24 results on '"Zancanella L"'
Search Results
2. Low risk of colon cancer in patients with celiac disease
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Volta, Umberto, Vincentini, Olimpia, Quintarelli, Federica, Felli, Cristina, Silano, Marco, Gasbarrini, G, De Vitis, V, Santini, D, Scaggiante, F, Castellano, E, Grosso, S, Campanella, J, Corazza, GR, Sandri, G, Giorgetti, G, Caio, G, Lo Perfido, S, Perri F, Festa V, Pelli MA, Cavalletti ML, Segato S, Curzio M, Pennazio M, Rossini FP, Picarelli A, Pera A, Ercole E, Passaleva MT, Barbato M, Usai P, Dore MF, Chilovi F, Piazzi L, Zancanella L, Boarino V, Ferrari A., GRECO, LUIGI, AURICCHIO, SALVATORE, Volta, Umberto, Vincentini, Olimpia, Quintarelli, Federica, Felli, Cristina, Silano, Marco, Gasbarrini, G, De Vitis, V, Greco, Luigi, Auricchio, Salvatore, Santini, D, Scaggiante, F, Castellano, E, Grosso, S, Campanella, J, Corazza, Gr, Sandri, G, Giorgetti, G, Caio, G, Lo, Perfido, S, Perri, F, Festa, V, Pelli, Ma, Cavalletti, Ml, Segato, S, Curzio, M, Pennazio, M, Rossini, Fp, Picarelli, A, Pera, A, Ercole, E, Passaleva, Mt, Barbato, M, Usai, P, Dore, Mf, Chilovi, F, Piazzi, L, Zancanella, L, Boarino, V, Ferrari, A., Volta U, Vincentini O, Quintarelli F, Felli C, Silano M, and Collaborating Centres of the Italian Registry of the Complications of Celiac Disease
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Male ,Colorectal cancer ,COLON CANCER ,Disease ,Gastroenterology ,Colon carcinoma ,Retrospective Studie ,Medicine ,Child ,Colonic Neoplasm ,education.field_of_study ,Medicine (all) ,Incidence ,Celiac disease ,Gluten-free diet ,Adolescent ,Adult ,Carcinoma ,Celiac Disease ,Child, Preschool ,Colonic Neoplasms ,Diet, Gluten-Free ,Female ,Follow-Up Studies ,Humans ,Infant ,Infant, Newborn ,Italy ,Middle Aged ,Patient Compliance ,Retrospective Studies ,Risk Assessment ,Young Adult ,Population study ,Human ,Cohort study ,medicine.medical_specialty ,Population ,Follow-Up Studie ,NO ,Internal medicine ,In patient ,Preschool ,education ,business.industry ,Newborn ,medicine.disease ,digestive system diseases ,Diet ,Standardized mortality ratio ,Gluten-Free ,Celiac disease, colon carcinoma, gluten-free diet ,business - Abstract
Objective. Celiac disease (CD) has strongly been established as associated with some site-specific gastrointestinal malignancies. On the contrary, according to the few reports available, the risk of colon carcinoma in CD patients has been described similar to that of general population. In this cohort study, we describe the risk of colon carcinoma in a group of Italian celiac patients. Materials and methods. The study population included all CD patients diagnosed at the Collaborating Centers of the Italian Registry of CD between 1st January 1982 and 31st December 2006. Upon diagnosis of CD and upon at every subsequent clinical control, the Collaborating Centers filled in a validated form for each CD patient reporting information about demographic data, possible occurrence of a neoplasm and adherence to a gluten-free diet. Results. Out of 1757 celiac patients enrolled, 6 developed a colon carcinoma during the follow-up period (mean: 18.1 years). The standardized incidence ratio (SIR) resulted 0.29 (95% CI = 0.07–0.45). Stratifying the risk for the dietary gluten intake, the SIR dropped to 0.07 (95% CI = 0.009–0.27) for CD patients with a strict adherence to a gluten-free diet. Conclusion. We confirm the previous finding that there is low risk to develop a colon cancer in celiac patients.
