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Clinical and economic impact of infliximab one-hour infusion protocol in patients with inflammatory bowel diseases:A multicenter study

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2017年第2期8卷 131-136页

作者： Anna Viola Giuseppe Costantino antonino carlo privitera Fabrizio Bossa Angelo Lauria Laurino Grossi Maria Beatrice Principi Nicola Della Valle Maria Cappello Gastroenterology and Hepatology Section Dipartimento Biomedico di Medicina Interna e Specialistica University of Palermo IBD Unit Dipartimento di Medicina Interna e Terapia Medica University of Messina IBD and PelvicF loor Unit Azienda Ospedaliera per l’Emergenza Ospedale Cannizzaro Gastroenterology Section Casa Sollievo della Sofferenza S. Giovanni Rotondo Gastroenterology and Endoscopy Unit A.O.Bianchi-Melacrino-Morelli Fisiopatologia Digestiva Ospedale Spirito Santo Gastroenterology Section Gastroenterologia

AIM To assess the impact of short infliximab(IFX) infusion on hospital resource utilization and *** All inflammatory bowel diseases(IBD) patients who received IFX 1 h infusion from March 2007 to September 2014 in eight centers from Southern Italy were included in the analysis. Demographic, clinical and infusion related data were collected. The potential benefits related to the short infusion protocol were assessed both in terms of time saving and increased infusion unit capacity. In addition, indirect patient-related cost savings were *** One hundred and twenty-five patients were recruited(64 with ulcerative colitis and 61 with Crohn's disease). Median duration of disease was of 53 mo and mean age of pts at diagnosis was of 34 years(SD: ± 13). Adverse infusion reactions were reported in less than 4% both before and after short infusion. The total number of infusions across the selected centers was of 2501(30.5% short infusions). In the analyzed cohort, 1143 h were saved(762 in the infusion and 381 in observation phases) through the rapid IFX infusion protocol. This time saving(-15% compared to the standard protocol in infusion phase) represents, from the hospital perspective, an opportunity to optimize infusion unit capacity by allocating the saved time in alternative cost-effective treatments. This is the case of opportunity cost that represents the value of forgone benefit which could be obtained from a resource in its next-best alternative use. Hence, an extra hour of infusion in the case of standard 2-h IFX represents a loss in opportunity to provide other cost effective services. The analysis showed that the short infusion increased the infusion units capacity up to 50% on days when the IFX infusions were scheduled(infusion phase). Furthermore, the analysis showed that the short IFX infusion protocol leads to time savings also in the post-infusion phase(observation) leading to a time saving of 10% on average among the analyzed centers. F

关键词： Infliximab One-hour infusion Cost savings Economic impact Multicenter study

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Non-invasive investigation in patients with inflammatory joint disease

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World Journal of Gastroenterology 2009年第20期15卷 2463-2468页

作者： Elisabetta Dal Pont Renata D’Incà antonino Caruso Giacomo carlo Sturniolo Department of Surgical and Gastro-enterological Sciences University of Padova

Gut inflammation can occur in 30%-60% of patients with ***, the presence of such gut inflammation is underestimated, only 27% of patients with histological evidence of gut inflammation have intestinal symptoms, but subclinical gut inflammation is documented in two-thirds of patients with inflammatory joint *** are common genetic and immunological mechanisms behind concomitant inflammation in the joints and intestinal tract.A number of blood tests, *** sedimentation rate, orosomucoid, C-reactive protein, and white cell and platelet counts, are probably the most commonly used laboratory markers of inflammatory disease, however, these tests are difficult to interpret in arthropathies associated with gut inflammation, since any increases in their blood levels might be attributable to either the joint disease or to gut ***, it would be useful to have a marker capable of separately identifying gut *** proteins, which are indirect markers of neutrophil migration in the gut wall, and intestinal permeability, seem to be ideal for monitoring intestinal inflammation:they are easy to measure non-invasively and are specific for intestinal disease in the absence of gastrointestinal *** the traditional markers for characterizing intestinal inflammation, there are also antibodies, in all probability generated by the immune response to microbial antigens and auto-antigens, which have proved useful in establishing the diagnosis and assessing the severity of the condition, as well as the prognosis and the risk of *** short, noninvasive investigations on the gut in patients with rheumatic disease may be useful in clinical practice for a preliminary assessment of patients with suspected intestinal disease.

