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1. Derivation and validation of Re.Co.De death score risk in patients with acute nonvariceal upper GI bleeding

Author

Marmo, Riccardo, primary, Soncini, Marco, additional, Bucci, Cristina, additional, Occhipinti, Vincenzo, additional, Pellegrini, Lucienne, additional, Zullo, Angelo, additional, L, Amitrano, additional, A, Andriulli, additional, V, Annese, additional, G, Baldassarre, additional, S, Bargiggia, additional, A, Balzano, additional, F, Bazzoli, additional, R, Bennato, additional, M A, Bianco, additional, A, Bizzotto, additional, V, Boarino, additional, AG, Bonanomi, additional, P, Borgheresi, additional, G, Bresci, additional, F, Buffoli, additional, E, Buscarini, additional, G, Castrignanò, additional, LG, Cavallaro, additional, P, Cesaro, additional, A, Chirico, additional, F, Cipolletta, additional, L, Cipolletta, additional, R, Conigliaro, additional, D, Conte, additional, G, Costamagna, additional, G, D’ Amico, additional, C, De Fanis, additional, FR, De Filippo, additional, R, de Franchis, additional, A, Dell‘ Era, additional, F, De Nigris, additional, M, De Matthaeis, additional, P, Di Giorgio, additional, E, Di Giulio, additional, P, Esposito, additional, L, Ferraris, additional, A, Filippino, additional, M, Franceschi, additional, L, Furio, additional, B, Germana, additional, R, Grassia, additional, G, Imperiali, additional, R, Lamanda, additional, A, Lauri, additional, C, Londoni, additional, S, Mangiafico, additional, M, Manno, additional, C, Marmo, additional, R, Meroni, additional, S, Metrangolo, additional, M, Montalbano L., additional, G, Napolitano, additional, A, Nucci, additional, L, Orsini, additional, F, Parente, additional, M, Parravicini, additional, A, Paterlini, additional, R, Pumpo, additional, L, Purita, additional, A, Repici, additional, ME, Riccioni, additional, A, Russo, additional, S, Segato, additional, I, Sorrentino, additional, G, Spinzi, additional, D, Spotti, additional, A, Tortora, additional, O, Triossi, additional, RM, Zagari, additional, and A, Zambelli, additional

Published
2022
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2. The 'Hub and Spoke' model has no effect on mortality in acute upper gastrointestinal bleeding: A prospective multicenter cohort study

Author

Cristina Bucci, L. Amitrano, C. Londoni, A. Chirico, O. Triossi, A. Zambelli, F. Bazzoli, B. Germanà, F. Cipolletta, Marco Soncini, S. Mangiafico, F. Parente, E Di-Giulio, A. Andriulli, G. D'Amico, G. Baldassarre, Riccardo Marmo, A. Repici, A. Paterlini, G. Imperiali, Angelo Zullo, V Annese, F. De Nigris, R. Bennato, S. Metrangolo, L. Orsini, S. Bargiggia, I Sorrentino, M. Manno, Maria Elena Riccioni, C. Tomba, A. Nucci, A. Bizzotto, FR De-Filippo, A. Merighi, Guido Costamagna, R de-Franchis, C. Marmo, A. Anderloni, L.G. Cavallaro, P Esposito, A. Russo, R. Pumpo, D. Conte, M.A. Bianco, F Buffoli, L. Cipolletta, R. Conigliaro, P Di-Giorgio, A Filippino, G. Bresci, F Covello, P. Borgheresi, L.M. Montalbano, R.M. Zagari, E. Buscarini, Annalisa Tortora, D. Spotti, L. Ferraris, R. Lamanda, M. Franceschi, G Castrignanò, G. Spinzi, A. Lauri, S. Segato, R Grassia, V. Boarino, P. Cesaro, C De-Fanis, R. Meroni, G. Napolitano, L. Furio, AG Bonanomi, M De-Matthaeis, M. Parravicini, A Dell‘Era, L. Purita, Marmo R., Soncini M., Bucci C., Zullo A., Amitrano L., Anderloni A., Andriulli A., Annese V., Baldassarre G., Bargiggia S., Bazzoli F., Bennato R., Bianco M.A., Bizzotto A., Boarino V., Bonanomi A.G., Borgheresi P., Bresci G., Buffoli F., Buscarini E., Castrignano G., Cavallaro L.G., Cesaro P., Chirico A., Cipolletta F., Cipolletta L., Conigliaro R., Conte D., Costamagna G., Covello F., D'Amico G., De-Fanis C., De-Filippo F.R., de-Franchis R., Dell'Era A., De Nigris F., De-Matthaeis M., Di-Giorgio P., Di-Giulio E., Esposito P., Ferraris L., Filippino A., Franceschi M., Furio L., Germana' B., Grassia R., Imperiali G., Lamanda R., Lauri A., Londoni C., Mangiafico S., Manno M., Marmo C., Merighi A., Meroni R., Metrangolo S., Montalbano L.M., Napolitano G., Nucci A., Orsini L., Parente F., Parravicini M., Paterlini A., Pumpo R., Purita L., Repici A., Riccioni M.E., Russo A., Segato S., Sorrentino I., Spinzi G., Spotti D., Tortora A., Tomba C., Triossi O., Zagari R.M., and Zambelli A.

Subjects
medicine.medical_specialty, Gastrointestinal bleeding, Multivariate analysis, Organizational model, Improved survival, Comorbidity, 03 medical and health sciences, Organizational setting, 0302 clinical medicine, Health care, Spoke-hub distribution paradigm, Medicine, Humans, Hub and spoke network, Mortality, Aged, Hepatology, business.industry, Delivery of Health Care, Integrated, Gastroenterology, Acute upper gastrointestinal bleeding, Length of Stay, Middle Aged, medicine.disease, Italy, 030220 oncology & carcinogenesis, Case-Control Studies, Emergency medicine, 030211 gastroenterology & hepatology, business, Gastrointestinal Hemorrhage, Acute gastrointestinal bleeding, Cohort study
Abstract

Background: the lack of standardized pathways for patients with gastrointestinal bleeding may have led to differences in their management and inequity to medical care access. The "Hub & Spoke" model was adopted to fill this gap in many disciplines, but, to our knowledge, no data exist on its efficacy on mortality in GI bleeding. We aimed to evaluate if the "Hub & Spoke" organizational model has an impact on mortality risk from UGIB. Methods: from January 2014 to December 2015, 3324 consecutive patients admitted for UGIB in 50 Italian hospitals were enrolled (1977 patients in hospitals within the "Hub & Spoke" network for digestive hemorrhagic emergency and 1347 in hospitals outside the "Hub & Spoke" network). Clinical, endoscopic and organizational data were recorded. Results: we observed no differences in mortality between patients admitted to hospitals included or not included in the "Hub & Spoke" network (5.2% vs 6.1%, p = 0.3). On multivariate analysis, admission in gastroenterology wards (OR 0.61, p = 0.001) or an academic hospital (OR 0.65, p < 0.056) were independent protective factors while being in "Hub & Spoke" organization system did not affect mortality (OR 1.09, p = 0.57). Conclusion: the "Hub & Spoke" model per sé does not impact on mortality while being treated in academic hospital or gastroenterology wards improved survival.

Published
2021

3. A COMPARATIVE EVALUATION OF RENAL FUNCTION IN INPATIENTS TAKING 4L- AND 1- PEG-BASED BOWEL PREPARATION: A POST-HOC ANALYSIS OF A MULTICENTRE PROSPECTIVE STUDY

Author

Franco Bazzoli, Emanuele Rondonotti, O. Triossi, C Hassan, C Spada, S. Piccirelli, Leonardo Frazzoni, Lorenzo Fuccio, Marina La Marca, F Radaelli, and A Mussetto

Subjects
medicine.medical_specialty, business.industry, Post-hoc analysis, PEG ratio, Urology, medicine, Bowel preparation, Renal function, business, Prospective cohort study, Comparative evaluation
Published
2020
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4. T05.02.9 A COMPARATIVE EVALUATION OF RENAL FUNCTION AND ELECTROLYTE SHIFTS IN INPATIENTS TAKING 4L- AND 1-PEG-BASED BOWEL PREPARATION: A POST-HOC ANALYSIS OF AN ITALIAN MULTICENTRE PROSPECTIVE STUDY

Author

S. Piccirelli, O. Triossi, Franco Radaelli, Leonardo Frazzoni, Emanuele Rondonotti, Cristiano Spada, Lorenzo Fuccio, M. La Marca, and Alessandro Mussetto

Subjects
medicine.medical_specialty, Hepatology, business.industry, Post-hoc analysis, PEG ratio, Gastroenterology, Bowel preparation, Urology, medicine, Renal function, business, Prospective cohort study, Comparative evaluation
Published
2020
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5. T06.02.1 MORTALITY OF ACUTE LOWER GASTROINTESTINAL BLEEDING: A PROSPECTIVE, MULTICENTRE, COHORT STUDY

Author

Cristiano Spada, A. Repici, Cesare Hassan, S. Segato, V. Festa, Piera Alessia Galtieri, O. Triossi, Alessandro Musso, Alida Andrealli, Paola Soriani, Lorenzo Fuccio, I. Biviano, Chiara Coluccio, L. Ferraris, G. De Nucci, E. Di Giulio, E. Grassi, Alessandro Mussetto, Marcella Feliziani, Franco Radaelli, Andrea Iannone, Leonardo Frazzoni, and Gianpiero Manes

Subjects
medicine.medical_specialty, Acute lower gastrointestinal bleeding, Hepatology, business.industry, Internal medicine, Gastroenterology, medicine, business, Cohort study
Published
2020
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6. OC.10.1 THE USE OF PRE-ENDOSCOPIC INTRAVENOUS PROTON PUMP INHIBITORS (PPIS) HAD NO IMPACT ON CLINICAL OUTCOMES IN ACUTE UPPER GASTROINTESTINAL BLEEDING: A PROSPECTIVE MULTICENTER ITALIAN COHORT STUDY

