MEDICINE :: Arturo Tozzi

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PEDIATRIC DERMATOLOGY

Tozzi A. 2015. Oral Propranolol for Infantile Hemangioma. The New England Journal of Medicine 373 (3): 284–85. doi:10.1056/NEJMc1505699. Back to pediatrics.

GASTROENTEROLOGY

Tozzi A, Minella R. 2024. Dynamics and metabolic effects of intestinal gases in healthy humans. Biochimie. https://doi.org/10.1016/j.biochi.2024.02.001 PDF

Tozzi A, Minella R. 2024. Dynamics and metabolic effects of intestinal gases in healthy humans. Biochimie. https://doi.org/10.1016/j.biochi.2024.02.001. Intestinal gases are not just useless sub-products of colonic fermentation...

PEDIATRIC GASTROENTEROLOGY

Tozzi, A. To Know them, Remove their Information: An Outer Methodological Approach to Biophysics and Humanities. Philosophia (2022). https://doi.org/10.1007/s11406-022-00576-y. Investigating objects from outside. Turing spots and Hirschsprung Disease: an unusual theoretical relationship.

Minella R, Minelli R, Rossi E, Cremone G, Tozzi A. 2020. Gastroesophageal and gastric ultrasound in children: the state of the art. Journal of Ultrasound. https://doi.org/10.1007/s40477-020-00471-w. Online ahead of print.

Vittoria Buccigrossi , Carla Armellino, Arturo Tozzi, Emanuele Nicastro, Ciro Esposito, Francesca Alicchio, Santolo Cozzolino, Alfredo Guarino. 2013. Time- and segment-related changes of postresected intestine: a 4-dimensional model of intestinal adaptation. J Pediatr Gastroenterol Nutr . 2013 Jan;56(1):40-5. doi: 10.1097/MPG.0b013e318268a9a4.

Staiano A, Basile P, Simeone D, Stanco A, Tozzi A, Caria MC. 1996. Proximal esophageal pH metry in children with respiratory symptoms. The Italian journal of gastroenterology 05/1996; 28(3):136-9

Staiano A, Santoro L, De Marco R, Stanco A, Fiorillo F, Tozzi A. 1996. Autonomic dysfunction in children with Hirschsprung’s disease. Journal of Pediatric Gastroenterology and Nutrition 05/1996; 22(4)., DOI:10.1097/00005176-199605000-00065.

Tozzi A, Mossetti G, Miele E, D’Armiento FP, Toraldo C, Staiano A. 1997. Development of submucosal and myenteric plexuses in relation to gestational age. Journal of Pediatric Gastroenterology and Nutrition 04/1997; 24(4)., DOI:10.1097/00005176-199704000-00122.

Tozzi A, Ascione G, Carpentieri ML, Staiano A. 1997. Intestinal neuronal dysplasia associated with cystic fibrosis. Archives of Disease in Childhood 10/1997; 77(3):277. DOI:10.1136/adc.77.3.276a.

Staiano A, Tozzi A. 1998. Diagnosis and treatment of constipation in children. Current Opinion in Pediatrics 11/1998; 10(5):512-5., DOI:10.1097/00008480-199810000-00011.

Fitzgerald JF, Troncone R, Tozzi A, Tramontano A, Toraldo C. 1998. Clinical Quiz. Journal of Pediatric Gastroenterology and Nutrition 11/1998; 27(5):546-+., DOI:10.1097/00005176-199811000-00005.

Oderda G, Palli D, Saieva C, Chiorboli E, Bona G, Tozzi A. 1998. Short stature and Helicobacter pylori infection in italian children: prospective multicenter hospital based case-control study. The Italian Study Group on Short Stature and H pylori. BMJ Clinical Research 09/1998; 317(7157):514-5.

Tozzi A, Tramontano A, Toraldo C. 1998. Clinical quiz. Long-segment Hirschsprung's disease (total colonic aganglionosis). Journal of Pediatric Gastroenterology and Nutrition 12/1998; 27(5):546,559.

Auricchio A, Griseri P, Carpentieri ML, Betsos N, Staiano A, Tozzi A, Priolo M, Thompson H, Bocciardi R, Romeo G, Ballabio A, Ceccherini I. 1999. Double Heterozygosity for a RET Substitution Interfering with Splicing and an EDNRB Missense Mutation in Hirschsprung Disease. The American Journal of Human Genetics 05/1999; 64(4):1216-21., DOI:10.1086/302329.

Miele M, Staiano A, Troncone R, Tozzi A, Ciarla C, Paparo F. 1999. Clinical Response to Amino Acid-Based Enteral Formula in Neurologically Impaired Children With Refractory Esophagitis. Journal of Pediatric Gastroenterology and Nutrition 05/1999; 28(5):561., DOI:10.1097/00005176-199905000-00090.

