Publications by authors named "Gionchetti P"

Background: Nowadays, there is a clear need for new viable therapeutic options to face complex perianal Crohn's disease (PCD). Results of our previous pilot study demonstrated the efficacy and safety of local injection of autologous microfragmented adipose tissue (MFat) in this setting. This study aims to evaluate the long-term follow-up results in the same cohort of patients.

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  • Cytomegalovirus (CMV) colitis significantly worsens the prognosis for patients suffering from moderate-to-severe ulcerative colitis (UC), with a study identifying several risk factors related to its occurrence.
  • In a study of 135 hospitalized patients, CMV colitis was diagnosed in approximately 27.4% of cases, and those with CMV colitis had a higher age and comorbidity index, along with increased rates of steroid refractoriness and CMV-DNAemia.
  • Patients with CMV colitis were more likely to require colectomy within 30 days, highlighting the importance of early diagnosis and potential benefits of antiviral treatment, with the need for further research suggested to clarify CMV-DNA
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Background & Aims: Vedolizumab is indicated for the treatment of chronic pouchitis in the European Union. We assessed whether vedolizumab induced mucosal healing (MH) and if MH was associated with clinical improvements.

Methods: EARNEST, a randomized, double-blind, placebo-controlled study, evaluated vedolizumab efficacy and safety in adults with chronic pouchitis.

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  • The study investigates postoperative complications following ileocaecal resection in patients with Crohn's Disease, specifically focusing on intra-abdominal septic complications (IASCs) and severe POCs.
  • Analysis of 853 patients revealed significant rates of complications, with lower preoperative albumin levels and a history of cardiovascular diseases being key predictors of severe POCs.
  • The findings suggest that oral budesonide is linked to a higher risk of IASCs, indicating the need for careful evaluation of this medication before surgery.
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  • Spondyloarthritis (SpA), rheumatoid arthritis (RA), and inflammatory bowel diseases (IBD) are chronic autoimmune diseases linked to gut microbiota imbalances, known as dysbiosis, which may drive joint and spine inflammation.
  • Anti-TNF biologic drugs are effective treatments for these conditions and can help restore the disrupted microbiome, potentially providing dual benefits for intestinal and joint health.
  • Despite their effectiveness, many patients do not respond to anti-TNF therapy, and this review explores whether changes in the intestinal microbiota could be used to predict treatment outcomes.
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Background: Pan-enteric capsule endoscopy (PCE) provides useful information for the management of Crohn's disease (CD), especially in children. No study has evaluated the ability of PCE to characterize CD phenotypes and outcomes in children and adults.

Methods: In a prospective multicenter observational study, we recruited patients with CD >6 years from 4 centers in Italy.

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Background: COVID-19, whose causative pathogen is the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), was declared a pandemic in March 2020. The gastrointestinal tract is one of the targets of this virus, and mounting evidence suggests that gastrointestinal symptoms may contribute to disease severity. The gut-lung axis is involved in the immune response to SARS-CoV-2; therefore, we investigated whether COVID-19 patients' bacterial and fungal gut microbiome composition was linked to disease clinical outcome.

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  • The study aimed to identify poor prognostic factors related to pharmacokinetics that affect immune responses and disease control in inflammatory bowel disease (IBD) patients treated with infliximab or adalimumab.
  • It found that certain baseline clearance rates and genetic variants (HLA DQA1*05) significantly increase the likelihood of forming antidrug antibodies, which negatively impact remission rates.
  • Proactive therapeutic drug monitoring was shown to effectively mitigate these negative effects, especially when higher drug levels are maintained during treatment.
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Ectopic liver (EL) is a rare congenital anomaly characterized by the presence of a mass composed of hepatic tissue localized in a different anatomical location with no connection to the native liver. Usually an incidental finding, EL can rarely cause symptoms such as abdominal pain due to torsion, intraperitoneal bleeding, compression, obstruction, or neoplastic transformation, both benign and malignant. EL is often suspected after instrumental investigations such as ultrasound, CT and MRI, however a definitive diagnosis is necessarily bioptic.

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Crohn's disease (CD) is a chronic disorder of the digestive tract characterized by an uncontrolled immune-mediated inflammatory response in genetically predisposed individuals exposed to environmental risk factors. Although diet has been identified as one of the major environmental risk factors, the role of nutrients in the clinical management of CD patients has not yet been fully investigated. In this prospective observational study, fifty-four patients diagnosed with active Crohn's disease and undergoing anti-TNF-α biological therapy were enrolled and subjected to nutrient intake analysis through a daily food diary.

