161 results on '"Usai-Satta P."'
Search Results
2. Prevalence of Endoscopic and Histological Lesions at Upper Endoscopy: A Cross-Sectional, Multicentre Study in Clinical Practice
- Author
-
Vincenzo De Francesco, Angelo Zullo, Arnaldo Amato, Irene Bergna, Emanuele Bendia, Giorgia Giorgini, Elisabetta Buscarini, Guido Manfredi, Sergio Cadoni, Renato Cannizzaro, Stefano Realdon, Mario Ciuffi, Orazio Ignomirelli, Paola Da Massa Carrara, Giovanni Finucci, Antonietta Di Somma, Chiara Frandina, Mariafrancesca Loria, Francesca Galeazzi, Francesco Ferrara, Carlo Gemme, Noemi Sara Bertetti, Federica Gentili, Antonio Lotito, Bastianello Germanà, Nunzia Russo, Giuseppe Grande, Rita Conigliaro, Federico Cravero, Giovanna Venezia, Riccardo Marmo, Piera Senneca, Angelo Milano, Konstantinos Efthymakis, Fabio Monica, Paolo Montalto, Mario Lombardi, Olivia Morelli, Danilo Castellani, Daniela Nigro, Roberto Festa, Sergio Peralta, Maria Grasso, Antonino Carlo Privitera, Maria Emanuela Di Stefano, Giuseppe Scaccianoce, Mariangela Loiacono, Sergio Segato, Marco Balzarini, Paolo Usai Satta, Mariantonia Lai, and Raffaele Manta
- Subjects
upper endoscopy ,peptic ulcer ,cancer ,helicobacter pylori ,precancerous lesions ,esofagogastroduodenoscopia ,ulcera peptica ,câncer ,h. pylori ,lesões pré-cancerosas ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background/Aim: Prevalence of gastroduodenal endoscopic and histological lesions may modify over time due to different factors. We assessed both macroscopic and histological lesions currently detected at upper endoscopy performed in routine practice. Patients and Methods: Clinical, endoscopic, and histological data of consecutive adult patients referred for upper endoscopy in the 28 participating centres were analysed. Only patients who underwent the first endoscopic examination were considered. Prevalence of erosive/ulcerative lesions, cancers and extensive precancerous lesions in the stomach, and Helicobacter pylori infection was computed. Results: A total of 1,431 patients underwent endoscopy for gastro-oesophageal reflux symptoms (31.5%), dyspepsia (29.4%), or alarm symptoms (18.5%). Erosive oesophagitis or Barrett’s oesophagus was detected in 210 (14.7%) cases, peptic ulcer in 49 (3.4%), and a neoplastic lesion in 17 (1.2%). H. pylori was present in 201 (22.6%) cases, and extensive precancerous lesions on gastric mucosa in 46 (5.6%) patients. Gastric lesions were more prevalent in patients aged ≥50 years (26% vs. 18%; p = 0.001), and peptic ulcers were more frequently detected in patients with H. pylori (9.4% vs. 2.3%; p = 0.001) and in males (5.8% vs. 1.6%; p = 0.001), while neoplastic lesions in patients with alarm symptoms (3.8% vs. 0.6%; p = 0.001). Conclusions: The overall endoscopic lesions were more prevalent in patients aged ≥50 years, peptic ulcer and erosions were more frequent in H. pylori-infected patients, and extensive gastric precancerous lesions were present in less than 6% of cases.
- Published
- 2024
- Full Text
- View/download PDF
3. Adalimumab biosimilar ABP 501 is equally effective and safe in long-term management of inflammatory bowel diseases patients when used as first biologic treatment or as replace of the ADA originator for a non-medical reason
- Author
-
Giammarco Mocci, Arianna Cingolani, Giorgia Orrù, Carla Felice, Francesca Maria Onidi, Gianmarco Lombardi, Davide Checchin, Raffaele Colucci, Laurino Grossi, Antonio Ferronato, Chiara Rocchi, Marta Ascolani, Paolo Usai Satta, Lucia Fanini, Stefano Pilati, and Antonio Tursi
- Subjects
adalimumab ,ABP 501 ,biosimilar ,Crohn’s disease ,ulcerative colitis ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
ObjectiveBiosimilars represent a new opportunity for inflammatory bowel disease (IBD) treatment and economic sustainability of therapies. This study aimed to evaluate the efficacy and long-term safety of the adalimumab biosimilar ABP 501 in biologic-naïve vs. biologic-switched IBD patients.MethodsA retrospective observational study was conducted using a database of patients with IBD treated with ABP 501, biologic-naïve or switched from the original, at eight IBD centers. We included adult patients with at least one year of follow-up. The primary objective of this study was to assess the efficacy (persistence) and safety (adverse event rate) of ABP 501 therapy.ResultsA total of 118 patients with IBD were included in the analysis: 84 patients with Crohn’s disease (CD) (39 women, 45 men, mean age 40.4 ± 14.3 years; 33% biologic-naïve) and 34 patients with ulcerative Colitis (UC) (16 women, 18 men, mean age 38.9 ± 14.9 years; 61.8% biologic-naïve). Regarding the primary endpoint, no difference was observed in the efficacy between biologic-naïve patients and patients with Adalimumab (ADA) originator replacement for non-medical reasons in terms of long-term persistence. However, ABP 501 showed a higher percentage of sustained clinical remission at 2 years in patients with CD (64 patients, 77%) than in those with UC (15 patients, 45.5%; p=0.00091). Nine patients (six with CD and three with UC) experienced adverse events that led to drug discontinuation in three.ConclusionsAPB 501 showed a good safety and efficacy profile in maintaining clinical response at 2 years in patients with IBD, both as a treatment-naïve and as a replacement for ADA originator for non-medical reasons.
- Published
- 2023
- Full Text
- View/download PDF
4. Ustekinumab in the Treatment of Inflammatory Bowel Diseases: Evolving Paradigms
- Author
-
Giammarco Mocci, Antonio Tursi, Francesca Maria Onidi, Paolo Usai-Satta, Giovanni Mario Pes, and Maria Pina Dore
- Subjects
Crohn’s disease ,inflammatory bowel diseases ,mucosal healing ,safety ,remission ,ulcerative colitis ,Medicine - Abstract
Inflammatory bowel diseases, comprising Crohn’s disease (CD) and ulcerative colitis (UC), are chronic, relapsing, and remitting immune-mediated inflammatory diseases affecting the gastrointestinal tract. Ustekinumab (UST) is a monoclonal antibody that blocks the p40 subunit of the anti-interleukin (IL) 12/23. Pivotal trials (CERTIFI and UNITI-IM for CD, UNIFI for UC) established the efficacy of UST for the induction and maintenance of remission in both CD and UC, with the most favorable results in naïve patients to biologics. In recent years, a wealth of ‘real-world’ data has emerged supporting positive clinical, endoscopic, and histological outcomes in patients treated with UST, as well as reassuring safety data. More recently, the results of the first head-to-head trials of UST and tumor necrosis factor (TNF) antagonists were reported. Moreover, a number of studies exploring the role of UST in specific clinical settings, such as perianal CD, postoperative complications and recurrence, extraintestinal manifestations, chronic antibiotic-refractory pouchitis, and pregnancy, were reported. This review explores the results reported to date on UST, including those from pivotal trials, real-world data, and emerging studies regarding therapeutic drug monitoring and immunogenicity. The safety profile of UST was also reviewed.
