90 results on '"Brandimarte, G."'
Search Results
2. The “Cristo Re” hospital experience on telerehabilitation for treatment post thyroidectomy neck pain
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Nasi, G, primary, Princi, P, additional, Galeoto, G, additional, Brandimarte, G, additional, D'Avino, A, additional, La Penna, M L, additional, Nigro, C, additional, Lombardi, C P, additional, and Tempera, S E, additional
- Published
- 2023
- Full Text
- View/download PDF
3. Combined Overview on Diverticular Assessment:a new score for the management of diverticular disease
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Nasi, G, primary, Tursi, A, additional, Di Mario, F, additional, Lammert, F, additional, Poskus, T, additional, Reichert, MC, additional, Regula, J, additional, Bonovas, S, additional, Sapienza, M, additional, and Brandimarte, G, additional
- Published
- 2022
- Full Text
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4. The DICA Endoscopic Classification for Diverticular Disease of the Colon Shows a Significant Interobserver Agreement among Community Endoscopists: an International Study
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Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G. A., Biondi A., Biondo S., Cassieri C., Crucitti A., Dumitrascu D. L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P. G., Maconi G., Malfertheiner P., Mazzarri A., Mearin F., Milosavljevic T., Nardone G., de Oliveira E. C., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L. L., Walker M. M. D., Allegretta L., Altavilla N., Amaro P., Annunziata M. L., Barberio F., Basile G., Bedogni G., Belfiori V., Benvenuti S., Bertolami C., Bisello M., El Dammak M. B., Bozzi R., Buono M., Cambie G., Capezzuto E., Casamassima C., Chavoushian A., Ciofani R., Citarella C., Compare D., Cotruta B., D'amico F., Dulk M. D., Dyrda B. E., Festa V., Gallina S., Grasso R., Hanzel J., Taieb J. M., Lai M. A., Latella G., Lisi D., Lodi L., Marangi S., Mardegan A., Marlicz W., Maurano A., Milazzo G., Militaru V., Miraglia S., Monica F., Moskalev A., Natale A., Nicolas C., Pancetti A., Penna A., Pepe A. S., Pisano M., Pontone S., Prati M., Prisco A., Rando L., Hernandez E. R., Rosati O., Rossi G., Passoni G. R., Papa V., Nesme N. S., Schiffino L., Schillaci D., Selvaggi G., Taborchi F., Tornar A., Trebuna F., Triggiani C., Testai F. V., Vassallo R., Violi A., Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, A., Biondo, S., Cassieri, C., Crucitti, A., Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzarri, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, A., Papagrigoriadis, S., Pera, M., Persiani, R., Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Walker, M. M. D., Allegretta, L., Altavilla, N., Amaro, P., Annunziata, M. L., Barberio, F., Basile, G., Bedogni, G., Belfiori, V., Benvenuti, S., Bertolami, C., Bisello, M., El Dammak, M. B., Bozzi, R., Buono, M., Cambie, G., Capezzuto, E., Casamassima, C., Chavoushian, A., Ciofani, R., Citarella, C., Compare, D., Cotruta, B., D'Amico, F., Dulk, M. D., Dyrda, B. E., Festa, V., Gallina, S., Grasso, R., Hanzel, J., Taieb, J. M., Lai, M. A., Latella, G., Lisi, D., Lodi, L., Marangi, S., Mardegan, A., Marlicz, W., Maurano, A., Milazzo, G., Militaru, V., Miraglia, S., Monica, F., Moskalev, A., Natale, A., Nicolas, C., Pancetti, A., Penna, A., Pepe, A. S., Pisano, M., Pontone, S., Prati, M., Prisco, A., Rando, L., Hernandez, E. R., Rosati, O., Rossi, G., Passoni, G. R., Papa, V., Nesme, N. S., Schiffino, L., Schillaci, D., Selvaggi, G., Taborchi, F., Tornar, A., Trebuna, F., Triggiani, C., Testai, F. V., Vassallo, R., Violi, A., Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G.A., Biondi A., Biondo S., Cassieri C., Crucitti A., Dumitrascu D.L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P.G., Maconi G., Malfertheiner P., Mazzari A., Mearin F., Milosavljevic T., Nardone G., Chavez De Oliveira E., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L.L., and Walker M.M.
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BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences ,Diverticular Disease ,Endoscopic classification ,Video Recording ,Colonoscopy ,Gastroenterology ,Severity of Illness Index ,endoscopic classification ,Diverticulum ,classification ,complications ,Diverticular diseases ,Endoscopy ,methods ,Colonic Diseases ,0302 clinical medicine ,Community Health Services ,Community Health Service ,Observer Variation ,0303 health sciences ,medicine.diagnostic_test ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti ,agreement − colonoscopy − community setting − diverticular disease of the colon− endoscopic classification ,3. Good health ,Diverticulosis ,Malalties del còlon ,Diverticular disease of the colon ,Diverticular disease ,616.344-007.64 [udc] ,Community setting ,030211 gastroenterology & hepatology ,Human ,medicine.medical_specialty ,Scoring system ,Colonic Disease ,Settore MED/12 - GASTROENTEROLOGIA ,Reproducibility of Result ,agreement ,colonoscopy ,community setting ,diverticular disease of the colon ,Agreement ,03 medical and health sciences ,Internal medicine ,Severity of illness ,medicine ,Diverticulosis, Colonic ,Humans ,Colonic diseases ,030304 developmental biology ,Diverticular Diseases ,business.industry ,Colonoscòpia ,Reproducibility of Results ,medicine.disease ,Inter-rater reliability ,business ,Kappa - Abstract
Background and Aims: The Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification of diverticulosis and diverticular disease (DD) is currently available. It scores severity of the disease as DICA 1, DICA 2 and DICA 3. Our aim was to assess the agreement on this classification in an international endoscopists community setting. Methods: A total of 96 doctors (82.9% endoscopists) independently scored a set of DD endoscopic videos. The percentages of overall agreement on DICA score and a free-marginal multirater kappa (κ) coefficient were reported as statistical measures of interrater agreement. Results: Overall agreement in using DICA was 91.8% with a free-marginal kappa of 88% (95% CI 80-95). The overall agreement levels were: DICA 1, 85.2%; DICA 2, 96.5%; DICA 3, 99.5%. The free marginal κ was: DICA 1 = 0.753, DICA 2 = 0.958, DICA 3 = 0.919. The agreement about the main endoscopic items was 83.4% (k 67%) for diverticular extension, 62.6% (k 65%) for number of diverticula for each district, 86.8% (k 82%) for presence of inflammation, and 98.5 (k 98%) for presence of complications. Conclusions: The overall interrater agreement in this study ranges from good to very good. DICA score is a simple and reproducible endoscopic scoring system for diverticulosis and DD.
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- 2019
5. Assessment of the nutritional status in patients with acute diverticulitis
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Giorgetti, G, primary, Fabiocchi, F, additional, D'Avino, A, additional, Tursi, A, additional, Brandimarte, MA, additional, Paoloni, A, additional, Meucci, T, additional, Parrocchia, S, additional, Brandimarte, G, additional, and Nasi, G, additional
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- 2021
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6. Benchmarking between two different hospitals on health risk management in the covid-19 emergency
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Nasi, G, primary, Brandimarte, G, additional, Marrone, R, additional, Sponzilli, A, additional, Sorbara, D, additional, Benedetti, P, additional, Grande, D, additional, Brando, C, additional, D'Avino, A, additional, and Parrocchia, S, additional
- Published
- 2021
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7. Letter: infliximab vs. adalimumab in treating ambulatory perianal fistulising Crohnʼs disease
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Tursi, A., Elisei, W., Picchio, M., Zampaletta, C., Faggiani, R., and Brandimarte, G.
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- 2014
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8. Letter: diverticulosis in inflammatory bowel diseases
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Tursi, A., Elisei, W., Picchio, M., Forti, G., Giorgetti, G., Faggiani, R., Zampaletta, C., and Brandimarte, G.
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- 2014
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9. Randomised clinical trial: mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease – a double-blind, randomised, placebo-controlled study
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Tursi, A., Brandimarte, G., Elisei, W., Picchio, M., Forti, G., Pianese, G., Rodino, S., DʼAmico, T., Sacca, N., Portincasa, P., Capezzuto, E., Lattanzio, R., Spadaccini, A., Fiorella, S., Polimeni, F., Polimeni, N., Stoppino, V., Stoppino, G., Giorgetti, G. M., Aiello, F., and Danese, S.
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- 2013
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10. Inflammatory manifestations at colonoscopy in patients with colonic diverticular disease
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Tursi, A., Elisei, W., Giorgetti, G. M., Aiello, F., and Brandimarte, G.
