, ileocolonoscopy and video-capsule endoscopy in suspected Crohn's disease. Methods: A decision-analytic model was used to assess the costs in low (25%), intermediate (50%) or high (75%) pre-test probability...

A new meningococcal serogroup B vaccine (4CMenB) has recently been licensed. This study assessed the acceptability of 4CMenB vaccine among parents and healthcare workers (HCWs). From May to July 2013 in Milan, Italy, self-administered questionnaires were distributed to 2050 parents of infants presenting at immunization clinics for the mandatory hex...

The Fondazione Umberto Veronesi ethics committee recently published a statement concerning the inherent ethical issues of randomized clinical trials (RCTs), mainly focusing on randomization, raising many questions, and suggesting possible solutions. The main concern is that the patients enrolled in a RCT are used to improve medical knowledge, but t...

Unlabelled: The diagnostic research process can be divided into five phases, designed to establish the clinical utility of a new diagnostic test--the index test. The aim of the present review is to illustrate the study designs that are appropriate for each diagnostic phase, using clinical examples regarding liver fibrosis diagnosed with transient...

Background: Perinatal stroke is a common cause of neurologic disability. Being clinically under-recognized, its true incidence is not known. Maternal thrombophilia is likely to be a predisposing factor. To date, a general consensus for evaluation of babies born to mothers with genetic thrombotic predisposition is missing. This study was undertaken...

Study objectives: There is limited evidence to guide the emergency department (ED) evaluation and management of syncope. The First International Workshop on Syncope Risk Stratification in the Emergency Department identified key research questions and methodological standards essential to advancing the science of ED-based syncope research. Methods...

Abstract Background: Following the "back to sleep" recommendations, a striking rise in deformational plagiocephaly (DP) occurred. However additional maternal, pregnancy and infant conditions may play a role. Objectives: We aimed to evaluate the prevalence of and risk factors for DP at birth. Additionally, given the association between assisted repr...

The editorial and peer-review processes should guarantee readers as to the reliability of published data. The first step of these processes is to check for errors. The aim of our study was to look for the presence of objective errors in consecutive articles published on three of the most authoritative clinical journals. Two reviewers evaluated the...

Low Molecular Weight Heparins (LMWH) are at least as effective antithrombotic drugs as Unfractionated Heparin (UFH). However, it is still unclear whether the safety profiles of LMWH and UFH differ. We performed a systematic review to compare the bleeding risk of fixed dose subcutaneous LMWH and adjusted dose UFH for treatment of venous thromboembol...

Subgroup analysis: number of daily LMWH administrations (once daily vs twice daily). (DOC)

Subgroup analysis by type of LMWH. (DOC)

Overall meta-analysis, including dose-finding studies (studies grouped by VTE or ACS patients). (DOC)

Subgroup analysis: number of daily LMWH administrations (once daily vs twice daily) in VTE and ACS studies. (DOC)

Subgroup analysis, after the exclusion of studies in which LMWH was was under-dosed (less than 75% of the recommended daily dose) or overdosed (more than 125% of the recommended dose). (DOC)

Subgroup analysis, after exclusion of low quality studies (Jadad Score<3). (DOC)

To systematically review the evidence regarding long-term prophylaxis in the prevention or reduction of attacks in hereditary angio-oedema (HAE). Systematic review and meta-analysis. Electronic databases were searched up to April 2011. Two reviewers selected the studies and extracted the study data, patient characteristics and outcomes of interest....

One group of six male control rats [12 months old] and one group of six male rats of the same age, singularly main-tained in a cage, and treated with acetyl-L-carnitine-HCl [(gamma-trimethyl-beta-acetyl-butyrobetaine-HCl: Sigma-Tau code ST200 or ALCAR: 60 mg/kg/day[7]/po)] for six months were tested in the spatial learning/memory Morris maze-water...

Autologous haematopoietic stem cells transplantation (HSCT) has been shown to be effective in refractory Crohn's disease. We analysed the effects of HSCT on the immune response of patients treated for moderate-severe Crohn's disease, refractory or intolerant to multiple drugs. Unselected peripheral blood stem cells were collected after mobilisation...

Syncope is a clinical event characterized by a transient loss of consciousness, estimated to affect 6.2/1000 person-years, resulting in remarkable health care and social costs. Human pathophysiology suggests that heat may promote syncope during standing. We tested the hypothesis that the increase of air temperatures from January to July would be ac...

Chronic hepatitis C is more aggressive during HIV infection. Available data about risk factors of liver fibrosis in HIV/HCV co-infected patients derive from studies based on a single liver biopsy. To evaluate the risk factors of liver fibrosis progression (LFP) and to investigate the role of antiretroviral therapy (ARV) in HIV/HCV patients who unde...

