scispace - formally typeset
Search or ask a question
Author

Frank Senatore

Bio: Frank Senatore is an academic researcher from University of Connecticut Health Center. The author has contributed to research in topics: Adenocarcinoma & Cancer. The author has an hindex of 3, co-authored 9 publications receiving 21 citations.

Papers
More filters
Journal ArticleDOI
TL;DR: This work has shown a clear link between the initiation of anti-TNF therapy and the risk of herpes zoster, and the need for further research to establish a causative mechanism behind this association.

9 citations

Journal ArticleDOI
TL;DR: Innovative regimens including sequential and concomitant therapy, as well as the introduction of new antibiotics into previous treatment schedules, have shown promising improvements in eradication rates.
Abstract: Helicobacter pylori is a common worldwide bacterium, possessing adaptability that has created difficulty achieving eradication. While the standard treatment was thought to be triple therapy with a proton pump inhibitor, amoxicillin, and clarithromycin, growing rates of treatment failure and antibiotic resistance have stimulated research into novel regimens. Quadruple therapy with bismuth has been compared for both first- and second-line treatments, but eradication still has not reached expected goals. Innovative regimens including sequential and concomitant therapy, as well as the introduction of new antibiotics into previous treatment schedules, have shown promising improvements in eradication rates. We discuss and compare these unique regimens, reviewing the current literature to deduce those which are most likely to provide the highest success in curing H. pylori infection.

4 citations

Journal ArticleDOI
TL;DR: A 26-year-old African American female with no known medical history presented with complaints of severe left lower quadrant abdominal pain, which acutely worsened over the past 24 h, associated with nausea, dizziness and diaphoresis, and was diagnosed with antiphospholipid syndrome (APS).
Abstract: A 26-year-old African American female with no known medical history presented with complaints of severe left lower quadrant abdominal pain. The pain had been intermittent over the prior 2months, but acutely worsened over the past 24 h, associated with nausea, dizziness and diaphoresis. On physical exam, mental status was appropriate, without the presence of rashes or leg swelling, but she was febrile and tachycardic, with abdominal distension, diffuse tenderness to palpation, rebound and guarding. Laboratory data revealed a lactic acid of 2.6 mg/dL; complete blood count, electrolytes, and liver function tests were within normal limits. Urine pregnancy test was negative, and a computed tomography scan of the abdomen and pelvis showed intraperitoneal free air suspicious for intestinal perforation, as well as a splenic infarction with evidence of atrophic changes (Fig. 1). She underwent emergent resection of the rectosigmoid colon after a perforated sigmoid colon with fecal peritonitis was discovered. Histopathology from the colon specimen demonstrated an ischemic mucosal injury pattern, sigmoid ulcer with hemorrhage, transmural acute inflammation, and intravascular organizing thrombi (Figs 2, 3). She was given broad-spectrum parenteral antibiotics, yet despite these interventions, her abdominal pain persisted, and she was noted to have new bright red blood at her colostomy site. Further laboratory evaluation revealed positive antinuclear antibodies with a titer of 1 : 5120, an anticardiolipin IgM titer of 42 MPL (positive result: > 40 MPL) and a beta-2 glycoprotein IgG titer of 47 U/mL (positive result: >15 U/mL) confirming the diagnosis of antiphospholipid syndrome (APS). The patient was started on an unfractionated heparin infusion with significant symptomatic improvement. She was transitioned to an oral factor Xa inhibitor and remained clinically stable at 3-month follow-up. The diagnosis of APS is established by clinical episodes of arterial or venous small vessel thrombosis or pregnancy morbidity, combined with the presence anticardiolipin antibodies, anti beta-2 glycoprotein antibodies or lupus anticoagulant. Splenic and

