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Optimization of transdisciplinary management of elderly with femur proximal extremity fracture:A patient-tailored plan from orthopaedics to rehabilitation

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World Journal of Orthopedics 2021年第7期12卷 456-466页

作者： Alessandro de Sire Marco Invernizzi alessio Baricich Lorenzo Lippi Antonio Ammendolia Federico Alberto Grassi Massimiliano Leigheb Department of Medical and Surgical Sciences University of Catanzaro“Magna Graecia”Catanzaro 88100Italy Physical Medicine and Rehabilitation Department of Health SciencesUniversity of Piemonte OrientaleNovara 28100Italy Infrastruttura Ricerca Formazione Innovazione Azienda Ospedaliera SS.Antonio e Biagio e Cesare ArrigoAlessandria 15121Italy Orthopaedics and Traumatology Unit Department of Health SciencesUniversity of Piemonte OrientaleNovara 28100Italy

Fractures of femur proximal extremity(FFPE)are the most common fragility fractures requiring hospitalization,with a high risk of mortality,low independence in the activities of daily living and severe consequences on healthrelated quality of *** for surgery has a key role in the management of elderly patients with FFPE as recommended by the Australian and New Zealand guidelines and the National Institute for Health and Care Excellence *** surgery(within 48 h from hospital admission)allows significant benefits in terms of lower rates of postoperative complications and risk of death and can provide better functional ***,time for surgery could be considered as a comorbidity *** choice between conservative or surgical approach surprisingly seems to be still not strongly supported by available literature,but it seems that both 30 d and 1 year risk of mortality is higher with the conservative treatment rather than with *** light of these considerations,the optimization of FFPE management care is mandatory to improve functional outcomes and to reduce sanitary *** it is widely accepted that transdisciplinary approach to patients suffering from FFPE is mandatory to optimize both short-term and long-term outcomes,the feasibility of a comprehensive approach in clinical practice is still a *** particular,the large variability of figures involved could be considered both a resource and an additional disadvantage taking into account the difficulty to coordinate multidisciplinary approach covering care in all ***,the aim of the present article was to summarize current evidence supporting transdisciplinary management of patients with FFPE,highlighting the benefits,feasibility and limitations of this approach.

关键词： Transdisciplinary management Elderly Femur fracture Hip fracture Rehabilitation Pathway

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Which octogenarian patients are at higher risk after cholecystectomy for symptomatic gallstone disease? A single center cohort study

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World Journal of Clinical Cases 2022年第24期10卷 8556-8567页

作者： Fabrizio D'Acapito Leonardo Solaini Daniela Di Pietrantonio Francesca Tauceri Maria Teresa Mirarchi ElenaAntelmi Francesca Flamini alessio Amato Massimo Framarini Giorgio Ercolani Department of General and Oncologic Surgery Morgagni-Pierantoni HospitalAUSL RomagnaForlì47121Italy Department of Medical and Surgical Sciences University of BolognaBologna 40126Italy

BACKGROUND Incidence of gallstones in those aged≥80 years is as high as 38%-53%.The decision-making process to select those oldest old patients who could benefit from cholecystectomy is *** To assess the risk of morbidity of the“oldest-old”patients treated with cholecystectomy in order to provide useful data that could help surgeons in the decision-making process leading to surgery in this *** A retrospective study was conducted between 2010 and *** variables were collected and compared between patients who had postoperative complications.A model was created and tested to predict severe postoperative *** The 269 patients were included in the study(193 complicated).The 9.7%of complications were grade 3 or 4 according to the Clavien-Dindo *** levels were lower in patients who did not have any postoperative *** Society of Anesthesiologists scale 4 patients,performing a choledocholithotomy and bilirubin levels were associated with Clavien-Dindo>2 complications(P<0.001).The decision curve analysis showed that the proposed model had a higher net benefit than the treating all/none options between threshold probabilities of 11%and 32%of developing a severe *** Patients with American Society of Anesthesiologists scale 4,higher level of bilirubin and need of choledocholithotomy are at the highest risk of a severely complicated postoperative *** endoscopic or percutaneous treatments should be considered in this subgroup of octogenarians.