Author

A. Andriulli, R. Pumpo, G. Spinzi, L. Amitrano, G. Baldassarre, Marco Soncini, Riccardo Marmo, M. De Matthaeis, C. Londoni, L. Furio, L. Ferraris, S. Metrangolo, A. Balzano, L.G. Cavallaro, G. D'Amico, A. Lauri, E. Buscarini, V. Boarino, A. Merighi, B. Germanà, D. Spotti, P. Di Giorgio, L. Orsini, G. Imperiali, R. Lamanda, F. De Nigris, Alessandra Dell'Era, S. Bargiggia, D. Conte, F. Cipolletta, A. Nucci, P. Cesaro, A. Bizzotto, F.R. De Filippo, A. Anderloni, Maria Elena Riccioni, C. Marmo, A. Repici, A. Paterlini, A. Chirico, G. Napolitano, S. Mangiafico, C. De Fanis, O. Triossi, G. Rotondano, Annalisa Tortora, Guido Costamagna, F. Esposito, P. Borgheresi, L.M. Montalbano, E. Di Giulio, M. Franceschi, Cristina Bucci, R. Bennato, M. Manno, L. Purita, L. Cipolletta, R. Conigliaro, R.M. Zagari, R. De Franchis, A. Zambelli, F. Bazzoli, A. Russo, M.A. Bianco, G. Bresci, M. Parravicini, F. Parente, and S. Segato

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Gastroenterology, Medicine, Acute upper gastrointestinal bleeding, business, Cohort study
Published
2020
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7. T01.01.7 THE USE OF A SPECIALIZED BLEEDING-MANAGEMENT TEAM HAD NO IMPACT ON MORTALITY FOR ACUTE UPPER GASTROINTESTINAL BLEEDING: AN ITALIAN PROSPECTIVE MULTICENTER COHORT STUDY

Author

L. Purita, S. Segato, L. Ferraris, G. D'Amico, E. Buscarini, G. Imperiali, L. Orsini, F. Parente, Maria Elena Riccioni, P. Borgheresi, L.M. Montalbano, Annalisa Tortora, Guido Costamagna, G. Spinzi, M. Franceschi, S. Mangiafico, A. Balzano, A. Lauri, C. De Fanis, A. Russo, M.A. Bianco, G. Bresci, R.M. Zagari, C. Londoni, A. Andriulli, R. De Franchis, A. Zambelli, F. Bazzoli, L.G. Cavallaro, S. Bargiggia, R. Bennato, D. Conte, M. Manno, F. Esposito, A. Chirico, S. Metrangolo, A. Anderloni, V. Boarino, D. Spotti, O. Triossi, B. Germanà, R. Lamanda, G. Baldassarre, P. Cesaro, M. Parravicini, Cristina Bucci, L. Cipolletta, R. Conigliaro, F. Cipolletta, Alessandra Dell'Era, A. Repici, A. Paterlini, F. De Nigris, G. Napolitano, R. Pumpo, A. Nucci, Marco Soncini, A. Merighi, Riccardo Marmo, A. Bizzotto, F.R. De Filippo, C. Marmo, G. Rotondano, L. Furio, E. Di Giulio, L. Amitrano, M. De Matthaeis, and P. Di Giorgio

Subjects
medicine.medical_specialty, Hepatology, business.industry, Emergency medicine, Gastroenterology, Medicine, Acute upper gastrointestinal bleeding, business, Cohort study
Published
2020
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8. OC.11.5 TRIGGER AND TARGET TRANSFUSION STRATEGY IN PATIENTS WITH NON-VARICEAL ACUTE UPPER GASTROINTESTINAL BLEEDING (NV-AUGIB): A PROSPECTIVE MULTICENTRE OBSERVATIONAL STUDY

Author

L. Amitrano, C. Spada, L. Purita, R. Pumpo, L. Furio, L. Orsini, S. Metrangolo, M. Parravicini, G. D'Amico, F. Esposito, G. Spinzi, R. Bennato, A. Andriulli, A. Merighi, M. Manno, L. Cipolletta, R. Conigliaro, Alessandra Dell'Era, Maria Elena Riccioni, G. Imperiali, A. Lauri, D. Conte, V. Boarino, Guido Costamagna, G. Napolitano, E. Buscarini, G. Baldassarre, P. Cesaro, Cristina Bucci, R. Lamanda, A. Balzano, A. Anderloni, P. Borgheresi, L.M. Montalbano, S. Mangiafico, C. Londoni, A. Russo, C. De Fanis, F. Cipolletta, L. Ferraris, R. De Franchis, A. Zambelli, M.A. Bianco, F. Bazzoli, G. Bresci, L.G. Cavallaro, A. Repici, A. Chirico, O. Triossi, F. Parente, Marco Soncini, Riccardo Marmo, S. Segato, R.M. Zagari, M. De Matthaeis, P. Di Giorgio, F. De Nigris, A. Nucci, A. Bizzotto, F.R. De Filippo, C. Marmo, E. Di Giulio, B. Germanà, G. Rotondano, S. Bargiggia, P. Gasparini, Annalisa Tortora, and M. Franceschi

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Gastroenterology, Medicine, Observational study, In patient, Acute upper gastrointestinal bleeding, business
Published
2019
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9. White Paper of Italian Gastroenterology: Delivery of services for digestive diseases in Italy: Weaknesses and strengths

Author

Giovanni Ferrini, Antonietta Bianco, Paolo Ravelli, Michele Cicala, Aurora Bortoli, Renato Cannizzaro, Piero Leo, Emanuele Meroni, Paolo Spolaore, Gianni Gatto, Manola Lisiero, Filippo Antonini, Angelo Zullo, Antonio Balzano, Sabrina Bianchi, Emanuele Scafato, Giancarlo Spinzi, Lucio Amitrano, Luca Frulloni, Renzo Gullotta, Eugenio Brunelli, O. Triossi, Italo Sorrentini, Mario Marini, Diego Fregonese, Paolo Borro, Danilo Badiali, Giovanni Sansoè, R. Cuppone, Enrico Corazziari, Luciana Framarin, L.M. Montalbano, P. Brosolo, T. Federici, Gianni Testino, Alessandro Sumberaz, Attilio Solinas, A. Salmi, Renato Marin, L. Buri, Ivo Boskovski, Italo Stroppa, Ivano Lorenzini, Giovanni Di Matteo, Salvatore Cucchiara, Ilaria Tarantino, Cesare Hassan, Nicola Muscatiello, Giovanni M. Claar, Stefano Bellentani, Luca Barresi, Francesco Guardascione, Mario Del Piano, Mario Angelico, Luigi Vilardo, Paolo Usai-Satta, Luigi Pasquale, G. Scarpulla, Santino Marchi, Roberto Penagini, Vincenzo Gallo, Luigi Familiari, Francesco Cupella, Livio Cipolletta, Egiziano Peruzzi, Gianfranco Delle Fave, Salvatore Adamo, Luca Elli, S. Crotta, Maurizio Zilli, Antonio Cilona, Bastianello Germanà, Francesco Pallone, Leonardo Tammaro, P. Fracasso, Fabio Pace, Giovanni de Pretis, Alfredo Di Leo, Pietro Familiari, Giorgio Frosini, Giuseppe Milazzo, Maria Teresa Bardella, Michele Di Cillo, Fausto Chilovi, Enrico Ciliberto, Floriano Rosina, Alessandro Zambelli, Franco Bazzoli, Maria Rendina, Francesco Ridolfi, Franco Radaelli, Massimo Conio, Massimiliano Biagini, Massimo Bellini, Claudio De Angelis, Maria Caterina Parodi, Guido Costamagna, Pietro Fusaroli, Gioacchino Leandro, Pier Alberto Testoni, Piero Loriga, Ornella Ancarani, Giacomo Germani, Fabio Farinati, Giancarlo Caletti, Sergio Morini, Carlo Gemme, Antonio Benedetti, Adriano Lauri, Gianmarco Fava, Mauro Borzio, Mario Traina, Marcello Ingrosso, Amuso M, Giampiero Macarri, Rosa Filiberti, A. Marino, Cinzia Quondamcarlo, Francesco Bortoluzzi, L. Piazzi, Raffaele Manta, Salvatore De Stefano, Rita Conigliaro, Michele De Boni, Andrea Ederle, Clara Virgilio, Marco Soncini, Mario Cottone, G.C. Sturniolo, Anna Kohn, Maurizia Rossana Brunetto, Matteo Neri, Elisabetta Buscarini, Nicola D'Imperio, Gennaro D'Amico, Patrizia Burra, Antonio Craxì, S. Peralta, Alessandro Natali, Giuseppe Del Favero, Giovanni Actis, Andrea Nucci, Dario Conte, Stefano Fagiuoli, Santo Monastra, Fabrizio Magnolfi, Buscarini, E, Conte, D, Cannizzaro, R, Bazzoli, F, De Boni, M, Delle Fave, G, Farinati, F, Ravelli, P, Testoni, P, Lisiero, M, Spolaore, P, Fagiuoli, S, Testoni, PIER ALBERTO, Italian Association of Hospital, Gastroenterologist, Endoscopists, Italian Society of, Endoscopy, Italian Society of, Gastroenterology, Buscarini E, Conte D, Cannizzaro R, Bazzoli F, De Boni M, Fave GD, Farinati F, Ravelli P, Testoni PA, Lisiero M, Spolaore P, Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO), Italian Society of Endoscopy (SIED), Italian Society of Gastroenterology (SIGE): [.., Pietro Fusaroli, and ]

