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2. The practical management of chronic constipation as detected by a survey conducted on Italian gastroenterologists

Author

Fabbri, Carlo, Spada, Cristiano, Aragona, S. E., Ciprandi, Guido, Alberico, G., Antoniazzi, S., Arrigoni, A., Astegiano, M., Astretto, S., Baroni, S., Battaglia, E., Belcari, C., Beretta, P., Bianchetti, Maddalena, Bianchi, M. L., Bindi, B., Buda, C., Camilleri, S., Caronna, S., Cautela, G., Cavallaro, Fabio, Cocco, A., Colucci, R., Consalvo, D., Cordone, G., Cortelezzi, C., Cozzoli, G., Curro, E. A., Damiani, Andrea, D'Amore, F., De Falco, P., De Girolamo, Maria Vittoria, De Luca, L., Di Lorenzo, F., Di Marzo, S., Di Nardo, G., Ferrara, M., Fiaccavento, R., Fina, D., Frasca, R., Gallo, M., Gennarelli, N., Ghittoni, G., Giangregorio, F., Giannetti, A., Giglio, L. A., Giuncato, S., Grosso, S., Iannuzziello, D., Ibba, I., Incarbone, S., La Spada, S., Lagoussis, P., Lecca, G., Leonardi, G., Licari, G., Lucia, Mothanje Barbara Patricia, Lupinacci, G., Magri, S., Oppezzi, M., Paiano, P., Palombo, V., Pardocchi, D., Parodi, A., Pati, A., Petrini, C., Pinto, A., Pirrotta, P., Piscopo, A., Polimeni, N., Preatoni, P., Quintigliano, D., Radice, E., Ricco, G., Rodella, Luigi Fabrizio, Schettino, M., Schettino, Paola, Schicchi, A. A., Schiffino, L., Severi, C., Sinagra, E., Tarantello, M., Valeri, Giovanni, Vanni, R., Vinti, M., Zulli, C., Fabbri C., Spada C. (ORCID:0000-0002-5692-0960), Ciprandi G., Bianchetti M., Cavallaro F., Damiani A., De Girolamo V., Lucia M. (ORCID:0000-0001-7648-2198), Rodella L., Schettino P., Valeri G., Fabbri, Carlo, Spada, Cristiano, Aragona, S. E., Ciprandi, Guido, Alberico, G., Antoniazzi, S., Arrigoni, A., Astegiano, M., Astretto, S., Baroni, S., Battaglia, E., Belcari, C., Beretta, P., Bianchetti, Maddalena, Bianchi, M. L., Bindi, B., Buda, C., Camilleri, S., Caronna, S., Cautela, G., Cavallaro, Fabio, Cocco, A., Colucci, R., Consalvo, D., Cordone, G., Cortelezzi, C., Cozzoli, G., Curro, E. A., Damiani, Andrea, D'Amore, F., De Falco, P., De Girolamo, Maria Vittoria, De Luca, L., Di Lorenzo, F., Di Marzo, S., Di Nardo, G., Ferrara, M., Fiaccavento, R., Fina, D., Frasca, R., Gallo, M., Gennarelli, N., Ghittoni, G., Giangregorio, F., Giannetti, A., Giglio, L. A., Giuncato, S., Grosso, S., Iannuzziello, D., Ibba, I., Incarbone, S., La Spada, S., Lagoussis, P., Lecca, G., Leonardi, G., Licari, G., Lucia, Mothanje Barbara Patricia, Lupinacci, G., Magri, S., Oppezzi, M., Paiano, P., Palombo, V., Pardocchi, D., Parodi, A., Pati, A., Petrini, C., Pinto, A., Pirrotta, P., Piscopo, A., Polimeni, N., Preatoni, P., Quintigliano, D., Radice, E., Ricco, G., Rodella, Luigi Fabrizio, Schettino, M., Schettino, Paola, Schicchi, A. A., Schiffino, L., Severi, C., Sinagra, E., Tarantello, M., Valeri, Giovanni, Vanni, R., Vinti, M., Zulli, C., Fabbri C., Spada C. (ORCID:0000-0002-5692-0960), Ciprandi G., Bianchetti M., Cavallaro F., Damiani A., De Girolamo V., Lucia M. (ORCID:0000-0001-7648-2198), Rodella L., Schettino P., and Valeri G.

Abstract

BACKGROUND: Chronic constipation represents a widespread medical condition, mainly in elderly people. The management is compelling as these patients frequently have comorbidity and polypharmacy. Polyethylene glycol (PEG) is commonly used but does not resolve some complaints, mainly concerning pain and bloating. Therefore, a new medical device containing PEG plus simethicone, an antifoaming agent, has been developed. The present survey explored its use in clinical practice. METHODS: A group of 64 Italian gastroenterologists visited 2426 patients with chronic primary constipation. In about two/third, gastroenterologists freely prescribed the new medical device, and in the remaining patients, other treatments were freely chosen by doctors. Patients were followed up for three months. The number of evacuations, stool characteristics, patients’ perception of illness assessed by VAS, frequency of patients with pain and intestinal symptoms, and discontinuing patients was observed during the experience. RESULTS: The new medical device was significantly better than other therapies in improving all parameters (P<0.05 for all parameters). CONCLUSIONS: The present survey demonstrated that a new medical device containing PEG plus simethicone represents a favorable option in managing patients with chronic primary constipation as significantly and safely improves intestinal transit, reduces stool consistency, reduces symptom severity, and is highly satisfactory.

