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Management of liver transplantation biliary stricture: Results from a tertiary hospital

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World Journal of Gastrointestinal Endoscopy 2015年第7期7卷 747-757页

作者： Fernanda Prata Martins Michel Kahaleh angelo P ferrari Endoscopy Unit Hospital Israelita Albert Einstein Division of Gastroenterology and Hepatology Department of Medicine Weill Cornell Medical College Division of Gastroenterology Universidade Federal de Sao Paulo

AIM: To review results of endoscopic treatment for anastomotic biliary strictures after orthotopic liver transplantation(OLT) during an 8-year period. METHODS: This is a retrospective review of all endoscopic retrograde cholangiopancreatographys(ERCPs) performed between May 2006 and June 2014 in deceased OLT recipients with anastomotic stricture at a tertiary care hospital. Patients were divided into 2 groups, according to the type of stent used(multiple plastic or covered self-expandable metal stents), which was chose on a case-by-case basis and their characteristics. The primary outcome was anastomotic stricture resolution rate determined if there was no more than a minimum waist at cholangiography and a 10 mm balloon could easily pass through the anastomosis with no need for further intervention after final stent removal. Secondary outcomes were technical successrate, number or ERCPs required per patient, number of stents placed, stent indwelling, stricture recurrence rate and therapy for recurrent anastomotic biliary stricture(AS). Stricture recurrence was defined as clinical laboratorial and/or imaging evidence of obstruction at the anastomosis level, after it was considered completely treated, requiring subsequent interventional ***: A total of 195 post-OLT patients were assessed for eligibility. One hundred and sixty-four(164) patients were diagnosed with anastomotic biliary stricture. ERCP was successfully performed in 157/164(95.7%) patients with AS, that were treated with either multiple plastic(n = 109) or metallic billiary stents(n = 48). Mean treatment duration, number of procedures and stents required were lower in the metal stent group. Acute pancreatitis was the most common procedure related complication, occurring in 17.1% in the covered self-expandable metal stents(c SEMS) and 4.1% in the multiple plastic stent(MPS) group. Migration was the most frequent stent related complication, observed in 4.3% and 5.5%(c SEMS and MPS respectively

关键词： Biliary stricture Benign Liver transplant Endoscopic retrograde cholangiopancreatographys Endoscopic treatment Plastic stent Self-expandablemetal stent

Chronic radiation proctopathy: A practical review of endoscopic treatment

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World Journal of Gastrointestinal Surgery 2016年第2期8卷 151-160页

作者： Luciano Lenz Rachel Rohr Frank Nakao Ermelindo Libera angelo ferrari Fleury Medicina e Saue Centro de Medicina Diagnatica SaPaulo 04513-100 Brazil Endoscopy Unity Universidade Federal de SaPaulo SaPaulo 04513-100 Brazil Endoscopy Unit Hospital Israelita Albert EinsteinSao Paulo 04513-100 Brazil

Chronic radiation proctopathy(CRP) is a troublesome complication of pelvic radiotherapy. The most common presentation is rectal bleeding. CRP symptoms interfere with daily activities and decrease quality of life. Rectal bleeding management in patients with CRP represents a conundrum for practitioners. Medical therapy is ineffective in general and surgical approach has a high morbidmortality. Endoscopy has a role in the diagnosis,staging and treatment of this disease. Currently available endoscopic modalities are formalin,potassium titanyl phosphate laser,neodymium:yttrium-aluminum-garnet laser,argon laser,bipolar electrocoagulation(BiCAP),heater probe,band ligation,cryotherapy,radiofrequency ablation and argon plasma coagulation(APC). Among these options,APC is the most promising.

关键词： Endoscopic treatment Radiation proctopathy Proctitis Argon plasma coagulation Cryotherapy Radiofrequency ablation Formalin Laser Bipolar probe Pelvic radiotherapy

Small heat shock protein B8:from cell functions to its involvement in diseases and potential therapeutic applications

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Neural Regeneration Research 2025年第10期20卷 2872-2886页

作者： Marta Chierichetti Riccardo Cristofani Valeria Crippa Veronica ferrari Marta Cozzi Elena Casarotto Paola Pramaggiore Laura Cornaggia Guglielmo Patelli Ali Mohamed Margherita Piccolella Mariarita Galbiati Paola Rusmini Barbara Tedesco angelo Poletti Laboratory of Experimental Biology Dipartimento di Scienze Farmacologiche e Biomolecolari“Rodolfo Paoletti”(DiSFeB)Universitàdegli Studi di MilanoMilanItaly