Subjects
Male, Gastrointestinal Diseases, Treatment outcome, Diseases, Medical care, Gastroenterology, Cancer, Digestive diseases, Emergency, Gastrointestinal bleeding, Hospital discharge record, Hospital stay, Mortality, Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Emergencies, Female, Gastrointestinal Hemorrhage, Health Planning, Health Services, Health Services Needs and Demand, Hospital Mortality, Hospital Units, Humans, Incidence, Infant, Infant, Newborn, Italy, Length of Stay, Middle Aged, Prevalence, Societies, Medical, Treatment Outcome, Young Adult, Health services, White paper, Digestive disease, italy, 80 and over, Medicine, Hepatology, Settore MED/12 - Gastroenterologia, Incidence (epidemiology), Digestive diseases Emergency Gastroenterology Gastrointestinal bleeding Hospital discharge record Hospital stay Mortality, Christian ministry, gastroenterology, medicine.medical_specialty, Case mix index, Medical, Internal medicine, Cancer, Digestive diseases, Emergency, Gastroenterology, Gastrointestinal bleeding, Hospital discharge record, Hospital stay, Mortality, Preschool, business.industry, Newborn, Societies, business
Abstract

In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999–2009, with more than 1,500,000 admissions/year; however only 5–9% of these admissions was in specialized Gastroenterology units. Reported data show a better outcome in Gastroenterology Units than in non-specialized units: shorter average length of stay, in particular for admissions with ICD-9-CM codes proxying for emergency conditions (6.7 days versus 8.4 days); better case mix (higher average diagnosis-related groups weight in Gastroenterology Units: 1 vs 0.97 in Internal Medicine units and 0.76 in Surgery units); lower inappropriateness of admissions (16–25% versus 29–87%); lower in-hospital mortality in urgent admissions (2.2% versus 5.1%); for patients with urgent admissions due to gastrointestinnal haemorrhage, in-hospital mortality was 2.3% in Gastroenterology units versus 4.0% in others. The present document summarizes the scientific societies’ official report, which constitutes the “White paper of Italian Gastroenterology”

Published
2014
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10. Predictors of favourable outcome in non-variceal upper gastrointestinal bleeding: Implications for early discharge?

Author

Angelo Dezi, Salvatore Tronci, Alessandro Casadei, F. Giangregorio, Tommaso Ceglia, Nicola Pandolfo, Giuseppe Chianese, Giovanni Aragona, I. Stroppa, Riccardo Marmo, R. Macchiarelli, Giorgio Chiozzini, Paolo Giorgio, A. Buzzi, Paola Romagnoli, Francesca Rogai, Anna Tanzilli, Angelo Pera, Mario Salvagnini, L. Pietrini, Renato Fasoli, S. Boschetto, Fabio Fornari, Giorgio Minoli, Livio Cipolletta, W. Piubello, Giampiero Bagnalasta, Sergio Segato, Daniela Di Muzio, Lisa Girardi, G. Frosini, U. Germani, Fabrizio Bonfante, Claudio Cortini, G. Trallori, Sirio Bagnoli, Renzo Cestari, Maria Antonia Bianco, Roberto Di Mitri, Elena Sainz Torre, Salvatore De Stefano, G. Imperiali, G. Gatto, Paolo Michetti, V. Peri, M. Pagliarulo, Amuso M, Rodolfo Rocca, Luciano Allegretta, Gianluca Rotondano, Sergio Brunati, O. Triossi, Andrea Nucci, Tino Casetti, Ivano Lorenzini, Domenico Della Casa, Marco Martorano, F. Barberani, I. Sorrentini, Massimo Proietti, Alfredo Pastorelli, Alessandro Gigliozzi, Marino Di Cicco, Enzo Grossi, Maurizio Koch, Claudio Leoci, Maria Tebaldi, and Barbara Ferri

Subjects
Male, medicine.medical_specialty, Gastrointestinal bleeding, Multivariate analysis, Adverse outcomes, Stomach Diseases, Esophageal Diseases, Risk Assessment, Outcome (game theory), Recurrence, Internal medicine, medicine, Humans, Blood Transfusion, Endoscopy, Digestive System, Prospective Studies, Early discharge, Aged, Aged, 80 and over, Aspirin, Hepatology, business.industry, Hemostasis, Endoscopic, Age Factors, Gastroenterology, Middle Aged, Prognosis, medicine.disease, Patient Discharge, Surgery, Treatment Outcome, ROC Curve, Multivariate Analysis, Female, Upper gastrointestinal bleeding, Gastrointestinal Hemorrhage, Risk assessment, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract

There is a lack of validated predictors on which to decide the timing of discharge in patients already hospitalized for upper nonvariceal bleeding.Identify factors that appear to protect nonvariceal bleeders from the development of negative outcome (rebleeding, surgery, death).Secondary analysis of two prospective multicenter studies. Multivariate analyses for each investigated outcome were performed; a single model was developed including all factors that were statistically significant in each sub-model. A final score was developed to predict favourable outcomes. Prognostic accuracy was tested with ROC curve analysis.Out of 2398 patients, 211 (8.8%) developed one or more adverse outcomes: 87 (3.63%) had rebleeding, 46 (1.92%) needed surgery and 107 (4.46%) died. Predictors of favourable prognosis were: ASA score 1 or 2, absence of neoplasia, outpatient bleeding, use of low-dose aspirin, no need for transfusions, clean-based ulcer, age70 years, no haemodynamic instability successful endoscopic diagnosis/therapy, no Dieulafoy's lesion at endoscopy, no hematemesis on presentation and no need for endoscopic treatment. Overall prognostic accuracy of the model was 83%. The final score accurately identified 20-30% of patients that eventually do not develop any negative outcome.The "good luck score" may be a useful tool in deciding when to discharge a patient already hospitalized for acute non-variceal bleeding.

Published
2014
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11. OC.14.2 PREDICTIVE FACTORS OF MORTALITY IN ACUTE GASTROINTESTINAL BLEEDING IN ITALY (AUGIB): A NEW PRE-ENDOSCOPY PROGNOSTIC MODEL FROM A MULTICENTER STUDY

Author

R. Bennato, M. Manno, S. Segato, M. De Matthaeis, L.G. Cavallaro, E. Buscarini, G. D'Amico, P. Di Giorgio, A. Balzano, G. Imperiali, R. De Franchis, A. Zambelli, F. Bazzoli, Guido Costamagna, F. De Nigris, F. Esposito, A. Andriulli, G. Spinzi, A. Nucci, B. Germanà, L. Ferraris, A. Bizzotto, F.R. De Filippo, V. Boarino, Cristina Bucci, C. Marmo, L. Amitrano, L. Orsini, Marco Soncini, Riccardo Marmo, P. Cesaro, R.M. Zagari, F. Parente, Maria Elena Riccioni, R. Lamanda, A. Anderloni, P. Borgheresi, L.M. Montalbano, E. Di Giulio, A. Lauri, S. Mangiafico, A. Russo, S. Metrangolo, R. Pumpo, C. De Fanis, M.A. Bianco, L. Purita, G. Bresci, A. Chirico, O. Triossi, F. Cipolletta, L. Cipolletta, R. Conigliaro, C. Londoni, A. Repici, A. Paterlini, A. Merighi, M. Parravicini, D. Conte, G. Baldassarre, L. Furio, G. Napolitano, A. Dell'Eera, G. Rotondano, Annalisa Tortora, M. Franceschi, S. Bargiggia, and P. Gasparini

Subjects
medicine.medical_specialty, Hepatology, Multicenter study, medicine.diagnostic_test, Acute gastrointestinal bleeding, business.industry, Internal medicine, Gastroenterology, Prognostic model, medicine, business, Endoscopy
Published
2018
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12. P.10.8: Mortality from Acute Upper Gastrointestinal Bleeding (UGIB): The Role of the Organizational and Health Care Course: A Prospective Multicentre Observational Study in Italy

Author

L. Purita, L. Orsini, S. Mangiafico, S. Segato, C. De Fanis, Maria Elena Riccioni, M. Parravicini, L. Furio, F. De Nigris, Cristina Bucci, A. Andriulli, C. Londoni, Guido Costamagna, E. Buscarini, A. Russo, M.A. Bianco, G. Baldassarre, A. Merighi, L. Ferraris, F. Zingone, A. Nucci, B. Germanà, G. Bresci, R. Pumpo, F. Cipolletta, S. Bargiggia, A. Bizzotto, F.R. De Filippo, C. Marmo, A. Repici, F. Esposito, P. Gasparini, R. Bennato, M. Manno, Marco Soncini, A. Chirico, G. Rotondano, G. Spinzi, A. Anderloni, Riccardo Marmo, D. Conte, G. D'Amico, O. Triossi, V. Boarino, A. Lauri, P. Cesaro, S. Metrangolo, A. Balzano, G. Imperiali, P. Borgheresi, L.M. Montalbano, L.G. Cavallaro, M. De Matthaeis, Alessandra Dell'Era, Annalisa Tortora, M. Guardascione, R.M. Zagari, M. Franceschi, L. Cipolletta, R. Conigliaro, P. Di Giorgio, G. Napolitano, R. De Franchis, A. Zambelli, F. Bazzoli, R. Lamanda, and F. Parente

Subjects
medicine.medical_specialty, Hepatology, business.industry, Health care, Gastroenterology, medicine, Observational study, Acute upper gastrointestinal bleeding, Intensive care medicine, business
Published
2017
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13. P.10.10: Mortality Causes from Acute Upper Gastrointestinal Bleeding: A Prospective Multicentre Observational Study

Author

S. Segato, M. De Matthaeis, F. Cipolletta, V. Boarino, A. Repici, A. Paterlini, G. Spinzi, P. Di Giorgio, L. Orsini, P. Cesaro, G. D'Amico, L. Cipolletta, R. Conigliaro, F. De Nigris, G. Imperiali, R. Bennato, A. Lauri, A. Anderloni, Maria Elena Riccioni, Alessandra Dell'Era, A. Nucci, A. Bizzotto, F.R. De Filippo, B. Germanà, M. Manno, C. Marmo, F. Esposito, Guido Costamagna, G. Napolitano, R. Pumpo, R.M. Zagari, A. Russo, L. Furio, A. Balzano, L. Ferraris, M.A. Bianco, E. Di Giulio, G. Bresci, S. Mangiafico, F. Parente, C. De Fanis, L. Purita, S. Bargiggia, Marco Soncini, G. Rotondano, Riccardo Marmo, A. Merighi, M. Parravicini, P. Borgheresi, L.M. Montalbano, M. Guardascione, P. Gasparini, R. De Franchis, A. Zambelli, F. Bazzoli, E. Buscarini, S. Metrangolo, D. Conte, R. Lamanda, G. Baldassarre, Annalisa Tortora, M. Franceschi, A. Andriulli, L.G. Cavallaro, C. Londoni, Cristina Bucci, A. Chirico, and O. Triossi

