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Cavoto G, Chakraborty R, Doinaki A, Dutsov C, Giovannozzi M, Hume T, Kirch K, Michielsen K, Morvaj L, Papa A, Renga F, Sakurai M, Schmidt-Wellenburg P. Anomalous spin precession systematic effects in the search for a muon EDM using the frozen-spin technique. Eur Phys J C Part Fields 2024; 84:262. [PMID: 38487792 PMCID: PMC10933177 DOI: 10.1140/epjc/s10052-024-12604-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/22/2024] [Indexed: 03/17/2024]
Abstract
At the Paul Scherrer Institut (PSI), we are developing a high-precision apparatus with the aim of searching for the muon electric dipole moment (EDM) with unprecedented sensitivity. The underpinning principle of this experiment is the frozen-spin technique, a method that suppresses the spin precession due to the anomalous magnetic moment, thereby enhancing the signal-to-noise ratio for EDM signals. This increased sensitivity enables measurements that would be difficult to achieve with conventional g - 2 muon storage rings. Given the availability of the 125 MeV / c muon beam at PSI, the anticipated statistical sensitivity for the EDM after a year of data collection is 6 × 10 - 23 e · cm . To achieve this goal, it is imperative to do a detailed analysis of any potential spurious effects that could mimic EDM signals. In this study, we present a quantitative methodology to evaluate the systematic effects that might arise in the context of the frozen-spin technique utilised within a compact storage ring. Our approach involves the analytical derivation of equations governing the motion of the muon spin in the electromagnetic (EM) fields intrinsic to the experimental setup, validated through numerical simulations. We also illustrate a method to calculate the cumulative geometric (Berry's) phase. This work complements ongoing experimental efforts to detect a muon EDM at PSI and contributes to a broader understanding of spin-precession systematic effects.
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Affiliation(s)
- G. Cavoto
- Istituto Nazionale di Fisica Nucleare, Sez. di Roma, P.le A. Moro 2, 00185 Rome, Italy
| | | | - A. Doinaki
- Paul Scherrer Institut, 5232 Villigen PSI, Switzerland
- ETH Zürich, 8092 Zurich, Switzerland
| | - C. Dutsov
- Paul Scherrer Institut, 5232 Villigen PSI, Switzerland
| | - M. Giovannozzi
- CERN Beams Department, Esplanade des Particules 1, 1211 Meyrin, Switzerland
| | - T. Hume
- Paul Scherrer Institut, 5232 Villigen PSI, Switzerland
- ETH Zürich, 8092 Zurich, Switzerland
| | - K. Kirch
- Paul Scherrer Institut, 5232 Villigen PSI, Switzerland
- ETH Zürich, 8092 Zurich, Switzerland
| | - K. Michielsen
- Paul Scherrer Institut, 5232 Villigen PSI, Switzerland
- ETH Zürich, 8092 Zurich, Switzerland
- École Polytechnique, Route de Saclay, 91128 Palaiseau Cedex, France
| | - L. Morvaj
- Paul Scherrer Institut, 5232 Villigen PSI, Switzerland
| | - A. Papa
- Istituto Nazionale di Fisica Nucleare, Sez. di Pisa, Largo B. Pontecorvo 3, 56127 Pisa, Italy
| | - F. Renga
- Istituto Nazionale di Fisica Nucleare, Sez. di Roma, P.le A. Moro 2, 00185 Rome, Italy
| | - M. Sakurai
- ETH Zürich, 8092 Zurich, Switzerland
- Present Address: University College London, Gower Street, London, WC1E 6BT UK
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Tursi A, Mocci G, Del Gaudio A, Papa A. Clinical use of biologics for Crohn's disease in adults: lessons learned from real-world studies. Expert Opin Biol Ther 2024:1-19. [PMID: 38321868 DOI: 10.1080/14712598.2024.2316180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/05/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION The therapeutic armamentarium for managing Crohn's disease (CD) has expanded significantly in recent decades. Several biologics with three different mechanisms of action [anti-tumor necrosis factor (TNF)-α, anti-integrin α4β7, and anti-IL 12/23] are currently available to manage CD. AREA COVERED This narrative review aims to summarize the most significant efficacy and safety data on the use of infliximab (IFX), adalimumab (ADA), vedolizumab (VDZ) and ustekinumab (UST) for the treatment of CD obtained from studies conducted in the real world (RW), compared to the results of randomized clinical trials (RCTs). EXPERT OPINION RW studies reported that biologic agents included in this analysis have higher remission rates and lower adverse event rates than findings from RCTs for treating patients with CD. All biological agents have proven effective and safe in RW studies, even when using biosimilars or switching to subcutaneous administration of the molecules for which they are available. Finally, anti-TNF-α agents, particularly IFX, have a higher rate of adverse events (AEs) than VDZ and UST. Therefore, patients at higher risk of AEs may benefit from other biologics than anti-TNF-α. However, further long-term RW studies are needed to confirm these findings.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria, Italy
- Department of Medical and Surgical Sciences, Catholic University, School of Medicine, Rome, Italy
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Angelo Del Gaudio
- Division of Internal Medicine and Gastroenterology, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Alfredo Papa
- Department of Medical and Surgical Sciences, Catholic University, School of Medicine, Rome, Italy
- Division of Internal Medicine and Gastroenterology, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
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Baglivo I, Colantuono S, Lumaca A, Papa A, Gasbarrini A, Caruso C. The last step to achieve barrier damage control. Front Immunol 2024; 15:1354556. [PMID: 38415254 PMCID: PMC10897052 DOI: 10.3389/fimmu.2024.1354556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/29/2024] [Indexed: 02/29/2024] Open
Abstract
Heterogeneity characterises inflammatory diseases and different phenotypes and endotypes have been identified. Both innate and adaptive immunity contribute to the immunopathological mechanism of these diseases and barrier damage plays a prominent role triggering type 2 inflammation through the alarmins system, such as anti-Thymic Stromal Lymphopoietin (TSLP). Treatment with anti-TSLP monoclonal antibodies showed efficacy in severe asthma and clinical trials for other eosinophilic diseases are ongoing. The aim of this perspective review is to analyse current advances and future applications of TSLP inhibition to control barrier damage.
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Affiliation(s)
- Ilaria Baglivo
- Centro Malattie Apparato Digerente (CEMAD) Digestive Disease Center, Fondazione Policlinico Universitario “A. Gemelli” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Stefania Colantuono
- Unità Operativa Semplice Dipartimentale Day Hospital (UOSD DH) Medicina Interna e Malattie dell’ApparatoDigerente, Fondazione Policlinico Universitario “A. Gemelli” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Arianna Lumaca
- Unità Operativa Semplice Dipartimentale (UOSD) di Allergologia, Ospedale Maria Santissima (SS) Dello Splendore, Teramo, Italy
| | - Alfredo Papa
- Unità Operativa Semplice Dipartimentale Day Hospital (UOSD DH) Medicina Interna e Malattie dell’ApparatoDigerente, Fondazione Policlinico Universitario “A. Gemelli” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Antonio Gasbarrini
- Centro Malattie Apparato Digerente (CEMAD) Digestive Disease Center, Fondazione Policlinico Universitario “A. Gemelli” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Cristiano Caruso
- Unità Operativa Semplice Dipartimentale Day Hospital (UOSD DH) Medicina Interna e Malattie dell’ApparatoDigerente, Fondazione Policlinico Universitario “A. Gemelli” Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Università Cattolica del Sacro Cuore, Roma, Italy
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Napolitano D, Settanni CR, Parisio L, Orgiana N, Poscia A, Schiavoni E, Turchini L, Cascio AL, Germini F, Sblendorio E, Milani A, Patteril C, Laterza L, Lopetuso LR, Pugliese D, Papa A, Gasbarrini A, Scaldaferri F. Transition from intravenous to subcutaneous biological therapies in inflammatory bowel disease: An online survey of patients. Indian J Gastroenterol 2024; 43:215-225. [PMID: 38244138 DOI: 10.1007/s12664-023-01500-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 12/05/2023] [Indexed: 01/22/2024]
Abstract
BACKGROUND The transition from in-hospital intravenous administration to subcutaneous therapies to treat inflammatory bowel disease (IBD) can raise some concerns among patients due to the self-administration concerns, the management of potential side effects and the overall worries related to a change of treatment. This study aimed at evaluating patients' opinion about the switch from intravenous to subcutaneous formulations and their knowledge on new available therapeutic options. METHODS We conducted a survey using a questionnaire prepared by a team of gastroenterologists and nurses working at the IBD unit. It consists of 31 items and has been divided into four sections: descriptive, commitment, knowledge and passage mode opinion. The questions were formulated in Italian and conceived according to daily consultations with patients in everyday practice, without any previous piloting or specific medical literature reference. The survey was administered to consecutive IBD patients in intravenous biological treatment; patients currently or previously treated with subcutaneous therapy were excluded. RESULTS Four hundred questionnaires were distributed to participants. As many as 311 patients (77.7%) completed the survey, while the remaining were excluded from the analysis; 155 (49.8%) patients were favorable to switch from intravenous to subcutaneous therapy, while only 78 (25.1%) disagreed. In univariate and multi-variate analysis, the approval rate for home therapy was significantly associated with the distance from the IBD center and work/family/personal commitments. Surprisingly, only a quarter of the IBD patients knew that almost all available therapeutic agents have a subcutaneous administration route. Regarding patients' opinion on the efficacy of subcutaneous administration of biological agents compared to intravenous drugs, 194 (63%) had no definite idea, while 44 (14%) believed that the effectiveness could be reduced. CONCLUSION The transition from in-hospital to subcutaneous therapeutic management of biological therapy at home was generally viewed favorably by patients, especially if they have commitments or were residents far from the IBD center.
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Affiliation(s)
- Daniele Napolitano
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
| | | | - Laura Parisio
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | | | - Andrea Poscia
- Fondazione Policlinico A. Gemelli IRCCS, 00168, Rome, Italy
| | - Elisa Schiavoni
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Laura Turchini
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | | | | | - Elena Sblendorio
- Azienda Ospedaliero-Universitaria Consorziale Policlinico di Bari, Bari, Italy
| | | | | | - Lucrezia Laterza
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Loris Riccardo Lopetuso
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Daniela Pugliese
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Alfredo Papa
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Antonio Gasbarrini
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - Franco Scaldaferri
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
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Tursi A, Mocci G, Scaldaferri F, Napolitano D, Maresca R, Pugliese D, Semprucci G, Savarino E, Cuomo A, Donnarumma L, Bodini G, Pasta A, Maconi G, Cataletti G, Pranzo G, Rodinò S, Sebkova L, Costa F, Ferronato A, Gaiani F, Marzo M, Luppino I, Fabiano G, Paese P, Elisei W, Monterubbianesi R, Faggiani R, Grossi L, Serio M, Scarcelli A, Lorenzetti R, Allegretta L, Chiri S, Grasso G, Antonelli E, Bassotti G, Spagnuolo R, Luzza F, Fanigliulo L, Rocco G, Sacchi C, Zampaletta C, Rocchi C, Bolognini L, Bendia E, Bianco MA, Capone P, Meucci C, Colucci R, Tonti P, Neve V, Della Valle N, Felice C, Pica R, Cocco A, Forti G, Onidi FM, Usai Satta P, Checchin D, Gravina AG, Pellegrino R, Picchio M, Papa A. Ustekinumab safety and effectiveness in patients with ulcerative colitis: results from a large real-life study. Expert Opin Biol Ther 2024; 24:101-109. [PMID: 38250818 DOI: 10.1080/14712598.2024.2309300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/19/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Ustekinumab (UST) is an interleukin-12/interleukin-23 receptor antagonist recently approved for treating ulcerative colitis (UC) but with limited real-world data. Therefore, we evaluated the effectiveness and safety of UST in patients with UC in a real-world setting. RESEARCH DESIGN AND METHODS This is a multicenter, retrospective, observational cohort study. The primary endpoints were the clinical remission rate (partial Mayo score, PMS, ≤1) and the safety of UST. Other endpoints were corticosteroid-free remission (CSFR) rate, clinical response rate (PMS reduction of at least 2 points), and fecal calprotectin (FC) reduction at week 24. RESULTS We included 256 consecutive patients with UC (M/F 139/117, median age 52). The clinical remission and clinical response rates at eight weeks were 18.7% (44/235) and 53.2% (125/235), respectively, and 27.6% (42/152) and 61.8% (94/152) at 24 weeks, respectively. At 24 weeks, CSFR was 20.3% (31/152), and FC significantly dropped at week 12 (p = 0.0004) and 24 (p = 0.038). At eight weeks, patients naïve or with one previous biologic treatment showed higher remission (p = 0.002) and clinical >response rates (p = 0.018) than patients previously treated with ≥ 2. Adverse events occurred in six patients (2.3%), whereas four patients (1.6%) underwent colectomy. CONCLUSION This real-world study shows that UST effectively and safely treats patients with UC.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria, Italy
- Department of Medical and Surgical Sciences, Catholic University, Rome, Italy
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Franco Scaldaferri
- Digestive Diseases Centre (CEMAD), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
| | - Daniele Napolitano
- Digestive Diseases Centre (CEMAD), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy
| | - Rossella Maresca
- Digestive Diseases Centre (CEMAD), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy
| | - Daniela Pugliese
- Digestive Diseases Centre (CEMAD), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
| | - Gianluca Semprucci
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Edoardo Savarino
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Antonio Cuomo
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Laura Donnarumma
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Giorgia Bodini
- Department of Internal Medicine and Medical Specialties, Division of Gastroenterology, IRCCS "San Martino" Hospital, University of Genoa, Genoa, Italy
| | - Andrea Pasta
- Department of Internal Medicine and Medical Specialties, Division of Gastroenterology, IRCCS "San Martino" Hospital, University of Genoa, Genoa, Italy
| | - Giovanni Maconi
- Gastroenterology Unit, Department Biomedical and Clinical Sciences, "L. Sacco" University Hospital, Milan, Italy
| | - Giovanni Cataletti
- Gastroenterology Unit, Department Biomedical and Clinical Sciences, "L. Sacco" University Hospital, Milan, Italy
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy
| | - Stefano Rodinò
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Francesco Costa
- IBD Unit, Department of General Surgery and Gastroenterology, Pisa University Hospital, Pisa, Italy
| | - Antonio Ferronato
- Digestive Endoscopy Unit, Hospital of Santorso, ULSS7, Santorso (VI), Italy
| | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Manuela Marzo
- Division of Gastroenterology, "Veris-Delli Ponti" Hospital, Scorrano (LE), Italy
| | - Ileana Luppino
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Giulia Fabiano
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Pietro Paese
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Walter Elisei
- Division of Gastroenterology, A.O. "S. Camillo-Folanini", Rome, Italy
| | | | - Roberto Faggiani
- Division of Gastroenterology, A.O. "S. Camillo-Folanini", Rome, Italy
| | - Laurino Grossi
- Gastroenterology Unit, "Spirito Santo" Hospital, "G d'Annunzio" University, Pescara, Italy
| | - Mariaelena Serio
- Division of Gastroenterology, "San Salvatore" Hospital, Pesaro, Italy
| | | | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Roma, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Stefania Chiri
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Giuseppina Grasso
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Elisabetta Antonelli
- Gastroenterology and Hepatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Gabrio Bassotti
- Gastroenterology and Hepatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Rocco Spagnuolo
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Libera Fanigliulo
- Division of Gastroenterology, "S.S. Annunziata" Hospital, Taranto, Italy
| | - Giulia Rocco
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | - Carlotta Sacchi
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | | | - Chiara Rocchi
- Division of Gastroenterology and Digestive Endoscopy, "Mater Olbia" Hospital, Olbia (SS), Italy
| | - Laura Bolognini
- Division of Digestive Diseases, Digestive Endoscopy and Inflammatory Bowel Diseases, A.O. "Ospedali Riuniti", Ancona, Italy
| | - Emanuele Bendia
- Division of Digestive Diseases, Digestive Endoscopy and Inflammatory Bowel Diseases, A.O. "Ospedali Riuniti", Ancona, Italy
| | - Maria Antonia Bianco
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Pietro Capone
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Costantino Meucci
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo degli Infermi" Hospital, Spoleto (PG), Italy
| | - Paolo Tonti
- Division of Gastroenterology, "A. Perrino" Hospital, Brindisi, Italy
| | - Viviana Neve
- Division of Gastroenterology, "A. Perrino" Hospital, Brindisi, Italy
| | | | - Carla Felice
- Division of Internal Medicine, "Ca' Foncello" University Hospital, Treviso, Italy
| | - Roberta Pica
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Andrea Cocco
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Giacomo Forti
- Division of Digestive Endoscopy, "S. Maria Goretti" Hospital, Latina, Italy
| | | | | | - Davide Checchin
- Division of Gastroenterology, " S Giovanni e Paolo" Hospital, Mestre - Venezia, Italy
| | - Antonietta Gerarda Gravina
- Department of Precision Medicine, Hepatogastroenterology and Digestive Endoscopy Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Raffaele Pellegrino
- Department of Precision Medicine, Hepatogastroenterology and Digestive Endoscopy Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri (Roma), Italy
| | - Alfredo Papa
- Digestive Diseases Centre (CEMAD), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" Foundation, IRCCS, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
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Maresca R, Varca S, Di Vincenzo F, Ainora ME, Mignini I, Papa A, Scaldaferri F, Gasbarrini A, Giustiniani MC, Zocco MA, Laterza L. Cytomegalovirus Infection: An Underrated Target in Inflammatory Bowel Disease Treatment. J Clin Med 2023; 13:130. [PMID: 38202138 PMCID: PMC10779749 DOI: 10.3390/jcm13010130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
CMV infection is still a matter of concern in IBD patients, especially regarding the disease's relapse management. Why IBD patients, particularly those affected by ulcerative colitis, are more susceptible to CMV reactivation is not totally explained, although a weakened immune system could be the reason. Various techniques, ranging from serology to histology, can be employed to detect intestinal CMV infection; however, there is currently disagreement in the literature regarding the most effective diagnostic test. Furthermore, CMV involvement in steroid resistance has been broadly discussed, but whether CMV infection is a cause or consequence of the disease severity and, consequently, steroid refractoriness is still debated. Its potential contribution to the lack of response to advanced therapy and small molecules must be more valued and wholly explored. In this review, we look at the actual literature on CMV in IBD patients, and we suggest a pragmatic algorithm for clinical practice management of CMV infection.
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Affiliation(s)
- Rossella Maresca
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy; (R.M.); (S.V.); (F.D.V.); (M.E.A.); (I.M.); (A.P.); (F.S.); (A.G.); (L.L.)
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Simone Varca
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy; (R.M.); (S.V.); (F.D.V.); (M.E.A.); (I.M.); (A.P.); (F.S.); (A.G.); (L.L.)
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Federica Di Vincenzo
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy; (R.M.); (S.V.); (F.D.V.); (M.E.A.); (I.M.); (A.P.); (F.S.); (A.G.); (L.L.)