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- 2011
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11. Azathioprine in the maintainance remission in inflammatory bowel disease patients: 7-year follow up
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Cassieri, C, primary, Mastromatteo, A M, additional, Pica, R, additional, Zippi, M, additional, Corazziari, E S, additional, Paoluzi, P, additional, Lecca, G P, additional, Vernia, P, additional, Brandimarte, G, additional, and Nasi, G, additional
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- 2020
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12. DICA endoscopic classification: 2-year analysis from an international, multicenter prospective study
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Nasi, G, primary, Tursi, A, additional, Di Mario, F, additional, Elisei, W, additional, Picchio, M, additional, Bafutto, M, additional, Dumitrascu, D, additional, Regula, J, additional, Mastromatteo, A M, additional, and Brandimarte, G, additional
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- 2020
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13. Prognostic value of the Diverticular Inflammation and Complication Assessment (DICA) classification
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Nasi, G, primary, Mastromatteo, A M, primary, Cambiè, G, primary, Di Mario, F, primary, Elisei, W, primary, Franceschi, M, primary, Nouvenne, A, primary, Tursi, A, primary, Violi, A, primary, and Brandimarte, G, primary
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- 2019
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14. Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study
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Tursi A, Brandimarte G, Di Mario F, Annunziata ML, Bafutto M, Bianco MA, Colucci R, Conigliaro R, Danese S, De Bastiani R, Elisei W, Escalante R, Faggiani R, Ferrini L, Forti G, Latella G, Graziani MG, Oliveira EC, Papa A, Penna A, Portincasa P, Soreide K, Spadaccini A, Usai P, Bonovas S, Scarpignato C, Picchio M, Di Cesare L, Lecca PG, Zampaletta C, Cassieri C, Damiani A, Desserud KF, Fiorella S, Landi R, Goni E, Lai MA, Pigo F, Rotondano G, Schiaccianoce G, Tursi, A, Brandimarte, G, Di Mario, F, Annunziata, Ml, Bafutto, M, Bianco, Ma, Colucci, R, Conigliaro, R, Danese, S, De Bastiani, R, Elisei, W, Escalante, R, Faggiani, R, Ferrini, L, Forti, G, Latella, G, Graziani, Mg, Oliveira, Ec, Papa, A, Penna, A, Portincasa, P, Soreide, K, Spadaccini, A, Usai, P, Bonovas, S, Scarpignato, C, Picchio, M, Di Cesare, L, Lecca, Pg, Zampaletta, C, Cassieri, C, Damiani, A, Desserud, Kf, Fiorella, S, Landi, R, Goni, E, Lai, Ma, Pigo, F, Rotondano, G, and Schiaccianoce, G
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medicine.medical_specialty ,Settore MED/12 - GASTROENTEROLOGIA ,colon ,Colonoscopy ,diverticular disease ,endoscopic classification ,outcome ,surgery ,Oncology ,Gastroenterology ,Inflammation ,digestive system ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Special section on Fibrosis in Crohn's disease and inflammatory bowel disorders ,medicine.diagnostic_test ,business.industry ,General surgery ,digestive, oral, and skin physiology ,medicine.disease ,Predictive value ,digestive system diseases ,Surgery ,Diverticulosis ,surgical procedures, operative ,030220 oncology & carcinogenesis ,Diverticular disease ,030211 gastroenterology & hepatology ,medicine.symptom ,Complication ,business - Abstract
Background Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification has been recently developed for patients suffering from diverticulosis and diverticular disease. Aims We assessed retrospectively the predictive value of DICA in patients for whom endoscopic data and clinical follow-up were available. Methods For each patient, we recorded: age, severity of DICA, presence of abdominal pain, C-reactive protein and faecal calprotectin test (if available) at the time of diagnosis months of follow-up therapy taken during the follow-up to maintain remission (if any) occurrence/recurrence of diverticulitis need of surgery. Results We enrolled 1651 patients (793M, 858F, mean age 66.611.1 years): 939 (56.9%) patients were classified as DICA 1, 501 (30.3%) patients as DICA 2 and 211 (12.8%) patients as DICA 3. The median follow-up was 24 (9-38) months. Acute diverticulitis (AD) occurred/recurred in 263 (15.9%) patients surgery was necessary in 57 (21.7%) cases. DICA was the only factor significantly associated to the occurrence/recurrence of diverticulitis and surgery either at univariate ((2)=405.029 p
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- 2016
15. Confirmatory factor analysis of the Patient Assessment of Constipation-Symptoms (PAC-SYM) among patients with chronic constipation
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Neri L, Conway PM, Basilisco G, Altomare DF, Annese V, Badiali D, Bassotti G, Battaglia E, Bazzocchi G, Bellini M, Bendia E, Benini L, Biscaglia G, Biviano I, Bocchini R, Bonfrate L, Bonventre S, Bossa F, Brandimarte G, Cannizzaro R, Cicala M, Cipolletta L, Clara V, Cogliandro R, Comandini G, Corazziari E, Crotta S, CUOMO, ROSARIO, D'Alba L, De Giorgi F, Del Piano M, Di Fonzo M, Di Mario Francesco, Di Stefano M, D'Onofrio V, Efthymakis K, Fiore P, Fortuna M, Fries W, Gaetani E, Galeazzi F, Gasbarrini A, Geccherle' A, Giangregorio F, Girardi L, Grassini M, Groppo M, Guarnieri G, Iovino P, Lo Cascio M, Lolli R, Luzza F, Macarri G, Marino M, Miraglia S, Monastra S, Neri MC, Neri M, Noris RA, Orselli S, Passaretti S, Paviotti A, Pazzi P, Pilotto A, Portincasa P, Ranaldo N, Ravelli P, Rogai F, Sablich R, Savarino V, Spinzi G, Stanghellini V, Tammaro L, Torresan F, Usai Satta P, Valle C., Neri, L, Conway, Pm, Basilisco, G, Stanghellini, V, Neri, L., Conway, P., Basilisco, G., Bonventre, S, Altomare, Df, Annese, V, Badiali, D, Bassotti, G, Battaglia, E, Bazzocchi, G, Bellini, M, Bendia, E, Benini, L, Biscaglia, G, Biviano, I, Bocchini, R, Bonfrate, L, Bossa, F, Brandimarte, G, Cannizzaro, R, Cicala, M, Cipolletta, L, Clara, V, Cogliandro, R, Comandini, G, Corazziari, E, Crotta, S, Cuomo, Rosario, D'Alba, L, De Giorgi, F, Del Piano, M, Di Fonzo, M, Di Mario, Francesco, Di Stefano, M, D'Onofrio, V, Efthymakis, K, Fiore, P, Fortuna, M, Fries, W, Gaetani, E, Galeazzi, F, Gasbarrini, A, Geccherle', A, Giangregorio, F, Girardi, L, Grassini, M, Groppo, M, Guarnieri, G, Iovino, P, Lo Cascio, M, Lolli, R, Luzza, F, Macarri, G, Marino, M, Miraglia, S, Monastra, S, Neri, Mc, Neri, M, Noris, Ra, Orselli, S, Passaretti, S, Paviotti, A, Pazzi, P, Pilotto, A, Portincasa, P, Ranaldo, N, Ravelli, P, Rogai, F, Sablich, R, Savarino, V, Spinzi, G, Tammaro, L, Torresan, F, Usai Satta, P, and Valle, C.
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Adult ,Male ,medicine.medical_specialty ,Abdominal pain ,Constipation ,Constipation severity ,Chronic constipation ,Chronic non-organic constipation ,Quality of life ,Chronic Disease ,Female ,Humans ,Middle Aged ,Patient Care ,Quality of Life ,Reproducibility of Results ,Surveys and Questionnaires ,Factor Analysis, Statistical ,Public Health, Environmental and Occupational Health ,Medicine (all) ,Reproducibility of Result ,Internal medicine ,medicine ,Criterion validity ,Surveys and Questionnaire ,Settore MED/12 - Gastroenterologia ,business.industry ,Minimal clinically important difference ,Environmental and Occupational Health ,Settore MED/09 - MEDICINA INTERNA ,Statistical ,medicine.disease ,Confirmatory factor analysis ,Settore MED/18 - Chirurgia Generale ,Physical therapy ,Functional constipation ,Public Health ,medicine.symptom ,business ,Factor Analysis ,Human - Abstract
Background and aim: PAC-SYM is widely adopted to asses constipation severity. However, it has been validated in a small sample, few items have been included based on expert opinion and not on empirical grounds, and its factor structure has never been replicated. We aimed at evaluating the psychometric properties of PAC-SYM in patients with chronic constipation. Methods: We enrolled 2,203 outpatients with chronic constipation in two waves. We used wave I sample to test the psychometric properties of the PAC-SYM and wave II sample to cross-validate its factor structure, to assess criterion validity, responsiveness to clinical change, and its minimal clinically important difference. Results: Only a minority of patients reported any rectal tearing (38 %). Deletion of such item leads to a 11-item version (M:PAC-SYM). The remaining items in the rectal domain were moderately correlated with the stool domain. Exploratory factor analysis and confirmatory factor analysis revealed a bifactor structure with two subscales (stool and abdominal symptoms) and a general severity factor. The M:PAC-SYM demonstrated excellent reliability, moderate correlation with SF-12 and treatment satisfaction (r = 0.28–0.45), discrimination across Rome III criteria for functional constipation and abdominal pain, and responsiveness to clinical change (β = −0.49; ω 2 = 0.25). M:PAC-SYM minimal clinically important difference was 0.24. Conclusion: Our analysis shows that the rectal domain may not represent a relevant cluster of symptoms for patients with chronic constipation. We developed a modified version of the PAC-SYM which might better represent symptom severity of most patients seeking care in gastroenterology referral centers
- Published
- 2014
16. Analysis of microbiota and metaboloma in symptomatic uncomplicated diverticular disease of the colon
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Tursi, A, Elisei, W, Picchio, M, Giorgetti, Gm, Mastromarino, Paola, Capobianco, Daniela, Miccheli, Alfredo, Di Fonzo, M, and Brandimarte, G.
- Published
- 2015
17. Evidences of explosive events from microstructural changes in metal objects
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Firrao, Donato, Matteis, Paolo, Pozzi, Chiara, Scavino, G., Ubertalli, Graziano, Ienco, M. G., Piccardo, P., Pinasco, M. R., Montanari, R., Costanza, G., Tata, M. E., Brandimarte, G., and Petralia, S.
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- 2007
18. Microstructural changes due to small charge explosions in FCC metals
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Firrao, D., Matteis, Paolo, Scavino, Giorgio, Ubertalli, Graziano, Pozzi, Chiara, Ienco, M. G., Piccardo, P., Pinasco, M. R., Montanari, R., Tata, M. E., Costanza, G., Brandimarte, G., and Petralia, S.
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Settore ING-IND/21 - Metallurgia - Published
- 2007
19. Effetti di esplosioni di piccola carica sull’acciaio AISI 304Cu
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Firrao, Donato, Matteis, Paolo, Scavino, Giorgio, Ubertalli, Graziano, Ienco, M. G., Pellati, G., Piccardo, P., Pinasco, M. R., Stagno, E., Montanari, R., Tata, M. E., Brandimarte, G., and Petralia, S.
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- 2005
20. Inflammatory manifestations at colonoscopy in patients with colonic diverticular disease
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Tursi, A., primary, Elisei, W., additional, Giorgetti, G. M., additional, Aiello, F., additional, and Brandimarte, G., additional
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- 2010
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21. Effect of a symbiotic preparation on the clinical manifestations of irritable bowel syndrome, constipation-variant: Results of an open, uncontrolled multicenter study
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Colecchia, A., Vestito, A., La Rocca, A., FRANCESCA PASQUI, Nikiforaki, A., DAVIDE FESTI, Abruzzo, F., Almureden, N., Angiolucci, A., Arrigoni, A., Balzano, A., Brandimarte, G., Buono, M., Calcamuggi, G., Cammarota, G., Gabriele campana, Cotticeli, G., Cuomo, R., D Amore, F., Felici, I., Anna, A., Di Bona, A., Di Cesare, D., Di Napoli, A., Sughera, L., Febbraio, I., Ferrini, G., Fornaciari, G., Gallo, S., Glielmo, G., Iafrancesco, G., La Barbera, M., Lavanda, R., Manca, A., Matarazzo, F., Mazzei, C., Monastra, S., Montalto, M., Morace, F., Murgia, R., Nico Pagano, Pio, A., Panarese, A., Paraocchi, D., Peccetti, A., Perasso, A., Perego, M., Piscopo, R., Rizzi, S., Romano, M., Rosati, S., Santoro, G., Surrenti, E., Villa, E., Colecchia, A., Vestito, A., La Rocca, A., Pasqui, F., Nikiforaki, A., Festi, D., Abruzzo, F., Almureden, N., Angiolucci, A., Arrigoni, A., Balzano, A., Brandimarte, G., Buono, M., Calcamuggi, G., Cammarota, G., Campana, G., Cotticeli, G., Cuomo, R., D'Amore, F., De Felici, I., Dell'Anna, A., Di Bona, A., Di Cesare, D., Di Napoli, A., Sughera, L., Febbraio, I., Ferrini, G., Fornaciari, G., Gallo, S., Glielmo, G., Iafrancesco, G., La Barbera, M., Lavanda, R., Manca, A., Matarazzo, F., Mazzei, C., Monastra, S., Montalto, M., Morace, F., Murgia, R., Pagano, N., Pio, A., Panarese, A., Paraocchi, D., Peccetti, A., Perasso, A., Perego, M., Piscopo, R., Rizzi, S., Romano, M., Rosati, S., Santoro, G., Surrenti, E., Villa, E., Colecchia, A, Vestito, A, La Rocca, A, Pasqui, F, Nikiforaki, A, Festi, D, Almureden, N, Angiolucci, A, Arrigoni, A, Balzano, A, Brandimarte, G, Buono, M, Calcamuggi, G, Cammarota, G, Campana, G, Cotticeli, G, Cuomo, Rosario, and others of Symbiotic Study, Group
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Male ,Time Factors ,Endocrinology, Diabetes and Metabolism ,Oligosaccharides ,Prebiotic ,Probiotic ,Irritable Bowel Syndrome ,Endocrinology ,Surveys and Questionnaires ,Nutrition and Dietetic ,Internal Medicine ,Humans ,Intestinal microflora ,Symbiosis ,Aged ,Aged, 80 and over ,Nutrition and Dietetics ,Probiotics ,Gastroenterology ,Abdominal Pain ,Intestines ,Diabetes and Metabolism ,Treatment Outcome ,Prebiotics ,Data Interpretation, Statistical ,Female ,Bifidobacterium ,Constipation - Abstract
Aim. Irritable bowel syndrome (IBS) is frequently associated with an imbalance in intestinal bacteria. To date, few studies have evaluated the efficacy and safety of probiotic administration in patients with constipation-variant IBS. A new agent recently available in clinical practice is a symbiotic consisting of a probiotic, Bifidobacterium longum W11, and the short chain oligosaccharide prebiotic Fos Actilight. The aim of this study was to evaluate the efficacy and safety of this symbiotic in patients with constipation-variant IBS. Methods. A total of 636 patients (250 men, 386 women) diagnosed with constipation-type IBS according to the Roma II criteria were enrolled in 43 centers and received the symbiotic at a dose of 3 g/die for at least 36 days. A validated questionnaire investigating symptoms and stool frequency was administered before and after treatment. Results. Based on patient responses to visual scale items, frequency increased significantly after treatment in the "no symptom" class from 3% to 26.7% for bloating and from 8.4% to 44.1% for abdominal pain (P
22. Microstructural modifications after small charge explosions in aluminum and copper targets
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Firrao, D., Paolo Matteis, Pozzi, C., Scavino, G., Ubertalli, G., Ienco, M. G., Pellati, G., Piccardo, P., Pinasco, M. R., Costanza, G., Montanari, R., Tata, M. E., Brandimarte, G., and Petralia, S.
