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Andreozzi P, de Nucci G, Devani M, Redaelli D, Schettino M, Iuliano D, Zulli C, Maurano A, Bottiglieri ME, Paspatis G, Dinelli M, Manes G. The high rate of spontaneous migration of small size common bile duct stones may allow a significant reduction in unnecessary ERCP and related complications: results of a retrospective, multicenter study. Surg Endosc 2021; 36:3542-3548. [PMID: 34494152 DOI: 10.1007/s00464-021-08676-8] [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: 03/28/2021] [Accepted: 08/07/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Common bile duct stones (CBDS) can spontaneously migrate through the duodenal papilla. In this case, ERCP could be unnecessary and a significant rate of complications could be avoided. In this study, we aim at retrospectively evaluating the rate of spontaneous stone passage in patients with an imaging diagnosis of CBDS and at analysing the factors associated to spontaneous stone migration. METHODS We conducted a retrospective multi-centre analysis of patients undergoing ERCP for CBDS in a 12-month period. 1016 patients with CBDS were analysed. In all patients CBDS was diagnosed with adequate imaging methods performed prior to ERCP. ERCPs with failed biliary cannulation were excluded. Data regarding patients' characteristics, imaging findings and ERCP procedure were analysed. RESULTS 1016 patients with CBDS undergoing ERCP were analysed (male sex 43.3%; mean age 69.9 ± 16.5 years). Diagnosis of CBDS was obtained by EUS in 415 patients (40.8%), MR in 343 (33.8%), CT in 220 (21.7%), and US in 38 (3.7%). No stones were found at ERCP in 179 patients (17.6%), in 14 (6.2%) when ERCP was performed within 6 h from imaging study, in 114 (18.5%) between 7 h and 7 days, in 32 (24.6%) between 8 and 29 days, and in 19 (43.2%) after 30 days. The rate of unnecessary ERCP occurred significantly more frequently in patients in whom imaging methods demonstrated either sludge or ≤ 5 mm CBDS (29.9 vs. 8.3%; p < 0.001). DISCUSSION Spontaneous migration of small CBDS is a frequent event, and ≤ 5 mm size and a delay in ERCP > 7 days represent predictive factors for it. We suggest that CBDS ≤ 5 mm should not undergo immediate removal and this fact would allow reducing the rate of unnecessary ERCP with their related complications. Prospective studies are needed to confirm these results and demonstrate the safety of a conservative management in this setting.
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Affiliation(s)
- Paolo Andreozzi
- Gastroenterology and Endoscopy Unit, ASL Caserta, Marcianise Hospital, Marcianise, Caserta, Italy
| | - Germana de Nucci
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate M.se Hospitals, Viale Forlanini 95, Garbagnate Milanese, Milan, Italy
| | - Massimo Devani
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate M.se Hospitals, Viale Forlanini 95, Garbagnate Milanese, Milan, Italy
| | - Davide Redaelli
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate M.se Hospitals, Viale Forlanini 95, Garbagnate Milanese, Milan, Italy
| | - Mario Schettino
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate M.se Hospitals, Viale Forlanini 95, Garbagnate Milanese, Milan, Italy
| | - Donato Iuliano
- Gastroenterology and Endoscopy Unit, ASL Caserta, Marcianise Hospital, Marcianise, Caserta, Italy
| | - Claudio Zulli
- Endoscopic Unit of Fucito Hospital, University Hospital of Salerno, Salerno, Italy
| | - Attilio Maurano
- Endoscopic Unit of Fucito Hospital, University Hospital of Salerno, Salerno, Italy
| | | | - Gregorios Paspatis
- Gastroenterology Department, Benizelion General Hospital, Heraklion, Crete, Greece
| | - Marco Dinelli
- Gastroenterology and Endoscopy Unit, San Gerardo Hospital, Monza, Italy
| | - Gianpiero Manes
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate M.se Hospitals, Viale Forlanini 95, Garbagnate Milanese, Milan, Italy.