- Published
- 2024
- Full Text
- View/download PDF
5. Increased Prevalence of Rare Sucrase-isomaltase Pathogenic Variants in Irritable Bowel Syndrome Patients
- Author
-
Garcia-Etxebarria, Koldo, Zheng, Tenghao, Bonfiglio, Ferdinando, Bujanda, Luis, Dlugosz, Aldona, Lindberg, Greger, Schmidt, Peter T, Karling, Pontus, Ohlsson, Bodil, Simren, Magnus, Walter, Susanna, Nardone, Gerardo, Cuomo, Rosario, Usai-Satta, Paolo, Galeazzi, Francesca, Neri, Matteo, Portincasa, Piero, Bellini, Massimo, Barbara, Giovanni, Jonkers, Daisy, Eswaran, Shanti, Chey, William D, Kashyap, Purna, Chang, Lin, Mayer, Emeran A, Wouters, Mira M, Boeckxstaens, Guy, Camilleri, Michael, Franke, Andre, and D’Amato, Mauro
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Chronic Pain ,Digestive Diseases ,Genetics ,Pain Research ,Aetiology ,2.1 Biological and endogenous factors ,Oral and gastrointestinal ,Gene Frequency ,Genotype ,Humans ,Irritable Bowel Syndrome ,Prevalence ,Sucrase-Isomaltase Complex ,Gastroenterology & Hepatology ,Clinical sciences - Abstract
Patients with irritable bowel syndrome (IBS) often associate their symptoms to certain foods. In congenital sucrase-isomaltase deficiency (CSID), recessive mutations in the SI gene (coding for the disaccharidase digesting sucrose and 60% of dietary starch)1 cause clinical features of IBS through colonic accumulation of undigested carbohydrates, triggering bowel symptoms.2 Hence, in a previous study,3 we hypothesized that CSID variants reducing SI enzymatic activity may contribute to development of IBS symptoms. We detected association with increased risk of IBS for 4 rare loss-of-function variants typically found in (homozygous) CSID patients, because carriers (heterozygous) of these rare variants were more common in patients than in controls.1,4 Through a 2-step computational and experimental strategy, the present study aimed to determine whether other (dys-)functional SI variants are associated with risk of IBS in addition to known CSID mutations. We first aimed to identify all SI rare pathogenic variants (SI-RPVs) on the basis of integrated Mendelian Clinically Applicable Pathogenicity (M-CAP) and Combined Annotation Dependent Depletion (CADD) predictive (clinically relevant) scores; next, we inspected genotype data currently available for 2207 IBS patients from a large ongoing project to compare SI-RPV case frequencies with ethnically matched population frequencies from the Exome Aggregation Consortium (ExAC).
- Published
- 2018
6. Misinterpreting Diarrhea-Predominant Irritable Bowel Syndrome and Functional Diarrhea: Pathophysiological Highlights
- Author
-
Giusi Desirè Sciumè, Ginevra Berti, Christian Lambiase, Italia Paglianiti, Vincenzo Villanacci, Francesco Rettura, Antonio Grosso, Angelo Ricchiuti, Nicola de Bortoli, Paolo Usai Satta, Gabrio Bassotti, and Massimo Bellini
- Subjects
irritable bowel syndrome ,microscopic colitis ,bile acid malabsorption ,diarrhea ,BAM ,IBS ,Medicine - Abstract
Irritable bowel syndrome with predominant diarrhea (IBS-D) and functional diarrhea (FD) are disorders of gut–brain interaction characterized by recurring symptoms which have a serious impact on the patient’s quality of life. Their pathophysiology is far from being completely understood. In IBS-D growing evidence suggests that bile acid malabsorption (BAM) could be present in up to 30% of patients. Microscopic colitis (MC) is a well-known cause of watery diarrhea and some patients, at first, can be diagnosed as IBS-D or FD. Both BAM and MC are often responsible for the lack of response to conventional treatments in patients labelled as “refractory”. Moreover, because BAM and MC are not mutually exclusive, and can be found in the same patient, they should always be considered in the diagnostic workout when a specific treatment for BAM or MC is unsatisfactory. In the present review the possible shared pathogenetic mechanisms between BAM and MC are discussed highlighting how MC can induce a secondary BAM. Moreover, a brief overview of the current literature regarding the prevalence of their association is provided.
- Published
- 2023
- Full Text
- View/download PDF
7. Female-Specific Association Between Variants on Chromosome 9 and Self-Reported Diagnosis of Irritable Bowel Syndrome
- Author
-
Bonfiglio, Ferdinando, Zheng, Tenghao, Garcia-Etxebarria, Koldo, Hadizadeh, Fatemeh, Bujanda, Luis, Bresso, Francesca, Agreus, Lars, Andreasson, Anna, Dlugosz, Aldona, Lindberg, Greger, Schmidt, Peter T, Karling, Pontus, Ohlsson, Bodil, Simren, Magnus, Walter, Susanna, Nardone, Gerardo, Cuomo, Rosario, Usai-Satta, Paolo, Galeazzi, Francesca, Neri, Matteo, Portincasa, Piero, Bellini, Massimo, Barbara, Giovanni, Latiano, Anna, Hübenthal, Matthias, Thijs, Vincent, Netea, Mihai G, Jonkers, Daisy, Chang, Lin, Mayer, Emeran A, Wouters, Mira M, Boeckxstaens, Guy, Camilleri, Michael, Franke, Andre, Zhernakova, Alexandra, and D'Amato, Mauro
- Subjects
Genetics ,Prevention ,Digestive Diseases ,Pain Research ,Human Genome ,2.1 Biological and endogenous factors ,Aetiology ,Adult ,Aged ,Chromosomes ,Human ,Pair 9 ,Constipation ,Europe ,Female ,Genetic Predisposition to Disease ,Genetic Variation ,Genome-Wide Association Study ,Genotype ,Humans ,Irritable Bowel Syndrome ,Male ,Menarche ,Middle Aged ,Polymorphism ,Single Nucleotide ,Self Report ,Sex Factors ,Sweden ,United States ,SNP ,Biobank Research ,Bowel Symptoms ,Clinical Sciences ,Neurosciences ,Paediatrics and Reproductive Medicine ,Gastroenterology & Hepatology - Abstract
Background & aimsGenetic factors are believed to affect risk for irritable bowel syndrome (IBS), but there have been no sufficiently powered and adequately sized studies. To identify DNA variants associated with IBS risk, we performed a genome-wide association study (GWAS) of the large UK Biobank population-based cohort, which includes genotype and health data from 500,000 participants.MethodsWe studied 7,287,191 high-quality single nucleotide polymorphisms in individuals who self-reported a doctor's diagnosis of IBS (cases; n = 9576) compared to the remainder of the cohort (controls; n = 336,499) (mean age of study subjects, 40-69 years). Genome-wide significant findings were further investigated in 2045 patients with IBS from tertiary centers and 7955 population controls from Europe and the United States, and a small general population sample from Sweden (n = 249). Functional annotation of GWAS results was carried out by integrating data from multiple biorepositories to obtain biological insights from the observed associations.ResultsWe identified a genome-wide significant association on chromosome 9q31.2 (single nucleotide polymorphism rs10512344; P = 3.57 × 10-8) in a region previously linked to age at menarche, and 13 additional loci of suggestive significance (P < 5.0×10-6). Sex-stratified analyses revealed that the variants at 9q31.2 affect risk of IBS in women only (P = 4.29 × 10-10 in UK Biobank) and also associate with constipation-predominant IBS in women (P = .015 in the tertiary cohort) and harder stools in women (P = .0012 in the population-based sample). Functional annotation of the 9q31.2 locus identified 8 candidate genes, including the elongator complex protein 1 gene (ELP1 or IKBKAP), which is mutated in patients with familial dysautonomia.ConclusionsIn a sufficiently powered GWAS of IBS, we associated variants at the locus 9q31.2 with risk of IBS in women. This observation may provide additional rationale for investigating the role of sex hormones and autonomic dysfunction in IBS.
