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Renal function and physical fitness after 12-mo supervised training in kidney transplant recipients

World Journal of Transplantation 2018年第1期8卷 13-22页

作者： Giulio Sergio Roi Giovanni Mosconi Valentina Totti Maria Laura Angelini Erica Brugin Patrizio Sarto Laura Merlo Sergio Sgarzi Michele Stancari Paola Todeschini Gaetano La Manna Andrea Ermolao Ferdinando Tripi Lucia Andreoli Gianluigi Sella Alberto Anedda Laura Stefani Giorgio Galanti Rocco Di Michele Franco Merni Manuela Trerotola Daniela Storani alessandro nanni costa Department of Education and Research Isokinetic Medical Group Department of Nephrology and Dialysis Morgagni-Pierantoni Hospital Department of Biomedical & Neuromotor Sciences University of Bologna Associazione Nazionale Emodializzati Dialisi e Trapianto Department of Cardiovascular Sports Medicine Sports Medicine ULSS Company 9 Sports Medicine Regional Hospital of Bologna Department of Nephrology and Dialysis S. Orsola Hospital Sports Medicine Unit DIMED Department of Medicine University of Padua Sports Medicine Regional Hospital of Modena Sports Medicine Regional Hospital of Ravenna Sports Medicine Regional Hospital of Parma Department of Experimental and Clinical Medicine School of Sports Medicine University of Florence Sports Medicine Centre Italian National Transplant Centre

AIM To evaluate the effect of a 12-mo supervised aerobic and resistance training, on renal function and exercise capacity compared to usual care recommendations.METHODS Ninety-nine kidney transplant recipients(KTRs) were assigned to interventional exercise(Group A; n = 52) and a usual care cohort(Group B; n = 47). Blood and urine chemistry, exercise capacity, muscular strength, anthropometric measures and health-related quality of life(HRQo L) were assessed at baseline, and after 6 and 12 mo. Group A underwent a supervised training three times per week for 12 mo. Group B received only general recommendations about home-based physical activities.RESULTS Eighty-five KTRs completed the study(Group A, n = 44; Group B, n = 41). After 12 mo, renal function remained stable in both groups. Group A significantly increased maximum workload(+13 W, P = 0.0003), V'O2 peak(+3.1 mL/kg per minute, P = 0.0099), muscular strength in plantar flexor(+12 kg, P = 0.0368), height in the countermovement jump(+1.9 cm, P = 0.0293) and decreased in Body Mass Index(-0.5 kg/m^2, P = 0.0013). HRQo L significantly improved in physical function(P = 0.0019), physical-role limitations(P = 0.0321) and social functioning scales(P = 0.0346). Noimprovements were found in Group B.CONCLUSION Twelve-month of supervised aerobic and resistance training improves the physiological variables related to physical fitness and cardiovascular risks without consequences on renal function. Recommendations alone are not sufficient to induce changes in exercise capacity of KTRs. Our study is an example of collaborative working between transplant centres, sports medicine and exercise facilities.

关键词： Kidney transplant recipients Renal function Supervised exercise Aerobic exercise Muscle strength

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World Journal of Gastroenterology 2022年第12期28卷 1226-1238页

作者： Nadia Marascio Salvatore Rotundo Angela Quirino Giovanni Matera Maria Carla Liberto Chiara costa alessandro Russo Enrico Maria Trecarichi Carlo Torti Department of Health Sciences Unit of MicrobiologyUniversity“Magna Graecia”of CatanzaroCatanzaro 88100Italy Department of Medical and Surgical Sciences Unit of Infectious and Tropical Diseases"Magna Graecia"University of CatanzaroCatanzaro 88100Italy

Hepatitis E virus(HEV)and hepatitis C virus(HCV)are both RNA viruses with a tropism for liver parenchyma but are also capable of extrahepatic manifestations.Hepatitis E is usually a viral acute fecal-oral transmitted and self-limiting disease presenting with malaise,jaundice,nausea and vomiting.Rarely,HEV causes a chronic infection in immunocompromised persons and severe fulminant hepatitis in pregnant women.Parenteral HCV infection is typically asymptomatic for decades until chronic complications,such as cirrhosis and cancer,occur.Despite being two very different viruses in terms of phylogenetic and clinical presentations,HEV and HCV show many similarities regarding possible transmission through organ transplantation and blood transfusion,pathogenesis(production of antinuclear antibodies and cryoglobulins)and response to treatment with some direct-acting antiviral drugs.Although both HEV and HCV are well studied individually,there is a lack of knowledge about coinfection and its consequences.The aim of this review is to analyze current literature by evaluating original articles and case reports and to hypothesize some interactions that can be useful for research and clinical practice.

