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Factors affecting the quality of bowel preparation for colonoscopy in hard-to-prepare patients:Evidence from the literature

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World Journal of Gastroenterology 2023年第11期29卷 1685-1707页

作者： Endrit Shahini Emanuele Sinagra Alessandro Vitello Rocco Ranaldo antonella Contaldo Antonio Facciorusso Marcello Maida Gastroenterology Unit National Institute of Gastroenterology-IRCCS“Saverio de Bellis”Castellana GrotteBari 70013Italy Gastroenterology and Endoscopy Unit Fondazione Istituto G.GiglioCefalù90015Italy Gastroenterology and Endoscopy Unit S.Elia-Raimondi HospitalCaltanissetta 93100Italy Department of Internal Medicine “Mazzolani-Vandini”HospitalDigestive EndoscopyFerrara 744011Italy Gastroenterology Unit National Institute of Gastroenterology“S de Bellis”Research HospitalBari 70013Italy Department of Medical Sciences University of FoggiaSection of GastroenterologyFoggia 71122Italy

Adequate bowel cleansing is critical for a high-quality colonoscopy because it affects diagnostic accuracy and adenoma ***,almost a quarter of procedures are still carried out with suboptimal preparation,resulting in longer procedure times,higher risk of complications,and higher likelihood of missing *** guidelines recommend high-volume or low-volume polyethylene glycol(PEG)/non-PEG-based split-dose *** patients who have had insufficient bowel cleansing,the colonoscopy should be repeated the same day or the next day with additional bowel cleansing as a salvage option.A strategy that includes a prolonged low-fiber diet,a split preparation regimen,and a colonoscopy within 5 h of the end of preparation may increase cleansing success rates in the ***,even though no specific product is specifically recommended in the other cases for difficult-to-prepare patients,clinical evidence suggests that 1-L PEG plus ascorbic acid preparation are associated with higher cleansing success in hospitalized and inflammatory bowel disease *** with severe renal insufficiency(creatinine clearance<30 mL/min)should be prepared with isotonic high volume PEG *** data on cirrhotic patients are currently available,and no trials have been conducted in this *** accurate characterization of procedural and patient variables may lead to a more personalized approach to bowel preparation,especially in patients undergoing resection of left colon lesions,where intestinal preparation has a poor *** purpose of this review was to summarize the evidence on the risk factors influencing the quality of bowel cleansing in difficult-to-prepare patients,as well as strategies to improve colonoscopy preparation in these patients.

关键词： Colorectal cancer Colonoscopy Adenoma detection rate Bowel preparation Polyethylene glycol

Acute small bowel obstruction caused by endometriosis:A case report and review of the literature

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World Journal of Gastroenterology 2008年第21期14卷 3430-3434页

作者： antonella De Ceglie Claudio Bilardi Sabrina Blanchi Massimo Picasso Massimo Conio Marcello Di Muzio Alberto Trimarchi Department of Gastroenterology Giovanni Paolo ⅡCancer InstituteBari 70126Italy Department of Gastroenterology General HospitalSanremo 18038Italy Department of Pathology General HospitalSanremo 18038Italy Department of Surgery General HospitalSanremo 18038Italy

Gastrointestinal involvement of endometriosis has been found in 3%-37% of menstruating women and exclusive localization on the ileum is very rare(1%-7%).Endometriosis of the distal ileum is an infrequent cause of intestinal obstruction,ranging from 7% to 23% of all cases with intestinal *** report a case in which endometrial infiltration of the small bowel caused acute obstruction requiring emergency surgery,in a woman whose symptoms were not related to *** of the resected specimen showed that endometriosis was mainly prevalent in the muscularis propria and submucosa and that the mucosa was not ulcerated but had inflammation and glandular *** lymph node involvement,with a cystic glandular pattern was also detected.

