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1. Vaccination Recommendations in Solid Organ Transplant Adult Candidates and Recipients

Author

Vigano, M, Beretta, M, Lepore, M, Abete, R, Benatti, S, Grassini, M, Camagni, S, Chiodini, G, Vargiu, S, Vittori, C, Iachini, M, Terzi, A, Neri, F, Pinelli, D, Casotti, V, Di Marco, F, Ruggenenti, P, Rizzi, M, Colledan, M, Fagiuoli, S, Vigano M., Beretta M., Lepore M., Abete R., Benatti S. V., Grassini M. V., Camagni S., Chiodini G., Vargiu S., Vittori C., Iachini M., Terzi A., Neri F., Pinelli D., Casotti V., Di Marco F., Ruggenenti P., Rizzi M., Colledan M., Fagiuoli S., Vigano, M, Beretta, M, Lepore, M, Abete, R, Benatti, S, Grassini, M, Camagni, S, Chiodini, G, Vargiu, S, Vittori, C, Iachini, M, Terzi, A, Neri, F, Pinelli, D, Casotti, V, Di Marco, F, Ruggenenti, P, Rizzi, M, Colledan, M, Fagiuoli, S, Vigano M., Beretta M., Lepore M., Abete R., Benatti S. V., Grassini M. V., Camagni S., Chiodini G., Vargiu S., Vittori C., Iachini M., Terzi A., Neri F., Pinelli D., Casotti V., Di Marco F., Ruggenenti P., Rizzi M., Colledan M., and Fagiuoli S.

Abstract

Prevention of infections is crucial in solid organ transplant (SOT) candidates and recipients. These patients are exposed to an increased infectious risk due to previous organ insufficiency and to pharmacologic immunosuppression. Besides infectious-related morbidity and mortality, this vulnerable group of patients is also exposed to the risk of acute decompensation and organ rejection or failure in the pre- and post-transplant period, respectively, since antimicrobial treatments are less effective than in the immunocompetent patients. Vaccination represents a major preventive measure against specific infectious risks in this population but as responses to vaccines are reduced, especially in the early post-transplant period or after treatment for rejection, an optimal vaccination status should be obtained prior to transplantation whenever possible. This review reports the currently available data on the indications and protocols of vaccination in SOT adult candidates and recipients.

Published
2023

2. Hepatotoxicity of Small Molecule Protein Kinase Inhibitors for Cancer

Author

Vigano, M, La Milia, M, Grassini, M, Pugliese, N, De Giorgio, M, Fagiuoli, S, Vigano M., La Milia M., Grassini M. V., Pugliese N., De Giorgio M., Fagiuoli S., Vigano, M, La Milia, M, Grassini, M, Pugliese, N, De Giorgio, M, Fagiuoli, S, Vigano M., La Milia M., Grassini M. V., Pugliese N., De Giorgio M., and Fagiuoli S.

Abstract

Small molecule protein kinase inhibitors (PKIs) have become an effective strategy for cancer patients. However, hepatotoxicity is a major safety concern of these drugs, since the majority are reported to increase transaminases, and few of them (Idelalisib, Lapatinib, Pazopanib, Pexidartinib, Ponatinib, Regorafenib, Sunitinib) have a boxed label warning. The exact rate of PKI-induced hepatoxicity is not well defined due to the fact that the majority of data arise from pre-registration or registration trials on fairly selected patients, and the post-marketing data are often based only on the most severe described cases, whereas most real practice studies do not include drug-related hepatotoxicity as an end point. Although these side effects are usually reversible by dose adjustment or therapy suspension, or by switching to an alternative PKI, and fatality is uncommon, all patients undergoing PKIs should be carefully pre-evaluated and monitored. The management of this complication requires an individually tailored reappraisal of the risk/benefit ratio, especially in patients who are responding to therapy. This review reports the currently available data on the risk and management of hepatotoxicity of all the approved PKIs.

Published
2023

3. OC.08.2 NETWORK META-ANALYSIS OF FIRST-LINE SYSTEMIC THERAPIES FOR ADVANCED HEPATOCELLULAR CARCINOMA: WHO IS THE WINNER?

Author

Celsa, C., primary, Cabibbo, G., additional, Rizzo, G.E.M., additional, Giuffrida, P., additional, Di Maria, G., additional, Battaglia, S., additional, Vaccaro, M., additional, Enea, M., additional, Giacchetto, C., additional, Rancatore, G., additional, Grassini, M., additional, Ciccia, R., additional, Grova, A., additional, Salvato, M., additional, and Camma, C., additional

Published
2023
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4. Sfide identitarie e strategie di fronteggiamento. Intraprendere un dottorato in Social work

Author

Masciocchi, Sofia, Occhi, Deborah, Vezzoli, Federica, Scalvini, Sonia, Grassini, Marco, Berardi, Giulia, Masciocchi S. (ORCID:0000-0001-7714-0122), Occhi D., Vezzoli F., Scalvini S. (ORCID:0000-0002-3649-6648), Grassini M., Berardi G., Masciocchi, Sofia, Occhi, Deborah, Vezzoli, Federica, Scalvini, Sonia, Grassini, Marco, Berardi, Giulia, Masciocchi S. (ORCID:0000-0001-7714-0122), Occhi D., Vezzoli F., Scalvini S. (ORCID:0000-0002-3649-6648), Grassini M., and Berardi G.

Abstract

Il presente contributo vuole condividere alcune riflessioni frutto dell’esperienza di sei giovani assistenti sociali, studenti di dottorato in Social Work and Personal Social Services presso il Dipartimento di Sociologia dell’Università Cattolica di Milano intrapreso nell’a.a. 2020/2021. Approcciarsi al mondo della ricerca e della produzione di conoscenza, mantenendo un aggancio con la pratica professionale sul campo, ha costituito fin da subito una sfida nell’avvio del percorso di dottorato. La nuova identità, in via di sviluppo, di ricercatori in formazione si è posta in tensione con l’identità di operatori sociali. La riflessione critica su queste identità apparentemente distanti li ha accompagnati in una «struggle quotidiana». Essere immersi contemporaneamente in due mondi, la pratica e la ricerca, ha rappresentato e rappresenta una sfida non solo di conciliazione di impegni ed esigenze, ma soprattutto di contesti e rappresentazioni. L’articolo affronta dunque alcuni quesiti: quali contaminazioni avvengono fra il ruolo di operatore sociale e quello di ricercatore? Quali punti di forza e quali criticità è possibile leggere in questo doppio sguardo? In conclusione verranno condivise alcune strategie di fronteggiamento sperimentate nel percorso dottorale.

Published
2022

6. Autoimmune Hepatitis after Ten Years from Pegylated Interferon Treatment- A Case Report

Author

Grassini M, Battaglia E, Boano, and Elia C

Subjects
business.industry, Alpha interferon, General Medicine, Hepatitis C, Autoimmune hepatitis, Disease, medicine.disease, Liver disease, Pegylated interferon, Interferon, Immunology, medicine, Adverse effect, business, medicine.drug
Abstract

Interferon is an effective therapy in several diseases; it was a milestone of hepatitis c treatment for a long time. Pegylated interferon is more effective than alpha interferon, adding polyethylene glycol. It has an immunomodulatory effect through the antiviral and cellular activity, but it is burden with adverse effects, some of them are serious. It can be explain with the immunological role of interferon and it is derived in the genesis of some disease like autoimmune hepatitis, it is a liver disease with a multifactorial genesis, an environment agent can stimulate the predisposed subject. We present a case of autoimmune hepatitis ten years later than pegylated interferon therapy.

Published
2020

7. Ethmoiditis during Autoimmune Hepatitis Treatment: A Case Report

Author

Battaglia E, Boano, Grassini M, and Elia C

Subjects
medicine.medical_specialty, Cirrhosis, biology, business.industry, Inflammation, Azathioprine, General Medicine, Disease, Autoimmune hepatitis, medicine.disease, Gastroenterology, Immunoglobulin G, Liver disease, Internal medicine, medicine, biology.protein, medicine.symptom, Antibody, business, medicine.drug
Abstract

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease, characterized by the elevation of aminotransferases, presence of anti-nuclear antibody or anti-smooth muscle antibody, elevated immunoglobulin G (IgG), and interface hepatitis/plasma-lymphocytic inflammation based on histology. The disease can be serious, and if left untreated, it can lead to cirrhosis of the liver and eventual liver failure. The recommended treatment for AIH includes corticosteroids and azathioprine. Azathioprine (AZA) is indicated in immunosuppressive regimens as an adjunct to immunosuppressive agents that form the mainstay of treatment. AZA is indicated either alone or in combination with corticosteroids and/or other drugs and procedures in several diseases. There are potential dangers in the use of AZA; they should therefore not be prescribed unless the patient can be adequately monitored for toxic effects throughout the duration of therapy. We present here the case of a 50-year-old female, with autoimmune hepatitis on AZA therapy who developed ethmoiditis.

