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Book ; Online: Gluten-Free Diet

Elli, Luca

2019

Abstract: In the last few years, an increasing number of individuals have adopted a gluten free diet (GFD). A significant proportion of that includes patients affected by celiac disease (CD), who have to follow a strict GFD for medical purposes. However, a high ... ...

Abstract	In the last few years, an increasing number of individuals have adopted a gluten free diet (GFD). A significant proportion of that includes patients affected by celiac disease (CD), who have to follow a strict GFD for medical purposes. However, a high number of individuals are currently following a GFD without medical counseling and without a specific diagnosis needing a gluten withdrawal from the diet. This is due to the frequently incorrect information diffused on the Internet and mass media on the topic of GFD. For these reasons, research on the GFD and its clinical use and biological effects is urgently needed
Keywords	Medicine (General) ; Nutritional diseases. Deficiency diseases
Size	1 electronic resource (318 p.)
Publisher	MDPI - Multidisciplinary Digital Publishing Institute
Document type	Book ; Online
Note	eng ; Open Access
HBZ-ID	HT020103076
ISBN	9783038977360 ; 9783038977377 ; 3038977365 ; 3038977373
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Author's reply: "Time is over: step back to reusable and step forward to recyclable!"

Sorge, Andrea / Elli, Luca

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2023 Volume 55, Issue 8, Page(s) 1152

Language	English
Publishing date	2023-06-09
Publishing country	Netherlands
Document type	Letter ; Comment
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2023.05.020
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Article ; Online: Past, present and future of non-invasive tests to assess gluten exposure, celiac disease activity, and end-organ damage.

Silvester, Jocelyn A / Elli, Luca / Khosla, Chaitan / Tye-Din, Jason

Gastroenterology

2024

Abstract: Although many biomarkers have been proposed and several are in widespread clinical use, there is no single readout or combination of readouts that correlates tightly with gluten exposure, disease activity or end-organ damage in treated celiac disease ... ...

Abstract	Although many biomarkers have been proposed and several are in widespread clinical use, there is no single readout or combination of readouts that correlates tightly with gluten exposure, disease activity or end-organ damage in treated celiac disease patients. Challenges to developing and evaluating better biomarkers include significant interindividual variability related to immune amplification of gluten exposure and how effects of immune activation are manifest. Furthermore, the current "gold standard" for assessment of end-organ damage, small intestinal biopsy, is itself highly imperfect, such that a marker that is actually a better reflection of the "ground truth" may indeed appear to perform poorly. The goal of this review is to review past and present efforts to establish robust non-invasive tools for monitoring treated celiac disease patients and to highlight emerging tools that may prove to be useful in clinical practice.
Language	English
Publishing date	2024-04-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	80112-4
ISSN	1528-0012 ; 0016-5085
ISSN (online)	1528-0012
ISSN	0016-5085
DOI	10.1053/j.gastro.2024.01.053
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Article ; Online: Clinical practices and adherence to guidelines for eosinophilic esophagitis: A European survey.

Sorge, Andrea / Coletta, Marina / Elli, Luca / Bredenoord, Albert J

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver

2024

Abstract: Background: We aimed to assess the clinical practices and adherence to guidelines for adult Eosinophilic Esophagitis (EoE) patients in Europe.: Methods: A cross-sectional web survey containing 23 questions was distributed to members of the European ... ...

Abstract	Background: We aimed to assess the clinical practices and adherence to guidelines for adult Eosinophilic Esophagitis (EoE) patients in Europe. Methods: A cross-sectional web survey containing 23 questions was distributed to members of the European Consortium for Eosinophilic Diseases of the Gastrointestinal Tract (EUREOS) and the Italian Association of Hospital Gastroenterologists and digestive endoscopists (AIGO). We conducted a subgroup analysis to assess the impact of EoE expertise and practice setting on clinical practices. Results: 228 physicians from 18 European countries participated. Adherence to guidelines varied from 72% to 98.6%. 83.4% of total respondents obtained ≥ 6 esophageal biopsies in suspected EoE. 42% of total respondents, 82.5% of EoE experts (vs. non-experts 33%; P < 0.0001), and 55% of academics (vs. 29.1 non-academics; P < 0.0001) routinely used the EREFS score. Regarding first-line therapy, 82.9% of total respondents prescribed proton pump inhibitors, 41.6% topical steroids, 20.6% elimination diets, and 9.2% combination therapies. Only 72% of respondents used symptoms and endoscopy with <15 Eosinophils/HPF to define treatment response. 21.5% of all respondents did not prescribe maintenance therapies and 12.7% discontinued therapy before response evaluation endoscopy. Conclusion: Our findings revealed significant heterogeneity in practice patterns and suboptimal adherence to EoE guidelines across Europe. Expertise in EoE and working in an academic hospital positively influenced clinical practices and adherence to guidelines.
Language	English
Publishing date	2024-01-29
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1459373-7
ISSN	1878-3562 ; 1125-8055
ISSN (online)	1878-3562
ISSN	1125-8055
DOI	10.1016/j.dld.2023.12.011
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Article ; Online: Thalidomide for Bleeding from Small-Intestinal Angiodysplasia.