关键词： Cholecystitis Gallstones Choledocholithotomy Elderly Post-operative complications

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Coronavirus disease 2019 (COVID-19) and prosthetic heart valve: An additional coagulative challenge

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World Journal of Emergency Medicine 2020年第4期11卷 258-259页

作者： Attilio Allione Jacopo Davide Giamello Sara Bernardi Giulia Paglietta Giulia Lucia Massimina Cavalot Luca alessio Dutto Daniela Caruso Andrea Tortore Giuseppe Lauria Department of Emergency Medicine Santa Croce and Carle HospitalCuneoItaly School of Emergency Medicine University of TurinTurinItaly

Dear editor,A new infectious disease outbreak,caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),is now spreading all around the world.[1]One of the most critical understandings of the current pandemic of the coronavirus disease 2019(COVID-19)focuses on an imbalanced coagulation *** on the current evidence,we can divide the COVID-19-related hypercoagulable state into two categories[2]:patients without other pre-existing indications for anticoagulant therapy who develop a state of hypercoagulability linked to SARS-CoV-2 infection especially during the cytokine storm phase,and patients already on anticoagulation in whom we have to reevaluate their drug choices,dosages,and *** the same time,recent literature recommends the use of heparin in severe SARS-CoV-2 infection,both as thromboembolic prophylaxis and as an anticoagulant therapy,in light of possible anti-infl ammatory and antiviral mechanisms and less pharmacological interferences.[3]This indication should be adopted in all patients except for those with prosthetic heart valves,in whom vitamin K antagonists continue to remain the drug of choice.[4]In this subgroup of patients,strict monitoring of PT-INR is required to maintain the therapeutic *** purpose of this article is to underline the need for good quality evidence regarding the management of this high-risk category of the patient population.

关键词： dosage vitamin respiratory

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Communication of a Natural *** Earthquake Case in Social Media and Online Newspapers

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Sociology Study 2018年第6期8卷 257-266页

作者： Andrea Volterrani Domenica Fioredistella Iezzi alessio Ceccherelli University of Rome Tor Vergata Italy Department of Enterprise Engineering University of Rome Tor VergataVia Columbia 200137 RomeItaly

In history,every media development has contributed to a change in human beings’perception of reality and in the way we have acted in that ***,literacy,the printing press,and electricity have done it,and so is digital and social ***,horizontalization,distributed and informal learning are some of the keywords of this *** change in perception of natural disaster management through social media(Twitter)both in real time and in the following months is at the centre of the reflection of the *** study the opinions of Italians regarding the natural disaster of Central Italy in 2016,the authors scraped Italian language Tweets from the web on the subject of *** collected all of the Tweets containing the hashtag“terremoto”for nine months(from August 2016 to May 2017).Data analytics was performed with Twitter of R statistics and has resulted in a large corpus to which the authors have applied multivariate techniques in order to identify the contents and the sentiments behind the shared *** results show how social media relations and perception change are complex and articulated and can be one of the ways to improve communication activities for prevention.

关键词： Digital social media natural disaster perception

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Robot-assisted kidney transplantation:Is it getting ready for prime time?

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World Journal of Transplantation 2022年第7期12卷 163-174页

作者： Vincenzo Li Marzi alessio Pecoraro Maria Lucia Gallo Leonardo Caroti Adriano Peris Graziano Vignolini Sergio Serni Riccardo Campi Department of Minimally Invasive and Robotic Urologic Surgery Careggi University HospitalUniversity of FlorenceFlorence 50134Italy Nephrology Unit Careggi HospitalFlorence 50134Italy Intensive Care Unit and Regional ECMO Referral Centre Careggi HospitalFlorence 50134Italy Department of Minimally Invasive and Robotic Urologic Surgery University of FlorenceFlorence 50134Italy Department of Experimental and Clinical Medicine University of FlorenceFlorence 50134Italy

Kidney transplantation(KT)is the treatment of choice for patients with end-stage renal disease,providing a better survival rate and quality of life compared to *** the progress in the medical management of KT patients,from a purely surgical standpoint,KT has resisted innovations during the last 50 ***,robot-assisted KT(RAKT)has been proposed as an alternative approach to open surgery,especially due to its potential benefits for fragile and immunocompromised *** was not until 2014 that the role of RAKT has found value thanks to the pioneering Vattikuti Urology Institute-Medanta collaboration that conceptualized and developed a new surgical technique for RAKT following the Idea,Development,Exploration,Assessment,Long-term follow-up recommendations for introducing surgical innovations into real-life *** the last years,mirroring the Vattikuti-Medanta technique,several centers developed RAKT program worldwide,providing strong evidence about the safety and the feasibility of this ***,the majority of RAKT are still performed in the living donor setting,as an“eligible”procedure,while only a few centers have realized KT through a robotic approach in the challenging scenario of cadaver *** addition,despite the spread of minimally-invasive(predominantly robotic)surgery worldwide,many KTs are still performed in an open *** of the type of incision employed by surgeons,open KT may lead to nonnegligible risks of wound complications,especially among obese ***,the assessment for KT should consider not only the added surgical technical challenges but also the higher risk of postoperative *** this context,robotic surgery could offer several benefits,including providing a better exposure of the surgical field and better instrument maneuverability,as well as the possibility to integrate other technological nuances,such as the use of intraoperative fluorescence vascular imagi