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  • - The study aimed to assess how effectively faecal calprotectin can differentiate between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), considering that their symptoms often overlap.
  • - Researchers reviewed data from 17 studies including nearly 2,000 patients, finding that faecal calprotectin had a sensitivity of 85.8% and specificity of 91.7%, indicating it can be a reliable diagnostic tool.
  • - The results showed that faecal calprotectin performed better in Western countries and at lower cut-off levels (≤50 μg/g), although most studies analyzed had a high risk of bias.
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Background: Crohn's disease and ulcerative colitis are inflammatory bowel diseases (IBDs) with a rapidly growing worldwide incidence. The last decades presented rapid progress in pharmacological treatment leading in many cases to clinical and endoscopic remission, including biological treatment with anti-TNF agents.

Aim: The exact timing of introduction, optimization and maintenance of anti-TNF therapy in IBDs is not thoroughly covered in current guidelines.

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  • The study aimed to determine if the clearance rate of adalimumab (ADA) is more crucial for treatment outcomes in Crohn's disease patients than the actual concentration of the drug in their system.
  • Results showed that patients achieving endoscopic remission had lower ADA clearance rates, while ADA concentration did not significantly differ between remission and recurrence cases.
  • The findings suggest that lower ADA clearance correlates with better clinical outcomes, indicating it might be a more effective measure for assessing treatment efficacy than drug concentration.
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Inflammatory bowel diseases comprise Crohn's disease and ulcerative colitis, two chronic inflammatory disorders of the digestive tract that develop in adolescence and early adulthood and show a rising pattern in industrialized societies, as well as in developing countries, being strongly influenced by environmental pressures such as nutrition, pollution and lifestyle behaviors. Here, we provide a narrative review of the bidirectional link between nutritional factors and IBD, of dietary deficits observed in IBD patients due to both the disease itself and dietary habits, and of the suggested nutritional interventions. Research of the literature was conducted.

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Background: Approximately half the patients with ulcerative colitis who undergo restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) will subsequently have pouchitis, and among those patients, one fifth will have chronic pouchitis.

Methods: We conducted a phase 4, double-blind, randomized trial to evaluate vedolizumab in adult patients in whom chronic pouchitis had developed after undergoing IPAA for ulcerative colitis. Patients were assigned (in a 1:1 ratio) to receive vedolizumab intravenously at a dose of 300 mg or placebo on day 1 and at weeks 2, 6, 14, 22, and 30.

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Background: Crohn's disease (CD) is an inflammatory, chronic disorder that alternates between a quiescent phase and inflammatory flare-ups. Research has begun to elucidate the impact of CD in modulating brain structure and function. The previous neuroimaging studies mainly involved CD patients in remission (CD-R); therefore, little is known about how inflammation influences brain-related features in different stages of the disease.

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Background: Anastomotic leak (AL) remains one of the most relevant complications after intestinal resection for Crohn's disease (CD). While surgery has always been considered the standard treatment for perianastomotic collection, percutaneous drainage (PD) has been proposed as a potential alternative.

Methods: Retrospective study in consecutive patients treated with either PD or surgery for AL after intestinal resection for CD between 2004 and 2022.

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Wrong dietary habits, such as the Western-style diet, are considered important risk factors for the development of Inflammatory Bowel Diseases (IBDs). Nevertheless, the role of dietary patterns in the clinical management of IBD patients has not been fully investigated yet. Fifty-four patients diagnosed with active Crohn's disease (CD) were enrolled and subjected to nutritional intake analysis through a weekly food diary.

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  • This study aimed to understand the long-term gastrointestinal effects and gut-brain interaction disorders in patients hospitalized for COVID-19 compared to those without the infection.
  • The analysis included data from 883 patients, revealing that gastrointestinal symptoms were more prevalent in COVID-19 patients during hospitalization, but by the 12-month follow-up, controls reported higher rates of constipation and hard stools.
  • Additionally, COVID-19 patients showed a significantly higher prevalence of irritable bowel syndrome (IBS) compared to controls, with certain factors like allergies and medication usage being associated with IBS diagnosis.
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Background: Crohn's disease (CD) is a potentially debilitating condition that burdens Italian healthcare substantially. The symptomatic management relies on prompt therapy adjustment to reduce flares and follow-up diagnostic inputs to maximise remission. Capsule endoscopy (CE) has introduced advantages in CD diagnostics, allowing the direct inspection of the entire gastrointestinal mucosa.

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Unlabelled: Geraniol is an acyclic monoterpene alcohol with well-known anti-inflammatory and antimicrobial properties which has shown eubiotic activity towards gut microbiota (GM) in patients with irritable bowel syndrome (IBS).

Methods: Fifty-six IBS patients diagnosed according to Rome III criteria were enrolled in an interventional, prospective, multicentric, randomized, double-blinded, placebo-controlled trial. In the treatment arm, patients received a low-absorbable geraniol food supplement (LAGS) once daily for four weeks.

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