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1. The Alpha Magnetic Spectrometer (AMS) on the international space station:Part II — results from the first seven years

Author

Aguilar, M. (M.), Cavasonza, L. A. (L. Ali), Ambrosi, G. (G.), Arruda, L. (L.), Attig, N. (N.), Barao, F. (F.), Barrin, L. (L.), Bartoloni, A. (A.), Basegmez-du Pree, S. (S.), Bates, J. (J.), Battiston, R. (R.), Behlmann, M. (M.), Beischer, B. (B.), Berdugo, J. (J.), Bertucci, B. (B.), Bindi, V. (V), de Boer, W. (W.), Bollweg, K. (K.), Borgia, B. (B.), Boschini, M. (Mj), Bourquin, M. (M.), Bueno, E. F. (E. F.), Burger, J. (J.), Burger, W. J. (W. J.), Burmeister, S. (S.), Cai, X. D. (X. D.), Capell, M. (M.), Casaus, J. (J.), Castellini, G. (G.), Cervelli, F. (F.), Chang, Y. H. (Y. H.), Chen, G. M. (G. M.), Chen, H. S. (H. S.), Chen, Y. (Y.), Cheng, L. (L.), Chou, H. Y. (H. Y.), Chouridou, S. (S.), Choutko, V. (V), Chung, C. H. (C. H.), Clark, C. (C.), Coignet, G. (G.), Consolandi, C. (C.), Contin, A. (A.), Corti, C. (C.), Cui, Z. (Z.), Dadzie, K. (K.), Dai, Y. M. (Y. M.), Delgado, C. (C.), Della Torre, S. (S.), Demirkoz, M. B. (M. B.), Derome, L. (L.), Di Falco, S. (S.), Di Felice, V. (V), Diaz, C. (C.), Dimiccoli, F. (F.), von Doetinchem, P. (P.), Dong, F. (F.), Donnini, F. (F.), Duranti, M. (M.), Egorov, A. (A.), Eline, A. (A.), Feng, J. (J.), Fiandrini, E. (E.), Fisher, P. (P.), Formato, V. (V), Freeman, C. (C.), Galaktionov, Y. (Y.), Gamez, C. (C.), Garcia-Lopez, R. J. (R. J.), Gargiulo, C. (C.), Gast, H. (H.), Gebauer, I. (I), Gervasi, M. (M.), Giovacchini, F. (F.), Gomez-Coral, D. M. (D. M.), Gong, J. (J.), Goy, C. (C.), Grabski, V. (V), Grandi, D. (D.), Graziani, M. (M.), Guo, K. H. (K. H.), Haino, S. (S.), Han, K. C. (K. C.), Hashmani, R. K. (R. K.), He, Z. H. (Z. H.), Heber, B. (B.), Hsieh, T. H. (T. H.), Hu, J. Y. (J. Y.), Huang, Z. C. (Z. C.), Hungerford, W. (W.), Incagli, M. (M.), Jang, W. Y. (W. Y.), Jia, Y. (Yi), Jinchi, H. (H.), Kanishev, K. (K.), Khiali, B. (B.), Kim, G. N. (G. N.), Kirn, T. (Th), Konyushikhin, M. (M.), Kounina, O. (O.), Kounine, A. (A.), Koutsenko, V. (V), Kuhlman, A. (A.), Kulemzin, A. (A.), La Vacca, G. (G.), Laudi, E. (E.), Laurenti, G. (G.), Lazzizzera, I. (I), Lebedev, A. (A.), Lee, H. T. (H. T.), Lee, S. C. (S. C.), Leluc, C. (C.), Li, J. Q. (J. Q.), Li, M. (M.), Li, Q. (Q.), Li, S. (S.), Li, T. X. (T. X.), Li, Z. H. (Z. H.), Light, C. (C.), Lin, C. H. (C. H.), Lippert, T. (T.), Liu, Z. (Z.), Lu, S. Q. (S. Q.), Lu, Y. S. (Y. S.), Luebelsmeyer, K. (K.), Luo, J. Z. (J. Z.), Lyu, S. S. (S. S.), Machate, F. (F.), Mana, C. (C.), Marin, J. (J.), Marquardt, J. (J.), Martin, T. (T.), Martinez, G. (G.), Masi, N. (N.), Maurin, D. (D.), Menchaca-Rocha, A. (A.), Meng, Q. (Q.), Mo, D. C. (D. C.), Molero, M. (M.), Mott, P. (P.), Mussolin, L. (L.), Ni, J. Q. (J. Q.), Nikonov, N. (N.), Nozzoli, F. (F.), Oliva, A. (A.), Orcinha, M. (M.), Palermo, M. (M.), Palmonari, F. (F.), Paniccia, M. (M.), Pashnin, A. (A.), Pauluzzi, M. (M.), Pensotti, S. (S.), Phan, H. D. (H. D.), Plyaskin, V. (V), Pohl, M. (M.), Porter, S. (S.), Qi, X. M. (X. M.), Qin, X. (X.), Qu, Z. Y. (Z. Y.), Quadrani, L. (L.), Rancoita, P. G. (P. G.), Rapin, D. (D.), Conde, A. R. (A. Reina), Rosier-Lees, S. (S.), Rozhkov, A. (A.), Rozza, D. (D.), Sagdeev, R. (R.), Schael, S. (S.), Schmidt, S. M. (S. M.), von Dratzig, A. S. (A. Schulz), Schwering, G. (G.), Seo, E. S. (E. S.), Shan, B. S. (B. S.), Shi, J. Y. (J. Y.), Siedenburg, T. (T.), Solano, C. (C.), Song, J. W. (J. W.), Sonnabend, R. (R.), Sun, Q. (Q.), Sun, Z. T. (Z. T.), Tacconi, M. (M.), Tang, X. W. (X. W.), Tang, Z. C. (Z. C.), Tian, J. (J.), Ting, S. C. (Samuel C. C.), Ting, S. M. (S. M.), Tomassetti, N. (N.), Torsti, J. (J.), Tuysuz, C. (C.), Urban, T. (T.), Usoskin, I. (I), Vagelli, V. (V.), Vainio, R. (R.), Valente, E. (E.), Valtonen, E. (E.), Vazquez Acosta, M. (M.), Vecchi, M. (M.), Velasco, M. (M.), Vialle, J. P. (J. P.), Wang, L. Q. (L. Q.), Wang, N. H. (N. H.), Wang, Q. L. (Q. L.), Wang, S. (S.), Wang, X. (X.), Wang, Z. X. (Z. X.), Wei, J. (J.), Weng, Z. L. (Z. L.), Wu, H. (H.), Xiong, R. Q. (R. Q.), Xu, W. (W.), Yan, Q. (Q.), Yang, Y. (Y.), Yi, H. (H.), Yu, Y. J. (Y. J.), Yu, Z. Q. (Z. Q.), Zannoni, M. (M.), Zhang, C. (C.), Zhang, F. (F.), Zhang, F. Z. (F. Z.), Zhang, J. H. (J. H.), Zhang, Z. (Z.), Zhao, F. (F.), Zheng, Z. M. (Z. M.), Zhuang, H. L. (H. L.), Zhukov, V. (V), Zichichi, A. (A.), Zimmermann, N. (N.), and Zuccon, P. (P.)

Subjects
Cosmic ray detectors, Particle dark matter, Astrophysics::High Energy Astrophysical Phenomena, Cosmic ray composition & spectra, Cosmic ray propagation, International space station, Alpha Magnetic Spectrometer, Cosmic ray sources, Cosmic ray acceleration, Particle astrophysics
Abstract

The Alpha Magnetic Spectrometer (AMS) is a precision particle physics detector on the International Space Station (ISS) conducting a unique, long-duration mission of fundamental physics research in space. The physics objectives include the precise studies of the origin of dark matter, antimatter, and cosmic rays as well as the exploration of new phenomena. Following a 16-year period of construction and testing, and a precursor flight on the Space Shuttle, AMS was installed on the ISS on May 19, 2011. In this report we present results based on 120 billion charged cosmic ray events up to multi-TeV energies. This includes the fluxes of positrons, electrons, antiprotons, protons, and nuclei. These results provide unexpected information, which cannot be explained by the current theoretical models. The accuracy and characteristics of the data, simultaneously from many different types of cosmic rays, provide unique input to the understanding of origins, acceleration, and propagation of cosmic rays.

Published
2020

2. REMOTE HANDLING OF SHIELD/BLANKET SEGMENTS

Author

Sironi, M., primary, Chiocchio, S., additional, Hubert, P., additional, Maisonnier, D., additional, Malavasi, G., additional, Blight, J., additional, Dagenais, J.-F., additional, Amelotti, F., additional, Turroni, P., additional, Vecchi, M., additional, Becquet, M., additional, Biggio, M., additional, Castillo, E., additional, and Farfalletti-Casali, F., additional

Published
1993
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3. Measurement of the group velocity of light in sea water at the ANTARES site