关键词： Deceased donors Living donors Kidney transplantation Minimally invasive surgery Robotics

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Modelling and Analysis of Base Isolated Structures with Friction Pendulum System Considering near Fault Events

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Open Journal of Civil Engineering 2013年第2期3卷 86-93页

作者： Luigi Petti Fabrizio Polichetti alessio Lodato Bruno Palazzo Department of Civil Engineering University of Salerno Salerno Italy

The seismic behavior of base isolated structures with friction pendulum slide bearings devices subjected to near fault events characterized by significant vertical ground motion components is investigated. In particular, in order to evaluate the effects of vertical components on seismic response, non-linear dynamic analysis, carried out by using several numerical models, have been performed by considering two near-fault seismic events, L’Aquila 2009 and Emilia Romagna 2012. The obtained results show that increasing vertical seismic motion base shear significantly increases while relative displacements increase very little.

关键词： Base Isolated Structures Friction Pendulum Slide Bearings Spatial Seismic Demand

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Mallory-Weiss syndrome from giant gastric trichobezoar: A case report

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World Journal of Gastrointestinal Surgery 2023年第5期15卷 972-977页

作者： Eva Lieto Annamaria Auricchio Maria Paola Belfiore Giovanni Del Sorbo Gabriele De Sena Vincenzo Napolitano alessio Ruggiero Gennaro Galizia Francesca Cardella Department of Translational Medical Sciences University of Campania L.VanvitelliNapoli 80138CampaniaItaly Department of Precision Medicine University of Campania L.VanvitelliNapoli 80138CampaniaItaly

BACKGROUND Mallory-Weiss syndrome(MWS),representing a linear mucosal laceration at the gastroesophageal junction,is a quite frequent cause of upper gastrointestinal bleeding,usually induced by habitual *** subsequent cardiac ulceration in this condition is likely due to the concomitance of increased intragastric pressure and inappropriate closure of the gastroesophageal sphincter,collectively inducing ischemic mucosal ***,MWS is associated with all vomiting conditions,but it has also been described as a complication of prolonged endoscopic procedures or ingested foreign *** SUMMARY We described herein a case of upper gastrointestinal bleeding in a 16-year-old girl with MWS and chronic psychiatric distress,the latter of which deteriorated following her parents’*** patient,who was residing on a small island during the coronavirus disease 2019 pandemic lockdown period,presented with a 2-mo history of habitual vomiting,hematemesis,and a slight depressive ***,a huge intragastric obstructive trichobezoar was detected and discovered to be due to a hidden habit of continuously eating her own hair;this habit had persisted for the past 5 years until a drastic reduction in food intake and corresponding weight loss *** relative isolation in her living status without school attendance had worsened her compulsory *** hair agglomeration had reached such enormous dimensions and its firmness was so hard that its potential for endoscopic treatment was judged to be *** patient underwent surgical intervention instead,which culminated in complete removal of the *** According to our knowledge,this is the first-ever described case of MWS due to an excessively large trichobezoar.

关键词： Mallory-Weiss syndrome Upper gastrointestinal bleeding Trichobezoar Ringworm Psychiatric distress Case report

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The Archaeoseismology of Historical Buildings： A Model Study from the L＇Aquila Area in Italy

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Journal of Civil Engineering and Architecture 2017年第10期11卷 971-977页

作者： alessio Marchetti Fabio Redi Francesca Savini Ilaria Trizio ITC-CNR Institute for Construction Technologies Italian National Research Council L 'Aquila 67100 Italy DSU-Univaq Department of Human Studies University of L 'Aquila L 'Aquila 67100 Italy

Much of Italy is characterised by two features： an increased risk of seismic activity and a profusion of old and historic buildings. These factors force us to consider the relationship between building safety and practices of conservation and protection, and as such have a direct bearing on our approach to preserving the country＇s cultural heritage in general. The guidelines issued on the assessment and reduction of seismic risk to cultural heritage assets in the Prime Ministerial Decree （DPCM） of 9 February 201 l underline the importance of studying such properties in terms of their vulnerability to seismic activity, using ＂factors of confidence＂（FC） to translate the qualitative assessments produced during previous phases into quantitative measurements. In addition to the building survey, which describes the precise three-dimensional form of a structure and the relationships between its constituent parts, a substantial part of our knowledge of a building is provided by stratigraphic analysis of the above-ground elements. Similarly, a great deal of useful information can be derived from historical analysis. This paper outlines an archaeoseismological study developed by archaeologists from the University of L＇Aquila and researchers from the ITC-CNR in the same city, which applies a multi-disciplinary approach to the study of historic buildings in areas of seismic activity.