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Bezzio C, Manes G, Schettino M, Arena I, de Nucci G, Della Corte C, Devani M, Mandelli E, Morganti D, Omazzi B, Pellegrini L, Picascia D, Redaelli D, Reati R, Saibeni S. Inflammatory bowel disease in a colorectal cancer screening population: Diagnosis and follow-up. Dig Liver Dis 2021; 53:587-591. [PMID: 32863160 DOI: 10.1016/j.dld.2020.07.036] [Citation(s) in RCA: 3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is usually diagnosed in subjects with gastrointestinal symptoms, but may also be asymptomatic and diagnosed incidentally. AIMS to determine the prevalence of IBD in asymptomatic adults. METHODS we identified subjects who underwent colonoscopy between 1 September 2013 and 31 August 2019 in a regional colorectal cancer screening program with endoscopic findings suggestive of IBD, and retrieved their clinical, histological and therapeutic information. RESULTS 5116 subjects underwent colonoscopy, and 4640 persons were considered assessable. Of these, 54 (1.16%) had endoscopic findings suggestive of IBD, including 40 of Crohn's disease (CD) and 14 of ulcerative colitis (UC). A definite diagnosis of IBD was made in 19 patients, for an overall IBD prevalence of 0.41%, with 13 cases of CD (0.28%) and 6 of UC (0.13%). The mean follow-up was 26.8 months after the first colonoscopy. Therapy was started in 5 of 13 CD patients and all UC patients. CONCLUSION Endoscopic findings suggestive of IBD are not infrequent in an asymptomatic colorectal cancer screening population. Visualization of the terminal ileum is recommended in this setting. A definite diagnosis of IBD was made in about 1 out of 3 subjects with endoscopic lesions. Most IBD patients had a mild form of disease, but some needed biologic therapy.
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Affiliation(s)
- Cristina Bezzio
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho (MI), Italy
| | - Gianpiero Manes
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho (MI), Italy; Gastroenterology Unit, Garbagnate Milanese Hospital, ASST Rhodense, Italy
| | - Mario Schettino
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho (MI), Italy
| | - Ilaria Arena
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho (MI), Italy
| | - Germana de Nucci
- Gastroenterology Unit, Garbagnate Milanese Hospital, ASST Rhodense, Italy
| | - Cristina Della Corte
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho (MI), Italy
| | - Massimo Devani
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho (MI), Italy
| | - Enzo Mandelli
- Gastroenterology Unit, Garbagnate Milanese Hospital, ASST Rhodense, Italy
| | - Daniela Morganti
- Gastroenterology Unit, Garbagnate Milanese Hospital, ASST Rhodense, Italy
| | - Barbara Omazzi
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho (MI), Italy
| | - Lucienne Pellegrini
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho (MI), Italy
| | - Desirée Picascia
- Gastroenterology Unit, Garbagnate Milanese Hospital, ASST Rhodense, Italy
| | - Davide Redaelli
- Gastroenterology Unit, Garbagnate Milanese Hospital, ASST Rhodense, Italy
| | - Raffaella Reati
- Gastroenterology Unit, Garbagnate Milanese Hospital, ASST Rhodense, Italy
| | - Simone Saibeni
- Gastroenterology Unit, Rho Hospital, ASST Rhodense, Corso Europa 250, 20017 Rho (MI), Italy.