Author

Adrian Martinez, S., Al Samarai, I., Albert, A., Andre, M., Anghinolfi, M., Anton, G., Anvar, S., Ardid, M., Assis Jesus, A. C., Aca, Jesus, Astraatmadja, T., Aubert, J. J., Baret, B., Basa, S., Bertin, V., Biagi, S., Bigi, A., Bigongiari, C., Bogazzi, C., Bou Cabo, M., Bouhou, B., Bouwhuis, M. C., Brunner, J., Busto, J., Camarena, F., Capone, Antonio, Carloganu, C., Carminati, G., Carr, J., Cecchini, S., Charif, Z., Charvis, Ph, Chiarusi, T., Circella, M., Costantini, H., Coyle, P., Curtil, C., DE BONIS, Giulia, Decowski, M. P., Dekeyser, I., Deschamps, A., Distefano, C., Donzaud, C., Dornic, D., Dorosti, Q., Drouhin, D., Eberl, T., Emanuele, U., Enzenhofer, A., Ernenwein, J. P., Escoffier, S., Fermani, Paolo, Ferri, M., Flaminio, V., Folger, F., Fritsch, U., Fuda, J. L., Galata, S., Gay, P., Geyer, K., Giacomelli, G., Giordano, V., Gomez Gonzalez, J. P., Graf, K., Guillard, G., Halladjian, G., Hallewell, G., Van Haren, H., Hartman, J., Heijboer, A. J., Hello, Y., Hernandez Rey, J. J., Herold, B., Hossl, J., Hsu, C. C., De Jong, M., Kadler, M., Kalekin, O., Kappes, A., Katz, U., Kavatsyuk, O., Kooijman, P., Kopper, C., Kouchner, A., Kreykenbohm, I., Kulikovski, V., Kulikovskiy, V., Lahmann, R., Lamare, P., Larosa, G., Lattuada, D., Lefvre, D., Lefevre, D., Lim, G., Lopresti, D., Lo Presti, D., Loehner, H., Loucatos, S., Mangano, S., Marcelin, M., Margiotta, A., Martinez Mora, J. A., Mcmillan, J. E., Meli, A., Montaruli, T., Moscoso, L., Motz, H., Neff, M., Nezri, E., Palioselitis, D., Pvla, G. E., Pavalas, G. E., Payet, K., Payre, P., Petrovic, J., Piattelli, P., Picot Clemente, N., Popa, V., Pradier, T., Presani, E., Racca, C., Reed, C., Riccobene, G., Richardt, C., Richter, R., Rivire, C., Riviere, C., Robert, A., Roensch, K., Rostovtsev, A., Ruiz Rivas, J., Rujoiu, M., Russo, G. V., Salesa, F., Samtleben, D. F. E., Sapienza, P., Schock, F., Schuller, J. P., Schussler, F., Schussleraf, F., Seitz, T., Shanidze, R., Simeone, Francesco, Spies, A., Spurio, M., Steijger, J. J. M., Stolarczyk, Th, Sanchez Losa, A., Taiuti, M., Tamburini, C., Thompson, L. F., Toscano, S., Vallage, B., Van Elewyck, V., Vannoni, G., Vecchi, M., Vernin, P., Wagner, S., Wijnker, G., Wilms, J., De Wolf, E., Yepes, H., Zaborov, D., Zornoza, J. D., Zuniga, J., Centre Tecnològic de Vilanova i la Geltrú, Universitat Politècnica de Catalunya. LAB - Laboratori d'Aplicacions Bioacústiques, Centre de Physique des Particules de Marseille (CPPM), Aix Marseille Université (AMU)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Groupe de Recherche en Physique des Hautes Energies (GRPHE), Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-IUT de Colmar, Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA)), Département d'Electronique, des Détecteurs et d'Informatique pour la Physique (ex SEDI) (DEDIP), Institut de Recherches sur les lois Fondamentales de l'Univers (IRFU), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris-Saclay, AstroParticule et Cosmologie (APC (UMR_7164)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Astrophysique de Marseille (LAM), Aix Marseille Université (AMU)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Physique Corpusculaire - Clermont-Ferrand (LPC), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Géoazur (GEOAZUR 6526), Institut de Recherche pour le Développement (IRD)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut national des sciences de l'Univers (INSU - CNRS)-Observatoire de la Côte d'Azur, COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Centre National de la Recherche Scientifique (CNRS), Centre d'océanologie de Marseille (COM), Université de la Méditerranée - Aix-Marseille 2-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS), Institut Pluridisciplinaire Hubert Curien (IPHC), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), ANTARES, Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Aix Marseille Université (AMU), Institut Universitaire de Technologie de Colmar-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA)), Département d'Electronique, des Détecteurs et d'Informatique (ex SEDI) (DEDI), APC - Astrophysique des Hautes Energies (APC - AHE), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Observatoire de Paris, PSL Research University (PSL)-PSL Research University (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Observatoire de Paris, PSL Research University (PSL)-PSL Research University (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Dipartimento di Astronomia, Universita degli Studi di Bologna, Università di Bologna [Bologna] (UNIBO)-Università di Bologna [Bologna] (UNIBO), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Aix Marseille Université (AMU)-Centre National d'Études Spatiales [Toulouse] (CNES), PSL Research University (PSL)-PSL Research University (PSL)-Université Paris Diderot - Paris 7 (UPD7), Observatoire de la Côte d'Azur, Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Nice Sophia Antipolis (... - 2019) (UNS), Université Côte d'Azur (UCA)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Université de la Méditerranée - Aix-Marseille 2, Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut Universitaire de Technologie de Colmar, Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS), Université de Strasbourg (UNISTRA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Montaruli, Teresa, KVI - Center for Advanced Radiation Technology, S. ADRIAN-MARTıNEZ, J. A. AGUILAR, I. AL SAMARAI, A. ALBERT, M. ANDRÈ, M. ANGHINOLFI, G. ANTON, S. ANVAR, M. ARDID, A. C. ASSIS JESUS, T. ASTRAATMADJA, J.-J. AUBERT, B. BARET, S. BASA, V. BERTIN, S. BIAGI, A. BIGI, C. BIGONGIARI, C. BOGAZZI, M. BOU-CABO, B. BOUHOU, M. C. BOUWHUIS, J. BRUNNER, J. BUSTO, F. CAMARENA, A. CAPONE, C. CARLOGANU, G. CARMINATI, J. CARR, S. CECCHINI, Z. CHARIF, PH. CHARVIS, T. CHIARUSI, M. CIRCELLA, R. CONIGLIONE, H. COSTANTINI, P. COYLE, C. CURTIL, M. P. DECOWSKI, I. DEKEYSER, A. DESCHAMPS, C. DISTEFANO, C. DONZAUD, D. DORNIC, Q. DOROSTI, D. DROUHIN, T. EBERL, U. EMANUELE, A. ENZENHOFER, J.-P. ERNENWEIN, S. ESCOFFIER, P. FERMANI, M. FERRI, V. FLAMINIO, F. FOLGER, U. FRITSCH, J.-L. FUDA, S. GALATÀ, P. GAY, G. GIACOMELLI, V. GIORDANO, J. P. GOMEZ-GONZALEZ, K. GRAF, G. GUILLARD, G. HALLADJIAN, G. HALLEWELL, H. VAN HAREN, J. HARTMAN, A. J. HEIJBOER, Y. HELLO, J. J. HERNANDEZ-REY, B. HEROLD, J. HOSSL, C. C. HSU, M. DE JONG, M. KADLER, O. KALEKIN, A. KAPPES, U. KATZ, O. KAVATSYUK, P. KOOIJMAN, C. KOPPER, A. KOUCHNER, I. KREYKENBOHM, V. KULIKOVSKIY, R. LAHMANN, P. LAMARE, G. LAROSA, D. LATTUADA, D. LEFÈVRE, G. LIM, D. LO PRESTI, H. LOEHNER, S. LOUCATOS, S. MANGANO, M. MARCELIN, A. MARGIOTTA, J. A. MARTıNEZ-MORA, A. MELI, T. MONTARULI, L. MOSCOSO, H. MOTZ, M. NEFF, E. NEZRI, D. PALIOSELITIS, G. E. PAVALA¸S, K. PAYET, P. PAYRE, J. PETROVIC, P. PIATTELLI, N. PICOT-CLEMENTE, V. POPA, T. PRADIER, E. PRESANI, C. RACCA, C. REED, C. RICHARDT, R. RICHTER, C. RIVIÈRE, A. ROBERT, K. ROENSCH, A. ROSTOVTSEV, J. RUIZ-RIVAS, M. RUJOIU, G. V. RUSSO, F. SALESA, D. F. E. SAMTLEBEN, P. SAPIENZA, F. SCHOCK, J.-P. SCHULLER, F. SCHUSSLER, T. SEITZ, R. SHANIDZE, F. SIMEONE, A. SPIES, M. SPURIO, J. J. M. STEIJGER, TH. STOLARCZYK, A. SANCHEZ-LOSA, M. TAIUTI, C. TAMBURINI, S. TOSCANO, B. VALLAGE, V. VAN ELEWYCK, G. VANNONI, M. VECCHI, P. VERNIN, S. WAGNER, G. WIJNKER, J. WILMS, E. DE WOLF, H. YEPES, D. ZABOROV, J. D. ZORNOZA, J. ZUNIGA, and ANTARES (IHEF, IoP, FNWI)

Subjects
Light velocity, Refractive index, Atmospheric sciences, Neutrino telescope, 01 natural sciences, law.invention, High Energy Physics - Experiment, High Energy Physics - Experiment (hep-ex), Mediterranean sea, law, Optical beacon system, Physics, Optical beacon, Pressure and temperature, [SDU.ASTR.HE]Sciences of the Universe [physics]/Astrophysics [astro-ph]/High Energy Astrophysical Phenomena [astro-ph.HE], Wavelength, optical beacon system, neutrino telescope, antares, refractive index, velocity of light, Velocity of light, Group velocity, Física nuclear, [PHYS.ASTR.HE]Physics [physics]/Astrophysics [astro-ph]/High Energy Astrophysical Phenomena [astro-ph.HE], [PHYS.ASTR.IM]Physics [physics]/Astrophysics [astro-ph]/Instrumentation and Methods for Astrophysic [astro-ph.IM], Parametrisation, FOS: Physical sciences, ddc:500.2, 010309 optics, Optics, Light--Speed--Measurement, 0103 physical sciences, Optical systems, Seawater, 14. Life underwater, Física::Acústica [Àrees temàtiques de la UPC], ANTARES, 010308 nuclear & particles physics, business.industry, Astronomy and Astrophysics, Laser, [SDU.ASTR.IM]Sciences of the Universe [physics]/Astrophysics [astro-ph]/Instrumentation and Methods for Astrophysic [astro-ph.IM], Salinity, Llum -- Velocitat, FISICA APLICADA, Neutrino telescopes, business, [PHYS.ASTR]Physics [physics]/Astrophysics [astro-ph], SYSTEM
Abstract

The group velocity of light has been measured at eight different wavelengths between 385 nm and 532 nm in the Mediterranean Sea at a depth of about 2.2 km with the ANTARES optical beacon systems. A parametrisation of the dependence of the refractive index on wavelength based on the salinity, pressure and temperature of the sea water at the ANTARES site is in good agreement with these measurements., The authors acknowledge the financial support of the funding agencies: Centre National de la Recherche Scientifique (CNRS), Commissariat a l'enegie atomique et aux energies alternatives (CEA), Agence National de la Recherche (ANR), Commission Europeenne (FEDER fund and Marie Curie Program), Region Alsace (contrat CPER), Region Provence-Alpes-Cote d'Azur, Departement du Var and Ville de La Seyne-sur-Mer, France; Bundesministerium fur Bildung und Forschung (BMBF), Germany; Istituto Nazionale di Fisica Nucleare (INFN), Italy; Stichting voor Fundamenteel Onderzoek der Materie (FOM), Nederlandse organisatie voor Wetenschappelijk Onderzoek (NWO), The Netherlands; Council of the President of the Russian Federation for young scientists and leading scientific schools supporting grants and Rosatom, Russia; National Authority for Scientific Research (ANCS), Romania; Ministerio de Ciencia e Innovacion (MICINN), Prometeo of Generalitat Valenciana and MultiDark, Spain. We also acknowledge the technical support of Ifremer, AIM and Foselev Marine for the sea operation and the CC-IN2P3 for the computing facilities.

Published
2012
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4. Inflammatory bowel diseases in italy: incidence trends and patients’ characteristics

Author

Fornari, C, Madotto, F, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, FORNARI, CARLA, MADOTTO, FABIANA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Fornari, C, Madotto, F, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, FORNARI, CARLA, MADOTTO, FABIANA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Published
2013

5. Resource utilization and costs for patients with inflammatory bowel diseases in italy: a population-based assessment

Author

Madotto, F, Fornari, C, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, CESANA, GIANCARLO, Madotto, F, Fornari, C, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, Cesana, G, MADOTTO, FABIANA, FORNARI, CARLA, CONTI, SARA, MANTOVANI, LORENZO GIOVANNI, and CESANA, GIANCARLO

Published
2013

6. Assessment of thrombin-activatable fibrinolysis inhibitor (TAFI) plasma levels in inflammatory bowel diseases.

Author

Saibeni, S, Bottasso, B, Spina, L, Bajetta, Maria Teresa, Danese, Silvio, Gasbarrini, Antonio, De Franchis, R, Vecchi, M, Gasbarrini, Antonio (ORCID:0000-0002-7278-4823), Saibeni, S, Bottasso, B, Spina, L, Bajetta, Maria Teresa, Danese, Silvio, Gasbarrini, Antonio, De Franchis, R, Vecchi, M, and Gasbarrini, Antonio (ORCID:0000-0002-7278-4823)

Abstract

OBJECTIVES: Hypofibrinolysis has been proposed as a possible mechanism underlying the known risk of thrombosis observed in patients with inflammatory bowel diseases (IBD). Thrombin-activatable fibrinolysis inhibitor (TAFI) is a recently described inhibitor of fibrinolysis. Increased TAFI plasma levels are associated with a risk for venous thrombosis. The objective was to evaluate TAFI plasma levels and their possible correlations with clinical features and acute-phase reactants in IBD patients. METHODS: Eighty-one IBD patients (47 Crohn's disease and 34 ulcerative colitis) and 81 sex- and age-matched healthy controls were enrolled in the study; moreover, we studied 30 inflammatory controls (13 Reiter's syndrome, 4 Behçet's syndrome, and 13 patients with newly diagnosed celiac disease). TAFI plasma levels were assessed by means of a commercially available ELISA kit. Erythrocytes sedimentation rate, C-reactive protein, and alpha1-acid glycoprotein were measured as acute-phase reactants. Statistical analysis was performed by means of nonparametric tests and Fisher's exact test and chi(2) test for independence. RESULTS: Median TAFI plasma levels were significantly higher in IBD patients (116.0%, range: 39.0-232.0%) and in inflammatory controls (176.0%, 50.0-435.0%) than in healthy controls (99.0%, 40.0-170.0%) (p< or = 0.05 and p< or = 0.001, respectively). TAFI plasma levels higher than the 95th percentile of control values were significantly more frequent in IBD patients (19.7%) and in inflammatory controls (53.3%) than in healthy controls (4.9%) (p< or = 0.008 and p< or = 0.0001, respectively) and more frequent in clinically active IBD than in clinically quiescent IBD (31.4%vs 10.9%, p< or = 0.03). Finally, in IBD, significant correlations were observed between TAFI plasma levels and erythrocytes sedimentation rate (p< or = 0.02), C-reactive protein (p< or = 0.001), and alpha1-acid glycoprotein (p< or = 0.05). CONCLUSIONS: TAFI plasma levels a

Published
2004

7. Nutritional status, function of the small intestine and jejunal morphology after total gastrectomy for carcinoma of the stomach

Author

Cristallo, M, Braga, M, Agape, D, Primignani, M, Zuliani, W, Vecchi, M, Murone, M, Sironi, M, Di Carlo, V, De Franchis, R, Cristallo, M, Braga, M, Agape, D, Primignani, M, Zuliani, W, Vecchi, M, Murone, M, Sironi, M, Di Carlo, V, and De Franchis, R

Abstract

We studied the nutritional status and the prevalence of malabsorption in 12 patients one to three years after total gastrectomy (TG) for gastric neoplasm. The Roux-en Y technique was used for reconstruction. A correct dietary regimen according to the recommended daily allowance was suggested and patients were seen quarterly on an out patient basis. The nutritional status was evaluated by measuring serum albumin levels, total iron binding capacity, cholinesterase, area muscular circumference, triceps skinfold and delayed hypersensitivity response. Work-up studies for the small intestine included: stool fat, D-xylose and glucose tolerance tests, Schilling test (phase II and III), serum iron levels, serum vitamin B12 levels and biopsy of the jejunum. Malnutrition, defined as the occurrence of two or more abnormal nutritional parameters, was observed in one patient; glucose and D-xylose tolerance tests were normal in all. A mild degree of steatorrhea was observed in four patients. The second phase of the Schilling test was abnormal in eight patients, but urinary excretion of vitamin B12 increased in three of four patients after use of antibiotics. Low serum vitamin B12 levels were common after the twentieth postoperative month. Serum iron levels were initially low and returned to normal six months after TG. All patients had normal jejunal histolic findings. These data indicate that malnutrition after TG is not common if an adequate dietary intake is maintained. Malabsorption, possibly due to bacterial overgrowth, is not a major clinical problem.