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Gastroenterology, Medicine, Observational study, Acute upper gastrointestinal bleeding, business
Published
2017
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14. Split dosing with a low-volume preparation is not inferior to split dosing with a high-volume preparation for bowel cleansing in patients with a history of colorectal resection: a randomized trial

Author

Silvia Paggi, Silvia Dari, O. Triossi, Cesare Hassan, Lorenzo Fuccio, Alessandro Mussetto, Liboria Laterza, Franco Radaelli, Leonardo Frazzoni, Mussetto, A, Frazzoni, L, Paggi, S, Dari, S, Laterza, L, Radaelli, F, Hassan, C, Triossi, O, and Fuccio, L

Subjects
preparation, medicine.medical_specialty, business.industry, medicine.medical_treatment, Gastroenterology, Ottawa Bowel Preparation Scale, Retrospective cohort study, law.invention, Surgery, bowel, Randomized controlled trial, Tolerability, law, quality, surgery, Medicine, adenoma, cancer, Dosing, Bisacodyl, endoscopy, business, Prospective cohort study, Colectomy, medicine.drug
Abstract

BACKGROUND AND STUDY AIM: The study compared the efficacy of bowel cleansing using a low-volume mixed preparation (15 mg bisacodyl plus 2 L polyethylene glycol [PEG] solution) versus a standard high-volume preparation (4 L PEG) in patients with previous colorectal resection. PATIENTS AND METHODS: A total of 120 patients with prior colorectal resection for cancer undergoing surveillance colonoscopy were randomized to receive either a split-dose low-volume (n = 60) or high-volume (n = 60) preparation for bowel cleansing. The quality of bowel preparation, rated according to a modified Ottawa Bowel Preparation scale (mOBPS), represented the primary outcome measure. Tolerability, safety, and lesion detection rates were secondary outcomes. RESULTS: No significant difference was observed between the low-volume and high-volume preparations in achievement of adequate cleansing (i. e. mOBPS ≤ 4; low-volume vs. high-volume group, 85.0 % vs. 81.7 %, P = 0.624). The low-volume preparation showed a higher success rate for cleansing of the right colon (P = 0.025); better tolerability in terms of intake of the whole amount of the preparation (P

Published
2015

15. Management and outcomes of hepatic cirrhosis: Findings from the RING study

Author

A.M. Bertelè, R. Muratori, V. Belfiori, G. Brambilla, P. Leo, F. Pompeo, S. Caruso, A. Federico, M. Verta, Alessandro Tozzi, C. Breda, G. Tritto, P. Bonazzi, T. Grasso, R. Bottelli, M. Soncini, A. Mondardini, G.P. Marone, R. Sega, L. Pietrini, O. Triossi, A. Spadaccini, L.A. Giglio, L. Ferraris, A.F. Attili, M.R. Magnolia, A. Cosentini, M. Proietti, Soncini, M, Leo, P, Triossi, O, Breda, C, Attili, A. F., Mondardini, A, Federico, Alessandro, Cosentini, A, Tritto, G, Bottelli, R, Pompeo, F, Marone, G. P., Bonazzi, P, Magnolia, M. R., Pietrini, L, Proietti, M, Belfiori, V, Tozzi, A, Giglio, L. A., Muratori, R, Bertele, A. M., Grasso, T, Spadaccini, A, Verta, M, Ferraris, L, Caruso, S, Sega, R, and Brambilla, G.

Subjects
medicine.medical_specialty, Cirrhosis, Hepatology, business.industry, Encephalopathy, child pugh, in-patients, liver cirrhosis, Odds ratio, medicine.disease, Gastroenterology, Infectious Diseases, Hepatorenal syndrome, Internal medicine, Hepatocellular carcinoma, Ascites, medicine, Hospital discharge, medicine.symptom, Varices, business
Abstract

Background/aim Hepatic cirrhosis is a frequent reason for ordinary hospital admission (OA). The RING study collected hospital discharge files (HDF) from Italian hospital gastroenterology units (IGU). This caselist provides a broad picture of the patients admitted for this pathology. Material/methods More than 50,000 HDF for OA were collected between 2001 and 2004 from 26 IGU. Results Eight thousand four hundred and eighty-seven HDF (16%) had a diagnosis of hepatic cirrhosis; Child-Pugh classes were 20.2% A, 34.8% B and 45.0% C. Patients’ mean age was 63.7 ± 12.1 years and 62.5% were male. A 61.1% of the cirrhosis cases had ascites, 29.9% portal-systemic encephalopathy, 29.2% hepatocellular carcinoma (HCC), 10% bleeding varices, 3.0% hepatorenal syndrome (HRS). Mortality for OA for cirrhosis was 5.7% versus 2.6% for other diagnoses. The proportion varied with the severity of the cirrhosis: 0% for Child A, 1.1% B, 10.5% C. Mortality was significantly associated with: Child-Pugh at admission (odds ratio: OR 9.2), HRS (OR 11.7), bleeding varices (OR 2.2), HCC (OR 1.8). Conclusions Hepatic cirrhosis was found in 16% of the OA to IGU and mortality was double the rate for all the other pathologies in the same wards. Child-Pugh is a useful prognostic tool, higher classes implying a greater risk of death. HRS and bleeding varices were the complications with most influence on in-hospital mortality.

Published
2006
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16. P.15.3 INCREASED PERFORMANCE OF AN UPDATED ROCKALL SCORE IN ACUTE NON VARICEAL UPPER GASTRO INTESTINAL BLEEDING: A PROSPECTIVE MULTICENTRE ITALIAN STUDY

Author

E. Masci, S. De Stefano, S. Segato, A. Russo, D. Conte, L.G. Cavallaro, M. Martorano, M.A. Bianco, R.M. Zagari, L. Cipolletta, G. Bresci, R. Marin, G. Spinzi, A. Andreloni, Cristina Bucci, S. Metrangolo, G. Baldassarre, R. Lamanda, A. Lauri, L. Amitrano, G. D'Amico, L. Ferraris, A. Merighi, A. Chirico, C. De Fanis, R. De Franchis, O. Triossi, G. Imperiali, F. Cipolletta, G. Coccia, A. Repici, A. Paterlini, B. Germanà, S. Antoniazzi, E. Buscarini, Alessandra Dell'Era, Annalisa Tortora, M. Franceschi, L. Furio, G. Rotondano, S. Bargiggia, A. Maringhini, P. Gasparini, M. De Matthaeis, P. Di Giorgio, F. De Nigris, A. Nucci, F. Politi, A. Bizzotto, M. Parravicini, P. Borgheresi, L.M. Montalbano, C. Marmo, L. Purita, E. Di Giulio, R. Pumpo, R. Bennato, A. Balzano, Marco Soncini, Riccardo Marmo, V. Boarino, P. Cesaro, F. Parente, and Maria Elena Riccioni

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Gastroenterology, medicine, Gastro intestinal bleeding, business, Rockall score
Published
2016
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17. Inflammatory bowel disease and hospital treatment in Italy: the RING multi-centre study

Author

P. Leo, M. Soncini, G. Magni, and O. Triossi

Subjects
medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, Gastroenterology, Magnetic resonance imaging, Disease, medicine.disease, Inflammatory bowel disease, Ulcerative colitis, digestive system diseases, Malnutrition, Parenteral nutrition, Internal medicine, medicine, Pharmacology (medical), Observational study, business, Barium enema
Abstract

Summary Aim : To explore the management of chronic inflammatory bowel disease, specifically Crohn's disease and ulcerative colitis, in Italian gastroenterology units. Methods : The RING (Ricerca Informatizzata in Gastroenterologia) project is an observational study collecting hospital discharge forms from 56 centres. Factors associated with the length of hospital stay were studied using multivariate logistic regression. Results : In 24 months starting from August 2000, out of 29 376 hospital discharge forms, 2131 (7.3%) were collected for inflammatory bowel disease (1163 for Crohn's disease and 968 for ulcerative colitis). The Crohn's disease and ulcerative colitis groups were compared according to demographic characteristics, diagnoses, procedures and hospital stay. In Crohn's disease, computed tomography/magnetic resonance imaging, x-rays/barium enema, number of procedures and number of diagnoses were significantly associated with a hospital stay longer than 10 days. In ulcerative colitis, this association was found for parenteral nutrition, malnutrition, computed tomography/magnetic resonance imaging and number of procedures. Conclusions : Crohn's disease was confirmed as a disabling disorder requiring more frequent hospital treatment than ulcerative colitis. For the latter, parenteral nutrition and malnutrition were related to a longer hospital stay. The number of procedures, especially abdominal computed tomography/magnetic resonance imaging, was a major item for both pathologies.

