A5001468603- Gastroesophageal reflux and treatments
- Eosinophilic Esophagitis
- Esophageal and GI Pathology
- Helicobacter pylori-related gastroenterology studies
- Dysphagia Assessment and Management
- Gallbladder and Bile Duct Disorders
- Organ Transplantation Techniques and Outcomes
- Gastrointestinal Bleeding Diagnosis and Treatment
- Eosinophilic Disorders and Syndromes
- Gastrointestinal motility and disorders
- Esophageal Cancer Research and Treatment
- Gastrointestinal disorders and treatments
- Colorectal Cancer Screening and Detection
- Liver Disease and Transplantation
- Pediatric Hepatobiliary Diseases and Treatments
- COVID-19 and healthcare impacts
- Tracheal and airway disorders
- Gastrointestinal Tumor Research and Treatment
- Respiratory and Cough-Related Research
- Gastric Cancer Management and Outcomes
- Cholangiocarcinoma and Gallbladder Cancer Studies
- Diet and metabolism studies
- Infection Control and Ventilation
- COVID-19 Clinical Research Studies
- IL-33, ST2, and ILC Pathways
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
2016-2025
University of Milan
2016-2025
Ospedale Maggiore
2008-2023
Istituti di Ricovero e Cura a Carattere Scientifico
1995-2023
Mylan (Switzerland)
2022
Stanford University
2021
College Track
2020
Azienda Socio Sanitaria Territoriale Bergamo Est
2020
Ospedale Civile di Giaveno
2014
Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani
2014
Achalasia is a relatively rare primary motor esophageal disorder, characterized by absence of relaxations the lower sphincter and peristalsis along body. As result, patients typically present with dysphagia, regurgitation occasionally chest pain, pulmonary complication malnutrition. New diagnostic methodologies therapeutic techniques have been recently added to armamentarium for treating achalasia. With aim offer clinicians an up-to-date framework making informed decisions on management this...
Abstract Background Criteria for transient lower esophageal sphincter relaxations ( TLESR s) are well‐defined Dentsleeve manometry. As high‐resolution manometry HRM ) is now the gold standard to assess motility, our aim was propose a consensus definition of s using . Methods Postprandial combined with impedance performed in 10 patients gastroesophageal reflux disease. Transient identification by 17 experts Delphi process. Four investigators then characterized candidates that achieved 100%...
We developed and evaluated objective manometric criteria that define transient lower esophageal sphincter (LES) relaxation. In 23 normal subjects 9 patients with gastroesophageal reflux disease, systematic analysis of swallow-induced LES relaxation showed dry swallows preceded by a median 1.4 s. The rate was always > 1 mmHg/s, the nadir occurred within 7 s, duration < During concurrent manometry pH monitoring, 104 episodes associated pressure fall not related to swallowing were...
Multiple rapid swallowing (MRS) stimulates neural inhibition resulting in abolition of contractions the oesophageal body (OB) and complete lower sphincter (LOS) relaxation which is followed by peristalsis LOS contraction. The aim this study was to evaluate yield MRS detect abnormalities inhibitory or excitatory mechanisms patients with symptoms either normal standard manometry ineffective motility (IOM). (five water swallows, 2 mL, separated 2-3 s) evaluated 23 healthy subjects, 109...
Objective Antireflux surgery can be proposed in patients with GORD, especially when proton pump inhibitor (PPI) use leads to incomplete symptom improvement. However, date, international consensus guidelines on the clinical criteria and additional technical examinations used patient selection for antireflux are lacking. We aimed at generating key recommendations of surgery. Design included 35 experts (gastroenterologists, surgeons physiologists) a Delphi process developed 37 statements that...
End points used to determine treatment efficacy in eosinophilic esophagitis (EoE) have evolved over time. With multiple novel therapies development for EoE, harmonization of outcomes measures will facilitate evidence synthesis and appraisal when comparing different treatments. We sought develop a core outcome set (COS) controlled observational studies pharmacologic diet interventions adult pediatric patients with EoE. Candidate were generated from systematic literature reviews patient...