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- 2014
3. Effect of a gluten-free diet on the risk of enteropathy-associated T-cell lymphoma in celiac disease
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Silano, Marco, Volta, Umberto, Vincenzi, Alessandro De, Dessì, Mariarita, Vincenzi, Massimo De, Gasbarrini, G., De Vitis, V., Santini, D., F. , Scaggiante M., Vincenzi, M., Federici, Null, Castellano, E., Calvi, A., Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Volta, U., Parisi, C., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., Ferrari, A., GRECO, LUIGI, AURICCHIO, SALVATORE, Silano, Marco, Volta, Umberto, Vincenzi, Alessandro De, Dessì, Mariarita, Vincenzi, Massimo De, Gasbarrini, G., De Vitis, V., Greco, Luigi, Auricchio, Salvatore, Santini, D., F., Scaggiante M., Vincenzi, M., Federici, Null, Castellano, E., Calvi, A., Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Volta, U., Parisi, C., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., and Ferrari, A.
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Male ,Time Factors ,Lymphoma ,Physiology ,Gastroenterology ,Coeliac disease ,Celiac disease, Enteropathy-associated T-cell lymphoma, Gluten-free diet ,Child ,chemistry.chemical_classification ,Settore BIO/12 ,Middle Aged ,Child, Preschool ,Gluten-free diet ,Enteropathy-associated T-cell lymphoma ,Female ,Human ,Adult ,medicine.medical_specialty ,Intestinal Neoplasm ,Glutens ,Adolescent ,Time Factor ,Diet therapy ,Malignancy ,Lymphoma, T-Cell ,Follow-Up Studie ,Celiac disease ,Celiac Disease ,Follow-Up Studies ,Humans ,Infant ,Intestinal Neoplasms ,Patient Compliance ,Stomach Neoplasms ,Stomach Neoplasm ,Internal medicine ,medicine ,Risk factor ,Preschool ,business.industry ,nutritional and metabolic diseases ,medicine.disease ,T-Cell ,Gluten ,digestive system diseases ,chemistry ,Gluten free ,business - Abstract
Patients with celiac disease have an increased rate of enteropathy-associated T-cell lymphoma, but conflicting data are available about the protective role of a gluten-free diet with regard to the development of this malignancy. We followed 1,757 celiac patients for a total period of 31,801 person-years, collecting data about the frequency of gluten intake and the incidence of the enteropathy-associated T-cell lymphoma. Out of the nine celiac patients who developed an intestinal lymphoma [standard morbidity ratio of 6.42 (95% CI = 2.9-12.2; P < 0.001)], only two kept a strict gluten-free diet after the diagnosis of celiac disease and developed the malignancy after the peridiagnosis period of 3 years, dropping therefore the standard morbidity ratio to 0.22 (95%CI = 0.02-0.88; P < 0.001). The risk of developing an intestinal lymphoma for the celiac patients that used to have dietary gluten was significant (X(2 )= 4.8 P = 0.01). These results show that a strict gluten-free diet is protective towards the development of enteropathy-associated T-cell lymphoma.
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- 2008
4. Delayed diagnosis of coeliac disease increases cancer risk
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Silano, Marco, Volta, Umberto, Mecchia, Anna, Dessì, Mariarita, Di Benedetto, Rita, De Vincenzi, Massimo, Gasbarrini, G., De Vitis, D., Greco, L., Auricchio, S., Santini, D., Scaggiante, F., Federici, M. D., Castellano, E., Sategna-Guidetti, Null, Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Amici, Monica, De Franceschi, L., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., Ferrari, A., Silano, Marco, Volta, Umberto, Mecchia, Anna, Dessì, Mariarita, Di Benedetto, Rita, De Vincenzi, Massimo, Gasbarrini, G., De Vitis, D., Greco, Luigi, Auricchio, Salvatore, Santini, D., Scaggiante, F., Federici, M. D., Castellano, E., Sategna Guidetti, Null, Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Amici, Monica, De Franceschi, L., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, A., Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., and Ferrari, A.