Tozzi A, Staiano A, Tramontano A, Miele E, Toraldo C. 1999. Hyperganglionosis and Hirschsprung's disease. Journal of Pediatric Gastroenterology and Nutrition 05/1999; 28(5)., DOI:10.1097/00005176-199905000-00132.

Staiano A, Tozzi A. 2000. Approccio alla stipsi cronica.

Staiano A, Simeone D, Del Giudice E, Miele E, Tozzi A, Toraldo C. 2000. Effect of the dietary fiber glucomannan on chronic constipation in neurologically impaired children. Journal of Pediatrics 02/2000; 136(1):41-5., DOI:10.1016/S0022-3476(00)90047-7.

Miele E, Tozzi A, Staiano A, Toraldo C, Esposito C, Clouse RE. 2000. Persistence of abnormal gastrointestinal motility after operation for Hirschsprung's disease. The American Journal of Gastroenterology 06/2000; 95(5):1226-30., DOI:10.1111/j.1572-0241.2000.02014.x.

Tozzi A, De Angelis A, Tramontano A, Scoppa A, Pinto L, Staiano A. 2001. Colonic transit times in children with anorectal malformations. Journal of Pediatric Gastroenterology and Nutrition 04/2001; 32:S55., DOI:10.1097/00005176-200104001-00048.

Tozzi A, Staiano A, Paparo F, Miele E, Maglio M, Di Meo M, Simeone D, Troncone R. 2001. Characterization of the inflammatory infiltrate in peptic oesophagitis. Digestive and Liver Disease 08/2001; 33(6):452-8., DOI:10.1016/S1590-8658(01)80021-9.

Miele E, Staiano A, Tozzi A, Auricchio R, Paparo F, Troncone R. 2002. Clinical Response to Amino Acid-Based Formula in Neurologically Impaired Children With Refractory Esophagitis. Journal of Pediatric Gastroenterology and Nutrition 10/2002; 35(3):314-9., DOI:10.1097/00005176-200209000-00014.

NEONATOLOGY

Tozzi A. 2016. A safer approach to umbilical granuloma with silver nitrate stick. (Electronic response to: A baby with a discharging umbilical lesion. BMJ 2016;355:i5587)

NEUROLOGY

Tozzi A. 2024. Approaching Electroencephalographic Pathological Spikes in Terms of Solitons. Signals, 5, 281-295. https://doi.org/10.3390/signals5020015. The astonishing traveling solitary waves that do not waste energy could be present in EEG traces of epileptic patients.

Tozzi, A. 2022. Why Should Natural Principles Be Simple? Philosophia 50, 321–335. h ttps://doi.org/10.1007/s11406-021-00359-x. Alzheimer’s disease and brain viscoelasticity

A very nice 2017 paper (Adult enteric nervous system in health is maintained by a dynamic balance between neuronal

apoptosis and neurogenesis, by Jae-Byum Chang, Fei Chen, Young-Gyu Yoon, Erica E Jung, Hazen Babcock, Jeong Seuk Kang, Shoh Asano, Ho-Jun Suk, Nikita Pak, Paul W Tillberg, Asmamaw T Wassie, Dawen Cai & Edward S Boyden in PNAS. Published online April 18 2017 doi:10.1073/pnas.1619406114) provides new evidence that, contrary to dogma, a healthy adult gut loses and regenerates a third of its nerve cells weekly. This is an astonishing, revolutionary claim. What a pity… What a pity, and a waste, that, in 2010, I (with my former group) studied and wrote exactly the same… The post-natal gut generates novel neurons.

GENETICS

Murgia N, Corsico AG, D’Amato G, Maesano CN, Tozzi A, Annesi Maesano I. 2021. Do gene-environment interactions play a role in COVID-19 distribution? The case of Alpha-1 Antitrypsin, air pollution and COVID-19. Multidis Res Med, Vol. 16. https://mrmjournal.org/mrm/article/view/741.

ENDOCRINOLOGY

NEFROLOGY

A WEIRD URINE SAMPLE. A 5-year female, who had suffered from a very mild strangury in the last few days, brought to the primary care pediatrician a urine sample in a winter morning, in order to perform a urine test strip for the rapid determination of ten parameters. When the mother opened the disposable urine container in front of the pediatrician, they realized that three ivory-white, half-round objects, unnoticed during the sampling, floated on the urine surface. They displayed a diameter of approximately 1 centimeters. In order to appreciate their size, notice that, in the Figure, the total diameter of the 150 ml cylinder is 5,8 cm. The three cupola-shaped structures were hard to the touch. Despite their hard plastic consistency, they cracked in 4-5 smaller pieces after a strong pressure between two fingers. The test strip did not show urinary pathological findings. Physical examination did not reveal alterations in child’s perineal and genital areas. The young female did not suffer from systemic diseases, such as hyperoxaluria or metabolic alterations. She was taking levetiracetam (oral solution), because of a recent diagnosis of early onset occipital epilepsy The mother was fully reliable and trustworthy and did not suffer from any psychiatric or psycological diseases. Note that the well mixed, non-centrifuged, protected from light, not older than two hours urine was collected in a clean, well rinsed container, free of detergents and preservatives. No one manipulated the container after the sampling.