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de Nucci G, Reati R, Arena I, Bezzio C, Devani M, Corte CD, Morganti D, Mandelli ED, Omazzi B, Redaelli D, Saibeni S, Dinelli M, Manes G. Efficacy of a novel self-assembling peptide hemostatic gel as rescue therapy for refractory acute gastrointestinal bleeding. Endoscopy 2020; 52:773-779. [PMID: 32316041 DOI: 10.1055/a-1145-3412] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [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: 02/08/2023]
Abstract
BACKGROUND Acute gastrointestinal bleeding (AGIB) results in significant morbidity and mortality. Topical hemostatic products have been developed for endoscopic use to help in the management of difficult bleeding. Our aim was to demonstrate the ease of use, safety, and efficacy of PuraStat, a novel hemostat, to control AGIB. METHODS We describe 77 patients (41 men) who were treated for acute upper and lower AGIB in a 2-year period. In 50 patients, bleeding occurred as a complication of a previous endoscopic procedure, predominantly endoscopic mucosal resection (EMR) and endoscopic retrograde cholangiopancreatography (ERCP); however, in the other 27 patients, it derived from peptic ulcers, angiodysplasia, cancers, and surgical anastomoses. Bleeding was spurting in 13 of the 77 patients and oozing in 64. PuraStat was used after the failure of at least two conventional hemostatic methods. RESULTS A mean of 2.6 conventional hemostatic methods had been attempted prior to the application of PuraStat. PuraStat achieved successful hemostasis in 90.9 % of patients. In 41 patients, once hemostasis was obtained with PuraStat, endoscopists further stabilized hemostasis by using at least one additional method. Recurrence of bleeding was observed in eight patients (10.4 %). In 16 patients with intraprocedural bleeding, it was possible to complete the procedures (14 EMR, 2 ERCP) after PuraStat hemostasis. No adverse events related to PuraStat were recorded. CONCLUSIONS PuraStat is feasible, safe, and effective in controlling different types of gastrointestinal hemorrhage after failure of conventional hemostatic methods. Its application also does not hinder continuing endotherapy.
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Affiliation(s)
- Germana de Nucci
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Garbagnate Milanese, Milan, Italy
| | - Raffaella Reati
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Garbagnate Milanese, Milan, Italy
| | - Ilaria Arena
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Rho Hospital, Milan, Italy
| | - Cristina Bezzio
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Rho Hospital, Milan, Italy
| | - Massimo Devani
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Rho Hospital, Milan, Italy
| | - Cristina Della Corte
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Rho Hospital, Milan, Italy
| | - Daniela Morganti
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Garbagnate Milanese, Milan, Italy
| | - Enzo Domenico Mandelli
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Garbagnate Milanese, Milan, Italy
| | - Barbara Omazzi
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Rho Hospital, Milan, Italy
| | - Davide Redaelli
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Garbagnate Milanese, Milan, Italy
| | - Simone Saibeni
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Rho Hospital, Milan, Italy
| | | | - Gianpiero Manes
- Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Garbagnate Milanese, Milan, Italy.,Gastroenterology and Endoscopy Unit, Aziende Socio Sanitaria Territoriale Rhodense - Rho Hospital, Milan, Italy
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Arrigoni F, Peruzzo D, Mandelstam S, Amorosino G, Redaelli D, Romaniello R, Leventer R, Borgatti R, Seal M, Yang JYM. Characterizing White Matter Tract Organization in Polymicrogyria and Lissencephaly: A Multifiber Diffusion MRI Modeling and Tractography Study. AJNR Am J Neuroradiol 2020; 41:1495-1502. [PMID: 32732266 DOI: 10.3174/ajnr.a6646] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 05/11/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Polymicrogyria and lissencephaly may be associated with abnormal organization of the undelying white matter tracts that have been rarely investigated so far. Our aim was to characterize white matter tract organization in polymicrogyria and lissencephaly using constrained spherical deconvolution, a multifiber diffusion MR imaging modeling technique for white matter tractography reconstruction. MATERIALS AND METHODS We retrospectively reviewed 50 patients (mean age, 8.3 ± 5.4 years; range, 1.4-21.2 years; 27 males) with different polymicrogyria (n = 42) and lissencephaly (n = 8) subtypes. The fiber direction-encoded color maps and 6 different white matter tracts reconstructed from each patient were visually compared with corresponding images reconstructed from 7 age-matched, healthy control WM templates. Each white matter tract was assessed by 2 experienced pediatric neuroradiologists and scored in consensus on the basis of the severity of the structural abnormality, ranging from the white matter tracts being absent to thickened. The results were summarized by different polymicrogyria and lissencephaly subgroups. RESULTS More abnormal-appearing white matter tracts were identified in patients with lissencephaly compared with those with polymicrogyria (79.2% versus 37.3%). In lissencephaly, structural abnormalities were identified in all studied white matter tracts. In polymicrogyria, the more frequently affected white matter tracts were the cingulum, superior longitudinal fasciculus, inferior longitudinal fasciculus, and optic radiation-posterior corona radiata. The severity of superior longitudinal fasciculus and cingulum abnormalities was associated with the polymicrogyria distribution and extent. A thickened superior fronto-occipital fasciculus was demonstrated in 3 patients. CONCLUSIONS We demonstrated a range of white matter tract structural abnormalities in patients with polymicrogyria and lissencephaly. The patterns of white matter tract involvement are related to polymicrogyria and lissencephaly subgroups, distribution, and, possibly, their underlying etiologies.