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Registrie ,tumors ,Adult ,Male ,Risk ,medicine.medical_specialty ,Time Factors ,Time Factor ,Delayed diagnosis ,Gastroenterology ,Coeliac disease ,Internal medicine ,Neoplasms ,medicine ,Neoplasm ,Humans ,Age Factor ,In patient ,Registries ,lcsh:RC799-869 ,Coeliac disease, neoplasm, tumors ,Age Factors ,Celiac Disease ,Female ,Middle Aged ,business.industry ,Medicine (all) ,Settore BIO/12 ,Cancer ,General Medicine ,Hepatology ,medicine.disease ,Population study ,lcsh:Diseases of the digestive system. Gastroenterology ,Cancer risk ,business ,neoplasm ,Human ,Research Article - Abstract
Background The association between coeliac disease (CD) and neoplasms has been long established, but few data are available about the risk factors. The aim of this paper is to estimate the risk of developing a neoplasm among non diagnosed coeliac patients and to evaluate if this risk correlates with the age of patients at diagnosis of coeliac disease. Methods The study population consists of patients (n = 1968) diagnosed with CD at 20 Italian gastroenterology referral Centers between 1st January 1982 and 31st March 2005. Results The SIR for all cancers resulted to be 1.3; 95% CI = 1.0–1.7 p < 0.001. The specific SIRs for non Hodgkin lymphoma was 4.7; 95% CI = 2.9–7.3 p < 0.001, for the small bowel carcinoma 25; 95% CI = 8.5–51.4 p < 0.001, for non Hodgkin lymphoma 10; 95% CI = 2.7–25 p = 0.01, finally for the stomach carcinoma 3; 95% CI = 1.3–4.9 p < 0.08. The mean age at diagnosis of CD of patients that developed sooner or later a neoplasm was 47,6 ± 10.2 years versus 28.6 ± 18.2 years of patients who did not. Conclusion Coeliac patients have an increased risk of developing cancer in relation to the age of diagnosis of CD. This risk results higher for malignancies of the gastro-intestinal sites. An accurate screening for tumors should be performed in patients diagnosed with CD in adulthood and in advancing age.
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- 2007
5. Clinical features of chronic C virus hepatitis in patients with celiac disease
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Silano, M., Volta, U., Vincentini, O., De Vincenzi, M., Gasbarrini Italian Registry Of The Complications Of Celiac Disease, (., De Vitis, V., Greco, L., Auricchio, S., Santini, D., Scaggiante, F., Vincenzi, M., Federici, Castellano, E., Calvi, A., Sategna, Guidetti, Grosso, S., Campanella, J., Corazza, G. R., Sandri, G., Giorgetti, G., Amici, M., Parisi, C., Lo Perfido, S., Perri, F., Festa, V., Pelli, M. A., Cavalletti, M. L., Segato, S., Curzio, M., Pennazio, M., Rossini, F. P., Picarelli, Antonio, Pera, A., Ercole, E., Passaleva, M. T., Barbato, M., Usai, P., Dore, M. F., Chilovi, F., Piazzi, L., Zancanella, L., Boarino, V., and Ferrari, A.
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Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Hepatitis C virus ,Population ,Autoimmune hepatitis ,medicine.disease_cause ,Gastroenterology ,Antiviral Agents ,Coeliac disease ,Primary sclerosing cholangitis ,Primary biliary cirrhosis ,Internal medicine ,medicine ,Prevalence ,Humans ,education ,Hepatitis ,education.field_of_study ,Anemia, Iron-Deficiency ,business.industry ,Depression ,General Medicine ,Hepatitis C ,Hepatitis C, Chronic ,medicine.disease ,Arthralgia ,digestive system diseases ,Celiac Disease ,Infectious Diseases ,Diabetes Mellitus, Type 2 ,Immunology ,Female ,business - Abstract