关键词： Biochemical markers Fecal markers Inflammatory bowel disease Intestinal permeability Serological markers Spondyloarthropathies

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Diabetic foot syndrome:Immune-inflammatory features as possible cardiovascular markers in diabetes

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World Journal of Orthopedics 2015年第1期6卷 62-76页

作者： antonino Tuttolomondo carlo Maida Antonio Pinto Dipartimento Biomedico di Medicina Interna e Specialistica U.O.C di Medicina Interna e CardioangiologiaUniversità degli Studi di Palermo

Diabetic foot ulcerations have been extensively reported as vascular complications of diabetes mellitus associated with a high degree of morbidity and mortality. Diabetic foot syndrome(DFS), as defined by the World Health Organization, is an "ulceration of the foot(distally from the ankle and including the ankle) associated with neuropathy and different grades of ischemia and infection". Pathogenic events able to cause diabetic foot ulcers are *** the commonest causes of this pathogenic pathway it's possible to consider peripheral neuropathy, foot deformity, abnormal foot pressures, abnormal joint mobility, trauma, peripheral artery disease. Several studies reported how diabetic patients show a higher mortality rate compared to patients without diabetes and in particular these studies under filled how cardiovascular mortality and morbidity is 2-4 times higher among patients affected by type 2 diabetes mellitus. This higher degree of cardiovascular morbidity has been explained as due to the observed higher prevalence of major cardiovascular risk factor, of asymptomatic findings of cardiovascular diseases, and of prevalence and incidence of cardiovascular and cerebrovascular events in diabetic patients with foot complications. In diabetes a fundamental pathogenic pathway of most of vascular complications has been reported as linked to a complex interplay of inflammatory, metabolic and procoagulant variables. These pathogenetic aspects have a direct interplay with an insulin resistance, subsequent obesity, diabetes, hypertension, prothrombotic state and blood lipid disorder. Involvement of inflammatory markers such as IL-6 plasma levels and resistin in diabetic subjects as reported by Tuttolomondo et al confirmed the pathogenetic issue of the a "adipo-vascular" axis that may contribute to cardiovascular risk in patients with type 2 diabetes. This "adipo-vascular axis" in patients with type 2 diabetes has been reported as characterized by lower plasma l

关键词： Diabetic foot syndrome Inflammation Cytokines Cardiovascular risk Marker

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Taper-wedge stem suitable for anterior approach total hip arthroplasty:Adequate biomechanical reconstruction parameters and excellent clinical outcome at mid-term follow-up

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World Journal of Orthopedics 2022年第12期13卷 1047-1055页

作者： carlo Trevisan antonino Salvatore Lombardo Gianluca Gallinari Marco Zeppieri Raymond Klumpp UOC Ortopedia e Traumatologia Ospedale Bolognini Seriate ASSTBergamo Est 24068Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy UOC Ortopedia e Traumatologia Ospedale Treviglio-Caravaggio ASSTBergamo Ovest 24047Italy

BACKGROUND The direct anterior approach(DAA) for total hip arthroplasty(THA) is a less invasive and muscle-sparing approach that seems to improve early function and patient satisfaction. Several studies, however, have reported high complication and revision rates due to the technical difficulties related to the femoral *** To evaluate the usefulness and safety of a new stem equipped with a morphometric design and a size-specific medial curvature in DAA for *** This retrospective study was based on 130 patients that underwent mini-invasive DAA procedures for THA using the Accolade Ⅱ stem. A total of 144 procedures were included in the assessment, which was based on postoperative complications, survival rates, functional parameters, and patient related *** Overall complications were recorded in 6 procedures(4.2%). There were no complications related to the stem implantation and no intraoperative fractures. Only one patient was revised for deep infection. On radiographs, biomechanical hip reconstruction was satisfactory and no stem showed any subsidence greater than 2 mm. Full osseointegration based on Engh scores was seen in all of the implanted stems. Median Harris hip score at final follow-up was 99 points(range 44-100 points), which resulted excellent in 91.3% of patients. The median values of the osteaorthritis outcome score ranged from 87.5 to *** The mid-term positive outcomes and low complication rate in our consecutive series of patients support the safety and suitability of this new stem design in DAA for THA.