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Affiliation(s)
- F Arrigoni
- From the Scientific Institute, IRCCS E. Medea (F.A., D.P., G.A., D.R., R.R.), Bosisio Parini, Italy
| | - D Peruzzo
- From the Scientific Institute, IRCCS E. Medea (F.A., D.P., G.A., D.R., R.R.), Bosisio Parini, Italy
| | - S Mandelstam
- Murdoch Children's Research Institute (S.M., R.L., M.S., J.Y.-M.Y.), Parkville, Australia.,Royal Children's Hospital (S.M., R.L.), Parkville, Australia; Neuroscience Advanced Clinical Imaging Suite (NACIS) (J.Y.-M.Y.), Department of Neurosurgery, The Royal Children's Hospital, Victoria, Australia.,University of Melbourne (S.M., R.L., M.S., J.Y.-M.Y.), Parkville, Australia.,Florey Institute of Neuroscience and Mental Health (S.M.), Parkville, Australia
| | - G Amorosino
- From the Scientific Institute, IRCCS E. Medea (F.A., D.P., G.A., D.R., R.R.), Bosisio Parini, Italy.,Bruno Kessler Foundation (G.A.), Trento, Italy.,University of Trento, Center for Mind/Brain Sciences (G.A.), Rovereto, Italy
| | - D Redaelli
- From the Scientific Institute, IRCCS E. Medea (F.A., D.P., G.A., D.R., R.R.), Bosisio Parini, Italy
| | - R Romaniello
- From the Scientific Institute, IRCCS E. Medea (F.A., D.P., G.A., D.R., R.R.), Bosisio Parini, Italy
| | - R Leventer
- Murdoch Children's Research Institute (S.M., R.L., M.S., J.Y.-M.Y.), Parkville, Australia.,Royal Children's Hospital (S.M., R.L.), Parkville, Australia; Neuroscience Advanced Clinical Imaging Suite (NACIS) (J.Y.-M.Y.), Department of Neurosurgery, The Royal Children's Hospital, Victoria, Australia.,University of Melbourne (S.M., R.L., M.S., J.Y.-M.Y.), Parkville, Australia
| | - R Borgatti
- Istituto di ricovero e cura a carattere scientifico Mondino Foundation (R.B.), Pavia, Italy.,University of Pavia (R.B.), Pavia, Italy
| | - M Seal
- Murdoch Children's Research Institute (S.M., R.L., M.S., J.Y.-M.Y.), Parkville, Australia.,University of Melbourne (S.M., R.L., M.S., J.Y.-M.Y.), Parkville, Australia
| | - J Y-M Yang
- Murdoch Children's Research Institute (S.M., R.L., M.S., J.Y.-M.Y.), Parkville, Australia.,Royal Children's Hospital (S.M., R.L.), Parkville, Australia; Neuroscience Advanced Clinical Imaging Suite (NACIS) (J.Y.-M.Y.), Department of Neurosurgery, The Royal Children's Hospital, Victoria, Australia.,University of Melbourne (S.M., R.L., M.S., J.Y.-M.Y.), Parkville, Australia
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Manes G, Andreozzi P, Omazzi B, Bezzio C, Redaelli D, Devani M, Morganti D, Reati R, Saibeni S, Mandelli E, Arena I, Hassan C, de Nucci G. Efficacy of withdrawal time monitoring in adenoma detection with or without the aid of a full-spectrum scope. Endosc Int Open 2019; 7:E1135-E1142. [PMID: 31475231 PMCID: PMC6715423 DOI: 10.1055/a-0854-3946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 01/22/2019] [Indexed: 02/08/2023] Open
Abstract
