Publications by authors named "Sara Massironi"

Article Synopsis
  • * The only current treatment is a strict lifelong gluten-free diet, but adherence can be tough, boosting research into alternative therapies like enzymatic gluten breakdown and immune modulation.
  • * New pharmacologic strategies, including transglutaminase inhibitors and nanoparticle therapies, aim to improve patient outcomes and quality of life by shifting treatment from dietary restrictions to more flexible options.
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  • * The review identifies gaps in understanding the nutritional requirements of NEN patients and discusses how certain diets, like the Mediterranean or ketogenic diets, may positively influence NEN outcomes while emphasizing the importance of addressing micronutrient deficiencies.
  • * The conclusion highlights that nutritional management is crucial for improving the quality of life and survival in NEN patients, advocating for its integration into personalized cancer treatment plans.
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Background: Psychiatric disorders in patients with inflammatory bowel disease (IBD) represent a significant but uncertain facet of the disease, with unsolved questions regarding their overall magnitude, their impact on intestinal disease, and the whole burden of psychiatric manifestations.

Aim: This systematic review summarizes the evidence on the prevalence and impact of psychiatric disorders, including depression, anxiety, bipolar disorder (BD), and schizophrenia, among patients with IBD.

Methods: A systematic search across PubMed/MEDLINE, Embase, and Scopus databases from January 2010 to January 2023 was performed to identify relevant studies.

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  • Autoimmune gastritis (AIG) causes higher gastrin levels, leading to changes in the gastric mucosa and an increased risk of developing gastric polyps.
  • A study involving 612 AIG patients over a median of 4 years found that 36.3% developed gastric polyps, with various types identified, including inflammatory and adenomatous types, along with some cases of gastric neuroendocrine neoplasms (gNENs) and adenocarcinomas.
  • The findings highlight the need for regular endoscopic monitoring and histopathological assessments in AIG patients due to the significant risk of gastric polyps and related complications.
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  • Inflammatory bowel disease (IBD), which includes Crohn's disease and ulcerative colitis, is still challenging to treat, but new drug classes like sphingosine-1-phosphate (S1P) modulators and interleukin-23 (IL-23) inhibitors are showing promise in clinical trials up to 2024.
  • This review summarizes findings from these clinical trials, focusing on drugs such as ozanimod, etrasimod, and various IL-23 inhibitors, all of which have demonstrated effectiveness and safety in managing IBD.
  • Both S1P modulators and IL-23 inhibitors present strong potential for becoming key treatment options in IBD management, but more research is needed on
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  • The study aimed to analyze the clinical characteristics and gastric tumor risk in patients with autoimmune gastritis (AIG) across eight Italian hospitals, focusing on those with and without Helicobacter pylori infection.
  • A total of 1,598 AIG patients were assessed; findings indicated that those who were H. pylori-naive had a higher tendency for certain autoimmune conditions and significant family health history.
  • The overall incidence of gastric adenocarcinoma was low, but a notable percentage developed type 1 gastric neuroendocrine neoplasm (gNEN), especially in patients presenting with vitamin B12/iron deficiencies, suggesting these individuals should receive closer monitoring.
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  • * Specific hormones such as serotonin, gastrin, and glucagon, along with newer genomic and proteomic markers, are now playing a crucial role in accurately identifying functional NENs and enhancing diagnosis and monitoring.
  • * The review emphasizes the need for continued research to validate these markers in larger studies and develop standardized testing methods to improve patient outcomes in NEN treatment, despite existing challenges in standardization.
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Introduction: Neuroendocrine neoplasms (NENs) represent a complex group of tumors arising from neuroendocrine cells, characterized by heterogeneous behavior and challenging diagnostics. Despite advancements in medical technology, NENs present a major challenge in early detection, often leading to delayed diagnosis and variable outcomes. This review aims to provide an in-depth analysis of current diagnostic methods as well as the evolving and future directions of diagnostic strategies for NENs.

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Our aim was to investigate the clinical outcome of patients with well-differentiated gastric, duodenal, and rectal neuroendocrine tumors after treatment with incomplete endoscopic resection due to the finding of microscopic positive resection margins (R1). This is a retrospective analysis of consecutive patients with type 1 gastric, non-ampullary non-functioning duodenal, or rectal neuroendocrine neoplasms with positive R1 margins after endoscopic resection. The rate of tumor recurrence and progression-free survival were considered to be the study's main endpoints.

