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Article: Pyoderma gangrenosum in ulcerative colitis patient treated with vedolizumab: adsorptive granulocyte/monocyte apheresis as a new therapeutic option refractory cases - a case report and literature review.

Mastronardi, Mauro / Cavalcanti, Elisabetta / Labarile, Nunzia / Armentano, Raffaele / Gabriele, Francesco / Curlo, Margherita

Therapeutic advances in chronic disease

2023 Volume 14, Page(s) 20406223231194190

Abstract: Extraintestinal manifestations occur rather frequently in ulcerative colitis (UC) and Crohn's disease patients and are usually related to an exacerbation of the underlying intestinal bowel disease but sometimes may run a course independent of the ... ...

Abstract	Extraintestinal manifestations occur rather frequently in ulcerative colitis (UC) and Crohn's disease patients and are usually related to an exacerbation of the underlying intestinal bowel disease but sometimes may run a course independent of the inflammatory bowel diseases (IBD). About one-third of patients with IBD develop extraintestinal manifestations, such as pyoderma gangrenosum (PG). PG is an uncommon inflammatory skin disorder of unknown pathogenesis. There are no specific serological or histological markers, and diagnosis is predominantly clinical. Topical and systemic therapies are both vital aspects of treatment and immune modulators have been used with increasing success in recent years, although immunosuppressive drugs raise some concerns due to an increased risk of serious and opportunistic infections and cancer, particularly in elderly and comorbid patients, underlining the unmet need for safer alternative therapies. Thus, in this case report, we highlighted an adsorptive granulocyte/monocyte apheresis (GMA) as a new therapeutic possibility in IBD patients with extraintestinal manifestations. We report a case of a 60-year woman with a history of UC with a Mayo grade 3 score which was associated with a PG. Given that the patients maintained clinical remission with vedolizumab, we preferred not to perform a combined treatment with other antitumor necrosis factor-alpha or ciclosporin, thus avoiding an increased risk of serious infections in the patient. Therefore, we performed the extracorporeal leukocyte apheresis. The patient progressed favorably, with progressive improvement of skin and bowel disease. Therefore, adsorptive GMA has a very favorable safety profile and has been confirmed in numerous studies. In this study, we underlined that an intensive regimen of GMA paves the way to an ideal option for patients with severe and refractory PG complicated with UC.
Language	English
Publishing date	2023-11-03
Publishing country	United States
Document type	Case Reports
ZDB-ID	2554816-5
ISSN	2040-6231 ; 2040-6223
ISSN (online)	2040-6231
ISSN	2040-6223
DOI	10.1177/20406223231194190
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Article ; Online: Prevention of influenza complications in patients with liver disease: a retrospective cohort study.

Bianchi, Francesco Paolo / Losito, Francesco / Labarile, Nunzia / Shahini, Endrit / Cozzolongo, Raffaele

Frontiers in public health

2023 Volume 11, Page(s) 1288126

Abstract: Introduction: Patients with chronic liver disease are highly prone to acquiring influenza infection diseases and experiencing associated complications. National and international guidelines recommend the influenza vaccine for patients with liver ... ...

Abstract	Introduction: Patients with chronic liver disease are highly prone to acquiring influenza infection diseases and experiencing associated complications. National and international guidelines recommend the influenza vaccine for patients with liver disorders to reduce the risk of influenza complications. Our study aims to evaluate the risk of flu complications faced by patients with liver disease and assess influenza vaccination coverage. Methods: The archive of hospital discharge forms was used to define the list of Apulian patients with liver disease, considering data from 2017 through 2022. The vaccination status of these patients was assessed via data collected from the Regional Immunization Database. We focused on influenza vaccine shots administered during the 2020/21, 2021/22, and 2022/23 flu seasons. Results: A declining trend across the flu seasons was observed, with a VC of 49.5% in the 2020/21 flu season, 48.1% in the 2021/22 season, and 45.0% in the 2022/23 season. Subjects with multiple comorbidities have higher vaccination rates. Additionally, the multivariate models demonstrate that vaccination compliance increases with age and is strongly associated with having received a previous influenza vaccine shot. Conclusion: The VC rates reported in our study are unsatisfactory and did not reach the minimum achievable goal (75%) the Italian Ministry of Health set. A multifactorial approach is required to raise the immunization rates and therefore protect the patients from the influenza-associated risk of collateral liver damage; the role of gastroenterologists and hepatologists is crucial, as their responsibilities should extend beyond patient care to the prevention of complications after infectious diseases.
MeSH term(s)	Humans ; Influenza Vaccines ; Influenza, Human/complications ; Influenza, Human/prevention & control ; Retrospective Studies ; Liver Diseases/complications ; Vaccination
Chemical Substances	Influenza Vaccines
Language	English
Publishing date	2023-12-20
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.1288126
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Article ; Online: Women in Gastroenterology: What Is the Current Situation? Results of an Italian National Survey.

