المؤلفون: Dragoni, Gabriele, Innocenti, Tommaso, Amiot, Aurelien, Castiglione, Fabiana, Melotti, Laura, Festa, Stefano, Savarino, Edoardo, Truyens, Marie, Argyriou, Konstantinos, Noviello, Daniele, Molnar, Tamas, Bouillon, Vincent, Bezzio, Cristina, Eder, Piotr, Fernandes, Samuel, Kagramanova, Anna, Armuzzi, Alessandro, Oliveira, Raquel, Viola, Anna, Ribaldone, David Guiseppe, Drygiannakis, Ioannis, Viganò, Chiara, Calella, Francesca, Gravina, Antonietta Gerada, Pugliese, Daniela, Chaparro, Maria, Ellul, Pierre, VIEUJEAN, Sophie, Milla, Monica, Caprioli, Flavio, TOFA-poSTOP Study Group

المصدر: European Crohn's and Colitis Organisation 2024, 21-24 February 2024

مصطلحات موضوعية: Human health sciences, Gastroenterology & hepatology, Sciences de la santé humaine, Gastroentérologie & hépatologie

الوصف: Background: Patients with ulcerative colitis (UC) receiving immunomodulators are at substantial risk of colectomy. Since robust evidence regarding the post-operative outcomes of patients treated with anti-JAKs in the pre-operative phase is lacking, we aimed to assess the risk of complications of tofacitinib exposure prior to colectomy in comparison with anti-TNFs, vedolizumab, and ustekinumab.Methods: A multicentre, retrospective, observational study was conducted across 27 European Centres. Patients with active UC who underwent a total colectomy for medically refractory disease were included. Patients were considered exposed to tofacitinib when they had received the last dose within 4 weeks of surgery and exposed to biologics when they had received the last dose within 12 weeks of surgery. Primary outcome was the occurrence of any complications within 30 days (early) and 90 days (late) after surgery. Secondary outcomes were the occurrence of infections, sepsis, surgical site complications (SSC), venous thromboembolic events (VTE), hospital re-admissions and re-do surgery within the same timepoints.Results: In total, 301 patients were recruited, whose baseline characteristics are reported in Table 1A. No significant differences were found in any outcome across the groups, except for a significantly higher rate of early VTE with anti-TNFs (P=0.047) and of late VTE with VDZ (P=0.03) (Table 1B). In the multivariate analysis, drug class was not associated with a significantly higher risk of any complications both at 30 and 90 days. However, urgent surgery provided a higher risk of any early complications (OR 3.04, 95%CI 1.33-6.96) and late complications (OR 4.57, 95%CI 1.31-15.91), early hospital re-admission (OR 9.90, 95%CI 2.23-43.95) and early re-do surgery (OR 6.86, 95%CI 1.40-33.47). A steroid dose higher than 20 mg of oral prednisone increased the risk of any early complications (OR 2.42, 95%CI 1.14-5.13), early SSC (OR 2.38, 95%CI 1.02-5.55), and early re-do surgery (OR 7.70, 95%CI 1.59-37.14). A higher Charlson comorbidity index increased the risk of any early complications (OR 1.40, 95%CI 1.06-1.84), early infections (OR 1.67, 95%CI 1.17-2.37), early sepsis (OR 2.67, 95%CI 1.46-4.90), and early SSC (OR 1.38, 95%CI1.04-1.84).Conclusion: Pre-operative tofacitinib treatment demonstrated a post-operative safety profile comparable to that of biologicals in patients with UC undergoing colectomy. No warning signals were found, with particular regard to VTE and infections. Due to its fast wash-out, tofacitinib could represent an appealing strategy in severe cases in which likelihood of urgent surgery is increased.

الوصول الحر: https://orbi.uliege.be/handle/2268/312058Test

المؤلفون: Dragoni, Gabriele, Innocenti, Tommaso, Amiot, Aurelien, Castiglione, Fabiana, Melotti, Laura, Festa, Stefano, Savarino, Edoardo Vincenzo, Truyens, Marie, Argyriou, Konstantinos, Noviello, Daniele, Molnar, Tamas, Bouillon, Vincent, Bezzio, Cristina, Eder, Piotr, Fernandes, Samuel, Kagramanova, Anna, Armuzzi, Alessandro, Oliveira, Raquel, Viola, Anna, Ribaldone, Davide Giuseppe, Drygiannakis, Ioannis, Vigano, Chiara, Calella, Francesca, Gerarda Gravina, Antonietta, Pugliese, Daniela, Chaparro, María, Ellul, Pierre, Vieujean, Sophie, Milla, Monica, Caprioli, Flavio, “TOFA-poSTOP” Study Group