23. AISI 304Cu steel subjected to small charge explosions: Microstructural changes with limited or no macro-deformation
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Firrao, D., Paolo Matteis, Scavino, G., Ubertalli, G., Ienco, M. G., Pellati, G., Piccardo, P., Pinasco, M. R., Stagno, E., Montanari, R., Tata, M. E., Brandimarte, G., and Petralia, S.
24. Course of the Diverticular Disease: What is changing?
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Carmelo Scarpignato, Adi Lahat, Giovanni Barbara, Angel Lanas, Valerio Papa, Tomica Milosavljeviĉ, Giovanni Brandimarte, Antonio Tursi, Gerardo Nardone, Neil Stollman, Milasavljevic, T., Brandimarte, G., Stollman, N., Barbara, G., Lahat, A., Scarpignato, C., Lanas, A., Papa, V., Tursi, A., Nardone, G., Milasavljevic T., Brandimarte G., Stollman N., Barbara G., Lahat A., Scarpignato C., Lanas A., Papa V., Tursi A., and Nardone G.
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medicine.medical_specialty ,Diverticular Disease ,Settore MED/18 - CHIRURGIA GENERALE ,Colonoscopy ,Segmental colitis associated with diverticulosi ,Disease ,Diagnosis, Differential ,Irritable Bowel Syndrome ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Mesalazine ,Risk Factors ,Internal medicine ,Diagnosis ,Secondary Prevention ,medicine ,Humans ,Diverticulitis ,Diverticuliti ,Irritable bowel syndrome ,Diverticular Diseases ,medicine.diagnostic_test ,business.industry ,Risk Factor ,Gastroenterology ,food and beverages ,medicine.disease ,Colorectal cancer ,3. Good health ,Rifaximin ,Diverticulosis ,chemistry ,030220 oncology & carcinogenesis ,Differential ,Acute Disease ,Disease Progression ,Diverticular disease ,030211 gastroenterology & hepatology ,Segmental colitis associated with diverticulosis ,business ,Human - Abstract
In this session several critical issues in diverticular disease were considered, including “It is Symptomatic Diverticular Disease or Irritable Bowel Syndrome?”, “What do determine evolution to diverticulitis, bowel habits alteration or inflammation?”, and “Prevention of acute diverticulitis: Is it at all possible?”. The first talking compared symptoms and laboratory findings between Symptomatic Uncomplicated Diverticular Disease (SUDD) and Irritable Bowel Syndrome (IBS). Although both disease share some symptoms, and although IBS can occur in patients having diverticulosis, SUDD and IBS can be differentiate using a combination of symptoms and laboratory tools. The second talking debated what are the most important risk factors for the evolution towards acute diverticulitis. Current data seem to exclude a significant role of bowel habits alteration, while inflammation seems to have a stronger role, especially in causing acute diverticulitis recurrence. The third talking analyzed about the acute diverticulitis prevention. Primary prevention seem to be little better when using mesalazine, while no definite conclusion can be drawn about the use of fiber and rifaximin. About the secondary prevention, no drugs can be currently advised due to lacking of definite results. At the same time, surgery should be advised on case-by-case basis.
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- 2020
25. International consensus on diverticulosis and diverticular disease. Statements from the 3rd international symposium on diverticular disease
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Marjorie M. Walker, László Herszényi, Giovanni Barbara, Gabrio Bassotti, Wolfgang Kruis, Angel Lanas, G. Cambiè, Enio Chavez De Oliveira, Andrea Mazzari, A. Violi, Jaroslaw Regula, Giovanni Brandimarte, Roberto Persiani, Walter Elisei, Miguel Pera, Marcello Picchio, Sebastiano Biondo, Fermín Mearin, Claudio Cassieri, Juozas Kupcinskas, Savvas Papagrigoriadis, Antonio Tursi, Giovanni Maconi, Davor Štimac, Antonio Crucitti, Ricardo Escalante, Neil Stollman, Lisa L. Strate, P.G. Lecca, M. Bafutto, Gerardo Nardone, Tomica Milosavljeviċ, Carmelo Scarpignato, Alfredo Papa, Francesco Di Mario, Alberto Biondi, Gian Andrea Binda, Dan L. Dumitrascu, Adi Lahat, Peter Malfertheiner, Tursi A., Brandimarte G., Di Mario F., Lanas A., Scarpignato C., Bafutto M., Barbara G., Bassotti G., Binda G.A., Biondi A., Biondo S., Cambie G., Cassieri C., Crucitti A., Dumitrascu D.L., Elisei W., Escalante R., Herszenyi L., Kruis W., Kupcinskas J., Lahat A., Lecca P.G., Maconi G., Malfertheiner P., Mazzari A., Mearin F., Milosavljevic T., Nardone G., de Oliveira E.C., Papa A., Papagrigoriadis S., Pera M., Persiani R., Picchio M., Regula J., Stimac D., Stollman N., Strate L.L., Violi A., Walker M.M.D., Tursi, A., Brandimarte, G., Di Mario, F., Lanas, A., Scarpignato, C., Bafutto, M., Barbara, G., Bassotti, G., Binda, G. A., Biondi, A., Biondo, S., Cambie, G., Cassieri, C., Crucitti, A., Dumitrascu, D. L., Elisei, W., Escalante, R., Herszenyi, L., Kruis, W., Kupcinskas, J., Lahat, A., Lecca, P. G., Maconi, G., Malfertheiner, P., Mazzari, A., Mearin, F., Milosavljevic, T., Nardone, G., de Oliveira, E. C., Papa, A., Papagrigoriadis, S., Pera, M., Persiani, R., Picchio, M., Regula, J., Stimac, D., Stollman, N., Strate, L. L., Violi, A., and Walker, M. M. D.
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BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences ,Medical therapy ,Etiology ,Disease ,0302 clinical medicine ,Voting ,Diagnosis ,Medicine ,Disease management (health) ,Diverticuliti ,health care economics and organizations ,media_common ,Diverticulosis ,Evidence-Based Medicine ,Diverticulosi ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti ,Gastroenterology ,Consensus ,Diverticular disease ,Diverticulitis ,Surgical therapy ,3. Good health ,Malalties inflamatòries intestinals ,Hot topics ,030220 oncology & carcinogenesis ,Etiologia ,030211 gastroenterology & hepatology ,Diagnosi ,medicine.medical_specialty ,Settore MED/12 - GASTROENTEROLOGIA ,media_common.quotation_subject ,education ,MEDLINE ,Consensu ,Therapeutics ,Inflammatory bowel diseases ,diverticulosis – diverticular disease – diverticulitis – consensus – diagnosis – medical therapy – surgical therapy ,03 medical and health sciences ,Humans ,Diverticular Diseases ,business.industry ,Evidence-based medicine ,Congresses as Topic ,medicine.disease ,Terapèutica ,Diverticulum ,Family medicine ,business - Abstract
The statements produced by the Chairmen and Speakers of the 3rd International Symposium on Diverticular Disease, held in Madrid on April 11th-13th 2019, are reported. Topics such as current and evolving concepts on the pathogenesis, the course of the disease, the news in diagnosing, hot topics in medical and surgical treatments, and finally, critical issues on the disease were reviewed by the Chairmen who proposed 39 statements graded according to level of evidence and strength of recommendation. Each topic was explored focusing on the more relevant clinical questions. The vote was conducted on a 6-point scale and consensus was defined a priori as 67% agreement of the participants. The voting group consisted of 124 physicians from 18 countries, and agreement with all statements was provided. Comments were added explaining some controversial areas.
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- 2019
26. Hericium erinaceus, a medicinal fungus with a centuries-old history: Evidence in gastrointestinal diseases
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Antonietta Gerarda Gravina, Raffaele Pellegrino, Salvatore Auletta, Giovanna Palladino, Giovanni Brandimarte, Rossella D’Onofrio, Giusi Arboretto, Giuseppe Imperio, Andrea Ventura, Marina Cipullo, Marco Romano, Alessandro Federico, Gravina, A. G., Pellegrino, R., Auletta, S., Palladino, G., Brandimarte, G., D'Onofrio, R., Arboretto, G., Imperio, G., Ventura, A., Cipullo, M., Romano, M., and Federico, A.
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Gastriti ,Gastroenterology ,General Medicine ,Fungu ,Inflammatory bowel diseases ,Gastric cancer ,Colorectal cancer ,Hericium erinaceu - Abstract
Hericium erinaceus is an edible and medicinal mushroom commonly used in traditional Chinese medicine for centuries. Several studies have highlighted its therapeutic potential for gastrointestinal disorders such as gastritis and inflammatory bowel diseases. In addition, some components of this mushroom appear to possess strong antineoplastic capabilities against gastric and colorectal cancer. This review aims to analyse all available evidence on the digestive therapeutic potential of this fungus as well as the possible underlying molecular mechanisms.
