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1. Italian consensus guidelines for chronic pancreatitis

Author

Frulloni, L, Falconi, M, Gabbrielli, A, Gaia, E, Graziani, R, Pezzilli, R, Uomo, G, Andriulli, A, Balzano, G, Benini, L, Calculli, L, Campra, D, Capurso, G, Cavestro, Gm, De Angelis, C, Ghezzo, L, Manfredi, R, Malesci, A, Mariani, A, Mutignani, M, Ventrucci, M, Zamboni, G, Amodio, A, Vantini, I, Bassi, C, Delle Fave, G, Capurso, Iv, Magarini, F, Albarello, L, Alfieri, S, Anti, M, Arcidiacono, P, Baiocchi, L, Berretti, D, Boraschi, P, Buscarini, E, Carroccio, A, Celebrano, Mr, Casadei, R, Chilovi, F, Conigliaro, R, Dall'Oglio, L, De Boni, M, De Pretis, G, Di Priolo, S, Di Sebastiano PL, Doglietto, Gb, Filauro, M, Frieri, G, Fuini, A, Loriga, P, Macarri, G, Manes, G, Massucco, P, Milani, S, Pasquali, Claudio, Pederzoli, P, Pietrangeli, M, Rocca, R, Russello, D, Siquini, W, Traina, M, Veneroni, L, Zilli, M, Italian Association for the Study of the Pancreas, Frulloni L, Falconi M, Gabbrielli A, Gaia E, Graziani R, Pezzilli R, Uomo G, Andriulli A, Balzano G, Benini L, Calculli L, Campra D, Capurso G, Cavestro GM, De Angelis C, Ghezzo L, Manfredi R, Malesci A, Mariani A, Mutignani M, Ventrucci M, Zamboni G, Amodio A, Vantini I, Italian Association for the Study of the Pancreas (AISP), Bassi C, Delle Fave G, Capurso IV, Magarini F, Albarello L, Alfieri S, Anti M, Arcidiacono P, Baiocchi L, Berretti D, Boraschi P, Buscarini E, Carroccio A, Celebrano MR, Casadei R, Chilovi F, Conigliaro R, Dall'Oglio L, De Boni M, De Pretis G, Di Priolo S, Di Sebastiano PL, Doglietto GB, Filauro M, Frieri G, Fuini A, Loriga P, Macarri G, Manes G, Massucco P, Milani S, Pasquali C, Pederzoli P, Pietrangeli M, Rocca R, Russello D, Siquini W, Traina M, Veneroni L, Zilli M, Zamboni G., Frulloni, L, Falconi, M, Gabbrielli, A, Gaia, E, Graziani, R, Pezzilli, R, Uomo, G, Andriulli, A, Balzano, G, Benini, L, Calculli, L, Campra, D, Capurso, G, Cavestro, Gm, De Angelis, C, Ghezzo, L, Manfredi, R, Malesci, A, Mariani, A, Mutignani, M, Ventrucci, M, Zamboni, G, Amodio, A, Vantini, I, Italian Association for the Study of the Pancreas, (AISP), Bassi, C, Delle Fave, G, Capurso, Iv, Magarini, F, Albarello, L, Alfieri, S, Anti, M, Arcidiacono, P, Baiocchi, L, Berretti, D, Boraschi, P, Carroccio, A, Celebrano, Mr, Casadei, R, Chilovi, F, Conigliaro, R, Dall'Oglio, L, De Boni, M, De Pretis, G, Di Priolo, S, Di Sebastiano, Pl, Doglietto, Gb, Filauro, M, Frieri, G, Fuini, A, Macarri, G, Manes, G, Massucco, P, Milani, S, Pasquali, C, Pederzoli, P, Pietrangeli, M, Rocca, R, Russello, D, Siquini, W, Traina, M, Veneroni, L, Zilli, M, and Zamboni, G.