Published
1986

8. Italian Expert Panel on the management of patients with coexisting spondyloarthritis and inflammatory bowel disease

Author

Fabiana Castiglione, Ignazio Olivieri, Raffaele Scarpa, Maurizio Vecchi, Paolo Gionchetti, Alessandro Armuzzi, Carla Felice, Carlo Salvarani, Ambrogio Orlando, Fabrizio Cantini, Olivieri I, Cantini F, Castiglione F, Felice C, Gionchetti P, Orlando A, Salvarani C, Scarpa R, Vecchi M, Armuzzi A, Ignazio, Olivieri, Fabrizio, Cantini, Castiglione, Fabiana, Carla, Felice, Paolo, Gionchetti, Ambrogio, Orlando, Carlo, Salvarani, Scarpa, Raffaele, Maurizio, Vecchi, and Alessandro, Armuzzi

Subjects
musculoskeletal diseases, medicine.medical_specialty, Variable manifestations, Settore MED/16 - REUMATOLOGIA, Integrated management, Settore MED/12 - GASTROENTEROLOGIA, IBD, Immunology, Disease, Inflammatory bowel disease, Dactylitis, Spondylarthritis, Spondyloarthritis, medicine, Immunology and Allergy, Humans, In patient, SpA, Crohn's disease, business.industry, Remission Induction, Settore MED/09 - MEDICINA INTERNA, medicine.disease, Inflammatory Bowel Diseases, Ulcerative colitis, Dermatology, digestive system diseases, Therapeutic algorithm, Algorithms, Joints, stomatognathic diseases, Physical therapy, Anterior uveitis, business
Abstract

Spondyloarthritis (SpA) is a group of diseases with similar clinical, radiologic and serologic features, including SpA associated with inflammatory bowel disease (IBD-associated SpA). Several studies have estimated the occurrence of SpA in IBD patients as ranging from 17% to 39%, confirming that SpA is the most frequent extra-intestinal manifestation in patients with IBD. In this paper, the expert panel presents some red flags to guide clinicians - both rheumatologists and gastroenterologists - to make a correct diagnosis of IBD-associated SpA in clinical practice. IBD-associated SpA classification, clinical presentation and diagnostic work-up are also presented. From the therapeutic point of view, only separate recommendations/guidelines are currently available for the treatment of Crohn's disease, ulcerative colitis and for both axial and peripheral SpA. However, when IBD and SpA coexist, the therapeutic strategy should be modulated to take into account the variable manifestations of IBD in terms of intestinal and extra-intestinal features, and the clinical manifestations of SpA, with particular attention to peripheral enthesitis, dactylitis and anterior uveitis. To our knowledge, this is the first attempt to define therapeutic algorithms for the integrated management of different IBD-associated SpA clinical scenarios.

Published
2014

9. Inflammatory bowel diseases in italy: incidence trends and patients’ characteristics

Author

A. Bortoli, Flavio Caprioli, M. Vecchi, A. Massari, Lorenzo G. Mantovani, Claudio Camillo Cortelezzi, Giancarlo Cesana, S. Danese, Gionata Fiorino, Fabiana Madotto, S. Ardizzone, Sara Conti, Carla Fornari, G. Meucci, P. Ravelli, R. Cestari, Fornari, C, Madotto, F, Fiorino, G, Ardizzone, S, Bortoli, A, Caprioli, F, Cestari, R, Conti, S, Cortelezzi, C, Mantovani, L, Massari, A, Meucci, G, Ravelli, P, Vecchi, M, Danese, S, and Cesana, G

Subjects
medicine.medical_specialty, Inflammatory bowel diseases, Epidemiology, business.industry, Health Policy, Internal medicine, Epidemiology, Incidence trends, Public Health, Environmental and Occupational Health, medicine, Inflammatory Bowel Diseases, Patient characteristics, business
Published
2013

10. Nutritional status, function of the small intestine and jejunal morphology after total gastrectomy for carcinoma of the stomach

Author

M, Cristallo, M, Braga, D, Agape, M, Primignani, W, Zuliani, M, Vecchi, M, Murone, M, Sironi, V, Di Carlo, R, De Franchis, Cristallo, M, Braga, M, Agape, D, Primignani, M, Zuliani, W, Vecchi, M, Murone, M, Sironi, M, Di Carlo, V, and De Franchis, R

Subjects
Male, Time Factors, Iron, Body Weight, total gastrectomy, Middle Aged, Postgastrectomy Syndromes, Nutrition Disorders, Celiac Disease, Vitamin B 12, Jejunum, Gastrectomy, Humans, Female, Intestinal Mucosa, Aged
Abstract

We studied the nutritional status and the prevalence of malabsorption in 12 patients one to three years after total gastrectomy (TG) for gastric neoplasm. The Roux-en Y technique was used for reconstruction. A correct dietary regimen according to the recommended daily allowance was suggested and patients were seen quarterly on an out patient basis. The nutritional status was evaluated by measuring serum albumin levels, total iron binding capacity, cholinesterase, area muscular circumference, triceps skinfold and delayed hypersensitivity response. Work-up studies for the small intestine included: stool fat, D-xylose and glucose tolerance tests, Schilling test (phase II and III), serum iron levels, serum vitamin B12 levels and biopsy of the jejunum. Malnutrition, defined as the occurrence of two or more abnormal nutritional parameters, was observed in one patient; glucose and D-xylose tolerance tests were normal in all. A mild degree of steatorrhea was observed in four patients. The second phase of the Schilling test was abnormal in eight patients, but urinary excretion of vitamin B12 increased in three of four patients after use of antibiotics. Low serum vitamin B12 levels were common after the twentieth postoperative month. Serum iron levels were initially low and returned to normal six months after TG. All patients had normal jejunal histologic findings. These data indicate that malnutrition after TG is not common if an adequate dietary intake is maintained. Malabsorption, possibly due to bacterial overgrowth, is not a major clinical problem.

Published
1986

11. Mannitol for bowel preparation: Efficacy and safety results from the SATISFACTION randomised clinical trial.

Author

Vecchi M, Tontini GE, Fiori G, Bocus P, Carnovali M, Cesaro P, Costamagna G, Paolo DD, Elli L, Fedorishina O, Hinkel C, Jakobs R, Kashin S, Magnoli M, Manes G, Melnikova E, Orsatti A, Ponchon T, Prada A, Radaelli F, Sferrazza S, Soru P, Valats JC, Veselov V, Spada C, and Uebel P

Abstract

Background: Bowel preparation represents a significant issue to high-quality colonoscopy. Oral mannitol requires a single dose, is of low volume, and has a pleasant taste and rapid action., Aims: This SATISFACTION study compared single-dose (same day) oral mannitol 100 g/750 mL with standard split-dose PEG-ASC2 L (MoviPrep®)., Methods: The primary endpoint was the proportion of patients with adequate bowel cleansing. Secondary endpoints included efficacy (adenoma detection rate, caecal intubation rate, time of evacuation), safety (intestinal gases concentration, haemato-chemical parameters, adverse events), and patient satisfaction., Results: The study included 703 patients (352 treated with mannitol and 351 with PEG-ASC). Mannitol was not inferior to PEG-ASC for the primary endpoint (91.1 % and 95.5 %, respectively; p-value for the non-inferiority =0.0131). There was no significant difference for secondary efficacy endpoints. The acceptability profile was significantly better in the mannitol group for ease of use, taste, and willingness to reuse (p < 0.0001 for all). The concentration of intestinal gases (H 2 , CH 4 ) was similar between groups and well below those potentially critical., Conclusions: The SATISFACTION study indicated that low-volume, single-dose mannitol may satisfy an unmet clinical need since it was more acceptable to the patient and not inferior to the split-dose PEG-ASC for bowel cleansing efficacy., Competing Interests: Declaration of competing interest AO is an employee of NTC. MC and MM are consultants with NTC. MV and GET received a consultant fee after the study end. The remaining Authors declare that there is no conflict of interest. NTC is developing a bowel cleansing preparation based on mannitol., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2024
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12. Computer aided villi morphometric quantification in video-capsule enteroscopy: A newly developed software to quantify small bowel atrophy.

Author

Nandi N, Topa M, Rimondi A, Ciulla MM, Tontini GE, Scaramella L, Sidhu R, Vecchi M, and Elli L

Abstract

Background and Aims: Small bowel capsule endoscopy (SBCE) has an established role in patients with non-responsive celiac disease (CeD). A non-invasive method to quantify small bowel atrophy is still lacking., Methods: We analysed SBCE frames from CeD patients from 2018 to 2020. Histology was the reference standard, with atrophy defined as Marsh-Oberhuber score ≥ 3a. Three regions of interest (ROI) were blindly selected from each frame by an expert gastroenterologist and analysed using a National Institute of Health J image-processing software into a numerical scale. A 3D surface plot macro identified intestinal villi density through isolines plots., Results: We acquired 306 ROIs from 57 frames with macroscopic atrophy and 45 with normal mucosa. Frames were classified as atrophic (n = 63) or non-atrophic (n = 39) per Marsh-Oberhuber classification. Median density score significantly differed between atrophic and non-atrophic frames (p < 0.001). The morphometric analysis showed a sensitivity of 77 % and a specificity of 79 % in discriminating between atrophic or non-atrophic mucosa with a 14.10 cut-off (Youden Index) and an overall AUC of 0.805 (CI 95 % 0.712-0.897)., Conclusions: Our newly developed SBCE software can effectively quantify villous atrophy. Further studies are needed to validate its applicability in an external cohort., Competing Interests: Conflict of interest All authors of the manuscript “Computer aided villi morphometric quantification in video-capsule enteroscopy: a newly developed software to quantify small bowel atrophy” declare no conflict of interest., (Copyright © 2024 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2024
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13. Distribution of esophageal inflammation in patients with eosinophilic esophagitis and its impact on diagnosis and outcome.

Author

Sorge A, Aldinio G, Marinoni B, Visaggi P, Penagini R, Maniero D, Ghisa M, Marabotto E, de Bortoli N, Pasta A, Dipace V, Calabrese F, Vecchi M, Savarino EV, and Coletta M

Abstract

Background: This study aimed to assess the distribution of esophageal inflammation in patients with eosinophilic esophagitis (EoE) and its impact on diagnosis and outcome., Aims and Methods: Data from consecutive adult EoE patients who were followed-up at four Italian referral centers from October 2022 to October 2023 were retrospectively collected., Results: One hundred forty-nine patients were included. Proximal EoE was observed in 8.1 % of patients; distal EoE in 27.5 %; and diffuse EoE in 64.4 %. Allergic rhinitis was more prevalent in distal and diffuse than proximal EoE (72.5 % vs. 61.5 % vs 33.3 %; P = 0.049). The prevalence of asthma, atopic dermatitis, oral allergy syndrome, and gastroesophageal reflux disease was not significantly different among the three EoE extent groups. Endoscopic inflammatory features at diagnosis were more prevalent in proximal EoE (91.7 % vs. 53.8 % distal [P = 0.01] vs. 66 % diffuse[P = 0.05]). No significant differences in fibrotic features and esophageal stenoses were observed. The clinical and histological remission rates after first-line therapy were comparable in all groups., Conclusion: Esophageal inflammation in EoE more frequently involves the entire esophagus, followed by isolated distal and proximal involvement. No clear correlation was observed between the histological extent of EoE at diagnosis and comorbidities or treatment response., Competing Interests: Declaration of competing interest Edoardo Vincenzo Savarino has served as speaker for Abbvie, Abivax, Agave, AGPharma, Alfasigma, CaDiGroup, Celltrion, Dr Falk, EG Stada Group, Fenix Pharma, Galapagos, Johnson&Johnson, JB Pharmaceuticals, Innovamedica/Adacyte, Eli Lilly, Malesci, Mayoly Biohealth, Omega Pharma, Pfizer, Reckitt Benckiser, Sandoz, SILA, Sofar, Takeda, Tillots, Unifarco; has served as consultant for Abbvie, Agave, Alfasigma, Biogen, Bristol-Myers Squibb, Celltrion, Dr. Falk, Eli Lilly, Fenix Pharma, Johnson&Johnson, JB Pharmaceuticals, Merck & Co, Nestlè, Pfizer, Reckitt Benckiser, Regeneron, Sanofi, SILA, Sofar, Takeda, Unifarco; he received research support from Bonollo, Difass, Pfizer, Reckitt Benckiser, SILA, Sofar, Unifarco, Zeta Farmaceutici; Nicola de Bortoli has served as speaker for: Reckitt-Benkiser, Malesci, Sofar, Dr Falk. Advisory Board: Astra-Zenecahe; the other authors have no disclosures to declare., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Published
2024
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14. Follow-up evaluation and management of anemia in inflammatory bowel disease: A study by the Italian Group for Inflammatory Bowel Diseases (IG-IBD).

