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Bloating and functional gastro-intestinal disorders: Where are we and where are we going?

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World Journal of Gastroenterology 2014年第39期20卷 14407-14419页

作者： Paola Iovino Cristina Bucci Fabrizio Tremolaterra antonella santonicola Giuseppe Chiarioni Gastrointestinal Unit Department of Medicine and SurgeryUniversity of Salerno 84081 Baronissi Salerno Italy IRCCS Centro di riferimento Oncologico di Basilicata Rionero in Vulture 85100 Potenza Italy Division of Gastroenterology of the University of Verona Azienda Ospedaliera Universitaria Integrata di Verona 37100 Verona Italy Division of Gastroenterology and Hepatology and Center for functional GI and Motility Disorders University of North Carolina at Chapel HillChapel HillNC 27599 United States

Bloating is one of the most common and bothersome symptoms complained by a large proportion of patients. This symptom has been described with various definitions, such as sensation of a distended abdomen or an abdominal tension or even excessive gas in the abdomen, although bloating should probably be defined as the feeling (e.g. a subjective sensation) of increased pressure within the abdomen. It is usually associated with functional gastrointestinal disorders, like irritable bowel syndrome, but when bloating is not part of another functional bowel or gastrointestinal disorder it is included as an independent entity in Rome III criteria named functional bloating. In terms of diagnosis, major difficulties are due to the lack of measurable parameters to assess and grade this symptom. In addition, it is still unclear to what extent the individual patient complaint of subjective bloating correlates with the objective evidence of abdominal distension. In fact, despite its clinical, social and economic relevance, bloating lacks a clear pathophysiology explanation, and an effective management endorsement, turning this common symptom into a true challenge for both patients and clinicians. Different theories on bloating etiology call into questions an increased luminal contents (gas, stools, liquid or fat) and/or an impaired abdominal empting and/or an altered intra-abdominal volume displacement (abdomino-phrenic theory) and/or an increased perception of intestinal stimuli with a subsequent use of empirical treatments (diet modifications, antibiotics and/or probiotics, prokinetic drugs, antispasmodics, gas reducing agents and tricyclic antidepressants). In this review, our aim was to review the latest knowledge on bloating physiopathology and therapeutic options trying to shed lights on those processes where a clinician could intervene to modify disease course.

关键词： Bloating Functional gastro-intestinal disorders Irritable bowel syndrome Constipation Diarrhea

Anhedonia and functional dyspepsia in obese patients:Relationship with binge eating behaviour

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World Journal of Gastroenterology 2020年第20期26卷 2632-2644页

作者： antonella santonicola Mario Gagliardi Giovanni Asparago Luna Carpinelli Luigi Angrisani Paola Iovino Gastroenterology Unit Department of MedicineSurgery and Dentistry"Scuola Medica Salernitana"University of SalernoBaronissi 84081SalernoItaly General and Endoscopic Surgery Unit San Giovanni Bosco HospitalNaples 80100Italy

BACKGROUND Obese patients(Ob)with a binge eating disorders(BED)behavior pattern have a higher prevalence of postprandial distress syndrome(PDS)compared to Ob without a BED behavior pattern,while an increase of PDS has been described in Ob after sleeve gastrectomy(SG).Hedonic response to a meal is dissociable from satiation in healthy *** is the lowered ability to experience *** are no studies investigating the presence of anhedonia in Ob with and without SG and its relationship to PDS *** To assess the relationship among anhedonia,BED and upper gastrointestinal symptoms in two group of morbidly Ob with and without *** Eighty-one Ob without SG,45 Ob with SG and 55 healthy controls(HC)were *** subjects fulfilled the binge eating scale(BES)to investigate BED,the validated 14 items Snaith-Hamilton pleasure scale(SHAPS)to assess Anhedonia as well as the Beck Depression Inventory-II(BDI II)and State Trait Anxiety Inventory(STAI)questionnaires to screen for depression and *** patients underwent a standardized questionnaire investigating the intensity-frequency scores(0-6)of upper gastrointestinal symptoms and were diagnosed for the presence of functional dyspepsia(FD)and its subtypes according to ROME IV *** Ob without SG who were positive for BED had a 4.7 higher risk of FD compared to Ob without SG who were negative for BED(OR:4.7;95.0%CI 1.23-18.24;P=0.02).STAI-Y2 scores were significantly higher in Ob without SG positive for BED(42.2±1.5 vs Ob negative for BED:39.6±1.0,P=0.04),while SHAPS scores and BDI II did not differ in the two groups(1.16±1.30 vs 0.89±1.02,P=0.49).A lower prevalence of BED(BES>17:11.4%vs 40.7%,P=0.001)and BDI-II(6.8±1.2 vs 13.8±1.9,P=0.005)was reported in Ob with SG than Ob without SG,on the contrary total mean scores of STAI-Y1 and STAI-Y2 were significantly higher in Ob with SG than Ob without ***-five percent of Ob with SG fulfilled the diagnosis of *** mean score