Subjects
medicine.medical_specialty, complications, pancreatic supplements, diagnostic imaging, pancreatitis, MEDLINE, cholangiopancreatography, chronic, endoscopic retrograde, pain, quality of life, radiography, sphincterotomy, steatorrhea, surgery, therapy, ultrasonography, Appropriate use, guidelines, chronica pancreatitis, Pancreatitis, Chronic, Pancreatitis, chronic, Complications, Surgery, Medical imaging, Medicine, Humans, Pancreatic stones, Intensive care medicine, Surgical treatment, Hepatology, medicine.diagnostic_test, business.industry, Pancreatitis, Radiography, Therapy, Ultrasonography, Cholangiopancreatography, Sphincterotomy, Diagnostic imaging, Pain, Quality of life, Steatorrhea, Pancreatic supplements, Gastroenterology, medicine.disease, Endoscopy, Pancreatic pain, Italy, CHRONIC PANCREATITIS, Radiology, business
Abstract

This paper gives practical guidelines for diagnosis and treatment of chronic pancreatitis. Statements have been elaborated by working teams of experts, by searching for and analysing the literature, and submitted to a consensus process by using a Delphi modified procedure. The statements report recommendations on clinical and nutritional approach, assessment of pancreatic function, treatment of exocrine pancreatic failure and of secondary diabetes, treatment of pain and prevention of painful relapses. Moreover, the role of endoscopy in approaching pancreatic pain, pancreatic stones, duct narrowing and dilation, and complications was considered. Recommendations for most appropriate use of various imaging techniques and of ultrasound endoscopy are reported. Finally, a group of recommendations are addressed to the surgical treatment, with definition of right indications, timing, most appropriate procedures and techniques in different clinical conditions and targets, and clinical and functional outcomes following surgery. © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved. Keywords: Pancreatitis, chronic; Complications; Surgery; Radiography; Therapy; Ultrasonography; Cholangiopancreatography

Published
2010

2. Surgical management of acute pancreatitis in Italy: lessons from a prospective multicentre study

Author

De Rai, Paolo, Zerbi, Alessandro, Castoldi, Laura, Bassi, Claudio, Frulloni, Luca, Uomo, Generoso, Gabbrielli, Armando, Pezzilli, Raffaele, Cavallini, Giorgio, Di Carlo, Valerio, Agugiaro, S., Turri, L., Bartoli, A., Barberini, F., Cavazzoni, G., Bartolo, F., Della Papa, D., Bassi, N., Massani, M., Benedetti, A., Macarri, G., Piergallini, L., Briani, G., Bartolasi, L., Bugnano, L., Buonanno, G. M., Esposito, C., Cordovana, A., Cavina, E., Seccia, M., Lippolis, P., Musco, B., Barletta, M., Chilovi, E., De Guelfi, A., Chirletti, P., Caronna, R., Scozzafava, S., Cardi, M., Cirino, E., Buffone, A., Colangelo, E., Caracino, V., Cortese, F., Casentini, A., Costamagna, G., Trincali, A., Curzio, M., Clivio, S., Segato, S., D'Alessandro, A., Ambrosiani, V., D'Ambrosio, B., Chiodo, C., Dicillo, M., Reale, L., Grandolfo, A., Fabbrucci, P., Bruscino, A., Mugnaini, P., Ferrarese, S., Ugenti, I., Forte, G. B., Rocco, P., Franzè, A., Bertelè, A., Sereni, G., Friedman, Daniele, Mariani, L., Morelli, F., Gai, V., Antro, C., Garcea, D., Gardini, A., Lucci, E., Giulianotti, P. C., Sbrana, F., Balestracci, T., Giulini, S. M., Pellizzari, A., Ronconi, M., Cimaschi, S., Grassini, M., Lacignola, S., Calandro, L., Mazzitelli, L., Costarella, S. M., Egidio, A., Mello Teggia, P., Stefano, E., Cassini, P., Modica, G., Lupo, F., Giraci, G., Mosca, F., Del Chiaro, M., Mosella, G., Benassai, G., Nanni, M., D'Aristotile, A., Negro, P., Pirazzoli, A., Rabitti, P. G., Romano, C., Gerardi, G., Troianello, B., Russello, D., Di Stefano, A., Avelli, S., Salval, N., Bellini, N., Scalon, P., Staudacher, C., Parolini, D., Strazzabosco, M., Signorelli, S., Tedeschi, U., Testoni, P. A., Masci, E., Mariani, A., Torelli, E., Garcea, M. R., Lombardi, V., Lecconi, L., Valeri, L., Presenti, L., Alessio, F., Ventrucci, M., Virzi, S., Cipolla, A., De Rai, P, Zerbi, A, Castoldi, L, Bassi, C, Frulloni, L, Uomo, G, Gabbrielli, A, Pezzilli, R, Cavallini, G, Di Carlo, V, Proinf, Aisp, and Testoni, PIER ALBERTO

