G Rotolo

Università degli Studi di Palermo, Palermo, Sicily, Italy

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Publications (34)27.8 Total impact

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    ABSTRACT: To analyze the main etiological factors and some clinical characteristics of patients with HCC at diagnosis and to compare them with those we described ten years ago. 179 patients were included in Group 1, while 132 patients were included in Group 2. For all patients age, sex, serum markers of hepatitis B and C viruses, alcohol consumption, serum alpha feto-protein (AFP) levels and the main liver function parameters at HCC diagnosis were recorded. Mean age was 66.0 years for Group 1 and 69.0 for Group 2 (P=0.005). HCV was responsible for 80.3% of HCC cases in Group 2 versus 72% in Group 1 (P=0.005). HBV alone and co-infection of HCV+HBV decreased, but not significantly. In Group 1 only four patients had an underlying normal liver, while in Group 2 no patients showed an underlying normal liver (P=ns). HCC was more frequently associated with Child class A in Group 2 (P=0.0001), whereas in Group 1 it was more frequently associated with class C (P=0.0001). Staging of HCC correlated inversely when patients of Groups 1 and 2 were compared (P<0.03). AFP serum levels were above normal in 72% of cases in Group 1 and in 41.5% in Group 2 (P=0.0001). This study shows that over the last decade a number of characteristics of patients with HCC in our region have changed, particularly age at onset of HCC, staging of underlying liver disease and staging of HCC.
    No preview · Article · Apr 2010 · European Journal of Internal Medicine
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    ABSTRACT: Despite Helicobacter pylori (HP) infection is highly prevalent in older populations, low rates of HP diagnosis and eradication are reported in older persons, even in geriatric wards. We aim to evaluate the results of a HP-eradicating program in a sample of older patients in relation to dyspeptic symptoms and to endoscopic findings. A pool of 140 subjects (female/ale=86/54, mean age 68.6±5.4 years) with positive C(13)-urea breath test were recruited, clinically evaluated to investigate the presence and characteristics of dyspepsia and abdominal pain, and underwent gastric endoscopic examination. HP-eradication was obtained in 87.9% of subjects with first-line triple therapy, regardless of endoscopic findings. Sixty-eight (48.6%) patients were symptomatic and 72 (51.4%) were asymptomatic. HP-related organic disease in endoscopic examination was frequent (present in 53.6% of the patients) but the distribution of different pathologies were similar in patients with and without symptoms (p=0.86). Conclusions: even if diagnosis and treatment of HP infection in older patients is underestimated, this population should be a priority for HP-eradication since the infection is more frequent, peptic disease and gastric cancer are frequent, and eradication is effective.
    No preview · Article · Dec 2009 · Archives of gerontology and geriatrics
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    ABSTRACT: Eosinophil count in nasal fluid (ECNF) was used to differentiate nasal pathologies. Receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC) were performed to evaluate the ECNF's accuracy in distinguishing allergic rhinitis (AR) from non-allergic rhinitis (NAR). We also evaluated the accuracy of ECNF in recognizing patients with mild and severe symptoms of rhinitis and patients with ineffective and effective clinical responses to antihistamines. 1,170 consecutive adult patients with a clinical history of rhinitis were studied. ECNF's median in AR was 6.0 and 2.0 in NAR and the best cut-off value was > 3.0, AUC = 0.75. ECNF's median in AR with mild nasal symptoms was 3.0 and 7.0 with severe symptoms, and the best cut-off value was 4.0, AUC = 0.90. ECNF's median in NAR with mild nasal symptoms was 2.0 and 8.5 with severe symptoms, and the best cut-off value was > 4.0, AUC = 0.86. ECNF's median in AR with effective clinical response to antihistamines was 4.0 and 8.0 with ineffective response, the best cut-off value was < or = 5.0, AUC = 0.94. ECNF's median in NAR with an effective clinical response to antihistamines was 1.0 and 2.0 with ineffective response, and the best cut-off value was < or = 3.0, AUC = 0.64. Our results suggest an interesting practical use of ECNF data as evaluator of the clinical severity both AR and NAR. As predictor of the clinical response to antihistamines, ECNF is accurate only in patients with AR. The ECNF's performance was moderately accurate in distinguish patients with AR and NAR.
    No preview · Article · Oct 2009 · International journal of immunopathology and pharmacology