The association between celiac disease (CD) and several liver disorders has long been documented. About 40% of adult celiac patients have been reported to have mild to moderate hypertransaminasemia (up to five times the upper limit of normal) at the time of diagnosis of CD [1, 2]. In addition, CD has been found in roughly 10% of patients with unexplained hypertransaminasemia, and the majority of them have had their liver enzyme levels normalized after one year of following a strict gluten-free diet [3, 4]. In addition, an increased prevalence of primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis among CD patients has been reported [5, 6]. CD might also be linked to very severe liver conditions such as end-stage liver failure and hepatocellular carcinoma [7]. There is also evidence, even contrasting reports, about the association of CD with nonalcoholic steatohepatitis and fatty liver disease [8]. In contrast, no definitive evidence is available about the association between chronic hepatitis C (hepatitis C virus [HCV]) and CD. Fine et al. described a three-fold increase of CD prevalence among HCV patients compared to noninfected celiac individuals [9]. It has also been reported the activation of silent CD during the antiviral treatment for HCV with interferon-α and ribavirin, both alone and in combination [10]. Consequently, a routine serological screening for CD has been proposed in HCV patients before starting antiviral therapy. In case of HCV positivity, the achievement of the histological normalization of the intestinal mucosa after following a gluten-free diet has been advised before starting the therapy [10]. On the contrary, some recent prospective studies have not shown increased prevalence of CD among HCV patients and reported that the link between these two conditions is biased by the route of transmission [11, 12]. Among the 3,725 celiac patients included in the Italian Registry of the Complication of Celiac Disease, we identified 34 individuals (0.91%) that had an HCV chronic hepatitis at the time of diagnosis of CD. For the diagnosis of HCV, we considered the serological positivity of antiHCV antibodies. Some of the patients had the diagnosis made in the early 1980s, when the molecular tests for the detection of the viral antigens were not yet available. The demographic and clinical features of the patients with both CD and HCV with respect to those of patients with CD only are listed in Table 1. The prevalence of HCV among our celiac series is lower than the overall prevalence of HCV among the general population in Italy, matched for age and gender, which is estimated to be around 2% [13]. This finding does not support the hypothesis of a potential correlation between these two disorders. It has been assumed that antiviral therapy with INF-α and ribavirin may precipitate the onset of CD in susceptible individuals, promoting a Th1-specific response in the small intestine [14]. However, in our series, only 12 of the 34 celiac patients with HCV had antiviral therapy before CD diagnosis. Looking at our series, it seems more likely that an overall increased risk of CD in HCV patients exists, due to the predisposition for autoimmune diseases related to Eur J Clin Microbiol Infect Dis (2009) 28:1267–1269 DOI 10.1007/s10096-009-0769-6
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- 2009
6. Tamoxifen in treatment of hepatocellular carcinoma: a randomised controlled trial
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Daniele, B., Pignata, S., Cremona, F., Izzo, F., Parisi, V., Fiore, F., Vallone, P., Perrone, F., Monfardini, S., Adinolfi, L. E., Ragone, E., Ruggiero, G., Utili, R., Gaeta, G. B., Giolitto, G., Giusti, G., Caporaso, N., De Sio, I., Pasquale, G., Piccinino, F., Stanzione, M., Calandra, M., Castellano, L., Del Vecchio Blanco, C., Colurcio, R., Galanti, B., Russo, M., Palmentieri, B., D’Alfonso, M. Persico G., Gallo, C., Signoriello, G., Budillon, G., Capuano, G., Cimino, L., Belli, D. Pomponi G., Iannelli, A., Santangelo, M. L., Bianco, A. R., De Placido, S., Palmieri, G., Castiglione, F., Mazzacca, G., Rispo, A., D’Agostino, L., Mattera, D., Puzziello, Alessandro, Cuomo, O., Di Palma, M., Manno, E., Militerno, G., Arena, U., Di Fiore, G., Gentilini, P., Mazzanti, R., Farinati, F., Rinaldi, M., Coviello, A., Elba, S., Manghisi, G., Crispino, B., Laviscio, R., Piai, G., D’Angelo, V., Francica, G., Marone, G., Aiello, A., Ferraù, O., Freni, M. A., Aloisio, V., Giorgio, A., Perrotta, A., Felder, M., Zancanella, L., Belli, M., Colantuono, G., De Sena, G., Guardascione, F., Petrelli, G., Lamorgese, I. B., Manzione, L., Pedicini, T., and D’Aprile, M.