Author

Bergamaschi G, Castiglione F, D'Incà R, Astegiano M, Fries W, Milla M, Ciacci C, Rizzello F, Saibeni S, Ciccocioppo R, Orlando A, Bossa F, Principi M, Vernia P, Ricci C, Scribano ML, Bodini G, Mazzucco D, Bassotti G, Riegler G, Buda A, Neri M, Caprioli F, Monica F, Manca A, Villa E, Fiorino G, Aronico N, Lenti MV, Mengoli C, Testa A, Vecchi M, Klersy C, and Di Sabatino A

Subjects
Humans, Male, Female, Italy epidemiology, Adult, Follow-Up Studies, Middle Aged, Iron administration & dosage, Iron therapeutic use, Fatigue etiology, Anemia etiology, Recurrence, Young Adult, Quality of Life, Hemoglobins analysis, Inflammatory Bowel Diseases complications, Anemia, Iron-Deficiency etiology, Anemia, Iron-Deficiency drug therapy
Abstract

Background: The RIDART I study found a 13.6% prevalence of anemia in Italian patients with inflammatory bowel disease (IBD); most cases were due to iron-deficiency anemia (IDA)., Aims: To evaluate changes in hemoglobin concentration during a 24-week follow-up of anemic patients with IBD., Methods: Follow-up laboratory and clinical data were obtained from RIDART I study patients with anemia. Factors affecting hemoglobin concentration, the impact of anemia on fatigue and quality of life (QoL), and its relationship with treatment, disease activity and disease complications were investigated., Results: Hemoglobin was 108 g/L at baseline, increased to 121 g/L at follow-up week 12 (p < 0.001) and then stabilized until week 24, but most patients remained anemic, with IDA, throughout the study. Hemoglobin improvement was greater in patients receiving either oral or parenteral iron supplementation. Following hemoglobin normalization, anemia relapse rate during follow-up was 30%. Oral iron did not cause disease reactivation. Lower follow-up hemoglobin was associated with a higher probability of having active disease, clinical complications, increased fatigue and reduced QoL., Conclusions: In anemic patients with IBD, anemia represents a long-lasting problem, in most cases persisting for up to 24 weeks, with high relapse rate and a negative impact on fatigue and QoL., Competing Interests: Conflict of interest The Authors have no conflict of interest to declare. No specific funding. This work was supported by the Italian Group for Inflammatory Bowel Diseases (IG-IBD); the Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia; and the University of Pavia, Pavia, Italy. No specific funding was obtained., (Copyright © 2024. Published by Elsevier Ltd.)

Published
2024
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15. Occurrence and characteristics of endoscopic gastric polyps in patients with autoimmune gastritis (AGAPE study): A multicentric cross-sectional study.

Author

Massironi S, Gallo C, Lahner E, Sciola V, Cavalcoli F, Lenti MV, Zilli A, Dottori L, De Rossi G, Miceli E, Annibale B, Vecchi M, Cantù P, Di Sabatino A, Invernizzi P, and Danese S

Abstract

Background: Autoimmune gastritis (AIG) leads to increased gastrin (G) levels due to hypo-achlorhydria, providing proliferative stimuli on the gastric mucosa., Aims: To evaluate the incidence and characteristics of gastric polyps in AIG patients across six tertiary centers in Italy., Methods: A multicentric, cross-sectional study enrolled patients with AIG diagnosed from January 2000 to June 2023, who underwent at least one endoscopy. Data on demographics, clinical history, biochemical profiles, and endoscopic and histopathological findings were systematically collected., Results: Among 612 AIG patients followed for a median of 4 years, 222 (36.3 %) developed at least one gastric polyp. Of these, 214 were non-endocrine lesions detected in 162 patients, including 151 inflammatory (70.5 %), 29 adenomatous (13.6 %), 18 fundic gland polyps (8.4 %), 13 adenocarcinomas (6.1 %), and one MALT lymphoma. Additionally, 108 patients had gastric neuroendocrine neoplasms (gNENs), with 48 also having non-endocrine polyps. Older age and higher gastrin and chromogranin A levels were associated with polyp occurrence. No differences in OLGA/OLGIM stages or Helicobacter pylori status were noted among patients with and without lesions., Conclusion: This large multicentric study underscores the substantial occurrence of gastric polyps in AIG patients, including notable rates of gNENs and adenocarcinomas, emphasizing the importance of proactive endoscopic surveillance and histopathological examination for effective management., Competing Interests: Conflict of interest Silvio Danese reports consultancy fees from AbbVie, Alimentiv, Allergan, Amgen, AstraZeneca, Athos Therapeutics, Biogen, Boehringer Ingelheim, Celgene, Celltrion, Eli Lilly, Enthera, Ferring Pharmaceuticals Inc., Gilead, Hospira, Inotrem, Janssen, Johnson & Johnson, MSD, Mundipharma, Mylan, Pfizer, Roche, Sandoz, Sublimity Therapeutics, Takeda, TiGenix, UCB Inc., and Vifor. There are no financial disclosures or conflicts of interest among the other authors., (Copyright © 2024 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2024
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16. Reproducibility and accuracy of a pocket-size ultrasound device in assessing liver steatosis.

Author

Costantino A, Piagnani A, Caccia R, Sorge A, Maggioni M, Perbellini R, Donato F, D'Ambrosio R, Sed NPO, Valenti L, Prati D, Vecchi M, Lampertico P, and Fraquelli M

Subjects
Humans, Male, Female, Reproducibility of Results, Middle Aged, Prospective Studies, Adult, Liver diagnostic imaging, Liver pathology, Aged, Biopsy instrumentation, Sensitivity and Specificity, Feasibility Studies, Predictive Value of Tests, Ultrasonography instrumentation, Fatty Liver diagnostic imaging, Fatty Liver pathology
Abstract

Background: This diagnostic prospective study compared the feasibility and diagnostic accuracy of Pocket-size Ultrasound Devices (PUDs) against standard ultrasound (US) in detecting liver steatosis using the controlled attenuation parameter (CAP) and liver biopsy as reference standards., Materials and Methods: Consecutive patients with chronic liver diseases were assessed for the presence of steatosis using PUD and US. A CAP cut-off value >275 dB/m was applied to establish ≥S1. A 26-patient subgroup underwent liver biopsy. PUD reproducibility was evaluated using Cohen's k statistic. Diagnostic accuracy of PUD and US was given as Sensibility (Sn), Specificity (Sp), Positive and Negative Predictive Values (PPV, NPV), positive and negative Likelihood Ratio (LR+, LR-)., Results: 81 consecutive patients (69% males) with multiple etiologies were enroled. PUD inter-observer agreement was good (k 0.77, 95%CI 0.62-0.93). PUD and US identified ≥S1 according to CAP values respectively with Sn 0.87, Sp 0.61, PPV 0.49, NPV 0.91, LR+ 2.04, LR- 0.07, AUROC 0.74 and Sn 0.96, Sp 0.54, PPV 0.47, NPV 0.97, LR+ 2.10, LR- 0.07, AUROC 0.75., Conclusions: PUD shows good reproducibility and diagnostic accuracy in ruling liver steatosis out, representing a useful point-of-care tool to avail of hepatologists interested in excluding NAFLD, but with basic US skills., Competing Interests: Conflict of interest The authors have declared no conflict of interest for this article., (Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2024
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17. Drug resistant epilepsies: A multicentre case series of steroid therapy.

Author

Falsaperla R, Collotta AD, Marino SD, Sortino V, Leonardi R, Privitera GF, Pulvirenti A, Suppiej A, Vecchi M, Verrotti A, Farello G, Spalice A, Elia M, Spitaleri O, Micale M, Mailo J, and Ruggieri M

Subjects
Humans, Male, Female, Retrospective Studies, Adolescent, Child, Child, Preschool, Methylprednisolone therapeutic use, Methylprednisolone administration & dosage, Dexamethasone therapeutic use, Adult, Young Adult, Treatment Outcome, Anticonvulsants therapeutic use, Adrenal Cortex Hormones therapeutic use, Hydrocortisone therapeutic use, Drug Resistant Epilepsy drug therapy, Drug Resistant Epilepsy physiopathology, Electroencephalography
Abstract

Purpose: Our study aimed to evaluate the effectiveness of corticosteroids on seizure control in drug-resistant epilepsies (DREs). Our primary goal was to assess the response to steroids for various underlying etiologies, interictal electroencephalographic (EEG) patterns and electroclinical seizure descriptions. Our second goal was to compare steroid responsiveness to different treatment protocols., Methods: This is a retrospective multicentre cohort study conducted according to the STROBE guidelines (Strengthening the Reporting of Observational Studies in Epidemiology). The following data were collected for each patient: epilepsy etiology, interictal EEG pattern, seizure types and type of steroid treatment protocol administered., Results: Thirty patients with DRE were included in the study. After 6 months of therapy, 62.7 % of patients experienced reduced seizure frequency by 50 %, and 6.6 % of patients experienced complete seizure cessation. Findings associated with favourable response to steroids included structural/lesional etiology of epilepsy, immune/infectious etiology and focal interictal abnormalities on EEG. Comparing four different steroid treatment protocols, the most effective for seizure control was treatment with methylprednisolone at the dose of 30 mg/kg/day administered for 3 days, leading to greater than 50 % seizure reduction at 6 months in 85.7 % of patients. Treatment with dexamethasone 6 mg/day for 5 days decreased seizure frequency in 71.4 % of patients. Hydrocortisone 10 mg/kg administered for 3 months showed a good response to treatment in 71 %., Conclusions: In our study, two-thirds of patients with DRE experienced a significant seizure reduction following treatment with steroids. We suggest considering steroids as a potential therapeutic option in children with epilepsy not responding to conventional antiseizure medicines (ASM)., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024. Published by Elsevier Ltd.)

Published
2024
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18. iNKT cell-neutrophil crosstalk promotes colorectal cancer pathogenesis.

Author

Lattanzi G, Strati F, Díaz-Basabe A, Perillo F, Amoroso C, Protti G, Rita Giuffrè M, Iachini L, Baeri A, Baldari L, Cassinotti E, Ghidini M, Galassi B, Lopez G, Noviello D, Porretti L, Trombetta E, Messuti E, Mazzarella L, Iezzi G, Nicassio F, Granucci F, Vecchi M, Caprioli F, and Facciotti F

Subjects
Mice, Animals, Neutrophils, Immunotherapy, Tumor Microenvironment, Natural Killer T-Cells, Antineoplastic Agents pharmacology, Colorectal Neoplasms pathology
Abstract

iNKT cells account for a relevant fraction of effector T-cells in the intestine and are considered an attractive platform for cancer immunotherapy. Although iNKT cells are cytotoxic lymphocytes, their functional role in colorectal cancer (CRC) is still controversial, limiting their therapeutic use. Thus, we examined the immune cell composition and iNKT cell phenotype of CRC lesions in patients (n = 118) and different murine models. High-dimensional single-cell flow-cytometry, metagenomics, and RNA sequencing experiments revealed that iNKT cells are enriched in tumor lesions. The tumor-associated pathobiont Fusobacterium nucleatum induces IL-17 and Granulocyte-macrophage colony-stimulating factor (GM-CSF) expression in iNKT cells without affecting their cytotoxic capability but promoting iNKT-mediated recruitment of neutrophils with polymorphonuclear myeloid-derived suppressor cells-like phenotype and functions. The lack of iNKT cells reduced the tumor burden and recruitment of immune suppressive neutrophils. iNKT cells in-vivo activation with α-galactosylceramide restored their anti-tumor function, suggesting that iNKT cells can be modulated to overcome CRC-associated immune evasion. Tumor co-infiltration by iNKT cells and neutrophils correlates with negative clinical outcomes, highlighting the importance of iNKT cells in the pathophysiology of CRC. Our results reveal a functional plasticity of iNKT cells in CRC, suggesting a pivotal role of iNKT cells in shaping the tumor microenvironment, with relevant implications for treatment., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

Published
2023
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19. Effectiveness of double-balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography (DBE-ERCP): A multicenter real-world study.

Author

Farina E, Cantù P, Cavallaro F, Iori V, Rosa-Rizzotto E, Cavina M, Tontini GE, Nandi N, Scaramella L, Sassatelli R, Penagini R, Vecchi M, and Elli L

Subjects
Male, Humans, Aged, Female, Treatment Outcome, Anastomosis, Roux-en-Y methods, Anastomosis, Surgical, Retrospective Studies, Cholangiopancreatography, Endoscopic Retrograde methods, Double-Balloon Enteroscopy methods
Abstract

Background and Aims: To investigate the effectiveness of double-balloon enteroscope-assisted retrograde cholangiopancreatography (DBE-ERCP) in patients with gastrointestinal surgically altered anatomy (SAA)., Methods: From May 2013 to October 2021, all consecutive patients undergoing DBE-ERCP in three gastroenterological referral centers in Northern Italy were enrolled in the study. Patients were assessed regarding their medical history, previous surgery, time from previous surgery to the DBE-ERCP procedure, and the success or failure of DBE-ERCP., Results: Fifty-three patients (60% men, median age 65 (23-89) years) undergoing 67 DBE-ERCP procedures (1-3 DBE-ERCP per patient) were enrolled. Reasons for SAA included orthotopic liver transplantation (23%), ulcers (15%), malignancies (43%), difficult cholecystectomy (17%), and other causes (2%). Types of surgery included Roux-en-Y biliodigestive anastomosis (45%), Roux-en-Y gastrectomy (32%), pancreaticoduodenectomy (17%), and Billroth II gastrectomy (6%). The overall DBE-ERCP success rate was 86%. The type of surgery, indications, and the length of time between previous surgery and DBE-ERCP were not statistically associated with DBE-ERCP success. The DBE-ERCP success rate increased from 2018 to 2021., Conclusions: DBE-ERCP is a successful procedure in challenging patients with SAA. The improvement in results over time indicates the necessity of adequate training and of centralizing patients in referral centers., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2022. Published by Elsevier Ltd.)

Published
2023
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20. Clinical features of type 1 and 2 refractory celiac disease: Results from a large cohort over a decade.