Published
2003
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18. P.10.9: Outpatient Management of Patients with Glasgow-Blatchford Bleeding Score Low-Risk Upper-Gastrointestinal Hemorrhage: A Multicenter Validation Study in Italy

Author

F. De Nigris, A. Nucci, F. Cipolletta, R. Bennato, A. Bizzotto, F.R. De Filippo, C. Marmo, M. Manno, A. Repici, A. Paterlini, M. De Matthaeis, P. Di Giorgio, S. Segato, E. Di Giulio, R. Lamanda, G. Spinzi, G. Rotondano, M. Guardascione, G. Baldassarre, S. Bargiggia, A. Balzano, S. Mangiafico, L.G. Cavallaro, L. Ferraris, C. De Fanis, P. Gasparini, A. Merighi, R. Pumpo, A. Lauri, S. Metrangolo, Marco Soncini, Riccardo Marmo, L. Furio, A. Chirico, M. Parravicini, B. Germanà, D. Conte, R.M. Zagari, O. Triossi, F. Esposito, Annalisa Tortora, Alessandra Dell'Era, M. Franceschi, V. Boarino, A. Andriulli, R. De Franchis, A. Zambelli, F. Bazzoli, L. Cipolletta, C. Londoni, R. Conigliaro, L. Purita, E. Buscarini, P. Cesaro, G. Napolitano, Cristina Bucci, L. Orsini, P. Borgheresi, L.M. Montalbano, Maria Elena Riccioni, Guido Costamagna, G. D'Amico, G. Imperiali, A. Russo, M.A. Bianco, G. Bresci, A. Anderloni, and F. Parente

Subjects
medicine.medical_specialty, Validation study, Hepatology, business.industry, Gastroenterology, medicine, Upper gastrointestinal, Outpatient management, Intensive care medicine, business
Published
2017
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19. P.10.3: Mortality in Upper Gastrointestinal Bleeding in Italy: Data from National Survey

Author

A. Chirico, O. Triossi, Cristina Bucci, C. Londoni, S. Mangiafico, Guido Costamagna, M. De Matthaeis, C. De Fanis, F. Cipolletta, G. Baldassarre, A. Andriulli, A. Balzano, A. Repici, A. Paterlini, F. Parente, V. Boarino, R. Lamanda, A. Russo, P. Di Giorgio, S. Segato, M.A. Bianco, R. Bennato, G. Bresci, P. Cesaro, M. Manno, G. D'Amico, G. Spinzi, E. Di Giulio, G. Imperiali, L. Orsini, F. De Nigris, L. Cipolletta, R. Conigliaro, A. Nucci, A. Lauri, A. Bizzotto, F.R. De Filippo, C. Marmo, Maria Elena Riccioni, F. Esposito, L. Amitrano, C. Tomba, D. Conte, L.G. Cavallaro, B. Germanà, A. Anderloni, S. Metrangolo, A. Merighi, E. Buscarini, R. Pumpo, R.M. Zagari, Marco Soncini, Riccardo Marmo, R. De Franchis, A. Zambelli, F. Bazzoli, M. Parravicini, L. Ferraris, L. Purita, P. Borgheresi, L.M. Montalbano, S. Bargiggia, L. Furio, P. Gasparini, Annalisa Tortora, M. Franceschi, Alessandra Dell'Era, G. Napolitano, and G. Rotondano

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, General surgery, Gastroenterology, medicine, Upper gastrointestinal bleeding, medicine.disease, business
Published
2017
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20. P.10.1: Transfusion Strategy and Death Risk in Patients with Acute Non-Variceal Upper Gastro Intestinal Bleeding (NV-UGIB) in Italy: A Prospective Multicenter Observational Study

Author

A. Balzano, R. Bennato, M. Manno, S. Mangiafico, C. De Fanis, F. Esposito, F. De Nigris, R. De Franchis, A. Zambelli, F. Bazzoli, V. Boarino, Annalisa Tortora, A. Nucci, M. Franceschi, R. Lamanda, A. Bizzotto, F.R. De Filippo, S. Segato, C. Marmo, A. Andriulli, P. Cesaro, E. Buscarini, F. Zingone, A. Chirico, L. Amitrano, S. Mastrangelo, P. Borgheresi, L.M. Montalbano, L.G. Cavallaro, E. Di Giulio, O. Triossi, S. Bargiggia, A. Merighi, F. Parente, C. Londoni, M. De Matthaeis, G. D'Amico, R. Lauri, F. Cipolletta, P. Gasparini, G. Imperiali, Guido Costamagna, P. Di Giorgio, A. Repici, A. Paterlini, A. Anderloni, R.M. Zagari, Cristina Bucci, A. Russo, L. Ferraris, M.A. Bianco, R. Pumpo, G. Baldassarre, G. Bresci, D. Conte, L. Cipolletta, R. Conigliaro, B. Germanà, Marco Soncini, Riccardo Marmo, L. Orsini, Maria Elena Riccioni, Alessandra Dell'Era, G. Napolitano, L. Furio, M. Parravicini, L. Purita, and G. Spinzi

Subjects
medicine.medical_specialty, Hepatology, business.industry, Death risk, Emergency medicine, Gastroenterology, medicine, In patient, Observational study, Gastro intestinal bleeding, Intensive care medicine, business
Published
2017
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21. MiroCam capsule for obscure gastrointestinal bleeding: a prospective, single centre experience

Author

Lorenzo Fuccio, O. Triossi, S. Gasperoni, T. Casetti, M.L. Brancaccio, Silvia Dari, F. Cantoni, Alessandro Mussetto, Mussetto A, Fuccio L, Dari S, Gasperoni S, Cantoni F, Brancaccio ML, Triossi O, and Casetti T.

Subjects
Adult, Male, medicine.medical_specialty, Angiodysplasia, law.invention, Lesion, Capsule endoscopy, law, Intestine, Small, medicine, Humans, Prospective Studies, Prospective cohort study, Aged, DIAGNOSTIC ACCURACY, Aged, 80 and over, Hepatology, business.industry, Significant difference, Gastroenterology, Capsule, Middle Aged, Occult, GASTROINTESTINAL BLEEDING, Surgery, Single centre, CAPSULE ENDOSCOPY, Female, medicine.symptom, Gastrointestinal Hemorrhage, business, Obscure gastrointestinal bleeding
Abstract

Background Capsule endoscopy is an established tool for the evaluation of obscure gastrointestinal bleeding but published literature is mostly limited to PillCam™ SB (Given Imaging, Israel). Aims The aims of this study were to determine the findings, the diagnostic yield and the rebleeding rate in a series of patients with overt or occult obscure gastrointestinal bleeding studied with MiroCam™ (Intromedic, Seoul, Korea) capsule endoscopy. Methods Data of 118 patients who underwent capsule endoscopy for overt or occult obscure gastrointestinal bleeding were prospectively collected between March 2009 and March 2011. Results Evaluation of the entire small bowel (completion rate) was achieved in 96% of cases. Relevant lesions occurred in 58% of patients. Angiodysplasias was the most common finding. Six patients (9% of the positive findings) had a non-small-bowel lesion detected by capsule. The yield of capsule endoscopy in the overt group was greater than in the occult group but without achieving a significant difference (61% vs. 54%, p > 0.05). Rebleeding rate was lower in patients with a negative examination (6%) than in patients with a positive one (17%) (p = 0.03). Capsule retention was registered in 3 of 118 patients (2.5%). Conclusions MiroCam capsule endoscopy is a safe and effective tool for exploring small bowel with a high completion rate.

Published
2013

22. P.15.9 TRANSFUSION STRATEGY AND DEATH RISK IN PATIENTS WITH ACUTE NON VARICEAL UPPER GASTRO INTESTINAL BLEEDING (NV-UGIB) IN ITALY: A PROSPECTIVE MULTICENTER OBSERVATIONAL STUDY

Author

R. Marmo, M. Soncini, L. Cipolletta, F. Parente, A. Paterlini, R. Bennato, F. Cipolletta, L. Orsini, S. Bargiggia, P. Cesaro, A. Bizzotto, A. Dell'Era, B. Germanà, L.G. Cavallaro, M.E. Riccioni, C. Marmo, A. Tortora, S. Segato, M. Parravicini, L. Purita, A. Chirico, G. Spinzi, G. Imperiali, A. Maringhi, V. Boarino, G. Bresci, S. Metrangolo, C. Bucci, G. Baldassarre, M. Franceschi, A. Nucci, F. De Nigris, E. Masci, R. Marin, S. Antoniazzi, L. Ferraris, A. Repici, A. Andreloni, M.A. Bianco, G. Rotondano, M. De Matthaeis, A. Lauri, C. De Fanis, P. Borgheresi, S. De Stefano, R. Lamanda, L. Furio, A. Russo, P. Di Giorgio, F. Politi, R. Pumpo, O. Triossi, G. Coccia, L.M. Montalbano, R.M. Zagari, A. Balzano, E. Buscarini, D. Conte, G. D'Amico, E. Di Giulio, P. Gasparini, and R. De Franchis

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Death risk, Gastroenterology, medicine, Observational study, In patient, Gastro intestinal bleeding, business
Published
2016
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23. Gastroenterology in Italian clinical practice. The RING Study: six years' data from gastroenterology departments

Author

M, Soncini, P, Leo, O, Triossi, and C, Buniolo

Subjects
Male, Time Factors, Italy, Computer Systems, Gastrointestinal Diseases, Medical Records Department, Hospital, Humans, Female, Middle Aged, Diagnosis-Related Groups
Abstract

Computer systems in hospitals provide information on the work of each single operative unit and the complexity of its caselist. However, in Italy, there is no official data-base for Gastroenterology Departments, to summarize their work.The RING (Ricerca-INformatizzata-in-Gastroenterologia) study has collected, through a software made on purpose, 113 237 hospital discharge files (HDF) from 55 Italian hospital Gastroenterology Units, since 2001. This caselist provides a picture of the patients and is useful for clinical/management evaluation.Between January 2001 and December 2006, 55 Gastroenterology Units gathered 88240 HDF referring to ''ordinary admissions''. The male:female rate was 1:1, mean age was 61.3+/-18.5 years. Mean hospital stay was around eight days. Over the years there was a significant drop in DRG183 (miscellaneous digestive disorders-without complications) from 11.5% to 7.4% (P0.0001), with no similar increase in DRG182 (with complications) which rose from 3.1% to 4.0%. Principal discharge diagnoses are post-hepatic and alcohol-related cirrhosis, hepatocarcinoma, acute pancreatitis, duodenal/gastric ulcer.The RING data show that the gastroenterologist has been working increasingly with patients whose pathologies would have been ''inappropriately'' treated surgically (DRGs 204 and 174). Inappropriate gastroenterological treatment seems to have decreased as well as the DRG183 with no apparent ''opportunistic'' compensatory increase in DRGs with complications, such as 182.