关键词： Hepatitis C virus Hepatitis E virus Co-infection Genomic variability Extrahepatic diseases Vaccine

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Endoscopic management of difficult common bile duct stones:Where are we now?A comprehensive review

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World Journal of Gastroenterology 2021年第44期27卷 7597-7611页

作者： Alberto Tringali Deborah costa alessandro Fugazza Matteo Colombo Kareem Khalaf alessandro Repici Andrea Anderloni Gastroenterology and Endoscopy Unit Department of MedicineConegliano HospitalULSS 2 Marca TrevigianaConegliano 31015Italy Digestive Endoscopy Unit Department of GastroenterologyHumanitas Research Hospital IRCCSRozzano 20089MilanItaly Department of Biomedical Sciences Humanitas UniversityPieve Emanuele 20072MilanItaly

Endoscopic management for difficult common bile duct(CBD)stones still presents a challenge for several reasons,including anatomic anomalies,patients’individual conditions and stone features.In recent years,variable methods have emerged that have attributed to higher stone removal success rates,reduced cost and lower adverse events.In this review,we outline a stepwise approach in CBD stone management.As first line therapy,endoscopic sphincterotomy and large balloon dilation are recommended,due to a 30%-50%reduction of the use of mechanical lithotripsy.On the other hand,cholangioscopy-assisted lithotripsy has been increasingly reported as an effective and safe alternative technique to mechanical lithotripsy but remains to be reserved in special settings due to limited large-scale evidence.As discussed,findings suggest that management needs to be tailored to the patient’s characteristics and anatomical conditions.Furthermore,we evaluate the management of CBD stones in various surgical altered anatomy(Billroth II,Roux-en-Y and Roux-en-Y gastric bypass).Moreover,we could conclude that cholangioscopy-assisted lithotripsy needs to be evaluated for primary use,rather than following a failed management option.In addition,we discuss the importance of dissecting other techniques,such as the primary use of interventional endoscopic ultrasound for the management of CBD stones when other techniques have failed.In conclusion,we recognize that endoscopic sphincterotomy and large balloon dilation,mechanical lithotripsy and intraductal lithotripsy substantiate an indication to the management of difficult CBD stones,but emerging techniques are in rapid evolution with encouraging results.

关键词： Common bile duct stones Balloon dilation Endoscopic retrograde cholangiopancreatography Endoscopic ultrasonography Anastomoses,Roux en y Double balloon enteroscopy Mechanical lithotripsy Cholangioscopy

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Metabolomics characterization of colostrum in three sow breeds and its influences on piglets' survival and litter growth rates

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Journal of Animal Science and Biotechnology 2018年第3期9卷 618-629页

作者： Gianfranco Picone Martina Zappaterra Diana Luise Alessia Trimigno Francesco Capozzi Vincenzo Motta Roberta Davoli Leonardo nanni costa Paolo Bosi Paolo Trevisi Department of Agricultural and Food Sciences (DISTAL) Alma Mater Studiorum-University of Bologna

Background: Colostrum is the first secretion produced by mammary glands during the hours immediately preceding and succeeding parturition. This secretion differs from milk and represents an essential vehicle of passive immunity,prebiotic compounds and growth factors involved in intestinal development. Most of the literature concerning colostrum composition refers mainly to human and cow; and little is known about pig colostrum metabolome and how it varies between pig breeds and different farrowing parity. Thus, the aim of the present research is to provide new information about pig colostrum composition and the associations between metabolites, the sows' breed and the survival and growth rates of their litters.Results: Colostrum samples were gathered from 58 parturitions of sows belonging to three different breeds chosen for their importance in Italian heavy pig production: 31 Large White, 15 Landrace and 12 Duroc respectively. The defatted and ultrafiltered colostrum samples were analysed using1 H–NMR spectroscopy. Principal Components Analysis(PCA) was assessed on the obtained spectra. In addition, using a Stepwise Regression and a Linear Regression analyses the metabolites named after the signals assignment were tested for their associations with piglets' performances.Twenty-five metabolites were identified, comprehending monosaccharides, disaccharides(such as lactose), organic acids(lactate, citrate, acetate and formate), nitrogenous organic acids(such as creatine) and other compounds,including nucleotides. PCA results evidence a clustering due to breed and season effects. Lactose was the main compound determining the assignment of the samples into different clusters according to the sow breed. Furthermore, some metabolites showed to be associated with piglets' performance and survival traits: acetate and taurine were positively related to litter weight gain and piglets' survival rate, respectively, while dimethylamine and cis-aconitate were linked to new-borns' impaired ability to survive.Conclusions: The re