Venezia, Ludovica / Labarile, Nunzia / Maselli, Roberta / Benedetti, Antonio / Annibale, Bruno / Parodi, Maria Caterina / Soncini, Marco / Zingone, Fabiana

Digestive diseases and sciences

2024

Abstract: Background: Many women grow up dreaming of becoming doctors, preferring specialties that allow more focus on time outside the hospital and on family life. Nowadays, specialties, like gastroenterology, have still a significant gender gap.: Methods: ... ...

Abstract	Background: Many women grow up dreaming of becoming doctors, preferring specialties that allow more focus on time outside the hospital and on family life. Nowadays, specialties, like gastroenterology, have still a significant gender gap. Methods: Based on this known discrepancy, a web-based questionnaire was designed by the Young Component of the Scientific Committee of the Federation of Italian Scientific Societies of Digestive Diseases 2023 (FISMAD) to examine the current situation of female gastroenterologists in Italy. The survey, designed specifically for this study, was sent by email to all female gastroenterologists and residents gastroenterologists, members of the three major Italian societies of Gastroenterology. Results: A total of 423 female physicians responded to the survey: 325 (76.8%) had full-time employment, and only a few had an academic career (7.2%). The main occupations were outpatient clinics (n = 288, 68%) and diagnostic endoscopy (n = 289, 68.3%); only 175 (41.3%) performed interventional endoscopy. One hundred and forty-seven (34.7%) had the chance to attend a master in advanced or interventional endoscopy, while 133 (31.4%) faced disadvantages that enabled them to attend. Of the 244 (58%) who reported feeling underappreciated, 194 (79.5%) said it was due to gender bias. We found that women doctors considered themselves disadvantaged compared with men doctors due to career opportunities (n = 338), salary negotiations (n = 64), and training opportunities (n = 144). Conclusions: In conclusion, gastroenterology still has a long way to go before approaching greater gender parity.
Language	English
Publishing date	2024-04-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	304250-9
ISSN	1573-2568 ; 0163-2116
ISSN (online)	1573-2568
ISSN	0163-2116
DOI	10.1007/s10620-024-08407-8
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Article ; Online: Emotional state should not be used to differentiate IBD from IBS - Authors' reply.

Iacucci, Marietta / Cannatelli, Rosanna / Labarile, Nunzia / Ghosh, Subrata

The lancet. Gastroenterology & hepatology

2020 Volume 5, Issue 8, Page(s) 723–724

MeSH term(s)	Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Endoscopy ; Humans ; Inflammatory Bowel Diseases/epidemiology ; Irritable Bowel Syndrome/epidemiology ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-07-13
Publishing country	Netherlands
Document type	Letter ; Comment
ISSN	2468-1253
ISSN (online)	2468-1253
DOI	10.1016/S2468-1253(20)30199-0
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Article: Emotional state should not be used to differentiate IBD from IBS - Authors' reply

Iacucci, Marietta / Cannatelli, Rosanna / Labarile, Nunzia / Ghosh, Subrata

Lancet Gastroenterol Hepatol

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #640921
Database	COVID19

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Article: Effects of Different Biological Therapies on S1/S2 Antibody Response to SARS-CoV-2 Vaccination in a Cohort of Patients with Inflammatory Bowel Disease.

Labarile, Nunzia / Castellana, Fabio / Sila, Annamaria / Pesole, Pasqua Letizia / Coletta, Sergio / Curlo, Margherita / Sardone, Rodolfo / Giannelli, Gianluigi / Mastronardi, Mauro

Vaccines

2022 Volume 10, Issue 7

Abstract: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected the entire planet. The objectives of our study were to compare responses to the vaccine (Pfizer-Biontech COMIRNATY) in a population of patients with intestinal bowel ... ...

Abstract	The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected the entire planet. The objectives of our study were to compare responses to the vaccine (Pfizer-Biontech COMIRNATY) in a population of patients with intestinal bowel syndrome undergoing different biological therapies or conventional therapy. The study recruited 390 patients who received the first vaccination dose during the dedicated vaccination campaign for inflammatory bowel disease (IBD) patients. The inclusion criteria were a diagnosis of CD or UC and complete vaccination with the Pfizer-BioNTech COVID-19 (Comirnaty) vaccine. The exclusion criteria were other significant diseases or important therapies under way or contraindications to vaccination according to the European drug surveillance recommendations. Linear rank models were run to assess the association between the different therapies and S1/S2 antibodies at three different times. The models showed that in patients with IBD receiving Vedolizumab a significant increase in mean IgG levels was observed, independently of other therapies and confounding factors (β: 57.45, 95% CI 19.62 to 19.00). This study confirmed the complete antibody response to vaccination against COVID-19 in patients with IBD undergoing biological therapy-particularly Vedolizumab treatment-but also a reduced immune response due to concomitant steroid therapy.
Language	English
Publishing date	2022-07-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2703319-3
ISSN	2076-393X
ISSN	2076-393X
DOI	10.3390/vaccines10071077
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Article: Tests that now deserve to be more widely adopted in IBD clinical practice.