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Elena Ainora
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy; (R.M.); (S.V.); (F.D.V.); (M.E.A.); (I.M.); (A.P.); (F.S.); (A.G.); (L.L.)
| | - Irene Mignini
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy; (R.M.); (S.V.); (F.D.V.); (M.E.A.); (I.M.); (A.P.); (F.S.); (A.G.); (L.L.)
| | - Alfredo Papa
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy; (R.M.); (S.V.); (F.D.V.); (M.E.A.); (I.M.); (A.P.); (F.S.); (A.G.); (L.L.)
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Franco Scaldaferri
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy; (R.M.); (S.V.); (F.D.V.); (M.E.A.); (I.M.); (A.P.); (F.S.); (A.G.); (L.L.)
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio Gasbarrini
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy; (R.M.); (S.V.); (F.D.V.); (M.E.A.); (I.M.); (A.P.); (F.S.); (A.G.); (L.L.)
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Maria Cristina Giustiniani
- Department of Pathology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy;
| | - Maria Assunta Zocco
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy; (R.M.); (S.V.); (F.D.V.); (M.E.A.); (I.M.); (A.P.); (F.S.); (A.G.); (L.L.)
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Lucrezia Laterza
- CEMAD Digestive Diseases Center, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Rome, Italy; (R.M.); (S.V.); (F.D.V.); (M.E.A.); (I.M.); (A.P.); (F.S.); (A.G.); (L.L.)
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Parisio L, Settanni CR, Varca S, Laterza L, Lopetuso LR, Napolitano D, Schiavoni E, Turchini L, Fanali C, Alfieri N, Pizzoferrato M, Papa A, Pafundi PC, Armuzzi A, Gasbarrini A, Pugliese D, Scaldaferri F. Effectiveness and Safety of Switching from Intravenous to Subcutaneous Vedolizumab Formulation in Inflammatory Bowel Disease Patients in Clinical Remission. J Gastrointestin Liver Dis 2023; 32:452-459. [PMID: 38147610 DOI: 10.15403/jgld-5084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/21/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND AND AIMS Subcutaneous vedolizumab formulation has been shown to be as effective and safe as the intravenous one in randomized control trials. Real-life data are limited especially for patients receiving long-term intravenous therapy. This study aimed to evaluate the safety and effectiveness of switching from intravenous to subcutaneous vedolizumab in a large cohort of patients with stable clinical remission. METHODS In this prospective cohort study, we enrolled consecutive patients attending our center between September 2021 and April 2022. The baseline demographic characteristics, 12- and 24-weeks follow-up clinical activity, C-reactive protein levels, and adverse events were recorded. The primary endpoint was to assess combined steroid-free clinical remission plus biochemical remission 24-week after the switch. RESULTS 93 patients (43 Crohn's disease, 50 ulcerative colitis), switched to subcutaneous vedolizumab after a median duration of intravenous treatment of 36 months [IQR 16-52]. At baseline, 80 patients (86%) had a combined remission. At 24-week, 89.2% (n=74) maintained combined steroid-free clinical remission plus biochemical remission. 25 adverse events were reported, mostly SARS-CoV-2 infections and injection site reactions, with a further four recurrence episodes. Twelve patients (12.9%) discontinued subcutaneous administration and restarted intravenous vedolizumab. CONCLUSIONS Switching from intravenous to subcutaneous vedolizumab can be considered effective and safe for maintaining remission in patients with inflammatory bowel disease. In addition, this might reduce healthcare costs. However, large-scale real-life studies with long-term follow-up are necessary.
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Affiliation(s)
- Laura Parisio
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy. .
| | - Carlo Romano Settanni
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
| | - Simone Varca
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome; Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Lucrezia Laterza
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
| | - Loris Riccardo Lopetuso
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome; Department of Medicine and Ageing Sciences, Center for Advanced Studies and Technology, Università degli Studi "G. D'Annunzio", Chieti-Pescara, Italy.
| | - Daniele Napolitano
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
| | - Elisa Schiavoni
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
| | - Laura Turchini
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
| | - Caterina Fanali
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
| | - Norma Alfieri
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
| | - Marco Pizzoferrato
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
| | - Alfredo Papa
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome; Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Pia Clara Pafundi
- Epidemiology and Biostatistics Research Core Facility, Gemelli Science and Technology Park, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy.
| | - Alessandro Armuzzi
- IBD Center, IRCCS Humanitas Research Hospital, Rozzano, Milan; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
| | - Antonio Gasbarrini
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome; Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Daniela Pugliese
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
| | - Franco Scaldaferri
- IBD UNIT - CEMAD (Centro malattie apparato digerente), Medicina Interna e Gastroenterologia, Fondazione Policlinico A. Gemelli IRCCS, Rome; Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.
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Papa A, Santini P, De Lucia SS, Maresca R, Porfidia A, Pignatelli P, Gasbarrini A, Violi F, Pola R. Gut dysbiosis-related thrombosis in inflammatory bowel disease: Potential disease mechanisms and emerging therapeutic strategies. Thromb Res 2023; 232:77-88. [PMID: 37951044 DOI: 10.1016/j.thromres.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/23/2023] [Accepted: 11/03/2023] [Indexed: 11/13/2023]
Abstract
Patients with inflammatory bowel disease (IBD) have an increased risk of developing venous thromboembolic events, which have a considerable impact on morbidity and mortality. Chronic inflammation plays a crucial role in the pathogenesis of thrombotic events in patients with IBD. However, many unresolved questions remain, particularly regarding the mechanisms that determine the persistent inflammatory state independent of disease activity. This review explored the role of gut microbiota dysbiosis and intestinal barrier dysfunction, which are considered distinctive features of IBD, in determining pro-thrombotic tendencies. Gut-derived endotoxemia due to the translocation of bacterial lipopolysaccharides (LPS) from the intestine to the bloodstream and the bacterial metabolite trimethylamine-N-oxide (TMAO) are the most important molecules involved in gut dysbiosis-related thrombosis. The pathogenic prothrombotic pathways linked to LPS and TMAO have been discussed. Finally, we present emerging therapeutic approaches that can help reduce LPS-mediated endotoxemia and TMAO, such as restoring intestinal eubiosis, normalizing intestinal barrier function, and counterbalancing the effects of LPS and TMAO.
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Affiliation(s)
- Alfredo Papa
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Agostino Gemelli University Polyclinic Foundation IRCCS, Rome, Italy; Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, Rome, Italy.
| | - Paolo Santini
- Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, Rome, Italy; Thrombosis Clinic, Agostino Gemelli University Polyclinic Foundation IRCCS, Rome, Italy
| | - Sara Sofia De Lucia
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Agostino Gemelli University Polyclinic Foundation IRCCS, Rome, Italy; Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - Rossella Maresca
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Agostino Gemelli University Polyclinic Foundation IRCCS, Rome, Italy; Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - Angelo Porfidia
- Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, Rome, Italy; Thrombosis Clinic, Agostino Gemelli University Polyclinic Foundation IRCCS, Rome, Italy
| | - Pasquale Pignatelli
- Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy; Mediterranea Cardiocentro-Napoli, Naples, Italy
| | - Antonio Gasbarrini
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Agostino Gemelli University Polyclinic Foundation IRCCS, Rome, Italy; Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - Francesco Violi
- Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy; Mediterranea Cardiocentro-Napoli, Naples, Italy
| | - Roberto Pola
- Department of Translational Medicine and Surgery, Catholic University of Sacred Heart, Rome, Italy; Thrombosis Clinic, Agostino Gemelli University Polyclinic Foundation IRCCS, Rome, Italy
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Tursi A, Piovani D, Brandimarte G, Di Mario F, Elisei W, Picchio M, Allegretta L, Annunziata ML, Bafutto M, Bassotti G, Bianco MA, Colucci R, Conigliaro R, Dumitrascu DL, Escalante R, Ferrini L, Forti G, Franceschi M, Graziani MG, Lammert F, Latella G, Maconi G, Compare D, Nardone G, Camara De Castro Oliveira L, Chaves Oliveira E, Papagrigoriadis S, Pietrzak A, Pontone S, Stundiene I, Pranzo G, Reichert MC, Rodinò S, Regula J, Scaccianoce G, Scaldaferri F, Vassallo R, Zampaletta C, Zullo A, Spaziani E, Bonovas S, Papa A, Danese S. Prevalence and Natural History of Segmental Colitis Associated With Diverticulosis. Am J Gastroenterol 2023; 118:2088-2092. [PMID: 37314163 DOI: 10.14309/ajg.0000000000002362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/27/2023] [Indexed: 06/15/2023]
Abstract
INTRODUCTION We assessed the prevalence and clinical outcomes of segmental colitis associated with diverticulosis (SCAD) in patients with newly diagnosed diverticulosis. METHODS A 3-year international, multicenter, prospective cohort study was conducted involving 2,215 patients. RESULTS SCAD diagnosis was posed in 44 patients (30 male patients; median age: 64.5 years; prevalence of 1.99%, 95% confidence interval, 1.45%-2.66%). Patients with SCAD types D and B showed worse symptoms, higher fecal calprotectin values, needed more steroids, and reached less likely complete remission. DISCUSSION Although SCAD generally had a benign outcome, types B and D were associated with more severe symptoms and worse clinical course.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria, Barletta-Andria-Trani, Italy
- Department of Medical and Surgical Sciences, School of Medicine, Catholic University, Rome, Italy
| | - Daniele Piovani
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giovanni Brandimarte
- Division of Internal Medicine and Gastroenterology, "Cristo Re" Hospital, Rome, Italy
| | - Francesco Di Mario
- Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Parma, Parma, Italy
| | - Walter Elisei
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy
| | - Marcello Picchio
- Division of Surgery, "P. Colombo" Hospital, ASL RM6, Velletri, Rome, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina, Lecce, Italy
| | - Maria Laura Annunziata
- Division of Gastroenterology, "San Donato" Hospital, San Donato Milanese, Michigan, Italy
| | - Mauro Bafutto
- Institute of Gastroenterology and Digestive Endoscopy, Goiânia, Goiás, Brazil
| | - Gabrio Bassotti
- Department of Medicine and Surgery, Gastroenterology and Hepatology Unit, "Santa Maria Della Misericordia" University Hospital, University of Perugia, Perugia, Italy
| | - Maria Antonia Bianco
- Division of Gastroenterology, "T. Maresca" Hospital, Torre Del Greco, Naples, Italy
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo Degli Infermi" Hospital, Spoleto, Perugia, Italy
| | - Rita Conigliaro
- Digestive Endoscopy Unit, "Sant'Agostino Estense" Hospital, Baggiovara, Missouri, Italy
| | - Dan L Dumitrascu
- 2nd Medical Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ricardo Escalante
- Central University of Venezuela, Loira Medical Center, Caracas, Venezuela
| | - Luciano Ferrini
- Service of Digestive Endoscopy, "Villa Dei Pini" Home Care, Civitanova Marche, Macerata, Italy
| | - Giacomo Forti
- Digestive Endoscopy Unit, "Santa Maria Goretti" Hospital, Latina, Italy
| | - Marilisa Franceschi
- Digestive Endoscopy Unit, ULSS7 Alto Vicentino, Santorso, Virgin Islands, Italy
| | - Maria Giovanna Graziani
- Division of Gastroenterology and Digestive Endoscopy "S. Giovanni-Addolorata" Hospital, Rome, Italy
| | - Frank Lammert
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany
- Health Sciences, Hannover Medical School (MHH), Hannover, Germany
| | - Giovanni Latella
- Division of Gastroenterology, Hepatology and Nutrition, San Salvatore Hospital, Department of Life, Health & Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Giovanni Maconi
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Debora Compare
- Department of Clinical Medicine and Surgery, Division of Gastroenterology and Hepatology, Federico II" University Hospital, Naples, Italy
| | - Gerardo Nardone
- Department of Anorectal Physiology, "São José" Home Care, Rio de Janeiro, Brazil
| | | | - Enio Chaves Oliveira
- Department of Colorectal Surgery, King's College Hospital, London, United Kingdom
| | - Savvas Papagrigoriadis
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Anna Pietrzak
- 1st Division of General Surgery, "Umberto I" University Hospital, "Sapienza" University, Rome, Italy
| | - Stefano Pontone
- Institute of Clinical Medicine, Vilnius University Hospital, Vilnius, Lithuania
| | - Ieva Stundiene
- Digestive Endoscopy Unit, "Valle D'Itria" Hospital, Martina Franca, Taranto, Italy
| | - Giuseppe Pranzo
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany
| | | | - Stefano Rodinò
- 1st Division of General Surgery, "Umberto I" University Hospital, "Sapienza" University, Rome, Italy
| | - Jaroslaw Regula
- Institute of Clinical Medicine, Vilnius University Hospital, Vilnius, Lithuania
| | | | - Franco Scaldaferri
- Division of Internal Medicine and Gastroenterology, IRCCS "A. Gemelli" Hospital, Fondazione Policlinico Gemelli, Catholic University, Rome, Italy
| | - Roberto Vassallo
- Division of Gastroenterology and Digestive Endoscopy, "Bucchieri-La Ferla" Hospital, Palermo, Italy
| | | | - Angelo Zullo
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Rome, Italy
| | - Erasmo Spaziani
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Rome, Italy
- Department of Surgery, "Sapienza" University of Rome-Polo Pontino, Terracina, Latina, Italy
| | - Stefanos Bonovas
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alfredo Papa
- Division of Internal Medicine and Gastroenterology, IRCCS "A. Gemelli" Hospital, Fondazione Policlinico Gemelli, Catholic University, Rome, Italy
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS Ospedale "San Raffaele" and University "Vita-Salute San Raffaele," Milan, Italy
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Tursi A, Palieri AP, Lattarulo V, Elefante A, Gigliobianco A, Spinazzola D, Elisei W, Papa A. How we can improve the appropriateness of ambulatory gastrointestinal endoscopy: the lesson of the COVID-19 outbreak. Eur J Gastroenterol Hepatol 2023; 35:1149-1153. [PMID: 37665614 DOI: 10.1097/meg.0000000000002626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) outbreak has significantly modified hospital and outpatient activities. AIMS To assess the pandemic's impact on the appropriateness of outpatient gastrointestinal (G.I.) endoscopy in a southern Italy Region. METHODS Between 1 January 2019 and 31 December 2022, we compared the number, the type of activities, and the appropriateness of the G.I. endoscopy procedures in the four territorial gastroenterology and digestive endoscopy services of the Apulia region. RESULTS In 2019, 11 173 outpatient procedures were provided, which dropped by about 44% (P < 0.05) during 2020. The endoscopic activity was slightly reduced during 2020 (-18.77%), while every other activity dropped significantly. During 2021-2022, the overall activities slightly increased but remained below the number of activities provided before the pandemic (P < 0.05). However, the endoscopic activity increased by +6.86% from 2019 to 2022, mainly due to more colonoscopies. During the 4 years analysed, the overall appropriateness rate of the endoscopic examinations increased during 2020 (2019: 67%; 2020: 81%) while dropping again in the following years (2021: 75%; 2022; 69%). CONCLUSION The appropriateness of the G.I. endoscopic procedures in the territorial gastroenterology services in the Apulia Region has improved during the acute phase of the COVID-19 pandemic, dropping again in the following years. Overall, the appropriateness of endoscopic procedures remains suboptimal; thus, educational activities are needed to improve the appropriateness rate to optimise the limited resources.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria (BT)
- Department of Medical and Surgical Sciences, School of Medicine, Catholic University, Rome
| | | | - Vincenzo Lattarulo
- Territorial Digestive Endoscopy Service, Gioia del Colle Territorial Hospital, ASL BA, Gioia del Colle (BA)
| | - Antonio Elefante
- Territorial Digestive Endoscopy Service, Mesagne Territorial Hospital, ASL BR, Mesagne (BR)
| | | | | | - Walter Elisei
- Division of Gastroenterology, 'S. Camillo' Hospital, Rome
| | - Alfredo Papa
- Department of Medical and Surgical Sciences, School of Medicine, Catholic University, Rome
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Fondazione Policlinico Universitario 'A. Gemelli', IRCCS, Rome, Italy
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11
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Tursi A, Piovani D, Brandimarte G, Di Mario F, Elisei W, Picchio M, Allegretta L, Annunziata ML, Bafutto M, Bassotti G, Bianco MA, Colucci R, Conigliaro R, Dumitrascu DL, Escalante R, Ferrini L, Forti G, Franceschi M, Graziani MG, Lammert F, Latella G, Maconi G, Compare D, Nardone G, Camara De Castro Oliveira L, Oliveira EC, Papa A, Papagrigoriadis S, Pietrzak A, Pontone S, Poskus T, Pranzo G, Reichert MC, Rodinò S, Regula J, Scaccianoce G, Scaldaferri F, Vassallo R, Zampaletta C, Zullo A, Spaziani E, Bonovas S, Danese S. Diverticular Inflammation and Complication Assessment classification, CODA score and fecal calprotectin in clinical assessment of patients with diverticular disease: A decision curve analysis. United European Gastroenterol J 2023; 11:642-653. [PMID: 37550901 PMCID: PMC10493361 DOI: 10.1002/ueg2.12369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/29/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND AND AIMS The Diverticular Inflammation and Complication Assessment (DICA) classification and the Combined Overview on Diverticular Assessment (CODA) were found to be effective in predicting the outcomes of Diverticular Disease (DD). We ascertain whether fecal calprotectin (FC) can further aid in improving risk stratification. METHODS A three-year international, multicentre, prospective cohort study was conducted involving 43 Gastroenterology and Endoscopy centres. Survival methods for censored observations were used to estimate the risk of acute diverticulitis (AD) in newly diagnosed DD patients according to basal FC, DICA, and CODA. The net benefit of management strategies based on DICA, CODA and FC in addition to CODA was assessed with decision curve analysis, which incorporates the harms and benefits of using a prognostic model for clinical decisions. RESULTS At the first diagnosis of diverticulosis/DD, 871 participants underwent FC measurement. FC was associated with the risk of AD at 3 years (HR per each base 10 logarithm increase: 3.29; 95% confidence interval, 2.13-5.10) and showed moderate discrimination (c-statistic: 0.685; 0.614-0.756). DICA and CODA were more accurate predictors of AD than FC. However, FC showed high discrimination capacity to predict AD at 3 months, which was not maintained at longer follow-up times. The decision curve analysis comparing the combination of FC and CODA with CODA alone did not clearly indicate a larger net benefit of one strategy over the other. CONCLUSIONS FC measurement could be used as a complementary tool to assess the immediate risk of AD. In all other cases, treatment strategies based on the CODA score alone should be recommended.
