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Body composition changes after transjugular intrahepatic portosystemic shunt in patients with cirrhosis

World Journal of Gastroenterology 2010年第3期16卷 348-353页

作者： Jonathan Montomoli Peter Holland-Fischer giampaolo bianchi Henning GrФnbk Hendrik Vilstrup Giulio Marchesini Marco Zoli Department of Internal Medicine Aging and Nephrological DiseasesUniversity of Bologna Department of Medicine V Aarhus University Hospital

AIM:To investigate the effect of transjugular intra-hepatic porto-systemic shunt (TIPS) on malnutrition in portal hypertensive cirrhotic ***: Twenty-one patients with liver cirrhosis and clinical indications for TIPS insertion were investigated before and 1, 4, 12, 52 wk after TIPS. For each patient we assayed body composition parameters [dry lean mass, fat mass, total body water (TBW)], routine liver and kidney function tests, and free fatty acids (FFA). Glucose and insulin were measured for the calculation of the homeostasis model assessment insulin resistance (HOMA-IR); liver function was measured by the galactose elimination capacity (GEC); the severity of liver disease was graded by model for end-stage liver disease (MELD).RESULTS: Porto-systemic gradient decreased after TIPS (6.0±2.1 mmHg vs 15.8±4.8 mmHg, P<0.001). Patients were divided in two groups according to initial body mass index. After TIPS, normal weight patients had an increase in dry lean mass (from 10.9±5.9 kg to 12.7±5.6 kg, P=0.031) and TBW (from 34.5±7.6 L to 40.2±10.8 L,P=0.007), as well as insulin (from 88.9±49.2 pmol/L to 164.7±107.0 pmol/L,P=0.009) and HOMA-IR (from 3.36%±2.18% to 6.18%±4.82%,P=0.023). In overweight patients only FFA increased significantly (from 0.59±0.24 mmol/L to 0.93±0.34 mmol/L, P=0.023).CONCLUSION: TIPS procedure is effective in lowering portal pressure in patients with portal hypertension and improves body composition without significant changes in metabolic parameters.

关键词： Insulin resistance Liver cirrhosis Malnutrition Portal hypertension Transjugular intrahepatic porto-systemic shunt

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Retrospective descriptive analysis of the physiological kinetics of prostate-specific antigen in men older than 75 years

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Asian Journal of Andrology 2009年第4期11卷 493-497页

作者： Maria Chiara Sighinolfi Salvatore Micali Stefano De Stefani Arrigo Cicero Filippo Cianci Marco Giacometti giampaolo bianchi Department of Urology University of Modena and Reggio Emilia Modena 41100 Italy Clinical Medicine and Applied Biotechnology Department Alma Mater Studiorum University of Bologna Bologna 40100 Italy

Several studies have compared prostate-specific antigen （PSA） kinetics in men with and without cancer, but there has been no adequate analysis of the longitudinal variation in PSA. The aim of this study was to assess the fluctuations in PSA in a cohort of elderly men in an attempt to define a physiological pattern of PSA kinetics. We searched a specific cohort of patients aged 〉 75 years and with PSA value 〈 2.0 ng mL^-1. A history of all PSA values over the past 10 years was compiled for each patient to create a database of patients fitting the following criteria：（1） minimum of five PSA measurements, （2） over at least 5 years. Exclusion criteria were：（1） PSA 〈 0.2 ng mL^-1 at each measurement and （2） having had more than one PSA test per year. In all, 1 327 patients （mean age： 78.52 years） fit the inclusion criteria. The mean variation from the first to the last PSA test was 0.05 ± 0.43, with a mean follow-up of 6.79 ± 1.71 years. Over the same period, the mean fluctuation from the lowest to the highest PSA value was 0.04 ± 0.55 （P = 0.925）. The mean annual PSA velocity （PSAV） was calculated by dividing the mean variation from the first to the last PSA test by the number of years of observation for each patient and was set at 0.0104 ± 0.1050. Concluding, in a large-scale cohort of elderly individuals considered healthy and evaluated for a considerable follow-up, the average annual PSAV as well as the average fluctuation from the lowest to the highest PSA value are insignificant.

关键词： human sperm nucleus histones protamine telomere

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Benign intratesticular schwannoma:a rare finding

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Asian Journal of Andrology 2006年第1期8卷 101-103页

作者： Maria Chiara Sighinolfi Alessandro Mofferdin Stefano S.De Stefani Antonio Celia Salvatore Micali Giovanni Saredi Giulio Rossi Riccardo Valli giampaolo bianchi Division of Urology Department of Pathology Section of Anatomic Pathology University of Modena 41100 ModenaItaly

Schwannoma is a peripheral nerve tumour, occasionally located in the genitourinary tract. We described an extremely rare case of intratesticular neurinoma in a 79-year-old patient. （Asian JAndrol 2006 Jan; 8： 101-103）

关键词： schwannoma Schwann cells testicular neoplasm S 100 protein

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Congenital Cardiac Defects, Such as Eustachian Valve, May Increase the Risk of Cryptogenic Stroke: A Case Report

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World Journal of Cardiovascular Diseases 2020年第6期10卷 379-384页

作者： Chiara Bandinelli Giovanni Maria Puddu Anna Balducci giampaolo bianchi Marco Zoli U.O. Stroke Unit Policlinico di Sant’Orsola Bologna Italy U.O. Cardiologia Pediatrica e dell’Età Evolutiva Policlinico di Sant’Orsola Bologna Italy