关键词： Endometriosis Small bowel Ileum Obstruction Abdominal pain Intestinal resection

Irreversible electroporation for the management of pancreatic cancer: Current data and future directions

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World Journal of Gastroenterology 2023年第2期29卷 223-231页

作者： Stavros Spiliopoulos Lazaros Reppas Dimitrios Filippiadis antonella Delvecchio Maria Conticchio Riccar do Memeo Riccardo Inchingolo Second Department of Radiology School of MedicineNational and Kapodistrian University of AthensAthens 12461AttikiGreece Unit of Hepato-Pancreatic-Biliary Surgery “F.Miulli”Regional General HospitalAcquaviva delle Fonti 70021BariItaly Interventional Radiology Unit “F.Miulli”Regional General HospitalAcquaviva delle Fonti 70021Italy

Pancreatic cancer is currently the seventh leading cause of cancer death(4.5%of all cancer deaths)while 80%-90%of the patients suffer from unresectable disease at the time of *** remains poor,with a mean survival up to 15 mo following systemic ***-regional thermal ablative techniques are rarely implemented due to the increased risk of thermal injury to the adjacent structures,which can lead to severe adverse *** electroporation,a promising novel non-thermal ablative modality,has been recently introduced in clinical practice for the management of inoperable pancreatic cancer as a safer and more effective loco-regional treatment *** and initial clinical data are *** review will focus on the basic principles of IRE technology,currently available data,and future directions.

关键词： Pancreatic cancer Interventional oncology Irreversible electroporation Ablation Loco-regional treatment Image-guided treatment

Exerav as a Parameter for Buildina Enerav Assessment

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Journal of Civil Engineering and Architecture 2015年第6期9卷 741-748页

作者： Lorenzo Leoncini Marta Giulia baldi Department oflndustrial Engineering University of Florence Florence 50139 ltaly Department of Civil and Environmental Engineering University of Florence Florence 50139 Italy

The energy and environmental impacts resulting from the buildings sector are one of the impending problems which address the international action. The main strategies implemented to answer to this problem are the energy efficiency improvement, the CO2 emissions reduction and the renewable energy share increase in the energy mix. The key subject discussed in this paper is the ＂building energy impact＂, aimed to leading the building sector towards the energy efficiency improvement. The paper＇s aim is to show that an energy assessment is not able to give a consistent evaluation of building energy use, and it could be misleading. Therefore, the paper proposes the exergy assessment as complementary evaluation method, in order to achieve a complete description of the concept ＂building＇s energy impact on the environment＂. In the first section, we describe the parameters currently used for the building energy assessment, focusing on the primary energy index and the CO2 emissions index. In the second section, we introduce the exergy as a complementary index. This index is a possible answer to the problems previously identified. Finally, in the third section, we present three test-cases, analyzed through transient simulation software TRNSYS. The purpose of the test-cases analysis is to show the difference between energy and exergy assessment.

关键词： Building energy assessment energy performance exergy performance indices.

Fluoroquinolone-macrolide combination therapy for chronic bacterial prostatitis： retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction

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Asian Journal of Andrology 2011年第6期13卷 819-827页

作者： Vittorio Magri Emanuele Montanari Visnja Skerk Alemka Markotic Emanuela Marras antonella Restelli Kurt G Naber Gianpaolo Perletti Urology and Sonography Secondary Care Clinic Azienda Ospedaliera Istituti Clinici di Perfezionamento Milano 20132 Italy Clinica Urologica III University of Milan/San Paolo Hospital Milano 20142 Italy University Hospital for Infectious Diseases Dr. Fran Mihaljevic Zagreb 10000 Croatia Laboratory of Toxicology and Pharmacology Department of Biomedical Informatic Environmental and Communication Sciences Universita degli Studi dell＇Insubria Busto A.Narese 21052 Italy Microbiology Unit Fondazione I RCCS Osp. Maggiore Policlinico Mangiagalli Regina Elena Milano 20122 Italy Technical University Munich 80333 Germany

We previously demonstrated the safety and efficacy of fluoroquinolone-macrolide combination therapy in category Ⅱ chronic bacterial prostatitis （CBP）. The aim of this study is to retrospectively compare the microbiological and clinical findings of two treatment schemes for CBP based on the combination of azithromycin （500 rag, thrice-weekly） with a once-daily 500- or 750-mg dose of ciprofloxacin （Cipro-500 or Cipro-750 cohort, respectively）. Combined administration of azithromycin （1500 mg week^-1） with ciprofloxacin at the rate of 750 mg day^- 1 for 4 weeks rather than at 500 mg day^- 1 for 6 weeks increased the eradication rates from 62.35% to 77.32% and the total bacteriological success from 71.76% to 85.57%. A significant decrease in pain and voiding signs/symptoms and a significant reduction in inflammatory leukocyte counts and serum prostate-specific antigen （PSA） were sustained throughout an 18-month follow-up period in both groups. Ejaculatory pain, haemospermia and premature ejaculation were significantly attenuated on microbiological eradication in both groups, but the latter subsided more promptly in the Cipro-750 cohort. In total, 59 Cipro-750 patients showed mild-to-severe erectile dysfunction （ED） at baseline, while 22 patients had no ED on microbiological eradication and throughout the follow-up period. In conclusion fluoroquinolone-macrolide therapy resulted in pathogen eradication and CBP symptom attenuation, including pain, voiding disturbances and sexual dysfunction. A once-daily 750-mg dose of ciprofloxacin for 4 weeks showed enhanced eradication rates and lower inflammatory white blood cell counts compared to the 500-mg dose for 6 weeks. Our results are open to further prospective validation.