Published
2023

6. CT-GUIDED TRANSTHORACIC NEEDLE BIOPSY: ADVANTEGES IN HISTOPATHOLOGICAL AND MOLECULAR TESTS

Author

Porrello,C, Gullo,R, Gagliardo,MC, Vaglica,A, Palazzolo,M, Giangregorio,F, Iadicola,D, Catanzaro,A, Scerrino,G, Lo Faso,F, carini,F, Tomasello,G, Porrello,C, Gullo,R, Gagliardo,MC, Vaglica,A, Palazzolo,M, Giangregorio,F, Iadicola,D, Catanzaro,A, Scerrino,G, Lo Faso,F, carini,F, and Tomasello,G

Subjects
lung adenocarcinoma, lung nodule, molecular oncology, transthoracic needle biopsy
Abstract

Aim: The present study aimed to demonstrate that computed tomography-guided transthoracic needle biopsy (TTNB) is a safe procedure that gives a more accurate pre-operative tissue diagnosis for peripheral lung nodules than transthoracic needle aspiration, obtaining suitable samples for molecular test in lung adenocarcinomas. Patients and methods: Between December 2016 and March 2018 at Thoracic Surgery Department of the University of Palermo - Policlinico Paolo Giaccone Hospital, TTNB was performed in 42 patients with computed tomography-detected peripheral lung nodules > 10 mm, using 16-18 -Gauge tru-Cut needles. Results: With TTNB, we have estimated an accuracy for tissue diagnosis of 97,6%. At the molecular test, EGFR overexpression and ALK mutation resulted positive for 12/23 patients with lung adenocarcinoma. Conclusion: TTNB has showed a low rate of complications and it is adoptable as standard diagnostic procedure for peripheral lung nodules.

Published
2020

7. Risk of COVID 19 in patients with inflammatory bowel diseases compared to a control population.

Author

Ardizzone S., Saibeni S., Alicante S., Ferretti F., Rizzardini G., Galli M., Maconi G., Bosetti C., De Monti A., Boyapati R.K., Shelton E., Piazza N., Carvalhas Gabrielli A.M., Lenti M.V., Bezzio C., Ricci C., Greco S., Romeo S., Giangregorio F., Gridavilla D., Tagliani F., Massari A., Pastorelli L., Di Sabatino A., Ardizzone S., Saibeni S., Alicante S., Ferretti F., Rizzardini G., Galli M., Maconi G., Bosetti C., De Monti A., Boyapati R.K., Shelton E., Piazza N., Carvalhas Gabrielli A.M., Lenti M.V., Bezzio C., Ricci C., Greco S., Romeo S., Giangregorio F., Gridavilla D., Tagliani F., Massari A., Pastorelli L., and Di Sabatino A.

Abstract

Background: It is unclear whether patients with inflammatory bowel disease (IBD) are at increased risk of COVID-19. Objective(s): This observational study compared the prevalence of COVID-19 symptoms, diagnosis and hospitalization in IBD patients with a control population with non-inflammatory bowel disorders. Method(s): This multicentre study, included 2733 outpatients (1397 IBD patients and 1336 controls), from eight major gastrointestinal centres in Lombardy, Italy. Patients were invited to complete a web-based questionnaire regarding demographic, historical and clinical features over the previous 6 weeks. The prevalence of COVID-19 symptoms, diagnosis and hospitalization for COVID-19 was assessed. Result(s): 1810 patients (64%) responded to the questionnaire (941 IBD patients and 869 controls). IBD patients were significantly younger and of male sex than controls. NSAID use and smoking were more frequent in controls. IBD patients were more likely treated with vitamin-D and vaccinated for influenza. Highly probable COVID-19 on the basis of symptoms and signs was less frequent in the IBD group (3.8% vs 6.3%; OR:0.45, 95%CI:0.28-0.75). IBD patients had a lower rate of nasopharyngeal swab-PCR confirmed diagnosis (0.2% vs 1.2%; OR:0.14, 95%CI:0.03-0.67). There was no difference in hospitalization between the groups (0.1% vs 0.6%; OR:0.14, 95%CI:0.02-1.17). Conclusion(s): IBD patients do not have an increased risk of COVID-19 specific symptoms or more severe disease compared with a control group of gastroenterology patients.Copyright © 2021 Editrice Gastroenterologica Italiana S.r.l.

Published
2021

8. POSTOPERATIVE COMPLICATIONS,PAIN AND QUALITY OF LIFE AFTER THORACOSCOPIC OF THOREACOTOMIC LOBECTOMY FOR LUNG CANCER

Author

Porrello, C., Scerrino, S., Vaglia, A., Palazzolo, M., Gagliardo, C., Giangregorio, F., Dario Iadicola, GIOVANNI TOMASELLO, Lo Faso, F., Kawamukay, K., Lacava, N., Gianfranco Cocorullo, Gullo, R., Porrello,C, Scerrino,S, Vaglia,A, Palazzolo,M, Gagliardo, CM, Giangregorio F, Iadicola,D, Tomasello,G, Lo Faso,F, Kawamukay,K, Lacava,N, Cocorullo,G, and Gullo,R

Subjects
Settore MED/18 - Chirurgia Generale, Lobectomy, Thoracoscopy, lung cancer, quality of life, complications, Settore MED/21 - Chirurgia Toracica
Abstract

Aim: Thoracoscopic lobectomy is superior to thoracotomy, but the evidence for this assumption is low. We present a comparison between thoracotomy and thoracoscopy in term of postoperative complications, mortality, postoperative, hospital stay and quaklity of life. Patients and methods: This is a rectrospective analysis of 224 lobectomies in 24-months. 128 patients (57.1%) were operated by thoracotomy; 96 patients (42.9%) by videothoracoscopy. Results: Major complications were observed in 4/128 (3.1%) in thoracotomy group and in 1/96 (16.7%) thoracoscopy. Thoracoscopy patients had a shorter hospital stay. Conclusion: our study shows an advantage of thorascopy over thoracotomy but furher studies are needed.

