G A Lanfranchi

University of Bologna, Bolonia, Emilia-Romagna, Italy

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Publications (86)603.09 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Methods: A multicentre randomized controlled trial was conducted to evaluate the efficacy of oral mesalazine (5-aminosalicylic acid) for the prevention of post-operative recurrence in 110 patients operated on for Crohn's disease by first intestinal resection. Patients were randomly allocated to receive 2.4 g/day of mesalazine, or no treatment at all. The protocol included colonoscopy with ileoscopy at 6 months and yearly thereafter. Recurrence was denned on the basis of endoscopic criteria and classified as mild or severe.Results: The demographic and pre-trial characteristics were very similar in the two groups of patients. The cumulative proportion of recurrence at 6, 12 and 24 months was significantly lower in the mesalazine group than in untreated group (P= 0.002). At 24 months the cumulative proportions of endoscopic recurrence were 0.52 + 0.12 (± S.E.M.) and 0.85 (±0.07), respectively. At the same time the cumulative proportions of symptomatic recurrence were 0.18 + 0.09 and 0.41 + 0.09 (P= 0.006). The cumulative proportions of the severe recurrence was also significantly lower in the mesalazine group (0.17±0.09 vs. 0.38±0.09; P= 0.021). Conclusions: The preliminary results of this study show that administration of oral mesalazine soon after surgery is effective in preventing post-operative endoscopic recurrence in Crohn's disease over a 2-year period. It is estimated that this treatment prevents 39% of all recurrences and 55% of the severe recurrences.
    No preview · Article · Mar 2007 · Alimentary Pharmacology & Therapeutics
  • A Tragnone · G Corrao · F Miglio · R Caprilli · G A Lanfranchi
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    ABSTRACT: The epidemiology of inflammatory bowel disease (IBD) in Southern Europe is still unclear. Sporadic reports suggest a lower incidence of IBD in Italy than in other Western Countries and the USA. A nationwide population-based study was carried out to estimate IBD incidence rates in eight Italian cities. All new cases of IBD diagnosed over 4 years in the target populations were collected from multiple information sources. From 1989 to 1992, 509 ulcerative colitis (UC), 222 Crohn's disease (CD) and 10 undefined IBD cases were collected, giving age-adjusted incidence rates (per 100,000 per year) of 5.2 for UC and 2.3 for CD. Using the capture-recapture method, an estimated completeness of 0.81 was obtained for case archives, without appreciable and significant differences between areas. The rates computed after correcting underestimation were 6.8 for UC and 2.8 for CD. The sex ratio M/F was 1.7 for UC and 1.0 for CD. The highest age-specific incidence rates were between 30 and 39 years for UC and between 20 and 29 years for CD. The incidence rate of CD in italy is homogeneous between the cities investigated and lower than those reported for other Mediterranean countries. In contrast, the UC incidence rate is within the range of those reported in European studies. A wide variability in the UC rates between the cities was also observed. These results could be related to different environmental factors or the genetic background of the populations, or both.
    No preview · Article · Nov 1996 · International Journal of Epidemiology
  • A Tragnone · G Bazzocchi · G Aversa · M G Pecorelli · G Elmi · S Venerato · G A Lanfranchi
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    ABSTRACT: Inflammatory bowel disease, in addition to intestinal involvement, may be complicated also by other extra-intestinal manifestations. Moreover, drugs commonly employed in the treatment of ulcerative colitis and Crohn's disease may induce iatrogenic pancreatitis. Acute pancreatitis is described in two ulcerative colitis patients following azathioprine treatment.