关键词： azithromycin chronic bacterial prostatitis chronic pelvic pain syndrome ciprofloxacin erectile dysfunction InternationalIndex of Erectile Function (IIEF) National Institutes of Health Chronic Prostatitis Symptom Index (NiH-CPSI)

Chlamydia pneumoniae replicates in Kupffer cells in mouse model of liver infection

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World Journal of Gastroenterology 2006年第40期12卷 6453-6457页

作者： antonella Marangoni Manuela Donati Francesca Cavrini Rita Aldini Silvia Accardo Vittorio Sambri Marco Montagnani Roberto Cevenini Sezione di Microbiologia DMCSS University of Bologna Bologna Italy Dipartimento SMETC University of Bologna Bologna Italy Dipartimento di Medicina Interna e Gastroenterologia University of Bologna Bologna Italy

AIM: To develop an animal model of liver infection with Chlamydia pneumoniae (C. pneumoniae) in intraperito-neally infected mice for studying the presence of chlamy-diae in Kupffer cells and ***: A total of 80 BALB/c mice were inoculated intraperitoneally with C. pneumoniae and sacrificed at various time points after infection. Chlamydiae were looked for in liver homogenates as well as in Kupffer cells and hepatocytes separated by liver perfusion with collagenase. C. pneumoniae was detected by both isola-tion in LLC-MK2 cells and fluorescence in situ hybridiza-tion (FISH). The releasing of TNFA-α by C. pneumoniae in vitro stimulated Kupffer cells was studied by enzyme-linked immunosorbent ***: C. pneumoniae isolation from liver homoge-nates reached a plateau on d 7 after infection when 6 of 10 animals were positive, then decreased, and became negative by d 20. C. pneumoniae isolation from sepa-rated Kupffer cells reached a plateau on d 7 when 5 of 10 animals were positive, and became negative by d 20. The detection of C. pneumoniae in separated Kupffer cells by FISH, confirmed the results obtained by culture. Isolated hepatocytes were always negative. Stimula-tion of Kupffer cells by alive C. pneumoniae elicited high TNF-α levels. CONCLUSION: A productive infection by C. pneumo-niae may take place in Kupffer cells and C. pneumoniae induces a local pro-inflammatory activity. C. pneumoniae is therefore, able to act as antigenic stimulus when local-ized in the liver. One could speculate that C. pneumoniaeinfection, involving cells of the innate immunity such as Kupffer cells, could also trigger pathological immune re-actions involving the liver, as observed in human patients with primary biliary cirrhosis.

关键词： Chlamydia pneumoniae Liver infection Kupffer cells Hepatocytes Culture-isolation Fluorescence in situ hybridization TNF-α Primary biliary cirrhosis

Endoscopic mucosal resection of large hyperplastic polyps in 3 patients with Barrett’s esophagus

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World Journal of Gastroenterology 2006年第35期12卷 5699-5704页

作者： antonella De Ceglie Gabriella Lapertosa Sabrina Blanchi Marcello Di Muzio Massimo Picasso Rosangela Filiberti Francesco Scotto Massimo Conio Department of Gastroenterology National Cancer Institute Bari Italy Department of Surgical and Morphological Sciences Division of Pathology University of Genova Genova Italy Department of Gastroenterology General Hospital Sanremo Italy Department of Pathology General Hospital Sanremo Italy Division of Enviromental Epidemiology and Biostatistics National Cancer Research Institute Genova Italy

