Prothrombin time predicts steroid response in severe alcohol-related hepatitis Claudia Tarli, Sergio Mannucci, Michele Vecchione, Mariangela Antonelli, Luisa Sestito, et al. Liver International, 2024 Background and AimsAlcohol‐related hepatitis (AH) is the most severe form of acute alcohol‐related liver disease. Maddrey's discriminant function ≥32 defines the severe form of AH, which is associated with a high mortality. Steroid therapy represents the main medical treatment that may reduce short‐term mortality. Lille score at day 7 assesses the therapeutic response to steroid therapy. At present, no parameters able to predict the response to steroid therapy have been highlighted. The aim of the present study was to evaluate if baseline prothrombin time (BPT) could predict the response to steroid in severe AH (sAH).MethodsPatients consecutively admitted in two Italian Liver Units, from 2017 to 2022, suffering from sAH were included. Data were collected prospectively. In order to evaluate if BPT could predict steroid response, we assessed the correlation between BPT using the Lille score at day 7.ResultsA total of 52 patients received steroid treatment were enrolled in the study. The response to therapy was assessed by Lille score at day 7. Responders were 34 patients (65%), non‐responders 18 patients (34%). BPT significantly predicted the steroid response (p < .001). The likelihood of not responding to the steroid therapy was significantly higher in patients with higher BPT (OR = 2.954).ConclusionsBPT value predicted steroid response in patients with sAH. BPT could quickly identify non‐responder patients to steroid therapy, reducing the risk of infections and it could allow the early evaluation for liver transplantation.
Gut Microbiota, LADA, and Type 1 Diabetes Mellitus: An Evolving Relationship Andrea Piccioni, Federico Rosa, Sergio Mannucci, Federica Manca, Giuseppe Merra, et al. Biomedicines, 2023 There is much evidence confirming the crucial role played by the gut microbiota in modulating the immune system in the onset of autoimmune diseases. In this article, we focus on the relationship between alterations in the microbiome and the onset of diabetes mellitus type 1 and LADA, in light of the latest evidence. We will then look at both how the role of the gut microbiota appears to be increasingly crucial in the pathogenesis of these disorders and how this aspect may be instrumental in the development of new potential therapeutic strategies that modulate the gut microbiota, such as probiotics, prebiotics, and fecal microbiota transplantation.
Risk of burnout and stress in physicians working in a COVID team: A longitudinal survey Tommaso Dionisi, Luisa Sestito, Claudia Tarli, Mariangela Antonelli, Alberto Tosoni, et al. International Journal of Clinical Practice, 2021 The COVID‐19 pandemic represents a source of stress and potential burnout for many physicians. This single‐site survey aimed at assessing perceived stress and risk to develop burnout syndrome among physicians operating in COVID wards.
