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Awake laparoscopic cholecystectomy:A case report and review of literature

World Journal of Clinical Cases 2023年第13期11卷 3002-3009页

作者： chiara Mazzone Maria Sofia Iacopo Sarvà Giorgia Litrico Andrea Maria Luca Di Stefano Gaetano La Greca Saverio Latteri Dipartimento di Scienze Mediche Chirurgiche e Tecnologie Avanzate"G.F.Ingrassia"Universitàdegli Studi di CataniaCatania 95123Italy

BACKGROUND Laparoscopic cholecystectomy(LC)is one of the most widely practiced surgical procedures in abdominal surgery.Patients undergo LC during general anaesthesia;however,in recent years,several studies have suggested the ability to perform LC in patients who are awake.We report a case of awake LC and a literature review.CASE SUMMARY A 69-year-old patient with severe pulmonary disease affected by cholelithiasis was scheduled for LC under regional anaesthesia.We first performed peridural anaesthesia at the T8-T9 level and then spinal anaesthesia at the T12-L1 level.The procedure was managed in total comfort for both the patient and the surgeon.The intra-abdominal pressure was 8 mmHg.The patient remained stable throughout the procedure,and the postoperative course was uneventful.CONCLUSION Evidence has warranted the safe use of spinal and epidural anaesthesia,with minimal side effects easily managed with medications.Regional anaesthesia in selected patients may provide some advantages over general anaesthesia,such as no airway manipulation,maintenance of spontaneous breathing,effective postoperative analgesia,less nausea and vomiting,and early recovery.However,this technique for LC is not widely used in Europe;this is the first case reported in Italy in the literature.Regional anaesthesia is feasible and safe in performing some types of laparoscopic procedures.Further studies should be carried out to introduce this type of anaesthesia in routine clinical practice.

关键词： Laparoscopic cholecystectomy Awake surgery Awake laparoscopy Gallstone disease Regional anaesthesia Spinal anesthesia Case report

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Exploring pre-degenerative alterations in humans using induced pluripotent stem cell-derived dopaminergic neurons

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Neural Regeneration Research 2017年第7期12卷 1068-1070页

作者： Federica Bono chiara Fiorentini Division of Pharmacology Department of Molecular andTranslational Medicine University of Brescia Brescia Italy

Understanding the cellular and molecular mechanisms underlying human neurological disorders is hindered by both the complexity of the disorders and the lack of suitable experimental models recapitulating key pathological features of the disease.This is a crucial issue since a limited understanding of pathogenic mechanisms precludes the development of drugs counteracting the progression of the disease.Among neurological disorders,

关键词： in Exploring pre-degenerative alterations in humans using induced pluripotent stem cell-derived dopaminergic neurons stem DAT been that of cell PSC

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Fungal spores and pollen in particulate matter collected during agricultural activities in the Po Valley(Italy)

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Journal of Environmental Sciences 2016年第8期28卷 229-240页

作者： chiara Telloli Milvia Chicca Marilena Leis Carmela Vaccaro Italian National Agency for New Technologies Energy and Sustainable Economic Development (ENEA) Technical Unit for Environmental Assessment Models Methods and Technologies (UTVALAMB) Air Quality Laboratory (AIR) Department of Life Science and Biotechnologies Ferrara University Department of Physics and Earth Sciences Ferrara University

Airborne particulate matter（PM） containing fungal spores and pollen grains was sampled within a monitoring campaign of wheat threshing, plowing and sowing agricultural operations. Fungal spores and pollen grains were detected and identified on morphological basis. No studies were previously available about fungal spore and pollen content in agricultural PM in the Po Valley. Sampling was conducted in a Po Valley farmland in Mezzano（Ferrara, Italy）. The organic particles collected were examined by scanning electron microscopy with energy dispersive X-ray spectrometer. Fungal spores and pollen grains were identified when possible at the level of species. The most frequent components of the organic particles sampled were spores of Aspergillus sp., which could represent a risk of developing allergies and aspergillosis for crop farmers.