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    ABSTRACT: Hyponatremia, an electrolyte disturbance, can be due to loss of solutes or to an increase of ''free'' water concentration, predominantly caused by excessive antidiuretic hormone (ADH) secretion. When acute, hyponatremia is threatening, because it can cause cell swelling and severe neuromuscular symptoms (central pontine myelinolysis). In a sample of 220 subjects with hyponatremia (123 males, 97 females) aged from 47 to 83, hospitalized in the Department of Clinic Medicines and Emergent Pathologies, from 2000 till today, age, serum and urinary sodium concentration, urine specific gravity, signs, symptoms and causes of electrolyte disturbance were evaluated. Student's t-test was applied for parametric spread data, Mann-Whitney Test for no parametric spread data, ANOVA test for statistic comparison between groups. Hyponatremia due to an increase of ''free'' water prevails in respect to hyponatremia due to loss of solutes (55.9% vs 44%). In the first case the prevalent causes are: decompensated hepatic cirrhosis (37.3%), heart failure (31.7%), glucosate solutions at 5% (17.8%) and drugs that can potentially increase ADH secretion (antidepressants, etc.) (13%), especially in elderly people. In the second case chronic diarrhea, vomiting (40%, 32.9%) and diuretic-induced hypernatriuresis (18.5%) prevail. Laboratory results follow the grade of efficient volemia, registering statistically significant differences between the two variants of hyponatremia. Different diagnosis and adequate treatment are essential when hyponatremia is acute. Particular attention must be reserved to elderly people with hyponatremia, in which the mechanisms of ''free'' water clearance are inefficient and such hypotonic glucosate solutions as medicines that increase ADH secretion (psychodrugs) must be administered with caution and under clinical control.
    No preview · Article · May 2008 · Minerva medica
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    ABSTRACT: Diagnosing asthma cannot be always easy. It is important to consider the validity of the diagnostic tests, and/or how much more commonly they are positive in patients with asthma compared to healthy subjects and, particularly, to patients with asthma-like symptoms. To evaluate the validity of diagnostic tests for asthma, in terms of sensitivity, specificity, positive and negative predictive values, in patients with bronchial asthma compared to patients affected by gastro-oesophageal reflux disease (GERD) with asthma-like symptoms, and healthy control subjects without asthma and gastro-oesophageal reflux (GER). Single-center, cross-sectional, observational study. We studied 60 patients with mild asthma, 30 patients with GERD and asthma-like symptoms and 25 healthy control subjects. We measured provocative concentration of methacholine causing a 20% fall in the forced expiratory volume in 1s (MCh PC(20)/FEV(1)), the amplitude percent mean of peak expiratory flow (A%M of PEF), derived from twice-daily readings for >2 weeks, the FEV(1)/forced vital capacity (FEV(1)/FVC) ratio, the eosinophil count in blood and in induced sputum and the serum eosinophil cationic protein (ECP) levels. FEV(1)/FVC ratio, A%M of PEF, blood eosinophils counts and serum ECP levels were less sensitive and specific when the reference population was composed of patients with asthma-like symptoms by GER. While, MCh PC(20)/FEV(1) and induced sputum eosinophils count were the most sensitive (both 90%) and specific (89% and 92%, respectively) tests. Our findings demonstrate that MCh PC(20)/FEV(1) and the induced sputum eosinophil count are the most useful objective tests in patients with mild asthma. All patients with asthma presented both an MCh PC(20)/FEV(1) <1500 microg and eosinophils count in the induced sputum >1%.
    Full-text · Article · Jul 2007 · Respiratory Medicine
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    ABSTRACT: Primitive hyperparathyroidism (pHPT) is the most common form of hyperparathyroidism. The asintomatic form (apHPT) accounts for 75-80 percent of cases and is characterized by minimal symptoms secondary to high levels of calcemia. Bisphosphonate and calciomimetic drugs represent a potential alternative to the surgery in the treatment of apHPT patients, but at the present there are not guidelines on medical therapy in the management of these kind of patients.
    No preview · Article · Jun 2006 · Recenti progressi in medicina
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    ABSTRACT: In the management of uncomplicated arterial hypertension in pregnancy, blood pressure (BP) values of pregnant women should be treated in order to reduce risks of both maternal and fetal complications. To reduce these risks, it is necessary to monitor BP, some hematochemical parameters and albuminuria, to try to prevent more serious clinical complications. Moreover, repeated measurements of BP, as well as frequent ambulatory blood pressure monitoring (ABPM) over 24 h are necessary. In the treatment of hypertension in pregnancy, if there are no high risks, it is possible to try a non pharmacological antihypertensive therapy consisting of a suitable diet, reduction of weight, abolition of some lifestyles (smoking, excessive alcohol consumption and heavy physical exercises). If these measures are not sufficient or the risk is high, a pharmacological therapy with neither toxic nor teratogenic drugs for the fetus will be administered in order to normalize BP without reducing perfusion of the uterus/placenta. Only in case of severe hypertension, a more aggressive pharmacological treatment should be carried out and, if necessary, hospitalization. The drugs suggested in these cases are those which have already been recognised as presenting low side effects. Antihypertensive drugs used in pregnancy can be classified as: suitable (methyldopa, clonidine, long acting calcioantagonists); cautiously used (alpha-blockers, beta-betablockers); contraindicated (ACE-inhibitors, sartans, short acting calcioantagonists). Hyper-tensive crises should be treated with an injection therapy (clonidine, labetalol), with hospital admission if necessary, or if preeclampsia or eclampsia may occur.