المساهمون: “TOFA-poSTOP” Study Group

مصطلحات موضوعية: Colectomy, Colon (Anatomy) -- Surgery, Ulcerative colitis, Inflammatory bowel diseases, Crohn's disease

الوصف: Three hundred one patients (64 tofacitinib, 162 anti-tumor necrosis factor-a agents, 54 vedolizumab, and 21 ustekinumab) were included. No significant differences were reported in any outcome, except for a higher rate of early VTE with anti-tumor necrosis factor-a agents (P 5 0.047) and of late VTE with vedolizumab (P 5 0.03). In the multivariate analysis, drug class was not associated with a higher risk of any early and late complications. Urgent colectomy increased the risk of any early (odds ratio [OR] 1.92, 95% confidence interval [CI] 1.06–3.48) complications, early hospital readmission (OR 4.79, 95% CI 1.12–20.58), and early redo surgery (OR 7.49, 95% CI 1.17–47.85). A high steroid dose increased the risk of any early complications (OR 1.96, 95% CI 1.08–3.57), early surgical site complications (OR 2.03, 95% CI 1.01–4.09), and early redo surgery (OR 7.52, 95% CI 1.42–39.82). Laparoscopic surgery decreased the risk of any early complications (OR 0.54, 95% CI 0.29–1.00), early infections (OR 0.39, 95% CI 0.18–0.85), and late hospital readmissions (OR 0.34, 95% CI 0.12–1.00). ; peer-reviewed

العلاقة: Dragoni, G., Innocenti, T., Amiot, A., Castiglione, F., Melotti, L., Festa, S., . & Caprioli, F. (2024). Rates of adverse events in patients with ulcerative colitis undergoing colectomy during treatment with tofacitinib vs biologics: a multicenter observational study. The American Journal of Gastroenterology, 10, 14309.; https://www.um.edu.mt/library/oar/handle/123456789/120375Test

الإتاحة: https://doi.org/10.14309/ajg.0000000000002676Test
https://www.um.edu.mt/library/oar/handle/123456789/120375Test

المؤلفون: Dragoni, Gabriele, Castiglione, Fabiana, Bezzio, Cristina, Pugliese, Daniela, Spagnuolo, Rocco, Viola, Anna, Cocomazzi, Francesco, Aratari, Annalisa, Savarino, Edoardo Vincenzo, Balestrieri, Paola, Onali, Sara, Viganò, Chiara, Ribaldone, Davide Giuseppe, Innocenti, Tommaso, Testa, Anna, Saibeni, Simone, Privitera, Giuseppe, Milla, Monica, Armuzzi, Alessandro, Fantini, Massimo Claudio, Fiorino, Gionata

المساهمون: Dragoni, Gabriele, Castiglione, Fabiana, Bezzio, Cristina, Pugliese, Daniela, Spagnuolo, Rocco, Viola, Anna, Cocomazzi, Francesco, Aratari, Annalisa, Savarino, Edoardo Vincenzo, Balestrieri, Paola, Onali, Sara, Viganò, Chiara, Ribaldone, Davide Giuseppe, Innocenti, Tommaso, Testa, Anna, Saibeni, Simone, Privitera, Giuseppe, Milla, Monica, Armuzzi, Alessandro, Fantini, Massimo Claudio, Fiorino, Gionata

مصطلحات موضوعية: Crohn's disease, Rutgeerts Score, endoscopic recurrence, ileo-colonic resection, immunoprophylaxi, inflammatory bowel disease, postoperative Crohn's disease, postoperative recurrence

الوصف: BackgroundThe management of postoperative recurrence (POR) in Crohn's disease (CD) after ileo-colonic resection is a highly debated topic. Prophylactic immunosuppression after surgery is currently recommended in the presence of at least one clinical risk factor. ObjectiveOur aim was to determine whether early immunosuppression can be avoided and guided by endoscopy in CD patients with only one risk factor. MethodsCD patients with only one risk factor for POR, including previous intestinal resection, extensive small intestine resection (>50 cm), fistulising phenotype, history of perianal disease, and active smoking, were retrospectively included. Two groups were formed based on whether immunosuppression was started immediately after surgery ("prophylaxis group") or guided by endoscopy ("endoscopy-driven group"). Primary endpoints were rates of any endoscopic recurrence (Rutgeerts >= i2a) and severe endoscopic recurrence (i4) within 12 months after surgery. Secondary outcomes were clinical recurrence rates at 6, 12 and 24 months after surgery. ResultsA total of 195 patients were enroled, of whom 61 (31.3%) received immunoprophylaxis. No differences between immunoprophylaxis and the endoscopy-driven approach were found regarding any endoscopic recurrence (36.1% vs. 45.5%, respectively, p = 0.10) and severe endoscopic recurrence (9.8% vs. 15.7%, respectively, p = 0.15) at the first endoscopic evaluation. Clinical recurrence rates were also not statistically different (p = 0.43, p = 0.09, and p = 0.63 at 6, 12, and 24 months, respectively). ConclusionsIn operated CD patients with only one risk factor for POR, immediate immunoprophylaxis does not decrease the rate of early clinical and endoscopic recurrence. Prospective studies are needed to confirm our results.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/36942657; info:eu-repo/semantics/altIdentifier/wos/WOS:000950750400001; volume:11; issue:3; firstpage:271; lastpage:281; numberofpages:11; journal:UNITED EUROPEAN GASTROENTEROLOGY JOURNAL; https://hdl.handle.net/2318/1899632Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85150780171

