Publications by authors named "Giovanni Maconi"
Ustekinumab (UST) is an interleukin-12/interleukin-23 receptor antagonist approved for the treatment of Crohn's disease (CD). Only limited real-life data on the long-term outcomes of CD patients treated with UST are available. This study assessed UST's long-term effectiveness and safety in a large population-based cohort of moderate to severe CD patients.
View Article and Find Full Text PDFBackground: It is known that the subcutaneous (SC) route administration of biologic drugs has several potential benefits for patient and the healthcare system. Since few real-world data are available yet about the rate of transition from intravenous (IV) to SC Vedolizumab (VDZ) in the Italian population, we assessed this rate in a large cohort of inflammatory bowel disease (IBD) patients under remission receiving IV VDZ as standard of care in a real-world setting.
Methods: Searching who was asked to switch from IV VDZ To SC VDZ, and assessing the rate of acceptance.
Background: Diagnostic imaging using CT enterography, magnetic resonance enterography, and intestinal ultrasound are important tools in evaluating stricturing Crohn's disease. Definitions of strictures have been developed for CT enterography and magnetic resonance enterography. However, expert recommendations for definitions and treatment response of strictures on intestinal ultrasound are not available.
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- - Gastrointestinal complications are common in systemic sclerosis (SSc) and may be linked to autoimmune factors and blood vessel damage, but the exact causes are unclear.
- - The study examined the small blood vessels in the abdomen of SSc patients using Doppler Ultrasound to explore their relationship with GI symptoms and disease progression.
- - Results showed differences in blood flow measurements between types of SSc and found significant correlations between blood vessel function and GI symptoms like fecal incontinence.
Gastro-intestinal ultrasound (GIUS) is a non-invasive and cost-effective tool, widely used as a first-line diagnostic method in patients presenting with abdominal complaints, especially in patients affected by inflammatory bowel disease (IBD), such as Crohn's disease and ulcerative colitis. In this setting, gastro-intestinal ultrasound has been especially used to evaluate the bowel wall features (thickening, stratification, vascularization) and complications related to IBD (fistulas, abscesses). Nevertheless, gastro-intestinal ultrasound can be also used to detect and evaluate the content of several segments of the gut.
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- The study looked at patients with diverticular disease (DD) and how their bowel movements, like constipation and diarrhea, relate to the seriousness of their condition.
- Researchers measured the severity using different tools and checked how changes in bowel habits might predict future health problems.
- They found that people with worse constipation or diarrhea had more severe DD and were more likely to develop a serious illness called acute diverticulitis over three years.
Article Synopsis
- There is a wealth of ideas in both mainstream and alternative medicine regarding diet's role in treating or preventing illnesses, but our understanding of how dietary changes affect the gastrointestinal (GI) tract is still limited.
- The review focuses on understanding "leaky gut syndrome" through better testing of intestinal barrier function, stressing the need to consider its dynamic nature and the effects of stressors.
- It also highlights the potential of intestinal ultrasound as a tool for assessing GI function and structure in real-time, particularly concerning gut-brain interactions, paving the way for improved dietary strategies in personalized healthcare.
Article Synopsis
- The study investigates factors affecting transmural healing in Crohn's disease patients on anti-TNF therapy who have been in clinical remission for over a year.
- It involved 68 patients, with assessments of clinical features, anti-TNF drug levels, and ultrasound findings to determine correlations with bowel wall thickening.
- Results highlighted that higher BMI and lower bowel wall thickening at baseline were linked to transmural healing, while low drug levels and strictures were associated with treatment non-response.
Article Synopsis
- - The study investigates the effectiveness of Narrow Band Imaging (NBI) for identifying lesions in ulcerative colitis (UC) using three different classification systems: NICE, Kudo, and the modified Kudo-IBD.
- - Results showed disparities in diagnostic performance, with Kudo-IBD achieving the highest sensitivity (86%) and specificity (79%), indicating its superiority for UC lesion characterization compared to NICE and Kudo classifications.
- - The findings suggest that while NBI's overall diagnostic accuracy for distinguishing between neoplastic and non-neoplastic lesions in UC is generally low, the modified Kudo classification significantly improves this accuracy.