关键词： Colostrum 1H–NMR spectroscopy Metabolome Pig breeds Piglets survival

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Surgical treatment of ulcerative colitis in the biologic therapy era

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世界胃肠病学杂志：英文版 2012年第16期18卷 1861-1870页

作者： Alberto Biondi Marco Zoccali Stefano costa Albert Troci Ettore Contessini-Avesani alessandro Fichera Emergency and General Surgery Unit Fondazione IRCCS "Ca' Granda" Policlinico Maggiore20122 MilanItaly Department of Surgery University of Chicago Medical CenterChicagoIL 60637United States First General Surgery Unit Department of SurgeryCatholic University00168 RomeItaly

Recently introduced in the treatment algorithms and guidelines for the treatment of ulcerative colitis,biological therapy is an effective treatment option for patients with an acute severe flare not responsive to conventional treatments and for patients with steroid dependent disease.The reduction in hospitalization and surgical intervention for patients affected by ulcerative colitis after the introduction of biologic treatment remains to be proven.Furthermore,these agents seem to be associated with increase in cost of treatment and risk for serious postoperative complications.Restorative proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice in ulcerative colitis patients.Surgery is traditionally recommended as salvage therapy when medical management fails,and,despite advances in medical therapy,colectomy rates remain unchanged between 20% and 30%.To overcome the reported increase in postoperative complications in patients on biologic therapies,several surgical strategies have been developed to maintain long-term pouch failure rate around 10%,as previously reported.Surgical staging along with the development of minimally invasive surgery are among the most promising advances in this field.

关键词：溃疡性结肠炎生物治疗手术治疗药物治疗治疗方案住院治疗风险成本抢救治疗

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2D vs 3D laparoscopic right colectomy:A propensity score-matching comparison of personal experience with systematic review and meta-analysis

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World Journal of Gastrointestinal Surgery 2021年第6期13卷 597-619页

作者： Gianluca costa Pietro Fransvea Luca Lepre Fabio Rondelli alessandro costa Michela Campanelli Giorgio Lisi Maria Rosaria Mastrangeli Giovanni Guglielmo Laracca Giovanni Maria Garbarino Graziano Ceccarelli Surgery Center Campus Bio-MedicoRome 00128Italy Department of Emergency and Trauma Surgery Fondazione Policlinico Universitario A.Gemelli IRCCSRome 00168Italy General Surgery Unit Santo Spirito in Sassia HospitalRome 00193Italy Department of Surgical Science University of PerugiaSanta Maria Teaching HospitalTerni 05100Italy Catholic University“Our Lady of Good Council”School of Medicine Tirane 1023Albania Department of Emergency Surgery Tor Vergata University HospitalRome 00133Italy Department of General Surgery Sant'Eugenio HospitalRome 00144Italy Department of Medical Surgical Science and Translational Medicine Sapienza University of RomeSant'Andrea HospitalRome 00189Italy General Surgery Unit San Giovanni Battista HospitalFoligno 06034Italy