Author

Elli L, Soru P, Roncoroni L, Rossi FG, Ferla V, Baldini L, Nandi N, Scaramella L, Scricciolo A, Rimondi A, Fusco N, Croci GA, Gianelli U, Cro L, Barbieri M, Lombardo V, Costantino A, Vaira V, Ferrero S, Tontini GE, Barigelletti G, Fabiano S, Doneda L, and Vecchi M

Subjects
Humans, Retrospective Studies, Atrophy, Celiac Disease complications, Celiac Disease therapy, Celiac Disease diagnosis, Hypoalbuminemia complications, Lymphoma complications
Abstract

Objectives: Refractory celiac disease (RCeD) is a rare complication of celiac disease (CeD) with a severe prognosis. We describe a cohort of patients with RCeD, their clinical and histological features at diagnosis, after therapy and at lymphoma onset, and the rate and causes of death over a 17-year follow-up., Methods: We retrospectively enrolled RCeD-I and RCeD-II patients attending our center between January 2002 and October 2019. Medical data were collected at diagnosis and during monitoring. Response to therapy, changes in RCeD molecular markers, number of hospitalizations, discharge diagnosis, and cause and date of death were evaluated. The control cohort consisted of 1015 responsive CeD patients., Results: Compared with RCeD-I, RCeD-II more frequently exhibits diarrhea (83 vs 64%), anemia (61 vs 50%), hypoalbuminemia (70 vs 21%), parenteral nutrition need (48 vs 7%), ulcerative jejuno-ileitis (7 vs 39%), and extended small intestinal atrophy (62 vs 21%). One RCeD-I and six RCeD-II patients developed lymphoma. Ten RCeD-II patients died, four from lymphoma progression. Among RCeD-II patients, atrophy extension was the only parameter correlated with hypoalbuminemia and mortality., Conclusions: Clinical severity, response to therapy, and mortality differ between RCeD-I and RCeD-II. Atrophy extension, evaluated at capsule endoscopy, was associated with disease severity and mortality., Competing Interests: Declaration of Competing Interest The authors have no conflicts of interest to declare. All co-authors have seen and agreed with the content of the manuscript. There are no financial interests to report., (Copyright © 2022. Published by Elsevier Ltd.)

Published
2023
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21. Similar survival but higher and delayed hepatocellular carcinoma recurrence in HIV-positive compared to negative cirrhotics undergoing liver transplantation.

Author

Rossotti R, Merli M, Mazzarelli C, De Carlis RM, Travi G, Vecchi M, Viganò R, Lauterio A, Raimondi A, Belli LS, De Carlis LG, and Puoti M

Subjects
Humans, Retrospective Studies, Antiviral Agents therapeutic use, Neoplasm Recurrence, Local pathology, Liver Cirrhosis complications, Liver Cirrhosis drug therapy, Carcinoma, Hepatocellular pathology, Liver Neoplasms pathology, Liver Transplantation, HIV Infections complications, HIV Infections drug therapy, End Stage Liver Disease, Hepatitis C drug therapy
Abstract

Background: Liver transplantation (LT) represents the best therapeutic option for hepatocellular carcinoma (HCC) and end-stage liver disease (ESLD). Although HIV infection does not seem to lower survival rates, HCV and HCC recurrence appear more harmful., Aims: To compare the overall survival after LT; evaluate the impact of anti-HCV direct-acting agents (DAA); assess the rate of HCC recurrence in HIV-positive and negative patients., Methods: Subjects with HCV/HBV infection who underwent LT for HCC or ESLD from 2012 to 2019 were retrospectively evaluated., Results: Study population included 299 individuals, 31 (10.4%) were HIV-positive. Overall mortality was similar (16.1% versus 19.0%, p = 0.695). HCC recurrence was observed in 6 HIV-positive (19.4%) and in 17 negative subjects (6.3%, p = 0.022). Time to relapse was 831 days in HIV-positive and 315 days in negative patients (p = 0.046). Cox model found a significant role for HIV in univariate analysis but, after adjusting for variables, extra-hepatic tumor was the only factor associated to recurrence (aHR 56.379, p < 0.001)., Conclusions: Post-LT survival improved after DAA availability and HIV has no impact on mortality. A higher and delayed rate of HCC recurrence was observed in co-infected individuals: surveillance protocols should be strengthened along time in this population., Competing Interests: Declaration of Competing Interest none of the Authors has conflicts of interests to declare., (Copyright © 2022. Published by Elsevier Ltd.)

Published
2023
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22. Enteroscopy in diagnosis and treatment of small bowel bleeding: A Delphi expert consensus.

Author

Sorge A, Elli L, Rondonotti E, Pennazio M, Spada C, Cadoni S, Cannizzaro R, Calabrese C, de Franchis R, Girelli CM, Marmo R, Riccioni ME, Marmo C, Oliva S, Scarpulla G, Soncini M, Vecchi M, and Tontini GE

Subjects
Humans, Consensus, Delphi Technique, Endoscopy, Gastrointestinal, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage therapy
Abstract

Background: Enteroscopy plays an important role in the management of small bowel bleeding. However, current guidelines are not specifically designed for small bowel bleeding and recommendations from different international societies do not always align. Consequently, there is heterogeneity in the definitions of clinical entities, clinical practice policies, and adherence to guidelines among clinicians. This represents an obstacle to providing the best patient care and to obtain homogeneous data for clinical research., Aims: The aims of the study were to establish a consensus on the definitions of bleeding entities and on the role of enteroscopy in the management of small bowel bleeding using a Delphi process., Methods: A core group of eight experts in enteroscopy identified five main topics of small bowel bleeding management and drafted statements on each topic. An expert panel of nine gastroenterologists participated in three rounds of the Delphi process, together with the core group., Results: A total of 33 statements were approved after three rounds of Delphi voting., Conclusion: This Delphi consensus proposes clear definitions and a unifying strategy to standardize the management of small bowel bleeding. Furthermore, it provides a useful guide in daily practice for both clinical and technical issues of enteroscopy., Competing Interests: Conflict of Interest Dr. Spada is consultant for Medtronic and Norgine and received grant from AlfaSigma, Pentax, Olympus. Dr.Pennazio received speaker's honoraria from Medtronic and Olympus. Dr. Rondonotti is member of the expert group of Fujifilm, received speaker's honoraria from Fujifilm and consultancy agreement from Medtronic. Dr. Tontini is a consultant for NTC Pharma and F. Hoffmann-La Roche Ltd and received speaker's honoraria from Pentax, Medtronic and NTC Pharma., (Copyright © 2022. Published by Elsevier Ltd.)

Published
2023
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24. Effect of an Escherichia coli F4/F18 bivalent oral live vaccine on gut health and performance of healthy weaned pigs.

Author

Correa F, Luise D, Amatucci L, Palumbo F, Virdis S, Negrini C, Clavenzani P, Vecchi M, Mazzoni M, Bosi P, and Trevisi P

Subjects
Swine, Animals, Weaning, Vaccines, Combined, Diet veterinary, Health Status, Animal Feed analysis, Dietary Supplements, Enterotoxigenic Escherichia coli, Escherichia coli Infections prevention & control, Escherichia coli Infections veterinary
Abstract

Oral live vaccines stimulate host immunity, but they could also affect intestinal mucosa development and gut microbiota of piglets during the postweaning. The aim of this study was to determine the effect of an oral vaccine against Escherichia coli F4 and F18 (Coliprotec F4/F18®), on gut functionality and integrity, growth performance and health status of postweaning piglets. A total of 96 weaned piglets (23.30 ± 1.85 days of age; 7334 ± 1039 g BW) were divided into two groups (16 replicates/group; three piglets/replicate) as follows: (1) Control (CO), fed a standard diet (prestarter up to 14 days, then starter feed); (2) Treated (TRT): as CO but vaccinated with Coliprotec F4/F18® at weaning (day 0). Piglets were weighed at day 0 and weekly until day 35. Individual faecal score was recorded daily. Piglets were sacrificed at days 10 (1/3 of total) and 35 (2/3). Samples of jejunum mucosa and of cecum content were collected for morphometric, immunohistochemistry analysis and for microbiota profile analysis, respectively. Data were fitted using a linear model including treatment, class of starting BW as fixed factors and litter as random factor. From days 0 to 7, piglets from the TRT group tended to have a higher average daily gain (+22.6%, P = 0.08) and average daily feed intake compared to the CO group (+13.2%, P = 0.022). Gain to feed ratio was lower in the TRT group from days 14 to 35 (-6.6%, P = 0.011). From days 7 to 14, the TRT group had a higher diarrhoea index (-199%, P < 0.001). Crypt depth was higher in the CO group (+10.9%, P = 0.04) at day 10, but not at day 35. Jejunal expression of Claudin-4 (probability of having a score = 3) was higher in the TRT group at day 10 (CO = 1.50% vs TRT = 2.69%, P < 0.0001) and day 35 (CO = 1.29% vs TRT = 1.92%, P = 0.012). Oral vaccine affected beta diversity at day 10 (P = 0.040; R 2  = 0.05) and increased the abundance of specific taxa and genera in the cecum at day 10, including Prevotella (lg2FC = 23.2, FDR < 0.001). The results showed how an Escherichia coli-based vaccine supplied to weaned pigs can promote gut health by controlling symptoms of the postweaning perturbation in the first 2 weeks postweaning. In addition, the vaccine strains showed a probiotic-like effect by modulating gut microbiota favouring the establishment of beneficial bacteria, and by promoting gut barrier integrity., (Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.)

Published
2022
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25. Quality of endoscopic screening for colorectal cancer in Italy: A national survey.

Author

Maida M, Annibale B, Benedetti A, Burra P, Frulloni L, Ianiro G, Luzza F, Repici A, Savarino E, Sinagra E, Vecchi M, and Ricciardiello L

Subjects
Cecum, Early Detection of Cancer, Humans, Italy epidemiology, Mass Screening, Occult Blood, Colonoscopy, Colorectal Neoplasms diagnosis, Colorectal Neoplasms epidemiology
Abstract

Background: Colorectal cancer (CRC) is a major healthcare problem all over the world and screening is effective in reducing mortality and increasing survival. Since colonoscopy has a central role in faecal immunochemical test (FIT)-based CRC screening and surveillance, consistent quality measures are essential to ensure quality and outcomes. Nevertheless, screening modalities in clinical practice may differ according to the centers experience and the local availability of instrumentation and devices., Aims: to assess the quality of endoscopic screening for CRC and adherence to international guidelines across Gastroenterology Departments in Italy., Methods: All members of the Italian Society of Gastroenterology (SIGE) were invited to answer a web-based survey., Results: Data from 64 hospitals from 17 Italian regions were analyzed. 32/64 (50.0%) were from northern, 12/64 (18.75%) from central and 20/64 (31.25%) from southern Italy. Each center is equipped with a median of 5.0 (3.5-7.0) endoscopists involved in CRC screening, 71.4% of which are gastroenterologists. After a positive FIT, most centers (93.8%) schedule a colonoscopy within 3 months. High-definition video endoscopy is routinely performed in 68.8% and chromoendoscopy in 53.1% of centers. Withdrawal time is ≥6 min in 79.9% and cecal intubation rate is ≥90% in 94.4% of departments. Finally, in 92.7% of centers adenoma detection rate (ADR) overcome the minimum standard of 25%. Analyzing the data by regional areas, a significant higher number of median endoscopic examinations/year (6500 vs 4000 and 3000, respectively, p = 0.024) and of endoscopists per center (6.5 vs 5.0 and 3.5, respectively, p < 0.001) has been registered in the northern compared to central-southern centers., Conclusions: Data from this survey show adequacy and good quality of endoscopic screening for CRC in Italy, highlighting, at the same time, relevant deficiencies and a discrepancy in procedural attitudes between the different centers. These findings call for a urgent action to overcome the shortcomings, refine and homogenize the behaviour of all screening centers in the national territory and improve the outcomes., Competing Interests: Conflict of interest The authors have no proprietary, financial, professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of this manuscript., (Copyright © 2022. Published by Elsevier Ltd.)

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2022
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26. Jejunal necrosis following caustic (NH3) ingestion in patient with total gastrectomy.

Author

Nandi N, Rimondi A, Tontini GE, and Vecchi M

Subjects
Eating, Gastrectomy, Humans, Necrosis, Burns, Chemical, Caustics
Abstract

Competing Interests: Conflict of interest The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest in the subject matter or materials discussed in this manuscript.

Published
2022
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27. Use of a proline-specific endopeptidase to reintroduce gluten in patients with non-coeliac gluten sensitivity: A randomized trial.

Author

Scricciolo A, Lombardo V, Elli L, Bascuñán KA, Doneda L, Rinaldi F, Pinto D, Araya M, Costantino A, Vecchi M, and Roncoroni L

Subjects
Adult, Diet, Gluten-Free, Humans, Proline, Prolyl Oligopeptidases, Quality of Life, Celiac Disease, Glutens adverse effects
Abstract

Background: A gluten-free diet (GFD) is the main therapy for non-coeliac gluten sensitivity (NCGS). However, the availability of novel enzymes with the ability to digest gluten could represent a therapeutic opportunity for NCGS patients to avoid a GFD., Aims: To evaluate the controlled reintroduction of gluten with or without the endopeptidase P1016 in NCGS patients., Methods: This is a randomized, double-blind, placebo-controlled monocentric study, Registered under ClinicalTrials.gov Identifier no. NCT01864993. Gluten was reintroduced incrementally over a 3-week period under nutritional control. NCGS patients were randomized into two groups and administered P1016 or placebo during gluten reintroduction. We evaluated symptoms (visual analogue scale, VAS), quality of life (SF-36) and mental health symptoms (SCL-90) on a weekly basis., Results: We enrolled a total 23 patients who were allocated to a placebo group (n = 11, age 38.4 ± 2.9) or an intervention group (n = 12, age 39.5 ± 3.1). No effect of P1016 on symptoms was found. During gluten reintroduction, patients reported a significant increase in abdominal pain and a worsening of stool consistency. Furthermore, no differences were found between the groups regarding SCL-90 and SF-36 scores., Conclusions: Our results demonstrate a lack of effect of P1016 in the management of NCGS patients and the possible reintroduction of gluten., Competing Interests: Conflict of interest The authors declare no conflict of interest., (Copyright © 2022 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Published
2022
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28. Clinical impact of videocapsule and double balloon enteroscopy on small bowel bleeding: Results from a large monocentric cohort in the last 19 years.