关键词： Morbid obesity Functional dyspepsia Postprandial distress syndrome Epigastric pain syndrome Anhedonia Binge eating disorders Sleeve gastrectomy

Human leukocyte antigen DQ2/8 prevalence in non-celiac patients with gastrointestinal diseases

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World Journal of Gastroenterology 2013年第16期19卷 2507-2513页

作者： Daniel DiGiacomo antonella santonicola Fabiana Zingone Edoardo Troncone Maria Cristina Caria Patrizia Borgheresi Gianpaolo Parrilli Carolina Ciacci Gastrointestinal Unit University Federico Ⅱ Naples Department of Medicine Celiac Disease Center Columbia University Celiac Center Loreto Crispi Hospital Celiac Center Gastrointestinal Unit San Giovanni di Dio e Ruggi d'Aragona Hospital University of Salerno Department of Medicine and Surgery Campus di Baronissi University of Salerno Medical School

AIM: To investigate the prevalence of human leukocyte antigen (HLA) DQ2/8 alleles in Southern Italians with liver and gastrointestinal (GI) diseases outside of celiac disease. METHODS: HLA DQ2/8 status was assessed in 443 patients from three ambulatory gastroenterology clinics in Southern Italy (University of Federico Ⅱ, Naples, Loreto Crispi Hospital, Ruggi D'Aragona Hospital, Salerno). Patients were grouped based on disease status [pre-post transplant liver disease, esophageal/gastric organic and functional diseases, irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD)] and DQ2/8 alleles, which correspond to a celiac disease genetic risk gradient. Subject allele frequencies were compared to healthy Italian controls. RESULTS: One hundred and ninety-six out of four hundred and forty-three (44.2%) subjects, median age 56 years and 42.6% female, were DQ2/8 positive. When stratifying by disease we found that 86/188 (45.7%) patients with liver disease were HLA DQ2/8 positive, 39/73 (53.4%) with functional upper GI diseases and 19/41 (46.3%) with organic upper GI diseases were positive. Furthermore, 38/105 (36.2%) patients with IBS and 14/36 (38.9%) with IBD were HLA DQ2/8 positive (P = 0.21). Compared to healthy controls those with functional upper GI diseases disorders had a 1.8 times higher odds of DQ2/8 positivity. Those with liver disease had 1.3 times the odds, albeit not statistically significant, ofDQ2/8 positivity. Both those with IBS and IBD had a lower odds of DQ2/8 positivity compared to healthy controls. CONCLUSION: The proportion of individuals HLA DQ2/8 positive is higher in those with liver/upper functional GI disease and lower in IBS/IBD as compared to general population estimates.

关键词： Human leukocyte antigen DQ2/8 Gastrointestinal and liver disease Celiac disease

Prevalence of functional dyspepsia and its subgroups in patients with eating disorders

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World Journal of Gastroenterology 2012年第32期18卷 4379-4385页

作者： antonella santonicola Monica Siniscalchi Pietro Capone Serena Gallotta Carolina Ciacci Paola Iovino Department of Clinical and Experimental Medicine University of NaplesFederico II80131 NaplesItaly Department of Medicine and Surgery University of Salerno84081 SalernoItaly