    No preview · Article · Jan 1996 · The Italian journal of gastroenterology
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    ANTONELLA TRAGNONE · GIOVANNI CORRAO · FEDERICO MIGLIO · RENZO CAPRILLI · GIORGIO ASSUERO LANFRANCHI
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    ABSTRACT: Tragnone A (Institute of Internal Medicine and Gastroenterology, University of Bolgna, Bologna, Italy) Corrao G, Miglio F, Caprilli R, Lanfranchi G A and Gruppo Italiano per lo Studio del Colon e del Retto (GISC). Incidence of inflammatory bowel disease in Italy: A nationwide population-based study. International Journal of Epidemiology 1996; 25: 1044–1052. Background The epidemiology of inflammatory bowel disease (IBD) in Southern Europe is still unclear. Sporadic reports suggest a lower incidence of IBD in Italy than in other Western Countries and the USA. Methods A nationwide population-based study was carried out to estimate IBD incidence rates in eight Italian cities. All new cases of IBD diagnosed over 4 years in the target populations were collected from multiple information sources. Results From 1989 to 1992, 509 ulcerative colitis (UC), 222 Crohn's disease (CD) and 10 undefined IBD cases were collected, giving age-adjusted incidence rates (per 100 000 per year) of 5.2 for UC and 2.3 for CD. Using the capture-recapture method, an estimated completeness of 0.81 was obtained for case archives, without appreciable and significant differences between areas. The rates computed after correcting underestimation were 6.8 for UC and 2.8 for CD. The sex ratio M/F was 1.7 for UC and 1.0 for CD. The highest age-specific incidence rates were between 30 and 39 years for UC and between 20 and 29 years for CD Conclusions The incidence rate of CD in Italy is homogeneous between the cities investigated and lower than those reported for other Mediterranean countnes. In contrast, the UC incidence rate is within the range of those reported in European studies. A wide variability in the UC rates between the cities was also observed These results could be related to different environmental factors or the genetic background of the populations, or both.
    Preview · Article · Jan 1996 · International Journal of Epidemiology
  • A Tragnone · D Valpiani · F Miglio · G Elmi · G Bazzocchi · E Pipitone · G A Lanfranchi
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    ABSTRACT: To examine the influence of dietary factors in Italian patients with ulcerative colitis and Crohn's disease. We studied dietary habits immediately prior to the onset of disease in 104 patients enrolled in a prospective, epidemiological study of the incidence of inflammatory bowel disease in Italy. Each patient was interviewed using a recall questionnaire to provide information on the daily intake of nutrients. The differences in diet between patients and healthy subjects matched for age, sex and city of residence were determined. Our data confirm that patients with Crohn's disease and ulcerative colitis have a high intake of total carbohydrate, starch and refined sugar. This resulted in a significantly higher relative risk (P < 0.001) in both ulcerative colitis and Crohn's disease patients. Total protein intake was significantly higher in ulcerative colitis, but not in Crohn's disease patients, than in controls. Fibre consumption did not differ between patients and controls. Our results confirm that carbohydrate consumption is significantly higher in IBD patients than in healthy controls. Ulcerative colitis patients also consumed more total protein than controls. The pathogenetic significance of these findings, however, remains unclear.
    No preview · Article · Feb 1995 · European Journal of Gastroenterology & Hepatology
  • R Caprilli · A Andreoli · L Capurso · G Corrao · G D'Albasio · A Gioieni · G Assuero Lanfranchi · I Paladini · F Pallone · V Ponti
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    ABSTRACT: A multicentre randomized controlled trial was conducted to evaluate the efficacy of oral mesalazine (5-aminosalicylic acid) for the prevention of post-operative recurrence in 110 patients operated on for Crohn's disease by first intestinal resection. Patients were randomly allocated to receive 2.4 g/day of mesalazine, or no treatment at all. The protocol included colonoscopy with ileoscopy at 6 months and yearly thereafter. Recurrence was defined on the basis of endoscopic criteria and classified as mild or severe. The demographic and pre-trial characteristics were very similar in the two groups of patients. The cumulative proportion of recurrence at 6, 12 and 24 months was significantly lower in the mesalazine group than in untreated group (P = 0.002). At 24 months the cumulative proportions of endoscopic recurrence were 0.52 +/- 0.12 (+/- S.E.M.) and 0.85 (+/- 0.07), respectively. At the same time the cumulative proportions of symptomatic recurrence were 0.18 +/- 0.09 and 0.41 +/- 0.09 (P = 0.006). The cumulative proportions of the severe recurrence was also significantly lower in the mesalazine group (0.17 +/- 0.09 vs. 0.38 +/- 0.09; P = 0.021). The preliminary results of this study show that administration of oral mesalazine soon after surgery is effective in preventing post-operative endoscopic recurrence in Crohn's disease over a 2-year period. It is estimated that this treatment prevents 39% of all recurrences and 55% of the severe recurrences.