Author

Elli L, Scaramella L, Tontini GE, Topa M, Conte D, Sidhu R, Rondonotti E, Penagini R, and Vecchi M

Subjects
Aged, Aged, 80 and over, Female, Humans, Intestine, Small diagnostic imaging, Intestine, Small surgery, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Capsule Endoscopy statistics & numerical data, Double-Balloon Enteroscopy statistics & numerical data, Gastrointestinal Hemorrhage diagnosis, Intestinal Diseases diagnosis
Abstract

Background: Suspected small bowel bleeding (SSBB) is the main indication for videocapsule endoscopy (VCE) and double balloon enteroscopy (DBE). We assessed the impact of both modalities in a large cohort of SSBB patients in a European tertiary center., Methods: We retrospectively evaluated consecutive patients with SSBB undergoing VCE and/or DBE from March 2001 to July 2020. Demographic/clinical parameters, anticoagulant therapies, technical characteristics and adverse events were collected, as well as diagnostic yield (DY), VCE-DBE concordance, hemoglobin (Hb) values before and after DBE, and complications., Results: 807 VCEs and 407 DBEs were performed in 751 patients. The DY was significantly higher in DBE compared with VCE (68.8% vs 57.7%), with the highest (75%) yield for overt active SB bleeding. The agreement between VCE and DBE was generally suboptimal (k = 0.059). This improved in cases where both procedures were done within 1-5 days of the other (k = 0.323). Post-procedural Hb values were significantly higher. In patients treated with direct oral anticoagulants (DOACs), there were no differences in DY, complications or Hb values compared with non-DOAC patients., Conclusion: VCE and DBE play a pivotal role in the diagnostic and therapeutic approach to SSBB, having a high clinical impact even in patients treated with DOACs., (Copyright © 2021. Published by Elsevier Ltd.)

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2022
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29. Anti-SARS-CoV-2 immunoglobulin profile in patients with celiac disease living in a high incidence area.

Author

Elli L, Facciotti F, Lombardo V, Scricciolo A, Sanders DS, Vaira V, Barisani D, Vecchi M, Costantino A, Scaramella L, dell'Osso B, Doneda L, and Roncoroni L

Subjects
Adult, Angiotensin-Converting Enzyme 2 metabolism, COVID-19 prevention & control, Celiac Disease diet therapy, Diet, Gluten-Free, Duodenum metabolism, Female, Humans, Incidence, Italy, Male, Patient Compliance, SARS-CoV-2 immunology, COVID-19 immunology, Celiac Disease immunology, Immunoglobulin A immunology, Immunoglobulin G immunology
Abstract

Background and Aim: How symptoms and antibodies related to SARS-CoV-2 infection develop in patients with celiac disease (CD) is unclear. We aimed to investigate the impact of SARS-CoV-2 infection in CD patients., Methods: CD patients were interviewed about the development of COVID-19 symptoms, compliance with anti-virus measures and adherence to a gluten-free diet (GFD). The presence of anti-SARS-CoV-2 IgG and IgA (anti-RBD and N proteins) was compared to that in non-CD subjects. Expression of the duodenal ACE2 receptor was investigated. When available, data on duodenal histology, anti-tissue transglutaminase IgA (tTGA), comorbidities and GFD adherence were analyzed., Results: Of 362 CD patients, 42 (12%) reported COVID-19 symptoms and 21% of these symptomatic patients presented anti-SARS-CoV-2 Ig. Overall, 18% of CD patients showed anti-SARS-CoV-2 Ig versus 25% of controls (p = 0.18). CD patients had significantly lower levels of anti-N IgA. tTGA, duodenal atrophy, GFD adherence or other comorbidities did not influence symptoms and/or antibodies. The ACE2 receptor was detected in the non-atrophic duodenal mucosa of patients; atrophy was associated with lower expression of the ACE2 receptor., Conclusion: CD patients have an anti-SARS-CoV-2 Ig profile similar to non-celiac controls, except for anti-N IgA. No risk factors were identified among CD parameters and GFD adherence., Competing Interests: Declaration of Competing Interest None declared., (Copyright © 2021. Published by Elsevier Ltd.)

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2022
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30. Agreement between real-time elastography and delayed enhancement magnetic resonance enterography on quantifying bowel wall fibrosis in Crohn's disease.

Author

Mazza S, Conforti FS, Forzenigo LV, Piazza N, Bertè R, Costantino A, Fraquelli M, Coletta M, Rimola J, Vecchi M, and Caprioli F

Subjects
Adult, Crohn Disease pathology, Cross-Sectional Studies, Female, Fibrosis, Humans, Ileum diagnostic imaging, Intestinal Mucosa diagnostic imaging, Male, Middle Aged, Outcome Assessment, Health Care, Reproducibility of Results, Crohn Disease diagnostic imaging, Elasticity Imaging Techniques statistics & numerical data, Ileum pathology, Intestinal Mucosa pathology, Magnetic Resonance Imaging statistics & numerical data
Abstract

Background: the assessment of fibrosis in Crohn's disease (CD) bowel lesions helps to guide therapeutic decisions. Real-time elastography (RTE) and delayed-enhancement magnetic resonance enterography (DE-MRE) have demonstrated good accuracy in quantifying CD-related ileal fibrosis as compared with histological examination. To date no study has compared DE-MRE and RTE., Aims: we aimed to evaluate the agreement between RTE and DE-MRE on quantifying CD-related ileal fibrosis., Methods: consecutive patients with ileal or ileocolonic CD underwent RTE and DE-MRE. Ileal fibrosis was quantified by calculating the strain ratio (SR) at RTE and the 70s-7 min percentage of enhancement gain (%EG) of both mucosa and submucosa at DE-MRE. A SR ≥2 was applied to define severe fibrosis. Clinically relevant outcomes occurring at follow-up were recorded., Results: 40 CD patients were enrolled. A significant linear correlation was observed between SR and submucosal %EG (r = 0.594, p < 0.001). Patients with severe fibrosis (SR ≥2) had significantly higher submucosal %EG values than patients with low/moderate fibrosis (median values 26.4% vs. 9.5%, p < 0.001). During a median 43.8-month follow-up relevant disease outcomes occurred more frequently in the severe-fibrosis group (75% vs. 36%, HR 5.4, 95% CI 1.2-24.6, p = 0.029)., Conclusions: the study demonstrates an excellent agreement between RTE and DE-MRE in assessing ileal fibrosis in CD., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2021. Published by Elsevier Ltd.)

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2022
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31. Towards population-based genetic screenings for breast and ovarian cancer: A comprehensive review from economic evaluations to patient perspectives.

Author

Ficarazzi F, Vecchi M, Ferrari M, and Pierotti MA

Subjects
Cost-Benefit Analysis, Early Detection of Cancer, Female, Genetic Predisposition to Disease, Genetic Testing, Humans, Breast Neoplasms diagnosis, Breast Neoplasms genetics, Ovarian Neoplasms diagnosis, Ovarian Neoplasms genetics
Abstract

Genetic testing for hereditary breast and ovarian cancer following genetic counseling is based on guidelines that take into account particular features of the personal and family history, and clinical criteria conferring a probability of having a BRCA mutation greater than 10% as a threshold for accessing the test. However, besides reducing mortality and social impact, the extension of screening programs also for healthy family members would allow a huge saving of the rising costs associated with these pathologies, supporting the choice of the "Test" strategy versus a "No Test" one. Analyses of different health care systems show that by applying the "Test" strategy on patients and their families, a decrease in breast and ovarian cancer cases is achieved, as well as a substantial decrease in costs of economic resources, including the costs of the clinical management of early detected tumors. In this review, we analyzed the most recent papers published on this topic and we summarized the findings on the economic evaluations related to breast and ovarian cancer population screenings. These results proved and validated that the population-wide testing approach is a more accurate screening and preventive intervention than traditional guidelines based on personal/family history and clinical criteria to reduce breast and ovarian cancer risk., Competing Interests: Declaration of competing interest FF, MV and MAP are employees of Cogentech Ltd Benefit Corporation, MF is a consultant for Cogentech srl activities. Cogentech Ltd Benefit Corporation is a private limited company owned by the no-profit research institute IFOM (FIRC Institute of Molecular Oncology) whose mission is to provide technological services for the post-genomic era to researchers and clinicians. Cogentech services are dedicated to members of the international scientific community and clinicians who wish to use them for diagnostic purposes. Cogentech specifically, provides and develops genetic tests of susceptibility to various hereditary cancers including those related to the evaluation of BRCA gene mutations in patients with breast and ovarian cancer. In this perspective, the topic of the manuscript is related to general public benefits and a positive impact on cancer patients and society, at large, interests that are part of the mission of Cogentech Ltd Benefit Corporation activity. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Published
2021
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32. Endoscopy during the COVID-19 pandemic: Is it time to down-grade personal protective equipment for vaccinated personnel?

Author

Elli L, Rimondi A, Tontini E, Gori A, Vecchi M, and Penagini R

Subjects
COVID-19 transmission, Humans, Infection Control, Italy, Pandemics, COVID-19 prevention & control, COVID-19 Vaccines, Endoscopy, Digestive System, Infectious Disease Transmission, Patient-to-Professional prevention & control, Personal Protective Equipment
Abstract

Competing Interests: Declaration of Competing Interest None declared.

Published
2021
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33. Low prevalence of colorectal neoplasia in microscopic colitis: A large prospective multi-center study.

Author

Borsotti E, Barberio B, D'Incà R, Bonitta G, Cavallaro F, Spina L, Pastorelli L, Rondonotti E, Samperi L, Dinelli M, Vecchi M, and Tontini GE

Subjects
Aged, Biopsy, Chronic Disease, Colonoscopy methods, Colorectal Neoplasms diagnosis, Colorectal Neoplasms etiology, Early Detection of Cancer methods, Female, Humans, Italy, Male, Middle Aged, Prevalence, Prospective Studies, Regression Analysis, Colitis, Microscopic complications, Colonoscopy statistics & numerical data, Colorectal Neoplasms epidemiology, Diarrhea complications, Early Detection of Cancer statistics & numerical data
Abstract

Background and Aims: Microscopic colitis (MC) is the most frequent condition in subjects undergoing ileocolonoscopy for chronic non-bloody diarrhea (CNBD) in Western countries. Emerging evidence has shown a negative association between MC and colorectal cancer. Within this prospective multi-center study we have evaluated the risk of colorectal neoplasia in MC and non-MC patients with CNBD receiving ileocolonoscopy with high-definition plus virtual chromoendoscopic imaging and histopathological assessment., Methods: Patients with CNBD of unknown origin were prospectively enrolled in 5 referral centers in Northern Italy for ileocolonoscopy with high-definition and digital/optical chromoendoscopy plus multiple biopsies in each segment. The prevalence of colorectal neoplasia (cancer, adenoma, serrated lesion) in MC was compared to that observed in a control group including CNBD patients negative for MC, inflammatory bowel disease or eosinophilic colitis., Results: From 2014 and 2017, 546 consecutive CNBD patients were recruited. Among the 492 patients (mean age 53±18 years) fulfilling the inclusion criteria against the exclusion critieria, MC was the predominant diagnosis at histopathological assessment (8.7%: N=43, 28 CC, 15 LC). The regression model adjusted for age and gender showed a significant negative association between the diagnosis of CM and colorectal neoplasia (OR=0.39; 95% CI 0.22-0.67, p <0.001) with a 60% decreased risk of adenomatous and neoplastic serrated polyps as compared to the control group (n=412)., Conclusion: This multi-center study confirms MC as a low-risk condition for colorectal neoplasia. No surveillance colonoscopy program is to be performed for MC diagnosis., Competing Interests: Conflict of interest None declared., (Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2021
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34. Inflammatory bowel disease course in liver transplant versus non-liver transplant patients for primary sclerosing cholangitis: LIVIBD, an IG-IBD study.

Author

Ribaldone DG, Imperatore N, Le Grazie M, Furfaro F, Balestrieri P, De Blasio F, Fagoonee S, Mosso E, Boano V, Reggio D, Sarli E, Castiglione F, Milla M, Vecchi M, Saracco GM, Salizzoni M, Romagnoli R, Fiorino G, and Astegiano M

Subjects
Adult, Cholangitis, Sclerosing complications, Disease Progression, Female, Humans, Inflammatory Bowel Diseases complications, Italy, Kaplan-Meier Estimate, Male, Middle Aged, Retrospective Studies, Risk Factors, Cholangitis, Sclerosing surgery, Inflammatory Bowel Diseases physiopathology, Liver Transplantation adverse effects
Abstract

Background: Data regarding the effect of orthotopic liver transplantation (OLT) for primary sclerosing cholangitis (PSC) on inflammatory bowel disease (IBD) course are scarce and conflicting., Aims: To compare the incidence of refractory IBD in two groups (OLT and non-OLT) of patients affected by IBD and PSC., Methods: An observational, multicentre, cohort retrospective study was conducted by the Italian Group for the study of IBD in Italy. The primary outcome was the need for biologic therapy or bowel resection for medically refractory IBD or hospitalization due to IBD relapse during the follow-up. Secondary outcomes were rate of colonic dysplasia, colorectal cancer, other solid tumours, lymphoma., Results: Eighty-four patients were included in the study. The primary outcome was not different between OLT and non-OLT groups (11/27, 40.7%, versus 20/57, 35.1%, respectively, p = 0.62). The lymphoma and other tumours (thyroid cancer, kidney cancer, ileal tumour, ovarian cancer, cervical cancer) rates were significantly higher in the OLT group (p = 0.04 and p = 0.005, respectively), at the limit of statistical significance for high-grade colonic dysplasia (p = 0.06)., Conclusion: OLT in patients affected by IBD and PSC is not a risk factor for a more severe IBD course, but it is associated with a higher occurrence of cancer., Competing Interests: Conflict of interest None declared., (Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

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2021
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35. Trust in telemedicine from IBD outpatients during the COVID-19 pandemic.