Published
2019

9. ROUTINARY USE OF FIBRIN SEALANTS TO PREVENT PROLONGED AIR LEAK IN THORACIC SURGERT: OUR EXPERIENCE

Author

Porrello, C., Dario Iadicola, Grutta, E., Palazzolo, M., Vaglica, A., Gagliardo, C., Giangregorio, F., Gulotta, E., Lo Faso, F., Gullo, R., francesco carini, GIOVANNI TOMASELLO, Gianfranco Cocorullo, porrello,c, iadicola,d, grutta,em, palazzolo,m, vaglica,a, gagliardo,c, giangregorio,f, gulotta,e, lo faso,f, gullo,r, carini,f, tomasello,g, and cocorullo,g

Subjects
Adult, Aged, 80 and over, Male, prolonged air leak, pneumothorax, alveolo-pleural fistula, fibrin glue, thoracic surgery, lung, Air, Suture Techniques, Anastomotic Leak, Fibrin Tissue Adhesive, Length of Stay, Middle Aged, Settore MED/18 - Chirurgia Generale, Chest Tubes, Quality of Life, Humans, Female, Tissue Adhesives, Pneumonectomy, Aged
Abstract

Introduction: prolonged air leak (PAL) is one of the most common postoperative complications after lung surgery. It is associatred with increased significant morbidity, lower quality of life, longer hospital stay and higher hospital costs. Since its great clinical and economic burden, it is important to establish the feasibility and the effectiveness of the routinary preventive use of a fibrin sealant in order to reduce the incidence of prolonged air leaks. Patients and methods: this is a randomized study on 189 adult patients - 118 men (62,4%) and 71 women (37,6%) aged from 39 to 87 y.o. (mean age 68,3 y.o.) - who underwent lung surgery (lobectomy or bilobectomy) with intraoperatory detection of air leakage, from January 2013 to December 2017, at Department of Thoracic Surgery in "Ospedale Maggiore Carlo Alberto Pizzardi" (Bologna, Italy) and Department of Thoracic Surgery in "Paolo Giaccone" Teaching Hospital (Palermoo, Italy). Patients were randomnly assigned to the "Glue" arm (90 patients) or the "Control" group (99 patients). We only used stapler or manual suture to acheve aerostasis. In addition, we used a fibrin sealant ("glue") to cover the suture line on patients in the "glue" arm. The primary endpoints were incidence of prolonged air leaks, days with chest tube and mean hospital stay. Results: in the "Glue" arm we experienced ONLY 1 prolonged air leak (1,1%), while in the "Control group) there were 8 leaks. (8,1%). Patients kept chest tube for average 4,15 days in the "Glue" arm and 4,45 days in the "control" group. The mean hospital stay was average 7,4 days for the 2Glue" arm, while 9.1 days in the "control" group. Conclusions: according to our experience it seems that the routinary preventive use of a fibrin sealant results in a lower incidence of prolonged air leaks, a shorter hospital stay with lower hospital costs, representing a cost-effective, feasible and effective system to decrease morbility and mortality among surgical patients.

Published
2019

12. Relieving laryngopharingeral reflux (RELIEF) survey in otolaryngology - II the viewpoint of the patient

Author

Gelardi, M., Silvestrf, M., Ciprandp, G., Aielli, F., Alessandrini, P., Allosso, G., Angelillo, S., Anni, A., Antoniacomi, G., Aragona, S. E., Armone Caruso, A., Asprea, F., Azzaro, R., Balata, G., Bellini, C., DI BENEDETTO, Daniela, Bernardi, R., Buccolieri, M., Caligo, G., Campobasso, G., Canevari, F. R., Cantaffa, A., Capone, A., Carboni, S., Castagna, G., Castellani, C., Clemente, I., Cordier, A., Cossu, D., Costanzo, M., Cugno Garrano, A., Cupido, G., Danteo, M., De Luca, C., Degli Innocenti, M., Dei, A., Denuli, G., Di Bartolo, L., Dolores, A., Falcetti, S., Falciglia, AURORA MARIA ROSARIA, Fera, G., Ferraro, G., Fini, O., Giangregorio, F., Grazioli, F., Grillo, C., Guiso, M. L., Ianniello, F., Lerace, M., Ingria, F., La Mantia, I., La Pietra, G., Lambertoni, C., Lauletta, R., Lazzoni, D., Leo, S., Leone, M., Lo Iacono, Y., Maio, M., Mangiatordi, F. G., Maniscalco, F., Matricciani, A., Mirra, N., Montanaro, S. C., Montesi, P., Moro, D., Muiit, F., Mure, C., Nacci, A., Nipo, Tarsia, Pace, Annamaria, Panetti, G., Paoletti, M., Pasquarella, G., Pedrotti, I., Pellegrino, A., Petrone, D., Pinto, P., Pizzolante, M. C., Pollastrini, L., Poma, S., Quaranta, N., Reale, G., Rigo, S., Scarpa, A., Scelsi, F., Sellari, L., Serraino, E. G., Spano', Piero Giovanni Maria, Stufano, V., Tomacelli, G., Tombolini, A., and Zirone, A.

Published
2018

13. Confirmatory factor analysis of the Patient Assessment of Constipation-Symptoms (PAC-SYM) among patients with chronic constipation