Background and study aims Withdrawal time (WT) monitoring and full-spectrum endoscopy (FUSE) have been suggested to increase adenoma detection rate (ADR) due to more accurate evaluation of the hidden areas of the colon. We aimed to evaluate the efficacy of WT monitoring and FUSE on ADR. Patients and methods This was a prospective observational study involving consecutive outpatients, aged 18 to 85 years, undergoing colonoscopy with unselected indications. In phase 1, endoscopists performed 660 colonoscopies either with standard forward-viewing endoscope (SFVE) (n = 330) or with FUSE (n = 330). In this phase, WTs were measured without endoscopist awareness of being monitored. In phase 2, endoscopists were informed of being monitored and performed additional 660 colonoscopies either with SFVE (n = 330) or with FUSE (n = 330). Results WT was lower in phase 1 compared to phase 2 (SFVE: 269 ± 83 vs. 386 ± 60 sec, P < 0.001; FUSE: 289 ± 97 vs. 403 ± 65 sec, P < 0.001). Use of FUSE increased ADR both in phase 1 (33.0 % vs. 27.3 %, P = 0.127) and in phase 2 (41.8 % vs. 33.6 %, P = 0.037). When endoscopists were aware of being monitored, ADR was higher in SFVE (33.6 % vs. 27.3 %; P = 0.090) and FUSE arms (41.8 % vs. 33.0 %; P = 0.024). Improvement in detection of proximal adenomas was associated with WT monitoring [OR 1.577 (95 % C. I. 1.158 - 2.148); P = 0.004], whereas detection of distal adenomas was associated with use of FUSE [OR 1.320 (95 % C. I. 1.022 - 1.705); P = 0.037]. Conclusions Unmonitored endoscopists have suboptimal WT, which increases when they are monitored. WT monitoring and use of FUSE are two reliable and alternative strategies to increase ADR.
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Affiliation(s)
- Gianpiero Manes
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy
| | - Paolo Andreozzi
- Gastroenterology Unit, ASL Caserta, Marcianise Hospital, Italy
| | - Barbara Omazzi
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy
| | - Cristina Bezzio
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy
| | - Davide Redaelli
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy
| | - Massimo Devani
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy
| | - Daniela Morganti
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy
| | - Raffaella Reati
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy
| | - Simone Saibeni
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy
| | - Enzo Mandelli
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy
| | - Ilaria Arena
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy
| | - Cesare Hassan
- Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy
| | - Germana de Nucci
- Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milan, Italy