Author

Costantino A, Noviello D, Mazza S, Berté R, Caprioli F, and Vecchi M

Subjects
Adult, Aged, Ambulatory Care, COVID-19, Female, Humans, Male, Middle Aged, SARS-CoV-2, Surveys and Questionnaires, Young Adult, Attitude to Health, Inflammatory Bowel Diseases, Telemedicine, Trust, Videoconferencing
Abstract

Competing Interests: Declaration of Competing Interest AC received lecturer fees from Takeda, a sponsorship from Bracco, FC served as a consultant to: Mundipharma, Abbvie, MSD, Takeda, Janssen, Roche, Celgene. FC received lecturer fees from Abbvie, Ferring, Takeda, Allergy Therapeutics, Janssen and unrestricted research grants from Giuliani, Sofar, MSD, Takeda, Abbvie. MV served as consultant to: Abbvie, MSD, Takeda, Janssen-Cilag, Celgene. He received lecturer fees from Abbvie, Ferring, Takeda, MSD, Janssen-Cilag, Zambon. All the remaining authors declare no conflict of interest.

Published
2021
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36. Post-operative biliary strictures.

Author

Cantù P, Mauro A, Cassinotti E, Boni L, Vecchi M, and Penagini R

Subjects
Cholangiopancreatography, Endoscopic Retrograde, Cholangiopancreatography, Magnetic Resonance, Cholestasis diagnostic imaging, Common Bile Duct injuries, Constriction, Pathologic diagnostic imaging, Constriction, Pathologic therapy, Endoscopy, Gastrointestinal, Humans, Liver Transplantation adverse effects, Treatment Outcome, Cholecystectomy, Laparoscopic adverse effects, Cholestasis etiology, Cholestasis therapy, Constriction, Pathologic etiology, Stents adverse effects
Abstract

Post-operative biliary stricture is a cumbersome condition, secondary to biliary or vascular damage. Its risk factors include biliary or vascular anatomical variants, local inflammation, and poor surgical expertise. Intra-operative diagnosis is difficult, and in most cases, patients present with obstructive symptoms within a few weeks. Magnetic resonance cholangiography is a pivotal test to confirm the clinical picture, to study the level of the damage, and to guide treatment. Nowadays, endoscopic stenting is the first-line treatment in most centers. Multi-stenting treatment achieves long-term clinical success for more than 90% of patients, however multiple procedures are needed. In order to optimize healthcare provider costs, shorter duration endotherapies with covered metal stents are under evaluation. Radiological and surgical approaches are considered in the event of endoscopy failure., Competing Interests: Declaration of Competing Interests No conflict of interest are declared, (Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2020
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37. Endoscopy during the Covid-19 outbreak: experience and recommendations from a single center in a high-incidence scenario.

Author

Elli L, Rimondi A, Scaramella L, Topa M, Vecchi M, Mangioni D, Gori A, and Penagini R

Subjects
Betacoronavirus isolation & purification, COVID-19, Humans, Italy epidemiology, Organizational Innovation, Patient Selection, Risk Adjustment methods, Risk Adjustment organization & administration, SARS-CoV-2, Coronavirus Infections epidemiology, Coronavirus Infections prevention & control, Disease Transmission, Infectious prevention & control, Endoscopy methods, Gastrointestinal Diseases diagnosis, Gastrointestinal Diseases epidemiology, Gastrointestinal Diseases surgery, Infection Control methods, Infection Control organization & administration, Pandemics prevention & control, Patient Care Management organization & administration, Patient Care Management trends, Pneumonia, Viral epidemiology, Pneumonia, Viral prevention & control
Abstract

A dramatic SARS-Cov-2 outbreak is hitting Italy hard. To face the new scenario all the hospitals have been re-organised in order to reduce all the outpatient services and to devote almost all their personnel and resources to the management of Covid-19 patients. As a matter of fact, all the services have undergone a deep re-organization guided by: the necessity to reduce exams, to create an environment that helps reduce the virus spread, and to preserve the medical personnel from infection. In these days a re-organization of the endoscopic unit, sited in a high-incidence area, has been adopted, with changes to logistics, work organization and patients selection. With the present manuscript, we want to support gastroenterologists and endoscopists in the organization of a "new" endoscopy unit that responds to the "new" scenario, while remaining fully aware that resources, availability and local circumstances may extremely vary from unit to unit., Competing Interests: Declaration of Competing Interest All the authors declare no conflict of interest., (Copyright © 2020 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2020
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38. Understanding short bowel syndrome: Current status and future perspectives.

Author

Massironi S, Cavalcoli F, Rausa E, Invernizzi P, Braga M, and Vecchi M

Subjects
Disease Management, Gastrointestinal Agents therapeutic use, Humans, Intestines transplantation, Parenteral Nutrition, Home, Peptides therapeutic use, Quality of Life, Intestines physiopathology, Short Bowel Syndrome epidemiology, Short Bowel Syndrome physiopathology, Short Bowel Syndrome therapy
Abstract

Short bowel syndrome (SBS) is a rare malabsorptive disorder as a result of the loss of bowel mass mostly secondary to surgical resection of the small intestine. Other causes are vascular diseases, neoplasms or inflammatory bowel disease. The spectrum of the disease is widely variable from single micronutrient malabsorption to complete intestinal failure, depending on the remaining length of the small intestine, the anatomical portion of intestine and the function of the remnant bowel. Over the last years, the management of affected patients has remarkably improved with the increase in patients' quality of life and survival, mainly thanks to advances in home-based parenteral nutrition (PN). In the last ten years new treatment strategies have become available together with increasing experience and the encouraging results with new drugs, such as teduglutide, have added a new dimension to the management of SBS. This review aims to summarize the knowledge available in the current literature on SBS epidemiology, pathophysiology, and its surgical (including intestinal lengthening procedures and intestinal transplantation) and medical management with emphasis on the recent advances. Moreover, this review attempts to provide the new understanding and recent approaches to SBS complications such as sepsis, catheter thrombosis, and intestinal failure-associated liver disease., (Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2020
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39. Is pocket-size ultrasound a reliable tool for bowel investigation? A study on its feasibility, reproducibility and diagnostic accuracy.

Author

Costantino A, Giunta M, Casazza G, Arona S, Colli A, Conte D, Vecchi M, and Fraquelli M

Subjects
Adult, Feasibility Studies, Female, Humans, Male, Middle Aged, Reproducibility of Results, Sensitivity and Specificity, Intestinal Diseases diagnostic imaging, Physical Examination instrumentation, Ultrasonography instrumentation
Abstract

Background: Intestinal ultrasound (IUS) examination is a first-line non-invasive imaging procedure for patients with suspicion of bowel diseases., Aim: To assess the feasibility, reproducibility and diagnostic accuracy of a pocket-size ultrasound device (PUD) in identifying the presence of intestinal alterations in patients consecutively recruited to undergo IUS examination., Methods: 200 consecutive patients (57% female, 48.8 years) underwent both PUD (two independent investigators) and IUS examination on the same day. Nine ultrasonographic signs were systematically searched for. PUD inter-observer reproducibility was assessed by kappa statistic and ICC. The diagnostic accuracy of PUD as compared to IUS results was assessed by calculating sensitivity, specificity and corresponding positive and negative likelihood ratios., Results: PUD and IUS examinations were successful in 100% of the patients. PUD reproducibility was good/excellent at evidencing the presence (ICC 0.84) and length (ICC 0.85) of an intestinal tract with thickened wall and abdominal free fluid (ICC 0.87). The diagnostic accuracy of PUD, compared to traditional IUS, was good with regard to the presence of bowel wall thickening (sensitivity 92%, specificity 95%), the length of the thickened bowel (sensitivity 94%, specificity 95%) and the presence of free fluid (sensitivity 81%, specificity 99%)., Conclusions: PUD is a feasible, reproducible and accurate first-line screening tool for the assessment of the gastro-intestinal tract., (Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2020
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40. Are we choosing wisely for inflammatory bowel disease care? The IG-IBD choosing wisely campaign.

Author

Lenti MV, Armuzzi A, Castiglione F, Fantini MC, Fiorino G, Orlando A, Pugliese D, Rizzello F, Vecchi M, and Di Sabatino A

Subjects
Adult, Analgesics, Opioid therapeutic use, Delphi Technique, Female, Humans, Italy, Male, Middle Aged, Physician-Patient Relations, Quality Improvement, Societies, Medical, Steroids therapeutic use, Tomography, X-Ray Computed, Disease Management, Inflammatory Bowel Diseases diagnosis, Inflammatory Bowel Diseases drug therapy, Practice Guidelines as Topic, Unnecessary Procedures standards
Abstract

Background: The "Choosing Wisely" campaigns have the aim of promoting a better clinician-patient relationship., Aims: The Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) conducted a choosing wisely campaign for IBD., Methods: Ten IG-IBD panellists conducted the campaign through a modified Delphi process. All IG-IBD members were asked to submit five statements starting with "Do not…" addressing any IBD-related procedure or treatment the necessity of which should be questioned. All recommendations were evaluated by the panellists who prioritised each item. The top ten recommendations were prioritised again by IG-IBD members, and the top five recommendations were identified., Results: 110 members (mean age 42 ± 12; 62 males) participated in the campaign. The top five recommendations were as follow: 1. Do not use corticosteroids for maintenance therapy, or without a clear indication; 2. Do not forget venous thromboembolism prophylaxis in hospitalised patients with active disease; 3. Do not treat perianal Crohn's disease with biologics without prior surgical evaluation; 4. Do not discontinue IBD-related medications during pregnancy unless specifically indicated; 5. Do not delay surgery., Conclusion: The IG-IBD promoted a campaign with a bottom-up approach, identifying five recommendations that could be useful for providing a better IBD care, especially among non-IBD experts., (Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2020
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41. Photosensitive epilepsy and long QT: expanding Timothy syndrome phenotype.

Author

Po' C, Zordan R, Vecchi M, Cerutti A, Sartori S, Trevisson E, Ludwig K, Castaldi B, Salviati L, Leoni L, and Toldo I

Subjects
Adolescent, Child, Child, Preschool, Electrocardiography, Humans, Male, Autistic Disorder diagnosis, Autistic Disorder physiopathology, Long QT Syndrome diagnosis, Long QT Syndrome physiopathology, Phenotype, Syndactyly diagnosis, Syndactyly physiopathology
Published
2019
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42. Adherence to European Society of Gastrointestinal Endoscopy recommendations of endoscopists performing small bowel capsule endoscopy in Italy.

Author

Rondonotti E, Spada C, Pennazio M, de Franchis R, Cadoni S, Girelli C, Hassan C, Marmo R, Riccioni ME, Scarpulla G, Soncini M, Vecchi M, and Cannizzaro R

Subjects
Capsule Endoscopy methods, Endoscopy, Gastrointestinal methods, Humans, Intestine, Small diagnostic imaging, Italy, Practice Guidelines as Topic, Societies, Medical, Capsule Endoscopy standards, Endoscopy, Gastrointestinal standards, Guideline Adherence statistics & numerical data, Intestinal Diseases diagnostic imaging
Abstract

Background: The European Society of Gastrointestinal Endoscopy (ESGE) has recently issued a technical review focused on small bowel capsule endoscopy (SBCE)., Aim: To compare SBCE current practice in Italy to ESGE technical recommendations., Material and Methods: A dedicated per-centre semi-quantitative questionnaire was prepared by a group of SBCE experts. One-hundred-fifty Centres were invited to participate in the data collection concerning SBCEs performed between June 2016 and June 2017. Data were compared with ESGE recommendations., Results: 120 Centres participated in the data collection. Current practices agreed with ESGE recommendations in 56.3% (9/16) of the issues evaluated. Differences between ESGE recommendations and current practice concerned the management of patients with pacemakers or cardiac implantable defibrillators (which was in agreement with ESGE recommendations in 31.7% and 15.8% of Centres, respectively), the SBCE setting (only 51% of SBCEs were performed as outpatients procedures), the assessment of capsule excretion (timing and modality were in agreement with ESGE recommendation in 20.0% of Centres), and in the involvement of trained nurses or fellows in training as pre-readers (7/120; 5.8%)., Conclusions: Although SBCE is widely used and largely available in Italy, there are still some technical, practical and organizational issues that can be modified to bridge the gap between current practice and ESGE guideline recommendations., (Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2019
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43. Risk factors and timing for colectomy in chronically active refractory ulcerative colitis: A systematic review.