Subjects
Male, Time Factors, Pancreatitis, Alcoholic, medicine.medical_treatment, Acute pancreatitis, Surgery, Aged, Biliary Tract Diseases, Chi-Square Distribution, Cholangiopancreatography, Endoscopic Retrograde, Cholecystectomy, Laparoscopic, Female, Guideline Adherence, Humans, Italy, Pancreatitis, Pancreatitis, Acute Necrotizing, Practice Guidelines as Topic, Prospective Studies, Risk Assessment, Risk Factors, Severity of Illness Index, Treatment Outcome, Cholecystectomy, Jejunostomy, Pancreatectomy, Practice Patterns, Physicians', Hepatology, Gastroenterology, Physician's Practice Patterns, Practice Patterns, surgery, Endoscopic Retrograde, Medicine, Cholangiopancreatography, Laparoscopic, Acute Necrotizing, Alcoholic, Prospective cohort study, health care economics and organizations, acute pancreatitis, Corrigendum, Risk assessment, medicine.medical_specialty, education, Severity of illness, Intensive care medicine, Physicians', business.industry, General surgery, Original Articles, medicine.disease, business
Abstract

OBJECTIVE: This study aimed to evaluate the surgical treatment of acute pancreatitis in Italy and to assess compliance with international guidelines. METHODS: A series of 1173 patients in 56 hospitals were prospectively enrolled and their data analysed. RESULTS: Twenty-nine patients with severe pancreatitis underwent surgical intervention. Necrosectomy was performed in 26 patients, associated with postoperative lavage in 70% of cases. A feeding jejunostomy was added in 37% of cases. Mortality was 21%. Of the patients with mild pancreatitis, 714 patients with a biliary aetiology were evaluated. Prophylactic treatment of relapses was carried out in 212 patients (36%) by cholecystectomy and in 161 using a laparoscopic approach. Preoperative endoscopic retrograde cholangiopancreatography was associated with cholecystectomy in 83 patients (39%). Forty-seven patients (22%) were treated at a second admission, with a median delay of 31 days from the onset of pancreatitis. Eighteen patients with severe pancreatitis underwent cholecystectomy 37.9 days after the first admission. There were no deaths. DISCUSSION: The results indicate poor compliance with published guidelines. In severe pancreatitis, early surgical intervention is frequently performed and enteral feeding is seldom used. Only a small number of patients with mild biliary pancreatitis undergo definitive treatment (i.e. cholecystectomy) within 4 weeks of the onset of pancreatitis.

Published
2010
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3. Diagnostic assessment and outcome of acute pancreatitis in Italy: results of a prospective multicentre study. ProInf-AISP: Progetto informatizzato pancreatite acuta, Associazione Italiana Studio Pancreas, phase II

Author

Uomo, G, Pezzilli, R., Gabbrielli, A., Castoldi, L., Zerbi, A., Frulloni, L., De Rai, P., Cavallini, G., Di Carlo, V., Agugiaro, S., Turri, L., Bartoli, A., Barberini, F., Cavazoni, G., Bartolo, F., Della Papa, D., Bassi, C., Bassi, N., Massani, M., Benedetti, A., Macarri, G., Piergallini, L., Briani, G., Bartolasi, L., Brugnano, L., Buonanno, G. M., Esposito, C., Cardovana, A., Cavina, E., Seccia, M., Lipollis, P., Musco, B., Barletta, M., Chilovi, E., De Guelmi, A., Chirletti, P., Caronna, R., Scozzafava, S., Cardi, M., Cirrino, E., Buffone, A., Colangelo, E., Caracino, V., Cortese, F., Cosentini, A., Costamagna, G., Tringali, A., Curzio, M., Clivio, S., Segato, S., D'Alessandro, A., Ambrosini, V., D'Amborsio, B., Chiodo, C., Dicillo, M., Reale, L., Grandolfo, A., Fabbrucci, P., Bruscino, A., Mugnaini, P., Ferrarese, S., Ugenti, I., Forte, G. B., Rocco, P., Franzè, A., Bertelè, A., Sereni, G., Friedman, Daniele, Mariani, L. M., Murelli, Federica, Gai, V., Antro, C., Garcea, D., Gardini, A., Lucci, E., Giulianotti, P. C., Sbrana, F., Balestracci, T., Giulini, S. M., Pellizzari, A., Ronconi, M., Cimaschi, S., Grassini, M., Lacitignola, S., Caliandro, L., Mazzitelli, R., Costarella, S. M., Egidio, A., Mello Teggia, P., Stefano, E., Cassini, P., Modica, G., Lupo, F., Giraci, G., Mosca, F., Del Chiaro, M., Mosella, G., Benassai, G., Nanni, M., D'Aristotile, A., Negro, P., Pirazzoli, A., Rabitti, P. G., Romano, C., Gerardi, G., Troianello, B., Russello, D., Di Stefano, A., Avelli, S., Salvai, M., Bellini, N., Scalon, P., Staudacher, C., Parolini, D., Strazzabosco, M., Signorelli, S., Tedeschi, U., Testoni, P. A., Masci, E., Mariani, A., Torelli, E., Garcea, M. R., Lombardi, V., Cecconi, L., Valeri, A., Presenti, L., Alessio, F., Ventrucci, M., Virzì, S., and Cipolla, A.