BACKGROUND The benefits of laparoscopic approach for right colectomy have been well established.However,the technical difficulty to construct the intra-corporeal anastomosis is still cumbersome.AIM To analyze the results of 3D and 2D laparoscopic right colectomy and to compare it to the published series through a systematic review and meta-analysis.METHODS A retrospective study with propensity score matching analysis of patients undergoing laparoscopic right colectomy at Umbria2 Hospitals from January 2014 to March 2020 was performed.A systematic review was accomplished comparing 2D and 3D right colectomy.RESULTS In the personal series 47 patients of the 2D group were matched to 47 patients of the 3D group.The 3D group showed a favorable trend in terms of mean operative time(170.7±32.9 min vs 183.8±35.4 min;P=0.053)and a significant lower anastomotic time(16.9±2.3 min vs 19.6±2.9 min,P<0.001).The complete mesocolic excision(CME)subgroups analysis showed a shorter anastomotic time(16.5±1.8 min vs 19.9±3.0 min;P<0.001)and operative time(175.0±38.5 min vs 193.7±37.1 min;P=0.063)in the 3D group.Six studies and our series were included in the meta-analysis with 551 patients(2D group:291;3D group:260).The pooled analysis demonstrated a significant difference in favour of the 3D group regarding the operative time(P<0.001)and the anastomotic time(P<0.001)while no differences were identified between groups in terms of blood loss(P=0.827),LNH yield(P=0.243),time to first flatus(P=0.333),postoperative complications(P=0.718)and length of stay(P=0.835).CONCLUSION The meta-analysis results showed that 3D laparoscopic right colectomy shortens operative and anastomotic time without affecting the standard lymphadenectomy.In our series,the advantage of the 3D system becomes evident when CME and/or more complex associated procedure are requested significantly reducing both the total operative and the anastomotic time.

关键词： Colon cancer Right colectomy Laparoscopy Complete mesocolic excision Two-dimensional Three-dimensional

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Ileal loop interposition:an alternative biliary bypass technique

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Hepatobiliary & Pancreatic Diseases International 2010年第6期9卷 654-657页

作者： Felipe JF Coimbra alessandro L Diniz Heber SC Ribeiro Wilson L costa Jr. Eduardo NP Lima AndréL Montagnini Abdominal Surgery Department Hospital do Cncer A.C.CamargoRua Professor Antnio Prudente 211LiberdadeSo PauloSP 01509-010Brazil Nuclear Medicine Imaging Department Hospital do Cncer A.C.CamargoRua Professor Antnio Prudente 211LiberdadeSo PauloSP 01509-010Brazil

BACKGROUND:Obstructive jaundice is a common condition in advanced digestive cancer.Palliative procedures can improve quality of life and allow patients to attempt a systemic treatment.Bilioenteric anastomosis is still the procedure of choice for patients in many centers.When a surgical bypass is not possible,biliary drainage can be done by placing endoscopic or transparietal stents,which are less durable methods even when an expandable stent is employed. METHODS:A 47-year-old male with an excellent clinical status and a previous cholecystectomy and an exploratory laparotomy for advanced gastric cancer was referred with obstructive jaundice.A preoperative CT scan showed a dilated bile duct and a small mass at the distal hepatic hilum.No other signs of metastasis were found.A surgical bilioenteric anastomosis was indicated.At surgery,a distal choledochal obstruction and a mesenteric retraction by a lymph node mass prevented the jejunum to ascend for a bilioenteric anastomosis. Surgically,an alternative bilioenteric bypass was performed by means of an ileal loop interposition between the bile duct and the jejunum. RESULT:The recovery of the patient was uneventful and his bilirubin levels normalized after one week.The patient was then referred for systemic chemotherapy. CONCLUSIONS:This alternative biliary bypass can be safely and easily performed,and may be a good alternative for patients already referred for surgery because of a better life expectancy and when the jejunum is not an alternative.

关键词： biliary bypass ileal loop interposition biliary cancer

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Fine Tuning of Real Time PCR as a First Tool for the Detection of G143A Substitution in <i>Venturia inaequalis</i>Samples

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American Journal of Plant Sciences 2021年第6期12卷 960-974页

作者： Ceren Turan Irene Maja nanni Lucia Landi alessandro Pirondi Marina Collina Department of Agricultural and Food Sciences University of Bologna Bologna Italy Department of Agricultural Food and Environmental Sciences Polytechnic University of Marche Ancona Italy

Apple scab caused by Venturia inaequalis (Cke.) Wint. is the most important disease of apple trees worldwide and requires a high number of fungicide applications. The G143A substitution in the inhibitor binding site of cytochrome b of V. inaequalis confers a high level of resistance to strobilurins targeting the bc1 complex. The aim of this work was to substitute the labor intensive in vitro assays, with the faster quantitative PCR. An allele-specific qPCR method with a newly designed primer set was successfully developed to quantitatively determine the frequency of QoI-resistant A143 allele in populations of V. inaequalis. To be able to suggest that the molecular method could be applied as unique and robust technique, we carried out in vitro sensitivity test to trifloxystrobin;first testing the relative germination and subsequently confirmed with the quantification of mutated allele frequencies by qPCR on forty-nine Italian V. inaequalis populations. qPCR gave a similar pattern to that obtained using in vitro conidial germination test in predominantly sensitive and resistant populations, the variability between these two tests was observed in some heterogen