    No preview · Article · Mar 2006 · Minerva medica
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    ABSTRACT: COPD patients were treated with both short-acting and long-acting inhaled β2-antagonists therapy. We wanted to verify if there were cardiac implications during this treatment. After a seven days washout of bronchodilators drugs, 17 patients have been previously treated with 100 μg 4/die inhaled salbutamol for a week and later with 25 μg 2/die inhaled salmeterol for one more week. Other 16 patients have been previously treated with 25 μg 2/die inhaled salmeterol for a week and later with 100 μg 4/die inhaled salbutamol for one more week. We used to check: 1) Diurnal and nocturnal HR average recorded with ECG-Holter in 24 hours, 2) Diurnal and nocturnal BP average with ambulatorial monitoring (ABPM), 3) Quantity of diurnal and nocturnal AEB and VEB recorded with ECG-Holter in 24 hours, 4) Dosage of blood potassium. As regards statistical evaluation of diurnal and nocturnal BP, HR and kaliemia before and after treatment, we used Paired Student's t- test. After salbutamol treatment we noticed an increase of both diurnal and nocturnal BP and HR, a reduction of blood potassium and an increase of AEB and VEB and 4 patients (12,12%) presented two episodes of double VEB in 24 hours while 3 patients (9,09%) presented an episode of VEB in 24 hours. After salmeterol therapy we noticed an increase of nocturnal HR and a reduction of blood potassium, that seems statistically significant. Furthermore we also proved an increase of VEB and AEB, even if inferior to the usual value after salbutamol treatment. It is interesting to underline that 3 patients (9,09%) only presented one episode of double VEB. Making a comparison between the data obtained by the two studies on the treatment with salbutamol and salmeterol, we noticed a statistically significant difference not only between diurnal and nocturnal systolic and diastolic BP but also in the diurnal HR while nocturnal HR and blood potassium values were not so important. In this way we underline the existence of potentially dangerous cardiac implications. For this reason it is suitable, during the treatment with these drugs, a continuous monitoring of all cardiac parameters we considered in our study, avoiding high dose and eventually testing the combination with other drugs that, even without the same therapeutic effects, (according to the international literature), may have less severe undesired effects. Furthermore, these substances will not have to be used when COPD patient has important arrhythmias and when they use drugs that can cause hypokalemia (diuretics: thiazide or furosemide). The authors think that it is necessary to verify the issue with a wider survey, in order to assess cardiac implications in COPD β2-agonists therapy more precisely.
    No preview · Article · Jan 2006 · Acta Medica Mediterranea
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    ABSTRACT: Aminobisphosphonates and statins act in the same metabolic way, Bisphosphonates are considered the drugs of choice for the treatment of osteoporosis, like statins for the treatment of atherosclerosis. Aminobisphosphonates inhibit cholesterol biosynthesis and this might be relevant for their actions on atherosclerosis too. Recently, HMG-CoA reductase inhibitors (statins), have been correlated to protective effects on bone metabolism. Because of their widespread use, prevention of bone loss and fractures would be a desirable side effect. However, the mechanisms by which statins may affect bone metabolism and amino-bisphosphonates may affect atherosclerosis are poorly defined. Further studies are necessary to assess the effects of those drugs in combination or alone on the prevention of osteoporosis, atherosclerosis and other age-related diseases.
    No preview · Article · Jan 2006 · Acta Medica Mediterranea