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- 2023
27. Assessment and grading of mucosal inflammation in colonic diverticular disease
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Giovanni Brandimarte, Antonio Tursi, Gian Marco Giorgetti, Silvio Danese, Walter Elisei, Fabio Aiello, Cosimo Damiano Inchingolo, Tursi, A, Brandimarte, G, Elisei, W, Giorgetti, Gm, Inchingolo, Cd, Danese, S, Aiello, F, Tursi A, Brandimarte G, Elisei W, Giorgietti GM, Inchingolo CD, Danese S, Aiello F, TURSI A, BRANDIMARTE G, ELISEI W, GIORGIETTI GM, INCHINGOLO CD, DANESE S, and AIELLO F
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Male ,medicine.medical_specialty ,Pathology ,Colonoscopy ,Inflammation ,Cell Count ,Gastroenterology ,Severity of Illness Index ,Diverticulitis, Colonic ,Internal medicine ,Severity of illness ,medicine ,Diverticulosis, Colonic ,Humans ,Lymphocytes ,Intestinal Mucosa ,Grading (tumors) ,Aged ,Diverticular disease, microscopic inflammation, staging and grading ,medicine.diagnostic_test ,business.industry ,Case-control study ,Diverticulitis ,Middle Aged ,medicine.disease ,Diverticulosis ,Neutrophil Infiltration ,Case-Control Studies ,Diverticular disease ,Female ,medicine.symptom ,business - Abstract
Goal: The aim of this study was to assess and grade the mucosal inflammatory infiltrate in different degrees of diverticular disease (DID) and to compare them with healthy matched controls. Background: Mucosal inflammation in colonic DD has never been investigated. In particular, it is unknown whether inflammation may be found in every degree of DD. Materials and Methods: Thirty consecutive patients with a new endoscopic diagnosis of D-D (10 with asymptomatic diverticulosis, 10 with symptomatic uncomplicated DD, and 10 with acute uncomplicated diverticulitis) and 10 healthy controls were studied. Results: A neutrophilic inflammatory infiltrate was found only in acute uncomplicated diverticulitis (overall score, 26). The mean lymphocytic cell density was significantly higher in symptomatic DD (median lymphocytic density, 7) and acute uncomplicated diverticulitis (median lymphocytic density, 11). Subdividing the patients according to different degrees of DD, we found higher lymphocytic cell density even in asymptomatic diverticulosis (median lymphocytic density, 6.5) than healthy controls (median lymphocytic density, 4; P < 0.02). Conclusions: We found an increased inflammatory infiltrate in DD according to the degree of the disease and higher than healthy controls. Moreover, also asymptomatic diverticulosis shows higher inflammatory cell density than controls.
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- 2008
28. Hot Topics in Medical Treatment of Diverticular Disease: Evidence Pro and Cons
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Claudio Cassieri, Davor Štimac, M. Bafutto, Giovanni Brandimarte, Alessandro D'Avino, Wolfgang Kruis, P.G. Lecca, Luka Vranić, Peter Malfertheiner, Giovanni Barbara, Carmelo Scarpignato, Fermín Mearin, Brandimarte G., Bafutto M., Kruis W., Scarpignato C., Mearin F., Barbara G., Stimac D., Vranic L., Cassieri C., Lecca P.G., D'Avino A., and Malfertheiner P.
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Antibiotics ,diverticular disease ,Disease ,Gut flora ,Probiotic ,01 natural sciences ,Gastroenterology ,chemistry.chemical_compound ,0302 clinical medicine ,Diverticuliti ,BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina ,Evidence-Based Medicine ,biology ,Medical treatment ,Diverticulosi ,Anti-Inflammatory Agents, Non-Steroidal ,Diverticulitis ,Anti-Bacterial Agents ,rifaximin ,030220 oncology & carcinogenesis ,mesalazine ,Diverticular disease ,diverticulosis – diverticular disease – diverticulitis – rifaximin – mesalazine – probiotics ,Mesalazine ,010407 polymers ,medicine.medical_specialty ,medicine.drug_class ,diverticulosis ,Rifaximin ,03 medical and health sciences ,Gastrointestinal Agents ,Internal medicine ,medicine ,Humans ,BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine ,Diverticular Diseases ,business.industry ,Probiotics ,biology.organism_classification ,medicine.disease ,0104 chemical sciences ,Gastrointestinal Microbiome ,diverticulitis ,chemistry ,probiotics ,business - Abstract
Symptomatic Uncomplicated Diverticular Disease (SUDD) is the most common clinical form of Diverticular Disease (DD). The therapy should be aimed at reducing both the intensity and frequency of symptoms as well as preventing complications. The pharmacological treatments include fibers, not absorbable antibiotics (for example rifaximin), anti-inflammatory drugs (for example 5-amino-salycilic acid) and probiotics, alone or in combination with other drugs. Although some of these treatments seem to be effective in treating SUDD, but their efficacy in preventing complications of the disease is still uncertain. It has been hypothesized that microbial imbalance associated with bacterial overgrowth of the colon, may be the key to the development of diverticular disease (DD). Therefore, drugs that can manipulate gut microbiota such as probiotics or rifaximine are considered as a potential key therapy. Rifaximine is able to modulate the intestinal ecosystem, restoring eubiosis. Traditionally, DD of the colon is thought to be related to low grade of inflammation. By analogy with other inflammatory bowel diseases mesalazine has been studied also in DD. There are several evidences that may support the use of mesalazine in the SUDD. Unfortunately, mesalazine cannot be used to prevent diverticulitis because of the paucity of high-quality studies. Currently, mesalazine has a limited place for the management of SUDD. In SUDD probiotics have been proven as an effective therapy in reducing abdominal symptoms, but unfortunately there has been limited number of relevant studies regarding efficacy of this therapy.
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- 2019
29. Bloating is associated with worse quality of life, treatment satisfaction, and treatment responsiveness among patients with constipation-predominant irritable bowel syndrome and functional constipation
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Neri, L., Iovino, P., Altomare, Donato Francesco, Annese, Vito, Badiali, Danilo, Basilisco, Guido, Bassotti, Gabrio, Battaglia, Edda, Bazzocchi, Gabriele, Bellini, Massimo, Bendia, Emanuele, Benini, Luigi, Biscaglia, Giuseppe, Biviano, Ivano, Bocchini, Renato, Bonventre, Sebastiano, Bossa, Fabrizio, Brandimarte, Giovanni, Cannizzaro, Renato, Cicala, Michele, Cipolletta, Livio, Clara, Virgilio, Cogliandro, Rosanna, Comandini, Giulia, Corazziari, Enrico, Crotta, Sergio, Cuomo, Rosario, D'Alba, Lucia, De Giorgi, Francesco, Del Piano, Mario, Di Fonzo, Michela, Di Mario, Francesco, Di Stefano, Michele, D'Onofrio, Vittorio, Efthymakis, Kostantinos, Fiore, Pierluigi, Fortuna, Manuela, Fries, Walter, Gaetani, Eleonora, Galeazzi, Francesca, Gasbarrini, Antonio, Geccherle, Andrea, Giangregorio, Francesco, Girardi, Lisa, Grassini, Mario, Groppo, Marzia, Guarnieri, Giovanni, Lo Cascio, Massimiliano, Lolli, Roberto, Luzza, Francesco, Macarri, Giampiero, Marino, Maria, Miraglia, Stefania, Monastra, Santo, Neri, Maria Cristina, Neri, Matteo, Noris, Roberto Antonio, Orselli, Silvia, Passaretti, Sandro, Paviotti, Alberto, Pazzi, Paolo, Pilotto, Alberto, Portincasa, Piero, Ranaldo, Nunzio, Ravelli, Paolo, Rogai, Francesca, Sablich, Renato, Savarino, Vincenzo, Spinzi, Giancarlo, Stanghellini, Vincenzo, Tammaro, Leonardo, Torresan, Francesco, Usai Satta, Paolo, Valle, C. Claudio, Neri, L., Iovino, P., Altomare, Donato Francesco, Annese, Vito, Badiali, Danilo, Basilisco, Guido, Bassotti, Gabrio, Battaglia, Edda, Bazzocchi, Gabriele, Bellini, Massimo, Bendia, Emanuele, Benini, Luigi, Biscaglia, Giuseppe, Biviano, Ivano, Bocchini, Renato, Bonventre, Sebastiano, Bossa, Fabrizio, Brandimarte, Giovanni, Cannizzaro, Renato, Cicala, Michele, Cipolletta, Livio, Clara, Virgilio, Cogliandro, Rosanna, Comandini, Giulia, Corazziari, Enrico, Crotta, Sergio, Cuomo, Rosario, D'Alba, Lucia, De Giorgi, Francesco, Del Piano, Mario, Di Fonzo, Michela, Di Mario, Francesco, Di Stefano, Michele, D'Onofrio, Vittorio, Efthymakis, Kostantino, Fiore, Pierluigi, Fortuna, Manuela, Fries, Walter, Gaetani, Eleonora, Galeazzi, Francesca, Gasbarrini, Antonio, Geccherle, Andrea, Giangregorio, Francesco, Girardi, Lisa, Grassini, Mario, Groppo, Marzia, Guarnieri, Giovanni, Lo Cascio, Massimiliano, Lolli, Roberto, Luzza, Francesco, Macarri, Giampiero, Marino, Maria, Miraglia, Stefania, Monastra, Santo, Neri, Maria Cristina, Neri, Matteo, Noris, Roberto Antonio, Orselli, Silvia, Passaretti, Sandro, Paviotti, Alberto, Pazzi, Paolo, Pilotto, Alberto, Portincasa, Piero, Ranaldo, Nunzio, Ravelli, Paolo, Rogai, Francesca, Sablich, Renato, Savarino, Vincenzo, Spinzi, Giancarlo, Stanghellini, Vincenzo, Tammaro, Leonardo, Torresan, Francesco, Usai Satta, Paolo, Valle, C. Claudio, Altomare, D., Annese, V., Badiali, D., Basilisco, G., Bassotti, G., Battaglia, E., Bazzocchi, G., Bellini, M., Bendia, E., Benini, L., Biscaglia, G., Biviano, I., Bocchini, R., Bonventre, S., Bossa, F., Brandimarte, G., Cannizzaro, R., Cicala, M., Cipolletta, L., Clara, V., Cogliandro, R., Comandini, G., Corazziari, E., Crotta, S., Cuomo, R., D'Alba, L., De Giorgi, F., Del Piano, M., Di Fonzo, M., Di Mario, F., Di Stefano, M., D'Onofrio, V., Efthymakis, K., Fiore, P., Fortuna, M., Fries, W., Gaetani, E., Galeazzi, F., Gasbarrini, A., Geccherle, A., Giangregorio, F., Girardi, L., Grassini, M., Groppo, M., Guarnieri, G., Lo Cascio, M., Lolli, R., Luzza, F., Macarri, G., Marino, M., Miraglia, S., Monastra, S., Neri, M., Noris, R., Orselli, S., Passaretti, S., Paviotti, A., Pazzi, P., Pilotto, A., Portincasa, P., Ranaldo, N., Ravelli, P., Rogai, F., Sablich, R., Savarino, V., Spinzi, G., Stanghellini, V., Tammaro, L., Torresan, F., Usai Satta, P., and Valle, C.