Published
2020

9. Long-term efficacy of dolutegravir in treatment-experienced subjects failing therapy with HIV-1 integrase strand inhibitor-resistant virus

Author

Castagna, A., Ferrara, M., Galli, L., Comi, L., Sterrantino, G., Cenderello, G., Zaccarelli, M., Focà, E., Roncadori, A., Lazzarin, A., Chichino, G., Mantia, E., Butini, L., Costantini, A., Giacometti, A., Tavio, M., Grassini, M., Valle, M., Vaccher, E., Martellotta, F., Schioppa, O., Maggiolo, F., Viale, P., Borderi, M., Calza, L., Moratello, L., Magistrelli, E., Castelli, F., Festa, E., Quirino, T., Campus, M., Businco, F., Celesia, B. M., La Rosa, R., Pan, A., Fornabaio, C., Mazzotta, F., Di Pietro, M., Bartoloni, A., Ferrara, S., Mastroianni, A., Di Cesare, S., Viscoli, C., Di Biagio, A., Cassola, G., Penco, G., Cericola, A, Nencioni, C., Carli, T., Viganò, P., Re, T., Del Fiorentino, A., Gattuso, G., Palvarini, L., Taurozzi, M., Gianotti, N., Galizzi, N., Poli, A., Rusconi, S., Salvaggio, S. E., Galli, M., Rizzardini, G., Mussini, C., Menozzi, M., Gori, A., Muscatello, A., Cappelletti, E., Gargiulo, M., Garavelli, P. L., Bargiacchi, O., Prestileo, T., Di Lorenzo, F., Bonanno, S., Ferrari, C., degli Antoni, A. M., Cattelan, A. M., Gulminetti, R., Pagnucco, L., Menichetti, F., Iapoce, R., Baldelli, F., Schiaroli, E., Italiani, F., Aquilini, D., Magnani, G., Corsini, R., Barchi, E., Ferrari, E., Antinori, A., Cristaudo, A., Latini, A., Cauda, R., Vullo, V., Maffongelli, G., Andreoni, M., Sassett, L., Viviani, F., De Luca, A., Rossetti, B., Franco, A., Resta, F., Di Perri, G., Bonora, S., Bassetti, M., Londero, A., Malena, M., Luzzati, Roberto, Castagna, A., Ferrara, M., Galli, L., Comi, L., Sterrantino, G., Cenderello, G., Zaccarelli, M., Focà, E., Roncadori, A., Lazzarin, A., Chichino, G., Mantia, E., Butini, L., Costantini, A., Giacometti, A., Tavio, M., Grassini, M., Valle, M., Vaccher, E., Martellotta, F., Schioppa, O., Maggiolo, F., Viale, P., Borderi, M., Calza, L., Moratello, L., Magistrelli, E., Castelli, F., Festa, E., Quirino, T., Campus, M., Businco, F., Celesia, B. M., La Rosa, R., Pan, A., Fornabaio, C., Mazzotta, F., Di Pietro, M., Bartoloni, A., Ferrara, S., Mastroianni, A., Di Cesare, S., Viscoli, C., Di Biagio, A., Cassola, G., Penco, G., Cericola, A, Nencioni, C., Carli, T., Viganò, P., Re, T., Del Fiorentino, A., Gattuso, G., Palvarini, L., Taurozzi, M., Gianotti, N., Galizzi, N., Poli, A., Rusconi, S., Salvaggio, S. E., Galli, M., Rizzardini, G., Mussini, C., Menozzi, M., Gori, A., Muscatello, A., Cappelletti, E., Gargiulo, M., Garavelli, P. L., Bargiacchi, O., Prestileo, T., Di Lorenzo, F., Bonanno, S., Ferrari, C., degli Antoni, A. M., Cattelan, A. M., Gulminetti, R., Pagnucco, L., Menichetti, F., Iapoce, R., Baldelli, F., Schiaroli, E., Italiani, F., Aquilini, D., Magnani, G., Corsini, R., Barchi, E., Ferrari, E., Antinori, A., Cristaudo, A., Latini, A., Cauda, R., Vullo, V., Maffongelli, G., Andreoni, M., Sassett, L., Viviani, F., De Luca, A., Rossetti, B., Franco, A., Resta, F., Di Perri, G., Bonora, S., Bassetti, M., Londero, A., Malena, M., and Luzzati, Roberto

Subjects
HIV, dolutegravir, efficacy, Male, Anti-HIV Agents, Pyridones, Drug Resistance, HIV Infections, HIV Integrase, 3-Ring, Piperazines, Coinfection, Drug Resistance, Viral, Drug Therapy, Combination, Female, HIV Integrase Inhibitors, HIV-1, Hepatitis C, Chronic, Heterocyclic Compounds, 3-Ring, Humans, Middle Aged, Treatment Outcome, Viral Load, Drug Therapy, Heterocyclic Compounds, Oxazines, Pharmacology (medical), Viral, Chronic, Pharmacology, Pharmacology, Pharmacology (medical), Infectious Diseases, Hepatitis C, Infectious Diseases, Combination
Abstract

OBJECTIVES: This study evaluated the virological efficacy of dolutegravir 50 mg twice daily in 190 HIV-1 failing antiretroviral-experienced patients with previous exposure to first-generation integrase strand transfer inhibitor (INSTI) over a 5 year follow-up using data from clinical practice. PATIENTS AND METHODS: This analysis included HIV-1-infected patients who were ≥18 years of age, treatment experienced, had HIV-1 RNA >50 copies/mL, with INSTI-resistant virus, who started dolutegravir 50 mg twice daily plus optimized background therapy (OBT), recorded in the national prospective database PRESTIGIO (www.progettoprestigio.it). Follow-up accrued from the start of dolutegravir 50 mg twice daily + OBT until virological failure (VF) or dolutegravir discontinuation for any reason or the last treatment visit on dolutegravir 50 mg twice daily treatment. VF was defined by the lack of achievement of HIV-1 RNA 100000 copies/mL (adjusted HR = 4.73, 95% CI = 1.33-16.78, P = 0.016) and with ≥1 INSTI mutations plus Q148H/K/R/N and the G140S/A/C as compared with other subjects (adjusted HR = 4.18, 95% CI = 1.32-13.23, P = 0.015). CONCLUSIONS: Our data showed a favourable long-term efficacy of dolutegravir 50 mg twice daily in association with OBT in treatment-experienced failing subjects, with INSTI-resistant virus, in the real world. A close monitoring of adherence is crucial for maintenance of virological response in this fragile subgroup of subjects.

Published
2018

10. Italian nationwide survey of pharmacologic treatments in diverticular disease: Results from the REMAD registry

Author

Cremon, C, Carabotti, M, Cuomo, R, Pace, F, Andreozzi, P, Barbaro, Mr, Annibale, B, Barbara, G, on behalf of the REMAD Group, Andrealli, A, Andriulli, A, Ardizzone, S, Astegiano, M, Bachetti, F, Bartolozzi, S, Bargiggia, S, Bassotti, G, Bianco, Ma, Binda, Ga, Biscaglia, G, Bosani, M, Bottiglieri, Me, Cargiolli, M, Ciacci, C, Colecchia, A, Dell’Era, A, De Matthaeis, M, Dinelli, M, Festa, V, Festi, D, Galliani, E, Garribba, A, Germana’, B, Grassini, M, Guido, E, Iafrate, F, Iovino, P, Iuliano, D, Laghi, A, Latella, G, Lorusso, M, Manes, G, Marchi, S, Mauro, B, Maurano, A, Nascimbeni, R, Neri, M, Occhipinti, P, Parravicini, M, Pennazio, M, Peralta, S, Portincasa, P, Radaelli, F, Rossi, M, Salerno, R, Savarino, V, Segato, S, Severi, C, Scaccianoce, G, Usai, P, Valle, V, Virgilio, C, Viscido, A, Cremon C., Carabotti M., Cuomo R., Pace F., Andreozzi P., Barbaro M.R., Annibale B., and Barbara G.