Author

Macaluso FS, Cavallaro F, Felice C, Mazza M, Armuzzi A, Gionchetti P, Vecchi M, and Orlando A

Subjects
Chronic Disease, Humans, Recurrence, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Colectomy, Colitis, Ulcerative surgery
Abstract

Background: In patients with chronic refractory ulcerative colitis (UC) the precise timing for indication to colectomy is unclear., Aims: We performed a systematic review of the literature on the risk factors for colectomy in patients with chronic refractory UC in the biologic era., Methods: PubMed Central/Medline and Embase were systemically searched for records published between January 2000 and December 2017. Current evidence was summarized and filtered by expert opinion., Results: 70 studies were included in the qualitative synthesis. Several factors were found to be associated with a higher or reduced risk for colectomy, including variables at baseline - such as progression from proctitis/left-sided to extensive colitis, extensive colitis at diagnosis, high baseline C Reactive Protein or erythrocyte sedimentation rate, male gender, and younger age at diagnosis - previous medical history, and factors arising during therapy with biologics, including the absence of clinical response after induction with infliximab or adalimumab, and the lack of mucosal healing during therapy with anti-TNFs., Conclusions: Two main points may help physicians to decide when the surgical option may be considered in patients with chronic refractory UC: (1) a first risk stratification can be obtained by analyzing factors at baseline and medical history, including the previous exposure to anti-TNFs; (2) during therapy with biologics, the early assessment (after 12-16 weeks of treatment) of clinical and endoscopic response is a strong predictor of the subsequent risk of colectomy., (Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2019
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44. Use of biosimilars in inflammatory bowel disease: a position update of the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD).

Author

Fiorino G, Caprioli F, Daperno M, Mocciaro F, Principi M, Viscido A, Fantini MC, Orlando A, Papi C, Annese V, Danese S, Vecchi M, Rizzello F, and Armuzzi A

Subjects
Adalimumab, Antibodies, Monoclonal therapeutic use, Biosimilar Pharmaceuticals chemical synthesis, Humans, Infliximab, Italy, Randomized Controlled Trials as Topic, Societies, Medical, Biosimilar Pharmaceuticals therapeutic use, Inflammatory Bowel Diseases drug therapy, Tumor Necrosis Factor-alpha antagonists & inhibitors
Abstract

The first infliximab biosimilar for the treatment of inflammatory bowel disease (IBD) was introduced in 2013, and today eight anti-TNF alpha biosimilars (three for infliximab and five for adalimumab) have been approved and licensed by the European Medicines Agency. Biosimilars present great potential in terms of cost saving and possible consequential reinvestment in the health care system. The increasing knowledge about the process of biosimilar development and use in IBD and the publication of many prospective clinical studies and real-life clinical experiences have progressively changed the point of view of IBD physicians. In the present position paper, the Italian Group for the Study of Inflammatory Bowel Disease present and discuss their updated statements and positions on this topic, with emphasis on the concepts of biosimilarity and extrapolation across indications, safety and immunogenicity, interchangeability and switching, automatic substitution, and, finally, patient education about biosimilars., (Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2019
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45. Previous colonic resection is a risk factor for surgical relapse in Crohn's disease.

Author

Coletta M, Zefelippo A, Mazza S, D'Abrosca V, Botti F, Oreggia B, Prati M, Boni L, Vecchi M, and Caprioli F

Subjects
Adult, Age Factors, Digestive System Surgical Procedures methods, Female, Humans, Ileitis epidemiology, Italy epidemiology, Male, Middle Aged, Postoperative Complications surgery, Recurrence, Reoperation methods, Retrospective Studies, Risk Assessment statistics & numerical data, Risk Factors, Smoking epidemiology, Crohn Disease diagnosis, Crohn Disease epidemiology, Crohn Disease surgery, Digestive System Surgical Procedures adverse effects, Ileitis surgery, Postoperative Complications epidemiology, Reoperation statistics & numerical data
Abstract

Background: Despite the improvement of medical therapies, nearly half of patients with Crohn's disease require surgery within 10 years after diagnosis. However, intestinal resection is not curative and recurrence may occur., Aims: To evaluate post-surgical outcomes for patients with Crohn's disease in a large monocentric cohort, and to identify variables associated with clinical and surgical relapse., Methods: Patients with Crohn's disease who had surgery for ileal and colonic Crohn's disease between 2004 and 2016 and on at least one-year follow-up following surgery were included., Results: One hundred ninety-three patients were included in the study. Crohn's disease recurrence concerned 53% of patients after a median 56-month (6-158) follow-up and 29% of patients required a second surgical intervention. At logistic regression analysis, active smoking and young age at diagnosis were identified as independent risk factor for post-surgical relapse (p = 0.01), while colonic or ileocolonic resection was recognized as a risk factor for surgical Crohn's disease relapse (p = 0.003)., Conclusions: Post-surgery recurrence is frequent for patients with Crohn's disease. Active smoking and young age at diagnosis are risk factors for Crohn's disease recurrence. As compared with patients undergoing small-bowel surgery, patients with colonic resection are proner to relapse requiring a second surgical intervention., (Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2019
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46. Ustekinumab in the management of Crohn's disease: Expert opinion.

Author

Armuzzi A, Ardizzone S, Biancone L, Castiglione F, Danese S, Gionchetti P, Orlando A, Rizzello F, Scribano ML, Vecchi M, and Daperno M

Subjects
Administration, Intravenous, Clinical Trials, Phase II as Topic, Humans, Tumor Necrosis Factor-alpha antagonists & inhibitors, Biological Products therapeutic use, Crohn Disease drug therapy, Ustekinumab therapeutic use
Abstract

This expert-opinion paper reviews available evidence for the use of ustekinumab, a human interleukin 12/23 monoclonal antibody, in the treatment of Crohn's disease and discusses its potential role in the current treatment scenario for the condition. Ustekinumab appears to be associated with rapid and sustained clinical effect, as reported from the clinical research program, with additional support for potential mucosal healing. These characteristics are paralleled by a favorable safety profile, lack of immunogenicity and the presence of systemic anti-inflammatory activity. Importantly, ustekinumab requires only one single intravenous administration, while subsequent dosing is administered subcutaneously, with potential advantages for home-based therapy. Lastly, the dosage of ustekinumab is flexible. On the basis of the evidence, ustekinumab has a role in patients with primary failure or secondary loss of response to anti-tumor necrosis factor agents, as well as in those who have adverse events on front-line biologics or are reinitiating therapy after a treatment holiday. Current evidence suggests that ustekinumab may be particularly suitable in patients who present extra-intestinal manifestations of the disease or are at risk of infections. Ustekinumab may also be considered in the first-line setting, especially in frail patients, in young subjects or in those who have concomitant immune-mediated diseases., (Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2018
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47. Multidisciplinary management of patients with coexisting inflammatory bowel disease and spondyloarthritis: A Delphi consensus among Italian experts.

Author

Armuzzi A, Felice C, Lubrano E, Cantini F, Castiglione F, Gionchetti P, Orlando A, Salvarani C, Scarpa R, Marchesoni A, Vecchi M, and Olivieri I

Subjects
Consensus, Delphi Technique, Humans, Inflammatory Bowel Diseases complications, Italy, Spondylitis, Ankylosing complications, Case Management standards, Inflammatory Bowel Diseases therapy, Spondylitis, Ankylosing therapy
Abstract

Background: Treatment of patients with coexisting spondyloarthritis (SpA) and inflammatory bowel disease (IBD) often requires multidisciplinary collaboration between gastroenterologists and rheumatologists., Aim: To describe the results of the first Delphi consensus to define shared therapeutic strategies for the best management of patients with coexisting SpA and IBD., Methods: A scientific steering committee of 10 Italian experts in the field of SpA and IBD developed 27 statements on 5 possible clinical scenarios and selected 40 specialists from across Italy, both gastroenterologists and rheumatologists, to vote them using a Delphi method. Each participant expressed a level of agreement on each statement using a 5-point scale (1="absolutely disagree"; 5="absolutely agree"). Total cumulative agreement was defined as the sum of the percentage of responses to items 4 ("agree") and 5 ("absolutely agree"). Total cumulative agreement ≥70% defined consensus for each statement., Results: After the first round, positive consensus was reached for 22 statements. Statements without consensus were discussed in a plenary session before the second vote. Positive consensus was then reached in all statements, with final total cumulative agreement ranging from 80% to 100%., Conclusion: This is the first Delphi consensus defining specific treatment algorithms for patients with coexisting SpA and IBD., (Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2017
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48. A consumer's guide for probiotics: 10 golden rules for a correct use.

Author

Toscano M, De Grandi R, Pastorelli L, Vecchi M, and Drago L

Subjects
Drug Resistance, Bacterial, Evidence-Based Medicine, Humans, Microbial Interactions, Probiotics adverse effects, Terminology as Topic, Gastrointestinal Tract microbiology, Practice Guidelines as Topic, Probiotics therapeutic use
Abstract

Probiotics are used all over the world as their beneficial effects on the human organism have been widely demonstrated. Certain probiotics can down-regulate production of pro-inflammatory cytokines and promote intestinal epithelial barrier functions, increasing an anti-inflammatory response and contributing to the host's overall health. The main mechanisms by which probiotic microorganisms can interact with the host are by modulating the immune system and the epithelial cell functions and interacting with intestinal gut microbiota. To date, hundreds of different microorganisms are used for the formulation of numerous probiotic products; therefore, it is very difficult to choose the best probiotic product for specific or more general needs. Therefore, physicians are getting more and more confused due to the high number of commercial products which are often lacking healthy effects on the host. Therefore, the aim of this paper is to demonstrate the main characteristics that probiotic microorganisms and products should possess to have a positive impact on the host's health. To this purpose, this review suggests "10 golden rules" or "commandments" that clinicians should follow to properly select the optimal probiotic product and avoid misidentifications, mislabelling and "pie in the sky" stories., (Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2017
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49. Use of corticosteroids and immunosuppressive drugs in inflammatory bowel disease: Clinical practice guidelines of the Italian Group for the Study of Inflammatory Bowel Disease.

Author

Gionchetti P, Rizzello F, Annese V, Armuzzi A, Biancone L, Castiglione F, Comberlato M, Cottone M, Danese S, Daperno M, D'Incà R, Fries W, Kohn A, Orlando A, Papi C, Vecchi M, and Ardizzone S

Subjects
Humans, Italy, Remission Induction, Societies, Medical, Adrenal Cortex Hormones therapeutic use, Immunosuppressive Agents therapeutic use, Inflammatory Bowel Diseases drug therapy
Abstract

The two main forms of intestinal bowel disease, namely ulcerative colitis and Crohn's disease, are not curable but can be controlled by various medical therapies. The Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) has prepared clinical practice guidelines to help physicians prescribe corticosteroids and immunosuppressive drugs for these patients. The guidelines consider therapies that induce remission in patients with active disease as well as treatment regimens that maintain remission. These guidelines complement already existing guidelines from IG-IBD on the use of biological drugs in patients with inflammatory bowel diseases., (Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2017
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50. Safety of treatments for inflammatory bowel disease: Clinical practice guidelines of the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD).

Author

Biancone L, Annese V, Ardizzone S, Armuzzi A, Calabrese E, Caprioli F, Castiglione F, Comberlato M, Cottone M, Danese S, Daperno M, D'Incà R, Frieri G, Fries W, Gionchetti P, Kohn A, Latella G, Milla M, Orlando A, Papi C, Petruzziello C, Riegler G, Rizzello F, Saibeni S, Scribano ML, Vecchi M, Vernia P, and Meucci G

Subjects
Adrenal Cortex Hormones adverse effects, Adrenal Cortex Hormones therapeutic use, Aminosalicylic Acid adverse effects, Aminosalicylic Acid therapeutic use, Anti-Bacterial Agents adverse effects, Anti-Bacterial Agents therapeutic use, Antibodies, Monoclonal, Humanized adverse effects, Antibodies, Monoclonal, Humanized therapeutic use, Cyclosporine adverse effects, Cyclosporine therapeutic use, Drug Therapy, Combination, Female, Humans, Italy, Mercaptopurine adverse effects, Mercaptopurine therapeutic use, Methotrexate adverse effects, Methotrexate therapeutic use, Pregnancy, Randomized Controlled Trials as Topic, Treatment Outcome, Tumor Necrosis Factor-alpha antagonists & inhibitors, Evidence-Based Medicine, Inflammatory Bowel Diseases drug therapy
Abstract

Inflammatory bowel diseases are chronic conditions of unknown etiology, showing a growing incidence and prevalence in several countries, including Italy. Although the etiology of Crohn's disease and ulcerative colitis is unknown, due to the current knowledge regarding their pathogenesis, effective treatment strategies have been developed. Several guidelines are available regarding the efficacy and safety of available drug treatments for inflammatory bowel diseases. Nevertheless, national guidelines provide additional information adapted to local feasibility, costs and legal issues related to the use of the same drugs. These observations prompted the Italian Group for the Study of Inflammatory Bowel Disease (IG-IBD) to establish Italian guidelines on the safety of currently available treatments for Crohn's disease and ulcerative colitis. These guidelines discuss the use of aminosalicylates, systemic and low bioavailability corticosteroids, antibiotics (metronidazole, ciprofloxacin, rifaximin), thiopurines, methotrexate, cyclosporine A, TNFα antagonists, vedolizumab, and combination therapies. These guidelines are based on current knowledge derived from evidence-based medicine coupled with clinical experience of a national working group., (Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Published
2017
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