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- 1998
7. P.1.72: DIAGNOSTIC EFFICACY AND OUTCOME OF DBE IN OGIB
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Benvenuti, S., primary, De Guelmi, A., additional, Zancanella, L., additional, Ierace, S., additional, and Chi, F., additional
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- 2011
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8. MULTICENTER PRELIMINARY EXPERIENCE WITH “MIROCAM” CAPSULE ENDOSCOPY
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Pezzoli, A., primary, Fusetti, N., additional, Grasso, T., additional, Cantoni, F., additional, Di Bella, S., additional, Cantù, P., additional, Brancaccio, M.L., additional, Zancanella, L., additional, Chilovi, F., additional, Casetti, T., additional, Iaquinto, G., additional, Brunati, S., additional, Grazia, M., additional, and Gullini, S., additional
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- 2009
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9. MULTICENTER STUDY OF INTEROBSERVER AGREEMENT IN DESCRIBING CAPSULE ENDOSCOPY FINDINGS
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Pezzoli, A., primary, Cannizzaro, R., additional, Pennazio, M., additional, Rondonotti, E., additional, Bidoli, E., additional, Zancanella, L., additional, Cantoni, F., additional, Brancaccio, M.L., additional, Caravelli, G., additional, Melina, R., additional, Casetti, T., additional, Iaquinto, G., additional, Chilovi, F., additional, and Gullini, S., additional
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- 2009
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10. OC1.06.3 PROSPECTIVE, RANDOMIZED, DOUBLE-BLINDED, MULTICENTER STUDY COMPARING PEG VS NAP FOR CAPSULE ENDOSCOPY BOWEL PREPARATION
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Pezzoli, A., primary, Cannizzaro, R., additional, Fusetti, N., additional, Bidoli, E., additional, Cantoni, F., additional, Casetti, T., additional, Zancanella, L., additional, Chilovi, F., additional, Melina, R., additional, Iaquinto, G., additional, Caravelli, G., additional, Monastra, S., additional, and Gullini, S., additional
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- 2008
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11. PA.219 DOUBLE BALLOON ENTEROSCOPY (DBE) IN PATIENTS WITH OBSCURE GASTROINTESTINAL BLEEDING (OGIB) AFTER CAPSULE ENDOSCOPY (VCE)
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Benvenuti, S., primary, De Guelmi, A., additional, Grasso, T., additional, Zancanella, L., additional, Amplatz, S., additional, Comberlato, M., additional, Farris, P., additional, Felder, M., additional, Di Fede, F., additional, Mega, A., additional, Battisti Matscher, M., additional, Piazzi, L., additional, Bertozzo, A., additional, and Chilovi, F., additional
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- 2008
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12. The need for long-term treatment of peptic ulcer
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DOBRILLA, G., primary, ZANCANELLA, L., additional, and AMPLATZ, S., additional
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- 2007
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13. Prevention of post-ERCP pancreatitis with somatostatin versus gabexate mesylate: A randomized placebo controlled multicenter study
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Benvenuti, S., primary, Zancanella, L., additional, Piazzi, L., additional, Comberlato, M., additional, Chilovi, F., additional, Germanà, B., additional, Lecis, P., additional, Brosolo, P., additional, and Ederle, A., additional
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- 2006
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14. 24 P Clearance of refractory bile duct stones with extracorporeal shock-wave lithotripsy (ESWL)
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Amplatz, S., primary, Piazzi, L., additional, Farris, P., additional, Comberlato, M., additional, Zancanella, L., additional, Benvenuti, S., additional, Deguelmi, A., additional, Di Fede, F., additional, Felder, M., additional, Bertozzo, A., additional, Grasso, T., additional, and Chilovi, F., additional
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- 2002
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15. 22 P Prevalence and characteristics of patients with gastroesophageal reflux disease (GERD) in a GI endoscopy unit
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Benvenuti, S., primary, Mayr, C., additional, Bertozzo, A., additional, Comberlato, M., additional, De Guelmi, A., additional, Di Fede, F., additional, Farris, P., additional, Felder, M., additional, Grasso, T., additional, Amplatz, S., additional, Piazzi, L., additional, Zancanella, L., additional, and Chilovi, F., additional
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- 2002
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16. The need for long-term treatment of peptic ulcer.
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DOBRILLA, G., ZANCANELLA, L., and AMPLATZ, S.