ANSWER: Where did the objects come from? After a careful anamnestic investigation, it sorted out that the child suffered from a recent onset otalgia, and that the mother treated the painful symptoms with paracetamol by rectal suppository in the past two days. In order to confirm the “diagnosis”, a rectal examination was performed: traces of a white, semisolid material, compatible with the remnants of a paracetamol suppository, were found 2-3 centimeters above the dentate line.

INFECTIOUS DISEASES

Tozzi A. 2020. Towards dewetting monoclonal antibodies for therapeutical purposes. Progress in Biophysics and Molecular Biology, 150:153-159. https://doi.org/10.1016/j.pbiomolbio.2019.09.001. Extracellular matrix, lipid bilayers, receptors, active sites of channels, nervous ion channels, Escherichia coli, Influenza A’s M2; Pseudomonas; Coronavirus, Engelmann syndrome, diabetes.

Tozzi A. 2022. Anopheles' peri-equatorial migration via Coriolis forces (electronic response to: Wu RL, Idris AH, Berkowitz NM, Happe M, Gaudinski MR, et al. 2022. Low-Dose Subcutaneous or Intravenous Monoclonal Antibody to Prevent Malaria. N Engl J Med 2022; 387:397-407. DOI: 10.1056/NEJMoa2203067). How do mosquitoes survive during the dry African seasons?

Tozzi A. 2023. Study proposal: towards streptococcal infections with nonspecific symptoms. Researchgate. DOI: 10.13140/RG.2.2.26331.13601. New diagnostic approaches to the fearful Group A Streptococcus?

Minella R, Carlomagno, Tozzi A 2015. Prevalenza di faringotonsillite da streptococco β-emolitico di gruppo A in una popolazione della Campania. Pediatria preventiva & Sociale. X(1), 18.19. Local prevalence of Streptococcus.

Tozzi A. 2017. Bacteria may produce resistance to antibiotics... although never exposed to them. BMJ, https://www.bmj.com/content/358/bmj.j3418/rr-9. Response to: Llewelyn MJ, Fitzpatrick JM, Darwin E, Tonkin-Crine S, Gorton C, et al. 2017. The antibiotic course has had its day. BMJ, 358:j3418. Antibiotic resistance to antibiotics did not evolve when the bacteria were directly exposed to them, rather is natural, ancient and hard wired in the microbial pangenome.

COVID

Tozzi, A. 2022. Why Should Natural Principles Be Simple? Philosophia 50, 321–335. https://doi.org/10.1007/s11406-021-00359-x. The underrated role of the host's lipid bilayer: SARS-Cov-2 virions produced in human hosts of different ages may display phenotypical differences.

Tozzi A. 2020. Endoplasmic reticulum-Golgi intermediate compartment: a novel target for SARS-Cov-2 therapies? https://www.bmj.com/content/368/bmj.m1252/rr-2 (electronic response to: Mahase E. 2020. Covid-19: what treatments are being investigated? BMJ. 2020 Mar 26;368:m1252. doi: 10.1136/bmj.m1252).

Tozzi A. 2020. SARS-Cov-2 virions produced in human hosts of different ages may display phenotypical differences (electronic response to: Argenziano MG, Bruce SL, Slater CL, Tiao JR, Baldwin MR. Characterization and clinical course of 1000 patients with coronavirus disease 2019 in New York: retrospective case series. BMJ 2020;369:m1996).

Tozzi A. 2020. S protein tilting & lipid bilayer (electronic response to: Ke Z, Oton J, Qu K, Cortese M, Zila V, McKeane L, et al. 2020. Structures and distributions of SARS-CoV-2 spike proteins on intact virions. Nature).

Tozzi A. 2020. The underrated role of the host's lipid bilayer (electronic response to: Wolff G, Limpens RWAL, Zevenhoven-Dobbe JC, Laugks U, Zheng S, et al. 2020. A molecular pore spans the double membrane of the coronavirus replication organelle. Science: eabd3629. DOI: 10.1126/science.abd3629).

Tozzi A. 2020. Mild COVID-19 symptoms and low viral load: a form of mithridatization? (electronic response to: Berger ZD, Evans NG, Phelan AL, Silverman RD. 2020. Covid-19: control measures must be equitable and inclusive. BMJ. 2020 Mar 20;368:m1141. doi: 10.1136/bmj.m1141).