AIM:To study the prevalence of functional dyspepsia(FD)(Rome Ⅲ criteria) across eating disorders(ED),obese patients,constitutional thinner and healthy ***:Twenty patients affected by anorexia nervosa,6 affected by bulimia nervosa,10 affected by ED not otherwise specified according to diagnostic and statistical manual of mental disorders,4th edition,nine constitutional thinner subjects and,thirtytwo obese patients were recruited from an outpatients clinic devoted to eating behavior *** healthy volunteers matched for age and gender were enrolled as healthy *** participants underwent a careful clinical *** and anthropometric characteristics were obtained from a structured *** presence of FD and,its subgroups,epigastric pain syndrome and postprandial distress syndrome(PDS) were diagnosed according to Rome Ⅲ *** intensity-frequency score of broader dyspeptic symptoms such as early satiety,epigastric fullness,epigastric pain,epigastric burning,epigastric pressure,belching,nausea and vomiting were studied by a standardized questionnaire(0-6).Analysis of variance and post-hoc Sheffè tests were used for ***:90% of patients affected by anorexia nervosa,83.3% of patients affected by bulimia nervosa,90% of patients affected by ED not otherwise specified,55.6% of constitutionally thin subjects and 18.2% healthy volunteers met the Postprandial Distress Syndrome Criteria(χ 2,P < 0.001).Only one bulimic patient met the epigastric pain syndrome *** fullness intensity-frequency score was significantly higher in anorexia nervosa,bulimia nervosa and ED not otherwise specified groups compared to the score calculated in the constitutional thinner group(4.15 ± 2.08 vs 1.44 ± 2.35,P = 0.003;5.00 ± 2.45vs 1.44 ± 2.35,P = 0.003;4.10 ± 2.23vs 1.44 ± 2.35,P = 0.002,respectively),the obese group(4.15 ± 2.08vs 0.00 ± 0.00,P < 0.001;5.00 ± 2.45vs 0.00 ± 0.00,P < 0.001;4.10 ± 2.23

关键词： Eating disorders Functional dyspepsia Post prandial distress syndrome Epigastric pain sindrome Rome Ⅲ criteria Upper abdominal symptoms Anorexia nervosa Bulimia nervosa Eating disorders not otherwise specified Constitutional thinness

Probabilistic Quantitative Temporal Constraints:Representing,Reasoning,and Query Answering

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Journal of Electronic Science and Technology 2018年第1期16卷 1-10页

作者： Paolo Terenziani antonella Andolina Dipartimento di Scienze e Innovazione Tecnologica University of Eastern PiedmontAlessandria 15121 Istituto Tecnico Commerciale Sommeiller Torino 10129

In many applications and domains,temporal constraints between actions, and their probabilities play an important role. We propose the first approach in the literature coping with probabilistic quantitative constraints. To achieve such a challenging goal, we extend the widely used simple temporal problem(STP) framework to consider ***,we propose i) a formal representation of probabilistic quantitative constraints, ii) an algorithm,based on the operations of intersection and composition,for the propagation of such temporal constraints, and iii) facilities to support query answering on a set of such constraints. As a result, we provide users with the first homogeneous method supporting the treatment(representing,reasoning,and querying) of probabilistic quantitative constraints, as required by many applications and domains.

关键词： Artificial intelligence(AI) probabilities query answering quantitative temporal constraints temporal reasoning

The intricate debate on neurodegeneration and neuroinflammation in Parkinson’s disease:which came first?

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Neural Regeneration Research 2023年第1期18卷 125-126页

作者： antonella Cardinale Valeria Calabrese Experimental Neurophysiology Laboratory IRCCS San Raffaele RomaRomeItaly Department of Medicine Universitàdegli Studi di PerugiaPerugiaItaly

Parkinson’s disease(PD)is a heterogeneous multifactorial disorder and,during the last years,new scientific evidence has supported this *** principal hallmarks of PD are the loss of dopaminergic neurons in the substan... 详细信息

关键词： inflammation aggregation debate

Continuous dynamic monitoring of a centenary iron bridge for structural modification assessment

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Frontiers of Structural and Civil Engineering 2015年第1期9卷 26-41页

作者： Carmelo GENTILE antonella SAISI Department of Architecture Built environment and Construction engineering (ABC) Piazza Leonardo da Vinci 32 Milan 20133Italy

A multi-channel continuous dynamic monitoring system has been installed in a centenary iron arch bridge on late November 2011. The historic infrastructure, completed in 1889 and crossing the Adda river about 50 km far from Milan, is the most important monument of XIX century iron architecture in Italy and is still used as roadway and railway bridge. The monitoring project follows a series of preliminary ambient vibration tests carried out on the bridge since June 2009. The paper describes the bridge structure and its dynamic characteristics identified from the experimental studies developed since 2009, the installed monitoring system and the software developed in LabVIEW for automatically processing the collected data. Subsequently, the tracking of automatically identified natural frequencies over a period of about 18 months is presented and discussed, highlighting the effects of environmental and operational conditions on the bridge dynamic characteristics as well as the detection of structural changes, mainly based on natural frequencies shifts.