    No preview · Article · Mar 1994 · Alimentary Pharmacology & Therapeutics
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    ABSTRACT: A new experimental system was designed to study human uterine activities based on the extra-corporeal perfusion of isolated human uteri. Electromechanical activities in the uterine wall were recorded using bipolar silver-silver electrodes, endoluminal pressure catheters and a dedicated acquisition, storage and analytical system. The electrical signals recorded were isolated spikes and rhythmic activities; the last being primarily associated with organized mechanical events. Perfusion media containing 17 beta-oestradiol alone or with progesterone were used for those uteri obtained during proliferative (n = 5) or secretory (n = 5) phases of the menstrual cycle, respectively. Progesterone caused a reduction of frequency (P < 0.001) and duration (P < 0.001) of the rhythmic electrical activity, and decreased the endoluminal pressure at both detection sites (P < 0.01). 17 beta-Oestradiol increased both frequency (P < 0.001) and duration (P < 0.001) of the rhythmic electrical activity as well as the endoluminal pressure at two different detection sites (3 and 5 cm from the fundus) (P < 0.05). Significant differences between the fundus and cervix sites in the uterine wall were detected. In conclusion, uterine perfusion would be useful to examine the effects of uterotonic and tocolytic drugs before administration to humans, at no risk to the patients. Oestrogens increase and progesterone decreases both electrical and mechanical uterine activities.
    No preview · Article · Oct 1993 · Human Reproduction
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    ABSTRACT: This Working Team Report (WTR) was planned with the aim of addressing the issue of postoperative recurrence in Crohn's disease, examining the criteria used for definition. The WTR was also intended to provide an optimal schedule of surveillance of patients after bowel resection. The team agreed that Recurrence is to be defined as the reappearance of new macroscopic disease and that disease-specific gross anatomical changes may occur without overt clinical symptoms (Asymptomatic Recurrence). The relative merits of radiology, imaging and endoscopy in detecting these changes have been examined by the team. It was also agreed that the early detection of asymptomatic recurrence and the definition of criteria helpful in identifying patients developing active symptoms and in predicting the clinical course are important clinical issues. A tentative schedule of surveillance after bowel resection was provided based on the use of non-invasive tests for early detection of asymptomatic recurrence and regular endoscopy for defining and assessing established recurrence.
    No preview · Article · Jan 1993
  • Antonella Tragnone · Carlo Hanau · Gabriele Bazzocchi · Giorgio Assuero Lanfranchi
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    ABSTRACT: Recently, in Bologna, an inflammatory bowel disease incidence of 7.7/10(5)/year has been calculated, about one third of that reported in Northern Europe, confirming the existence of a 'North-South gradient'. A first peak of incidence was observed at 20-29 years of age and a second peak at 60-69 years of age for ulcerative colitis (UC) alone. A prevalence of UC males, mainly after the 7th decade, and of Crohn's disease (CD) females in the first peak was found. A greater frequency of ex-smokers in UC, with a relative risk (RR) significantly higher in males for all age groups (RR = 6.1; p < 0.01) and of smokers in CD with a RR significantly higher in 20- to 29-year-old females (RR = 11.6; p < 0.05) was observed. A different pattern for the two diseases exists: male ex-smokers and young female smokers are at risk of developing UC and CD, respectively.
    No preview · Article · Jan 1993 · Digestion
  • Gabriele Bazzocchi · Antonella Difalco · Giuliano Bensi · Giorgio A. Lanfranchi
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    ABSTRACT: Anorectal manometry was performed after giving 5 mg of cimetropium bromide, an antimuscarinic compound, and placebo intravenously, according to a crossover design, to 13 patients with constipation, chronic abdominal pain, and normal or slightly delayed intestinal transit in the left colon. Patients with delayed transit in each of the colonic segments and with anal or pelvic floor pathology were excluded. Anal resting tone and internal anal sphincter relaxation were in the upper area of the normal range; rectal sensitivity in the lower. Motor and sensitivity parameters did not show any significant difference after cimetropium and placebo, apart from the threshold to onset of painful sensation, which was reduced after cimetropium. Previous studies have shown that anticholinergic agents inhibit the increased sigmoid colon motility in patients with irritable bowel syndrome. Our study shows that in painful constipation (a clinical variety of irritable bowel syndrome), the anorectal motor parameters are not modified by the muscarinic blockade as it occurs in the sigmoid colon. Moreover, these results confirm that internal anal sphincter resting tone and its relaxation due to rectal distention are not cholinergically modulated.
    No preview · Article · Jul 1992 · Current Therapeutic Research
  • G.A. Lanfranchi · A Tragnone

    No preview · Article · May 1992 · The Lancet
  • G Bazzocchi · G A Lanfranchi
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    ABSTRACT: In an attempt to computerize the measurements of various analytical features of gastrointestinal motility signals, a brief description of these signals, particularly for myoelectric and contractile activities, is given. The study of myoelectrical activity includes frequency and coupling based on period (1/T) and Fast Fourier Transform (FFT) based correlation and spectral analysis techniques. The contractile signals are studied for motility index as an indication of the amount of activity, waveform features, propagational characteristics, and the frequency of contractions. To deal with situations where only electrical activities are recorded, a methodology for the analysis of spike bursts as per contractile activities is given.