Subjects
Adult, Male, Pancreatic necrosis, Severity of Illness Index, Body Mass Index, Acute Pancreatitis, Clinical outcome, Computed tomography, Diagnosis, Pancreatitis, Prognosis, Ultrasonography, Aged, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde, Creatinine, Female, Humans, Italy, Middle Aged, Prospective Studies, Treatment Outcome, Hepatology, Gastroenterology, Endoscopic Retrograde, 80 and over, treatment, Medicine (all), Cholangiopancreatography, acute pancreatitis, diagnosis
Abstract

Up till now, only one study providing practically complete information on acute pancreatitis in Italy has been published. The aim of this prospective study was to evaluate the clinical characteristics, in terms of diagnostic assessment and outcome, of a large series of patients affected by acute pancreatitis in Italy.The study involved 56 Italian centres, homogeneously distributed throughout the entire national territory. Each participating centre was furnished with an ad hoc software including 530 items along with subsequent collection, tabulation and quality control of the data.One thousand five hundred and forty case report forms of patients affected by acute pancreatitis were collected but 367 of them (24%) were subsequently eliminated from the final analysis. Therefore, 1173 patients (581 females and 592 males) were recruited. Mean age of patients was 62.0+/-18.2 years (95% confidence interval, 60.9-63.0). On the basis of Atlanta classification, 1006 patients (85.8%) were defined as mild and 167 (14.2%) as severe pancreatitis. Biliary forms represented the most frequent aetiological category (813 cases, 69.3%) while alcoholic forms only 6.6% (77 cases); the remaining aetiologies accounted for 7.1% (83 cases) while 200 cases (17.1%) remained without a definite aetiological factor. Complete recovery was achieved in 1016 patients (86.6%) whereas morphological sequelae were found in 121 patients (10.3%) and mortality in 36 patients (3.1%; 0.4% in mild and 19.2% in severe acute pancreatitis). Ultrasonography was largely utilised as a first line diagnostic tool in all patients, with valuable visualisation of the pancreas in 85% of patients. Computer tomography scan was also widely used, with 66.7% of exams in mild and 33.3% in severe pancreatitis. Patients affected by biliary pancreatitis presented more severe (p=0.004) and necrotizing forms (p=0.021). Mortality was significantly related (p0.001) with the extension of pancreatic necrosis and with an age of over 70 years. Body mass index presented significantly greater values in severe than in mild forms (p0.001).Association of creatinine serum level over 2mg/dl with an abnormal chest X-ray showed a high significant correlation with a more severe outcome in terms of morphological sequelae and mortality (p=0.0001). Acute pancreatitis in Italy more commonly presents biliary aetiology and favourable outcome with low rate of complications and mortality. From a cost-effectiveness standpoint, diagnostic approach to this disease needs to be better standardised.