Published
2008

24. Seasonal patterns of hospital treatment for inflammatory bowel disease in Italy

Author

M. Soncini, L. Ferraris, L. Frulloni, L.A. Giglio, G. Magni, F. Pompeo, V. D’Offizi, P. Leo, G.P. Marone, E. Azzola, S. Bonecco, A. Tanzilli, L. Pietrini, S. Caruso, P.G. Mosca, R. Muratori, B. Casanova, T. Grasso, V. Belfiori, G. Sciampa, A.M. Bertelè, O. Triossi, and G. Brambilla

Subjects
Adult, Male, medicine.medical_specialty, Gastrointestinal pathology, Inflammatory bowel disease, Gastroenterology, Internal medicine, medicine, Humans, Aged, Crohn's disease, Chi-Square Distribution, business.industry, Inflammatory bowel disease, chronic, Ulcerative colitis, Middle Aged, medicine.disease, Inflammatory Bowel Diseases, chronic, Hospitalization, Hospital treatment, Italy, Female, Seasons, business
Abstract

Aim: It is still debated whether clinical flare-ups of chronic inflammatory bowel disease follow a seasonal pattern, and the various reports are based on general practitioners’ records or hospital discharge charts. There are, however, no specific figures for treatment in hospital gastroenterology units, which serve as a reference point for these disorders. This study was therefore designed to investigate whether there is a seasonal pattern in admissions for inflammatory intestinal disease in Italy, differing from what is generally known about gastrointestinal pathologies, since there are no nation-wide figures on the subject. Methods: The RING (Ricerca Informatizzata in Gastroenterologia) project is an observational study collecting hospital discharge forms from 22 centers in Italy. Results: From winter 2000 to autumn 2003, the 22 gastroenterology units participating in the RING project discharged 32,357 patients following ordinary hospital admissions. Of these, 2,856 (8.8%) had a main diagnosis of inflammatory bowel disease: 1,541 Crohn’s disease, and 1,315 ulcerative colitis. No seasonal patterns were detected for either category, or when the analysis was done by age, sex and site of disease. Conclusions: The most serious flare-ups of inflammatory bowel disease, i.e. those requiring routine hospital treatment, do not appear to follow any seasonal pattern, regardless of the site of the disease or the patient’s age or sex.

Published
2005

25. Inflammatory bowel disease and hospital treatment in Italy: the RING multi-centre study

Author

M, Soncini, O, Triossi, P, Leo, and G, Magni

Subjects
Adult, Aged, 80 and over, Hospitalization, Male, Crohn Disease, Italy, Humans, Regression Analysis, Colitis, Ulcerative, Female, Middle Aged, Aged
Abstract

To explore the management of chronic inflammatory bowel disease, specifically Crohn's disease and ulcerative colitis, in Italian gastroenterology units.The RING (Ricerca Informatizzata in Gastroenterologia) project is an observational study collecting hospital discharge forms from 56 centres. Factors associated with the length of hospital stay were studied using multivariate logistic regression.In 24 months starting from August 2000, out of 29,376 hospital discharge forms, 2131 (7.3%) were collected for inflammatory bowel disease (1163 for Crohn's disease and 968 for ulcerative colitis). The Crohn's disease and ulcerative colitis groups were compared according to demographic characteristics, diagnoses, procedures and hospital stay. In Crohn's disease, computed tomography/magnetic resonance imaging, x-rays/barium enema, number of procedures and number of diagnoses were significantly associated with a hospital stay longer than 10 days. In ulcerative colitis, this association was found for parenteral nutrition, malnutrition, computed tomography/magnetic resonance imaging and number of procedures.Crohn's disease was confirmed as a disabling disorder requiring more frequent hospital treatment than ulcerative colitis. For the latter, parenteral nutrition and malnutrition were related to a longer hospital stay. The number of procedures, especially abdominal computed tomography/magnetic resonance imaging, was a major item for both pathologies.

Published
2003

26. P.1.43: APPROPRIATENESS OF POST-POLYPECTOMY SURVEILLANCE COLONOSCOPY: PRELIMINARY DATA FROM A PROSPECTIVE MULTICENTER STUDY

Author

P. Brosolo, Aurora Bortoli, Pietro Occhipinti, M.M. Terpin, O. Triossi, R. Franch, S. Crotta, Silvia Paggi, Franco Radaelli, R. Pometta, Enrico Colombo, D. Drago, A. Lauri, E. Tasini, Armando Gabbrielli, Ottaviano Tarantino, A. Solinas, S. Peyre, G. De Pretis, F. Magnolfi, S. Ierace, Mario Marini, R. De Marco, and L. Ferraris

Subjects
medicine.medical_specialty, Hepatology, Multicenter study, business.industry, General surgery, medicine.medical_treatment, Gastroenterology, medicine, Surveillance colonoscopy, business, Polypectomy
Published
2011
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30. OC1.10.4 HIGH RATE OF TUMOR'S PERFORATION IN PATIENTS WITH MALIGNANT COLONIC OBSTRUCTION TREATED WITH SELF-EXPANDABLE METAL STENTS AS A BRIDGE TO SURGERY

Author

T. Casetti, O. Triossi, C.A.A. Petrini, A. Buzzi, and I. Tampieri

Subjects
High rate, medicine.medical_specialty, Hepatology, business.industry, Perforation (oil well), Gastroenterology, Self Expandable Metal Stents, Surgery, Colonic obstruction, medicine, In patient, Radiology, Bridge to surgery, business
Published
2008
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32. 32 OC Botulinum toxin injection in patient with achalasia and esophageal varices

Author

A. Salzetta, G.P. Caprio, T. Casetti, O. Triossi, E. Bertinelli, E. Cristoferi, M.L. Brancaccio, A. Buzzi, F. Cantoni, I. Tampieri, G. Rani, and M. Ricci Maccarini

Subjects
medicine.medical_specialty, Esophageal varices, Hepatology, business.industry, Internal medicine, Gastroenterology, medicine, Achalasia, In patient, Botulinum toxin injection, business, medicine.disease
Published
2002
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34. Effectiveness of eradicating helicobacter pylori treatment in daily clinical practice: An example of collaboration between the general practitioner and the gastroenterologist

Author

A. Salzetta, A. Buzzi, C. Sgarzani, M. Ricci Maccarini, T. Casetti, F. Cantoni, I. Tampieri, O. Triossi, G. Rani, E. Bertinelli, P. Caprio, E. Cristoferi, and D. Santini

Subjects
Clinical Practice, medicine.medical_specialty, Hepatology, biology, business.industry, Internal medicine, Gastroenterology, medicine, Helicobacter pylori, biology.organism_classification, business
Published
2000
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35. Factors affecting treatment decisions for endoscopically resected low- and high-risk malignant colorectal polyps in a screening setting.

Author

Giuliani O, Baldacchini F, Bucchi L, Mancini S, Ravaioli A, Vattiato R, Zamagni F, Sassatelli R, Triossi O, Trande P, Palmonari C, Mussetto A, Fabbri C, Giovanardi M, de Padova A, and Falcini F

Abstract

Introduction: The European Guidelines for colorectal cancer screening of 2006 state that only high-risk endoscopically resected malignant colorectal polyps (MCPs), defined as poor/no differentiation or positive resection margins or lymphovascular invasion, require colonic resection., Methods: A multicentre series of 954 patients with screen-detected MCP (northern Italy, 2005-2016, age 50-69) was studied to identify (1) the factors affecting the choice of colonic resection, and (2) the factors associated with deviation from the European Guidelines for low- and high-risk patients. Data analysis was based on multilevel logistic regression models., Results: Five hundred sixty-four (59.1 %) patients underwent colonic resection. The factors significantly associated with surgical referral included: distal and rectal versus proximal tumour site (inverse association); sessile and flat versus pedunculated morphology (direct association); tumour size (direct); moderate/poor versus good differentiation (direct); adenocarcinoma of not otherwise specified type versus adenocarcinoma with a residual adenoma component (direct); positive versus negative resection margins (direct); lymphovascular invasion (direct); and high-grade versus low-grade/absent tumour budding (direct). In low-risk MCPs, tumour budding encouraged strongly the decision for surgery. In high-risk MCPs, a distal/rectal tumour site encouraged the follow-up option., Conclusion: The identification of factors associated with treatment choices other than those currently recommended may help prioritise the clinical questions in the development of future guidelines., Competing Interests: Conflict of interest The authors have no conflicts of interest to declare., (Copyright © 2024 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2024
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36. An Italian prospective multicenter study on colonoscopy practice and quality: What has changed in the last 10 years.

Author

Testoni PA, Notaristefano C, Soncini M, Hassan C, Monica F, Radaelli F, Triossi O, Pasquale L, Neri M, Cannizzaro R, and Leandro G

Subjects
Humans, Prospective Studies, Colonoscopy methods, Benchmarking, Italy, Early Detection of Cancer methods, Colorectal Neoplasms diagnosis, Adenoma diagnosis
Abstract

Background: A relevant number of adenomas can be missed during colonoscopy., Aims: Assess the current status of colonoscopy procedures in Italian centers., Methods: A prospective observational study involving 17 hospitals (34 endoscopists) included consecutive patients undergoing standard colonoscopy. In the first phase, endoscopists performed consecutive colonoscopies. In the second phase, retraining via an online learning platform was planned, while in the third phase data were collected analogously to phase 1., Results: A total of 3,504 patients were enrolled. Overall, a BBPS score ≥6 was obtained in 95.6% of cases (94.8% and 96.9% in the pre- and post-training phases, respectively). 88.4% of colonoscopies had a withdrawal time ≥6 min (88.2% and 88.7% in the pre- and post-training phases). Median adenoma detection rate (ADR) was 39.1%, with no significant differences between the pre- and post-training phases (40.1% vs 36.9%; P = 0.83). In total, 81% of endoscopists had a ADR performance above the 25% threshold., Conclusion: High colonoscopy quality standards are achieved by the Italian hospitals involved. Quality improvement initiatives and repeated module-based colonoscopy-training have been promoted in Italy during the last decade, which appear to have had a significant impact on quality colonoscopy metrics together with the activation of colorectal cancer screening programs., Competing Interests: Declaration of Competing Interest None to declare., (Copyright © 2022. Published by Elsevier Ltd.)