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Bernardo M, Gentner B, Tucci F, Fumagalli F, Silvani P, Filisetti C, Redaelli D, Acquati S, Zonari E, Rovelli A, Parini R, Marca GL, Naldini L, Aiuti A. PS1220 EX-VIVO HEMATOPOIETIC STEM CELL GENE THERAPY (GT) FOR MUCOPOLYSACCHARIDOSIS TYPE I HURLER (MPSIH): PRELIMINARY RESULTS FROM A PHASE I/II CLINICAL STUDY. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000563164.44448.4c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Giacomini A, Esposito A, Nisi T, Lapenna E, Bartesaghi S, Redaelli D, Pappalardo F, Colombo G, De Bonis M. Preoperative Computational Fluid Dynamics Simulation of the Best Anastomosis Site and Angle of the Outflow Graft and Ascending Aorta in Continuous Flow Mechanical Assist Devices. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Hassan C, Senore C, Manes G, Fuccio L, Iacopini F, Ricciardiello L, Anderloni A, Frazzoni L, Ballanti R, de Nucci G, Colussi D, Redaelli D, Lorenzetti R, Devani M, Arena I, Grossi C, Andrei F, Balestrazzi E, Sharma P, Rex DK, Repici A. Diagnostic yield and miss rate of EndoRings in an organized colorectal cancer screening program: the SMART (Study Methodology for ADR-Related Technology) trial. Gastrointest Endosc 2019; 89:583-590.e1. [PMID: 30365984 DOI: 10.1016/j.gie.2018.10.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [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] [Received: 08/25/2018] [Accepted: 10/06/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS The EndoRings add-on has been claimed to improve adenoma detection at colonoscopy, but available data are inconsistent. When testing a new technology, parallel and crossover methodologies measure different outcomes, leaving uncertainty about their correspondence. The aims of this study were to compare the diagnostic yield and miss rate of the EndoRings for colorectal neoplasia. METHODS Consecutive patients undergoing colonoscopy after a positive fecal immunochemical test (FIT) within an organized screening program in 7 Italian centers were randomized between a parallel (EndoRings or standard) or a crossover (EndoRings/standard or standard/EndoRings) methodology. Outcomes measures were the adenoma detection rate (ADR) and advanced adenoma detection rate (AADR) in the parallel arms and the miss rate of adenomas in the crossover arms. RESULTS Of 958 eligible patients, 927 (317 EndoRings; 317 standard; 142 EndoRings/standard; 151 standard/Endo-Rings) were included in the final analysis. In the parallel arms (mean ADR, 51.3%; mean AADR, 25.4%), no difference between standard and EndoRings was found for both ADR (relative risk [RR], 1.10; 95% confidence interval [CI], 0.95-1.28) and AADR (RR, 1.16; 95% CI, 0.88-1.51), as well as for the mean number of adenomas and advanced adenomas per patient (EndoRings, 1.9 ± 1.3 and 1.0 ± 1.2; standard, 2.1 ± 1.5 and 1.0 ± 1.2; P = not significant for both comparisons). In the crossover arms, no difference in the miss rate for adenomas between EndoRings and standard was found at per polyp (RR, 1.43; 95% CI, 0.97-2.10) or per-patient analysis (24% vs 26%; P = .76). CONCLUSIONS No statistically significant difference in diagnostic yield and miss rate between EndoRings and standard colonoscopy was detected in patients with a positive FIT result. A clinically relevant correspondence between miss and detection rates was shown, supporting a cause-effect relationship. (ISRCTN registry: ISRCTN10357435.).