Published
2007

4. A prospective multicentre survey on the treatment of acute pancreatitis in Italy

Author

Pezzilli, R, Uomo, G., Gabbrielli, A., Zerbi, A., Frulloni, L., De Rai, P., Castoldi, L., Cavallini, G., Di Carlo, V., Agugiaro, S., Turri, L., Bartoli, A., Barberini, F., Cavazoni, G., Bartolo, F., Della Papa, D., Bassi, C., Bassi, N., Massani, M., Benedetti, A., Macarri, G., Piergallini, L., Briani, G., Bartolasi, L., Brugnano, L., Buonanno, G. M., Esposito, C., Cardovana, A., Cavina, E., Seccia, M., Lipollis, P., Musco, B., Barletta, M., Chilovi, E., De Guelmi, A., Chirletti, Piero, Caronna, Roberto, Scozzafava, S., Cardi, Maurizio, Cirino, E., Buffone, A., Colangelo, E., Caracino, V., Cortese, F., Cosentini, A., Costamagna, G., Tringali, A., Curzio, M., Clivio, S., Segato, S., D'Alessandro, A., Ambrosini, V., D'Amborsio, B., Chiodo, C., Dicillo, M., Reale, L., Grandolfo, A., Fabbrucci, P., Bruscino, A., Mugnaini, P., Ferrarese, S., Ugenti, I., Forte, G. B., Rocco, P., Franzè, A., Bertelè, A., Sereni, G., Friedman, D., Mariani, L. M., Murelli, F., Gai, V., Antro, C., Garcea, D., Gardini, A., Lucci, E., Giulianotti, P. C., Sbrana, F., Balestracci, T., Giulini, S. M., Pellizzari, A., Ronconi, M., Cimaschi, S., Grassini, M., Lacitignola, S., Caliandro, L., Mazzitelli, R., Costarella, S. M., Egidio, A., Mello Teggia, P., Stefano, E., Cassini, P., Modica, G., Lupo, F., Giraci, G., Mosca, F., Del Chiaro, M., Mosella, G., Benassai, G., Nanni, M., D'Aristotile, A., Negro, P., Pirazzoli, A., Rabitti, P. G., Romano, C., Gerardi, G., Troianello, B., Russello, D., Di Stefano, A., Avelli, S., Salvai, M., Bellini, N., Scalon, P., Staudacher, C., Parolini, D., Strazzabosco, M., Signorelli, S., Tedeschi, U., Testoni, P. A., Masci, E., Mariani, A., Torelli, E., Garcea, M. R., Lombardi, V., Cecconi, L., Valeri, A., Presenti, L., Alessio, F., Ventrucci, M., Virzi, S., and Cipolla, A.

Subjects
Adult, Male, medicine.medical_specialty, ERCP, Pancreatitis, Pancreatitis acute necrotising, Aged, Aged, 80 and over, Analgesics, Anti-Bacterial Agents, Digestive System Surgical Procedures, Female, Histamine Antagonists, Humans, Italy, Middle Aged, Prospective Studies, Severity of Illness Index, Treatment Outcome, Medicine (all), Hepatology, Gastroenterology, Therapeutic approach, Internal medicine, Severity of illness, 80 and over, Medicine, Prospective cohort study, business.industry, medicine.disease, Surgery, medicine.anatomical_structure, Acute pancreatitis, Tramadol, business, Pancreas, medicine.drug
Abstract

The Italian Association for the Study of the Pancreas released a diagnostic and therapeutic algorithm for acute pancreatitis in 1999.This study focused on the analysis of the therapeutic approach for the treatment of acute pancreatitis in Italy.One thousand, one hundred and seventy-three patients were recruited: 1006 patients (85.8%) had mild acute pancreatitis (MAP) and 167 (14.2%) had the severe acute pancreatitis (SAP); 161 patients showed pancreatic necrosis at computed tomography; 121 patients (10.3%) had sequelae and 36 (3.1%) died.Non-steroidal anti-inflammatory drugs and tramadol were used more frequently in patients with the MAP whereas opioids and the association schedules were used more frequently in patients with the SAP (P0.001). Gabexate mesilate was utilised in 831 out of 1173 patients (70.8%); in particular, gabexate mesilate was used in 70.6% patients with MAP and in 73.1% of those with SAP (P=0.521). The duration of the drug administration was significantly shorter in those having MAP than in those having the SAP (P0.001). The antibiotics most frequently used for the prophylaxis against infection from pancreatic necrosis (43.1%) were carbapenems. Only a small number of patients received enteral nutrition (4.7%). Endoscopic retrograde cholangiopancreatography was carried out in 344 of the 1173 patients (29.3%). Surgery was performed in 48 with SAP (19 had elective biliary surgery and 29 had pancreatic surgery).The results of this survey indicate a lack of compliance with the guidelines which regard the indications mainly for interventional endoscopy and surgery.