Author

Neri L, Conway PM, Basilisco G, Altomare DF, Annese V, Badiali D, Bassotti G, Battaglia E, Bazzocchi G, Bellini M, Bendia E, Benini L, Biscaglia G, Biviano I, Bocchini R, Bonfrate L, Bonventre S, Bossa F, Brandimarte G, Cannizzaro R, Cicala M, Cipolletta L, Clara V, Cogliandro R, Comandini G, Corazziari E, Crotta S, CUOMO, ROSARIO, D'Alba L, De Giorgi F, Del Piano M, Di Fonzo M, Di Mario Francesco, Di Stefano M, D'Onofrio V, Efthymakis K, Fiore P, Fortuna M, Fries W, Gaetani E, Galeazzi F, Gasbarrini A, Geccherle' A, Giangregorio F, Girardi L, Grassini M, Groppo M, Guarnieri G, Iovino P, Lo Cascio M, Lolli R, Luzza F, Macarri G, Marino M, Miraglia S, Monastra S, Neri MC, Neri M, Noris RA, Orselli S, Passaretti S, Paviotti A, Pazzi P, Pilotto A, Portincasa P, Ranaldo N, Ravelli P, Rogai F, Sablich R, Savarino V, Spinzi G, Stanghellini V, Tammaro L, Torresan F, Usai Satta P, Valle C., Neri, L, Conway, Pm, Basilisco, G, Stanghellini, V, Neri, L., Conway, P., Basilisco, G., Bonventre, S, Altomare, Df, Annese, V, Badiali, D, Bassotti, G, Battaglia, E, Bazzocchi, G, Bellini, M, Bendia, E, Benini, L, Biscaglia, G, Biviano, I, Bocchini, R, Bonfrate, L, Bossa, F, Brandimarte, G, Cannizzaro, R, Cicala, M, Cipolletta, L, Clara, V, Cogliandro, R, Comandini, G, Corazziari, E, Crotta, S, Cuomo, Rosario, D'Alba, L, De Giorgi, F, Del Piano, M, Di Fonzo, M, Di Mario, Francesco, Di Stefano, M, D'Onofrio, V, Efthymakis, K, Fiore, P, Fortuna, M, Fries, W, Gaetani, E, Galeazzi, F, Gasbarrini, A, Geccherle', A, Giangregorio, F, Girardi, L, Grassini, M, Groppo, M, Guarnieri, G, Iovino, P, Lo Cascio, M, Lolli, R, Luzza, F, Macarri, G, Marino, M, Miraglia, S, Monastra, S, Neri, Mc, Neri, M, Noris, Ra, Orselli, S, Passaretti, S, Paviotti, A, Pazzi, P, Pilotto, A, Portincasa, P, Ranaldo, N, Ravelli, P, Rogai, F, Sablich, R, Savarino, V, Spinzi, G, Tammaro, L, Torresan, F, Usai Satta, P, and Valle, C.

Subjects
Adult, Male, medicine.medical_specialty, Abdominal pain, Constipation, Constipation severity, Chronic constipation, Chronic non-organic constipation, Quality of life, Chronic Disease, Female, Humans, Middle Aged, Patient Care, Quality of Life, Reproducibility of Results, Surveys and Questionnaires, Factor Analysis, Statistical, Public Health, Environmental and Occupational Health, Medicine (all), Reproducibility of Result, Internal medicine, medicine, Criterion validity, Surveys and Questionnaire, Settore MED/12 - Gastroenterologia, business.industry, Minimal clinically important difference, Environmental and Occupational Health, Settore MED/09 - MEDICINA INTERNA, Statistical, medicine.disease, Confirmatory factor analysis, Settore MED/18 - Chirurgia Generale, Physical therapy, Functional constipation, Public Health, medicine.symptom, business, Factor Analysis, Human
Abstract

Background and aim: PAC-SYM is widely adopted to asses constipation severity. However, it has been validated in a small sample, few items have been included based on expert opinion and not on empirical grounds, and its factor structure has never been replicated. We aimed at evaluating the psychometric properties of PAC-SYM in patients with chronic constipation. Methods: We enrolled 2,203 outpatients with chronic constipation in two waves. We used wave I sample to test the psychometric properties of the PAC-SYM and wave II sample to cross-validate its factor structure, to assess criterion validity, responsiveness to clinical change, and its minimal clinically important difference. Results: Only a minority of patients reported any rectal tearing (38 %). Deletion of such item leads to a 11-item version (M:PAC-SYM). The remaining items in the rectal domain were moderately correlated with the stool domain. Exploratory factor analysis and confirmatory factor analysis revealed a bifactor structure with two subscales (stool and abdominal symptoms) and a general severity factor. The M:PAC-SYM demonstrated excellent reliability, moderate correlation with SF-12 and treatment satisfaction (r = 0.28–0.45), discrimination across Rome III criteria for functional constipation and abdominal pain, and responsiveness to clinical change (β = −0.49; ω 2 = 0.25). M:PAC-SYM minimal clinically important difference was 0.24. Conclusion: Our analysis shows that the rectal domain may not represent a relevant cluster of symptoms for patients with chronic constipation. We developed a modified version of the PAC-SYM which might better represent symptom severity of most patients seeking care in gastroenterology referral centers

Published
2014

14. Clinical and economical impact of 2010 AASLD guidelines for the diagnosis of hepatocellular carcinoma

Author

Matteo Angelo Manini, Angelo Sangiovanni, Fabio Fornari, Marco Biolato, Libera Fanigliulo, Elisa Ravaldi, Antonio Grieco, Massimo Colombo, Aghemo A, Grassi E, Iavarone M, Triolo M, Vavassori S, Giangregorio F, Pompili M, Gian Ludovico R, Riccardi L, De Gaetano AM, Forzenigo LV, Fraquelli M, Michieletti E., PISCAGLIA, FABIO, BOLONDI, LUIGI, GRANITO, ALESSANDRO, LEONI, SIMONA, MARINELLI, SARA, GOLFIERI, RITA, Matteo Angelo Manini, Angelo Sangiovanni, Fabio Fornari, Fabio Piscaglia, Marco Biolato, Libera Fanigliulo, Elisa Ravaldi, Antonio Grieco, Massimo Colombo, Aghemo A, Grassi E, Iavarone M, Triolo M, Vavassori S, Giangregorio F, Bolondi L, Granito A, Leoni S, Marinelli S, Pompili M, Gian Ludovico R, Riccardi L, De Gaetano AM, Forzenigo LV, Fraquelli M, Golfieri R, and Michieletti E.