Published
2023
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37. Effects of Attendance to an Organized Fecal Immunochemical Test Screening Program on the Risk of Colorectal Cancer: An Observational Cohort Study.

Author

Baldacchini F, Bucchi L, Giuliani O, Mancini S, Ravaioli A, Vattiato R, Zamagni F, Giorgi Rossi P, Mangone L, Campari C, Sassatelli R, Trande P, Esposito P, Rossi F, Carrozzi G, Triossi O, Fabbri C, Strocchi E, Giovanardi M, Canuti D, Sassoli de Bianchi P, Ferretti S, and Falcini F

Subjects
Cohort Studies, Colonoscopy, Feces chemistry, Female, Hemoglobins analysis, Humans, Male, Mass Screening, Occult Blood, Colorectal Neoplasms diagnosis, Colorectal Neoplasms epidemiology, Early Detection of Cancer
Abstract

Background & Aims: This cohort study compared colorectal cancer (CRC) incidence and mortality between people who participated in an Italian regional biennial fecal immunochemical test (FIT) screening program and people who did not., Methods: The program started in 2005. The target population included over 1,000,000 people aged 50 to 69 years. The FIT was a one-sample OC-Sensor (Eiken Chemical Co, Tokyo, Japan) (cutoff, ≥20 μg hemoglobin/g feces). The average annual response rate to invitation was 51.4%. The records of people invited up to June 2016 were extracted from the screening data warehouse. Attenders were subjects who responded to the first 2 invitations or to the single invitation sent them before they became ineligible. Non-attenders were subjects who did not respond to any of these invitations. The records were linked with the regional CRC registry. People registered up to December 2016 were identified. Self-selection-adjusted incidence rate ratios (IRRs) and incidence-based CRC mortality rate ratios (MRRs) for attenders to non-attenders, with 95% confidence intervals (CIs), were calculated., Results: The cohort generated 2,622,131 man-years and 2,887,845 woman-years at risk with 4490 and 3309 CRC cases, respectively. The cohort of attenders was associated with an IRR of 0.65 (95% CI, 0.61-0.69) for men, 0.75 (95% CI, 0.70-0.80) for women and 0.69 (95% CI, 0.66-0.72) for both sexes combined. The self-selection-adjusted IRR was 0.67 (95% CI, 0.62-0.72) for men and 0.79 (95% CI, 0.72-0.88) for women. The IRR for stage I, II, III, and IV CRC was 1.35 (95% CI, 1.20-1.50), 0.61 (95% CI, 0.53-0.69), 0.60 (95% CI, 0.53-0.68) and 0.28 (95% CI, 0.24-0.32) for men and 1.64 (95% CI, 1.43-1.89), 0.60 (95% CI, 0.52-0.69), 0.73 (95% CI, 0.63-0.85) and 0.35 (95% CI, 0.30-0.42) for women. The overall incidence-based CRC MRR was 0.32 (95% CI, 0.28-0.37) for men, 0.40 (95% CI, 0.34-0.47) for women and 0.35 (95% CI, 0.31-0.39) for both sexes combined. The adjusted MRR was 0.35 (95% CI, 0.29-0.41) for men and 0.46 (95% CI, 0.37-0.58) for women., Conclusions: Attendance to a FIT screening program is associated with a CRC incidence reduction of 33% among men and 21% among women, and a CRC mortality reduction of 65% and 54%, respectively., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2022
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38. Food impaction mimicking dislodgment of a lumen-apposing metal stent in a patient undergoing endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis.

Author

De Vincentis F, Triossi O, and Brancaccio M

Subjects
Drainage, Endosonography, Humans, Stents, Ultrasonography, Interventional, Cholecystitis, Acute diagnostic imaging, Cholecystitis, Acute surgery, Gallbladder diagnostic imaging, Gallbladder surgery
Abstract

Competing Interests: The authors declare that they have no conflict of interest.

Published
2021
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39. Safety and protection in endoscopic services during phase II of COVID-19 pandemic: a national survey.

Author

Vassallo R, Venezia L, Zullo A, Stasi E, Milazzo G, Soncini M, Triossi O, Neri Bortoluzzi F, Montalto P, Usai Satta P, and Monica F

Subjects
Humans, Italy epidemiology, Pandemics, Surveys and Questionnaires, COVID-19 prevention & control, Endoscopy, Personal Protective Equipment
Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic requires appropriate measures for containing infection spreading. Endoscopic procedures are considered at increased risk of infection transmission. We evaluated organizational aspects and personal behaviours in Italian Endoscopic Units during phase II of the pandemic., Methods: A questionnaire on organizational aspects and use of personal protective equipment (PPE) were e-mailed to gastroenterologists working in Endoscopic Units. Data were analysed accordingly to the National Health Institute and Gastroenterology Societies recommendations., Results: Data of 117 centres were collected, and different shortcomings emerged. Specific protocols for containing infection and training programs for operators were lacking in 20 and 30% of centres, respectively, and telephone triage 24-72 h before the endoscopy was not implemented in 25% of hospitals. In 30% of centres, the slot time for endoscopies and between examinations was not prolonged. PPE, masks, shirts and gloves were universally adopted, although with some differences. In 20% of centres, a FFPE-FFP3 mask was not adopted during endoscopic examinations. Postendoscopy patient tracking/contact was completed in only one-third of centres., Conclusions: Our survey provides information on organizational and medical behaviours during COVID-19 phase II in Italy, which could be useful for adopting appropriate measures for containing COVID-19 spread during phase II., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2021
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40. Right-sided diverticulosis is an independent risk factor for bleeding in patients admitted for diverticular disease.

Author

Arena R, Lisotti A, Mussetto A, Merighi A, Pezzoli A, and Triossi O

Subjects
Age Factors, Aged, Databases, Factual, Diverticular Diseases pathology, Diverticulum pathology, Female, Fibrinolytic Agents adverse effects, Hospitalization statistics & numerical data, Humans, Male, Middle Aged, Prospective Studies, Retrospective Studies, Risk Factors, Sex Factors, Diverticular Diseases complications, Diverticulum complications, Gastrointestinal Hemorrhage etiology
Abstract

Background: Diverticular bleeding is the main cause of lower gastrointestinal bleeding in both Eastern and Western countries. Several risk factors have been identified, such as comorbidities and concomitant medications. In Eastern population, the prevalence of right-side diverticulosis is higher than in Western one, and some Authors identified bilateral diverticulosis as a risk factor for bleeding., Aims: To identify risk factors for diverticular bleeding in patients admitted for diverticular disease (DD)., Methods: All patients admitted for DD from January 2017 to December 2018 were retrieved from the hospital Information System. For each patient, age, gender, clinical presentation and concomitant medication were recorded. All patient underwent imaging assessment (computed tomography, ultrasound or MRI) and colonoscopy during hospitalization or within one month., Results: Among 1248 patients discharged with a diagnosis of DD during the study period, 293 (52.2% male, median age 75 years) were finally analyzed; of them, 105 (35.8%) for diverticular bleeding. On multivariate analysis, male gender (OR 4.27), age (OR 1.12), anti-thrombotic medications (OR 2.60) and right-sided DD (OR 5.70) were independently correlated to diverticular bleeding., Conclusion: Our study provides evidence that, together with age, male gender and concomitant anti-thrombotic treatment, right-sided DD represents an independent risk factor for bleeding., Competing Interests: Declaration of Competing Interest The Authors declare no conflict of interest., (Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2021
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41. Asymptomatic Colonic Anisakiasis.

Author

De Vincentis F, Caponi A, Mussetto A, and Triossi O

Subjects
Animals, Anisakis isolation & purification, Asymptomatic Diseases, Colonoscopy, Female, Humans, Middle Aged, Anisakiasis diagnosis, Colonic Diseases diagnosis
Abstract

Competing Interests: Declaration of Competing interest The authors disclose no conflicts.

Published
2021
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42. A new panenteric capsule endoscopy-based strategy in patients with melena and a negative upper gastrointestinal endoscopy: a prospective feasibility study.

Author

Mussetto A, Arena R, Fuccio L, Trebbi M, Tina Garribba A, Gasperoni S, Manzi I, Triossi O, and Rondonotti E

Subjects
Aged, Endoscopy, Gastrointestinal, Feasibility Studies, Female, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage etiology, Humans, Melena etiology, Pilot Projects, Prospective Studies, Capsule Endoscopy
Abstract

Objective: patients presenting with melena and nondiagnostic esophagogastroduodenoscopy are usually investigated with colonoscopy and if negative, with small bowel capsule endoscopy. In this pilot study, we tested feasibility and performance of panenteric capsule endoscopy (PCE) in patients presenting with melena and negative esophagogastroduodenoscopy., Methods: Between January and December 2018, consecutive patients presenting with melena, clinically significant bleeding and negative esophagogastroduodenoscopy were invited to undergo PCE by swallowing PillCam Colon 2 (Medtronic Inc., Dublin, Ireland). PCE results, further diagnostic or therapeutic examinations, rebleeding rates at 30 days and 12 months were recorded., Results: Out of 128 patients with melena, 23 had negative esophagogastroduodenoscopy. Of them, 12 (8 female, mean age 76 years) underwent PCE, which allowed complete small bowel and colonic evaluation in 12 (100%) and 11 (91.7%) patients, respectively. The small bowel and colon cleansing were adequate in 100 and 83.3%, respectively. No PCE-related complications were observed. The PCE diagnostic yield was 83.3%: significant findings were located in the small bowel, colon or both in 5 (41.7%), 4 (33.3%) and 1 (8.3%) patients, respectively. Device-assisted enteroscopy was performed in 6 (50%) patients. Thirty days and 1 year rebleeding rates were 0 and 18.1%, respectively., Conclusions: In this proof-of-concept study, PCE was feasible and safe in patients with melena and negative esophagogastroduodenoscopy, identifying the bleeding site in 83% of patients. PCE lead to small bowel therapeutic interventions in 50% of patients, thus avoiding unnecessary standard colonoscopy. Further large prospective randomized studies investigating this strategy are warranted., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2021
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44. Proportional incidence of interval colorectal cancer in a large population-based faecal immunochemical test screening programme.