关键词： Archaeoseismology cultural heritage knowledge conservation assessment.

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Individualized hepatocellular carcinoma risk: The challenges for designing successful chemoprevention strategies

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World Journal of Gastroenterology 2013年第9期19卷 1359-1371页

作者： Cristina Della Corte alessio Aghemo Massimo Colombo AM Migliavacca Center for Liver Diseases First Division of Gastroenterology Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Università degli Studi di Milano 20122 Milan Italy

Hepatocellular carcinoma (HCC) develops in the context of environmental risk factors like chronic viral hepatitis, diabetes and alcohol exposure, often associated to an increased risk of cirrhosis. Antiviral treatments that are effective to counteract hepatitis B and C may also attenuate the risk of tumor development. However, since hepatitis B-related carcinogenesis is promoted independently of the onset of cirrhosis, such antiviral treatments as nucleo(t)side analogs can promote regression of cirrhosis, prevent clinical decompensation and variceal bleeding but not HCC. This means that in successfully treated patients with cirrhosis, HCC is often the consequence of their extended survival. In hepatitis C patients, a sustained virological response to interferon-based therapies can reduce the rate of HCC development, even in patients with cirrhosis who experience histological regression of their liver disease. Future therapies aimed at this endpoint in at risk populations should take into consideration pretreatment patient stratification for host, viral and environmental risk factors. In this context the recent discovery of single nucleotide polymorphisms involved in the immune system function and tumorigenesis, might permit enrollment of populations of patients enriched with HCC risk factors for targeted chemopreventive therapies. This could finally pave the way to personalized algorithms, as already seen in the diagnosis and treatment schemes for chemoprevention.

关键词： Hepatocellular carcinoma Hepatitis C virus Peginterferon Hepatitis B virus Human immunodeficiency virus Nucleoside analogues Sustained virological response Single nucleotide polymorphisms

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Estimated additional lifetime risk of cancer attributable to diagnostic CT in a pediatric bone marrow transplant cohort: Experience at a single academic institution

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Open Journal of Clinical Diagnostics 2012年第1期2卷 4-9页

作者： Jonathan O. Swanson Adam alessio Teresa Chapman Department of Radiology Seattle Children’s Hospital/University of Washington Seattle USA Department of Radiology University of Washington Seattle USA

Purpose: To determine the frequency of CT procedures in a cohort of bone marrow transplant patients and estimate the effective dose from each CT procedure as well as rough estimates of lifetime attributable risk (LAR) of cancer (both incidence and mortality). Background: Pediatric patients who undergo bone marrow transplant benefit greatly from the diagnostic power of computed tomography, but due to the need for frequent imaging, these patients are repeatedly exposed to the carcinogenic potential of ionizing radiation. Methods: CT Imaging and patient parameters were collected from a retrospective cohort of bone marrow transplant patients. Dosimetry was estimated as a function of age, dose length product (DLP), and scan region based on published DLP to effective dose tables. Lifetime attributable risk (LAR) of cancer as a function of age, gender, and organ specific dose was derived from BEIR VII phase 2 estimates. Results: 44 patients with bone marrow transplant were included and ranged in age from 7 months to 20 years (average age, 9 years). The average number of CT studies per patient was 3.2 over the 15 month period. The average effective dose for each study was 5.9 +/– 4.5 mSv. Cumulative effective dose to each patient was 20 +/– 32 mSv. It was estimated that in this cohort, the CT imaging performed over a 15-month period on a 64-slice scanner led to a lifetime additional risk of cancer incidence of 5 in 1000 and a lifetime additional risk of cancer mortality of 2 in 1000. Conclusion: Diagnostic CT is important in the assessment and management of ill patients following bone marrow transplant. The risk of ionizing radiation leading to additional development of cancer merits using as low a CT technique as reasonable to achieve a diagnostic study.

关键词： Ionizing Radiation Effective Dose CT Lifetime Additional Risk

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