Labarile, Nunzia / Ghosh, Subrata / Ng, Siew C / Walters, Julian / Iacucci, Marietta

Therapeutic advances in gastroenterology

2020 Volume 13, Page(s) 1756284820944088

Abstract: Inflammatory bowel diseases are chronic relapsing immune-mediated diseases of the intestinal tract with multifaceted manifestations and treatment related morbidity. Faecal and blood tests, radiological, endoscopic and histologic investigations are now ... ...

Abstract	Inflammatory bowel diseases are chronic relapsing immune-mediated diseases of the intestinal tract with multifaceted manifestations and treatment related morbidity. Faecal and blood tests, radiological, endoscopic and histologic investigations are now widely used for managing both ulcerative colitis and Crohn's disease. Over the years, a number of new investigations have been proposed but not widely adopted yet. Patients with Crohn's disease may have multiple causes of diarrhoea, not always attributable to disease exacerbation, but sometimes linked to bile acid malabsorption; we have a reliable serum test, C4, that allows us to recognize and treat this cause of diarrhoea efficaciously and not empirically, but it is not available or used widely. There is genetic inter-individual variability in drug responses, in terms of both efficacy and toxicity, leading to high rates of therapeutic failure. Patients treated with thiopurine or, more rarely, 5-aminosalicylic acid may suffer from unpredictable and serious adverse events, some of these with pathogenesis related to genetic variants: myelosuppression, acute pancreatitis and nephrotoxicity. The identification of pre-treatment genetic tests can optimize therapeutic choice and avoid adverse events. With regard to biological drugs, patients can experience primary non-response or loss of response due to induction of immune responses to the drugs affecting drug efficacy and determining hypersensitivity reactions. We have specifically reviewed a number of investigations, whose use is currently limited, and highlighted four tests that deserve to be more widely incorporated in clinical practice as these could improve medical decision-making and patient outcomes.
Language	English
Publishing date	2020-07-27
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2440710-0
ISSN	1756-2848 ; 1756-283X
ISSN (online)	1756-2848
ISSN	1756-283X
DOI	10.1177/1756284820944088
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Article: Advanced technology for assessment of endoscopic and histological activity in ulcerative colitis: a systematic review and meta-analysis.

Nardone, Olga Maria / Snir, Yifat / Hodson, James / Cannatelli, Rosanna / Labarile, Nunzia / Siau, Keith / Hassan, Cesare / Yanai, Henit / Dotan, Iris / Ghosh, Subrata / Iacucci, Marietta

Therapeutic advances in gastroenterology

2022 Volume 15, Page(s) 17562848221092594

Abstract: Background: Advanced endoscopic technologies led to significant progress in the definition of endoscopic remission of ulcerative colitis (UC) and correlate better with histological changes, compared with standard endoscopy. However, while studies have ... ...

Abstract	Background: Advanced endoscopic technologies led to significant progress in the definition of endoscopic remission of ulcerative colitis (UC) and correlate better with histological changes, compared with standard endoscopy. However, while studies have assessed the diagnostic accuracy of endoscope technologies individually, there are currently limited data comparing between technologies. As such, the aim of this systematic review was to pool data from the existing literature and compare the correlations between endoscopy and histologic disease activity scores across endoscope technologies. Methods: We searched PubMed and Embase until February 2021 for eligible studies reporting the correlation between endoscopy and histology activity scores in UC. Studies were grouped by endoscope technology as standard-definition white light (SD-WLE), high-definition white light (HD-WLE) or electronic virtual chromoendoscopy (VCE) and comparisons made between these groups. Results: A total of Conclusion: Activity scores assessed using endoscopy are strongly correlated with activity on histology regardless of endoscopic technology. VCE seems to be more accurate in predicting histological remission than WLE. However, given the heterogeneity between the included studies, head-to-head trials are warranted to confirm these findings.
Language	English
Publishing date	2022-04-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2440710-0
ISSN	1756-2848 ; 1756-283X
ISSN (online)	1756-2848
ISSN	1756-283X
DOI	10.1177/17562848221092594
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Article: HCV-positive kidney transplant patients treated with direct-acting antivirals maintain stable medium-term graft function despite persistent reduction in tacrolimus trough levels.

