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  1. Article ; Online: "Per ELISA": Time to adopt anti-transglutaminase/deamidated gliadin peptide diagnostic combination in coeliac disease of adults?

    Rispo, Antonio / Calabrese, Giulio / Toro, Benedetta / Olmo, Oriana / Ricciolino, Simona / Cantisani, Nicola Mattia / Limansky, Lara / Giaquinto, Miriam / Caso, Rossella / Imperatore, Nicola

    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: Anti-endomysial antibodies (EMA) and anti-tissue transglutaminases (a-tTg) play a pivotal role in coeliac disease (CD) diagnosis. Deamidated anti-gliadin peptides (DGP) were added to the CD diagnostic workup.: Aims: We aimed to compare ... ...

    Abstract Background: Anti-endomysial antibodies (EMA) and anti-tissue transglutaminases (a-tTg) play a pivotal role in coeliac disease (CD) diagnosis. Deamidated anti-gliadin peptides (DGP) were added to the CD diagnostic workup.
    Aims: We aimed to compare the diagnostic accuracies of ELISA-based (a-tTg/DGP) and immunofluorescence-ELISA-based strategies (EMA/a-tTg) for CD diagnosis.
    Methods: From November 2020 to November 2022, we undertook an observational prospective study including consecutive adult patients with suspected CD. All subjects were tested for EMA, a-tTg and DGP IgA. An ROC curve was plotted to establish the best specificity cut-off of a-tTg and DGP levels, which would predict the presence of Marsh≥2 and Marsh=3. The diagnostic accuracies of a-tTg/DG and EMA/a-tTg were compared.
    Results: The study included 275 CD patients. Histology showed Marsh=1 in 9.9%, Marsh=2 in 4.5%, and Marsh=3 in 85.6.%. The best cut-off value of a-tTg for predicting Marsh≥2 was 42 U/mL, while the best cut-off for predicting atrophy was 68.4 U/mL. The best cut-off value of DGP for predicting Marsh≥2 was 56 U/mL, while the best cut-off for predicting atrophy was 78 U/mL. A-tTg/EMA showed 97% sensitivity and 100% specificity, whereas a-tTg/DGP showed 94% sensitivity and 100% specificity.
    Conclusion: A-tTg/DGP is accurate for CD diagnosis and could reduce costs and operator-dependency of EMA. DGP, together with a-tTg, could replace EMA in CD diagnosis.
    Language English
    Publishing date 2024-03-26
    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.2024.03.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1134: Show issues Location:
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  2. Article ; Online: "The crackers challenge": A reassuring low-dose gluten challenge in adults on gluten-free diet without proper diagnosis of coeliac disease.

    Rispo, Antonio / Guarino, Alessia Dalila / Siniscalchi, Monica / Imperatore, Nicola / Santonicola, Antonella / Ricciolino, Simona / de Sire, Roberto / Toro, Benedetta / Cantisani, Nicola Mattia / Ciacci, Carolina

    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: Gluten-free diet (GFD) is the one therapy in coeliac disease (CeD). Unfortunately, some patients adopt GFD before the diagnostic work-up. The guidelines suggest a 14-day gluten intake > 3 gr to get CeD diagnosis, although many subjects ... ...

    Abstract Background: Gluten-free diet (GFD) is the one therapy in coeliac disease (CeD). Unfortunately, some patients adopt GFD before the diagnostic work-up. The guidelines suggest a 14-day gluten intake > 3 gr to get CeD diagnosis, although many subjects refuse this approach. Other evidence showed that the intake of 50 mg/day of gluten for 3 months could be useful for CeD diagnosis.
    Aims: We performed a dietary study, administering a low dose of gluten in form of "crackers" (about 60-120 mg of gluten/day) for 3 months, to get a final diagnosis of CeD in subjects already on GFD.
    Methods: We enrolled adult patients with a suspicion of CeD on self-prescribed GFD. All subjects performed the crackers challenge for 3 months. At the end, all patients were analysed for CeD serology and if positive underwent endoscopy/histology. Also, we recorded the grade of satisfaction for the gluten challenge and the onset of adverse events.
    Results: We enrolled 120 patients. All patients concluded the challenge without relevant adverse events. Serological positivity was detected in 54 patients (45%). Histology showed atrophy in 87% and Marsh 1-2 grade in 13% of patients. Ninety-nine patients (83%) were satisfied by this challenge.
    Conclusions: The "crackers challenge" is a useful and safe diagnostic approach in people on self-administered GFD.
    Language English
    Publishing date 2024-03-22
    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.2024.03.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1134: Show issues Location:
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  3. Article ; Online: Towards personalized treatment of T2N0 rectal cancer: A systematic review of long-term oncological outcomes of neoadjuvant therapy followed by local excision.