Randomized controlled trials (RCTs) that use the modified intention-to-treat (mITT) approach are increasingly being published. Such trials have a preponderance of post-randomization exclusions, industry sponsorship, and favourable findings, and little is known whether in terms of these items mITT trials are different with respect to trials that rep...

I donatori di sangue in occasione della donazione, e quindi potenzialmente più volte all’anno, vengono sottoposti a controlli clinici finalizzati a valutare la sicurezza del sangue donato. Il controllo sanitario rappresenta spesso una delle motivazioni principali alla donazione di sangue, ed è elemento importante per la fidelizzazione del donatore....

The objective of the study is to assess the prevalence of target organ damage (TOD) at carotid, cardiac, renal and peripheral vascular levels in a population at intermediate cardiovascular risk, with adjunctive major risk factors (AMRF). From March 2007 to July 2009 we examined 979 subjects at intermediate cardiovascular risk, as indicated by the I...

Aim of this study is to examine the epidemiology of paediatric headache and periodic syndromes in a school population and to evaluate the co-existence of environmental predisposing conditions. A 60-item questionnaire was completed by a school-based sample (n = 1536, ages 6-18 years). Diagnostic assessment of primary headache and periodic syndromes...

It is uncertain whether mucosal healing after the first course of corticosteroids therapy predicts outcome in patients with ulcerative colitis (UC). We evaluated whether early clinical and endoscopic responses to this therapy are associated with late outcomes in UC. Patients with newly diagnosed UC who were prescribed corticosteroid therapy (n = 15...

To compare retinal thickness measurements produced by different time-domain and spectral-domain optical coherence tomography (TD-OCT and SD-OCT) devices when imaging normal and pathologic eyes. Prospective, observational study in an academic institutional setting. A total of 110 eyes were imaged by 6 different OCT devices: Stratus and Cirrus (Carl...

The aim of this study was to evaluate the diagnostic accuracy of bedside lung ultrasound and chest radiography (CXR) in patients with suspected pneumonia compared with CT scan and final diagnosis at discharge. Design A prospective clinical study. Lung ultrasound and CXR were performed in sequence in adult patients admitted to the emergency departme...

The study aimed to compare the efficacy of the Osservatorio Epidemiologico sulla Sincope nel Lazio (OESIL) risk score, San Francisco Syncope Rule, and clinical judgment in assessing the short-term prognosis of syncope. We studied 488 patients consecutively seen for syncope at the emergency department of 2 general hospitals between January and July...

Long-term follow-up studies of achalasia after pneumatic dilation, mostly retrospective, have shown variable results. To examine the outcome of achalasia after pneumatic dilation using a prospective follow-up programme. One or two dilations (first dilation treatment) in 77 patients to achieve stable (>1 year) remission and patients followed up with...

The National UK IBD audit tool is an electronic database created to improve the quality and safety of care for IBD patients by auditing individual patient care, service resources and organisation against national standards. We used the National UK IBD audit tool to compare the organisation and process of IBD care between services in Oxford (UK) and...

In the era of screening colonoscopy, assessment of operator competence is warranted. To evaluate feasibility of a computer simulator (CS) use for assessment of competence in colonoscopy by investigating performance of expert endoscopists at CS. Twenty expert endoscopists involved in screening colonoscopy. Experts returned a questionnaire regarding...

Whether the duration of maintenance treatment with azathioprine (AZA) affects the outcome of ulcerative colitis (UC) is unclear. We investigated clinical outcomes and any predictive factors after withdrawal of AZA in UC. In this multicenter observational retrospective study, 127 Italian UC patients, who were in steroid-free remission at the time of...

Several studies have investigated, with conflicting results, the risk factors for reoperation in Crohn's disease (CD) patients. CARD15 gene variants have been identified as a major genetic risk factor for CD patients and associated with ileal disease, stenosis, and risk of surgery. However, data regarding the association between these variants and...

Cytokine production, immune activation, T lymphocytes maturation, and serum IL-7 concentration were examined in 24 youngsters with Down syndrome and no acquired diseases (healthy Down syndrome [12 prepubertal, 13 pubertal]) and 42 age- and gender-matched controls (20 prepubertal, 22 pubertal). Results showed that a complex immune and impairment is...

One group of six male control rats [21 months old] and one group of six male rats of the same age, singularly stored in a cage, and treated with acetyl-l-carnitine-HCl (ALCAR: 60 mg/kg/day/p.o.) for six months were tested in the spatial learning/memory Morris maze-water task and for atrophy and cell loss in seven myelo- and cytostructurally defined...