Heat shock protein family B(small)member 8(HSPB8)is a 22 kDa ubiquitously expressed protein belonging to the family of small heat shock ***8 is involved in various cellular mechanisms mainly related to proteotoxic stress response and in other processes such as inflammation,cell division,and ***8 binds misfolded clients to prevent their aggregation by assisting protein refolding or degradation through chaperone-assisted selective *** line with this function,the pro-degradative activity of HSPB8 has been found protective in several neurodegenerative and neuromuscular diseases characterized by protein misfolding and *** cancer,HSPB8 has a dual role being capable of exerting either a pro-or an anti-tumoral activity depending on the pathways and factors expressed by the model of cancer under ***,HSPB8 exerts a protective function in different diseases by modulating the inflammatory response,which characterizes not only neurodegenerative diseases,but also other chronic or acute conditions affecting the nervous system,such as multiple sclerosis and intracerebellar *** note,HSPB8 modulation may represent a therapeutic approach in other neurological conditions that develop as a secondary consequence of other *** is the case of cognitive impairment related to diabetes mellitus,in which HSPB8 exerts a protective activity by assuring mitochondrial *** review aims to summarize the diverse and multiple functions of HSPB8 in different pathological conditions,focusing on the beneficial effects of its ***-based and alternative therapeutic approaches targeting HSPB8 and its regulated pathways will be discussed,emphasizing how new strategies for cell and tissue-specific delivery represent an avenue to advance in disease treatments.

关键词： aggregation autophagy cancer chaperone chaperone-assisted selective autophagy cognitive impairment HSPB8 neuroinflammation neuromuscular diseases therapy

Efficacy and safety of endoscopic prophylactic treatment with undiluted cyanoacrylate for gastric varices

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World Journal of Gastrointestinal Endoscopy 2014年第6期6卷 254-259页

作者： Matheus Cavalcante Franco Gustavo Flores Gomes Frank Shigeo Nakao Gustavo Andrade de Paulo angelo Paulo ferrari Jr Ermelindo Della Libera Jr Digestive Endoscopy Unit Division of GastroenterologyFederal University of Sao Paulo Endoscopy Division Fleury Medicina e Saúde Endoscopy Division Hospital Israelita Albert Einstein

AIM:To evaluate the efficacy and safety of undiluted N-butyl-2 cyanoacrylate plus methacryloxysulfolane(NBCM)as a prophylactic treatment for gastric varices(GV)***:This prospective study was conducted at a single tertiary-care teaching hospital between October 2009 and March *** with portal hypertension(PH)and GV,with no active gastrointestinal bleeding,were enrolled in primary prophylactic treatment with NBCM injection without lipiodol *** diagnosis of GV was based on endoscopy and confirmed with endosonography(EUS); the same procedure was used after treatment to confirm eradication of *** puncturing the GV with a regular injection needle,1 mL of undiluted NBCM was injected intranasally into *** injection was repeated as necessary to achieve eradication or until a maximum total volume of 3 mL of NBCM had been *** were followed clinically and evaluated with endoscopy at 3,6 and 12 *** follow-ups were performed *** main outcome measures were efficacy(GV eradication),safety(adverse events related to cyanoacrylate injection),recurrence,bleeding from GV and mortality related to GV ***:A total of 20 patients(15 male)with PH and GV were enrolled in the study and treated with undiluted NBCM *** 2(10%)patients had no esophageal varices(EV); 18(90%)patients were treated with endoscopic band ligation to eradicate EV before inclusion in the *** patients were followed clinically and endoscopically for a median of 31 mo(range:6-40 mo).Eradication of GV was observed in all patients(13 patients were treated with 1 session and 7 patients with 2 sessions),with a maximum injected volume of 2 mL *** patient had GV recurrence,confirmed by EUS,at 6-mo follow-up,and another had late recurrence with GV bleeding after 35 mo of follow-up; overall,GV recurrence was observed in 2 patients(10%),after 6 and 35 mo of follow-up,and GV bleeding rate was 5%(1 patient).Mild epigastric pain was r

关键词： Gastric varices Primary prevention Endoscopy Gastrointestinal Cyanoacrylates Gastrointestinal hemorrhage

Endoscopic therapy using a self-expandable metallic stent with an anti-migration system for postorthotopic liver transplantation anastomotic biliary stricture

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World Journal of Gastrointestinal Endoscopy 2022年第9期14卷 547-554页