    No preview · Article · May 1991 · Minerva chirurgica
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    ABSTRACT: Levels of zinc in plasma from patients with Crohn's disease were significantly lower than those of sex and age matched controls. We also measured the level of plasmic thymulin, a hormone released by the thymus gland, which in its active form binds one zinc molecule. The zinc unbound form of thymulin is biologically inactive and its level in the blood is a very sensitive marker of even marginal zinc deficiency. Levels of active thymulin were significantly reduced in plasma from patients with Crohn's disease, whereas plasma concentrations of the inactive form was higher than in controls. The in vitro addition of zinc ions restored thymulin activity in plasma from patients with Crohn's disease, and induced the disappearance of the inactive form. These findings suggest the existence of a zinc dependent alteration regarding the biological function of thymic hormones in patients with Crohn's disease. Such a defect might explain some of the immunological abnormalities observed in these pathological conditions.
    No preview · Article · Jul 1990 · Journal of clinical & laboratory immunology
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    A Tragnone · G A Lanfranchi

    Preview · Article · Jan 1990 · Gut
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    ABSTRACT: In Crohn's disease, prednisone is believed to be ineffective for relapse prevention. Because all patients with Crohn's Disease Activity Index lower than 150 and with some altered lab tests (erythrocyte sedimentation rate, C-reactive protein, alpha-1-acid glycoprotein, alpha-1-acid antitrypsin, and white blood cell count) had a clinical relapse in 18 months of follow-up, we tried to ascertain whether methylprednisolone could reduce the risk of clinical relapse in such patients. Eighteen patients were included in a controlled study against placebo. Nine patients were treated with methylprednisolone at a dosage of 0.25 mg/kg daily for a period of 6 months; treatment was discontinued if disease relapsed or if lab tests were normalized. During the steroid treatment, 1 of 9 patients showed a clinical relapse; in 7, the normalization of lab tests was obtained; in 5 of these 7 patients a relapse occurred within 1 month after the suspension of the treatment; in 1 patient, lab tests remained altered. In those 9 patients on placebo, relapses occurred in 7. We conclude that methylprednisolone was effective in the prevention of relapses for patients in clinical remission but with altered lab tests.
    No preview · Article · Jan 1989 · Journal of Clinical Gastroenterology
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    G A Lanfranchi · G Bazzocchi · M Campieri · C Brignola · F Fois · B P Imbimbo
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    ABSTRACT: Cimetropium bromide is an antimuscarinic compound with antispasmodic properties. Its effect on meal-stimulated sigmoid motor activity in 30 patients with the irritable bowel syndrome, mainly with pain and constipation, has been evaluated. The mechanical activity of the sigmoid colon was recorded with a probe with three open-tipped tubes ending 45, 30, and 15 cm from the anal margin. After a recording period of 60 min, 5 mg cimetropium bromide or saline was given i.v., according to a randomized, double-blind design 5 min before a 1000 calorie meal, and motility was then recorded for 2 h. The meal caused a significant increase in motor activity for 90 min in the saline-treated group. Cimetropium bromide abolished the peak of motor activity 10-20 min after the meal and significantly inhibited postprandial colonic motility for at least 2 h (p less than 0.01). This effect provides a rationale for the use of cimetropium bromide in treatment of the irritable bowel syndrome.
    Full-text · Article · Jun 1988 · European Journal of Clinical Pharmacology
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    ABSTRACT: The clinical course of Crohn's disease in 131 patients was studied for a mean period of 4.2 +/- 3.2 years. The clinical activity of the disease, expressed as percentage of patients per year in an active phase, is high in the first year (70.2 percent) and progressively decreases during subsequent years (25 percent after seven years). The percentage of patients who needed steroid treatment is high during the first year (68 percent) and falls to 19 percent after seven years. An operative risk rate of 54 percent was registered, with a probability of reoperation equal to 34 percent. Clinical relapse after the first surgery occurred in 70 percent of cases. The registered mortality was 6.9 percent, with a ratio of 6 to 1 between observed and expected mortality. In conclusion, the disease, while showing a tendency to reduce its activity over the years, is burdened by a risk of surgery and mortality which progressively increases with time.