    Peltrini, Roberto / Imperatore, Nicola / Di Nuzzo, Maria Michela / Pellino, Gianluca

    Journal of gastroenterology and hepatology

    2022  Volume 37, Issue 8, Page(s) 1426–1433

    Abstract: Background and aim: Total mesorectal excision (TME) remains the treatment of choice in T2N0 tumors. However, evidence suggest that one-size-fits-all approach is not always beneficial for this group of patients. The aim of this study is to synthesize ... ...

    Abstract Background and aim: Total mesorectal excision (TME) remains the treatment of choice in T2N0 tumors. However, evidence suggest that one-size-fits-all approach is not always beneficial for this group of patients. The aim of this study is to synthesize data on long-term outcomes after neoadjuvant therapy (NAT) followed by local excision (LE) in T2N0 rectal cancer patients in the perspective of a rectal-preserving strategy.
    Methods: A systematic search of PubMed/MEDLINE, SCOPUS, and Web of Science databases was conducted until October 2021 to identify studies comparing LE after NAT and TME or reporting oncologic outcomes after conservative approach. A pooled analysis was conducted using a fixed-effect model in the case of non-significant heterogeneity (P > 0.1), and a random effect model (DerSimonian-Laird method) when significant heterogeneity was present (P < 0.1) CRD42022300344.
    Results: Nine studies were included in the analysis. Three of them were comparative studies. The pooled 3-year DFS, 5-year DFS, 3-year OS, 5-year OS, local and distant recurrence rates were 92.8% (95% CI 81.6-99.5%), 91.3% (95% CI 88.3-94.3%), 96.1% (95% CI 90.5-100%), 72.6% (95% CI 57.5-87.7%), 4% (95% CI 18-63%), and 4.9% (95% CI 2-7.8%), respectively, in subjects treated with NAT followed by LE. No heterogeneity was found for all these analyses, except for the 5-year OS sub-analysis (I
    Conclusion: LE following neoadjuvant CRT may provide comparable survival benefit to radical surgery for patients with clinical stage T2N0 in selected patients although the evidence is still limited to provide solid recommendations. A personalized therapeutic approach taking into account tumor and patient-related factors should be considered.
    MeSH term(s) Humans ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local/pathology ; Neoplasm Staging ; Precision Medicine ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery ; Treatment Outcome
    Language English
    Publishing date 2022-06-03
    Publishing country Australia
    Document type Journal Article ; Review ; Systematic Review
    ZDB-ID 632882-9
    ISSN 1440-1746 ; 0815-9319
    ISSN (online) 1440-1746
    ISSN 0815-9319
    DOI 10.1111/jgh.15898
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    Zs.A 2180: Show issues Location:
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    Zs.MO 299: Show issues

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  4. Article ; Online: The price of being a doctor during the COVID-19 outbreak.

    Imperatore, Nicola / Rispo, Antonio / Lombardi, Giovanni

    Gut

    2020  Volume 69, Issue 8, Page(s) 1544–1545

    MeSH term(s) Betacoronavirus ; COVID-19 ; China ; Coronavirus ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-05-10
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 80128-8
    ISSN 1468-3288 ; 0017-5749
    ISSN (online) 1468-3288
    ISSN 0017-5749
    DOI 10.1136/gutjnl-2020-321646
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    Zs.A 160: Show issues Location:
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  5. Article ; Online: Vanek's tumor, a very rare case of massive acute gastrointestinal bleeding.