作者： Larissa Wermelinger Pinheiro Fernanda Prata Martins Gustavo Andrade De Paulo Mðnica Lúcia Campos Contini angelo Paulo ferrari Ermelindo Della Libera Department of Gastroenterology Federal University of São Paulo/Escola Paulista de MedicinaSão Paulo 04023-900Brazil Department of Endoscopy Unit Hosp Israelita Albert EinsteinSão Paulo 04042033Brazil

BACKGROUND Endoscopic therapy using multiple plastic stents(MPSs)is the standard therapy for postorthotopic liver transplantation(p-OLT)anastomotic biliary stricture(ABS).However,this approach demands repeated *** studies us-ing fully covered self-expandable metallic stents(FCSEMS)have shown en-couraging results,but migration occurs in 10%to 40%of *** objective of this retrospective study was to evaluate the efficacy of endoscopic treatment using FCSEMS with an anti-migration system(Am-FCSEMS)in patients with p-OLT *** To evaluate the efficacy of endoscopic treatment using an Am-FCSEMS in patients with p-OLT *** This study was conducted in a private tertiary care centre in S?o Paulo,Brazil and was approved by our institution's Human Research *** April 2018 to October 2020,regardless of previous endoscopic treatment(MPS or FCSEMS),17 patients with p-OLT ABS and indications for endoscopic therapy were included in this *** exclusion criteria were pregnancy,nonanastomotic biliary or hilar stricture,hepatic artery stenosis/thrombosis,isolated biliary fistulae,a distance shorter than 2 cm from the stricture to the hepatic hilum,and patient *** primary endpoint was the efficacy of p-OLT ABS endoscopic treatment using an Am-FCSEMS that re-mained in place for a 12-mo *** sphincterotomy was performed in patients with native papilla,and an Am-FCSEMS(10 mm in final diameter and 60 or 80 mm in length)was placed(Hanarostent TM MI Tech,Co).Balloon stricture dilation was performed only if necessary to introduce the *** Three patients were excluded due to loss to follow-up before stent *** the 14 patients included and followed,7 were women,and the average age was 56 years(range:28-76).The average period of Am-FCSEMS placement was 362±109 *** success occurred in all 14 patients(100%).There were no cases of distal stent *** resolution of the stricture occurred in 13/14 patien

关键词： Liver transplantation Endoscopy Endoscopic retrograde cholangiopancreatography Biliary strictures Self-expandable metallic biliary stents

Current impact in the treatment of advanced hepatocellular carcinoma:The challenge remains

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World Journal of Gastrointestinal Oncology 2025年第3期17卷 479-483页

作者： angelo A de Mattos Cristiane V Tovo Isadora Z Bombassaro Luis F Ferreira Department of Hepatology Federal University of Health Sciences of Porto AlegrePorto Alegre 90050-170Rio Grande do SulBrazil School of Electronics Electrical Engineering and Computer ScienceQueen’s University of BelfastBelfast BT95BNBelfastUnited Kingdom

Hepatocellular carcinoma remains a significant cause of mortality worldwide,particularly among patients with liver *** most cases,surveillance in cirrhotic patients is neglected,leading to a diagnosis when the neoplasm is at an advanced *** this context,Zhou et al carried out a network metaanalysis to demonstrate the effectiveness of hepatic arterial infusion chemotherapy,concluding that it is a superior approach compared to sorafenib and transarterial chemoembolization in the treatment of advanced hepatocellular ***,the meta-analysis in question lacks methodological rigor,preventing the authors from making more definitive ***,we understand that transarterial chemoembolization,when properly indicated,is a highly effective therapeutic option,and that sorafenib,given the results of new therapies based on immune checkpoint inhibitors,is no longer the recommended drug for the treatment of these ***,we believe the use of hepatic arterial infusion chemotherapy is increasingly limited and lacks strong scientific support.

关键词： Hepatocellular carcinoma Meta-analysis Treatment Liver diseases Liver neoplasms

Performance of Artificial Intelligence Chatbots on Standardized Medical Examination Questions in Obstetrics & Gynecology

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Open Journal of Obstetrics and Gynecology 2025年第1期15卷 1-9页

作者： angelo Cadiente Natalia DaFonte Jonathan D. Baum Hackensack Meridian School of Medicine Nutley NJ USA Department of Obstetrics and Gynecology Jersey Shore University Medical Center Neptune NJ USA