关键词： Venturia inaequalis qPCR Strobilurin Cytochrome b

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Digital literacy as a potential barrier to implementation of cardiology tele-visits after COVID-19 pandemic: the INFO-COVID survey

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Journal of Geriatric Cardiology 2021年第9期18卷 739-747页

作者： Giuseppe Boriani Anna Maisano Niccolo Bonini alessandro Albini Jacopo Francesco Imberti Andrea Venturelli Matteo Menozzi Valentina Ziveri Vernizia Morgante Giovanni Camaioni Matteo Passiatore Gerardo De Mitri Giulia nanni Denise Girolami Riccardo Fontanesi Valerio Siena Daria Sgreccia Vincenzo Livio Malavasi Anna Chiara Valenti Marco Vitolo Cardiology Division Department of BiomedicalMetabolic and Neural SciencesUniversity of Modena and Reggio EmiliaPoliclinico di ModenaModenaItaly Clinical and Experimental Medicine University of Modena and Reggio EmiliaModenaItaly

BACKGROUND During the COVID-19 pandemic,the implementation of telemedicine has represented a new potential option for outpatient care.The aim of our study was to evaluate digital literacy among cardiology outpatients.METHODS From March to June 2020,a survey on telehealth among cardiology outpatients was performed.Digital literacy was investigated through six main domains:age;sex;educational level;internet access;availability of internet sources;knowledge and use of teleconference software programs.RESULTS The study included 1067 patients,median age 70 years,41.3%females.The majority of the patients(58.0%)had a secondary school degree,but among patients aged≥75 years old the most represented educational level was primary school or none.Overall,for internet access,there was a splitting between"never"(42.1%)and"every day"(41.0%),while only 2.7%answered"at least 1/month"and 14.2%"at least 1/week".In the total population,the most used devices for internet access were smartphones(59.0%),and WhatsApp represented the most used app(57.3%).Internet users were younger compared to non-internet users(63 vs.78 years old,respectively)and with a higher educational level.Age and educational level were associated with nonuse of internet(age-per 10-year increase odds ratio(OR)=3.07,95%CI:2.54-3.71,secondary school OR=0.18,95%CI:0.12-0.26,university OR=0.05,95%CI:0.02-0.10).CONCLUSIONS Telemedicine represents an appealing option to implement medical practice,and for its development it is important to address the gaps in patients’digital skills,with age and educational level being key factors in this setting.

关键词： the INFO-COVID survey Internet Digital literacy as a potential barrier to implementation of cardiology tele-visits after COVID-19 pandemic

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Safety and feasibility of thullium laser transurethral resection of prostate for the treatment of benign prostatic enlargement in overweight patients

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Asian Journal of Urology 2019年第3期6卷 270-274页

作者： Luca Carmignani Maria Chiara Clementi Claudia Signorini Gloria Motta Sebastiano Nazzani Franco Palmisano Elisa De Lorenzis Michele Catellani alessandro Francesco Mistretta Andrea Conti Valeria Tringali Maria Beatrice costa Damiano Vizziello Policlinico San Donato UrologySan DonatoMilaneseItaly Ospedale Maggiore Policlinico UrologyMilanItaly Istituto Europeo di Oncologia UrologyMilanItaly Ospedale San Giuseppe UrologyMilanItaly

Objective:We aimed to determine safety and feasibility of thulium laser transurethral vapoenucleation of prostate(ThuVEP)for treatment of obese patients affected by benign prostatic hyperplasia(BPH).Methods:We retrospectively analysed data of 452 patients with BPH who underwent ThuVEP from February 2012 to March 2016 in a single center.Patients were divided into three groups according to body mass index(BMI,kg/m^2):Normal weight(18.5≤BMI0.05).There was no statistically significant difference among three groups as for hospital stay and days of catheterization(p>0.05).Conclusion:Our results showed that ThuVEP was safe and feasible even in overweight patients with substantially enlarged prostate.

关键词： Laser Thulium Prostate Overweight

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