Author

Mancini S, Bucchi L, Giuliani O, Ravaioli A, Vattiato R, Baldacchini F, Ferretti S, Sassoli de Bianchi P, Mezzetti F, Triossi O, Serafini M, Ricci E, Palazzi M, Imolesi C, Giovanardi M, Canuti D, Voci C, Altini M, and Falcini F

Subjects
Aged, Colorectal Neoplasms diagnosis, Female, Humans, Incidence, Italy epidemiology, Male, Middle Aged, Registries, Sensitivity and Specificity, Colorectal Neoplasms epidemiology, Early Detection of Cancer, Occult Blood
Abstract

Background: The European guidelines for quality assurance in colorectal cancer (CRC) screening recommend that interval cancer rate be expressed as a proportion of background incidence rate., Aim: To determine the crude and adjusted proportional incidence of interval CRC in an Italian regional two-yearly faecal immunochemical test (FIT) screening programme., Methods: The programme (year of implementation, 2005) is targeted at over 1,000,000 people aged 50-69 years. The test is a one-sample OC-Sensor (Eiken Chemical Co., Tokyo, Japan). The study covered one-third of the regional area. Excerpts of 434,295 eligible negative FIT records dated 2005-2012 from 193,193 subjects were retrieved from the regional CRC screening data warehouse. By 31 December 2013, the cohort accumulated 198,302 man-years and 235,370 woman-years. Interval CRCs were identified by record-linkage with the local population-based cancer registry. Their number was divided by the expected number, estimated with age-period-cohort models, to obtain the proportional incidence., Results: The proportional incidence of interval CRC for men and women was, respectively, 0.06 (95% confidence interval (CI), 0.04-0.09) and 0.17 (95% CI, 0.13-0.23) in the first interval year, and 0.21 (95% CI, 0.16-0.26) and 0.28 (95% CI, 0.22-0.36) in the second year., Conclusions: The results were acceptable and in line with previous studies., (Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2020
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45. Five common errors to avoid in clinical practice: the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) Choosing Wisely Campaign.

Author

Stasi E, Michielan A, Morreale GC, Tozzi A, Venezia L, Bortoluzzi F, Triossi O, Soncini M, Leandro G, Milazzo G, and Anderloni A

Subjects
Gastroenterologists psychology, Gastroenterologists standards, Humans, Italy, Medical Overuse prevention & control, Societies, Medical organization & administration, Surveys and Questionnaires, Gastroenterologists organization & administration, Medical Errors prevention & control, Societies, Medical trends
Abstract

Modern medicine provides almost infinite diagnostic and therapeutic possibilities if compared to the past. As a result, patients undergo a multiplication of tests and therapies, which in turn may trigger further tests, often based on physicians' attitudes or beliefs, which are not always evidence-based. The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) adhered to the Choosing Wisely Campaign to promote an informed, evidence-based approach to gastroenterological problems. The aim of this article is to report the five recommendations of the AIGO Choosing Wisely Campaign, and the process used to develop them. The AIGO members' suggestions regarding inappropriate practices/interventions were collected. One hundred and twenty-one items were identified. Among these, five items were selected and five recommendations were developed. The five recommendations developed were: (1) Do not request a fecal occult blood test outside the colorectal cancer screening programme; (2) Do not repeat surveillance colonoscopy for polyps, after a quality colonoscopy, before the interval suggested by the gastroenterologist on the colonoscopy report, or based on the polyp histology report; (3) Do not repeat esophagogastroduodenoscopy in patients with reflux symptoms, with or without hiatal hernia, in the absence of different symptoms or alarm symptoms; (4) Do not repeat abdominal ultrasound in asymptomatic patients with small hepatic haemangiomas (diameter < 3 cm) once the diagnosis has been established conclusively; (5) Do not routinely prescribe proton pump inhibitors within the context of steroid use or long-term in patients with functional dyspepsia. AIGO adhered to the Choosing Wisely Campaign and developed five recommendations. Further studies are needed to assess the impact of these recommendations in clinical practice with regards to clinical outcome and cost-effectiveness.

Published
2019
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46. Current uses and outcomes of lumen-apposing metal stents.

Author

Mussetto A, Fugazza A, Fuccio L, Triossi O, Repici A, and Anderloni A

Abstract

The lumen-apposing metal stent (LAMS) is one of the revolutionary devices recently developed for gastrointestinal endoscopy. This device has a saddle-shaped design and large lumen. It was originally designed for drainage of transmural pancreatic fluid collection and in the last few years it has been used extensively for that indication. More recently, other in- and off-label indications have been proposed. Several types of LAMS are available, with or without an electrocautery-enhanced delivery system. In the current review we discuss the state of the art with regard to LAMS and their indications, usage, and outcomes., Competing Interests: Conflict of Interest: None

Published
2018
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48. Long-term efficacy of vacuum-assisted therapy (Endo-SPONGE ® ) in large anastomotic leakages following anterior rectal resection.

Author

Mussetto A, Arena R, Buzzi A, Fuccio L, Dari S, Brancaccio ML, and Triossi O

Abstract

Background: The aim of our study was to test the long-term efficacy of Endo-SPONGE ® therapy in a group of patients treated in our center with vacuum-assisted therapy because of anastomotic leakages after colorectal surgery., Methods: Eleven patients [male: 6; mean age: 71 (range: 44-82) years] who had anastomotic leakage treated with Endo-SPONGE ® placement were included in the study. Patient records were examined retrospectively. All patients with documented anastomotic leakage on abdominal computed tomography following an anterior resection of the rectum for rectal cancer underwent sigmoidoscopy to determine the extent of the anastomotic defect and the size of the presacral abscess., Results: Ten of the 11 patients (90.9%) showed closure of the anastomotic leakage after a mean of 16 sponge changes. During follow up [mean: 29 (range: 6-64) months], we observed two cases of anastomotic stricture. Treatment failure was observed in one patient who presented an increased size of dehiscence after 23 sessions of endoscopic treatment, despite an initial good response., Conclusions: Our study substantially confirms previous conclusions and reaffirms that Endo-SPONGE ® treatment for colorectal anastomotic leakages, performed in suitable patients, represents a successful and safe approach. The reduction in wound closure time, mild-to-moderate discomfort and possibly shorter hospitalization suggest that Endo-SPONGE ® treatment can be a prominent therapeutic regimen with adequate patient acceptance., Competing Interests: Conflict of Interest: None

Published
2017
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49. A 69-year-old woman with an unusual case of dysphagia.

Author

Arena R, Brancaccio ML, Vincentis F, Mussetto A, Buzzi A, and Triossi O

Subjects
Aged, Endoscopy, Gastrointestinal, Esophageal Stenosis diagnostic imaging, Esophagitis drug therapy, Female, Humans, Proton Pump Inhibitors therapeutic use, Deglutition Disorders etiology, Esophageal Stenosis etiology, Esophagitis complications
Published
2016
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50. Split dosing with a low-volume preparation is not inferior to split dosing with a high-volume preparation for bowel cleansing in patients with a history of colorectal resection: a randomized trial.

Author

Mussetto A, Frazzoni L, Paggi S, Dari S, Laterza L, Radaelli F, Hassan C, Triossi O, and Fuccio L

Subjects
Administration, Oral, Aged, Dose-Response Relationship, Drug, Drug Administration Schedule, Drug Combinations, Female, Humans, Male, Middle Aged, Patient Satisfaction, Postoperative Period, Prospective Studies, Retrospective Studies, Single-Blind Method, Bisacodyl administration & dosage, Cathartics administration & dosage, Citric Acid administration & dosage, Colectomy, Colon drug effects, Colonoscopy methods, Polyethylene Glycols administration & dosage
Abstract

Background and Study Aim: The study compared the efficacy of bowel cleansing using a low-volume mixed preparation (15 mg bisacodyl plus 2 L polyethylene glycol [PEG] solution) versus a standard high-volume preparation (4 L PEG) in patients with previous colorectal resection., Patients and Methods: A total of 120 patients with prior colorectal resection for cancer undergoing surveillance colonoscopy were randomized to receive either a split-dose low-volume (n = 60) or high-volume (n = 60) preparation for bowel cleansing. The quality of bowel preparation, rated according to a modified Ottawa Bowel Preparation scale (mOBPS), represented the primary outcome measure. Tolerability, safety, and lesion detection rates were secondary outcomes., Results: No significant difference was observed between the low-volume and high-volume preparations in achievement of adequate cleansing (i. e. mOBPS ≤ 4; low-volume vs. high-volume group, 85.0 % vs. 81.7 %, P = 0.624). The low-volume preparation showed a higher success rate for cleansing of the right colon (P = 0.025); better tolerability in terms of intake of the whole amount of the preparation (P < 0.001) was also observed. According to the logistic regression analysis, the only predictors of unsuccessful cleansing were previous left colectomy (P = 0.012) and a longer elapsed time since the intervention (P = 0.034). Lesion detection rates were comparable between the groups. No serious adverse events were reported., Conclusion: A low-volume preparation is not inferior to a high-volume preparation for adequate bowel cleansing in patients with prior colorectal resection for cancer. If larger, multicenter, prospective studies confirm our findings, a low-volume preparation will represent a more tolerable option for such patients., Trial Registration Number: ClinicalTrial.gov identifier NCT01887158., (© Georg Thieme Verlag KG Stuttgart · New York.)

Published
2015
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