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Adult ,Male ,Quality of life ,medicine.medical_specialty ,Constipation ,Cross-sectional study ,Physiology ,Bloating ,Chronic constipation ,Functional constipation ,Irritable bowel syndrome ,Patient-reported outcomes ,Treatment satisfaction ,Endocrine and Autonomic Systems ,Gastroenterology ,Cross-Sectional Studies ,Female ,Flatulence ,Humans ,Irritable Bowel Syndrome ,Middle Aged ,Prevalence ,Quality of Life ,Surveys and Questionnaires ,Endocrine and Autonomic System ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Patient-reported outcome ,Settore MED/12 - Gastroenterologia ,business.industry ,Settore MED/09 - MEDICINA INTERNA ,medicine.disease ,Settore MED/18 - Chirurgia Generale ,Tolerability ,030220 oncology & carcinogenesis ,Physical therapy ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
Background The management of bloating is unclear and its relationship with patients' well-being and treatment satisfaction independent of other abdominal symptoms is uncharacterized. We evaluated the association of bloating with patient-reported outcomes. Methods Thirty-nine centers for functional gastrointestinal disorders joined the laxative inadequate relief survey. We enrolled 2203 consecutive outpatients with functional constipation (FC) or constipation-predominant irritable bowel syndrome (IBS-C) in two cross-sectional waves. Both wave 1 and 2 included the SF-12, the patient assessment of constipation-symptoms (PAC-SYM), and the treatment satisfaction questionnaire for medication (TSQM-2). Wave 2 only included a global rating of change (GRC) scale to assess patients' assessment of efficacy concerning treatment switches occurred in the 3 months prior to the interview. Bloating in the abdomen was defined on the basis of PAC-SYM item 3. Key Results The average age was 50.1 years (SD, 16.7) and 82.1% of patients were women. The prevalence of bloating was 91.6% (n = 1970). Bloating was associated with SF-12 Physical Composite Score (p < 0.01), SF-12 Mental Composite Score (p < 0.01), GRC (p < 0.01), Satisfaction with treatment effectiveness (p < 0.01), convenience of administration (p < 0.01), and side effects (p < 0.01) after adjustment for possible confounders. Conclusions & Inferences Our data suggest that patients regard bloating as a key element in assessing clinical changes and treatments' efficacy as this symptom exerts a strong influence on patient-reported outcomes independent of possible confounders and other symptoms of constipation. Our data provide the rationale to investigate the efficacy and tolerability of new treatments specifically addressing this important, yet disregarded, patients' complain.
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- 2016
30. Randomised clinical trial: mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease--a double-blind, randomised, placebo-controlled study
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Silvio Danese, Marcello Picchio, E. Capezzuto, G. Stoppino, S. Fiorella, G. Pianese, Giovanni Brandimarte, Antonio Tursi, R. Lattanzio, S. Rodino, V. Stoppino, A. Spadaccini, Walter Elisei, F. Polimeni, N. Polimeni, T. D'Amico, Fabio Aiello, Piero Portincasa, N. Sacca, G. Forti, GianMarco Giorgetti, Tursi, A, Brandimarte, G, Elisei, W, Picchio, M, Forti, G, Pianese, G, Rodino, S, D'Amico, T, Sacca, N, Portincasa, P, Capezzuto, E, Lattanzio, R, Spadaccini, A, Fiorella, S, Polimeni, F, Polimeni, N, Stoppino, V, Stoppino, G, Giorgetti, Gm, Aiello, F, and Danese, S
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p-group ,Male ,medicine.medical_specialty ,Lactobacillus casei ,Abdominal pain ,Placebo-controlled study ,Placebo ,Diverticulum, Colon ,Gastroenterology ,chemistry.chemical_compound ,Mesalazine ,Double-Blind Method ,Lactobacillus ,Internal medicine ,Secondary Prevention ,Medicine ,Humans ,Pharmacology (medical) ,Mesalamine ,Aged ,Hepatology ,biology ,business.industry ,Probiotics ,Anti-Inflammatory Agents, Non-Steroidal ,Middle Aged ,biology.organism_classification ,Surgery ,Abdominal Pain ,Clinical trial ,Treatment Outcome ,chemistry ,Female ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Summary Background Placebo-controlled studies in maintaining remission of symptomatic uncomplicated diverticular disease (SUDD) of the colon are lacking. Aim To assess the effectiveness of mesalazine and/or probiotics in maintaining remission in SUDD. Methods A multicentre, double-blind, placebo-controlled study was conducted. Two hundred and ten patients were randomly enrolled in a double-blind fashion in four groups: Group M (active mesalazine 1.6 g/day plus Lactobacillus casei subsp. DG placebo), Group L (active Lactobacillus casei subsp. DG 24 billion/day plus mesalazine placebo), Group LM (active Lactobacillus casei subsp. DG 24 billion/day plus active mesalazine), Group P (Lactobacillus casei subsp. DG placebo plus mesalazine placebo). Patients received treatment for 10 days/month for 12 months. Recurrence of SUDD was defined as the reappearance of abdominal pain during follow-up, scored as ≥5 (0: best; 10: worst) for at least 24 consecutive hours. Results Recurrence of SUDD occurred in no (0%) patient in group LM, in 7 (13.7%) patients in group M, in 8 (14.5%) patients in group L and in 23 (46.0%) patients in group P (LM group vs. M group, P = 0.015; LM group vs. L group, P = 0.011; LM group vs. P group, P = 0.000; M group vs. P group, P = 0.000; L group vs. P group, P = 0.000). Acute diverticulitis occurred in six group P cases and in one group L case (P = 0.003). Conclusion Both cyclic mesalazine and Lactobacillus casei subsp. DG treatments, particularly when given in combination, appear to be better than placebo for maintaining remission of symptomatic uncomplicated diverticular disease. (ClinicalTrials.gov: NCT01534754).
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- 2013
31. Treatment of relapsing mild-to-moderate ulcerative colitis with the probiotic VSL#3 as adjunctive to a standard pharmaceutical treatment: a double-blind, randomized, placebo-controlled study
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Maria Ester Modeo, Sergio Morini, Vito Annese, Ladislava Sebkova, Teresa D'Amico, Francesco Luzza, Emilio Di Giulio, Walter Elisei, N. Saccà, A. Giglio, Cesare Hassan, Maria Imeneo, Maria Antonietta Pistoia, Gian Marco Giorgetti, Silvio Danese, Salvatore Di Rosa, Tiziana Larussa, Giacomo Forti, S. Rodinò, Antonio Gasbarrini, Giovanni Brandimarte, Antonio Tursi, Alfredo Papa, Tursi, A, Brandimarte, G, Papa, A, Giglio, A, Elisei, W, Giorgetti, Gm, Forti, G, Morini, S, Hassan, C, Pistoia, Ma, Modeo, Me, Rodino', S, D'Amico, T, Sebkova, L, Sacca', N, Di Giulio, E, Luzza, F, Imeneo, M, Larussa, T, Di Rosa, S, Annese, V, Danese, S, and Gasbarrini, A
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Adult ,Male ,medicine.medical_specialty ,Settore MED/12 - GASTROENTEROLOGIA ,Placebo-controlled study ,Gastroenterology ,Severity of Illness Index ,law.invention ,Double blind ,Probiotic ,Randomized controlled trial ,Double-Blind Method ,law ,Recurrence ,Internal medicine ,Severity of illness ,Azathioprine ,medicine ,Humans ,Streptococcus thermophilus ,Colitis ,Mesalamine ,Diet treatment ,therapy ,Hepatology ,business.industry ,Patient Selection ,Probiotics ,Inflammatory Bowel Disease ,Remission Induction ,VSL#3 ,Middle Aged ,medicine.disease ,Ulcerative colitis ,Combined Modality Therapy ,Surgery ,Lactobacillus ,Treatment Outcome ,Colitis, Ulcerative ,Female ,Bifidobacterium ,business - Abstract
OBJECTIVES: VSL#3 is a high-potency probiotic mixture that has been used successfully in the treatment of pouchitis. The primary end point of the study was to assess the effects of supplementation with VSL#3 in patients affected by relapsing ulcerative colitis (UC) who are already under treatment with 5-aminosalicylic acid (ASA) and/or immunosuppressants at stable doses. METHODS: A total of 144 consecutive patients were randomly treated for 8 weeks with VSL#3 at a dose of 3,600 billion CFU/day (71 patients) or with placebo (73 patients). RESULTS: In all, 65 patients in the VSL#3 group and 66 patients in the placebo group completed the study. The decrease in ulcerative colitis disease activity index (UCDAI) scores of 50 % or more was higher in the VSL#3 group than in the placebo group (63.1 vs. 40.8; per protocol (PP) P=0.010, confi dence interval (CI)(95%) 0.51-0.74; intention to treat (ITT) P=0.031, CI(95%) 0.47-0.69). Signifi cant results with VSL#3 were recorded in an improvement of three points or more in the UCDAI score (60.5% vs. 41.4%; PP P=0.017, CI(95%) 0.51-0.74; ITT P=0.046, CI(95%) 0.47-0.69) and in rectal bleeding (PP P=0.014, CI(95%) 0.46-0.70; ITT P=0.036, CI(95%) 0.41-0.65), whereas stool frequency (PP P=0.202, CI(95%) 0.39-0.63; ITT P=0.229, CI(95%) 0.35-0.57), physician ' s rate of disease activity (PP P=0.088, CI(95%) 0.34-0.58; ITT P=0.168, CI(95%) 0.31-0.53), and endoscopic scores (PP P=0.086, CI(95%) 0.74-0.92; ITT P=0.366, CI(95%) 0.66-0.86) did not show statistical differences. Remission was higher in the VSL#3 group than in the placebo group (47.7% vs. 32.4%; PP P=0.069, CI(95%) 0.36-0.60; ITT P=0.132, CI(95%) 0.33-0.56). Eight patients on VSL#3 (11.2%) and nine patients on placebo (12.3%) reported mild side effects. CONCLUSIONS: VSL#3 supplementation is safe and able to reduce UCDAI scores in patients affected by relapsing mild-to-moderate UC who are under treatment with 5-ASA and/or immunosuppressants. Moreover, VSL#3 improves rectal bleeding and seems to reinduce remission in relapsing UC patients after 8 weeks of treatment, although these parameters do not reach statistical signifi cance.
- Published
- 2010
32. Efficacy of long term cyclic administration of the poorly absorbed antibiotic Rifaximin in symptomatic, uncomplicated colonic diverticular disease
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Giovanni Brandimarte, Francesca Pasqui, Enrico Roda, Francesca Pistoia, Antonio Colecchia, Davide Festi, Giuseppe Mazzella, Amanda Vestito, Colecchia A, Vestito A, Pasqui F, Mazzella G, Roda E, Pistoia F, Brandimarte G, and Festi D
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Adult ,Male ,medicine.medical_specialty ,DIETARY FIBER ,ANTIBIOTICS ,ABDOMINAL SYMPTOMS ,DIVERTICULITIS ,Physical examination ,Gastroenterology ,Rifaximin ,law.invention ,chemistry.chemical_compound ,Pharmacotherapy ,Randomized controlled trial ,Anti-Infective Agents ,law ,Clinical Research ,Internal medicine ,Diverticulosis, Colonic ,Medicine ,Humans ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,digestive, oral, and skin physiology ,General Medicine ,Diverticulitis ,Middle Aged ,medicine.disease ,Rifamycins ,Diverticulosis ,Surgery ,Treatment Outcome ,chemistry ,Diverticular disease ,Drug Therapy, Combination ,Female ,business ,Complication - Abstract
AIM: To comparatively evaluate the long term efficacy of Rifaximin and dietary fibers in reducing symptoms and/or complication frequency in symptomatic, uncomplicated diverticular disease. METHODS: 307 patients (118 males, 189 females, age range: 40-80 years) were enrolled in the study and randomly assigned to: Rifaximin (400 mg bid for 7 d every month) plus dietary fiber supplementation (at least 20 gr/d) or dietary fiber supplementation alone. The study duration was 24 mo; both clinical examination and symptoms’ questionnaire were performed every two months. RESULTS: Both treatments reduced symptom frequency, but Rifaximin at a greater extent, when compared to basal values. Symptomatic score declined during both treatments, but a greater reduction was evident in the Rifaximin group (6.4 ± 2.8 and 6.2 ± 2.6 at enrollment, p = NS, 1.0 ± 0.7 and 2.4 ± 1.7 after 24 mo, p < 0.001, respectively). Probability of symptom reduction was higher and complication frequency lower (Kaplan-Meyer method) in the Rifaximin group (p < 0.0001 and 0.028, respectively). CONCLUSION: In patients with symptomatic, uncomplicated diverticular disease, cyclic administration of Rifaximin plus dietary fiber supplementation is more effective in reducing both symptom and complication frequency than simple dietary fiber supplementation. Long term administration of the poorly absorbed antibiotic Rifaximin is safe and well tolerated by the patients, confirming the usefulness of this therapeutic strategy in the overall management of diverticular disease.