关键词： Wheat Aspergillosis Emilia-Romagna Morphology SEM–EDS

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Genetic testing in neurology exploiting next generation sequencing:state of art

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Neural Regeneration Research 2020年第2期15卷 265-266页

作者： chiara Di Resta Maurizio Ferrari Vita-Salute San Raffaele University MilanItaly Unit of Genomics for Human Disease Diagnosis Division of Genetics and Cell BiologyIRCCS San Raffaele Scientific InstituteMilanItaly Clinical Molecular Biology Laboratory IRCCS San Raffaele HospitalMilanItaly

Next generations sequencing (NGS) is definitely one of the most revolutionary technology of the last years in genetic and medical field (Kricka and Di Resta, 2013). It brought important changes in genetic testing of inherited human disorders, in particular in neurological Mendelian forms, such as inherited neuropathies, ataxias or monogenic form of epilepsy, where “diagnostic odyssey” is quite common.

关键词： Genetic testing NGS diagnostic odyssey

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Current role of surgery for tuberous sclerosis complex-associated epilepsy

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Pediatric Investigation 2022年第1期6卷 16-22页

作者： Nicola Specchio Giusy Carfi Pavia Luca de Palma Alessandro De Benedictis chiara Pepi Marta Conti Carlo Efisio Marras Federico Vigevano Paolo Curatolo Rare and Complex Epilepsy Unit Department of NeurosciencesBambino GesùChildren’s HospitalIRCCSRomeItaly Neurosurgery Unit Department of NeurosciencesBambino GesùChildren’s HospitalIRCCSRomeItaly Department of Neurosciences Bambino GesùChildren’s HospitalIRCCSRomeItaly Child Neurology and Psychiatry Unit Systems Medicine DepartmentTor Vergata UniversityRomeItaly

Tuberous sclerosis complex(TSC)is a rare multisystem,autosomal dominant neurocutaneous syndrome in which epilepsy is the most common of several neurological and psychiatric manifestations.Around two thirds of patients develop drug-resistant epilepsy for whom surgical resection of epileptogenic foci is indicated when seizures remain inadequately controlled following trial of two antiseizure medications.The challenge with presurgical and surgical approaches with patients with TSC is overcoming the complexity from the number of tubers and the multiplex epileptogenic network forming the epileptogenic zone.Data suggest that seizure freedom is achieved by 55%-60%of patients,but predictive factors for success have remained elusive,which makes for unconfident selection of surgical candidates.This article presents three different cases as illustrations of the potential challenges faced when assessing the suitability of TSC patients for epilepsy surgery.

关键词： Epilepsy Everolimus Imaging Prognostics Surgery Tuberous sclerosis complex(TSC)

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Haemodynamic management in brain death donors:Influence of aetiology of brain death

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World Journal of Transplantation 2023年第4期13卷 183-189页

作者： chiara Lazzeri Manuela Bonizzoli Stefano Batacchi Cristiana Guetti Walter Vessella Alessandra Valletta Alessandra Ottaviano Adriano Peris Department of Emergency Intensive Care Unit and Extracorporeal Membrane Oxygenation CenterFlorence 50134Italy

BACKGROUND In brain death donors(BDDs),donor management is the key in the complex donation process.Donor management goals,which are standards of care or clinical parameters,have been considered an acceptable barometer of successful donor management.AIM To test the hypothesis that aetiology of brain death could influence haemodynamic management in BDDs.METHODS Haemodynamic data(blood pressure,heart rate,central venous pressure,lactate,urine output,and vasoactive drugs)of BDDs were recorded on intensive care unit(ICU)admission and during the 6-h observation period(Time 1 at the beginning;Time 2 at the end).RESULTS The study population was divided into three groups according to the aetiology of brain death:Stroke(n=71),traumatic brain injury(n=48),and postanoxic encephalopathy(n=19).On ICU admission,BDDs with postanoxic encephalopathy showed the lowest values of systolic and diastolic blood pressure associated with higher values of heart rate and lactate and a higher need of norepinephrine and other vasoactive drugs.At the beginning of the 6-h period(Time 1),BDDs with postanoxic encephalopathy showed higher values of heart rate,lactate,and central venous pressure together with a higher need of other vasoactive drugs.CONCLUSION According to our data,haemodynamic management of BDDs is affected by the aetiology of brain death.BDDs with postanoxic encephalopathy have higher requirements for norepinephrine and other vasoactive drugs.