- Published
- 2018
8. Chronic Idiopathic Constipation in Adults: A Review on Current Guidelines and Emerging Treatment Options
- Author
-
Bassotti G, Usai Satta P, and Bellini M
- Subjects
chronic idiopathic constipation ,guidelines ,osmotic laxatives ,pelvic floor rehabilitation ,prokinetics ,secretagogues ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Gabrio Bassotti,1 Paolo Usai Satta,2 Massimo Bellini3 1Gastroenterology & Hepatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; 2Gastrointestinal Unit, “G. Brotzu” Hospital, Cagliari, Italy; 3Gastrointestinal Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, ItalyCorrespondence: Gabrio BassottiClinica di Gastroenterologia ed Epatologia, Ospedale Santa Maria della Misericordia, Piazzale Menghini, 1, San Sisto (Perugia), 06156, ItalyEmail gabassot@tin.itAbstract: Chronic idiopathic constipation (CIC) is a common functional bowel disorder characterized by difficult, infrequent, and/or incomplete defecation. It has a great impact on the quality of life and on health care system and represents a heavy economic burden. The diagnosis is based on symptoms, classified by the Rome IV criteria. The aim of this review was to evaluate the current therapeutic guidelines for adult CIC and highlight new emerging treatments. In detail, European, French, Spanish and Korean guidelines have been identified and compared. Osmotic laxatives, and in particular polyethylene glycol, represent the first-line therapeutic approach. Stimulant laxatives are recommended as a second-line therapy. Pelvic floor rehabilitation is recommended in patients with ano-rectal dyssynergia. In patients who fail to improve with pharmacological therapies sacral nerve stimulation is considered as last chance before surgery. Surgical approach has however limited indications in selected cases. Inertia coli refractory to any approach and obstructed defecation are two subtypes which can benefit from surgery. Among emerging agents, prucalopride, a prokinetic agent, is recommended as a second-line treatment in refractory CIC patients. In addition, the secretagogues linaclotide and plecanatide and the bile acid transported inhibitor elobixibat can be effective in patients not responsive to a second-line therapeutic regimen, although they are not worldwide commercially available.Keywords: chronic idiopathic constipation, guidelines, osmotic laxatives, pelvic floor rehabilitation, prokinetics, secretagogues
- Published
- 2021
9. N34 Transition of Inflammatory Bowel Disease patients from pediatric to adult Care: A single-center ten-years experience
- Author
-
Onidi, F M, primary, Mocci, G, additional, Elisei, W, additional, Corpino, M, additional, Orru', G, additional, Marongiu, A, additional, Argiolas, G, additional, Runfola, M, additional, Locci, G, additional, Tamponi, E, additional, Zolfino, T, additional, Usai Satta, P, additional, Muscas, A, additional, Congia, M, additional, and Savasta, S, additional
- Published
- 2024
- Full Text
- View/download PDF
10. P544 Ustekinumab safety and effectiveness in ulcerative colitis patients: results from a large real-life study
- Author
-
Mocci, G, primary, Scaldaferri, F, additional, Pugliese, D, additional, Savarino, E, additional, Bodini, G, additional, Cuomo, A, additional, Donnarumma, L, additional, Maconi, G, additional, Cataletti, G, additional, Rodino, S, additional, Sebkova, L, additional, Ferronato, A, additional, Gaiani, F, additional, Marzo, M, additional, Luppino, I, additional, Paese, P, additional, Elisei, W, additional, Monterubbianesi, R, additional, Faggiani, R, additional, Napolitano, D, additional, Grossi, L, additional, Serio, M, additional, Scarcelli, A, additional, Lorenzetti, R, additional, Allegretta, L, additional, Rocco, G, additional, Zampaletta, C, additional, Bolognini, L, additional, Meucci, C, additional, Colucci, R, additional, Tonti, P, additional, Della Valle, N, additional, Piga, R, additional, Forti, G, additional, Onidi, F M, additional, Usai Satta, P, additional, Picchio, M, additional, Papa, A, additional, and Tursi, A, additional
- Published
- 2024
- Full Text
- View/download PDF
11. P1127 Diagnostic delay and economic burden in IBD: a multicenter italian experience in patients treated with biologics
- Author
-
Mocci, G, primary, Orrù, G, additional, Onidi, F M, additional, Bodini, G, additional, Picchio, M, additional, Ferronato, A, additional, Zampaletta, C, additional, Corpino, M, additional, Lorenzetti, R, additional, Usai Satta, P, additional, Elisei, W, additional, and Tursi, A, additional
- Published
- 2024
- Full Text
- View/download PDF
12. New Perspectives on Lactose Malabsorption, Celiac Disease and Related Disorders
- Author
-
Paolo Usai-Satta and Mariantonia Lai
- Subjects
n/a ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Lactose malabsorption (LM) is caused by the incomplete hydrolysis of lactose due to lactase deficiency [...]
- Published
- 2023
- Full Text
- View/download PDF
13. Translational Gap between Guidelines and Clinical Medicine: The Viewpoint of Italian General Practitioners in the Management of IBS
- Author
-
Massimo Bellini, Cesare Tosetti, Francesco Rettura, Riccardo Morganti, Christian Lambiase, Gabrio Bassotti, Pierfrancesco Visaggi, Andrea Pancetti, Edoardo Benedetto, Nicola de Bortoli, Paolo Usai-Satta, and Rudi De Bastiani
- Subjects
irritable bowel syndrome ,general practitioners ,Rome Criteria IV ,Bristol Scale ,primary care ,Medicine - Abstract
Irritable bowel syndrome (IBS) guidelines are generally developed by experts, with the possibility of a translational gap in clinical medicine. The aim of our study was to assess an Italian group of general practitioners (GPs) for their awareness and use of criteria for the diagnosis and management of IBS. For this purpose, a survey was carried out involving 235 GPs, divided into two groups according to their years of activity: 65 “junior general practitioners” (JGPs) (≤10 years) and 170 “senior general practitioners” (SGPs) (>10 years). JGPs were more familiar with the Rome IV Criteria and Bristol Scale than SGPs. Abdominal pain, bowel movement frequency and bloating were the symptoms most frequently used to make a diagnosis. The most probable causes of IBS were reported to be abnormal gastrointestinal motility and psychological triggers. SGPs reported more frequently than JGPs that challenging management and patient’s request were motivations for a gastroenterological consultation. The practice of clinical medicine is still far from the guidelines provided by the specialists. Abdominal pain related to defecation and changes in bowel frequency are considered to be the more important symptoms for IBS diagnosis, but most GPs, both JGPs and SGPs, like to consider abdominal bloating as another useful symptom. Involving both gastroenterologists and GPs in developing shared guidelines would be highly desirable in order to improve IBS management strategies in everyday clinical practice.
- Published
- 2022
- Full Text
- View/download PDF
14. Lactose Malabsorption and Presumed Related Disorders: A Review of Current Evidence
- Author
-
Paolo Usai-Satta, Mariantonia Lai, and Francesco Oppia
- Subjects
lactose malabsorption and intolerance ,celiac disease ,inflammatory bowel disease ,irritable bowel syndrome ,bone mass density ,Hashimoto’s thyroiditis ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Background. Lactose malabsorption (LM) is a frequent clinical problem associated with several digestive and extra-digestive diseases. The aim of this manuscript was to clarify the real clinical impact of LM on these disorders. Methods. A literature search for digestive and extra-digestive disorders related to LM was carried out using PubMed, Medline and Cochrane. Results. A transient lactase deficiency is present in celiac disease (CD) on a normal diet. The persistence of symptoms in CD on a gluten-free diet may be instead, in part, attributed to a primary LM. Similar circumstances are present in inflammatory bowel diseases (IBD), in which LM can be responsible for a part of persistent symptoms in IBD on clinical remission. LM and irritable bowel syndrome (IBS) are instead independent conditions. On the other hand, a lactose-restricted diet may be useful for some IBS patients. A reduced lactose intake can lead to low bone mass and limited risk of fragility fractures. Finally, the absorption of levothyroxine could be conditioned by LM. Conclusions. LM can be responsible for persistent symptoms in CD and IBD. The association with IBS seems to be casual. Bone mass and levothyroxine absorption can be affected by LM.
- Published
- 2022
- Full Text
- View/download PDF
15. Pelvic floor rehabilitation for defecation disorders
- Author
-
Bocchini, R., Chiarioni, G., Corazziari, E., Pucciani, F., Torresan, F., Alduini, P., Bassotti, G., Battaglia, E., Ferrarini, F., Galeazzi, F., Londoni, C., Rossitti, P., Usai Satta, P., Iona, L., Marchi, S., Milazzo, G., Altomare, D. F., Barbera, R., Bove, A., Calcara, C., D’Alba, L., De Bona, M., Goffredo, F., Manfredi, G., Naldini, G., Neri, M. C., Turco, L., La Torre, F., D’Urso, A. P., Berni, I., Balestri, M. A., Busin, N., Boemo, C., and Bellini, M.