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- 1993
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17. Prospective validation of the CLIP score: A new prognostic system for patients with cirrhosis and hepatocellular carcinoma
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Pererrone, F., Daniele, B., Battista Gaeta, G., Pignata, S., Gallo, C., Izzo, F., Cuomo, O., Capuano, G., Ruggiero, G., Mazzanti, R., Farinati, F., Elba, S., Cremona, F., Parisi, V., Fiore, F., Vallone, P., Di Palma, M., Manno, E., Militerno, G., Budillon, G., Cimino, L., Pomponi, D., Elio Adinolfi, L., Ragone, E., Utili, R., Arena, U., Di Fiore, G., Gentilini, P., Rinaldi, M., Coviello, A., Giuseppe Pasquale, Crispino, B., Laviscio, R., Piai, G., Caporaso, N., Sio, I., Belli, G., Iannelli, A., Luigi Santangelo, M., Ascione, T., Giusti, G., D Angelo, V., Francica, G., Marone, G., Pasquale, G., Piccinino, F., Stanzione, M., Raffaele Bianco, A., Placido, S., Palmieri, G., D Agostino, L., Mattera, D., Puzziello, A., Aiello, A., Ferraú, O., Antonietta Freni, M., Aloisio, V., Giorgio, A., Perrotta, A., Calandra, M., Castellano, L., Del Vecchio Blanco, C., Castiglione, F., Mazzacca, G., Rispo, A., Colurcio, R., Galanti, B., Russo, M., Palmentieri, B., Persico, M., Felder, M., Zancanella, L., Belli, M., Colantuoni, G., Sena, G., Guardascione, F., Petrelli, G., Lamorgese, B., Manzione, L., Pedicini, T., and D Aprile, M.
18. Gastrectomy, lack of gastric first pass metabolism of ethanol and alcoholic liver disease. Results of a multicentre study
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Frezza, M., Buda, A., Terpin, M. M., Arico, S., Benvenuti, S., Patrizia Burra, Casini, A., Laquinto, G., Manghisi, O. G., Pasquale, L., Petruzzi, J., Salvagnini, M., Surrenti, E., Tabone, M., and Zancanella, L.
19. Colorectal Cancer Screening Program by Colonoscopy in 55-Yr-Old Subjects
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Fausto, C., Andrea, B., Stefano, A., Stefano, B., Michele, C., Guelmi, A.d., Francesco, D.F., Piercarlo, F., Martina, F., Tiziana, G., Susanne, H., Lucia, P., and Zancanella, L.
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- 2004
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20. Interobserver agreement in describing video capsule endoscopy findings: a multicentre prospective study.
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Pezzoli A, Cannizzaro R, Pennazio M, Rondonotti E, Zancanella L, Fusetti N, Simoni M, Cantoni F, Melina R, Alberani A, Caravelli G, Villa F, Chilovi F, Casetti T, Iaquinto G, D'imperio N, and Gullini S
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- Angiodysplasia diagnosis, Angiodysplasia epidemiology, Gastrointestinal Hemorrhage etiology, Humans, Intestinal Diseases complications, Intestinal Polyps diagnosis, Intestinal Polyps epidemiology, Italy epidemiology, Observer Variation, Predictive Value of Tests, Prospective Studies, Sensitivity and Specificity, Capsule Endoscopy, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage epidemiology, Intestinal Diseases diagnosis, Intestinal Diseases epidemiology
- Abstract
Background and Aim: Few studies have specifically addressed interobserver agreement in describing lesions identified during capsule endoscopy. The aim of our study is to evaluate interobserver agreement in the description of capsule endoscopy findings., Materials and Methods: Consecutive short segments of capsule endoscopy were prospectively observed by 8 investigators. Seventy-five videos were prepared by an external investigator (gold standard). The description of the findings was reported by the investigators using the same validated and standardized capsule endoscopy structured terminology. The agreement was assessed using Cohen's kappa statistic., Results: As concerns the ability to detect a lesion, the agreement with the gold standard was moderate (kappa 0.48), as well as the agreement relating to the final diagnosis (κ 0.45). The best agreement was observed in identifying the presence of active bleeding (κ 0.72), whereas the poorest agreement concerned the lesion size (κ 0.32). The agreement with the GS was significantly better in endoscopists with higher case/volume of capsule endoscopy per year. Diagnostic concordance was better in the presence of angiectasia than in the presence of polyps or ulcers/erosions., Conclusions: Correct lesion identification and diagnosis seem more likely to occur in presence of angiectasia, and for readers with more experience in capsule endoscopy reading., (Published by Elsevier Ltd.)
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- 2011
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21. Diagnostic value of endoscopic markers for celiac disease in adults: a multicentre prospective Italian study.