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- 2007
33. Bowel movement alterations predict the severity of diverticular disease and the risk of acute diverticulitis: a prospective, international st.
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Tursi A, Piovani D, Brandimarte G, Di Mario F, Elisei W, Picchio M, Figlioli G, Bassotti G, Allegretta L, Annunziata ML, Bafutto M, Bianco MA, Colucci R, Conigliaro R, Dumitrascu DL, Escalante R, Ferrini L, Forti G, Franceschi M, Graziani MG, Lammert F, Latella G, Lisi D, Maconi G, Compare D, Nardone G, Camara de Castro Oliveira L, Enio CO, Papagrigoriadis S, Pietrzak A, Pontone S, Stundiene I, Poškus T, Pranzo G, Reichert MC, Rodino S, Regula J, Scaccianoce G, Scaldaferri F, Vassallo R, Zampaletta C, Zullo A, Spaziani E, Bonovas S, Papa A, and Danese S
- Abstract
Background/aims: Patients with diverticular disease (DD) frequently have abnormal bowel movements. However, it is unknown whether the entity of these alterations is associated with the severity of DD. We aimed to assess bowel habits and their relationship with the severity of DD according to Diverticular Inflammation and Complication Assessment (DICA) classification, Combined Overview on Diverticular Assessment (CODA) score, and fecal calprotectin (FC)., Methods: An international, multicenter, prospective cohort study was conducted in 43 centers. A 10-point visual analog scale (VAS) was used to assess the severity of constipation and diarrhea. The association of constipation and diarrhea with DICA classification, CODA score, and basal FC was tested using non-parametric tests. Survival methods for censored observations were applied to test the association of constipation and diarrhea with the incidence of acute diverticulitis over a 3-year follow-up., Results: Of 871 patients with DD were included in the study. Of these, 208 (23.9%) and 199 (22.9%) reported a VAS score for constipation and diarrhea at least 3 at baseline, respectively. Higher constipation and diarrhea scores were associated with increasing DICA classification, CODA score and basal FC (P< 0.001). Constipation and diarrhea scores were independently associated with an increased hazard of developing acute diverticulitis (hazard ratio [HR]constipation = 1.15 per 1-VAS point increase, 95% confidence interval [CI], 1.04-1.27; P=0.004; and HRdiarrhea =1.14; 95% CI, 1.03-1.26; P=0.014, respectively)., Conclusions: In newly diagnosed patients with DD, higher endoscopic and combined scores of DD severity were associated with higher scores of constipation and diarrhea at baseline. Both constipation and diarrhea were independent prognostic factors of acute diverticulitis.
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- 2024
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34. Patient journey in gastroesophageal reflux disease: real-world perspectives from Italian gastroenterologists, primary care physicians, and ENT specialists.
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Pasta A, Pelizzaro F, Marabotto E, Calabrese F, Formisano E, Djahandideh Sheijani S, Brandimarte G, Manes G, Gravina AG, and Savarino EV
- Abstract
Background: Gastroesophageal reflux disease (GERD) is a challenging condition that involves different physicians, such as general practitioners (GPs), gastroenterologists, and ears, nose and throat (ENT) specialists. A common approach consists of proton-pump inhibitors (PPIs) administration. Adjunctive pharmacological treatment may have a role in the management of non-responders to PPIs., Objectives: We aimed to survey GPs and different medical specialists to investigate the medical approaches to patients reporting GERD symptoms. In addition, we examined the use of adjunctive pharmacological treatments in patients with GERD symptoms who do not respond to PPIs., Design: Retrospective observational study., Methods: A survey was conducted among a large sample of gastroenterologists, GPs, and ENT specialists. Symptoms were divided into typical and extraesophageal, and their severity and impact on quality of life were explored with the GERD Impact Scale and with Reflux Symptom Index (RSI). All therapies administered usually for GERD were investigated., Results: A total of 6211 patients were analyzed in this survey. Patients with typical symptoms were 53.5%, while those with extraesophageal symptoms were 46.5%. The latter were more frequently reported by ENT patients (53.6%, p < 0.0001). The GSI was higher in patients followed by gastroenterologists (9 points) and GPs (9 points) than ENT specialists (8 points), but the RSI was higher in the ENT group (14.3 ± 6.93) than in GPs and gastroenterologist groups (10.36 ± 6.36 and 10.81 ± 7.30, p < 0.0001). Chest pain had the highest negative impact on quality of life ( p < 0.0001). Of the 3025 patients who used PPIs, non-responders showed a lower GSI when treated with a combination of adjunctive pharmacological treatments and bioadhesive compounds, than with single-component drugs., Conclusion: Patients with GERD referred to a gastroenterologist had more severe disease and poorer quality of life. The combination of adjunctive pharmacological treatments and bioadhesive compounds seems to be effective in the management of PPI refractory patients., (© The Author(s), 2024.)
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- 2024
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35. Diverticular Inflammation and Complication Assessment classification, CODA score and fecal calprotectin in clinical assessment of patients with diverticular disease: A decision curve analysis.
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Tursi A, Piovani D, Brandimarte G, Di Mario F, Elisei W, Picchio M, Allegretta L, Annunziata ML, Bafutto M, Bassotti G, Bianco MA, Colucci R, Conigliaro R, Dumitrascu DL, Escalante R, Ferrini L, Forti G, Franceschi M, Graziani MG, Lammert F, Latella G, Maconi G, Compare D, Nardone G, Camara De Castro Oliveira L, Oliveira EC, Papa A, Papagrigoriadis S, Pietrzak A, Pontone S, Poskus T, Pranzo G, Reichert MC, Rodinò S, Regula J, Scaccianoce G, Scaldaferri F, Vassallo R, Zampaletta C, Zullo A, Spaziani E, Bonovas S, and Danese S
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- Humans, Colonoscopy, Leukocyte L1 Antigen Complex, Prospective Studies, Inflammation diagnosis, Inflammation complications, Diverticulosis, Colonic diagnosis, Diverticulosis, Colonic therapy, Diverticulosis, Colonic complications, Diverticular Diseases complications, Diverticular Diseases diagnosis, Diverticular Diseases therapy, Diverticulum complications
- Abstract
Background and Aims: The Diverticular Inflammation and Complication Assessment (DICA) classification and the Combined Overview on Diverticular Assessment (CODA) were found to be effective in predicting the outcomes of Diverticular Disease (DD). We ascertain whether fecal calprotectin (FC) can further aid in improving risk stratification., Methods: A three-year international, multicentre, prospective cohort study was conducted involving 43 Gastroenterology and Endoscopy centres. Survival methods for censored observations were used to estimate the risk of acute diverticulitis (AD) in newly diagnosed DD patients according to basal FC, DICA, and CODA. The net benefit of management strategies based on DICA, CODA and FC in addition to CODA was assessed with decision curve analysis, which incorporates the harms and benefits of using a prognostic model for clinical decisions., Results: At the first diagnosis of diverticulosis/DD, 871 participants underwent FC measurement. FC was associated with the risk of AD at 3 years (HR per each base 10 logarithm increase: 3.29; 95% confidence interval, 2.13-5.10) and showed moderate discrimination (c-statistic: 0.685; 0.614-0.756). DICA and CODA were more accurate predictors of AD than FC. However, FC showed high discrimination capacity to predict AD at 3 months, which was not maintained at longer follow-up times. The decision curve analysis comparing the combination of FC and CODA with CODA alone did not clearly indicate a larger net benefit of one strategy over the other., Conclusions: FC measurement could be used as a complementary tool to assess the immediate risk of AD. In all other cases, treatment strategies based on the CODA score alone should be recommended., (© 2023 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.)
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- 2023
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36. A comparison of different symptomatic reflux esophagitis treatments: A real-world study.
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Di Mario F, Crafa P, Franzoni L, Tursi A, Brandimarte G, Russo M, Rodriguez-Castro KI, Franceschi M, Bortoli N, and Savarino E
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Background: Proton pump inhibitors (PPIs) are currently the reference drugs for gastroesophageal reflux disease (GERD), but symptoms often recur after their withdrawal. Moreover, whether prokinetics or barrier drugs used alongside PPIs are more effective remains under debate., Objectives: The aim of the study was to assess the efficacy of different therapeutic approaches to GERD treatment., Material and Methods: We enrolled 211 grade A reflux esophagitis patients who consented to participate in this non-randomized, open-label trial. The study consisted of 6 sequentially administered medical treatments for GERD, lasting 2 months, with a 3-week washout period between each drug schedule: Group A: PPI (esomeprazole 40 mg/day before breakfast); Group B: mucosal protective drugs (a combination of hyaluronic acid, chondroitin sulfate and poloxamer 407, or a combination of hyaluronic acid, chondroitin sulfate and aluminum, 3 times daily after a meal); Group C: prokinetics (levosulpiride 25 mg or domperidone 10 mg, 3 times daily before a meal); Group D: barrier drug (alginate 3 times daily after a meal); Group E: PPI (esomeprazole 40 mg/day before breakfast) and mucosal protective drugs (a combination of hyaluronic acid, chondroitin sulfate and poloxamer 407, or a combination of hyaluronic acid, chondroitin sulfate and aluminum, before sleep); Group F: PPI (esomeprazole 40 mg/day before breakfast) and prokinetics (levosulpiride 25 mg or domperidone 10 mg before lunch and dinner). Symptoms were evaluated using the visual analogue scale (VAS) and global symptomatic score (GSS), as follows: heartburn: 0-3; retrosternal chest pain: 0-3; regurgitation: 0-3., Results: All but 2 treatments (groups C and D) significantly improved VAS and GSS, with group E showing the most significant GSS improvement. Group C had the highest number of dropouts due to treatment failure and reported more side effects., Conclusion: Using PPIs and mucosal protective drugs resulted in significant symptom alleviation. However, the administration of prokinetics caused higher dropouts due to treatment failure.
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- 2023
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37. Hericium erinaceus , in combination with natural flavonoid/alkaloid and B 3 /B 8 vitamins, can improve inflammatory burden in Inflammatory bowel diseases tissue: an ex vivo study.