- Published
- 2019
- Full Text
- View/download PDF
16. Ustekinumab safety and effectiveness in patients with ulcerative colitis: results from a large real-life study
- Author
-
Tursi, Antonio, Mocci, Giammarco, Scaldaferri, Franco, Napolitano, Daniele, Maresca, Rossella, Pugliese, Daniela, Semprucci, Gianluca, Savarino, Edoardo, Cuomo, Antonio, Donnarumma, Laura, Bodini, Giorgia, Pasta, Andrea, Maconi, Giovanni, Cataletti, Giovanni, Pranzo, Giuseppe, Rodinò, Stefano, Sebkova, Ladislava, Costa, Francesco, Ferronato, Antonio, Gaiani, Federica, Marzo, Manuela, Luppino, Ileana, Fabiano, Giulia, Paese, Pietro, Elisei, Walter, Monterubbianesi, Rita, Faggiani, Roberto, Grossi, Laurino, Serio, Mariaelena, Scarcelli, Antonella, Lorenzetti, Roberto, Allegretta, Leonardo, Chiri, Stefania, Grasso, Giuseppina, Antonelli, Elisabetta, Bassotti, Gabrio, Spagnuolo, Rocco, Luzza, Francesco, Fanigliulo, Libera, Rocco, Giulia, Sacchi, Carlotta, Zampaletta, Costantino, Rocchi, Chiara, Bolognini, Laura, Bendia, Emanuele, Bianco, Maria Antonia, Capone, Pietro, Meucci, Costantino, Colucci, Raffaele, Tonti, Paolo, Neve, Viviana, Della Valle, Nicola, Felice, Carla, Pica, Roberta, Cocco, Andrea, Forti, Giacomo, Onidi, Francesca Maria, Usai Satta, Paolo, Checchin, Davide, Gravina, Antonietta Gerarda, Pellegrino, Raffaele, Picchio, Marcello, and Papa, Alfredo
- Abstract
ABSTRACTBackgroundUstekinumab (UST) is an interleukin-12/interleukin-23 receptor antagonist recently approved for treating ulcerative colitis (UC) but with limited real-world data. Therefore, we evaluated the effectiveness and safety of UST in patients with UC in a real-world setting.Research design and methodsThis is a multicenter, retrospective, observational cohort study. The primary endpoints were the clinical remission rate (partial Mayo score, PMS, ≤1) and the safety of UST. Other endpoints were corticosteroid-free remission (CSFR) rate, clinical response rate (PMS reduction of at least 2 points), and fecal calprotectin (FC) reduction at week 24.ResultsWe included 256 consecutive patients with UC (M/F 139/117, median age 52). The clinical remission and clinical response rates at eight weeks were 18.7% (44/235) and 53.2% (125/235), respectively, and 27.6% (42/152) and 61.8% (94/152) at 24 weeks, respectively. At 24 weeks, CSFR was 20.3% (31/152), and FC significantly dropped at week 12 (p = 0.0004) and 24 (p = 0.038). At eight weeks, patients naïve or with one previous biologic treatment showed higher remission (p = 0.002) and clinical >response rates (p = 0.018) than patients previously treated with ≥ 2. Adverse events occurred in six patients (2.3%), whereas four patients (1.6%) underwent colectomy.ConclusionThis real-world study shows that UST effectively and safely treats patients with UC.
- Published
- 2024
- Full Text
- View/download PDF
17. Prevalence of Endoscopic and Histological Lesions at Upper Endoscopy: A Cross-Sectional, Multicentre Study in Clinical Practice
- Author
-
De Francesco, Vincenzo, Zullo, Angelo, Amato, Arnaldo, Bergna, Irene, Bendia, Emanuele, Giorgini, Giorgia, Buscarini, Elisabetta, Manfredi, Guido, Cadoni, Sergio, Cannizzaro, Renato, Realdon, Stefano, Ciuffi, Mario, Ignomirelli, Orazio, Da Massa Carrara, Paola, Finucci, Giovanni, Di Somma, Antonietta, Frandina, Chiara, Loria, Mariafrancesca, Galeazzi, Francesca, Ferrara, Francesco, Gemme, Carlo, Bertetti, Noemi Sara, Gentili, Federica, Lotito, Antonio, Germanà, Bastianello, Russo, Nunzia, Grande, Giuseppe, Conigliaro, Rita, Cravero, Federico, Venezia, Giovanna, Marmo, Riccardo, Senneca, Piera, Milano, Angelo, Efthymakis, Konstantinos, Monica, Fabio, Montalto, Paolo, Lombardi, Mario, Morelli, Olivia, Castellani, Danilo, Nigro, Daniela, Festa, Roberto, Peralta, Sergio, Grasso, Maria, Privitera, Antonino Carlo, Di Stefano, Maria Emanuela, Scaccianoce, Giuseppe, Loiacono, Mariangela, Segato, Sergio, Balzarini, Marco, Usai Satta, Paolo, Lai, Mariantonia, and Manta, Raffaele
- Abstract
Background/Aim:Prevalence of gastroduodenal endoscopic and histological lesions may modify over time due to different factors. We assessed both macroscopic and histological lesions currently detected at upper endoscopy performed in routine practice. Patients and Methods:Clinical, endoscopic, and histological data of consecutive adult patients referred for upper endoscopy in the 28 participating centres were analysed. Only patients who underwent the first endoscopic examination were considered. Prevalence of erosive/ulcerative lesions, cancers and extensive precancerous lesions in the stomach, and Helicobacter pyloriinfection was computed. Results:A total of 1,431 patients underwent endoscopy for gastro-oesophageal reflux symptoms (31.5%), dyspepsia (29.4%), or alarm symptoms (18.5%). Erosive oesophagitis or Barrett’s oesophagus was detected in 210 (14.7%) cases, peptic ulcer in 49 (3.4%), and a neoplastic lesion in 17 (1.2%). H. pyloriwas present in 201 (22.6%) cases, and extensive precancerous lesions on gastric mucosa in 46 (5.6%) patients. Gastric lesions were more prevalent in patients aged ≥50 years (26% vs. 18%; p= 0.001), and peptic ulcers were more frequently detected in patients with H. pylori(9.4% vs. 2.3%; p= 0.001) and in males (5.8% vs. 1.6%; p= 0.001), while neoplastic lesions in patients with alarm symptoms (3.8% vs. 0.6%; p= 0.001). Conclusions:The overall endoscopic lesions were more prevalent in patients aged ≥50 years, peptic ulcer and erosions were more frequent in H. pylori-infected patients, and extensive gastric precancerous lesions were present in less than 6% of cases.
- Published
- 2024
- Full Text
- View/download PDF
18. T.06.8 REAL WORD LONG-TERM EFFICACY AND SAFETY OF VEDOLIZUMAB IN MANAGING ULCERATIVE COLITIS VERSUS CROHN'S DISEASE: RESULTS FROM “LONG VEDO” ITALIAN MULTICENTER STUDY
- Author
-
Mocci, G., primary, Maconi, G., additional, Cataletti, G., additional, Mantia, B., additional, Serio, M., additional, Scarcelli, A., additional, Onidi, F.M., additional, Pagnini, C., additional, Graziani, M., additional, Di Paolo, M., additional, Pranzo, G., additional, Luppino, I., additional, Paese, P., additional, Monterubbianesi, R., additional, Faggiani, R., additional, Ferronato, A., additional, Perini, B., additional, Savarino, E., additional, Binaghi, L., additional, Schiavoni, E., additional, Napolitano, D., additional, Scaldaferri, F., additional, Papa, A., additional, Lorenzetti, R., additional, Pica, R., additional, Cocco, A., additional, Rodino, S., additional, Sebkova, L., additional, Zampaletta, C., additional, Gaiani, F., additional, Fanigliulo, L., additional, Allegretta, L., additional, Cuomo, A., additional, Donnarumma, L., additional, Della Valle, N., additional, Forti, G., additional, Dore, M., additional, Antonelli, E., additional, Bassotti, G., additional, Iannelli, C., additional, Aragona, G., additional, Lauria, A., additional, Piergallini, S., additional, Colucci, R., additional, Meucci, C., additional, Usai Satta, P., additional, Elisai, W., additional, and Tursi, A., additional
- Published
- 2023
- Full Text
- View/download PDF
19. N25 Diagnostic delay and economic burden in ibd: a multicenter italian experience in patients treated with biologics
- Author
-
Mocci, G, primary, Onidi, F M, additional, Magri', S, additional, Bodini, G, additional, Lorenzetti, R, additional, Binaghi, L, additional, Dore, M F, additional, Martello, S, additional, Usai Satta, P, additional, Elisei, W, additional, and Tursi, A, additional
- Published
- 2023
- Full Text
- View/download PDF
20. Hydrogen Breath Tests: Are They Really Useful in the Nutritional Management of Digestive Disease?
- Author
-
Paolo Usai-Satta, Francesco Oppia, Mariantonia Lai, and Francesco Cabras
- Subjects
hydrogen breath testing ,lactose malabsorption and intolerance ,fructose and sorbitol malabsorption ,FODMAP ,nutritional management ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Background: Carbohydrate malabsorption is a frequent digestive problem associated with abdominal pain, bloating and diarrhea. Hydrogen breath testing (BT) represents the most reliable and validated diagnostic technique. The aim of this manuscript was to clarify the usefulness of BTs in the nutritional management of these disorders. Methods: A literature search for BT related to carbohydrate malabsorption was carried out using the online databases of Pubmed, Medline and Cochrane. Results: Lactose BT showed good sensitivity and optimal specificity for lactose malabsorption. However, an accurate diagnosis of lactose intolerance should require blind lactose challenge although this method is difficult to utilize in clinical practice. Regarding dose-depending fructose and sorbitol malabsorption, BTs could not add diagnostic advantage compared with a direct dietary intervention. In addition, carbohydrates are fundamental components of fermentable oligo-, di- and monosaccharides and polyols (FODMAPs). Before starting a low FODMAP diet, lactose BT should be suggested in a population with low prevalence of hypolactasia. Conclusions: BTs represent a valid and noninvasive technique in many digestive conditions. Regarding the management of carbohydrate intolerance, lactose BT can be recommended with some limitations. No sufficient evidence is available about the usefulness of BTs for other sugars in clinical practice.