关键词： Total hip arthroplasty Orthopedics Direct anterior approach Orthopedic surgery Stem implantation Accolade II stem

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Diagnosis of ruptured superior mesenteric artery aneurysm mimicking a pancreatic mass

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World Journal of Gastroenterology 2010年第18期16卷 2298-2301页

作者： Stefano Palmucci Letizia Antonella Mauro Pietro Milone Francesco Di Stefano antonino Scolaro Antonio Di Cataldo Giovanni carlo Ettorre Department DOGIRA Section of Radiological Sciences"Policlinico-Vittorio Emanuele" University Hospital Division of Phlebologic Vascular Surgery Hospital "Garibaldi Nesima" Department of General and Colorectal Surgery "Policlinico-Vittorio Emanuele" University Hospital

Aneurysms and pseudoaneurysms of the superior mesenteric artery are potentially lethal and should be treated as urgently as *** a 52-year-old man with occasional epigastric pain,we accidentally discovered a superior mesenteric artery aneurysm that was ruptured with spontaneous tamponade in the uncinate process and in the head of the *** ruptured aneurysm had a heterogeneous appearance due to its thrombotic and hemorrhagic content,and it simulated a voluminous mass in the head and uncinate process of the pancreas,associated with mild dilatation of the main pancreatic *** advances in multidetector computed tomography and magnetic resonance imaging have enabled radiologists to develop a correct diagnosis of mesenteric aneurysms and pseudoaneurysms of the visceral branches of the abdominal aorta,and to differentiate this diagnosis from that of pancreatic or peripancreatic masses;angiography is currently used to confirm a diagnosis and to develop therapeutic treatments.

关键词： Superior mesenteric artery Magnetic resonance imaging Computed tomography Ruptured aneurysm

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When sepsis affects the heart: A case report and literature review

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World Journal of Clinical Cases 2015年第8期3卷 743-750页

作者： Giuseppe Clemente antonino Tuttolomondo Daniela Colomba Rosaria Pecoraro Chiara Renda Vittoriano Della Corte carlo Maida Irene Simonetta Antonio Pinto U.O.C.di Medicina Interna e Cardioangiologia University of Palermo

A 59-year-old nursing home patient with Down syndrome was brought to the internal medicine department of our hospital due to fever, cough without expectorate, and dyspnea. A thoracic computed tomography revealed the presence of bilateral basal parenchymal opacities. Her condition deteriorated after admission and troponin reached a peak serum concentration of 16.9 ng/m L. The patient was in cardiogenic shock. In addition to fluid resuscitation, vaso-active amine infusion was administered to achieve hemodynamic stabilization. The differential diagnosis investigated possible pulmonary embolism, myocardial infarction, and myocarditis. Furthermore, a second transthoracic echocardiogram suggested Tako-Tsubo syndrome. This is a septic patient. The purpose of this manuscript is to review studies which formerly examined the possible association between high levels of troponin and mortality to see if it can be considered a positive predictive factor of fatal prognosis as the case of thrombocytopenia, already a positive independent predictive factor of multiple organ failure syndrome, and generally to characterize risk profile in a septic patient.

关键词： Sepsis Shock Hypotension Troponin Myocardial dysfunction

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Interferon β-1a alone or in combination with ribavirin: A randomized trial to compare efficacy and safety in chronic hepatitis C

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World Journal of Gastroenterology 2005年第29期11卷 4484-4489页

作者： Rinaldo Pellicano Antonio Craxì Piero Luigi Almasio Mario Valenza Giovanna Venezia Alfredo Alberti Silvia Boccato Luigi Demelia Orazio Sorbello antonino Picciotto Francesco Torre Gaetano Ideo carlo Cattaneo Mara Berrutti Mario Rizzetto U.O.A.D.U. Gastro-Hepatology S. Giovanni Battista (Molinette) Hospital Turin Italy Venezia Department of Gastroenterology and Hepatology University of Palermo Italy Department of Internal Medicine University of Padua Italy Institute of Clinical Medicine University of Cagliari Italy Department of Internal Medicine University of Genoa Italy Department of Hepatology San Giuseppe Hospital Milan Italy U.O.A.D.U. Gastro-Hepatoiogy S. Giovanni Battista (Molinette) Hospital Turin Italy