4 citations

Journal ArticleDOI
TL;DR: A patient with ampulla of Vater adenocarcinoma who had an exceptional response to fluoropyrimidine-based chemotherapy is described, including a discussion reviewing the clinicopathologic aspects of this neoplasm.
Abstract: The scientific literature on adenocarcinoma of the ampulla (papilla) of Vater suggests that it either represents a distinct entity or is more closely related to small bowel adenocarcinoma than to the biliary malignancies. The ambiguity surrounding this rare cancer has kindled research exploring its immunohistochemistry aspects and gene expression profiling. While the basis of management for resectable disease remains surgical intervention, the role of adjuvant chemotherapy is not clear. A recent large phase 3 clinical trial conducted in patients with resected ampulla of Vater adenocarcinoma favored adjuvant chemotherapy over observation alone. The standards of therapy for the advanced small bowel adenocarcinoma and biliary cancer are fluoropyrimidine derivatives and gemcitabine-based combinations, respectively. In addition, new biologic and targeted agents may enhance clinical results seen in this cancer type. Therefore, diligently designed clinical trials are necessary to establish its optimal treatment strategies. We describe herein a patient with ampulla of Vater adenocarcinoma who had an exceptional response to fluoropyrimidine-based chemotherapy. We further include a discussion reviewing the clinicopathologic aspects of this neoplasm as well as focus on currently available and future therapeutic options.

3 citations

Journal ArticleDOI
TL;DR: Screening for second malignancies should be considered early after remission of the primary cancer is documented, especially when a prolonged survival or a cure is anticipated, and consideration should be given to increasing the frequency of colonoscopy.
Abstract: Cancer survivors are known to be at increased risk for second primary cancers. In addition, immunosuppression and previous cancer treatments such as radiotherapy and systemic chemotherapy are linked with increased risk of both colonic adenomas and adenocarcinomas. We performed a systematic review searching for manuscripts discussing second colon cancers, accelerated polyposis, immunosuppression, radiation, and chemotherapy. We sought to identify a link between immunosuppression and increased risks specific to premalignant polyposis and second colon cancers. We identified multiple studies demonstrating associations between radiotherapy, systemic chemotherapy, and immunosuppression with a higher propensity for second colon adenomas and adenocarcinomas. When compared to the general population, these risks were more profound and the rate at which these second malignancies developed was significantly increased. We believe that timing for colonoscopic surveillance in these patients should be different from the general population in order to identify promptly these rapidly progressive neoplasms. Screening for second malignancies should be considered early after remission of the primary cancer is documented, especially when a prolonged survival or a cure is anticipated. We also recommend consideration be given to increasing the frequency of colonoscopy in these cohorts. Future studies are required in order to establish the optimal time interval for surveillance colonoscopy in these high-risk individuals.

3 citations


Cited by
More filters
Journal ArticleDOI
TL;DR: The epidemiology, characteristics and management of the main gastrointestinal manifestations of systemic vasculitides, including polyarteritis nodosa and antineutrophil cytoplasm antibody-associated vasculinides, as well as isolated vascultides limited to the gastrointestinal tract are reviewed.
Abstract: Systemic vasculitides are caused by inflammation of blood vessels and can affect any organ and any part of the gastrointestinal tract, hepatic and biliary system, as well as the pancreas. These disorders can cause a wide array of gastrointestinal manifestations, from asymptomatic elevated transaminase levels and mild abdominal pain to potentially life-threatening bowel perforations and peritonitis. A diagnosis based solely on gastrointestinal symptoms is challenging as these manifestations are not specific. Conversely, diagnostic and therapeutic delays can be rapidly detrimental. In this article, we review the epidemiology, characteristics and management of the main gastrointestinal manifestations of systemic vasculitides, including polyarteritis nodosa and antineutrophil cytoplasm antibody-associated vasculitides, as well as isolated vasculitides limited to the gastrointestinal tract.