Rendina, Maria / Paoletti, Ernesto / Labarile, Nunzia / Marra, Antonella / Iannone, Andrea / Castellaneta, Antonino / Bussalino, Elisabetta / Ravera, Maura / Schena, Antonio / Castellaneta, Nicola M / Barone, Michele / Simone, Simona / Gesualdo, Loreto / Di Leo, Alfredo

Therapeutic advances in chronic disease

2022 Volume 13, Page(s) 20406223221117975

Abstract: Background/aim: Direct-acting antivirals (DAAs) have improved the treatment of HCV-positive kidney transplant recipients (KTRs). However, their medium-term follow-up effects on graft function are conflicting. This study aimed to analyze how the ... ...

Abstract	Background/aim: Direct-acting antivirals (DAAs) have improved the treatment of HCV-positive kidney transplant recipients (KTRs). However, their medium-term follow-up effects on graft function are conflicting. This study aimed to analyze how the interplay between DAAs, calcineurin inhibitors (CNI), and HCV eradication impacts 12-month kidney graft function. Methods: This double-center retrospective study with a prospective follow-up enrolled 35 KTRs with HCV treated with DAAs for 12 weeks. We compared three parameters: estimated glomerular filtration rate (eGFR), 24-h proteinuria, and CNI trough levels at three time points: baseline, end of treatment (EOT), and 12 months later. Results: Kidney allograft function remained stable when comparing baseline and 12-month post-treatment values of eGFR (60.7 Conclusion: DAA therapy is safe and effective in HCV-positive KTRs. It also produces a persistent significant reduction in Tac trough levels that does not influence graft function at 12 months.
Language	English
Publishing date	2022-09-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2554816-5
ISSN	2040-6231 ; 2040-6223
ISSN (online)	2040-6231
ISSN	2040-6223
DOI	10.1177/20406223221117975
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Article ; Online: Reproducibility of the electronic chromoendoscopy PICaSSO score (Paddington International Virtual ChromoendoScopy ScOre) in ulcerative colitis using multiple endoscopic platforms: a prospective multicenter international study (with video).

Cannatelli, Rosanna / Bazarova, Alina / Furfaro, Federica / Parigi, Tommaso Lorenzo / Zardo, Davide / Nardone, Olga Maria / Spaggiari, Paola / Villanacci, Vincenzo / Cadei, Moris / Labarile, Nunzia / Smith, Samuel Charles Lloyd / Danese, Silvio / Ghosh, Subrata / Iacucci, Marietta

Gastrointestinal endoscopy

2022 Volume 96, Issue 1, Page(s) 73–83

Abstract: Background and aims: Endoscopic and histologic remission (HR) are key therapeutic targets in the management of ulcerative colitis (UC). The aim of this study was to evaluate the reproducibility of the Paddington International virtual ChromoendoScopy ... ...

Abstract	Background and aims: Endoscopic and histologic remission (HR) are key therapeutic targets in the management of ulcerative colitis (UC). The aim of this study was to evaluate the reproducibility of the Paddington International virtual ChromoendoScopy ScOre (PICaSSO), a virtual chromoendoscopy score originally validated by use of the iSCAN platform, with the narrow-band imaging (NBI), linked-color imaging (LCI), and blue-laser imaging (BLI) platforms. Methods: We evaluated endoscopic activity using the Mayo Endoscopic Score (MES), the Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and PICaSSO in 159 UC patients (78 NBI and 81 BLI/LCI) who underwent colonoscopy in 2 tertiary referral centers. HR was defined by the Robarts Histopathology Index (RHI) and the Nancy Histologic Index (NHI). Receiver operating characteristic curves were plotted to evaluate endoscopic scores for the prediction of HR. Intraclass correlation coefficients (ICC) between endoscopists were evaluated. Results: PICaSSO had an ICC of 0.825 when the NBI and BLI/LCI cohorts were combined, higher than MES and UCEIS. The correlation between PICaSSO and RHI and NHI was 0.83 and 0.79 in the NBI cohort and between 0.63 and 0.65 in LCI/BLI. In the NBI cohort, the accuracy of MES, UCEIS, and PICaSSO was 0.936, 0.897, and 0.808 for HR measured by RHI and 0.897, 0.885, and 0.821 by NHI, respectively. In the BLI/LCI cohort, the accuracy of MES, UCEIS, LCI PICaSSO and BLI PICaSSO was 0.765, 0.778, 0.827, and 0.79 to predict HR with RHI and NHI, respectively. Conclusions: The PICaSSO score can be consistently and accurately reproduced with NBI and LCI/BLI and therefore can be applied to all virtual electronic chromoendoscopy platforms.
MeSH term(s)	Colitis, Ulcerative/pathology ; Colonoscopy/methods ; Electronics ; Humans ; Prospective Studies ; Reproducibility of Results ; Severity of Illness Index
Language	English
Publishing date	2022-02-17
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Video-Audio Media
ZDB-ID	391583-9
ISSN	1097-6779 ; 0016-5107
ISSN (online)	1097-6779
ISSN	0016-5107
DOI	10.1016/j.gie.2022.02.012
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