Topa, Matilde / Pessarelli, Tommaso / Elli, Luca

The New England journal of medicine

2023 Volume 390, Issue 5, Page(s) 479

MeSH term(s)	Humans ; Thalidomide/adverse effects ; Hemorrhage/chemically induced ; Angiogenesis Inhibitors/therapeutic use ; Intestine, Small/diagnostic imaging ; Angiodysplasia/complications ; Angiodysplasia/drug therapy
Chemical Substances	Thalidomide (4Z8R6ORS6L) ; Angiogenesis Inhibitors
Language	English
Publishing date	2023-10-31
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMc2314599
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Article ; Online: Serotonin syndrome: A pharmacovigilance comparative study of drugs affecting serotonin levels.

Elli, Chiara / Novella, Alessio / Pasina, Luca

European journal of clinical pharmacology

2023 Volume 80, Issue 2, Page(s) 231–237

Abstract: Background: Serotonin syndrome is a rare and potentially fatal adverse drug reaction caused by serotonergic drugs and is due to an increase in serotonin concentration or activation of the 5-HT receptor in the central nervous system. We analysed adverse ... ...

Abstract	Background: Serotonin syndrome is a rare and potentially fatal adverse drug reaction caused by serotonergic drugs and is due to an increase in serotonin concentration or activation of the 5-HT receptor in the central nervous system. We analysed adverse events in the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) data set to investigate the main drug classes related to reports of serotonin syndrome and the reporting risk in relation to age and sex. Methods: We analysed data from the FAERS database to evaluate the main drug classes related to reports of the serotonin syndrome, and the reporting risk in relation to age and sex. Results: We found 8,997 cases of serotonin syndrome; selective serotonin reuptake inhibitors (SSRIs) was the class of drugs with most reports, followed by opioids and other antidepressants. The highest Reporting Odds Ratios (ROR) for drug classes was for monoamine oxidase (MAO) inhibitors (45.99, 95% confidence interval (CI): 41.21-51.33) and SSRIs (32.66, 95% CI: 31.33-34.04), while the ten active substances with the highest ROR were moclobemide, isocarboxazid, oxitriptane, tranylcypromine, melitracen, phenelzine, linezolid, amoxapine, reboxetine and tryptophan; with values of ROR ranging from 44.19 (95% CI: 25.38-76.94) of tryptophan to 388.36 (95% CI: 314.58-479.46) of moclobemide. The ROR for the most commonly involved drugs was higher in the group of older adults (65 > years old), and higher in males. Conclusion: Prescribers need to be vigilant about drugs that can raise serotonin concentration or influence serotonergic neurotransmission, also when using drugs with less well-known risk for serotonin syndrome, like linezolid and triptans.
MeSH term(s)	Male ; Humans ; Aged ; United States ; Serotonin Syndrome/chemically induced ; Serotonin Syndrome/epidemiology ; Serotonin ; Selective Serotonin Reuptake Inhibitors/adverse effects ; Pharmaceutical Preparations ; Pharmacovigilance ; Moclobemide ; Linezolid ; Tryptophan ; Monoamine Oxidase Inhibitors/adverse effects ; Adverse Drug Reaction Reporting Systems ; United States Food and Drug Administration
Chemical Substances	Serotonin (333DO1RDJY) ; Selective Serotonin Reuptake Inhibitors ; Pharmaceutical Preparations ; Moclobemide (PJ0Y7AZB63) ; Linezolid (ISQ9I6J12J) ; Tryptophan (8DUH1N11BX) ; Monoamine Oxidase Inhibitors
Language	English
Publishing date	2023-11-30
Publishing country	Germany
Document type	Journal Article
ZDB-ID	121960-1
ISSN	1432-1041 ; 0031-6970
ISSN (online)	1432-1041
ISSN	0031-6970
DOI	10.1007/s00228-023-03596-z
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Article ; Online: Anticholinergic Burden and Cognitive Impairment in Nursing Homes: A Comparison of Four Anticholinergic Scales.