50 citations

Journal ArticleDOI
TL;DR: Clinicians are highly recommended to consider all alternatives to eradicate H. pylori until a universal vaccine becomes practically available, as well as designing an actual overview to gain optimal strategies against this infection.
Abstract: Infection with Helicobacter pylori plays an essential role in the development of duodenal and gastric ulcers as well as in the pathobiology of gastric adenocarcinoma. Thus, successful elimination of the bacterium can reduce the risk of development of these diseases. Currently, most guidelines recommend standard triple therapy (amoxicillin + clarithromycin + proton pump inhibitor), although its efficacy is rapidly falling. Notably, traditional first-line therapy fails in almost 32% of H. pylori- carrying cases, suggesting the importance of choosing the best formulation for first-line therapy. Hence, due to the decreasing effectiveness of first-line treatment, we should be prepared to confront increasing H. pylori therapeutic defeat. Owing to increasing reports of antibiotic resistance worldwide, newer approaches and directions are necessary for managing this problematic infection. Developing and providing better anti- H. pylori strategies (probiotics, antibiotic therapy and non-traditional medicine) without using current clinical experience in treating the infection is impossible. Furthermore, development and examination of new preventive vaccines may also be a new therapeutic direction. Taken together, with regard to current experience, clinicians are highly recommended to consider all alternatives to eradicate H. pylori until a universal vaccine becomes practically available. This article aims to give an overview regarding the current status of H. pylori treatment, accordingly designing an actual overview to gain optimal strategies against this infection.

27 citations

Journal ArticleDOI
TL;DR: This paper elucidates available knowledge concerning role of dupA in virulence of H. pylori after a decade of its discovery and concludes that current confusing epidemiological reports will continue.
Abstract: Helicobacter pylori (H. pylori) is a gastric human pathogen associated with acute and chronic gastritis, 70% of all gastric ulcers, 85% of all duodenal ulcers, and both forms of stomach cancer, mucosal-associated lymphoid tissue (MALT) lymphoma and adenocarcinoma. Recently, attention has focused on possible relationship between presence of certain virulence factor and H. pylori-associated diseases. Some contradictory data between this bacterium and related disorders has been observed since not all the colonized individuals develop to severe disease. The reported diseases plausibility related to H. pylori specific virulence factors became an interesting story about this organism. Although a number of putative virulence factors have been identified including cytotoxin-associated gene a (cagA) and vacA, there are conflicting data about their actual participation as specific risk factor for H. pylori-related diseases. Duodenal ulcer promoting gene a (dupA) is a virulence factor of H. pylori that is highly associated with duodenal ulcer development and reduced risk of gastric cancer. The prevalence of dupA in H. pylori strains isolated from western countries is relatively higher than in H. pylori strains from Asian countries. Current confusing epidemiological reports will continue unless future sophisticated and molecular studies provide data on functional and complete dupA cluster in H. pylori infected individuals. This paper elucidates available knowledge concerning role of dupA in virulence of H. pylori after a decade of its discovery.

25 citations

Journal ArticleDOI
01 Nov 2017-Medicine
TL;DR: Recognition of this syndrome could help doctors avoid unnecessary invasive procedures and emphasize the importance of alcohol abstinence as the mainstay of management and Glucocorticoids may not be useful in treating hemolytic anemia in Zieve syndrome.

18 citations

Journal ArticleDOI
TL;DR: ARMS‐PCR is a simple and fast method that has high sensitivity and specificity and can be used to detect the clarithromycin resistance of H. pylori in gastric mucosa.
Abstract: The goal of this study was to evaluate the feasibility of detecting Helicobacter pylori clarithromycin resistance in gastric mucosa using the amplification refractory mutation system combined with quantitative real-time PCR (ARMS-PCR). Gastric mucosal specimens (150) were collected from patients who were unsuccessfully treated for H. pylori eradication. Each specimen was divided into 2 samples. One sample was used to extract genomic DNA and detect any gene mutations of H. pylori produced by ARMS- PCR. Sequencing was used to assess the accuracy of this method. The other sample was used to culture H. pylori. The E-test minimum inhibitory concentration (MIC) was used to assess clarithromycin resistance. The results were compared with a paired chi-square test to validate the coincidence rate among the 3 methods. The coincidence rate between the sequencing and ARMS-PCR results was 98.7%, thus verifying the accuracy of ARMS-PCR. E-tests detected 144 clarithromycin resistance cases, including 45 sensitivity cases; the resistance rate was 70%. The coincidence rate between the results of the E-test and ARMS-PCR was 97.1%, and no significant difference between the 2 methods was observed. ARMS-PCR is a simple and fast method that has high sensitivity and specificity and can be used to detect the clarithromycin resistance of H. pylori in gastric mucosa. ARMS-PCR is expected to be used to study drug resistance mechanisms and use in assays of individual therapies for H. pylori eradication.

17 citations