- Published
- 2021
- Full Text
- View/download PDF
21. New Perspectives on Gluten-Free Diet
- Author
-
Paolo Usai-Satta and Mariantonia Lai
- Subjects
n/a ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Celiac disease (CD) is a permanent, chronic, gluten-sensitive disorder characterized by small intestinal inflammation and malabsorption in genetically predisposed individuals [...]
- Published
- 2020
- Full Text
- View/download PDF
22. Irritable Bowel Syndrome and Gluten-Related Disorders
- Author
-
Paolo Usai-Satta, Gabrio Bassotti, Massimo Bellini, Francesco Oppia, Mariantonia Lai, and Francesco Cabras
- Subjects
irritable bowel syndrome ,celiac disease ,nonceliac gluten/wheat sensitivity ,gluten-free diet ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Background: Irritable bowel syndrome (IBS) is frequently associated with celiac disease (CD) and nonceliac gluten/wheat sensitivity (NCGS/NCWS), but epidemiological and pathophysiological aspects are still unclear. Furthermore, a gluten-free diet (GFD) can positively influence IBS symptoms. Methods: A comprehensive online search for IBS related to CD, NCGS and GFD was made using the Pubmed, Medline and Cochrane databases. Results: Although a systematic screening for CD in IBS is not recommended, CD prevalence can be increased in diarrhea-predominant IBS patients. On the other hand, IBS symptoms can be persistent in treated CD patients, and their prevalence tends to decrease on a GFD. IBS symptoms may overlap and be similar to those associated to nonceliac gluten and/or wheat sensitivity. Increased gut permeability could explain the gluten/wheat effects in IBS patients. Finally, a GFD could improve symptoms in a subgroup of IBS patients. Conclusions: The possible interplay between IBS and gluten-related disorders represents a scientifically and clinically challenging issue. Further studies are needed to confirm these data and better clarify the involved pathophysiological mechanisms.
- Published
- 2020
- Full Text
- View/download PDF
23. Use of tofacitinib as first or second-line therapy is associated with better outcomes in patients with ulcerative colitis: data from a real-world study
- Author
-
Tursi, Antonio, Mocci, Giammarco, Cingolani, Linda, Savarino, Edoardo, Pica, Roberta, Cocco, Andrea, Zippi, Maddalena, Napolitano, Daniele, Schiavoni, Elisa, Pugliese, Daniela, Scaldaferri, Franco, Costa, Francesco, Marzo, Manuela, Serio, Mariaelena, Scarcelli, Antonella, Bolognini, Laura, Bendia, Emanuele, Maconi, Giovanni, Cannatelli, Rosanna, Piergallini, Simona, Bodini, Giorgia, Calabrese, Francesco, Ferronato, Antonio, Pranzo, Giuseppe, Elisei, Walter, Monterubbianesi, Rita, Faggiani, Roberto, Rodinò, Stefano, Sebkova, Ladislava, Grossi, Laurino, Gaiani, Federica, dè Angelis, Gianluigi, Lorenzetti, Roberto, Allegretta, Leonardo, Cazzato, Alessia Immacolata, Scorza, Stefano, Della Valle, Nicola, Sacco, Rodolfo, Forti, Giacomo, Colucci, Raffaele, Tonti, Paolo, Neve, Viviana, Rocco, Giulia, Sacchi, Carlotta, Zampaletta, Costantino, Pagnini, Cristiano, Graziani, Maria Giovanna, Di Paolo, Maria Carla, Onidi, Francesca Maria, Usai Satta, Paolo, Picchio, Marcello, and Papa, Alfredo
- Abstract
ABSTRACTBackgroundData regarding the real-world (RW) use of tofacitinib (TOF) in patients with ulcerative colitis (UC) are limited. We aimed to investigate TOF’s RW efficacy and safety in Italian UC patients.Research design and methodsA retrospective assessment of clinical and endoscopic activity was performed according to the Mayo score. The primary endpoints were to evaluate the effectiveness and safety of TOF.ResultsWe enrolled 166 patients with a median follow-up of 24 (IQR 8–36) weeks. Clinical remission was achieved in 61/166 (36.7%) and 75/166 (45.2%) patients at 8-week and 24-week follow-ups, respectively. The optimization was requested in 27 (16.3%) patients. Clinical remission was achieved more frequently when TOF was used as a first/second line rather than a third/fourth line treatment (p = 0.007). Mucosal healing was reported in 46% of patients at the median follow-up time. Colectomy occurred in 8 (4.8%) patients. Adverse events occurred in 12 (5.4%) patients and severe in 3 (1.8%). One case of simple Herpes Zoster and one of renal vein thrombosis were recorded.ConclusionsOur RW data confirm that TOF is effective and safe in UC patients. It performs remarkably better when used as the first/second line of treatment.
- Published
- 2023
- Full Text
- View/download PDF
24. Motility Disorders in Celiac Disease and Non-Celiac Gluten Sensitivity: The Impact of a Gluten-Free Diet
- Author
-
Paolo Usai-Satta, Francesco Oppia, Mariantonia Lai, and Francesco Cabras
- Subjects
celiac disease ,non-celiac gluten sensitivity ,gut motility ,gluten-free diet ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Background: There is evidence that digestive motor disorders are frequently present in untreated celiac disease (CD) patients. Similarly, non-celiac gluten sensitivity (NCGS) can be associated with gut motor disorders. In both cases, gut dysmotility can improve or be completely reversed with a gluten-free diet (GFD). Methods: A literature search for motility disorders in CD and NCGS patients was carried out using the online databases PubMed, Medline and Cochrane. Results: Esophageal, gastric, small bowel and gallbladder motor disorders are common in both children and adults with CD. Although the clinical consequences of these disorders are not clearly defined, gastric dysfunction could affect drug absorption and metabolism in the thyroid and neurological conditions associated with CD. The impact of a GFD on motility disorders is, however, controversial. No systematic studies are available on NCGS. NCGS frequently overlaps with irritable bowel syndrome (IBS) and similar pathophysiological mechanisms may be hypothesized. Conclusions: Mucosal damage may affect gut motility in untreated CD through perturbation of hormonal and neuro-immunomodulatory regulation. A persistent low-grade mucosal inflammation could explain the cases of persistent motor disorders despite a GFD. Further studies are needed to definitely assess the role of gut motor disorders in NCGS.
- Published
- 2018
- Full Text
- View/download PDF
25. Dyspepsia: When and How to Test for Helicobacter pylori Infection
- Author
-
Maria Pina Dore, Giovanni Mario Pes, Gabrio Bassotti, and Paolo Usai-Satta
- Subjects
Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Dyspepsia is defined as symptoms related to the upper gastrointestinal tract. Approximately 25% of western populations complain of dyspeptic symptoms each year. 70% of them do not have an organic cause and symptoms are related to the so-called functional dyspepsia, characterized by epigastric pain, early satiety, and/or fullness during or after a meal occurring at least weekly and for at least 6 months according to ROME III criteria. In order to avoid invasive procedures and adverse effects, to minimize costs, to speed up diagnosis, and to provide the most appropriate treatments, primary care physicians need to recognize functional dyspepsia. Because symptoms do not reliably discriminate between organic and functional forms of the disease, anamnesis, family history of peptic ulcer and/or of gastric cancer, medication history, especially for nonsteroidal anti-inflammatory drugs, age, and physical examination could help the physician in discerning between functional dyspepsia and organic causes. For patients without alarm symptoms, noninvasive testing for H. pylori, with either carbon-13-labeled urea breath testing or stool antigen testing, is recommended as a first-line strategy. In this review, we provide recommendations to guide primary care physicians for appropriate use of diagnostic tests and for H. pylori management in dyspeptic patients.