Novella, Alessio / Elli, Chiara / Ianes, Aladar / Pasina, Luca

Drugs & aging

2023 Volume 40, Issue 11, Page(s) 1017–1026

Abstract: Background: Medications with anticholinergic effects are commonly used in nursing homes, and their cumulative effect is of particular concern for the risk of adverse effects on cognition.: Objective: The relation between cognitive function and ... ...

Abstract	Background: Medications with anticholinergic effects are commonly used in nursing homes, and their cumulative effect is of particular concern for the risk of adverse effects on cognition. Objective: The relation between cognitive function and anticholinergic burden measured with four scales, the Anticholinergic Cognitive Burden (ACB) Scale, the Anticholinergic Risk Scale, the German Anticholinergic Burden Scale, and the CRIDECO Anticholinergic Load Scale, is assessed according to the hypothesis that a higher anticholinergic burden is associated with reduced cognitive performance. Methods: This retrospective cross-sectional multicenter study was conducted in a sample of Italian long-term-care nursing homes (NH). Sociodemographic details, diagnosis, and drug treatments of each NH resident were collected using medical records four times during 2018 and 2019. Cognitive status was rated with the Mini-Mental State Examination (MMSE). The prevalence of anticholinergic use and its burden were calculated referring to the last time point for each patient. A longitudinal analysis was done on NH residents with at least two MMSE between 2018 and 2019 to assess the relation between the anticholinergic load and decline in MMSE. The relationship between drug-related anticholinergic burden and cognitive performance was analyzed using Poisson regression model theory. Multivariate analyses were adjusted according to the known risk factors of reduced cognitive performance available [age, sex, history of stroke or transient ischemic attack (TIA), and number of non-anticholinergic drugs] and for cholinesterase inhibitors. In view of the high number of subjects with an MMSE score = 0 among residents with dementia, for this group a zero-inflated Poisson regression model was used to give more consistent results. The association of anticholinergic burden with mortality was examined from each patient's last visit using a multivariate logistic model adjusted for age, sex, and Charlson Comorbidity Index (CCI). Results: Among 1412 residents recruited, a clear direct relationship was found between higher anticholinergic burden and cognitive impairment only for the Anticholinergic Cognitive Burden Scale. Residents taking an anticholinergic who scored 5 or more had 2.5 points more decline than those not taking them (p < 0.001). Among residents without dementia there was a trend toward direct relationship for the Anticholinergic Cognitive Burden Scale and the Anticholinergic Risk Scale. Residents with higher scores had about 2 points more decline than residents not taking anticholinergic drugs. No relation was found between anticholinergic burden and cognitive decline or mortality. Conclusions: The cumulative effect of medications with modest antimuscarinic activity may influence the cognitive performance of NH residents. The anticholinergic burden measured with the ACB scale should help identify NH residents who may benefit from reducing the anticholinergic burden. A clear direct relationship between anticholinergic burden and cognitive impairment was found only for the ACB Scale.
MeSH term(s)	Humans ; Cholinergic Antagonists/adverse effects ; Retrospective Studies ; Cross-Sectional Studies ; Cognitive Dysfunction/chemically induced ; Cognitive Dysfunction/epidemiology ; Cognitive Dysfunction/drug therapy ; Nursing Homes ; Dementia/chemically induced ; Dementia/epidemiology ; Dementia/drug therapy
Chemical Substances	Cholinergic Antagonists
Language	English
Publishing date	2023-08-24
Publishing country	New Zealand
Document type	Multicenter Study ; Journal Article
ZDB-ID	1075770-3
ISSN	1179-1969 ; 1170-229X
ISSN (online)	1179-1969
ISSN	1170-229X
DOI	10.1007/s40266-023-01058-w
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Undiagnosed cognitive impairment in older adults hospitalized in internal medicine wards: Data from the REPOSI registry.