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Artificial intelligence (AI) is making significant strides in revolutionizing the detection of Barrett's esophagus (BE), a precursor to esophageal adenocarcinoma. In the research article by Tsai , researchers utilized endoscopic images to train an AI model, challenging the traditional distinction between endoscopic and histological BE. This approach yielded remarkable results, with the AI system achieving an accuracy of 94.

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The optimal management of duodenal neuroendocrine neoplasms (dNENs) sized 10-20 mm remains controversial and although endoscopic resection is increasingly performed instead of surgery, the therapeutic approach in this setting is not fully standardized. We performed a systematic review of the literature and a meta-analysis to clarify the outcomes of endoscopic resection for 10-20 mm dNENs in terms of efficacy (i.e.

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Background: Sarcopenia is prevalent in patients with inflammatory bowel disease (IBD) and impacts surgical and therapeutic outcomes; thus, effective diagnostic tools are needed to assess muscle mass and function in this population.

Methods: 153 consecutive patients were included, 100 in the training cohort and 53 in the study cohort. Three superficial muscles (rectus femoris = RF, rectus abdominis = RA, and biceps brachii = BB) were selected for the detection of sarcopenia using muscle ultrasound (US).

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Autoimmune pancreatitis (AIP) is an autoimmune subtype of chronic pancreatitis resulting from the aberrant immune response against the pancreas, leading to inflammation and fibrosis. Although AIP is rare, its incidence is increasing and is often misdiagnosed as other pancreatic diseases. AIP is commonly classified into two types.

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Intrahepatic cholangiocarcinoma (iCCA) is recognized as the second most frequently diagnosed liver malignancy, following closely after hepatocellular carcinoma. Its incidence has seen a global upsurge in the past several years. Unfortunately, due to the lack of well-defined risk factors and limited diagnostic tools, iCCA is often diagnosed at an advanced stage, resulting in a poor prognosis.

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The present paper reflects the position of the Italian Association for Neuroendocrine Tumors (Itanet), the Italian Society of Gastroenterology (SIGE), and the Italian Society of Digestive Endoscopy (SIED) regarding the management of patients affected by gastric, duodenal, and rectal neuroendocrine neoplasms (NENs) amenable to endoscopic treatment. The key questions discussed in this paper are summarized in Table 1. Data were extracted from the MEDLINE database through searches; expert opinions and recommendations are provided in accordance with the available scientific evidence and the authors' expertise.

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Article Synopsis
  • Neuroendocrine neoplasms (NENs) are rare tumors, and existing databases like SEER are outdated due to recent advancements in diagnostics and treatments, prompting the need for updated information.
  • In 2019, the Italian Association for Neuroendocrine Tumors (Itanet) launched a nationwide database to collect data on gastroenteropancreatic NENs from 37 Italian centers, focusing on details like age, diagnostics, tumor stage, and treatments.
  • By October 2023, the database has recorded data from 1,600 patients, with plans to reach 3,600 by the end of 2025, aiming to improve understanding of GEP-NENs and enhance patient
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Purpose Of Review: The incidence of celiac disease (CD) has increased over the last decades in part due to better disease awareness. Small bowel ultrasound (sb US) enables dynamic assessment of the bowel; although this topic has been addressed, the use of sb US in the diagnosis and in the follow-up of CD patients is limited to a few specialized tertiary referral centers. Herein, we aimed at summarizing the available literature on this topic to better define the potential clinical implications of sb US in CD, also through a comparison with other available diagnostic techniques.

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: Gastric neuroendocrine neoplasms (gNENs) represent rare but increasingly recognized tumors. They are distinguished into three main clinical types (type-1, type-2, and type-3) according to gastrin level and at histological evaluation in well-differentiated G1, G2, or G3 lesions, as well as poorly-differentiated lesions. Small type-1 and type-2 neoplasms with low proliferation indices demonstrated excellent survival without progression during an extended follow-up period, and for these reasons, active endoscopic observation or endoscopic resection are feasible options.

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Eosinophilic esophagitis (EoE) is a chronic inflammatory disease characterized by eosinophilic infiltration of the esophagus. It arises from a complex interplay of genetic predisposition (susceptibility loci), environmental triggers (allergens and dietary antigens), and a dysregulated immune response, mainly mediated by type 2 T helper cell (Th2)-released cytokines, such as interleukin (IL)-4, IL-5, and IL-13. These cytokines control eosinophil recruitment and activation as well as tissue remodeling, contributing to the characteristic features of EoE.

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Introduction: Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus with increasing prevalence worldwide. It is a multifactorial disease caused by a combination of immunologic, genetic, and environmental factors. The clinical presentation of EoE varies largely, especially between different age groups.

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