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Parallel pathways:A chronicle of evolution in rectal and breast cancer surgery

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1091-1096页

作者： Antonio Pesce Nicolòfabbri Diletta Iovino Carlo Vittorio Feo Unit of General Surgery University of FerraraAzienda USL of FerraraFerrara 44023LagosantoItaly

In this editorial,we have analyzed the historical evolution of rectal and breast cancer surgery,focusing on the progressive reduction of demolitive approaches and the increasing use of more conservative strategies,accompanied by a growing emphasis on perioperative treatments aimed at enhancing surgical outcomes.All of these changes have been made possible due to an increased awareness and understanding of oncological diseases and improved perioperative treatments.

关键词： Rectal cancer History Breast surgery Demolitive treatment Conservative surgery

Asthma and gastroesophageal reflux disease: Effect of long-term pantoprazole therapy

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World Journal of Gastroenterology 2005年第48期11卷 7657-7660页

作者： Calabrese Carlo fabbri anna Areni Alessandra Scialpi Carlo Zahlane Desiree Di Febo Giulio Department of Internal Medicine and Gastroenterology

AIM: To define the prevalence of gastroesophageal reflux disease (GERD) in mild persistent asthma and to value the effect of pantoprazole therapy on asthmatic symptoms.METHODS: Seven of thirty-four asthmatic patients without GERD served as the non-GERD control group.Twenty-seven of thirty-four asthmatic patients had GERD (7/27 also had erosive esophagitis, sixteen of them presented GERD symptoms. An upper gastrointestinal endoscopy was performed in all the subjects to obtain five biopsy specimens from the lower 5 cm of the esophagus. Patients were considered to have GERD when they had a dilation of intercellular space (DIS)＞0.74 μm at transmission electron microscopy.Patients with GERD were treated with pantoprazole,80 mg/day. Forced expiratory volume in one second (FEV1) was performed at entry and after 6 mo of treatment. Asthmatic symptoms were recorded. The required frequency of inhaling rapid acting 32-agonists was self-recorded in the patients' diaries.RESULTS: Seven symptomatic patients presented erosive esophagitis. Among the 18 asymptomatic patients, 11 presented DIS, while all symptomatic patients showed ultrastructural esophageal damage.Seven asymptomatic patients did not present DIS. At entry the mean of FEV1 was 1.91 L in symptomatic GERD patients and 1.88 L in asymptomatic GERD patients.After the treatment, 25 patients had a complete recovery of DIS and reflux symptoms. Twenty-three patients presented a regression of asthmatic symptoms with normalization of FEV1. Four patients reported a significant improvement of symptoms and their FEV1 was over 80%.CONCLUSION: GERD is a highly prevalent condition in asthma patients. Treatment with pantoprazole (80 mg/day)determines their improvement and complete regression.

关键词：哮喘胃食管逆流治疗病理机制

Evaluation of Fusarium Graminearum Growth and Deoxynivalenol Content in Susceptible and Tolerant Varieties of Triticum Aestivum

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Journal of Life Sciences 2011年第2期5卷 81-90页

作者： Chiara Nobili Massimo Reverberi Alessandra Ricelli Valeria Scala Gabriella Aureli Flavia Pinzari anna Adele fabbri Corrado Fanelli ENEA Via Anguillarese 301 Roma 00123 Italy Universith degli Studi ＂Sapienza ＂ Largo Cristina di Svezia 24 Roma 00165 Italy ICB-CNR P.le Aldo Moro 5 Roma 00185 Italy QCE-CRA Via Cassia 176 Roma 00100 Italy Istituto Centrale per il Restauro e la Conservazione del Patrimonio Librario Via Milano 76 Roma 00184 Italy