Subjects
Male, medicine.medical_specialty, Treatment outcome, Anti-Inflammatory Agents, symptomatic uncomplicated, symptomatic uncomplicated diverticular disease, registry, previous diverticuliti, Nationwide survey, 03 medical and health sciences, 0302 clinical medicine, pharmacological treatment, Risk Factors, medicine, Diverticulosis, management, pharmacological treatments, previous diverticulitis, registry, symptomatic uncomplicated, Effective treatment, Humans, Registries, Intensive care medicine, Aged, Diverticulosis, Diverticular Diseases, management, pharmacological treatments, previous diverticulitis, business.industry, Diverticulosi, digestive, oral, and skin physiology, Gastroenterology, Original Articles, Middle Aged, medicine.disease, digestive system diseases, Treatment Outcome, Oncology, Italy, 030220 oncology & carcinogenesis, Health Care Surveys, Female, Diverticular disease, 030211 gastroenterology & hepatology, business
Abstract

Background: Although diverticular disease is a common condition, its effective treatment is challenging in clinical practice. Objective: The objective of this article is to assess pharmacological management in different clinical settings of diverticular disease and factors associated with treatment using the Italian registry Registro Malattia Diverticolare (REMAD). Methods: At study enrolment, patients were categorised into subgroups: diverticulosis, symptomatic uncomplicated diverticular disease and previous diverticulitis. We registered demographic, clinical and lifestyle factors, quality of life and the use of treatments for diverticular disease in the last year. Logistic regression analysis assessed the association between clinical factors and treatment consumption. Results: A total of 500 of the 1206 individuals included had had at least one treatment for diverticular disease in the last year: 23.6% (166/702) of patients with diverticulosis, 55.9% (165/295) of patients with symptomatic diverticular disease, and 80.9% (169/209) of patients with previous diverticulitis (p < 0.001). In multivariate analysis, the following factors were significantly associated with treatment use: female gender, family history of colonic diverticula, organic digestive comorbidity and impaired physical quality of life components. Conclusion: Individuals with diverticular disease take medications based on the different clinical settings of disease. We identified different features associated with treatment use in the distinct clinical entities of diverticular disease. ClinicalTrial.gov Identifier: NCT03325829.

Published
2019

11. 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

12. 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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13. 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

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

Author

DE RAI, P, Zerbi, A, Castoldi, L, Bassi, C, Frulloni, L, Uomo, G, Gabbrielli, A, Pezzilli, R, Cavallini, G, DI CARLO, V, PROINF AISP PROGETTO INFORMATIZZATO PANCREATITE ACUTA, ASSOCIAZIONE ITALIANA PER LO STUDIO DEL PANCREAS COMPUTERIZED PROJECT ON ACUTE PANCREATITIS, COLLABORATORS AGUGIARO S, ITALIAN ASSOCIATION FOR THE STUDY OF THE PANCREAS STUDY G. R. O. U. P., Turri, L, Bartoli, A, Barberini, F, Cavazzoni, G, Bartolo, F, Papa, Dd, Bassi, Nicolo', Massani, M, Benedetti, A, Macarri, G, Piergallini, L, Briani, G, Bartolasi, L, Bugnano, L, Buonanno, Gm, 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, Gb, Rocco, P, Franzãˆ, A, Bertelãˆ, A, Sereni, G, Friedman, D, Mariani, L, Morelli, F, Gai, V, Antro, C, Garcea, D, Gardini, A, Lucci, E, Giulianotti, Pc, Sbrana, F, Balestracci, T, Giulini, Sm, Pellizzari, A, Ronconi, M, Cimaschi, S, Grassini, M, Lacignola, S, Calandro, L, Mazzitelli, L, Costarella, Sm, Egidio, A, Teggia, Pm, 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, Pg, 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, Pa, Masci, E, Mariani, A, Torelli, E, Garcea, Mr, Lombardi, V, Lecconi, L, Valeri, L, Presenti, L, Alessio, F, Ventrucci, M, Virzi, S, and Cipolla, A.

Published
2010

17. Mejoría de la hinchazón funcional mediante una enterovacuna: un estudio preliminar

Author

Grassini, M., Battaglia, E., Verna, C., Niola, P., Repici, A., Corazzi, N., and Bassotti, G.

Subjects
Functional disorder, Enterovaccine, Bloating, digestive, oral, and skin physiology, digestive system diseases, humanities
Abstract

Background: bloating is a fastidious symptom reported by many patients who also have other gastrointestinal functional disorders. Bloating is more common in women, and it is often associated with meals and improves or disappears overnight. No specific treatments are to date available for this disturbing symptom. Aims: to evaluate the effects of an oral enterovaccine (Colifagina®) on bloating and other abdominal symptoms in patients with prevalent complaints of functional bloating. Patients and methods: one hundred and forty-eight patients with functional bloating according to Rome III criteria were recruited. Questionnaires and a VAS scale on their symptoms were administered at baseline and after four weeks of therapy with Colifagina®. Results: after treatment, a significant amelioration of bloating (p < 0.0001), abdominal pain (p < 0.0001) and flatus (p < 0.0001) was observed; nausea and vomiting scores were not significantly different at the end of the treatment. Subjective wellbeing was also generally improved (p < 0.001) in treated patients. Conclusion: treatment with an enterovaccine may help improve symptoms in patients with functional bloating.

Published
2009

18. Colonoscopy practice in Italy: a prospective survey on behalf of the Italian Association of Hospital Gastroenterologists