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12
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Tursi A, Mocci G, Cingolani L, Savarino E, Pica R, Cocco A, Zippi M, Napolitano D, Schiavoni E, Pugliese D, Scaldaferri F, Costa F, Marzo M, Serio M, Scarcelli A, Bolognini L, Bendia E, Maconi G, Cannatelli R, Piergallini S, Bodini G, Calabrese F, Ferronato A, Pranzo G, Elisei W, Monterubbianesi R, Faggiani R, Rodinò S, Sebkova L, Grossi L, Gaiani F, Dè Angelis G, Lorenzetti R, Allegretta L, Cazzato AI, Scorza S, Della Valle N, Sacco R, Forti G, Colucci R, Tonti P, Neve V, Rocco G, Sacchi C, Zampaletta C, Pagnini C, Graziani MG, Di Paolo MC, Onidi FM, Usai Satta P, Picchio M, Papa A. Use of tofacitinib as first or second-line therapy is associated with better outcomes in patients with ulcerative colitis: data from a real-world study. Expert Opin Pharmacother 2023; 24:1649-1656. [PMID: 37358928 DOI: 10.1080/14656566.2023.2230126] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/07/2023] [Accepted: 06/23/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND Data regarding the real-world (RW) use of tofacitinib (TOF) in patients with ulcerative colitis (UC) are limited. We aimed to investigate TOF's RW efficacy and safety in Italian UC patients. RESEARCH DESIGN AND METHODS A retrospective assessment of clinical and endoscopic activity was performed according to the Mayo score. The primary endpoints were to evaluate the effectiveness and safety of TOF. RESULTS We enrolled 166 patients with a median follow-up of 24 (IQR 8-36) weeks. Clinical remission was achieved in 61/166 (36.7%) and 75/166 (45.2%) patients at 8-week and 24-week follow-ups, respectively. The optimization was requested in 27 (16.3%) patients. Clinical remission was achieved more frequently when TOF was used as a first/second line rather than a third/fourth line treatment (p = 0.007). Mucosal healing was reported in 46% of patients at the median follow-up time. Colectomy occurred in 8 (4.8%) patients. Adverse events occurred in 12 (5.4%) patients and severe in 3 (1.8%). One case of simple Herpes Zoster and one of renal vein thrombosis were recorded. CONCLUSIONS Our RW data confirm that TOF is effective and safe in UC patients. It performs remarkably better when used as the first/second line of treatment.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, Asl Bat, Andria, Italy
- Department of Medical and Surgical Sciences, Catholic University, Rome, Italy
| | - Giammarco Mocci
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Linda Cingolani
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Edoardo Savarino
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Roberta Pica
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Andrea Cocco
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Maddalena Zippi
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Daniele Napolitano
- CEMAD (Digestive Disease Center), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Elisa Schiavoni
- CEMAD (Digestive Disease Center), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Daniela Pugliese
- CEMAD (Digestive Disease Center), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
| | - Franco Scaldaferri
- CEMAD (Digestive Disease Center), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
| | - Francesco Costa
- IBD Unit, Department of General Surgery and Gastroenterology, Pisa University Hospital, Pisa, Italy
| | - Manuela Marzo
- Division of Gastroenterology, "Veris-Delli Ponti" Hospital, Scorrano (LE), Italy
| | - Mariaelena Serio
- Division of Gastroenterology, "San Salvatore" Hospital, Pesaro, Italy
| | | | - Laura Bolognini
- Division of Digestive Diseases, Digestive Endoscopy and Inflammatory Bowel Diseases, Ancona, Italy
| | - Emanuele Bendia
- Division of Digestive Diseases, Digestive Endoscopy and Inflammatory Bowel Diseases, Ancona, Italy
| | - Giovanni Maconi
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Rosanna Cannatelli
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Simona Piergallini
- Division of Gastroenterology, IBD Unit, "A. Murri" Hospital, Fermo, Italy
| | - Giorgia Bodini
- Department of Internal Medicine and Medical Specialties, Division of Gastroenterology, IRCCS "San Martino" Hospital, University of Genoa, Genoa, Italy
| | - Francesco Calabrese
- Department of Internal Medicine and Medical Specialties, Division of Gastroenterology, IRCCS "San Martino" Hospital, University of Genoa, Genoa, Italy
| | | | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy
| | - Walter Elisei
- Division of Gastroenterology, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | | | - Roberto Faggiani
- Division of Gastroenterology, "S. Camillo-Forlanini" Hospital, Rome, Italy
| | - Stefano Rodinò
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Laurino Grossi
- Gastroenterology Unit, "Spirito Santo" Hospital, "G d'Annunzio" University, Pescara, Italy
| | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Gianluigi Dè Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Rome, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | | | - Stefano Scorza
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | | | - Rodolfo Sacco
- Division of Gastroenterology, A.O. "Ospedali Riuniti", Foggia, Italy
| | - Giacomo Forti
- Division of Digestive Endoscopy, "S. Maria Goretti" Hospital, Latina, Italy
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo Degli Infermi" Hospital, Spoleto (PG), Italy
| | - Paolo Tonti
- Division of Gastroenterology, "A. Perrino" Hospital, Brindisi, Italy
| | - Viviana Neve
- Division of Gastroenterology, "A. Perrino" Hospital, Brindisi, Italy
| | - Giulia Rocco
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | - Carlotta Sacchi
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | | | - Cristiano Pagnini
- Division of Gastroenterology, "S. Giovanni - Addolorata" Hospital, Rome, Italy
| | | | | | | | - Paolo Usai Satta
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri (Roma), Italy
| | - Alfredo Papa
- CEMAD (Digestive Disease Center), Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- School of Medicine, Catholic University, Rome, Italy
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13
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Laterza L, Boldrini L, Tran HE, Votta C, Larosa L, Minordi LM, Maresca R, Pugliese D, Zocco MA, Ainora ME, Lopetuso LR, Papa A, Armuzzi A, Gasbarrini A, Scaldaferri F. Radiomics could predict surgery at 10 years in Crohn's disease. Dig Liver Dis 2023; 55:1042-1048. [PMID: 36435716 DOI: 10.1016/j.dld.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Predicting clinical outcomes represents a major challenge in Crohn's disease (CD). Radiomics provides a method to extract quantitative features from medical images and may successfully predict clinical course. AIMS The aim of this pilot study is to evaluate the use of radiomics to predict 10-year surgery for CD patients. METHODS We selected a cohort of CD patients with CT scan enterographies and a 10-year follow up. The R library Moddicom was used to extract radiomic features from each lesion of CD, segmented in the CT scans. A logistic regression model based on selected radiomic features was developed to predict 10-year surgery. The model was evaluated by computing the area under the curve (AUC) of the receiver operating characteristic curve, sensitivity, specificity, positive and negative predictive values (PPV, NPV). RESULTS We enroled 30 patients, with 44 CT scans and 93 lesions. We extracted 217 radiomic features from each lesion. The developed model was based on two radiomic features and presented an AUC (95% CI) of 0.83 (0.73-0.91) in predicting 10-year surgery. Sensitivity, specificity, PPV, NPV of the radiomic model were equal to 0.72, 0.90, 0.79, 0.86, respectively. CONCLUSION Radiomics could be a helpful tool to identify patients with high risk for surgery and needing a stricter monitoring.
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Affiliation(s)
- Lucrezia Laterza
- IBD Unit -UOS Malattie Infiammatorie Croniche Intestinali, CEMAD, Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, Roma 00168, Italy.
| | - Luca Boldrini
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology - Fondazione Policlinico Universitario "A. Gemelli" IRCCS, L. go A. Gemelli 8, Rome 00168, Italy.
| | - Huong Elena Tran
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology - Fondazione Policlinico Universitario "A. Gemelli" IRCCS, L. go A. Gemelli 8, Rome 00168, Italy.
| | - Claudio Votta
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology - Fondazione Policlinico Universitario "A. Gemelli" IRCCS, L. go A. Gemelli 8, Rome 00168, Italy.
| | - Luigi Larosa
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology - Fondazione Policlinico Universitario "A. Gemelli" IRCCS, L. go A. Gemelli 8, Rome 00168, Italy.
| | - Laura Maria Minordi
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology - Fondazione Policlinico Universitario "A. Gemelli" IRCCS, L. go A. Gemelli 8, Rome 00168, Italy.
| | - Rossella Maresca
- IBD Unit -UOS Malattie Infiammatorie Croniche Intestinali, CEMAD, Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, Roma 00168, Italy.
| | - Daniela Pugliese
- IBD Unit -UOS Malattie Infiammatorie Croniche Intestinali, CEMAD, Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, Roma 00168, Italy.
| | - Maria Assunta Zocco
- IBD Unit -UOS Malattie Infiammatorie Croniche Intestinali, CEMAD, Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, Roma 00168, Italy.
| | - Maria Elena Ainora
- IBD Unit -UOS Malattie Infiammatorie Croniche Intestinali, CEMAD, Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, Roma 00168, Italy.
| | - Loris Riccardo Lopetuso
- IBD Unit -UOS Malattie Infiammatorie Croniche Intestinali, CEMAD, Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, Roma 00168, Italy; Department of Medicine and Ageing Sciences,"G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
| | - Alfredo Papa
- IBD Unit -UOS Malattie Infiammatorie Croniche Intestinali, CEMAD, Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, Roma 00168, Italy.
| | | | - Antonio Gasbarrini
- IBD Unit -UOS Malattie Infiammatorie Croniche Intestinali, CEMAD, Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, Roma 00168, Italy; Dipartimento di Medicina e Chirurgia traslazionale, Università Cattolica del Sacro Cuore, L. go F. Vito 1, Rome 00168, Italy.
| | - Franco Scaldaferri
- IBD Unit -UOS Malattie Infiammatorie Croniche Intestinali, CEMAD, Digestive Diseases Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, Roma 00168, Italy; Dipartimento di Medicina e Chirurgia traslazionale, Università Cattolica del Sacro Cuore, L. go F. Vito 1, Rome 00168, Italy.
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14
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Papa A, Covino M, De Lucia SS, Del Gaudio A, Fiorani M, Polito G, Settanni CR, Piccioni A, Franceschi F, Gasbarrini A. Impact of COVID-19 in individuals with and without pre-existent digestive disorders with a particular focus on elderly patients. World J Gastroenterol 2023; 29:4099-4119. [PMID: 37475841 PMCID: PMC10354572 DOI: 10.3748/wjg.v29.i26.4099] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/10/2023] [Accepted: 03/20/2023] [Indexed: 07/10/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has several extrapulmonary symptoms. Gastrointestinal (GI) symptoms are among the most frequent clinical manifestations of COVID-19, with severe consequences reported in elderly patients. Furthermore, the impact of COVID-19 on patients with pre-existing digestive diseases still needs to be fully elucidated, particularly in the older population. This review aimed to investigate the impact of COVID-19 on the GI tract, liver, and pancreas in individuals with and without previous digestive diseases, with a particular focus on the elderly, highlighting the distinctive characteristics observed in this population. Finally, the effectiveness and adverse events of the anti-COVID-19 vaccination in patients with digestive disorders and the peculiarities found in the elderly are discussed.
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Affiliation(s)
- Alfredo Papa
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
- CEMAD, Università Cattolica del Sacro Cuore, Roma 00168, Italy
| | - Marcello Covino
- Department of Emergency, Università Cattolica del Sacro Cuore - Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome 00168, Italy
- Emergency Medicine, Università Cattolica del Sacro Cuore, Roma 00168, Italy
| | - Sara Sofia De Lucia
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
| | - Angelo Del Gaudio
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
| | - Marcello Fiorani
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
| | - Giorgia Polito
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
| | - Carlo Romano Settanni
- Digestive Disease Center, Fondazione Policlinico Universitario A. Gemelli IRCCS - Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Andrea Piccioni
- Department of Emergency, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
| | - Francesco Franceschi
- Department of Emergency, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
- Department of Emergency, Università Cattolica del Sacro Cuore, Roma 00168, Italy
| | - Antonio Gasbarrini
- CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma 00168, Italy
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15
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Papa V, Schepis T, Coppola G, Chiappetta MF, Del Vecchio LE, Rozera T, Quero G, Gasbarrini A, Alfieri S, Papa A. The Role of Microbiota in Pancreatic Cancer. Cancers (Basel) 2023; 15:3143. [PMID: 37370753 DOI: 10.3390/cancers15123143] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
Pancreatic cancer (PC) has an unfavorable prognosis with few effective therapeutic options. This has led researchers to investigate the possible links between microbiota and PC. A disrupted gut microbiome can lead to chronic inflammation, which is involved in the pathogenesis of PC. In addition, some bacterial strains can produce carcinogens that promote the growth of cancer cells. Research has also focused on pancreatic and oral microbiota. Changes in these microbiota can contribute to the development and progression of PC. Furthermore, patients with periodontal disease have an increased risk of developing PC. The potential use of microbiota as a prognostic marker or to predict patients' responses to chemotherapy or immunotherapy is also being explored. Overall, the role of microbiota-including the gut, pancreatic, and oral microbiota-in PC is an active research area. Understanding these associations could lead to new diagnostic and therapeutic targets for this deadly disease.
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Affiliation(s)
- Valerio Papa
- Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy
- Digestive Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Tommaso Schepis
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Gaetano Coppola
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Michele Francesco Chiappetta
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Livio Enrico Del Vecchio
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Tommaso Rozera
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Giuseppe Quero
- Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy
- Digestive Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Sergio Alfieri
- Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy
- Digestive Surgery Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
| | - Alfredo Papa
- Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo Agostino Gemelli 8, 00168 Rome, Italy
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16
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Lopetuso LR, Cuomo C, Mignini I, Gasbarrini A, Papa A. Focus on Anti-Tumour Necrosis Factor (TNF)-α-Related Autoimmune Diseases. Int J Mol Sci 2023; 24:ijms24098187. [PMID: 37175894 PMCID: PMC10179362 DOI: 10.3390/ijms24098187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/01/2023] [Accepted: 05/02/2023] [Indexed: 05/15/2023] Open
Abstract
Anti-tumour necrosis factor (TNF)-α agents have been increasingly used to treat patients affected by inflammatory bowel disease and dermatological and rheumatologic inflammatory disorders. However, the widening use of biologics is related to a new class of adverse events called paradoxical reactions. Its pathogenesis remains unclear, but it is suggested that cytokine remodulation in predisposed individuals can lead to the inflammatory process. Here, we dissect the clinical aspects and overall outcomes of autoimmune diseases caused by anti-TNF-α therapies.
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Affiliation(s)
- Loris Riccardo Lopetuso
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Gastroenterology Department, Fondazione Policlinico Gemelli, IRCCS, 00168 Rome, Italy
- Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
- Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy
| | - Claudia Cuomo
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Gastroenterology Department, Fondazione Policlinico Gemelli, IRCCS, 00168 Rome, Italy
| | - Irene Mignini
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Gastroenterology Department, Fondazione Policlinico Gemelli, IRCCS, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Gastroenterology Department, Fondazione Policlinico Gemelli, IRCCS, 00168 Rome, Italy
- Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy
| | - Alfredo Papa
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Gastroenterology Department, Fondazione Policlinico Gemelli, IRCCS, 00168 Rome, Italy
- Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy
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17
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Kelly L, Koopmans MPG, Horigan V, Papa A, Sikkema RS, Koren LGH, Snary EL. Assessing the quality of data for drivers of disease emergence. REV SCI TECH OIE 2023; 42:90-102. [PMID: 37232315 DOI: 10.20506/rst.42.3352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Drivers are factors that have the potential to directly or indirectly influence the likelihood of infectious diseases emerging or re-emerging. It is likely that an emerging infectious disease (EID) rarely occurs as the result of only one driver; rather, a network of sub-drivers (factors that can influence a driver) are likely to provide conditions that allow a pathogen to (re-)emerge and become established. Data on sub-drivers have therefore been used by modellers to identify hotspots where EIDs may next occur, or to estimate which sub-drivers have the greatest influence on the likelihood of their occurrence. To minimise error and bias when modelling how sub-drivers interact, and thus aid in predicting the likelihood of infectious disease emergence, researchers need good-quality data to describe these sub-drivers. This study assesses the quality of the available data on sub-drivers of West Nile virus against various criteria as a case study. The data were found to be of varying quality with regard to fulfilling the criteria. The characteristic with the lowest score was completeness, i.e. where sufficient data are available to fulfil all the requirements for the model. This is an important characteristic as an incomplete data set could lead to erroneous conclusions being drawn from modelling studies. Thus, the availability of good-quality data is essential to reduce uncertainty when estimating the likelihood of where EID outbreaks may occur and identifying the points on the risk pathway where preventive measures may be taken.