Agosti, Pasquale / Novella, Alessio / Custodero, Carlo / Elli, Chiara / Pasina, Luca

European journal of internal medicine

2023 Volume 117, Page(s) 129–133

MeSH term(s)	Humans ; Aged ; Internal Medicine ; Hospitalization ; Hospitals ; Cognitive Dysfunction/diagnosis ; Cognitive Dysfunction/epidemiology ; Registries
Language	English
Publishing date	2023-08-04
Publishing country	Netherlands
Document type	Letter
ZDB-ID	1038679-8
ISSN	1879-0828 ; 0953-6205
ISSN (online)	1879-0828
ISSN	0953-6205
DOI	10.1016/j.ejim.2023.07.030
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Article: The low-FODMAP diet and the gluten-free diet in the management of functional abdominal bloating and distension.

Pessarelli, Tommaso / Sorge, Andrea / Elli, Luca / Costantino, Andrea

Frontiers in nutrition

2022 Volume 9, Page(s) 1007716

Abstract: This review summarizes current knowledge on the role of low-FODMAP diet and gluten-free diet in functional abdominal bloating and distension, an emerging disorder of gut-brain interaction characterized by remarkable costs for healthcare systems and a ... ...

Abstract	This review summarizes current knowledge on the role of low-FODMAP diet and gluten-free diet in functional abdominal bloating and distension, an emerging disorder of gut-brain interaction characterized by remarkable costs for healthcare systems and a significant impact on the patient's quality of life. Ingested food plays a key role in the pathophysiology of disorders of gut-brain interaction as up to 84% of patients with irritable bowel syndrome (IBS) report food-triggered symptoms. Potential pathogenetic mechanisms of food-related symptoms in these patients are discussed, focusing on bloating and abdominal distension. These mechanisms provide the rationale for dietary treatment in patients with functional abdominal bloating and distension. The role of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) and gluten in functional abdominal bloating and distension is examined. Current literature evaluating the efficacy of the low-FODMAP diet and the gluten-free diet in abdominal bloating and distension is analyzed. Available evidence originates mainly from studies on patients with IBS, since clinical studies on selected cohorts of patients with only functional abdominal bloating and distension have been missing to date. Promising evidence on the potential efficacy of the low-FODMAP diet in functional abdominal bloating and distension is provided by the reduction of the bloating observed in patients with IBS. Regarding the gluten-free diet, there is insufficient evidence to recommend it to reduce bloating and abdominal distension. In conclusion, this review asserts the need for a close collaboration with experts in nutrition to optimize the management of these patients and reduce the risks associated with elimination diets.
Language	English
Publishing date	2022-11-08
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2776676-7
ISSN	2296-861X
ISSN	2296-861X
DOI	10.3389/fnut.2022.1007716
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Article ; Online: Biomarkers for the diagnosis and monitoring of celiac disease: can you count on me?

Topa, Matilde / Sanders, David Surendran / Elli, Luca

Current opinion in gastroenterology

2022 Volume 38, Issue 3, Page(s) 263–269

Abstract: Purpose of review: Different markers are available to diagnose and monitor celiac disease (CeD); however, the concordance among them and their efficacy are still controversial. We aim at defining the efficacy of CeD biomarkers, their advantages and ... ...

Abstract	Purpose of review: Different markers are available to diagnose and monitor celiac disease (CeD); however, the concordance among them and their efficacy are still controversial. We aim at defining the efficacy of CeD biomarkers, their advantages and limits. Recent findings: CeD diagnostic criteria are widely accepted, being a positive serology and duodenal atrophy (according to the Marsh-Oberhuber score) the main hallmarks. Flow cytometry and other molecular biomarkers support the diagnosis of refractory CeD. On the other side, CeD monitoring is less defined, as the biomarkers are not always reliable. To date, the reference standard to detect mucosal healing is represented by duodenal histology, but its timing and significance are debated. Novel scores may better define the trend of mucosal damage and MicroRNAs are among the innovative noninvasive biomarkers. The assessment of a correct gluten-free diet (GFD) is another aspect of CeD monitoring, based upon questionnaires and recently developed tools such as dosage of urinary or faecal gluten immunogenic peptides. Summary: Clinicians lack of a widely acknowledged tools to monitor CeD and GFD. Here, we present the efficacy of the most used markers.
MeSH term(s)	Biomarkers ; Celiac Disease/diagnosis ; Diet, Gluten-Free/methods ; Duodenum/pathology ; Glutens ; Humans
Chemical Substances	Biomarkers ; Glutens (8002-80-0)
Language	English
Publishing date	2022-02-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	632571-3
ISSN	1531-7056 ; 0267-1379
ISSN (online)	1531-7056
ISSN	0267-1379
DOI	10.1097/MOG.0000000000000825
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