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Piazzi L, Zancanella L, Chilovi F, Merighi A, De Vitis I, Feliciangeli G, Borgheresi P, Snider L, Grassi SA, Manfrini C, Orzes N, Bianco MA, Cugia L, Lenoci N, and Castagnini A
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- Adult, Female, Humans, Italy, Male, Prospective Studies, Celiac Disease pathology, Duodenoscopy
- Abstract
Aim: Some endoscopic features of duodenal mucosa are marker of mucosal injury, the most common cause being celiac disease (CD). The aim of this study was to prospectively assess the diagnostic value of the endoscopic markers for the diagnosis of CD in the adult population undergoing routine upper endoscopy., Methods: This was a prospective multicenter study conducted at 37 Italian endoscopic centers. A total of 509 consecutive patients submitted to routine upper endoscopy who presented one or more of following endoscopic markers were included: 1) mucosal mosaic pattern in the bulb and/or descending duodenum (DD); 2) nodularity in the bulb and/or DD; 3) scalloping of Kerkring's folds; 4) reduction in the number or absence of folds in the DD. 4 biopsies samples were taken from descending duodenum. In patients with histological findings consistent with CD, according to Oberhuber classification, sierologic test (EMA, tTGA) were performed for confirm the diagnosis., Results: At endoscopy, 249 patients showed an isolated marker; 260 subjects showed a coexistence of more than one marker; 369 patients (72.5%) presented mucosal lesions at histological examination and in 347 of these patients the diagnosis of CD was confirmed by serologic markers (94.0%). For 10 patients the diagnosis remained uncertain because of negative sierology and exclusion of other other cause of mucosal lesions. The diagnosis of CD was made in 61.3% patients who showed the mosaic pattern, in 65.7% of patients with nodular mucosa, in 64.4% of patients with scalloping of folds, in 40.2% of patients with reduction of folds, and in 61.5% of patients with loss of folds and in 83.6% of patients who showed the coexistence of more than one marker. The endoscopic markers overall had a PPV of 68% for the diagnosis of CD; the markers that singularly have demonstrated a higher correlation with CD are: mosaic mucosa of DD (PPV 65.0%), nodular mucosa of the bulb and DD (PPV 75.5%), and scalloping of folds (PPV 64.4%)., Conclusion: The study confirms the important role of endoscopy in the diagnostic process of CD not only for the bioptic sampling in patients with clinical suspicion of CD, but especially for the opportunity to evaluate alterations of the duodenal mucosa suggestive of CD in the general population and, consequently, to identify those patients who should undergo a duodenal biopsy.
- Published
- 2008
22. Gastrectomy, lack of gastric first pass metabolism of ethanol and alcoholic liver disease. Results of a multicentre study.
- Author
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Frezza M, Buda A, Terpin MM, Aricò S, Benvenuti S, Burra P, Casini A, Iaquinto G, Manghisi OG, Pasquale L, Petruzzi J, Salvagnini M, Surrenti E, Tabone M, and Zancanella L
- Subjects
- Aged, Chronic Disease, Female, Humans, Liver Diseases, Alcoholic metabolism, Male, Middle Aged, Ethanol metabolism, Gastrectomy, Liver Diseases epidemiology, Liver Diseases, Alcoholic surgery
- Abstract
Background: Some conditions characterized by a loss (anatomical or functional) of parietal cells of the gastric antrum, containing an alcohol-dehydrogenase, may reduce the first pass metabolism of ethanol at that level and, simultaneously, raise its bioavailability. The observation that the first pass metabolism was drastically suppressed after gastrectomy would appear to suggest that the latter condition represents a risk for the development of liver damage in patients who continue to consume alcohol even in a non relevant amount., Methods: Consecutively enrolled in the study were 304 individuals of both sexes aged between 45 and 70 years of whom 114 gastrectomized and 190 pair-matched control subjects all submitted to an Upper Gastrointestinal Endoscopy for whatever disturbance. All the patients were diagnosed as having liver disease with routine clinical and instrumental means. Information was collected concerning the mean daily alcohol intake, both before and after the operation., Results: The overall prevalence of hepatic lesions was shown to be higher in the gastrectomized than in the control group (42.1% vs 25.8%, p = 0.005). Moreover, referring only to alcohol-related hepatic lesions (steatosis, steato-fibrosis