Publications by authors named "Sandro Ardizzone"

Article Synopsis
  • Patients with Immune-Mediated Inflammatory Diseases (IMIDs) face a higher risk of cancer, although the reasons behind this link are still debated.
  • The review discusses how factors like environmental influences, genetics, and chronic inflammation contribute to both IMIDs and cancer development, focusing on mechanisms such as an inflammatory microenvironment and abnormal cell communication.
  • The authors emphasize the need for further research to address existing gaps in knowledge and improve patient care related to the connections between IMIDs and cancer.
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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.
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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.
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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.

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Article Synopsis
  • - Patients with Crohn's disease (CrD) have a higher risk of developing small bowel adenocarcinomas (SBAs), and a study found that IDH1 mutations, specifically the R132C variant, are present in about 20% of these cancers, more frequently than in sporadic SBAs.
  • - The study compared various features between IDH1-mutated and wild-type CrD-SBAs, revealing that the mutated cases had lower cytokeratin 7 expression, higher p53 overexpression, and increased MGMT methylation, indicating unique clinical characteristics.
  • - Despite the differences in tumor features, there was no significant difference in cancer-specific survival rates between patients with IDH1 mutations and those without
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Amyloidosis includes a heterogeneous group of diseases caused by the extracellular deposition of insoluble fibrillar proteins, leading to multiple organ dysfunction and a poor life expectancy. In the early stages of amyloidosis, gastrointestinal (GI) symptoms are uncommon. We describe a rare case of hereditary transthyretin amyloidosis (ATTRv) with involvement of the heart, nervous system and GI tract.

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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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Background: In Italy, the incidence of SARS-CoV-2 infection peaked in April and November 2020, defining two pandemic waves of coronavirus disease 2019 (COVID-19). This study compared the characteristics and outcomes of patients with inflammatory bowel disease (IBD) and SARS-CoV-2 infections between pandemic waves.

Methods: Observational longitudinal study of IBD patients with SARS-CoV-2 infection.

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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.

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Endoscopic procedures are performed more frequently in children due to technological advances that can be safely performed in an adequate setting with a support of a multidisciplinary team. Pediatric indications for ERCP (endoscopic retrograde cholangiopancreatography) and EUS (endoscopic ultrasound) occur mainly due to congenital malformations. In a pediatric case series, we report the application of EUS combined with duodenoscopy, eventually associated with ERCP and minimally invasive surgery, highlighting the importance of defining a tailored dedicated management pathway for each patient.

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Inflammatory bowel disease (IBD), which includes Crohn's disease (CD) and ulcerative colitis (UC), is a complex, immune-mediated, disorder which leads to several gastrointestinal and systemic manifestations determining a poor quality of life, disability, and other negative health outcomes. Our knowledge of this condition has greatly improved over the last few decades, and a comprehensive management should take into account both biological (i.e.

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Introduction: To evaluate the ability of intestinal ultrasound (IUS) in discriminating symptomatic uncomplicated diverticular disease (SUDD) among patients with abdominal symptoms including irritable bowel syndrome (IBS).

Methods: This observational, prospective study included consecutive patients classified into the following categories: (i) SUDD; (ii) IBS; (iii) unclassifiable abdominal symptoms; and (iv) controls, including asymptomatic healthy subjects and diverticulosis. The IUS evaluation of the sigmoid: assessed the presence of diverticula, thickness of the muscularis propria, and IUS-evoked pain, namely the intensity of pain evoked by compression with the ultrasound probe on sigmoid colon compared with an area of the left lower abdominal quadrant without underlying sigmoid colon.

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Patients with chronic inflammatory bowel diseases (IBD) have increased risk of developing intestinal and extraintestinal cancers. However, once a diagnosis of malignancy is made, the therapeutic management of Crohn's disease (CD) and ulcerative colitis (UC) can be challenging as major guidelines suggest discontinuing the ongoing immunosuppressant and biological therapies for at least 2-5 years after the end of cancer treatment. Recently, new molecules such as vedolizumab and ustekinumab have been approved for IBD and limited data exist on the real risk of new or recurrent cancer in IBD patients with prior cancer, exposed to immunosuppressants and biologic agents.