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    ABSTRACT: Background: Previous studies showed that after H. pylori eradication, the effectiveness of the proton pump inhibitors therapy is lower in patients affected with oesophagithis Furtherome, there is an inverse correlation between the frequency of the oesophagithis and H. pylori infection. Aims: To verify 24 hours pHmetry gastric and oesophageal index, the influence of H. pylori eradication on the onset of the new reflux-like symptoms in H. pylori subjects who were initially included for functional dyspepsia. Materials and Methods: We studied 44 male (mean age 38.1, S.D. ± 2.5) suffering from functional dyspepsia and H. pylori infection. Half of these subjects underwent to H. pylori eradication (group A), whereas the others did not (Group B). During the successive follow-up all patients showed reflux like symptoms and underwent 24-hours pHmetric tracing with a double channel probe. Results: None of the patients of both groups showed abnormal pHmetry tracing. Conclusions: H. pylori eradication treatment did not increase the frequency of gastroesophageal reflux.
    No preview · Article · Sep 2003
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    ABSTRACT: Hypertension in the elderly represents a cardiovascular risk factor which increases due to ageing and to the raise of blood pressure (BP) values. The occurrence of hypertension depends on an interaction between genes and environment. An available antihypertensive therapy causes a reduction in the incidence of cardiovascular events. An antihypertensive therapy in the elderly must take into account: in these subjects BP might be spontaneously lower over 30 mmHg in 24 hours; people normally have a postprandial BP reduction; sudden raises or falls of pressure cause cerebral hypoperfusion; some adverse vents of hypertensive drugs worsen their quality of life, not reducing myocardial hypertrophy; possible electrolytic troubles might worsen a congestive heart failure; drastic diets cause a raise in the incidence of colorectal tumours; a high heart rate increases the risk of sudden death; a chronic NSAID intake might cause or aggravate a hypertensive state; a reduction of natrium chlorure and lipides in the diet might cause a BP fall. In short, the BP reduction should be gradual in the hypertensive elderly in order to avoid the occurrence of cardiovascular events, diets should be balanced, rich in fibres and vitamins to avoid colorectal tumours. Besides, NSAID must be used by these patients for a short time and all therapeutic interventions should improve their quality of life.
    No preview · Article · Jan 2000 · Minerva medica
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    ABSTRACT: The authors report the case of an unfit patient who, following intensive and prolonged physical exercise involving the abdominal muscles, presented a massive and diffuse subcutaneous edema (abdomen, scrotum, chest and face) together with abdominal and thoracic pain which increased in response to finger pressure. In addition, this was accompanied by a marked increase in CK, CK-MB and LDH, and TGO and TGP. Chest or heart pathologies were excluded by monitoring ECG and other clinical parameters, like heart rate and blood pressure, and by performing a chest X-ray. Muscular ultrasonography confirmed the massive subcutaneous edema and abdominal MR showed a slight edema in the suprasacral region, as well as confirming the subcutaneous edema. Hematological data gradually reduced and returned to normal after a week. Edema and pain also regressed gradually: the former finally disappeared after one week and the latter after five days. The authors conclude that clinical and laboratory findings were particularly severe because the subject was unfit and subcutaneous edema was larger than the free liquid in the abdominal cavity because the latter was absorbed by the peritoneum which acted as a dialysing membrane.
    Full-text · Article · Oct 1998 · Minerva medica
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    ABSTRACT: The authors take into consideration risk factors responsible for pulmonary embolism and analyse methodology for a prophylaxis as much as subjective in this pathology. The methodology described: mechanicals (with the use of elastic stocking, graduate compressed elastic bandages, intermittence pneumatic compression, implantation of caval filters); pharmacologicals (anticoagulants by mouth or by intramuscular injection, dextrane, dermatansulphate, antiaggregant of platelets); mixed therapy. These methodologies attempt to save human lifes, to reduce hospital charges being to people's advantage, to reduce the number and the seriousness of pulmonary embolism. Finally, the authors hope for a new accurate research of others unknown risk factors and experimentation of new technical method reducing the incidence of pulmonary embolism.
    No preview · Article · Jun 1996 · Minerva pneumologica

  • No preview · Article · Aug 1989 · Journal of chemotherapy (Florence, Italy)

  • No preview · Article · Aug 1989 · Journal of chemotherapy (Florence, Italy)

  • No preview · Article · Aug 1989 · Journal of chemotherapy (Florence, Italy)

  • No preview · Article · Aug 1989 · Journal of chemotherapy (Florence, Italy)
  • M Scardavi · G Rotolo · F Salamone · G B Rini · F Rubino

    No preview · Article · May 1988 · Bollettino della Società italiana di biologia sperimentale

  • No preview · Article · Nov 1987 · Giornale di clinica medica

  • No preview · Article · Nov 1987 · Bollettino della Società italiana di biologia sperimentale