Author

Radaelli, F, Meucci, G, Minoli, G, Italian Association of Hospital Gastroenterologists Alluminio, P, Amuso, M, Angelini, G, Anti, M, Baldi, F, Balzana, M, Barberani, F, Bargiggia, S, Barresi, G, Bedosti, M, Belmonte, A, Benedetti, A, Benedetti, E, Benini, M, Beretta, L, Beretta, P, Fontana, A, Mauro, B, Bianco, R, Bierti, L, Bigazzi, U, Boccia, S, Bonello, F, Boscarino, S, Bottini, E, Bresci, G, Briglia, U, Brunelli, E, Buggiani, D, Calandra, A, Candidi, A, Caneschi, F, Cannizzaro, R, Cappuccino, V, Caputi, O, Cardelli, A, Caronia, V, Cattuto, C, Cestari, E, Chilovi, F, Cifatte, D, Ciliberto, E, Cimino, F, Cipolletta, V, Cirillo, M, Cocozza, U, Colantuoni, E, Coli, A, Colombo, E, Comin, U, Conti, W, Cortini, C, Criscione, S, Crotta, S, Cutela, P, D'Imperio, N, Dalia, G, Dall'Oglio, L, Dal Pane, M, Dante, P, Dato, D, Dattola, L, De Bernardin, M, De Boni, M, De Conca, V, Dell'Amico, I, Dell'Anna, A, Della Spoletina, A, Delogu, G, Del Piano, M, Di Cicco, M, Di Filippo, G, Di Giorgio, P, Di Mitri, R, Di Piero, A, Di Piramo, D, Di Todaro, E, Dicillo, M, Dodero, C, Doldo, P, Drago, D, Dubla, G, Dughera, L, Dusio, P, Ederle, A, Evola, M, Fachinetti, F, Faraldo, G, Farroni, F, Fasoli, R, Ferrara, A, Ferrari, A, Ferrari, C, Ferraris, L, Ferraris, R, Ferrini, G, Ferrini, L, Foco, A, Forte, G, Francavilla, A, Franzè, A, Fregoni, D, Frieri, Giuseppe, Gaia, E, Galasso, F, Galgani, P, Gamberucci, G, Gatti, L, Gatti, M, Gemme, C, Ghione, S, Ghisotti, E, Giaccari, S, Giannelli, C, Giorcelli, V, Giuri, G, Giurissa, A, Grassini, M, Grasso, G, Graziani, Mg, Gualtiero, J, Gullini, S, Gullotta, R, Iaquinto, G, Jacoponi, S, Laganà, S, Lamanda, R, Lattanzio, R, Lauri, A, Lecis, Pe, Ledda, P, Leone, S, Ligas, E, Liuzzi, N, Lochis, D, Longaroni, M, Lorenzini, I, Loriga, P, Lussu, B, Luzza, F, Madia, D, Malfitana, G, Mallozzi, Ef, Mancini, S, Mangiarotti, R, Manildo, M, Manneschi, L, Marcon, V, Marino, M, Marrucci, A, Martines, H, Maruelli, A, Massari, M, Massidda, C, Mauri, R, Mazzarello, Pl, Mazzolla, E, Mellone, C, Meloni, M, Merighi, A, Mescia, P, Michetti, P, Milan, L, Milandri, G, Miori, G, Monastra, S, Moncelli, G, Monica, F, Montanaro, F, Moretti, M, Morini, S, Mosca, F, Mosca, D, Moschetta, R, Mura, G, Naim, G, Nardella, G, Natale, A, Negrini, F, Niccoli, G, Nova, A, Occhipinti, P, Ocera, S, Orlandi, Pg, Orsini, O, Pagani, E, Paliani, O, Pardocchi, D, Parodi, Cm, Pasini, D, Pasquale, L, Pasquali, L, Paterlini, A, Pellecchia, A, Pera, A, Perego, M, Perugini, B, Petracca, F, Peyre, S, Piccoli, F, Pilati, S, Pierucci, E, Pizzetti, P, Pizzolato, S, Polimeni, F, Politano, S, Polo, S, Portaluri, F, Prada, A, Privitera, U, Quaranta, S, Raguzzi, I, Ravelli, P, Recchia, S, Revetria, P, Ripoli, D, Rocca, F, Roda, E, Rogheto, M, Rosati, S, Rosina, F, Rossi, A, Rotolo, A, Sabadini, Gr, Saffiotti, O, Salerno, D, Sanesi, A, Sanna, S, Saracco, G, Savarino, V, Scaccianoce, G, Scarpulla, G, Schiffino, L, Schippa, P, Sebastiani, P, Servillo, F, Sgarbi, D, Sigillito, D, Snider, L, Sorrentini, I, Spadaccini, A, Sticchi, V, Sturniolo, Gc, Suriani, R, Tammaro, L, Tarchi, F, Tasini, E, Tebaldi, M, Terruzzi, V, Testoni, Pa, Tonelli, F, Trapè, R, Triossi, O, Usai, P, Usula, E, Vecchi, M, Vecchi, E, Ventrucci, M, Viero, K, Virgilio, C, Viviani, G, Zampaletta, U, and Zilli, M.

Subjects
Colonoscopy, Endoscopy
Published
2008

20. 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

21. 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

23. Rabeprazole is equivalent to omeprazole in the treatment of erosive gastro-oesophageal reflux disease. A randomised, double-blind, comparative study of rabeprazole and omeprazole 20 mg in acute treatment of reflux oesophagitis, followed by a maintenance open-label, low-dose therapy with rabeprazole

Author

Pace, F., Annese, V., Prada, A., Zambelli, A., Casalini, S., Nardini, P., Bianchi Porro, G., Rossi, Z., Fenderico, P., Molinari, F., Molinari, A., Poletti, M., Benedetti, A., Bolognini, L., Cercamondi, P., Piergallini, S., Pieroni, N., Ridolfi, F., Palazzi, A., Agnolucci, A., Ceccatelli, P., Laurenzi, F., Grassini, M., Iaquinto, G., D'Onofrio, V., Giardullo, N., Pasquale, L., Sedici, A., Moschetta, R., Maurogiovanni, G., Costan, F., Germana, B., Lecis, P., Negrini, F., Signorelli, S., Landi, P., Malaguti, P., Roda, E., De, E., Gandolfi, L., Torresan, F., Chilovi, F., Benvenuti, S., Grasso, T., Adamo, S., Azzurro, M., Carrara, M., Rubbiani, C., P. V., Di, Di, M., Belvedere, F., Di, A., Giglio, A., De Medici, A., Rodino, S., Sacca, N., Neri, M., Carbone, F., Laterza, F., Trimboli, V., Accattatis, G. C., Rizzuti, L. F., Sabatino, A., Lupinacci, G., Faleo, D., De Francesco, V., Lombardi, L. P, Minenna, M., Nocchiero, M. C., Tonti, P., Bocchini, R., D'Imperio, N., Giaccari, S., Tronci, S., Dall'Acqua, S., Berrini, E., Garatti, S., Putignano, R., Sferrazzo, A., Giacosa, A., Blanchi, S., Munizzi, F., Morlando, L., Bruno, G., Guardascione, F., Benedetti, E., Orzes, N., Pincione, F., Dell'Amico, I., Vannucci, P., Maurano, A., Calabrese, A., Napoli, G., Quagliariello, G., Sabarese, G., Pracanica, G., Gullotti, G., Princiotta, A., Rando, L., Anderloni, A., Pallotta, S., Fesce, E., Abbiati, D., Crippa, C., Ideo, G. M., Mannucci, P. M., Abbiati, C., De Franchis, R., Fazzini, L., Rossi, A., Bini, M., Chahin, N. J., Testoni, P. A., Fossati, D., Frego, R., Passaretti, S., Catanzano, C., Siciliano, S., Sivero, L., Cattaneo, D., Di Martino, V., Inzirillo, A., Lavelli, M., Del Genio, A., Maffettone, V., Napolitano, V., Del Piano, M., Ballare, M., Garello, E., Orsello, M., Capezzuto, E., Amuso, M., Marino, M., Reina, G., Craxi, A., Arini, A., Di Pisa, M., Peralta, S., Ficano, L., Miceli, D., Tarantello, M., Orlando, A., Perego, M., Alvisi, C., Pozzi, L., Torello Viera, F., Marchi, S., Arpe, P., Bellini, M., Costa, F., Da Massa Carrara, P., Manghetti, M., Meletis, P., Romano, A., Torelli, E., Garcea, M. R., Lombardi, M., Tristaino, B., Farroni, F., Di Cicco, M., Proietti, M., Tanzilli, A., Benedetti, G., Guido, E., Lacchin, T., Sablich, R., Vitalba, A., Casetti, T., Cantoni, F., Salzetta, A., Polimeni, F., Bortoli, A., Buono, M., Gozzini, C., Barberani, F., Boschetto, S., Giovannone, M., Casale, V., Assisi, D., Grassi, A., Lapenta, R., Stigliano, V., Fedeli, G., Pirozzi, G. A., Pippa, G., Bazuro, M. E., Romano, M., Borgheresi, P., Andriulli, A., Fiorella, S., De Rocco, R., Greco, G., Meloni, M., Fina, G., Frosini, G., Macchiarelli, R., Virgilio, C., Borina, E., Lauria, M., Cappelletti, F., Puglisi, F., Ravizza, M., Emanuelli, G., Battaglia, E., Dughera, L., Navino, M., Ferrari, A., Martinoglio, P., Turco, D., Pera, A., Daperno, M., Lombardo, L., Gusmaroli, R., Milesi, F., Zilli, M., Brosolo, P., De, G., Zoratti, L., Curzio, M., Amato, A., Bisso, G., Feliziani, M., Gianfrate, L., Natale, C., Petillo, A., Spadaccini, A., Meddi, P., Sciampa, G., and Ubalducci, G. M.