Objective: This study assesses the quality of artificial intelligence chatbots in responding to standardized obstetrics and gynecology questions. Methods: Using ChatGPT-3.5, ChatGPT-4.0, Bard, and Claude to respond to 20 standardized multiple choice questions on October 7, 2023, responses and correctness were recorded. A logistic regression model assessed the relationship between question character count and accuracy. For each incorrect question, an independent error analysis was undertaken. Results: ChatGPT-4.0 scored a 100% across both obstetrics and gynecology questions. ChatGPT-3.5 scored a 95% overall, earning an 85.7% in obstetrics and a 100% in gynecology. Claude scored a 90% overall, earning a 100% in obstetrics and an 84.6% in gynecology. Bard scored a 77.8% overall, earning an 83.3% in obstetrics and a 75% in gynecology and would not respond to two questions. There was no statistical significance between character count and accuracy. Conclusions: ChatGPT-3.5 and ChatGPT-4.0 excelled in both obstetrics and gynecology while Claude performed well in obstetrics but possessed minor weaknesses in gynecology. Bard comparatively performed the worst and had the most limitations, leading to our support of the other artificial intelligence chatbots as preferred study tools. Our findings support the use of chatbots as a supplement, not a substitute for clinician-based learning or historically successful educational tools.

关键词： Large Language Models ChatGPT Bard Claude Medical Education

科研绩效评估的副作用：对“拆分发表”（Salami slicing）现象的实证研究（英文）

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Journal of Data and Information Science 2025年第1期 74-100+234-235页

作者： Ciriaco Andrea D'angelo Department of Engineering and Management Tor Vergata University of Rome

研究目的：本研究探讨意大利2012年实施的教授任职国家科学认证（ASN）制度中，以发表为中心的激励机制是否导致学术界采取“拆分发表”策略。研究方法：通过对25,000余名意大利理工科教授的发表记录进行纵向文献计量分析，考察ASN实施... 详细信息

研究目的：本研究探讨意大利2012年实施的教授任职国家科学认证（ASN）制度中，以发表为中心的激励机制是否导致学术界采取“拆分发表”策略。研究方法：通过对25,000余名意大利理工科教授的发表记录进行纵向文献计量分析，考察ASN实施后其论文产出量与原创性的变化。研究发现：分析显示，ASN实施后学者的论文产出数量显著增加，但论文原创性同步下降。然而，未发现这些趋势与研究者“拆分发表”行为增加的直接关联。研究局限性：鉴于我们观察的领域规模较大，我们提出了一种创新的间接方法，通过分析论文参考文献的原创性来研究学术行为。文献耦合虽然无法直接捕捉“拆分发表”出版行为，但是能够反映不同出版物之间的主题相关性。另一方面，通过控制作者在该时期的专业化水平，我们认为，较高的文献耦合度可能表明作者在传播研究成果时策略的变化。尽管如此，我们模型中的较低R平方值（0.3-0.4）反映了该现象的复杂性，揭示了未被测量的因素在结果中的影响。未来研究应探索更多变量或替代模型，以解释更大比例的变异性。尽管存在这一局限性，我们分析中识别的重要预测因素为理解观察结果提供了宝贵的见解。实践意义：研究结果支持那些认为量化研究评估框架产生了积极影响的观点，反驳了那些声称量化评估会导致学术不端行为（如“拆分发表”）的论点。原创性/价值：基于微观大数据集的实证研究，本研究揭示了关于ASN对学术发表行为的影响，为关于量化研究评估对学术出版行为影响的更广泛讨论做出了贡献。

关键词：碎片化发表学术不端投机行为科研评价文献计量

基于全局工作空间理论的机器人认知架构（英文）

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宁波大学学报(理工版) 2025年第02期 49-58页

作者： HUANG Wenjie CangeloSI angelo CHELLA Antonio 曼彻斯特大学曼彻斯特机器人与人工智能中心意大利国家研究委员会高性能计算与网络研究所巴勒莫大学

采用适用于神经科学的全局工作空间理论开发有意识的认知架构.基于这一架构实现了不同的认知要素,使得全局工作空间理论与人脑工作机制的兼容性得以增强.从注意力、记忆和学习机制这些针对智能系统的研究主题开始进行探讨,并对相关实验... 详细信息

采用适用于神经科学的全局工作空间理论开发有意识的认知架构.基于这一架构实现了不同的认知要素,使得全局工作空间理论与人脑工作机制的兼容性得以增强.从注意力、记忆和学习机制这些针对智能系统的研究主题开始进行探讨,并对相关实验进行总结.随后讨论了如何基于这三个基本要素及其相互关系研究认知机器人开发这一新主题.这些工作为认知机器人认知架构的未来长期发展提供了基础.此外,采用渐进式研究路线用以上述架构的实现,这与生物启发式认知架构的研究路线图相一致.

关键词：全局工作空间理论认知架构渐进生物启发式认知架构