Subjects
Adult, Liver Cirrhosis, Male, Clinical guidelines, medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Hepatocellular carcinoma, Settore MED/12 - GASTROENTEROLOGIA, Biopsy, Fine-Needle, Contrast Media, Imaging techniques, Likelihood ratios in diagnostic testing, NaN, medicine, Humans, Prospective Studies, Diagnostic Errors, Societies, Medical, Aged, Ultrasonography, Aged, 80 and over, Surveillance, Cirrhosis, Clinical guidelines, Hepatocellular carcinoma, Imaging techniques, Surveillance, Hepatology, medicine.diagnostic_test, business.industry, Liver Neoplasms, Ultrasound, Magnetic resonance imaging, Middle Aged, medicine.disease, Magnetic Resonance Imaging, United States, Liver biopsy, Practice Guidelines as Topic, Costs and Cost Analysis, Female, Radiology, Tomography, X-Ray Computed, Nuclear medicine, business, Algorithms, Contrast-enhanced ultrasound
Abstract

BACKGROUND AND AIMS: Although contrast-enhanced computed tomography (CT), dynamic magnetic resonance (MRI) and fine needle biopsy (FNB) are the standard of care to diagnose hepatocellular carcinoma (HCC), the clinical and economic benefits of the updated AASLD diagnostic algorithm, including the drop of contrast enhanced ultrasound (CEUS), have not been previously evaluated. METHODS: 119 de novo liver nodules detected during ultrasound (US) surveillance in 98 cirrhotics, 7 2cm in size, were sequentially examined by CEUS and CT, using MRI as a rescue approach in patients lacking a typical vascular pattern for HCC by one or both contrast techniques in the 1-2cm nodules and by CT in the >2cm nodules. A FNB was performed when required to meet both 2005 and 2010 AASLD criteria. RESULTS: Eighty-four (70%) nodules were HCC: the radiological diagnosis was done in 38 (88%) of those 1-2cm and in 38 (95%) for those >2cm HCCs according to 2010 AASLD criteria. CT or MRI detected 13 HCC nodules that were missed by unenhanced US. Despite an absolute specificity, CEUS failed to identify any HCC uncharacterized by CT or MRI. By updated AASLD criteria, 6 (17%) FNB procedures were spared in patients with 1-2cm nodules (p=0.025), as compared to 2005 criteria. The 2010 vs. 2005 AASLD per patient cost was similar in 1-2cm nodules, 432 € vs. 451 € (p=0.46), but lower in >2cm nodules, 248 € vs. 321 € (p

Published
2014

15. Resection of a giant mediastinal leiomyosarcoma.

Author

PORRELLO, C., GULLO, R., GAGLIARDO, C. M., VAGLICA, A., PALAZZOLO, M., GIANGREGORIO, F., IADICOLA, D., GULOTTA, E., MANNINO, V., LO FASO, F., TOMASELLO, G., CARINI, F., and COCORULLO, G.

Published
2019

18. Bloating is associated with worse quality of life, treatment satisfaction, and treatment responsiveness among patients with constipation-predominant irritable bowel syndrome and functional constipation

Author

Neri, L., Iovino, P., Altomare, D. F., Annese, V., Badiali, D., Basilisco, G., Bassotti, G., Battaglia, E., Bazzocchi, G., Bellini, M., Bendia, E., Benini, L., Biscaglia, G., Biviano, I., Bocchini, R., Bonventre, S., Bossa, F., Brandimarte, G., Cannizzaro, R., Cicala, M., Cipolletta, L., Clara, V., Cogliandro, R., Comandini, G., Corazziari, E., Crotta, S., Cuomo, R., D'Alba, L., De Giorgi, F., Del Piano, M., Di Fonzo, M., Di Mario, F., Di Stefano, M., D'Onofrio, V., Efthymakis, K., Fiore, P., Fortuna, M., Fries, W., Gaetani, Eleonora, Galeazzi, F., Gasbarrini, Antonio, Geccherle, A., Giangregorio, F., Girardi, L., Grassini, M., Groppo, M., Guarnieri, G., Lo Cascio, M., Lolli, R., Luzza, F., Macarri, G., Marino, M., Miraglia, S., Monastra, S., Neri, M. C., Neri, M., Noris, R. A., Orselli, S., Passaretti, S., Paviotti, A., Pazzi, P., Pilotto, A., Portincasa, P., Ranaldo, N., Ravelli, P., Rogai, F., Sablich, R., Savarino, V., Spinzi, G., Stanghellini, V., Tammaro, L., Torresan, F., Usai Satta, P., Valle C., Claudio, Gaetani E. (ORCID:0000-0002-7808-1491), Gasbarrini A. (ORCID:0000-0002-7278-4823), Neri, L., Iovino, P., Altomare, D. F., Annese, V., Badiali, D., Basilisco, G., Bassotti, G., Battaglia, E., Bazzocchi, G., Bellini, M., Bendia, E., Benini, L., Biscaglia, G., Biviano, I., Bocchini, R., Bonventre, S., Bossa, F., Brandimarte, G., Cannizzaro, R., Cicala, M., Cipolletta, L., Clara, V., Cogliandro, R., Comandini, G., Corazziari, E., Crotta, S., Cuomo, R., D'Alba, L., De Giorgi, F., Del Piano, M., Di Fonzo, M., Di Mario, F., Di Stefano, M., D'Onofrio, V., Efthymakis, K., Fiore, P., Fortuna, M., Fries, W., Gaetani, Eleonora, Galeazzi, F., Gasbarrini, Antonio, Geccherle, A., Giangregorio, F., Girardi, L., Grassini, M., Groppo, M., Guarnieri, G., Lo Cascio, M., Lolli, R., Luzza, F., Macarri, G., Marino, M., Miraglia, S., Monastra, S., Neri, M. C., Neri, M., Noris, R. A., Orselli, S., Passaretti, S., Paviotti, A., Pazzi, P., Pilotto, A., Portincasa, P., Ranaldo, N., Ravelli, P., Rogai, F., Sablich, R., Savarino, V., Spinzi, G., Stanghellini, V., Tammaro, L., Torresan, F., Usai Satta, P., Valle C., Claudio, Gaetani E. (ORCID:0000-0002-7808-1491), and Gasbarrini A. (ORCID:0000-0002-7278-4823)