The aim of this work was to verify if the wheat susceptibility/tolerance phenotype to Fusarium head blight (FHB) into the field could be related to the ability of the re-activated seeds to hamper deoxynivalenol (DON) synthesis by Fusarium graminearum into non optimal (i. e. high humidity) storage conditions. On this purpose, two Fusarium graminearum strains, Fg126 and Fg8308, were separately inoculated on active but not germinating kernels of Triticum aestivum L. cv "Sagittario" (FHB-susceptible) and cv "Blasco" (FHB-tolerant). The growth of the fungal strains on wheat kernels was monitored from 0 to 15 days post inoculation through a quantitative SYBR green real-time PCR, as well as ergosterol content through HPLC for comparison. DON biosynthesis into the contaminated wheat seeds was quantified by HPLC method in the same time intervals as above. Significant differences in the ability to grow and synthesize DON, acetylated and glucosylated forms, emerged between the strains also in relation to the wheat variety on which the pathogen developed. The results obtained indicated that the wheat variety which from the epidemiological studies carried out into the field is FHB-tolerant, i. e. Blasco, resulted as the more efficient in hampering DON synthesis in both F. graminearum strains. Thus, this preliminary study could represent a contribution to find out less time consuming methods for screening the wheat varieties tolerant to DON accumulation in non optimal storage conditions.

关键词：小麦赤霉病菌小麦品种呕吐毒素生长监测毒素含量高效液相色谱法真菌菌株评价

Conservative management of an early abdominal complication during a Tullio percutaneous endoscopic excision of renal pelvis urothelial carcinoma:A case report

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World Journal of Clinical Urology 2024年第1期13卷 1-6页

作者： Massimiliano Bernabei Nicolòfabbri Danila Romeo Elisa Paiolo Martina Bandi Maurizio Simone Department of Urology Azienda USL di FerraraFerrara 44100Italy Department of Surgery University of FerraraAzienda USL of FerraraAzienda USL of FerraraFerrara 44100FerraraItaly Local Health Agency of Ferrara Ferrara 44100Italy

BACKGROUND Upper tract urothelial carcinoma(UTUC)representing only a small fraction of all urothelial tumors.It predominantly affects the renal pelvis in men,often coexisting with bladder carcinoma.UTUC displays a more aggressive genetic profile compared to bladder neoplasms,with the majority of patients presenting with advanced disease.Histologically,about a quarter of UTUC cases exhibit high-grade subtypes,associated with a worse prognosis.Tobacco use and past exposure to aromatic amines are significant risk factors for UTUC.Imaging modalities such as Uro-computed tomography and magnetic resonance imaging play crucial roles in diagnosis.Ureterorenoscopy is vital for direct visualization and biopsy sampling,but its limited sampling capacity presents challenges in determining tumor depth and staging.Traditionally,nephroureterectomy with bladder cuff excision has been the gold-standard treatment for UTUC.Endoscopic conservative treatment has recently emerged as a viable option for selected patients,offering comparable oncological outcomes to radical surgery.Percutaneous access is also feasible for larger intrarenal tumors.CASE SUMMARY We present a case of an 84-year-old woman who underwent percutaneous endoscopic excision of a renal pelvis neoplasm using the Tullio laser.Despite successful tumor removal,the patient experienced a postoperative complication with abdominal fluid leakage.Conservative management effectively resolved the complication.Given the patient's age and refusal for radical surgery,the conservative approach proved to be a valid therapeutic choice.CONCLUSION Overall,UTUC remains a diagnostic and therapeutic challenge due to its rarity.However,advances in endoscopic and percutaneous techniques provide valuable alternatives for selected patients,warranting further exploration in this evolving field.

关键词： Upper tract urothelial carcinoma Endoscopic treatment Damage management Case report

The outcomes and safety of patients undergoing endoscopic retrograde cholangiopancreatography combining a single-use cholangioscope and a single-use duodenoscope:A multicenter retrospective international study