Subjects
Adult, Male, Gastrointestinal, Time Factors, Severity of Illness Index, 2-Pyridinylmethylsulfinylbenzimidazoles, Endoscopy, Gastrointestinal, Helicobacter Infections, Dose-Response Relationship, Gastro-oesophageal reflux disease, Double-Blind Method, Heartburn, Esophagitis, Humans, Esophagitis, Peptic, Curative/maintenance therapy, Peptic, Hepatology, Dose-Response Relationship, Drug, Helicobacter pylori, Rabeprazole, Antacids, Anti-Ulcer Agents, Benzimidazoles, Female, Gastroesophageal Reflux, Middle Aged, Omeprazole, Patient Satisfaction, Treatment Outcome, Gastroenterology, Endoscopy, Drug
Abstract

Previous studies have shown similar effects of rabeprazole and omeprazole, when used at the same dose in the treatment of reflux oesophagitis. However, such studies have been conducted as superiority studies but interpreted as equivalence ones.To properly assess the comparative efficacy of rabeprazole and omeprazole in inducing complete endoscopic healing and symptom relief in patients with reflux oesophagitis.Patients (n=560) with Savary-Miller grade I-III reflux oesophagitis were randomised in a double-blind, double-dummy fashion to rabeprazole or omeprazole 20 mg once daily for 4-8 weeks. Then, patients endoscopically healed and symptomatically relieved were openly maintained with rabeprazole 10 mg or 2x10 mg once daily (in the event of clinical and/or endoscopic relapse) for a maximum of 48 weeks.After 4-8 weeks of treatment, healing (primary end-point) was observed in 228/233 (97.9%) patients in the rabeprazole group and in 231/237 (97.5%) in the omeprazole one (equivalence effect demonstrated by p0.0001 at Blackwelder test and an upper confidence limit at 97.5% of 0.023). However, rabeprazole was faster in inducing heartburn relief than omeprazole (2.8+/-0.2 versus 4.7+/-0.5 days of therapy to reach the first day with satisfactory heartburn relief, p=0.0045 at log-rank test). In the maintenance phase, 15.2% of patients had an endoscopic and/or clinical relapse.Rabeprazole is equivalent to omeprazole in healing reflux oesophagitis, but shows a faster activity on reflux symptoms in the early treatment phase.

Published
2005

25. Long term outcome of acute pancreatitis in Italy: Results of a multicentre study

Author

Castoldi, L, De Rai, P, Zerbi, A, Frulloni, L, Uomo, G, Gabbrielli, A, Bassi, C, Pezzilli, R, Agugiaro, S, Turri, L, Bartoli, A, Barberini, F, Cavazzoni, G, Bartolo, F, Papa, D, Bassi, N, Massani, M, Benedetti, A, Macarri, G, Piergallini, L, Briani, G, Bartolasi, L, Bugnano, L, Buonanno, G, Esposito, C, Cordovana, A, Cavina, E, Seccia, M, 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, Rocco, P, Franzè, A, Bertelè, A, Sereni, G, Friedman, D, Mariani, L, Morelli, F, Gai, V, Antro, C, Garcea, D, Gardini, A, Lucci, E, Giulianotti, P, Sbrana, F, Balestracci, T, Giulini, S, Pellizzari, A, Ronconi, M, Cimaschi, S, Grassini, M, Lacignola, S, Martina, C, Mazzitelli, L, Costarella, S, Reggio, E, Mello Teggia P., N, 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, Romano, C, Gerardi, G, Troianello, B, Ruscello, D, Di Stefano, A, Avelli, S, Salval, N, Bellini, N, Scalon, P, Staudacher, C, Parolini, D, Strazzabosco, M, Signorelli, S, Tedeschi, U, Testoni, P, Masci, E, Mariani, A, Torelli, E, Garcea, M, Lombardi, V, Lecconi, L, Valeri, L, Presenti, L, Alessio, F, Ventrucci, M, Virzi, S, Cipolla, A, FERRARESE, SAMUELE, Mello Teggia P. , n, Cipolla, A., STRAZZABOSCO, MARIO, Castoldi, L, De Rai, P, Zerbi, A, Frulloni, L, Uomo, G, Gabbrielli, A, Bassi, C, Pezzilli, R, Agugiaro, S, Turri, L, Bartoli, A, Barberini, F, Cavazzoni, G, Bartolo, F, Papa, D, Bassi, N, Massani, M, Benedetti, A, Macarri, G, Piergallini, L, Briani, G, Bartolasi, L, Bugnano, L, Buonanno, G, Esposito, C, Cordovana, A, Cavina, E, Seccia, M, 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, Rocco, P, Franzè, A, Bertelè, A, Sereni, G, Friedman, D, Mariani, L, Morelli, F, Gai, V, Antro, C, Garcea, D, Gardini, A, Lucci, E, Giulianotti, P, Sbrana, F, Balestracci, T, Giulini, S, Pellizzari, A, Ronconi, M, Cimaschi, S, Grassini, M, Lacignola, S, Martina, C, Mazzitelli, L, Costarella, S, Reggio, E, Mello Teggia P., N, 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, Romano, C, Gerardi, G, Troianello, B, Ruscello, D, Di Stefano, A, Avelli, S, Salval, N, Bellini, N, Scalon, P, Staudacher, C, Parolini, D, Strazzabosco, M, Signorelli, S, Tedeschi, U, Testoni, P, Masci, E, Mariani, A, Torelli, E, Garcea, M, Lombardi, V, Lecconi, L, Valeri, L, Presenti, L, Alessio, F, Ventrucci, M, Virzi, S, Cipolla, A, FERRARESE, SAMUELE, Mello Teggia P. , n, Cipolla, A., and STRAZZABOSCO, MARIO

Abstract

Background: In Italy, no long-term studies regarding the natural history of acute pancreatitis have been carried out. Aim: To report the results of a follow-up on a large series of patients hospitalised for pancreatitis. Methods: Data of 631 patients admitted to 35 Italian hospitals were retrospectively evaluated 51.7 ± 8.4 months after discharge. Results: The average recovery time after mild or severe pancreatitis was 28.2 and 53.4 days respectively. Fourteen sequelae were not resolved and 9 cases required late surgical intervention. Eighty patients (12.7%) had a second hospital admission. Of the patients with mild biliary pancreatitis, 67.9% underwent a cholecystectomy. The overall incidence of relapse was 12.7%. Mortality was 9.8% and no death was related to pancreatitis. Three patients died from carcinoma of the pancreas. Conclusion: Reported recovery time after an attack of pancreatitis was longer than expected in the mild forms. The treatment of sequelae was delayed beyond one year after discharge. The incidence of relapse of biliary pancreatitis in patients not undergoing a cholecystectomy was low, due to endoscopic treatment. Mortality from pancreatic-related causes is low, but there is an association with malignant pancreatic or ampullary tumours not diagnosed during the acute phase of the illness. © 2013 Editrice Gastroenterologica Italiana S.r.l

Published
2013

29. P.1.350: INDIVIDUALIZED COUNSELLING GIVEN BY NURSES INCREASES MOTIVATION AND REDUCES ANXIETY IN PATIENTS UNDERGOING COLONOSCOPY

Author

Carretto, D., primary, Battaglia, E., additional, Niola, P., additional, Usai, S. Pirastu, additional, Di Franco, A., additional, Tartaglino, C., additional, Rainero, A., additional, Sordi, P., additional, Gallucci, L., additional, Rana, L., additional, Barbero, L., additional, Verna, C., additional, Giacobbe, U., additional, Rolle, E., additional, Rivara, C., additional, Peyre, S., additional, and Grassini, M., additional

Published
2011
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31. P.1.110: CLINICAL PATTERNS CAN DISTINGUISH DIVERTICULAR DISEASE FROM IRRITABLE BOWEL SYNDROME: A CASE-CASE MATCHING STUDY

Author

Cuomo, R., primary, Annibale, B., additional, Barbara, G., additional, Sarnelli, G., additional, Vozzella, L., additional, Cammarota, S., additional, Bassotti, G., additional, Casetti, T., additional, Grassini, M., additional, Ierardi, E., additional, Maconi, G., additional, Marchi, S., additional, Savarino, V., additional, and Usai, P., additional

Published
2011
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35. A case of Chagas’ disease

Author

Niola, P., primary, Battaglia, E., additional, Casabianca, A., additional, Verna, C., additional, Biglino, A., additional, and Grassini, M., additional

Published
2008
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41. Input-Output Modeling: Proceedings of the Third IIASA Task Force Meeting

Author

Grassini, M. and Smyshlyaev, A.

Abstract

The papers in this volume fall into two groups: the first deals with the linkage of input-output models and describes several models that are now ready to be linked, while the second concentrates on the analysis of structural change as well as reporting recent developments in the INFORUM group of models. Some of the papers in the first group examine the linkage of seven national models using the INFORUM international trade model, the development of a linked system for modeling the small open economies of the Nordic countries, and the definition of an appropriate international scenario for a single national model. Others discuss problems of disaggregation, the relationship between regional and national models, and the role of input-output models as policy-making tools. The section closes with papers on national models for Poland and Finland and a report describing the price-income block of the advanced US INFORUM model. The second group opens with analyses of factor inputs and of energy-economy interactions. It continues with suggestions on how to develop consistent dynamic input-output models using poor data bases and describes how an input-output model can be used to derive aggregate characteristics of probable future structural change. Further papers are devoted to changes in technical coefficients, the development of effective national models using limited or inconsistent data bases, and estimation techniques. The volume closes with a "system for systems design" for use in input-output related work.