الإتاحة: https://doi.org/10.1002/ueg2.12367Test
https://hdl.handle.net/2318/1899632Test

المؤلفون: Frisella, Sara, Bonosi, Lapo, Ippolito, Mariachiara, Giammalva, Giuseppe Roberto, Ferini, Gianluca, Viola, Anna, Marchese, Valentina Anna, Umana, Giuseppe Emmanuele, Iacopino, Domenico Gerardo, Giarratano, Antonino, Cortegiani, Andrea, Maugeri, Rosario

المساهمون: Frisella, Sara, Bonosi, Lapo, Ippolito, Mariachiara, Giammalva, Giuseppe Roberto, Ferini, Gianluca, Viola, Anna, Marchese, Valentina Anna, Umana, Giuseppe Emmanuele, Iacopino, Domenico Gerardo, Giarratano, Antonino, Cortegiani, Andrea, Maugeri, Rosario

مصطلحات موضوعية: brain tumor, supportive care, end-of-life therapie, neuro intensive care unit, neuro-ICU, neurosurgery, palliative care

الوصف: Background and Objectives: Palliative care is an interdisciplinary medical specialty focused on improving the quality of life of critically ill patients, including those with frailty, during their illness. Materials and Methods: We conducted an extensive literature review on Pubmed focusing on palliative care in neuro-oncology patients admitted to intensive care units (ICUs). Results: We identified 967 articles and, after excluding 952 articles in accordance with the PRISMA flow chart, we included a total of 15 articles in the final selection. The potential role of palliative care in neuro-oncology appears necessary to ensure comprehensive end-of-life patient care. However, this seems underestimated and poorly applied, especially in the context of intensive care units. Medical personnel also face ethical dilemmas, considering not only the pathology but also the socio-spiritual context of the patient. In addition, caregivers' understanding of prognosis and realistic goals is critical for optimal end-of-life management. Conclusions: The provision of palliative care to neuro-oncological patients admitted to ICU is a complex challenge supported by fragmented evidence. Additional research on palliative care and communication about end-of-life care in the neuro-oncology and neuro-ICU setting is needed.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/36837489; info:eu-repo/semantics/altIdentifier/wos/WOS:000940000400001; volume:59; issue:2; firstpage:288; numberofpages:11; journal:MEDICINA; https://hdl.handle.net/10447/582670Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85148909396; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962237Test/

الإتاحة: https://doi.org/10.3390/medicina59020288Test
https://hdl.handle.net/10447/582670Test
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962237Test/

المؤلفون: Viola,Anna, Demarzo,Maria Giulia, Abbruzzese,Alfredo, Muscianisi,Marco, Chiappetta,Michele Francesco, Costantino,Giuseppe, Ksissa,Omar, Alibrandi,Angela, Fries,Walter