关键词： Brain death donor Postanoxic encephalopathy Stroke Acute traumatic injury Haemodynamic management Utilization rate

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Left atrium veno-arterial extra corporeal membrane oxygenation as temporary mechanical support for cardiogenic shock:A case report

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世界临床病例杂志 2023年第27期11卷 6531-6536页

作者： Rossana Lamastra David Michael Abbott Antonella Degani Carlo Pellegrini Roberto Veronesi Stefano Pelenghi chiara Dezza Giulia Gazzaniga Mirko Belliato Department of Surgical Pediatric and Diagnostic SciencesUniversity of PaviaPavia 27100PVItaly Department of Cardiothoracic Surgery Fondazione IRCCS Policlinico San MatteoPavia 27100PVItaly Clinical SurgicalDiagnostic and Pediatric Sciences DepartmentUniversity of PaviaItaly-Department of Cardiac SurgeryFondazione IRCCS Policlinico San Matteo FoundationPavia 27100PVItaly SC-AR2 Anestesia e Terapia Intensiva Cardiotoracica Fondazione IRCCS Policlinico San Matteo Pavia 27100PVItaly Department of Cardiac Surgery 1 IRCCS University Hospital Foundation"San Matteo"Pavia 27100Italy

BACKGROUND Veno-arterial extra corporeal membrane oxygenation(VA-ECMO)support is commonly complicated with left ventricle(LV)distension in patients with cardiogenic shock.We resolved this problem by transeptally converting VAECMO to left atrium veno-arterial(LAVA)-ECMO that functioned as a temporary paracorporeal left ventricular assist device to resolve LV distension.In our case LAVA-ECMO was also functioning as a bridge-to-transplant device,a technique that has been scarcely reported in the literature.CASE SUMMARY A 65 year-old man suffered from acute myocardial injury that required percutaneous stents.Less than two weeks later,noncompliance to antiplatelet therapy led to stent thrombosis,cardiogenic shock,and cardiac arrest.Femorofemoral VA-ECMO support was started,and the patient underwent a second coronary angiography with re-stenting and intra-aortic balloon pump placement.The VA-ECMO support was complicated by left ventricular distension which we resolved via LAVA-ECMO.Unfortunately,episodes of bleeding and sepsis complicated the clinical picture and the patient passed away 27 d after initiating VA-ECMO.CONCLUSION This clinical case demonstrates that LAVA-ECMO is a viable strategy to unload the LV without another invasive percutaneous or surgical procedure.We also demonstrate that LAVA-ECMO can also be weaned to a left ventricular assist device system.A benefit of this technique is that the procedure is potentially reversible,should the patient require VA-ECMO support again.A transeptal LV venting approach like LAVA-ECMO may be indicated over ImpellaTM in cases where less LV unloading is required and where a restrictive myocardium could cause LV suctioning.Left ventricular over-distention is a well-known complication of peripheral VA-ECMO in cardiogenic shock and LAVA ECMO through transeptal cannulation offers a novel and safe approach for treating LV overloading,without the need of an additional percutaneous access.

关键词： Left atrium venoarterial extra corporeal membrane oxygenation Shock Case report

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Seismic response of continuous span bridges through fiber-based finite element analysis

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Earthquake Engineering and Engineering Vibration 2006年第1期5卷 119-131页

作者： chiara Casarotti Rui Pinho University of Pavia Structural Mechanics Dept. Via Ferrata 1 27100 Pavia Italy