Abstract

Background: The management of bloating is unclear and its relationship with patients' well-being and treatment satisfaction independent of other abdominal symptoms is uncharacterized. We evaluated the association of bloating with patient-reported outcomes. Methods: Thirty-nine centers for functional gastrointestinal disorders joined the laxative inadequate relief survey. We enrolled 2203 consecutive outpatients with functional constipation (FC) or constipation-predominant irritable bowel syndrome (IBS-C) in two cross-sectional waves. Both wave 1 and 2 included the SF-12, the patient assessment of constipation-symptoms (PAC-SYM), and the treatment satisfaction questionnaire for medication (TSQM-2). Wave 2 only included a global rating of change (GRC) scale to assess patients' assessment of efficacy concerning treatment switches occurred in the 3 months prior to the interview. Bloating in the abdomen was defined on the basis of PAC-SYM item 3. Key Results: The average age was 50.1 years (SD, 16.7) and 82.1% of patients were women. The prevalence of bloating was 91.6% (n = 1970). Bloating was associated with SF-12 Physical Composite Score (p < 0.01), SF-12 Mental Composite Score (p < 0.01), GRC (p < 0.01), Satisfaction with treatment effectiveness (p < 0.01), convenience of administration (p < 0.01), and side effects (p < 0.01) after adjustment for possible confounders. Conclusions & Inferences: Our data suggest that patients regard bloating as a key element in assessing clinical changes and treatments' efficacy as this symptom exerts a strong influence on patient-reported outcomes independent of possible confounders and other symptoms of constipation. Our data provide the rationale to investigate the efficacy and tolerability of new treatments specifically addressing this important, yet disregarded, patients' complain.

Published
2016

20. Single Hepatocellular Carcinoma Smaller than 2 cm: Are Ethanol Injection and Radiofrequency Ablation Equally Effective?

Author

Pompili, Maurizio, De Matthaeis, Nicoletta, Saviano, Antonio, De Sio, I, Francica, G, Brunello, F, Cantamessa, A, Giorgio, A, Scognamiglio, U, Fornari, F, Giangregorio, F, Piscaglia, F, Gualandi, S, Caturelli, E, Roselli, P, Riccardi, Laura, Rapaccini, Gian Ludovico, Pompili, Maurizio (ORCID:0000-0001-6699-7980), Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), Pompili, Maurizio, De Matthaeis, Nicoletta, Saviano, Antonio, De Sio, I, Francica, G, Brunello, F, Cantamessa, A, Giorgio, A, Scognamiglio, U, Fornari, F, Giangregorio, F, Piscaglia, F, Gualandi, S, Caturelli, E, Roselli, P, Riccardi, Laura, Rapaccini, Gian Ludovico, Pompili, Maurizio (ORCID:0000-0001-6699-7980), and Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X)

Abstract

The impact of radiofrequency ablation (RFA) and percutaneous ethanol injection (PEI) on survival in patients with small hepatocellular carcinoma (HCC) is unclear. We compared their efficacy in cirrhotics with single HCC ≤2 cm.

Published
2015

21. Predicting mortality in non-variceal upper gastrointestinal bleeders: validation of the Italian PNED Score and Prospective Comparison with the Rockall Score

Author

Marmo, R, Koch, M, Cipolletta, L, Capurso, L, Grossi, E, Cestari, Renzo, Bianco, Ma, Pandolfo, N, Dezi, A, Casetti, T, Lorenzini, I, Germani, U, Imperiali, G, Stroppa, I, Barberani, F, Boschetto, S, Gigliozzi, A, Gatto, G, Peri, V, Buzzi, A, Della Casa, D, Di Cicco, M, Proietti, M, Aragona, G, Giangregorio, F, Allegretta, L, Tronci, S, Michetti, P, Romagnoli, P, Piubello, W, Ferri, B, Fornari, F, Del Piano, M, Pagliarulo, M, Di Mitri, R, Trallori, G, Bagnoli, S, Frosini, G, Macchiarelli, R, Sorrentini, I, Pietrini, L, De Stefano, S, Ceglia, T, Chiozzini, G, Salvagnini, M, Di Muzio, D, Rotondano, G, and Italian registry on upper gastrointestinal bleeding

Subjects
Male, medicine.medical_specialty, Validation study, Upper Gastrointestinal Tract, Internal medicine, Epidemiology, 80 and over, medicine, Upper gastrointestinal, Humans, Aged, Aged, 80 and over, Settore MED/12 - Gastroenterologia, Prognosis, Gastrointestinal Hemorrhage, Middle Aged, Female, Hepatology, business.industry, Gastroenterology, Surgery, Multicenter study, Varices, business, Rockall score, Venous disease
Abstract

We sought (i) to validate a new prediction rule of mortality (Progetto Nazionale Emorragia Digestiva (PNED) score) on an independent population with non-variceal upper gastrointestinal bleeding (UGIB) and (ii) to compare the accuracy of the Italian PNED score vs. the Rockall score in predicting the risk of death.We conducted prospective validation of analysis of consecutive patients with UGIB at 21 hospitals from 2007 to 2008. Outcome measure was 30-day mortality. All the variables used to calculate the Rockall score as well as those identified in the Italian predictive model were considered. Calibration of the model was tested using the chi2 goodness-of-fit and performance characteristics with receiver operating characteristic (ROC) analysis. The area under the ROC curve (AUC) was used to quantify the diagnostic accuracy of the two predictive models.Over a 16-month period, data on 1,360 patients were entered in a national database and analyzed. Peptic ulcer bleeding was recorded in 60.7% of cases. One or more comorbidities were present in 66% of patients. Endoscopic treatment was delivered in all high-risk patients followed by high-dose intravenous proton pump inhibitor in 95% of them. Sixty-six patients died (mortality 4.85%; 3.54-5.75). The PNED score showed a high discriminant capability and was significantly superior to the Rockall score in predicting the risk of death (AUC 0.81 (0.72-0.90) vs. 0.66 (0.60-0.72), P0.000). Positive likelihood ratio for mortality in patients with a PNED risk score8 was 16.05.The Italian 10-point score for the prediction of death was successfully validated in this independent population of patients with non-variceal gastrointestinal bleeding. The PNED score is accurate and superior to the Rockall score. Further external validation at the international level is needed.