关键词： automated modal identification continuous dynamic monitoring environmental/operational effects iron arch bridge structural health monitoring

100 years of high GEM concentration in the Central Italian Herbarium and Tropical Herbarium Studies Centre(Florence,Italy)

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Journal of Environmental Sciences 2020年第1期32卷 377-388页

作者： Jacopo Cabassi Valentina Rimondi Zhang Yeqing antonella Vacca Orlando Vaselli antonella Buccianti Pilario Costagliola Department of Earth Sciences University of FlorenceVia G.La Pira4-50121 FlorenceItaly CNR-Institute of Geosciences and Earth Resources Via G.La Pira4-50121 FlorenceItaly

Up to 1980 s,the most used preservative for herbaria specimens was HgCl2,sublimating at ambient air conditions;ionic Hg then reduces to Hg0(gaseous elemental mercury,GEM)and diffuses throughout poor ventilated *** GEM levels may indeed persist for decades,representing a health *** this study,we present new GEM data from the Central Italian Herbarium and Tropical Herbarium Studies Centre of the University of Florence(Italy).These herbaria host one of the largest collection of plants in the ***,HgCl2 was documented as plant preservative up to the 1920 *** surveys were conducted in July 2013 and July and December 2017,to account for temporal and seasonal *** show GEM concentrations well above those of external locations,with peak levels within specimen storage cabinets,exceeding 50,000 ng/*** concentrations up to^7800 ng/m3 were observed where the most ancient collections are stored and no ventilation systems were *** the contrary,lower GEM concentrations were observed at the first ***,lower and more homogeneously distributed GEM concentrations were measured in 2017 than in 2013 since the air-conditioning system was updated in *** concentrations were similar to other herbaria worldwide and lower than Italian permissible exposure limit of 20,000 ng/m3(8-hr working day).Our results indicate that after a century from the latest HgCl2 treatment GEM concentrations are still high,i.e.,the treatment itself is almost *** conditioning and renewing is probably the less expensive and more effective method for GEM lowering.

关键词： Gaseous elemental mercury(GEM) Mercuric chloride Herbaria Florence Health safety

Intravascular contrast agents in diagnostic applications： Use of red blood cells to improve the lifespan and efficacy of blood pool contrast agents

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Nano Research 2017年第3期10卷 731-766页

作者： antonella Antonelli Carla Sfara Mauro Magnani Department of Biomolecular Sciences Biochemistry and Molecular Biology Section University of Urbino 'Carlo Bo' Via Saffi 2 61029Urbino (PU) Italy

In medicine, discrimination between pathologies and normal areas is of great importance, and in most cases, such discrimination is made possible by novel imaging technologies. Numerous modalities have been developed to visualize tissue vascularization in cardiovascular diseases or during angiogenic and vasculogenic processes. Here, we report the recent advances in vasculature imaging, providing an overview of the current non-invasive approaches in biomedical diagnostics and potential future strategies for prognostic assessment of vessel diseases, such as aneurysms and coronary artery occlusion leading to myocardial infarction. There are several contrast agents （CAs） available to improve the visibility of specific tissues at the early stage of diseases, allowing for rapid treatment. However, CAs are also hampered by numerous limitations, including rapid diffusion from blood vessels into the interstitial space, toxicity, and low sensitivity. Extravasation from blood vessels leads to a rapid loss of the image. If the contrast medium can fully be confined to the vascular space, high-resolution structural and functional vascular imaging could be obtained. Many scientists have contributed new materials and/or new carrier systems. For example, the use of red blood cells （RBCs） as CA-delivery systems appears to provide a scalable alternative to current procedures that allows adequate vascular imaging. Recognition and removal of CAs from the circulation can be prevented and/or delayed by using RBCs as biomimetic CA-carriers, and this technology should be clinically validated.

关键词： diagnostic applications magnetic resonanceimaging (MRI) vascular contrast agents red blood cells medical imaging new tomography