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Gravina AG, Pellegrino R, Palladino G, Coppola A, Brandimarte G, Tuccillo C, Ciardiello F, Romano M, and Federico A
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- Humans, Interleukin-10 genetics, Interleukin-10 metabolism, Tumor Necrosis Factor-alpha metabolism, Vitamins metabolism, Flavonoids, Biotin metabolism, Quercetin metabolism, Cyclooxygenase 2 genetics, Cyclooxygenase 2 metabolism, Intestinal Mucosa metabolism, Cytokines metabolism, RNA, Messenger metabolism, Niacin metabolism, Berberine, Inflammatory Bowel Diseases metabolism, Antineoplastic Agents
- Abstract
Hericium erinaceus , berberine, and quercetin are effective in experimental colitis. It is unknown whether they can ameliorate inflammatory bowel diseases in humans. This ex vivo study aimed to evaluate the anti-inflammatory potential of a nutraceutical compound of HBQ-Complex
® ( H. erinaceus , berberine, and quercetin), biotin, and niacin in inflammatory bowel disease patients. Tissue specimens were obtained either from Normal-Appearing Mucosa (NAM) or from Inflamed Mucosa (IM) in 20 patients with inflammatory bowel disease. mRNA and protein expression of COX-2, IL-10, and TNF-α were determined in NAM and IM biopsy samples (T0). IM samples were then incubated in HBQ-Complex® (with the addition of niacin and biotin), and COX-2, IL-10, and TNF-α tissue levels were evaluated at 120 minutes (T1) and 180 minutes (T2). Incubation with this compound resulted in a progressive decrease in gene and protein COX-2 and TNF-α expression at T1/T2 in the IM. IL-10 showed an opposite trend, with a progressive increase of mRNA and protein expression over the same time window. HBQ-Complex® (with the addition of niacin and biotin) decreased the expression of proinflammatory cytokines at the mRNA and protein levels in IBD tissue. On the contrary, mRNA and protein expression of the anti-inflammatory cytokine IL-10 showed a progressive increase., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Gravina, Pellegrino, Palladino, Coppola, Brandimarte, Tuccillo, Ciardiello, Romano and Federico.)- Published
- 2023
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38. PPIs and gastric cancer: any causal relationship?
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Crafa P, Franceschi M, Rodriguez-Castro KI, Franzoni L, Russo M, Brandimarte G, Tursi A, Rugge M, and Di Mario F
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- Humans, Proton Pump Inhibitors adverse effects, Omeprazole adverse effects, Causality, Gastritis, Atrophic chemically induced, Gastritis, Atrophic complications, Stomach Neoplasms etiology
- Abstract
Hydrochloric acid is crucial in gastric physiology. In 1978 cimetidine, the first H2 antagonist of histamine receptors on the gastric parietal cell was introduced into therapy, inducing acid. Lasting the years, several studies focused on the potential relationship between inducing hypo-achlorhydria and risk of developing gastric cancer. In 1988 omeprazole, the first proton pump inhibitor, entered therapy. In 1996, Kuipers underlined the danger of progression of chronic atrophic gastritis in subjects taking PPIs. In 2018, one paper from Korea and an another on from Sweden suggested a possible relationship between long-term PPI therapy and the development of gastric cancer. Over the years, several articles, meta-analyzes and population based focused on relationship between long-term of PPI use and the onset of gastric cancer, with conflicting results. As reported, the presence of bias in the collection of cases, in particular concerning the evaluation of the H.p. status and presence of atrophic gastritis and intestinal metaplasia in subjects treated with PPI, can lead to noticeable errors in the results and conclusions, as demonstrated in the literature by exhaustive methodological studies of pharmacoepidemiology. A possible bias in the collection of case histories is due to the fact that PPIs are often administered to dyspeptic patients, among which there are patients already carriers of gastric neoplasia: the so-called inverse causality. Literature data, amended by methodological bias (sampling errors, lack of comparative assessment of Hp status and atrophic gastritis) NOT support a causal relationship between long-term PPIs therapy and the onset of gastric cancer.
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- 2023
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39. Hericium erinaceus , a medicinal fungus with a centuries-old history: Evidence in gastrointestinal diseases.
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Gravina AG, Pellegrino R, Auletta S, Palladino G, Brandimarte G, D'Onofrio R, Arboretto G, Imperio G, Ventura A, Cipullo M, Romano M, and Federico A
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- Humans, Hericium, Agaricales, Gastritis
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Hericium erinaceus is an edible and medicinal mushroom commonly used in traditional Chinese medicine for centuries. Several studies have highlighted its therapeutic potential for gastrointestinal disorders such as gastritis and inflammatory bowel diseases. In addition, some components of this mushroom appear to possess strong antineoplastic capabilities against gastric and colorectal cancer. This review aims to analyse all available evidence on the digestive therapeutic potential of this fungus as well as the possible underlying molecular mechanisms., Competing Interests: Conflict-of-interest statement: The authors declare no conflicts of interest for this article., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)
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- 2023
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40. Appropriateness of Proton Pump Inhibitor Prescription Evaluated by Using Serological Markers.
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Russo M, Rodriguez-Castro KI, Franceschi M, Ferronato A, Panozzo MP, Brozzi L, Di Mario F, Crafa P, Brandimarte G, and Tursi A
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- Humans, Proton Pump Inhibitors pharmacology, Proton Pump Inhibitors therapeutic use, Pepsinogen A, Gastritis, Atrophic, Helicobacter Infections drug therapy, Helicobacter Infections diagnosis, Helicobacter pylori
- Abstract
Inappropriate prescription of proton pump inhibitors (PPI) has been widely reported, often lacking initial exclusion of Helicobacter pylori (HP) infection and evaluation of gastric functional status. The aim of this study was to evaluate the utility of gastric functional tests to define the acid output, as well as HP status, in order to better direct PPI therapy prescription. Dyspeptic patients without alarm symptoms from a primary care population were evaluated. For each patient, serum Pepsinogen I (PGI) and II (PGII), gastrin 17 (G17) and anti-HP IgG antibodies (Biohit, Oyj, Finland) were determined. For each subject, data were collected regarding symptoms, past medical history of HP infection, and PPI use. Therapeutic response to PPIs was determined according to PGI and G17 values, where G17 > 7 in the presence of elevated PGI and absence of chronic atrophic gastritis (CAG) was considered an adequate response. Among 2583 dyspeptic patients, 1015/2583 (39.3%) were on PPI therapy for at least 3 months before serum sampling, and were therefore included in the study. Active HP infection and CAG were diagnosed in 206 (20.2%) and 37 (3.6%) patients, respectively. Overall, an adequate therapeutic response to PPIs was observed in 34.9%, reaching 66.7% at the highest dose. However, 41.1% and 20.4% of patients showed low (G17 1-7) or absent (G17 < 1) response to PPI, regardless of the dosage used. According to gastric functional response, most patients currently on PPI maintenance therapy lack a proper indication for continuing this medication, either because acid output is absent (as in CAG) or because gastrin levels fail to rise, indicating absence of gastric acid negative feedback. Lastly, HP eradication is warranted in all patients, and gastric function testing ensures this pathogen is sought for and adequately treated prior to initiating long-term PPI therapy., Competing Interests: This research received no external funding and authors declare no competing interest.
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- 2023
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41. Faecalibacterium prausnitzii is not decreased in symptomatic uncomplicated diverticular disease of the colon.
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Tursi A, Mastromarino P, Capobianco D, Elisei W, Campagna G, Picchio M, Giorgetti G, Fabiocchi F, and Brandimarte G
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In this letter, assessment of the amount of fecal Faecalibacterium prausnitzii in symptomatic uncomplicated diverticular disease (SUDD) is described. Among 44 consecutive patients, comprising 15 SUDD patients, 13 patients with asymptomatic diverticulosis (AD), and 16 healthy controls (HC), the fecal amount of Faecalibacterium prausnitzii was not found to be significantly different between HC, AD and SUDD subjects (p=0.871). Moreover, its count in the HC microbiota (-4.57 ± 2.15) was lower compared with those in the AD (-4.11 ± 1.03) and SUDD subjects (-4.03 ± 1.299). This behavior seems to be different from that occurring in inflammatory bowel disease (IBD) and similar to that of other mucin-degrading species in a SUDD setting., (©2023 BMFH Press.)
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- 2023
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42. Recovery of gastric function in patients affected by chronic atrophic gastritis using l-cysteine (Acetium®): one year survey in comparison with a control group.
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Crafa P, Di Mario F, Grillo S, Landi S, Franceschi M, Rodriguez-Castro K, Tursi A, Brandimarte G, and Franzoni L
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- Acetaldehyde, Control Groups, Cysteine therapeutic use, Humans, Pepsinogen A, Gastritis, Atrophic drug therapy, Helicobacter Infections drug therapy, Helicobacter pylori
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Background and Aim: Chronic Atrophic Gastritis (CAG) is a precancerous condition for gastric cancer (GC) as single risk factor, being a consequence of a previous Helicobacter pylori (Hp) infection or based on autoimmune mechanisms. Achlorhydria plays an important role towards the formation of a class I carcinogen, acetaldehyde, after food intake. L-cysteine has been claimed to be able to bind in a covalent way acetaldehyde when administered at means., Methods: In this study we enrolled two CAG groups of patients, one treated whit 300 mg/daily of L-cysteine for one year, the other one untreated. We assessed gastric function lasting the one year follow-up by using non invasive surrogates, i.e. Pepsinogen I (PGI) and gastrin 17 (G17)., Results: In the group of 77 CAG on therapy we found a statistically significative increase in PGI values and a decrease in G17 levels, in comparison with unchanged values in control group., Conclusions: L-cysteine seems able to provide a recovery in gastric function when administered in CAG patients and could be proposed as a possible therapy in such patients.
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- 2022
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43. The natural history of symptomatic uncomplicated diverticular disease: a long-term follow-up study.
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Tursi A, Franceschi M, Elisei W, Picchio M, Mario FD, and Brandimarte G
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Background: Symptomatic uncomplicated diverticular disease (SUDD) affects about 20% of patients who have diverticulosis. However, the natural history of SUDD is not yet completely understood. Our aim was to assess the outcomes of a cohort of SUDD patients during a long-term follow up., Methods: One hundred eighty-five patients suffering from SUDD were identified from a large electronic database. Symptoms assessed were abdominal pain, bloating, bowel movement/day, each of which was scored using a visual analogic scale (VAS); the symptom score was calculated by considering the value of the worst symptom present during assessment. Another VAS was used to assess patients' quality of life (QoL). Patients were treated at the physician's discretion (with rifaximin, mesalazine, probiotics, spasmolytics) only when symptoms occurred during the follow up. Follow-up visit was performed every year or whenever patients consider it necessary., Results: During the follow up (156 months, interquartile range 9-171), 47 patients were lost to follow up. Among these, 9 died from causes not related to SUDD. Acute diverticulitis occurred in 14 patients (7.6% of the overall population): 6 patients (3.2% of the overall population) underwent surgery, and 2 patients (1.1% of the overall population) died because of peritonitis. Both the symptom score and the QoL score were substantially unmodified during the study period., Conclusions: SUDD is an important disease able to affect patients significantly in the long term. Acute diverticulitis may sometimes occur in these patients, often leading to surgery with possible severe complications., Competing Interests: Conflict of Interest: None, (Copyright: © 2021 Hellenic Society of Gastroenterology.)