- Published
- 2016
- Full Text
- View/download PDF
26. Real-world efficacy and safety of vedolizumab in managing ulcerative colitis versus Crohn’s disease: results from an Italian multicenter study
- Author
-
Mocci, Giammarco, Tursi, Antonio, Maconi, Giovanni, Cataletti, Giovanni, Mantia, Beatrice, Serio, Mariaelena, Scarcelli, Antonella, Pagnini, Cristiano, Graziani, Maria Giovanna, Di Paolo, Maria Carla, Pranzo, Giuseppe, Luppino, Ileana, Paese, Pietro, Elisei, Walter, Monterubbianesi, Rita, Faggiani, Roberto, Ferronato, Antonio, Perini, Barbara, Savarino, Edoardo, Onidi, Francesca Maria, Binaghi, Laura, Usai Satta, Paolo, Schiavoni, Elisa, Napolitano, Daniele, Scaldaferri, Franco, Pugliese, Daniela, Pica, Roberta, Cocco, Andrea, Zippi, Maddalena, Rodino, Stefano, Sebkova, Ladislava, Rocco, Giulia, Sacchi, Carlotta, Zampaletta, Costantino, Gaiani, Federica, De Angelis, Gianluigi, Kayali, Stefano, Fanigliulo, Libera, Lorenzetti, Roberto, Allegretta, Leonardo, Scorza, Stefano, Cuomo, Antonio, Donnarumma, Laura, Della Valle, Nicola, Sacco, Rodolfo, Forti, Giacomo, Antonelli, Elisabetta, Bassotti, Gabrio, Iannelli, Chiara, Luzza, Francesco, Aragona, Giovanni, Perazzo, Patrizia, Lauria, Angelo, Piergallini, Simona, Colucci, Raffaele, Bianco, Maria Antonia, Meucci, Costantino, Giorgetti, Gianmarco, Clemente, Valeria, Fiorella, Serafina, Penna, Antonio, De Medici, Antonio, Picchio, Marcello, and Papa, Alfredo
- Abstract
ABSTRACTBackgroundVedolizumab (VDZ) can be used to treat refractory ulcerative colitis (UC) and Crohn’s disease (CD). We assessed whether there are differences in treating UC vs CD with VDZ.Research design and methods Mayo score in UC and the Harvey-Bradshaw Index (HBI) in CD scored the clinical activity. Achievement and maintenance of clinical remission during the follow-up, and safety were the primary endpoints.Results729 patients (475 with UC and 254 with CD), median follow-up of 18 (IQR 6-36) months, were enrolled. Clinical remission at the 6thmonth of treatment was achieved in 488 (66.9%) patients (74.4% in CD vs 62.9% in UC, p<0.002) while, during the follow-up, no difference was found (81.5% in the UC group and 81.5% pts in the CD group; p=0.537). The clinical remission at the 6thmonth of treatment (p=0.001) and being naïve to biologics (p<0.0001) were significantly associated with prolonged clinical remission. The clinical response was significantly higher in UC (90.1%) vs CD (84.3%) (p=0.023), and surgery occurred more frequently in CD (1.9% in UC vs 5.1% in CD, p=0.016).ConclusionWe found differences when using VDZ in UC vs CD in real life. These parameters can help the physician predict this drug’s longterm efficacy.
- Published
- 2023
- Full Text
- View/download PDF
27. Letter: a physiological dose of lactose and fructose is necessary to demonstrate intolerance
- Author
-
Usai-Satta, P.
- Published
- 2014
- Full Text
- View/download PDF
28. Pharmacotherapeutic advances for chronic idiopathic constipation in adults
- Author
-
Bassotti, Gabrio, Usai Satta, Paolo, Berti, Ginevra, Lai, Mariantonia, Villanacci, Vincenzo, and Bellini, Massimo
- Abstract
ABSTRACTIntroductionChronic idiopathic constipation is a common gastrointestinal disorder whose treatment is still far from being satisfactory for patients. Osmotic laxatives, in particular polyethylene glycol, are the first-line approach, but new emerging pharmacological agents may be useful in refractory patients.Areas coveredPublished articles regarding the development and clinical efficacy of new agents in treating chronic idiopathic constipation were reviewed. Among emerging agents, elobixibat, a drug blocking the reabsorption of bile acids, is a promising one, especially in slow transit constipation. Linaclotide, lubiprostone and plecanatide, by a secretagogue action, improve stool consistency and increase colonic transit. Apart from prucalopride, approved in Europe for refractory chronic idiopathic constipation patients, the selective 5-HT4 agonists velusetrag and naronapride are in advanced development. In addition, relamorelin, a ghrelin agonist, seems promising for accelerating colonic transit.Expert opinionSeveral new promising drugs have been released with the potential to be effective in the treatment of chronic idiopathic constipation. On the other hand, the experience with these new agents is still limited, especially for long-term treatment. Another important point is that these new treatments for chronic idiopathic constipation are not available worldwide and their use could be somewhat limited by their still relatively high cost.
- Published
- 2022
- Full Text
- View/download PDF
29. Genetic testing improves the diagnosis of adult type hypolactasia in the Mediterranean population of Sardinia
- Author
-
Schirru, E, Corona, V, Usai-Satta, P, Scarpa, M, Oppia, F, Loriga, F, Cucca, F, De Virgiliis, S, Rossino, R, Doloretta Macis, M, Jores, R-D, and Congia, M
- Published
- 2007
- Full Text
- View/download PDF
30. Extrinsic autonomic neuropathy in a case of transition from diffuse esophageal spasm to achalasia
- Author
-
Usai Satta, P., Oppia, F., Piras, R., and Loriga, F.
- Published
- 2004
- Full Text
- View/download PDF
31. Effects of Prokinetics on the Digestive Tract
- Author
-
Usai-Satta, Paolo, Lai, Mariantonia, Oppia, Francesco, and Cabras, Francesco
- Abstract
Background: Functional gastrointestinal disorders account for at least a third of visits togastroenterology clinics. Despite pathophysiological complexity, impaired gut motility may be frequentlypresent in these disorders. Introduction: Prokinetics are a class of drugs that promote gastrointestinal motility, accelerate transit,and potentially improve digestive symptoms. Several prokinetic agents with a great variety of mechanismsof action are available. Aim: The purpose of this paper is to update our current knowledge about the efficacy and safety of prokinetics.Methods: A literature search on efficacy and safety of prokinetics was carried out using the online databasesof Pubmed, Medline, and Cochrane. Results: Based on the action of different receptors, prokinetics mainly comprise dopamine antagonists,5HT4 agonists, motilin agonists, ghrelin agonists, and cholinergic agonists. Prokinetics have thepotential to improve motility function in all segments of the digestive tract, from the esophagus to thecolon. In particular, drug international agencies have approved antidopaminergic metoclopramide forthe treatment of gastroparesis and serotoninergic prucalopride for chronic constipation not responsiveto traditional laxatives. Arrhythmias by QT prolongation and galactorrhea by prolactin stimulation arethe more frequent side effects related to prokinetics use. Conclusion: Old and new prokinetics are effective in ameliorating digestive motility disorders and relatedsymptoms and are widely prescribed. Special attention should be paid to the potential adverseevents of these agents.
- Published
- 2022
- Full Text
- View/download PDF
32. Autonomic dysfunction and upper digestive functional disorders in untreated adult coeliac disease
- Author
-
USAI, P., USAI SATTA, P., LAI, M., CORDA, M. G., PIRAS, E., CALCARA, C., BOY, M. F., MORELLI, A., BALESTRIERI, A., and BASSOTTI, G.
- Published
- 1997
33. Overview of pathophysiological features of GERD
- Author
-
Oppia F, Cabras F, and Usai Satta P
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Esophageal Mucosa ,Nerd ,Endocrinology, Diabetes and Metabolism ,Gastroenterology ,Esophageal Sphincter, Lower ,Hiatal hernia ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Esophagus ,Esophagitis, Peptic ,Gastric emptying ,business.industry ,Stomach ,digestive, oral, and skin physiology ,medicine.disease ,digestive system diseases ,Stomach emptying ,030104 developmental biology ,medicine.anatomical_structure ,Gastric Emptying ,030220 oncology & carcinogenesis ,Gastroesophageal Reflux ,GERD ,business ,Esophagitis - Abstract
Gastroesophageal reflux disease (GERD) is a very prevalent condition and has a high impact on the quality of life. Nevertheless, pathophysiology is complex and multi-factorial. Several mechanisms have been proposed: decreased salivation, decreased lower esophageal sphincter pressure resting tone, presence of hiatal hernia, increased number of transient lower esophageal sphincter relaxations, increased acid, and pepsin secretion, duodeno-gastro-esophageal reflux of bile acids and trypsin. Other factors contributing to the pathophysiology of GERD include poor esophageal clearance, delayed gastric emptying and impaired mucosal defensive factors. Esophageal mucosa integrity is impaired both in patients with erosive esophagitis also in regions macroscopically normal and in NERD patients. Patients with functional heartburn have instead a normal mucosal integrity. The mechanisms underlying extra-esophageal GERD are instead more controversial. Reflux symptoms could be caused by esophageal hypersensitivity as a result of visceral neural pathway dysfunction. Multiple mechanisms influence the perception of GERD symptoms, such as the acidity of the refluxate, its proximal extent, the presence of gas in the refluxate, duodeno-gastro-esophageal reflux, mucosal integrity, and peripheral and central sensitization. Furthermore several risk factors can influence the onset of GERD and its complications such as life style, obesity, genetics, pregnancy, and stress. In particular obesity is associated with complications related to longstanding reflux such as erosive esophagitis, Barrett's esophagus, and esophageal adenocarcinoma. Understanding the pathophysiology of gastro-esophageal reflux is important for future targets for therapy. Further research is necessary to improve the current knowledge of the contributing factors leading to GERD.