and cirrhosis), the prevalence was higher in the gastrectomized patients than in the controls (29.8% vs 17.9%, p = 0.02). As far as concerns alcohol consumption, the gastrectomized group had consumed 71 g/day and the control group 39 g/day alcohol per person (p < 0.05) in a similar period of time (35 and 33 years, respectively). Also the non alcohol-related liver damage (especially the viral type) was slightly higher in the gastrectomized patients (gastrectomized 12.3% vs control 7.9%, p = ns). Accordingly, the percentage of serum markers of viral infection was higher in this group (HBs Ag: gastrectomized 3.9% vs control 2.2%, p = ns; anti-HCV: gastrectomized 13.5% vs control 5.0%, p = 0.03). Finally, to test the eventual damaging effects of gastrectomy alone (excluding ethanol and/or viral infection), two groups of patients with a medium to low alcoholic negative assumption (30-60 g ethanol/day) and no signs of viral infection (HBsAg and anti-HCV negative) were extrapolated. In these two selected groups, the prevalence of alcoholic-related hepatic lesions were not statistically different (28 gastrectomized 20.3% vs 44 control 18.4%)., Conclusions: In conclusion, data emerging from investigations on the population under study indicate that the alcohol and viral infection appear to play a more important role in determining hepatic lesions than gastroresection.
- Published
- 1997
23. Chronic gastritis, intestinal metaplasia, dysplasia and Helicobacter pylori in gastric cancer: putting the pieces together.
- Author
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Dobrilla G, Benvenuti S, Amplatz S, and Zancanella L
- Subjects
- Chronic Disease, Gastritis pathology, Helicobacter Infections microbiology, Helicobacter Infections pathology, Humans, Intestinal Diseases complications, Metaplasia, Stomach Neoplasms microbiology, Stomach Neoplasms pathology, Gastritis complications, Helicobacter Infections complications, Helicobacter pylori isolation & purification, Intestinal Diseases pathology, Stomach Neoplasms etiology
- Abstract
Chronic gastritis may favour the development of gastric cancer more as a condition than as precancerous lesion. Since, in most cases, it is pathologically correlated with Helicobacter pylori infection, it is reasonable to postulate at least an indirect role for this organism in the pathogenesis of gastric cancer. H. pylori, however, is only one of the risk factors involved, in that additional factors (excess salt, cigarette smoking, deficiency of foodstuffs with an antioxidizing effect) may facilitate the malignant transformation of chronic atrophic gastritis into intestinal-type gastric cancer. Gastric carcinogenesis therefore presents itself as a multifactorial, multistage process, furthered by the occurrence of precancerous lesions which are usually interrelated (type-III intestinal metaplasia, severe dysplasia) and by functional alterations such as achlorhydria, which, though it is not enough in itself to cause gastric cancer, promotes abnormal intragastric bacterial development, a condition which may be followed by abnormal intragastric formation of cancerogenous nitroso compounds. The existence of a close correlation between both gastric cancer and H. pylori infection and low socio-economic and hygienic status of the population lends further strength to the hypothesis that an "H. pylori factor" is involved in gastric carcinogenesis. Consequently, to reduce the risk of gastric cancer, various strategies have been devised to prevent H. pylori infection (improvement in socio-environmental conditions, anti-H. pylori vaccine) and/or to eradicate the organism (by means of therapeutic regimens including antimicrobial agents, which, however, can be implemented only in patients who have not developed diffuse atrophy and/or dysplasia, in whom H. pylori may no longer be detectable). Definitive proof of the real extent of the relationship between H. pylori and gastric cancer and of the efficacy of therapeutic and preventive measures can be provided only by controlled trials in populations with a high prevalence of chronic non-atrophic gastritis which are difficult to organize.
- Published
- 1994
24. Cowden's disease with gastrointestinal polyposis.
- Author
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Chilovi F, Zancanella L, Perino F, Wallnoefer W, Vigl EE, Colombetti V, and Dobrilla G
- Subjects
- Aged, Biopsy, Humans, Male, Hamartoma Syndrome, Multiple pathology, Intestinal Polyps pathology, Neoplasms, Multiple Primary pathology
- Published
- 1990
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