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- 2021
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44. Incidental Schwannoma of the Sigmoid.
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Brandimarte G, Festa V, Balsamo G, Dezi A, Marzano C, and Tursi A
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- Biomarkers, Tumor analysis, Biopsy, Female, Humans, Immunohistochemistry, Middle Aged, Neurilemmoma chemistry, Neurilemmoma surgery, Sigmoid Neoplasms chemistry, Sigmoid Neoplasms surgery, Sigmoidoscopy, Incidental Findings, Neurilemmoma pathology, Sigmoid Neoplasms pathology
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- 2020
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45. Acute Diverticulitis Is at Significant Risk of Malnutrition: an Analysis of Hospitalized Patients in a Medicine Department.
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Giorgetti G, Fabiocchi F, Brandimarte G, and Tursi A
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- Acute Disease, Aged, Aged, 80 and over, Feasibility Studies, Female, Hospitalization, Humans, Length of Stay statistics & numerical data, Male, Malnutrition diagnosis, Mass Screening methods, Middle Aged, Nutrition Assessment, Nutritional Status, Nutritional Support methods, Retrospective Studies, Risk Factors, Diverticulitis, Colonic complications, Malnutrition etiology
- Abstract
Background and Aim: The Nutritional Risk Security (NRS2002) System is recommended for hospitalized patients in order to assess their nutritional status. However, studies assessing large-scale systematic screening policies are lacking. The aim of this study was to assess the feasibility of implementing a screening strategy concerning all admissions for diverticular disease (DD) of the colon in the Department of Medicine of a Tertiary Hospital., Methods: All patients suffering from acute diverticulitis (AD) and admitted to the Medicine Department from January 1st to 31 December 2017, were pre-screened by NRS2002 System by the nursing staff of the Nutritional team at the day of the admission. If the pre-screening was positive, the patients were referred to a supplementary assessment performed by a dietician., Results: The global number of admissions in the observational period was 4,667 and 133 patients suffered from AD. A positive pre-screening test was recorded in 97 (72.9%) patients: a NRS2002 score > 3, describing a severe impaired nutritional status was found in 61 patients (62.9%). All 97 patients with a NRS2002 positive screening received initial nutritional support by oral supplements (17 patients, 17.52%) or enteral nutrition (22 patients, 22.68%) or total parenteral nutrition (58 patients, 59.8%). The mean length of hospital stay for all 133 patients was 6,9 days. However, the length of hospital stay was significantly longer for patients with a positive NRS2002, with a mean of 18 days (p= 0.01) Conclusions: A large number of hospitalized patients due to AD are at nutritional risk and have a significantly longer hospital stay.
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- 2019
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46. Hot Topics in Medical Treatment of Diverticular Disease: Evidence Pro and Cons.
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Brandimarte G, Bafutto M, Kruis W, Scarpignato C, Mearin F, Barbara G, Štimac D, Vranić L, Cassieri C, Lecca PG, D'Avino A, and Malfertheiner P
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- Anti-Bacterial Agents therapeutic use, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Diverticular Diseases complications, Diverticular Diseases microbiology, Evidence-Based Medicine methods, Gastrointestinal Microbiome, Humans, Probiotics therapeutic use, Rifaximin therapeutic use, Diverticular Diseases drug therapy, Gastrointestinal Agents therapeutic use
- Abstract
Symptomatic Uncomplicated Diverticular Disease (SUDD) is the most common clinical form of Diverticular Disease (DD). The therapy should be aimed at reducing both the intensity and frequency of symptoms as well as preventing complications. The pharmacological treatments include fibers, not absorbable antibiotics (for example rifaximin), anti-inflammatory drugs (for example 5-amino-salycilic acid) and probiotics, alone or in combination with other drugs. Although some of these treatments seem to be effective in treating SUDD, but their efficacy in preventing complications of the disease is still uncertain. It has been hypothesized that microbial imbalance associated with bacterial overgrowth of the colon, may be the key to the development of diverticular disease (DD). Therefore, drugs that can manipulate gut microbiota such as probiotics or rifaximine are considered as a potential key therapy. Rifaximine is able to modulate the intestinal ecosystem, restoring eubiosis. Traditionally, DD of the colon is thought to be related to low grade of inflammation. By analogy with other inflammatory bowel diseases mesalazine has been studied also in DD. There are several evidences that may support the use of mesalazine in the SUDD. Unfortunately, mesalazine cannot be used to prevent diverticulitis because of the paucity of high-quality studies. Currently, mesalazine has a limited place for the management of SUDD. In SUDD probiotics have been proven as an effective therapy in reducing abdominal symptoms, but unfortunately there has been limited number of relevant studies regarding efficacy of this therapy.
- Published
- 2019
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47. International Consensus on Diverticulosis and Diverticular Disease. Statements from the 3rd International Symposium on Diverticular Disease.
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Tursi A, Brandimarte G, Di Mario F, Lanas A, Scarpignato C, Bafutto M, Barbara G, Bassotti G, Binda GA, Biondi A, Biondo S, Cambiè G, Cassieri C, Crucitti A, Dumitrascu DL, Elisei W, Escalante R, Herszènyi L, Kruis W, Kupcinskas J, Lahat A, Lecca PG, Maconi G, Malfertheiner P, Mazzari A, Mearìn F, Milosavljeviċ T, Nardone G, Chavez De Oliveira E, Papa A, Papagrigoriadis S, Pera M, Persiani R, Picchio M, Regula J, Štimac D, Stollman N, Strate LL, Violi A, and Walker MM
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- Congresses as Topic, Diverticular Diseases diagnosis, Diverticular Diseases etiology, Diverticulum diagnosis, Diverticulum etiology, Diverticulum therapy, Evidence-Based Medicine methods, Humans, Diverticular Diseases therapy
- Abstract
The statements produced by the Chairmen and Speakers of the 3rd International Symposium on Diverticular Disease, held in Madrid on April 11th-13th 2019, are reported. Topics such as current and evolving concepts on the pathogenesis, the course of the disease, the news in diagnosing, hot topics in medical and surgical treatments, and finally, critical issues on the disease were reviewed by the Chairmen who proposed 39 statements graded according to level of evidence and strength of recommendation. Each topic was explored focusing on the more relevant clinical questions. The vote was conducted on a 6-point scale and consensus was defined a priori as 67% agreement of the participants. The voting group consisted of 124 physicians from 18 countries, and agreement with all statements was provided. Comments were added explaining some controversial areas.
- Published
- 2019
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48. Budesonide MMX Is Effective in Patients Having Persistent Symptoms and Raised Fecal Calprotectin Following Treatments for Diverticular Disease.
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Tursi A, Cassieri C, Colucci R, Elisei W, Picchio M, and Brandimarte G
- Subjects
- Aged, Budesonide administration & dosage, Colonic Diseases metabolism, Diverticular Diseases metabolism, Drug Administration Schedule, Drug Therapy, Combination, Feces chemistry, Female, Follow-Up Studies, Gastrointestinal Agents administration & dosage, Glucocorticoids administration & dosage, Humans, Male, Mesalamine therapeutic use, Middle Aged, Severity of Illness Index, Treatment Outcome, Budesonide therapeutic use, Colonic Diseases drug therapy, Diverticular Diseases drug therapy, Gastrointestinal Agents therapeutic use, Glucocorticoids therapeutic use, Leukocyte L1 Antigen Complex metabolism
- Abstract
Background and Aim: Although rifaximin and mesalazine seem to be effective in treating the majority of people suffering from diverticular disease (DD), some patients still experience symptoms following those treatments. The aim of this study was to assess the efficacy of budesonide MMXTM in managing symptoms and raised fecal calprotectin (FC) in patients with endoscopic diagnosis of DD and not responding to standard treatments., Methods: We performed a post-hoc analysis of the patients enrolled in the DICA prospective study. All patients were at the first diagnosis of DD, scored according to DICA classification. We assessed abdominal pain, meteorism, constipation and diarrhea (scored from 0 to 10) and FC expression at baseline and after six months. Patients were treated with budesonide MMXTM for 4 weeks (9 mg/day for 2 weeks, followed by 9 mg every other day for further 2 weeks), followed by mesalazine 2.4 grams/day for further 5 months., Results: We studied 24 patients (18 females and 6 males, median age 64, inter quartile range (IQR): 57.5- 73.5), previously treated with mesalazine and/or rifaximin (equally subdivided between DICA 2 and DICA 3). At 6-month follow-up, a significant reduction of all symptoms assessed was observed (abdominal pain and meteorism: p<0.001; constipation: p=0.007; diarrhea: p=0.009). Median (IQR) FC level was 244.5 (171.5- 322.0) μg/g at baseline and 51.0 (IQR: 35.5-61.5) μg/g (p< 0.001) after 6 months. No side effects were recorded., Conclusions: Treatment with budesonide MMXTM seems to be effective in obtaining symptoms' control and dropping of FC in patients with DD and not responding to standard treatments.
- Published
- 2019
- Full Text
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49. Course of the Diverticular Disease: What is changing?
- Author
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Milosavljeviĉ T, Brandimarte G, Stollman N, Barbara G, Lahat A, Scarpignato C, Lanas A, Papa V, Tursi A, and Nardone G
- Subjects
- Acute Disease, Colonoscopy, Diagnosis, Differential, Disease Progression, Diverticulitis etiology, Diverticulitis prevention & control, Humans, Irritable Bowel Syndrome diagnosis, Risk Factors, Secondary Prevention methods, Diverticular Diseases diagnosis
- Abstract
In this session several critical issues in diverticular disease were considered, including "It is Symptomatic Diverticular Disease or Irritable Bowel Syndrome?", "What do determine evolution to diverticulitis, bowel habits alteration or inflammation?", and "Prevention of acute diverticulitis: Is it at all possible?". The first talking compared symptoms and laboratory findings between Symptomatic Uncomplicated Diverticular Disease (SUDD) and Irritable Bowel Syndrome (IBS). Although both disease share some symptoms, and although IBS can occur in patients having diverticulosis, SUDD and IBS can be differentiate using a combination of symptoms and laboratory tools. The second talking debated what are the most important risk factors for the evolution towards acute diverticulitis. Current data seem to exclude a significant role of bowel habits alteration, while inflammation seems to have a stronger role, especially in causing acute diverticulitis recurrence. The third talking analyzed about the acute diverticulitis prevention. Primary prevention seem to be little better when using mesalazine, while no definite conclusion can be drawn about the use of fiber and rifaximin. About the secondary prevention, no drugs can be currently advised due to lacking of definite results. At the same time, surgery should be advised on case-by-case basis.
- Published
- 2019
- Full Text
- View/download PDF
50. No changes in Interleukin-10 expression in symptomatic uncomplicated diverticular disease of the colon.
- Author
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Tursi A, Mastromarino P, Capobianco D, Elisei W, Picchio M, and Brandimarte G
- Subjects
- Aged, Biomarkers metabolism, Diverticulosis, Colonic diagnosis, Feces chemistry, Female, Humans, Middle Aged, Retrospective Studies, Colon metabolism, Diverticulosis, Colonic metabolism, Interleukin-10 metabolism
- Published
- 2018
- Full Text
- View/download PDF
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