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Exit strategies in inflammatory bowel disease:Looking beyond antitumor necrosis factors

World Journal of Clinical Cases 2023年第12期11卷 2657-2669页

作者： Federica Crispino Andrea Michielan Mauro Grova Chiara Tieppo marta mazza Teresa Marzia Rogger Franco Armelao Azienda Provinciale per i Servizi Sanitari Gastroenterology and Digestive Endoscopy UnitSanta Chiara HospitalTrento 38122Italy Inflammatory Bowel Disease Unit Department of MedicineAzienda Ospedaliera Ospedali RiunitiVilla Sofia-CervelloPalermo 90146Italy

The long-term management of patients with inflammatory bowel disease(IBD)is still a matter of debate,and no clear guidelines have been *** clinical practice,gastroenterologists often have to deal with patients in prolonged remission after immunomodulatory or immunosuppressive *** planning an exit strategy for drug withdrawal,the risk of disease relapse must be balanced against the risk of drug-related adverse events and healthcare ***,there is still a dearth of data on the withdrawal of novel biologics,such as the anti-α4β7 integrin antibody(vedolizumab)and anti-IL12/23 antibody(ustekinumab),as well as the small molecule *** for estimating the risk of disease relapse and the efficacy of retreatment should be evaluated according to the patient's age and IBD *** models should guide clinicians in programming a temporary drug withdrawal after discussing realistic outcomes with the *** would shift the paradigm from an exit strategy to a holiday strategy.

关键词： Exit strategy Biologic withdrawal Drug holiday Vedolizumab Ustekinumab Tofacitinib

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Reconsidering the role of depression and common psychiatric disorders as partners in the type 2 diabetes epidemic

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World Journal of Diabetes 2024年第6期15卷 1374-1380页

作者： Angelo Emilio Claro Clelia Palanza Marianna mazza Alessandro Rizzi Andrea Corsello Linda Tartaglione Giuseppe Marano Giovanna Elsa Ute Muti Schuenemann marta Rigoni Alfredo Pontecorvi Luigi Janiri Paola Muti Dario Pitocco Diabetes Care Unit Department of Medical and Surgical SciencesFondazione Policlinico Universitario A Gemelli IRCCSRome 00168Italy Department of Biomedical Surgical and Dental SciencesUniversity of MilanMilan 20122Italy Istituto Italiano di Antropologia ISItARome 00100Italy Unit of Psychiatry Department of NeurosciencesFondazione Policlinico Universitario A Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Dipartimento di Medicina e Chirurgia Traslazionale UniversitàCattolica del Sacro CuoreRome 00168Italy Health Research Methods Evidence and Impact DepartmentMcMaster UniversityOntario 1280Canada Department of Endocrine-Metabolic and Dermo-Rheumatology Fondazione Policlinico Universitario A Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy

Common psychiatric disorders(CPDs)and depression contribute significantly to the global epidemic of type 2 diabetes(T2D).We postulated a possible pathophysiological mechanism that through Bridge-Symptoms present in depression and CPDs,promotes the establishment of emotional eating,activation of the reward system,onset of overweight and obesity and,ultimately the increased risk of developing *** plausibility of the proposed pathophysiological mechanism is supported by the mechanism of action of drugs such as naltrexonebupropion currently approved for the treatment of both obesity/overweight with T2D and as separate active pharmaceutical ingredients in drug addiction,but also from initial evidence that is emerging regarding glucagon-like peptide 1 receptor agonists that appear to be effective in the treatment of drug *** hope that our hypothesis may be useful in interpreting the higher prevalence of CPDs and depression in patients with T2D compared with the general population and may help refine the integrated psychiatric-diabetic therapy approach to improve the treatment and or remission of T2D.