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18
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Tursi A, Mocci G, Allegretta L, Aragona G, Bianco MA, Colucci R, Cuomo A, Della Valle N, Ferronato A, Forti G, Gaiani F, Giorgetti G, Graziani MG, Lofano K, Lorenzetti R, Larussa T, Penna A, Pica R, Pranzo G, Rodino' S, Scarcelli A, Zampaletta C, Bassotti G, Cazzato AI, Chiri S, Clemente V, Cocco A, De' Angelis G, Donnarumma L, Faggiani R, Graziosi C, Le Grazie M, Luzza F, Meucci C, Monterubbianesi R, Pagnini C, Perazzo P, Picchio M, Sacco R, Sebkova L, Serio M, Napolitano D, Pugliese D, Scaldaferri F, Schiavoni E, Turchini L, Armuzzi A, Elisei W, Maconi G, Papa A. Comparison of Performances of Adalimumab Biosimilars SB5, ABP501, GP2017, and MSB11022 in Treating Patients with Inflammatory Bowel Diseases: A Real-Life, Multicenter, Observational Study. Inflamm Bowel Dis 2023; 29:376-383. [PMID: 35579320 DOI: 10.1093/ibd/izac092] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Adalimumab (ADA) biosimilars have entered the therapeutic armamentarium of inflammatory bowel disease (IBD), allowing for the treatment of a greater number of patients for their reduced cost than the originator. However, comparative data on the efficacy and safety of the various ADA biosimilars remains scarce.We compare the efficacy and safety of ADA biosimilars SB5, ABP501, GP2017, and MSB11022 in treating IBD outpatients in a real-life Italian setting. METHODS A retrospective analysis was performed on consecutive IBD outpatients with complete clinical, laboratory, and endoscopic data. Clinical activity was measured using the Mayo score in ulcerative colitis (UC) and the Harvey-Bradshaw Index in Crohn's disease (CD). The primary endpoints were the following: (1) induction of remission in patients new to biologics and patients new to ADA but previously exposed to other anti-tumor necrosis factor agents or other biologics; (2) maintenance of remission in patients switched from the ADA originator to an ADA biosimilar; and (3) safety of various biosimilars. RESULTS A total of 533 patients were enrolled according to the inclusion criteria: 162 patients with UC and 371 patients with CD. Clinical remission was obtained in 79.6% of patients new to biologics and 59.2% of patients new to ADA but not to other biologics; clinical remission was maintained in 81.0% of patients switched from the originator, and adverse events were recorded in 6.7% of patients. There was no significant difference between the 4 ADA biosimilars for each predetermined endpoint. CONCLUSIONS Adalimumab biosimilars are effective and safe in IBD treatment, both in new patients and in patients switched from the ADA originator. No difference in efficacy and safety was found between ADA biosimilars.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria, Italy
- Department of Medical and Surgical Sciences, Post-graduate School of Digestive Diseases, Catholic University, Rome, Italy
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Giovanni Aragona
- Division of Gastroenterology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Maria Antonia Bianco
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo degli Infermi" Hospital, Spoleto (PG), Italy
| | - Antonio Cuomo
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Nicola Della Valle
- Division of Gastroenterology, "Ospedali Riuniti" Hospital, Foggia, Italy
| | | | - Giacomo Forti
- Digestive Endoscopy Unit, "S. Maria Goretti" Hospital, Latina, Italy
| | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - GianMarco Giorgetti
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy
| | | | - Katia Lofano
- Division of Gastroenterology, "S. Paolo" Hospital, Bari, Italy
| | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Rome, Italy
| | - Tiziana Larussa
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Antonio Penna
- Territorial Gastroenterology Service, ASL BA, Bari, Italy
| | - Roberta Pica
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy
| | - Stefano Rodino'
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | | | | | - Gabrio Bassotti
- Gastroenterology & Hepatology Section, Department of Medicine & Surgery, University of Perugia, Perugia, Italy
| | | | - Stefania Chiri
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Valeria Clemente
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy
| | - Andrea Cocco
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Gianluigi De' Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Laura Donnarumma
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Roberto Faggiani
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy
| | - Camilla Graziosi
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | - Marco Le Grazie
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Costantino Meucci
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | | | - Cristiano Pagnini
- Division of Gastroenterology, "S. Giovanni - Addolorata" Hospital, Rome, Italy
| | - Patrizia Perazzo
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri (Roma), Italy
| | - Rodolfo Sacco
- Division of Gastroenterology, "Ospedali Riuniti" Hospital, Foggia, Italy
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Mariaelena Serio
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Daniele Napolitano
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Daniela Pugliese
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Franco Scaldaferri
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- Catholic University, School of Medicine, Rome, Italy
| | - Elisa Schiavoni
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Laura Turchini
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | | | - Walter Elisei
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy
| | - Giovanni Maconi
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Alfredo Papa
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
- Catholic University, School of Medicine, Rome, Italy
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19
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Mocci G, Tursi A, Maconi G, Cataletti G, Mantia B, Serio M, Scarcelli A, Pagnini C, Graziani MG, Di Paolo MC, Pranzo G, Luppino I, Paese P, Elisei W, Monterubbianesi R, Faggiani R, Ferronato A, Perini B, Savarino E, Onidi FM, Binaghi L, Usai Satta P, Schiavoni E, Napolitano D, Scaldaferri F, Pugliese D, Pica R, Cocco A, Zippi M, Rodino S, Sebkova L, Rocco G, Sacchi C, Zampaletta C, Gaiani F, De Angelis G, Kayali S, Fanigliulo L, Lorenzetti R, Allegretta L, Scorza S, Cuomo A, Donnarumma L, Della Valle N, Sacco R, Forti G, Antonelli E, Bassotti G, Iannelli C, Luzza F, Aragona G, Perazzo P, Lauria A, Piergallini S, Colucci R, Bianco MA, Meucci C, Giorgetti G, Clemente V, Fiorella S, Penna A, De Medici A, Picchio M, Papa A. Real-world efficacy and safety of vedolizumab in managing ulcerative colitis versus Crohn's disease: results from an Italian multicenter study. Expert Opin Biol Ther 2023; 23:293-304. [PMID: 36843568 DOI: 10.1080/14712598.2023.2185510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
BACKGROUND Vedolizumab (VDZ) can be used to treat refractory ulcerative colitis (UC) and Crohn's disease (CD). We assessed whether there are differences in treating UC vs CD with VDZ. RESEARCH DESIGN AND METHODS Mayo score in UC and the Harvey-Bradshaw Index (HBI) in CD scored the clinical activity. Achievement and maintenance of clinical remission during the follow-up, and safety were the primary endpoints. RESULTS 729 patients (475 with UC and 254 with CD), median follow-up of 18 (IQR 6-36) months, were enrolled. Clinical remission at the 6th month of treatment was achieved in 488 (66.9%) patients (74.4% in CD vs 62.9% in UC, p<0.002) while, during the follow-up, no difference was found (81.5% in the UC group and 81.5% pts in the CD group; p=0.537). The clinical remission at the 6th month of treatment (p=0.001) and being naïve to biologics (p<0.0001) were significantly associated with prolonged clinical remission. The clinical response was significantly higher in UC (90.1%) vs CD (84.3%) (p=0.023), and surgery occurred more frequently in CD (1.9% in UC vs 5.1% in CD, p=0.016). CONCLUSION We found differences when using VDZ in UC vs CD in real life. These parameters can help the physician predict this drug's longterm efficacy.
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Affiliation(s)
- Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria, Italy.,Department of Medical and Surgical Sciences, Catholic University, School of Medicine, Rome, Italy
| | - Giovanni Maconi
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Giovanni Cataletti
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Beatrice Mantia
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Mariaelena Serio
- Division of Gastroenterology, "San Salvatore" Hospital, Pesaro, Italy
| | | | - Cristiano Pagnini
- Division of Gastroenterology, "S. Giovanni - Addolorata" Hospital, Rome, Italy
| | | | | | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy
| | - Ileana Luppino
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Pietro Paese
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Walter Elisei
- Division of Gastroenterology, A.O. "S. Camillo-Folanini", Rome, Italy
| | | | - Roberto Faggiani
- Division of Gastroenterology, A.O. "S. Camillo-Folanini", Rome, Italy
| | | | - Barbara Perini
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | - Edoardo Savarino
- Gastroenterology Unit, Azienda Ospedale-Università di Padova (AOUP), Padua, Italy
| | | | - Laura Binaghi
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Paolo Usai Satta
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Elisa Schiavoni
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Daniele Napolitano
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy
| | - Franco Scaldaferri
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.,School of Medicine, Catholic University, Rome, Italy
| | - Daniela Pugliese
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.,School of Medicine, Catholic University, Rome, Italy
| | - Roberta Pica
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Andrea Cocco
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Maddalena Zippi
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy
| | - Stefano Rodino
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy
| | - Giulia Rocco
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | - Carlotta Sacchi
- Division of Gastroenterology, "Belcolle" Hospital, Viterbo, Italy
| | | | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Gianluigi De Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Stefano Kayali
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Libera Fanigliulo
- Division of Gastroenterology, "S.S. Annunziata" Hospital, Taranto, Italy
| | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Roma, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Stefano Scorza
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy
| | - Antonio Cuomo
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | - Laura Donnarumma
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy
| | | | - Rodolfo Sacco
- Division of Gastroenterology, A.O. "Ospedali Riuniti", Foggia, Italy
| | - Giacomo Forti
- Division of Digestive Endoscopy, "S. Maria Goretti" Hospital, Latina, Italy
| | - Elisabetta Antonelli
- Gastroenterology & Hepatology Section, Department of Medicine & Surgery, University of Perugia, Perugia, Italy
| | - Gabrio Bassotti
- Gastroenterology & Hepatology Section, Department of Medicine & Surgery, University of Perugia, Perugia, Italy
| | - Chiara Iannelli
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Giovanni Aragona
- Division of Gastroenterology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Patrizia Perazzo
- Division of Gastroenterology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Angelo Lauria
- Division of Gastroenterology, A.O. "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy
| | - Simona Piergallini
- Division of Gastroenterology, IBD Unit, "A. Murri" Hospital, Fermo, Italy
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo degli Infermi" Hospital, Spoleto (PG), Italy
| | - Maria Antonia Bianco
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Costantino Meucci
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy
| | - Gianmarco Giorgetti
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy
| | - Valeria Clemente
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy
| | - Serafina Fiorella
- Division of Gastroenterology, "Padre Pio" Hospital, Vasto (CH), Italy
| | - Antonio Penna
- Territorial Gastroenterology Service, ASL BA, Bari, Italy
| | - Antonio De Medici
- Territorial Gastroenterology Service, PST Catanzaro Lido, Catanzaro, Italy
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, Velletri (Roma), Italy
| | - Alfredo Papa
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.,School of Medicine, Catholic University, Rome, Italy
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20
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Adamczak A, Antognini A, Berger N, Cocolios TE, Deokar N, Düllmann CE, Eggenberger A, Eichler R, Heines M, Hess H, Indelicato P, Kirch K, Knecht A, Krauth JJ, Nuber J, Ouf A, Papa A, Pohl R, Rapisarda E, Reiter P, Ritjoho N, Roccia S, Seidlitz M, Severijns N, von Schoeler K, Skawran A, Vogiatzi SM, Warr N, Wauters F. Muonic atom spectroscopy with microgram target material. Eur Phys J A Hadron Nucl 2023; 59:15. [PMID: 36751673 PMCID: PMC9898421 DOI: 10.1140/epja/s10050-023-00930-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Muonic atom spectroscopy-the measurement of the x rays emitted during the formation process of a muonic atom-has a long standing history in probing the shape and size of nuclei. In fact, almost all stable elements have been subject to muonic atom spectroscopy measurements and the absolute charge radii extracted from these measurements typically offer the highest accuracy available. However, so far only targets of at least a few hundred milligram could be used as it required to stop a muon beam directly in the target to form the muonic atom. We have developed a new method relying on repeated transfer reactions taking place inside a 100 bar hydrogen gas cell with an admixture of 0.25% deuterium that allows us to drastically reduce the amount of target material needed while still offering an adequate efficiency. Detailed simulations of the transfer reactions match the measured data, suggesting good understanding of the processes taking place inside the gas mixture. As a proof of principle we demonstrate the method with a measurement of the 2p-1s muonic x rays from a 5 μ g gold target.
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Affiliation(s)
- A. Adamczak
- Institute of Nuclear Physics, Polish Academy of Sciences, Krakow, Poland
| | - A. Antognini
- Paul Scherrer Institut, Villigen, Switzerland
- Institut für Teilchen- und Astrophysik, ETH Zürich, Zürich, Switzerland
| | - N. Berger
- Institute of Nuclear Physics, Johannes Gutenberg University Mainz, Mainz, Germany
- PRISMA+ Cluster of Excellence, Johannes Gutenberg University Mainz, Mainz, Germany
| | - T. E. Cocolios
- Instituut voor Kern- en Stralingfysica, KU Leuven, Leuven, Belgium
| | - N. Deokar
- Institute of Nuclear Physics, Johannes Gutenberg University Mainz, Mainz, Germany
- PRISMA+ Cluster of Excellence, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ch. E. Düllmann
- PRISMA+ Cluster of Excellence, Johannes Gutenberg University Mainz, Mainz, Germany
- Department of Chemistry-TRIGA Site, Johannes Gutenberg University Mainz, Mainz, Germany
- GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt, Germany
- Helmholtz Institute Mainz, Mainz, Germany
| | - A. Eggenberger
- Institut für Teilchen- und Astrophysik, ETH Zürich, Zürich, Switzerland
| | - R. Eichler
- Paul Scherrer Institut, Villigen, Switzerland
| | - M. Heines
- Instituut voor Kern- en Stralingfysica, KU Leuven, Leuven, Belgium
| | - H. Hess
- Institut für Kernphysik, Universität zu Köln, Köln, Germany
| | - P. Indelicato
- Laboratoire Kastler Brossel, Sorbonne Université, CNRS, ENS-PSL Research University, Collège de France, Case 74; 4, place Jussieu, 75005 Paris, France
| | - K. Kirch
- Paul Scherrer Institut, Villigen, Switzerland
- Institut für Teilchen- und Astrophysik, ETH Zürich, Zürich, Switzerland
| | - A. Knecht
- Paul Scherrer Institut, Villigen, Switzerland
| | - J. J. Krauth
- PRISMA+ Cluster of Excellence, Johannes Gutenberg University Mainz, Mainz, Germany
- Institute of Physics, Johannes Gutenberg Universität Mainz, Mainz, Germany
| | - J. Nuber
- Paul Scherrer Institut, Villigen, Switzerland
- Institut für Teilchen- und Astrophysik, ETH Zürich, Zürich, Switzerland
| | - A. Ouf
- Institute of Physics, Johannes Gutenberg Universität Mainz, Mainz, Germany
| | - A. Papa
- Paul Scherrer Institut, Villigen, Switzerland
- Department of Physics, Universitá di Pisa, Pisa, Italy
| | - R. Pohl
- PRISMA+ Cluster of Excellence, Johannes Gutenberg University Mainz, Mainz, Germany
- Institute of Physics, Johannes Gutenberg Universität Mainz, Mainz, Germany
| | | | - P. Reiter
- Institut für Kernphysik, Universität zu Köln, Köln, Germany
| | - N. Ritjoho
- Paul Scherrer Institut, Villigen, Switzerland
- Institut für Teilchen- und Astrophysik, ETH Zürich, Zürich, Switzerland
| | - S. Roccia
- Université Grenoble Alpes, CNRS, Grenoble INP, LPSC-IN2P3, 38026 Grenoble, France
| | - M. Seidlitz
- Institut für Kernphysik, Universität zu Köln, Köln, Germany
| | - N. Severijns
- Instituut voor Kern- en Stralingfysica, KU Leuven, Leuven, Belgium
| | - K. von Schoeler
- Institut für Teilchen- und Astrophysik, ETH Zürich, Zürich, Switzerland
| | - A. Skawran
- Paul Scherrer Institut, Villigen, Switzerland
- Institut für Teilchen- und Astrophysik, ETH Zürich, Zürich, Switzerland
| | - S. M. Vogiatzi
- Paul Scherrer Institut, Villigen, Switzerland
- Institut für Teilchen- und Astrophysik, ETH Zürich, Zürich, Switzerland
| | - N. Warr
- Institut für Kernphysik, Universität zu Köln, Köln, Germany
| | - F. Wauters
- Institute of Nuclear Physics, Johannes Gutenberg University Mainz, Mainz, Germany
- PRISMA+ Cluster of Excellence, Johannes Gutenberg University Mainz, Mainz, Germany
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21
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Tursi A, Mocci G, Cuomo A, Ferronato A, Elisei W, Picchio M, Maconi G, Scaldaferri F, Papa A, Allegretta L, Aragona G, Bianco MA, Colucci R, Della Valle N, Faggiani R, Forti G, Gaiani F, Giorgetti G, Graziani MG, Lofano K, Lorenzetti R, Larussa T, Penna A, Bassotti G, Cazzato AI, Chiri S, Clemente V, Cocco A, De' Angelis G, Donnarumma L, Graziosi C, Le Grazie M, Luzza F, Meucci C, Monterubbianesi R, Pagnini C, Perazzo P, Pica R, Pranzo G, Rodino' S, Sacco R, Sebkova L, Scarcelli A, Serio M, Napolitano D, Pugliese D, Schiavoni E, Turchini L, Armuzzi A, Zampaletta C. Replacement of Adalimumab Originator to Adalimumab Biosimilar for a Non-Medical Reason in Patients with Inflammatory Bowel Disease: A Real-life Comparison of Adalimumab Biosimilars Currently Available in Italy. J Gastrointestin Liver Dis 2022; 31:411-416. [PMID: 36535057 DOI: 10.15403/jgld-4608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/28/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS Adalimumab (ADA) biosimilars have been included into the therapeutic armamentarium of inflammatory bowel disease (IBD); however, comparative data on the efficacy and safety of the different ADA biosimilars after replacing the ADA originator for a non-medical reason remains scarce. We aimed to compare in a real-life setting the efficacy and safety of four ADA biosimilars SB5, APB501, GP2017, and MSB11022 in IBD patients after replacing the originator for a non-medical reason. METHODS A multicenter retrospective study was performed on consecutive IBD patients, analyzing clinical, laboratory, and endoscopic data. The primary endpoints of the study were maintenance of clinical remission and safety of the different biosimilars. RESULTS 153 patients were enrolled, 26 with UC and 127 with CD. Clinical remission was maintained in 124 out of 153 (81%) patients after a median (IQR) follow-up of 12 (6-24) months, without any significant difference between the four ADA biosimilars. ADA biosimilars dosage was optimized in five patients (3.3%). Loss of remission was significantly higher in UC patients (10/26 patients, 38.5%) than in CD patients (19/127 patients, 14.9%, p<0.025). Adverse events occurred in 12 (7.9%) patients; the large majority were mild. CONCLUSIONS No difference in efficacy and safety was found between ADA biosimilars when used to replace the ADA originator for a non-medical reason. However, in UC patients the replacement of ADA originator for this reason should be carefully assessed.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria; Department of Medical and Surgical Sciences, School of Medicine, Catholic University, Rome, Italy.
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy.
| | - Antonio Cuomo
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy.
| | | | - Walter Elisei
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy.
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, ASL Roma 6, Velletri (Roma), Italy.
| | - Giovanni Maconi
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy.
| | - Franco Scaldaferri
- Gastroenterology Department, CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Gemelli, IRCCS, Rome; Catholic University, School of Medicine, Rome, Italy.
| | - Alfredo Papa
- Gastroenterology Department, CEMAD, Center for Diagnosis and Treatment of Digestive Diseases, Fondazione Policlinico Gemelli, IRCCS, Rome; Catholic University, School of Medicine, Rome, Italy.
| | | | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy.
| | - Giovanni Aragona
- Division of Gastroenterology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy.
| | - Maria Antonia Bianco
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy.
| | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo degli Infermi" Hospital, Spoleto (PG), Italy.
| | | | - Roberto Faggiani
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy.
| | - Giacomo Forti
- Digestive Endoscopy Unit, "S. Maria Goretti" Hospital, Latina, Italy.
| | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - GianMarco Giorgetti
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy.
| | | | - Katia Lofano
- Division of Gastroenterology, "S. Paolo" Hospital, Bari, Italy.
| | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Rome, Italy.
| | - Tiziana Larussa
- Department of Health Science, University of Catanzaro, Catanzaro, Italy.
| | - Antonio Penna
- Territorial Gastroenterology Service, ASL BA, Bari, Italy.
| | - Gabrio Bassotti
- Gastroenterology and Hepatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
| | | | - Stefania Chiri
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina (LE), Italy.
| | - Valeria Clemente
- Digestive Endoscopy and Nutritional Unit, "S. Eugenio" Hospital, Rome, Italy.
| | - Andrea Cocco
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy.
| | - Gianluigi De' Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Laura Donnarumma
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore (SA), Italy.
| | - Camilla Graziosi
- Department of Health Science, University of Catanzaro, Catanzaro, Italy.
| | - Marco Le Grazie
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy.
| | - Costantino Meucci
- Division of Gastroenterology, "T. Maresca" Hospital, Torre del Greco (NA), Italy.
| | | | - Cristiano Pagnini
- Division of Gastroenterology, "S. Giovanni - Addolorata" Hospital, Rome.
| | - Patrizia Perazzo
- Division of Gastroenterology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy.
| | - Roberta Pica
- Division of Gastroenterology, IBD Unit, "S. Pertini" Hospital, Rome, Italy.
| | - Giuseppe Pranzo
- Ambulatory for IBD Treatment, "Valle D'Itria" Hospital, Martina Franca (TA), Italy.
| | - Stefano Rodino'
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy.
| | - Rodolfo Sacco
- Division of Gastroenterology, "Ospedali Riuniti" Hospital, Foggia, Italy.
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-Pugliese" Hospital, Catanzaro, Italy.
| | | | - Mariaelena Serio
- Division of Gastroenterology, "San Salvatore" Hospital, Pesaro, Italy.
| | - Daniele Napolitano
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.
| | - Daniela Pugliese
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.
| | - Elisa Schiavoni
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.
| | - Laura Turchini
- Division of Internal Medicine and Gastroenterology, Department of Medical and Surgical Sciences, Policlinico Universitario "A. Gemelli" IRCCS Foundation, Rome, Italy.