    Imperatore, Nicola / Cargiolli, Martina / Boscaino, Amedeo / Lombardi, Giovanni

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

    2020  Volume 54, Issue 5, Page(s) 704–706

    MeSH term(s) Gastrointestinal Hemorrhage/etiology ; Humans ; Intestinal Polyps/pathology ; Neoplasms
    Language English
    Publishing date 2020-12-07
    Publishing country Netherlands
    Document type Case Reports ; Journal Article
    ZDB-ID 1459373-7
    ISSN 1878-3562 ; 1125-8055
    ISSN (online) 1878-3562
    ISSN 1125-8055
    DOI 10.1016/j.dld.2020.11.032
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    Zs.A 1134: Show issues Location:
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  6. Article ; Online: Therapy in elderly IBD patients.

    Castiglione, Fabiana / Imperatore, Nicola / Zingone, Fabiana / D'Incà, Renata

    Minerva gastroenterology

    2021  Volume 70, Issue 1, Page(s) 89–97

    Abstract: Introduction: Appropriate treatment is critical in elderly inflammatory bowel disease (IBD) subjects since they are at higher risk of complications such as infections, malignancies and mortality.: Evidence acquisition: We conducted an extensive ... ...

    Abstract Introduction: Appropriate treatment is critical in elderly inflammatory bowel disease (IBD) subjects since they are at higher risk of complications such as infections, malignancies and mortality.
    Evidence acquisition: We conducted an extensive PubMed search for guidelines, systematic reviews and primary studies to perform a critical analysis of the existing literature on the efficacy and safety of conventional and biological therapies for elderly IBD patients.
    Evidence synthesis: Due to the exclusion of elderly population from clinical trials, most evidences comes from real-life studies. While aminosalicylates remain a cornerstone treatment of elderly patients with ulcerative colitis (UC), for their effectiveness and safety, their use in Crohn's disease (CD) should not be further supported. Corticosteroid use should be limited for the induction of remission, while as maintenance treatment it should be avoided, due to the low safety profile. Although as efficacious as in the younger population, immunosuppressant use has been associated with higher risk of infective/malignant issues and further use should be carefully evaluated. Biologics have demonstrated high effectiveness in the elderly. However, due to increased morbidity and mortality described in elderly subjects treated with anti-TNF alpha agents, vedolizumab and ustekinumab should be favoured over anti-TNF alpha agents.
    Conclusions: Treatment of elderly IBD patients remains challenging, since comorbidities and the risk of adverse events can complicate the effectiveness and safety of therapy. Close monitoring of such patients in a multidisciplinary team is advocated to reduce the risk of infections and optimize the treatment, choosing a suitable agent.
    MeSH term(s) Aged ; Humans ; Tumor Necrosis Factor Inhibitors/therapeutic use ; Remission Induction ; Inflammatory Bowel Diseases/drug therapy ; Crohn Disease/drug therapy ; Colitis, Ulcerative/drug therapy
    Chemical Substances Tumor Necrosis Factor Inhibitors
    Language English
    Publishing date 2021-06-23
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 3062713-8
    ISSN 2724-5365
    ISSN (online) 2724-5365
    DOI 10.23736/S2724-5985.21.02895-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Ui V Zs.51: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  7. Article ; Online: Hocus Pocus: the Role of Hand-held Ultrasonography in Predicting Disease Extension and Endoscopic Activity in Ulcerative Colitis.

    Rispo, Antonio / Calabrese, Giulio / Testa, Anna / Imperatore, Nicola / Patturelli, Marta / Allocca, Mariangela / Guarino, Alessia Dalila / Cantisani, Nicola Mattia / Toro, Benedetta / Castiglione, Fabiana

    Journal of Crohn's & colitis

    2023  Volume 17, Issue 7, Page(s) 1089–1096

    Abstract: Background: Ulcerative colitis [UC] assessment still requires ileocolonoscopy [IC]. Intestinal ultrasound [IUS] has emerged as a non-invasive assessment tool, and the Milan Ultrasound Criteria [MUC] score has been validated to estimate and grade UC ... ...