Published
1983

42. Estimation of Capital Matrices for Multisectoral Models: An Application to Italy and Tuscany

Author

Westin, L., Johansson, B., Grassini, M., Westin, L., Johansson, B., and Grassini, M.

Abstract

This paper refers to the Tuscany case study which constitutes a systems analysis of integrated regional development in the Tuscany region. A core of this study is the development of applied models and methods undertaken by the Regional Development Group at IIASA, in collaboration with the Regional Institute for Economic Planning of Tuscany (IRPET). A bi-regional input-output model has a central part in the system of model development. In order to capture the dynamic process of capacity creation and removal, the capital formation has to be included into the input-output framework in a systematic way. This presupposes an estimation of capacity change and of capital coefficient matrices. This paper presents a systematic approach to obtain these estimates, also in the case where only a limited set of data is available. In summary, the method combines a vintage type production theory and an estimation technique based on information theory.

Published
1982

43. Potential feasibility of atezolizumab-bevacizumab therapy in patients with hepatocellular carcinoma treated with tyrosine-kinase inhibitors

Author

Benedetta Stefanini, Laura Bucci, Valentina Santi, Nicola Reggidori, Davide Rampoldi, Lorenzo Lani, Alessandro Granito, Angelo Sangiovanni, Giuseppe Cabibbo, Fabio Farinati, Claudia Campani, Francesco Giuseppe Foschi, Gianluca Svegliati-Baroni, Giovanni Raimondo, Antonio Gasbarrini, Andrea Mega, Elisabetta Biasini, Rodolfo Sacco, Filomena Morisco, Eugenio Caturelli, Gianpaolo Vidili, Francesco Azzaroli, Edoardo G. Giannini, Gian Ludovico Rapaccini, Maurizia Rossana Brunetto, Alberto Masotto, Gerardo Nardone, Mariella Di Marco, Donatella Magalotti, Franco Trevisani, Maurizio Biselli, Paolo Caraceni, Annagiulia Gramenzi, Francesco Tovoli, Luca Muratori, Francesca Benevento, Gloria Allegrini, Calogero Cammà, Ciro Celsa, Paolo Giuffrida, Caterina Stornello, Mauro Grova, Carmelo Marco Giacchetto, Gabriele Rancatore, Maria Vittoria Grassini, Valentina Adotti, Stefano Gitto, Fabio Marra, Martina Rosi, Vittoria Bevilacqua, Alberto Borghi, Andrea Casadei Gardini, Fabio Conti, Anna Chiara Dall'Aglio, Giorgio Ercolani, Federica Mirici, Nicoletta de Matthaeis, Francesca Romana Ponziani, Gabriele Missale, Andrea Olivani, Maria Guarino, Valentina Cossiga, Mario Capasso, Ester Marina Cela, Antonio Facciorusso, Valentina Lauria, Giorgia Ghittoni, Giorgio Pelecca, Fabrizio Chegai, Fabio Coratella, Mariano Ortenzi, Serena Dell'Isola, Maria Stella Franzè, Carlo Saitta, Assunta Sauchella, Elton Dajti, Federico Ravaioli, Giulia Pieri, Maria Corina Plaz Torres, Filippo Oliveri, Gabriele Ricco, Veronica Romagnoli, Alessandro Inno, Fabiana Marchetti, Pietro Coccoli, Antonio Malerba, Alberta Cappelli, Rita Golfieri, Cristina Mosconi, null Matteo Renzulli, Stefanini, B., Bucci, L., Santi, V., Reggidori, N., Rampoldi, D., Lani, L., Granito, A., Sangiovanni, A., Cabibbo, G., Farinati, F., Campani, C., Foschi, F. G., Svegliati-Baroni, G., Raimondo, G., Gasbarrini, A., Mega, A., Biasini, E., Sacco, R., Morisco, F., Caturelli, E., Vidili, G., Azzaroli, F., Giannini, E. G., Rapaccini, G. L., Brunetto, M. R., Masotto, A., Nardone, G., Di Marco, M., Magalotti, D., Trevisani, F., Biselli, M., Caraceni, P., Gramenzi, A., Tovoli, F., Muratori, L., Benevento, F., Allegrini, G., Camma, C., Celsa, C., Giuffrida, P., Stornello, C., Grova, M., Giacchetto, C. M., Rancatore, G., Grassini, M. V., Adotti, V., Gitto, S., Marra, F., Rosi, M., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, F., Dall'Aglio, A. C., Ercolani, G., Mirici, F., de Matthaeis, N., Ponziani, F. R., Missale, G., Olivani, A., Guarino, M., Cossiga, V., Capasso, M., Cela, E. M., Facciorusso, A., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Dell'Isola, S., Franze, M. S., Saitta, C., Sauchella, A., Dajti, E., Ravaioli, F., Pieri, G., Torres, M. C. P., Oliveri, F., Ricco, G., Romagnoli, V., Inno, A., Marchetti, F., Coccoli, P., Malerba, A., Cappelli, A., Golfieri, R., Mosconi, C., Matteo, Renzulli, Stefanini, Benedetta, Bucci, Laura, Santi, Valentina, Reggidori, Nicola, Rampoldi, Davide, Lani, Lorenzo, Granito, Alessandro, Sangiovanni, Angelo, Cabibbo, Giuseppe, Farinati, Fabio, Campani, Claudia, Foschi, Francesco Giuseppe, Svegliati-Baroni, Gianluca, Raimondo, Giovanni, Gasbarrini, Antonio, Mega, Andrea, Biasini, Elisabetta, Sacco, Rodolfo, Morisco, Filomena, Caturelli, Eugenio, Vidili, Gianpaolo, Azzaroli, Francesco, Giannini, Edoardo G, Rapaccini, Gian Ludovico, Brunetto, Maurizia Rossana, Masotto, Alberto, Nardone, Gerardo, Di Marco, Mariella, Magalotti, Donatella, and Trevisani, Franco

Subjects
Atezolizumab-bevacizumab, Clinical Trials as Topic, Antineoplastic Combined Chemotherapy Protocol, Carcinoma, Hepatocellular, Systemic therapy, Hepatology, Hepatocellular carcinoma, Tirosin-kinase inhibitor, Liver Neoplasms, Gastroenterology, Bevacizumab, Feasibility Studie, Tyrosine, Human
Abstract

Background: The combination of atezolizumab-bevacizumab has been proven to be superior to sorafenib for the treatment of unresectable hepatocellular carcinoma not amenable to locoregional treatments, be-coming the standard of care of systemic therapy.Aim: This study aimed at assessing real-world feasibility of atezolizumab-bevacizumab in patients treated with tyrosine-kinase inhibitors.Methods: Among 1447 patients treated with tyrosine-kinase inhibitors from January 2010 to December 2020, we assessed the percentage of those potentially eligible to atezolizumab-bevacizumab (according to IMbrave-150 trial criteria), and the overall survival of eligible and non-eligible patients.Results: 422 (29%) patients were qualified for atezolizumab-bevacizumab therapy. The main exclusion causes were Child-Pugh class and Performance Status. Adopting the more permissive inclusion criteria of SHARP trial, 535 patients became eligible. The median overall survival of tyrosine-kinase inhibitors patients was 14.9 months, longer in eligible patients than in their counterpart due to better baseline liver function and oncological features.Conclusion: Real-world data indicate that less than one-third of hepatocellular carcinoma patients treated with tyrosine-kinase inhibitors are potentially eligible to atezolizumab-bevacizumab according to the reg-istration trial criteria. These patients have a longer survival than the non-eligible ones. If the selection criteria of atezolizumab-bevacizumab trial are maintained in clinical practice, tyrosine-kinase inhibitors will remain the most used systemic therapy for hepatocellular carcinoma patients.(c) 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Published
2022