مصطلحات موضوعية: Patient Preference and Adherence

الوصف: Anna Viola,1 Maria Giulia Demarzo,1,2 Alfredo Abbruzzese,1,3 Marco Muscianisi,1 Michele Francesco Chiappetta,1,3 Giuseppe Costantino,1 Omar Ksissa,1,3 Angela Alibrandi,4 Walter Fries1 1Department of Clinical and Experimental Medicine, IBD-Unit, University of Messina, Messina, Italy; 2Department of Internal Medicine, Ospedale Policlinico San Martino-IRCCS per l’Oncologia, Gastroenterology Unit, University of Genoa, Genoa, Italy; 3Department of Health Promotion, Mother & Child Care, Internal Medicine & Medical Specialties, PROMISE, Gastroenterology & Hepatology Unit, University of Palermo, Palermo, Italy; 4Department of Economics; Unit of Statistical and Mathematical Sciences, University of Messina, Messina, ItalyCorrespondence: Anna Viola, Clinical Unit of Gastroenterology and Chronic Bowel Disorders, Department of Clinical and Experimental Medicine, Via Consolare Valeria 1, Messina, 9815, Italy, Tel +39 3338377928, Email aviola@unime.itPurpose: New therapeutic approaches for ulcerative colitis (UC) are now available, but there is still no robust evidence for predictors of poor outcomes. We aimed to evaluate the factors associated with a chronic active UC disease course.Patients and Methods: Data of all UC outpatients followed for at least 3 years after diagnosis between 2005 and 2018 were retrospectively collected. The primary aim was to identify risk factors for chronic active disease 3 years after diagnosis. Moreover, the following variables were investigated: proximal disease extension or disease regression, proctocolectomy, early use of biologics (BIO) or immunomodulators (IMM), hospitalization, colorectal cancer, and adherence. We defined adherence as both, taking the prescribed therapy and constancy in scheduled follow-up visits.Results: A total of 345 UC patients followed for a median period of 82 months were included. Patients with extensive colitis at diagnosis had a higher rate of chronic active disease 3 years after diagnosis (p< 0.012) together with a higher rate of surgery (p< ...

وصف الملف: text/html

العلاقة: https://www.dovepress.com/low-adherence-is-associated-with-chronic-active-disease-in-ulcerative--peer-reviewed-fulltext-article-PPATest

الإتاحة: https://doi.org/10.2147/PPA.S390349Test
https://www.dovepress.com/low-adherence-is-associated-with-chronic-active-disease-in-ulcerative--peer-reviewed-fulltext-article-PPATest

المؤلفون: Bergamaschi, Luca, Vincini, Maria Giulia, Zaffaroni, Mattia, Pepa, Matteo, Angelicone, Ilaria, Astone, Antonio, Bergamini, Cristiana, Buonopane, Sergio, Conte, Mario, De Rosa, Nicola, Deantoni, Chiara, Dell’Oca, Italo, Di Gennaro, Davide, Di Muzio, Nadia, Osti, Mattia Falchetto, Federico, Manuela, Ferini, Gianluca, Franzese, Ciro, Gatti, Marco, Grillo, Antonietta, Iorio, Vincenzo, Manzo, Roberto, Marmiroli, Luca, Martin, Giuseppe, Mazzuca, Federica, Molinaro, Maria Angela, Muto, Matteo, Pacelli, Roberto, Pepe, Alfonsina, Perillo, Annarita, Russo, Donatella, Salerno, Francesca, Spadaro, Pietro, Viola, Anna, Iorio, Giuseppe Carlo, Muto, Paolo, Ricardi, Umberto, Alterio, Daniela

المصدر: Supportive Care in Cancer ; volume 32, issue 1 ; ISSN 0941-4355 1433-7339

مصطلحات موضوعية: Oncology

الوصف: Aim Radiation-induced oral mucositis (RIOM) is the most frequent side effect in head and neck cancer (HNC) patients treated with curative radiotherapy (RT). A standardized strategy for preventing and treating RIOM has not been defined. Aim of this study was to perform a real-life survey on RIOM management among Italian RT centers. Methods A 40-question survey was administered to 25 radiation oncologists working in 25 different RT centers across Italy. Results A total of 1554 HNC patients have been treated in the participating centers in 2021, the majority (median across the centers 91%) with curative intent. Median treatment time was 41 days, with a mean percentage of interruption due to toxicity of 14.5%. Eighty percent of responders provide written oral cavity hygiene recommendations. Regarding RIOM prevention, sodium bicarbonate mouthwashes, oral mucosa barrier agents, and hyaluronic acid-based mouthwashes were the most frequent topic agents used. Regarding RIOM treatment, 14 (56%) centers relied on literature evidence, while internal guidelines were available in 13 centers (44%). Grade (G)1 mucositis is mostly treated with sodium bicarbonate mouthwashes, oral mucosa barrier agents, and steroids, while hyaluronic acid-based agents, local anesthetics, and benzydamine were the most used in mucositis G2/G3. Steroids, painkillers, and anti-inflammatory drugs were the most frequent systemic agents used independently from the RIOM severity. Conclusion Great variety of strategies exist among Italian centers in RIOM management for HNC patients. Whether different strategies could impact patients’ compliance and overall treatment time of the radiation course is still unclear and needs further investigation.

