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World Journal of Gastroenterology 2014年第17期20卷 4839-4845页

作者： Gianluca Rizzo daniela pugliese Alessandro Armuzzi Claudio Coco Department of Surgical Sciences Complesso Integrato ColumbusCatholic University of the Sacred Heart00168 RomeItaly Internal Medicine and Gastroenterology Unit Complesso Integrato ColumbusCatholic University of the Sacred Heart00168 RomeItaly

Ulcerative colitis (UC) is an inflammatory bowel disease affecting large bowel with variable clinical course. The history of disease has been modified by the introduction of biologic therapy, in particular Infliximab (IFX), that has demonstrated efficacy in inducing fast symptoms remission, promoting mucosal healing and maintaining long-term remission. However, surgery is still needed for UC patients: in case of failure of medical therapy and if acute complications or a malignancy occurred. Surgical treatment is associated with a short-term post-operative mortality and morbidity respectively of 0%-4% and 30%. In this study we systematically analyzed: the role of IFX in reducing the colectomy rate, the risk of post-operative morbidity in pre-operatively IFX-treated patients and the cost-effectiveness of IFX therapy. Four of 5 analyzed randomized controlled trials demonstrated that therapy with IFX significantly reduces the colectomy rate. Moreover, pre-operative treatment with IFX doesn’t seem to increase post-operative infectious complications. By an economic point of view, the cost-effectiveness of IFX-therapy was demonstrated for UC patients suffering from moderate to severe UC in a study based on a cost estimation of the National Health Service of England and Wales. However, the argument is debated.

关键词： Ulcerative colitis Infliximab Colectomy Post-operative complications Cost-effectiveness Inflammatory bowel disease

A rare case of epiploic appendagitis in a patient affected by ulcerative colitis on vedolizumab therapy

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Gastroenterology Report 2022年第1期10卷 661-664页

作者： daniela pugliese Giuseppe Privitera Luigi Larosa Valentin Calvez Diana Broglia Nicoletta de Matthaeis Alessandro Armuzzi CEMAD IBD UNITUnita Operativa Complessa di Medicina Interna e GastroenterologiaDipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario“A.Gemelli”IRCCSRomeItaly Dipartimento Universitario di Medicina e Chirurgia Traslazionale Universita Cattolica del Sacro CuoreRomeItaly Fondazione Policlinico Universitario A.Gemelli IRCCS UOC di Radiodiagnostica Presidio ColumbusDipartimento di Diagnostica per immaginiRadioterapia Oncologica ed EmatologiaLargo Francesco VitoRomeItaly Universita Cattolica del Sacro Cuore RomeItaly IBD Center IRCCS Humanitas Research HospitalRozzanoMilanItaly Department of Biomedical Sciences Humanitas UniversityPieve EmanueleMilanItaly

Introduction Epiploic appendagitis(EA)is an acute inflammation of the pedunculated mesenteric fat attached to the colonic surface,distinguished into two forms:primary EA,seemingly elicited by local ischaemic factors;and secondary EA(SEA),elicited by the inflammation of the adjacent organs,with diverticulitis being the most common trigger[1].Few case series have described the association between SEA and inflammatory bowel disease(IBD);however,information about clinical,laboratory and imaging findings,outcomes,and the impact of IBD-specific therapy were not *** first report the case of a woman affected by ulcerative colitis(UC)who developed a SEA during vedolizumab therapy(Figure 1A).

关键词： inflammation organs acute

Orphan patients with inflammatory bowel disease-when we treat beyond evidence

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World Journal of Gastroenterology 2021年第47期27卷 8047-8057页

作者： Giuseppe Privitera daniela pugliese Loris Riccardo Lopetuso Franco Scaldaferri Alfredo Papa GianLodovico Rapaccini Antonio Gasbarrini Alessandro Armuzzi Dipartimento Universitario di Medicina e Chirurgia Traslazionale UniversitàCattolica del Sacro CuoreRome 00168Italy CEMAD–IBD UNIT-UnitàOperativa Complessa di Medicina Interna e Gastroenterologia Dipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario"A.Gemelli"IRCCSRome 00168Italy CEMAD–IBD UNIT-UnitàOperativa Complessa di Medicina Interna e Gastroenterologia Dipartimento di Scienze Mediche e ChirurgicheFondazione Policlinico Universitario“A.Gemelli”IRCCSRome 00168Italy Department of Medicine and Ageing Sciences “G.d’Annunzio”University of Chieti-PescaraChieti 66100Italy Center for Advanced Studies and Technology(CAST) “G.d’Annunzio”University of Chieti-PescaraChieti 66100Italy

Inflammatory bowel disease(IBD)is a chronic condition that requires continuous medical *** date,the medical management of patients with moderatelyto-severely active IBD who develop dependence or resistance to corticosteroids is based on immunomodulator *** therapies are licenced after passing through three phases of randomized controlled trials(RCTs),and are subsequently adopted in clinical ***,the real-life population of IBD patients who require these therapies can significantly differ from those included in *** a matter of fact,there is a number of exclusion criteria–nearly ubiquitous in all RCTs–that prevent the enrolment of specific patients:Chronic refractory pouchitis or isolated proctitis in ulcerative colitis,short-bowel syndrome and stomas in Crohn’s disease,ileorectal anastomosis in both ulcerative colitis and Crohn’s disease,and elderly age are some representative *** this frontier article,we aim to give an overview of current literature on this topic,in order to address the main knowledge gaps that need to be filled in the upcoming years.

关键词： Pouchitis Proctitis Stoma Short-bowel Ileo-rectal anastomosis Biologics

Management of perianal fistulas in Crohn's disease:An upto-date review

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World Journal of Gastroenterology 2015年第5期21卷 1394-1403页

作者： Manuela Marzo Carla Felice daniela pugliese Gianluca Andrisani Giammarco Mocci Alessandro Armuzzi Luisa Guidi IBD Unit Complesso Integrato ColumbusUniversità Cattolica del Sacro Cuore00168 RomeItaly

Perianal disease is one of the most disabling manifestations of Crohn's disease.A multidisciplinary approach of gastroenterologist,colorectal surgeon and radiologist is necessary for its management.A correct diagnosis,based on endoscopy,magnetic resonance imaging,endoanal ultrasound and examination under anesthesia,is crucial for perianal fistula *** medical and surgical therapies are discussedin this review,including new local treatment modalities that are under investigation.

关键词： Crohn’s disease Perianal fistula Surgery Drug ther

What is the best way to manage screening for infections and vaccination of inflammatory bowel disease patients?

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2016年第3期7卷 387-396页

作者： Gianluca Andrisani Alessandro Armuzzi Manuela Marzo Carla Felice daniela pugliese Alfredo Papa Luisa Guidi IBD Unit Complesso Integrato Columbus Università Cattolica del Sacro Cuore

The use of biological agents and immunomodulators for inflammatory bowel disease(IBD) is associated with an increased risk of opportunistic infections, in particular of viral or bacterial etiology. Despite the existence of international guidelines, many gastroenterologists have not adopted routine screening and vaccination in those patients with IBD, which are candidate for biologic therapy. Available strategies to screen, diagnose and prevent bacterial and viral infections in patients with IBD prior to start biological therapy are discussed in this review.

关键词： Inflammatory bowel disease Opportunistic infections Immunomodulators Corticosteroids Anti-tumor necrosis factor agents