Published
2010

22. The safety of Sonovue in abdominal applications: retrospective analysis of 23188 investigations

Author

Piscaglia, F, Bolondi, L, Italian Society for Ultrasound in Medicine, Aiani, Biology Study Group on Ultrasound Contrast Agents 1 L., Luigi Angeli, M., Arienti, V., Barozzi, L., Basilico, R., Bertolotto, M., Biasini, E., Busilacchi, P., Calliada, F., Caremani, * M., Caturelli, E., Celli, N., Colecchia, A., Cova, L., Assunta Cova, M., Crocetti, L., de Sio, I., Drudi, Francesco Maria, Ferraioli, G., Filice, C., Fornari, F., Gaiani, S., Giangregorio, F., Giorgio, A., Ierace, T., Lencioni, R., Livraghi, T., Magnolfi, F., Martegani, A., Meloni, F., Menozzi, G., Pelosi, G., Pompili, M., Riccardi, L., Ricci, P., Rubaltelli, L., Sacerdoti, D., Serafini, G., Serra, C., Solbiati, L., Tacconi, D., Valentino, M., Vidili, G., Vitali, F., Piscaglia F., Bolondi L., and Italian Society for Ultrasound in Medicine and Biology (SIUMB) Study Group on Ultrasound Contrast Agents.

Subjects
medicine.medical_specialty, Acoustics and Ultrasonics, Sulfur Hexafluoride, Biophysics, Contrast Media, Abdomen, medicine, Retrospective analysis, Adverse Drug Reaction Reporting Systems, Humans, Radiology, Nuclear Medicine and imaging, Adverse effect, Phospholipids, Retrospective Studies, Ultrasonography, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Incidence (epidemiology), Magnetic resonance imaging, Retrospective cohort study, Safety profile, medicine.anatomical_structure, Liver, Abdominal examination, Radiology, business
Abstract

The aim of the present retrospective study was to assess the incidence of adverse events (AE) of a second-generation ultrasound contrast agent in real clinical practice. A total of 28 Italian Centres provided data on the postmarketing use of SonoVue (Bracco Spa, Milan, Italy) in abdominal examination performed between December 2001 and December 2004. A total of 23 188 investigations were reported. No fatal event occurred. AEs were reported in 29 cases, of which only two were graded as serious; the rest, 27, were nonserious (23 mild, three moderate and one severe). The overall reporting rate of serious AE was 0.0086%. Overall, only four AEs required treatment (two serious, two nonserious including one moderate and one severe AEs). In conclusion, the present large-scale retrospective analysis showed that SonoVue has a good safety profile in abdominal applications, with an AE reporting rate lower than or similar to that reported for radiologic and magnetic resonance contrast agents.

Published
2006

24. Long-term effectiveness of Radiofrequency Ablation for solitary small Hepatocellular Carcinoma: A retrospective analysis of 363 patients

Author

Francica, G, Saviano, Antonio, De Sio, I, De Matthaeis, Nicoletta, Brunello, F, Cantamessa, A, Giorgio, A, Scognamiglio, U, Fornari, F, Giangregorio, F, Piscaglia, F, Gualandi, S, Caturelli, E, Roselli, P, Rapaccini, Gian Ludovico, Pompili, Maurizio, Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), Pompili, Maurizio (ORCID:0000-0001-6699-7980), Francica, G, Saviano, Antonio, De Sio, I, De Matthaeis, Nicoletta, Brunello, F, Cantamessa, A, Giorgio, A, Scognamiglio, U, Fornari, F, Giangregorio, F, Piscaglia, F, Gualandi, S, Caturelli, E, Roselli, P, Rapaccini, Gian Ludovico, Pompili, Maurizio, Rapaccini, Gian Ludovico (ORCID:0000-0002-6467-857X), and Pompili, Maurizio (ORCID:0000-0001-6699-7980)

Abstract

BACKGROUND: Radiofrequency Ablation is the most widely performed percutaneous treatment for Hepatocellular Carcinoma. This multicentre study was aimed at assessing the complication, overall survival and disease-free survival rates in cirrhotic patients with single Hepatocellular Carcinoma nodule ≤3cm undergoing Radiofrequency Ablation. METHODS: Data of 365 patients (59% males; mean age 67±8 years), Child-Pugh A/B, with single Hepatocellular Carcinoma nodule ≤3cm (tumours >2-3cm=127/236), showing complete necrosis after Radiofrequency Ablation between 1998 and 2010 in 7 Italian Centers were retrospectively reviewed. Complication, overall survival and disease-free survival rates were analyzed as main clinical end-points. RESULTS: Major complications were observed in 8 patients (2.2%) and minor complications in 23 patients (6.3%). The 3-, and 5-year overall survival rates were 80% and 64%. One hundred and seven patients (29.5%) died, being 41 deaths (38.3%) Hepatocellular Carcinoma-related. At multivariate analysis only age (p=0.04; OR 2.29), ascites (p<0.001; OR 3.74) and Child-Pugh class ≥B8 (p=0.003; OR 2.42) were confirmed as independent predictors for overall survival. The disease-free survival rates at 3- and 5-year were 50%, and 41.8%. CONCLUSIONS: Radiofrequency Ablation is an effective and safe tool for the treatment of single Hepatocellular Carcinoma ≤3cm providing excellent 5-year overall survival and disease-free survival rates. Patient's age and liver status appeared as main determinants of outcome.

Published
2012

25. 254 SINGLE HEPATOCELLULAR CARCINOMA SMALLER THAN 2 cm: ARE PERCUTANEOUS ETHANOL INJECTION AND RADIOFREQUENCY ABLATION EQUALLY EFFECTIVE?