AIM： To report the endoscopic treatment of large hyperplastic polyps of the esophagus and esophagogastric junction （EGJ） associated with Barrett＇s esophagus （BE） with low-grade dysplasia （LGD）, by endoscopic rnucosal resection （EMR）. METHODS： Cap fitted EMR （EMR-C） was performed in 3 patients with hyperplastic-inflammatory polyps （HIPs） and BE. RESULTS： The polyps were successfully removed in the 3 patients. In two patients, with short segment BE （SSBE）（≤ 3 cm）, the metaplastic tissue was completely excised. A 2 cm circumferential EMR was performed in one patient with a polyp involving the whole EGJ. A simultaneous EMR-C of a BE-associated polypoid dysplastic lesion measuring 1 cm × 10 cm, was also carried out. In the two patients, histologic assessment detected LGD in BE. No complications occurred. Complete neosquamous reepithelialization occurred in the two patients with SSBE. An esophageal recurrence occurred in the remaining one and was successfully retreated by EMR. CONCLUSION： EMR-C appears to be a safe and effective method for treating benign esophageal mucosal lesions, allowing also the complete removal of SSBE.

关键词： Hyperplastic polyps Endoscopic mucosal resection Barrett's esophagus

Inhibin B:are modified ranges needed for orchiectomised testicular cancer patients?

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Asian Journal of Andrology 2019年第4期21卷 332-336页

作者： Alessandra Petrozzi Francesco Pallotti Marianna Pelloni antonella Anzuini Antonio Francesco Radicioni Andrea Lenzi Donatella Paoli Francesco Lombardo Laboratory of Seminology Sperm Bank "Loredana Gandini" Department of Experimental Medicine Medical Pathophysiology Section"Sapienza" University of Rome Rome 00161 Italy Hormone Laboratory Department of Experimental Medicine Medical Pathophysiology Section"Sapienza" University of Rome Rome 00161 Italy

Inhibin B is a gon adal horm one that down regulates the pituitary production of follicle-stimulati ng horm one (FSH). In recent years, inhibin B has proved to be an excellent marker of spermatogenesis and even a predictive factor for the recovery of fertility in patients undergoing orchiectomy and antineoplastic treatments. We propose to study inhibin B levels in orchiectomised testicular cancer patients, in order to identify a minimum value representative of normal semen quality. This retrospective study evaluates horm onal and semen parameters of 290 no rmozoospermic patie nts atte nding the Laboratory of Semi no logy - Sperm Bank "Loredana Gandini"(Rome, Italy) for cryopreservation of seminal fluid following a diagnosis of testicular cancer (TC group) and 117 healthy, normozoospermic men as a control group (CTR group). The percentile distribution of gonadotropin and inhibin B values in the TC and CTR groups was analyzed. There was a statistically significant differenee between the two groups in the levels of all hormones (P ≤ 0.001) and in all semen parameters (P 95^th percentile of CTR group. Orchiectomised patients for testicular cancer presented inhibin B levels lower than healthy patients, despite normozoospermia. Our study revealed the poor sensitivity of the current inhibin B reference range when applied to monorchidic patients, suggesting the need to establish more representative ranges to enable more appropriate counseling in relation to the patienfs new endocrine condition.

关键词： inhibin B orchiectomy referenee range testicular cancer

Culture-guided treatment approach for Helicobacter pylori infection:Review of the literature

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World Journal of Gastroenterology 2014年第18期20卷 5205-5211页

作者： Giovanni Cammarota Gianluca Ianiro Stefano Bibbò Teresa antonella Di Rienzo Luca Masucci Maurizio Sanguinetti Antonio Gasbarrini Division of Internal Medicine and Gastroenterology Department of Internal MedicineA Gemelli University Hospital00168 RomeItaly Department of Microbiology A Gemelli University Hospital00168 RomeItaly

The progressive loss of efficacy of standard eradication therapies has made the treatment of Helicobacter pylori (H. pylori) more challenging than ever. Endoscopic-guided antibiotic susceptibility testing had previously been suggested to guide treatment after failure of second-line therapies. However, its role has expanded over the years, in accordance with the current Maastricht Guidelines. Several authors have dealt with this topic, developing both efficacy trials and cost-effectiveness trials against resistant H. pylori infections as well as infections in naïve patients. However, results are not homogeneous enough to provide definite advice, because antibiotic resistance is not the only reason for treatment failure. Moreover, the culture-guided approach is surrounded by many practical issues, such as the availability of both endoscopy units and microbiology laboratories, and the need for a standard of quality that cannot be satisfied everywhere. Finally, pre-treatment susceptibility testing should be part - and not the only weapon - of a targeted, personalized strategy to overcome H. pylori infection.

关键词： Helicobacter pylori Antibiotic resistance Antibiotic susceptibility testing Culture-guided approach Personalized therapy