It is widely recognized that nonlinear time-history analysis constitutes the most accurate way to simulate the response of structures subjected to strong levels of seismic excitation. This analytical method is based on sound underlying principles and has the capability to reproduce the intrinsic inelastic dynamic behavior of structures. Nonetheless, comparisons with experimental results from large-scale testing of structures are still needed, in order to ensure adequate levels of confidence in this numerical methodology. The fiber modelling approach employed in the current endeavor inherently accounts for geometric nonlinearities and material inelasticity, without a need for calibration of plastic hinges mechanisms, typical in concentrated plasticity models. The resulting combination of analysis accuracy and modelling simplicity, allows thus to overcome the perhaps not fully justifiable sense of complexity associated to nonlinear dynamic analysis. The fiber-based modelling approach is employed in the framework of a finite element program downloaded from the Intemet for seismic response analysis of framed structures. The reliability and accuracy of the program are demonstrated by numerically reproducing pseudo-dynamic tests on a four span continuous deck concrete bridge. Modelling assumptions are discussed, together with their implications on numerical results of the nonlinear time-history analyses, which were found to be in good agreement with experimental results.

关键词： bridges seismic response pseudo-dynamic testing nonlinear dynamic analysis fiber modelling

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Assessment of SARS-CoV-2 RNA shedding in semen of 36 males with symptomatic,asymptomatic,and convalescent infection during the first and second wave of COVID-19 pandemic in Italy

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Asian Journal of Andrology 2022年第2期24卷 135-138页

作者： Carlo Pavone Giovanni M Giammanco Andrea Pio Cascino Davide Baiamonte Mirko Pinelli Enrico Cangelosi chiara Filizzolo Giuseppa Sciortino Simona De Grazia Floriana Bonura Section of Urology Department of SurgicalOncological and Oral SciencesUniversity of PalermoPalermo 90127Italy Section of Microbiology Department of Health PromotionMother and Child CareInternal Medicine and Medical SpecialtiesUniversity of PalermoPalermo 90127Italy Section of Internal Medicine Department of Health PromotionMother and Child CareInternal Medicine and Medical SpecialtiesUniversity of PalermoPalermo 90127Italy

The severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)receptor,angiotensin-converting enzyme 2(ACE2),has been identified in the human testis,but the risk of transmission of SARS-CoV-2 through sexual intercourse still needs to be defined.The goal of our study was to determine if SARS-CoV-2 is detectable in the semen of patients suffering or recovering from coronavirus disease-19(COVID-19),still testing positive at nasopharyngeal swabs but showing mild or no symptoms at the time of sampling.Detection of SARS-CoV-2 RNA in semen was performed by real-time reverse transcriptase-polymerase chain reaction(RT-PCR)and nested PCR targeting open reading frame(ORF)1ab.Medical history of the enrolled patients was taken,including COVID-19-correlated symptoms,both at the time of diagnosis and at the time of interview.Results of real-time RT-PCR and nested PCR in semen showed no evidence of SARS-CoV-2 RNA in the 36 patients suffering or recovering from COVID-19 but still positive in a nasopharyngeal swab,from over 116 patients enrolled in the study.SARS-CoV-2 detection and persistence in semen would have an impact on both clinical practice and public health strategies,but our results would suggest that SARS-CoV-2 is not present in the semen of men recovering from COVID-19.

关键词： coronavirus COVID-19 Italy SARS-CoV-2 semen sexual transmission

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Nanotechnological approaches for counteracting multidrug resistance in cancer

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Cancer Drug Resistance 2020年第4期3卷 1003-1020页

作者： chiara Martinelli Marco Biglietti Independent Researcher Como 22100Italy Independent Researcher Milan 20148Italy

Every year,cancer accounts for a vast portion of deaths worldwide.Established clinical protocols are based on chemotherapy,which,however,is not tumor-selective and produces a series of unbearable side effects in healthy tissues.As a consequence,multidrug resistance(MDR)can arise causing metastatic progression and disease relapse.Combination therapy has demonstrated limited responses in the treatment of MDR,mainly due to the different pharmacokinetic properties of administered drugs and to tumor heterogeneity,challenges that still need to be solved in a significant percentage of cancer patients.In this perspective,we briefly discuss the most relevant MDR mechanisms leading to therapy failure and we report the most advanced strategies adopted in the nanomedicine field for the design and evaluation of ad hoc nanocarriers.We present some emerging classes of nanocarriers developed to reverse MDR and discuss recent progress evidencing their limits and promises.

关键词： Multidrug resistance cancer nanotechnology nanomedicine nanocarriers targeted delivery

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