Author

de Matthaeis, N., primary, Saviano, A., additional, De Sio, I., additional, Francica, G., additional, Brunello, F., additional, Cantamessa, A., additional, Giorgio, A., additional, Scognamiglio, U., additional, Fornari, F., additional, Giangregorio, F., additional, Piscaglia, F., additional, Gualandi, S., additional, Caturelli, E., additional, Roselli, P., additional, Rapaccini, G.L., additional, and Pompili, M., additional

Published
2013
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30. OC.03.5 ECHOGRAPHIC DETECTION OF HEPATOCELLULAR CARCINOMA (HCC) DURING FOLLOW UP IN CIRRHOTIC PATIENTS WITH PREVIOUS HCC. COMPARISON AMONG US, CT AND A NEW PANORAMIC 3-DIMENSIONAL CONTRAST-ENHANCED US WITH NAVIGATOR SYSTEM (3-D NAV CEUS)

Author

Giangregorio, F., primary, Marinone, M., additional, Aragona, G., additional, Comparato, G., additional, Fanigliulo, L., additional, Sbolli, G., additional, Di Stasi, M., additional, Tansini, P., additional, and Fornari, F., additional

Published
2010
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34. PREDICTIVE FACTORS OF MORTALITY IN UPPER NONVARICEAL GI BLEEDING: VALIDATION OF A NEW PROGNOSTIC MODEL FROM A MULTICENTER ITALIAN STUDY

Author

Marmo, R., primary, Rotondano, G., additional, Koch, M., additional, Cipolletta, L., additional, Capurso, L., additional, Trallori, G., additional, Cestari, R., additional, Frosini, G., additional, Imperiali, G., additional, Casetti, T., additional, Boschetto, S., additional, DiMitri, S., additional, Stroppa, I., additional, DelPiano, M., additional, Salvagnini, M., additional, Gatto, G., additional, Sorrentini, I., additional, DeStefano, S., additional, Di Cicco, M., additional, Michetti, P., additional, Lorenzini, I., additional, Fornari, F., additional, Piubello, W., additional, Dezi, A., additional, Milla, M., additional, Bianco, M.A., additional, Della Casa, N., additional, Longobardi, G., additional, Triossi, O., additional, Gigliozzi, A., additional, Carmagnola, S., additional, DiMuzio, D., additional, Marino, M., additional, Russo, F., additional, Lamanda, R., additional, Proietti, M., additional, Allegretti, A., additional, Germani, U., additional, Giangregorio, F., additional, Zagni, I., additional, and Grossi, E., additional

Published
2009
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35. OC2.01.6 ECHOGRAPHIC DETECTION OF NEW HCCS IN CIRRHOTIC PATIENTS (PREVIOUSLY TREATED WITH MULTIPLE TECHNIQUES): COMPARISON AMONG CONVENTIONAL US, SPIRAL CT AND 3-DIMENSIONAL CONTRAST-ENHANCED US WITH NAVIGATOR TECHNIQUE (3DNAV CEUS)

Author

Giangregorio, F., primary, Comparato, G., additional, Fanigiulo, L., additional, Sbolli, G., additional, Di Stasi, M., additional, Marinone, G., additional, Tansini, P., additional, Aragona, G., additional, and Fornari, F., additional

Published
2008
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49. Endosonographic diagnosis of submucosal upper gastrointestinal tract lesions and large fold gastropathies by catheter ultrasound probe

Author

Buscarini, E., Di Stasi, M., Rossi, S., Silva, M., Giangregorio, F., Adriano, Z., and Buscarini, L.

Abstract

Background: The unique ability of EUS to depict wall layers makes it possible to accurately evaluate submucosal lesions of the digestive tract and large-fold gastropathies. Although EUS requires a second endoscopic examination, miniature US probes introduced through the accessory channel of a conventional endoscope permit US examination during routine endoscopy. Methods: By means of catheter probe sonography and conventional EUS, we evaluated 33 patients with a radiographic or endoscopic finding of a submucosal lesion of the upper GI tract or with large-fold gastropathies and histologically negative biopsies obtained at a previous endoscopy. A miniature multifrequency probe was used for catheter probe sonography. Results: For 25 submucosal lesions catheter probe sonography results were superimposable on those obtained with EUS. In evaluating submucosal lesions, catheter probe sonography yielded the same results as conventional EUS in terms of depiction, measurement, and identification of the originating layer of the tumor. In the study of 8 large-fold gastropathies, catheter probe sonography missed the presence of ascites and enlarged lymph nodes in a case of gastric linitis, but produced the same results as conventional EUS in the other cases. Conclusions: For the evaluation of benign submucosal lesions and large-fold gastropathies, catheter probe sonography appears to be sufficient and could thus replace conventional EUS for these indications. (Gastrointest Endosc 1999;49:184-91.)

Published
1999
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50. Resection of a giant mediastinal leiomyosarcoma

Author

Porrello, C., Gullo, R., Gagliardo, C., Vaglica, A., Palazzolo, M., Giangregorio, F., Dario Iadicola, Gulotta, E., Mannino, V., Lo Faso, F., GIOVANNI TOMASELLO, francesco carini, Gianfranco Cocorullo, Porrello,C, Gullo,R, Gagliardo,CM, Vaglica,A, Palazzolo,M, Giangregorio,F, Iadicola,D, Gulotta,E, Mannino,V, Lo Faso,F, Tomasello,G, Carini,F, and Cocorullo,G

Subjects
Settore MED/18 - Chirurgia Generale, giant leiomyosarcoma- lung leiomyosarcoma- mediastinal mass- pericardiectomy- pnemonectomy- Hemiclamshell incision, Settore MED/21 - Chirurgia Toracica
Abstract

Primary leiomyosarcomas of the lung are rare tumors. We report a case of 49-year-old female with history of cough, breathless at rest, right sided chest pain. Chest CT showed a huge (16 cm) mediastinal mass located on the right mediastinum encasing the right main pulmonary artery and infiltrating the main right bronchus and pericardium. The tumor was resected with combined pericardiectomy and pnemonectomy via hemiclamshell incision. This surgical access provided an adequate exposure of the chest “blind zones” and it allowed a radical and safe surgical resection of lung, pleura, pericardium and diaphragm. The final diagnosis showed a low grade differentiation leiomyosarcoma.

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