- Published
- 2017
34. A SIGE-SINGEM-AIGO technical review on the clinical use of esophageal reflux monitoring.
- Author
-
Savarino, Edoardo, Frazzoni, Marzio, Marabotto, Elisa, Zentilin, Patrizia, Iovino, Paola, Costantini, Mario, Tolone, Salvatore, Battaglia, Edda, Cicala, Michele, Usai-Satta, Paolo, de Bortoli, Nicola, Penagini, Roberto, and Savarino, Vincenzo
- Abstract
Patients with esophageal symptoms potentially associated with gastroesophageal reflux disease such as heartburn, regurgitation, chest pain, or cough represent one of the most frequent reasons for referral to gastroenterological evaluation. The utility of esophageal reflux monitoring in clinical practice is: (1) to accurately define reflux burden, (2) to segregate patients according to reflux monitoring results as true GERD, reflux hypersensitivity and functional heartburn, and (3) to establish a treatment plan. With this in mind, in the last decade, investigations and technical advances, with the introduction of impedance-pH monitoring and wireless pH capsule, have enhanced our understanding and management of GERD. The following recommendations were discussed and approved after a comprehensive review of the medical literature pertaining to reflux testing techniques and their recent application. This review created under the auspices of the Società Italiana di Gastroenterologia ed Endoscopia Digestiva (SIGE), Società Italiana di Neuro-Gastro-Enterologia e Motilità (SINGEM) and Associazione Italiana Gastroenterologi ed Endoscopisti Digestivi Ospedalieri (AIGO) is intended to help clinicians in applying reflux studies in the most fruitful manner within the context of their patients with esophageal symptoms. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
35. 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
36. IBS clinical management in Italy: The AIGO survey.
- Author
-
Soncini, Marco, Stasi, Cristina, Usai Satta, Paolo, Milazzo, Giuseppe, Bianco, Margherita, Leandro, Gioacchino, Montalbano, Luigi Maria, Muscatiello, Nicola, Monica, Fabio, Galeazzi, Francesca, and Bellini, Massimo
- Abstract
Irritable bowel syndrome (IBS) is the most frequent functional gastrointestinal disorder, both in primary and secondary care. (1) To describe diagnostic tools and treatments suggested to IBS patients by Italian gastroenterologists; (2) To evaluate patients' quality of life and psychological involvement and the relationship of these factors with symptom severity. Twenty-six gastroenterologists recorded the demographic and clinical data of 677 IBS patients. Diagnostic and treatment measures taken in the previous year and those suggested by gastroenterologists were analysed. IBS with constipation was found in 43.4%, with diarrhoea in 21.6%, mixed-IBS in 35.0%. Routine blood tests, ultrasonography, colonoscopy, barium enema and CT were more frequently requested in the previous year than by the gastroenterologists (p < 0.001). Colonoscopy (11%), and ultrasonography (20.4%) were also suggested by the gastroenterologists in a non-negligible number of patients. Abdominal pain and distension, bowel dissatisfaction, anxiety and depression were more severe in females than in males. Quality of life decreased with increasing IBS-symptom severity. IBS diagnosis is still largely based on exclusion criteria even if gastroenterologists try to improve diagnostic appropriateness. However, therapy remains symptom-based also in the gastroenterological setting even if gastroenterologists use a wide variety of approaches, including innovative therapies such as linaclotide and psychotherapy. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
37. Loss-of-function of the voltage-gated sodium channel NaV1.5 (Channelopathies) in patients with irritable bowel syndrome
- Author
-
Beyder, A. Mazzone, A. Strege, P.R. Tester, D.J. Saito, Y.A. Bernard, C.E. Enders, F.T. Ek, W.E. Schmidt, P.T. Dlugosz, A. Lindberg, G. Karling, P. Ohlsson, B. Gazouli, M. Nardone, G. Cuomo, R. Usai-Satta, P. Galeazzi, F. Neri, M. Portincasa, P. Bellini, M. Barbara, G. Camilleri, M. Locke III, G.R. Talley, N.J. D'Amato, M. Ackerman, M.J. Farrugia, G.
- Subjects
cardiovascular system ,cardiovascular diseases - Abstract
Background & Aims SCN5A encodes the α-subunit of the voltage-gated sodium channel NaV1.5. Many patients with cardiac arrhythmias caused by mutations in SCN5A also have symptoms of irritable bowel syndrome (IBS). We investigated whether patients with IBS have SCN5A variants that affect the function of NaV1.5. Methods We performed genotype analysis of SCN5A in 584 persons with IBS and 1380 without IBS (controls). Mutant forms of SCN5A were expressed in human embryonic kidney-293 cells, and functions were assessed by voltage clamp analysis. A genome-wide association study was analyzed for an association signal for the SCN5A gene, and replicated in 1745 patients in 4 independent cohorts of IBS patients and controls. Results Missense mutations were found in SCN5A in 13 of 584 patients (2.2%, probands). Diarrhea-predominant IBS was the most prevalent form of IBS in the overall study population (25%). However, a greater percentage of individuals with SCN5A mutations had constipation-predominant IBS (31%) than diarrhea-predominant IBS (10%; P
- Published
- 2014
38. OC.06.9 IRRITABLE BOWEL SYNDROME: RESULTS OF AIGO SURVEY 2014–2015
- Author
-
Soncini, M., primary, Milazzo, G., additional, Leandro, G., additional, Bellini, M., additional, Carrara, M., additional, Montalbano, L., additional, Muscatiello, N., additional, Monica, F., additional, Usai Satta, P., additional, Cabras, F., additional, Camilleri, S., additional, Gambaccini, D., additional, Tammaro, L., additional, D'Alba, L., additional, Turco, L., additional, Gasparini, P., additional, Galeazzi, F., additional, Solinas, A., additional, Russo, G., additional, Salvioli, B., additional, Anderloni, A., additional, Bassotti, G., additional, Lai, M., additional, Antonino, M., additional, De Bona, M., additional, Boschetto, S., additional, Rentini, S., additional, Rossitti, P., additional, Limido, E., additional, and Balzano, A., additional
- Published
- 2016
- Full Text
- View/download PDF
39. IMPEDANCE-PH MONITORING AND SYMPTOMANALYSIS IN NON-CARDIAC CHEST PAIN PATIENTS ON AND OFF THERAPY
- Author
-
Savarino, E., Zentilin, P., Lo Cuoco, D., Frazzoni, M., Martinucci, I., De Bortoli, N., Casini, V., Pace, F., Barbera, R., Bergonzi, M., Di Stefano, M., Oppia, F., Usai Satta, P., Ricci, Giorgio, De BonA, M., De Boni, M., Sturniolo, G. C., and Savarino, V.
- Published
- 2012
40. SYMPTOMS ASSOCIATED TOWEAKLY ACIDIC REFLUX AND ESOPHAGEAL MOTILITY ABNORMALITIES ARE COMMON FINDINGS IN PATIENTS WITH NCCP NON-RESPONDING TO PPI THERAPY
- Author
-
Savarino, E., Zentilin, P., Lo Cuoco, D., Frazzoni, M., De Bortoli, N., Martinucci, I., Casini, V., Pace, F., Barbera, R., Bergonzi, M., Di Stefano, M., Oppia, F., Usai Satta, P., Ricci, Giorgio, De Bona, M., De Boni, M., Sturniolo, G. C., and Savarino, V.
- Published
- 2012
41. IMPEDANCE-PH MONITORING AND SYMPTOM ANALYSIS IN EROSIVE AND NON-EROSIVE REFLUX DISEASE PATIENTS WITH NON-CARDIAC CHEST PAIN − A STUDY ON AND OFF THERAPY
- Author
-
Savarino, E., Zentilin, P., Lo Cuoco, D., Frazzoni, M., de Bortoli, N., Casini, V., Pace, F., Barbera, R., Bergonzi, M., Michele, D. S., Oppia, F., Usai Satta, P., Ricci, Giorgio, de Bona, M., de Boni, M., Sturniolo, G. C., and Savarino, V.