AIM： To compare the efficacy and safety of recombinant human IFN β-la alone or in combination with ribavirin in treatment-naive subjects with chronic hepatitis C. METHODS： Open, randomized trial was performed in 6 Italian tertiary centers： 102 of the 108 patients screened were randomized to receive 6 MIU of recombinant human IFN β-la subcutaneously daily for 24 wk, alone （Group 1, n = 51） or in combination with ribavirin 1 000 to 1 200 mg/d （Group 2, n = 51）. RESULTS： The end-of-treatment virologic response rate was 29.4% in Group 1 and 41.2% in Group 2 （nonsignificant）. Twenty-four weeks after stopping therapy, sustained virologic response rate was 21.6% in Group 1 and 27.4% in Group 2 （non-significant）. All subjects in Group 1 completed treatment, while two subjects in Group 2 stopped therapy due to treatment-related adverse events. CONCLUSION： Recombinant human IFN β-la, alone or in combination with ribavirin, has an excellent safety profile and, may represent an alternative for chronic hepatitis C patients who are unable to tolerate pegylated α-interferon.

关键词： Chronic hepatitis C IFN β-1a Ribavirin

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Optimization of Contrast Material Dose for Abdominal Multi-Detector Row CT: Predicting Patient Lean Body Weight by Using Preliminary Transverse CT Images

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Advances in Computed Tomography 2014年第1期3卷 1-10页

作者： antonino Guerrisi Daniele Marin Huiman Barnhart Lisa Ho Thomas L. Toth carlo Catalano Rendon C. Nelson Department Department of Radiological Sciences University of Rome Sapienza Rome Italy Department of Biostatistics and Bioinformatics Duke Clinical Research Institute Durham USA Department of Radiology Duke University Medical Center Durham USA G.E. Medical Systems Milwaukee USA

Estimated LBW could be used to determine the contrast material dose and rate during MDCT. The aim of this study is to test the accuracy of a technique for estimation of lean body weight (LBW) from a single multi-detector row computed tomographic (MDCT) abdominal image, using a bioelectrical body composition analyzer scale as the reference standard. CT images of 21 patients with previously measured LBW (mLBW) were processed using computer-assisted, vendor-specific software (Advantage Windows 4.2;GE Healthcare, Inc). For each transverse image, a fat-fraction was automatically measured as the number of fat pixels (-200 to -50 HU) divided by the total number of pixels having an attenuation value ≥-200 HU. Estimated LBW (eLBW) of five single contiguous sections was calculated in each of three abdominal regions (upper abdomen, mid abdomen and pelvis) by multiplying TBW by (1 – fat-fraction). Bland-Altman plot with limits of agreement was used to assess agreement between mLBW and eLBW. The mean mLBW for all patients was 56 kg (range, 39 - 75 kg). Mean differences and limits of agreement between mLBW and eLBW measurements for the upper abdomen, mid abdomen and pelvis reported were -8.9 kg (-25.6 kg, +7.5 kg), -10.6 kg (-27.7 kg, +6.4 kg), and +0.5 kg (-12.8 kg, +13.8 kg) respectively. eLBW deriving directly from a transverse CT image of the pelvis can accurately predict mLBW.

关键词： Lean Body Weight Multi-Detector CT Contrast Dose

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Multiscale modeling of ultrafast melting phenomena

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npj Computational Materials 2022年第1期8卷 324-333页

作者： Gaetano Calogero Domenica Raciti Pablo Acosta-Alba Fuccio Cristiano Ioannis Deretzis Giuseppe Fisicaro Karim Huet Sébastien Kerdilès Alberto Sciuto antonino La Magna CNR IMM CataniaItaly UniversitéGrenoble Alpes CEA-LETIGrenobleFrance LAAS CNRSUniversitéde ToulouseToulouseFrance Laser Systems&Solutions of Europe(LASSE) GennevilliersFrance Dipartimento di Fisica e Astronomia Universitàdi CataniaCataniaItaly