关键词： Depression Glucagon-like peptide-1 receptor agonists Diabetes mellitus type 2 Stress psychological Sleep wake disorders Food addiction

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Why do we not reverse the path?Stress can cause depression,reduction of brain-derived neurotrophic factor and increased inflammation

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World Journal of Psychiatry 2022年第9期12卷 1264-1267页

作者： Angelo Emilio Claro Clelia Palanza Marianna mazza Alessandro Rizzi Linda Tartaglione Giuseppe Marano Giovanna Muti-Schuenemann marta Rigoni Paola Muti Alfredo Pontecorvi Luigi Janiri Gabriele Sani Dario Pitocco Department of Geriatrics Neuroscience and OrthopedicsFondazione Policlinico Universitario A.Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Istituto Italiano di Antropologia IsiTaRome 00185Italy Department of Medical and Surgical Sciences Policlinico Universitario A.Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Health Research Methods Evidence and Impact DepartmentMcMaster UniversityOntario K9V 0A0Canada Department of Biomedical Surgical and Dental SciencesUniversity of MilanMilan 20126Italy Department of Endocrine-Metabolic and Dermo-Rheumatology Fondazione Policlinico Universitario A.Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Department of Medical and Surgical Sciences Fondazione Policlinico Universitario A.Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy

The aim of this paper is to describe the direction of the link between stress,depression,increased inflammation and brain-derived neurotrophic factor(BDNF)*** hypothesize that severe stress or prolonged stress can be the driving factor that promote the onset of *** stress and depression,if not resolved over time,activate the production of transcription factors that will switch on pro-inflammatory genes and translate them into *** cascade fosters systemic chronic inflammation and reduced plasma BDNF *** people with depression have a 60%increased risk of developing type 2diabetes(T2D)and show high levels of inflammation and low levels of BDNF,we hypothesize possible reasons that might explain why T2D,depression and dementia are often associated in the same patient.

关键词： Depression Inflammation Brain-derived neurotrophic factor Type 2 diabetes mellitus Dementia Psychological stress

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World Journal of Clinical Cases 2022年第19期10卷 6370-6384页

作者： Daniela Chieffo Carla Avallone Annamaria Serio Georgios Demetrios Kotzalidis marta Balocchi Ilaria De Luca Daniele Hirsch Angela Gonsalez del Castillo Pierluigi Lanzotti Giuseppe Marano Lucio Rinaldi Antonio Lanzone Eugenio Mercuri Marianna mazza Gabriele Sani Service of Clinical Psychology Catholic University of Sacred HeartRome 00168Italy Department of Neurosciences Catholic University of Sacred HeartRome 00168Italy Department of Obstetrics and Gynaecology Catholic University of Sacred HeartRome 00168Italy Paediatric Neurology Unit Catholic University of Sacred HeartRome 00168Italy Department of Geriatrics Neuroscience and OrthopedicsFondazione Policlinico Universitario Agostino Gemelli IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic impacted in a still undefined way pregnant women’s mental *** are reports of mood and affect changes in the general population and the suggestion that similar changes occur also in the pregnant *** greater vulnerability of women during the COVID-19 restriction period may translate into a greater risk for mental disorders in the gestational *** hypothesised that pregnant women in the prepandemic period would have less psychopathology and more psychological support than pregnant women during the pandemic restriction *** To compare pregnant women for anxiety,prenatal depression,psychopathology,and social support before and after the awareness of the *** administered to women willing to participate in their 2nd-3rd trimesters of pregnancy theEdinburgh Postnatal Depression Scale(EPDS),the State-Trait Anxiety Inventory Form Y(STAI-Y),and the Symptom CheckList-90-Revised(SCL-90R);we further collected sociodemographicvariables and explored women’s social *** comparison was *** firstsample was termed nonCOVID-19 because data were gathered before the COVID-19 outbreak(January 2020-February 2020)was declared,and the second sample termed COVID-19 becauseparticipants were already subjected to the COVID-19-related restrictive measures(January 2021-February 2021).Since normal distribution was not met(Shapiro-Wilk test applied),we appliednonparametric Mann-Whitney’s U-test to compare psychometric *** standards were *** nonCOVID-19 group reported higher support from partners only,while the COVID-19 groupreported multiple support(χ^(2)=9.7181;P=0.021);the nonCOVID-19 group scored higher than theCOVID-19 group only on state anxiety among psychometric scales[STAI-Y1,nonCOVID-19median=39(95%CI:39.19-51.10)vs COVID-19 median=32(95%CI:30.83-38.90);Mann-Whitney’sU=117.5,P=0.00596].Other measures did not differ meaningfully between the two gr

关键词： COVID-19 pandemic Pregnancy Social Support Anxiety Depression Psychopathology

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