The Lyon Consensus designates Los Angeles (LA) grade C/D esophagitis or acid exposure time (AET) >6% on impedance-pH monitoring (MII-pH) as conclusive for gastroesophageal reflux disease (GERD). We aimed to evaluate proportions with objective GERD among symptomatic patients LA A, B, and C endoscopy.Demographics, clinical data, endoscopy findings, proton-pump inhibitor response were collected from prospectively enrolled 2 referral centers. Off-therapy MII-pH parameters included AET, number of...
Summary Background The diagnosis of gastro‐oesophageal reflux disease (GERD) based on otolaryngologist's assessment laryngoscopic findings remains contentious in terms sensitivity and specificity. Aims To evaluate GERD prevalence, applying Lyon 2.0 Consensus criteria, patients with extra‐oesophageal symptoms undergoing examination impedance‐pH monitoring. Methods In this retrospective assessment, we included 470 symptoms, either isolated or combined typical who had been referred to six...
Abstract Information on the mechanism of gastro‐oesophageal reflux in patients with disease is limited largely to studies resting recumbent subjects. Evidence exists that both posture and physical activity may influence reflux. The aim this study was investigate mechanisms ambulant oesophagitis. Concurrent ambulatory oesophageal manometry pH monitoring were performed 11 erosive Lower sphincter (LOS) pressure monitored a perfused sleeve sensor. Recordings made for 90 min before 180 after...
The diagnosis of functional heartburn is important for management, however it stands on fragile pH monitoring variables, ie, acid exposure time varies from day to and symptoms are often few or absent. Aim this study was investigate consistency the in subsequent days using prolonged wireless its impact patients' outcome.
OBJECTIVES: Rising trends in eosinophilic esophagitis (EoE) have been repeatedly linked to decliningHelicobacter pylori (H. pylori)infection, mostly retrospective studies. We aimed prospectively evaluate this inverse association. METHODS: Prospective case-control study conducted 23 centers. Children and adults naïve eradication therapy forH. pyloriwere included. Cases were EoE patients, whereas controls defined by esophageal symptoms <5 eos/HPF on biopsies.H. pyloristatus was diagnosed...
Abstract Background Association between proportions of hypomotile swallows on esophageal high‐resolution manometry (HRM) and reflux burden remains incompletely understood. We investigated relationships hypomotility, acid exposure time (AET), mean nocturnal baseline impedance (MNBI) ambulatory monitoring. Methods Clinical data, HRM, pH‐impedance studies (performed off suppression) from patients with persisting symptoms were reviewed five international centers. AET (abnormal > 6%) MNBI <...
Abstract Esophageal hypomotility disorders manifest with abnormal esophageal body contraction vigor, breaks in peristaltic integrity, or failure of peristalsis the context normal lower sphincter relaxation on high‐resolution manometry (HRM). The Chicago Classification version 4.0 recognizes two disorders, ineffective motility (IEM) and absent contractility, while fragmented has been incorporated into IEM definition. Updated criteria for swallows consist weak vigor measured using distal...
To validate Lyon Consensus criteria for diagnosing gastro-oesophageal reflux disease (GORD) by monitoring.Manual review of impedance-pH tracings from patients with proton pump inhibitor (PPI)-dependent heartburn, evaluated off PPI. Acid exposure time (AET) thresholds defined the and impedance parameters were investigated, namely, total refluxes (TRs), postreflux swallow-induced peristaltic wave (PSPW) index mean nocturnal baseline (MNBI).The study included 488 patients, 178 (36%) normal...
Summary Background A hierarchical approach for gastro‐oesophageal reflux disease (GERD) diagnosis by impedance‐pH monitoring was proposed the Lyon Consensus, based on acid exposure time (AET) and supportive impedance metrics. Aims To establish clinical value of Consensus criteria in work‐up patients with proton pump inhibitory (PPI)‐refractory heartburn. Methods Expert review off‐therapy tracings from unproven GERD PPI‐refractory heartburn prospectively evaluated at referral centers....
The abnormally high postprandial rate of transient lower oesophageal sphincter relaxations seen in patients with reflux disease may be related to altered proximal gastric motor function. Heightened visceral sensitivity also contribute reporting symptoms these patients.To assess function the stomach and perception a barostat.Fasting motility, sensation, were measured nine healthy subjects. Gastric emptying solids liquids was assessed six on different day (and compared historical...