Published
2007

5. Identification of a novel mutation (c279delC) and a polymorphism (c291CG) in the von Hippel-Lindau gene in Italian patients

Author

Moore, Ps1, Antonello, D, Martignoni, Guido, Racchini, C, Ventrucci, M, and Scarpa, Aldo

Subjects
von Hippel-Lindau gene, Italian patients, Polymorphism, Genetic, von Hippel-Lindau Disease, Tumor Suppressor Proteins, Ubiquitin-Protein Ligases, Glycine, Proteins, G%29%22">polymorphism (c291C>G), Ligases, Amino Acid Substitution, Italy, Von Hippel-Lindau Tumor Suppressor Protein, Mutation, novel mutation (c279delC), Humans, Genes, Tumor Suppressor, Cysteine
Published
2000

6. Quality control study of H2 breath testing for the diagnosis of carbohydrate malabsorption in Italy. The 'Tenue Club' Group

Author

Strocchi A, Gr, Corazza, Anania C, Benati G, Malservisi S, Mv, Cherchi, Certo M, Malorgio E, Marano M, Mazzeo V, Lia Ginaldi, Gm, Giorgetti, Pimpo T, Sciarretta G, Ventrucci M, Quondamcarlo C, Ma, Pelli, and Perri F

Subjects
Quality Control, Lactose Intolerance, Breath Tests, Italy, Humans, Reproducibility of Results, Prospective Studies, Sensitivity and Specificity, Hydrogen
Abstract

H2 breath testing is increasingly used in Italy. The aim of this multicenter study was to assess the accuracy of this technique in the diagnosis of carbohydrate malabsorption.An anonymous questionnaire was used to collect information about H2 breath testing methods and to design the quality control study. Fifteen out of 23 laboratories responded to the questionnaire and 12/23 completed the entire study.The survey revealed that a large variety of H2 testing methods are employed in Italy, but none have been previously tested for accuracy. This prospective study showed that these tests fail to identify20% of patients with malabsorption. In contrast, a new method based on single H2 breath measurement at 6 hours after lactulose ingestion and a cutoff value of greater than 5 ppm, had a sensitivity of 92% +/- 4% and a specificity of 94% +/- 0.5%. Increasing the cut-off to 10 ppm resulted in a sensitivity of 88% +/- 9% and a specificity of 100%. This improved accuracy was obtained with a much simpler testing procedure in which only one breath sample is analyzed, in contrast to the baseline and multiple subsequent samples that are analyzed using the currently employed techniques.A great improvement in the accuracy of the H2 breath test, as well as a considerable saving in terms of time and costs, may be possible through the use of a new, simplified H2 breath test followed by careful H2 analysis.

7. Italian consensus guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms

Author

Buscarini, Elisabetta, Pezzilli, Raffaele, Cannizzaro, Renato, De Angelis, Claudio, Gion, Massimo, Morana, Giovanni, Zamboni, Giuseppe, Arcidiacono, Paolo, Balzano, Gianpaolo, Barresi, Luca, Basso, Daniela, Bocus, Paolo, Calculli, Lucia, Capurso, Gabriele, Canzonieri, Vincenzo, Casadei, Riccardo, Crippa, Stefano, D'Onofrio, Mirko, Frulloni, Luca, Fusaroli, Pietro, Manfredi, Guido, Pacchioni, Donatella, Pasquali, Claudio, Rocca, Rodolfo, Ventrucci, Maurizio, Venturini, Silvia, Villanacci, Vincenzo, Zerbi, Alessandro, Falconi, Massimo, Cystic Pancreatic Neoplasm Study Group, Collaborators: Luca Albarello, Lorenzo, Camellini, Cantu, Paolo, Rita, Conigliaro, Guido, Costamagna, Giuseppe Del Favero, Giovanna Del Vecchio Blanco, Pierluigi Di Sebastiano, Carlo, Fabbri, Paolo, Federici, Niccola, Funel, Andrea, Galli, Gabbrielli, Armando, Graziani, Rossella, Tiziana, Guadagnini, Andrea, Laghi, Giampiero, Macarri, Fabrizio, Magnolfi, Marco, Marzioni, Fabio, Monica, Nicola, Muscatiello, Massimiliano, Mutignani, Antonio, Pisani, Enrico, Scarano, Carla, Serra, Marco, Spada, Marco, Visconti, Alessandro, Zambelli, Buscarini, E, Pezzilli, R, Cannizzaro, R, Angelis, Cd, Gion, M, Morana, G, Zamboni, G, Arcidiacono, P, Balzano, G, Barresi, L, Basso, D, Bocus, P, Calculli, L, Capurso, G, Canzonieri, V, Casadei, R, D'Onofrio, M, Frulloni, L, Fusaroli, P, Manfredi, G, Pacchioni, D, Pasquali, C, Rocca, R, Ventrucci, M, Venturini, S., Villanacci, V., Zerbi, A., Falconi, Massimo, Crippa, Stefano, DIPARTIMENTO DI SCIENZE MEDICHE E CHIRURGICHE, Da definire, AREA MIN. 06 - Scienze mediche, Italian Association of Hospital Gastroenterologists and Endoscopist, Italian Association for the Study of the Pancrea, Buscarini E, Pezzilli R, Cannizzaro R, De Angelis C, Gion M, Morana G, Zamboni G, Arcidiacono P, Balzano G, Barresi L, Basso D, Bocus P, Calculli L, Capurso G, Canzonieri V, Casadei R, Crippa S, D'Onofrio M, Frulloni L, Fusaroli P, Manfredi G, Pacchioni D, Pasquali C, Rocca R, Ventrucci M, Venturini S, Villanacci V, Zerbi A, Falconi M, and Cystic Pancreatic Neoplasm Study Group