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 71-76页

作者： Alessandro Fugazza Matteo Colombo Michel Kahaleh V.Raman Muthusamy Bick Benjamin Wim Laleman Carmelo Barbera Carlo fabbri Jose Nieto Abed Al-Lehibi Mohan Ramchandani Amy Tyberg Haroon Shahid Avik Sarkar Dean Ehrlich Stuart Shermand Cecilia Binda Marco Spadaccini Andrea Iannone Kareem Khalaf Nageshwar Reddy Andrea Anderloni Alessandro Repici Division of Gastroenterology and Digestive Endoscopy Humanitas Research Hospital-IRCCSVia Manzoni 5620089RozzanoMilanoItaly Gastroenterology Rutgers Robert Wood JohnsonNew BrunswickNew JerseyUSA Vatche and Tamar Manoukian Division of Digestive Diseases University of CaliforniaLos Angeles School of Medicine at UCLALos AngelesCaliforniaUSA Division of Digestive and Liver Disorders Indiana University School of MedicineIndianapolisINUSA Department of Gastroenterology and Hepatology University Hospitals LeuvenKU Leuven3000 LeuvenBelgium U.O.C.di Gastroenterologia ed Endoscopia Digestiva Ospedale Giuseppe MazziniASL TeramoItaly Gastroenterology and Digestive Endoscopy Unit Forlì-Cesena HospitalsAUSL RomagnaForlì-CesenaItaly Borland Groover Clinic JacksonvilleFloridaUSA Department of Gastroenterology and Hepatology King Fahad Medical CityRiyadhSaudi Arabia Asian Institute of Gastroenterology HyderabadIndia Section of Gastroenterology Department of Emergency and Organ TransplantationUniversity of BariBari 70124Italy Department of Biomedical Sciences Humanitas UniversityVia Rita Levi Montalcini 420090Pieve EmanueleMilanItaly

Background: Duodenoscope-related multidrug-resistant organism(MDRO) infections raise concerns. Disposable duodenoscopes have been recently introduced in the market and approved by regulatory agencies with the aim to reduce the risk of endoscopic retrograde cholangiopancreatography(ERCP) associated infections. The aim of this study was to evaluate the outcome of procedures performed with single-use duodenoscopes in patients with clinical indications to single-operator cholangiopancreatoscopy. Methods: This is a multicenter international, retrospective study combining all patients who underwent complex biliopancreatic interventions using the combination of a single-use duodenoscope and a single-use cholangioscope. The primary outcome was technical success defined as ERCP completion for the intended clinical indication. Secondary outcomes were procedural duration, rate of cross-over to reusable duodenoscope, operator-reported satisfaction score(1 to 10) on performance rating of the single-use duodenoscope, and adverse event(AE) rate. Results: A total of 66 patients(26, 39.4% female) were included in the study. ERCP was categorized according to ASGE ERCP grading system as 47(71.2%) grade 3 and 19(28.8%) grade 4. The technical success rate was 98.5%(65/66). Procedural duration was 64(interquartile range 15-189) min, cross-over rate to reusable duodenoscope was 1/66(1.5%). The satisfaction score of the single-use duodenoscope classified by the operators was 8.6 ± 1.3 points. Four patients(6.1%) experienced AEs not directly related to the single-use duodenoscope, namely 2 post-ERCP pancreatitis(PEP), 1 cholangitis and 1 bleeding.Conclusions: Single-use duodenoscope is effective, reliable and safe even in technically challenging procedures with a non-inferiority to reusable duodenoscope, making these devices a viable alternative to standard reusable equipment.

关键词： Single-operator cholangioscopy Single-use duodenoscope Endoscopic retrograde cholangiopancreatography Indeterminate biliary stricture Difficult biliary stones

Vascular injury during laparoscopic cholecystectomy:An oftenoverlooked complication

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World Journal of Gastrointestinal Surgery 2023年第3期15卷 338-345页

作者： Antonio Pesce Nicolò fabbri Carlo Vittorio Feo Department of Surgery University of FerraraAzienda USL of FerraraAzienda USL of FerraraLagosanto 44023FerraraItaly

Laparoscopic cholecystectomy is one of the most frequently performed procedures in gastrointestinal surgery worldwide.Bleeding complications due to vascular injuries represent an important cause of morbidity and mortality,especially when facing major bleeding during laparoscopy,where bleeding control can be technically challenging in inexperienced hands.Interestingly,the reported incidence rate of conversion to open surgery due to vascular lesions is approximately 0%-1.9%,with a mortality rate of approximately 0.02%.The primary aim of this article was to perform an up-to-date overview regarding the incidence and surgical management of vascular injuries during laparoscopic cholecystectomy according to the available scientific evidence.

关键词： Laparoscopic cholecystectomy Vascular injury Vascular anomalies Surgical management Specialized hepatobiliary centers

Diet and nutrition against inflammatory bowel disease: Trick or treat(ment)?

