MESENCHIMAL STEM CELLS IN INFLAMMATORY BOWEL DISEASES: CLINICAL EVIDENCES AND POTENTIAL INSIGHTS FOR THE CLINICIANS

Mesenchimal stem cells (MSCs) have been used experimentally and clinically in the treatment of a wide variety of pathologies MSCs can be safely transplanted in autologous and allogenic ways as they are non-immunogenic, and consequently represent a therapeutic option for refractory connective tissue diseases, fibrosing diseases like scleroderma and fistulizing colitis like in Crohn's disease (CD). The immunomodulatory properties of MSCs have already shown promise when used as therapy for otherwise medically refractory CD. Accumulating evidence suggests that the properties may also be exploited of several other conditions. The currently available experimental and clinical data indicate that, …

Adalimumab in steroid-dependent Crohn's disease patients: Prognostic factors for clinical benefit

Is splenectomy a treatment option for aseptic abscesses in patients with Crohn's disease?

Inflammatory Bowel Disease Phenotype as Risk Factor for Cancer in a Prospective Multicentre Nested Case-Control IG-IBD Study

Background and Aims: Cancer risk in inflammatory bowel disease [IBD] is still debated. In a prospective, multicentre, nested case-control study, we aimed to characterise incident cases of cancer in IBD. The role of immunomodulators vs clinical characteristics of IBD as risk factors for cancer was also investigated. Materials and Methods: From January 2012 to December 2014, each IBD patient with incident cancer was matched with two IBD patients without cancer for: IBD type, gender, and age. Risk factors were assessed by multivariate regression analysis. Results: IBD patients considered numbered 44619: 21953 Crohn’s disease \[CD], 22666 ulcerative colitis [UC]. Cancer occurred in 174 patients…

Effectiveness of adalimumab for ulcerative colitis: A multicentre, retrospective study of clinical practice in Italy.

Abstract Background Adalimumab is used to treat ulcerative colitis, but additional effectiveness and safety data are needed. Patients and methods This retrospective study considered adults with ulcerative colitis treated with adalimumab at 19 hospitals. Clinical data were collected from the start of treatment, after 2, 6 and 12 months, and at the last visit. Outcome measures of effectiveness were treatment duration, reasons for discontinuation and colectomy. Results We studied 381 patients treated with adalimumab for a median of 12.1 months. Disease activity at the start of treatment was moderate to severe in 262 cases (68.8%) and endoscopic activity was moderate to severe in 339 cases (89.…

Adalimumab in active ulcerative colitis: A “real-life” observational study

Abstract Background and aims The effectiveness of adalimumab in the treatment of ulcerative colitis is under debate. Although controlled trials have shown that adalimumab is significantly better than placebo, the absolute clinical benefit is modest. We report data on the effectiveness of adalimumab in a cohort of ulcerative colitis patients treated in 22 Italian centres. Methods All patients with active disease treated with adalimumab were retrospectively reviewed. Co-primary endpoints were clinical remission at weeks 4, 12, 24 and 54. Secondary endpoints were sustained clinical remission, steroid discontinuation, endoscopic remission and need for colectomy. Results Eighty-eight patients we…

Transcatheter arterial chemoembolization for hepatocellular carcinoma in cirrhosis;survival rate and prognostic factors

Background: The role of prognostic variables in the treatment of hepatocellular carcinoma (HCC) by transarterial chemoembolisation (TACE) is controversial. Aims: To evaluate the survival of patients with HCC on cirrhosis treated with TACE and to analyse the prognostic factors affecting survival. Methods: From 1996 to 2006, 580 consecutive patients with HCC in cirrhosis were observed. Of these 194 patients underwent TACE. The primary end-point was survival. Independent predictors of survival were identified using the Cox model. Results: The cumulative 1-year, 3-year, and 5-year survival rates were 96%, 60%, and 41%, respectively. The multivariate analysis showed significant reduction of surv…

Cyclosporine or infliximab as rescue therapy in severe 2 refractory ulcerative colitis: Early and long-term data 3 from a retrospective observational study

Introduction: About 30–40% of patients with acute severe ulcerative colitis (UC) fail to respond 23 to intensive intravenous (iv) corticosteroid treatment. Iv cyclosporine and infliximab are an ef- 24 fective rescue therapy in steroid-refractory UC patients but up to now it is still unclear which is Q225 the best therapeutic choice in this setting of patients. 26 Methods: We reviewed our series of severe steroid-refractory colitis admitted consecutively in 27 our referral center since 1994 comparing two historical cohort treated with cyclosporine or 28 infliximab. Iv cyclosporine was administered at the dosage of 2 mg/kg and infliximab at the dos- 29 age of 5 mg/kg. The main outcome was the…

Palermo. La villa dei Padri Filippini

Presentazione del rilievo della villa dei Padri Filippini a Palermo. Il rilievo, condotto con metodi diretti, è stato restituito digitalmente.