Eustachian valve is an embryonic endocardial heart structure;after birth it becomes an embryogenic residue and its persistance in adult life is unusual. The literature reports some cases of association between Eustachian valve and PFO and is known that the prominent Eustachian valve can represent a way facilitating systemic embolism.Several studies also investigated the role of Eustachian valve in the pathophysiology of both migraine and cerebral embolism. In addiction is known how Eustachian valve may increase the risk of endocarditis, which mostly affects intravenous drug abusers or those with implanted medical devices or central venous catheters. The most commonly identified organism is Staphylococcus aureus (approximately 53% of cases). We present a case of a 46-year-old woman with known migraine. She was hospitalized in Stroke Unit for a cryptogenic stroke with a right-to-left shunt detected with transcranial doppler ultrasound with “bubble test” and a patent foramen ovale with right-to-left shunt with a fenestration of atrial septum and a voluminous Eustachian valve detected with transesophageal echocardiography;she developed fever with a blood cultures positive for methicillin-resis- tant Staphylococcus aureus (MRSA), even if without evidence of endocarditis vegetations.

关键词： Eustachian Valve Cryptogenic Stroke Patent Foramen Ovale PFO Endocarditis Staphylococcus aureus Transesophageal Echocardiography Migraine

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Does needle calibre affect pain and complication rates in patients undergoing transperineal prostate biopsy？ A prospective, randomized trial

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Asian Journal of Andrology 2009年第6期11卷 678-682页

作者： Saredi Giovanni Maria Chiara Sighinolfi Fidanza Francesco De Stefani Stefano Micali Salvatore Maurizio Paterlini Roberto D＇Amico bianchi giampaolo Department of Urology University of Modena and Reggio Emilia Modena 41100 Italy Department of Oncology University of Modena and Reggio Emilia Modena 41100 Italy

Transperineal prostate biopsy is a procedure that can be used to obtain histological samples from the prostate. To improve both the quality of the biopsy core samples and prostate cancer detection, we are currently performing a prospective, randomized trial comparing prostate biopsy samples obtained using an 18 G-needle to those obtained using a 16 G-needle. The aim of this preliminary study was to evaluate pain and complication rates in both groups in order to assess whether performing a prostate biopsy with a larger calibre needle is a feasible procedure. One hundred and eighty-seven patients undergoing transperineal prostate biopsy were prospectively evaluated and divided into two groups. The first group （94 patients, Group A） received a transperineal prostate biopsy using a 16 G-needle and the second group （93 patients, Group B） underwent transperineal prostate biopsy with an 18 G-needle. Anaesthesia was obtained with a single perineal injection at the prostatic apex in all subjects. A visual analogue scale （VAS） and facial expression scale （FES） were used to assess pain during multiple steps of the procedure in each group. A detailed questionnaire was used to obtain information about drug use because it could potentially influence the pain and complications that patients experienced. Two weeks after the procedure, early and late complications were evaluated. Statistical analysis was carried out using non-parametric tests. Prostate Specific Antigen （PSA） and drug use were similar at baseline between the two groups. Pain during prostate biopsy, which was measured with both the VAS and FES instruments, did not differ significantly between the 18- and 16 G-needle groups, and no significant differences were found in early or late complication rates between the groups. Transperineal prostate biopsy with a 16 G-needle is a feasible Further studies with larger patient populations are required to prostate cancer detection rates. procedure in terms of pain and complicati

关键词： needle calibre prostatic biopsy side effects

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Total mesorectal excision for mid and low rectal cancer: laparoscopic vs robotic surgery

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World Journal of Gastroenterology 2016年第13期22卷 3602-3610页

作者： Francesco Feroci Andrea Vannucchi Paolo Pietro bianchi Stefano Cantafio Alessia Garzi giampaolo Formisano Marco Scatizzi Department of General and Oncological Surgery Santo Stefano Hospital Department of General and Minimally Invasive Surgery Misericordia Hospital

AIM: To compare the short- and long-term outcomes of laparoscopic and robotic surgery for middle and low rectal ***: This is a retrospective study on a prospectively collected database containing 111 patients who underwent minimally invasive rectal resection with total mesorectal excision (TME) with curative intent between January 2008 and December 2014 (robot, n = 53; laparoscopy, n = 58). The patients all had a diagnosis of middle and low rectal adenocarcinoma with stage I-III disease. The median follow-up period was 37.4 mo. Perioperative results, morbidity a pathological data were evaluated and compared. The 3-year overall survival and disease-free survival rates were calculated and ***: Patients were comparable in terms of preoperative and demographic parameters. The median surgery time was 192 min for laparoscopic TME (L-TME) and 342 min for robotic TME (R-TME) (P < 0.001). There were no differences found in the rates of conversion to open surgery and morbidity. The patients who underwent laparoscopic surgery stayed in the hospital two days longer than the robotic group patients (8 d for L-TME and 6 d for R-TME, P < 0.001). The pathologic evaluation showed a higher number of harvested lymph nodes in the robotic group (18 for R-TME, 11 for L-TME, P < 0.001) and a shorter distal resection margin for laparoscopic patients (1.5 cm for L-TME, 2.5 cm for R-TME, P < 0.001). The three-year overall survival and disease-free survival rates were similar between ***: Both L-TME and R-TME achieved acceptable clinical and oncologic outcomes. The robotic technique showed some advantages in rectal surgery that should be validated by further studies.

关键词： Robotic surgery Laparoscopic surgery Rectal cancer Total mesorectal excision Minimally invasive surgery

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