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22
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Tursi A, Papa V, Lopetuso LR, Settanni CR, Gasbarrini A, Papa A. Microbiota Composition in Diverticular Disease: Implications for Therapy. Int J Mol Sci 2022; 23:ijms232314799. [PMID: 36499127 PMCID: PMC9736941 DOI: 10.3390/ijms232314799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022] Open
Abstract
Gut microbiota (GM) composition and its imbalance are crucial in the pathogenesis of several diseases, mainly those affecting the gastrointestinal tract. Colon diverticulosis and its clinical manifestations (diverticular disease, DD) are among the most common digestive disorders in developed countries. In recent literature, the role of GM imbalance in the onset of the different manifestations within the clinical spectrum of DD has been highlighted. This narrative review aims to summarize and critically analyze the current knowledge on GM dysbiosis in diverticulosis and DD by comparing the available data with those found in inflammatory bowel disease (IBD). The rationale for using probiotics to rebalance dysbiosis in DD is also discussed.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, 70031 Andria, Italy
- Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy
| | - Valerio Papa
- Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy
- Digestive Surgery, Fondazione Policlinico Universitario “A. Gemelli”, IRCCS, 00168 Rome, Italy
| | - Loris Riccardo Lopetuso
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Gastroenterology Department, Fondazione Policlinico Gemelli, IRCCS, 00168 Rome, Italy
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Carlo Romano Settanni
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Gastroenterology Department, Fondazione Policlinico Gemelli, IRCCS, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Gastroenterology Department, Fondazione Policlinico Gemelli, IRCCS, 00168 Rome, Italy
| | - Alfredo Papa
- Department of Translational Medicine and Surgery, School of Medicine, Catholic University, 00168 Rome, Italy
- Center for Diagnosis and Treatment of Digestive Diseases, CEMAD, Gastroenterology Department, Fondazione Policlinico Gemelli, IRCCS, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-06-30157781
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23
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Nussbaumer C, Schwitz F, Elchinova E, Goulouti E, Wustmann K, Papa A, Schwerzmann M. Impact of left atrial size and strain on new atrial arrhythmias during a 5-year follow-up in adults with congenital heart disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Atrial arrhythmias are a common and important cause of morbidity and mortality in adults with congenital heart disease (ACHD). In acquired heart disease, left atrial (LA) strain has been shown to predict supraventricular tachyarrhythmias (SVT). This study sought to investigate if LA strain is also a reliable predictor of SVT in the ACHD population.
Method
We retrospectively obtained baseline clinical and echocardiographic data, including LA function parameters and strain, in 206 ACHD patients. Only patients with sinus rhythm at baseline and 5-years follow-up were included (median age 29, IQR 22–41 years). 157 participants had a left heart defect (aortic stenosis or aortic coarctation, with or without correction) and 49 a right heart defect (Fallot physiology). Diagnosis of sustained SVT was determined from clinical reports during the follow-up period (standard 12-lead ECG, ECG Holter).
Results
During a median follow-up of 6.2 years, a new or recurrent sustained SVT occurred in 16 patients (7.8%). Patients baseline characteristics are depicted in Table 1. Patients who developed SVT were older, had larger LA dimensions and left ventricular mass, more likely diastolic dysfunction on echo, and a lower peak LA longitudinal strain (PALS). PALS was a good predictor of SVT risk in patients with left and right heart defects with an area under the receiver-operating-curve of 0.857. By Cox regression analysis, patient in the lowest quartile for PALS had a 16.7-fold higher hazard ratio of SVT (95% confidence interval, 4.7 to 59.0, p<0.001) in comparison with the top three quartiles. Overall freedom from arrhythmia after 1, 3 and 5 years of follow-up was 98.1%, 96.1% and 94.2%, respectively. The freedom from SVT as a function of PALS quartiles is shown in Figure 1.
Conclusion
PALS provides predictive information about the occurrence of SVT in the ACHD population, regardless of the type of the lesion. Including the measurement of LA strain in the follow-up of these patients may permit to better identify patients at risk of future atrial arrhythmias.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Universitätsklinik für Kardiologie, Inselspital Bern
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Affiliation(s)
- C Nussbaumer
- Bern University Hospital, Inselspital, Center for Congenital Heart Disease , Bern , Switzerland
| | - F Schwitz
- Bern University Hospital, Inselspital, Center for Congenital Heart Disease , Bern , Switzerland
| | - E Elchinova
- Bern University Hospital, Inselspital, Center for Congenital Heart Disease , Bern , Switzerland
| | - E Goulouti
- Bern University Hospital, Inselspital, Center for Congenital Heart Disease , Bern , Switzerland
| | - K Wustmann
- Bern University Hospital, Inselspital, Center for Congenital Heart Disease , Bern , Switzerland
| | - A Papa
- Bern University Hospital, Inselspital, Center for Congenital Heart Disease , Bern , Switzerland
| | - M Schwerzmann
- Bern University Hospital, Inselspital, Center for Congenital Heart Disease , Bern , Switzerland
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24
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Bossa F, Valvano MR, Vetrone LM, Guerra M, Lopetuso LR, Carparelli S, Mignini I, Cocomazzi F, Napolitano D, Costantino A, Caprioli F, Gasbarrini A, Perri F, Papa A. Evaluation of factors associated with trust in telemedicine in patients with inflammatory bowel disease during COVID-19 pandemic: a multicenter cross-sectional survey. Eur Rev Med Pharmacol Sci 2022; 26:7277-7284. [PMID: 36263539 DOI: 10.26355/eurrev_202210_29921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Telemedicine (TM) has had a powerful impact in recent years, particularly on managing chronic diseases such as inflammatory bowel disease (IBD). Knowing patients' expectations and concerns is essential to increase their confidence in this mode of medical care. PATIENTS AND METHODS We interviewed a large cohort of IBD patients enrolled at two Italian tertiary referral centers to investigate their trust in TM. RESULTS A total of 376 patients completed the survey and were included in the study: 293 (77.9%) considered TM valuable for managing their disease, and 307 (85%) wanted to have TM service at their center. However, only 99 patients (26.3%) believed that TM guarantees the same level of care as the in-person visit. Among the socio-demographic variables, those independently associated with trust in TM were the higher education qualification (p=0.02) and the level of competence in information and communication technologies (ICT) (p=0.03). CONCLUSIONS Our findings highlighted the importance of equipping IBD patients with basic ICT skills to utilize TM services and increase their confidence in ICT with the help of caregivers. Additionally, to improve the perceived value of TM, it will be helpful to use additional tools such as telemonitoring of disease activity using patients' reported outcomes or remote measurement of fecal calprotectin.
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Affiliation(s)
- F Bossa
- Gastroenterology Department, Quality and Accreditation Unit, Casa Sollievo Della Sofferenza Hospital, IRCCS, Foggia, Italy.
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25
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Tursi A, Lopetuso LR, Vetrone LM, Gasbarrini A, Papa A. SARS-CoV-2 infection as a potential trigger factor for de novo occurrence of inflammatory bowel disease. Eur J Gastroenterol Hepatol 2022; 34:883-884. [PMID: 35802531 PMCID: PMC9245529 DOI: 10.1097/meg.0000000000002379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/20/2022] [Indexed: 12/10/2022]
Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria
- Department of Medicine and Surgery, Post-Graduate School of Digestive Disease, Catholic University, Rome
| | - Loris Riccardo Lopetuso
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti- Pescara
- Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, Chieti
- CEMAD, Digestive Disease Center, Fondazione Policlinico A. Gemelli, IRCCS
| | | | - Antonio Gasbarrini
- CEMAD, Digestive Disease Center, Fondazione Policlinico A. Gemelli, IRCCS
- Department of Medicine and Surgery, Catholic University, Rome, Italy
| | - Alfredo Papa
- CEMAD, Digestive Disease Center, Fondazione Policlinico A. Gemelli, IRCCS
- Department of Medicine and Surgery, Catholic University, Rome, Italy
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26
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Tursi A, Brandimarte G, Di Mario F, Elisei W, Picchio M, Allegretta L, Annunziata ML, Bafutto M, Bassotti G, Bianco MA, Colucci R, Conigliaro R, Dumitrascu D, Escalante R, Ferrini L, Forti G, Franceschi M, Graziani MG, Lammert F, Latella G, Maconi G, Nardone G, Camara de Castro Oliveira L, Chaves Oliveira E, Papa A, Papagrigoriadis S, Pietrzak A, Pontone S, Poskus T, Pranzo G, Reichert MC, Rodinò S, Regula J, Scaccianoce G, Scaldaferri F, Vassallo R, Zampaletta C, Zullo A, Piovani D, Bonovas S, Danese S. Prognostic performance of the 'DICA' endoscopic classification and the 'CODA' score in predicting clinical outcomes of diverticular disease: an international, multicentre, prospective cohort study. Gut 2022; 71:1350-1358. [PMID: 34702716 DOI: 10.1136/gutjnl-2021-325574] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/29/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate the predictive value of the Diverticular Inflammation and Complication Assessment (DICA) classification and to develop and validate a combined endoscopic-clinical score predicting clinical outcomes of diverticulosis, named Combined Overview on Diverticular Assessment (CODA). DESIGN A multicentre, prospective, international cohort study. SETTING 43 gastroenterology and endoscopy centres located in Europe and South America. PARTICIPANTS 2215 patients (2198 completing the study) at the first diagnosis of diverticulosis/diverticular disease were enrolled. Patients were scored according to DICA classifications. INTERVENTIONS A 3-year follow-up was performed. MAIN OUTCOME MEASURES To predict the acute diverticulitis and the surgery according to DICA classification. Survival methods for censored observation were used to develop and validate a novel combined endoscopic-clinical score for predicting diverticulitis and surgery (CODA score). RESULTS The 3-year cumulative probability of diverticulitis and surgery was of 3.3% (95% CI 2.5% to 4.5%) in DICA 1, 11.6% (95% CI 9.2% to 14.5%) in DICA 2 and 22.0% (95% CI 17.2% to 28.0%) in DICA 3 (p<0.001), and 0.15% (95% CI 0.04% to 0.59%) in DICA 1, 3.0% (95% CI 1.9% to 4.7%) in DICA 2 and 11.0% (95% CI 7.5% to 16.0%) in DICA 3 (p<0.001), respectively. The 3-year cumulative probability of diverticulitis and surgery was ≤4%, and ≤0.7% in CODA A; <10% and <2.5% in CODA B; >10% and >2.5% in CODA C, respectively. The CODA score showed optimal discrimination capacity in predicting the risk of surgery in the development (c-statistic: 0.829; 95% CI 0.811 to 0.846) and validation cohort (c-statistic: 0.943; 95% CI 0.905 to 0.981). CONCLUSIONS DICA classification has a significant role in predicting the risk of diverticulitis and surgery in patients with diverticulosis, which is significantly enhanced by the CODA score. TRIAL REGISTRATION NUMBER NCT02758860.
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Affiliation(s)
- Antonio Tursi
- Azienda Sanitaria Locale Barletta Andria Trani, Andria, Italy .,Department of Medical and Surgical Sciences, Catholic University, Roma, Italy
| | | | | | - Walter Elisei
- Azienda Ospedaliera San Camillo Forlanini, Roma, Italy
| | | | | | | | - Mauro Bafutto
- Institute of Gastroenterology and Digestive Endoscopy, Goiânia, Brazil
| | - Gabrio Bassotti
- Gastroenterology and Hepatology Section, San Sisto (Perugia), Italy
| | | | | | - Rita Conigliaro
- Nuovo Ospedale Civile Sant'Agostino Estense di Baggiovara, Modena, Italy
| | - Dan Dumitrascu
- 2nd Medical Department, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ricardo Escalante
- Central University of Venezuela, Loira Medical Center, Caracas, Venezuela, Bolivarian Republic of
| | | | | | | | | | - Frank Lammert
- Department of Medicine II, Saarland University Medical Center, Homburg, Germany
| | - Giovanni Latella
- Division of Gastroenterology, Department of Life, Health & Environmental Sciences, Hepatology and Nutrition, "San Salvatore" Hospital, University of L'Aquila, L'Aquila, Italy
| | | | - Gerardo Nardone
- Clinical Medicine and Surgery, University Federico II of Naples, Naples, Italy
| | | | - Enio Chaves Oliveira
- Department of Colorectal Surgery, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Alfredo Papa
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | | | - Anna Pietrzak
- Department of Gastroenterology, Hepatology and Clinical Oncology, Centre of Postgraduate Medical Education and Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Stefano Pontone
- Department of Surgical Sciences, 'Sapienza'-University of Rome, Roma, Italy
| | - Tomas Poskus
- Institute of Clinical Medicine, Vilnius University Hospital, Vilnius, Lithuania
| | | | | | | | - Jaroslaw Regula
- Gastroenterology, Medical Centre for Postgraduate Education, Warsaw, Poland.,Gastroenterology, the Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
| | | | - Franco Scaldaferri
- Department of Medical and Surgical Sciences, Internal Medicine, Gastroenterology Division, Catholic University of Rome, Roma, Italy
| | - Roberto Vassallo
- Division of Gastroenterology and Digestive Endoscopy, 'Bucchieri-La Ferla' Hospital, Palermo, Italy
| | | | - Angelo Zullo
- Gastroenterology, Presidio Territoriale di Prossimità Nuovo Regina Margherita, Roma, Italy
| | - Daniele Piovani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Stefanos Bonovas
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.,IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Silvio Danese
- Gastroenterology and Endoscopy, IRCCS Ospedale "San Raffaele" and University "Vita-Salute San Raffaele", Milano, Italy
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27
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Pugliese D, Privitera G, Fiorani M, Parisio L, Calvez V, Papa A, Gasbarrini A, Armuzzi A. Targeting IL12/23 in ulcerative colitis: update on the role of ustekinumab. Therap Adv Gastroenterol 2022; 15:17562848221102283. [PMID: 35721840 PMCID: PMC9201364 DOI: 10.1177/17562848221102283] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/04/2022] [Indexed: 02/06/2023] Open
Abstract
As our comprehension of the pathogenic mechanisms of inflammatory bowel disease (IBD) increases, the therapeutic armamentarium for its treatment can expand, and novel target therapies join the treatment pipeline. Interleukin (IL)-12 and IL23 are two key cytokines responsible for promoting and perpetuating bowel inflammation in IBD. Ustekinumab is a monoclonal antibody directed against the shared p40 subunit of both cytokines, and it was recently approved for the treatment of ulcerative colitis (UC). In the pivotal phase III UNIFI trial, ustekinumab showed a superiority over placebo in both clinical and endoscopic outcomes; furthermore, it was characterized by a favorable safety profile, with a similar rate of adverse events as compared with placebo. Recent evidence from real-life experiences have started accumulating, generally confirming the effectiveness and safety figures emerged from the registration studies. However, most of these observational studies enrolled multirefractory patients; moreover, comparative data with other target therapies are lacking, leaving physicians without clear indications about the appropriate positioning of ustekinumab in the therapeutic pipeline for UC. This review examines the basis of targeting IL12-23 in UC therapy and summarizes the data from both clinical trials and real-life studies, to highlight the main evidence already available and the research gaps that need to be filled for the optimal usage of ustekinumab in UC.
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Affiliation(s)
- Daniela Pugliese
- CEMAD, IBD CENTER, Unità Operativa Complessa di
Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e
Chirurgiche, Fondazione Policlinico Universitario ‘A. Gemelli’ IRCCS, Rome,
Italy
| | - Giuseppe Privitera
- Dipartimento Universitario di Medicina e
Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome,
Italy
| | - Marcello Fiorani
- Dipartimento Universitario di Medicina e
Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome,
Italy
| | - Laura Parisio
- CEMAD, IBD CENTER, Unità Operativa Complessa di
Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e
Chirurgiche, Fondazione Policlinico Universitario ‘A. Gemelli’ IRCCS, Rome,
Italy
| | - Valentin Calvez
- Dipartimento Universitario di Medicina e
Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome,
Italy
| | - Alfredo Papa
- CEMAD, IBD CENTER, Unità Operativa Complessa di
Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e
Chirurgiche, Fondazione Policlinico Universitario ‘A. Gemelli’ IRCCS, Rome,
Italy,Dipartimento Universitario di Medicina e
Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome,
Italy
| | - Antonio Gasbarrini
- CEMAD, IBD CENTER, Unità Operativa Complessa di
Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e
Chirurgiche, Fondazione Policlinico Universitario ‘A. Gemelli’ IRCCS, Rome,
Italy,Dipartimento Universitario di Medicina e
Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome,
Italy
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28
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Tursi A, Papa A. Intestinal Microbiome Modulation During Coronavirus Disease 2019: Another Chance to Manage the Disease? Gastroenterology 2022; 162:2134. [PMID: 32946905 PMCID: PMC7492138 DOI: 10.1053/j.gastro.2020.08.056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/26/2020] [Indexed: 01/22/2023]
Affiliation(s)
| | - Alfredo Papa
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico A. Gemelli, IRCCS, Rome, Italy and Università Cattolica del S. Cuore, Rome, Italy
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29
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Bianchi V, Viani S, De Filippo P, Dello Russo A, Checchi L, Biffi M, Caravati F, Giammaria M, Pisano’ E, Papa A, Francia P, Bongiorni M, Valsecchi S, D’onofrio A. The subcutaneous ICD replacement in the clinical practice: preliminary observations from the multicentre RHYTHM DETECT. Europace 2022. [DOI: 10.1093/europace/euac053.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Experience with the subcutaneous implantable cardioverter-defibrillator (S-ICD) is expanding rapidly. However, few data on generator replacement exist.
Purpose
The aim of this analysis was to describe the procedural characteristics of the pulse generator replacement in the current Italian practice and to provide a preliminary insight in the possible acute complications associated with first elective S-ICD generator replacements.
Methods
We analyzed 106 consecutive patients enrolled in the Rhythm Detect registry who underwent elective replacement of the S-ICD generator from September 2019 to July 2021. Procedures were accomplished according to the local clinical practice. A chest X-ray was performed, and the PRAETORIAN score was assessed and compared with the one measured after the first implantation.
Results
All replacements were performed in electrophysiology laboratories, 50% in day-hospital regimen, by 1 or 2 expert operators. Procedures were performed using local (87%) or general anaesthesia (13%). The median procedure duration was 40 (30-45) min. The previous S-ICD generator was in a subcutaneous pocket in 58 (55%) patients, and in an intermuscular pocket in the remaining patients. The PRAETORIAN score of the previous system was low (<90) in 93% of patients and intermediate in 7% of patients. In all patients with the device in an intermuscular pocket, the PRAETORIAN score was <90. During the replacement procedure, 22 S-ICD (3 with PRAETORIAN ≥90 before replacement) were removed from the initial subcutaneous position and placed in an intermuscular pocket. After replacement all patients with intermuscular devices had a score <90, and the overall proportion of patients with low-risk PRAETORIAN score raised to 97%. Defibrillation testing was performed only in 10% of patients, while testing was performed in 77% of patients at the first implantation procedure. No procedure-related complications occurred.