IL-23R determines susceptibility in Crohn's disease in a Mediterranean area

Progress Report The ItalianSocietyofGastroenterology(SIGE)andtheItalianGroupforthestudy of InflammatoryBowelDisease(IG-IBD)ClinicalPracticeGuidelines:The useof tumor necrosisfactor-alphaantagonisttherapyinInflammatoryBowelDisease

Biological therapiesareanimportantstepinthemanagementofInflammatoryBowelDiseases.Incon- sideration ofhighcostandsafetyissuesthereistheneedtohaveclearrecommendationsfortheiruse. Despite theAmericanGastroenterologicalAssociationandtheEuropeanCrohn’sandColitisOrganisation have publishedexhaustiveInflammatoryBowelDiseaseguidelines,nationalguidelinesmaybeneces- sary asculturalvalues,economicalandlegalissuesmaydifferbetweencountries.Forthesereasonsthe Italian SocietyofGastroenterologyandtheItalianGroupforthestudyofInflammatoryBowelDisease have decidedtoelaboratetheItalianguidelinesontheuseofbiologicsinInflammatoryBowelDisease. The followingitemshavebeenchosen:definitionsofactive,inactive,steroidd…

Severe cutaneous psoriasis after certolizumab pegol treatment;report of a case.

Biologic therapies versus conventional therapies. A series of Crohn’s disease patients: “a pair-matched study”

THE ROLE OF CARD15 MUTATIONS AND SMOKING IN THE COURSE OF DISEASE IN A MEDITERRANEAN AREA

. Am J Gastroenterol. 2008 Mar;103(3):649-55. The role of CARD15 mutations and smoking in the course of Crohn's disease in a Mediterranean area. Renda MC, Orlando A, Civitavecchia G, Criscuoli V, Maggio A, Mocciaro F, Rossi F, Scimeca D, Modesto I, Oliva L, Cottone M. Ematologia II Ospedale V. Cervello, Palermo, Italy. AIM: To evaluate the role of CARD15 mutations and smoking in the main events of Crohn's disease (CD). PATIENTS AND METHODS: A total of 182 patients with CD were included in a prospective study in order to evaluate the role of CARD15 mutations and smoking in the main outcomes of disease course: first operation and surgical recurrence. The following variables were evaluated in …

randomized clinical trials in perianal disease.

Abstract: Crohn’s disease can be complicated by the development of fistulas, 54% of which involve the perianal region. The presence of perianal fistulas predicts a disabling course of Crohn’s disease. The treatment of complex perianal disease is difficult and the chance of complete fistula healing is no more than 50%. The best management of this condition is a combining medical and surgical therapy. Studies which evaluated the efficacy of medical treatments in this setting are small, open label and considered the efficacy on perianal disease as a second outcome or as the result of a subgroup analysis. In the few available trials the efficacy outcomes were evaluated by the Fistula Drainage A…

CLINICAL COURSE OF SEVERE COLITIS: A COMPARISON BETWEEN CROHN'S DISEASE AND ULCERATIVE COLITIS.

Few data are available about the clinical course of severe colonic Crohn’s disease (CD). The aim of this study is to describe the clinical course of severe Crohn’s colitis in a patient cohort with isolated colonic or ileocolonic CD, and to compare it with the clinical course of patients with severe ulcerative colitis (UC). Thirty-four patients with severe Crohn’s colitis were prospectively identified in our cohort of 593 consecutive hospitalized patients through evaluation of the Crohn’s Disease Activity Index score and the Harvey-Bradshaw Index. One hundred sixty-nine patients with severe ulcerative colitis were prospectively identified in our cohort of 449 consecutive hospitalized patient…

Z.E.N. 01 - Linking Park Ipotesi progettuali per l’area tra Cardillo e ZEN a Palermo

L'articolo contiene un estratto del lavoro di ricerca condotto nell'area tra Cardillo e ZEN a Palermo nell'ambito del progetto MIUR PRIN 2007 "Riqualificazione e aggiornamento del patrimonio di edilizia pubblica. Linee guida per gli interventi nei quartieri innovativi IACP nell’Italia centromeridionale", coordinatore nazionale prof. Benedetto Todaro - "Progetto di ricerca: Palermo: quartieri, periferie e città contemporanea", responsabile dell'unità di ricerca prof. Andrea Sciascia.