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Affiliation(s)
- Cesare Hassan
- Endoscopy Unit, Ospedale Nuovo Regina Margherita, Rome, Italy
| | - Carlo Senore
- AOU Città della Salute e della Scienza, CPO Piemonte, Turin, Italy
| | | | - Lorenzo Fuccio
- Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Federico Iacopini
- Gastroenterology Endoscopy Unit, Ospedale S. Giuseppe, Albano Laziale, Rome, Italy
| | - Luigi Ricciardiello
- Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | - Leonardo Frazzoni
- Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | | | - Germana de Nucci
- Endoscopy Unit, ASST-Rhodense, Garbagnate Milanese, Milan, Italy
| | - Dora Colussi
- Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Davide Redaelli
- Endoscopy Unit, ASST-Rhodense, Garbagnate Milanese, Milan, Italy
| | | | | | - Ilaria Arena
- Endoscopy Unit, ASST-Rhodense, Rho, Milan, Italy
| | - Cristina Grossi
- Gastroenterology Endoscopy Unit, Ospedale S. Giuseppe, Albano Laziale, Rome, Italy
| | - Fabio Andrei
- Gastroenterology Endoscopy Unit, Ospedale S. Giuseppe, Albano Laziale, Rome, Italy
| | - Eleonora Balestrazzi
- Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Prateek Sharma
- Division of Gastroenterology & Hepatology, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Missouri, USA
| | - Douglas K Rex
- Division of Gastroenterology/Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Ricotta R, Ghezzi S, Verrioli A, Porcu L, Cremolini C, Argiles G, Adenis A, Ychou M, Barone C, Bouche O, Humblet Y, Mineur L, Sobrero A, Pietrogiovanna L, Maiolani M, Galbiati D, Tosi F, Redaelli D, Grothey A. Cavitation of lung metastases induced by regorafenib is associated with radiological response in metastatic colorectal cancer: data from the phase III correct study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv340.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Makovec F, Peris W, Revel L, Giovanetti R, Redaelli D, Rovati LC. Antiallergic and cytoprotective activity of new N-phenylbenzamido acid derivatives. J Med Chem 1992; 35:3633-40. [PMID: 1433173 DOI: 10.1021/jm00098a006] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A series of new N-phenylbenzamido acid derivatives was synthesized and evaluated for their ability to inhibit the IgE-mediated passive cutaneous anaphylaxis in the rat (PCA), as well as for their capacity to inhibit gastric mucosal damage induced by the oral administration of absolute alcohol in the rat. Some of these new derivatives exhibit potent antiallergic and cytoprotective activity, 20-80 times higher than that of the reference, disodium cromoglycate (DSCG). Structure-activity relationships are discussed. The antiallergic activity of one of the more potent compounds of this series, i.e. 4-(1H-tetrazol-5-yl)-N-[4-(1H-tetrazol-5-yl)phenyl]benzamide (compound 44, CR 2039) was further evaluated in vivo. This compound antagonizes the bronchoconstriction induced by aerosolized ovalbumin in both anesthetized and conscious IgE sensitized guinea pigs with ID50 of 3.7 mg/animal (tracheal insufflation) and 20 mg/kg (im). Further cytoprotective effects were evaluated in gastric ulcer models induced by the acute oral administration of hypertonic sodium chloride solution or by acetic acid and by the subchronic administration of glucose in fasted animals. In the models used experimentally CR 2039 is effective, whereas DSCG seems to be devoid of any protective activity. Such a potent antiallergic and mucosal protectant could provide a new potential agent in the therapy of atopic allergic diseases.
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Affiliation(s)
- F Makovec
- Rotta Research Laboratorium, Monza, (Milan), Italy
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Colombo E, Redaelli D, Bocchi M. Is gastric mucosal biopsy useful? Am J Gastroenterol 1991; 86:647-8. [PMID: 2028964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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12
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Colombo E, Bocchi M, Redaelli D, Spinelli M. [Cancer of the gastric stump. Review of endoscopic case records]. Minerva Med 1986; 77:387-90. [PMID: 3703331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
An endoscopic series of 4610 patients examined for dyspeptic symptoms has been reviewed. The purpose was to verify the prevalence of gastric stump cancer. In 266 patients previously gastrectomized for benign peptic ulcer, 10 cases of gastric carcinoma were found (3.61%) whereas in 4344 not previously gastrectomized patients 157 gastric carcinomas were diagnosed (3.75%). Among the 10 patients affected from gastric stump carcinoma, 5 had been operated before, and 5 after, the age 45. The statistical comparison between the two groups showed a significant difference (p less than 0.02) as for the mean time intervals between surgical intervention and onset of gastric stump carcinoma, whereas the mean ages of onset of gastric stump carcinoma resulted substantially identical. We conclude that advanced age, rather than a previous gastrectomy, confers a major risk of gastric carcinoma.
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