Tozzi, A.; Peters, J.F.; Annesi-Maesano, I.; D'Amato, G. 2020. The Social Life of SARS-Cov-2 With Therapeutic Implications (electronic response to: Sanders JM, Monogue ML, Jodlowski TZ, Cutrell JB. 2020. Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19) –A review. JAMA, doi:10.1001/jama.2020.6019).

Tozzi A, D’Amato G. 2020. Cross-reactivity between COVID-19 and childhood vaccines? (electronic response to: del Rio C; Malani PN. 2020. 2019 Novel Coronavirus—Important Information for Clinicians. JAMA. Published online February 5, 2020. doi:10.1001/jama.2020.1490; Xu X-W, Wu X-X, Jiang X-G, Xu K-J, Ying L-J, et al. 2020. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m606; Bi Q, Wu Y, Mei S, Ye C, Zou X. 2020. Epidemiology and Transmission of COVID-19 in Shenzhen China: Analysis of 391 cases and 1,286 of their close contacts. medRxiv, doi: https://doi.org/10.1101/2020.03.03.20028423).

Tozzi A, D’Amato G, Guarino A. 2020. Towards cross-reaction between SARS-CoV-2 and childhood vaccines? (electronic response to: Kupferschmidt K, Cohen J. 2020. Can China's COVID-19 strategy work elsewhere? Science, 367(6482): 1061-1062. DOI: 10.1126/science.367.6482.1061).

Tozzi A. 2020a. Measles vaccine: protective against COVID-19? (electronic response to: Mina MJ, Kula T, Leng Y, Li M, de Vries RD, et al. 2019. Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens. Science, Vol. 366, Issue 6465, pp. 599-606. DOI: 10.1126/science.aay6485). Tozzi A. 2020. COVID-19 and Kawasaki: a problematic correlation (electronic response to: Mahase E. Covid-19: Cases of inflammatory syndrome in children surge after urgent alert. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1990).

Mitroi-Symeonidis FC, Anghel I, Tozzi A. 2020. Preventing a COVID-19 pandemic flashover (electronic response to: Day M. 2020. Covid-19: identifying and isolating asymptomatic people helped eliminate virus in Italian village. BMJ. 2020 Mar 23;368:m1165. doi: 10.1136/bmj.m1165).

Tozzi A. 2020. Mild COVID-19 Cases: Who Might Be Hospitalized And Who Can Be Quarantined? (electronic response to: Grasselli G, Pesenti A, Cecconi M. 2020. Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy Early Experience and Forecast During an Emergency Response. JAMA. Published online March 13, 2020. doi:10.1001/jama.2020.4031).

Tozzi A, D’Amato G, Guarino A. 2020. Rectal swabs for COVID-19 diagnosis (electronic response to: Vetter P, Vu DL, L’Huillier AG, Schibler M, Kaiser L, Jacquerioz F. 2020. Clinical features of covid-19. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1470).

Tozzi A. 2020. A deluge of disinfectants and skin lesions during covid-19 pandemics. (Electronic response to: Madigan LM, Micheletti RG, Shinkai K. 2020. How Dermatologists Can Learn and Contribute at the Leading Edge of the COVID-19 Global Pandemic. JAMA Dermatol. 2020;156(7):733-734. doi:10.1001/jamadermatol.2020.1438).

Tozzi A. 2020. Covid-19 and Kawasaki: a problematic correlation. (Electronic response to: Mahase E. 2020. Covid-19: Cases of inflammatory syndrome in children surge after urgent alert. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1990).

Tozzi A. 2020. Healthy children’s blood for treating COVID-19? (electronic response to: Li Q, Guan X, Wu P, Wang X, Zhou L, et al. 2020. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020 Mar 26;382(13):1199-1207. doi: 10.1056/NEJMoa2001316).

Tozzi A, D’Amato G. 2020. SARS-CoV-2 viroporin: a behind the scenes therapeutic target (electronic response to: Mahase E. 2020. Covid-19: Remdesivir is helpful but not a wonder drug, say researchers. BMJ 2020;369:m1798).

PEDIATRIC METHODOLOGY

Tozzi, A. A "nonlinear approach to pediatric diseases (electronic response to Hymel KP et al. Validation of a clinical prediction rule for pediatric abusive head trauma. Pediatrics. 2014 Dec;134(6):e1537-44. doi: 10.1542/peds.2014-1329). DOI: 10.13140/2.1.3360.8007

A lesson for parents: why no-vax conspiracy theories are untenable. Electronic Response to: Pediatrics, January 2018, VOLUME 141 / ISSUE 1 MeetingAbstract. Time for Your Check Up: The Impact of Vaccine Refusal on the Frequency of Physician Office Visits

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