Ultraviolet Nanosecond Laser Annealing(LA)is a powerful tool for both fundamental investigations of ultrafast,nonequilibrium phase-change phenomena and technological applications(e.g.,the processing of 3D sequentially integrated nano-electronic devices)where strongly confined heating and melting is *** the LA process along with the experimental design is challenging,especially when involving complex 3D-nanostructured systems with various shapes and *** this purpose,it is essential to model critical nanoscale physical LA-induced phenomena,such as shape changes or formation and evolution of point and extended *** date,LA simulators are based on continuum models,which cannot fully capture the microscopic kinetics of a solid–liquid *** this work a fully atomistic LA simulation methodology is presented,based on the parallel coupling of a continuum,finite elements,μm-scale electromagnetic-thermal solver with a super-lattice Kinetic Monte carlo atomistic model for *** against phase-field models and experimental data validate the *** of a Si(001)surface is studied varying laser fluence and pulse shape,assuming both homogeneous and inhomogeneous nucleation,revealing how liquid Si nuclei generate,deform and coalesce during *** proposed methodology is applicable to any system where the atom kinetics is determined by a strongly space-and time-dependent field,such as temperature or strain.

关键词： kinetics shape melting

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Serum SCCA-IgM as a predictor of hepatocellular carcinoma in patients with liver cirrhosis

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Open Journal of Gastroenterology 2012年第2期2卷 56-61页

作者： Daniela Buccione Gianluca Fatti Andrea Gallotta Elisabetta Loggi Roberto Di Donato Lilia Testa carlo Saitta Valentina Santi Antonio Di Micoli Virginia Erroi Marta Frigerio Valentina Fazio antonino Picciotto Alessandra Biasiolo Francoise Degos Patrizia Pontisso Giovanni Raimondo Franco Trevisani APHP Hopital Beaujon INSERM U 773 Clichy France Dipartimento di Medicina Clinica e Sperimentale “G. Patrassi” Università di Padova Padova Italia Dipartimento di Medicina Clinica Alma Mater Studiorum-Università di Bologna Bologna Italia Dipartimento di Medicina Interna Policlinico Universitario di Messina Messina Italia Dipartimento di Medicina Interna Università di Genova Genova Italia Xeptagen S.p.A. Venezia Italia

Aberrant Squamous Cell Carcinoma Antigen (SCCA) expression is an early hepatocarcinogenetic event and circulating SCCA-IgM complexes are elevated in most HCC patients. We evaluated whether serum SCCA-IgM levels can identify HCV +ve cirrhotic patients at low HCC risk. In this retrospective study we enrolled 29 cirrhotic patients in whom serum SCCA-IgM was measured 8 - 69 months (median 31) before HCC diagnosis, and 28 cirrhotic patients who remained HCC- free, with SCCA-IgM measured 15 - 68 months (median 48) before the study end. The best discriminating value of SCCA-IgM was calculated and tested in predicting HCC diagnosis within 12, 24 and 36 months. Sensitivity analysis, considering different HCC incidence, was conducted to identify the patient subgroup with an annual cancer risk below the threshold of a cost-effective semiannual surveillance with ultrasound. Cumulative HCC incidence at 12, 24 and 36 months was 7.0%, 15.7% and 26.3%, respectively. SCCA-IgM levels were higher in HCC than in cirrhotic patients [median: 381 (95% C.I.: 50 - 5289) vs. 100 (70 - 493) AU/mL, P = 0.005]. The SCCA-IgM value ≤ 200 AU/mL accurately identified patients at low risk of HCC development in the subsequent year (sensitivity 75%, specificity 62%, positive predictive value 13% and negative predictive value 97%). Considering an annual HCC incidence ≤ 3%, patients with SCCA-IgM ≤ 200 AU/mL (60% of the whole patients) had an HCC risk below the accepted threshold of a cost-effective surveillance (1.5%). In conclusion, provided that our provocative results are confirmed in larger studies, SCCA-IgM serum measurement could permit implementation of a two step (with different costs) surveillance: an initial serological surveillance, based on the annual monitoring of this biomarker, and the conventional surveillance by semiannual US when SCCA-IgM becomes >200 AU/mL. This could improve the cost/effectiveness of surveillance of HCV infected patients at risk of HCC.

关键词： SCCA-IgM HCC Risk Assessment Surveillance Cost/Effectiveness

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