- Published
- 2012
42. SYMPTOMS ASSOCIATED TO WEAKLY ACIDIC REFLUX AND ESOPHAGEAL MOTILITY ABNORMALITIES ARE MORE COMMON THAN FUNCTIONAL CHEST-PAIN IN PATIENTS WITH NON-CARDIAC CHEST PAIN REFRACTORY TO PPI THERAPY
- Author
-
Savarino, E., Zentilin, P., Lo Cuoco, D., Frazzoni, M., de Bortoli, N., Casini, V., Pace, F., Barbera, R., Michele, D. S., Oppia, F., Usai Satta, P., Debona, M., de Boni, M., Ricci, Giorgio, Sturniolo, G. C., and Savarino, V.
- Published
- 2012
43. Genetic testing is ready to change the diagnostic scenario of lactose malabsorption
- Author
-
Usai Satta, P., Congia, M., Schirru, E., Scarpa, M., and Mura, G.
- Subjects
Lactose intolerance -- Diagnosis ,Genetic screening -- Usage ,Health - Published
- 2008
44. Methodology and indications of H2-breath testing in gastrointestinal diseases: the Rome Consensus Conference
- Author
-
Gasbarrini, A., Corazza, G. R., Gasbarrini, G., Montalto, M., Di Stefano, M., Basilisco, G., Parodi, A., Usai Satta, P., Vernia, P., Anania, C., Astegiano, M., Barbara, G., and Benini, Luigi
- Subjects
lactose ,breath test ,intolerance ,guidelines ,glucose - Published
- 2009
45. Extrinsic autonomic neuropathy in a case of transition from diffuse esophageal spasm to achalasia
- Author
-
Loriga F, Oppia F, Piras R, and Usai Satta P
- Subjects
medicine.medical_specialty ,Neurology ,Endocrine and Autonomic Systems ,business.industry ,Achalasia ,medicine.disease ,Diabetes mellitus ,Internal medicine ,Esophageal sphincter ,Cardiology ,Medicine ,Esophageal spasm ,Neurology (clinical) ,business ,Autonomic neuropathy - Published
- 2004
46. P.02.13 GASTRIC EMPTYING IS DELAYED IN ADULT CELIAC DISEASE BUT DOES NOT NORMALIZE AFTER GLUTEN FREE DIET
- Author
-
Usai Satta, P., primary, Oppia, F., additional, Scarpa, M., additional, and Cabras, F., additional
- Published
- 2014
- Full Text
- View/download PDF
47. Therapeutic Approach for Irritable Bowel Syndrome: Old and New Strategies
- Author
-
Usai-Satta, Paolo, Bellini, Massimo, Lai, Mariantonia, Oppia, Francesco, and Cabras, Francesco
- Abstract
Background: Irritable bowel syndrome (IBS) is the most frequently diagnosed functional gastrointestinal disorder. It is characterised by abdominal pain, bloating and changes in bowel habits that can have a serious impact on the patient's quality of life. Treatment strategies are based on the nature and severity of the symptoms, the degree of functional impairment of the bowel habits, and the presence of psychosocial disorders. The purpose of this review is to update our current knowledge of therapeutic approach of this disorder. Method: A literature search for IBS therapy was carried out using the online databases of Pubmed, Medline and Cochrane. Results: An ideal treatment begins by explaining this condition and providing reassurance to the patients. There is limited evidence for the efficacy, and tolerability of the therapies currently available for the treatment of IBS. There is also a limited availability of pharmacological agents licensed specifically for the treatment of IBS subtypes, although new agents have been recently proposed to this goal. Furthermore, patients often associate their complaints with the ingestion of foods containing FODMAPs (fermentable oligo-di-monosaccharides, and polyols) and gluten derivates and a personalized diet can be proposed. However, more severe symptoms can be associated with greater levels of psychosocial problems and a psychological approach and antidepressant drugs can be needed. Conclusion: The treatment of IBS remains focused on treating the patient's predominant, or most troublesome, symptoms. New promising treatments have recently become available for the treatment of IBS but long term studies are still needed.
- Published
- 2018
- Full Text
- View/download PDF
48. Linaclotide for the treatment of chronic constipation
- Author
-
Bassotti, Gabrio, Usai-Satta, Paolo, and Bellini, Massimo
- Abstract
ABSTRACTIntroduction: Chronic constipation (CC) is a common gastrointestinal disorder with limited treatment options. Linaclotide is a potent peptide agonist of the guanylate cyclase-C receptor. This action activates intracellular conversion of guanosine 5-triphosphate to cyclic guanosine monophosphate resulting in the stimulation of intestinal fluid secretion. Linaclotide is a promising new agent for refractory constipation.Areas covered: All published articles regarding the development, clinical efficacy, and safety of linaclotide in treating CC were reviewed. Pharmacodynamics, pharmacokinetics, and metabolism of this secretagogue agent were examined. Clinical studies showed that linaclotide increases the number of spontaneous bowel movements and stool consistency scores. Overall, patients reported relief from abdominal discomfort and severity of constipation. Finally, linaclotide has a good safety profile, with diarrhea being the main side effect.Expert opinion: Linaclotide appears to be a well-tolerated and effective agent for patients with CC, and could be effectively combined with other drugs in patients with refractory constipation. However, data on the efficacy and safety of linaclotide in pediatric patients and in opioid-induced constipation are currently limited and more studies need to be undertaken.
- Published
- 2018
- Full Text
- View/download PDF
49. Functional variants in the sucrase–isomaltase gene associate with increased risk of irritable bowel syndrome
- Author
-
Henstrom, Maria, Diekmann, Lena, Bonfiglio, Ferdinando, Hadizadeh, Fatemeh, Kuech, Eva-Maria, von Kockritz-Blickwede, Maren, Thingholm, Louise B, Zheng, Tenghao, Assadi, Ghazaleh, Dierks, Claudia, Heine, Martin, Philipp, Ute, Distl, Ottmar, Money, Mary E, Belheouane, Meriem, Heinsen, Femke-Anouska, Rafter, Joseph, Nardone, Gerardo, Cuomo, Rosario, Usai-Satta, Paolo, Galeazzi, Francesca, Neri, Matteo, Walter, Susanna, Simrén, Magnus, Karling, Pontus, Ohlsson, Bodil, Schmidt, Peter T, Lindberg, Greger, Dlugosz, Aldona, Agreus, Lars, Andreasson, Anna, Mayer, Emeran, Baines, John F, Engstrand, Lars, Portincasa, Piero, Bellini, Massimo, Stanghellini, Vincenzo, Barbara, Giovanni, Chang, Lin, Camilleri, Michael, Franke, Andre, Naim, Hassan Y, and D'Amato, Mauro
- Abstract
ObjectiveIBS is a common gut disorder of uncertain pathogenesis. Among other factors, genetics and certain foods are proposed to contribute. Congenital sucrase–isomaltase deficiency (CSID) is a rare genetic form of disaccharide malabsorption characterised by diarrhoea, abdominal pain and bloating, which are features common to IBS. We tested sucrase–isomaltase (SI) gene variants for their potential relevance in IBS.DesignWe sequenced SIexons in seven familial cases, and screened four CSID mutations (p.Val557Gly, p.Gly1073Asp, p.Arg1124Ter and p.Phe1745Cys) and a common SIcoding polymorphism (p.Val15Phe) in a multicentre cohort of 1887 cases and controls. We studied the effect of the 15Val to 15Phe substitution on SI function in vitro. We analysed p.Val15Phe genotype in relation to IBS status, stool frequency and faecal microbiota composition in 250 individuals from the general population.ResultsCSID mutations were more common in patients than asymptomatic controls (p=0.074; OR=1.84) and Exome Aggregation Consortium reference sequenced individuals (p=0.020; OR=1.57). 15Phe was detected in 6/7 sequenced familial cases, and increased IBS risk in case–control and population-based cohorts, with best evidence for diarrhoea phenotypes (combined p=0.00012; OR=1.36). In the population-based sample, 15Phe allele dosage correlated with stool frequency (p=0.026) and Parabacteroidesfaecal microbiota abundance (p=0.0024). The SI protein with 15Phe exhibited 35% reduced enzymatic activity in vitro compared with 15Val (p<0.05).ConclusionsSIgene variants coding for disaccharidases with defective or reduced enzymatic activity predispose to IBS. This may help the identification of individuals at risk, and contribute to personalising treatment options in a subset of patients.
- Published
- 2018
- Full Text
- View/download PDF
50. Manometria e pH-metria esofagea nella malattia celiaca dell'adulto
- Author
-
USAI SATTA, P, Bassotti, Gabrio, Pardocchi, D, Corda, G, Lai, Ma, Piras, E, Chiarito, C, Boy, Mf, Morelli, Antonio, Balestrieri, A, and Usai, P.
- Published
- 1996
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.