Subjects
Endoscopic ultrasound, medicine.medical_specialty, Consensus, Delphi Technique, mucinous, Pancreatic neoplasms, Cholangiopancreatography, Magnetic Resonance, Delphi method, Modified delphi, Appropriate use, Neoplasms, cystic, mucinous, and serous, Pancreatic cyst, Endosonography, ENDOSCOPIC ULTRASONOGRAPHY, Settore MED/12, Neoplasms, Biomarkers, Tumor, medicine, Humans, In patient, cystic, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, PANCREATIC CYSTS, and serous, Work-up, Tomography x ray computed, Italy, Positron-Emission Tomography, Radiology, Tomography, X-Ray Computed, business
Abstract

none 33 no This report contains clinically oriented guidelines for the diagnostic work-up and follow-up of cystic pancreatic neoplasms in patients fit for treatment. The statements were elaborated by working groups of experts by searching and analysing the literature, and then underwent a consensus process using a modified Delphi procedure. The statements report recommendations regarding the most appropriate use and timing of various imaging techniques and of endoscopic ultrasound, the role of circulating and intracystic markers and the pathologic evaluation for the diagnosis and follow-up of cystic pancreatic neoplasms open Italian Association of Hospital Gastroenterologists and Endoscopists; Italian Association for the Study of the Pancreas; Buscarini E; Pezzilli R; Cannizzaro R; De Angelis C; Gion M; Morana G; Zamboni G; Arcidiacono P; Balzano G; Barresi L; Basso D; Bocus P; Calculli L; Capurso G; Canzonieri V; Casadei R; Crippa S; D'Onofrio M; Frulloni L; Fusaroli P; Manfredi G; Pacchioni D; Pasquali C; Rocca R; Ventrucci M; Venturini S; Villanacci V; Zerbi A; Falconi M; Cystic Pancreatic Neoplasm Study Group Italian Association of Hospital Gastroenterologists and Endoscopists; Italian Association for the Study of the Pancreas; Buscarini E; Pezzilli R; Cannizzaro R; De Angelis C; Gion M; Morana G; Zamboni G; Arcidiacono P; Balzano G; Barresi L; Basso D; Bocus P; Calculli L; Capurso G; Canzonieri V; Casadei R; Crippa S; D'Onofrio M; Frulloni L; Fusaroli P; Manfredi G; Pacchioni D; Pasquali C; Rocca R; Ventrucci M; Venturini S; Villanacci V; Zerbi A; Falconi M; Cystic Pancreatic Neoplasm Study Group

Published
2014
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8. A note on intrinsic conditional autoregressive models for disconnected graphs

Author

Massimo Ventrucci, Anna Freni-Sterrantino, Haavard Rue, and Freni-Sterrantino A, Ventrucci M, Rue H

Subjects
FOS: Computer and information sciences, Conditional autoregressive, CAR model, Epidemiology, Computer science, Health, Toxicology and Mutagenesis, Gaussian, Geography, Planning and Development, Infectious Disease, 01 natural sciences, Island, Methodology (stat.ME), 010104 statistics & probability, 03 medical and health sciences, symbols.namesake, Spatio-Temporal Analysis, 0302 clinical medicine, Stomach Neoplasms, INLA, Humans, Applied mathematics, 030212 general & internal medicine, 0101 mathematics, Gaussian markov random fields, Statistics - Methodology, Models, Statistical, Disconnected graph, Infectious Diseases, Italy, Scotland, Data Interpretation, Statistical, Lip Neoplasms, symbols, Disease mapping, Gaussian Markov random field
Abstract