الإتاحة: https://doi.org/10.1007/s00520-023-08185-5Test

المؤلفون: Viola, Anna, Demarzo, Maria Giulia, Abbruzzese, Alfredo, Muscianisi, Marco, Chiappetta, Michele Francesco, Costantino, Giuseppe, Ksissa, Omar, Alibrandi, Angela, Fries, Walter

المصدر: Patient Preference and Adherence ; volume Volume 17, page 807-816 ; ISSN 1177-889X

الإتاحة: https://doi.org/10.2147/ppa.s390349Test
https://www.dovepress.com/getfile.php?fileID=88380Test

المؤلفون: Ferini, Gianluca, Zagardo, Valentina, Viola, Anna, Aiello, Marco Maria, Harikar, Mandara Muralidhar, Venkataram, Tejas, Palmisciano, Paolo, Illari, Salvatore Ivan, Valenti, Vito, Umana, Giuseppe Emmanuele

المصدر: Frontiers in Oncology ; volume 13 ; ISSN 2234-943X

مصطلحات موضوعية: Cancer Research, Oncology

الوصف: Background The rarity of hand acrometastases hampers the consensus-building for their optimal management among the involved oncology professionals. In the current literature, demolitive surgery overcomes the use of palliative radiotherapy, which proved to be ineffective in more than 30% of cases treated with classic palliative dose schemes, carrying also a not negligible radiation-related adverse event rate. Against this background, stereotactic body radiation therapy (SBRT) could emerge as a well-balanced therapeutic option. Case summary Here we describe the methods and outcomes of a SBRT treatment of a painful and function-limiting hand acrometastasis in a patient with a history of stage IIIB lung adenocarcinoma. We delivered a total dose of 30 Gy in five daily fractions to a soft-tissue metastasis abutting the fifth metacarpal bone through the SBRT protocol generally used for intracranial treatments. A few weeks later, the patient reported a clinical complete response with acrometastasis and pain disappearance, function recovery, and no significant toxicity. The acrometastasis was the first sign of an atypical cancer progression. Conclusions SBRT for hand acrometastases is feasible and might have the best therapeutic profile among the currently available treatment options for this rare clinical scenario. Larger investigations are needed to confirm the present single-case experience.

الإتاحة: https://doi.org/10.3389/fonc.2023.1146041Test

المؤلفون: Pinzi, Valentina, Marchetti, Marcello, Viola, Anna, Tramacere, Irene, Cane, Irene, Iezzoni, Cecilia, Fariselli, Laura

المساهمون: Ministry of Health

المصدر: International Journal of Radiation Oncology*Biology*Physics ; volume 115, issue 1, page 153-163 ; ISSN 0360-3016

مصطلحات موضوعية: Cancer Research, Radiology, Nuclear Medicine and imaging, Oncology, Radiation

الإتاحة: https://doi.org/10.1016/j.ijrobp.2022.08.064Test
https://api.elsevier.com/content/article/PII:S0360301622032369?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S0360301622032369?httpAccept=text/plainTest

المؤلفون: Baglieri, Orazio, Viola, Anna, Fonsati, Arianna, Osello, Anna

المصدر: Engineering Proceedings. 17

مصطلحات موضوعية: BIM, PIM, database, Civil and Architectural Engineering, Byggvetenskap

الوصف: The application of BIM methods and tools plays a key role in transportation infrastructure asset management. Road pavements represent one of the main components of the asset, which greatly influences safety and quality of service for users. The work presented herein exploited the potentialities of BIM processes and methods for management of road pavement structures. The specific goal was to define best practice for development of a methodological framework for Pavement Information Modelling (PIM). The starting point of the process was the identification of the specific BIM use, as intended by Kreider and Messner [1]. In this case, the BIM use identified concerned the 3rd (3D), 4th (4D), and 5th (5D) dimensions of BIM. The adopted approach had the aim to define the steps to build PIM based on geometrical and structural parameters to be used as a database for different kinds of maintenance strategies. Within this context, the main objectives of the study can be summarized as follows:(1)Define the steps to develop a PIM including all the relevant information to be stored for management purposes, from data collection to data restitution,(2)Define a best practice for the integration among BIM tools and road pavement management methods in order to obtain a digital repository for predictive maintenance strategies,(3)Define a planning and cost database for the different technologies and materials involved in the different maintenance strategies.From a practical point of view, the methodological framework was divided into three main categories (Figure 1) dealing with data: (i) data collection and input definition, which includes the analysis of available data and the BIM tools to be used to develop specific workflows; (ii) data processing, by dividing the workflows and related tasks in sub-sections for the fulfilment of the previously enounced objectives; (iii) data output, by defining the final result of each workflow.

وصف الملف: electronic

الوصول الحر: https://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-331068Test
https://kth.diva-portal.org/smash/get/diva2:1780083/FULLTEXT01.pdfTest