    Abstract Background: Ulcerative colitis [UC] assessment still requires ileocolonoscopy [IC]. Intestinal ultrasound [IUS] has emerged as a non-invasive assessment tool, and the Milan Ultrasound Criteria [MUC] score has been validated to estimate and grade UC disease activity. Recently, hand-held IUS [HHIUS] has been used in several clinical settings, but data about its use in UC are limited. We aimed to evaluate the diagnostic accuracy of HHIUS compared with conventional IUS in detecting UC extension and activity.
    Patients and methods: From November 2021 to September 2022, we prospectively enrolled UC patients afferent to our third-level IBD Unit for IC evaluation. Patients underwent IC, HHIUS, and IUS. Ultrasound activity was defined by MUC >6.2, and endoscopic activity was defined by a Mayo endoscopic score [MES] >1. Cohen's k test was applied to test the concordance between IUS-MUC and HHIUS-MUC after MUC dichotomisation [MUC >6.2, yes/no].
    Results: In all, 86 patients with UC were enrolled. No significant difference was recorded between IUS and HHIUS at the per-segment extension [p = N.S.], and both procedures were comparable in terms of results of bowel wall thickness [BWT] and bowel wall stratification [BWS] assessment [p = N.S.]. IUS and HHIUS displayed excellent agreement when the MUC score system was applied [k = 0.86, p <0.01].
    Conclusion: Hand-held intestinal ultrasound and IUS are comparable in UC extension definition and MUC evaluation. HHIUS could be reliable for detecting disease activity and estimating its extension, providing close monitoring. It also represents a non-invasive, easily practicable investigation, allowing immediate medical decisions with significant time and cost advantages.
    MeSH term(s) Humans ; Colitis, Ulcerative/diagnostic imaging ; Colonoscopy/methods ; Intestines ; Ultrasonography/methods ; Severity of Illness Index
    Language English
    Publishing date 2023-02-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2390120-2
    ISSN 1876-4479 ; 1873-9946
    ISSN (online) 1876-4479
    ISSN 1873-9946
    DOI 10.1093/ecco-jcc/jjad024
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    Zs.A 6634: Show issues Location:
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  8. Article ; Online: Response to the Comment on "Surgical Prevention of Anastomotic Recurrence by Excluding Mesentery in Crohn's Disease: The SuPREMe-CD Study-A Randomized Clinical Trial".

    Luglio, Gaetano / Imperatore, Nicola / Tropeano, Francesca Paola / Rispo, Antonio

    Annals of surgery

    2020  Volume 274, Issue 6, Page(s) e738–e739

    MeSH term(s) Anastomosis, Surgical/adverse effects ; Crohn Disease/prevention & control ; Crohn Disease/surgery ; Humans ; Mesentery/surgery
    Language English
    Publishing date 2020-09-24
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000004129
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    Uk I Zs.35/1: Show issues Location:
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  9. Article ; Online: SARS-CoV-2 as a Trigger for De Novo Ulcerative Colitis.

    Imperatore, Nicola / Bennato, Raffaele / D'Avino, Alfredo / Lombardi, Giovanni / Manguso, Francesco

    Inflammatory bowel diseases

    2021  Volume 27, Issue 7, Page(s) e87–e88

    MeSH term(s) COVID-19/complications ; COVID-19/transmission ; COVID-19/virology ; Colitis, Ulcerative/drug therapy ; Colitis, Ulcerative/etiology ; Colitis, Ulcerative/pathology ; Humans ; Male ; Middle Aged ; Prognosis ; SARS-CoV-2/isolation & purification
    Language English
    Publishing date 2021-02-16
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 1340971-2
    ISSN 1536-4844 ; 1078-0998
    ISSN (online) 1536-4844
    ISSN 1078-0998
    DOI 10.1093/ibd/izab040
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