In this note we discuss (Gaussian) intrinsic conditional autoregressive (CAR) models for disconnected graphs, with the aim of providing practical guidelines for how these models should be defined, scaled and implemented. We show how these suggestions can be implemented in two examples on disease mapping., 14 pages

Published
2018
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9. Prevalence and risk factors of extrapancreatic malignancies in a large cohort of patients with intraductal papillary mucinous neoplasm (IPMN) of the pancreas

Author

Carlo Fabbri, Nikola Panic, M Del Chiaro, Roberto Salvia, Antonella Carnuccio, Walter Ricciardi, Ilaria Tarantino, Emanuele Leoncini, G. Delle Fave, Stefania Boccia, Raffaele Manta, Paolo Giorgio Arcidiacono, Matteo Piciucchi, Claudio Bassi, Alberto Larghi, Maurizio Ventrucci, Gabriele Capurso, Dario Arzani, Alessandro Zerbi, Ugo Boggi, Raffaele Pezzilli, Luca Frulloni, Milutin Bulajic, Guido Costamagna, Larghi, A, Panic, N, Capurso, G, Leoncini, E, Arzani, D, Salvia, R, Del Chiaro, M, Frulloni, L, Arcidiacono, P, Zerbi, A, Manta, R, Fabbri, C, Ventrucci, M, Tarantino, I, Piciucchi, M, Carnuccio, A, Boggi, U, Costamagna, G, Delle Fave, G, Pezzilli, R, Bassi, C, Bulajic, M, Ricciardi, W, and Boccia, S.

Subjects
Settore MED/18 - CHIRURGIA GENERALE, neoplasms, multiple primary, carcinoma, Gastroenterology, prostatic neoplasms, Neoplasms, Multiple Primary, 0302 clinical medicine, cohort studies, Renal cell carcinoma, papillary, italy, middle aged, 80 and over, breast neoplasms, kidney neoplasms, risk factors, Family history, humans, pancreatic ductal, Aged, 80 and over, thyroid neoplasms, Incidence (epidemiology), adult, pancreatic neoplasms, Neoplasms, Second Primary, Hematology, Adenocarcinoma, Mucinous, 3. Good health, aged, second primary, female, Oncology, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, epidemiology, Carcinoma, Pancreatic Ductal, Cohort study, medicine.medical_specialty, mucinous, prevalence, Thyroid carcinoma, 03 medical and health sciences, ipmn, male, Internal medicine, adenocarcinoma, colorectal neoplasms, extrapancreatic malignancies, incidence, renal cell, parasitic diseases, medicine, Risk factor, Settore MED/42 - IGIENE GENERALE E APPLICATA, Carcinoma, Renal Cell, Intraductal papillary mucinous neoplasm, business.industry, General surgery, Cancer, medicine.disease, Carcinoma, Papillary, business
Abstract

Background The objectives of this study are to estimate prevalence and incidence of extrapancreatic malignancies (EPMs) among intraductal papillary mucinous neoplasms (IPMNs) of the pancreas, and to identify risk factors for their occurrence. Patients and methods We conducted multicentric cohort study in Italy from January 2010 to January 2011 including 390 IPMN cases. EPMs were grouped as previous, synchronous (both prevalent) and metachronous (incident). We calculated the observed/expected (O/E) ratio of prevalent EPMs, and compared the distribution of demographic, medical history and lifestyle habits. Results Ninety-seven EPMs were diagnosed in 92 patients (23.6%), among them 78 (80.4%) were previous, 14 (14.4%) were synchronous and 5 (5.2%) were metachronous. O/E ratios for prevalent EPMs were significantly increased for colorectal carcinoma (2.26; CI 95% 1.17–3.96), renal cell carcinoma (6.00; CI 95% 2.74–11.39) and thyroid carcinoma (5.56; CI 95% 1.80–12.96). Increased age, heavy cigarette smoking, alcohol consumption and first-degree family history of gastric cancer are significant risk factors for EPMs, while first-degree family history of colorectal carcinoma was borderline. Conclusion We report an increased prevalence of EPMs in Italian patients with IPMN, especially for colorectal carcinoma, renal cell and thyroid cancers. A systematic surveillance of IPMN cases for such cancer types would be advised.

Published
2013

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