Background: Tofacitinib is an oral Janus kinase inhibitor recently approved to induce and maintain remission in ulcerative colitis (UC).
Aims: Considering the number of anti-TNF non-responders, this study aims to assess the effectiveness and safety of tofacitinib in a cohort of multi-failure patients with moderate-to-severe UC at 52 weeks.
Methods: From January 2021 to March 2023, we performed a prospective multicenter study observing adult patients with moderate-to-severe UC starting tofacitinib after an anti-TNF failure for a 52-week-long period.
Background: Stricturing Crohn's disease (CD) occurs most commonly in the terminal ileum and poses a clinical problem. Cross-sectional imaging modalities such as intestinal ultrasound (IUS), computed tomography enterography (CTE), and magnetic resonance enterography (MRE) allow for assessment of the entire bowel wall and associated peri-enteric findings. Radiologic definitions of strictures have been developed for CTE and MRE; their reliability and responsiveness are being evaluated in index development programs.
View Article and Find Full Text PDFBackground And Aims: Intestinal ultrasonography (IUS) is challenging to learn. This prospective study examined how the accuracy of IUS increases with operator experience ("learning curve") and if prior abdominal ultrasound experience facilitates the learning process.
Methods: The study included two trainees with limited abdominal ultrasound experience (< 50 exams) and two with extensive experience (> 500 exams).
Purpose: Colonic pseudopolyps are a frequent finding in inflammatory bowel disease (IBD). Yet there are no published data describing the characteristics of pseudopolyposis in intestinal ultrasound (IUS). This study aimed at identifying the key features of pseudopolyposis in IUS.
View Article and Find Full Text PDFBackground: Ustekinumab (UST) is an interleukin-12/interleukin-23 receptor antagonist recently approved for treating ulcerative colitis (UC) but with limited real-world data. Therefore, we evaluated the effectiveness and safety of UST in patients with UC in a real-world setting.
Research Design And Methods: This is a multicenter, retrospective, observational cohort study.
Intestinal ultrasound, an underutilized tool for assessing colonic motility.
Am J Physiol Gastrointest Liver Physiol
January 2024
Introduction: Accessory spleen is a congenital defect characterised by a separated ectopic splenic parenchyma usually located in the splenic hilum and the tail of the pancreas. It is present in about 10%-30% of the population and, generally, does not cause any symptoms.
Case Report: We report an interesting case of a woman with symptomatic intramesenteric accessory spleen detected and characterised by contrast-enhanced ultrasound.
Chios mastic gum, the product of the tree var. , has been used for more than 2500 years in traditional Greek medicine for treating several diseases, thanks to the anti-inflammatory and antioxidant properties of its components. Despite the long-time use of mastic in gastroenterology and in particular in chronic-inflammation-associated diseases, to date, the literature lacks reviews regarding this topic.
View Article and Find Full Text PDFBackground 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.
Purpose: Intestinal ultrasound (IUS) is widely used as the first exam in patients with suspected inflammatory bowel disease (IBD). This study investigated the accuracy of several IUS parameters, including increased bowel wall thickening (BWT), in detecting IBD in a paediatric population.
Methods: The study included an unselected series of 113 patients aged 2-18 years (mean age 10.
The majority of patients affected by Crohn's disease (CD) develop a chronic condition with persistent inflammation and relapses that may cause progressive and irreversible damage to the bowel, resulting in stricturing or penetrating complications in around 50% of patients during the natural history of the disease. Surgery is frequently needed to treat complicated disease when pharmacological therapy failes, with a high risk of repeated operations in time. Intestinal ultrasound (IUS), a non-invasive, cost-effective, radiation free and reproducible method for the diagnosis and follow-up of CD, in expert hands, allow a precise assessment of all the disease manifestations: Bowel characteristics, retrodilation, wrapping fat, fistulas and abscesses.
View Article and Find Full Text PDFBackground: Data regarding the real-world (RW) use of tofacitinib (TOF) in patients with ulcerative colitis (UC) are limited. We aimed to investigate TOF's RW efficacy and safety in Italian UC patients.
Research Design And Methods: A retrospective assessment of clinical and endoscopic activity was performed according to the Mayo score.