Conclusions
S-ICD replacements seem easy to perform with no peri-procedural complications. The adoption of an intermuscular pocket is associated with optimal positioning according to the PREATORIAN score, and seems preferred also in many cases of generators previously placed subcutaneously. In the Italian clinical practice conversion testing is rarely performed at device replacement.
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Affiliation(s)
- V Bianchi
- AO dei Colli - Monaldi Hospital, Naples, Italy
| | - S Viani
- Cisanello Hospital, Pisa, Italy
| | - P De Filippo
- ASST Papa Giovanni XXIII Bergamo, Bergamo, Italy
| | - A Dello Russo
- University Hospital Riuniti of Ancona, Ancona, Italy
| | - L Checchi
- Careggi University Hospital, Florence, Italy
| | - M Biffi
- S. Orsola-Malpighi Policlinic, Bologna, Italy
| | - F Caravati
- Circolo Hospital and Macchi Foundation of Varese, Varese, Italy
| | | | | | - A Papa
- University of Campania Luigi Vanvitell, Naples, Italy
| | | | | | | | - A D’onofrio
- AO dei Colli - Monaldi Hospital, Naples, Italy
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30
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Petala M, Kostoglou M, Karapantsios T, Dovas CI, Lytras T, Paraskevis D, Roilides E, Koutsolioutsou-Benaki A, Panagiotakopoulos G, Sypsa V, Metallidis S, Papa A, Stylianidis E, Papadopoulos A, Tsiodras S, Papaioannou N. Relating SARS-CoV-2 shedding rate in wastewater to daily positive tests data: A consistent model based approach. Sci Total Environ 2022; 807:150838. [PMID: 34627900 PMCID: PMC8497956 DOI: 10.1016/j.scitotenv.2021.150838] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/15/2021] [Accepted: 10/02/2021] [Indexed: 05/13/2023]
Abstract
During the COVID-19 pandemic, wastewater-based epidemiology (WBE) has been engaged to complement medical surveillance and in some cases to also act as an early diagnosis indicator of viral spreading in the community. Most efforts worldwide by the scientific community and commercial companies focus on the formulation of protocols for SARS-CoV-2 analysis in wastewater and approaches addressing the quantitative relationship between WBE and medical surveillance are lacking. In the present study, a mathematical model is developed which uses as input the number of daily positive medical tests together with the highly non-linear shedding rate curve of individuals to estimate the evolution of global virus shedding rate in wastewater along calendar days. A comprehensive parametric study by the model using as input actual medical surveillance and WBE data for the city of Thessaloniki (~700,000 inhabitants, North Greece) during the outbreak of November 2020 reveals the conditions under which WBE can be used as an early warning tool for predicting pandemic outbreaks. It is shown that early warning capacity is different along the days of an outbreak and depends strongly on the number of days apart between the day of maximum shedding rate of infected individuals in their disease cycle and the day of their medical testing. The present data indicate for Thessaloniki an average early warning capacity of around 2 days. Moreover, the data imply that there exists a proportion between unreported cases (asymptomatic persons with mild symptoms that do not seek medical advice) and reported cases. The proportion increases with the number of reported cases. The early detection capacity of WBE improves substantially in the presence of an increasing number of unreported cases. For Thessaloniki at the peak of the pandemic in mid-November 2020, the number of unreported cases reached a maximum around 4 times the number of reported cases.
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Affiliation(s)
- M Petala
- Laboratory of Environmental Engineering & Planning, Department of Civil Engineering, Aristotle University of Thessaloniki, Thessaloniki 54 124, Greece
| | - M Kostoglou
- Laboratory of Chemical and Environmental Technology, Dept. of Chemistry, Aristotle University of Thessaloniki, 54 124, Thessaloniki 54124, Greece
| | - Th Karapantsios
- Laboratory of Chemical and Environmental Technology, Dept. of Chemistry, Aristotle University of Thessaloniki, 54 124, Thessaloniki 54124, Greece.
| | - C I Dovas
- Faculty of Veterinary Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Th Lytras
- National Public Health Organization, Athens, Greece; European University Cyprus, Nicosia, Cyprus
| | - D Paraskevis
- National and Kapodistrian University of Athens, Athens, Greece
| | - E Roilides
- Infectious Diseases Unit and 3rd Department of Pediatrics, Aristotle University School of Health Sciences, Hippokration Hospital, Thessaloniki 54642, Greece
| | - A Koutsolioutsou-Benaki
- Department of Environmental Health, Directory of Epidemiology and Prevention of Non Communicable Diseases and Injuries, National Public Health Organization, Athens, Greece
| | | | - V Sypsa
- National and Kapodistrian University of Athens, Athens, Greece
| | - S Metallidis
- Department of Haematology, First Department of Internal Medicine, Faculty of Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
| | - A Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - E Stylianidis
- School of Spatial Planning and Development, Faculty of Engineering, Aristotle University of Thessaloniki, 54124, Greece
| | - A Papadopoulos
- EYATH S.A., Thessaloniki Water Supply and Sewerage Company S.A., Thessaloniki 54636, Greece
| | - S Tsiodras
- National and Kapodistrian University of Athens, Athens, Greece
| | - N Papaioannou
- Faculty of Veterinary Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
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Tursi A, Mocci G, Allegretta L, Aragona G, Bianco MA, Colucci R, Cuomo A, Della Valle N, Ferronato A, Forti G, Gaiani F, Graziani MG, Lorenzetti R, Luzza F, Paese P, Penna A, Pica R, Pranzo G, Rodinò S, Scarcelli A, Zampaletta C, Brozzi L, Cicerone C, Cocco A, De' Angelis G, Donnarumma L, Fiorella S, Iannelli C, Larussa T, Le Grazie M, Luppino I, Meucci C, FaggianI R, Pagnini C, Perazzo P, Rodriguez-Castro KI, Sacco R, Sebkova L, Serio M, De Monti A, Picchio M, Napolitano D, Schiavoni E, Turchini L, Scaldaferri F, Pugliese D, Guidi L, Laterza L, Privitera G, Pizzoferrato M, Lopetuso LR, Armuzzi A, Elisei W, Maconi G, Papa A. Comparison of performances of infliximab biosimilars CT-P13 versus SB2 in the treatment of inflammatory bowel diseases: a real-life multicenter, observational study in Italy. Expert Opin Biol Ther 2021; 22:313-320. [PMID: 34904510 DOI: 10.1080/14712598.2022.2007881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND To compare the performances of Infliximab (IFX) biosimilar CT-P13 and SB2 in the treatment of Inflammatory Bowel Diseases (IBD) outpatients in Italy. RESEARCH DESIGN AND METHODS Three hundred and eighty IBD outpatients were retrospectively evaluated. The primary endpoint was to compare the two IFX biosimilars in terms of reaching and maintenance of remission at any timepoint. RESULTS 197 patients with Ulcerative Colitis (UC) and 183 patients with Crohn's Disease (CD) treated with CT-P13 or SB2 and having a median (IQR) follow-up of 12 (6-36) months were compared: 230 (60.5%) were naïve to anti-TNFα, 20 (5.26%) were switched from IFX originator or from IFX CT-P13 to IFX SB2. Clinical remission was achieved in 133 (67.5%) UC patients and in 164 (89.6%) CD patients (p < 0.000), with no differences between CT-P13 and SB2 in the rate of remission in UC (p = 0.667) and CD (p = 0.286). Clinical response, steroid-free remission, rate of surgery, mucosal healing (MH) in UC, switching from IFX originator or from other biosimilar, and safety were similar. Higher MH rate was obtained in CD patients treated with CT-P13 (p = 0.004). CONCLUSION This first comparative study found that both IFX biosimilars CT-P13 and SB2 are effective and safe in managing IBD outpatients.
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Affiliation(s)
- Antonio Tursi
- Territorial Gastroenterology Service, Asl Bat, Andria, Italy.,Department of Medical and Surgical Sciences, Post-graduate School of Digestive Diseases Catholic University, Rome, Italy
| | - Giammarco Mocci
- Division of Gastroenterology, "Brotzu" Hospital, Cagliari, Italy
| | - Leonardo Allegretta
- Division of Gastroenterology, "Santa Caterina Novella" Hospital, Galatina, Italy
| | - Giovanni Aragona
- Division of Gastroenterology, "Guglielmo Da Saliceto" Hospital, Piacenza, Italy
| | | | - Raffaele Colucci
- Digestive Endoscopy Unit, "San Matteo Degli Infermi" Hospital, Spoleto, Italy
| | - Antonio Cuomo
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore, Italy
| | - Nicola Della Valle
- Division of Gastroenterology, "Ospedali Riuniti" Hospital, Foggia, Italy
| | | | - Giacomo Forti
- Digestive Endoscopy Unit, "S. Maria Goretti" Hospital, Latina, Italy
| | - Federica Gaiani
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | | | - Roberto Lorenzetti
- Division of Gastroenterology, "Nuovo Regina Margherita" Territorial Hospital, Rome, Italy
| | - Francesco Luzza
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Pietro Paese
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Antonio Penna
- Territorial Gastroenterology Service, Asl Ba, Bari, Italy
| | - Roberta Pica
- Division of Gastroenterology, Ibd Unit, "S. Pertini" Hospital, Rome, Italy
| | - Giuseppe Pranzo
- Ambulatory for Ibd Treatment, "Valle D'Itria" Hospital, Martina Franca, Italy
| | - Stefano Rodinò
- Division of Gastroenterology, "Ciaccio-pugliese" Hospital, Catanzaro, Italy
| | | | | | - Lorenzo Brozzi
- Digestive Endoscopy Unit, ULSS7 Pedemontana, Santorso, Italy
| | - Clelia Cicerone
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Andrea Cocco
- Division of Gastroenterology, Ibd Unit, "S. Pertini" Hospital, Rome, Italy
| | - Gianluigi De' Angelis
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Laura Donnarumma
- Division of Gastroenterology, "Umberto I" Hospital, Nocera Inferiore, Italy
| | | | - Chiara Iannelli
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Tiziana Larussa
- Department of Health Science, University of Catanzaro, Catanzaro, Italy
| | - Marco Le Grazie
- Gastroenterology and Endoscopy Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Ileana Luppino
- Division of Gastroenterology, "Annunziata" Hospital, Cosenza, Italy
| | - Costantino Meucci
- Division of Gastroenterology, "T. Maresca" Hospital, Torre Del Greco, Italy
| | - Roberto FaggianI
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy
| | - Cristiano Pagnini
- Division of Gastroenterology, "S. Giovanni - Addolorata" Hospital, Rome, Italy
| | - Patrizia Perazzo
- Division of Gastroenterology, "Guglielmo Da Saliceto" Hospital, Piacenza, Italy
| | | | - Rodolfo Sacco
- Division of Gastroenterology, "Ospedali Riuniti" Hospital, Foggia, Italy
| | - Ladislava Sebkova
- Division of Gastroenterology, "Ciaccio-pugliese" Hospital, Catanzaro, Italy
| | - Mariaelena Serio
- Division of Gastroenterology, "San Salvatore" Hospital, Pesaro, Italy
| | - Alberta De Monti
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Marcello Picchio
- Division of General Surgery, "P. Colombo" Hospital, Velletri, Italy
| | - Daniele Napolitano
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy
| | - Elisa Schiavoni
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy
| | - Laura Turchini
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy
| | - Franco Scaldaferri
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy
| | - Daniela Pugliese
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy
| | - Luisa Guidi
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy
| | - Lucrezia Laterza
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy
| | - Giuseppe Privitera
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy
| | - Marco Pizzoferrato
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy
| | - Loris R Lopetuso
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy.,Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Alessandro Armuzzi
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy
| | - Walter Elisei
- Division of Gastroenterology, "S. Camillo" Hospital, Rome, Italy
| | - Giovanni Maconi
- Division of Gastroenterology, "L. Sacco" University Hospital, Milan, Italy
| | - Alfredo Papa
- Department of Medical and Surgical Sciences, Università Cattolica Del S. Cuore and Cemad, Fondazione Policlinico Universitario "A. Gemelli," Irccs, Rome, Italy
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Privitera G, Pugliese D, Lopetuso LR, Scaldaferri F, Papa A, Rapaccini GL, Gasbarrini A, Armuzzi A. Orphan patients with inflammatory bowel disease - when we treat beyond evidence. World J Gastroenterol 2021; 27:8047-8057. [PMID: 35068853 PMCID: PMC8704270 DOI: 10.3748/wjg.v27.i47.8047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/12/2021] [Accepted: 12/08/2021] [Indexed: 02/06/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic condition that requires continuous medical treatment. To date, the medical management of patients with moderately-to-severely active IBD who develop dependence or resistance to corticosteroids is based on immunomodulator drugs. Such therapies are licenced after passing through three phases of randomized controlled trials (RCTs), and are subsequently adopted in clinical practice. However, the real-life population of IBD patients who require these therapies can significantly differ from those included in RCTs. As a matter of fact, there is a number of exclusion criteria – nearly ubiquitous in all RCTs – that prevent the enrolment of specific patients: Chronic refractory pouchitis or isolated proctitis in ulcerative colitis, short-bowel syndrome and stomas in Crohn’s disease, ileorectal anastomosis in both ulcerative colitis and Crohn’s disease, and elderly age are some representative examples. In this frontier article, we aim to give an overview of current literature on this topic, in order to address the main knowledge gaps that need to be filled in the upcoming years.
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Affiliation(s)
- Giuseppe Privitera
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Daniela Pugliese
- CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy
| | - Loris Riccardo Lopetuso
- CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche , Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome 00168, Italy
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti 66100, Italy
- Center for Advanced Studies and Technology (CAST), “G.d’Annunzio” University of Chieti-Pescara, Chieti 66100, Italy
| | - Franco Scaldaferri
- CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy
| | - Alfredo Papa
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy
- CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy
| | - Gian Lodovico Rapaccini
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy
- CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy
| | - Antonio Gasbarrini
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy
- CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy
| | - Alessandro Armuzzi
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome 00168, Italy
- CEMAD – IBD UNIT - Unità Operativa Complessa di Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome 00168, Italy
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Olivera PA, Zuily S, Kotze PG, Regnault V, Al Awadhi S, Bossuyt P, Gearry RB, Ghosh S, Kobayashi T, Lacolley P, Louis E, Magro F, Ng SC, Papa A, Raine T, Teixeira FV, Rubin DT, Danese S, Peyrin-Biroulet L. International consensus on the prevention of venous and arterial thrombotic events in patients with inflammatory bowel disease. Nat Rev Gastroenterol Hepatol 2021; 18:857-873. [PMID: 34453143 PMCID: PMC8395387 DOI: 10.1038/s41575-021-00492-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 12/11/2022]
Abstract
Patients with inflammatory bowel disease (IBD) are at increased risk of thrombotic events. Therapies for IBD have the potential to modulate this risk. The aims of this Evidence-Based Guideline were to summarize available evidence and to provide practical recommendations regarding epidemiological aspects, prevention and drug-related risks of venous and arterial thrombotic events in patients with IBD. A virtual meeting took place in May 2020 involving 14 international IBD experts and 3 thrombosis experts from 12 countries. Proposed statements were voted upon in an anonymous manner. Agreement was defined as at least 75% of participants voting as 'fully agree' or 'mostly agree' with each statement. For each statement, the level of evidence was graded according to the Scottish Intercollegiate Guidelines Network (SIGN) grading system. Consensus was reached for 19 statements. Patients with IBD harbour an increased risk of venous and arterial thrombotic events. Thromboprophylaxis is indicated during hospitalization of any cause in patients with IBD. Disease activity is a modifiable risk factor in patients with IBD, and physicians should aim to achieve deep remission to reduce the risk. Exposure to steroids should be limited. Antitumour necrosis factor agents might be associated with a reduced risk of thrombotic events.
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Affiliation(s)
- Pablo A Olivera
- Gastroenterology Section, Department of Internal Medicine, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - Stephane Zuily
- Vascular Medicine Division and Regional Competence Center for Rare Vascular and Systemic Autoimmune Diseases, Centre Hospitalier Régional Universitaire de Nancy, Vandoeuvre-lès-Nancy, France
- University of Lorraine, INSERM, DCAC, Nancy, France
| | - Paulo G Kotze
- IBD outpatient clinics, Colorectal Surgery Unit, Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | | | - Sameer Al Awadhi
- Gastroenterology Division, Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - Peter Bossuyt
- Imelda GI Clinical Research Center, Imelda General Hospital, Bonheiden, Belgium
| | - Richard B Gearry
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Subrata Ghosh
- NIHR Biomedical Research Centre, University of Birmingham and University Hospitals NHS Foundation Trust, Birmingham, UK
| | - Taku Kobayashi
- Center for Advanced IBD Research and Treatment, Kitasato University, Kitasato Institute Hospital, Tokyo, Japan
| | | | - Edouard Louis
- Department of Gastroenterology, CHU Liège University Hospital, Liège, Belgium
| | - Fernando Magro
- Department of Gastroenterology, Centro Hospitalar São João, Porto, Portugal
| | - Siew C Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Alfredo Papa
- Division of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
- Catholic University of Rome, Rome, Italy
| | - Tim Raine
- Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - David T Rubin
- University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, IL, USA
| | - Silvio Danese
- IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center - IRCCS, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology and INSERM NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France.
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Scaldaferri F, Papa A, Napolitano D, Rizzatti G, Pistone MT, Poscia A, Volpe M, Lopetuso LR, Schiavoni E, Guidi L, Gaetani E, Holleran G, Cammarota G, Rapaccini G, Pugliese D, Ojetti V, Franceschi F, Armuzzi A, Gasbarrini A. Changes in admissions, and hospitalization outcomes of IBD patients in an Italian tertiary referral center over a 13-year period. Eur Rev Med Pharmacol Sci 2021; 25:5826-5835. [PMID: 34604974 DOI: 10.26355/eurrev_202109_26801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The management of Inflammatory Bowel Disease (IBD) has changed significantly in recent years, mainly due to the introduction of biologic medications, however, other factors may also have a role. The aim of this study was to evaluate the evolution of IBD admissions, including trends, modality of admission and rates of surgical intervention, in a tertiary care center. PATIENTS AND METHODS Hospitalization of patients with a diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) were identified between 2000 and 2013, using ICD-9-CM codes for IBD, from our hospital database. The following parameters were evaluated for each admission: type of admission (ordinary vs. day care service), mode of admission (elective vs. emergency care, for ordinary admissions only), admission code, surgical procedures and complication rates. Comparison between pre- and post-biologic therapy introduction years was also performed. RESULTS Between 2000 and 2013 a total of 8834 IBD-related admissions were recorded. Hospitalizations increased linearly reaching a peak in 2006, with a downward trend in the following years. The downward trend was especially marked for patients younger than 40 years. No significant differences in hospitalization trends between CD and UC were recorded. Disease flare represented the cause of hospitalization in approximately 50% of cases. Overall, 10.8% of patients underwent surgery with no difference between the two conditions. Complications occurred in 28.7% of admissions. CONCLUSIONS Hospitalizations for IBD patients have decreased in recent years, especially in younger patients. However, a significant proportion of patients are still admitted to complete diagnostic workup, indicating the need to better implement outpatient services. A clear reduction in surgery occurrence over time could not be observed in our study.