    No preview · Article · Dec 1987 · Diseases of the Colon & Rectum
  • C Brignola · M Campieri · G Bazzocchi · P Farruggia · A Tragnone · G A Lanfranchi
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    ABSTRACT: Currently there are no completely reliable methods for predicting an impending relapse in Crohn's disease. As approximately 50% of patients in remission [Crohn's disease activity index (CDAI) less than 150] show some laboratory abnormalities, we inquired whether these alterations might be of value for predicting relapse. We prospectively studied 41 patients with Crohn's disease who had been showing CDAI less than 150 for at least 6 mo before entering the study and who were not receiving any long-term treatment. The 41 patients were studied at the ninth and at the 18th month after inclusion in the study. Disease activity was monitored by CDAI calculation and by measurement of erythrocyte sedimentation rate, white blood cell count, hemoglobin, albumin, alpha 2-globulin, serum iron, C-reactive protein, alpha 1-glycoprotein, and alpha 2-antitrypsin. Seventeen of the 41 patients had a clinical relapse during follow-up. At the beginning of the study the patients who later relapsed showed a remarkable alteration of acid alpha 1-glycoprotein (p less than 0.0001), alpha 2-globulin (p less than 0.0003), and erythrocyte sedimentation rate (p less than 0.0006), in comparison with the patients who remained in remission. by discriminant analysis a prognostic index with these laboratory investigations provided a high percentage (88%) of accuracy according to the outcome at the 18th month.
    No preview · Article · Jan 1987 · Gastroenterology
  • C Brignola · R Miniero · M Campieri · G Bazzocchi · S Vegetti · P Farruggia · G A Lanfranchi
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    ABSTRACT: The role of allergic responses to dietary antigens in the pathogenesis of inflammatory Bowel Disease (IBD) remains speculative. We studied 50 patients with Ulcerative Colitis (UC), 50 patients with Crohn's Disease (CD) and 100 healthy controls (HC) matched for sex and age. In these patients total serum IgE and specific IgE to ten selected foods were estimated using Phadebas PRIST and RAST. There was no significant difference in the total serum IgE level between UC, CD and HC. The percentage of positive reaction to specific IgE was significantly lower in HC (score 1-2: 7%; score 2: 3%) compared with UC (score 1-2: 24%, p less than 0.004; score 2: 8%, n.s.) and CD (score 1-2: 16%, n.s.; score 2: 12%, p less than 0.03). In CD with colic or ileocolic involvement, the percentage of patients with a positive response to RAST was significantly greater (score 1-2: 26%; score 2: 21%) than in CD with ileal involvement. The considerable increase in positive results to RAST in IBD may be due to a greater absorption of antigens through the diseased wall.
    No preview · Article · Jul 1986 · Hepato-gastroenterology
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    ABSTRACT: Some laboratory investigations are abnormal during the course of Crohn's disease (CD). We investigated the trend of some of these laboratory tests in a group of patients with CD to study the relationships between an activity index made up of such laboratory parameters only (LCDAI) and the usual Crohn's disease activity index (CDAI). One hundred thirty-one examinations of 63 patients were evaluated. At each investigation, besides calculation of the CDAI, 10 laboratory investigations were carried out. Three gastroenterologists independently gave an overall evaluation of the laboratory activity for each of the 131 examinations on the basis of the results of the blood tests alone. The sum of the evaluations was used as an independent variable on which a laboratory index was developed by multiple regression analysis. C reactive protein, red cell sedimentation rate, acid alpha 1-glycoprotein, alpha 1-antitrypsin, and white blood cells had an important share in the development of this laboratory index. The evaluation of the relationships existing between LCDAI and CDAI showed that in patients with moderate to severe clinical disease activity, LCDAI was constantly altered. The same happened in 55% of cases in clinical remission, which suggests an inflammatory activity that is not clinically evident. These results point to the advisability of supplementing a predominantly clinical index, such as CDAI, with a laboratory index such as LCDAI in the evaluation of CD.
    No preview · Article · Jul 1986 · Journal of Clinical Gastroenterology

Publication Stats

2k Citations
603.09 Total Impact Points

Institutions

  • 1972-2007
    • University of Bologna
      • • Department of Pharmacy and Biotechnology FaBiT
      • • Department of Experimental, Diagnostic and Specialty Medicine DIMES
      Bolonia, Emilia-Romagna, Italy
  • 1994
    • Università degli Studi dell'Aquila
      Aquila, Abruzzo, Italy
  • 1975
    • Società Italiana di Radiologia Medica
      Milano, Lombardy, Italy