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World Journal of Experimental Medicine 2022年第5期12卷 104-107页

作者： Salvatore Greco Beatrice Bonsi Nicolòfabbri Department of Translational Medicine University of FerraraFerrara 44100Italy Department of Internal Medicine Azienda UnitàSanitaria Locale Di FerraraOspedale del DeltaAzienda UnitàSanitaria Locale di FerraraFerrara 44100Italy Unit of General Surgery Azienda UnitàSanitaria Locale di FerraraOspedale del DeltaAzienda UnitàSanitaria Locale di FerraraFerrara 44100Italy

Even if the relationships between nutrition and inflammatory bowel disease(IBD)remain underexplored,the current literature is providing,day by day,much more evidence on the effects of various diets in both prevention and treatment of such illnesses.Wrong dietary habits,together with other environmental factors such as pollution,breastfeeding,smoke,and/or antibiotics,are among the theoretical pathogenetic causes of IBD,whose multifactorial aetiology has been already confirmed.While some of these risk factors are potentially reversible,some others cannot be avoided,and efficient treatments become necessary to prevent IBD spread or recurrence.Furthermore,the drugs currently available for treatment of such disease provide low-to-no effect against the symptoms,making the illnesses still strongly disabling.Whether nutrition and specific diets will prove to effectively interrupt the course of IBD has still to be clarified and,in this sense,further research concerning the applications of such dietary interventions is still needed.

关键词： Crohn’s disease Ulcerative colitis Inflammatory bowel disease Diet Nutrition Treatment

New oral agents for erectile dysfunction: what is changing in our practice?

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Asian Journal of Andrology 2001年第3期3卷 175-179页

作者： Antonio Aversa Andrea fabbri AFaR-CRCC Fatebenefratelli-Isola Tiberina Hospital and Endocrinology Unit Department of Internal Medicine University of Rome 'Tor Vergata' 00133 Rome ItalyEndocrinology Unit Department of Internal Medicine University of Rome 'Tor Vergata' 00133 Rome Italy

Erectile dysfunction (ED) is a highly prevalent disorder affecting an estimated 152 million men worldwide and isassociated with a variety of behavioral risk factors, such as cigarette smoking and excessive alcohol consumption, aswell as numerous age - related medical conditions, notably type-2 diabetes mellitus and cardiovascular disease. A ratio-nal step - wise approach which includes comprehensive medical and sexual history, a focused physical examination andessential laboratory tests such as fasting glucose, lipid profile and testosterone assay is to be preferred. Current diagnos-tic work - up does not recommend any of the specialized tests which were previously considered mandatory-i. e. penilepharmacotesting, Duplex ultrasound and nocturnal penile tumescence. Hormonal replacement therapy is appropriate onlyin the hypogonadal male with ED. Prior to direct intervention, the physician should consider altering modifiable riskfactors or causes, although frequently insufficient to reverse ED completely. When indicated, oral therapy with newmolecules (phosphodiesterase inhibitors or apomorphine) is the first - line treatment for the majority of patients becauseof potential benefits and lack of invasiveness. (Asian J Androl 2001 Sep; 3: 175-179 )

关键词： erectile dysfunction oral medicine therapy phosphodiesterase inhibitors apomorphine nitric oxide

Risk, Contract Management, and Financing of the Gotthard Base Tunnel in Switzerland

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Engineering 2019年第3期5卷 379-383页

作者： Davide fabbri Lombardi Engineering Ltd. Minusio 6648 Switzerland

1. Introduction With the opening ceremony of the Gotthard Base Tunnel on 1 June 2016, a new world record was established: the commissioning of the longest railway tunnel in the world. Many challenges have been overcome and many technical innovations have been developed and considered in this project. As of 11 December 2016, the Gotthard Base Tunnel has been an integral part of the new timetable of the Swiss Federal Railways (SBB-CFF-FFS), and is in full operation. With a total length of 57 km and a cruising speed of 200 km·h^-1 for passenger trains, the Gotthard Base Tunnel reduces the journey time through the Alps by 40 min, significantly reducing the distance between the south and north of Europe.

关键词： Risk Contract Management Financing Gotthard Base Tunnel Switzerland