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Affiliation(s)
- F Scaldaferri
- CEMAD Digestive Disease Center, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
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Liccardi G, Bilo MB, Milanese M, Martini M, Calzetta L, Califano F, Carucci L, Ciccarelli A, Cutajar M, D'Auria P, De Bartolomeis F, Dello Iacono I, Franzese A, Gargano D, Inciso G, Giordano AC, Iannaccone R, Lo Schiavo M, Nappi L, Madonna F, Montera C, Onorati G, Papa A, Pedicini A, Sabatino G, Sacerdoti C, Savoia A, Scopano E, Iannotta MP, Bartiromo M, Del Monaco G, Rogliani P. Face masks during COVID-19 pandemic lockdown and self-reported seasonal allergic rhinitis symptoms. Rhinology 2021; 59:481-484. [PMID: 34459840 DOI: 10.4193/rhin21.202] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- G Liccardi
- Postgraduate School of Respiratory Medicine, Department of Experimental Medicine. University of Rome "Tor Vergata", Rome, Italy
| | - M B Bilo
- Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti, Ancona - Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Italy
| | - M Milanese
- Division of Pulmonology, S.Corona Hospital, Pietra Ligure, Savona, Italy
| | - M Martini
- Global Clinical Development, Chiesi Farmaceutici, Parma, Italy
| | - L Calzetta
- Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, University of Parma, Parma, Italy
| | - F Califano
- Allergy and Clinical Immunology. 'G. Fucito' Hospital and University Hospital, Salerno, Italy
| | - L Carucci
- Department of Translational Medical Sciences and Interdepartmental Center for Research in Basic and Clinical Immunology, Sciences, University of Naples Federico II, Naples, Italy
| | - A Ciccarelli
- Allergy Unit, Presidio Sanitario Polispecialistico 'Loreto Crispi' Naples, Italy
| | - M Cutajar
- Allergy Center, Division of Internal Medicine. Ospedali Riuniti Penisola Sorrentina, Sorrento, Naples, Italy
| | - P D'Auria
- Regional Environmental Protection Agency Campania Region (ARPAC), Naples, Italy
| | - F De Bartolomeis
- Allergy Unit, High Speciality 'San Giuseppe Moscati' Hospital, Avellino, Italy
| | - I Dello Iacono
- Unit of Allergology. Division of Internal Medicine, 'Fatebenefratelli' Hospital, Benevento, Italy
| | - A Franzese
- Allergy and Clinical Immunology Unit, ASL Na 3 sud and ASL Na 2 nord, Naples, Italy
| | - D Gargano
- Allergy Unit, High Speciality 'San Giuseppe Moscati' Hospital, Avellino, Italy
| | - G Inciso
- Allergy Unit, ASL Na 3 (Sanitary District 59), Meta di Sorrento (Naples), Italy
| | - A C Giordano
- Postgraduate School of Internal Medicine. University of Salerno, Salerno, Italy
| | - R Iannaccone
- Unit of Allergology. Division of Internal Medicine, 'Fatebenefratelli' Hospital, Benevento, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology.'Fucito' Hospital and University Hospital, Salerno, Italy
| | - L Nappi
- L.N. Center, Scafati (Salerno), Italy
| | - F Madonna
- Allergy Unit. ASL (Sanitary District no. 12), Caserta, Italy
| | - C Montera
- Allergy and Clinical Immunology. 'G. Fucito' Hospital and University Hospital, Salerno, Italy
| | - G Onorati
- Regional Environmental Protection Agency Campania Region (ARPAC), Naples, Italy
| | - A Papa
- ASL (Sanitary District), Avellino, Italy
| | - A Pedicini
- Unit of Allergology, Division of Internal Medicine, 'Fatebenefratelli' Hospital, Benevento, Italy
| | | | | | - A Savoia
- Unit of Allergology. Division of Internal Medicine, 'Fatebenefratelli'Hospital, Benevento, Italy
| | - E Scopano
- Air pollution Unit, Regional Environmental Protection Agency Campania Region (ARPAC), Caserta, Italy
| | - M P Iannotta
- Air pollution Unit, Regional Environmental Protection Agency Campania Region (ARPAC), Caserta, Italy
| | - M Bartiromo
- Air pollution Unit, Regional Environmental Protection Agency Campania Region (ARPAC), Caserta, Italy
| | - G Del Monaco
- Air pollution Unit, Regional Environmental Protection Agency Campania Region (ARPAC), Caserta, Italy
| | - P Rogliani
- Postgraduate School of Respiratory Medicine, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy; Department of Experimental Medicine, Unit of Respiratory Medicine, University of Rome, Tor Vergata, Rome, Italy
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Minordi LM, Bevere A, Papa A, Larosa L, Manfredi R. CT and MRI Evaluations in Crohn's Complications: A Guide for the Radiologist. Acad Radiol 2021; 29:1206-1227. [PMID: 34583864 DOI: 10.1016/j.acra.2021.07.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 07/27/2021] [Accepted: 07/29/2021] [Indexed: 12/12/2022]
Abstract
Inflammatory bowel diseases (IBD) are a group of chronic inflammatory intestinal conditions with unknown etiology. Crohn's disease (CD) and ulcerative colitis (UC) are the two main types of IBD and they have some interchangeable and some different clinical and pathological characteristics. When diagnosis is performed for the first time, the majority of CD patients have a predominant inflammatory condition. As the disease progresses most patients experience the development of complications, such as abscesses, fistulas, perforation, strictures, and others. Both computed tomography (CT) and Magnetic Resonance Imaging (MRI) allow great view of the whole length of the intestinal tract together with the eventual extra-and intra-intestinal complications. MR enterography (MRE) and CT enterography (CTE), performed after oral administrations of contrast medium, have similar diagnostic accuracy for the diagnosis of CD and its complications. Even though CT is still the most familiar diagnostic technique used for studying CD worldwide, MRE have several important benefits that are leading to rapid increase in its employment in the last years. In particular, MRE allows a superior soft tissue contrast resolution compared to CT, offering a better visualization of bowel wall and its inflammatory and fibrotic characteristics. Moreover, Pelvic Magnetic Resonance is the principal technique in patients with perianal disease due to its ability of providing precise and fine detail images of the sphincter complex, which are crucial for evaluating pelvic disease. In this paper we describe common and uncommon complications in patients with CD, and explain how to identify their findings in CT and MR exams.
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Papa A, Gasbarrini A, Lopetuso LR. Winter Is Coming and COVID-19 Vaccine Is Available! The Role of Gastroenterologist in Increasing COVID-19 Vaccine Acceptability Among IBD Patients. Gastroenterology 2021; 161:368-369. [PMID: 33417944 PMCID: PMC7836773 DOI: 10.1053/j.gastro.2020.12.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 12/30/2020] [Indexed: 12/02/2022]
Affiliation(s)
| | | | - Loris Riccardo Lopetuso
- Complex Operational Unit Medicina Interna E Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy; Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; Center for Advanced Studies and Technology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
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Liccardi G, Milanese M, Bilò MB, Liccardi MV, Gargano D, Giordano A, Habetswallner F, Lo Schiavo M, Madonna F, Montera MC, Pane G, Papa A, Pedicini A, Rogliani P. Lessons from peculiar cases of anaphylaxis: why allergists should be prepared for the unexpected. Eur Ann Allergy Clin Immunol 2021; 54:99-106. [PMID: 33939345 DOI: 10.23822/eurannaci.1764-1489.198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Anaphylaxis is the most severe systemic hypersensitivity reaction, it can be caused by a number of well identified triggers such as foods, drugs, stinging insects and facilitated by predisposing clinical conditions. However, sometimes anaphylaxis shows up with uncommon or peculiar characteristics which could delay diagnosis and therapeutic treatment. In this report we aimed to describe less accounted / difficult-to-approach shapes of anaphylaxis to facilitate clinicians to suspect these severe reactions even in uncommon conditions. We choose to present data on anaphylaxis regarding simulation, mode of exposure to sensitizing agents, pregnancy, exposure to animals, intimate behaviour, psychological stress and other situations.
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Affiliation(s)
- G Liccardi
- Department of Experimental Medicine, Postgraduate School of Respiratory Medicine, Tor Vergata University of Rome, Rome, Italy
| | - M Milanese
- Division of Pulmonology, S. Corona Hospital, Pietra Ligure, Italy
| | - M B Bilò
- Department of Clinical and Molecular Sciences, Marche Polytechnic University, Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti, Ancona, Italy
| | | | - D Gargano
- Allergy Unit, High Speciality San Giuseppe Moscati Hospital, Avellino, Italy
| | - A Giordano
- Postgraduate School of Internal Medicine, University of Salerno, Salerno, Italy
| | - F Habetswallner
- Division of Neurophysiology A. Cardarelli Hospital, Naples, Italy
| | - M Lo Schiavo
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- Allergy Unit, ASL (Sanitary District n°12), Caserta, Italy
| | - M C Montera
- Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - G Pane
- Department of Experimental Medicine, Unit of Respiratory Medicine, Tor Vergata University of Rome, Rome, Italy
| | - A Papa
- ASL (Sanitary District), Avellino, Italy
| | - A Pedicini
- Unit of Allergology, Division of Internal Medicine, Fatebenefratelli Hospital, Benevento, Italy
| | - P Rogliani
- Department of Experimental Medicine, Postgraduate School of Respiratory Medicine, Tor Vergata University of Rome, Rome, Italy.,Department of Experimental Medicine, Unit of Respiratory Medicine, Tor Vergata University of Rome, Rome, Italy
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Liccardi G, Calzetta L, Milanese M, Bilò MB, Liccardi MV, Baiardini I, Gargano D, Lo Schiavo M, Madonna F, Montera MC, Papa A, Pedicini A, Habetswallner F, Giordano A, Rogliani P. Can placebo challenge test (inducing a "nocebo effect") be a suitable model to assess stress-induced bronchial obstruction? Suggestions from the multidisciplinary Working Groups "Stress-Asthma" and "AAIITO Regione Campania". Eur Ann Allergy Clin Immunol 2021; 53:284-287. [PMID: 33728834 DOI: 10.23822/eurannaci.1764-1489.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- G Liccardi
- Department of Experimental Medicine, Postgraduate School of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy
| | - L Calzetta
- Department of Experimental Medicine, Postgraduate School of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine, Unit of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy
| | - M Milanese
- Division of Pulmonology, S. Corona Hospital, Pietra Ligure, Savona, Italy
| | - M B Bilò
- Department of Internal Medicine, Allergy Unit, University Hospital Ospedali Riuniti - Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | | | - I Baiardini
- Department of Biomedical Science, Humanitas University, Milan, Italy
| | - D Gargano
- High Speciality San Giuseppe Moscati Hospital, Allergy Unit, Avellino, Italy
| | - M Lo Schiavo
- Departiment of Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - F Madonna
- ASL (Sanitary District n. 12), Allergy Unit, Caserta, Italy
| | - M C Montera
- Departiment of Allergy and Clinical Immunology, G. Fucito Hospital and University Hospital, Salerno, Italy
| | - A Papa
- ASL (Sanitary District), Avellino, Italy
| | - A Pedicini
- Division of Internal Medicine, Unit of Allergology, Fatebenefratelli Hospital, Benevento, Italy
| | - F Habetswallner
- Division of Neurophysiology, A. Cardarelli Hospital, Naples, Italy
| | - A Giordano
- Postgraduate School of Internal Medicine, University of Salerno, Salerno, Italy
| | - P Rogliani
- Department of Experimental Medicine, Postgraduate School of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy.,Department of Experimental Medicine, Unit of Respiratory Medicine, University of Rome Tor Vergata, Rome, Italy
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Petala M, Dafou D, Kostoglou M, Karapantsios T, Kanata E, Chatziefstathiou A, Sakaveli F, Kotoulas K, Arsenakis M, Roilides E, Sklaviadis T, Metallidis S, Papa A, Stylianidis E, Papadopoulos A, Papaioannou N. A physicochemical model for rationalizing SARS-CoV-2 concentration in sewage. Case study: The city of Thessaloniki in Greece. Sci Total Environ 2021; 755:142855. [PMID: 33199018 PMCID: PMC7550162 DOI: 10.1016/j.scitotenv.2020.142855] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/06/2020] [Accepted: 10/02/2020] [Indexed: 05/17/2023]
Abstract
Detection of SARS-CoV-2 in sewage has been employed by several researchers as an alternative early warning indicator of virus spreading in communities, covering both symptomatic and asymptomatic cases. A factor that can seriously mislead the quantitative measurement of viral copies in sewage is the adsorption of virus fragments onto the highly porous solids suspended in wastewater, making them inaccessible. This depends not only on the available amount of suspended solids, but also on the amount of other dissolved chemicals which may influence the capacity of adsorption. On this account, the present work develops a mathematical framework, at various degrees of spatial complexity, of a physicochemical model that rationalizes the quantitative measurements of total virus fragments in sewage as regards the adsorption of virus onto suspended solids and the effect of dissolved chemicals on it. The city of Thessaloniki in Greece is employed as a convenient case study to determine the values of model variables. The present data indicate the ratio of the specific absorption (UV254/DOC) over the dissolved oxygen (DO) as the parameter with the highest correlation with viral copies. This implies a strong effect on viral inaccessibility in sewage caused (i) by the presence of humic-like substances and (ii) by virus decay due to oxidation and metabolic activity of bacteria. The present results suggest days where many fold corrections in the measurement of viral copies should be applied. As a result, although the detected RNA load in June 2020 is similar to that in April 2020, virus shedding in the city is about 5 times lower in June than in April, in line with the very low SARS-CoV-2 incidence and hospital admissions for COVID-19 in Thessaloniki in June.
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Affiliation(s)
- M Petala
- Laboratory of Environmental Engineering & Planning, Department of Civil Engineering, Aristotle University of Thessaloniki, Thessaloniki 54 124, Greece
| | - D Dafou
- Department of Genetics, Development and Molecular Biology, School of Biology, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - M Kostoglou
- Laboratory of Chemical and Environmental Technology, Dept. of Chemistry, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - Th Karapantsios
- Laboratory of Chemical and Environmental Technology, Dept. of Chemistry, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece.
| | - E Kanata
- Prion Diseases Research Group, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - A Chatziefstathiou
- Department of Genetics, Development and Molecular Biology, School of Biology, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - F Sakaveli
- Laboratory of Environmental Engineering & Planning, Department of Civil Engineering, Aristotle University of Thessaloniki, Thessaloniki 54 124, Greece
| | - K Kotoulas
- EYATH S.A., Thessaloniki Water Supply and Sewerage Company S.A., Thessaloniki, 54636, Greece
| | - M Arsenakis
- Department of Genetics, Development and Molecular Biology, School of Biology, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - E Roilides
- Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Hippokration General Hospital, Thessaloniki 54642, Greece
| | - T Sklaviadis
- Prion Diseases Research Group, School of Pharmacy, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - S Metallidis
- Department of Haematology, First Department of Internal Medicine, Faculty of Medicine, AHEPA General Hospital, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
| | - A Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
| | - E Stylianidis
- School of Spatial Planning and Development, Faculty of Engineering, Aristotle University of Thessaloniki, 54124, Greece
| | - A Papadopoulos
- EYATH S.A., Thessaloniki Water Supply and Sewerage Company S.A., Thessaloniki, 54636, Greece
| | - N Papaioannou
- Faculty of Veterinary Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece
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Covino M, Papa V, Tursi A, Simeoni B, Lopetuso LR, Vetrone LM, Franceschi F, Rapaccini G, Gasbarrini A, Papa A. Development and Validation of Predictive Assessment of Complicated Diverticulitis Score. J Pers Med 2021; 11:jpm11020080. [PMID: 33572940 PMCID: PMC7911244 DOI: 10.3390/jpm11020080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/19/2021] [Accepted: 01/27/2021] [Indexed: 12/16/2022] Open
Abstract
The prevalence of acute diverticulitis (AD) has progressively increased in recent decades, with correspondingly greater morbidity and mortality. The aim of the study is to develop a predictive score to identify patients with the highest risk of complicated AD. The clinical records of 1089 patients referred to the emergency department (ED) over a five-year period were reviewed. In multivariate analysis, male sex (p < 0.001), constipation (p = 0.002), hemoglobin < 11.9 g/dL (p < 0.001), C reactive protein > 80 mg/L (p < 0.001), severe obesity (p = 0.049), and no proton pump inhibitor treatment (p = 0.003) were independently associated with complicated AD. The predictive assessment of complicated (PACO)-diverticulitis (D) score, including these six variables, was applied to the retrospective cohort and then validated prospectively in a cohort including 282 patients. It categorized patients into three risk classes for complicated AD. The PACO-D score showed fair discrimination for complicated AD with an area under the receiver operating characteristic curve of 0.674 and 0.648, in the retrospective and prospective cohorts, respectively. The PACO-D score could be a practical clinical tool to identify patients at highest risk for complicated AD referred to the ED so that appropriate diagnostic and therapeutic resources could be appropriately allocated. Further external validation is needed to confirm these results.
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Affiliation(s)
- Marcello Covino
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (M.C.); (B.S.); (F.F.)
- Facoltà di Medicina e Chirurgia, Università Cattolica del S. Cuore, L.go A. Gemelli 8, 00168 Rome, Italy; (V.P.); (L.M.V.); (G.R.); (A.G.)
| | - Valerio Papa
- Facoltà di Medicina e Chirurgia, Università Cattolica del S. Cuore, L.go A. Gemelli 8, 00168 Rome, Italy; (V.P.); (L.M.V.); (G.R.); (A.G.)
- Digestive Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Antonio Tursi
- Territorial Gastroenterology Service, Azienda Sanitaria Locale Barletta-Andria-Trani, 70031 Andria, Italy;
| | - Benedetta Simeoni
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (M.C.); (B.S.); (F.F.)
| | - Loris Riccardo Lopetuso
- Department of Medicine and Ageing Sciences, G. d’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy;
- Center for Advanced Studies and Technology (CAST), G. d’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy
| | - Lorenzo Maria Vetrone
- Facoltà di Medicina e Chirurgia, Università Cattolica del S. Cuore, L.go A. Gemelli 8, 00168 Rome, Italy; (V.P.); (L.M.V.); (G.R.); (A.G.)
- Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Francesco Franceschi
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy; (M.C.); (B.S.); (F.F.)
- Facoltà di Medicina e Chirurgia, Università Cattolica del S. Cuore, L.go A. Gemelli 8, 00168 Rome, Italy; (V.P.); (L.M.V.); (G.R.); (A.G.)
| | - Gianludovico Rapaccini
- Facoltà di Medicina e Chirurgia, Università Cattolica del S. Cuore, L.go A. Gemelli 8, 00168 Rome, Italy; (V.P.); (L.M.V.); (G.R.); (A.G.)
- Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Facoltà di Medicina e Chirurgia, Università Cattolica del S. Cuore, L.go A. Gemelli 8, 00168 Rome, Italy; (V.P.); (L.M.V.); (G.R.); (A.G.)
- Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Alfredo Papa
- Facoltà di Medicina e Chirurgia, Università Cattolica del S. Cuore, L.go A. Gemelli 8, 00168 Rome, Italy; (V.P.); (L.M.V.); (G.R.); (A.G.)
- Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-063-0151
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Papa A, Lopetuso LR, Tursi A. Inflammatory Bowel Disease Patients With Coronavirus Disease 2019: The Picture Is Taking Shape. Clin Gastroenterol Hepatol 2021; 19:205-206. [PMID: 32822835 PMCID: PMC7434311 DOI: 10.1016/j.cgh.2020.08.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 08/17/2020] [Accepted: 08/17/2020] [Indexed: 02/07/2023]
Affiliation(s)
| | - Loris Riccardo Lopetuso
- Department of Gastroenterology, Fondazione Policlinico A. Gemelli, Istituto di Ricerca e Cura a Carattere Scientifico, Rome, Italy; Department of Medicine and Ageing Sciences, Center for Advanced Studies and Technology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy
| | - Antonio Tursi
- Territorial Gastroenterology Service, Azienda Sanitaria Locale Barletta-Andria-Trani, Andria (BT), Italy
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Papa A, Papa V, Lopetuso LR, Gasbarrini A, Tursi A. Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase. Therap Adv Gastroenterol 2020; 13:1756284820968747. [PMID: 33149764 PMCID: PMC7586260 DOI: 10.1177/1756284820968747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/01/2020] [Indexed: 02/04/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised several concerns for patients with chronic immune-mediated diseases, including inflammatory bowel disease (IBD). As the outbreak appears to be in the descending phase, at least in some part of the world, as in most European countries, guidance is urgently needed to provide optimal care for our IBD patients in order to gradually and safely reduce the gap in care that has been accumulated in the months of lockdown and to face all the backlogs. Therefore, we have provided a decalogue of practical recommendations for gastroenterologists to manage patients with IBD in the post-peak phase of the COVID-19 pandemic. They include all the aspects of IBD care, not only pharmacological ones but also endoscopy, surgery, psychological treatment, telemedicine, diagnostics and educational tasks provided by doctors and patient associations.
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Affiliation(s)
| | - Valerio Papa
- Catholic University, Rome, Italy,Department of Digestive Surgery, Policlinico Universitario “A. Gemelli” IRCCS Foundation, Rome, Italy
| | - Loris Riccardo Lopetuso
- Department of Medical and Surgical Sciences, Division of Internal Medicine and Gastroenterology, Policlinico Universitario “A. Gemelli” IRCCS Foundation, Rome, Italy,Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy,Center for Advanced Studies and Technology (CAST), “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Antonio Gasbarrini
- Department of Medical and Surgical Sciences, Division of Internal Medicine and Gastroenterology, Policlinico Universitario “A. Gemelli” IRCCS Foundation, Rome, Italy Catholic University, Rome, Italy
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Antognini A, Ayres NJ, Belosevic I, Bondar V, Eggenberger A, Hildebrandt M, Iwai R, Kaplan DM, Khaw KS, Kirch K, Knecht A, Papa A, Petitjean C, Phillips TJ, Piegsa FM, Ritjoho N, Stoykov A, Taqqu D, Wichmann G. Demonstration of Muon-Beam Transverse Phase-Space Compression. Phys Rev Lett 2020; 125:164802. [PMID: 33124843 DOI: 10.1103/physrevlett.125.164802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 08/17/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
We demonstrate efficient transverse compression of a 12.5 MeV/c muon beam stopped in a helium gas target featuring a vertical density gradient and crossed electric and magnetic fields. The muon stop distribution extending vertically over 14 mm was reduced to a 0.25 mm size (rms) within 3.5 μs. The simulation including cross sections for low-energy μ^{+}-He elastic and charge exchange (μ^{+}↔ muonium) collisions describes the measurements well. By combining the transverse compression stage with a previously demonstrated longitudinal compression stage, we can improve the phase space density of a μ^{+} beam by a factor of 10^{10} with 10^{-3} efficiency.
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Affiliation(s)
- A Antognini
- Institute for Particle Physics and Astrophysics, ETH Zürich, 8093 Zürich, Switzerland
- Paul Scherrer Institute, 5232 Villigen-PSI, Switzerland
| | - N J Ayres
- Institute for Particle Physics and Astrophysics, ETH Zürich, 8093 Zürich, Switzerland
| | - I Belosevic
- Institute for Particle Physics and Astrophysics, ETH Zürich, 8093 Zürich, Switzerland
| | - V Bondar
- Institute for Particle Physics and Astrophysics, ETH Zürich, 8093 Zürich, Switzerland
| | - A Eggenberger
- Institute for Particle Physics and Astrophysics, ETH Zürich, 8093 Zürich, Switzerland
| | - M Hildebrandt
- Paul Scherrer Institute, 5232 Villigen-PSI, Switzerland
| | - R Iwai
- Institute for Particle Physics and Astrophysics, ETH Zürich, 8093 Zürich, Switzerland
| | - D M Kaplan
- Illinois Institute of Technology, Chicago, Illinois 60616, USA
| | - K S Khaw
- Institute for Particle Physics and Astrophysics, ETH Zürich, 8093 Zürich, Switzerland
| | - K Kirch
- Institute for Particle Physics and Astrophysics, ETH Zürich, 8093 Zürich, Switzerland
- Paul Scherrer Institute, 5232 Villigen-PSI, Switzerland
| | - A Knecht
- Paul Scherrer Institute, 5232 Villigen-PSI, Switzerland
| | - A Papa
- Paul Scherrer Institute, 5232 Villigen-PSI, Switzerland
- Dipartimento di Fisica, Università di Pisa and INFN sez. Pisa, Largo B. Pontecorvo 3, 56127 Pisa, Italy
| | - C Petitjean
- Paul Scherrer Institute, 5232 Villigen-PSI, Switzerland
| | - T J Phillips
- Illinois Institute of Technology, Chicago, Illinois 60616, USA
| | - F M Piegsa
- Institute for Particle Physics and Astrophysics, ETH Zürich, 8093 Zürich, Switzerland
| | - N Ritjoho
- Paul Scherrer Institute, 5232 Villigen-PSI, Switzerland
| | - A Stoykov
- Paul Scherrer Institute, 5232 Villigen-PSI, Switzerland
| | - D Taqqu
- Institute for Particle Physics and Astrophysics, ETH Zürich, 8093 Zürich, Switzerland
| | - G Wichmann
- Institute for Particle Physics and Astrophysics, ETH Zürich, 8093 Zürich, Switzerland
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Abstract
INTRODUCTION It has been hypothesized that people suffering from inflammatory bowel disease (IBD) have an increased risk of coronavirus disease (COVID-19). However, it is not known whether immunosuppressive therapies exacerbate the COVID-19 outcome. METHODS We reviewed data on the prevalence and clinical outcomes of COVID-19 in patients with IBD. RESULTS COVID-19 prevalence in patients with IBD was comparable with that in the general population. Therapies using antitumor necrosis factor-α agents have been associated with better clinical outcomes. DISCUSSION Management and treatments provided by gastroenterologists were effective in reducing COVID-19 risk. Antitumor necrosis factor-α agents seem to mitigate the course of COVID-19.
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Affiliation(s)
- Alfredo Papa
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico A. Gemelli, IRCCS, Rome—Italy;
- Università Cattolica del S. Cuore, Rome, Italy;
| | - Antonio Gasbarrini
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico A. Gemelli, IRCCS, Rome—Italy;
- Università Cattolica del S. Cuore, Rome, Italy;
| | - Antonio Tursi
- Territorial Gastroenterology Service, ASL BAT, Andria (BT)—Italy
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Papa A, Lopetuso LR, Minordi LM, Di Veronica A, Neri M, Rapaccini G, Gasbarrini A, Papa V. A modern multidisciplinary approach to the treatment of enterocutaneous fistulas in Crohn's disease patients. Expert Rev Gastroenterol Hepatol 2020; 14:857-865. [PMID: 32673498 DOI: 10.1080/17474124.2020.1797484] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Enterocutaneous fistulas (ECFs) is a manifestation of penetrating Crohn's disease (CD) that is challenging to treat and has considerable morbidity and mortality rates. AREAS COVERED This review aims to explore the practical and updated principles for the optimal treatment of ECFs in CD patients. EXPERT OPINION Optimal ECF management requires a multidisciplinary approach. Treatment first includes fluid resuscitation and electrolyte rebalancing with control of sepsis by means of antibiotics and, when indicated, drainage of infected collections. Subsequent therapeutic steps include nutritional support, control of the fistula output and treatment of peristomal skin. Anti-TNF-α therapy seems to have limited utility only after sepsis is resolved and intestinal stenosis excluded. However, ECFs heal in only approximately one-third of cases without surgical intervention. Thus, correct surgical timing combined with adequate nutritional support, sepsis resolution and skin care is considered the appropriate preoperative setting.
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Affiliation(s)
- Alfredo Papa
- UOC Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS , Roma, Italy.,Università Cattolica del Sacro Cuore , Roma, Italia
| | - Loris Riccardo Lopetuso
- UOC Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS , Roma, Italy.,Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara , Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara , Chieti, Italy
| | - Laura Maria Minordi
- Dipartimento di Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS , Roma, Italia
| | - Alessandra Di Veronica
- Dipartimento di Radiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS , Roma, Italia
| | - Matteo Neri
- Department of Medicine and Ageing Sciences, "G. d'Annunzio" University of Chieti-Pescara , Chieti, Italy.,Center for Advanced Studies and Technology (CAST), "G. d'Annunzio" University of Chieti-Pescara , Chieti, Italy
| | - Gianludovico Rapaccini
- UOC Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS , Roma, Italy.,Università Cattolica del Sacro Cuore , Roma, Italia
| | - Antonio Gasbarrini
- UOC Medicina Interna e Gastroenterologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS , Roma, Italy.,Università Cattolica del Sacro Cuore , Roma, Italia
| | - Valerio Papa
- Università Cattolica del Sacro Cuore , Roma, Italia.,Dipartimento di Chirurgia, Fondazione Policlinico Universitario A. Gemelli IRCCS , Roma, Italia
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47
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Papa A, Covino M, Pizzolante F, Miele L, Lopetuso LR, Bove V, Iorio R, Simeoni B, Vetrone LM, Tricoli L, Mignini I, Schepis T, D'Alessandro A, Coppola G, Nicoletti T, Visconti E, Rapaccini G. Gastrointestinal symptoms and digestive comorbidities in an Italian cohort of patients with COVID-19. Eur Rev Med Pharmacol Sci 2020; 24:7506-7511. [PMID: 32706091 DOI: 10.26355/eurrev_202007_21923] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The Coronavirus Disease 2019 (COVID-19) pandemic mainly involves respiratory symptoms, though gastrointestinal (GI) symptoms are increasingly being recognized. In this context, the presence of comorbidities appears to be associated with adverse outcomes. However, the role of digestive manifestations is not yet well defined. The primary aim of this study was to assess the prevalence of GI symptoms and digestive comorbidities in a cohort of patients with COVID-19 compared to controls. The secondary aim was to determine the association of GI-symptoms and digestive comorbidities with clinical outcomes. PATIENTS AND METHODS Inpatients with COVID-19 and controls with similar symptoms and/or radiological findings were enrolled. Symptoms at admission and throughout hospitalization were collected as they were comorbidities. The measured clinical outcomes were mortality, intensive care unit admission and cumulative endpoint. RESULTS A total of 105 patients were included: 34 with COVID-19 and 71 controls. At admission, the prevalence of GI symptoms among COVID-19 patients was 8.8%. During hospitalization, the frequency of GI symptoms was higher in patients with COVID-19 than in controls (p=0.004). Among patients with COVID-19, the mortality and a cumulative endpoint rates of those with GI symptoms were both lower than for those without GI symptoms (p=0.016 and p=0.000, respectively). Finally, we found digestive comorbidities to be associated with a milder course of COVID-19 (p=0.039 for cumulative endpoint). CONCLUSIONS Our results highlighted the non-negligible frequency of GI symptoms in patients with COVID-19, partly attributable to the therapies implemented. In addition, the presence of GI symptoms and digestive comorbidities is associated with better outcomes. Most likely, digestive comorbidities do not hinder the host's immune response against SARS-COV-2, and the occurrence of GI symptoms might be linked to a faster reduction of the viral load via the faecal route.
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Affiliation(s)
- A Papa
- Gastroenterology Department, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
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48
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Scaldaferri F, Pugliese D, Privitera G, Onali S, Lopetuso LR, Rizzatti G, Settanni CR, Pizzoferrato M, Schiavoni E, Turchini L, Amatucci V, Napolitano D, Bernabei T, Mora V, Laterza L, Papa A, Guidi L, Rapaccini GL, Gasbarrini A, Armuzzi A. Impact of COVID-19 pandemic on the daily management of biotechnological therapy in inflammatory bowel disease patients: Reorganisational response in a high-volume Italian inflammatory bowel disease centre. United European Gastroenterol J 2020; 8:775-781. [PMID: 32438878 PMCID: PMC7435006 DOI: 10.1177/2050640620929133] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/22/2020] [Indexed: 12/18/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is having a major clinical as well as organisational impact on the national health-care system in Italy, particularly in high-volume hospitals which are usually active for many essential clinical needs, including inflammatory bowel disease (IBD). Here, we report major clinical and organisational challenges at a high-volume Italian IBD centre one month after the start of the Italian government's restrictions due to the COVID-19 pandemic. All routine follow-up IBD visits of patients in remission were cancelled or rescheduled for 8-12 weeks' time. However, access to the hospital for therapy or for unstable/relapsing patients was not considered postponable. Everyone attending the centre (e.g. physicians, nurses, administrative personnel and patients) were advised to respect the general recommended rules for hand hygiene and social distancing, to disclose if they had a fever or cough or flu-like symptoms and to wear a surgical mask and gloves. At the entrance of the therapy area, a control station was set up in order to double-check all patients with a clinical interview and conduct thermal scanning. A total of 1451 IBD patients under biotechnological or experimental therapy actively followed in the CEMAD IBD centre were included in the study. About 65% of patients maintained their appointment schedules without major problems, while in 20% of cases planned infusions were delayed because of the patient's decision or practical issues. About 10% of patients receiving subcutaneous therapy were allowed to collect their medicine without a follow-up visit. Finally, 10% of patients living outside the Lazio region requested access to their therapy at a local centre closer to their home. At present, five patients have been found to be positive for SARS-CoV-2 infection but with minimal symptoms, 22 are in 'quarantine' for contact considered to be 'at risk' for the infection. Up to now, none of them has experienced significant symptoms. This study represents the first observational detailed report about short-term impact of the COVID-19 pandemic on patient organisation and management in a high-volume IBD centre.
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Affiliation(s)
- Franco Scaldaferri
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Daniela Pugliese
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Giuseppe Privitera
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Sara Onali
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Loris Riccardo Lopetuso
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Gianenrico Rizzatti
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Carlo Romano Settanni
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Marco Pizzoferrato
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Elisa Schiavoni
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Laura Turchini
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Valeria Amatucci
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Daniele Napolitano
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Tiziana Bernabei
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Vincenzina Mora
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Lucrezia Laterza
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
| | - Alfredo Papa
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luisa Guidi
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gian Lodovico Rapaccini
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Gasbarrini
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Armuzzi
- CEMAD – IBD UNIT – Unitá Operativa Complessa di Medicina Interna e Gastroenterologia, c Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
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49
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Tursi A, Angarano G, Monno L, Saracino A, Signorile F, Ricciardi A, Papa A. COVID-19 infection in Crohn's disease under treatment with adalimumab. Gut 2020; 69:1364-1365. [PMID: 32312788 DOI: 10.1136/gutjnl-2020-321240] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/02/2020] [Accepted: 04/06/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Antonio Tursi
- Gastroenterology Service, Azienda Sanitaria Locale Barletta Andria Trani, Andria, Puglia, Italy
| | - Gioacchino Angarano
- Division of Infectious Diseases, Bari University Hospital, University of Bari, Bari, Puglia, Italy
| | - Laura Monno
- Division of Infectious Diseases, Bari University Hospital, University of Bari, Bari, Puglia, Italy
| | - Annalisa Saracino
- Division of Infectious Diseases, Bari University Hospital, University of Bari, Bari, Puglia, Italy
| | - Fabio Signorile
- Division of Infectious Diseases, Bari University Hospital, University of Bari, Bari, Puglia, Italy
| | - Aurelia Ricciardi
- Division of Infectious Diseases, Bari University Hospital, University of Bari, Bari, Puglia, Italy
| | - Alfredo Papa
- Division of Internal Medicine and Gastroenterology, Complesso Integrato "Columbus", Catholic University of the Sacred Heart Faculty of Medicine and Surgery, Roma, Lazio, Italy
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50
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Schepis T, Larghi A, Papa A, Miele L, Panzuto F, De Biase L, Annibale B, Cattani P, Rapaccini GL. SARS-CoV2 RNA detection in a pancreatic pseudocyst sample. Pancreatology 2020; 20:1011-1012. [PMID: 32498972 PMCID: PMC7254005 DOI: 10.1016/j.pan.2020.05.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 05/13/2020] [Accepted: 05/23/2020] [Indexed: 02/05/2023]
Abstract
The involvement of gastrointestinal system in SARS-CoV2 related disease, COVID-19, is increasingly recognized. COVID-19 associated pancreatic injury has been suggested, but its correlation with pancreatic disease is still unclear. In this case report, we describe the detection of SARS-CoV2 RNA in a pancreatic pseudocyst fluid sample collected from a patient with SARS-CoV2 associated pneumonia and a pancreatic pseudocyst developed as a complication of an acute edematous pancreatitis. The detection of SARS-CoV2 within the pancreatic collection arise the question of whether this virus has a tropism for pancreatic tissue and whether it plays a role in pancreatic diseases occurrence.
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Affiliation(s)
- T Schepis
- Department of Medical and Surgical Sciences, Gastroenterology Unit, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy.
| | - A Larghi
- Department of Medical and Surgical Sciences, Gastroenterology Unit, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
| | - A Papa
- Department of Medical and Surgical Sciences, Gastroenterology Unit, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
| | - L Miele
- Department of Medical and Surgical Sciences, Gastroenterology Unit, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
| | - F Panzuto
- Department of Clinical Sciences and Tralational Medicine, Digestive Disease Unit, Sant'Andrea University Hospital, Rome, Italy
| | - L De Biase
- Department of Clinical and Molecular Medicine, Heart Failure Unit, Sant'Andrea University Hospital, Rome, Italy
| | - B Annibale
- Department of Clinical Sciences and Tralational Medicine, Digestive Disease Unit, Sant'Andrea University Hospital, Rome, Italy
| | - P Cattani
- Department of Laboratory and Infective Sciences, Virology Unit, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
| | - G L Rapaccini
- Department of Medical and Surgical Sciences, Gastroenterology Unit, Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
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