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Article Synopsis
  • A study compared the effectiveness of four biologic drugs—adalimumab, infliximab biosimilar, golimumab, and vedolizumab—used to treat ulcerative colitis (UC) in Italy, focusing on achieving continuous clinical remission (CCR).
  • Researchers analyzed data from 416 UC patients treated from 2014 to 2019, measuring success based on a strict CCR definition over one year.
  • Results showed similar CCR rates among the four drugs, with vedolizumab proving more effective for patients who had previously failed anti-TNFα treatments, while safety profiles were comparable across all drugs.
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Introduction: Patients with inflammatory bowel disease (IBD) have a high risk of developing extra-intestinal manifestations (EIMs). We aimed to assess the cumulative incidence and clinical course of EIMs in patients treated with Vedolizumab (VDZ) and non-gut selective biologic drugs.

Materials And Methods: In this multicenter observational study, we enrolled 1,182 patients with IBD under biologic treatment in tertiary care centers, collecting the rate of new-onset EIMs and the clinical course of new and pre-existing EIMs since the introduction of the ongoing biologic drug (259 VDZ vs.

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Background: The extent of resection in colonic Crohn's disease [cCD] is still a topic of debate, depending on the number of locations, the risk of recurrence and permanent stoma, and the role of medical therapy.

Methods: The Segmental COlecTomy for CroHn's disease [SCOTCH] international study is a retrospective analysis on six tertiary centre prospective databases, comprising all consecutive, unselected patients operated on between 2000 and 2019 with segmental colectomy [SC] or total colectomy [TC] for cCD. The primary aim was long-term surgical recurrence.

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Intestinal tuberculosis (ITB) represents an important diagnostic challenge in the clinical setting, as it generally can occur as a chronic condition often mimicking other diseases such as Crohn's disease (CD), and can present itself with acute onset, which can be life-threatening. A 29-years-old Chinese woman coming to ER with abdominal pain, fever and weight loss. Computed tomography and colonoscopy images were not diagnostic.

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The main goals of Ulcerative Colitis (UC) treatment are to both induce and maintain the clinical and endoscopic remission of disease, reduce the incidence of complications such as dysplasia and colorectal carcinoma and improve quality of life. Although a curative medical treatment for UC has not yet been found, new therapeutic strategies addressing specific pathogenetic mechanisms of disease are emerging. Notwithstanding these novel therapies, non-biological conventional drugs remain a mainstay of treatment.

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Some evidence suggests a reduction in clinical and surgical recurrence after mesenteric resection in Crohn's Disease (CD). The aim of the REsection of the MEsentery StuDY (Remedy) was to assess whether mesenteric removal during surgery for ileocolic CD has an impact in terms of postoperative complications, endoscopic and ultrasonographic recurrences, and long-term surgical recurrence. Among the 326 patients undergoing primary resection between 2009 and 2019 in two referral centers, in 204 (62%) the mesentery was resected (Group A) and in 122 (38%) it was retained (Group B).

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From 30 to 70% of patients with Crohn's disease (CD) may develop perianal fistulas during their lifetime. The medical and surgical management of this complication is challenging, and its treatment still gives unsatisfactory results. However, recent studies on adipose-derived mesenchymal stem cells have proven their anti-inflammatory and immuno-modulatory potential, representing a new promising tool in the treatment of such stubborn disease.

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Background/aims: The coronavirus disease 2019 (COVID-19) outbreak has modified the activities of endoscopy units worldwide. Herein, we investigated the impact of the COVID-19 outbreak on anesthesiologist assistance for endoscopic procedures in Lombardy, Italy.

Methods: A questionnaire concerning anesthesiologist assistance provided from October 26 to December 6, 2020, in comparison with the same period in 2019, was sent to endoscopic units in Lombardy.

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