44. Hepatotoxicity of Small Molecule Protein Kinase Inhibitors for Cancer

Author

Mauro Viganò, Marta La Milia, Maria Vittoria Grassini, Nicola Pugliese, Massimo De Giorgio, Stefano Fagiuoli, Vigano, M, La Milia, M, Grassini, M, Pugliese, N, De Giorgio, M, and Fagiuoli, S

Subjects
Cancer Research, hepatotoxicity, tyrosine kinase inhibitor, Oncology, liver failure, cancer, drug-induced liver injury, hepatiti
Abstract

Small molecule protein kinase inhibitors (PKIs) have become an effective strategy for cancer patients. However, hepatotoxicity is a major safety concern of these drugs, since the majority are reported to increase transaminases, and few of them (Idelalisib, Lapatinib, Pazopanib, Pexidartinib, Ponatinib, Regorafenib, Sunitinib) have a boxed label warning. The exact rate of PKI-induced hepatoxicity is not well defined due to the fact that the majority of data arise from pre-registration or registration trials on fairly selected patients, and the post-marketing data are often based only on the most severe described cases, whereas most real practice studies do not include drug-related hepatotoxicity as an end point. Although these side effects are usually reversible by dose adjustment or therapy suspension, or by switching to an alternative PKI, and fatality is uncommon, all patients undergoing PKIs should be carefully pre-evaluated and monitored. The management of this complication requires an individually tailored reappraisal of the risk/benefit ratio, especially in patients who are responding to therapy. This review reports the currently available data on the risk and management of hepatotoxicity of all the approved PKIs.

Published
2023

45. Characteristics and survival of patients with primary biliary cholangitis and hepatocellular carcinoma

Author

Edoardo G. Giannini, Giulia Pieri, Sara Labanca, Maria Corina Plaz Torres, Antonio Gasbarrini, Elisabetta Biasini, Claudia Campani, Nora Cazzagon, Francesco Giuseppe Foschi, Andrea Mega, Alberto Masotto, Giovanni Raimondo, Gian Ludovico Rapaccini, Rodolfo Sacco, Eugenio Caturelli, Maria Guarino, Francesco Tovoli, Gianpaolo Vidili, Maurizia Rossana Brunetto, Gerardo Nardone, Gianluca Svegliati-Baroni, Donatella Magalotti, Francesco Azzaroli, Giuseppe Cabibbo, Maria Di Marco, Angelo Sangiovanni, Franco Trevisani, Maurizio Biselli, Paolo Caraceni, Annagiulia Gramenzi, Francesca Benevento, Alessandro Granito, Luca Muratori, Fabio Piscaglia, Federica Bertellini, Fabio Farinati, Giorgio Palano, Filippo Pelizzaro, Barbara Penzo, Elisa Pinto, Gloria Allegrini, Calogero Cammà, Ciro Celsa, Paolo Giuffrida, Caterina Stornello, Mauro Grova, Carmelo Marco Giacchetto, Gabriele Rancatore, Maria Vittoria Grassini, Valentina Adotti, Stefano Gitto, Fabio Marra, Martina Rosi, Vittoria Bevilacqua, Alberto Borghi, Andrea Casadei Gardini, Fabio Conti, Lucia Napoli, Marco Domenicali, Maria Teresa Migliano, Nicoletta de Matthaeis, Francesca Romana Ponziani, Andrea Olivani, Gabriele Missale, Valentina Cossiga, Mario Capasso, Filomena Morisco, Ester Marina Cela, Antonio Facciorusso, Valentina Lauria, Giorgia Ghittoni, Giorgio Pelecca, Fabrizio Chegai, Fabio Coratella, Mariano Ortenzi, Serena Dell'Isola, Maria Stella Franzè, Carlo Saitta, Assunta Sauchella, Elton Dajti, Federico Ravaioli, Filippo Oliveri, Gabriele Ricco, Veronica Romagnoli, Alessandro Inno, Fabiana Marchetti, Pietro Coccoli, Antonio Malerba, Alberta Cappelli, Rita Golfieri, Cristina Mosconi, Matteo Renzulli, Giannini, Edoardo G, Pieri, Giulia, Labanca, Sara, Plaz Torres, Maria Corina, Gasbarrini, Antonio, Biasini, Elisabetta, Campani, Claudia, Cazzagon, Nora, Foschi, Francesco Giuseppe, Mega, Andrea, Masotto, Alberto, Raimondo, Giovanni, Rapaccini, Gian Ludovico, Sacco, Rodolfo, Caturelli, Eugenio, Guarino, Maria, Tovoli, Francesco, Vidili, Gianpaolo, Brunetto, Maurizia Rossana, Nardone, Gerardo, Svegliati-Baroni, Gianluca, Magalotti, Donatella, Azzaroli, Francesco, Cabibbo, Giuseppe, Di Marco, Maria, Sangiovanni, Angelo, Trevisani, Franco, Giannini, E. G., Pieri, G., Labanca, S., Plaz Torres, M. C., Gasbarrini, A., Biasini, E., Campani, C., Cazzagon, N., Foschi, F. G., Mega, A., Masotto, A., Raimondo, G., Rapaccini, G. L., Sacco, R., Caturelli, E., Guarino, M., Tovoli, F., Vidili, G., Brunetto, M. R., Nardone, G., Svegliati-Baroni, G., Magalotti, D., Azzaroli, F., Cabibbo, G., Di Marco, M., Sangiovanni, A., Trevisani, F., Biselli, M., Caraceni, P., Gramenzi, A., Benevento, F., Granito, A., Muratori, L., Piscaglia, F., Bertellini, F., Farinati, F., Palano, G., Pelizzaro, F., Penzo, B., Pinto, E., Allegrini, G., Camma, C., Celsa, C., Giuffrida, P., Stornello, C., Grova, M., Giacchetto, C. M., Rancatore, G., Grassini, M. V., Adotti, V., Gitto, S., Marra, F., Rosi, M., Bevilacqua, V., Borghi, A., Gardini, A. C., Conti, F., Napoli, L., Domenicali, M., Migliano, M. T., de Matthaeis, N., Ponziani, F. R., Olivani, A., Missale, G., Cossiga, V., Capasso, M., Morisco, F., Cela, E. M., Facciorusso, A., Lauria, V., Ghittoni, G., Pelecca, G., Chegai, F., Coratella, F., Ortenzi, M., Dell'Isola, S., Franze, M. S., Saitta, C., Sauchella, A., Dajti, E., Ravaioli, F., Oliveri, F., Ricco, G., Romagnoli, V., Inno, A., Marchetti, F., Coccoli, P., Malerba, A., Cappelli, A., Golfieri, R., Mosconi, C., and Renzulli, M.

Subjects
Male, Carcinoma, Hepatocellular, Cholestatic liver disease, Outcome, Surveillance, Survival, Treatment, Hepatology, Prognosi, Liver Cirrhosis, Biliary, Risk Factor, Settore MED/12 - GASTROENTEROLOGIA, Liver Neoplasms, Gastroenterology, Prognosis, Risk Factors, Humans, Female, Human, Aged
Abstract

Background: Comprehensive and contemporary data pertaining large populations of patients with Primary Biliary Cholangitis (PBC) and hepatocellular carcinoma (HCC) are missing. Aim: To describe main characteristics and outcome of PBC patients with HCC diagnosed in the new millennium. Methods: Analysing the Italian Liver Cancer registry we identified 80 PBC patients with HCC diagnosed after the year 2000, and described their clinical characteristics, access to treatment and survival. Results: Median age of patients was 71 years and 50.0% were males. Cirrhosis was present in 86.3% of patients, being well-compensated in 58.0%. Median HCC diameter was smaller in patients under surveillance (2.6vs 4.0cm, P=0.007). Curative treatment, feasible in 50.0% of patients, was associated with improved survival compared to palliative and supportive care (42vs 33vs 6 months, P

Published
2022

46. Recent advances in the treatment of irritable bowel syndrome.

Author

Bonetto S, Fagoonee S, Battaglia E, Grassini M, Saracco GM, and Pellicano R

Subjects
Abdominal Pain, Constipation, Diarrhea, Female, Humans, Male, Quality of Life, Irritable Bowel Syndrome therapy
Abstract

Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder which presents with abdominal pain and altered bowel habits. It affects about 20% of the general population, mainly women, and has a considerable impact on the quality of life and health care costs. Four different entities of IBS have been identified: IBS with constipation (IBS‑ C), IBS with diarrhea (IBS D), IBS with a mixed pattern of constipation and diarrhea, and unclassified IBS. Although the precise pathogenesis of IBS remains unclear, its multifactorial nature is evident and includes environmental and host factors. Management of patients with this disease is challenging and a personalized approach is required. A strong, reassuring physician‑ patient relationship is crucial, followed by patient education, dietary advice, and stress reduction. For nonresponding patients, the therapeutic approach may include nonpharmacological therapies and / or pharmacotherapy. The choice of pharmacological treatment is based on the predominant symptom and a prespecified time point should be planned for effectiveness evaluation and dose adjustment. In patients with IBS‑ D, the therapeutic options include mainly antibiotics, such as rifaximin, peripheral opioid agonists, mixed opioid agonists / antagonists, bile acid sequestrants, and antagonists of serotonin 5‑ hydroxytryptamine type 3 receptors. Bulking agents and osmotic laxatives represent the first line therapy for IBS‑ C, while lubiprostone and linaclotide should be reserved for difficult to treat patients. The involvement of gastrointestinal microbiota constitutes a fascinating field of exploration as it offers the potential to be modulated by the use of probiotics, prebiotics, synbiotics as well as fecal microbiota transplantation. This review offers an updated overview on the recent advances in the treatment of IBS.

Published
2021
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47. Mapping factors associated with deaths in immigration detention in the United States, 2011-2018: A thematic analysis.

Author

Parmar P, Ross M, Terp S, Kearl N, Fischer B, Grassini M, Ahmed S, Frenzen N, and Burner E

Abstract

Background: Climate change, poverty, and violence increasingly drive migration to the United States. United States Immigration and Customs Enforcement (ICE) detain some individuals while awaiting determination of immigration status or potential deportation. Over the last two decades, more than 200 individuals died in ICE detention. In this study, we aim to identify systemic issues related to deaths of individuals in ICE detention to potentially mitigate further harm., Methods: The ICE Office of Detention Oversight conducts investigations after each death in detention, producing a report called a "Detainee Death Review". To identify systemic issues in these deaths, we used thematic analysis to review 55 Detainee Death Reviews available between 2011 and 2018., Findings: We identified 3 major themes of pervasive issues- Detainee Not Patient, System Over Patient, and Grossly Substandard Care- and 11 subthemes. Subthemes of culture of shortcuts, delays in care, and poor care delivered were present in the vast majority of cases. Subthemes bias and discrimination, language injustice, falsification of and inconsistencies between records and reports, willful indifference, security over health, communication breakdown, inadequate resources, failure of protective mechanisms, missing/ignoring red flags, and failure of emergency response were also prominent., Interpretation: This study identified underlying systems issues within the medical care provided in ICE detention. While there are issues with language services, discrimination, and inadequate response to medical emergencies, the greatest issue is the lack of independent, external review. Greater transparency is required, so that adherence to basic standards of care for individuals in ICE detention can be better evaluated., Funding: Haas Jr. Fund and the University of Southern California's Equity Research Institute., Competing Interests: The Haas Jr. Fund supported authors ST, EB, and PP in this research. EB receives funding for unrelated research from the NIH NIDDK. PP is affiliated faculty with the University of Southern California's Equity Research Institute, who provided funding to support this research., (© 2021 The Authors.)

Published
2021
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49. Characteristics of Deaths Among Individuals in US Immigration and Customs Enforcement Detention Facilities, 2011-2018.

Author

Grassini M, Terp S, Fischer B, Ahmed S, Ross M, Frenzen N, Burner E, and Parmar P

Subjects
Adult, Case-Control Studies, Emigration and Immigration statistics & numerical data, Female, Humans, Male, Middle Aged, Preexisting Condition Coverage statistics & numerical data, Prisons organization & administration, United States, Emigrants and Immigrants statistics & numerical data, Mortality trends, Prisons statistics & numerical data
Abstract

Importance: Concerns have been raised that substandard medical care has contributed to deaths in US Immigration and Customs Enforcement (ICE) detention facilities. After each in-custody death, ICE produces detainee death reviews, which describe the circumstances of the death and determine whether ICE Performance-Based National Detention Standards (PBNDS) were violated., Objective: To describe factors associated with deaths in ICE detention facilities., Design, Setting, and Participants: This case series used data extracted from detainee death reviews of deaths among individuals detained in ICE facilities for whom these reviews were available from January 2011 to December 2018., Exposures: All individuals were in the custody of ICE at the time of death., Main Outcomes and Measures: Data including demographic information, medical histories, recorded medical data, and reported violations of PBNDS were systematically extracted and summarized., Results: Among 71 individuals who died in an ICE detention facility during the study period, detainee death reviews were available for 55 (77.5%). Most were male (47 [85.5%]), and the mean (SD) age at death was 42.7 (11.5) years. Individuals resided in the US for a mean (SD) of 15.8 (13.2) years before detention and were in ICE custody for a median of 39 days (interquartile range, 9-76 days) before death. Most had low burdens of preexisting disease, with 18 (32.7%) having a Charlson Comorbidity Index score of 0 and 15 (27.3%) having a score of 1 or 2. A total of 47 deaths (85.5%) were attributed to medical causes and 8 (14.5%) to suicide. Markedly abnormal vital signs were documented in the death reviews before 29 of 47 deaths from medical causes (61.7%), and 21 of these 29 deaths (72.4%) were preceded by abnormal vital signs during 2 or more encounters with ICE personnel before death or terminal hospital transfer. Overall, 43 detainee death reviews (78.2%) identified PBNDS violations related to medical care, with a mean (SD) of 3.2 (3.0) deficiencies per detainee death review., Conclusions and Relevance: In this case series, deaths in ICE detention facilities from 2011 to 2018 occurred primarily among young men with low burdens of preexisting disease. Markedly abnormal vital signs preceded death or hospital transfer for most nonsuicide deaths. The PBNDS were violated in most detainee death reviews. These results suggest that additional oversight and external evaluation of practices related to medical and psychiatric care within ICE facilities are needed.

Published
2021
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50. Deaths in Immigration and Customs Enforcement (ICE) detention: FY2018-2020.

Author

Terp S, Ahmed S, Burner E, Ross M, Grassini M, Fischer B, and Parmar P

Abstract

Background: Many civil liberties organizations have raised concerns that substandard medical care in United States Immigration and Customs Enforcement (ICE) detention facilities have led to preventable deaths. The 2018 Department of Homeland Security Appropriations Bill required ICE to make public all reports regarding in-custody deaths within 90 days beginning in Fiscal Year (FY) 2018. Accordingly, ICE has released death reports following each in-custody death since April of 2018. This study describes characteristics of deaths among individuals in ICE detention following the FY2018 mandate., Methods: Data was extracted from death reports published by ICE following the FY2018 mandate. Causes of death were categorized as suicide or medical, and medical deaths as COVID-19-related or not. Characteristics were compared between medical and suicide deaths, and among medical deaths between COVID-19-related and non-COVID-19-related deaths. Additionally, death rates per person-year and per 100,000 admissions were calculated for FY2018, 2019, and 2020 using methods from prior work evaluating deaths among detained immigrants in the United States., Results: Since April 2018, 35 individuals have died in ICE detention. The death rate per 100,000 admissions in ICE detention was 2.303 in FY2018, 1.499 in FY2019, and 10.833 in FY2020. Suicide by hanging was identified as the cause of death in 9 (25.7%), and medical causes in the remaining 26 (74.3%). Among 26 deaths attributable to medical causes, 8 (30.8%) were attributed to COVID-19, representing 72.7% of 11 deaths occurring since April 2020., Conclusions: The death rate among individuals in ICE detention is increasing amidst the COVID-19 pandemic. Potentially preventable causes of death including COVID-19 and suicide contribute to at least half of recent deaths. Findings suggest that individuals detained by ICE may benefit from improved psychiatric care and prevention measures to combat suicide, as well as increased infection control efforts to reduce mortality associated with COVID-19., Competing Interests: Conflict of interest: All authors declare no conflicts of interest in this paper., (© 2021 the Author(s), licensee AIMS Press.)

Published
2021
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